Thyroid imbalance is one of the most common problems we hear in day to day life, be it in neighbourhood, office or home. With the increasing incidence of these issues, we are compelled to look into it timely to prevent it. Improving your lifestyle, diet, exercise routine and knowing what is going in your body by getting your blood tests done on required regular basis will help go the preventive way. DocNok helps you manage your health, make you aware and educate you about the temple in which your soul resides.
Let’s see what it is all about.
Thyroid is a butterfly shaped gland, located in front of the neck below the Adam’s apple.
It is our master gland of metabolic processes and energy. Thyroid uses iodine to produce vital hormones.
Thyroid balance is required for multiple important functions in our body like to think clearly, remember things, to maintain a balanced mood, grow hair and nails, have optimal basic energy, good vision, digestion, fertility, libido, etc.
Hypothalamus in brain releases Thyrotropin Releasing Hormone (TRH) which stimulates Pituitary gland to produce Thyroid Stimulating Hormone (TSH) and this in turn stimulates Thyroid gland to release more T4; Thyroxine (T4) is the primary hormone produced by thyroid gland. T4 is released in blood stream and to the target organs, the rest of it is converted into Triiodothyronine (T4).
SYMPTOMS OF THYROID DISEASE TEND TO REFLECT THE GLANDS’S:-
Underactivity, Overactivity, Autoimmune activation, and, or Inflammation or Enlargement in the neck area.
Insufficient amount of thyroid hormone is produced. Might be seen in cases of Hashimoto’s Thyroiditis, Thyroid hormone resistance, Postpartum thyroiditis, Chronic lymphocytic thyroiditis, Acute thyroiditis.
It can present with various symptoms like fatigue, hair loss, poor concentration (brain fog), dry skin, constipation, feeling cold, fluid retention, muscle and joint aches, depression, prolonged and increase in menstrual bleeding, etc.
COMPLICATIONS OF HYPOTHYROIDISM
Cardiac complications if left untreated.
Lowers kidney functions due to decreased blood flow to kidneys.
Causes nerve & muscle injury leading to breathing difficulties.
Trouble walking, talking, hoarseness in voice.
Pain in limbs.
It is caused due to excessive production of thyroid hormone. Increased metabolism is seen here. It is less common than hypothyroidism. The underlying cause might be excessive iodine consumption, Grave’s disease, Thyroid nodules, Toxic multinodular goitre, etc.
Enlargement of thyroid gland which might be due to Hyperthyroidism, Hypothyroidism or even in people with normal thyroid function. Dysphagia (difficulty in swallowing) is often complained by people with enlarged thyroid gland (seen as swelling in neck apparently), hoarseness in voice.
Thyroid carcinoma is of four types; Papillary – most common, found in around 80% cases, very slow spreading, better prognosis. Follicular- 15% cases, aggressive in progression. Medullary- in about 3% cases, hereditary pattern could be seen. Anaplastic – 2% cases, its rare but most serious of the thyroid cancers.
Under Preliminary investigations for thyroid disorders, blood test (Thyroid Function Test, free) shows the level of hormones.
Thyroglobulin antibody test, Nuclear scan for Radioactive iodine uptake, MRI, Thyroid Ultrasound and FNAP (Fine Needle Aspiration Biopsy) could be conducted according to the condition and requirement.
Along with oral Hormonal therapy for thyroid disorders, patient needs to be careful in her dietary habits, avoiding goitrogenic foods such as soy foods, broccoli, cauliflower, mustard seeds, millets, peanuts, etc and increase intake of citrus fruits, antioxidant rich foods, berries, Omega 3 fatty acids, hazelnuts, whole grains, etc.
How the infection takes place and what is the course of its spread?
Influenza virus – Infects respiratory tract of pigs, this might cause barking cough, decrease in appetite, nasal secretions, restless behaviour, etc.
Virus can be transmitted to humans. Found in the year 2009, H1N1 virus is the leading cause of swine flu and another virus H3N2 came under the lens in 2011.
Symptoms are similar to most influenza infections:- Fever, Cough , Nasal Secretions, Fatigue, Headache, etc.
It takes 1 to 4 days for the infection to manifest. Highly contagious, infects others from 1 day before symptoms develop till 7 days after the start of symptoms. Some patients may be contagious for a longer time span.
Who are most vulnerable?
Weakened immune system catches infection soon. For example people with existing diabetes and other immunocompromised conditions, children, also people who are exposed to crowded and unhygienic places.
Is it possible to prevent swine flu?
Symptomatic people should stay at home, avoid crowds, take off from work or school until the infection is no longer transmittable (2 to 3 weeks).
Infected people can wear surgical masks to reduce the amount of droplet spray from coughs and sneezes and throw away contaminated tissues in a covered bin.
What all we can do to prevent catching infection?
Kill or inactivate virus before it reaches a human cell by using soap & water to clean your hands, washing clothing & a shower will help in this.
Use an alcohol based hand sanitizer if no water and soap are available.
Do not touch your mouth, eyes, nose, unless hands are thoroughly washed.
Avoid crowds, parties where chances of infection are very much.
Use of surgical masks might prevent 50% of airborne exposures but not against surface droplets.
VACCINATION is another alternative to go the preventive way.
If a patient is diagnosed with swine flu, she/he has to get treatment from a medical expert, follow all the guidelines, and stay in isolation in order to prevent the spread as well as secondary complications for the self. Secondary bacterial infections may lead to Pneumonia, shortness of breath, seizures, when respiratory support becomes important.
The chances of catching infection minimize to a large extent if we are careful along with being healthy having good immunity levels. Taking all this in account, we realize the worth of undertaking a preventive health check up, to know where our body stands in keeping away and fighting the infections. At DocNok, prevention comes before treatment; it includes making you aware and educate you about the possibilities and precautions living a healthier, happier life.
Dengue is a mosquito borne virus infection (Female mosquito Aedesaegypti bite) presented by fever in case of classical dengue, at times bleeding manifestations may take place (dengue hemorrhagic fever) and in few cases it can lead to shock (Dengue Shock Syndrome). 4 types of Dengue virus (1,2,3,4 ) are there. It is a day biting mosquito. Time period between mosquito bite and onset of symptoms is 3 to 7 days.
Sudden onset of fever, headache, pain behind the eyes, severe body ache.
Sometimes can be associated with sore throat, nausea, vomiting and abdominal pain.
Red rashes beginning from the trunk could be seen.
Bleeding from nose, Red rashes and spots on abdomen, arms or legs, etc.
WHAT TO DO TO PREVENT DENGUE?
Avoid and eradicate mosquitoes and their larvae, their breeding sites from all the possible places like unmanaged drains, unused rubber tyres, uncovered drums and tubs, roofs of homes and offices.
FUMIGATION in affected areas.
Avoid storing water and try to use piped water.
Use covered containers, dry air coolers in rainy seasons and pour a drop of kerosene oil in air coolers with water to cut the oxygen supply, thus preventing mosquito reproduction at that site.
Maintain proper hygiene- both personal and of surroundings.
Wear full sleeves clothes, pay more attention when kids are playing outdoors covering body to prevent bites.
Active use of mosquito repellents like liquid repellants, ointments, fumes, net mesh, etc.
#Antipyretics like paracetamol, cold sponging of whole body, avoiding chest area in children and adults with throat infection.
# Give plenty of fluids orally along with normal diet (water, soup, milk and juices etc.)
# Complete rest is advised.
# To investigate & keep an eye on Hematrocrit (blood) values and Platelet count. #Donot take Aspirin or Brufen tablets on your own for fever.
Immediately consult a doctor if any of the following manifestations appear :
Red spots or points on the skin,
Difficulty in breathing.
Bleeding from nose or gums.
Frequent vomiting , Excessive thirst (dry mouth).
Vomiting with blood.
Pale, cold or clammy skin.
Fever is easy to recognize clinically in most cases, Blood investigation findings help monitor severity and prevent complications. Patient infected with dengue must take plenty of fluids and rest along with antipyretics like Paracetamol only. Self and over the counter medications should be STRICTLY AVOIDED.
.Complications associated with dengue fever usually appear on 3rd to 5th day of illness.
. Observe the patient for two days even after fever disappears.
. Severe cases need timely intervention, hospitalization, I.V. Fluid therapy, extremes may need blood transfusion also.
Stay covered, Stay hydrated, Stay clean and Stay safe.
When our heart beats, blood is pumped through arteries and veins , the blood vessels of our circulatory system .
A condition when blood flows through the blood vessels with a force greater than normal i.e. increased pressure against walls of the arteries.
It is also known as the SILENT KILLER as most of the times initially it does not manifest with any symptoms or signs but internal damage continues, often leading to serious problems.
85% of cases of hypertension are of Primary / Essential HTN- Where the cause is not known and family history might be positive; And 15% cases belong to secondary HTN, caused by specific underlying disease or abnormality.
Blood Pressure is measured in units: mm Hg (Millimeter of Mercury) showing 2 figures systolic B.P./ Diastolic B.P. whose normal range lies between 120/80 which varies with age group.
RISK FACTORS AND CAUSES
Genetics (Positive family history) – Predisposes you.
Race – More common in people with dark skin than in people with pale skin.
Age – Our blood vessels become more rigid as we age.
Timely investigations and B.P. charting for diagnosis shall be done alongwith modification in lifestyle, meditation, exercise and controlling obesity. Low sodium meals, restricted coffee intake and DASH diets are seen to have good effects along with Antihypertensive Therapy and treatment of the underlying cause.
The C word scares us away to ignorance but it is important to know about it to prevent it. Cancer is the second most common cause of death after Heart Attack in India.
CANCER is the result of uncontrolled growth of cells (both in number and or size) in the body. Whenever there is uncontrolled growth of cells, this causes tumours and invasion into adjacent tissue and organs causing damage.
A Cancer can arise from anywhere in the body. It can start from the skin or from the cells of any organ in the body; All cells in our body are cancer prone, some more than others.
Tumours, Lumps, masses or growths which are not cancerous are Benign & those which are cancerous are called Malignant.
There are five broad groups that used to classify cancer.
Carcinomas are characterized by cells that cover internal and external parts of the body such as lung, breast, and colon cancer.
Sarcomas are characterized by cells that are located in bone, cartilage, fat, connective tissue, muscle, and other supportive tissues.
Lymphomas are cancers that begin in the lymph nodes and immune system tissues.
Leukaemia are cancers that begin in the bone marrow and often accumulate in the blood stream.
Adenomas are cancers that arise in the thyroid, the pituitary gland, the adrenal gland, and other glandular tissues.
Most Common Cancers are:-
Breast Cancer and cancer of Cervix in females.
Lung, Prostate (males), gallbladder and pancreatic cancer.
Most common predisposing factors for cancer are – ageing, tobacco consumption, sun exposure, exposure to radiations, chemicals, some viruses, etc. Alcohol, poor diet, obesity, family history of cancer. The causes of cancer can be internal in our body (genes, mutation, hormones, poor immunity) or external (food habits), pollution. Many times the cause remains unknown.
How is cancer staged?
Every cancer is staged according to the extent of its spread. The staging is done clinically along with certain investigations.
The various stages of cancers:
Stage I – within the organ.
Stage II – spread to the neighbouring organs of tissues.
Stage III – spread to the abdomen or lymph nodes.
Stage IV – spread to distant organs like the liver or lungs.
Prevention of CANCER
The cancer can develop in both young and old Colon cancer is more common in people older than 50 years, whereas prostate cancer is found in those older than 65 years.
Lifestyle changes help to prevent many cancers. Use of tobacco is associated with cancer of lung, mouth, bladder and kidney. Stop smoking; reduce alcohol intake, regular exercise and good balanced diet helps in cutting the risk. If there is family history, then one needs to be more vigilant about cancer. Breast cancer can also occur in men.
Self- examination helps in early diagnosis. Breast and testicular cancer and Lymphomas can be diagnosed early if the person is alert and self aware.
Prostate-specific antigen (PSA) estimation is a useful test in males for prostate cancer, whereas in patients who have intestinal polyp –stool examination for occult blood, sigmoidoscopy /colonoscopy helps in early diagnosis.
Warning signs are persistent fatigue, unexplained fever, weight loss, change in bowel habit and chronic cough.
Timely and preventive health checkups and tests to find any pre cancerous conditions and preventing it from changing into full blown cancers.
Keeping an eye in case of positive family history of cancer self awareness regarding our own body changes.
Vitamin D levels should be maintained optimally, helps in keeping away from cancers and has good cancer fighting properties.
Role of Diet in Preventing Cancers
Vitamin A Dairy products, egg yolk, fruits such as apricots, peaches, mangoes,
papayas, green Leafy vegetables such as spinach, curry leaves,
garlic, green tea, soybeans, peas, spinach, turnips.
Treatments for cancer
The word ‘cancer’ does not mean death; with modern treatment most patients lead normal life. Thus, cancer is not fatal and many patients lead normal life despite having cancer. Thinking positive also helps to combat cancer. Being optimistic, joining cancer groups and social groups improve quality of life of the suffering patient. Tender Love and Care goes a long way in physical and emotional healing.
1) Surgery – Most preferred and required part of treatment.
2) Radiation – Radiotherapy uses ionizing radiation to kill cancer cells. It
is painless and curative in many cancers. It can be used with or after or during chemotherapy. It is generally well tolerated. Nausea, vomiting, soreness in mouth, neck; Stomach and intestinal discomfort are acute side effects, where a long-term fibrosis, scarring and lymphoedema can develop.
3) Chemotherapy – Chemotherapy and radiotherapy are safe options for treatment. The effects and side effects of drugs should be discussed at planning stage so that anxiety/depression and premature stopping of treatment should be avoided.
5) Hormone therapy
6) Gene therapy
7) Stem cell therapy – Stem cells are biologically active cells which can divide and can be used in treating cancer. These have been used in blood cancers. More research is going on regarding their use in other cancers.
Few Important steps to be taken for prevention of some common cancers:-
Anti HPV vaccine in females preferably between 9-26-years of age to prevent cancer of cervix.
Monitoring of PSA (Prostate Specific Antigen) via blood test in males above 50 years of age.
Tumour marker tests in people with family history of cancers.
Breast Ultrasound and or mammography in females above 40 years of age.
PAP smear test to detect cervical cancer in sexually active age group of females.
Global Action Plan for the prevention and control of Non communicable Diseases 2013-2020, launched in 2013 by WHO in association with United Nations aims to reduce, by 25%, premature mortality from cancer and other non communicable diseases by 2025. Lets join hands with them for our own sake.
In 2008, more than 1.4 billion adults, 20 and older, were overweight. Of these over 200 million men and nearly 300 million women were obese.
35% of adults aged 20 and over were overweight in 2008, and 11% were obese.
65% of the world’s population live in countries where overweight and obesity kills more people than underweight.
Overweight and obesity are the fifth leading risk for global deaths. At least 2.8 million adults die each year as a result of being overweight or obese.
44% of the diabetes burden, 23% of the ischaemic heart disease burden and between 7% and 41% of certain cancer burdens are attributable to overweight and obesity.
More than 40 million children under the age of five were overweight in 2011.
Obesity is preventable.
WHAT ARE OVERWEIGHT AND OBESITY?
Overweight and obesity:
are defined as abnormal or excessive fat accumulation that may impair health;
have important consequences for morbidity, disability and quality of life;
entail higher risk of developing type 2 diabetes, cardiovascular diseases, several common forms of cancer,
osteoarthritis and other health problems; and
are serious public health challenges in the WHO European Region.
Overweight and obesity are often measured using the BMI (Body Mass Index) scale. BMI:
is a simple index commonly used to classify overweight and obesity in schoolchildren and adults;
is calculated as a person’s weight (in kg) divided by his or her height (in m2); and
does not distinguish weight associated with muscle from weight associated with fat and therefore provides only a crude measure of fatness.
BMI provides the most useful population-level measure of overweight and obesity as it is the same for both sexes and for all ages of adults. However, it should be considered a rough guide because it may not correspond to the same degree of fatness in different individuals.
The WHO definitions of overweight and obesity are:
a BMI greater than or equal to 25 is overweight
a BMI greater than or equal to 30 is obesity
WHO BMI CUT OFF POINTS:
BMI range – kg/m2
Very severely underweight
>less than 15
Tfrom 15.0 to 16.0
from 16.0 to 18.5
Normal (healthy weight)
from 18.5 to 25
from 25 to 30
Obese Class I (Moderately obese)
from 30 to 35
Obese Class II (Severely obese)
from 35 to 40
Obese Class III (Very severely obese)
ROLE OF PREVENTION IN OBESITY
Obesity is a major health problem in today’s world. Overweight and obesity are major causes of type II diabetes, cardiovascular diseases, various cancers and other health problems, which can lead to further morbidity and mortality. The related health care costs are also substantial. Therefore, it is always better to take preventive measures to subside this major issue.
there are genetic, behavioral and hormonal influences on body weight, obesity occurs when you take in more calories than you burn through exercise and normal daily activities. Your body stores these excess calories as fat.
Principal causes of obesity are:
Unhealthy diet and eating habits
Social and economic issues
Lack of sleep
By regular clinical check-up’s & Lifestyle management services, it is easier for an individual to get rid of this serious issue, also one can easily prevent complications of it.
In every household we can see people from almost every age group having neck pain.
Most commonly affected people are from professions having long hours of Desk job, long standing hours with bent neck like doctors in operation theatres, computer professionals, etc.
It may be variable;
Mild to severe pain
Stiffness in neck
Pain in shoulder area, upper back or radiating to arms, ear or head.
Tingling, weakness or numbness that radiates to shoulders, arms or fingers.
What causes Neck Pain?
It can be caused due to multiple factors like:-
About 90 per cent of people with diabetes have Type 2 diabetes. It can come on slowly, usually over the age of 40. The signs may not be obvious, or there may be no signs at all, therefore it might be up to 10 years before you learn you have it.
That is why it’s very important to know the risk factors of diabetes, because then only we can do something about it.
A thorough full body examination is needed to find out the risk factors associated with diabetes.
Diabetes is a serious health condition that occurs when the amount of glucose (sugar) in the blood is too high because the body can’t use it properly. If left untreated, high blood glucose levels can cause serious health complications.
There are two main types of diabetes: Type 1 and Type 2. Type 1 diabetes develops when the insulin-producing cells in the body have been destroyed and the body is unable to produce any insulin. Type 2 diabetes develops when the insulin-producing cells in the body are unable to produce enough insulin, or when the insulin that is produced does not work properly (known as insulin resistance).
Osteoporosis is a condition that weakens bones, making them fragile and prone to breaking. It develops slowly over several years and is often only diagnosed when a minor fall or sudden impact causes a bone fracture.
Although a fracture is the first sign of osteoporosis, some older people develop the characteristic stooped (bent forward) posture. It happens when bone in spine have weakened and fractured, making it difficult to support the weight of the body.
Worldwide 8.9 million people are diagnosed with osteoporosis annually, osteoporotic fractures taking place every 3 seconds. More prevalent and acute in rural areas. World over, 1 in 3 women over the age of 50 years and 1 in 5 men over 50 experience osteoporotic fractures. By 2050, worldwide incidence of hip fractures in men is projected to increase by 310% and 240% in women compared to rates in 1990. The combined lifetime risk for hip, forearm and vertebral fractures coming to clinical attention is 40% almost equivalent to cardiovascular risk. Expert groups pegged number of Osteoporosis patients in INDIA at about 36 million as per 2013 projections.
Bones are at their thickest and strongest in your early adult life and their density increases until your late twenties. We gradually start losing bone density from around the age of 35 years.
Losing bone is part of the ageing process but some people lose bone density much faster than normal, leading to osteoporosis.
Bone is made up mostly of collagen fibres, upon which are laid down crystals made from calcium and phosphate that give the bone a structure like scaffolding with fibres forming strong cross-struts. Bone is a living tissue and it can increase its thickness in areas subjected to repeated heavy loads (remodelling) and repair itself when broken.
UNCHANGEABLE CAUSES OF INCREASED BONE LOSS
Increasing age, Family history of Osteoporosis, Female gender is more prone, Early menopause, very thin body frame.
CHANGEABLE CAUSES OF INCREASED BONE LOSS
Inactivity, poor diet with less consumption of calcium and vit D, smoking, alcohol abuse, low BMI.
MEDICALLY RELATED CAUSES OF INCREASED BONE LOSS
Prolonged use of medications which affect bone strength like corticosteroids, oral hypoglycaemic agents some medications for seizures. Vitamin D deficiency, Protein deficiency, Malabsorption syndromes, Crohn’s disease. Chronic liver or kidney disorders, Hyperthyroidism, low testosterone levels – hypogonadism, Hysterectomy.
Besides Xray of bones, Ultrasound or CT scan, BMD- Bone Mineral Density test is an important one and is a brief, painless investigation. National Osteoporosis Foundation, the American Medical Association and other major medical organizations advise DEXA Scan- Dual Energy X ray Absorptiometry.
Cases with slightly lower BMD values are said to be of Osteopenia, where BMD is low but not as low as to be categorized as Osteoporosis.
TREATMENT is advised according to the individual’s condition; with hot baths or cold packs, Transcutaneous Nerve Stimulation to reduce pain, supplements and lifestyle changes alongwith exercise routines including Strength exercises, Balance exercises, Flexibility exercises, Sitting exercises, Weight bearing exercises and Resistance training accordingly.
By making an effort towards lifestyle changes, including regular exercise in routine (moderate intensity aerobics for atleast 150 minutes per week), No smoking and restraining from alcohol abuse, eating healthy diet rich in calcium and sun vitamin D, an active healthy life can be experienced.