Hypothyroidism vs Hyperthyroidism

The thyroid is a butterfly-shaped gland producing the hormones T3 and T4 which regulate our metabolism and ensure proper functioning of our heart, brain and other organs. The pituitary gland in the brain regulates the thyroid and produces thyroid-stimulating hormone or TSH which signals the thyroid to produce more T3 and T4. When any part of this complex ecosystem malfunctions, the thyroid could end up producing too little or too much of T3 and T4, leading to complications.

While an underactive thyroid produces too little hormone, a condition called ‘hypothyroidism’, an overactive thyroid produces excess hormone, leading to ‘hyperthyroidism’. Triggers, symptoms and treatment protocols are all different for these two disorders. However, in a few cases, the symptoms could overlap, like enlargement of the thyroid called ‘goiter’, which can happen in both types of thyroid disease. Thyroid disorders seem to run in the family and affect women disproportionately more than men, although science still doesn’t know why.

Known signs and symptoms of hyperthyroidism

# Tremor in the hands

# Loss of weight

# Rapid heart rate

# Feeling fidgety

# Sleeplessness

# Brittle skin

# Muscular weakness

# Irritability

# Less frequent periods

What are the likely causes of hyperthyroidism?

# The most common cause is Graves’ disease, an autoimmune condition

# Toxic nodular goiter or small masses inside the thyroid can be the cause of the condition

# Thyroiditis from a virus or post-partum thyroiditis can lead to hyperthyroidism

# Excessive intake of thyroid hormone as a treatment for some other condition could be a likely cause

Hypothyroidism refers to an underactive thyroid that fails to produce enough of the necessary hormones. Signs of an underactive thyroid may not be visible in the early stages, however, over time it can lead to serious health problems like obesity, joint problems, heart condition and infertility.

Be aware of the following signs that may indicate hypothyroidism:

# Constipation

# Chronic tiredness

# Sensitivity towards cold

# Weight gain for no apparent reason

# Dryness of skin

# Tendency to forget

Causes of hypothyroidism

# Another autoimmune condition called ‘Hashimoto’s thyroiditis’, is a very common cause

# History of radioiodine or surgical treatment for hyperthyroidism, cancer or other thyroid disorders

# History of radiation treatment for head and neck cancer

# Some conditions impacting the pituitary gland

# Congenital hypothyroidism

# Certain medications like lithium or anti-leprosy drugs

How is a thyroid disorder diagnosed?

The best screening for a thyroid disorder is a blood test for TSH or serum thyrotropin. A high TSH count would indicate hypothyroidism and a low count point towards hyperthyroidism. Blood tests can also throw up the antibodies levels which would be helpful in detecting an autoimmune disorder.

How are the two conditions treated?

Hyperthyroidism

# As a first line of treatment, symptoms are addressed by beta blockers which help slow the heart rate, minimize tremors and curbs irritability.

# Depending on the cause, doctors often use anti-thyroid medications to reduce hormone production. For Graves’ disease patients, this is a good non-surgical option.

# When medications don’t work, the thyroid cells can be destroyed by radioactive iodine or the gland removed surgically.

Hypothyroidism

# The most widely used treatment for hypothyroidism involves the use of a synthetic supplemental thyroid hormone called levothyroxine.

# TSH levels are checked regularly during this treatment and the dosage adjusted if required.

# The target is to nudge back the TSH level to normal range and thus alleviate symptoms.

Are these conditions lifelong partners of patients?

# Hyperthyroidism need not be a permanent menace, and medication, radioactive iodine or surgery should be able to fix it in most cases. However, there’s a chance of the patient developing hypothyroidism after these treatments and might need regular medication.

# Hypothyroidism though remains a lifelong companion, and one must take medication every day for the rest of her/his life.

While Goiter (a condition where the thyroid gland becomes larger) could be a common fallout of both conditions, overactive and underactive thyroid are two completely different conditions with their own set of possible complications

What are the possible complications of hypothyroidism?

# Difficulty conceiving or infertility

# Peripheral neuropathy

# Elevated cholesterol levels

# Anemia

# Disease of the muscles

What are the possible complications of hyperthyroidism?

# Pregnancy issues

# Neonatal hyperthyroidism

# Atrial fibrillation

# Osteoporosis

# Thyroid storm – a potentially life-threatening condition where the affected person’s heart rate, blood pressure and temperature soar to abnormal levels.

Thyroid disorders are not uncommon, however, diagnosing and treating the condition as early as possible is essential to avoid future complications. Your lifestyle plays an important role in both preventing and managing the condition. Poor diet and lifestyle stress increases the risk. At MNBC, we provide comprehensive treatment facilities, which includes lifestyle management tips by experts.

Living with Vertigo

Vertigo is only a symptom, not a condition or illness. It’s that dreaded sensation when one feels off-balance and dizzy as if the world around you is spinning or you are twirling yourself, often accompanied by nausea. The ordeal could last just a few moments or plague you for days together, impeding your daily routine and putting you into a state of disorientation.

What causes vertigo?

Vertigo is usually caused by a problem with the inner ear. Some common causes include:

BPPV: Benign paroxysmal positional vertigo can occur if calcium particles collect in the inner ear which helps us maintain our balance. At times, BPPV could be linked to age.
Meniere’s disease: Fluid buildup could alter the pressure in the inner ear and cause vertigo along with hearing impairment and ringing.
Vestibular neuritis: Sometimes a viral infection causes inflammation in the inner ear affecting nerves which help us with our sense of balance.

Vertigo could also be linked to:

A head or neck injury
A brain tumour or stroke
Migraine headaches
Certain medications that could damage the ear

What are the common symptoms of vertigo?

The usual symptoms can include:

Spinning sensation
Feeling of tilting to one side
Feeling off-balance
A disturbing swaying sensation
Being pulled in one direction
Feeling of nausea, sickness
Headache and sweating
A ringing sensation in the ear

What are the available treatment options?

Treatment protocols would depend on what is causing the vertigo. Sometimes, it doesn’t need any treatment at all and goes away on its own as the brain comes to grips with the changes in the inner ear and makes necessary adjustments. For others, treatment options would be:

Vestibular rehab: This is a physical therapy option to boost the vestibular system which is tasked with informing the brain on head and body movements vis-à-vis gravity.
Repositioning canaliths: This is another physical therapy involving prescribed head and neck mobilization for BPPV. The targeted movements are designed to move the calcium deposits out of the canal so that the body could absorb those.
Medications: Doctors sometime prescribe medicines for nausea and motion sickness. For infections or inflammation, antibiotics might be needed. To reduce pressure from fluid gathering in the inner ear, diuretics are given.
Surgical intervention: In some cases, a surgical intervention might be required to treat the vertigo.
Treatment for other causes: If the vertigo is being caused by a tumour or an injury to the head or neck, those underlying conditions should be treated to relieve symptoms.

What can you do by way of lifestyle tweaks?

If any serious condition has been ruled out as the cause, you can address your vertigo with some simple lifestyle modifications like:

Take your meds: Don’t forget to take your prescription medications. This could include anti-anxiety medicines as well.
Cut down on alcohol: Alcohol causes dehydration, and vertigo is often linked to the body’s hydration levels. So reduce alcohol intake to maintain fluids balance.
Customize your diet: Strike the right balance in your daily diet between foods and drinks that cause dehydration and those that lead to water retention.
Cut down on caffeine consumption: Caffeine can also cause dehydration and even affect the nerves in the inner ear, thus making vertigo symptoms worse.
Quit smoking: Nicotine not only spikes blood pressure, but also constricts blood vessels, thus impeding blood supply to the inner ear. This can cause or worsen vertigo.
Beware of pain-killers: Some pain medication like NSAIDs can wreak havoc with your electrolyte balance and impact water retention, raising the risk of vertigo.
Vestibular rehab therapy: A regular VRT regimen can help treat nerve issues in the inner ear to relieve severe vertigo symptoms.

At Medica we provide comprehensive facilities for diagnosing the condition and treating the underlying condition.

Diabetes: Are your kidneys at risk?

Our kidneys regulate the salts and fluid levels in our body, which is vital for controlling blood pressure and protecting our cardiovascular health. Diabetic nephropathy is a chronic kidney disease precipitated by extremely high blood glucose levels among both Type 1 and Type 2 diabetics, which damage their kidney function.

It’s one of the most potent causes of long-term kidney disease and end-stage renal disease (ESRD), which in turn, could lead to renal failure. Nearly one-third of people with diabetes later develop diabetic nephropathy.

While in Type 1 diabetes patients, diabetic nephropathy rarely develops during the first decade following diagnosis, some Type 2 diabetics can already have kidney disease when they are diagnosed with diabetes.

What are the common symptoms of diabetic nephropathy?

In the early stages, a patient may not feel any symptoms. As the disease progresses, some of these symptoms could manifest:

Swollen ankles, hands and feet, sometimes face
Difficulty sleeping, flagging concentration levels
Lack of appetite, nausea, metallic taste
Blood in the urine
Fatigue and drowsiness
Dry skin and itching (in end-stage renal disease)
Irregular heart rhythm due to raised potassium levels in blood
Twitching of muscles
Shortness of breath

With progression of the disease, waste gathers in the body in dangerous levels, often leading to uremia, which can cause extreme confusion in the patient, sometimes even coma.

How do doctors diagnose diabetic nephropathy?

Blood tests: Certain blood tests can throw up specific blood chemistry pointing towards kidney damage
Urine tests: The disease can be detected early if traces of protein called albumin is found in the urine sample

How is diabetic nephropathy treated?

Whittling down blood pressure levels and controlling blood glucose are the keys to treating diabetic nephropathy. To slow down progress of the disease, doctors often use medications like:

Blood sugar-controlling medicines like SGLT2 inhibitors (like dapagliflozin)
ACE inhibitors like ramipril and quinapril to treat hypertension and diabetic complications
For those showing side-effects with ACE inhibitors, sometimes ARBs or angiotensin reception blockers are used

For late-stage patients:

Dialysis for ESRD patients to cleanse the blood regularly
Kidney transplant for some patients in the final stages if a suitable donor is found

Are there allied risk factors for developing diabetic nephropathy?

Yes, there are known risk factors besides diabetes like:

Smoking: Smokers have been seen to be more prone to hypertension, diabetes and kidney disease
Age: People above 65 years of age are more vulnerable to kidney disease than those younger
Sex: Men are more prone to this condition compared to women
Allied health issues: Obesity, high BP and cholesterol count, insulin resistance or chronic inflammation can raise the risk

What can I do to reduce the risk of diabetic nephropathy?

Managing your glycemic levels is the key. Diabetics can cut the risk of diabetic nephropathy by:

Regular monitoring of blood glucose levels
Sticking to a healthy diet low in sugar and salt
Getting into a regular exercising regimen
Following the treatment plan to a T, having meds, taking insulin on time
Watching their weight
Avoiding heavy drinking
Not smoking
Controlling stress better

What is the outlook for patients with diabetic nephropathy?

The outlook is totally dependent on how well blood sugar levels and hypertension are controlled and also at what stage the disease was detected. Earlier the diagnosis, better the outlook… Timely treatment can delay the progress of the disease and hence lessen complications. Hence, it is of utmost importance for diabetics to go for periodic kidney screening.

Medica Siliguri’s Department of Kidney Diseases offers comprehensive facilities for treatment of diabetic nephropathy. Our specialists adopt a multi-disciplinary approach to ensure regular monitoring and long-term care

Why are winters bad for arthritis?

It’s that time of the year again when joint pains and stiffness often take a violent turn for the worse, as the cold weather triggers more muscle spasms. Those with arthritis are among the worst sufferers, as the sudden plunge in barometric pressure causes swelling in the joints, putting extra load on the nerves that control the pain centres. Reduced circulation to the extremities of the body simply add to the woes, as does vitamin D deficiency, a quite common phenomenon in winter.

Yes, winters are really bad for arthritics, and while scientists are still grappling with all the probable causes which make joint pains worse in cold weather, another explanation is perhaps that low temperatures cause the synovial fluid, shock absorber to our joints, to thicken, rendering the joints more sensitive to pain. Another study has revealed that winter sparks an increase in our genes which promote inflammation, with a simultaneous waning of those which suppress inflammation.

Arthritis can be inflammatory, like rheumatoid arthritis, lupus arthritis, gout, etc, or non-inflammatory, including osteoarthritis or arthritis from thyroid disease. It is now known that both inflammatory and non-inflammatory arthritis get worse in cold weather.

What can I do to cope with arthritis pain in winter?

You can follow some simple tips to cope better:

Keep yourself warm: Wear those extra layers of clothing, particularly in the areas which ache more, like the knees and elbows, wear compression gloves or mittens and socks. A hot tub soak or a heated-pool swim can also help with the aches.
Eat healthy: Binging on sweet dishes or having too much of spicy or processed food can exacerbate symptoms in rheumatoid arthritis patients. An unhealthy diet also raises the risk of osteoporosis and heart diseases.
Try to manage stress better: Stress has been seen to worsen arthritis pain, more so in cold weather. So, try out ways to alleviate stress, and practice a method that works for you best.
Exercise regularly:Any kind of physical activity, be it walking, cycling, swimming, aerobics or yoga, gives you added flexibility and positivity, and you deal with your pain better. So, stick to an exercise regimen.
Sleep well: Try to get enough sleep as sleep deprivation is known to bring on fatigue and depression and worsen aches and pains.
Check your vitamin D count: Make sure your vitamin D count doesn’t fall drastically, which is often the case in winter months. It can severely aggravate pain in rheumatoid arthritis and other inflammatory arthritis patient groups.
Share your plight: Tell your family members or friends about the abominable pain you are suffering. Sharing often improves your depression and gives you positivity, to cope with pain better.
Get your annual flu shot: People with rheumatoid arthritis, psoriatic arthritis and other autoimmune types of arthritis are more vulnerable to influenza and pneumonia. So don’t forget your flu and pneumonia shots.
Watch your weight: Stay on guard against obesity, because those extra kilos add more pressure to your joints and make your arthritis pain worse.
Stay hydrated: Remember to keep yourself well hydrated by drinking plenty of fluids, an aspect we often tend to ignore in chilly weather.

Sometimes, in spite of all the precautions you take, you may still find it difficult to deal with the pain and discomfort. If the pain becomes unbearable or your movements become severely restricted, it would be advisable to visit a doctor. At Medica Siliguri, our joint pain clinic offers complete care for all ailments related to the bones and joints.

How serious are Uterine fibroids?

Uterine fibroids are non-cancerous growths in the uterus which can cause discomfort and blood loss, but aren’t usually dangerous. It can, however, lead to anaemia, fatigue and in rare cases, a blood transfusion might be required. These growths are not linked to an increased risk of uterine cancer.

These fibroids, which appear during childbearing age, can be multiple or sometimes there can even be a single growth, often not manifesting in any discernible symptoms. The doctor would typically detect uterine fibroids during a pelvic examination or prenatal USG.

What are the common symptoms of uterine fibroids?

While many women don’t feel any symptoms at all, some of the known symptoms, which depend on location, are:

Heavy periods
Periods stretching beyond a week
Pain or feeling of pressure in the pelvic region
Frequent urination
Difficulty passing urine
Constipation
Pain in the back or legs
Pain during sexual intercourse

You should see a doctor immediately if pelvic pain or heavy, prolonged periods persist.

Are there known factors causing uterine fibroids?

While the exact causes of uterine fibroids are not known, doctors can list certain factors from their clinical experience. These include:

Genetic alterations: Changes in genes in uterine muscle cells have sometimes been linked to uterine fibroids
Hormonal issues: Progesterone and estrogen, which stimulate development of the uterine lining during periods, sometimes could promote growth of fibroids
Other growth factors: Some substances that help the body maintain tissues, could also affect fibroid growth
Extra-cellular matrix: ECM binds the cells together and is increased in fibroids. It also causes biological changes in cells.

There are very few known risk factors for developing uterine fibroids except being a woman of reproductive age and having a family history of uterine fibroids.

Is there a heightened risk related to pregnancy due to uterine fibroids?

Normally, fibroids don’t affect the chances of conception. However, certain types of fibroids, particularly, submucosal fibroids, could lead to infertility and loss of pregnancy even, according to doctors. Fibroids could also elevate the risk of certain pregnancy-related complications like preterm delivery, placental abruption or impeding fetal growth.

How are uterine fibroids treated?

Small uterine fibroids most often don’t require treatment, while larger fibroids are treated with medicines or surgical procedures. Treatment will depend on the size, number and location of the fibroids and the symptoms.

Medicines:

Pain medications: Over-the-counter pain medications like ibuprofen and acetaminophen can help manage pain and discomfort
Iron supplements: If the fibroids are causing anemia from excess bleeding, you might be prescribed an iron supplement
Birth-control options: Contraceptive pills, intravaginal contraception or other birth-control methods are sometimes used to control symptoms like heavy bleeding
Gonadotropic-releasing hormone agonists: These medications are sometimes used to shrink the fibroids and can be administered through a nasal spray or injection
Oral therapies: A relatively recent oral therapy is Elagolix, which is used to manage heavy uterine bleeding

Surgery:

Doctors normally use the procedure of myomectomy to remove the fibroids without damaging the uterus. The different methods of myomectomy are:

Hysteroscopy: This minimally invasive procedure uses a scope to cut away and remove the fibroids
Laparoscopy: This technique also uses a scope, but entails making a few small incisions in the abdomen
Laparotomy: This procedure involves a larger cut to remove the fibroids

When future pregnancy is not planned, there are other modes of abdominal surgery like:

Hysterectomy: Total removal of the uterus
Embolization: This involves blocking the flow of blood from the uterine artery to the fibroids to shrink the fibroids
Radiofrequency ablation: Alleviates symptoms and is delivered by laparoscopic, transvaginal or transcervical routes.

Medica Siliguri’s Department of Gynaecology provides complete diagnostic and treatment facilities under specialists for management and treatment of uterine fibroids, along with related complications.

Childhood Asthma: Not Just Seasonal

Asthma is a condition involving chronic inflammation and narrowing of the airways. Childhood asthma isn’t any different from asthma in adults, but the difficulties it brings are often challenging to manage, sometimes leading to emergencies and hospitalization.

In childhood asthma, the lungs and airways become easily inflamed when exposed to certain triggers like inhaling pollen, a common cold or some other respiratory infection. Children often suffer miserably, miss school and games and can’t sleep.

Such triggers and allergens are substances usually present in the environment around us and children with “hyperactive airways”, overreact to these irritants which wouldn’t bother healthy kids. While childhood asthma allergens are mostly found in the air we breathe, the root cause of asthma isn’t really known.
Weather conditions certainly play a big part, and for some children, the problem gets worse during certain seasons, cold and dry air being a common cause for bad flare-ups. However, seasonal variations definitely are not the sole factor responsible for childhood asthma.

What are the other causes of childhood asthma?

While the causes of childhood asthma haven’t been fully fathomed yet, some of the other factors that could be involved include:

An inherited tendency to develop allergies
Parents with history of asthma
Some form of airway infection at an early age
Exposure to day-to-day irritants like cigarette smoke or other forms of air pollution
Viral infections like a common cold
Allergic reaction to dust mites, pet dander, pollen or mold
Physical activity like sports and exercise

What are the other risk factors for childhood asthma?

Children are more likely to develop asthma if exposed to some of these risk factors:

Exposure to tobacco smoke, perhaps even before birth
Earlier allergic reactions, food allergies or allergic rhinitis
Residing in a highly polluted neighborhood
Being obese
Respiratory conditions like chronic stuffy nose, sinusitis or pneumonia
Heartburn or gastroesophageal reflux disease
Boys often are more prone

What are the common symptoms of childhood asthma?

Some common symptoms include:

Tightness or pain around the chest
Feeling short of breath
Respiratory distress
Wheezing or a whistling noise when breathing
Bouts of coughing which gets worse at night

What are the basic treatment protocols for asthma in children?

The main target is to:

Keep symptoms under check
Prevent flare-ups
Keep the lungs healthy
Help the child enjoy an active life

Medication for childhood asthma

There are two types of asthma medication:

Preventers: These medicines render the airways less sensitive to triggers by reducing swelling and mucus inside.
Relievers: These are used to swiftly ease symptoms by relaxing the tight muscles around the airways. Such medication is usually used during an asthma attack.

What are the emergency signs to look out for?

Asthma emergency red flags are when the child:

Has difficulty breathing or is not breathing at all
Can’t speak comfortably and feels breathless
Has blue lips
Has symptoms worsening fast
Has ‘tugging in’ of the skin between ribs or at the base of the neck
Isn’t getting much relief from the inhaler, or the inhaler is not at hand

Remember that an asthma attack can quickly turn into an emergency in children. Prevention is always the best medicine, so keep a check on the triggers and try to avoid exposure to the same as much as possible. However, always keep in mind that not everything is in your control and things can go out of hand, so keep in touch with your child’s doctor at all times and keep the emergency number handy. Your child’s paediatrician is the best person to advice you in such situations.

Kidney Stones: Are They A Serious Health Risk?

Minerals and salts sometimes collect at hard deposits inside kidneys to form stones. These deposits are also known as renal calculi, nephrolithiasis or urolithiasis. The causes could range from diet, obesity, certain ailments or medical conditions or some medicines and supplements.

The substances that combine to form stones, can usually pass through the urinary system. But sometimes, they can’t, since there isn’t enough urine volume, and these become highly concentrated and crystalize. This can be largely attributed to not drinking enough water.

It’s possible that you have had kidney stones for years without even knowing it. You will typically experience pain when the stone moves out of the kidney. Kidney stones become a nuisance and can lead to damage if they are the trigger for serial infections or are causing kidney blockage for a long time. Some types of stones can impair kidney function if not treated.

Adults are more at risk

Research shows that approximately 1 in 10 people will get a stone in the kidneys during their lifetime. However, once it reaches the bladder, it usually passes within a few days. It may take longer though, especially for someone older and with a large prostate. While kidney stones in children are far less common than in adults, children with asthma are four times more likely to have kidney stones.

What are the symptoms to watch out for?

Normally, a kidney stone doesn’t cause symptoms if it isn’t moving around within the kidney or passing into the tubes (ureter) that connect the kidneys with the bladder. In the ureters, the stone is likely to block urine flow, leading to inflammation and spasm. You might then experience symptoms like:

Sharp pain in the side, back and below the ribs that can be severe
The pain can radiate to your lower abdomen and groin area
It can come in waves and with varying intensity
You may feel a burning sensation while passing urine
The colour of urine can be an indicator – pink, red or brown, instead of the normal amber
Foul smelling urine that is foggy
You may feel a constant need to urinate, yet be unable to empty your bladder
A feeling of nausea and tendency to vomit are common symptoms
Fever would indicate the presence of an infection

The site and intensity of the pain would depend on where the stone is lodged in the urinary tract.

Red flags for a doctor visit

Seek prompt medical aid if you have:

Severe pain that makes it difficult to even sit still
Nausea and vomiting accompany the pain
You have fevers with chills along with the pain
You pass blood with your urine
You find it difficult to pass urine

What are the known risk factors for developing kidney stones?

You are more at risk of developing kidney stones if:

You have a family history: Someone in your close family suffered from the same malaise.
You have a personal history: If you have suffered an earlier episode of stones in your kidneys, you are more susceptible.
You are not drinking enough water: Dehydration is a common cause, particularly for people living in warmer climates who have to deal with profuse perspiration.
You diet is high on protein, salt, sugar and sodium: Excess salt in the diet means your kidneys have to work overtime in removing the extra calcium. This increases the risk of stones.
You are overweight: Your body mass index or BMI and the size of your waist matter when it comes to kidney stones. Obesity is a known risk factor.
You have GI conditions: Like Inflammatory Bowel Disease (IBS) or chronic diarrhea and gastric bypass surgeries sometimes bring about changes in the digestive process which affects the body’s ability to absorb calcium and water, which in turn increase risk of stones.
You have certain medical conditions: Like Renal Tubular Acidosis, Cystinuria, Hyperthyroidism, recurring UTIs
You are on supplements and medications: Excessive use of laxatives, Vitamin C, food supplements, antacids, antidepressants and some medicines used to treat migraine increase risk.

How are kidney stones diagnosed and treated?

The doctor uses imaging tests like X-ray, CT scan and ultrasound to diagnose and locate kidney stones. Blood and urine tests also provide important clues.

Treatment options

Sometimes, no treatment is required and smaller kidney stones may pass through with your urine. If your doctor feels treatment is necessary, you might be prescribed medications or advised surgery.

Medications: Medicines are used to relieve pain, manage nausea/vomiting and relaxing the ureter to allow the stones to pass.

Surgery: There are four surgical options to treat kidney stones. The first three of these are minimally invasive procedures.

Ureteroscopy: A small instrument, an ureteroscope is inserted into the urethra, through the bladder and into a ureter to retrieve the kidney stones or breaking them apart using a laser.
Shockwave lithotripsy: In this procedure, high-energy shockwaves are sent through water to break apart the stones, making it easier for them to exit your body.
Percutaneous nephrolithotomy: In this procedure, a tube is inserted directly into your kidney through a small incision in the back. Stones are then disintegrated by an ultrasound probe and suctioned out.
Open stone surgery:For this surgery, a bigger cut is used, compared to minimally invasive procedures, and is very rarely performed (only in 0.3% to 0.7% of cases).

At Medica, our specialists offer surgical treatment of kidney stones using minimally invasive procedures which ensure less trauma, shorter hospital stay and faster recovery.

Juvenile Diabetes : The Children At Risk

Juvenile diabetes was the term earlier used to describe Type 1 diabetes in children, a condition in which the child’s pancreas fails to produce insulin. Without this critical hormone, sugar cannot travel from the blood into the cells, leading to high blood sugar levels. The child will need lifelong insulin injections or an insulin pump to substitute the missing insulin and keep blood glucose levels under control.

Although there is no cure for Type 1 diabetes in children, it can be managed and a good quality of life provided to them with all the progress made in blood sugar monitoring and insulin delivery in recent times. In the past decade or so, there has been a marked spike in the incidence of Type 1 diabetes in children. Early detection and treatment is the key to better life.

Common symptoms of Type 1 diabetes in children

Feeling thirsty all the time
Frequent urination, sometimes bed-wetting as well
Sense of unusual hunger
Loss of weight
Chronic fatigue
Irritability or changes in behaviour patterns
Fruity-smelling breath

What are the known risk factors?

The known risk factors for Type 1 diabetes in children include:

Family history: A child is at increased risk if a parent or a sibling has Type 1 diabetes.
Genetics: Certain gene types indicate an increased risk of Type 1 diabetes.
Viruses: If a child is exposed to some viruses, it could trigger autoimmune destruction of islet cells in the pancreas.

Complications of Type 1 diabetes in children

Type 1 diabetes has the potential to damage some of the child’s key organs. Keeping the blood glucose count in check can cut the risk of complications manifold. Some common complications are:

Cardiovascular diseases: Type 1 diabetes in children increases risk of arterial stenosis, hypertension, heart issues and even stroke in adult life.

Damage to nerves: Undigested sugar in the blood stream can lead to nerve damage over time, causing tingling, numbness, burning or pain.

Renal failure: Type 1 diabetes can cause damage to the minute blood vessel clusters responsible for filtering waste from the child’s blood.

Eye damage: The blood vessels of the retina could be damaged by high blood sugar, causing vision problems.

Brittle bones: Diabetes can also affect bone mineral density, thus putting the child at a heightened risk of osteoporosis later in life.

One must also guard against emergencies like:

Ketoacidosis: This is a serious condition in which blood sugar levels are very high and the body starts producing ketones (chemicals made in the liver). The child needs to be hospitalized immediately and treated in intensive care. Without emergency treatment, the child could slip into a diabetic coma because of brain swelling from the high blood sugar levels.

Low blood sugar or hypoglycemia: At times, blood glucose can dip to dangerously low levels, which could be due to an insulin reaction.

How are children with Type 1 diabetes treated?

These children require a daily dose of insulin injections to keep the blood glucose level within acceptable limits. Insulin can also be released through an insulin pump.

Other measures include:

Right balance of foods to manage blood glucose levels, including meal timings and calorie counts
Exercising to whittle down blood sugar count
Regular blood tests for monitoring blood-glucose levels
Frequent urine testing to keep a tab on ketone levels

True, rates of Type 1 diabetes and to some extent event Type 2 diabetes are on a sharp incline among children and adolescents. However, parents can take heart in the fact that symptoms of child and adolescent diabetes can be managed reasonably well by a combination of healthy diet, regular exercise, and medications, and these youngsters can grow up to lead full and healthy lives.

Our experienced Child Specialists are well equipped to handle this condition in children and can help in diagnosing, treating and managing the condition and emergencies related to it at all times.

Childhood Asthma: Is The Changing Weather Unkind To Your Child?

Any sort of breathing trouble is stressful, more so when children are afflicted. One of the most common chronic airway and non-communicable diseases worldwide is asthma and the incidence just keeps rising, with the WHO reporting that 235 million people suffer from this disease. And that’s only a conservative estimate.

Asthma involves chronic inflammation and obstruction of the airways. There are certain triggers to childhood asthma, like inhaling pollen, a common cold or other respiratory infections, and of course weather changes, particularly cold or damp air, which cause the lungs and airways to become inflamed, thus hampering routine activities like school, sports and even sleep. Sometimes, unmanaged asthma in children could lead to dangerous asthma attacks.

While childhood asthma isn’t curable and symptoms can often continue well into adulthood, it’s possible to manage the symptoms better with proper treatment, for children as well as adults.

Common symptoms to look out for:

The checklist includes:

Frequent, intermittent coughing
Difficulty sleeping because of shortness of breath, coughing or wheezing
Whistling or wheezing sound while breathing out
Breathlessness
Feeling of tightness or chest congestion
Younger children might feel pain in the chest
Coughing or wheezing bouts worsened by a respiratory infection, like a cold or the flu
Slow recovery and lingering bronchitis following a respiratory infection
Respiratory distress while exercising
Constant fatigue precipitated by inadequate sleep

These symptoms often vary from child to child and sometimes asthma could be difficult to tell from infectious bronchitis or some other respiratory issues. Nonetheless, you should see a doctor if you notice any of the above.

Red-flag signs for emergency treatment

You must seek emergency care if your child:

Needs to stop midsentence to catch his/her breath
Is breathing using the abdominal muscles
Is opening up the nostrils wide while breathing in
Has labored breathing and the abdomen is drawn inwards below the ribcage while breathing in

Very often, an asthma attack starts with a simple cough, which could progress to wheezing and severe respiratory distress.

The role weather change plays in childhood asthma

Weather conditions can trigger symptoms of asthma. For many children, their asthma symptoms take a turn for the worse during certain seasons. For some, even a severe storm could be a trigger. Cold, dry air often causes bad flare-ups. In our conditions, while the hot and humid air is also an issue, wet and windy weather can cause nasty exacerbations as well, by enabling mold growth, while wind blows mold and pollen through air. If you have noticed that pollen, mold or other allergens worsen your child’s asthma symptoms, tell your doctor. Perhaps an allergy test will be advised.

The risk factors for childhood asthma

These could include:

Exposure to tobacco smoke, including pre-birth
Some allergic reactions, including skin reactions, food allergies or allergic rhinitis
Any family history of asthma or allergies
Dwelling in a heavily polluted locality
Being obese
Breathing issues like rhinitis, sinusitis or pneumonia
Heartburn or gastro-esophageal reflux disease

Tips for prevention

Being careful to avoid asthma triggers are the best ways to prevent asthma attacks:

Look out for allergens and irritants that trigger asthma symptoms.
Make sure your child isn’t exposed to tobacco smoke during infancy.
Regular physical activity helps the lungs to work more efficiently.
Keep a close vigil on your child’s asthma signs and symptoms.
Keep in touch with your child’s pediatrician.
Watch your child’s weight.
Watch out for acid reflux or heartburn.
Make sure your child gets a flu shot every year.
Take adequate precautions during weather changes.

Our Child Specialists have the necessary expertise and experience in diagnosing and treating all respiratory problems in children.

Winter Is Coming!

Coping with the ailments that the cold weather brings along winter has its myriad charms and is often the season we most look forward to. However, cold weather does bring its fair share of ailments as well, some stubborn, like the common cold or flu, while others more critical, at times life-threatening even.

So, what are the winter ailments we should be aware of?

Common Cold

This is the most prevalent winter health issue, characterized by nose and throat infection, with sometimes the ears involved as well. You can catch it by someone coughing or sneezing around you or by touching a contaminated surface, like a doorknob. There are over 200 viruses that can cause colds, of which the most common is the rhinovirus. The symptoms include a runny nose, itchy throat, low-grade fever, tiredness, body aches, sneezing bouts and cough. While there’s no cure for common cold, anti-allergic medication, cough syrups and nasal decongestant drops help alleviate symptoms. Common cold is said to be responsible for the maximum work and study time lost. You should see a doctor if the symptoms linger beyond a few days or get worse.

Flu

Flu is another seasonal viral infection of the respiratory tract, involving the mouth, nose, throat and lungs. Like common cold, you can catch it from airborne droplets if someone coughs or sneezes near you or if you touch contaminated surfaces. It can be quite debilitating with fatigue, fever, body aches, sore throat, sneezing and coughing, and sometimes even diarrhoea. An annual flu shot can help, while treatment could involve anti-viral medications. The doctor will likely advise you rest and drinking plenty of fluids. Even after the symptoms disappear, you might feel quite weak and lethargic for a week or two.

Acute Bronchitis

A cold or flu can sometimes lead to acute bronchitis, which is an inflammation of the tubes that carry air to the lungs (bronchi), causing a buildup of excessive mucus. Smokers or those susceptible to allergies, sinusitis or tonsillitis can be a high-risk group, while sometimes you can catch it by inhaling bacteria. The usual symptoms are dry cough which later becomes mucus-productive cough, body aches and headaches, chills, sore throat, feeling breathless and wheezing. It normally tapers off on its own, but if it progresses to pneumonia, you will need antibiotics. In case your bronchitis comes back for two consecutive years and bothers you for 2-3 months, doctors consider the condition chronic.

Pneumonia

Pneumonia, which can be brought on by viruses, bacteria or fungi, infects the lungs, filling up the air sacs with pus and other fluids. Symptoms could be mild or serious, including fever, cough with mucus, breathing distress, chest pain, chills, loss of appetite, and even confusion. If pneumonia is caused by bacteria, antibiotics are prescribed. For the viral variety, the protocol is just rest, drinking plenty of fluids and a nutritious diet. You should see a doctor if you are coughing up pus, have high fever, shaking chills or difficulty breathing and also if you have other health conditions of the lungs or heart.

Whooping cough

Whooping cough mainly affects infants and young children. It is a severe and contagious bacterial infection caused by the bacterium Bordetella pertussis, and is spread through coughs and sneezes, sometimes even through breathing. It usually begins as a common cold and becomes worse, with painful coughing bouts accompanied by a whooping sound with respiratory distress. Your child may also have fever, sneezing, runny nose and watery eyes.

Prompt treatment with antibiotics can provide early relief and reduce chances of contagion. The doctor would advise drinking plenty of fluids and staying away from irritants like smoke or dust. Whooping cough can sometimes linger for over two months and even lead to pneumonia or other complications.

Other respiratory ailments

The cold, dry air in winter leads to tightening of the airways, making breathing labored. This is often made worse for those already suffering from respiratory conditions like asthma or COPD, particularly by inhalation of droplets exhaled by infected individuals. It is advisable to keep an inhaler handy and see a doctor if the symptoms get worse in the cold conditions.

Joint pain

Those suffering from chronic joint pains often complain of their symptoms getting worse over the winter months. One expert school of thought ascribes this to the pain receptors in the body becoming more sensitive as atmospheric pressure drops during the cold season. This could lead to tissue swelling and the resulting tension between the joints causes pain. Exercising to reduce joint and muscle stiffness can be very helpful.

Heart attack & stroke

Not just respiratory conditions. Winter is also a prime season for heart attacks and strokes. With the drop in temperature, the blood vessels tend to shrink, forcing the heart to work overtime to pump blood. This often results in a spike in blood pressure or clotting of platelets, which in turn could lead to heart attacks and strokes.

For a heart attack, the most common symptom is chest pain or discomfort while the stroke signs to watch out for include numbness of the face or limbs on one side of the body, difficulties with speech, vision and balance. These are both critical medical emergencies and must be treated as such.

At Medica, our expert team of Internal Medicine experts are experienced in treating all common ailments and infectious diseases with 24×7 support from our state-of-the-art critical care unit and emergency department.