Double Helical July 2018

RNI No. : UPENG /2014 / 59232 A

CO M PLE TE

July 2018

HE A LTH

J O U RN A L

VOL IV, Issue VIII, Rs. 100

Prof. Ramesh K. Goyal, Ph.D.

India’s March to Halt the Emerging Cardiovascular Epidemic

Dr. A K Aggarwal

Headphones & Hearing Problems – Are You Listening?

ALL IS NOT WELL

Contents Volume IV Issue VIII July - 2018 Advisory Board

Dr. A K Agarwal, Professor of Excellence, Ex-President, Delhi Medical Council and Medical Advisor, Apollo Hospital, New Delhi

Dr Vinay Aggarwal.

Member, Medical Council of India Dr. S P Yadav, Member, Medical Council of India Dr. J C Passey, Medical Director, LNJP Hospital,New Delhi Dr. Suneela Garg, Head, Department of Community Medicine, Maulana Azad, Medical College, New Delhi Dr. H P Singh, Sr. Child Specialist

COVER STORY

24

All is not well

10

Editor & Publisher Amresh K Tiwary Coordinating Editor Sarvesh Tiwari

34

Roaming Editor Dr. Manisha Yadav Editorial Team Hrishi Kumar, Abhigyan, Abhinav Advertisements & Marketing Monaly Sinha, Abhinav Kumar, Vikas Email:sales@doublehelical.com

Promoting Safe Abortions Medication Side Effects

18 India’s March to Halt the Emerging Cardiovascular Epidemic

Designer Aparna Thomas All material printed in this publication is the sole property of Double Helical Pvt. Ltd. All printed matter contained in the magazine is based on the information by those featured in it. The views, ideas, comments and opinions expressed are solely of those featured and the Editor and Publisher do not necessarily subscribe to the same.

Double Helical is owned, printed and published monthly. It is printed at Polykam offset, Naraina Industrial Area Phase 1, New Delhi-110028, and published from G-1, Antriksh Green, Kaushambi, Ghaziabad-201 010.

Tel: 0120-4165606 / 9953604965.

Gamming Addiction

30

52

Stay Sexually Agile After 50 Contact us : contact@doublehelical.com Email: doublehelicaldesign @gmail. com, editorial@doublehelical.com Website: www.doublehelical.com, www.doublehelical.in

40

Need of Woman and Child Hospital

Facebook: https://www.facebook.com/Double-Helical-1783106448421622/?modal=admin_todo_tour Twitter: @HelicalDouble Youtube: https://www.youtube.com/channel/UCmbMtYUwuppYzDHd_OrcMfg/featured?view_as=subscriber July 2018

3

Editorial

Double Helical once again organizes National Health Awards

D

ear readers, Thank you for your continuous support and encouragement. With your kind bless Double Helical once again organizes Double Helical National Health Awards 2018 at a glittering ceremony likely to be held in New Delhi on September 2018.

In this concern team Double Helical humbly seeks your support and blessings to make the event a success for the further advancement of this noble profession and welfare of the suffering humanity.

These times we highlight many informative stories. As a cover story Depression which is a common but serious mental illness. Most who experience depression need treatment to get better. The feelings like sadness, hopelessness, guilt, moodiness, angry outbursts, loss of interest in friends, family and favourite activities including sex drive point to the presence of depression. This also affects your thoughts, behaviour and your overall physical health.

During the treatment of depression, it is found that other illnesses may come on before depression, cause it, or be a consequence of it. But depression and other illnesses interact differently in different people. In any case, cooccurring illnesses need to be diagnosed and treated.

The most common behaviour patterns are withdrawing from people, substance abuse, missing work, school or other commitments and attempts to harm yourself. The persons who are under depression may face physical problems like tiredness or lack of energy, unexplained aches and pains, changes in appetite, weight loss and gain, changes in sleep – sleeping too little or too much and sexual problems.

It has been widely documented that women suffer from major depression about twice as often as men. Because the incidence of depressive disorders peaks during women’s reproductive years, it is believed that hormonal risk factors may be to blame.

Women are especially prone to depressive disorders during times when their hormones are in flux, such as around the time of their menstrual period, childbirth, and perimenopause. In addition, a woman’s depression risk declines after she goes through menopause.

It’s estimated that 10 to 15 percent of the general population will experience clinical depression in their lifetime. And the World Health Organization estimates 5 percent of men and 9 percent of women experience depressive disorders in any given year.

The story on Headphones and Hearing Problems written Dr A K Aggarwal reveals that gadgets and technologies

4

DOUBLE HELICAL

were aimed to make life entertaining but not at the cost of one’s own health. Improved technologies have made the mankind get entrapped in the comforts and luxuries, leading to imposition of many side effects on health. Ear phones and headsets are one such technology! Forced, improper or over use of ear phones, headsets, leads, iPods, and Bluetooth can cause impairment or loss or damage to hearing. Their use not only affects the user but the surroundings too. Exposing your ears to prolonged & high intensity of noise more than 85 db can lead to permanent hearing loss which can never be recovered back and permanent damage can occur.

Cochlea is the main sense organ of hearing & has very delicate hair cells which detect sound frequencies. These hair cells can get damage if exposed to prolonged duration of sound intensity of around 85- 125 db like from the noise of aeroplane or missile or gun firing or listening to head phones at very high volumes.

Once these hair cells are damaged they generally do not recover specially if the high intensity exposure is not controlled and patient may experience hearing loss at high intensities , continuous ringing or buzzing sensation called tinnitus , headache , irritation ,lack of sleep , depression and difficulty in routine day to day activities. Then they may require the support of hearing aids & when profound hearing loss occurs where hearing aids also don’t benefit they may require a cochlear implant surgery.

Studies suggest that gaming disorder affects only a small proportion of people who engage in- or video-gaming activities. However, people who partake in gaming should be alert to the amount of time they spend on gaming activities, particularly when it is to the exclusion of other daily activities, as well as to any changes in their physical or psychological health and social functioning that could be attributed to their pattern of gaming behaviour.

The WHO said classifying gaming addiction as a mental health disorder “will result in the increased attention of health professionals to the risks of development of this disorder and, accordingly, to relevant prevention and treatment measures Significant research attention needs to be given to this newly recognized disorder to improve understanding of risk factors to development, appropriate treatment and intervention strategies.

There are many more informative and though-provoking stories, based on intensive research and analysis. So, happy reading to all of you!

Amresh K Tiwary, Editor-in-Chief

Health News

F^aZbW^_ ^] ?^_d[PcX^] BcPQX[XiPcX^]

I

n recently held workshop on population stabilization J P nadda, Union Minister of Health and Family Welfare, said, “We are addressing the issue of population stabilization in the country within the lifecycle framework. As part of this strategy, right from the time of conception till the child grows, various programs of the Ministry cater to the needs of immunization of the pregnant mother and the child, carrying on till the adolescent stage and further. Also, it is part of the comprehensive strategy being implemented through various Ministries and Departments.�

On the occasion of World Population Day 2018, at the Pravasi Bhratiya Kendra, New Delhi. The workshop was jointly organized by the Ministry of Health & Family Welfare and Jansankhya Sthirta Kosh.

The Union Minister stated that it is a matter of pride for the country that we have been able to achieve steady decline in the Total Fertility Rate (TFR).

From a TFR of 2.9 in 2015 to a TFR rate close to 2.2 in 2018, means India is progressing at a good rate of decline, he added. He said that over the last few years, a host of new initiatives have been undertaken under the Family Planning programme such as expanded choice of contraceptives, Mission ParivarVikas in 146 High Priority Districts (HPDs) in the 7 high focus states, Family Planning Logistics Management Information System (FPLMIS), a comprehensive 360 degree media campaign including a dedicated FP webpage, radio chat shows etc. in an effort to take services down to the last mile. The recent expansion of basket of choices is poised to further impact the contraceptive coverage in the country. The Government is extensively focusing on strengthening post pregnancy contraception (postpartum as well as post-abortion) to meet the unmet need for family planning specifically in the immediate post-partum and post-abortion period.

6

DOUBLE HELICAL

Shri Naddastated that the population stabilization efforts have an economic argument attached to it, as the demographic dividend of the country can be harnessed only when the population is healthy. The Lifecycle Framework ensures that the health and wellbeing of the mother and child, carrying in the adolescent stage and further is taken care of.

Nadda stated that the programs and interventions under the umbrella of National Health Mission have played a very crucial role in this. As part of the Mission Parivar Vikas program, the focus is on creating awareness about the expanding choices of family planning and on ensuring that the services are easily accessible by the people, he stated.

J P Nadda also gave away ‘Prerna Awards’ to BPL couples who have broken the stereotype of early marriage, early childbirth and repeated child birth and have helped change the mindsets of the community.PRERNA, a Responsible Parenthood Strategy is being implemented in seven focus states namely Bihar, Uttar Pradesh, Madhya Pradesh, Chhattisgarh, Jharkhand, Odisha, and Rajasthan.

The Union Minister also conferred awards to the winners of the painting competition organised by Jansankhya Sthirita Kosh to create awareness regarding family stabilisation among young children.2000 schools of NCR had participated in the painting competition. The theme was: Small Family, Happy Family.

Also present at the function were Preeti Sudan, Secretary (HFW), Manoj Jhalani, AS&MD, Preeti Nath, Executive Director, Jansankhya Sthirata Kosh and Dr S Venkatesh, Dirctoe (DGHS) along with other senior officers of the Ministry and representatives of development partner

Health News

J P Nadda, Union Minister of Health and Family Welfare releasing guidelines on National Viral Hepatitis Control Program at a function, here today. Shri Manoj

Sinha, MoS (Independent Charge), Ministry of Communication along with Shri Ashwini Kumar Choubey and Smt Anupriya Patel, Ministers of State for

Health and Family are also seen along with other dignitaries.

J P Nadda, Union Minister of Health and Family Welfare and Shri Manoj Sinha, MoS (Independent Charge), Ministry of Communication releasing the commemorative stamp at the launch of National Viral Hepatitis Control Program. Shri Ashwini Kumar Choubey and Smt Anupriya Patel, Ministers of State for Health and Family are also seen along with other dignitaries. The learning/teaching and evaluation methods for NIeCer course- Health Research Fundamentals

8

DOUBLE HELICAL

Concern - Dental Care

Match Your Natural Teeth Many of Indians suffer tooth loss -- mostly due to tooth decay, periodontal disease, or injury. For many years, the only treatment options available for people with missing teeth were bridges and dentures. But, today, dental implants are available‌

BY ABHIGYAN /ABHINAV

10 DOUBLE HELICAL

www.doublehelical.com

D

ental implants are replacement tooth roots which provide a strong foundation for fixed (permanent) or removable replacement teeth that are made to match your natural teeth.

Success rates of dental implants vary, depending on where in the jaw the implants are placed but, in general, dental implants have a success rate of up to 98%. With proper care implants can last a lifetime. Dental implants can be used to replace a single tooth, several teeth, or all of the teeth. The goal of teeth replacement in dentistry is to restore function as well as esthetics.

When it comes to tooth replacement, generally, there are three options like removable dental appliance (complete denture or partial denture), fixed dental bridge (cemented), and dental implant.

Dentures are the more affordable option for replacement teeth but are the least desirable because of the inconvenience of a removable appliance in the mouth. Furthermore, dentures can affect one’s taste and sensory experience with food. Dental bridgework was the more common restorative option prior to the relatively recent shift to dental implant treatment.

The main disadvantage to bridgework is the dependence on existing natural teeth for support. Implants are

supported by bone only and do not affect surrounding natural teeth.

Deciding on which option to choose depends on many factors. Specifically for dental implants, these factors include • Location of missing tooth or teeth, • Quantity and quality of the jawbone where the dental implant is to be placed, • Health of the patient, • Cost, and • Patient preference.

A dental surgeon examines the area to be considered for the dental implant and makes a clinical assessment of whether the patient is a good candidate for a dental implant.

There are great advantages to choosing a dental implant for tooth replacement over the other options.

Dental implants are conservative in that missing teeth can be replaced without affecting or altering the adjacent teeth. Furthermore, because dental implants integrate into the bone structure, they are very stable and can have the look and feel of one’s own natural teeth.

Implant surgery can be performed by any licensed dentist provided that the treatment follows the standard of care and is in the best interest of the patient.

However, since implants are surgically placed in the jawbone, dental specialists

who routinely perform surgery within the jawbone are the natural fit for implant surgery. Oral maxillofacial surgeons (oral surgeons) treat all hard and soft-tissue diseases or defects, which includes extraction of teeth and jaw surgeries. Periodontists treat disease of the surrounding structures of teeth such as the gum and jawbone.

Both oral surgeons and periodontists often specialize in dental implant placement.

Once the implant has integrated fully into the jawbone, the next phase involves placement of the implant crown that will be supported by the implant. This is typically performed by the general dentist or a prosthodontist (dental specialist focused on tooth replacement).

Dental Implants are the ideal solution for replacement of missing teeth and they have changed the face of Dentistry over the last 25 years. A Dental Implant is a titanium post (like a tooth root) that is surgically placed into the jawbone beneath the gum line that allows the Implantologist to fix a crown on the top of that, thereby providing the appearance of a natural tooth. Implants look, feel and function like natural teeth thereby offers the most realistic, long lasting solution for the restoration of functionality of your smile.

The key to the success of all implants is a process called osseointegration.

July 2018 11

Concern - Dental Care

overall health. Raw fruits and vegetables require more chewing. Someone who finds it difficult to chew may avoid them.

Other options, such as blending, pureeing and juicing, are not always considered.

The loss of teeth can change your bite, the way your teeth come together.

Changes in your bite can lead to problems with your jaw joint, called the temporomandibular joint.

Losing teeth can lead to changes in your speech. This also can affect your self-confidence.

THERE ARE SEVERAL TYPES OF IMPLANTS, INCLUDING: • Root form • Subperiosteal • Mini Root-form implants are the most common type used today. A root-form implant is made of titanium. It looks like a small cylinder or screw. After an implant is placed in the jawbone, a metal cylinder called an abutment eventually is attached to it. The abutment serves as a base for a crown, denture or bridge.

Dr. Suresh Ahlawat This is how the bone in the jaw grows into and around the implant. Titanium is a special material that the jawbone accepts as part of the body. Depending on your particular problem, implants can be more expensive than the alternatives (denture or bridge). The fees will depend on many factors and vary considerably.

A few insurance companies cover implants, but may have low annual dollar limits. You should always check with your insurer.The upfront cost for implants can be more than for other types of restorations. But the investment can pay off in the long run. You may not need an implant for every missing tooth.

Your dentist can discuss how many implants you will need.

If you are considering implants, you must have healthy gums and adequate bone to support the implant. If your bone is too thin or soft and unable to support an implant, you may require a bone graft. Or if there is not enough

12 DOUBLE HELICAL

bone height in the upper jaw or the sinuses are too close to the jaw, you may require a sinus lift.

Implants are devices that replace the roots of missing teeth. They are used to support crowns, bridges or dentures.

Implants are surgically placed in your jawbone. Most of the time, implants feel more natural and secure than other methods of replacing missing teeth, such as dentures.

There are many reasons it’s important to replace missing teeth: . Having all of your teeth can make you more self-confident. You don’t worry that people notice that you have teeth missing. . When teeth are lost, the area of the jawbone that held those teeth starts to dissolve. Implants help to preserve the bone and the shape of your jaw. .Tooth loss affects how well you chew and what foods you are able to eat.

Some people who have missing teeth have poor nutrition, which can affect

WHY DENTAL IMPLANTS Implants seem to be today’s state-ofthe-art tooth replacement option regardless of whether you lost one or more or all teeth, implants are a perfect way of restoring your natural smile.

In exclusive interview with Double Helical, Dr Suresh Ahlawat lists the reasons for dentals implants to restore one’s natural smile: 1. IMPLANTS ARE JUST LIKE YOUR NATURAL TEETH: Your natural tooth has roots that hold it in place and securely anchor it to your jawbone. Similarly, implants develop a firm attachment with the jawbone, as they are made of titanium, a material known to have a unique ability to fuse with a living bone. The good thing with implants is that you can speak, eat, and smile with confidence because implants don’t slip off as dentures do.

2. IMPLANTS ARE DURABLE TOOTH REPLACEMENTS:

www.doublehelical.com

Dr. Ahlawat further adds that, “Since the implant becomes part of your jawbone, they offer a lasting solution to tooth loss. While other tooth replacement options such as bridgework and removable dentures may require replacement with time, implants may last a lifetime especially when cared for in the right way.”

3. IMPLANTS PREVENT BONE LOSS: Even when you lose one tooth, the bone tissue beneath the lost tooth starts resorbing and melting away. Dr Suresh illustrates that, “this can give your face an aging look and leave your jawbone vulnerable to fractures. Fortunately, implants can provide the required stimulation once they fuse with the jawbone and prevent bone loss.

4. IMPLANTS DON’T AFFECT THE ADJACENT TEETH: While other tooth replacement options can weaken the adjacent teeth, implants do not affect the health of the adjacent teeth. For instance, bridgework requires support from the adjacent teeth, resulting in the stress of these adjacent teeth. This makes them susceptible to decay. The good news is that implants don’t depend on adjacent teeth for support and that means that they don’t have any effect on the nearby teeth.

5. IMPLANTS ARE EASY TO TAKE CARE OF: Taking care of implants is just like caring for your natural teeth. You should brush and floss daily. Besides, you don’t have to apply special adhesives and creams or soak the implants in a glass of water overnight as you would if you were using dentures.

6. IMPLANTS HAVE BETTER QUALITY: Dental implants are of better quality than bridges and dentures. Therefore, if you have lost a tooth, then, implants are likely to offer you a better smile and boost your confidence as well.Implants require a very sound knowledge, skill and technology.

ABOUT DR. SURESH AHLAWAT Dr. Suresh Ahlawat, MDS, Maxillofacial Surgeon and Implantologist, BDS,DNB (USA) is an eminent Dental Surgeon (Implantologist) in Gurugram, Haryana. He has been facilitated by the Chief Minister of Haryana, Bhupender Singh Hooda for his excellence in dentistry. Also, he has been awarded the best Implantologist in Haryana by FAMDENT association in the year 2016. Adding to his list of awards, the Finance Minister (Govt of Haryana) has also awarded him for his exemplary dental services and skills.

He has been a dental practitioner for more than two and half decades now. In his long career, he went on to bring sparkling smiles over his patients’ faces by his maneuvered skills along with the latent reservoir of his dental knowledge.

He has successfully handled innumerable critical cases during his long professional tenure and provided gratifying results to his patients.

From the feedback given by his patients, he is known for empathic approach and gentle hands and hence extensively respected by his patients.

Patient’s ease and comfort are his prime concern and thus he keeps himself up-to-date with the recent technology and knowledge for their betterment.

Dr. Suresh Ahlawat (MDS) along with his team of doctors, is having an experience of more than 25 years in implants .He is well trained in implants across the globe (like in India ,Spain ,Korea ,Bangkok ) and is a renowned international speaker for implantology. He is a Diplomate of World Congress of Implantology (WCOI) and an international speaker for CWM Korea and Miami Medical Seminars MMS, USA. To keep upbeat with latest knowledge, Dr Suresh Ahlawat has travelled widely to USA, Switzerland, UK, France, Spain, S Korea, Bangkok etc His major interest areas are IMPLANTS, COSMETIC DENTISTRY AND FULL

MOUTH REHABILITATION. It is known fact that, a single wonderful smile on your face can bring numerous adversities round to your side. To achieve this, Cosmetic dentistry is endeavored to create a positive makeover to your teeth that will enhance your smile. In the modern-day dentistry, cosmetic practices embrace the gamut from elementary color correction to replacing the lost teeth by IMPLANTS, along with redefining the size and shape of your teeth.

At Gurgaon based Muskaan Dentals, there is state-of-the-art with the most recent trends as well as technology, which can shower benefits to the patients. The general oral health and esthetics of the patient is looked after well here. There are plenty of options available for you to augment your tooth function along with smile which Dr. Ahlawat explains you at length here at muskaan dentals.

Dental implants utilized at our centers are resourced from the best companies of the world like Noble biocare (Sweden), CWM (Korea),Adin (Israel) ,Straumann (USA) ,Briadent (Germany) etc. Majority of dental implants are executed under local anesthesia as well as the right medication and conscious sedation under stringent aseptic conditions by extremely trained and experienced implantologists where a solo implant procedure hardly takes about 15 minutes and completely painless.

Instant loading implants are done, also known as- TOOTH IN AN HOUR, where the crown or cap is located on the tooth implant right away subsequent to its surgical position in jaw bone in a solo sitting. In majority of implant cases, the crown, bridge or else denture is fabricated and placed around 3 to 6 months as of the date of the implant insertion. The price of the implant surgical procedures are reasonably economical compared to the excellence of the implants used, as well as the dexterity of the implantologists with International Standards.

July 2018 13

Concern - Dental Care

Medication Side (ƄHFWV Many medications can cause bothersome oral side effects, such as dry mouth/xerostomia, altered metallic taste affecting the taste buds, swollen and tender gums leading to periodontitis or gingivitis, mouth ulcers/sores. Learn how to cope……..

BY DR. DEEPTI SHARMA

M

any medications for curing general health conditions and medical diseases can affect your oral health. In addition to prescribed and over-the-counter drugs, vitamins, minerals, and herbal supplements can

14 DOUBLE HELICAL

also cause oral health issues that range from dry mouth to inflamed gums to taste alterations and bone loss.

ORAL HEALTH: MEDICATION SIDE EFFECTS Some of the most common side effects from medications that affect

oral health include: • Dry mouth/xerostomia • Abnormal bleeding • Altered taste • Inflammation, mouth sores, or discoloration of the soft tissues in your mouth • Enlarged gums

www.doublehelical.com

• Cavities • Teeth and gum color changes • Bone loss • Thrush, or an oral yeast infection MEDICATIONS THAT CAN CAUSE DRY MOUTH More than 400 medications have the potential to cause dry mouth. Saliva cleans your mouth but if it’s not flowing normally and dry mouth develops, you’ll be more prone to gum infections and tooth decay.

The most common types of medications that cause dry mouth include: • Antihistamines • Decongestants • High blood pressure medications (including diuretics, calcium channel blockers, and angiotensin-converting enzyme inhibitors) • Antidepressants • Sedatives • Pain medications • Parkinson’s disease medications • Antacids TREATMENT REMEDIES FOR DRY MOUTH If dry mouth is severe as a result of your medication, you can ask your doctor to switch your medication to something else. If that isn’t recommended, here are some tips to help alleviate dry mouth symptoms: • Ask your doctor or dentist about using an artificial saliva product.

• Sip water or any type of sugarless drink throughout the day.

• Skip or cut down on caffeinated beverages, alcohol, and tobacco because they contribute to a dry mouth.

• Drink water or a sugarless drink while eating to make swallowing and chewing easier.

• Suck on sugarless candy or gum to promote saliva production.

• Avoid salty and spicy foods, which can cause pain to an already dry mouth.

• Use a humidifier at night.

MEDICATIONS THAT CAN CAUSE ABNORMAL BLEEDING Aspirin and anticoagulants, also

known as blood thinners, lessen the ability for blood to clot. While they’re helpful in preventing heart attacks and stroke, they can cause your gums to bleed, especially during oral surgery.

TIPS FOR ABNORMAL BLEEDING Be sure to let your dentist know that you are taking these drugs so that precautions can be taken to minimize bleeding. Also, be sure to use a soft tooth brush and gentle motions when brushing and flossing your teeth to lessen the bleeding.

MEDICATIONS THAT CAN ALTER TASTE Certain drugs can leave a metallic or bitter taste affecting your taste buds in mouth. And some medications may simply change the taste of the things you eat. Such medications include: • Cardiovascular drugs (some beta

blockers and calcium channel blockers) • Central nervous system stimulants • Flagyl (metronidazole), an antibiotic drug • Nicotine skin patches for smoking cessation • Some respiratory inhalants WHAT TO DO ABOUT TASTE CHANGES If this side effect is intolerable, ask your doctor if your medication can be changed.

MEDICATIONS THAT CAN CAUSE SOFT TISSUE REACTIONS You can develop inflammation, mouth sores/ulcers, or discoloration of the soft tissues in your mouth affecting lips,tongue,floor of the mouth, inner area of cheek when taking the following prescribed drugs: • Blood pressure medications

July 2018 15

Concern - Dental Care

ABOUT DR. DEEPTI SHARMA Dr. Deepti Sharma is a Dental Surgeon, Root Canal Specialist, Implantologist and Smile Designer of Indian Origin. She did her Bachelor’s Degree in Dental Surgery from Baba Farid University of Health Sciences Faridkot ,Punjab. Afterwards she completed her P.G.D.F ( post graduate diploma in forensic science and related laws ) from Rashtrasant Tukdoji Maharaj Nagpur University.She has also successfully completed her Certification in Implants & Certification in 08 Medical Operations against WMD from National Civil Defence College Nagpur.

Working towards acknowledgement she has submitted her project report on Comparison between 5 commonly used method of human bite mark overlay production from the Dental Study Cast ,She has also done her paper presentation on The Use of Dental Study of the Enamel & Neonatal Line for revealing postnatal survival in skeletal remains of infants on National Conference on Forensic Science.

Currently she is operating her own Clinic as Dr .

Sharma’s Dental Care located at CMPDI Road Shobhalok Building Jaripatka, Nagpur.& Since 2016 she is on Panel with Central Mining Planning Design Institute Reg 4 Nagpur.She is renowned social worker & currently chairwomen of SSD & SNA Social Welfare Foundation & runs charitable hours on Sunday 11 am- 2 pm at her own clinic for the welfare of humanity by imparting her medical services at affordable costs Dr. Deepti Sharma is also associated with Vidharb Media Channel and has her regular program on Dental Talk Shows on Hello Doctor Episodes every week of the month. She is regular contributor for Double Helical, a leading national monthly health magazine. Recently she has been interviewed for Double Helical You Tube Channel as a successful Dental Surgeon.

16 DOUBLE HELICAL

• Immunosuppressive agents • Oral contraceptives • Certain chemotherapy medications WHAT TO DO ABOUT SOFT TISSUE REACTIONSLet your dentist know if you are taking any of these medications so he or she can recommend a special dental care regimen to reduce the discomfort.

MEDICATIONS THAT CAN CAUSE GUMS TO ENLARGE Enlarged gums, also known as gingival overgrowth,p eriodontitis,gingivitis, can occur when you take: • Antiseizure medications (such as those for epilepsy) • Immunosuppressant drugs (typically used after organ transplantations) • Calcium channel blockers (for cardiovascular conditions) • TIPS ON ENLARGED GUMS While taking these medications, you’ll need to take extra care when brushing and flossing. Ask your dentist for specific dental care instructions.

MEDICATIONS THAT CAN INCREASE THE RISK OF CAVITIES Many medications, especially those given to children, contain sugar. Sugar is also found in antacid tablets, antifungal agents, cough drops, and many chewable tablets, such as vitamins. Too much sugar can lead to

www.doublehelical.com

Behaviour-altering drugs, such as psychotropic drugs, can cause lethargy, fatigue, or memory impairment.

If you are taking any of these type of medications, take steps to help you remember to brush and floss your teeth regularly — whether that means setting an alarm, leaving yourself a note, or some other reminder method

cavities.

HOW TO COPE UP WITH SUGAR IN MEDICATIONS • If possible, take the medication in tablet form.

• Take the medications at mealtimes.

• Avoid taking the medication right before bed.

• Make sure you or your children brush with a fluoride toothpaste or chew sugarless gum after taking the medication.

• Seek regular preventive dental care.

MEDICATIONS THAT CAUSE DISCOLORATION OF TEETH AND

GUMS Certain drugs can change the color of your teeth or gums. For example, minocycline (which is used to treat acne) can cause an area of black pigmentation on your gums and a black or gray discoloration of your teeth.

Chlorhexidine, a mouth rinse used to treat gum disease, can also stain your teeth.

HOW TO TAKE CARE OF GUM OR TEETH DISCOLORATION If a medication has discolored your teeth, ask your dentist about tooth-whitening procedures /bleaching & polishing after scaling that may help.

MEDICATIONS THAT CAN CAUSE BONE LOSS Use of corticosteroids, such as prednisone, and antiepileptic drugs, can lead to the loss of bone that supports your teeth. Bisphosphonates, drugs used to treat osteoporosis, can sometimes cause a rare condition called osteonecrosis of the jawbone, which results in destruction of the jawbone. Symptoms include painful, swollen gums or jaw, loose teeth, jaw numbness, a heavy feeling in the jaw,

fluid in the gums and jaw, and exposed bone.

WHAT TO DO ABOUT OSTEONECROSIS Be sure to tell your dentist if you are taking a drug for osteoporosis. Your dentist may prescribe an antibiotic or nonsteroidal anti-inflammatory drug to slow your bone loss.

MEDICATIONS THAT CAN CAUSE THRUSH Thrush, also known as an oral yeast infection, is caused by a fungus (Candida) and appears as white lesions on the mouth and tongue. Taking antibiotics, steroids, or chemotherapy can cause thrush.

WHAT TO DO ABOUT THRUSH: Your dentist may prescribe an antifungal mouthwash or lozenges to treat the infection. If these don’t work, stronger antifungal medications can be prescribed.

BEHAVIOUR-ALTERING DRUGS AFFECTING ORAL HEALTH Behaviour-altering drugs, such as psychotropic drugs, can cause lethargy, fatigue, or memory impairment. If you are taking any of these type of medications, take steps to help you remember to brush and floss your teeth regularly — whether that means setting an alarm, leaving yourself a note, or some other reminder method. Never stop taking a psychotropic medication without first consulting your doctor. If a drug is causing bothersome oral health side effects, let your doctor know. In many cases, you may be able to take a different type of medication or make lifestyle changes that minimize the side effects. And, as always, take care of your mouth by regularly brushing and flossing your teeth, getting regular dental checkups, and treating any problems that arise.

(The author is Root Canal Specialist, Smile Designer, Implantologist, Dr, Sharma’s Dental Care, Nagpur)

July 2018 17

Focus - Cardiovascular Research

India’s March to Halt the Emerging Cardiovascular Epidemic Practice of modern cardiology and treatment of heart disease with allopathic drugs became a reality in India soon after the World War II, and research on the pathogenic and therapeutic aspects of cardiovascular diseases (CVD) was also initiated during the same period…….

PROF. RAMESH K. GOYAL, PH.D.

18 DOUBLE HELICAL

www.doublehelical.com

T

he research presents the current status of cardiovascular research in India with emphasis on emerging information on risk factors for CVD (cardiovascular diseases) and Indian efforts for arresting growing incidence of CVD, providing affordable care, and discovering new remedies.

Ayurvedic physicians of ancient India (2500 and 500 BC) recognized the heart as a controlling center connected to the

entire body through channels (siras and dhamanis), which supplied nutrients to various tissues and provided passage for waste products. They claimed that any obstruction in these channels led to sickness in the body and performed treatment on the basis of personal knowledge of various herbal formulations, which continue to be used by current practitioners of the traditional Indian systems of medicine.

The research presents the current status of cardiovascular research in

India with emphasis on emerging information on risk factors for CVD (cardiovascular diseases) and Indian efforts for arresting growing incidence of CVD, providing affordable care, and discovering new remedies.

EPIDEMIOLOGICAL TRANSITION IN CVDS Epidemiological studies on CVD in India have been reviewed recently.1 During the last decade, CVDs have emerged as the leading cause of

July 2018 19

Focus - Cardiovascular Research

morbidity and mortality in India and are responsible for healthcare burden to the tune of $237 billion during 2005 to 2015. Hospital-based studies from 1946 to 1962 reported an incidence rate of coronary heart disease ranging from 6% to 23% in cardiac patients of low-income groups and as high as 35% in high- and middle-income groups.

A dramatic epidemiological transition has been witnessed during the last two decades. This transition is coupled with increased life expectancy from 58.3 to 65.2 years, lifestyle changes, rapid unplanned expansion of cities, and rural migration. CVDs presently account for two thirds of the mortalities because of non communicable diseases with 52% of deaths occurring more than 70 years of age and the mortality rates being higher in urban areas (>35%) and lower in rural areas (<10%).

Cross-sectional studies from different parts of the country indicate that the prevalence of coronary heart disease has gone up from 1.7% in rural

20 DOUBLE HELICAL

and 2% in urban areas, respectively, in 1960 to 1970 to 7.4% in rural and 14% in urban areas by 2013. Hypertension is also a leading cause of morbidity (30% in the adult population).

Prevalence of diabetes mellitus is 17% in urban and 9% in rural India. Mortality from heart failure is 18.6%. A recent population-based urban stroke registry at Ludhiana found age-standardized stroke incidence rate of 130 per 100 000 popula-tion.4 It has to be noted that large-scale longitudinal studies to estimate the burden of heart diseases have not been conducted in India.

RISK FACTORS FOR CVDS IN INDIAN POPULATION Major no modifiable risk factors for CVDs in the Indian population are advancing age, family history, sex, and ethnicity. Major modifiable risk factors include hypertension, dyslipidemia, diabetes mellitus, obesity, and lifestyle risk factors, such as smoking, inadequate physical activity, and less

use of fresh vegetables and fruits (zero to 1 serving of fruit in a week). There are 275 million tobacco consumers in ,QGLD LQ WKH DJH JURXS Â&#x2022; \HDUV million use smokeless forms of tobacco.6 Although conventional risk factors are important, novel risk factors are considered to increase the risk of CVD in Indians. These factors include high lipoprotein (a), plasminogen activator inhibitor-1, fibrinogen, and low tissue plasminogen activator.

The added cardiovascular risk in people of South Asian origin cannot be explained by conventional risk factors alone. Several candidate gene studies have reported that Indians have a genetic predisposition to atherothrombotic risk. A genetic basis for an increased coronary heart disease risk among South Asians is supported by the finding that South Asians tend to have higher lipoprotein (a) levels than other ethnic groups.

Asian Indian phenotype refers to certain unique clinical and biochemical

www.doublehelical.com

abnormalities in Indians, which include increased insulin resistance, greater abdominal adiposity, that is, higher waist circumference, despite lower body mass index, lower adiponectin, and higher high-sensitivity C-reactive

protein levels. It seems likely that South Asiansâ&#x20AC;&#x2122; enhanced susceptibility to CVD results from both genetic and environmental influences. There is evidence that a traditional vegetarian diet consumed by populations as found

in Pune in India could lead to a genetic mutation in the gene FADS, which codes for a fatty acid denaturize catalyzing the rate limiting steps in the biosynthesis of long-chain poly unsaturated fatty acids that may increase inflammatory potential and individualâ&#x20AC;&#x2122;s risk for heart disease.

Current Indian pursuits that have translational potential are (1) discoidin domain receptors and cardiac fibrosis, (2) cyclophilin A and vascular disease in diabetes mellitus, (3) in-terleukin-1 receptorâ&#x20AC;&#x201C;associated kinase in atherosclerosis, (4) catestatin in hypertension, (5) genetic and evolutionary per-spectives of dilated cardiomyopathy, (6) targeting cytochrome b5 reductase 3 to modulate hypertension, (7) identifying strat-egies to control acute coronary syndrome, (8)

July 2018 21

Focus - Cardiovascular Research

unravelling the role of sleep apnea in coronary artery disease, (9) exomesequencing guided diagnostics for cardiomyopathy, and (10) communitylevel interventional studies.

DEVELOPMENT OF VALVE AND VACCINE FOR RHEUMATIC HEART DISEASE Rheumatic heart disease (RHD) continues to be a major cardiovascular problem in India. More than 2 million patients are estimated to experience RHD. The RE-LY (randomized evaluation of long term anticoagulant therapy) investigators observed that RHD contributes to 33% of the atrial fibrillation burden in India. RHD is also the leading cause of structural heartvalve damage in the country. Because a large majority of patients with RHD in India are unable to afford expensive imported artificial valves, an indigenous TTK Chitra valve was developed at Sree Chitra Tirunal Institute for Medical Sciences and Technology at Trivandrum.

This valve has >90 000 implantations to date. Efforts are also being made to develop a vaccine against group A Streptococcus—the causative agent for rheumatic fever. The wide heterogeneity of group A Streptococcus isolates from throat swabs of children with rheumatic fever poses challenges for development of an ideal vaccine.

DEVELOPMENT OF FIBRINOLYTICS AND CORONARY

22 DOUBLE HELICAL

STENTS Given the limited access, thanks to high cost of imported streptokinase, investigators at the Institute of Microbial Technology at Chandigarh developed an indigenous natural streptokinase in 2001 and a recombinant streptokinase in 2009, and recently, a third generation of clotspecific strepto-kinase by fusing the core of streptokinase with fibrinbinding domain 4 and 5 of human fibronectin. This clot buster has been given permission for phase II clinical trial. The require-ment for coronary stents has increased considerably in India. Sahajanand Medical Technology at Surat has developed mini-mally invasive coronary stent systems. Their sirolimus and everolimus drug-loaded stents have a blend of biodegradable polymers and a hydrophilic top layer.

Institute of Chemical Technology at Mumbai developed infinnium—a drugeluting stent, which received CE (Conformité Européenne) mark for biodegradable polymeric drug-coating technology.

STEM CELL RESEARCH IN INDIA Indian efforts in research on cardiac regeneration include in-vestigations using induced pluripotent stem cells, attempts to enhance the yield of cardiac stem cells for implantation, ge-netically modify progenitor cells for improving their function, and assessing efficacy of stem cell transplantation through

clinical trials.

TRANSLATIONAL RESEARCH ON HERBAL MEDICINES India has a rich heritage of ancient knowledge on herbal drugs. An early major contribution to cardiovascular sci-ences in modern India is the discovery by Rustom J. Vakil on the use of reserpin—an alkaloid from the extract of roots of Rauwolfia serpentina—in treating patients with hyperten-sion. Recently, several herbal medicines have been shown to possess antiplatelet, hypolipidemic, antiinflammatory, hypo-glycemic, and hypotensive actions. Gugulipid—a cholesterol-lowering agent developed from the plant Commiphoramukul by scientists at Central Drug Research Institute at Lucknow has an activity comparable with clofibrate. Allyl methyl sul-fide and allyl methyl sulfoxide, two ingredients of garlic, have been shown to increase the expression of Na+/K+ATPase protein, decrease intracellular calcium levels, and attenuate cardiac hypertrophy.Herbs namely Withania somnifera, Curcuma longa, and Ocimum sanctum and their combinations have been found beneficial in reducing myocardial injury.

Government of India has established a separate minis-try Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy to encourage research and promotion of Indian traditional systems of medicine. Ayurvedic Biology

www.doublehelical.com

Program of Science and Engineering Research Board of Department of Science and Technology is an independent new program which supports basic and translational research on Ayurvedic concepts and Ayurvedic medicines for use in clinical practice. Ayurnutrigenomics is an emerging field of research for understanding pathogenesis and evolving strategies for manage-ment of

CVD. FUNDING FOR CARDIOVASCULAR RESEARCH In 2007, Government of India created the Department of Health Research under the Ministry of Health and Family Welfare with a mandate to promote basic, applied, and clinical research through development of infrastructure, manpower, and skills in cutting-edge

areas. The problem of non communicable diseases was addressed in the National Health Policy in 2017, and the Government announced an increase in public health expenditure to 2.5% of the gross domestic product.

The major objective of this policy was to shift focus from sick care to wellness and target reduction of morbidity and mortality because of CVDs by 25 percent.

Indian Council of Medical Research under Department of Health Research coordinates Department of Science and Technology, Science and Engineering Research Board, Department of Biotechnology, and Council of Scientific and Industrial Research for funding various research projects. Funds disbursed by these agencies for cardiovascular research are not available in the public domain.

Currently, there is no separate and specific budgetary provision for funding cardiovascular research.

The budget of Indian Council of Medical Research for funding research in all domains in the current year (2017â&#x20AC;&#x201C; 2018) is an equivalent of $232 million, which is significantly less in comparison with 32 billion dollars a year the budget of National Institute of Health in the United States. Funding for projects is based on recommendations of program advisory committees of the funding agencies, which call for proposals from investigators, review them, and make recommendations for funding. Universities and institutions also support investigator centric projects.

A few Indian scientists have been successful in obtaining funding from international agencies, such as The Wellcome Trust, Melinda Gates Foundation, National Institutes of Health, United States, and through bilateral pro-grams between India and countries, such as Australia, Canada, France, Germany, United Kingdom, and the United States.

(The author is Vice Chancellor, Delhi Pharmaceutical Sciences and Research University, New Delhi)

July 2018 23

Cover Story - Depression

24 DOUBLE HELICAL

www.doublehelical.com

All is not well Depression is a disorder of the brain. It is not simply feeling down, but serious illness caused by changes in brain chemistry. Men and women of every age, educational level, and social and economic background are found to suffer from depression. The disease, though very complex, is very much treatable……..

BY AMRESH K TIWARY

M

anju, an 18-year-old student, started missing from her classes for days together, and her friends noticed that something is not right. She talked to her friend about the time she had been really depressed and had consulted her doctor.

Depression is a common but serious illness. Most who experience depression need treatment to get better. The feelings like sadness, hopelessness, guilt, moodiness, angry outbursts, loss of interest in friends, family and favourite activities including sex drive point to the presence of depression. This also affects your thoughts, behaviour and your overall physical health.

During the treatment of depression, it is found that other illnesses may come on before depression, cause it, or be a consequence of it. But depression and other illnesses interact differently in different people. In any case, co-occurring illnesses need to be diagnosed and treated.

The most common behaviour patterns are withdrawing from people, substance abuse, missing work, school or other commitments and attempts to harm yourself. The persons who are under depression may face physical problems like tiredness or lack of energy, unexplained aches and pains, changes in appetite, weight loss and gain, changes in sleep – sleeping too

little or too much and sexual problems.

Depression is believed to be caused by an imbalance in the neurotransmitters which are involved in mood regulation.

Neurotransmitters are chemical substances which help different areas of the brain communicate with each other. When certain neurotransmitters are in short supply, this may lead to the symptoms we recognize as clinical depression.

It has been widely documented that women suffer from major depression about twice as often as men. Because

the incidence of depressive disorders peaks during women’s reproductive years, it is believed that hormonal risk factors may be to blame.

Women are especially prone to depressive disorders during times when their hormones are in flux, such as around the time of their menstrual period, childbirth, and perimenopause.

In addition, a woman’s depression risk declines after she goes through menopause.

It’s estimated that 10 to 15 percent of the general population will experience clinical depression in their

July 2018 25

Cover Story - Depression

lifetime. And the World Health Organization estimates 5 percent of men and 9 percent of women experience depressive disorders in any given year.

The mind and the body are clearly linked. If you are experiencing a physical health problem you may discover changes in your mental health as well.

Illness is related to depression in two ways. The stress of having a chronic illness may trigger an episode of major depression.

In addition, certain illnesses, such as thyroid disorders, Addison’s disease and liver disease, can cause depression symptoms. Drugs and alcohol can contribute to depressive disorders.

But, even some prescription drugs have been linked to depression.

Some drugs that have been found to be associated with depression include anticonvulsants, statins, stimulants, benzodiazepines, corticosteroids, and beta-blockers.

It is important to review any medications that you’ve been prescribed and to speak with your physician if you are feeling depressed.

Stressful life events, which overwhelm a person’s ability to cope, may be a cause of depression.

Researchers suspect high levels of the hormone cortisol, which are secreted during periods of stress, may affect the neurotransmitter serotonin and contribute to depression.

Following the loss of a loved one, grieving individuals experience many of the same symptoms of depression.

Trouble sleeping, poor appetite, and a loss of pleasure or interest in activities are a normal response to loss.

The symptoms of grief are expected to subside over time. But when symptoms get worse, grief may turn into depression.

According to Prof (Dr.) Nimesh G Desai, Professor of Psychiatry and Director, Institute of Human Behaviour and Allied Sciences (IHBAS), Delhi, Alcohol and other substance abuse or dependence may also co-exist with depression.

26 DOUBLE HELICAL

Dr. Nimesh G Desai Research shows that mood disorders and substance abuse commonly occur together. Depression also may occur with other serious medical illnesses such as heart disease, stroke, cancer, HIV/AIDS, diabetes, and Parkinson’s disease. People who have depression along with another medical illness tend to have more severe symptoms of both depression and the medical illness, more difficulty adapting to their medical condition, and more medical costs than those who do not have co-existing depression. Treating the depression can also help improve the outcome of treating the cooccurring illness.

“Most likely, depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depressive illnesses are disorders of the brain. Longstanding theories about depression suggest that important neurotransmitters— chemicals that brain cells use to communicate—are out of balance in depression. But it has been difficult to prove this,” Prof (Dr.) Nimesh G Desai, said.

Brain-imaging technologies, such as magnetic resonance imaging (MRI), have shown that the brains of people who have depression look different

than those of people without depression. The parts of the brain involved in mood, thinking, sleep, appetite, and behaviour appear different. But these images do not reveal why the depression has occurred. They also cannot be used to diagnose depression.

Prof (Dr) Nimesh G Desai, said, “Some types of depression tend to run in families. However, depression can occur in people without family histories of depression too. Scientists are studying certain genes that may make some people more prone to depression. Some genetics research indicates that risk for depression results from the influence of several genes acting together with environmental or other factors. In addition, trauma, loss of a loved one, a difficult relationship, or any stressful situation may trigger a depressive episode. Other depressive episodes may occur with or without an obvious trigger.”

Dr. Anandi Lal, Senior Consultant and Head, Psychiatry, Max Superspeciality Hospital, Vaishali, said, “Depression can affect anyone at almost any age. And the reasons why some people grow depressed are not always known. There are many causes

www.doublehelical.com

Dr. Anandi Lal of depression.

Depressive illnesses are disorders of the brain. Depression is more common among women than among men. Biological, life cycle, hormonal, and psychosocial factors that women experience may be linked to women’s higher depression rate. We have observed hormones directly affect the brain chemistry that controls emotions and mood. For example, women are especially vulnerable to developing postpartum depression after giving birth, when hormonal and physical changes and the new responsibility of caring for a new-born can be overwhelming.”

Dr. N P Singh, Senior Consultant, Internal Medicine and Nephrology, Max Super speciality Hospital, Vaishali, said, Some women may also have a severe form of premenstrual syndrome (PMS) called premenstrual dysphonic disorder (PMDD). PMDD is associated with the hormonal changes that typically occur around ovulation and before menstruation begins.”

“During the transition into menopause, some women experience an increased risk for depression. In addition, osteoporosis—bone thinning

Dr. N P Singh or loss—may be associated with depression. Scientists are exploring all of these potential connections and how the cyclical rise and fall of estrogen and other hormones may affect a woman’s brain chemistry, Dr N P Singh, said.

Dr N P Singh , said, “Many women face the additional stresses of work and home responsibilities, caring for children and ageing parents, abuse, poverty, and relationship strains. It is still unclear, though, why some women faced with enormous challenges develop depression, while others with similar challenges do not.”

Men often experience depression differently than women. While women with depression are more likely to have feelings of sadness, worthlessness, and excessive guilt, men are more likely to be very tired, irritable, lose interest in oncepleasurable activities, and have difficulty in sleeping.

Men may be more likely than women to turn to alcohol or drugs when they are depressed. They also may become frustrated, discouraged, irritable, angry, and sometimes abusive. Some men throw themselves into their work

to avoid talking about their depression with family or friends, or behave recklessly.

Dr. Anandi Lal, Senior Consultant and Head, Psychiatry, Max Superspeciality Hospital, Vaishali, said, “ Depression is not a normal part of ageing. Studies show that most senior citizens feel satisfied with their lives, despite having more illnesses or physical problems. However, when older adults do have depression, it may be overlooked because seniors may show different, less obvious symptoms. They may be less likely to experience or admit to feelings of sadness or grief.”

Sometimes it can be difficult to distinguish grief from major depression. Grief after loss of a loved one is a normal reaction to the loss and generally does not require professional mental health treatment.

However, grief that is complicated and lasts for a very long time following a loss may require treatment.

Researchers continue to study the relationship between complicated grief and major depression.

Older adults also may have more medical conditions such as heart

July 2018 27

Cover Story - Depression

disease, stroke, or cancer, which may cause depressive symptoms. Or they may be taking medications with side effects that contribute to depression.

Some older adults may experience what doctors call vascular depression, also called arteriosclerotic depression or subcortical ischemic depression.

Vascular depression may result when blood vessels become less flexible and harden over time, becoming constricted. Such hardening of vessels prevents normal blood flow to the bodyâ&#x20AC;&#x2122;s organs, including the brain.

Those with vascular depression may have, or be at risk for, co-existing heart disease or stroke.

Older adults with depression improve when they receive treatment with an antidepressant, psychotherapy, or a combination of both. Research has shown that medication alone and combination treatment are both effective in reducing depression in older adults. Psychotherapy alone also can be effective in helping older adults stay free of depression, especially among those with minor depression.

28 DOUBLE HELICAL

Psychotherapy is particularly useful for those who are unable or unwilling to take antidepressant medication.

Children who develop depression often continue to have episodes as they enter adulthood. Children who have depression also are more likely to have other more severe illnesses in adulthood.

According to Dr. Anup Mohta, Director, Chacha Nehru Bal Chikitsalaya, East Delhi, childhood depression often persists, recurs, and continues into adulthood, especially if left untreated. A child with depression may pretend to be sick, refuse to go to school, cling to a parent, or worry that a parent may die.â&#x20AC;? Older children may sulk, get into trouble at school, be negative and irritable, and feel misunderstood.

Because these signs may be viewed as normal mood swings typical of children as they move through developmental stages, it may be difficult to accurately diagnose a young person with depression.

Children who have depression also

are more likely to have other more severe illnesses in adulthood. Before puberty, boys and girls are equally likely to develop depression. By the age of 15, however, girls are twice as likely as boys to have had a major depressive episode.

Depression during the teen years comes at a time of great personal changeâ&#x20AC;&#x201D;when boys and girls are forming an identity apart from their parents, grappling with gender issues and emerging sexuality, and making independent decisions for the first time in their lives. Depression in adolescence frequently co-occurs with other disorders such as anxiety, eating disorders, or substance abuse. It can also lead to increased risk for suicide.

Depression, even the most severe cases, can be effectively treated. The earlier that treatment can begin, the more effective it is.The first step to getting appropriate treatment is to visit a doctor or mental health specialist. Certain medications, and some medical conditions such as viruses or a thyroid disorder, can

www.doublehelical.com

cause the same symptoms as depression.

A doctor can rule out these possibilities by doing a physical exam, interview, and lab tests. If the doctor can find no medical condition that may be causing the depression, the next step is a psychological evaluation.

Once diagnosed, a person with depression can be treated in several ways. The most common treatments are medication and psychotherapy.

According to Dr N P Singh, all of us can expect to experience one or more of these symptoms on occasion. An occurrence of any one of these symptoms on its own does not constitute depression. When we suspect depression, we commonly look for clusters of these symptoms occurring regularly for two weeks or longer, and impacting functional aspects of the person’s life.

In medical terms, depression is a real illness that impacts the brain.

Anyone suffering from depression will tell you, it’s not imaginary or all in your head, depression is more than

just feeling down. It is a serious illness caused by changes in brain chemistry.

Research tells us that other factors contribute to the onset of depression, including genetics, changes in hormone levels, certain medical conditions, stress, grief or difficult life circumstances. Any of these factors alone or in combination can precipitate changes in brain chemistry that lead to depression’s many symptoms.

Dr Vinay Agarwal, Member, Indian Medical Association and Founder Chairman, Max Super Speciality Hospital, Vaishali, said, “Depression is a serious condition. It’s also, unfortunately, a common one.

The World Health Organization characterizes depression as one of the most disabling disorders in the world, affecting roughly one in five women and one in ten men at some point in their lifetime. Men and women of every age, educational level, and social and economic background suffer from depression.”

Dr Vinay Agarwal, adds, “There is no area of life that does not get affected

when depression is present. Marriage, parenting, friendships, careers, finances – every aspect of daily living is compromised by this disease. Once an episode of depression occurs, it is also quite likely that it will recur. And the impact of depression can be even more severe when it occurs in combination with other medical illnesses such as diabetes, stroke, or cardiovascular disease, or with related disorders such as anxiety or substance abuse.”

Says Dr Suneel Garg, Director Professor, Department of Community Medicines, Maulana Azad Medical College, New Delhi, “The problems caused by depression are made worse by the fact that most people suffering from the disease are never diagnosed, let alone treated. The good news is that when depression is promptly identified and treated, its symptoms are manageable and there are many effective strategies for living with the disease.”

“Many factors may contribute to the onset of depression, including genetic characteristics, changes in hormone levels, certain medical illnesses, stress, grief, or substance abuse. Any of these factors alone or in combination can bring about the specific changes in brain chemistry that lead to the many symptoms of depression, bipolar disorder and related conditions, Lifestyle changes, including improvements in sleeping and eating habits, physical activity and stress reduction have also proven very helpful in managing symptoms of depression,” adds Dr Suneela Garg.

Dr Vinay Agarwal, adds, “There are several strategies for treating depression. Depending upon each individual’s characteristics and symptoms, healthcare professionals may employ one or more types of psychotherapy that rely upon a sequence of interpersonal treatment sessions with a trained professional.

In addition, clinicians may suggest that a patient try one of a number of different medications.”

July 2018 29

Society - Sex Life

Stay Sexually Agile After 50 Mid-life crisis when you and your partner turn 5o or beyond brings with its agonizing times for the couple. Donâ&#x20AC;&#x2122;t lose heart, it is possible to revitalize your love life, the way it used to be: romantic, loving, and full of enjoyable sex

BY HRISHI KUMAR

30 DOUBLE HELICAL

www.doublehelical.com

H

ave you ever thought, sex after 50 can be the best sex of your life?

It is the time of life when men often suffer from problems like premature ejaculation, erectile dysfunction, and delayed ejaculation. Women too have to face low sex drive, lack of desire, and problems with orgasms. Hundreds of men and women begin to experience the first signs of a more mature life: getting tired more easily; the surprise when a man’s erection did not spring to attention when his partner kissed him; the bewilderment when an erection disappeared during intercourse or oral sex, a form of intimacy that would once have had a man groaning with pleasure; the distressing realization that it might be time to reach for a bottle of lube because things somehow are not as juicy as they need to be for pleasurable lovemaking; the sudden realization that your partner is actually avoiding sex with you, or even turning you down when you suggest it.

A woman might notice her clitoris and labia are not swelling up in the way that they used to during sex; she might notice that intercourse is uncomfortable because her vagina seems to be much more sensitive to thrusting and may even tear slightly during intercourse.

A man might notice that his erection

doesn’t stand up as high as it did, or that his ejaculation has much less force. Or he might suddenly find that he can’t get another erection for several hours or even days after an ejaculation.

And that can be something that shakes him to the core, especially if he has always regarded his sexuality as a crucial part of who he is.

According to a report, women are slightly better off, because there is a lot of information available which helps them prepare for the major life-change of the menopause, as well as online support groups which help them deal with the emotional and practical consequences of this period.

If you are a woman, and your male partner is refusing to talk about sex, how on earth would you even know what to do? You want the loving, sexual connection you once had. But every time you raise the subject of sex he brushes you off and avoids the subject.

Well, there are things that you can do to show him that his sexuality is still powerful and attractive, to restore his confidence. You can tell him, through some simple actions, that you still want those blessed moments of intimacy with him. He’ll respond to you with love.

If you are a man and your partner has lost interest in sex, how on earth do you ever get her to want to make love again? Or suppose your partner has gone through the menopause and now every time you try to make love, she complains intercourse is painful, or her vagina doesn’t lubricate, or she always fails to have an orgasm.

Would you know what to do or say to her, not just to reassure her, but to actually turn your sex life into something that’s passionate and exciting? Would you know how to help her become fully sexual once again, so you can enjoy the pleasures of intercourse, just as you always have?

The sexologists believe that most people don’t know the answers to these questions. They believe the majority of people need a way to deal with middleaged sexuality, a formula that restores intimacy and love, a set of techniques

July 2018 31

Society - Sex Life

and tools that reverses the physical changes taking place (or provides a way of working around them - for both partners).

In particular, if your sex drive is dropping and your motivation to have sex is lower, it’s all too easy to avoid having sex altogether. But once you start avoiding sex that becomes an established pattern. Why? Because it’s much easier to avoid sex than take the risk of losing your erection or experiencing vaginal dryness or having painful intercourse or not being able to ejaculate or reach orgasm.

If you are a woman going through the menopause, you may be very confused about hormone replacement therapy or low sex drive. You might need to solve the problem of lack of lubrication, or the thinning of the vaginal wall that results in uncomfortable sex. You might want to know how to cope with changes in the way you feel about your body as you see it maturing.

There are probably many questions that you want to ask about how to carry on being sexual, being orgasmic. If you’re feeling adventurous, you might want to know how best to explore new sexual techniques with your partner. Or you might just want to know how to carry on as before.

32 DOUBLE HELICAL

The common body issues of midlife are related to how do you cope with all the changes that midlife can bring - drooping, sagging, losing elasticity.

Women and men want to stay on good terms with their bodies so they can enjoy sex at least as much as before... perhaps even more than before……

As a woman, you might want to know how to support your man as he goes through changes in his sexual desire and libido, as he experiences a lessening of his staying power and his masculine strength, as he finds his erections and ejaculations changing, and as these things impact on his mood, self-image, and confidence.

As a man, you might be desperate to

know how to reassure your partner that she’s still attractive to you, and how much you still want sex. Or you might be struggling to understand why you don’t want sex any more. All of these things are possible; all these challenges can be overcome. How can I say this with such confidence?

If you are a man around 50, you may be scared about losing potency, or frightened by the signs that your sexual power is lessening. You might be experiencing challenges around your role in life, about exactly how you’ve spent your life up till now, or how you’re going to spend the years ahead of you.

You might be experiencing real discomfort at the threat of losing your sexuality, particularly if your sex drive is lower or your erections are less reliable, or your ejaculations are not as powerful. And of course, there is a lot more to the male midlife experience of sex and love than simple physical changes.

Midlife produces issues about purpose and power, about your role as a man, about how you see yourself as your sexuality evolves. Whereas you once expected instant erections as rigid as a pole, you might now need a very different kind of stimulation to become erect, just as you might need a different approach to intercourse to satisfy your partner’s needs.

If you have seen your sexual capacity as an expression of your love for your partner, or as an expression of your masculinity, then you’ll certainly be challenged by the changes you experience as you pass 50 years of age and enter the years beyond.

Sometimes Viagra is a solution for erectile issues. Sometimes hormone replacement therapy is needed to overcome depression or a lack of sex drive, or to counteract the changes in your body. You might also want to know how to keep a loving relationship with your partner going, how to improve it, and how to reach a place where you enjoy better sex than ever before.

Forget your pre conceptions; forget what you have been told in the past.

Sex is great, for both sexes, at 50 and

www.doublehelical.com

far beyond.

According to health expert, an experienced sex therapist, has turned 57 lives with a beautifully very sexy beautiful lady who has recently turned 59. Dr Ranjan shares about his sexual habit after fifty from experience.

First and foremost, if you are facing some of the challenges that can come with sex after 50 years of age, don’t despair! Almost every problem that affects lovers at this time in their lives can be solved.

Low sexual desire in men and women can sometimes stop a couple having sex altogether, but there are plenty of ways to keep romance alive and your sex life on the boil. Indeed, you can have the most passionate and enjoyable sex of your life after 50. You just need to know how dealing effectively with the symptoms of the female menopause, including low sex drive, hot flashes, natural changes in your body is response to sexual stimulation, unpredictable mood swings...and the rest, including the dilemma around hormone replacement therapy, problems with vaginal lubrication, and painful intercourse. beating the symptoms of the male andropause (that’s the word for all the changes in a man’s body around the age of 45 to 55) such as loss of sex drive and sexual desire.

Some symptoms like changes in your body’s response to sexual stimulation, especially less reliable erections and weaker ejaculations, and perhaps not even being able to get an erection, physical changes which might include penile and testicular shrinkage, aches and pains, muscle wasting, and more ... all can be dealt with very effectively if you know how.

Male mid-life crisis is a stage of life sometimes treated like a joke, which in fact is anything but funny, involving as it does a lack of motivation, depression, loss of confidence, lack of purpose, feelings of hopelessness, despair, a sense of grief at aging, irritability, anger, and more.

Difficulties with sexual intercourse whether these are caused by physical

A man might notice that his erection doesn’t stand up as high as it did, or that his ejaculation has much less force. Or he might VXGGHQO\ ͤQG WKDW KH can’t get another erection for several hours or even days after an ejaculation. And that can be something that shakes him to the core, especially if he has always regarded his sexuality as a crucial part of who he is………. issues which make sex difficult, like vaginal dryness and loss of erection, or by relationship difficulties that stop it happening, or even a puzzling dwindling away of intercourse for no obvious reason, you can find out here how to revitalize your sex life and enjoy some of the best sex you have ever had.

Erectile dysfunction or erection problems can range from once in a while failure to complete loss of erection, no matter what form they take, these problems can be devastating to a man’s confidence. And yet, given the right treatment approach, all these issues can be resolved, your confidence restored - together with your erection - and your enjoyment of sex renewed.

The common body issues of midlife are related to how do you cope with all the changes that midlife can bring drooping, sagging, losing elasticity.

Women and men want to stay on good terms with their bodies so they can enjoy sex at least as much as before... perhaps even more than before.

For women, the menopause is a crucial time, signaling the loss of

fertility and the end of the possibility of getting pregnant. For some women, this heralds a new dawn of sexual freedom (no worries now about contraception) and sparks an era of new desire and passionate sex. For others, it seems like the loss of an essential part of themselves. For men, too, there can be a sense of losing the male power and vitality which has fuelled so much of their adult life. For everyone, it’s a time of change. Yet in the natural order of things, women and men grow into a mature sexuality at this time of life that’s just as rewarding as anything you ever experienced before.

Relationship difficulties - many couples find that when their sex drive falls, or the children leave home, there doesn’t seem to be much keeping their relationship together. Yet really good sex definitely acts as the glue that keeps a couple together, no matter how old they are. It promotes affection, intimacy, bonding and mutual love. A couple can remain lovers, in every sense of that word - spiritually, physically, emotionally, and practically - with some simple, easy techniques that can transform your relationship.

This is essential information if you feel that you’re drifting away - possibly through a lack of sex - from your lover, partner or spouse.

Is growing into your mature sexuality more than the sum of all the things above? Yes, probably....it’s also about evolving emotionally, accepting that things aren’t what they were, they are different, probably better. You should know powerful techniques to help you move to a place of psychological power, no matter how you may think about life after 50 at the moment.

CONCLUSION The fact is, your sexual organs really do stay younger longer, the more you use them. And to prevent hardening of the arteries, as well as hardening of the attitudes, there is nothing like regular sex! You need to know all the sexual tips, tricks and techniques to ensure that your sexual desire remains high and your orgasms are powerful - no matter how old you are.

July 2018 33

Focus - Safe Abortions

PROMOTING SAFE ABORTIONS Abortion is the termination of pregnancy before the foetus becomes viable. The World Health Organization (WHO) defines the period of viability after 20 weeks of gestation or a fetus that weighs more than 500 gms. Abortions can be either spontaneous or induced. Spontaneous abortions also known as miscarriages occur on their own because of internal factors like autoimmune diseases, thyroid disorders, malformations etc. or due to any external factors like trauma. Induced abortions are induced owing to several reasons like unintended pregnancy, threat to the health of the mother etc……….

BY DR. SUNEELA GARG, DR`. PRIYANKA YADAV

A

bortions can be induced either medically or surgically.

Induced abortions are safe if carried out by a person who has the necessary skill and in an environment that conforms to

34 DOUBLE HELICAL

minimal medical standards.

According to the Guttmacher Institute, 25% of all pregnancies between 2010 and 2014 ended in abortions worldwide. A global metaanalysis report suggests that approximately 15% of all maternal

deaths occur due to abortions. The data from Ministry of Health and Family Welfare shows that despite a decline in the abortion rates (number of abortions per 1000 females in 1544 years of age) in India from 20072012, in the recent years, the

www.doublehelical.com

abortion rates have been increasing.

Even after legalization of abortion (Medical Termination of Pregnancy Act, 1971), India has the highest number of unsafe abortions (twothirds of all abortions performed are illegal). While the number of facilities have increased in India after the amendment of MTP Act, in 2002, the access to safe abortion services is limited in rural areas. Even where approved facilities exist, the services in public sector are rarely or erratically provided due to lack of trained manpower or equipment, or both. A very less proportion of women in India are aware that abortion has been legalized which results in a high rate of unsafe abortions. In addition, social stigma attached to abortions further result in a high rate of unsafe abortions.

SUGGESTIONS: • Increased facility: Out of 1.75 lakh facilities in India, only 20,000 are equipped and fully functional in terms of providing comprehensive care for maternal health. Despite legalization of abortions, the facilities are not readily available to majority of the women. It is essential that facilities and equipments for carrying safe abortions be made available in every area.

• Training of healthcare providers: More and more healthcare providers at primary care level need to be trained for performing safe abortions.

• Spreading awareness: Only 7% of women in India are aware that abortions are legal. They are also unaware of the serious complications of unsafe abortions. Women, especially in the rural areas, present with serious complications like bleeding and sepsis.

There is also high mortality associated with unsafe abortions. It is important that health education be imparted to the women at every level possible, by the means of counseling by the healthcare providers and ASHA workers, through media etc.

• Stringent rules: Many women have reported a relatively easy access to medications for inducing abortions.

This results in an increased rate of unsafe abortions most of which even go unreported unless the patients present with serious complications.

The existing laws need to be strictly enforced ensuring that these medications are not available without prescription by a qualified healthcare provider.

• Addressing unmet needs of contraception: Prevention is always better than cure. Unintended

pregnancy is the most common cause for induced abortions.

With appropriate knowledge about the importance of use of contraceptives and easy availability of contraceptives, unsafe abortions can be largely prevented.

(The authors are associated with Department of Community Medicine, Maulana Azad Medical College, New Delhi)

July 2018 35

Women - Abortion

Post-Abortion Complications Abortion is one of the most sensitive issues of all times;the repercussions of which need to be stronglyaddressed

BY TEAM DOUBLE HELICAL

A

woman may need abortion or termination of pregnancy due to multiple reasons.

Sometimes, unwanted pregnancies may force such a step, at other times a couple may decide on termination due to other reasons such as severe congenital defects in the foetus or potentially dangerous health complications of the pregnancy.

Whatever the cause is, it is seen that an abortion can affect both woman’s psychology and physiology. To put it more clearly, abortion is not safer than full-term pregnancy and childbirth (when pregnancy is safe). In a few studies, it is found that some women report to have a sense of relief after having an abortion and others tend to become depressed due to an unwanted abortion or miscarriage. Therefore, the reasons for relief and depression may also vary from woman to woman.

PSYCHOLOGICAL RISKS Psychological side effects of having an abortion are as real as physical side effects. Emotional and psychological effects following an abortion are more common than physical side effects and can range from mild regret to more serious complications such as depression. Post abortion, it is very much necessary to discuss all the risks in detail with an experienced professional who can address all the queries and related concerns.

One of the most important factors

36 DOUBLE HELICAL

Psychological side effects of having an abortion are as real as physical side effects.

Emotional and psychological effects following an abortion are more common than physical side effects and can range from mild regret to more serious complications such as depression. Post abortion, it is very much necessary to discuss all the risks in detail with an experienced professional who can address all the queries and related concern

related to the negative emotional or psychological effects has to do with your belief about the baby inside you.

Whereas some women experience lesser negative emotional consequences as theyhave a more detached view of the pregnancy and consider the foetus as an undeveloped life; other group of women might have a more emotional outlook towards pregnancy and strongly look at the life that lives and breathes inside them. Such women tend to face negative consequences after an abortion or miscarriage.

There are intense emotional and psychological risks of having an abortion. The intensity or duration of these effects will vary from one person to the other. Potential side effects includes eating disorders, anxiety, regret, anger, guilt, shame, relationship issues, sense of loneliness or isolation, loss of self confidence, insomnia or nightmares, suicidal thoughts/feelings and depression.

Following abortion it is quite likely that one can experience unexpected emotional or psychological side effects.

Women generally report that the abortion procedure affected them more than they expected. However, it is often noticed that some individuals are more prone to experiencing some kind of emotional or psychological struggle.

• Women with a higher probability of having a negative emotional or psychological side effect include: • Women who obtain an abortion

www.doublehelical.com

• •

•

• •

•

in the later stages of pregnancy Women with previous emotional or psychological concerns Women who have been coerced, forced or persuaded to get an abortion Women with religious beliefs that are in disagreement with abortion Women with moral or ethical views that conflict with abortion Women without support from significant others or their partner Women obtaining an abortion for genetic or foetal abnormalities

SUGGESTIONS Get Help – Probably the most important thing you can do when facing an unplanned pregnancy is to communicate with trained professionals who can answer your questions and discuss your individual circumstances comfortably with you.

You can even consult a psychologist if you are going through anxiety.

Avoid Isolation – If you are experiencing an unplanned pregnancy, you might have the tendency to withdraw from others to keep the matter a secret and/or to face the issue alone. Although it can be difficult, try to stay connected with family and friends who can support you. Too much isolation under these circumstances can lead to depression.

Feel free to discuss your problem with your loved ones and take them into confidence before arriving at a decision. This will reduce your guilt or anxiety.

Evaluate Your Circumstances – See the situations listed previously regarding individuals who are more likely to experience one or more side effects. Discuss your situation with someone who can help you give your perspective and understanding.

Avoid Pressure – Avoid people who put pressure on you to do what they think is best. Whether you opt to become a parent, choose adoption, or have an abortion, you are the one who

is going to live with your choice. So the decision has to be 100% your own.

Talk to Others – See if you can find someone who has gone through an unplanned pregnancy or had an abortion to find out what it was like for them.

PHYSICAL RISKS Physical side effects after an abortion can vary from woman to woman. It is important to know about the possible detailed side effects of abortions from either an experienced health professional or a doctor. It is mandatory that your period should return about 4- 6 weeks after abortion and you can conceive again after the abortion. Moreover, take prescribed antibiotics as directed by your doctor in order to help prevent infection.

Following are the physical side effects that are frequently experienced after an abortion.

The possible duration to experience these side effects are 2 to 4 weeks following procedure.

• Abdominal pain and cramping • Spotting and bleeding About 5-10% of women suffer from immediate complications. It is important to be aware of the following risks: • Heavy or persistent bleeding • Infection or sepsis/PID/ Endometriosis • Damage to the cervix • Scarring of the uterine lining (Asherman’s syndrome) • Damage to other organs • Perforation of the uterus • Endotoxic shock and death

SUGGESTIONS

It is necessary to have an abortion from a qualified and trained professional. Besides, it is also advised if you have an abortion you meet your doctor and seek his/her medical attention in order to get healthy and fit as soon as possible..

July 2018 37

Keeping Track - Balance Disorders

Brain Goes Haywireâ&#x20AC;Ś Sense of balance relies on a series of signals to the brain from several organs and structures in the body. Balance disorders occur when the balancing organ within the ear, heart and nerves is not able to maintain coordination of body systems.

BY ABHIGYAN/ABHINAV

38 DOUBLE HELICAL

www.doublehelical.com

B

alance disorders are a combination of physiological factors that can make you feel unsteady or dizzy. While sitting, standing or lying down, you may feel as if you are floating, moving, or spinning and you may feel dizzy and dazed for the time being. This disorder can intervene in your daily activities of life, and can even lead to falls and accidents, which may cause you to end up with fractures and other types of injuries.

Balance disorders can be caused by certain health conditions, medications, or a problem in the inner ear or the brain. A balance disorder can profoundly impact daily activities and cause psychological and emotional hardship.

If you have a balance disorder, you may stagger when you try to walk, or teeter or fall when you try to stand up.

You might experience other symptoms like dizziness or vertigo (a spinning sensation), falling or feeling as if you are going to fall, faintness, floating sensation, blurred vision, confusion or disorientation and other symptoms might include nausea and vomiting, diarrhea, changes in heart rate and blood pressure, and fear, anxiety, or panic.

A combination and coordination of many body systems such as muscles, bones, vision, the balancing organ within the ear, heart and nerves help maintain normal balance. Dysfunction of these systems can lead you to encounter balance problems. Balance disorders can be caused by many types of conditions.

Other symptoms are nausea and vomiting, diarrhea, changes in heart rate and blood pressure, and fear, anxiety, or panic. Some people also feel tired, depressed, or unable to concentrate. Symptoms may come and go over short time periods or last for longer periods of time.

A balance disorder may be caused by viral or bacterial infections in the ear, a head injury, or blood circulation disorders that affect the inner ear or

brain. Many people experience problems with their sense of balance as they get older. Balance problems and dizziness also can result from taking certain medications.

In addition, problems in the visual and skeletal systems and the nervous and circulatory systems can be the source of some posture and balance problems. A circulatory system disorder, such as low blood pressure, can lead to a feeling of dizziness when we suddenly stand up. Problems in the skeletal or visual systems, such as arthritis or eye muscle imbalance, also may cause balance problems.

However, many balance disorders can begin all of a sudden and with no obvious cause.

Unfortunately, many balance disorders start suddenly and with no obvious cause. Sense of balance relies on a series of signals to the brain from several organs and structures in the body, which together are known as the vestibular system. The vestibular system begins with a maze-like structure in your inner ear called the labyrinth, which is made of bone and soft tissue.

There are more than a dozen different balance disorders. Some of the most common are benign paroxysmal positional vertigo (BPPV) or positional vertigo â&#x20AC;&#x201C; a brief, intense episode of vertigo that occurs because

of a specific change in the position of the head. If you have BPPV, you might feel as if you are spinning when you look for an object on a high or low shelf or turn your head to look over your shoulder (such as when you back up your car).

Migraines: Migraines are a general cause of dizziness. Sensitivity to motion can also be caused by migraines. It can also lead to motion sickness, which is dizziness experienced when traveling in boats, cars or airplanes.

Head injury: A severe concussion can also cause vertigo.

Ramsay Hunt syndrome: Commonly known as zoster otitis, this condition affects the nerves close to the ears. It can be attributed to hearing loss, vertigo and pain in the ear.

Vestibular problems and nerve damage: Damaged nerves in the legs can cause difficulty in movement and locomotion. Abnormalities and dysfunctions in the inner ear can lead to a sensation of dizziness and a heavy head.

To find out if you have a balance problem, your will be asked to see an otolaryngologist. An otolaryngologist is a physician and surgeon who specializes in diseases and disorders of the ear, nose, neck, and throat. wThe otolaryngologist may ask you to have a hearing examination, blood tests, an electronystagmogram (a test that measures eye movements and the muscles that control them), or imaging studies of your head and brain.

Another possible test is called posturography. For this test, you stand on a special movable platform in front of a patterned screen. The doctor measures how your body responds to movement of the platform, the patterned screen, or both.

The first thing a doctor will do if you have a balance problem is determine if another health condition or a medication is to blame. If so, your doctor will treat the condition, suggest a different medication, or refer you to a specialist if the condition is outside his or her expertise.

July 2018 39

Concern - Gaming Addiction

Gaming Addiction Today Gaming Addiction Is Being Considered Mental Health Disorder. The Arrival Of Computer And Internet Has Changed The Fundamental Childhood Needs Very Rapidly. Kids And Adults Alike Now Search For The Latest Gaming Platforms With The Highest Processing Power Chipsets And An Internet Plan With The Fastest Surfing Speed……..

BY DR. ADITI SAJWAN

40 DOUBLE HELICAL

www.doublehelical.com

T

he contemporary world has rapidly changed in the past two decades and has become more globalised and digital in comparison to the previous times. The arrival of computer and internet has changed the fundamental childhood needs very rapidly. Kids and adults alike now search for the latest gaming platforms with the highest processing power chipsets and an internet plan with the fastest surfing speed. Computer and Smartphone-based games have revolutionized the world and the concept of virtual reality. The attraction of losing oneself in the realms of virtual reality that has been provided by these new platforms is beyond anything.

But, what happens in reality when people get busy losing themselves in this “virtual reality”? Internet gaming disorder (IGD) has manifested as a rapidly growing public health problem

mainly affecting the teen and preteen population worldwide. It has a negative impact upon physical, psychological, social, and occupational functioning of the affected individual, often leading to severe consequences. It is only recently, World Health Organization (WHO) has included gaming disorder alongside gambling disorder under “Disorders Due to Addictive behaviors” in its diagnostic International classification of diseases 11th edition (2018).

WHAT IS GAMING DISORDER? Gaming disorder is defined in the draft 11th Revision of the International Classification of Diseases (ICD-11) as a pattern of gaming behaviour (“digital gaming” or “video-gaming”) characterized by impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily

activities, and continuation or escalation of gaming despite the occurrence of negative consequences.

For gaming disorder to be diagnosed, the behaviour pattern must be of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning and would normally have been evident for at least 12 months.

WHY IS GAMING DISORDER BEING INCLUDED IN ICD-11?

A decision on inclusion of gaming disorder in ICD-11 is based on reviews of available evidence and reflects a consensus of experts from different disciplines and geographical regions that were involved in the process of technical consultations undertaken by WHO in the process of ICD-11 development. The inclusion of gaming disorder in ICD-11 follows the

July 2018 41

Concern - Gaming Addiction

development of treatment programmes for people with health conditions identical to those characteristic of gaming disorder in many parts of the world, and will result in the increased attention of health professionals to the risks of development of this disorder and, accordingly, to relevant prevention and treatment measures.

GAMING ADDICTION AND DSM-5 Internet Gaming Disorder is a “Condition for Further Study” in the DSM-5 (APA 2013). This means that it is not an “official” disorder in the DSM, but one on which the American Psychiatrists Association request additional research. Upon further research, the APA may or may not decide to make the disorder “official” in future editions of the DSM. The DSM-5 states that Internet Gaming Disorder is most common in male

According to WHO, gaming disorder is still very rare, with less than 3% of all gamers believed to be affected. Lots of countries are grappling with the issue and in South Korea the government has introduced a law banning access for children under 16 from online games between midnight and 06:00

42 DOUBLE HELICAL

adolescents 12 to 20 years of age.

According to studies, it is thought that Internet Gaming Disorder is more prevalent in Asian countries than in North America and Europe (APA, 2013) PATHOPHYSIOLOGY OF GAMING ADDICTION. In an influential 2001 article on the gaming industry website Gamasutra, then-psychology graduate student John Hopson deconstructed game design through the lens of behavioural psychology, introducing developers to language, such as “reinforcers” (game rewards: for example, advancing to higher levels or collecting new tokens or treasures) and “contingencies” (the game rules that govern when reinforcers are handed out).

At the center of this understanding of addiction is the brain’s reward system, in which using the substance triggers release of the neurotransmitter

dopamine, which influences cells in the brain areas, such as the prefrontal cortex. Repeatedly activating these complex circuits modifies neural connections until these circuits respond to mere anticipation of the reward —as in Pavlovian conditioning—and produces the classic symptom of craving There is little to no research, however, on whether these specific awards systems contribute to cases of video game addiction. Another way in which games may provoke an addiction-like cycle is through the march of technology: as manufacturers and developers create more powerful equipment and deliver better graphics, gamers take part in more immersive

www.doublehelical.com

and novel experience.

GLOBAL AND INDIAN SCENARIO According to WHO, gaming disorder is still very rare, with less than 3% of all gamers believed to be affected.

Lots of countries are grappling with the issue and in South Korea the government has introduced a law banning access for children under 16 from online games between midnight and 06:00. In Japan, players are alerted if they spend more than a certain amount of time each month playing games and in China, internet giant Tencent has limited the hours that children can play its most popular games. In India, the online gaming industry is estimated to be the highest growth sector in the media and entertainment industry, with an average growth rate of 27.5% between 2016 and 2020 compared to the overall industry’s 11.6% for the same period, according to a March 2018 report by industry association FICCI and consulting firm EY. There have been case reports in India of kids and young adults visiting psychiatrist and psychologist seeking medical help for changes in behavioural pattern owing to enormous time spent on both online and offline gaming .Recently one of the news report in Hindustan times, reported that In the last few years, the number of teenagers and young adults coming for counseling over gaming addiction has risen significantly, mostly due to increasing awareness about the problem. The addiction to online gaming is mostly being seen in the age group of 12 to 25 years. But there have been no substantial study on Internet gaming addiction in the country as yet.

SCIENTIFIC LITERATURE ON ADDICTION TO THE INTERNET, VIDEO GAMES, AND CELL PHONES So far this has been an area of very low quality research.The number of publications on technological addictions reached a peak in 2008.A

subsequent decrease in the pattern could be associated with the fact that scientific interest shifted from addictive properties of the Internet and specific applications, such as online games, to social networks. The scientific contributions of countries such as China, Taiwan, and Korea are overrepresented compared to other scientific fields such as drug addiction, something which could be due either to a higher prevalence of this addictive behaviour in these countries and/or to a publication bias. Studies also show that research on the effects of technology on human behaviour is riddled with methodological errors.

INTERNET GAMING ADDICTION: DISORDER OR A MORAL PANIC WHO’s action has been criticized by some researchers, who have said the evidence remains weak, and “there is a genuine risk of abuse of diagnoses”.

Whether video games can produce a true addiction in a clinical or scientific sense is still highly controversial. One reason is the lack of a “gold standard” for diagnosing Internet gaming disorder is because, to date, there have been at least 18 different ways researchers have operationalised Internet gaming disorder.

This is problematic because these different methodologies have produced prevalence rates of Internet gaming

disorder ranging from almost zero to a high of 45%. Another reason some oppose classifying IGD as an addiction is the term’s derogatory connotation.

CONCLUSION Studies suggest that gaming disorder affects only a small proportion of people who engage in- or video-gaming activities. However, people who partake in gaming should be alert to the amount of time they spend on gaming activities, particularly when it is to the exclusion of other daily activities, as well as to any changes in their physical or psychological health and social functioning that could be attributed to their pattern of gaming behaviour. The WHO said classifying gaming addiction as a mental health disorder “will result in the increased attention of health professionals to the risks of development of this disorder and, accordingly, to relevant prevention and treatment measures Significant research attention needs to be given to this newly recognized disorder to improve understanding of risk factors to development, appropriate treatment and intervention strategies..

(The author is Post graduate, Department of Community Medicine, Maulana Azad Medical College, New Delhi)

July 2018 43

Earcare - Hearing Problems

Headphones & Hearing Problems – Are You Listening?

BY DR. A K AGGARWAL

G

adgets and technologies were aimed to make life entertaining but not at the cost of one’s own health.

Improved technologies have made the mankind get entrapped in the comforts and luxuries, leading to imposition of many side effects on health. Ear phones and headsets are one such technology!

Forced, improper or over use of ear phones, headsets, leads, iPods, and Bluetooth can cause impairment or loss or damage to hearing. Their use not only affects the user but the surroundings too.

Exposing your ears to prolonged & high intensity of noise more than 85 db can lead to permanent hearing loss

44 DOUBLE HELICAL

which can never be recovered back & permanent damage can occur.

Cochlea is the main sense organ of hearing & has very delicate hair cells

which detect sound frequencies. These hair cells can get damage if exposed to prolonged duration of sound intensity of around 85- 125 db like from the noise of aeroplane or missile or gun firing or listening to head phones at very high volumes.

Once these hair cells are damaged they generally do not recover specially if the high intensity exposure is not controlled & patient may experience hearing loss at high intensities , continuous ringing or buzzing sensation called tinnitus , headache , irritation ,lack of sleep , depression & difficulty in routine day to day activities. Then they may require the support of hearing aids & when profound hearing loss occurs where hearing aids also don’t

www.doublehelical.com

benefit they may require a cochlear implant surgery” Moreover, many people just get lost in the world of music with the use of earphones, headsets, and loud speakers while driving, specially on highways, making the driver unable to hear the sound warnings given by other people or vehicles; thereby paving way to accidents. People also experience loss of balance owing to messed up air pressure effects.

In addition, these gadgets being constantly exposed to dirt and moisture also increase the risk of infections and other ear diseases. Prolonged ear phone use also irritates the temporomandibular joint near the ear canal causing soreness and pain in the ear. Also, sharing the leads with family and friends is a big unsafe practice. The bacteria from one person’s ear can travel to other person. Personal ear plugs are advisable.

People are advised to use ear phones in a subtle timed manner and buy only those products which fit their ear properly. Else, the skin inside the ear may get irritated or tear due to repeated adjustments. This may also cause bacterial infections.

Ear wax drains daily from our eyes.

Frequent prolonged use of ear leads hampers the movement of ear wax and may lead to conditions such as tinnitus (ringing of ears), pain in ears, infection, or even hearing loss.

These gadgets produce electromagnetic waves/currents which are proven to be really dangerous for the human brain. The idea of using electric currents to change the brain functions is not new. People using bluetooth daily often experience unexplained headaches.

World Health Organization (WHO) considered the wrong lifestyle of using earphones has aimed to reduce the hearing loss cases and deafness by by 90% over the next 15 years. Noise pollution is one of the most common causes of hearing impairments in adults.

The gadgets must not be used continuously beyond 15 minutes at one

• Ear phones, headsets, leads, and Bluetooth can cause impairment or loss or damage to hearing • Drivers unable to hear sound warnings due to loud music causing accidents • Ear gadgets cause many health ailments • 1 in 5 teens suffer from some hearing loss • Sound at 85 dB or below is considered safe. go. Otherwise, there is a hearing loss threat. Giving rest to ears in between is a must. Some brands are making ear phones that have to be inserted directly into the canal resulting in blockage of air passages leading to infections and hearing loss over a period of time. MP3 players should be used upto 60% of their maximum volume for maximum of 1 hour daily.

We should ensure regular cleaning of ear gadgets and also the ears. In case of any infection, the use of ear phones must be immediately discontinued and ENT doctor must be approached. Ear phones can be cleansed by immersing them in a bowl of lukewarm with few drops of anti-bacterial soap; cleansing the soap thoroughly later and drain excess water and letting the earphones dry completely before reuse. Even

hands should be washed thoroughly before using ear leads. In case of rubber or sponge covers, these must be changes at least monthly.

Ear plugs must be fitted in the ear with rotation. Never try to push it too far into the canal. Also, the removal of earphones must not be pulling harshly as it may damage the ear drum. Rather it should be twisted gently out of the ear. Older style, larger headsets that rest over the ear are far better than ear phones.

With the right tools, we need the right approach and right attitude, to generate smarter version of ourselves!.

(The author is Professor of Excellence, Senior ENT Specialist and Medical Advisor, Apollo Hospital, New Delhi)

July 2018 45

Health Check - Chronic Fatigue Syndrome

Unknown and Mysterious Fatigue Chronic Fatigue Syndrome is a strange and mysterious malady that has no known cause or origin but continues to puzzle and ravage the humans like no other disease. Here we take a broad look at the way the diseases haunts our life

BY DR. MANISHA YADAV

I

f you feel tired for a long period of time and find that nothing can boost your energy levels, then you might just be suffering from Chronic Fatigue Syndrome (CFS).

The fatigue caused by CFS may worsen with physical or mental stress. There are many symptoms like tiredness that may last for at least six months or even more which is not relieved by rest and is not caused bysome other medical conditions such asmood swings, dizziness, loss of memory, difficulty in concentration, myalgia (muscle pain), arthalgia (joint pain) with no signs of inflammation, headache, recurrent sore throat and tenderness of cervical and axillary lymph nodes.

CFS is a debilitating illness of unknown origin and cause. It is often thought of as a problem in adults, but it also affects children and adolescents.

Between 0.2% and 2.3% of children or adolescents suffer from CFS. It is more prevalent in adolescents than in younger children. In adolescents, CFS is more likely to develop after an acute fluor mononucleosis-like illness, but gradual onset of illness may occur.

Currently, the diagnosis is made on the basis of ruling out other conditions that could explain most of CFS symptoms.

Managing CFS can be as complex as the illness itself. Options for treating and managing it may include treating the most disruptive symptoms such as fatigue due to sleep problems, pain, and lightheadedness. CFS symptoms

46 DOUBLE HELICAL

can vary over time and may require periodic re-evaluation. Primary care providers can develop effective treatment plans based on their experience in treating other complex illnesses. Management may require input from a variety of healthcare professionals (e.g. medical doctors, rehabilitation specialists, mental health professionals, and physical or exercise therapists) when available.

People normally feel that fatigue is caused by excessive physical stress, exercise, lack of sleep and nutrition.

But there is another angle to this that most people are unaware of. Many serious illnesses may make you tired but there are a few minor health conditions that are found to leave you washedout. Iron deficiency anemia is one of the most common medical

reasons to make you feel tired. Your muscles will feel heavy or you will get tired easily, especially if you are pregnant. Depressed people usually feel exhausted due to sadness, loneliness and loss of appetite. Talk to your doctor to feel better and get rid of this problem quickly.

Underactive or over-active thyroid gland is found to make you feel tired.

Common in women, this condition usually happens once you get older.

Sleep apnea is clinical condition that results in snoring and difficulty in breathing causing low blood oxygen levels in the body. This makes you to wake up often in the night making you feel exhausted the next day.

If you feel tired while performing normal day-to-day activities or are experiencing trouble with your daily

www.doublehelical.com

exercise, then this is usually because of an undiagnosed heart trouble.

A few people develop Chronic Fatigue Syndrome after a viral infection.

So, it is also known as Post Viral Fatigue Syndrome (PVFS). People suffering from CFS have a slightly impaired immune system, but it is not clear whether this impairment is sufficient to actually cause this disorder.The significance of hormonal abnormalities is still unknown but the evidences point

to certain abnormalities in the hypothalamic–pituitary–adrenal axis in the chronic fatigue syndrome.As some patients produce low level of cortisol as compared to a healthy individual,their cortisol levels are still within the acceptable range of what is considered normal. Therefore, cortisol level is not used as a way to diagnose CFS. Neurally mediated hypotension (abnormally low levels of blood pressure) and nutritional deficiency are also cause of chronic fatigue syndrome Treatment strategies are usually symptomatic that is targeted to relieve the symptoms associated with it, so managing the disruptive symptoms first which are fatigue, sleep disorders, pain, depression, anxiety, dizziness, mood disorder, loss of concentration and infections. To maintain healthy,

People normally feel that fatigue is caused by excessive physical stress, exercise, lack of sleep and nutrition. But there is another angle to this that most people are unaware of. Many serious illnesses may make you tired but there are a few minor health conditions that are found to leave you washed out adding up of flax seed oil, green vegetables, avoiding coffee and junk and limiting the intake of dairy products are among a few changes in the dietary habit which will help to combat CFS. Improving the quality of life means cognitive behaviour therapy is a moderately effective psychological therapy when is used to treat CFS.It is often used with other therapies to manage activity levels, stress and symptoms.

To treat CFS, a management programme should address major

challenges, varying and unpredictable symptoms, a decrease in stamina that interferes with activities of daily life, memory and concentration problems that adversely affect school performance changes in relationships with family members and friends.

So doctors, family members, and patients need to communicate with one another about which symptoms are most disruptive or disabling so they can tailor the management plan accordingly.

Treatment can be directed toward the most problematic symptoms as agreed upon by the patient, family members and doctors.

When family members and children communicate with doctors about the child’s lifestyle and behaviours, they can make important distinctions. For instance, whether the child’s lack of usual energy is because of fatigue or the result of normal changes in sleep cycles that may begin at puberty. Such distinctions are important because they affect the management plan for the child.

Many CFS patients, including children and adolescents, experience sleep problems. Common sleep complaints include difficulty falling or staying asleep, daytime sleepiness, frequent awakening, and intense and vivid dreaming. Adult patients report that they feel less refreshed and restored

July 2018 47

Health Check - Chronic Fatigue Syndrome

after sleep than they felt before they became ill.

In young children, this problem is detected by a lack of their usual energy.

Sleep problems in adolescents with CFS may be challenging to detect, as sleep cycles may begin to change with the onset of puberty, such as staying up later and sleeping in. The demands of school classes, homework, after-school jobs, and social activities also affect sleep patterns.

Doctors can help people with CFS adopt good sleep habits. Patients should be advised to practise standard sleep hygiene techniques.

CFS patients frequently report experiencing post-exertional malaise or post-exertional relapse, which is the exacerbation of symptoms following physical or mental exertion. This relapse typically lasts 12-48 hours after activity and could even last days, weeks, or months. For patients with CFS, managing activity levels is a key part of managing the illness. It is important to find a balance between

48 DOUBLE HELICAL

CFS is a debilitating illness of unknown origin and cause. It is often thought of as a problem in adults, but it also affects children and adolescents.Many CFS patients, including children and adolescents, experience sleep problems.

Common sleep complaints include difficulty falling or staying asleep, daytime sleepiness, frequent awakening, and intense and vivid dreaming

inactivity and excessive activity, which can aggravate CFS symptoms. This often requires a new way of thinking about daily activities. For example, daily chores and school activities may need to be broken down into shorter time frames. A symptom diary can be very helpful for managing CFS. Keeping daily track of how patients feel and what patients do, may help to find patterns or identify triggers when symptoms start to affect daily activities.

Parents may work with teachers and administrators to redefine expectations of activity and performance for children with CFS. It is true that exercise can benefit children with certain chronic illnesses. While the overall goal is to help CFS patients tolerate exercise again, children with CFS should avoid activity that results in aggravated CFS symptoms. Activity programs aimed at vigorously increasing aerobic capacity are not recommended.

(The author is Medical Practitioner, New Delhi)

Your Guide to Healthy Living Subscribe to Double Helical Magazine Now

Subscription Offer Duration (year)

Issue

Newsstand Price INR

Subscription Price INR

Savings Price INR

1

12

1200

1020

180

2

24

2400

1920

480

3

36

3600

2520

1080

Please ďŹ ll this form in Capital Letters First Name......................................................................................................... Last Name.........................................................................................................

Designation/Profession................................................................................................................................................................................................................

Mailing Address.............................................................................................................................................................................................................................

City....................................................................................................................... Postal Code.....................................................................................................

State.................................................................................................................... Country.............................................................................................................

Telephone........................................................................................................... Fax......................................................................................................................

Email.................................................................................................................. Website..............................................................................................................

I/We would like to subscribe for

1

2

3

Year

I am encloing a cheque/DD No. .................................................................. Drawn on ............................................................................. (Specify Bank) Dated....................................................................................................................................................In favour of Double Helical Pvt. Ltd. payable at Ghaziabad For Rs ....................................................................................................................................................................................................only

Advertisements & Marketing Abhinav Kumar, Gaurav Gautam Email: SALES@doublehelical.com All material printed in this publication is the sole property of Double Helical. All printed matter contained in the magazine is based on the information of those featured in it. The views, ideas, comments and opinions expressed are solely of those featured and the Editor and Publisher do not necessarily sub-scribe to the same.

Double Helical is owned, printed and Published monthly. It is printed at Polykam offset, Naraina Industrial Area Phase 1, New Delhi-110028, and published from G-1, Antriksh Green, Kaushambi, Ghaziabad-201 010. Tel: 0120-4219575, 9953604965.

Contact us CONTACT DOUBLEHELICAL COM Email: EDITOR@doublehelical.com, DOUBLEHELICALDESIGN@gmail.com Website: www.doublehelical.com, www.doublehelical.in

Concern - Stress

Will Dying be optional?

DYING will be ‘optional’ within just 27 years and the ageing process will be ‘reversible’, according to two genetic engineers during the presentation of their new book in Barcelona………

BY ABHIGYAN/ABHINAV

J

osé Luis Cordeiro, born in Venezuela to Spanish parents, and Cambridge (UK) mathematician David Wood, founders of the operating system ‘Symbian’, have just published The Death of Death and say immortality is a real and scientific possibility that could come much earlier than originally thought.

Humans will only die in accidents, never of natural causes or illness, by around the year 2045, say Cordeiro and Wood, who say it is ‘crucial’ that old age starts to be classified as an ‘illness’ so that publiclyfunded research into its ‘cure’ can extend.

Nanotechnology is key, among other new genetic manipulation techniques, the engineers said during the presentation at Barcelona’s Equestrian Circle. The process will involve turning ‘bad’ genes into healthy ones, eliminating dead cells from the body, repairing damaged cells, treatments with stem cells and ‘printing’ vital organs in 3D. Cordeiro, who is based at the Massachusetts Institute of Technology (MIT) in the USA, says he has ‘chosen not to die’

50 DOUBLE HELICAL

www.doublehelical.com

and that in 30 years’ time, he will be ‘younger than he is today’.

Ageing is the result of DNA ‘tails’, known as ‘telomeres’, in chromosomes – of which every cell except red blood and sex cells has 23 pairs – becoming shorter, and reversing ageing involves lengthening the telomeres. Telomeres become damaged and shortened with the passage of time, a process that speeds up in the event of toxins entering the body – smoking, alcohol and air pollution are among elements that reduce the length of telomeres, thus accelerating ageing.

Cordeiro and Wood believe that within 10 years, illnesses such as cancer will be curable, and that major international corporations such as Google will be ‘entering the field of medicine’ because they are ‘beginning to realise that curing ageing is possible’.

Microsoft has reportedly already announced the setting up of a cryopreservation centre in which a scientist is researching the possibility of cancer being completely curable within a decade.The engineers explain that, although ‘people generally do not know about it’, it was discovered in 1951 how cancer cells are immortal: when Henrietta Lacks died from cervical cancer, surgeons removed the tumour and kept it – and it is still ‘alive’ today.

Immortality will not necessarily mean the planet becomes overcrowded, the scientists say: there is still plenty of room for more people on Earth, and these days, people do not have anywhere near as many children as they did in past decades and centuries; plus, ‘it will be possible to live in space by then’.

“Japan and the Koreas, if they continue with their current trend of hardly having any children, will become extinct – within two centuries, there’ll be no Japanese or Korean people on the planet,” Cordeiro says. “But thanks to these new techniques, there will indeed be Japanese and Korean people, because they’ll live forever and remain young.”

The cost of anti-ageing treatment

was compared to that of the latest SmartPhones. “At first, it’ll be expensive, but with a competitive market the price will gradually fall because it’ll be something that benefits everyone,” Cordeiro says.

“Technology, when it’s new, is poor and extremely expensive, but it eventually becomes democratic and mainstream and becomes cheaper.”

The engineers say they have already been employing their techniques for two years – illegally, but in Colombia where there are fewer regulations covering genetic manipulation.

Elisabeth Parrish, their first human patient, ‘started to see symptoms of

ageing and asked what could be done to prevent it’. Her treatment is ‘very risky and even illegal’, Wood explains, but at the moment is going well, has not had any adverse side-effects, and the level of telomeres in her blood is ‘20 years younger than before’.

“I want Spain to have a place in the world of these technologies and show that we’re not mad, it’s just that people still don’t know about them,” Wood concluded.The Death of Death will eventually be published in four languages at first – Spanish, English, Portuguese and Korean – and all proceeds from its sales will be ploughed back into the authors’ research.

July 2018 51

Special Focus - Child Care

Need of Woman and Child Hospital Many medications can cause bothersome oral side effects, such as dry mouth/xerostomia, altered metallic taste affecting the taste buds, swollen and tender gums leading to periodontitis or gingivitis, mouth ulcers/sores. Learn how to copeâ&#x20AC;Śâ&#x20AC;Ś..

BY DR. NEELAM MOHAN

52 DOUBLE HELICAL

www.doublehelical.com

I

ndia with 1.21 billion people constitutes as the second most population country in the world while children represented 39% of the total population of the country. One third of population is children in the age between 0-5 years.

India has the largest child population in world, 20% of children of the world live in India.

In India about 1.83 million children die annually before completing their fifth birthday which is about 20% of child death globally. Recent study published in the medical journal Lancet in last ten years 2005-06 to 2015-16 India’s infant mortality rate (IMR) reduced by 16 points, from 57 children below the age of one died per 1,000 live births a decade ago, reduced to 41.

There is 24-point reduction in India’s under-five mortality rate: From 74 children under five dying for every 1,000 live births in 2005-06, by 201516 it is 50. Still these figures are very high thus there is a need, to be more focused on the child health issues. For child care, mother shall be healthy. A report of World Health Organization, in 2013 reported about 800 women died everyday due to complications of pregnancy and child birth, 20% of these women are from India. The

recent World Bank data puts the Maternal Motility Rate (MMR) for India reported in 2015 at 174 per 100, 000 live births, which is a significant decline from the 215, figure that was reported in 2010.

In absolute numbers, nearly 45,000 mothers die due to causes related to childbirth every year in India. This is an alarming situation and needs to be addressed in priority. Sick children are not miniature adults, their needs are different, there disease profile and treatment requires specialized skill and equipments. World has moved on and created centres of Excellence for

Delhi/NCR has been working a lot in various health projects and has been DPRQJ WKH ͤUVW LQ India, several health care polices such as universal hepatitis B vaccination, Rota virus vaccination, TB eradication, etc

child care. It’s routine in USA, UK, Australia for last few decades to have large Children’s Hospital in their States such as Texas Children’s Hospital, The Children’s Hospital of Philadelphia, Sydney Children’s Hospital (Australia), Boston Children’s Hospital & Cincinnati Children’s Hospital Medical Centre (USA), Pittsburgh Children’s Hospital (USA) & Birmingham Children’s Hospital (UK).

In India, though we kept pace with adult care at par with world but dedicated pediatric hospitals are nowhere compared to adult super speciality set up. There is a desperate need for dedicated Children’s hospital in India. This is now probably in the list of Government of India and States Health Care.

Delhi/NCR has been working a lot in various health projects and has been among the first in India, several health care polices such as universal hepatitis B vaccination, Rota virus vaccination, TB eradication, etc. Our vision is to establish dedicated STATE OF THE ART CENTRE for mother and child care with world class facilities along with research unit, a much required need for India today. Delhi/NCR would be in the forefront in Health by show casing first of its kind a large Child and Women hospital.

July 2018 53

Special Focus - Child Care

DR. NEELAM MOHAN, DNB (PEDIATRICS), FPGH (UK) , FRCPCH (UK) , FIMSA, FACG (USA), FIAP is a President of CHILD Society. She is also one of the few women doctors in India who has balanced the various pillars of medical profession and is appreciated as an astute clinician/healer, bright teacher, researcher, efficient leader/ administrator and for her contribution in social work. For her pioneering achievements in her field of Pediatric Gastroenterology, Hepatology and Liver Transplantation, she has received the most prestigious award in medicine in India the ‘Dr. B.C. Roy award’ for best talents in encouraging the development of medical specialties, by the President of India probably the only women doctor to get in this field. She has to her credit many achievements that has put the country on the global medical map.

She is a pioneer in setting up a successful pediatric liver transplant program in India 1st at

54 DOUBLE HELICAL

Sir Ganga Ram Hospital, then at Medanta the Medicity Hospital. Her sincerity, dedication and passion was fruitful in producing excellent outcome at par with the best centres in World. India’s first doctor to start therapeutic endoscopic work in newborns and young infants. She is credited with establishing the busiest Pediatric Liver Transplant Programme in the country with more than 250 liver transplants in small children. She has achieved several firsts in her dynamic career, with few worlds, level credits and several national level credits.

Dr. Neelam Mohan has vast experience of teaching young doctors and established India’s first fellowship training programme in pediatric gastroenterology & Hepatology. She has >700 presentation of which >154 are international with 134 publication, 74 international and has authored 47 chapter in various books in her filed. To improve healthcare and outcome in mother and child care by providing current, safe and holistic healthcare services by well trained experts and healthcare workers at a

world class state of art institute using cutting edge technology at an affordable price to all sectors of society and most importantly with a charitable content (upto25%) that will allow world class “best in country” medical facilities to the destitute with serious/life threatening ailments and medical needs.

2. Leading healthcare beyond the bottom line by stressing on human resources, patient outcome, employees satisfaction and welfare of society and development of science.

OUR MISSION 1. To create a centre of excellence for Pediatric Superspeciality medical care, teaching, training and Research.

2. To create community outreach support programs for human well being.

3. To create an effective referral network within and outside India for smooth referral and transfer of patients.

4. To reduce infant and maternal mortality and morbidity rate.

www.doublehelical.com

5. To serve the needy and underprivileged sector The Institutes will train medical graduates, post-graduates with international levels of quality and efficiency in health care delivery. The Institutes will implement new approaches for medical education.

They will provide best facilities for postgraduate studies and research.

The Institutes will also have Nursing College intake will be 60 students with the Institutes of Paramedical sciences having annual intake of 60 students.

The Institutes, with state-of-theart high-tech medical equipment, will offer diagnostic and therapeutic care in clearly identified specialty and super-specialty services. The Institutes will also conduct health research, both basic and applied.

THE PROJECT WILL HAVE 3 PHASES: 1. Phase one: 150 beds.

2. Phase two: 150 beds.

3. Phase three: 200 beds.

DEPARTMENTS : INSTITUTION SHALL CONSIST OF: MOTHER CARE DEPARTMENT Obstetrics & Gynecology In Vitro fertility In Utero surgery NEONATAL CARE DEPARTMENT Neonatal Surgery Neonatology CHILD HEALTH DEPARTMENT Anaesthesiology Adolescent medicine Cardiology Critical Care Child Gynecology • Developmental Pediatrics • Dermatology • Emergency • Endocrinology & Metabolic Diseases • General Pediatrics

• Gastro-enterology and Hepatology • Hematology • Immunology • Neurology • Nephrology • Occupational therapy • Oto-rhinolaryngology (ENT) • Ophthalmology • Oncology • Orthopedics • Psychiatry & Pediatric Psychology • Physiotherapy • Play therapy • Pulmonary Medicine • Rheumatology SURGERY (OPEN / LAPAROSCOPIC / ROBOTIC) • Cardio -thoracic & Vascular Surgery • General Surgery • GI and Liver • Neuro surgery • Plastic surgery • Surgical Oncology • Urology ORGAN TRANSPLANTS • Liver, Kidney, Bone Marrow • Stem cell transplants ABORATORIES • Transfusion Medicine & Blood • Pathology with Central Laboratory Services • Microbiology • Radio-Diagnosis (X-Ray, USG, CT-Scan, MRI, PET-Scan) • Radio Therapy • Nuclear Medicine

CARE BED DISTRIBUTION • 200 General bed (10% free and 15% reserved for subsidised patients) • 150 bed in ICU,NICU, PICU, SNCU,HDU • 150 bed Private ward having facility of Twin sharing, single patient, Deluxe room and Suite.

FACILITY IN HOSPITAL • Bunkers for patient attendant admitted in ICU or other critical

• • • • • • • •

areas.

15 State of art OT 2 Minor OT, 1 emergency 5 Labour room Outpatient consultation room 60 Radio diagnostic (X-ray /CT Scan / MRI / Nuclear Medicine) Cath Lab, Endoscopy suites, interventional radiology suites Laboratories.

Classrooms / Meeting rooms

RESEARCH WING • Lecture theatres 2 each for 20,50 and 100 seats • Laboratories • Animal lab.

• Auditorium 500 seats • State of art research labs • Library • Meeting room • Administration offices.

Service needs of these facilities plays an important part in the development of the facility. Thus building services, mechanical systems, materials of Construction and movement systems for waste management etc form a major component of these facilities. Some of these services for purposes of broad identification are: • HVAC & Infection Control • PS & Emergency supply • Fire-fighting & Detection • Central Vacuuming and Centralized waste chute disposal • Building Maintenance Management • Green & Energy efficiencies • Paperless systems • Building cleaning systems • Medical Equipment interface Sarai/inn .Some accommodation for Sarai/Dharamshala is also required to be built for the relatives of the patients coming from far flung area. It should have all the facilities such as toilets, kitchen, stores for beds etc.

July 2018 55

Menâ&#x20AC;&#x2122;s Health - Common Problems

Men Beware There are some health issues that men can ignore only at their peril

BY DR. VINAY LABROO

56 DOUBLE HELICAL

www.doublehelical.com

G

eneral health is a topic that most men usually ignore. In todayâ&#x20AC;&#x2122;s fast paced life, they donâ&#x20AC;&#x2122;t take time out for themselves and often become careless about their health. Mentioned below few signals that the body shows which no one should ignore.

Excessive thirst: The repeated feeling of being thirsty is a typical symptom of Type 2 Diabetes. According to a recent data approximately 33 million men are suffering from diabetes in India. And out of that a good percentage has undiagnosed diabetes.

So, if you observe that you are constantly feeling thirsty along with other symptoms

July 2018 57

Men’s Health - Common Problems

like blurred vision, frequent urge to go to washroom, sudden weight loss and slow healing of any injury or cuts or wounds, visit a doctor for a blood sugar test. Also, if you are above 45 and have a family history of diabetes or if you are overweight, getting your blood sugar tested once is a year is very important.

Feeling tired and restless all the time: Increased work pressure often, makes one feel tired. But, if this problem extends for long time even after having a good night sleep, it is an indication of some underline disease like heart disease, diabetes or depression.

Persistent Constipation: Constipation is a very common problem faced equally by both men and women everywhere. But if this problem doesn’t get cleared after few days, consulting a doctor is very important. Continued constipation can be signal of Colon cancer if accompanied by dark colored urine or rectal bleeding.

Pain while urinating: Generally, this

58 DOUBLE HELICAL

CFS is a debilitating illness of unknown origin and cause. It is often thought of as a problem in adults, but it also affects children and adolescents.Many CFS patients, including children and adolescents, experience sleep problems. Common sleep complaints include GLIͤFXOW\ IDOOLQJ RU staying asleep, daytime sleepiness, frequent awakening, and intense and vivid dreaming

symptom is associated with urine infection but it can also be a sign of enlarged prostate or prostate cancer.

Other symptoms highlighting the possibility of this problem are swollen prostate leading to frequent urge to urinate, trouble in urinating or emptying your bladder or unusual smell from urine.

Snoring: Snoring isn’t just a sign of lack of rest but also, of Sleep Apnea which is found more in men as compared to women. Those men who snore regularly should visit a specialist.

Feeling out of breath while climbing stairs: This is a classic signal of any cardiovascular (heart) disease.

Heart diseases accounts for maximum number of deaths in men. So, if you feel breathless after doing any normal physical activity, make sure to get your blood pressure and cholesterol levels checked. Besides, few other symptoms like chest pain, light headedness, cold sweat are few other signals that no one especially men should never ignore.

Indigestion or heartburn: Irregularindigestion or the problem of acidity is normal. But if a manhas the problem of chronic indigestion on a regular basis, it can lead to esophageal ulcers or esophageal cancer.

(The author is Expert Internal Medicine, New Delhi)

sayahomes.in

TALLEST TOWERS AT OF INDIRAPURAM

Actual Image

Wow location close to proposed lane NH-24 Widening of National Highway 24 in progress Only 5 minutes drive from Delhi Surrounded by most happening operational shopping malls Quality construction with Modern Korean Technology Earthquake resistant structure approved by IIT Mumbai Semi furnished 2/3/4 BHK residences Possessions starting from December, 2018 Option to flexible payment plans

DELIVERED BEFORE TIME

TIMELY OFFERED FOR POSSESSION

eightowls.in

TIMELY DELIVERED

COMING SOON... COMMERCIAL EDUCATION

Call 9999955678

* Terms & Conditions Apply

LOADS OF AMENITIES SEMI-OLYMPIC SIZE SWIMMING POOL | HEALTH SPA WITH STEAM, SAUNA & JACUZZI | GYM & INDOOR GAMES AREA | ACTIVE SPORTS LAWN THREE TIER SECURITY | CAR PARKING IN THREE BASEMENTS & STILT LEVEL | SUFFICIENT NO. OF LATEST ELEVATORS | WATER SOFTENING PLANT 100% POWER BACK UP | PROVISION FOR PNG | FIRE FIGHTING SYSTEM | RAIN WATER HARVESTING

Home Loans Available From

SAYA HOMES PVT. LTD. Corp. & Site Office : Pot 10/1, 10, Vaibhav Khand, Opposite Shipra Mall, Indirapuram, Ghaziabad-201014 | Tel : 0120-4656200 | Email : info@sayahomes.in CIN NO. U70101DL2010PTC211055 Registered Office : B-7/45, Safdurjung Enclave Extension, New Delhi- 110029 | www.youtube.com/sayahomes | www.facebook.com/saya.homes

RERA COMPLIANT PROJECT PHASE 1 : UPRERAPRJ6548 PHASE 2 : UPRERAPRJ6678

Disclaimer: Map sanctioned & approved by GHAZIABAD DEVELOPMENT AUTHORITY vide map sanctioned letter no. “41/191/Zone - 6/12-13” , dated 22-6-2015, Transfer Deed executed & registered on 05-05-2015, in the office of sub-registrar-IV, Ghaziabad, mentioned in Bahi no. 1, Jild no. 29584. Page no. 145-182, Registration no. 8688. *Terms & conditions apply. 1sq mtr. = 10.764 sq. Ft.