INDIGESTION AND DYSPEPSIA CAN BE SIGN OF CANCER

Routinely people feeling dyspepsia and indigestion are consulting doctor and taking medications. Many patient taking medicines over the counter first considering dyspepsia is normal. But, dyspepsia and indigestion can be alarming symptoms of your inside pathology.

Here in IMH, Dubai, a 52 year old male, resident of Pakistan, attended hospital with symptoms of bloating of abdomen and burning in upper abdomen, for 1 year, for which he was taking antacid and medicines off and on. He consulted Dr. Anoop Kumar Joshi, Specialist Gastroenterologist in IMH, who did his Helicobacter pylori test which was positive. Then he did Gastroscopy which revealed swelling, erosions and tiny ulcerations with thickened fold in the fundus of the stomach. Overall picture is suggestive of Gastritis only, but, Doctor felt it was not a routine gastritis. So he took biopsy. Biopsy report suggestive of a rare type of cancer that is MALOTMA (Mucosa associated lymphoid tissue) Lymphoma. Worldwide and in UAE, very limited number of cases has been reported.
This disease is a type of cancer and this is caused by bacteria that is Helicobacter pylori. 14 days of medicines may eradicate bacteria. This treatment can give cancer free life up to 75-80% of the cases.
After 14 days, H. pylori laboratory test was repeated and the result was negative. Patient symptoms improved completely. He had a follow-up with the Doctor once again. He also advised to consult Cancer Specialist. This patient gives an insight that simple symptoms of dyspepsia and burning in abdomen should not be treated blindly and patient should go at least once consult Gastroeneterologist to rule out any major disease.
H. pylori can be detected by simple laboratory test and Gastroscopy. H. pylori can cause serious abdominal problems with simple symptoms of indigestion diseases like ulcers and cancers. In International Modern Hospital, the facility for detection of H. pylori and treatment of ulcer and associated cancers are available with simple tests of H. pylori and Endoscopy.

Minimally Invasive Therapy (Lasers) in Treatment of Anorectal Disorders

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Anorectal disorders are a group of medical disorders that occur at the junction of the anal canal and rectum. These disorders are very common in the UAE population due to the local climatic changes and lifestyle choices. Almost 50% of  all people experience this problem at least once in their lives by the age of 50. 75% of these disorders will worsen and progress if not treated at the right time.

The 4 most common problems encountered by people are hemorrhoids,anal fistula,anal fissure and pilonidal sinus.Almost 50% or more of patients seen by a Surgeon in his daily practice constitute these problems.Most of these disorders occur due to wrong diet ( lack of fibre and fluids), wrong lifestyle( less physical activity),constipation,laxative misuse, weak connective tissues and other causes. Of these, hemorrhoids are the most common and constitute around 60 to 65% of cases.

People who suffer from these problems present with bleeding while passing stools,painful stools,discharge,itching,swelling and at times fever.

It is important for these people to see a Surgeon at the earliest to enable an accurate diagnosis and initiate early treatment to prevent further complications. Over the counter medications  and creams are of limited use as almost all of these conditions present with more or less the same complaints, however the treatment is completely different for each one of them.

A proper history,physical examination by a Surgeon and relevant lab and other radiological tests may be required for a proper diagnosis and treatment of these conditions.

Till now, only traditional methods of surgery were available to treat these conditions causing a lot of pain, bleeding,large wounds and prolonged healing times for the patient. This prevented a lot of patients from seeking medical advice and undergoing treatment at the right stage.

However, with new developments in the field of surgery and  rapid advances in technology, new minimally invasive modalities are now available for treating these conditions. Of these, Lasers offer the most effective, safe and reliable method for treatment.Lasers have a tremendous benefit over an open operation in that they are painless, almost bloodless, have a short operative time of 15 to 20 minutes, cause no anal narrowing or loss of stool control,have no muscle or skin damage,no need for insertion of stitches or other foreign bodies and subsequently have much faster healing time. Patients can return to their normal work and activities in 4 to 5 days time.

These however, need to be performed by  experienced Surgeons who have undergone extensive training in this specialty and have the know how and technical expertise.

Patients who suffer from these disorders should take full advantage of this new option available  to them with the host of benefits it offers. So, my advice to those with these problems is “ Act now ,don’t suffer in silence!”

How To Prevent Common ENT Disorders

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There are many ways to prevent ENT disorders, though it is not always possible, as in the case of congenital conditions. However, multiple ENT disorders can be prevented. Here are some things you can do to prevent ENT disorders. Frequent hand washing is the single most important thing you can do to prevent infection. Avoid exposure to illness, and practice good hygiene, such as covering your mouth when you cough and staying at home when you are sick.
Since it is difficult to teach good hygiene to small children, toddlers who attend daycare or preschool are at a higher risk of developing chronic ENT disorders.

Preventing Ear Infections

Ear infections are a common ENT disorder. They occur when germs enter the ear and become trapped there. Due to their infectious nature, there are many things you can do to prevent ear infections. Certain inherited traits, though, make some people, especially children, more prone to ear infections.

Here are a list of ways to prevent ear infections:
• Avoid exposure to cigarette smoke.
• Identify and treat allergies.
• Keep your child’s immunizations up to date.
• Do not remove earwax unless your physician tells you to.

Preventing Sinus Infections
Sinus infections occur when germs enter one of the hollow cavities in the skull surrounding the eyes and nose. A sinus infection may feel like a very bad cold that doesn’t go away after the usual 2 to 3 weeks.

Here are some ways you can protect yourself.
• If you have a cold, use a saline nasal spray (available over the counter) to keep your nasal passages from becoming blocked.
• Do not fly if you have a cold. If you must fly, consider use of a decongestant and nasal spray 30 minutes before take-off.
• Identify and treat allergies; long-term sinusitis is usually caused by allergies, while acute sinusitis is usually caused by bacteria.
• Try using saline nasal spray daily for chronic sinusitis.

Preventing Sore Throat
There are many causes of sore throat, including infections, acid reflux, sleep apnea or more severe and rare disorders, such as cancer. A very common cause of sore throat is a bacterial or viral infection, so practicing good hygiene, such as frequent hand washing, is a good way to prevent sore throat. Here are some other suggestions:
• Get plenty of rest and exercise to bolster your immune system.
• Avoid exposure to cigarette smoke.
• Do not spend long periods of time outside when the air quality in your area is poor.
• Treat esophageal reflux.

Preventing Snoring and Sleep Apnea

Sleep apnea is a condition where a person stops breathing for brief periods of time while asleep. It is very common in the United Arab Emirates and can be harmful if left untreated. Fortunately, there are many treatments available, and sleep apnea can often be cured. Here are some good ideas to prevent or keep sleep apnea at bay.
• Maintain a healthy body weight.
• Avoid alcohol or sedatives at bedtime.
• Identify and treat tonsillitis, nasal polyps or other disorders that can cause airway obstruction.
• Quit smoking.

Not all ENT disorders can be prevented. Many depend on inherited traits; however, following these suggestions may serve to keep you healthier in the future. Hand washing remains at the forefront of disease prevention, along with other isolation practices, including coughing in to your sleeve and staying at home while you are sick. These guidelines can also help strengthen your immune system, decreasing the likelihood of catching an illness and limiting the amount of time you spend sick.

Not paying attention to your nasal symptoms may turn your sinusitis chronic

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Headache disorders Info Graphics in circle.Vector illustrationsApproximately 20% of the UAE population suffers from Chronic Sinusitis. Symptoms range from stuffy nose, nasal blockage, headache, facial pain, postnasal discharge, cough and bad breath. These are all symptoms of chronic sinusitis. The weather in UAE plays a significant role in the development of these symptoms. Fine sand in the air, humidity, allergies, sudden temperature changes too trigger it. Deviation of the nasal septum and nasal polyps too can lead to chronic sinusitis.

KNOW YOUR SYMPTOMS

When you have chronic sinusitis, the mucous membrane of the nose, sinuses and throat get inflamed, possibly from a pre-existing upper respiratory tract infection or allergies. Swelling obstructs the sinus opening and prevents normal mucous drainage, causes mucous and pressure to buildup.

Symptoms include – thick greenish post nasal discharge, nasal stuffiness, and pain around the eyes, cheeks, nose and forehead. There could be an associated reduced sense of smell and or taste.This condition if not treated on time can lead to Bronchitis, asthma or other respiratory diseases,

Many people with sinusitis either silently suffer or opt for self medication, making the problem worse leading to a chronic ailment. A common cold is usually caused by a viral infection and it gets better in approximately a week’s time. If it lasts for more than that, you need to see a Doctor.

HOW TO GET WELL

sinus-1Visual inspection, nasal endoscopy and CT scan, paranasal sinuses can help screen for chronic sinusitis. A CT scan can accurately diagnose chronic sinusitis. Once diagnosed, it is treated with nasal decongestants, steroid nasal sprays, antihistamines, antibiotics etc.
Sinus surgery may be required when conservative treatment fails. Endoscopic sinus surgery is done under local or general anesthesia. The main aim of the surgery is to enlarge the natural opening of the sinuses and to restore the normal sino-nasal ventilation and drainage.

HOME REMEDIES THAT CAN HELP

  • Steam inhalation
  • Saline spray
  • Pain in the nose and sinuses can be relieved by warm compress.

TIPS TO AVOID SINUSITIS

  • Keep yourself hydrated – Drinking water prevents mucus from thickening and blocking the sinuses.
  • Avoid smoking – Smokers are more prone to suffer from sinusitis.
  • Consult a Doctor if a cold persists for more than 10 days.
  • Complete prescribed course of antibiotics. When indicatedHeadache disorders Info Graphics in circle.Vector illustrations

Pain Management Clinic

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Pain is defined by International Association for study of Pain as an unpleasant sensory and emotional experience with actual or potential tissue damage.

Conquering pain has been a major limitation for the more evolved human race. Pain imposes a burden on those who suffer from it and impairs quality of life. Most often, it is the common symptom that brings the patient to see a Physician. Pain most commonly presents as a warning sign for any pathological process in the body nevertheless may also cause agony without a specific purpose. The most common forms of pain encountered in daily medical practice are musculoskeletal pain 30-40 %, neck and back pain 30%, headaches less than 10%, and cancer pain 1-2 %.

            Pain Clinic at International Modern HospitalPain may be classified into different types based on the origin, duration, periodicity and nature of pain. Accordingly, Pain management can broadly be classified as acute and chronic pain management. While acute pain deals with perioperative pain, pain in labour, trauma, burns etc., and the latter includes a diverse group of patients in the outpatient setting. The management of acute pain is primarily therapeutic. Chronic pain management requires various pharmacological and non pharmacological approaches to tackle the multidimensional components of pain. At International Modern Hospital we take a holistic approach so as to not only treat the underlying cause but also provide psychological support and rehabilitation to ailing patient.

Pain Clinic at International Modern HospitalPain management largely comprises of pharmacological and non-pharmacological modalities, commonly being medication, counselling, relaxation techniques, electrical stimulation and local anaesthetics. Few Prescribed medications include anti-depressants and systemic local anaesthetics.

Pain Clinic at International Modern HospitalAt International Modern Hospital we undertake Interventional modalities which include diagnostic and therapeutic nerve blocks, facet blocks, epidural steroids, intra articular injections, trigger point injections for myofacial syndromesetc. Therapeutic adjuvants include Psychiatric counselling, physiotherapy and electrical stimulation. Unrelieved and inadequate relief of pain is continuing to be a global health problem and serious efforts have to be taken to provide pain treatment as it is definitely a basic human right.

It may be real or unreal , but their distress is real!!!

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 “ Real beauty isn’t about symmetry or weight or makeup; it’s about looking life right in the face and seeing all its magnificence reflected in your own.”

(Valerie Monroe)

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“15 yr old 10th grade girl, not attending school, saying that she was not good looking and her face has some asymmetry. She doesn’t want to go out, and if at all she goes out, she covers her most of her face with scarf. She expresses severe suicidal ideas and was very much depressed.”

Most of us have something we don’t like about our appearance — a crooked nose, an uneven smile, or eyes that are too large or too small, but they don’t interfere with our daily lives.

Body Dysmorphophobic Disorder (BDD) people think about their real or perceived flaws for hours each day.

bdd-1They can’t control their negative thoughts and don’t believe people who tell them that they look fine. Their thoughts may cause severe emotional distress and interfere with their daily functioning. They may miss work or school, avoid social situations and isolate themselves, even from family and friends, because they fear others will notice their flaws.

They may even undergo unnecessary plastic surgeries to correct perceived imperfections, never finding satisfaction with the results.

Who they are? & what they do?

BDD is a body-image disorder characterized by persistent and intrusive preoccupations with an imagined or slight defect in one’s appearance.

They can dislike any part of their body, but most commonly find fault with their hair, skin, nose, chest, or stomach. In real sense, a perceived defect may be only a slight imperfection or nonexistent, but for people with BDD, the flaw is significant and prominent, often causing severe emotional distress and difficulties in daily functioning.bdd-1

Most often it develops in adolescents and teens, and research shows that it affects men and women almost equally.

They suffer from obsessions about their appearance that can last for hours or up to an entire day. This can lead to low self-esteem, avoidance of social situations, and problems at work or school.

They may avoid leaving their homes altogether and may even have thoughts of suicide or make a suicide attempt.

They may perform some type of compulsive or repetitive behavior to try to hide or improve their flaws.

 Examples are:

  • Camouflaging (with body position, clothing, makeup, hair, hats, etc.)
  • comparing body part to others’ appearance
  • seeking surgery
  • checking in a mirror
  • avoiding mirrors
  • skin picking
  • excessive grooming
  • excessive exercise
  • changing clothes excessively

Treatment

CBT & Antidepressants

“The human body is the best work of art.” 

(Jess C. Scott)

It’s Ability and not Disability

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“Let us work together for the full and equal participation of persons with disabilities in an inclusive and sustainable world that embraces humanity in all its diversity.” 

(UN-Secretary-General Ban Ki-moon)

According to the 2011 World Report on Disability by the World Health Organisation, there are an estimated 1 billion persons with disabilities worldwide. It also states that 1 in 5 of the world’s poorest people has disabilities

Numbers

  • 7 billion people: world population.
  • Over 1 billion people in the world have some form of disability, that’s 1 in 7.
  • More than 100 million disabled persons are children.
  • Children with disabilities are almost four times more likely to experience violence than non-disabled children.
  • 80% of all people with disabilities live in a developing country.
  • 50% of disabled persons cannot afford health care.

Disability

A condition or function judged to be significantly impaired relative to the usual standard of an individual of their group. It used to refer to individual functioning, including physical impairment, sensory impairment, cognitive impairment, intellectual impairment, mental illness, and various types of chronic disease.disability-5

Persons with disabilities

“The world’s largest minority”, has generally poorer health, lower education achievements, fewer economic opportunities and higher rates of poverty than people without disabilities. This is largely due to the lack of services available to them (like information and communications technology (ICT), justice or transportation) and the many obstacles they face in their everyday lives. These obstacles can take a variety of forms, including those relating to the physical environment, or those resulting from legislation or policy, or from societal attitudes or discrimination.

International Day of Persons with Disabilities, 3 December 2016- “Achieving 17 Goals for the Future We Want”.

The 2030 Agenda has 17 goals for sustainable development. disability-7

Disability is referenced specifically in parts related to education, growth and employment, inequality, accessibility of human settlements.

Goal 4 on inclusive and equitable quality education and promotion of life-long learning opportunities for all focuses on eliminating gender disparities in education and ensuring equal access to all levels of education and vocational training for the vulnerable, including persons with disabilities.

Goal 8: to promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all, the international community aims to achieve full and productive employment and decent work for all women and men, including for persons with disabilities, and equal pay for work of equal value.

Goal 10, which strives to reduce inequality within and among countries by empowering and promoting the social, economic and political inclusion of all, including persons with disabilities.

Goal 11 would work to make cities and human settlements inclusive, safe and sustainable. To realise this goal, Member States are called upon to provide access to safe, affordable, accessible and sustainable transport systems for all, improving road safety, notably by expanding public transport, with special attention to the needs of those in vulnerable situations, such as persons with disabilities. In addition, the proposal calls for providing universal access to safe, inclusive and accessible, green and public spaces, particularly for persons with disabilities.

Goal 17 stresses that in order to strengthen the means of implementation and revitalise the global partnership for sustainable development, the collection of data and monitoring and accountability of the SDGs are crucial.

 Inclusive society

Evidence and experience shows that when barriers to their inclusion are removed and persons with disabilities are empowered to participate fully in societal life, their entire community benefits.

disability-2The Convention on the Rights of Persons with Disabilities (CRPD) recognises that the existence of barriers constitutes a central component of disability.

Accessibility and inclusion of persons with disabilities are fundamental rights recognised by the Convention on the Rights of Persons with Disabilities.

“Science may have found a cure for most evils; but it has found no remedy for the worst of them all – the apathy of human beings.”

(Helen Keller)

Stuttering

What is stuttering? 

Stuttering is a communication disorder in which the  smooth continuous flow of speech is broken by repetitions (I- I -I want), prolongations (lllllet  me go), or abnormal stoppages (no sound silence pauses) of sounds and syllables . There may also be unusual facial and body movements associated with the effort to speak. Stuttering is also called to as stammering. But if you talk effort fully, with multiples disruptions that should be taken into consideration.stutter-2

What causes stuttering? 

There are four factors most likely to contribute to the development of stuttering:

Genetics (approximately 60% of those who stutter have a family member who does also);

Child development (children with other speech and language problems or developmental delays are more likely to stutter);

Neurophysiology (recent neurological research has shown that people who stutter process speech and language slightly differently than those who do not stutter);

and family atmosphere  (high expectations and fast-paced lifestyles can contribute to stuttering).

What is the ratio of males to females who stutter?

Males are affected four times more than females.

I think my child is beginning to stutter.

Should I wait or seek help? It is best to seek ways that you, the parents. How can I help him/her as soon as possible? If the stuttering persists beyond three to six months or is particularly severe, you may want to seek help from a speech-language pathologist who specializes in stuttering right away.

Can stuttering be treated?

Yes, of course there are a variety of successful approaches for treating both children and adults. In general, the earlier, the better……

Shot of a little boy talking to a psychologist

I read about a new cure for stuttering. Is there such a thing? 

There are no instant miracle or treatment cures for stuttering. However, a specialist in stuttering can help not only children but also teenagers, young adults and even older adults make significant progress toward fluency.

Good Sleep is a Reachable Dream

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Sleep:

Natural periodic state of rest for the mind and body, in which the eyes usually close and consciousness is completely or partially lost, so that there is a decrease inbodily movement and responsiveness to external stimuli.

Why to Sleep?

It plays a vital role in good health and well-being throughout your life. It protects your mental health, physical health, quality of life, and safety. We spent 33% of our lives in sleep.

Normal requirement:
3   to 5   yrs  —-  10 to 13  hrs
6   to 13 yrs  —-  9   to 11  hrs
14 to 17 yrs  —-  8   to 10  hrs
Adults           —-  7   to 9    hrs

Stages of Sleep

sleep-1Sleep follows a pattern of alternating REM (rapid eye movement) and NREM (non-rapid eye movement) sleep throughout a typical night in a cycle that repeats itself about every 90 minutes. NREM (75% of night): As we begin to fall asleep, we enter NREM sleep, which is composed of stages 1-4. REM (25% of night).

Numbers!
Almost 60 % of total population reports sleep problems at any point of their life time. Roughly 1/3 of general population are having sleep problems at any given time.

Common Sleep Disorders:

Insomnia (initial, middle, terminal insomnias or non restorative sleep).
Sleep apnea.
Restless legs syndrome.
Narcolepsy.

Impacts of Poor Sleep:

sleep-3Persons get irritable and exhausted, easily distracted and often don’t make sound decisions. Sleep deprivation negatively impacts the immune system, may also lead to weight gain, high blood pressure, cancer, heart disease, stroke, diabetes, bone loss and depression Sleep deprivation may also impair learning, memory, alertness, concentration, judgment, problem solving and reasoning, as well as increase your risk of accidents.

Assessment:

    • Keep a sleep log, Polysomnography (sleep lab)
    • How to treat?
    • Sleep hygiene
    • Medicines
    • Behavioral treatments
    • Surgery (OSA)

Sleep Hygiene:

  • Avoid napping during the day.
  • Avoid stimulants such as caffeine, nicotine, and alcohol too close to bedtime.
  • Exercise can promote good sleep.
  • Food can be disruptive right before sleep.
  • Ensure adequate exposure to natural light.
  • Establish a regular relaxing bedtime routine. Associate your bed with sleep.
  • Make sure that the sleep environment is pleasant and relaxing.

Medications: What to know about it?

  • Avoid as much as possible.
  • Always with advice from the specialist.
  • Be cautious about addiction.
  • Avoid driving while on medications.

“Sleep is that golden chain that ties health and our bodies together”

(Thomas Dekker)

Language Problem or Late Talking?

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 Our parents are smart. They are really concern about their child talk and how he / she communicate. They also listen to his or her peers who are at same age and may compare what older brothers and sisters did at the same age. This is how our parents mentally compare their child’s performance with other children. They immediately create an impression of whether the child is developing speech & language at normal rate or not.

st3If parents feel that development is slow, they check their impression with the other parents, relatives, and their pediatrician. You probably get an answer such as Oh!! Don’t worry, he / she will outgrow it. Look at my child she was so quiet and now she is a chatter box, give him/her time.

But…… suppose he / she doesn’t? Even after giving adequate time. 

st2You would feel guilty waiting and then finding out that I should have acted earlier. Waiting is so hard, why we have to be frustrated at last . We want the best for our child. What’s a parent to do?

But……. You’re not sure of what to do.

st1It’s hard to say the exact age when they hit speech and language milestones. It varies a lot on factors such as the child’s inborn ability to learn language, other skills the child is learning, the amount speech and language input he/she gets. and how others respond to his/her communication attempts .

Do you praise him/her? Listen to him/her carefully?

These factors can slow down or accelerate the speed of speech and language development of our children. Be aware of the certain factors that may increase the risk of late-talking child in the 18 to 30 month old age range even with normal intelligence.

The sooner The Better

If you are concerned about your child’s speech and language development, you should see a speech-language pathologist. The speech-language pathologist may suggest on early intervention program with follow up sessions. It’s important to have formal therapy sessions in case of severe problems.

Do you really want to wait for him/her to outgrow???Don’t leave a chance which leads you to feel guilty that I would have done with everything I could