YOUR BODY

Woman's Era - - Contents - – Dr San­jay Teo­tia

MY MOTHER IS ABOUT 60 YEARS OLD. SHE IS SUF­FER­ING FROM stiff­ness of knee joints along with weak­ness of calf mus­cles (mus­cles of legs). We have con­sulted in or­thopaedic sur­geon, he ad­vised ac­tive ex­er­cises. I want to know about the ac­tive ex­er­cises she can do.

Ac­tive ex­er­cises may be given for three pur­poses, to mo­bilise joints, to strengthen mus­cles and to im­prove co­or­di­na­tion or bal­ance. In mo­bil­is­ing ex­er­cises the pa­tient's ac­tive ef­forts to move the joint may be as­sisted by gen­tle pres­sure by the phys­io­ther­a­pist's hand (as­sisted ac­tive ex­er­cises). In mus­cle strength­en­ing ex­er­cises the pa­tient is en­cour­aged to con­tract the weak­ened mus­cles against the re­sis­tance of weights or springs, the re­sis­tance be­ing in­creased as the mus­cles gain power. Ex­er­cises to im­prove co­or­di­na­tion are of par­tic­u­lar im­por­tance in cere­bral palsy.

IAM A 27- YEAR- OLD WORK­ING WOMAN AND TWO MONTHS preg­nant. This is my first preg­nancy. I want to know the bod­ily changes dur­ing the en­tire phase of preg­nancy. Breast changes (en­large­ment, vas­cu­lar en­gorge­ment, colostrum), ab­dom­i­nal en­large­ment, cyanosis of vagina and cer­vi­cal portion (about the sev­enth week), soft­en­ing of the cervix (sev­enth week), soft­en­ing of the cer­vi­couter­ine junc­tion ( eighth week), gen­er­alised en­large­ment and dif­fuse soft­en­ing of the cor­pus (af­ter eighth week). The uter­ine fun­dus is pal­pa­ble above the pu­bic sym­ph­ysis by 12- 15 weeks from the last men­strual pe­riod ( LMP) and reaches the um­bli­cus by 20-22 weeks. Foea­tel heart tones can be heard by Doppler at 10-12 weeks of ges­ta­tion and at 20 weeks with an or­di­nary foe­to­scope.

MY DAUGH­TER IS 28 YEARS OLD AND WORK­ING. RE­CENTLY she has de­vel­oped fear of open places and pub­lic ar­eas. We have con­sulted a psy­chi­a­trist. He told us that she is suf­fer­ing from ago­ra­pho­bia and ad­vised medicine and psy­chother­apy. I want your opin­ion about the dis­ease.

Ago­ra­pho­bia is a pho­bic dis­or­der. Pho­bic ideation can be con­sid­ered a mech­a­nism of dis­place­ment in which pa­tients trans­fer feel­ings of anx­i­ety from their true ob­ject to one that can be avoided. How­ever, since pho­bias are in­ef­fec­tive de­fence mech­a­nisms, there tends to be an in­crease in their scope, in­ten­sity and num­ber. So­cial pho­bias are global or spe­cific, in the for­mer, all so­cial sit­u­a­tions are poorly tol­er­ated, while the lat­ter group in­cludes per­for­mance anx­i­ety or well de­lin­eated pho­bias. Ago­ra­pho­bia ( fear of open places and pub­lic ar­eas) is fre­quently as­so­ci­ated with se­vere panic at­tacks. Pa­tients of­ten de­velop the ago­ra­pho­bia in early adult life, mak­ing a nor­mal life­style dif­fi­cult.

MY DAUGH­TER IS 6 YEARS OLD AND DE­VEL­OPS Itch­ing and red­ness of skin when ex­posed to the sun. We have con­sulted a skin spe­cial­ist, who told us that she is suf­fer­ing from pho­to­sen­si­tiv­ity dis­or­ders and ad­vised sun­screens. I want to know about pho­to­sen­si­tiv­ity dis­or­ders and sun­screens.

Pro­tec­tion from ul­tra­vi­o­let light should be­gin at birth but will re­duce the in­ci­dence of ac­tinic ker­ato­sis and some non­melanoma skin can­cers when ini­ti­ated at any age. The best pro­tec­tion is shel­ter, but pro­tec­tive cloth­ing, avoid­ance of di­rect sun ex­po­sure dur­ing the peak hours of the day and the as­sid­u­ous use of chem­i­cal sun­screens are im­por­tant. Es­ti­mates are that if fair chil­dren were to use such sun­screens reg­u­larly, their life­time risk of skin can­cer might be re­duced by 75 per cent. A num­ber of highly ef­fec­tive sun­screens are avail­able in cream, lo­tion and non­greasy gel and liq­uid for­mu­la­tions. Fair com­plex­ioned per­sons should use a sun­screens with an sun pro­tec­tive fac­tors of at least 15 and prefer­ably 30- 40, every day. Sun­screens with high sun pro­tec­tive fac­tor val­ues, more than 30 af­ford some pro­tec­tion against ul­tra­vi­o­let A as well as B light ex­po­sure and may be help­ful in man­ag­ing pho­to­sen­si­tiv­ity dis­or­ders.

M●

Y MOTHER IS ABOUT 70 YEARS OLD AND USU­ALLY TAKES medicines for anx­i­ety and de­pres­sion and suf­fer­ing from con­sti­pa­tion. We have con­sulted a physi­cian, he told us that this is be­cause of medicines of anx­i­ety and de­pres­sion and ad­vise some diet and pro­phy­lac­tic mea­sures. What is your opin­ion?

Given the fre­quent use of opi­oids (used in anx­i­ety and de­pres­sion med­i­ca­tion), poor di­etary in­take and phys­i­cal in­ac­tiv­ity, con­sti­pa­tion is a com­mon prob­lem among the el­derly. Clin­i­cians must in­quire about any dif­fi­culty with hard or in­fre­quent stools. Con­sti­pa­tion is an eas­ily treat­able cause of dis­com­fort and dis­tress. Con­sti­pa­tion may be pre­vented or re­lieved if pa­tients can in­crease their ac­tiv­ity and their in­take of di­etary fi­bre and flu­ids.

Sim­ple con­sid­er­a­tions such as pri­vacy, undis­turbed toi­let time and a bed­side com­mode rather than a bed­pan may be im­por­tant for some pa­tients. For pa­tients tak­ing opi­oids, an­tic­i­pat­ing and pre­vent­ing con­sti­pa­tion is im­por­tant. A pro­phy­lac­tic bowel reg­i­men of stool soft­en­ers ( do­cusate) and stim­u­lants should be started when opi­oid treat­ment is be­gun. Lac­tu­lose, sor­bitol, mag­ne­sium cit­rate and en­e­mas can be added as needed.

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