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  • Sumanta 11:08 AM on April 21, 2018 Permalink |
    Tags: cholera, , enteric, enteropathy, spure, tropical,   

    Intestinal differences among developing and developed countries 

    People in developed nations generally have low diarrheal episodes due to fecal contamination than those of poorer nations due clean water and better sanitation.

    Interestingly this causes repeated attacks by enteric pathogens (microorganisms that commonly cause gut infection) related to faecal contamination in those living in countries vulnerable to poorer sanitation and hygiene. Such repeated infection changes the lining of the gut and leads to malabsorption related problem often known as tropical enteropathy. This condition causes alteration of immune system compromising with the functioning of oral vaccines’ and might cause oral vaccine failure (like cholera vaccine or rotavirus vaccine).

    Till date, not much is available to deal with tropical sprue, although improving sanitary situations might be a good option to prevent the problem happening in future.

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    References:

    1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5396246/
    2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3372657/
    3. http://www.gastro.org/news_items/tropical-enteropathy-normal-for-the-tropics-or-a-disease-of-poverty
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  • Sumanta 10:45 AM on February 11, 2018 Permalink |
    Tags: , genu, hyperextension, , recurvatum   

    Is your knee deviated backward while standing erect? 

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    Some people have knee joint deviated backwards when seen from the sides while the individual stands on their legs fully extended (i.e. when standing straight with full bodyweight on the feet). This condition is known as Genu recurvatum.

    The severity of this illness can vary although depending upon the angulation. It’s more common with females. It may be related to loose ligaments around the knee joint that might have been acquired by birth genetically, cerebral palsy etc.

    This condition might lead to knee pain, a decreased ability to walk or run, osteoarthritis etc. Strengthening of quadriceps muscles of the thigh is said to be helpful to retain the joints stability and decrease pain.

    However, depending on severity bracing or surgical intervention might also be needed.

    P.S.- This blog is not a professional medical guide for any purpose and contents in this blog have errors. For all your health concerns please be guided by a healthcare professional and/or other reliable resources.

     
  • Sumanta 11:54 AM on February 7, 2018 Permalink |
    Tags: canal, capping, Dental, gutta, guttapercha, , root,   

    Pain after root canal 

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    Dental pain can happen after the final capping of a root canal treatment. During the initial days it may be because of the wear and tear your teeth might have undergone during the process of capping and the overall treatment. Such pain should generally be alleviated by warm saline water gurgles and mild painkillers, unless otherwise complicated. If pain persists or is perceived to be out of proportion a visit to a dentist is possibly the best thing to do.

    One common problem that might be causing the pain is some elevated part of the newly fitted cap hitting the teeth in the other jaw. Generally, this is taken care in a rather straightforward way. The dentists’ commonly take a quick impression to detect any uneven or elevated part and then correct it by levelling.

    However, other problems like infection, abscess, mobile or fractured teeth root etc. can also cause pain following a root canal capping. In a worst case if the teeth can’t be survived it might lead to extraction of the affected tooth.

     
  • Sumanta 7:34 AM on January 13, 2018 Permalink |
    Tags: , complication, , episiotomy, incision,   

    Is episiotomy scary? 

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    Episiotomy is an incision or cut given at the opening of the vagina to allow more space for the baby to come out. This is generally done by an obstetrician while delivering a baby during vaginal delivery. Since the baby is delivered through abdominal route in case of a cesarean section, episiotomy is not needed for this type of delivery.

    Although this is still practised widely in many developing countries this not a scientifically  100% recommended procedure and the opinions vary among healthcare practitioners. Recent medical literature has a negative tone to continue this surgery as a regular practice for all vaginal deliveries.

    Generally, two types of incisions can be given one posteriorly in the midline towards the anus and the other mediolaterally. In developing world posterolateral is commonly seen. Posterolateral incisions are less likely to extend to the anus.

    This is a surgical incision and not necessarily free of complications. complications like pain, infection, dyspareunia (pain during intercourse) etc can be its short or long-term adversities. Such complications depend further on the practitioner’s experience. Unfortunately, a woman’s vulnerability to complications will probably rise if done by trainee professionals without enough experience.

    This author witnessed the use of this surgery on almost all normal deliveries in certain parts of the developing world and condemn such practice. One possible explanation may be that some healthcare providers would choose this surgery to hasten the delivery. Another explanation may be they learn to do vaginal delivery by means of episiotomy only and they continue to practice it and propagate the same to their successors.

    P.S.- This blog is not for professional medical advises of any sort. The information herein may not be error-free. For all your health concerns please visit your health care provider.
     
  • Sumanta 4:12 PM on January 10, 2018 Permalink |
    Tags: 72, , , hours, intercourse, , , pills, progesterone,   

    Should emergency contraceptive pills be used​ regularly? 

     

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    Emergency contraceptive pills are used to avoid unplanned pregnancy that might happen after unprotected sexual intercourse. Generally earlier the pills are taken its said to be best and generally, they are said to be of worth when using up to 72 hours of the intercourse, however, it might depend on the composition of the medicine, the manufacturer etc.

    Medication dosages in emergency contraceptive pills are generally quite larger than regular contraceptive pills. One of the popular types of emergency contraceptive pills is those purely progesterone based. Progesterone is a type of hormone which is normally produced in females.

    Therefore, regular frequent use of the emergency contraceptive pills is not appropriate. It increases chances of adverse effects. Many people feel that emergency contraceptive pills are a good solution for casual intercourse and undermine the need for the appropriate regular use of contraceptives. Such practice can be detrimental to those females who might plan to use emergency contraceptive pills causally.

    P.S.- This blog is not for professional medical advises of any sort. The information herein may not be error-free. For all your health concerns please visit your health care provider.
     
  • Sumanta 12:00 PM on March 13, 2017 Permalink |
    Tags: , , , , section,   

    Why cesarean sections are rising in private practice in India? 

    In the recent time, particularly in private practice the toll of cesarean sections are quite high in various parts of India. This author tried to speculate why cesarean sections are rising in India and here are the understandings of this author (which are also enriched by some real-life experiences).

    First question is whom to blame for this rising trend of C- sections in the private practice, the doctors or the patients. The answer might seem like to both, but I feel doctors. Why? Some people might cite that the ladies today are too softie and want everything smoothly without undergoing the labor pain. But I feel that it’s not wrong for a woman to avoid pain of all sort in life and even labor pain. Besides alleviating pain, since family sizes are shrinking these days and becoming restricted to 1 to 2 children a vaginal delivery might be perceived as risky health practice by some pregnant mothers and their families, who feel cesarean can be a safe alternative to achieve a complication-free birth.

    The point to understand in this regard is that patients can actually demand anything based on their understandings, but that shouldn’t be an alibi for doctors to incise a woman’s tummy. Ethically doctors are supposed to explain the pregnant lady and her family about the pros and cons of the cesarean section and also stating when such an operation is really indicated. Unfortunately, these ethical issues are only limited to legal papers and texts with not much real life utilisation. Therefore, in my opinion, the doctor should explain clearly the issues of delivery without any word game during conversation to bend the patient and her family members mindset towards an unnecessary cesarean section.

    Next question is why doctors in private practice incline more towards a c-section. I feel ‘money making’ will be a partly correct answer, a better phrase would be ‘easy money making’. When a doctor opts to do a cesarean section he doesn’t need to monitor the patient for long hours (unlike normal vaginal delivery). For long hours of observation, more staff are needed and more time needs to be dedicated, which counts as a negative feature for private practitioners. Not only that for conducting normal vaginal delivery doctors need to be available 24×7 because a pregnant patient may go into labor anytime, and private practitioners wouldn’t probably prefer to compromise their nights sleep regularly for their entire life, unlike their days when they worked as resident trainee doctors. Elective cesarean is just like regular outpatient practice, where the cesarean operation can be done at any time convenient to both the doctor and patient.

    A third query can be why then women who want a normal delivery with no indication for cesarean section voluntarily go to the government-run hospitals where normal delivery is generally offered for eligible cases. This is a complex issue to answer. Many people don’t find the state-run hospitals clean and hygienic enough. These hospitals are often accused for baby missing complaints after delivery. Sometimes, cats and other non-human species can find their way inside the hospital wards, and this author witnessed such multiple times. Unlike private practice setup where a woman can get treated under a particular obstetrician of her choice, in state-funded hospitals less likely all women will be delivered by senior experienced obstetricians  and things might worsen particularly at the night time when the lonely unsupervised trainee doctors makes a mess of situations like when shoulder of a baby which gets stuck in birth canal or the mother starts bleeding uncontrollably. Statistics is always good on paper and presentation, but in real life the loss of life or permanent complication of a mother and/or her baby is cent percent for that individual and her family. Its not wrong for a pregnant female to get delivered under skilled confident doctors rather than unsupervised learners. And at this particular point a cesarean section in private is possibly justified unless the government can make any drastic change in the trend.

    Lastly, what can be the solution to avoid the unwanted indication-less c-section problem. Bringing in strong laws is obviously an option to compel private practitioners to follow the conduct of medical ethics. Besides that the country should adopt better recruiting, training and licensing system for doctors from nations that are best in obstetric care in the world. Also, the patients and their family members should be made aware of the wrongdoing of unnecessary cesarean sections so that they can demand a normal delivery when there isn’t any indication for Caesarean section. Furthermore, patients should be given a legal right to record their doctors counselling about what mode of delivery should they choose so that at a later time they can take it to the court as a piece of evidence.

    Let’s hope, someday the social media loving policymakers will start tweeting on this topic too to get fame (which seems too delicious to them, ‘the Narcissistic farts’), and bring in some fragments of happiness to their citizens.

     

    P.S.: Views and opinions expressed in this post are author's individual, not meant to hurt anyone in any form. If such has happened unknowingly, please understand it as a mere accident and not intentional.
     
  • Sumanta 8:46 AM on October 28, 2015 Permalink |
    Tags: cold, commoncold, exposure, ,   

    Does exposure to cold causes common cold? 

    Many a times, we find that if we don’t take proper protection from cold, we might catch a flu and have runny nose and fever for about a week. That means we can get a viral due to cold sometimes.

    “Getting exposure to cold means getting a cold” – is not the rule, if it was so then 99% of the inhabitants of the cold weather nations should have got flu 24*7 and 365 days. However, that don’t happen. Cold weather don’t necessarily mean you will get a ‘common cold’, a dirty viral illness which can spoil your new year celebrations.

    Then how is cold associated with common cold. You can get cold, no matter you live in warm or cold climate. When your body is not protected properly from the harshness of severe weather or when you are exposed to situations above your tolerance duration like a bath in ice cool water for more time than you can really tolerate or staying in wet cloth for long hours, allowing your body heat to evaporate fast. Such cold exposures which don’t help to maintain you core body temperature, disturbs the way your immune system defend your body from common cold. So the temporary weakening or malfunction of immune system due to decreased body temperature will fail to protect the body from viruses that can cause common cold. Hence it is true that sometimes cold can give you a common cold.

    Hope you don’t get a single episode of common cold this year.

     
  • Sumanta 6:00 AM on October 17, 2015 Permalink |
    Tags: chronickidneydisease, diet, , , Protein   

    Chronic kidney disease and protein diet 

    wpid-wp-1412484257914.jpegGenerally in advanced cases of kidney failure, protein diet restriction is advised.

    Why?

    The protein products like meat and fish, which we eat get degraded in our body and these degraded metabolites act as toxins, since the chronically ill kidneys can’t flush them out of the body. Healthy kidneys would be successfully removing such toxins.

    When  these metabolites of protein accumulate they can aggravate the nitrogenous compound load on kidney and worsen the feeling of nausea, vomiting and other uremic symptoms. Furthermore, they can damage the kidney by increasing its filtration and more proteins might drain out of the body. It’s bit complex to understand properly.

    Is there any negative consequence of protein restricted diet?

    Yes. As protein is an essential component of our health since our muscles and various other organs are made of protein, lack of protein can cause an under-nourished health condition (referred as protein energy malnutrition). Therefore, total or absolute protein restriction is also not desirable.

    How much protein should you consume if you have a chronic kidney disease?

    Ask your health care provider how much protein should you consume. Based on individual person’s health status the requirement might vary from person to person.

     
  • Sumanta 8:33 PM on October 8, 2015 Permalink |
    Tags: , , , myocardialinfarction, pericarditis   

    Pericarditis after myocardial infarction (heart attack) 

    Pericarditis is inflammation that occur in the heart wall known as pericardium.

    Normally pericarditis is treated with NSAIDS (non-steroidal antiinflammatory drugs like ibuprofen).

    However in case of pericarditis developing after a myocardial infarction (heart attack) NSAIDS are not used for treatment as there may be risk of aneurysm formation and rupture of heart muscle, during the initial phase of recovery after a myocardial infarction.

    Henceforth, opiate based drugs may be used to treat pericarditis developing after myocardial infarction.

    Pericarditis that develop following a myocardial infarction generally tend to occur after 1 or 2 days after the latter. Patients with possible pericarditis might complain of chest pain that increases in certain body positions and/or on inspiration.

     
  • Sumanta 1:34 PM on September 11, 2015 Permalink |
    Tags: Activity, Fitness, , ,   

    When can you start regular physical activity after a heart attack? 

    Heart attack is one of the worst health nightmare you can imagine of. Not all heart attacks are same and severity of it varies from patient to patient. Most people after surviving a heart attack and following their discharge from hospital are haunted by the question when can they return to their daily normal active life.

    Well as discussed above the time may vary depending upon the severity of the heart attack. Generally the oxygen deprived wall of heart takes about 4-6 weeks to  get healed by means of fibrosis. Therfore, one should take rest for this period in minimum following which he or she can gradually return to active life. Sexual life can also be resumed then.

    Before wrapping up this discussion I must say that it’s wise to get guided by your doctor because of the above mentioned reason that not every heart attack is of the same type and severity. Different people have different health problems, henceforth such prescriptions are also different.

    Take care of your little beating heart ♥ !

     
  • Sumanta 6:34 AM on August 26, 2015 Permalink |
    Tags: , , Injection, oral, Polio, poliovaccine,   

    Polio vaccine: oral or injection – by which route should it be given to the children? 

    Oral polio drops are most popular for its use in various immunization camps organized by various health organizations around the world, particularly in 3rd world nations. However, where economic constraints are not an issue polio vaccine injections are also used.

    The oral vaccine rarely causes vaccine associated paralytic polio, in view of which certain developed nations are not using oral polio vaccine anymore, instead using injectable polio vaccine.

    Another reason why some nations less prefer the oral polio vaccine is because of the risk of spreading of wild live polio viruses. Oral polio vaccine contains live polio viruses, whereas injectable ones contain killed dead polio viruses.

    In certain developing nations where injectable polio vaccine is given, advise is also given to get the oral vaccine too, as part of various polio irradication initiatives that are taken by various health organizations.

     
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