Doctor’s blog

Diet can be defined as “the kind of food on which a person or a group of persons survive”. Balanced diet can be defined as “a diet which contains a variety of foods in such quality, quantity and proportions that the need for energy (calorie), proteins (amino acids), fats (including essential fatty acids), carbohydrates, vitamins, minerals, other nutrients and micronutrients are adequately met for maintaining health, vitality and general well-being and also makes a small provision for extra nutrients to withstand short duration of leanness”. Balanced diet has become the accepted means to safeguard the nutritional deficiencies of any nation, especially in the poor nations.

The balanced diet may vary in different countries of the world and in a same country also it may vary according to the regions. Some principles should be kept in mind while constructing balanced diet for a group of population. The principles are: (a) the most important part of a balanced diet is the protein content and it should be 10-15% of total energy intake. The protein should contain all the essential amino acids that are required by a human. (b) Next important is the fat content of balanced diet, which should not be more than 15-30% of total calorie intake and should contain essential fatty acids. (c) The remaining calorie intake should come from carbohydrates which are also rich source of dietary fibers. (d) Next important is provision of nutrients like vitamins, minerals and many other micronutrients.

The dietary pattern has wide variation in different parts of the world and the dietary habit generally develop according to the locally produced foods or imported foods, which in turn depends on the climatic condition of the region. The food or dietary habits also vary according to region, religion, economic capacity, customs, taboos, habits of the people etc. A balanced diet should address all the requirements for a group of population.

Anal fissures are tears or cuts in the anus and the tears or cuts may extend upward into the anal canal. Anal fissures are common health problem affecting men and women equally. Anal fissure can occur among young and old alike and can be very painful condition which is difficult to tolerate.

Anal fissures occur in the area called anoderm, which is the place where the skin and the mucosa of anal canal join. The anoderm do not have hairs, sweat glands, or sebaceous (oil) glands. Anoderm is richly supplied by large numbers of sensory nerve fibers which are responsible for light touch and pain sensation and cause severe and excruciating pain if cut or torn as seen in anal fissures. As anoderm is devoid of any gland (e.g. sweat gland, sebaceous glands) it may be responsible for easy tearing or cut injury.

Symptoms of anal fissures:

Pain, may be very severe, is the most common symptom of anal fissures. Pain of anal fissure may worsen with bowel movements. The pain of anal fissure may be short duration or may be long lasting. The pain of anal fissures may be severe sometimes and the patients do not want to have a bowel movement and results in constipation. In severe cases there may be impaction of feces. Constipation may cause worsening of the condition, as hard stool (which occurs in case of constipation) can cause further damage/tear/cut of anal fissures.

Some patients of anal fissure may have pain during urinating also. Other symptoms of anal fissure include bleeding (less frequent and small amount of bleeding, but more common among infants), itching, discharge of pus from fissures etc.

Anal fissure is a tear or a cut in the anus, which may extend upwards inside anal canal. Anal fissure is a common health problem and affect many people. It is estimated that approximately 10% (6-15%) of all visits to colorectal surgeon are due to anal fissure, which can help to understand that anal fissure is common health problem. Men and women are equally affected. The common symptoms of anal fissure are pain during passing of stool, bleeding from rectum, especially among infants etc.

Treatment of anal fissure:

The main aim of treatment of anal fissure is to prevent repeated tearing of anoderm and also spasm of anal sphincter. The treatment of anal fissure includes general measures, medical management and surgical treatment.

General measures:

General measures or non surgical measures (drug treatment) are generally successful in case of acute anal fissure, but may not be of much help in case of chronic anal fissures. General measures include intake of easily digestible high fiber diet, use of stool softeners (such as docusate or mineral oil) etc. Sitz baths can reduce spasm.

Pharmacological agents that can be used for treatment of anal fissure are local anesthetics (lidocaine), steroids, muscle relaxants, Botulinum toxin (Botox), calcium channel blocking agents such as nifedipine etc.

Surgical treatment of anal fissure:

Partial lateral internal sphincterotomy is the surgical procedure which is recommended by the American Society of Colon and Rectal Surgeons, for surgical treatment of anal fissure and it is the most preferred surgical method.

If you suffer from baldness, what is the best approach or treatment available? The answer to this question is not easy. The answer depends on you, e.g. what result do you want or expect from treatment of baldness or hair loss or are you ready to try something which has no scientific study or research to prove claim of successful treatment of hair loss. Will you accept known and less than desired result or are you willing to try something in the hope of better result.

If you want to know what your treatment can give you and if you can accept it, the best approach for treatment of thinning of hair or baldness is to use approved (by USFDA) pharmacological products for treatment of thinning hair, which are finesteride and minoxidil. Only these two drugs are approved by USFDA for treatment of hair loss or thinning of hair. So, use any of these products for treatment of you hair loss problem, which is the only scientific treatment method available, but the results are well below satisfactory level.

There are also many more products available at present, all of which claim to cure hair loss. But according to many scientific studies there is no cure for hair loss. But many products are claimed to cure hair loss. Before you decide to use products which claim to cure hair loss, be sure that the product will not worsen your problem of hair loss, even if it can not cure it. There are many products which may actually harm you more with side effects such as hair loss (that is, your problem is aggravated by these products rather than solving it).

As eye health problems are very common and it is true for the whole world (not in some areas alone). As many as half or more of adult population has some eye health problem and among eye problems, refractive errors of eye are the most common problems. If you suffer from myopia, astigmatism or hypermetropia, for which you might be using glass or contact lens, means you have refractive error problem of your eye/eyes.

Other than use of contact lens or corrective glasses, you may also undergo laser eye surgery for correction of your eye’s refractive errors. If you are resident of London or other parts of UK, you may use laser eye surgery London, for correction of your refractive errors of eye and get yourself rid of contact lenses or glasses.

It is always wise to plan your treatment for any illness, including eye health problems. The most important part of your healthcare planning is the cost of healthcare and how you deal with the skyrocketing cost of healthcare. The good news is that, there are treatment saver deals available for treatment of different ailments, including for correction of refractive errors of eye (examples of refractive errors of eye include myopia, astigmatism, hypermetropia etc.) with laser eye surgery. There are several specialized clinics which you can find online or offline which offer healthcare at low and affordable (for most of the people) cost. There are websites such as Treatment Savers which can help you to decide where you should undergo laser eye surgery for your eye problems, by allowing you to compare different eye care centers in terms of cost, service, and facilities available.

If you are residing in UK or any other parts of Europe you should consider undergoing your laser eye surgery with Optical express, as they are credited with performing largest number of eye surgeries in Europe every year. As they perform largest number of laser eye surgeries they have the most extensive experience, and when it comes to surgery, (especially delicate surgeries such as eye surgeries) it is always wise to go with the most experienced, so that you do not regret your decision later.

Field of medicine has many allied branches, such as nursing, first aid, emergency care etc. Nursing is a very important part of health care and as important as service provided by doctors, if not more important. Nursing care also has allied branches which provide necessary help to nursing professionals in healthcare delivery, such as Certified Nursing Assistants. Certified Nursing Assistants undergo training of 100 to 120 hours, which consist of both practical aspect as well as some basic theory aspects in health care. Certified Nursing Assistants help by assisting and discharging their duty in providing health care.

The Certified Nursing Assistant (CNA) course is a growing field as the requirement of this nursing allied service is increasing rapidly. Many health care service providers are training manpower for these free of cost (if done privately, the Certified Nursing Assistant course may cost anywhere between $400-$1000) with a signed contract that after training, the individual will work for the health care service provider for a particular length of time.

CNA Training Classes are conducted to provide the basic healthcare skills required to help the nursing professionals, in health care delivery. Some of the basic healthcare skills taught in Certified Nursing Assistant course are providing first aid, CPR (cardiopulmonary resuscitation), etc.

It is a time of economic recession and many people are losing their jobs and need to rethink the carrier they have opted. If you are in this category or just new in the job world without high skill, it may be the time for you to think of doing a Certified Nursing Assistant course and start your carrier.

Some of the advantages of doing Certified Nursing Assistant course are short duration course (only 6-12 weeks duration), can be done free of cost in many government sponsored health care facilities, growing demand, opportunity to advanced courses (there are opportunities to become registered nurse or licensed practical nurse) etc.

Gout is a metabolic disorder which commonly affects postmenopausal women and men of middle age to older age group. The metabolic disorder results in increase in uric acid level in blood (serum) and hyperuricemia (increased uric acid excretion in urine). Increased uric acid level in serum can result in deposition of uric acid crystals (monosodium urate or MSU crystals) in the joints, especially in the smaller joints such as joints of toes (interphalangeal joints and metatarsophalangeal joints of toes, especially big toes) and fingers (interphalangeal joints and metacarpophalangeal joints of fingers) which are known as “tophi”. There is also risk for deposition of monosodium urate crystals in kidney interstitium or uric acid nephrolithiasis.

What are the clinical features of gout?

Common clinical manifestations of gout are arthritis (usually involving single joint, most commonly the metatarsophalangeal joint of big toe, initially and become multi joints later on) and the first attack of acute arthritis is generally severe and painful swelling of the affected joint commonly at night which wakes up the patient. The initial attack subsides within 3-10 days even without treatment and later become intermittent with remissions and exacerbations.

How gout is diagnosed?

Clinical picture is strongly suggestive of gout and the diagnosis of gout is confirmed by needle aspiration of acutely or chronically involved joints or MSU deposits. Sometimes MSU crystals may also be demonstrated in the aspirates from inflamed joints.

Serum uric acid level may be high, normal or low during acute attacks of gout, although the serum uric acid level is generally elevated in gout and estimation of serum uric acid level can be used to decide and guide the course of the therapy.

Treatment of gout:

The mainstay of treatment of acute gout is use of NSAIDs (such as indomethacin, piroxicam etc.), colchicine, or glucocorticoids. Once the acute condition subsides the mainstay of treatment is hypouricemic agent allopurinol (a xanthine oxidase inhibitor drug) at the dose of 100-300 mg per day initially and may need up to 800 mg per day.

You may be using contact lens because you do not want to wear glasses or you may have an eye problem which is best managed with contact lens. Whatever may be the reason of your use of contact lens you should always consider using disposable contact lens, as use of disposable contact lens has several advantages, some of which are health advantages such as lower rate of infection and some are the comfort of use and no need of maintenance.

If you can afford (which most people can afford these days) disposable contact lenses you should go for disposable contact lenses. Before you start to use a specific brand of disposable contact lens, you should always compare contact lens with other brands that are available in your local market. The comparison should include not only price (although price is the most important factor to consider) but also the trustworthiness (it is important to use a well trusted brand, as you are dealing with eyes) of the brand you decide to use, and advice of your doctor (ophthalmic surgeon).

Availability of cheap contact lens (reusable as well as disposable contact lenses) has made use of disposable contact lens within affordable limit of most of the individuals who use contact lens. If you are using contact lens for therapeutic purpose or for cosmetic purpose you should use the contact lens which are of best quality and should not consider the cost, in other words quality should guide you to select the contact lens you will use and not price or other minor factors.

These are the personal view and opinion of the author and you should always use your discretion before you decide to use disposable contact lens for any purpose.

Contact lenses are used for correction of refractive errors of the eye, for therapeutic purpose (such as to deliver a particular drug to cornea or to protect the cornea from further damage due to friction of eyelids), cosmetic purpose etc. The commonest use of contact lens is for corrective purpose, instead of using glasses which may be cumbersome at times and many individuals do not want to wear glasses and prefer to use contact lens, which allows certain advantages over use of glass.

Disposable Contact Lens has gained popularity vary rapidly and still gaining popularity as the price of disposable lens is going southwards. Disposable contact lens or simply Disposable Contacts have several advantages over non disposable contact lenses. The biggest advantage of using disposable contact lens is the freedom from maintenance the disposable contact lenses provide and in this fast track and modern life many individuals do not find time to keep the contact lenses clean by cleaning the contact lenses with proper cleaning solutions. Another great advantage of disposable contact lens is the reduced chance of infection with the use of disposable contact lens. The disposable contact lens is not reused which reduce the chance of infection greatly. Infection can be a problem with use of non disposable contact lens as they need to be cleaned properly and everyday and if the cleaning is not proper it may cause infection or it may irritate the cornea due to presence of some debris on the contact lens.

The availability of Cheap Disposable Contact Lenses has made the life of contact lens user very simple and at affordable cheap rate. The user can use the disposable contact lens and just throw it and forget it and present generation wants exactly the same type products.

There are several different types of cleaning solutions available for cleaning contact lenses. For cleaning your contact lens, use of any type (should be used properly) can serve the purpose of cleaning contact lenses.

The main aim of cleaning contact lens is to keep the contact lens clear or transparent and to keep it free from microorganisms. Presence of microorganisms can cause infection to the eye. The different microorganism will cause different type of infection.

The commonly used cleaning solutions for cleaning the contact lens are saline solution, multipurpose solution, hydrogen peroxide solution, enzymatic cleaner etc.

Saline solution:

The saline solution is for rinsing the contact lens after cleaning it with other cleaning solution and used before inserting/using contact lens. Saline solution can not disinfect contact lens.

Multipurpose solution:

This is the most commonly used and also most popular cleaning solution for cleaning contact lenses. Multipurpose solution is used for cleaning, disinfection, and storing contact lenses. It can also be used for rinsing contact lens instead of saline solution. Use of multipurpose solution can serve all the purposes of cleaning in general. Newer multipurpose solution can remove bacteria, fungi and other microorganisms.

Hydrogen peroxide solution:

It is mainly used for disinfecting. But saline solution must be used for rinsing to wash off hydrogen peroxide from the contact lens after disinfecting with hydrogen peroxide solution; otherwise it may cause intense pain in the eye. Because of the need to rinse with saline solution, hydrogen peroxide solution is not very popular.

Enzymatic cleaner:

It is used for cleaning protein deposits from lens surface which may get deposited after using contact lens for few days. Generally enzymatic cleaner is used once a week. If there is any protein deposit in the contact lens, it makes wearing contact lens uncomfortable and also makes disinfection difficult and incomplete.