Board of Doctors

Prevention of Glaucoma

When you take care of yourself, it goes a long way in ensuring a healthy you for your tomorrow. As you grow older, you have to think about your eye health too. Going for a regular eye checkup is advisable after you turn forty. Sometimes, eye diseases come without warning and it may be too late before you realize you are losing vision. Glaucoma is a leading cause of irreversible blindness worldwide. It has been estimated that in India alone at least 12 million people are affected and nearly 1.2 million people are blind from the disease. 

What is Glaucoma?

Glaucoma is a disease that slowly damages the optic nerve, the important link between the eye and the brain. This damage is caused by an abnormally high pressure in your eye. People with glaucoma usually lose vision before they notice any problems with their eyes.  The effect is so gradual, it sneaks up on you! You may not notice a change until the condition is at an advanced stage.

Tips to prevent Glaucoma

Unfortunately, you cannot get back any vision you lose from glaucoma. However, there are ways to detect the onset of glaucoma, prevent serious vision loss or slow its progress.

  1. Regular eye checkup: It is advised to get regular comprehensive eye exams once every few years from an experienced ophthalmologist. As recommended by doctors, you must have eye examinations in the following frequency based on your age –

               Younger than age 40 – every 5 to 10 years

                Age 40-54: every 2 to 4 years

                Age 55-64 years: every 1 to 3 years

                Age 65 and older: every 1 to 2years

               If doctors see any risk of glaucoma in you, they will suggest regular screening and monitoring.

  1. Do not ignore your family’s eye history: if your parents or grandparents have/had glaucoma, chances are, you may too, as glaucoma tends to run in the family. If you run that risk, make sure you go for frequent screening.
  2. Diet goes a long way: you have to eat well to see well. Your eyes need good nutrition too! Rich coloured fruits, berries, vegetables and leafy greens contain vitamins and minerals that protect your body and your eyes. vitamins C, E, and A and minerals such as zinc, copper and selenium are beneficial for the eyes. Carrots are specially recommended. 
  3. Move that body but with caution: Moderate exercise and walking is advised to improve your overall health. It also helps lower your eye pressure. Avoid intense exercises that increase your heart rate as it may also result in a raised eye pressure. Hire a trained instructor to understand breathing while exercising. Right posture and breathing helps in maintaining your posture during exercise.
  4. Shield that eye from injury: eye injuries can cause glaucoma. Make sure you wear protective eye wear while playing sports or while doing any work that is a risk to the eye such as welding, any carpentry work etc.
  5. Clamp on that steroid medicine: steroid medicines, if consumed for a long period of time or in high doses can raise your eye pressure, especially if you have glaucoma. Consult with your ophthalmologist if you are on steroids.
  6. Avoid head-down positions: placing your head below your heart for long periods of time is not advisable if you have glaucoma or are at high risk of the disease. You may need to avoid certain yoga positions such as inversion postures. Head-down positions can greatly raise your eye pressure. Consult your doctor before starting any exercise that includes inversions.
  7. Sleep in the right position: while sleeping with your eye against the pillow or on your arm may be the most comfortable position for you, avoid this if you have glaucoma. If you snore heavily or stop breathing sometimes during the night because of sleep apnea, you are at a high risk for glaucoma. Consult your doctor and get tested for obstructive sleep apnea.  Never ignore the warning signs.
  8. Too much sunlight is not good: not only is excess sunlight not good for your skin, now evidence suggests sun’s UV rays can also be responsible for a type of glaucoma. Wear good quality polarized glasses and a large brimmed hat when out in the sun.
  9. Fresh and clean breath: gum disease can be bad for your heart and now some research connects optic nerve damage in glaucoma to gum disease. Brush and floss your teeth every day and pay that visit to your dentist from time to time.
  10. Keep your doctor informed about your blood pressure medicines: just as high pressure is not good for glaucoma; sudden low pressure can worsen glaucoma damage too. Inform your ophthalmologist if you take blood pressure medicines in the night or if you have low blood pressure symptoms. Do not change your medicines on your own. Consult with your primary care doctor for the same.
  11. Hydrate with love: drink fluids throughout the day but in moderate amounts. Gulping too much water suddenly may temporarily increase eye pressure.
  12. Cut that coffee: avoid drinking too much caffeine as studies have shown that it may result in sudden increase in eye pressure. 

Glaucoma is often a manageable disease. If you follow the advice of your ophthalmologist and primary care doctor, you will be able to manage your glaucoma and not let it affect your normal lifestyle.  Contact Specialist Ophthalmologists at the Board of Doctors for any queries on glaucoma or if you want to get your eyes tested. Our experienced team of doctors will ensure the right diagnosis and measures, all you need to do is click on www.boardofdoctors.com for a hassle free appointment.   Dr. Anil Wani, Dr. Anand Shroff, Dr. Sudha Manjunatha, Dr. Nitin Shetty

8 Steps to a Healthy Heart

In our everyday lives, we are constantly struggling to keep pressures at bay, to maintain an equilibrium between work and home, and to live heathy and happy. A healthy lifestyle is key to our good health and happy heart.

According to a DNA article, ‘In India, more than 17 Lakh people die every year due to heart diseases and by 2030, the figure is expected to increase with 2.3 crore deaths. According to the Indian Heart Association, 50% of all heart attacks in Indians occur under 50 years of age and 25% of all heart attacks in Indians occur under 40 years of age. Population in cities is three times more prone to heart attacks than people living in the village.’

This does not augur well for us and reflects our lack of commitment to a heart healthy lifestyle. Having a heart healthy lifestyle is our responsibility so, commit to this by following the steps below:

  1.  Learn your health history: Understand and know your risks. Discuss with your family and doctor about how your health has been, your family history of heart attacks and strokes and the factors leading to it. First step towards taking care of yourself is accepting and understanding your health and the state your health is in.
  2. Eat those vegetables: Your health largely depends on the food you eat. A healthy diet can control other factors such as cholesterol, blood pressure, diabetes and obesity that can lead to heart attack. A well-balanced meal with the right amount of carbohydrates, proteins and fats is essential to living a healthy lifestyle. Have food rich in fiber, vitamins and minerals.  Avoid refined sugars and carbohydrates or have them moderately.   Concentrate on nuts, legumes, lentils, vegetables, fruits and fish. If you follow a healthy diet, half of your battle is won.

  3.  Move your body: Being fit is good for your heart and blood vessels. Studies have proven that a minimum of 150 minutes of moderate to intense exercise per week is enough to lead a healthy life. Running, cycling and swimming are all good for your cardio. Even simple household chores like cleaning your floor, chopping vegetables, moderate movement at home constitute as exercise. The key is to not be sedentary. It is also said that to reach your healthy goal, we should aim for more than 7500 steps every day and a modicum of exercise. Being active goes a long way in keeping you healthy and your heart beating well!
  4.  Keep your weight in check: Obesity is one of the factors that is responsible for a weak heart. Reach your optimum weight and keep at it. Regular exercise and healthy food habits is a sure shot way to keep obesity at bay. Consult your nutritionist to understand food habits and what your daily intake should be. 
  5. Quit that butt: According to a WHO report, more than ten million die in      India due to tobacco each year. The first step towards a better lifestyle is to quit smoking if you are addicted to tobacco. There is no short cut to it. Avoid smoking, even second-hand smoking. If anyone around you smokes, encourage the person to quit smoking too. Seek help if you find it tough to quit. Your heart will thank you for it.   

  6. Say Cheers moderately:  When you do anything in excess, it can create problems. While drinking moderately is accepted, too much alcohol can increase the risk of stroke, high or low blood pressure, produce irregular heartbeats and sometimes can even be fatal. Limit your intake to no more than two drinks per day for men and one drink per day for women. The key is in moderation and understanding your limits.
  7. Don’t worry, be happy: With our hectic lifestyles and schedules, we often forget to take a pause and breathe, often leading to depression and stress. Stress increases the risk of coronary heart disease, stroke, high blood pressure and high cholesterol levels. It is important to manage stress in our day to day lives. Deep breathing and meditation help in managing stress. If it seems unmanageable, do not hesitate to consult your doctor or counsellor.  
  8. Take your medicines regularly: Do not try to self-medicate, always seek professional help to understand your medicine dosage and needs. If taking any medicines for cholesterol, high blood pressure or diabetes, take them regularly and consult your doctor if you think they are not helping. Do not hesitate to ask questions to your doctor to understand the importance of taking the medicines.

Our super specialist doctors at www.boardofdoctors are always available to guide you in your journey to living a heart healthy life. All you need to do is book an appointment at www.boardofdoctors.com and our expert doctors will be there for a hassle-free consultation. 

Doctors – cardiologist, dietician, counsellor

Skincare During COVID Times

Wearing masks and washing your hands frequently are critical preventive measures to slow the spread of coronavirus. While these are imperative steps to control the virus, frequent hand washing can cause severe dry skin that can itch, flake, crack and bleed if we are not careful enough. Further, prolonged use of masks can give acne, rashes, scars if used without proper precautions, causing open wounds in the skin that can allow bacteria and germs, thus increasing the risk for infection. While we are living in difficult times where frequent handwashing and wearing a mask is the norm, let our skincare not be compromised.
Our expert dermatologists from www.boardofdoctors.com share these tips to keep our skin healthy and hydrated during COVID19.

  1. Use lukewarm water: Wash your hands with mild soap for at least 20 seconds with cool or lukewarm water. Hot water is a big NO as it can increase skin damage. Make sure your soap is not laden with chemicals and antibacterial cleansers as they can irritate the skin. A normal soap will do just fine.
  2. Moisturize frequently: Apply moisturizer immediately after washing your hands. Let your hands be slightly damp while you work your moisturizer into your skin. Use a moisturizer that’s hypoallergenic and fragrance free. Keep applying moisturizer throughout the day as frequent washing can really dry your skin.
  3. . Look for heavy duty moisturizer: Moisturizers with mineral oil or petroleum jelly are hydrating as they seal the moisture in and prevent water loss. Lightweight creams may not be enough to protect your skin from dryness.
  4. Moisturize after using hand sanitizers: As the sanitizers contain more than 60% alcohol, it can be extremely drying for your hands. Apply a thick moisturizer to combat the dryness.
  5. Wear cotton gloves while sleeping: To further keep your hands hydrated, you can apply moisturizer or Vaseline in the night and cover it with cotton gloves overnight.
  6. Cleanse and moisturize: Though masks are vital to control the spread of the virus, they can lead to chafing of the skin on the chin, cheeks, behind ears and the bridge of your nose. Increased warmth and humidity within the mask provides an ideal environment for the bacteria that cause acne and clogged pores. Make sure to cleanse and moisturize your face before and after using a mask.
  7. Use non-comedogenic skincare: Use skin care as recommended by the dermatologists. Our doctors at http://www.boardofdoctors.com can help you choose the best one that works for your skin. Choose non comedogenic face products as they will not block your skin’s pores.
  8. Use a barrier gel: Dr Mukta Sachdev advises using a barrier gel such as zinc oxide acts as prevention as it forms a thin visible film on the skin which dries quickly and reduces skin contact with the mask to a certain degree.
  9. Protect your skin from blue light: Sunlight is not the only source of radiation our skin faces every day. While we may not be outdoors now, we are still exposed to the harmful blue rays of the laptops, TVs and phones while at home. Protect your skin from the blue rays that contribute to skin damage, hyper pigmentation and eyestrain, by applying sunscreen even when you are indoors.
  10. Eat healthy: Avoid resorting to binge eating junk food while at home. Focus on a healthy diet of fruits, vegetables, whole grains and lentils, making sure to keep the dinner light. When you eat a balanced and nutritious diet, your skin will reflect that.
  11. Keep hydrated: Drink at least 2 to 3 liters of water to keep your skin looking well hydrated and glowing. While you are home, you may as well take advantage and flush out those toxins as you increase your water intake.
  12. Sleep enough: Now that you are home, your sleep cycle may take a hit as you juggle your time between your work and the shows that you watch. Be mindful of your sleep routine. Sleep early and wake up early and definitely get at least eight hours of sleep. A restful sleep takes care of dark circles, puffy eyes and premature ageing of the skin.
  13. Workout routine: Having a good workout regime even at home, is a must. You do not need to go to a gym to exercise. There are many videos available online to guide you to exercise at home. Working out will help your body burn cortisone, shed your extra weight, reduce stress and help keep your skin clear. Do remember to take a shower immediately after exercising.

If you still have dry skin, itchiness, acne after following these tips, you must visit a dermatologist. A dermatologist can diagnose you, guide you and provide treatment that you need. Just click on www.boardofdoctors.com to get an online appointment with the best dermatologists, without any hassles. The highly qualified doctors at www.boardofdoctors.com will guide you to a skincare regime that will take care of all your skincare woes during this pandemic.
Expert Dermatologists available for online consultations on Board of Doctors:
Dr Mukta Sachdev, Dr Abel Francis, Dr Nina Madnani , Dr Vidya Rampradeep , Dr Sushil Tahiliani , Dr Padmavathi Surapaneni, Dr Maleeka Sachdev, Dr Mukesh Ramnane, Dr Ravi Hiremagalore, Dr Sachin Varma

Polycystic Ovarian Syndrome (PCOS)

Polycystic ovarian syndrome (PCOS) is the most common hormonal disorder in women of reproductive age (from the beginning of a woman’s periods to their end at menopause). PCOS affects one in every five women, many of whom do not have a diagnosis. This year, sedentary lifestyle because of COVID19 has led to a tremendous increase in PCOS among women.

What causes PCOS
The causes of PCOS are yet unknown but it is mainly attributed to both genetic as well as environmental factors. Women with PCOS often have a mother or sister with the condition and there is still research going on about the role that genetics or gene mutations might play in the development. Environmental risk factors, including low birth weight, rapid weight gain in infancy, early puberty development, childhood obesity, excess adult weight and unhealthy lifestyle may also interact with genes to lead to PCOS.

What causes the symptoms of PCOS
When there are higher than normal levels of hormones called androgens in a woman’s body, it leads to PCOS.
The ovaries produce hormones- estrogens, also called as female hormones as women produce it more than the men, and androgens, which are male hormones as men have more levels of these hormones. It is when these hormones are out of balance in a woman’s body – higher than normal levels of androgens and lower levels of estrogens that women become symptomatic of PCOS.
Insulin, another of body’s hormones, also plays a big factor in PCOS. When cells that use sugar from the bloodstream as energy do not respond normally to insulin, blood sugar levels rise, leading to a rise in insulin levels. Too much insulin increases the production of androgens, thus causing symptoms of PCOS.


Symptoms of PCOS

Irregular periods/Reduced fertility- if you have PCOS, chances are, your periods are irregular. High levels of insulin and androgens can disrupt the monthly cycle of ovulation and menstruation. In severe cases, as menstrual cycle lengthens, periods may stop altogether. This often leads to difficulty in getting pregnant. But with proper medication, this can be reversed. Visit our expert endocrinologists or gynaecologist, ——— at www.boardofdoctors.com to manage the symptoms of PCOS

Hirsutism (excess hair)- High levels of androgens due to PCOS, stimulate the hair follicles leading to hirsutism or excess dark and thick hair on the chin, upper lip, lower abdomen, chest and thighs, typically in those areas where it is usual for a man to grow hair.  We have medical experts at www.boardofdoctors.com who can guide you with the best course of action to combat hirsutism.

Alopecia (hair loss)- Women with PCOS sometimes face hair loss or thinning of the scalp hair due to the high levels of androgens.

Acne- Women with PCOS face acute acne as the higher level of androgens can increase the size of the oil production glands on the skin, which can lead to increased acne. Rough, dark, velvety patches of skin can also develop in women with PCOS in the armpits or neck area called acanthosis nigricans. Dermatologist Dr. Mukta Sachdev says, “

Depression/Anxiety– Depression, low self-esteem, body image issues are common symptoms of PCOS, arising from severe acne, weight gain, fertility issues and hirsutism which occur because of PCOS. These issues have to be handled sensitively. Fortunately, there are expert counsellors who can help you overcome your fear and anxieties regarding the same. Our specialist counsellor, Dr. —— has years of experience and is just the right doctor to help you understand and deal with the changes one goes through because of PCOS.

Diabetes – On an average, most women with PCOS suffer from type 2 diabetes before the age of 40. Obesity, associated with PCOS, not only compounds the problem of insulin resistance and type 2 diabetes, but also imparts cardiovascular risks. PCOS and obesity are associated with a higher risk of developing high blood pressure, that increase the chances of developing cardiovascular disease. Reducing the medical risks from PCOS-associated obesity is important. You may consult our super specialist endocrinologist, Dr —– at www.boardofdoctors.com  to manage anything related to diabetes or insulin resistance.

Tests and Diagnosis

It is not possible to determine the presence of PCOS with one single test, but a doctor can diagnose the condition through medical history, a physical exam that includes a pelvic exam, and blood tests to measure hormone, cholesterol, and glucose levels. A sonography is also recommended to examine cysts in the ovaries. Other disorders that mimic the clinical features of PCOS should also be tested: thyroid disease, high prolactin levels, and non-classical congenital adrenal hyperplasia

Treatment

While there is no cure for PCOS, treatments are available to manage the symptoms that affect an individual.
There are several recommended treatment options, including:
Birth control pills: These can help regulate hormones and menstruation.
Diabetes medications: These helps manage diabetes, if necessary.
Fertility medications: If pregnancy is desired, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) medications are advised.
Fertility treatments: These include in-vitro fertilization (IVF) or inseminations.
Medicines may also be given to control excessive hair growth.
Other possible options to manage hair growth is laser hair removal, and hormonal treatments.
Surgical options include:

  • Ovarian drilling:Tiny holes made in the ovaries can reduce the levels of androgens being produced.
  • Oophorectomy:Surgery removes one or both ovaries.
  • Hysterectomy:This involves removal of all or part of the uterus.
  • Cyst aspiration:Fluid is removed from the cyst.

Lifestyle Changes

PCOS has no cure but it can be managed by making some lifestyle changes.
These include:

  • Eating a healthy, well-balanced diet including plenty of fruits and vegetables
  • Regular physical activity
  • Maintaining a healthy weight, to reduce androgen levels and reduce the risk of diseases such as diabetes and heart disease
  • Not smoking, as this increases levels of androgens and the risk of heart disease
  • No stress
  • Good eight-hour sleep
  • Avoiding junk food and sweets

The causes of PCOS are unclear, but early diagnosis can help relieve symptoms and reduce the risk of complications. It is advised to consult a doctor if you have PCOS.
The Endocrinology experts on the Board of Doctors platform are Dr Priya Chinnappa & Dr Kavitha Bhat and Specialist Gynaecologists are Dr Prathima Reddy, Dr Philomena Vaz, Dr Amrita Rao, Dr Saba Fathima. Just click on www.boardofdoctors.com to get an online appointment with our super specialist doctors without any hassles.