Archives

Demystifying NASH: Understanding Nonalcoholic Steatohepatitis for Better Health

Understanding Nonalcoholic Steatohepatitis

Nonalcoholic steatohepatitis (NASH) is a liver ailment marked by inflammation and harm caused by the buildup of fat within the liver. As part of the nonalcoholic fatty liver disease spectrum, NASH can result in complications when not addressed.

In this blog, we’ll delve into the causes, symptoms, diagnosis, and treatment of NASH.

What is Nonalcoholic Steatohepatitis (NASH)?

NASH develops when excess fat in the liver triggers inflammation and damages liver cells. Though many people may have a fatty liver without experiencing symptoms, some individuals may suffer from liver dysfunction due to this fat buildup.

Unlike liver diseases associated with alcohol abuse, NASH occurs in individuals who do not misuse alcohol.

Symptoms of Nonalcoholic Steatohepatitis (NASH)

During the early stages, NASH may not present noticeable symptoms. However, as liver damage progresses, symptoms may include fatigue, unexplained weight loss, general weakness, and discomfort in the upper right part of the abdomen.
It can take several years for NASH to advance to a stage where symptoms become apparent.

Causes of Nonalcoholic Steatohepatitis (NASH)

The exact cause of NASH remains unclear, but factors such as environmental triggers or genetic predisposition may contribute.
Risk factors for NASH and associated liver damage include obesity, insulin resistance, type 2 diabetes, high cholesterol, high triglycerides, and metabolic syndrome.
While most individuals with NASH are between 40 to 50 years old and have these risk factors, the condition can also occur in those with none of these risk factors.

Diagnosing Nonalcoholic Steatohepatitis (NASH)

There is no single test for diagnosing NASH. Healthcare professionals rely on a combination of tests, including blood tests, abdominal ultrasound, CT scan, and MRI scan, to assess fat buildup in the liver and rule out other diseases. In some cases, a liver biopsy may be conducted to confirm the presence of NASH by examining liver tissue.

Treatment for Nonalcoholic Steatohepatitis (NASH)

Managing conditions that contribute to or worsen NASH is key to treatment. This includes reducing total cholesterol levels, achieving a healthy weight (with a 3% to 10% body weight loss making a significant impact), controlling diabetes, and limiting alcohol intake. Regular exercise is also recommended to support overall liver health.

Conclusion

Nonalcoholic Steatohepatitis (NASH) is a complex liver condition that requires careful management and attention to associated risk factors.
Understanding the causes, recognizing symptoms, and undergoing proper diagnosis are crucial steps in addressing NASH and working towards a healthier liver.
If you suspect you may have NASH or are at risk, consult with our Best Hepatologist at Medica North Bengal Clinic for personalized guidance and care.

Understanding Sports Injuries

Sports-Injuries

Sports injuries are not necessarily caused only by playing sports. The common cause of any sports injury is some kind of direct impact, overuse or application of force which is more than what that particular body part can endure. Such injuries could be precipitated by playing sports, exercising or other physical activities like climbing stairs.

Sports injuries can be acute or chronic. An injury like an ankle sprain when you land awkwardly is an acute sports injury, whereas chronic sports injuries are caused by recurring overuse of specific muscle groups and joints. Structural abnormalities or unscientific exercise techniques can also lead to chronic injuries. Sports injuries shouldn’t be taken lightly because a “simple” sprained ankle could turn out to be a fracture.

What are the common risk factors for sustaining sports injuries?

Risk for sports injuries is raised if:

  • You suddenly attempt a vigorous physical activity after days of inactivity
  • You don’t warm up sufficiently before commencing exercise
  • You are playing any contact sport like football, rugby or hockey
  • You are overweight
  • You are of advanced age

What are the most common types of sports injuries?

  • Sprains: When we overstretch or tear a ligament (tissue connecting two bones in a joint), we get a sprain.
  • Strains: When instead of a ligament, we overstretch or tear a muscle or tendon (tissue connecting bone to muscle), the injury is a ‘strain’, often confused with a sprain.
  • Knee injuries: If you have trouble moving your knee joint following an injury, it could be a sports injury caused by overstretch or even tear in tissue or muscle.
  • Muscle swelling: Very often, as a reaction to an injury, our muscles become inflamed. It can cause significant pain and weakness.
  • Rupture of Achilles tendon: The Achilles tendon, a thin but firm tendon behind our ankle, can break or rupture while playing sports like football. It can cause sudden severe pain and huge discomfort in walking.
  • Fractures: Bone fractures or broken bones are a common sports injury.
  • Dislocations: Sometimes, a sports injury can push a bone out of its socket, which is a very painful sports injury, leading to inflammation and weakness.
  • Rotator cuff injury: The rotator cuff which moves our shoulders in all directions is made of four different muscles. A tear in any of these muscles is a rotator cuff injury.
  • Stress fractures: Repeated running or jumping on hard surfaces can sometimes lead to stress and a crack in a bone, usually in the lower limbs, known as stress fracture.
  • Bruises: Small bleeds on the skin can be caused by an impact injury.
  • Groin strain: Can cause swelling and significant pain.
  • Hamstring strain: Again swelling, pain and bruising are common symptoms.
  • Concussion: A blow to the head can cause a mild reversible brain injury, which is called concussion. A person suffering from concussion can experience headache, dizziness and even lose consciousness.
  • Dental damage: Our teeth can break or dislodge from a blow to the jaw.

What are the universally accepted protocols for treating sports injuries?

The most accepted treatment regimen is RICE, standing for:

  • Rest
  • Icing
  • Compression
  • Elevation

The RICE methodology is very effective in treating mild sports injuries if applied within 24 to 36 hours post-injury. It helps with the swelling and the pain. There are also OTC pain medications available to manage pain and swelling. Physiotherapy is another effective treatment pathway which helps in a clutch of muscle and tissue injuries.

See a doctor or seek emergency care if:

  • There’s severe pain and swelling in the injured joint
  • There are noticeable deformities like lumps or bumps
  • You feel crunching sounds while using the injured joint
  • You feel weakness in the joint and can’t put weight on it
  • You are feeling unstable in the joint
  • You feel dizzy
  • You have difficulty breathing
  • You have fever

An ambulance must be hailed in case of:

  • Extended period of loss of consciousness
  • Injuries to neck or spine
  • Fractures
  • Head or face injuries
  • Eye injuries
  • Abdominal injuries

While acute sports injuries usually need immediate care, sometimes even emergency care, chronic conditions may need more long-term care under the guidance of a Sports Medicine specialist. Unsupervised therapy can lead to aggravation. At Medica we provide advanced care for sports injuries by specialists and with the support of expert physical and rehabilitation therapists.

PCOS: Is It A Lifestyle Disease?

PCOS

PCOS or polycystic ovarian syndrome is a common hormonal disorder that can afflict women during their reproductive age span, and is more prevalent among young adults. Undeniably a lifestyle disease, uncontrolled PCOS can lead to serious health problems like diabetes, cardiac conditions, infertility, depression, hypertension and even gynecological cancers.

Affecting the urban population more, PCOS is prevalent among one in four Indian women, with the global burden being nearly 10 million. Those suffering from PCOS develop multiple cysts in their ovaries, which by themselves are not harmful, but trigger hormonal imbalance.

The initial symptoms can include:

  • Unwanted body and facial hair
  • Baldness
  • Acne
  • Weight gain
  • Irregular or absent periods
  • Elevated male hormones
  • Darkened or excess skin on neck or armpits
  • Mood swings
  • Pelvic pain

Why is PCOS a lifestyle disease?

The breakneck speed and all-consuming stress of today’s urban lifestyle, particularly those of young adults, can be a bad cocktail, precipitating a raft of non-communicable lifestyle diseases, which is the greatest challenge in front of the medical fraternity at this juncture. In this mad scramble to excel, youngsters very often forget the need to eat right, sleep well and exercise regularly. Doctors associate PCOS with such a sedentary lifestyle. Hence, lifestyle modification is the most potent tool to combat this disorder and is the first line of treatment.

What lifestyle changes can help keep PCOS away?

  • Eat right: It’s important to have a balanced diet rich in high-fibre foods with lots of greens and fruits to fight insulin resistance, besides lean protein. Avoid foods with high glycemic index. Eat small, frequent meals. Avoid processed and junk food.
  • Exercise: Lack of exercise can lead to weight gain and obesity, triggering metabolic imbalances like insulin resistance which can cause diabetes.
  • Lose weight: Weight reduction is critical to stave off PCOS. However, don’t go for the crash diets fad. It can lead to severe nutritional deficiencies.
  • Vitamins & minerals: Women with PCOS are often deficient in Vitamin D, Vitamin B12, zinc, magnesium and folate, and need to add these supplements as advised by the doctor.
  • Hydrate yourself: Drinking plenty of water and fluids is extremely critical to keep your body well hydrated.
  • Sleep well: Getting around eight hours of sleep in a 24-hour cycle is absolutely vital. So maintain good sleep hygiene and disconnect all gadgets at least an hour before going to bed.
  • Rule out OSA: A sleep study test should be done to rule out obstructive sleep apnea or OSA, particularly for obese women.
  • Quit smoking & alcohol: Smoking and alcohol consumption can add to the risk of getting PCOS and make it worse if you already have it.

While PCOS may not cause any significant discomfort, it can be a cause of infertility in women. Monitoring the condition and adjusting one’s lifestyle is necessary to avoid other complications. It is essential to seek the advice of a doctor if you experience symptoms. At Medica, our team of gynecologists are adept at treating polycystic ovarian disorders.

Alcoholic Vs Non-Alcoholic Fatty Liver

Fatty Liver Disease

The presence of some amount of fat is par for the course in a healthy liver. However, accumulation of extra fat is harmful for the liver and is referred to as fatty liver disease or hepatic steatosis. While alcoholic liver disease (ALD) is brought on by consumption of alcohol, nonalcoholic fatty liver disease (NAFLD) is not caused by alcohol. Both ALD and NAFLD are major health issues globally.

While the trigger for ALD is heavy drinking, NAFLD is often caused by conditions like diabetes or pre-diabetes, high lipids count or hypertension. Both the diseases can often exist silently without the patients manifesting any symptoms and can have very similar pathological progression, sometimes leading to more serious disease like steatohepatitis, liver cirrhosis or even liver cancer. Both the liver diseases can also have extra-hepatic complications, including heart disease and cancer.

Nonalcoholic fatty liver disease has two types:

  • Simple fatty liver: This is the more common type, which entails presence of fat in the liver without any inflammation or cell damage. It doesn’t normally get worse and turn into a serious condition.
  • Nonalcoholic steatohepatitis or NASH: Afflicting nearly one-fifth of those having NAFLD, NASH signifies inflammation of the liver and is a much more serious condition than a simple fatty liver. The cell damage and inflammation can even lead to scarring of the liver including fibrosis and cirrhosis and even liver cancer.

What are the problems precipitated by ALD?

While alcoholic fatty liver disease is preventable and generally gets better once you kick the bottle, it can also cause complex conditions like:

  • Enlarged liver: This might cause pain or discomfort in the right upper side of the tummy, However, it may not show any symptoms at all.
  • Alcoholic hepatitis: This is an inflammatory condition of the liver which may cause nausea and vomiting, fever, tummy ache and jaundice.
  • Alcoholic cirrhosis: This is a serious condition, involving scar tissue buildup in the liver. Besides similar symptoms like hepatitis, cirrhosis can also lead to ascites or massive fluid buildup in the tummy, elevated blood pressure in the liver, bleeding, enlarged spleen, confusion, and even liver failure. Alcoholic hepatitis can over time turn into alcoholic cirrhosis.

What are the common symptoms of fatty liver disease?

While for ALD and NAFLD, there aren’t normally any significant symptoms except fatigue and tummy-ache, NASH and cirrhosis can manifest in symptoms like:

  • Swelling in the belly
  • Thickened blood vessels showing underneath the skin
  • Redness in the palms
  • Enlarged breasts in men
  • Yellowish tinge in eyes and skin because of jaundice

What are the known risk factors for fatty liver disease?

Too much alcohol is the primary cause for ALD, while other risk factors include:

  • Obesity
  • Malnourishment
  • Chronic viral hepatitis, particularly the C type
  • Older individuals are more vulnerable

The known risk factors for NAFLD or NASH include:

  • Being overweight or obese
  • If you have insulin resistance or type 2 diabetes
  • If your triglycerides and LDL (bad) cholesterol counts are high or HDL (good) cholesterol count is low
  • The elderly are more prone
  • If you have polycystic ovary syndrome
  • If you have sleep apneoa
  • If you have hypothyroidism
  • If you have hypopituitarism (underactive pituitary gland)
  • Malnourishment
  • Sudden weight loss
  • Exposure to certain toxins or chemicals
  • Having metabolic syndrome which makes one more prone to diabetes and heart disease

Medica’s Department of Gastroenterology & Hepatology provides advanced diagnosis and treatment facilities for gastric and liver disorders under the supervision of experienced specialist.

Gastritis – Causes & Treatment

 

Gastritis treatment

Gastritis is a general term used to indicate inflammation, irritation or erosion of the stomach lining or mucosa, causing stomach aches, dyspepsia, nausea and bloating. The condition can appear suddenly (acute gastritis) or gradually (chronic gastritis). Dietary changes and medications are advised to reduce acid in the stomach and ease the symptoms.

What are the common symptoms of gastritis?

Symptoms may vary from patient to patient. Sometimes there aren’t any at all. These are some of the more common ones though:

# Burning pain in the upper abdomen, often between meals

# Nausea, vomiting

# Recurrent stomach upsets

# Appetite loss

# Feeling of fullness in upper abdomen after meals

# Hiccups

# Black stools

# Blood in vomit

What are the known causes of and risk factors for gastritis?

When the mucus-lined protective barrier to the stomach is breached due to some injury or weaknesses, digestive juices can damage and inflame the stomach lining. A clutch of diseases can raise the risk of gastritis, including inflammatory bowel diseases (IBD) like Crohn’s disease.

Some of the known risk factors include:

# Bacterial infection: While Helicobacter pylori is one of the commonest infections, it doesn’t always lead to gastritis. It is believed that the risk of this infection is often multiplied by poor lifestyle choices, including an unhealthy diet, smoking and alcohol intake.

# Pain-killer abuse: Regular use of a group of pain-relievers called NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen, naproxen sodium, etc can lead to both acute and chronic gastritis by damaging the mucosa.

# Advancing age: Since the stomach lining tends to become progressively thinner with age, elderly individuals are more prone to H. pylori infection or autoimmune disorders.

# Excessive drinking: Since alcohol irritates and erodes the stomach lining, binge-drinking can cause acute gastritis.

# Medical stress: Any major surgical procedure, injury, burns or infections can cause severe stress, leading to acute gastritis.

# Treatment for cancer: Radiation treatment or chemotherapy for treating cancer can raise the risk of gastritis.

# Autoimmune gastritis: When your own immune system malfunctions and attacks the cells of the stomach lining, it can lead to gastritis. People with autoimmune disorders including Type 1 diabetes are more prone to this form of gastritis, which has also been linked to Vitamin B-12 deficiency.

How is gastritis diagnosed?

Following a thorough physical evaluation, these tests could be advised to diagnose gastritis:

# Upper endoscopy: To look at the stomach lining

# Blood tests: Including for H. pylori

# Fecal occult blood test: This test checks for blood in stool, a possible sign of gastritis

How is gastritis treated?

Routine treatment protocols include:

# Antacids and other medications like H-2 blockers and proton pump inhibitors (PPIs) to reduce stomach acid

# Avoiding spicy food

# Antibiotics for H. pylori infection plus heartburn medication

# Vitamin B-12 injections might be required if gastritis is precipitated by pernicious anemia

# Steering clear of foods that irritate the stomach, like lactose in milk or gluten in wheat

If gastritis is not treated and left to fester, it can lead to bleeding ulcers in the stomach. Some rare forms of chronic gastritis can also raise the risk of stomach cancer.

Medica North Bengal Clinic’s Gastro department is equipped to handle both acute and chronic gastritis under the supervision of experienced doctors.

Why Do Asthma Symptoms Increase In Summer?

Asthma Symptoms

Asthma is a condition more often than not associated with the cold season. However, hot summer weather can trigger asthma symptoms as well. Two plausible causes could be: Breathing in hot air resulting in narrowing of the airways leading to shortness of breath, cough and wheezing, or very high levels of pollutants, pollens and greenhouse gases in the air when the temperatures are soaring, which can be particularly challenging in case someone has allergic asthma.

What are the factors causing summertime asthma?

The season-specific risk factors for summertime asthma are:

# High temperatures: Extreme heat can affect airways and trigger symptoms. Dehydration also makes it worse.

# High humidity: Humid air is heavy and hence, harder to breathe. It also traps irritants like pollen, mold and dust mites, which are asthma triggers.

# Ozone: A product of sunlight and atmospheric chemicals, ozone can affect lung function and worsen asthma attacks during summers.

# Summer allergens: In case of allergic asthma triggered by allergens more prevalent in hot weather, summer months could usher in asthma attacks.

# Smoke: Smoke carries small particulate matter that could be particularly harmful for asthma patients.

What are the known symptoms of summertime asthma?

# Frequent coughing

# Shortness of breath

# Fatigue

# Common cold

# Wheezing

# Pain in the chest

# Allergies

# Trouble sleeping

How is summertime asthma treated?

If the trigger is a known allergen, you can try to avoid it to the extent possible. When that’s not happening, your doctor might augment your prescription with:

# Oral antihistamines: These medicines prevent narrowing of the airways and production of mucus by changing the immune system’s overreaction to allergens.

# Nasal decongestant sprays: These provide short-term relief for summertime nasal symptoms, but one must guard against overuse.

# Saline irrigation: This procedure uses salt water to rinse nasal cavities and flush out pollens and other allergens.

# Nasal steroid sprays: These OTC nasal sprays are very effective in relieving symptoms and are quite safe.

Tips to keep asthma at bay during summers

# Stay informed: Keep a check on the weather and local area air quality forecast and don’t let the heat stump you. Be informed before stepping out in the sun.

# Keep reliever handy: Keep your asthma reliever close at hand since symptoms might appear anytime, more so in searing heat.

# Act wise: Limit your outdoor activities and exercises if the weather is oppressively hot and always keep your asthma medication cool.

# Stay cool: It’s extremely important to keep your body cool in extreme heat by seeking refuge under a shade or indoors whenever possible, or by going for a swim.

# Have an action plan ready: It’s important to know early warning signs of a flare-up and have a checklist of steps to take immediately. Your doctor can guide you on this.

# Stay hydrated: This is a no-brainer. Drink lots of water to stay well hydrated, particularly when out in the hot sun.

# Start early: You can plan an early start for your outdoor activities or exercise regimen, to avoid the hottest part of the day.

# Don’t stop your medication: If you stop or cut down on your medication, you might experience an exacerbation of asthma symptoms.

In spite of all the precautions you may take, asthma symptoms may flare up suddenly owing to certain unavoidable triggers, and it may even require emergency care. At MNBC, our emergency specialists are equipped to handle all kinds of medical emergencies related to respiratory distress and our Pulmonologists are on call 24×7.

Common Infections That Summers Bring

Common infections in summer

Summer is upon us with its full fury as the mercury keeps rising. The scorching heat and the uncomfortable humidity make a bad cocktail, often bringing in their wake a clutch of typically summer-season infections that can affect our entire body, from our skin to the eyes to the gastric and respiratory systems and more.

Here are some of the common infections summer brings:

# Chicken pox: This is one of the common menaces of the summer season. Caused by the virus Varicella-zoster, it manifests in the shape of small, red rashes filled with fluid along with high fever, itchy skin, headache and appetite loss. The rashes turn into blisters and then crusts that peel off, leaving marks on the skin. Diabetics, cancer or TB patients or those with compromised immune systems are more vulnerable to this infection.

# Measles:Caused by the paramyxo virus and otherwise known as rubeola or morbilli, measles normally infects the lining at the rear of the throat. The early symptoms are cough, sore throat, high fever and red eyes. Subsequently, the body becomes peppered with measles rash and white spots. MMR vaccination is recommended as a preventive.

# Jaundice:A water-borne disease, jaundice can be a consequence of Hepatitis A caused by contaminated water or food. Without proper medical treatment, things can go south very quickly affecting liver function and leading to excess bile production. Symptoms can include yellow discoloration of the skin and whites of the eyes, foggy urine and itchy skin.

# Typhoid:Typhoid fever is another very common water-borne summer disease caused by the bacteria Salmonella typhi and spread by contaminated food and water. Usual symptoms of typhoid are general weakness, high fever, abdominal pain and appetite loss. A preventive vaccination is available for typhoid fever.

# Mumps:This is an extremely infectious viral disease typical to the summer season, afflicting primarily children. It spreads when an infectious person coughs or sneezes. Some common symptoms are fever, swelling in the salivary gland, body aches and headaches, appetite loss and feeling weak.

# Food poisoning: Triggered by consumption of contaminated food or water, often from roadside vendors, food poisoning is a very common summer-season illness. The heat and humidity provide a very conducive environment for bacteria and viruses to grow, which leads to food contamination. The condition is usually marked by stomach cramps, nausea, diarrhoea and/or vomiting.

Common cold: This is not the exclusive preserve of the monsoons or the cold season. Some families of bacteria and viruses actually thrive in the heat and humidity and the germs are easily spread when you tend to let your guard down. It is always advisable to cover your mouth while coughing or sneezing. You might need some cold medication.

# Asthma: The extreme heat and high humidity can also trigger asthma symptoms like shortness of breath and coughing, since the still air tends to trap dust and molds into the airways.

What can I do for protection against summer infections?

Try these simple tips:

# Avoid stepping out during peak sun hours

# Avoid direct exposure to the sun

# Increase your liquids intake

# Avoid roadside food or contaminated water

# Eat more fruits and vegetables

# Use sunscreen to prevent skin damage

# Wear light-coloured, loose-fitting clothes

# Keep your home clean and healthy

# Wash your hands after using the washroom

# Vaccinations like the MMR vaccine and the annual flu shot help

# Use mosquito-repellents where required

While we need to remember that prevention is always the best cure, it is not always possible to avoid exposure to conditions that may make us vulnerable to various infectious diseases. Do not delay is getting in touch with a doctor if you experience symptoms of any of the conditions. Our Internal Medicine specialists at Medica Siliguri are experienced in treating all types of infectious diseases and available 24×7 for emergency needs.

When Does A Fall At Home Get Serious?

Fall at home

Having a fall is quite a common occurrence among the elderly population, with generally 1 in 3 in the 65-plus population and 50% of those over 80 experiencing at least one fall annually. While most falls don’t result in serious injuries, the risk of broken bones in the wrist, arm, ankles, besides hip fractures, or worse, a head injury, always remains. It can also cause a severe dent in the person’s self-confidence and a sense of losing his/her independence.

What are the risk factors for a fall one can heed and minimize?

Most falls result from a combination of risk factors which include:

# Weakness of the lower body

# Vitamin D deficiency

# Difficulty walking and with balance

# Certain medications like sedatives or antidepressants

# Problems with eyesight

# Pain in the foot or using poor quality footwear

# Domestic hazards for slipping like uneven steps, a wet floor, dim lighting or throw rugs

What are the more serious consequences of a home fall?

# 1 out of 5 falls results in serious and debilitating bone injuries.

# Falls can lead to serious head injuries, particularly if the person is on certain medications like blood thinners. In fact, falls are the most common cause of traumatic brain injuries (TBI).

# Over 95% hip fractures are caused by falling, usually sideways.

# Sometimes the physical injury from a fall may not be serious, but it leaves the person fearful of routine daily activities, which in turn can make him/her weaker and more susceptible to falls.

What are the routine checks that should be carried out after a fall?

# Look for an underlying health condition: The checks should look for UTI, dehydration, anemia, pneumonia, a cardiac condition, strokes, including mild ones.

# Monitoring BP and pulse rate: Reading of the blood pressure and pulse is particularly significant if the fall is linked to lightheadedness or fainting.

# Blood tests: Doctors would usually go for a CBC or a complete blood cell count and check electrolytes levels, kidney function parameters and blood glucose levels. Falls are often triggered by too high or too low blood sodium or too low glucose levels.

# Review of medications: Doctors also check if the person is on medications like sedatives, tranquilizers or antidepressants, pain medication, BP and/or diabetes medication, etc which can spike the risk of falls.

# Check gait and balance: A gait assessment or watching minutely how the person walks. If gait and balance don’t seem OK, the doctor will either address the pain or discomfort impeding him/her or advise physical therapy.

# Check Vitamin D level: Research shows treating low vitamin D levels can help reduce fall risk in older adults. Weak and fragile bones are also caused by vitamin D deficiency.

# Screening for underlying heart or nerve conditions: Doctors often look for conditions like paroxysmal rapid atrial fibrillation, which can lead to a racing heart or a chronic neuro issue like Parkinson’s disease.

# Check vision: If the elderly fall patient hasn’t had an eye workup in a long time, it’s surely time for a comprehensive evaluation of eyesight.

What can I do to avert falls at home?

Here are some useful tips:

# Mop up spillages promptly

# De-clutter your home by removing loose rugs or wires

# Use anti-slip mats and rugs

# Ensure adequate lighting in all rooms, staircases and passages

# Keep furniture organized to minimize risk of bumping into stuff

# Seek help to fetch things that are out of your reach

# Don’t wear clothes that are too loose or are trailing so that you don’t trip

# Don’t walk on slippery floors, particularly with socks on

# Wear good quality and secure footwear that provides adequate ankle support

# Take good care of your feet. Visit a podiatrist if required

# Do strength-building and balance-training exercises regularly

# Avoid or limit your alcohol intake as it might raise your risk of a fall. Too much drinking can also contribute to osteoporosis

The broad takeaway is that elderly people who are frail and have pre-existing medical conditions stand a much lesser chance of recovering from fall-related injuries. Hence, it’s wise to be watchful and try and prevent a fall, particularly if you are 70 or more. Also remember, a fall can quickly turn serious, so keep out for signs of internal injuries like disorientation, sudden pain, temporary loss of consciousness or balance. 

At Medica Siliguri, our Emergency department is geared 24×7 to deal with home accidents and trauma, with specialist on call round the clock.

Living with Chronic Kidney Disease (CKD)

Chronic Kidney Disease

A gradual decline of kidney function over a period of time is called chronic kidney disease or CKD. Progressively worsening kidney function diminishes its ability to filter wastes from your blood, which then accumulate and reach dangerous levels. This can lead to complications like hypertension, anemia, weak bones, nerve damage and poor nutritional health. CKD also raises the risk of cardiac conditions and diseases of the blood vessels. If not treated, CKD could lead to kidney failure, requiring dialysis or transplant.

However, the silver lining is that if you take good care of yourself and stem the tide, you can still live a long and full life without being unduly impacted by the condition. Of course, damage that has already occurred can’t be reversed, but with proper care and treatment, you can prevent CKD from reaching an advanced stage, thus cutting the risks of associated health issues.

What are the known symptoms of CKD?

Very often symptoms don’t manifest till the disease has reached an advanced stage. Still, look out for these:

# A sense of unexplained fatigue

# Trouble concentrating

# Loss of appetite

# Difficulty sleeping

# Muscle cramps at night

# Swollen feet and ankles

# Puffiness around the eyes

# Dry, itchy skin

# Need to pass urine more often, especially during the night

What are the known risk factors for CKD?

While CKD can strike anyone, some groups are more vulnerable, like:

# Those who have diabetes

# Those suffering from hypertension

# Having a family history of kidney failure

# The elderly population

# Belonging to populations more prone to diabetes and high blood pressure, like Asians

# Having suffered any serious injury

When does CKD lead to kidney failure?

If CKD reaches Stage 4, severe kidney damage has already happened, and it’s extremely critical to slow down the loss of kidney function. However, if the patient progresses to Stage 5, kidney failure happens and he/she will need either dialysis or a transplant to live. However, even Stage 4 CKD patients might suffer kidney failure in certain cases.

Kidney failure happens when the organs lose 85-90% of their function, GFR (glomerular filtration rate) falls below 15% and the kidneys don’t function well enough to keep the body going.

What are the treatment options for kidney failure?

The two treatment options for kidney failure are kidney transplantation and dialysis, of which there are two types – hemodialysis and peritoneal dialysis.

# Kidney transplantation: This is a surgical procedure to replace a diseased kidney with a healthy kidney from a cadaver or a living donor. The new kidney can start functioning immediately, while special medication would be required to prevent the body from rejecting the organ. The patient though will need to stay on treatment for CKD.

# Hemodialysis: This treatment removes waste and extra fluids from your blood. It can be done at home or in a medical setup. The process uses a special filter to clean the blood and then return it to the blood stream, and typically takes 3-5 hours, thrice a week.

# Peritoneal dialysis: This is a home-based treatment and needs to be done on a daily basis. A minor surgery is required to place a catheter in the abdomen. In this process, the abdomen’s lining acts as a natural filter and blood is cleaned inside the body itself. Periodically, the used solution is drained out of the abdomen and refilled by fresh cleansing solution to repeat the process.

What can I do to look after myself better?

# Don’t forget your medicines: You must not miss your medication, even if you are feeling fine. Some medicines are prescribed to protect you from more serious problems in future.

# Eat healthy: A healthy and balanced diet can boost your wellbeing and prevent future damage. Eat plenty of fresh fruits and vegetables, whole grains, starchy food, dairy or dairy alternatives, beans or pulses, fish, eggs, etc. Avoid saturated fats, salt and sugar.

# Get into an exercise regimen: Regular physical activity will help boost overall health, increase energy, strengthen bones, keep your BP under check and help with sleep. Exercise also keeps heart disease at bay and helps fight depression. Patients with mild to moderate CKD should be able to exercise vigorously.

# Quit smoking: Kicking the habit can improve your overall health condition and cut the risk of other health issues.

# Watch the bottle: Avoid excessive alcohol intake and stick to permissible limits as advised by your doctor.

# Take your jabs: CKD makes you more vulnerable to infections. Hence it is advisable to go for the annual flu shot and the one-off pneumococcal vaccine.

# Regular monitoring & follow-ups: You must consult your doctor and care team on a regular basis and undergo prescribed tests to monitor your kidney function and other relevant parameters.

# Watch your weight: Shed those extra pounds if necessary. It will help you manage CKD better.

# Control diabetes: If you are a diabetic, it’s absolutely critical to maintain good glycemic control to put less pressure on your kidneys.

Dialysis is a life-saver in patients with kidney failure or end-stage kidney disease. When your damaged kidneys are no longer able to adequately filter out the toxins from your blood, the harmful toxins build up in your body and over a period can lead to multi-organ failure. Hemodialysis is an external filtering system that does the work of your kidneys. Medica Siliguri’s advanced dialysis unit uses the latest techniques to provide the most effective treatments.

GERD Is More Than Just Acidity

Symptoms of GERD

GERD or gastroesophageal reflux disease is the chronic form of acid reflux, when acid from the stomach continues to backflow into the mouth through the esophagus, causing acidity, heartburn, a sense of constriction in the throat and even difficulty swallowing. Acid reflux occurs when the lower esophageal sphincter (LES), a valve at the end of the esophagus, which is supposed to tighten the esophagus once food passes into the stomach, malfunctions and doesn’t shut properly. The acid backwash leaves an uncomfortable, persistent sour taste in the mouth.

What are the known symptoms of GERD?

Common symptoms include:

# Heartburn

# Bad breath

# Tooth enamel damage from hyperacidity

# Feeling of backflow of stomach contents

# Pain in the chest region

# Difficulty swallowing

# Dry cough

# Breathing distress

Are there any known causes of GERD?

While intermittent heartburn and acid reflux should not be too much cause for concern, GERD is a chronic condition where old habits and individual anatomy could play a role. Some probable causes include:

# Obesity that puts extra load on the stomach

# Hiatal hernia which tends to relax the LES

# Smoking

# Alcohol

# Pregnancy

# Certain medicines which weaken the LES, like anti-allergics, painkillers, sedatives and antidepressants

How can GERD be controlled?

Symptoms of GERD can be controlled through treatment and lifestyle modifications, like:

# Diet correction

# Quitting smoking

# Losing weight

# Exercising regularly

# Not drinking

# Eating smaller meals

# Avoiding tight-fitting clothes

# Sitting upright at least 3 hours after food

What are the diagnostic tools for detecting GERD?

# 24-hour impedance-probe study: In this diagnostic procedure, a flexible tube is inserted into the nose and pushed into the esophagus. The probe is fitted with sensors that can detect acid reflux into the esophagus.

# Upper GI tract endoscopy: A special tube fitted with a camera at its tip helps the doctor identify signs of damage in the intestines including ulcers, tumours or inflammation. Usually, a tissue sample is also taken for biopsy.

What medicines are prescribed for GERD?

# OTC antacids: Antacids help reduce the symptoms of acid reflux by reducing the impact of stomach acids.

When antacids don’t work with GERD, other options are used, like:

# H2 blockers: These include medicines like famotidine which curtail acid production in the stomach, thus relieving symptoms.

# PPIs: Proton pump inhibitors like esomeprazole and pantoprazole, besides reducing acid production, can also help heal the stomach lining.

# Surgery: If medication doesn’t work, the doctor might advise surgery to tighten the LES.

What are the common complications of GERD one should know of?

If GERD is left untreated, stomach acid backwash can damage the lining of the esophagus, leading to:

# Bleeding

# Ulcers

# Scarring

The corrosive acid can also cause a condition called ‘Barrett’s esophagus’ which elevates chances of a type of esophageal cancer. Around 10 to 15% of GERD patients are at risk.

When does one need emergency treatment for GERD?

Some such red-flag symptoms include:

# Persistent projectile vomiting

# Respiratory distress

# Difficulty swallowing

# Throwing up fluids with blood or coffee-like stuff

What is the prognosis for GERD?

Symptoms of GERD are usually controllable with medication and certain lifestyle changes including diet modification and correcting eating and sleeping habits. You can improve your quality of life considerably by diligently following the doctor’s advice.

Our Gastro Intestinal diseases department at Medica North Bengal Clinic provides comprehensive diagnostic and treatment facilities for all diseases/conditions related to the digestive tract, with 24×7 emergency services for aggravated conditions needing immediate intervention.