Women’s Health Matters

Despite making up half of the world’s population, women face major bias when it comes to healthcare. Most women don’t get timely access to healthcare services. A research conducted by a well known medical institute in India found only 37% of women got access to health care, as compared to 67% of men. Many of today’s health problems are preventable and manageable, as long as the appropriate time and care are given. It is time to increase the awareness about women’s diseases and ensure they get equal access to medical care. Women themselves must also make their health a priority and take the time to address their health concerns.

Common Women’s Diseases

Here is a list of the most common health disorders suffered by women:

1. Breast Cancer

Breast cancer is the most common form of cancer found in women. The earlier breast cancer is detected, the more treatable it is, so it’s important that women over the age of 40 years must do regular self-checks and mammograms. Here are the common risk factors of breast cancer:

• Genes such as BRCA1 and BRCA2.
• Family history of breast cancer.
• Early onset of menstruation (before age 12) or menopause.
• Smoking or excessive alcohol intake.
• Obesity.

2. Osteoporosis

Women have a lower bone density than men and they tend to lose bone mass more rapidly as they age, this can lead to osteoporosis. Like many other common health issues for women, osteoporosis is influenced by the hormone estrogen. Estrogen helps regulate your reproductive cycle and keeps your bones strong. Because women experience dramatic drops in estrogen with menopause, they’re more likely to experience bone loss and osteoporosis at that time.

Here are a few health tips for stronger bones:

• Ensuring adequate calcium intake.
• Maintaining proper vitamin D levels.
• Be regular with your exercise routine.
• Avoid aerated drinks.
• Reducing your intake of salt.

3. Heart Disease

Although heart disease is often thought of as a problem that mainly affects men, heart disease is the most common cause of death for both men and women. Women experience different symptoms of a heart attack as compared to men. Here are a few symptoms:

• Neck, jaw, shoulder, upper back or abdominal pain.
• Shortness of breath.
• Pain in one or both arms.
• Nausea or vomiting.
• Sweating.

4. Depression

More women are diagnosed with depression, compared with men, with one in five experiencing depression at some time in their life. Women are more likely to experience these conditions during pregnancy and postpartum. Here are a few symptoms to watch for:

• An ongoing sad and anxious mood.
• Loss of interest or pleasure in activities.
• Irritability, restlessness or persistent crying.
• Feelings of worthlessness and hopelessness.
• Sleeping problems – oversleeping or insomnia.

5. Fertility issues

10% of women between the ages of 15 and 44 have struggled with getting pregnant and/or staying pregnant. Some of the underlying reasons why women may be having issues with fertility are endometriosis, uterine fibroids, dysmenorrhea and polycystic ovary syndrome (PCOS).

6. Cervical Cancer

Cervical cancer is cancer arising from the cervix. It is due to the abnormal growth of cells that can invade or spread to other parts of the body. Early on, typically no symptoms are seen. Later symptoms may include abnormal vaginal bleeding, pelvic pain or pain during sexual intercourse.

7. Pregnancy issues

Certain complications during pregnancy can threaten the health of a mother and her child. Asthma, diabetes, hypertension, and depression can harm the mother and child during pregnancy if not managed properly.

8. Autoimmune Diseases

Autoimmune disease occurs when body cells that eliminate threats, such as viruses, attack healthy cells. Common autoimmune disease seen in women includes psoriasis, lupus, rheumatoid arthritis, thyroid disorders.

Recommended health tests for women

Women’s bodies go through a lot of hormonal imbalance during their life. Make regular health screenings a part of your life. Being proactive regarding your health can prevent several health problems. We highly recommend these health tests for women:

1. Breast Examination

It is recommended to start your mammograms once you cross 40 years. Early detection ensures better chances of recovery. Complete self breast self-examination is also recommended every month. Talk to your doctor if you spot anything unusual.

2. Pelvic examination

It is always advisable that you visit your Gynaecologist periodically and have a complete pelvic examination and a Pap smear test. Cervical cancer is a leading cause of death amongst women in India.

3. Bone density test

A Bone Density Test helps detect your bone condition. This helps detect osteoporosis.

4. Thyroid test

Many women complain of unexplained weight gain, hair loss, brittle nails, and exhaustion. A common reason for this is an underactive thyroid or hypothyroidism which controls the metabolism of the body. Get your thyroid levels checked.

5. Vitamin D test

This is a vital nutrient needed for bone growth and maintenance. The most important source of vitamin D is exposure to the sun. As we age, the tendency to synthesise this nutrient decreases.

6. Lipid profile tests

This test checks for good and bad cholesterol along with triglycerides and total cholesterol levels. Cholesterol is a fat molecule, which is present in higher levels can get accumulated in the blood vessels and can affect the health of your heart, blood vessels, and brain.

7. Blood sugar test

A blood sugar test helps to diagnose diabetes and pre-diabetes. Diabetes has a tremendous impact on a woman’s health and has severe long-term complications.

8. Cardiac check-up

Get your cardiac check-up done if you have a family history of hypertension, heart disease or if you’re overweight, or if you are a smoker.

This International Women’s Day be proactive about your health. Consult experts when in doubt, do not rely on home remedies and self-medication. Please find below link to our Departments which specialize in women’s healthcare:

https://www.kokilabenhospital.com/departments/centresofexcellence/centrefor_motherchild.html

https://www.kokilabenhospital.com/departments/centresofexcellence/centrefor_cancer.html

https://www.kokilabenhospital.com/departments/clinicaldepartments/gynaecologyobstetrics.html

Start this decade on a fresh note. Change old habits, quit the bad ones, adapt a healthy lifestyle and choose to eat better. This new year find a new you. If you want a fitter body and a healthier self, you need to focus on your health and make small changes in every part of your life. Take charge of your health and see the difference in a few months.

Did you know?

• The frequency of coronary heart disease in young Indians is 15-18% higher than in any other population group globally.
• 10% to 15% of strokes in Indians occur in people below the age of 40 years.
• 135 million Indians are affected by overweight and obesity.

A healthy lifestyle is extremely important to control the risk of chronic diseases. This new year decide to lead a healthy life to control the risk of diseases. Make your health your priority this new year. Here are 20 things to do in 2020 to be healthy:

1. Start a fitness routine that you enjoy

Find an exercise routine or join a class of your choice. This ensures you will be regular at your workout regime. It is recommended to exercise for at least 30 minutes most days of the week.

2. Take care of your digestive health

Your digestive system is something that needs utmost care. Address issues of bloating, stomach ache or discomfort. Have probiotics like curd to ensure your gut bacteria levels are in a normal range.

3. Have more fruits and vegetables

Cover half of your plate with fruits and vegetables. They should occupy more space than pasta, rice, or potatoes.

4. Get more quality sleep

Lack of sleep may increase your risk of weight gain, heart disease, and depression. Maintain a timely schedule to improve sleep quantity and quality.

5. Eat smart while dining out

Stay away from deep fried dishes, instead choose to have grilled or baked foods. Avoid dishes that are full of cheese.

6. Eat a healthy diet

Eat a combination of different foods, including fruits, vegetables, legumes, nuts and whole grains. Limit your intake of refined foods like maida and bread.

7. Consume less salt and sugar

Reduce your salt intake to 5g per day, equivalent to about one teaspoon. Limit intake of processed foods as they contain high amounts of sodium.

Consuming excessive amounts of sugar increases the risk of tooth decay and unhealthy weight gain. Limit sugary snacks, candies, desserts and sugar-sweetened beverages.

8. Reduce intake of harmful fats

Fats consumed should be less than 30% of your total energy intake. This will help prevent unhealthy weight gain and chronic diseases. There are different types of fats, but unsaturated fats are preferable over saturated fats and trans-fats.

9. Avoid alcohol

There is no safe level for drinking alcohol. Consuming alcohol can lead to health problems such as mental and behavioural disorders, including alcohol dependence, heart disease, liver cirrhosis, some cancers and heart diseases. Say no to alcohol.

10. Don’t smoke

Smoking tobacco causes non-communicable diseases such as lung disease, heart disease and stroke. Tobacco kills not only the direct smokers but even non-smokers through second-hand exposure..

11. Check your blood pressure regularly

Hypertension, or high blood pressure, is called a “silent killer”. This is because many people who have hypertension may not be aware of the problem as it may not have any symptoms. If left uncontrolled, hypertension can lead to heart, brain, kidney and other diseases.

12. Get vaccinated

Vaccines are for children as well as adults. Vaccination is one of the most effective ways to prevent diseases. Vaccines work with your body’s natural defences to build protection against diseases like cervical cancer, diphtheria, hepatitis B, influenza, measles, pneumonia, polio, tetanus, typhoid, etc.

13. Practice safe sex

Looking after your sexual health is important for your overall health and well-being. Use contraceptives to prevent HIV and other sexually transmitted infections.

14. Stay hydrated

Drinking more water will help your body absorb more body fluids effectively. Make a habit of drinking 2-3 liters of water every day this year.

15. Speak up

Depression is a common Illness worldwide with over 260 million people affected. It might make you think about negative and disturbing thoughts and may make you feel low. Talk to someone you trust such as a family member, friend, colleague or seek professional counselling.

16. Take antibiotics only as prescribed

Make sure you only take antibiotics if prescribed by a qualified health professional. And once prescribed, complete the treatment days as instructed. Never share antibiotics.

17. Clean your hands properly

Hand hygiene is critical for everyone. Clean hands can prevent the spread of infectious illnesses. You must wash your hands using soap and water before meals, after coming home from outside as well as after using the toilet.

18. Ensure your food is safe

Unsafe food containing harmful bacteria, viruses, parasites or chemical substances can lead to food poisoning. Check expiry dates before buying packaged foods. If you are cooking, make sure you maintain cleanliness, cook thoroughly, use safe water and ingredients.

19. Have regular check-ups

Regular check-ups can help find health problems before they start. Health professionals can help find and diagnose health issues early, when your chances for treatment and cure are better.

20. Limit Screen Time

Spending too much time on electronic devices – particularly on social media — has been linked to depression, anxiety, and loneliness in some studies. Set a resolution to cut back on the time you spend scrolling through social media, watching TV, or playing games on screens.

Here’s wishing a Happy and Healthy 2020 to all!

We at Kokilaben Dhirubhai Ambani Hospital are committed to support you in your health journey. From health check-ups, to cardiac diseases, to nutrition, to counseling, to cancer care we have various departments that cater to all health issues.

The much-awaited winter season is finally here. The pleasant and sometimes chilly winds are making their presence felt. Are you enjoying the wintery evenings? Winter brings along seasonal changes and temperature changes leading to many diseases. Viral fever, common cold, flu, and cough are the common diseases of this season. Winter also brings dullness and may cause feelings of depression. Winter may also weaken your immune system making you more susceptible to diseases.

Cover yourself well this winter, especially if you are travelling to places of colder climate. Use a scarf, cap, or a sweater if needed. It is important to keep infants and the elderly warm in this season. Certain dietary measures help ensure that the body stays warm from inside in winters.

Winter health tips

Here are some health tips to stay healthy during this winter:

1. Cook with Spices

Onions, garlic, turmeric, and ginger are the perfect items to add flavour to your dishes. Not only do they make food taste great, but they’re also shown to help improve immune function. Turmeric helps to combat many conditions including inflammation and heart disease, and it acts as a powerful antioxidant.

2. Add Omega 3 Fatty Acids

Omega 3 fatty acids are a healthy type of fat that is naturally found in many food types including fish, plant seeds and nuts. Omega 3 fatty acids are great for reducing joint pain and stiffness as they are a natural anti-inflammatory. Studies have also shown that omega 3 fatty acids help lower levels of depression, which people commonly feel during the shorter days of winter.

3. Cook in desi ghee

Ghee is a winter essential that can be used to keep warm naturally. Ghee is rich in unsaturated fat, which is responsible for keeping the body warm and also supplying it with energy, dispelling the sluggishness that is brought on by winters.

4. Snack On Dried Fruits:

Figs, or anjeer, is a great example of dried fruits that can help you stay warm during winters. Another excellent dried fruit to consume during winters is date. Figs and dates are rich in calcium and iron and are both help keep your body warm.

5. Get sunlight

Get outdoor and soak in the warm sun, your body requires vitamin D – which is essential for maintaining health and immunity, vitamin D is also required to regulate mood.

6. Green tea

Green tea is a powerful antioxidant and has strong antiviral and antibacterial properties. Drinking approximately three to five cups of green tea a day keeps your immune system in check.

7. Honey

It is known to be the safest and easiest way to cure cold and fever during winter. Honey is known for its antibacterial properties that help fight bacteria and virus. You can have honey every night before going to bed, or mix it in a cup of warm milk.

8. Leafy greens

Methi, Palak, Sarson are all available in abundance and are a good source of beta-carotene and Vitamin C – both powerful antioxidants that help fight disease and build immunity. Others in this category are coriander, amaranth, celery, radish greens, etc.

9. Wash your hands

Washing your hands after coming from outside helps prevent the spread of germs. Wash your hands thoroughly with soap and water to reduce the spread of viral infections like cold and cough.

10. Stay active

Maintain a healthy lifestyle by continuing your fitness regime in winters too. Running, jogging, going to a gym, playing a sport, choose an activity you enjoy the most.

Enjoy the winters by eating seasonal and taking the above health precautions. This helps boost your immune system. Have a healthy winter!

For temporary relief of itching, one may try these self-care measures:

• Avoid items or situations that cause you to itch.
• Perhaps the most important self care is to avoid scratching whenever possible.
• Moisturize daily.
• Use creams, lotions or gels that soothe and cool the skin with wet compresses.
• Use moisturising soap without dyes or perfume.
• Take a lukewarm water bath or shower.
• Stay hydrated with at least 3-4 litres of water everyday.
• Reduce stress.
• Try over-the-counter allergy medicine.
• Use a humidifier.

Short-term use of non prescription corticosteroid cream may temporarily relieve an itch accompanied by red, inflamed skin. Long term relief requires identifying and treating the cause of itching.

When to consult your skin doctor

• If dry, itchy skin doesn’t get better within 2 weeks.
• If its severe and affects your routine and disturbs sleep
• If it affects your whole body
• If it is accompanied by other symptoms like fever, change in urinary or bowel habits, tiredness and weight loss.

Diagnosis

Tracking down the cause of your itch can take time and involve a consult with a dermatologist with physical examination and questions about ones medical history. If the doctor thinks your itchy skin is the result of a medical condition, you might have tests, including:

Blood test. A complete blood count can provide evidence of an internal condition causing your itch, such as iron deficiency.

Tests of thyroid, liver and kidney function. Chest X-rays. A chest X-ray can show if you have enlarged lymph nodes, which can go along with diagnosis of blood cancers.

Treatment

Itchy skin treatment focuses on finding the cause of the itch and removing it. If home remedies don’t ease the itchy skin, your doctor may recommend prescription medications or other treatments. Topical options include: Moisturising creams, emollients, corticosteroid creams. Other treatments that may be recommended to your skin include calcineurin inhibitors, such as tacrolimus and pimecrolimus. Or you may find some relief with topical anesthetics, capsaicin and doxepin.

Oral medications include antihistaminic and steroids. Antidepressants called selective serotonin reuptake inhibitors, such as fluoxetine and sertraline may be helpful in easing some types of chronic itch. Antidepressants, Anticonvulsants, immunosuppressants and biologic agents are used in certain cases.

Light therapy (phototherapy). Phototherapy involves exposing your skin to a specific type of light. Multiple sessions are usually scheduled until the itching is under control.

Written by Dr. Jawahar Mansukhani.

For more details click here – This will go to Dermatology Department.

Itch is the most common presenting symptom to a dermatologist. It is an uncomfortable, irritating sensation that creates an urge to scratch that can involve any part of the body.

Common causes of this symptom

Itching can have external causes that aren’t due to underlying disease. Examples include hair regrowth, sunburns, insect bites, skin infections, contact allergic dermatitis, dry skin or healing wounds.

Itchy skin can be a symptom of an underlying illness.

• These include liver disease, kidney failure, iron deficiency anemia, thyroid problems and certain cancers, including multiple myeloma and lymphoma.
• Urticaria, Atopic and Seborrheic dermatitis
• Psoriasis, Dermatitis herpetiformis
• Drug reactions
• Nerve disorders, as in after shingles or meralgia parasthetica are other reasons.
• Stress and anxiety can affect your nervous system and cause sensory symptoms like burning or itching of the skin, with or without visible signs. Psychiatric illnesses like depression or obsessive compulsive disorder too can cause itchy skin.
• Itching, occasionally, can be seen in later stage of pregnancy.

Some of the major causes:

Hair Regrowth

After removal of hair from genital area and near folds, the growing stub of hair may cause a lot of itching and discomfort.

Soothing lotions and moisturising the area helps to tide over this phase of re-growth.

Sunburns

Prolonged sun exposure especially on beaches or high altitude often leads to itching and burning on directly exposed parts of the skin on face, neck, shoulders and forearms.

Antihistaminics, analgesics and soothing creams are recommended.

Prevention with sunscreens is ideal.

Dry Skin

Itching can be without a rash, especially as we get older due to dry skin or underlying conditions like hypothyroidism, menopausal skin changes and sjogrens disease. Anything that further dries your skin – such as overuse of soaps, antiperspirants, perfumes, or hot baths – will make the problem worse. Dehydration, sun exposure, smoking, and stress also may cause dry skin. Dry skin itches because it is irritated easily.

Skin Infections – are common in children, in those with poor hygiene, in diabetics and in immune-suppressed adults

• Fungal – commonly seen during humid months and mainly afflicting folds of the skin in those with poor hygiene,

Various dermatophytes or candida are common causes,

Presents as annular scaly or reddish patches. Clinically dermatophyosis are classified according to the site involved.

Fungal infections apart from clinical features are diagnosed with help of Woods lamp and microscopic examination of skin scales in 10-20% KOH preparation and or culturing in sabourads dextrose agar.

Patient with itch showing above signs should see a doctor immediately. Self medication especially with steroid containing creams should be avoided. Needs oral and topical antifungal treatment for at least a month,

Maintaining good hygiene and wearing appropriate clothing and footwear can prevent recurrences.

• Bacterial – Pyoderma is caused by pus producing organisms like Stapyloccus aureus or Streptococcus group A. A pus filled eruption with or without discharge and crusting is the basic lesion in pyodermas.

Following are various types of pyoderma

• Impetigo – small blisters with pus filled fluid spreads and ruptures to leave erosions and crusts,
• Ecthyma – ulcerated lesions with thick adherent crust which on removal bleeds,
• Erythrasma – well circumscribed superficial dry brownish patches with scaling near folds,
• Folliculitis – multiple superficial pus filled lesions on legs or elsewhere,
• Furuncle – Deep hair root infection with nodulo-pustular presentation,
• Carbuncle – this is a large indurated nodular lesion with multiple openings, often an indicator of poorly controlled diabetes or Being on long term steroid medications,
• Sycosis barbae – multiple pustules in beard area,
• Cellulitis – a warm tender swelling usually on one of the legs and accompanied by marked constitutional symptoms,
• Paronychia – painful and itchy swelling of nail folds, and
• Hideradenitis Suppurativa – firm nodular and ulcerated lesions with pus discharging openings

The last three are more painful and may not be very itchy.

Pyodermas may be secondary to other skin conditions like injury, eczemas, burns, etc.

While impetigo can be treated with topical anti-bacterial agents, carbuncles and hideradenitis suppurativa may need invasive and prolonged systemic treatment. For secondary pyodermas, treatment of predisposing condition is essential.

• Viral Infections Chicken pox, and other viral exanthema eruptioms may be associated with itching in initial stage. They are accompanied with fever and other constitutional symptoms.
• Mite – It is commonly transferred from contact with affected person or animals.

It presents with generalised nocturnal itch below neck with more than one family member affected in scabetic infestation.

The skin eruption in scabies is typical and classical lesions can be seen in finger webs, folds and genital areas.

It responds well to topical anti-scabetic application.

• Lice – Afflicted children in school and those with poor hygiene are a common source of this infestation,

Identifying the louse on the skin surface confirms the diagnosis

There are three types

Head louse is commonest in children and their close contacts and nits and louse can be observed on their scalp

Body louse affects those with poor hygiene and bed ridden with itching all over

Pubic louse cause itch below waist area and may be sexually transmitted

Perianal itching can be related to hookworm or pinworm infestation. Generalised itching can also be related to parasites such as threadworms infestation, insects such as bedbugs and mosquitoes.

Allergies

Allergy is an altered response by the human body to a variety of agents

• External reasons include irritation with chemicals, soaps, clothing, insect bites, contact with certain plants like parthenium, etc. The site of involvement usually helps to point the incriminator.
• Hives may be due to various reasons and may need prolonged treatment. Transient red and swollen patches may rarely present with mucous membrane involvement with swollen lips and breathlessness. Acute allergy to food, pollens, house dust and mites, cotton, pet animals, drugs, etc. can be identified with allergy tests. Specific triggers do not cause chronic urticaria, which can make allergy tests unhelpful. Hives can cause uncomfortable itching and be painful, but they are not contagious.
• Drug allergy usually shows up immediately after certain drugs. It may show up as localised blisters or symmetrical rash all over the body. Allergic rash to certain medicines may show up even after four weeks.
• Atopic dermatitis may be seen in more than one family member and its onset in early life and typical distribution of lesions assist in diagnosing. There may be associated asthama or allergic sneezing and rhinitis is self or in other family members.
• Seborrheic dermatitis seen after puberty age has itchy lesions in seborrheic areas.

Other causes

Uremia is a broad syndrome that occurs when the kidneys are severely damaged and cannot filter toxins from the body. With uremia, itching tends to be worse at night. It most commonly affects the back, arms, and abdomen. Psoriasis lesions are mildly pruritic and the classical scaly patches help in diagnosing and treating specifically. Shingles with a dermatomal distribution of grouped tiny blisters should be treated early with anti-virals to prevent complications.

Psychological

People may experience an itching feeling that has no physical cause. Some mental health conditions can make a person feel as if their skin is crawling, which creates an urge to scratch. Neither skin lesion, nor a crawling insect can be detected on examination. Excessive scratching though, can lead to skin damage.

Written by Dr. Jawahar Mansukhani.

For more details, click here – This will go to Dermatology Department.