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Aging milestonesChanges in old age depends on attitude as much as person to person. In young old age some changes begin to take place in a person’s appearance. Wrinkles, warts, age spots begin to form on the body. Hair begins to thin or becomes grey and even height lessens because the bone density decreases. While in ‘old‘ old age these changes are already permanent. Men might look distinguished if in good health, but women all look grandmotherly. In ‘young’ old age, cells begin to decay and muscle mass declines and immunity is no longer as strong as it used to be. People lose energy as the age progresses.  ‘Old’ old age brings in a lot of physical decline, profound changes in appearance and motor abilities, as also in sensation. Skin gets less elastic and becomes thin and blood vessels can break under the skin. The senses also begin to become dull. Eye lenses get affected and color perception and reading ability becomes very low. Hearing loss may lead to paranoia and ‘old’ old age people begin to think everyone is plotting against them because they can’t hear properly about what others are saying. Sense of smell also declines, but the taste remains almost intact. In ‘young’ old age, reflexes also slow down and so do the motor abilities. By the time they reach ‘old‘ old age most adults find that their response time has become quite reduced. This can be seen most in driving situations where it is difficult for ‘old‘ old aged adults to operate their vehicles as they have poor spontaneous responses. The ‘young’ old adults do not lose as much of their motor abilities as the ‘old‘ old adults, especially when holding small things like needles and pins. Of course, there are changes in sexuality and there may be a decline in the ability to have sex as men may not have an erection and women become dry due to lack of female hormones. Cognitive decline in 40% to 60% of older adults can be arrested with remedial training. Despite all the changes, most people even in their 70s remain comparatively active if they do not suffer any illness. Mental, physical, and social activity is necessary to maintain the quality of life. Old people begin to withdraw from work and other important roles and allow the younger people to take over. They are a lot happier as is also advised in Vedic literature as vridhashram. While activities are important, disengagement is equally important. Memory loss becomes aggravated and other cognitive abilities begin to decline and there are many ‘old‘ old adults who get Alzheimer’s and lose the ability to look after themselves. Old people also dwell on questions of death and sometimes go through a phase of denial and then anger that they have so little time left. Acceptance of death comes, but after a struggle and the idea of losing the family saddens them. Old people require support in their declining years as they begin to lose their faculties.
Is male menopause a reality?As opposed to the sudden drop in ovulation and hormonal levels in women, menopause in men is a gradual process. The consequences in men aren't that clear. The health risks, though, are significant and it is important to recognize the symptoms of male menopause early on. Read along to know more. A testosterone level of 300-1200 ng/dL is considered normal in a healthy male. As one ages, the testosterone levels too drop gradually. After 30 years of age, the levels drop by 1% per year. By the time a man crosses 50 years of age, he is in menopause. Look out for the following signs to know if your testosterone levels are dropping : Low Libido : A low sex drive or decrease in inclination to have sex is the first sign of decreasing testosterone levels. Erectile Dysfunction : Testosterone is responsible for releasing nitric oxide that leads to erection. As the levels of testosterone decrease with age, getting an erection and maintaining it for longer periods of time may become difficult. Low Semen Level : The normal amount of semen ejaculated each time varies between 0.1 and 10 mL. This normal level is due to the efficient functioning of the testes, seminal vesicles, and prostate, all of which work under the influence of testosterone. As you age, the testosterone levels drop and the amount of semen ejaculated also drops. Orgasm Troubles : As you age, having an orgasm every time may be a bit difficult due to the dropping testosterone levels. Mood Swings : This happens in men as much as in women! The interesting thing here is that the man who suffers from it is the last one to note it and acknowledge. So, if you find yourself snapping and getting irritated at the smallest of things, get your testosterone levels checked. Depression : When you feel dull and demotivated at all times, and even doing the slightest of activity seems like a chore, it means that your testosterone levels have dropped to a significantly low level. Abdominal Fat : This is again an early sign of decreasing testosterone level. Belly fat is a sign of advancing age. Low testosterone levels are a sign of advancing age. Not all men who have low testosterone levels may show symptoms. In such cases, there is no need for any kind of treatment. Low testosterone may also be due to some other conditions like thyroid disease, excessive alcohol use, sleep apnea, etc. After 30 years of age, the levels of testosterone drop by 1% per year. By the time a man crosses 50 years of age he is in menopause. Identifying and eliminating these causes will restore the testosterone levels to normal. However, if no cause can be attributed to the low testosterone levels, it is a clear indication of normal aging and 'menopause.' As with women, men too have the option of hormone replacement therapy. However, this treatment is controversial. In some men, the testosterone replacement may relive several symptoms, but the risks far outweigh the benefits. An increased chance of heart attack, prostate cancer, and other health problems are associated with testosterone replacement therapy. Herbal supplements for problems associated with decreasing testosterone levels are generally considered safe, but they too have no proven health benefits and are known to increase the risks for prostate cancer. Male menopause isn't as dramatic and abrupt as the menopause in women, but it is a reality. It happens gradually over a period of several years.
Leg toning exercises for womenFor those women who will leave 'no stone unturned', here are a few great exercises which work superbly on the legs and whole body. For those who have always wanted a great pair of legs, don't change your jeans brand. Just change your brand of exercise. Here are great leg toning exercises that can make your legs attention grabbers. Well-shaped legs are what every woman desires especially as it signifies 'movement', 'mobility' and 'strength'. When we say legs we mainly mean the thighs, the calves and the feet. To get more precise the quadriceps of the thighs the hamstrings and the hip adductors are the prime targets of most exercises. A complete leg work out would also include the 'Tibialis Anteriors' or the shin muscles. Exercising the legs can be quite a frustrating thing especially if the leg muscles don't show any cosmetic improvement. Here is an exercise regimen which will ensure that you will get those attention-grabbing legs along with the strength, flexibility and tone which you have always desired. The stand This is probably the most undermined exercise of them all since it doesn't involve lugging heavy weights around or running for miles or squatting! It is a foundation exercise for the legs.  Choose your favorite spot on the floor and just stand erect with both feet together and toes pointing forward. Hold the hands straight at the elbows and keep the shoulders square. Tuck the chin in and do not bend your knees. Feel the ground under the feet. Now flex your thigh muscles and keep your feet firmly on the ground. Direct your attention towards the back of your thighs and keep your knees taut. Stand firm for about 3-5 minutes initially and gradually extend to five minutes or more. This exercise is simpler than it actually is as it keeps the thighs taut and firm. The entire leg gets a marvelous stretch and any faulty standing or postural habits create unnecessary tension and uneven hip alignment. The standing pose will be your first step towards trim and well-sculpted legs. The One Leg Extension After you perfect the stand, here is another great leg exerciser - The one leg extension Perform a stand as in the previous exercise for about 30 seconds. Once you get your grounding and feel your foundations beneath the feet, take a deep breath. Now flex your thigh muscles and keep the kneecaps taut without feeling any strain. Bend the left leg at the knee and raise it without bending at the right leg. Now catch hold of the big toe with the left hand and hold the pose for a few breaths. You will initially struggle for balance as you have to keep the other leg straight. Now that you have caught the big toe of the flexed leg gradually straighten the leg out without letting go of your grip. This is a challenging pose especially for the hamstrings, the hip flexors and the calves since the leg muscles are going to be a little tight especially around the hips and the hamstrings. With regular practice, the pain will ease and then you can even try and take the toe towards as high as you can with the aid of your left hand. Repeat with other leg following the same sequence. One Legged Squat The one legged squat is a superior exercise to the two legged variety is that it doesn't require many repetitions as it is quite a strenuous exercise even for advanced exercisers. Stand with the back of a chair within easy reach initially. Extend the right leg out first and squat down to your heel with your left. Once you have reached the end of the squat try not to touch extended leg as there comes the difficult part - getting up to standing position without touching the floor with your hands for support. Raise yourself to standing position and repeat with other leg. You can do about 3-4 sets with the same leg or alternate legs using the back of a chair for hand support as you squat deeply. The single legged squat exercises the gluteus, the knees and the entire hip joint and also gives lower back strength. Initially your knees might hurt so don't try this without support of a chair or a partner. Stop in case of intense pain. Step Training If plain jogging doesn't do the trick for shapely legs for you, try using stadium stairs or any gradient which is at 30 degrees and comprises even steps. Your regular apartment stairwell or even a pedestrian over bridge can do the trick. First set only walk up one step at a time. Second set do alternate stairs. For the third set you can sprint up as fast as you can the entire flight of stairs or halt for exactly ten seconds when tired and start again. You have the option of stopping as many times you wish as long as you start again after ten seconds. This can work up quite a sweat and regular step training works out and touches muscle groups that even normal running or squats cannot reach.
Pregnancy and HIVMothers with higher level of viral load have been found to deliver infected babies. However, no amount of viral load can be safe as infections can occur any time during pregnancy. A high level of precaution is necessary during this phase. Mostly infection occurs during delivery but that's not the only way through which it can spread. HIV-infected mothers should not breast-feed, as virus can transmit through breast milk too. Antiretroviral medications are used to reduce chances of transmission of HIV. Keeping delivery time shorter can reduce the risk of transmission. Most of the times babies born to positive mothers are positive for HIV. Babies infected with HIV will have antibodies made in their system and will continue to test positive. But if babies aren't infected, the mother's antibodies in baby's blood will eventually disappear and babies will test negative after about one to one and half year. HIV positive women should consider possible problems with antiretroviral medications for HIV before getting pregnant. Talk to the doctor about choice, indications, and contraindications of these drugs. There's a risk of missing doses due to nausea and vomiting during early pregnancy, hence giving HIV a chance to develop resistance. Some doctors prefer the practice of stopping or modifying medications during pregnancy to lower the risk of birth defects. Short course of treatments can help eliminate or reduce risk of transmitting HIV to a newborn; but, short treatments increase the risk of resistance to the drugs used too. There is a risk of birth defects due to antiretroviral drugs during the first 3 months of pregnancy. Pregnancy does not worsen mother's HIV disease, but any HIV positive woman planning to get pregnant should discuss treatment options thoroughly and all the pros and cons with her doctor.   
Cranky kids in a diner? dealing with them made a bit easy!This has happened to many a parent. They make a reservation at a fine dining restaurant, perhaps with friends and relatives. But their kid screams, and cries,disturbing the entire restaurant, and spoiling the general mood. For this reason, many parents avoid going out altogether, especially to fancy places. But there are ways in which you can handle the toddler when you are at a restaurant. We will show you how. Carry toys Restaurant may be boring at times for toddlers. That's why they turn peevish and may start playing with forks, spoons or knife. So carry some toys, crayons, notebooks, or even a story book, which will keep them busy and you can have a good time. Order something yummy and healthy for the kid A hungry kid is an angry kid. So, order something which is your kid's favorite and also healthy at the same time. Or you can carry something along with you like fruits breads, cherries or other nutritious treats. Keep responding to what kid says The best way to keep childrenwell behavedis to talk to them and respond whenever the child speaks. Don't avoid them or get too engrossed with other people. They get cranky when they don't get a response from you. Take a round with your kid When the kid becomes difficult to handle, just pick him in your arms and take a mini tour of the restaurant or walk outside. This will distract him and relieve his boredom. Don't tolerate any bad behavior If the bad behavior of the kids is intolerable, then firmly tell them that they need to adopt good manners if they want to visit restaurants again. Disturbing other diners is not acceptable. But it doesn't mean that you punish them.You just have to remove them to a place where they don't bother anyone. Make your outing relaxed and enjoyable Above all, don't forget to have fun and make it an enjoyable evening. Don't get too carried away disciplining the kid. You can afford to be a bit silly and enjoy the time with your child.
Dealing with obsessive thinking and worriesAn old adage goes - 'Worry is like a rocking chair. It gives you something to do but it doesn't get you anywhere'. This is absolutely true for many of us who have developed the habit of worrying unnecessarily over outcomes and circumstances. Thinking about things and over our course of action is a good thing because you should always think twice before acting. What about obsessive thinking? Is it good for you? Anything in extremity is a bad thing, whether it is your favorite food or your thoughts. Worrying incessantly is a part of obsessive thinking where you cannot let go of negative thoughts and they circulate in your mind continuously. Obsessive thinking is a negative infinite loop, a broken record that is stuck without having anyone to click the stop button. So how should you deal with this obsessive thinking that is sure to spell your doom in the long run? Though psychologists have devised various scientific methods of overcoming obsessive thoughts and worries, here we have listed down some easy to follow rituals that will help you deal with such worries and thoughts. Meditation - Yoga swears by the art of meditation as it is thought to release all negative energy from the mind and soul. Concentrating on your breathing and also absorbing a positive source of energy is the essence of meditation. So whenever you are obsessed about something, sit down, calm your nerves and meditate. Physical activity - Exercising always helps. Engage in physical activity which increases the body's metabolism and requires effort. Indulge in those dance lessons or swimming or maybe cycling and you will divert your mind from those negative thoughts. Indulge in your hobbies - So you thought you don't have time for your hobbies, but your hobbies relax your mind and body. Moreover, a hobby also takes out the creative side in you. So, whether you like to collect coins or stamps, or lean towards arts and crafts, a hobby is sure to occupy your mind and take you away from worries. Socialize - Friends and relatives are your lifeline as they help you in those tough situations. Even if you are mentally not at peace, making social calls on your friends and relatives will take the edge off.  Try to meet people who can empathize with you and help you move out of it. Socializing will give you that much needed break from the vicious cycle of your thoughts. Though a short-term relief, going out for movies or taking a weekend getaway with your near and dear ones or even indulging your wife in shopping, can be helpful. Confide - Talking to someone close who understands you helps you in expressing your troubles. Thinking obsessively, you usually tend to ignore your feelings and emotions. Your mind remains trapped in the net of those obsessive thoughts and your emotional well-being takes a backseat. When you talk to another person, he or she will hear you out and help you relieve the stress that is on your mind. They would understand your state of well-being and support you emotionally. Be mindful - You may find it easy to go back into the same negative thought process. Don't let your mind chatter. Stop your mind by standing up for yourself. Stand in front of the mirror and say, "I am not a victim. I have the power and strength to move ahead" Do this whenever you become aware that you are going back into the same thought process.  This will give you the mental strength needed to come out of it.  Be mindful and aware but don't be too harsh on yourself. Be responsible -Your mind can make you or break you. If you understand this truth you will find it easier to manage your thoughts. Take responsibility of your thoughts good or bad.  The mind can create thoughts to project blame or judgments about others.  When you own your thoughts, you will find it easier to shape them the way you want. Create a higher vision of your life - When you keep a higher vision in your life, you can move ahead easily.  By developing a higher vision, you are asking yourself, who am I?and finally working towards it. You take positive actions and thus there would be more gratitude for what you have and less resentment for things that do not work.   This stops your mind from working unnecessarily. Obsessive worrying is a psychological disorder which in extreme cases has to be dealt with pathologically. Do not let your condition to reach the extreme end of the spectrum. Follow the above mentioned suggestions and try to deal with those thoughts yourself. It may take some time but rest assure, it will be effective in the long run.
Crossing the smoke screenWhy should someone quit smoking? Smoking is probably the worst sedentary lifestyle habit that we pick up. Quitting smoking changes everything right from the way you feel, taste and smell, your breath smells better and even your cough goes away. Quitting smoking cuts down the risk of cancer, stroke, neuropathy, heart disease and breathing disorders like bronchitis, pneumonia, and emphysema. Not just that, quitting saves money too... just one of the many financial rewards of quitting. Quit Smoking Tips Write down the reasons you want to quit for, and how it will benefit you: for e.g. live longer, feel better, family safety, save money, smell better, find a soul mate easily, etc. You know what's bad about smoking and you know what you'll get by quitting. Read the list daily. Ask for help from your family and friends. Help and support of family and friends without being judgmental helps a lot. You need their support when you become irritable and even irrational while you withdraw from your smoking habit. Set a Deadline. Set a quit date when you will extinguish forever. Prepare a plan. Talk with doctor and take his support and guidance. Exercise. Exercise helps relieve stress and recovers body from damage caused due to cigarettes. Start slow and increase up to 30 to 40 minutes. Begin to breathe. Daily deep breathing for 5-15 minutes will help cleanse the respiratory system and provide more oxygen repairing the damage caused to respiratory system and help cope with withdrawal symptoms. Do not quit abruptly. Cut down on cigarettes gradually. Plan everything about number of cigarettes you will smoke each day till the quit date, reduce the number each day. Buy single cigarette at a time. This helps a great deal to limit smoking. Change brands. This way you won't enjoy smoking as much. Undertake social commitment. Keep your packet of cigarettes with someone else, so that you have to ask for them each time you want to smoke. This way you'll feel guilty about asking and hence smoking; hence lowering the number of times you smoke. Find a mate who is trying to quit. This will boost the morale and keep up the positivity. Try finding a quitting chat room. Learn what triggers desire to smoke - like stress, the end of a meal, arrival at work, entering a bar, etc. Avoid these triggers or if that's impossible, plan alternative ways to deal with the triggers. Now, after you have read this, sit down and write your own list suitable to your personality and way of doing things and create your own plan for quitting.  
5 cardinal sins for the skinWhile cigarettes may not constitute food in the strictest sense, it does have a profound effect on skin complexion, health, color and tone. We eat that we may live, but sometimes we eat way too much and consume stuff that may be extremely hazardous to our health. Since we are talking about skin, here are 5 most hazardous foods for your skin: Grease adds to the crease Since healthy skin is all about healthy blood circulation, any food which is likely to clog up the blood vessels internally is deemed bad for skin tone. Packaged snacks like potato chips may have edible oil written in bold but this contributes significantly to the slowing down of 'collagen and elastin syntheses' which in turn causes the skin to appear aged and all wrinkly. The french fries that we consume as a TV snack can also cause an acne outbreak on the skin and face. Gluten Glutton Gluten is a substance found in wheat and other food grains. We may not even be aware that some of the food grains have gluten as a main constituent. Gluten intolerance can also cause inflammations on the skin in the form of rashes or acne. Bad news is that the pizzas, pastas, cakes and bread that we get off the rack may be heavy in gluten (Surprised that they don't say that on the pack) and that may be the reason for you to lose precious skin tone. So seek gluten free foods, though that might not be the easiest of tasks, but for your skin, it certainly will be worth it. Caffeine - the skin coffin If you are one of those coffee addicts then you may as well write an obituary column lamenting the loss of your skin tone and complexion. It's not without reason that health freaks love bashing coffee beans and caffeine rich beverages, as they are truly hazardous. How? Studies have proven that just 2-3 cups stimulate pituitary-adrenocortical response. Yes, but what does that have to do with your skin? Well this leads to the hormone cortisol to increase in our bodies. Cortisol is known as the stress hormone! So now here's what it does to your skin -it accelerates the ageing process which means wrinkled skin and causes dehydration causing the skin to show an unusual pallor. So before you turn the coffee faucet on think twice. Fad to Black How fad diets are not skin friendly? Some people go on a high protein, low-carb diet which could sound the death knell as far as complexion goes. Dieting depletes calcium levels, which means your bones are going to suffer and what's the point of having skin on bad bone density? Besides low-carb diets can utterly wreck the complexion as the delicate PH balance in the skin is ruined. Some of the meat, poultry and dairy products too can have artificial chemicals injected in them which cause a hormonal imbalance in our bodies leading to skin disasters. Fruits and vegetables have chemicals injected too sometimes! Beware! Cereal Killers Cereal killers are those people who ignore the need of a proper diet for skin health. So anybody who indulges in too much sugar, caffeine and greasy food stuffs is a 'Cereal Killer' A lack of cereals in the diet can literally kill your skin. Cereal foods have high fiber and antioxidants for moisturizing the skin and protecting it from skin damage. For great skin other than cereals which are simply fabulous for keeping skin hydrated and breathing easily, one can eat fruits, olive oil, healthy fats, almonds, tofu, grains, nuts and the good old vitamin B rich products. Ceramides in raw food diets, organic foods, wheat germ and brown rice protect the epidermis of the skin and make it impervious to external attacks and pollutants while maintaining their tone and beauty.
Fruit diet can be dangerousFruits are healthy and provide lots of nutrition, vitamins, antioxidants, carbohydrates, fibre and bioflavanoids to the body.These things together protect your body from different health conditions and heart disease. However if you only eat fruit, you miss many other essential nutrients such as fats and protein. This can upset your stomach and lead to indigestion. Hence it is very important to take a well-balanced diet to remain healthy. Check out why you should not rely solely on fruits for living. Fruits do not provide protein Protein is highly important for your growth and development. By eating only fruits, you are restricting your intake of proteins that can stop your overall development process. Your body requires calories and energy on a regular basis. Each cell of your body contains protein. To keep your body cells in top working condition it is important that you include protein-rich foods such as lentils, soy products,  nuts and beans in your regular diet. You can also consume low-fat dairy, lean meat, fish and skinless poultry to provide required amount of protein to your body. Fruits do not provide fat Although excess of fat is not good for health, it is essential that your body requires on daily basis to ensure smooth functioning of your immune system and also to help your body absorb various minerals and vitamins provided by other foods like fruit. If you continue being a fruitarian for long duration, the chances of stroke due to brain haemorrhage increases. According to health experts, you should get around 20 to 35 percent of your daily calories from fat. To provide your body with good fats you should include soybean, sunflower, olive or canola oil in your diet. Fish and poultry also provide good amount of healthy fats to the body. Too much of fruits can lead to digestive problems Fruits provide fibres to the body in large amounts. Although your body needs fibre as it is one of the essential nutrients, getting too much of fibre can lead to side effects. Fibre works as broom to clear of your abdomen and aid in the digestion process. However, too much of fibre leads to stomach problems and cause symptoms such as gas, cramps and bloating. Sometimes it may also lead to chronic diarrhoea, dehydration and loose stools. On a regular basis, a woman requires only 22 to 28 gm of fiber per day and a man needs 34 to 38 gm. Apart from fruits, seeds, vegetables and whole grains also provide fibre to the body. Other considerations If you limit your intake to fruits, you may not get enough calories required for producing the required amount of energy. Consuming calories less than 1100 per day can lead to lot of side-effects such as intolerance to cold, gallstones, hair loss and fatigue. So although fruits taste wonderful and are very tempting, being a fruitarian is not the best thing for your health. Your body needs all the nutrients for carrying out its different activities and hence you should include variety of foods in your diet.  
Stay healthy, keep flu at bayKeep the influenza virus away from you by following these simple routines : Wash your hands!Hands are a germ factory. Innumerable things are touched by us through the course of a day and that lends the germs a perfect breeding ground. Hence, it becomes imperative that we clean our hands thoroughly, especially before eating. Always keep a sanitizer handy in case you don have access to water and soap. Even while you wash your hands with soap and water, do not rush with the process. Wash thoroughly at least for 20 seconds. Clean the surfaces!Computer keyboards, tables, pens and pencils, shared stationary are all great places to find the flu virus. Regularly clean these surfaces with an alcohol-based disinfectant that will kill these germs. Exercise!Nothing can be as good as regular physical exercise for maintaining good health. Regular exercising boosts the immunity. This makes you fall ill less often. It also gives you greater resistance against viruses so you will not be affected by them no matter how strong the exposure. Top up on vitamin C!Vitamin C is known to boost your immunity levels. It also increases the resistance against viruses. Eat a lot of citrus fruits like oranges and tomatoes. Amla, that is a rich source of vitamin C, can also be consumed in the form of juice or eaten raw! Chicken soup for the ill-soul!Chicken soup is known to be the most effective against the flu virus. So if you feel you are coming down with a flu fever, rush to the kitchen and fix up some nourishing chicken soup for yourself. Nothing works as effectively as this does. Try poking yourself!The ancient Chinese system of medicine, acupuncture, has been known to treat everything from headaches to nausea to arthritis. Acupuncture experts may prick at particular pressure points with hair like needles to keep flu at bay and to reduce the severity if already infected. Though there is no significant scientific evidence against it, there is absolutely no harm in trying it, if you can tolerate the pain from the needles!. OTC drugs!Over-the-counter medications are available in plenty for flu symptoms. The achy feeling all over the body, the sore throat, and the muscle pain are the worst symptoms of flu. Doctors suggest that you do not over-medicate yourself. Instead of going for multi-drug combinations, doctors advise you go for generic medicines like acetaminophen for fever and a cough suppressant. Garlic pods!These smelly things can be of great use when it comes to prevent a lot of diseases, the flu included. Studies show that people who ate two or three pods of garlic daily had better resistance against the flu virus and fell ill less often. Proactive Probiotics!The strength of your immune system lies in your gut, called gut-associated lymphoid tissue or GALT. Almost 80% of the immunity comes from your gut. To keep the gut healthy, eat a lot of probiotic, pro-GALT foods like yoghurt. Sleep well!Sleep is the most essential component of staying healthy. A well-relaxed body is fitter and stronger and will have better immunity against diseases! Prevention is always the better form of cure. Stay protected and stay healthy.
Bile block - Understanding gallbladder problemsRavi was a young intern working the night shifts in a government hospital when he was asked to examine a patient who had just been brought in. The patient was a 45-year-old, a fat man, who was complaining of pain in the right side of the abdomen along with nausea and vomiting. On inquiry it was revealed that he had eaten a very heavy fat-laden dinner. Remembering what his surgery professor had taught him about cholelithiaisis, Ravi immediately guessed what the diagnosis could be. He, however, sent the patient for a blood test and an abdominal scan. The reports confirmed Ravi’s suspicions- cholelithiasis, gallstones. The gallbladder is a tiny pear shaped organ that lies just below the liver. It is responsible for storing the bile that is produced by the liver for digesting food. It ensures the smooth outflow of the bile from the bile ducts. When the bile components aggregate in the gallbladder, they build up to form gallstones, similar to kidney stones. The gallstones are usually small enough to pass on to the intestines and be eliminated without causing too much trouble. At times, these stones may be big enough to block the outflow of the bile and give rise to a variety of symptoms depending on the size of the stone and severity of the block. The symptoms include -  Intermittent colic. A bloated sensation with constant nausea. Inability to tolerate fats. Vomiting.  Fever with chills if the stone becomes infected. Gall stones though found in both sexes, is more common in females. The risk factors for developing gallstones include - Diabetes. Organ transplant. Diseases like hemolytic anemia, sickle cell anemia. Liver cirrhosis. Failure of the gallbladder to empty properly, e.g., during pregnancy. Rapid weight and nutrition loss due to any reason. Gallstones are confirmed by a blood test to check the liver function and by an abdominal scan. Medications to dissolve the stones, and surgery in case of large stones that do not dissolve with medications, are the treatment options.
Painful intercourseSome of the causes affecting women can be: Going too fast, penetrating from an awkward position. Do not hesitate to tell your partner that it hurts and he needs to slow down or change position in order to make you comfortable and prevent pain. Dry vagina or lack of natural lubrication in the vagina. This dry vagina is caused due to some medications, changes at the menopause. Sometimes just increasing the time of foreplay can help vaginal lubrication. Use water-based lubricant to reduce pain. Failure to fire off. Sometimes failure of the vagina and uterus to respond to sexual arousal can lead to irritation and tenderness. The vagina may be too tight for the intercourse sometimes or the uterus may not be raised so that the penis comes in contact with the cervix during penetration. Using other penetration methods can be helpful to explore the level of arousal before engaging in intercourse. Vaginismus can be the cause of discomfort. Muscles surrounding vagina are sometimes very tight and lead to pain and intercourse to be painful. Woman can examine herself with her fingers to see if vaginal walls are tighter than normal. It can be vaginismus. Normal cause is nervousness or anxiety. It is reversible. Good foreplay before intercourse will help to relax the muscles and help lubricate. Just relaxing before the act can be helpful. Vaginal infection and inflammation due to yeast, herpes, etc. can make intercourse uncomfortable. Fabrics, creams, perfumes may cause irritation in area in some women. Avoid these. First-time sex can be a little painful. Rupture of the hymen can cause discomfort during penetration. Start slowly or begin with forms of penetration other than intercourse. Psychological pain. Sexually traumatic experiences or feelings of guilt associated with sex can make the act painful. Consult a sex therapist or psychiatrist. Discomfort during intercourse is experienced by men too, various causes affecting this outcome for men are: Tight foreskin. During first attempt at intercourse, tight foreskin will make retraction painful. After sometime, the foreskin will become loose and make intercourse comfortable. Any lesion on the penis skin can make intercourse painful. These may result from non-lubricated masturbation or rapid intercourse or STDs. The blisters due to herpes infection can make intercourse extremely painful.
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