candida infection

Decoding candida

Your Health

Dr Gita Mathai Feb 14, 2018 00:00 IST

The commonest fungus that affects humans belongs to the candida species. That is why the infection is called candida or thrush.

We are usually resistant to a thrush infection because of our natural immunity. Babies, the elderly and people whose immunity is compromised by HIV infection, cancer or treatment with steroids are unable to withstand the infection.

The spores thrive in the mouth, vagina, penis, and in the sweaty folds of the body - in the armpits, under the folds of the breast, in the groin and diaper areas of babies. They can grow rapidly, causing the area to become inflamed, red, scaly and itchy.

In the mouth and vagina, thrush is visible as curdy white patches that cannot be scraped off. It makes the foreskin of the penis inflamed and cracked. There may be a foul odour. Scratching causes the organism to be deposited under the nails and transported to other areas.

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Prolonged sucking on pacifiers and bottle nipples can cause micro trauma to the mucous membrane of the mouth in babies, enabling candida to get a foothold. If the infant is on antibiotics, the protective microbes in the mouth can get suppressed, causing an overgrowth of candida. The infection can occur in breast-fed infants also and may be passed back and forth from nipple to mouth.

Diapers can promote the overgrowth of candida. The diaper area may be covered with red splotches or be scaly. It can occur because the baby is left in the soiled diaper too long or the baby or mother is on antibiotics.

Local applications of anti-fungal solutions or creams are usually all that is required for the infection to clear up.

Natural probiotics (like a tablespoon of curd) on an empty stomach in the morning will help to repopulate the body with good bacteria and prevent overgrowth of fungus.

The writer is a paediatrician with a family practice at Vellore and author of Staying Healthy in Modern India. If you have any questions on health issues please write to yourhealthgm@yahoo.co.in

feeding children

To feed or not to feed

Your Health

Dr Gita Mathai Jan 31, 2018 00:00 IST

The human race varies in shape and size, unlike articles manufactured on a conveyor belt. As people look around, they worry about this difference in weight. Parents are perturbed by thin children, and want them to gain weight. Actually, both ends of the spectrum — very thin and very fat (BMI over 30 or under 18.5) — can face health problems and need help.

Obesity, which once seemed a problem of developed countries, has arrived with a bang in India. We are now home to 3.7 per cent of obese men (around 9.8 million) and 5.3 per cent (around 20 million) of obese women in the world. India also has 40 per cent of the global underweight population. About 42 per cent of our children below the age of 5 are thin. 
Being over or underweight is not just an aesthetic problem — obesity is associated with lifestyle diseases such as diabetes, hypertension, arthritis, stroke and an increase in the incidence of many cancers.

Being “thin” may result in stunted growth in children as well as failure to attain their full physical and mental potential. In underweight people all age groups, essential nutrients like amino acids, vitamins and minerals may be deficient. This may produce inadequate muscle mass, weak osteoporotic bones and anaemia. The immune system may not function efficiently so that frequent infections are common. Underweight women are more likely to suffer miscarriages during the first three months of pregnancy. Children carried to term are likely to be underweight and anaemic.

A low BMI can be normal in a person genetically predisposed to be thin. It can occur with infections such as tuberculosis, cancer, untreated diabetes, an overactive thyroid gland, gastrointestinal and liver disease.

People can also have emaciation, an extreme form of  low weight with a gaunt appearance, loss of subcutaneous fat and lack of energy. It is caused by severe calorie restriction. The starvation may be due to poverty, infestations with intestinal parasites, malignancy and infections. It can be due to psychiatric illness or eating disorders like anorexia nervosa.

Parents worry about children who look thinner than their peers. Babies should ideally double their birth weight at the end of the fifth month and triple it by the first birthday. A child who was 2.5kg at birth should be 7.5kg on their first birthday. One who was 3.5kg at birth will be 10.5kg. Although both are normal, one child will appear bigger than the other. After the first birthday, 2-3 kilos are gained a year till puberty, when there is a growth spurt. Weight gain depends on the appetite, which in turn is controlled by a centre in the brain.

Most of the time, children spontaneously regulate their appetite and instinctively know how much food should be consumed. This mechanism fails if there is force feeding, if the child is a finicky eater who does not like the food, or if there is stress and conflict while eating. Allergy to milk or other food may cause stomach pain and refusal to feed. There may be undiagnosed gastrointestinal reflux.

The value of exercise cannot be underestimated. At any age, 60 minutes of continuous physical activity will help to control weight, working off the excess calories in the obese and increasing the appetite in the underweight. 

EAT RIGHT 

•  By the age of two, children should be eating the same things as the rest of the family

•  Meals should be eaten at fixed times

•  Food should be eaten at one place, the dining table, and not all over the house or in front of the television

•  Force feeding, scolding and beating should be avoided to reduce stress

•  Children require six meals a day as their stomach size is small

•  Avoid more than 400ml of milk per day

•  Avoid sugar-laden snacks

The writer is a paediatrician with a family practice at Vellore and author of Staying Healthy in Modern India. 
If you have any questions on health issues please write to yourhealthgm@yahoo.co.in

adult immunization

Take a shot, everyone

YOUR HEALTH

Dr Gita Mathai Jan 10, 2018 00:00 IST

We are all aware that timely immunisation prevents many childhood diseases. There are more than 15 infectious diseases - such as diphtheria, whooping cough, tetanus, rotavirus diarrhoea, jaundice (A and B), typhoid, chicken pox, measles, mumps, German measles, flu, cervical cancer, pneumococcal and meningococcal pneumonia - which can be prevented, or at least turned mild, with immunisation.

While our children are immunised against some, if not all, diseases, we often do not realise that immunising our old parents is necessary too. At present, life expectancy in India is around 68 years. About 8 per cent of the population falls into this age category. These seniors are at risk for many of the same diseases that affect children. Many do not have the benefit of childhood immunisation while others lose immunity to infectious diseases acquired in childhood with age. This is especially true of grandparents who share their house with grandchildren - who tend to bring home infections from school. The symptoms may be different in old people so diagnosis may be difficult and delayed.

Even mild illnesses such as the flu can lead to complications and progress rapidly to breathing difficulties and heart failure. The pain of herpes zoster can be long lasting and unbearable. Even immunity against tetanus wanes. An unattended wound can cause "lock jaw" spasms and death.

Timely boosters have to be given for these diseases. Immunisation against diphtheria and tetanus (dT) is available and has to be taken once in 10 years.

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The flu vaccine has to be taken every year because the virus constantly mutates. The best time to take the shot is during the flu season, October to March. Shots are now painless and given with fine needles. The side effects of soreness and pain last barely 24 hours.

Flu is like a heavy cold with body aches and fever. It can cause dehydration, sinusitis and ear infections. It can leave older people susceptible to life-threatening pneumonia and worsen pre-existing conditions such as asthma, diabetes, kidney disease and heart failure. The virus can affect the heart itself, causing myocarditis and pericarditis.

The pneumococcal vaccine has to be taken once after the age of 65. It is important for everyone but particularly those with asthma, emphysema and diabetes.

Herpes zoster occurs because of a reactivation of the chicken pox virus in people who had the disease decades ago as children. It is extremely painful and debilitating and can eventually lead to depression. The vaccine is available as a single dose and has few side effects.

Senior citizens (even educated ones) are not aware of the importance or necessity of protecting themselves from preventable diseases. It seems to them an unnecessary expense for an event that may never occur. This is far from the truth because if and when the disease strikes, it will mean hospitalisation, suffering and sometimes even death.

The writer is a paediatrician with a family practice at Vellore and author of Staying Healthy in Modern India.

If you have any questions on health issues please write to yourhealthgm@yahoo.co.i

exercise requirements

Time to move it, move it

Your Health

Dr Gita Mathai Dec 20, 2017 00:00 IST

You need to exercise regularly to maintain health, prevent weight gain, delay the onset of lifestyle diseases such as diabetes and hypertension, slow mental decline and even avert some cancers. It is essential for correct posture, restful sleep and a good mood. After an hour of working out, no problem seems insurmountable. The question, however, is "Just how much exercise is enough?"

Originally, 70 years ago, 10,000 steps per day was considered sufficient to maintain health. That translates to 5 miles or 8 kilometres. A sedentary person, who works at home or in an office, averages 1,500 to 3,000 steps a day.

People want to be fit. These publicised step statistics led to increased sales of wearable fitness devices, which calculated the number of steps taken. People became fixated on numbers and tried to frantically complete the requirement before bed.

After a series of studies, the number of steps needed per day to maintain health has been increased from 10,000 to 15,000. Usually, we take 100 steps a minute when we are walking fast. At this speed, it is possible to have short bursts of conversation. During speed walking or jogging, we take around 130 steps per minute. This means a person would need to walk for little more than two hours for 15,000 steps. Many of us cannot spare that much time!

Fortunately, continuous short bursts of activity throughout the day are also beneficial and more likely to result in sustained weight loss and fitness. After an intense 30-minute walk or run, if you sit at your desk the rest of the day (eight hours), you are unlikely to reach your 10,000-15,000 steps a day target. Also, despite all the effort, your lifestyle will be classified as "sedentary", with all its accompanying risks.

Hitting the gym is a popular concept among the fitness conscious. Unfortunately, studies show that gym memberships in India are more expensive than in Australia or the US. The timings are often inconvenient and the commute problematic. Motivation often dips after a few months. Since many gyms insist on advance payment for the whole year, money is often wasted.

Walking on the road is free. It is also possible to draw a figure of 8 on the terrace or the living room and walk for 30-40 minutes.

In addition to active exercise, muscles strength can be achieved with resistance exercises using dumb bells - 2kg for women and 5kg for men. This helps build muscle mass to support back, abdomen, knees, chest, neck and shoulders. Strong muscles speed up metabolism and increase endurance. Core exercises strengthen the spine, so you are less likely to suffer from degeneration, slipped discs and backache. Strong muscles burn calories faster and more efficiently, helping with weight loss.

Both the body and mind need healthy activities. Regular exercise releases chemicals from the leg muscles that keep the brain active. Irregular sleeping hours, late night television and texting take a toll on health. These produce a sluggish brain and a craving for unhealthy fatty foods, starting you off on that vicious circle of fighting weight gain again.

METABOLIC METER

• Have a heavy, protein-rich breakfast to give metabolism an early start

• Coffee, regular and green tea are also metabolic enhancers

• Skip the second drink to stop your metabolism turning sluggish

• Make weight training a part of your exercise regime to maintain muscle mass, which burns more calories than fat

exercise

how much exercise

Time to move it, move it

Your Health

Dr Gita Mathai Dec 20, 2017 00:00 IST

You need to exercise regularly to maintain health, prevent weight gain, delay the onset of lifestyle diseases such as diabetes and hypertension, slow mental decline and even avert some cancers. It is essential for correct posture, restful sleep and a good mood. After an hour of working out, no problem seems insurmountable. The question, however, is "Just how much exercise is enough?"

Originally, 70 years ago, 10,000 steps per day was considered sufficient to maintain health. That translates to 5 miles or 8 kilometres. A sedentary person, who works at home or in an office, averages 1,500 to 3,000 steps a day.

People want to be fit. These publicised step statistics led to increased sales of wearable fitness devices, which calculated the number of steps taken. People became fixated on numbers and tried to frantically complete the requirement before bed.

After a series of studies, the number of steps needed per day to maintain health has been increased from 10,000 to 15,000. Usually, we take 100 steps a minute when we are walking fast. At this speed, it is possible to have short bursts of conversation. During speed walking or jogging, we take around 130 steps per minute. This means a person would need to walk for little more than two hours for 15,000 steps. Many of us cannot spare that much time!

Fortunately, continuous short bursts of activity throughout the day are also beneficial and more likely to result in sustained weight loss and fitness. After an intense 30-minute walk or run, if you sit at your desk the rest of the day (eight hours), you are unlikely to reach your 10,000-15,000 steps a day target. Also, despite all the effort, your lifestyle will be classified as "sedentary", with all its accompanying risks.

Hitting the gym is a popular concept among the fitness conscious. Unfortunately, studies show that gym memberships in India are more expensive than in Australia or the US. The timings are often inconvenient and the commute problematic. Motivation often dips after a few months. Since many gyms insist on advance payment for the whole year, money is often wasted.

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Walking on the road is free. It is also possible to draw a figure of 8 on the terrace or the living room and walk for 30-40 minutes.

In addition to active exercise, muscles strength can be achieved with resistance exercises using dumb bells - 2kg for women and 5kg for men. This helps build muscle mass to support back, abdomen, knees, chest, neck and shoulders. Strong muscles speed up metabolism and increase endurance. Core exercises strengthen the spine, so you are less likely to suffer from degeneration, slipped discs and backache. Strong muscles burn calories faster and more efficiently, helping with weight loss.

Both the body and mind need healthy activities. Regular exercise releases chemicals from the leg muscles that keep the brain active. Irregular sleeping hours, late night television and texting take a toll on health. These produce a sluggish brain and a craving for unhealthy fatty foods, starting you off on that vicious circle of fighting weight gain again.

METABOLIC METER 

• Have a heavy, protein-rich breakfast to give metabolism an early start

• Coffee, regular and green tea are also metabolic enhancers

• Skip the second drink to stop your metabolism turning sluggish

• Make weight training a part of your exercise regime to maintain muscle mass, which burns more calories than fat