*Hushed voices*

“She must be on her period!”

“Are you PMSing?”

“I’m guessing it’s those days.”

Women have long faced a barrage of queries, questions even accusations about their periods. Myths have been perpetrated in the name of information. But the one myth or the one truth that remains intriguing is that of PMS. Do women really become angry, unreasonable people? Often characterised by irritation, anger and emotional outbursts, PMS also manifests as fatigue, pain, cramping, bloating, weight gain, food cravings, breast tenderness, headaches, etc.

The Lie

The myth about PMS affecting mental health is not without basis, premenstrual syndrome is caused by cyclical changes in hormones or chemical changes in the brain that cause a heightened sense of irritability. In most cases, however, it is not serious enough to require the attention of a doctor. In fact, a lot of women do not even experience PMS.

Women have historically been subjected to the myth that PMS affects their decision-making ability, but that is certainly not the case. Menstruating women go through a fair bit of emotional ups and downs, but so do men who may have had a big win at work, or received emotionally distressing news. PMS affecting productivity is often used as an excuse to keep women from assuming office or take on leadership roles; however, research indicates that such a hormonal change is no different from what people experience when their favourite sports teams win a game.

But I am especially cranky during those days! Is that PMS or am I just an irrational person?

Yes, it could be PMS, but it is temporary, often limited to a couple of days of the month. But if you do feel your hormones are affecting your everyday life or you seem irrational to others, a way to deal with it is to be upfront about it to your friends and family. Recognising that your periods affect your personality is the first step, processing emotions and acknowledging them is important without losing your confidence.

PMS is not a myth, but the various symptoms and how it affects life have certainly been twisted and turned. An honest conversation about periods and menstrual health will do everyone a world of good. All women have periods, it is a very basic bodily function that needs to be understood and spoken about, openly and freely.

Most of us wait till the dull winter passes, and summer to come along so that we can make a splash in the pool or bask in the bright sunshine. But long hours in the sun can cause the body to overheat abnormally and hamper the normal bodily functions. It also adversely affects vital organs like the heart and also the kidneys. Summers are especially known as the kidney stone season.

What happens to kidneys during summer:

Summers is when we tend to sweat more, thus robbing our bodies of essential hydration. The urine, as a result, becomes concentrated and the residual salt amount in the kidneys after detoxing also increases. This residue gradually hardens and forms crystal-like structures that are the kidney stones. When one stone forms, other stones form soon after which can be an excruciatingly painful situation for the person suffering.

Ways to prevent kidney stones in summers:

Stay hydrated: Since summers is when we sweat more, supply your body with that much more water by drinking lots of fluids throughout the day. Add a lemon wedge to your water as the citric acid in lemon would inhibit urinary crystal formation. Certain foods like green vegetables, fruits etc have a high water content so include them in your diet. Stay away from caffeine as much as you can in the form of iced tea or coffee as it aids in dehydration.

Monitor your diet: Studies have suggested that a diet rich in refined sugars, salt and animal protein is a factor in the increase of kidney stones in summers. Excessive salt extracts calcium from bones and deposits them in the kidneys while sugar breaks down into glucose and excess of it puts a toll on the kidneys. Non-fat dairy products, on the other hand, are high in calcium that helps in reducing kidney stone risk.

Learn if you’re vulnerable: If you have had kidney stones in the past, you are at a high risk of having them again. In such cases, prevention is better than cure. You can take medications that inhibit kidney stone formation. On the other hand, some medications that you already might be taking like antacids, calcium supplements, antibiotics, diuretics etc would be making you susceptible to stones. Speak to your urologist in both situations.

Attend to nature’s call as much as you can: Holding urine in your bladder, especially when the weather is harsh enough on your body, might not be a good idea as there’s enough time for waste minerals and salts to get crystallised in the process.

The key to preventing kidney stones is to drink lots of fluids so that all toxins are flushed out from the body. Even if kidney stones are formed in your body, it can be flushed out by drinking lot of water if it is very small. So keep these factors in mind and prevent the onset of kidney stones.

Smoking can be a difficult habit to shake off. This is because of the nicotine present in cigarettes which can be as addictive as some of the illegal drugs like cocaine. When a person starts smoking, nicotine has various effects on the brain that makes the smoker feel good by instantly boosting their mood, reducing irritability and producing a sense of general well being. They also feel that smoking helps them to focus. But these positive effects are only temporary.

Symptoms of nicotine withdrawal

In addition to addictive nicotine, tobacco is thought to be supremely carcinogenic and can lead to diseases like stroke, lung cancer, and heart diseases. Nicotine withdrawal makes it extremely difficult for smokers to quit, no matter how much they want to. The severity of symptoms depends on the level of addiction of the person, and it usually peaks within two to three days of quitting. Some of the most common symptoms of nicotine withdrawal include:

• Headaches
• Tingling in the hands and feet
• Anxiety and depression
• Insomnia
• Difficulty concentrating

How to manage nicotine withdrawal

• When a person tries to quit, the nicotine receptors in the brain are activated. Ignoring these receptors leads to withdrawal. Accept and believe that withdrawal symptoms would fade away with time, no matter their severity.
• Several treatment options are also available to tackle withdrawal symptoms. These include over-the-counter nicotine replacement medications such as nicotine gum and skin patches. Nasal sprays and inhalers have also proved to be effective.
• Make sure that you decide to quit when you do not have much on your plate. Managing withdrawal symptoms and quitting smoking together can be exhausting and overwhelming and would require sincere efforts, attention and dedication.
• Reaching out to family and friends would also be advised. Join a support group.
  Keep a journal and record your reasons for quitting. Go back to them once your cravings start to get the better of you.
• Drink plenty of water, practice deep breathing and workout regularly. Find ways to relax to curb your cravings and have a sound sleep at night.
• Identify the triggers that make you want to smoke like talking on the phone, feeling bored or stressed or being around other smokers and avoid them as much as you can.

Certain physical and mental changes occur after quitting smoking. There is no way to avoid nicotine withdrawal, but it can be combated effectively and permanently. Studies have shown that the more one tries to quit, the more are the chances of success at doing so!

With the mercury reaching a sweltering high, it’s important to be vigilant against the dangers of heat stroke. Most of us ignore the symptoms and pass them off as normal during hot weather. But heat stroke can have a profound effect on the body – it can be deadly.

What is a heat stroke?

The prolonged exposure to or physical exertion in high temperatures that result in the body overheating is known as heatstroke. “Heatstroke, also called sunstroke, is a severe heat illness that results in a body temperature greater than 40.0 °C (104.0 °F)”. When a body reaches high temperatures, a natural mechanism kicks in that helps the body cool itself down. However, when it reaches the high core temperature of 40° C, the natural cooling mechanisms (like sweating) is not enough and the body is no longer able to regulate its temperature.

Heatstroke is a serious condition and needs to be treated as an emergency. Untreated heatstroke can quickly damage the brain, heart, kidneys and muscles. The damage worsens the longer treatment is delayed, increasing the risk of serious complications or death.

Symptoms

Some of the visible signs of heatstroke include:

• A headache
• Dizziness and disorientation
• Loss of appetite and feeling sick
• Pale and dry skin
• Fast breathing
• A high body temperature of 38° C or above
• Increased thirst

Treatment

If someone is showing signs of heatstroke they need to be cooled down immediately. Somethings to be done:

• Move them to a cool, shady or air-conditioned place and remove any unnecessary clothing
• Get them to lie down and raise their feet slightly
• Get them to drink plenty of water
• Cool the person using wet towels or a wet sheet with a fan directed across the surface
• Placing cold packs under their armpits or groin, or on the back of their neck

Heatstroke is dangerous to our body, so taking all precautions is imperative. Staying hydrated and keeping cool is extremely important. Also, wearing clothes that ensure free circulation of air to allow evaporation of sweat and staying indoors in air-conditioned areas whenever possible is also imperative. It is always advisable to avoid spending time outdoors during the hottest hours of the day: 11 a.m. to 3 p.m. Keeping a tab on the summer weather forecast can be extremely helpful. Remember precaution is always better than cure – so do follow these simple steps to avoid getting heat stroke in the first place.

Summers are officially here and it’s time to revise your diet and adjust it according to the weather. In fact, it is not just about what you should eat, but also what you absolutely shouldn’t. Excessive heat can put the body under enormous stress and can lead to gastric problems, diarrhoea, loss of concentration, dehydration and what not. The food and drinks that you consume during these months play a vital role in regulating body temperature and managing that stress. Make sure you check what goes in your mouth and try to avoid these foods in summer as much as you can!

Chilies and spices

Indian food is incomplete without chilies and spices like ginger, cloves or cinnamon. But spicy food can be quite toxic at this time of the year. Chilly and spicy foods increase the rate of metabolism in the body producing more heat in the body than required. This hampers the cooling effect of anything else you eat or drink. It is better to avoid adding a lot of these ingredients in your diet.

Dry fruits

Sometimes indulging in even healthy things can interfere with health during summertime, like cashews, peanuts, almonds or raisins. Dry fruits raise the temperature inside the body which can get out of hand and make you feel nauseous and cause stomach issues.

Fried and junk food

Excess of fried food is never good in any season, but especially during summers. Excess of oil can cause digestive problems and other health woes when coupled with the weather outside!

Charred meat, chicken and fish

Many non-vegetarian foods like red meat, egg, prawns, squid and crab are known to generate heat inside the body. When animal protein is cooked at high temperatures it produces some chemicals which are hazardous to health. A non-veg fare during summers would induce a thermogenic effect in the body causing bloating, sluggishness and even diarrhoea. Stay away from this as much as possible.

Sugar-free ice cream

Ice cream is body warming, although it seems to provide respite from the heat. Sugar-free ice cream is even more harmful as artificial sweeteners can draw water from the intestines, which can result in diarrhea, while chemicals that contribute to the creaminess in the absence of fat could cause bloating.

The bottom line is this – any food or beverage that generates heat inside the body should be avoided as much as possible when the mercury levels are on a steep climb. You should also steer clear of caffeine – any amount of tea or coffee would make you dehydrated which one absolutely cannot afford to be! Choosing summer-friendly foods would definitely be a good idea. On top of that, keep yourself hydrated by drinking water and fluids at short intervals.

The sun might be good for a natural tan but long hours in the sun isn’t too good for heart health. However, outdoor activities like family barbecues, picnics and swimming sessions can’t be avoided either. Believe it or not but heat exhaustion and heat stroke are common occurrences which can be avoided by being just a little careful. Some symptoms of heat stroke include the following which needs medical intervention right away:

• Fever (temperature above 104°F)
• Irrational or confused behavior
• Dry, hot, and red skin
• Rapid, shallow breathing
• Seizures
• Losing consciousness

With a few tips and tricks, one can’t just safeguard the heart this summer, but also keep it healthy. Here are a few of them:

Take it easy:

Any activity that is causing you discomfort by being in the sun needs to be stopped immediately. You need to move to a shady area and cool yourself down by fanning or by using a wet cloth so that body’s reaction to heat can be controlled.

Hydrate:

Drink plenty of water before, during and after physical activity to avoid dehydration. Detox waters are delicious, low on calorie, hydrating as well as good for the heart. Try different variations such as berries, cucumber, apple, watermelon etc by soaking them in water for at least two hours and sipping them throughout the day. Heat makes the heart work harder so that it can retain the salt and water content in the body, and you can help manage this by keeping a check on your water intake.

Dress according to the weather:

Summer dressing up is a good idea to look and feel good, and let the heart perform its tasks optimally. That would mean dressing in light colors and fabrics such as cotton. Breathable shoes and sunglasses are also a must when you are out and about.
Exercise with caution: Avoid any strenuous activity or rigorous workout between noon and 3 pm. That is when the sun is at its strongest and you would be depleting more energy than required causing stress to the heart. Take breaks to hydrate with a sports drink and cool off.

Eat smaller and frequent meals:

This would help in keeping the heart rate steady. Try including salads, smoothies and other foods high in water content in the daily diet so that body temperature naturally stays low.

It doesn’t matter what brings one outside. It’s imperative to stay safe when the heat rises, especially if you’re a heart patient. Older people, above the age of 50 or overweight or obese people also need to take extra precautions whilst facing the sun.

Gynecomastia(sometimes referred to as “man boobs”) is a common condition where there is enlargement of breast tissue in boys and men. This condition is the most common reason for medical evaluation of the male breast.

It occurs transiently in many adolescent boys. Of these, in about 7 to 8 percent it persists.

Causes:

Most cases are idiopathic (occurring spontaneously without a known cause). The other causes include

• Side effects of numerous medications and drugs of abuse such as corticosteroids, antibiotics, opioids (narcotic drugs), anti-anxiety medication, etc.
• A medical condition such as kidney failure or liver disease, malnutrition and re-feeding (recovery from malnutrition), hyperthyroidism, etc.
• Lumps or infection in the testicles
• Alcohol dependence
• Klinefelter syndrome (a rare genetic disorder)
• Whatever the cause, it may affect either one or both breasts, many a time the breast enlargement is not equal and is more on one side than the other.

Signs & Symptoms

• Enlargement of the male breasts
• Tenderness and sensitivity
• Pain

Diagnosis

Gynecomastia can be diagnosed by a physical examination.

Further evaluation is necessary in case of clinical examination revealing a cause such as a lump that is tender and of recent onset / progressive / of unknown duration. It is also advisable to evaluate a patient further in case of signs of malignancy (Eg: hard or fixed lymph nodes or positive lymph node findings)

Laboratory tests that may be considered include the following:

• Serum chemistry panel
• Hormonal assays- free or total testosterone, luteinizing hormone (LH), estradiol, thyroid-stimulating hormone (TSH) and free thyroxine levels

Other studies that may be helpful include the following:

• Mammography/ Ultrasonography to clarify the nature of the breast enlargement
• Testicular ultrasonography if clinical examination findings suggest the possibility of a testicular neoplasm
• Karyotyping

Classification

Gynecomastia is classified into 3 grades based on factors like size of breast enlargement and feminization of the breast.

Management

In many cases of gynecomastia there is severe emotional distress and embarrassment leading to social withdrawal. There are instances of harassment from friends and peer groups which may lead to psychological issues.

In adolescents, a trial period of 2 to 3 years can be provided to observe for regression of the condition. Majority of them regress and resolve on their own.

In case of persistence of this condition, minimal scar treatment is an ideal option and can be done with good success rate. This is offered during the following situations or conditions -

• People suffer from emotional distress, social stigma, social withdrawal, harassment due to gynecomastia
• There is persistent increase in size of breasts
• Diagnosis is doubtful
• Symptoms like pain and tenderness are persistent

The procedure of minimal scar treatment for gynecomastia removal is done on an outpatient basis. The aim of this procedure is to remove the gland and surrounding fat with least scarring. The removal of surrounding fat is facilitated by ultrasound assisted techniques, this also helps in skin tightening.

In grade 3 gynecomastia, skin excision may be required to help skin tightening. The procedure of minimally invasive procedure usually gives long-lasting results.

We at Vikram Hospital have a experienced team of Plastic Surgeons who perform the minimally invasive procedure for gynecomastia with ultrasound assisted techniques.

The following images are from successful gynecomastia treatment -

Drink more water to stay hydrated. Our body needs at least 8 glasses of water every day to stay healthy…so on and so forth. We’ve heard them all! Certainly, staying hydrated does contribute to overall health, but numerous misconceptions have flowed from the basic principle that staying hydrated is a good thing. We have compiled a list of myths about hydration for you to discover the facts behind water intake.

You need to drink eight glasses of water per day

No question that drinking enough water is important but mindlessly drinking eight glasses of water won’t necessarily meet your hydration needs. This is because every person’s hydration needs are unique. There can be many factors affecting one’s hydration requirement, like gender, age, climate, exercise as well as pregnancy and lactation. Let your body’s thirst mechanism decide how much water it needs. The main goal is to replenish the water you lose, so if you’re sweating more because you’re pumping more at the gym, you’ll naturally want to hydrate more.

Checking the colour of urine is a good way to monitor hydration

Let’s just begin by saying that the colour of urine is influenced by many factors. For example, if we take multivitamins or are on a high-protein diet, the color could be dark for reasons other than dehydration. Colors ranging from amber to dark brown means you are in the danger zone for dehydration. However, the color of your urine does not directly confirm your balance of hydration.

Drinking more water flushes more toxins from the body

If you think that guzzling bottles of water all day long will help flush out your system, even more, it’s time for you to rethink. The kidneys are good at flushing toxins using the water provided through normal thirst. You don’t need to drink water mindlessly, for it might also create imbalances within the body. Yes, over-drinking is actually a real problem and can lead to the condition called hyponatremia. It can cause everything from lethargy, irregular heartbeat and nausea to seizures, and possibly death in rare occurrences.

Drinking a glass of water before bed prevents heart attacks and strokes

There’s very little science to support the theory! Drinking water before bed won’t combat the risk of stroke or heart attack. It’s a good idea to let the body and kidneys rest at night. Drinking a glass of water before bed can interrupt your sleep cycle as you may have to wake up in the middle of the night and go to the bathroom. Bottom line, this is just a myth. A healthy diet and lifestyle are your best options to fight cardiovascular disease.

Improving hydration brings well-being and better quality of life. Good hydration can help prevent pressure ulcers, constipation, urinary tract infections and incontinence, kidney stones, skin conditions and many other illnesses. Yet even though it is vital to health, it is important to understand the need to maintain only a healthy level of hydration. There’s no need to constantly gulp down water. Drink when you’re thirsty. Stop drinking when your thirst is quenched. Obey that one rule and there is no risk of dehydration.

Summer is here and we are already worried! Those pesky rays and rising temperatures can play havoc with our skin; giving us some real skin woes. One such unpleasant side effect of scorching summer is prickly heat. The itchy rash, which appears as small red spots and sometimes blisters, is the most common allergy to the sun and can be quiet unpleasant. This guide provides information and advice on prickly heat.

What is prickly heat?

Prickly heat, or heat rash, is an itchy skin rash with small red spots all over the affected areas. It is a common problem in hot and humid areas. The face, neck, shoulders, and chest are the most common places for prickly heat to occur, although it may show up anywhere. While it can affect anyone, children are more likely to get prickly heat than adults.

Symptoms

Prickly heat is usually easy to identify due to its straightforward symptoms, which are as mentioned below:

• Tiny red spots and blisters
• Irritating itch and prickling sensation
• Redness and mild swelling of the affected area

What causes prickly heat?

Prickly heat is caused by excess sweating and inadequate evaporation of the sweat. We have thousands of sweat glands just below the surface of the skin, and if the ducts become blocked the sweat can’t escape. Instead of evaporating, perspiration gets trapped beneath the skin, causing inflammation and rash.

Prevention & Treatment

Prickly heat is a common condition that will usually resolve without medical treatment. Episodes soon stop after the exposure to hot and humid climate ceases. Taking steps to prevent heat rash is the best way to avoid this annoyance. Here are a few things you can do to prevent and soothe your itching and discomfort.

• Wear lightweight, loose-fitting clothes ideally made from natural fibres like cotton
• Drink plenty of water to avoid dehydration
• If possible, avoid heat and humidity. Stay in cool or air-conditioned, or well-ventilated environments
• Frequent baths with cold water might also help
• Using an antibacterial soap or antiseptic wash may help to keep the number of germs (bacteria) on your skin down
• Calamine lotion and/or hydrocortisone cream can relieve itching and irritation

Heat rash is uncomfortable but it’s not a serious condition. It should clear up on its own after a few days. Prevention of heat rash is the best treatment for heat rash. However, if you do not see any significant reduction or improvement in your condition despite these aforementioned tips to treat heat rash, do visit a dermatologist for it could be a sign of a more serious skin condition.