FAQs

MEDICAL REHAB

What are the benefits of Rehab?

You have the advice and close supervision of health care professionals to help you to improve your health and decrease the risk of future health problems and can communicate with your health professionals on a daily basis.

Improves physical fitness

Allows end organ recovery after disease process.

Incorporates counseling and education regarding nutrition and lifestyle modification which enables you to lose weight, decrease blood pressure, decrease cholesterol levels and manage stress.

Prevents progression of the disease and end-organ damage in the long run, keeping the person healthy lifelong.

Improves self esteem and well being

Increases   productivity and work capacity.

What is Medical Rehab?

Medical Rehab is a professionally supervised program to help people to recover from their illness and enable them to lead a healthy and productive life.

What should I consider while picking a program?

Place: Is the program easy to get to.

Setting: Is it a group / individual program?

Time: Is the program offered at a convenient time

Is doctor’s evaluation required before enrolling for the program?   -Yes, to identify any risks to the individual following the exercise protocol and design the activity guidelines.

Are educational services available to you and family?  -Yes as they are a great support to all involved.

Will an individual plan be developed for you?  – Yes as the doctor and staff should identify the risks and tailor a program according to your requirements.

Is doctor’s supervision available during your exercise session?  -Yes, doctor must be in the immediate area   or in direct contact with staff

Are emergency equipments and supplies readily available?  -Yes

Who should enroll for rehab?

Rehab can be preventive or post disease.

Preventive rehab is for obesity (adults and teenagers).

Post disease is for cardiac, diabetic and osteoporotic patients.

Risk factor analysis in all rehab programs is important to identify the cause and the extent of the disease which would help to plan the rehab program

Why is it required?

Allows them to improve their overall physical, mental and social functioning.

ADOLESCENT MEDICINE

What are the life style disorders in adolescents?

Eating disorders leading to either obesity at one end and anorexia/ bulimia at other end of the spectrum
Hypertension
Dyslipidemia
Diabetes Mellitus
Cardiovascular Disorders
  • What is acne?

Acne is one of the most common skin disorders seen in children and adults. In most children, acne develops with puberty. The main cause for this is the hormonal changes during this period. The male sex hormone called androgen increases in both girls and boys. As a result, the sebaceous glands become more active and produce an increased amount of sebum.

  • What are the treatments for acne?

The right treatment for the child may vary based on many factors. The most common treatments include topical therapy and systemic therapy. Some of the commonly used topical medications include:

  • Benzoyl Peroxide

  • Antibiotics

  • Tretinoin

  • Adapalene

Systemic antibiotics such as Doxycycline, Erythromycin, and Tetracycline etc. are also used to treat moderate to severe cases of acne.

  • What are the other common skin problems among children and adults?

  • Blackheads

  • Papules and pustules

  • Cysts or nodules

  • Is there any problem if my child, who is an asthma patient, participates in sports?

Certain physical activities such as running can worsen the child’s conditions. But with proper care and management, it could be prevented. Discuss with your healthcare provider on how to make your child prepared to participate in sports.

  • Can exercising have bad effect on an asthma patient?

Strenuous physical activities can put asthma patients at risk. However, aerobic activities can be helpful, which will strengthen the breathing muscles and improve the airway function. If you/your child is an asthma patient, can follow these tips to avoid problems during exercise:

  • Try to breathe through the nose, not through the mouth, which will help to humidify the air.

  • Take/give asthma medication before the exercise. If you/your child exercises daily, inhaled corticosteroids can be the best option.

  • Carrying a “reliever” or “reserve” can be helpful.

  • Try to wear a scarf, covering the nose and mouth, during cold weather.

  • Can Diabetes Mellitus occur in adolescents?

Diabetes is a metabolic disorder and it can affect people of any age. Diabetes is seen more prevalent among adolescents these days. Type 1 diabetes is the most common among adolescents.

  • What is prediabetes?

If the blood glucose level is higher than the normal level and not high enough to be described as diabetes, the condition is called prediabetes. It is commonly seen among children and adolescents. If not managed carefully, it can be developed into type 2 diabetes. Prediabetes can be controlled through weight management, regular physical activity and healthy diet. 

What is the impact of obesity on teenagers?
Prevention of lifestyle disorders in adolescents
Weight management  program  with a change in eating habits
Supervised  regular exercise
Restricting TV viewing ( eating meals as a family instead of watching TV)
Health education
Medical Checkup and screening for diseases.
Ensuring adequate and regular sleep pattern.
Not giving in to peer pressure to smoke/ substance abuse etc.
Decreasing stress.

CARDIOLOGY

How do we decide whether to go in for angioplasty or bypass surgery?

If there are one or two blocks in the coronary arteries, one prefers angioplasty. Bypass surgery is preferred if there are multiple blocks. In young patients especially below age of 40, angioplasty is preferred.
What are the long term methods to prevent recurrence of CAD after bypass or angioplasty?
Controlling risk factors like blood pressure, diabetes and cholesterol and stopping smoking can prevent recurrence of CAD(coronary artery disease). A symptomatic cardiac rehab program with supervised exercise, cardiac monitoring and diet counseling goes a long way in preventing a second event.
What are the newer modalities of cardiac intervention?
Cardiac interventions including angiography and angioplasty are being carried out through the radial artery in the hand, instead of femoral artery in the thigh and this is more comfortable for the patient.Birth  heart defects like holes in the cardiac septum(partitions) can now be treated without surgery by catheter devices and newer generation pacemakers are being used for patients with rhythm disturbances and heart failures.

10 ways to beat stress and peer pressure amongst parents and adolescents before they appear for exam

Deep breathing exercises (fast relaxation tips)

Practise deep breathing, meditation and yoga as forms of relaxation. They help your body relax and reduce stress. Alternately, take a brisk walk in fresh air after your day’s revision is over.If you believe in God, pray before you start studying. Prayer will help you increase confidence reduce your stress as well.
Eat well
Food rich in vitamins and proteins, such as green leafy vegetables and fresh fruits, are a must as it helps the brain to focus.. Avoid food with high fat content.as it will make  you sleepy .Don’t drink too much coffee, tea or fizzy drinks. Caffeine will keep you up and reduce the clarityof your  thoughts. Breakfast is a must as it is brain food. Lack of breakfast can lead to decrease sugar in brain leading to decreased concentration  and focus. Nuts especially almonds and dates are good as it provides instant calories and prevents hypoglycaemia.
Maintain your self esteem Self-confidence
It is very important to have faith in oneself. After the exam don’t spend endless time criticising yourself for where you think you went wrong. Often our own self-assessment is far too harsh.
Parental support
Encourage your children to do as well as they can, but try not to pressure them or make them feel that you will be very disappointed if they don’t do well.Help them to set up a quiet place to study and protect their privacy.
Take an interest in what they are doing.
Lessen the chores around exam time, and encourage your young people to get some breaks from study.
Let them know that you trust them to do as well as they can.
Encourage your children to talk with teachers or lecturers about a study program that suits them – and to stick to it.
Encourage them to get ideas about revision techniques from teachers or friends and choose what suits them best.
Help them to balance their time and to allow time for exercise, going out, staying in touch with friends and having fun and enough rest.
Encourage them to get plenty of fresh air. Try studying outside for a change.
When people feel stressed their body needs to do something active. So encourage your teenager to do something active when he or she feels really stressed – go for a run or play an energetic game.
Make sure there is time for friends. Talking things over with others helps.
Plan your time and prioritise accordingly
Plan your time and prioritise accordingly  Be organised.. Make a list of the most important Prepare realistic  timetables and stick to them . Try to follow a routine , from the morning to night. This will decrease the stress at time of exams as the mind will be more focussed and in tune for the exams. Set realistic targets of what you can achieve in the time available. Plan your revision and complete it in time. This will give you a sense of achievement and build your confidence.
Power of positive thinking
Spend time with people who have a positive effect. It will rub off on you.  Think positive – Positive thinking is the best medicine for examination stress. If a student believes that he / she can do it, no one in this world can stop him / her from scoring the best Visualize SuccessVisualizing helps one have the mindset of success when working on a task like a board exam. This tool also works well to help students eliminate anxiety and focus on building a positive mindset that will help them achieve success.
Prepare in advance
while studying , prepare short summary of the chapters , which is meant to be scanned just before the exams. Display important formulae, facts and dates where they can be seen easily. Mneumonics may be prepared to remember difficult topics. Last minute studying rarely helps  Teachers can help students build a positive mindset to help them achieve strong scores on standardized tests. Practice tests are useful as it helps to build confidenceCreate a Checklist of Items Needed for Testing Day
Take steps to overcome problems if you do not understand certain topics .Don’t keep things bottled up. Confiding in someone you trust and is supportive helps to decrease stress and worry.Keep things in perspective. The exams might seem like the most crucial thing right now, but in the grander scheme of your whole life they are only a small part.Avoid panic. It’s natural to feel some exam nerves prior to starting the exam, but getting excessively nervous is counterproductive as you will not be able to think as clearly.
Recreation
Exercise helps one handle stress as it releases endorphins which produces a feel good effect. It also helps one fall asleep easier and sleep deeply.Eyes are tired from constant reading and lungs are exhausted from processing stale indoor air and require more oxygen rich air available outdoors. The spine is also tired due to maintaining stiff position to study and requires stretching and relaxation. When there is mental fatigue, take a short break as soon as you notice your mind is losing concentration. Stick to activities that do not break your study continuum during these breaks. Avoid television and loud music. You will then be able to come back to your revision refreshed.Keeping hobbies alive, keeps one motivated.
Sleep well
A regular seven hours of sleep is mandatory for the body to function well. Do not alter sleeping pattern as it will take its toll during exams.Try and stop working half an hour before bedtime.
Unfair comparison and peer pressure
This is mostly done by parents and teachers .Competition between parents is very unhealthy, so is trying to achieve career goals by parents through children , especially if the parent has not achieved that goal . This puts a lot of stress on the child for performance and ultimately breaks the child emotionally and mentally .Avoid stressful people.Stress actually is contagious. During exam week, resist the urge to have a study session with your super-tense friend. Their  stress will only add to your stress. Learn to say no to to the people who want to take up your time Say no to the distractions and be selfish for a day. Positive peer pressure Study in groups before the exams – Discussing and learning with friends, before the exams, always helps in understanding a subject better. Other than that, this way, one breaks away from the monotony of studying alone all the time. However, it is advisable not to follow this practice during the exams as friends may also add to stress.

HYPERTENSION

What is hypertension ?
Hypertension is persistently elevated blood pressure in the body `s arterial system which carries pure blood from the heart to all the organs of the body.
What is normal blood pressure ?
Blood pressure is  measured as two reading, systolic or upper Bp reading and diastolic or lower BP reading. Average  Normal blood pressure in an adult is  120/80 Mm Hg. A persistently elevated reading above  140/90 is considered as Hypertension. Newer  American recommendation  (JNC 7 criteria) recommends  that  a Bp of 110/70 is ideal and is more rigid in BP norms to prevent long term side effects.
 What are the long term side effects of elevated BP ?
Elevated  BP has harmful effect on the organs of the body including heart, kidney, brain and eye. It causes stiffening of arteries with loss of elasticity  making them more prone for internal narrowing. This can lead to heart attacks, brain stroke or kidney failure.
What are the causes of high blood pressure ?   
Family history of high BP in close relatives like father or mother  plays an important  role as high BP which often runs in families. Faulty Life style with obesity, lack of exercise, smoking, excessive drinking and consumption of a high salt diet contribute to elevated blood pressure. Persistant anxiety and psychological stress can also lead to elevated blood pressure.
What are the symptoms of High BP ?
Often elevated  B P  is detected in routine check up and may not produce any symptoms.If markedly elevated, the common symptoms are headache, blurring of vision, breathlessness, palpitations and feeling of exhaustion.
What is the best way to get BP checked ?
Blood pressure should be checked by an experienced doctor or nurse  and the machine used should be properly calibrated, Commonly available digital home machines often lose calibration and give inaccurate reading. These should be cross checked by getting it examined by and experienced doctor / nurse. One isolated reading that is elevated is  not reliable and several resting readings are often  necessary  to confirm the blood pressure.
What is white coat Hypertension, how do we evaluate it ?
When a patient is anxious about his BP recording in a clinic/ hospital setting, the reading often comes high even when the patient does not have hypertension – this is called  white coat hypertension, This is best evaluated by a test called  24 hour  Ambulatory  BP study. In this test a small automated BP machine is fixed to the patient.It records periodic B P readings  over a 24 hour period. The readings are measured and stored automatically in the machine outside the hospital /  clinic during the patient`s routine working day. This gives accurate assessment of the actual  B P and an average of multiple readings.
How is hypertension treated ?
Modification of lifestyle along with medications when indicated is the key to treatment of hypertension. Lifestyle modification by reducing salt and fats in diet, reducing weight, regular exercise, stopping smoking and restricting alcohol intake go a long  way in reducing blood pressure. Patients are often  hesitant to start BP medications, but this is essential for adequate and rapid control of blood pressure . patients should not stop or reduced BP medications without consulting their doctor  and regular monitoring and follow up is  essential.

High blood pressure

1) What is high blood pressure?

An abnormal blood pressure inside the arteries is usually, defined as high blood pressure. The condition of high blood pressure is also known as hypertension.

2) Is a blood pressure always the same?

The blood pressure may not always be the same. It may get affected by various factors such as:

  • Physical activity
  • Age, gender, height and weight
  • Emotional stress and mood swings
  • Other medical conditions

3) When can the blood pressure level be too high?

The blood pressure may vary according to various factors mentioned above. The normal blood pressure of an infant can be 80/45. whereas, a teenager’s normal BP is considered normal when it is 110/70. Comparatively, BP level is seen higher in boys than girls. Blood pressure level can also vary during the time of strenuous physical activity, when affected with another medical condition or during emotional stress and mood swings.

4) Why is high blood pressure a concern?

High blood pressure can increase the risk for Coronary Artery Disease, heart attack and stroke. High blood pressure can have a very harmful effect on the overall health of the children and adolescents.

5) What causes high blood pressure?

High blood pressure can be caused due to various reasons:

  • Inactivity
  • Smoking
  • Being overweight
  • High blood cholesterol levels
  • Use of prescription medication
  • Kidney and heart disease

6) Who is at risk for developing high blood pressure?

Obese children can be at an increased risk for developing high blood pressure. Children with a family history of hypertension can also be at risk.

7) How can high blood pressure be diagnosed?

High blood pressure is diagnosed by checking the blood pressure level. The doctor may also check the medical history and conduct a physical examination of the child.

8) How is the treatment for high blood pressure determined?

The treatment for high blood pressure can be determined by analysing the following factors:

  • Age of the child
  • Overall health of the child
  • Medical history
  • Opinion of the patient
  • Child’s resilience to certain medications, procedure and treatments

9) What are the treatments for high blood pressure?

Some of the common treatment options for high blood pressure in children and adolescents are:

  • Weight reduction
  • Healthy diet
  • Increased physical activity