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SURGICAL TREATMENT OF EPILEPSY IN ADULTS

Generally, the treatment for Epilepsy doesn’t require surgical intervention, until seizures occur at a single location in the brain. Also, there are chances that a person may not be able to tolerate the side effects of medication, or anti-seizure drugs may fail to control seizures. In such cases, doctors suggest going for epilepsy surgery. Before initiating the procedure, a neurologist will recommend some pre-surgical tests to determine the right time for surgery and how it is performed. Pre-Surgical Evaluation Since brain surgeries are complex, a surgeon needs to understand the anatomy of the patient’s brain to determine the precise areas that control motor skills, sensory functions, and other critical functions. After examining the site, the surgeon will try to preserve the function where seizures are formed to the greatest extent, while removing or altering the site during the surgery. The following tests are performed to evaluate: • Functional MRI – After performing MRI, the surgeon will get to know the exact location of your brain controlling particular functions. The test results help in identifying the regions while performing a specific activity such as reading or listening. • Brain Mapping -- During mapping, small electrodes are surgically placed on the brain’s surface. This test aims to match the number of tasks performed by the patient vis-à-vis the brain’s electrical activity, allowing the surgeon to protect the vital areas of the brain during surgery. • Neuropsychological tests -- Ideally, this test is performed to measure the verbal and non-verbal learning skills, along with memory function. The revelation of these tests undermines the area affected by seizures and the brain’s activity after the surgery. Types of Epilepsy Surgery Abnormal activity of neurons (certain brain cells) causes epileptic seizures in varying degrees from person to person. A neurosurgeon decides on the type of surgery, depending on the location of the neurons, intensity of the seizure, and the patient’s age. Following are the most successful surgical methods to treat the condition; 1) Resective surgery Most doctors commonly opt for resective surgery to treat epilepsy in adults, say senior NEUROLOGISTS OF AMRI HOSPITALS. The surgery is performed to remove the entire brain region where seizures occur, which can even be of the size of a golf ball. If required, the surgeon may remove a brain lesion or a portion of the brain lobe while performing the surgery. Temporal Lobectomy has shown the most successful results in reducing the effect of seizures and limiting the risk of permanent damage. 2) Multiple Subpial Transection People having frequent and severe seizure episodes may undergo multiple subpial transections. The effectiveness of the surgery is seen in patients whose seizures don’t occur in the same region of the brain. However, it requires cutting parts of the brain to prevent the uncontrollable spread of seizures. 3) Laser Interstitial Thermal therapy The procedure is less invasive and uses laser to destroy brain tissues from the affected area of the brain. The surgeon will use MRI for guidance throughout the entire process. 4) Deep brain stimulation While performing deep brain stimulation, the surgeon will implant a device in the patient’s brain to release regularly-timed electrical signals to disrupt abnormal activities caused by seizures. On the other hand, a generator is implanted on the patient’s chest to send the electrical pulse. Through MRI, the entire procedure is monitored by the surgeon. Outcome The expected outcome of the surgery is to free a patient from recurring seizures, using medical intervention. The time taken for recovery depends on the type of surgery performed by a neurosurgeon. Regular follow-ups are required to monitor the patient’s condition right after the surgery.

WHAT ARE THE BENEFITS OF MINIMALLY INVASIVE SURGERIES?

In all these years, advancements in surgical techniques have drastically changed the outlook of surgical interventions for patients. As surgeons get access to the latest technology and advanced training, the ‘Minimally invasive’ approach becomes an umbrella term for any surgery that is less invasive than open surgeries which enclose robotic, endoscopic, and laparoscopic procedures. The implication of minimally invasive surgeries (MIS) allows a person to get operated on in a less harmful way. Nowadays, the MIS technique has smoothly replaced conventional procedures that were once performed to treat gastrointestinal tract diseases, brain disorders, or orthopedic injuries. If you have been diagnosed with a condition that requires minimally invasive surgery, know that this technique has many benefits. This includes; Smaller Incisions Minimally invasive surgical procedures use a small incision to insert camera and surgical equipment to aid the surgeon in performing the operation, unlike in traditional surgeries, where a six to 12-inch incision is required to get easy access, and a wider view of the damaged or injured area. Minimal Scarring As this type of surgery requires smaller incisions, it is expected to have fewer stitches that often become the cause of scars. Many times, it only takes a few sutures to close the incisions that give smaller or less noticeable scars. Quicker Recovery Small incisions provide faster healing than traditional open surgery techniques. Generally, in minimally invasive surgery, the patient doesn’t need a long hospital stay and returns to work and normal activities quicker. Most patients can leave the hospital the next day or even the same day after the surgery. Safer surgical alternative Many surgery techniques now fall under minimally invasive surgery, such as laparoscopy, arthroscopy, gastroscopy, endoscopy, hysteroscopy, sigmoidoscopy, and others. Today, the best results of minimally invasive procedures are seen in orthopedics, where hip and knee replacement, Achilles tendon repair, or discectomy has improved the quality of recovery in patients after surgery. The use of minimally invasive surgery has expanded widely in many surgical specialties, including colon and lung surgeries. Less Risk of Infection Earlier the possibility of external contaminants infecting wounds and internal organs lingered on with larger incisions made during the open procedure. With the smaller incisions, this particular risk has significantly reduced as there is less room for exposure to germs. In addition to that, the risk of excessive bleeding, bacterial infection, and other complications is prevented to some extent with the use of smaller surgical incisions. Final Thought Minimally invasive procedures allow greater precision in surgical technique offering higher accuracy than open surgery. In some cases, traditional open surgery is still applied to operate on wider or complicated regions of the body. Talk to a surgeon specialising in comprehensive treatment to get you back on your feet, performing the right surgical process for you.

DENGUE FEVER

Dengue fever, commonly known as ‘Breakbone fever’ is a vector-borne disease, transmitted through the bite of an infected Aedes mosquito. It is important to understand that this infection cannot be spread from person-to-person. Dengue is a tropical disease that originates from four different viruses. Depending upon the infection, a person may experience some mild fever for a few days, along with common flu-like symptoms. However, the concern rises when dengue fever changes its course, showing atypical signs leading to potentially fatal conditions, such as shock syndrome or haemorrhagic fever. According to experts, if you are returning from a region where the disease is prevalent, then consult your doctor immediately and get yourself checked even before the symptoms begin to show. Earlier, the risk of vector-borne diseases was prevalent during a few seasons but now such illnesses thrive throughout the year due to fluctuating weather conditions. In such a scenario, it is essential to learn about the right measures and take preventive steps to check mosquito breeding. Read on to know more about Dengue fever, its symptoms, prevention, and treatment. Dengue Symptoms Unlike other viral infections, dengue fever has different symptoms, depending on the stage. Initially, a person might get high fever within 4-7 days of being bitten by an infected mosquito. Some common symptoms that come along with Dengue fever are: • Joint and muscle pain • Severe headache • Pain behind the eyes • Nausea and vomiting • Red rashes • Diarrhoea • Extreme dehydration Usually, a person may suffer from fever for 3-4 days, along with some mild symptoms. In children, skin rashes come as the prominent sign indicating dengue, whereas other symptoms may remain controlled. In rare cases, DENGUE FEVER changes into a life-threatening illness. A person may undergo unusual symptoms, such as bleeding of the nose, gums, or under the skin (due to damaged blood vessels), which develop into Dengue Haemorrhagic fever. In such situations, immediate hospitalization is required as it can be fatal. Dengue Prevention ‘An ounce of prevention is worth a pound of cure’, goes the old saying. There is no vaccine to prevent dengue fever. One needs to opt for different ways to protect themselves from mosquito-borne diseases, which include: • Wear clothes that cover well (full-sleeved shirts & long pants) • Consider using mosquito netting and repellents • Close windows and doors in the daytime • Use covered water containers in the house • Keep surroundings clean and sanitized • Don’t fill excessive water on plant pots • Keep a check on clogged gutters and poor drainage • Avoid standing near areas with stagnant water Dengue Treatment For treating ‘dengue fever’ the patient requires precise medical care. You cannot treat dengue fever with antiviral or antibacterial medications, without consulting your physician. As there is no specific cure for dengue, a qualified doctor can only advise on the right treatment methods, observing the severity of symptoms and infection. However, some effective methods to treat mild symptoms can be: • Medication: A person suffering from dengue might need common painkillers like tylenol or paracetamol to relieve body ache, and/or mild fever. Sometimes, late diagnosis can cause severe dehydration, which requires regular IV drips to regulate water level in the body • Proper Hydration: When suffering from dengue, our body is prone to dehydration as most of the body fluids are lost due to vomiting and high fever. According to doctors, continuous intake of fluids in the form of lukewarm water, juices, and coconut water, are a must to ensure proper hydration in the body • Hygiene: In any kind of infection, hygiene is an important factor in faster recovery. Similarly, for dengue patients, it is essential to have clean and hygienic surroundings. Also, it is advisable to take a sponge bath, if not a regular bath, even whiel having fever. You can add liquid disinfectant in warm water for bath and washing clothes

The relationship between food and disease

The phrase “you are what you eat” is commonly used in conversations about health and the connection between food and the body. Eating an unhealthy diet can have serious consequences and can increase someone’s risk of dying from heart disease, stroke and Type 2 diabetes. In this Mayo Clinic Minute, Dr. Stephen Kopecky, a preventive cardiologist at Mayo Clinic, discusses the relationship between food and disease. Things like smoking and genetics put us at risk for developing different diseases, but neither are the biggest risk factor. “Nutrition is now the No. 1 cause of early death, and early disease in our country and the world,” says Dr.Kopecky. Dr.Kopecky says having genes for disease will increase your risk by 30% to 40%, but having a bad lifestyle for disease will increase your risk by 300% to 400%. “About 57% of the calories we consume every day in this country are ultraprocessed foods,” says Dr.Kopecky. While ultraprocessed foods tend to be convenient and cost-effective, they are inflammatory and can cause a host of health issues over time. “It bothers our tissues. It bothers our heart. It bothers our arteries, our brains, our pancreas, our liver and our lungs. And that leads to disease,” says Dr.Kopecky. “It could be in the brain with Alzheimer’s, the heart with coronary artery disease, or cancers elsewhere.” The good news is it’s never too late to change your eating habits, and no change is too small. “It’s been shown if you take one bite of say a processed meat or ultraprocessed food, replace that with some unprocessed food or a healthier choice ― you know vegetables and black beans ― after a year or two, that will actually lower your risk of heart attack and stroke.” Of the four levels of food processing, the most processed are termed ultraprocessed foods. These foods have many added ingredients, such as sugar; salt; fat; and artificial colors, preservatives or stabilizers. The ingredient list sometimes has words that sound like chemicals. Examples are obvious foods like soft drinks, hot dogs, cold cuts, fast food, packaged snacks and cookies, but can also include canned baked beans, low-fat fruit yogurt, packaged bread, ready-made pasta sauces and breakfast cereals.

LUNG CANCER CARE AND TREATMENT: EFFECTIVE WAYS TO DIAGNOSE THIS MEDICAL CONDITION

Lung Cancer is a state of malicious tumor in the lungs, characterized by uncontrolled growth of cells in lung tissues. It begins in the lungs and might spread to other organs of the body. This process of cancer cells spreading from one body part to another is known as metastasis. The symptoms of lung cancer can be different in different people. Many a time, people get to experience the symptoms only after the condition has become quite serious. One can diagnose the disorder when he/she experiences chest pain, regular coughing, breathing problem, wheezing, etc. In addition, if you are losing weight without any reason, do not wait to visit a physician. Detecting lung cancer Low dose CT scan, nasal swabs, blood testing, etc. are some of the basic levels of testing methods recommended by physicians in the primary stage. In the next level, doctors suggest multiple kinds of tests to detect cancerous cells: • X-ray: An X-ray image of the lungs reveals the extra mass of cells that might have developed in the lungs. If the bruises are not detected in an X-ray image, a CT scan can be done. Image testing is an extremely important step for testing lung cancer, since it can tell a lot about the condition of your lungs and other nearby parts. • Sputum Cytology: It is about testing of phlegm to discover cancerous cells in the lungs. In many cases, a patient coughs up sputum (the mixture of saliva and mucus). It can be scanned through the microscopic lens to reveal the presence of infected cells. • Biopsy: Biopsy is the process of examining a sample of defective cells under a microscope. There are a number of ways of conducing a biopsy, such as bronchoscopy, mediastinoscopy, needle biopsy, etc. In bronchoscopy, the doctor inspects the affected regions of the lungs with a lit tube that goes into the lungs through the patient’s throat. Being careful about your lifestyle is the most important way to be healthy in life. It is recommended that you visit a doctor as soon as you experience any symptoms in your body.

WHAT IS OSTEOPOROSIS AND HOW IT CAN BE TREATED?

Our bones are complex living tissue comprised of a thick outer shell (known as the cortex) and a strong inner honeycomb mesh of tiny cross-members (known as the trabeculae). This structure enables our bones to be strong, lightweight and somewhat flexible. These properties are important because they allow our skeletons to support us while being able to cope with the stresses and strains that we impose upon them in the course of day-to-day life. During the first two decades of life our skeleton grows, reaching what is termed Peak Bone Mass – the point when our bones are at their most dense – in our early 20s mentions. In the middle period of life, a continual process of repair is ongoing which ensures that old worn-out bone is replaced by fresh new bone. In later life or when specific medical conditions occur in people in their middle years – the balance between old bone being broken down (known as resorption) and new bone being made (known as formation) can be lost. When there is more resorption than formation, the total amount of bone in the skeleton begins to decline and bones become more fragile. This is particularly common for women who have experienced the menopause because oestrogen plays an important role in maintaining the balancing act of this process known as bone remodeling. For significant numbers of men it should be noted that, after 70 years of age, loss of bone density is also an issue. When a person’s bone density drops below a specific level a diagnosis of osteoporosis will be made. Treatment of osteoporosis Calcium Calcium is an important component of bone. Therefore, it is important that we eat sufficient calcium to maintain our skeletons, but there is no evidence that taking more than this is helpful. There is controversy regarding what is an adequate intake, recent evidence suggesting that as little as 500 mg/day (2 servings of dairy products) is sufficient in adults, though some experts still recommend 1000 mg/day, or more. Many older people find it difficult to take 1000 mg/day in their diets, so use supplements. However, there are now several safety concerns related to calcium supplements, and the consensus is that calcium from the diet is to be preferred. People ingesting at least 2 servings of dairy products daily are likely to be receiving enough calcium. Vitamin D Vitamin D is a substance made in the skin as a result of sunlight exposure. It facilitates absorption of calcium from the diet. When vitamin D levels are very low, mineralisation of bone is impaired. Individuals who never go outside (e.g. frail elderly), those who are veiled, and those who have dark skin are at risk of vitamin D deficiency, so might benefit from a vitamin D supplement. The use of supplements by those who are not deficient does not improve bone health. Most healthy European New Zealand adults living independently do not require vitamin D supplements.

THE IMPORTANCE OF VACCINES

The ongoing World immunization Week is indeed a big opportunity to promote vaccination across all communities, for ensuring that they have good health all throughout. Not just that, IMMUNIZATION also helps to give thorough protection against all types of communicable and non-communicable diseases. The hospital’s list of doctors includes a number of experienced medical practitioners. Widely recognized for its success in saving lives of numerous people worldwide, and across India, these vaccination programmes have reached out to the most inaccessible communities with cost-efficient methods. Vaccination is not just meant for children. They are meant to support and maintain good health condition of one and all. Vaccines ensure protection of our health and body at every stage of our life. But the process of vaccination does not end during one’s childhood. After that, an adult should dutifully, get vaccinated. This will not only ensure protection against any further ailments, but at the same time boost the efficacy of the already existing vaccines, which have been embedded in the body. There are numerous challenges in implementing these immunization programmes. This is because, even today, people have deep-rooted thoughts and beliefs, guided by religious sentiments and dogmas. Even though the Indian government has worked hard to eradicate these issues, a great deal of work still needs to be done at the ground level to make people believe that the fruits of immunization can be beneficial to all, across all generations. Ensuring vaccination across all age groups can help in complete eradication of various types of diseases and ailments, making people, communities and societies healthier. Making a country or a society disease-free will ultimately help in adding to the country’s growth and economic prosperity. Vaccination has been termed as a mandatory preventive method, as it prevents the transmission of bacteria and other types of viruses. Many doctors have declared it as serious precautionary measure. There are different types of serious diseases such as yellow fever, tuberculosis, hepatitis, and meningitis that can be prevented through vaccination. Recently, a brand new vaccine known as RTS has been developed against malaria. Malaria has been declared as a deadly disease that has caused numerous deaths across the globe. This immunization, initially developed to cater to patients from Malawi in Africa, has been formulated and approved by the World Health Organization (WHO). If this turns out to be successful, then the vaccine can be circulated globally as an integral part of regular vaccination, on a large scale. Different types of vaccinations one gets at different stages of life: • Haemophilus influenza Type-B (Hib): A child is given 3-4 doses of Hib vaccine. The very first dose is given at the age of two months, the second one in the fourth month, and the third dose is given when the child is six months old. The fourth dose is given, if required, between 12 to 15 months of age. • Hepatitis A (Hep A): The child is given two doses of Hepatitis A vaccine. However, it can also be given to adults at any stage of their life, if required. • Influenza (Flu): This vaccination should be given to the vulnerable group every year, especially during winter. Children, who generally have a tendency to fall sick or quickly catch infections during winter, are considered vulnerable, say health experts. These children should specially be taken care of and vaccinated on time, to prevent them from any type of infections. • Measles, mumps, epidemic roseola (MMR): Two doses of MMR vaccine is given to a child suffering from these diseases; the first one at the age of 12-15 months and another at the age of 4-6 years. There are specific types of Vaccines which are given as preventive measures for specific type of diseases. Let us take a look: • Polio (IPV): If a baby has been diagnosed with polio, then based on his/her age, the child is given a specific dose of polio vaccine. Usually, a child affected by polio is given four doses of polio vaccines (IPV). The primary dose is given to a toddler at the age of two months, the second one is given at the age of four months, and the third dose is given between the age of six months to eighteen months and the fourth dose, between four and six years. • Diphtheria, tetanus, and other similar infectious diseases (DTaP): If a child is diagnosed with diptheria, tetanus or any such infectious diseases, doctors at AMRI Hospitals suggest 5 doses of DTaP vaccine as the primary vaccination. After this, a booster dose should be given once in every 10 years, until the child reaches the age of 65. • Chicken Pox: In case of chicken pox, a child needs 2 doses of chicken pox vaccine.. Normally the primary dose is administered at the age of 12-15 months, and the second dose is completed by the time the child is between four and six years old, at the Kolkata Hospital. • Hepatitis B (Hep B): A child suffering from Hepatitis B, has to be given few doses of Hep-B vaccination. The first dose is administered at birth, the second dose is given at the age of 1-2 months, and the third dose is given once the child is four months old. The fourth dose is given when he/she attains the age of 18 months, but it is only under the supervision of doctors. Currently, it has become mandatory for everybody to get the Hepatitis vaccine beforehand. • Haemophilus influenza type B (Hib): If a child is suffering from Haemophilus influenza type B then 3-4 doses of Hib vaccine is given to them. 1st dose is given at the age of two months, second is given at four months and the third dose is injected, once the child is six months old. The fourth dose is given, but only if is needed, that too between the age of twelve to fifteen months. • Hepatitis A (Hep-A): Children suffering from Hepatitis-B have to be given 2 doses of Hepatitis A vaccine. Apart from children, this vaccine may be required for adults as well, at any stage during their lives. • Influenza (Flu): This vaccination has to be given to children who have a relatively weaker immunity system and are more vulnerable towards catching infections, especially during winter. Some of the diseases that any vulnerable child is prone too are COPD, influenza, etc. Increasing awareness on vaccination across all age groups will help reduce the global burden of diseases, promote a healthier work force and stronger economic growth for the nation. Vaccines constitute a very important part of our life. The immunity system of a person is at its highest during one’s adulthood, which means that young children and elderly people are most susceptible to catching infections. But this can be controlled, if children are vaccinated from time-to-time. Vaccines still act as one of the age old preventive measures to protect a person’s immunity system. If a large part of the population is vaccinated, we can considerably reduce the rate of infections and strive towards a better society and a healthier world.

WHAT CAUSES KIDNEY STONES (AND WHAT TO DO)

If you’ve ever suffered from a kidney stone, you might be aware of the shooing and throbbing pain that it causes. Kidney stones can develop in anyone at any age, so understanding the do’s and don’ts is important for everyone. Many early signs can help prevent pain, discomfort, and life-long damage to the kidney. In this blog, we discuss the common causes of kidney stones. By understanding the main causes, one reduces the probability of developing kidney stones, while bringing a few alterations in your lifestyle. Kidney stones vary in shapes and sizes, ranging from a grain of sand to a large golf ball. Generally, the accumulation of undissolved salts and other minerals in urine forms kidney stones. Some medicines help stones pass through the urinary tract. While they can cause excruciating pain, these won’t damage the passage. Causes Often there is no single cause behind development of stones but, several factors come together to increase the risk. In men, risk percentage is higher than in women. Stones form when urine contains excess crystal-forming substances, including calcium, oxalate or uric acid, along with the deprivation of fluid that helps in diluting these substances, explain Urologists of AMRI Hospitals. Some factors that are generally linked with an increased risk of developing kidney stones are: • Inadequate water intake Many people don’t drink enough water throughout the day, which is one of the leading factors behind stone formation in kidney, particularly, when you are living in a warm and dry climate. This can lead to low urine volume. As a result, salts remain undissolved, creating a higher risk of forming stones. • Obesity Excess weight may create an abnormal change in acid level in the urine, leading to stone formation. Larger waist size, sudden weight gain, or high BMI (Body mass index) is associated with a greater risk of kidney stones. • Family History Chances of kidney stones developing are much higher if someone in the family has a history of kidney stones. Also, if you have previously suffered from kidney stones, your doctor will advise taking precautions to avoid the risk of stones forming in the future. • Medication/Supplements Some commonly-used medicines and dietary supplements used to treat depression or migraines are calcium-based antacids, prolonged use of which can lead to stone formation in the kidneys. Also, people who regularly workout in gyms are advised certain supplements that might increase the risk of kidney stones, if not taken under a doctor’s supervision. • Dietary patterns Consumption of food items high in protein, sodium, calcium, or sugar in daily diet increases your risk of all kinds of kidney stones. A high-sodium diet (smoked/canned food, salted snacks, frozen meat, restaurant prepared meals, ready-to-eat packs, pickles, or sauces) increases the build-up of calcium in your kidney. The undiluted or excess calcium significantly raises the chances of stone formation. • Bowel Conditions Chronic diarrhoea, inflammatory bowel disease, ulcerative colitis, urinary tract infections, or gastric bypass surgery can suddenly affect the digestive channel, and start absorbing more oxalate from the intestine than usual. The risk of developing calcium or oxalate stones is higher in such cases. What to Do: Managing or removing smaller kidney stones is easier with the help of certain medications that speed up the passing of stones naturally. Also, plenty of fluid intake and pain relief medications help in the process. You might be advised to make changes in your diet, avoiding high-sodium items or packaged snacks. Large stones, however, may need surgical intervention as a successful treatment option, including shock wave lithotripsy (SWL), ureteroscopy, or percutaneous nephrolithotomy (PCNL).

ORAL CANCER - FACTS, DIAGNOSIS & TREATMENT

Oral cancer develops in the mouth  and throat, interfering with the normal functioning of breathing, listening, chewing, swallowing, or talking. It’s one of the deadliest diseases that appears as a growth or sore inside the mouth and does not go away. Overall, the survival rate is much higher with all stages of oral cavity and pharynx cancers. When found early, treatment of oral cancer is likely to give positive results in patients. Important Facts about Oral Cancer  Men are affected about twice as often as women with oral, head and neck cancer and about 60% of the time it will be found at a later stage  Tobacco in any form and alcohol are the largest risk factors for oral cancer. Most of the oral diseases and risk of cancer could be prevented if people refrained from tobacco or alcohol  Initially, the first signs of oral cancer start on the lips, tongue, or the floor of the mouth. If spread hastily, it can affect and be found inside cheeks, gums, or on the roof of the patient’s mouth  Avoiding direct exposure to sunlight lowers the risk of lip cancer. Use lip protection with a sun protection factor (SPF) and reapply it frequently. Stay inside or walk in the shade in the middle of the day when the sun's rays are highly damaging  Human papillomavirus (HPV) is mainly responsible for the rise in the oropharynx (tonsils cancer) in younger non-smokers population especially and is related to oral sex. It’s an STI condition where the risk of HPV cancer increases when having more than oral sex partners.  Any discomfort, abnormal swelling, soreness, lump, white or red patches on gums or tongue indicates the need to consult your dentist or ENT specialist. Also, annual oral screenings can prevent the risk of many oral diseases or cancer. Symptoms The most common symptom of  ORAL CANCER  is an unhealed soreness in the mouth. Other signs that shouldn’t be ignored are;  A lump in the mouth, throat or the lip  Bleeding, pain, or numbness in the mouth  A sore throat that doesn’t go with the treatment  Swelling of the jaw  Difficulty in chewing or swallowing  White or red patch on gums, throat, tongue and lining of the mouth  Pain in the jaw and ear  Hoarseness or change in the voice Diagnosis of Oral Cancer If cancer is suspected, the doctor may use mirrors and a lighted tube to perform the examination. However, not all tests are meant for every person, depending on the symptoms, age, type of cancer suspected and results of previous medical tests,  the doctor may suggest or consider particular diagnostic tests which include:  Dental examination  Endoscopy  Biopsy  Oral Brush Biopsy  HPV testing  MRI  X-ray  Barium Swallow  CT Scan  Panendoscopy  PET-CT scan  Ultrasound Once done, a specialist will review the results and if cancer is found, the results will help determine the course of treatment for the doctor. Treatment For oral cancer, surgery (removing cancer cells) is the first line of treatment, if diagnosed in the early stage. “We prefer to develop a proper treatment plan for the oral cancer patients considering the best way possible, that will not affect their overall quality of life, ENT surgeon of AMRI Hospitals”. Depending on where the cancer is located, and the severity of the condition, patient’s age and overall health, oral cancer is treated. Other treatment options may include radiation therapy (using high-dose X-rays to kill cancer cells), chemotherapy (high-dose anti-cancer medicines) used in certain situations for advanced stages, and targeted therapy, helping in reducing or eradicating the risk of cancer in people.

CARDIAC ISSUES IN WOMEN

Many cardiac issues are found in women. A major cardiac issue is the threat of heart disease. But becoming aware of symptoms and risks unique to women, as well as eating a heart-healthy diet and exercising, can help protect you. Heart disease is the most common cause of death for women. Some heart disease symptoms in women may be different from men. Fortunately, women can take steps to understand their unique symptoms of heart disease and to begin to reduce their risk of heart disease. Symptoms The most common heart attack symptom in women is pain, pressure or discomfort in the chest. But it is not always the most prominent symptom, particularly in women. And, sometimes, women may have a heart attack without chest pain. Women are more likely than men to have heart attack symptoms unrelated to chest pain, such as: • Neck, jaw, shoulder, upper back or abdominal discomfort • Shortness of breath • Pain in one or both arms • Nausea or vomiting • Sweating • Light-headedness or dizziness • Unusual fatigue These symptoms can be more subtle than the obvious crushing chest pain often associated with heart attacks. Women may describe chest pain as pressure or tightness. This may be because women tend to have blockages not only in their main arteries but also in the smaller arteries that supply blood to the heart a condition called small vessel heart disease or coronary micro vascular disease. Women's symptoms may occur more often when women are resting, or even when they're asleep. Mental stress also may trigger heart attack symptoms in women. Women tend to show up in emergency rooms after heart damage has already occurred because their symptoms are not those usually associated with a heart attack, and because women may downplay their symptoms. If you experience these symptoms or think you're having a heart attack, call for emergency medical help immediately. Don't drive yourself to the emergency room unless you have no other options. Risk factors Although several traditional risk factors for coronary artery disease such as high cholesterol, high blood pressure and obesity affect women and men, other factors may play a bigger role in the development of heart disease in women. For example, risk factors may include: • Diabetes. Women with diabetes are at greater risk of heart disease than are men with diabetes. • Mental stress and depression. Women's hearts are affected by stress and depression more than men's. Depression makes it difficult to maintain a healthy lifestyle and follow recommended treatment, so talk to your doctor if you're having symptoms of depression. • Smoking. In women, smoking is a greater risk factor for heart disease in women than it is in men. • Inactivity. A lack of physical activity is a major risk factor for heart disease, and some research has found women to be more inactive than men. • Menopause. Low levels of estrogen after menopause pose a significant risk factor for developing cardiovascular disease in the smaller blood vessels (coronary microvascular disease). • Broken heart syndrome: this condition often brought on by stressful situations that can cause severe, but usually temporary, heart muscle failure — occurs more commonly in women after menopause. This condition may also be called takotsubo cardiomyopathy, apical ballooning syndrome or stress cardiomyopathy. • Pregnancy complications: High blood pressure or diabetes during pregnancy can increase women's long-term risk of high blood pressure and the risk of development of heart disease in the mothers. Preventive Measures Women can make several lifestyle changes to reduce the risk of heart disease, including: • Quit or don't start smoking. • Exercise regularly. • Maintain a healthy weight. • Eat a healthy diet that includes whole grains, a variety of fruits and vegetables, low-fat or fat-free dairy products, and lean meats. Avoid saturated or trans fat, added sugars, and high amounts of salt. Women also need to take prescribed medications appropriately, such as blood pressure medications, blood thinners and aspirin. And they'll need to better manage other conditions that are risk factors for heart disease, such as high blood pressure, high cholesterol and diabetes. Treatment Heart disease treatment is similar both for women and men. Treatment may include medications, angioplasty and stenting, or coronary bypass surgery. However, women who don't have typical chest pain are less likely to be offered these potentially lifesaving options. Doctors may recommend cardiac rehabilitation to improve health and recover from heart disease.

BREAST FEEDING-MYTHS & TRUTHS

Breast milk is undoubtedly the best food for a new-born baby. This is because a new born has various types of nutrient requirements, which include proteins, minerals, and vitamins. All these nutrients are present adequately in breast milk. There are two types of proteins present in breast milk - whey protein and casein. Breast milk is rich in whey protein and less in casein protein. Whey protein is good for infant health because it is easier to digest. On the other hand, casein is a little difficult to digest. We can elaborately discuss the two types of proteins: Casein and Whey Whey proteins are liquid and extremely simple to digest. Apart from it, whey protein contains certain antibodies, like lactoferrin, and muramidase, which fortifies a baby’s immunity system to repel infections. Casein protein levels are relatively higher and these have additional complicated macromolecule molecules, which are tougher to digest. Soon after your baby is born, your breast milk contains 90% whey protein and almost 10% casein proteins. Once your breast milk comes in and becomes mature milk, it has 60% whey and 40% casein. And with the passage of time, the whey macromolecules continue to drop till there is a uniform quantity of both whey and casein later, during lactation. If we talk about other sources of milk such as cow’s milk, then the constituency of the two types of protein is slightly different. In the case of cow milk, whey protein is less and casein is higher. Whey protein is definitely beneficial for babies, but casein is harmful because babies have difficulty in digesting it, and leads to other allergic manifestations as well. This is why breast milk is always healthier than outside milk. Apart from all the proteins, vitamins, and minerals in breast milk, there are some other components like lactoferrin and immunoglobulin, which are protective factors that are directly transmitted from a mother to a baby, through breast milk. And this helps in generating the inherent immunity system of babies. This immunogenicity not only helps the baby during the initial 6 months, but also protects the baby from various types of diseases like diarrhoea, allergies, etc at a later stage. Nutrients present in breast milk Water Breast milk is formedfrom90% water, and also the rest of its nutritious contents are found in that water. The physical body desires water for nearly everything. Among other alternative things, it keeps a baby hydrated, helps in managing blood heat, lubricates joints, and protects organs. Carbohydrates Carbohydrates are the body's best supply of energy. The primary sugar in breast milk comes from a form of lactose, known as a disaccharide. Compared to cow's milk, there are way more disaccharides in human milk. Disaccharide not only provides your baby with a serious supply of energy for growth and development, it also helps in developing the brain. Other carbohydrates found in breast milk, like oligosaccharides are required to push healthy microorganisms within the intestines. These microorganisms defend your baby's gut and help fight back diseases such as infant diarrhea. Lipids (Fats) Lipids may form only around 4% of breast milk on their own, but supplies50% of the calories that your baby gets from breast milk Lipids are a serious source of energy, sterol, which helps in controlling cholesterol, and essential fatty acids like DHA. According to the obstetricians at the maternity department of AMRI Hospitals, lipids are necessary for the development of a baby's brain, central nervous system, and vision. Lipids are liable for your baby's weight gain as he grows. Your breast milk contains all the lipids that your baby wants. However, if you are on a feeder diet, discuss along with your doctor whether or not you must take a DHA supplement, to make sure you are getting enough lipid intake. Proteins Proteins build, strengthen, and repair the body. They are additionally required to form hormones, enzymes, and antibodies. The protein in your breast milk is very easy for your baby to digest and your kid desires protein to grow and develop. One vital protein in breast milk is lactoferrin. Lactoferrin moves iron through your baby's body and also helps in guarding the newborn's intestines from infections. Immunoglobulins (Antibodies) Immunoglobulins are antibodies, which fight back germs that cause ill-health and unwellness. Your breast milk is like your baby's initial immunizing agent. It contains antibodies that fight back bacteria, viruses, fungus, and parasites. The immune properties found in breast milk can also help protect your kid from respiratory illness, ear infections, vomiting, diarrhea, and different dangerous infections that have an effect on newborns and infants. The main protein in your breast milk is secretory immunoglobulin (IgA). Immune serum globulin coats your baby's lungs and intestines. It seals them to stop germs from coming into your baby's body and blood. The antibodies in your breast milk are even more important if you have got a preterm baby or a baby, that the World Health Organization can move to childcare. Hormones Hormones have many roles within the body; they control growth and development, metabolism, stress, pain, and vital signs. The hormones in breast milk are lactogen, thyroid hormones, growth factors, relaxin, endorphin, glycoprotein, cortisol, leptin, oestrogen, progestogen, and many more. Scientists are still conducting research on hormones that are present in breast milk, making an attempt to find out more about these hormones and how they function in a baby, suggesting leading doctors at AMRI Hospitals. Enzymes Scientists have found more than 40 different enzymes in human breast milk, which are all unlike each other. Some enzymes help in digestion by breaking down fats or proteins, while others defend your baby from germs and sickness. There are some enzymes about the functions of which scientists are not yet certain. While we are yet unaware of the functions of all enzymes, we, however, understand that they do play a crucial role in the health and development of your child. Vitamins Vitamins contribute to healthy bones, eyes, as well as skin. They additionally facilitate to the prevention of diseases like scurvy and rachitis or rickets. The vitamins and minerals in breast milk are necessary for your baby's health as he/she grows. However, the amount of vitamin D, folate, or Vitamin B6 (depending on your diet) could also be lower in some female babies. Therefore, refer to your doctor and your baby's paediatrician concerning the suggested aliment supplements that you may require while breastfeeding. Minerals Breast milk is full of minerals, including iron, zinc, calcium, sodium, chloride, magnesium, and selenium. Vitamins are required for healthy growth and development. They help in building sturdy bones and building red blood cells so that these can move oxygen through the body, keeping muscles and nerves functioning properly. Amino Acids Amino acids are the building blocks of protein. Once the protein is digested in your baby's abdomen, it breaks down into amino acids. There are more than 20 totally different amino acids found in breast milk. Taurine is one such, which is found in giant amounts in breast milk but not at all found in cow milk. Studies show that taurine has several functions, in combination with bile acids and plays a crucial role in the development of a baby’s brain and eye. Some of the other amino acids found in breast milk include aminoalkanoic acid, cysteine, lysine, essential amino acid, tyrosine, and essential amino acids. Lactoferrin Lactoferrin is a part of whey protein. It's an iron-binding protein, which attaches to iron and transports it throughout the body but that is not the sole function of lactoferrin. It also stimulates the system and helps breastfed babies fight back organisms that may cause bacterial, viral, and flora infections of the digestive tube. It has been observed that prolonged breastfeeding protects a child from several diseases like diabetes, diarrhoea, cancers, etc, especially in the later stage of a baby’s life. In all these aspects, leading obstetricians say that breast milk is the most ideal food for the baby and feeding the baby directly from the breast is always advisable, as there are important vitamins and minerals in breast milk. However, if problem persists, then mothers can feed milk from a bottle or a bowl, but this simultaneously exposes the kid to all types of infections. So, mothers should try and feed their babies directly from the breast.

CERVICAL CANCER

CERVICAL CANCER is the most common cancer among women specially in the rural areas in India. This affects the cervix, the mouth or opening of the uterus. More than 1.25 lakh women are affected each year, claiming an estimated 50,000 lives. RISK FACTORS: Early onset of sexual activity Early marriage: First pregnancy before 20 years of age Multiple pregnancies at short intervals causing repeated injury to the cervix, leaving it no time to heal. Poor genital hygiene Genital tract infections especially HPV (human papilloma virus) Sexual promiscuity on part of either of the partners TOBACCO USE: Most of these factors are preventable but, unfortunately, because of ignorance, unhygienic conditions and lack of awareness about personal health, cervical cancer continues to be a cause of large number of deaths in India. SIGNS AND SYMPTOMS : Vaginal Bleeding / spotting between periods Bleeding during / after sexual intercourse Bleeding after a woman has attained menopause Unusual blood stained vaginal discharge Unexplained persistent pelvic / back pain Painful intercourse These symptoms do not always necessarily denote cancer but are abnormal and need to be investigated. EARLY DETECTION Regular examination by an oncologist or gynaecologist and pap smear test can help in early detection of cervical cancer. WHAT IS A PAP SMEAR TEST? Using a wooden sterile spatula or brush, cells from the cervix are collected, spread over a glass slide and examined under the microscope for abnormal cells. LIQUID BASED CYTOLOGY: It is similar to Pap smear but with higher sensitivity to detect abnormality. This can also detect HPV virus infection. PREVENTION: Regular pap smear tests done above the age of 30 or 3 years after initiation of sexual activity whichever is earlier can help detect pre-cancer stage when usually there are no symptoms. Delaying the age of marriage/first sexual intercourse. Postponing the birth of the first child to after 20 years. Avoid multiple and rapid pregnancies. Modifying lifestyle patterns like discouraging sexual intercourse at an early age, avoiding multiple sexual partners, quitting tobacco. Barrier contraception (condoms) prevents sexually transmitted infections and spaces pregnancies. Maintain good genital hygiene at all times, particularly while bathing and during menstruation. Your partner’s hygiene is equally important. Sex education of adolescents with stress on safe practices If you have any of the above signs and symptoms, seek medical help at the earliest. VACCINE: Human Papilloma Virusinfection (HPV) is the cause of 80-90% of cervical cancers in India. Vaccination against high risk strains of HPV may help in cervical cancer prevention. It is best taken before the onset of sexual activity in one’s life. It may also be taken later in life up to 35 years of age. However, the efficacy of the vaccine goes down as the age advances.

Mayo Clinic Minute: The relationship between food and disease

The phrase “you are what you eat” is commonly used in conversations about health and the connection between food and the body. Eating an unhealthy diet can have serious consequences and can increase someone’s risk of dying from heart disease, stroke and Type 2 diabetes. In this Mayo Clinic Minute, Dr. Stephen Kopecky, a preventive cardiologist at Mayo Clinic, discusses the relationship between food and disease. Things like smoking and genetics put us at risk for developing different diseases, but neither are the biggest risk factor. “Nutrition is now the No. 1 cause of early death, and early disease in our country and the world,” says Dr.Kopecky. Dr.Kopecky says having genes for disease will increase your risk by 30% to 40%, but having a bad lifestyle for disease will increase your risk by 300% to 400%. “About 57% of the calories we consume every day in this country are ultraprocessed foods,” says Dr.Kopecky. While ultraprocessed foods tend to be convenient and cost-effective, they are inflammatory and can cause a host of health issues over time. “It bothers our tissues. It bothers our heart. It bothers our arteries, our brains, our pancreas, our liver and our lungs. And that leads to disease,” says Dr.Kopecky. “It could be in the brain with Alzheimer’s, the heart with coronary artery disease, or cancers elsewhere.” The good news is it’s never too late to change your eating habits, and no change is too small. “It’s been shown if you take one bite of say a processed meat or ultraprocessed food, replace that with some unprocessed food or a healthier choice ― you know vegetables and black beans ― after a year or two, that will actually lower your risk of heart attack and stroke.” Of the four levels of food processing, the most processed are termed ultraprocessed foods. These foods have many added ingredients, such as sugar; salt; fat; and artificial colors, preservatives or stabilizers. The ingredient list sometimes has words that sound like chemicals. Examples are obvious foods like soft drinks, hot dogs, cold cuts, fast food, packaged snacks and cookies, but can also include canned baked beans, low-fat fruit yogurt, packaged bread, ready-made pasta sauces and breakfast cereals.

Strategies to prevent heart disease

You can prevent heart disease by following a heart-healthy lifestyle. Here are strategies to help you protect your heart. By Mayo Clinic Staff Heart disease is a leading cause of death, but it's not inevitable. While you can't change some risk factors — such as family history, sex or age — there are plenty of ways you can reduce your risk of heart disease. Get started with these seven tips for boosting your heart health: 1. Don't smoke or use tobacco One of the best things you can do for your heart is to stop smoking or using smokeless tobacco. Even if you're not a smoker, be sure to avoid secondhand smoke. Chemicals in tobacco can damage the heart and blood vessels. Cigarette smoke reduces the oxygen in the blood, which increases blood pressure and heart rate because the heart has to work harder to supply enough oxygen to the body and brain. There's good news though. The risk of heart disease starts to drop in as little as a day after quitting. After a year without cigarettes, the risk of heart disease drops to about half that of a smoker. No matter how long or how much you smoked, you'll start reaping rewards as soon as you quit. 2. Get moving: Aim for at least 30 to 60 minutes of activity daily Regular, daily physical activity can lower the risk of heart disease. Physical activity helps control your weight. It also reduces the chances of developing other conditions that may put a strain on the heart, such as high blood pressure, high cholesterol and type 2 diabetes. If you haven't been active for a while, you may need to slowly work your way up to these goals, but in general, you should do aim for at least: • 150 minutes a week of moderate aerobic exercise, such as walking at a brisk pace • 75 minutes a week of vigorous aerobic activity, such as running • Two or more strength training sessions a week Even shorter bouts of activity offer heart benefits, so if you can't meet those guidelines, don't give up. Just five minutes of moving can help, and activities such as gardening, housekeeping, taking the stairs and walking the dog all count toward your total. You don't have to exercise strenuously to achieve benefits, but you can see bigger benefits by increasing the intensity, duration and frequency of your workouts. 3. Eat a heart-healthy diet A healthy diet can help protect the heart, improve blood pressure and cholesterol, and reduce the risk of type 2 diabetes. A heart-healthy eating plan includes: • Vegetables and fruits • Beans or other legumes • Lean meats and fish • Low-fat or fat-free dairy foods • Whole grains • Healthy fats, such as olive oil Two examples of heart-healthy food plans include the Dietary Approaches to Stop Hypertension (DASH) eating plan and the Mediterranean diet. Limit intake of the following: • Salt • Sugar • Processed carbohydrates • Alcohol • Saturated fat (found in red meat and full-fat dairy products) and trans fat (found in fried fast food, chips, baked goods) 4. Maintain a healthy weight Being overweight — especially around the middle of the body — increases the risk of heart disease. Excess weight can lead to conditions that increase the chances of developing heart disease — including high blood pressure, high cholesterol and type 2 diabetes. The body mass index (BMI) uses height and weight to determine whether a person is overweight or obese. A BMI of 25 or higher is considered overweight and is generally associated with higher cholesterol, higher blood pressure, and an increased risk of heart disease and stroke. Waist circumference also can be a useful tool to measure how much belly fat you have. The risk of heart disease is higher if the waist measurement is greater than: • 40 inches (101.6 centimeters, or cm) for men • 35 inches (88.9 cm) for women Even a small weight loss can be beneficial. Reducing weight by just 3% to 5% can help decrease certain fats in the blood (triglycerides), lower blood sugar (glucose) and reduce the risk of type 2 diabetes. Losing even more helps lower blood pressure and blood cholesterol level. 5. Get good quality sleep People who don't get enough sleep have a higher risk of obesity, high blood pressure, heart attack, diabetes and depression. Most adults need at least seven hours of sleep each night. Make sleep a priority in your life. Set a sleep schedule and stick to it by going to bed and waking up at the same times each day. Keep your bedroom dark and quiet, so it's easier to sleep. If you feel like you've been getting enough sleep but you're still tired throughout the day, ask your health care provider if you need to be evaluated for obstructive sleep apnea, a condition that can increase your risk of heart disease. Signs of obstructive sleep apnea include loud snoring, stopping breathing for short times during sleep and waking up gasping for air. Treatments for obstructive sleep apnea may include losing weight if you're overweight or using a continuous positive airway pressure (CPAP) device that keeps your airway open while you sleep. 6. Manage stress Some people cope with stress in unhealthy ways — such as overeating, drinking or smoking. Finding alternative ways to manage stress — such as physical activity, relaxation exercises or meditation — can help improve your health. 7. Get regular health screenings High blood pressure and high cholesterol can damage the heart and blood vessels. But without testing for them, you probably won't know whether you have these conditions. Regular screening can tell you what your numbers are and whether you need to take action. • Blood pressure. Regular blood pressure screenings usually start in childhood. Starting at age 18, blood pressure should be measured at least once every two years to screen for high blood pressure as a risk factor for heart disease and stroke. If you're between 18 and 39 and have risk factors for high blood pressure, you'll likely be screened once a year. People age 40 and older also are given a blood pressure test yearly. • Cholesterol levels. Adults generally have their cholesterol measured at least once every four to six years. Cholesterol screening usually starts at age 20, though earlier testing may be recommended if you have other risk factors, such as a family history of early-onset heart disease. • Type 2 diabetes screening. Diabetes is a risk factor for heart disease. If you have risk factors for diabetes, such as being overweight or having a family history of diabetes, your health care provider may recommend early screening. If not, screening is recommended beginning at age 45, with retesting every three years. If you have a condition such as high cholesterol, high blood pressure or diabetes, your health care provider may prescribe medications and recommend lifestyle changes. Make sure to take your medications as your health care provider prescribes and follow a healthy-lifestyle plan. [Source : https://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/heart-disease-prevention/art-20046502]

ANTIBIOTIC USE IN DENTAL PRACTICE – A REVIEW

A. Abstract Antibiotics are used in the management of many dental infections since decades. Antibiotics are requisite drugs for the management of oral and maxillofacial infections. They are used for the treatment of odontogenic infections, non- odontogenic infections and as prophylaxis against local infections spreading to surrounding tissues and organs. It has been estimated that 10% of all antibiotics prescriptions are linked to dental infections, the combination Amoxicillin-clavulanate is the most preferred antibiotic amongst dentists. The concurrent prescription of non steroidal anti-inflammatory drugs (NSAIDs) can slightly alter the bioavailability of antibiotics. Over the years various new concepts are been devised in the antibiotic usage, but there is a universal abuse of antibiotics in both medical and dental field. The ultimate indication for the use of antibiotics is bounded and distinct. Pregnancy, kidney failure and liver failure are certain situations which demands special attention on the part of the professionals while indicating antibiotics. Keyword : antibiotics, prophylaxis, infection 2. INTRODUCTION Antibiotics were first discovered in 1929 in the form of sulfa drugs (1935), penicillin (1941), tetracycline (1948), erythromycin (1952). Endodontics and surgical therapy in cases like odontogenic infections, antibiotics are more judiciously used. Patients who are medically compromised such as diabetic or having organ transplants also require antibiotic coverage. In case of dental infections, penicillin is the first drug of choice. For avoiding less alterations in the gastrointestinal tract, narrow spectrum antibiotics are mainly preferred. Dilemma is often noticed among the dental practitioners concerning the use of antibiotics in dental practice. INDICATIONS : Antibiotics act as an adjunct in cases of dental intervention. They are mainly indicated when clinical signs are visible. Antibiotics are majorly used in dental procedures which includes bleeding in the oral cavity. Also In immunocompromised cases and infections which are progressing rapidly antibiotics usage is vastly seen.  ODONTOGENIC INFECTIONS : In cases of odontogenic infections, penicillin is the first drug of choice. They are more susceptible to gram positive bacteria (aerobes and anaerobes) and microorganisms found in alveolar and periodontal abscess also necrosis involving the pulp. Penicillin are more prone to both aerobic and anaerobic microorganisms. Infections caused by penicillinase producing staphylococcus, ampicillin like drugs are preferable. Penicillin with clavulanic acid can be preferred for infections involving staphylococci, Streptococci and pneumococci. Patients having resistance may be prescribed with clindamycin as the first choice of drug and also azithromycin and metronidazole. Since cephalosporin group falls under the broad spectrum antibiotics, it is advisable in delayed allergic reactions to penicillin where erythromycin is restricted. Tetracycline are important in cases of gingivitis as they are bacteriostatic in nature and inhibits the binding of Aminoacyl- t-RNA to the ribosomal acceptor site. Ciprofloxacin is mainly used in cases of endodontic infections. Therefore penicillin followed by clindamycin is more commonly used by health professionals.  NON ODONTOGENIC INFECTIONS : Non odontogenic infections such as syphilis, tuberculosis, leprosy and other. Infections of bone which are non specific, for them, a prolonged antibiotic coverage is required. New antibiotics such as fluoroquinolones is the drug of choice for non odontogenic infections. Fluoroquinolones are prescribed in cases of joint infections, respiratory tract infection, urinary tract infection. They have a broad spectrum of action. Tuberculosis require a prolonged duration of antibiotic therapy which consists of rifampicin, pyrazinamide, isoniazid, streptomycin and ethambutol. Penicillin G benzatine is used for the treatment for syphilis.  ANTIBIOTICS USAGE JN INFECTIVE ENDOCARDITIS : Infective endocarditis is an uncommon and serious condition which may impose certain life threatening condition. An intricate sequence of events are involved with endocarditis. The adherence of microorganisms is determined by various anatomic sites. Various research has found that dental procedures sometimes lead to infective endocarditis. Similarly a poor oral hygiene with compromised periodontal health impose as a risk factor. Antibiotics therapy work by not only destroying the microorganisms but also inhibiting its adherence. The first drug of choice includes high dose of amoxicillin in both children and adults, one hour prior to dental procedures. 2g of oral amoxicillin should be given to adults. In case of patients who are resistant to amoxicillin or B-lactamics, clindamycin can be given. In patients with amoxicillin and penicillin resistance, first generation cephalosporin can be given. Patients having prosthetic valves in heart, vancomycin and streptomycin is used. Negligence to administer proper antibiotics at time may lead to worst consequences for patients.  ANTIBIOTIC PROPHYLAXIS IN CASE OF LOCAL INFECTIONS : Various surgical and medical conditions are routinely prescribed with antimicrobials which also includes impacted third molars,orthognathic surgeries, implants, periapical surgery, benign tumor surgery and immunocompromised patients. In case of endodontics, antibiotics should be prescribed in case of fever and signs of local infection. Researches show that post operative pain reduce to certain extent after the usage of antibiotics in cases of removal of impacted third Molar. Abu Taa et al compared the pre and post operative antibiotics in patients undergoing periodontal surgery. Amoxicillin is the preferred choice of drug after third molar removal in a dose of 2000 mg for five days. As the site of periodontal surgery is contaminated with microorganisms, it is highly recommended to use antibiotic coverage. Immunocompromised patients are a special division for dental professionals as they are more prone to bactaremia which may lead to septecemia. In such cases dental extractions, deep periodontal cleaning is to be avoided as much as possible. Also, a hematologic, oncologic, and other microbiologist should be consulted with. Other Cases include dental implant placement, surgery related to tooth apex, intraligamentary local anaesthetic injections and subgingival placement of antibiotic fibers. In case of Diabetic patients, antibiotics are also prescribed. Only when the risk factors are controlled the treatment can proceed. Dental professionals play a vital role in treatment of medically compromised patients who undergo dental treatments as early diabetes is diagnosed during the treatment period. It's the dentists job to be involved in the health care team and help in the reduction of the diseases. Various studies have found the correlation between prosthetic joint infections and dental procedures. Cephalexin 2g given one hour prior is suggested for patients who are non allergic to penicillin and clindamycin 600mg for them who are allergic to penicillin. ANTIBIOTIC REGIMEN WITH PRECAUTIONS : Antibiotics prophylaxis should be considered in kidney, liver failure and pregnancy with caution. Renal failure affects the hard and soft tissues of mouth. After organ transplants, consultation from the physician is strictly advised. In case of prevention of adrenal crisis, additional need of corticosteroids is required. Dose is increased to 30-40mg per day. It is better to perform. Dental treatments after three months of surgery. Six months are considered best. In case of invasive dental treatment antibiotics coverage is necessary. To compensate with increased plasma drug concentration dose adjustments are required in case of kidney impairment. Penicillin, clindamycin and cephalosporin are the preferred antibiotics. Periodontitis disturbs the Renal function in kidney transplant patient. Patients are advised to get their dental procedures done on non dialysis days to ensure the the absence of heparin. The six months just after the kidney transplant is considered to be unfavourable to do any treatment. 25 mg of hydrocortisone administered iv reduces the risk of adrenal crisis. In case of liver failure dose of ethryomycin, clindamycin, metronidazole, and antitubercular drugs should be reduced. Zinc supplements is to be prescribed to the patients to decrease health related issues In case of hepatic encephalopathy. Douglas et al in cases of liver failure have restricted the use of tetracycline and anti tuberculosis drugs. As tetracycline and aminoglycosides have teratogenic effect on foetus it is contraindicated. Shrout et al gave importance to antibiotic prophylaxis for pregnant patients as it decreases bacterial load of periodontal pathogens. Azithromycin, cephalosporin, erythromycin, penicillin with or without beta lactamase inhibitors are prescribed cautiously during pregnancy. The use of NSAIDS during early pregnancy is involved with spontaneous abortion. Risk is also involved with use of diclofenac, naproxen, celecoxib, ibuprofen and rofecoxib alone or in combination. Every pregnant women is advised to get both medical and dental treatment during the period of pregnancy. Antibiotics are mandatory and essential in both medicine and dentistry. 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Make your heart smiling with fatty fish

Fish is a great source of high quality of animal protein and healthy fat. Some fatty fishes like salmon, eels, tuna, etc are rich in omega 3 polyunsaturated fatty acids, which have been shown to reduce inflammation and lower the risk of heart disease and stroke. The American Heart Association recommends eating 2 servings of fish (particularly fatty fish) per week. A study published by American physiological Society suggests that fatty fish oils can also protect the heart during the time of mental stress.

HUGE MYTH - PINEAPPLE CONSUMPTION DURING PREGNANCY

There is a huge myth that pineapple consumption during pregnancy is injurious to the mother and the baby, recently probably there was a popular Bengali serial in which it was mentioned, you are pregnant why are you taking pineapple I was told by the interviewer and I would ask to speak on this topic not only pineapple there was a lot of talk about ripened papaya, papaya and pineapple that you are not suppose to take in during pregnancy saying that there can be defect and there can be miscarriage, now if you ask me , my take on it usually there is no problems usually taking these fruits and any fruit during pregnancy they are by and large harmless, yes there is little bit of logic in certain countries when these foods are taken in large amount then there has been some kind of correlation with miscarriage and that is because of digestive enzyme present in these in higher amount which has been correlated with higher weights of miscarriage in those countries but whether it was a coincident or whether it was actually because of consumption of those fruits, no one know, if you ask me logically taking these fruits moderate amount does not cause any harm they are safe in pregnancy, but I have lot of patients come to me you know that my mom my grand mom my aunt are accompanying them and told them not to take these kind of fruits but then what I say is that people who have real reservation against them I say that look there are other fruits if you think you can land up with miscarriage because of pineapple and papaya then its better you don’t take them there are other fruits available I will tell you why because 10-20 percent of all pregnancy unfortunately can land up miscarriage any way and coincidentally if you also take pineapple and papaya and you might think that you know probably I took fruits and that’s why I landed up in miscarriage if you are not confidence in yourself, if you are not confidence well that your doctor is given you and you are more bend upon believing this myth then in that case do not take them because there are other fruits also that are available but by and large if you ask me whether it is safe to take pineapple and papaya during pregnancy as such there are no problems if you take in small amounts. For video interview click on link https://www.etvbharat.com/bengali/west-bengal/videos/top-videos/is-pineapple-not-to-be-eaten-during-pregnancy/wb20220420150700437437716

Self Diagnosis of Cardiac Pain (Angina)

Pressure, fullness, burning or tightness in the chest, Crushing or searing pain that spreads to back, neck, jaw, shoulders, and one or both arms , Pain that lasts more than twenty seconds, gets worse with activity, goes away and comes back, or varies in intensity, Shortness of breath, Above the umbilicus and below the chin, front or back and either of the arms, anginal pain may occur. - DR. DURGADAS BHATTACHARYYA

WANT TO LOSE WEIGHT……KEEP EATING

Accumulation of body fat is a reflection of the consumed calorie and how much of it has been burnt through daily activities. In the process of losing weight, many of us are tend to skip meals in order to control extra calorie consumption. But it is very much wrong. Never skip any meal. Doing so, may reduce the BMR (Basal Metabolic Rate), making a person inactive. This will make the person tend to over eat at the next meal.Instead of that we should have smaller, more frequent meals at a regular interval. For a healthy weight loss we may follow these tips…. Always have a heavy breakfast, as it is the most important meal of the day. It is that time, when the nutrient requirements are the highest in our body. A proper breakfast can energies a person throughout the day. Always eat something within 2-3hours gap throughout a whole day. More food gap means, more hunger & then more intake of calorie than needed. We have to choose complex carbohydrates, like brown rice, whole wheat atta, ragi etc. for heavy meals – breakfast, lunch, & dinner . For mid morning meal, afternoon & evening snacks we should have high fiber fruits, sprouts, salads and curd. Breakfast should be the heaviest meal of the day, & dinner should be the lightest. We should not fall asleep soon after dinner, as sleep slows down the body’s metabolism & we would tend to burn fewer calories & accumulate fat.So, we have to take frequent meals, in adequate portion & high in fiber throughout a day. Concentrating the required calorie, only a continuous feeding process can lead to a healthy weight loss.

'Bridge' or 'FPD' is a way to replace a missing tooth with fixed prosthesis

This is not removable, Rather it has Crowns/caps that are permanently attached to the teeth adjacent to the emptyspace in your mouth.This 'Bridges' fully mimic natural teeth and is a life time solution to tooth loss.The longer you wait replace a missing tooth, the greater your risk for getting gum disease. Also the remaining teeth moves into the spaces left by missing teeth.

SAY YES TO POTATO IN DIABETES MELLITUS

IN CASE OF DIABETES MELLITUS, WE NORMALLY BYPASS THE WAY TO EAT POTATOES. BUT POTATOES ARE NOT REALLY SO BAD AS WE THINK LITARALLY. POTATOES ARE AN EXCELLENT FOOD ESPECIALLY FOR PEOPLE WHO ARE ALREADY SUFFERING FROM DIABETES. POTATOES ARE LOW IN FAT AND RICH IN SEVERAL MICRONUTRIENTS INCLUDING, VIT C, VIT B1, B3, B6, PHOSPHORUS, MAGNESIUM, POTASSIUM, FOLET, PANTOTHENIC ACID, RIBOFLAVIN, AND LAST BUT NOT THE LIST, FIBER. PRESENCE OF COMPLEX CARBOHYDRATES, SOLUBLE AND INSOLUBLE FIBER, CAN FEEL A PERSON FULL FOR A LONG TIME. IT IS A MODERATE SOURCE OF IRON, AND ITS HIGH VIT C CONTENT PROMOTES A GOOD IRON ABSORPTION. POTATOES ALSO CONTAINTS DIETARY ANTIOXIDENTS, WHICH MAY PLAY A PART IN PREVENTING DISEASES RELATED TO DIABETES. BAKING OR COOKING POTATOES WITH THE SKIN IS THE BEST WAY TO GET THE MOST NUTRIENTS.