Largest Terrorist group of india…. Beaware!!!

By Dr Qazi Arif

All over the world, terrorism is a big problem but in India one terrorist group is very active, working day and night.These terrorists are all around us every time; we ignore them, but they are waiting for a single chance.

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It is said that ‘Terrorism has no religion’ , but they work as a unit. They are neither Muslims nor Hindus yet they are in a large number and many Indians help them to grow against their own people. Though some people do fight against them, but their efforts are restricted to themselves and their family only.
This terrorist group kills many people and affect so many people every single day.
Here I’m going to share their information, their locations, appearances, their activities and also strategies to eradicate them.
They work for different groups such as,
• Al-zika,
•lashkar-e-chikungunya,
•malaria night riders,
•fearless dengues
•Japanese evils etc.
Yes, They are Mosquitoes.
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Statistics say
○Buffalos kill 7 people every year.
○Lions kill 500 people every year.
○Spiders kill 5000 people every year.
○Scorpions kill 7000 people every year.
○Snakes kill 10000 people every year.
Guess what?
Mosquitoes kill 2.7 million people every year.
The smallest are the deadliest.
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There are about 3,500 different mosquito species worldwide. However, not all of them bite humans.
■Major groups which are of health importance-
1. Anopheles Mosquito
Anopheles mosquitoes commonly bite at night and rest indoors and outdoors during the day.
Females are the activists.
Anopheles mosquitoes are transmitters of Malaria.
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2. Culex Mosquitoes
Culex mosquitoes are transmitters of Japanese B Encephalitis, a very dangerous type of brain fever. They take a rest before and after blood meals and bite at night. They breed in polluted stagnant water, in India mostly in drains.
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3. Aedes Mosquitoes
Unlike others, Aedes mosquitoes (tiger mosquitoes) are active during the day. They breed in clean water in artificial containers, such as flower pots, water accumulation in tyres and cans.
Aedes mosquitoes are responsible for Chikungunya and Dengue.
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Though it is not well established how mosquitoes identify human beings, but it is supposed that
•Mosquitoes find hosts by detecting body heat and chemical signals
•Blood group O more than A and B
•Those who exhale more CO, e.g. pregnant.
■Activities
○Al-zikas: This group works at the international level. Although its activists are present in India but they are yet to attack here. So while traveling overseas protect yourself and your family from Al-zikas with the help of repellents.
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Aedes aegepty mosquitoes spread the zika virus through their bites. Thus causing fever, rash, joint and muscle pain, or red eyes. Often the symptoms are generalized discomfort lasting for several days to a week.
Infrequently, hospital admission is required, and deaths are rare. CDC (Anti terrorist squad for mosquitoes) has issued a travel notice for the people who are visiting to high alert zone for zika virus. As zika produces birth defects in babies born to women who were infected during pregnancy period with zika virus.
Considering these CDC has recommended followings precautions
•Pregnant women should not travel to any area where Zika virus is spreading.
•Pregnant women who must travel to one of these areas should talk to their doctor first and strictly follow steps to prevent mosquito bites.
•Women trying to become pregnant, and their male partners, should consult with their doctor before traveling to these areas and strictly follow the advices.
To date, there is no known vaccine to prevent or medication to treat the Zika virus infection.
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○Laskar-e-Chikungunya:
Chikungunya spreads through the bite of the Aedes aegypti mosquito, which also causes dengue. Symptoms typically start four to eight days after being bitten.When a patient is infected with chikungunya virus it produces sudden onset of a high fever and joint pain. Other symptoms may include headache, muscle pain, joint swelling, or rash.
Infection with chikungunya virus is rarely fatal, but the joint pain can often be severe and debilitating.
It is said “Chikungunya is generally not fatal, but the painful symptoms have led people to say ‘It won’t kill you, but it may make you wish you were dead!’”
Most patients recover in about a week, although long-term joint pain occurs in some people.
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They have repeatedly attacked in countries of Africa, Asia, Europe, and the Indian and Pacific Oceans. According to statistics in last 2yrs chikungunya has spread to 45 countries and almost 2 million cases have been reported.
Originally from Africa, chikungunya recurred in India after 32 years in 2006 with cases reported in India.
There is currently no vaccine or drug treatment.
○Fearless Dengues:
Forty percent of the world’s population lives in an area which are at the threat of dengue. It is estimated that 390 million people per year are infected with the viruses.
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Fearless Dengue transports the dangerous dengue virus which are of four types (dengue virus 1, 2, 3, or 4), and it is possible for someone to get dengue up to four times from 4 different types of viruses. Dengue is a leading cause of illness and death in the tropics and subtropics. Most people infected with dengue have mild or no symptoms.
25% people who are infected with dengue will develop some symptoms of disease. Mild symptoms of infection begin with a fever and severe headache, pain behind the eyes, joint and muscle pain, and rash. There can be dengue haemorrhagic shock and multi-organ failure.
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Dengue symptoms can quickly become severe and even fatal. Early recognition of severe disease and prompt treatment is the key.
○Malaria night riders:
Malaria is a life-threatening disease. It’s typically transmitted through the bite of an infected Anopheles mosquito. Malaria infection caused by four different species of a parasite Plasmodium (P) — P. falciparum, P. malariae, P. vivax, and P. ovale. Of these, P falciparum infection is the deadliest as it affects the brain and is most likely to cause death.
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Malaria is typically found in tropical and subtropical climates as it is favourable for parasites. The World Health Organization (WHO) estimates that about 3.2 billion people are at risk of malaria.
Common symptoms of malaria include:shaking chills, high fever, profuse sweating, headache, nausea, vomiting, diarrhea. Other symptomes includes anemia, muscle pain, convulsions and coma.
○Japanese evils and filariasis gang are other groups for them government has made different programms to control them.

■Let me tell you how to protect yourself and eradicate theses terrorists
In India, No matter what ever the weather is, there are always mosquitoes around.
They are practically every where in India. The main reason is mismanagement of open spaces and collection and stagnation of water thus creating a breeding area for mosquitoes.
•Before coming to India many tourist prefer to get anti malaria vaccine. This is a smart move.
The solution to mosquitoes that is available in India is simple and yet very effective.
1. Make a shield around you
•Cover-up with a loose, light colored, long sleeved shirts and pants. If possible wear socks.
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•Apply mosquito repellent to exposed skin. Avoid putting near eyes and mouth,or over cuts or broken skin.
•Use mosquito nets
• Stop adult mosquitoes entering the home by using screens on windows and doors.
2. Locate their breeding sites and eradicate them
•Potential mosquito breeding sites around the home should be removed.
•Mosquitoes need water to breed and some mosquitoes can breed in very small amounts of water.
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•Clean up backyard and remove all water-holding things including tires and containers
•Fill pot plant bases with sand to avoid standing water
•Keep drains and roof guttering clear and running to avoid stagnation of water.
•Add few drops of mineral oil (crude oil, kerosene oil, diesel, fuel oil) to the stagnant water. It kills larvas of mosquitoes.
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•Properly cleaned and chlorinated swimming pools or other water tanks are rarely a source of mosquito breeding but neglected pools can be a source of mosquitoes.
●Introduce mosquito fish (Gambusia affinis) or guppies into garden ponds to eat mosquito larvae.
3. Take extra precaution when you are travelling to high risk area
•Take all the above mentioned protections, in addition to that.
•Stay and sleep in clean air-conditioned rooms which are screened.
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•Use a bed net. Nets are most effective when they are treated with a pyrethroid insecticide, such as permethrin. Purchase it before travelling.
4. Instruction for children
•Use according to directions on the repellent. Some products are not safe for kids. Always check the product label for recommended age use.
Never allow young children to apply their own repellent.
5. Pregnancy and breast feeding
Mosquito repellents are considered safe and should be used according to product label instructions
6. Use appropriate insecticides
Aerosol insecticide sprays, mosquito coils (good for outdoors) and vapourising mats (good for indoors) are effective to repel mosquitoes.
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These products should be used in addition to, not in place of, other measures such as appropriate clothing and skin repellents.
7. Devices that use light to attract and electrocute insects have not been proven to be effective against mosquito.
8. Take extra care during peak mosquito biting hours especially around dawn and dusk to reduce the risk of infection. The mosquitoes that transmit diseases such as dengue, chikungunya, Zika will bite all through the day. The mosquitoes that transmit malaria are most active at dawn and dusk, and into the evening.
9. Mosquito-repelling smartphone apps sound too good to be true, there is no evidence that the ultrasonic frequencies they emit will actually repel the mosquitoes.
If we all work together to fight against them, we can make safe and healthy India.
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**For international readers my advice is don’t worry about mosquitoes when you travel to India. Just follow the advice mentioned and have safe stay.

You may also like: Don’t kill PV Sindhu, Sania Mirza, Sakshi Malik ….

Say Bye-Bye to piles

Article by Dr. Qazi Arif (currently doing research on treatments of piles)

Piles may not be anybody’s favorite topic of discussion, It is not something most people want to talk about. Even so, they are very common,its difficult to say how many people suffer because most people do not have the correct conception about piles and any pain or bleeding in stool passage is considered by them as piles. It’s only when the pain becomes unbearable and blood loss is more, a person tells to his family members or close friends and approaching to a doctor for proper treatment is probably the last option for them.

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Let’s know basics of piles which are also called haemorrhoids.
What are piles or haemorrhoids?
Hemorrhoids are clumps of swollen veins in the end part of stool passage (anus).
There is a network of blood vessels within the wall of the anal canal. Veins in that network sometimes become engorged and swollen. The engorged veins and the overlying stool passage wall may then form into one or more small swellings, which are actually piles.

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The anal canal is the last part of the large intestine and is about 4 cm long. Anus from where faeces come out is connected with the rectum.
■Causes:
The exact cause of piles is unknown but many conditions are there, which help in piles formation.
1. Constipation and Straining at the toilet

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It is the most common cause as pressure increases in anus causing the veins to swell.
2. Pregnancy
During pregnancy pressure effects of the baby lying above the rectum and anus, and hormones level change can play a role in piles formation.

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3. Ageing.
The tissues in the wall of the anus may become less supportive with growing age and hence increase the risk of piles.
4.Hereditary factors.
In some people, there is hereditary weakness of the wall of the veins in the anal region.
5. Obesity
People who are obese are likely to develop piles as are those who are constipated, since extra strain is being placed on the veins.

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6. Sitting too long at one place.
7. Lifting heavy weights
8. Chronic cough
9. Accumulation of fluid in the abdominal cavity (ascites )
10. Diarrhea has the same effect as constipation.

There are two types of piles.
• Internal piles
• External piles
Internal piles form in the upper part of back passage (anus).They are usually painless because the upper anal canal has no pain nerve fibres. Whereas External piles form in the lower part of the anal canal which may be painful because the lower part of the anal canal has lots of pain nerve fibres, which are very sensitive to pain.

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Some people develop internal and external piles at the same time.
■Internal piles can be classified as.
Grade 1 are small swellings and cannot be seen or felt from outside the anus.
Grade 2 are larger. They may be partly pushed out from the anus during defecation, but quickly go back inside again.
Grade 3 hangs out from the anus  and needs to be pushed back inside the anus with a finger.
Grade 4 permanently hangs down from within the anus, and cannot be pushed back inside.

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■Symptoms of piles
Symptoms are variable. Sometimes there are no symptoms and a person may not realize that he/she has piles.
Painless bleeding through the anus after defecation is the most common symptom. The blood is usually bright red and described as splash in the pan.

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A haemorrhoid can hang down outside the anus which can be pushed back inside.
Sticky discharge, some pain, irritation, and itch, fullness in the anus, incomplete emptying after defecation are other symptoms.
If piles get complicated it may cause intense pain.
■Complications
Hemorrhoids can cause a lot of complications if they’re not treated at the right time. These include:
Excessive bleeding leading to anaemia
Infection
Anal fistula
Gangrene
Rarely incontinence
Skin tags can develop because of repeated haemorrhoid

■Prevention and Treatment
Success after treatment is generally good. Prevention and medication are adequate for many people. About 10% of people will eventually need surgery.

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•Avoid constipation: Constipation can be avoided by increasing fluid and fibre intake. Aim for an intake of 25-30 g of insoluble fibre. If high fibre diet is not helping, then fibre supplement can be considered. Fibre helps to relieve constipation and avoid straining, which both are major risk factors for developing piles. Raw fruits, vegetables, whole-grain cereals, beans, leafy vegetables like spinach (palak), methi and citrus fruits like oranges are rich sources of dietary fibres. Try to keep the stool soft. In addition to eating a high-fiber diet, avoid foods that lead to constipation, refined or processed item can lead to constipation.
• Increase daily fluid intake
Daily water intake should be increased depending on season and location. Though urine volume will increase, but some is passed out in the gut and soften faeces.

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•Eat flavonoid rich foods: Flavonoid rich foods like blackberries, blueberries, cherries and citrus fruits increase the strength in the vein  hence improves circulation around the anus.

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•Use natural stool softners like bananas, figs, dried fruits
•Avoid too much caffeine.
•Avoid smoking and drinking alcohol
Alcoholic drinks can cause the fluids loss from body so may not be so good.
•Good hygiene in the area around the anus may be helpful in providing symptomatic relief and preventing skin inections.
•Straining at stool should be avoided as it can make symptoms worse. For western-style commode user elevating feet a bit with a step stool while sitting for the toilet changes the position of the rectum which may allow for easier passage of stools.
•Sitting too much often leads to piles, to avoid this take the time to get up and walk around. Avoid sitting in toilet for too long as it encourages straining. Don’t read newspaper or avoid mobile use in toilet.
•Exercise reduces the risk of hemorrhoids as it promotes regular and smooth bowel movements and fight obesity.

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•Don’t postpone the toilet. Go to the toilet as soon as possible after feeling the need. Postponement will make the stool harder and encourage straining.
•Hydrotherapy or sitz bath: sitz bath can be very effective for symptomatic relief for itchy, inflamed and painful piles.
Method: In a tub with slightly warm water, containing potassium permanganate tablets/povidone iodine solution soak the anus and surrounding area for about 10-15 minutes.

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The warm water and salt in it help to relieve congestion, improve circulation and reduce inflammation.
•Ice pack/cold compress: Ice is the most effective treatment for inflammation and swelling. Use ice cube or crush some ice cubes and wrap it in a plastic bag or sheet. Use a wash cloth to cover the plastic bag. Lie on your back in a comfortable position and apply on the anus for about 10 minutes.

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•Apply petroleum jelly: Piles patients usually strain during defecation. A lubricating agent like petroleum jelly can help to avoid straining if it is applied over anus before defecation.The above measures will often ease symptoms such as bleeding and discomfort.
•If it is not relieved, then treatment is required.
For Pain and symptom relief simple pain-killers are given to the patients. Ice packs and stool softeners may help to relieve pain.
•Local application of Anaesthetic preparations may reduce pain, burning, and itching. They should be used for only a few days, as they may cause sensitization of the anal skin.

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•Laxative medications are generally used to relieve constipation. These medicines either stimulate bowel movements and/or soften the stool. However, using them regularly can affect bowel movement pattern and may worsen constipation.
•In pregnancy women should take care while using any natural remedy for treating piles. Eat healthy, avoid spicy foods and do mild exercise regularly. Consult doctor before using any medications.Piles that occur during pregnancy often get better after delivery.

Treatment depends on the degree of piles and the severity of symptoms.
■Treatment without surgery
Banding is a common treatment for grade 2 and 3 piles. It may also be done to treat grade 1 piles which have not settled with the measures described above.It is outpatient clinic procedure where the surgeon grasps the haemorrhoid with a grasper, and rubber band is placed at the base. After few days haemorrhoid falls off as blood supply is cut off. The base heals after few days.

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Results are very good after banding procedure.
■Other treatment
•Injection sclerotherapy
Phenol in oil is injected into the base of the piles. It causes scarring of the base and thus blood supply interrupts. Piles die and shed off.
•Infrared coagulation/photocoagulation
This newer methods burns and cuts down the blood supply of piles.Other modalities use heat energy or current to destroy piles.
■Surgery
•Haemorrhoidectomy (the traditional operation)
This operation is done under anesthesia where piles are cut surgically. It is the best treatment for piles. Though success rate is very high, it is a painful procedure.

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•Circular stapled haemorrhoidectomy
In this procedure with the help of specialized circular stapling gun excision of a doughnut of the mucosa from the upper anal canal. It cuts off the blood supply and pulls up the prolapsed mucosa. It is comparitively less painful and allows quick recovery.
Haemorrhoidal artery ligation is another procedure where the blood vessel is tied to produce the desired effects.

■The biggest misconception is that hemorrhoid surgery cause loss of bowel control. It’s a myth. Though rarely it may occur sphincter fibres are damaged during operation but if detected earlier, it can be repaired. If at all it is irreparable artificial anal sphincter can be placed, but these are very rare in practice.

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You may also like: Kidney stones common but preventable problem…

Disclaimer: we do not guarantee any specific results as a result of the procedures mentioned here and the results may vary from person to person. The topics in these pages including text, graphics, videos and other material contained are for informational purposes only and not to be substituted for professional medical advice. Your doctor is the best person to treat you.

Happy Teachers’ Day

By Dr Qazi Arif

It was a usual weekday for me. Sitting in my out patient department (OPD) with the enthusiasm for treating surgical patients, I got my first patient an old gentleman, around 65years, bifocal spectacles, half sleeve shirt and black pant with a bag into his hand, through his wrinkled skin, I could see his experience of life. With the smiling face, he greeted me. I greeted him too and asked, “is everything alright?”
He said, “everything is ok but this leg pain…” his expression changed a bit. “These dilated vessels show their effects often” While telling this he lifted his pants up to knee, and I could see the elastic stockings around his leg. He removed it with his slow geriatric style. And it was really prominent, dilated elongated tortuous ugly looking veins along whole the length.
The very next question that came to my mind was whether he does any job asking him to stand for long time to which I got the expected answer he told in proud voice “I’m a retired school teacher” For a second, he forgot that he is in front doctor for his pain. I can’t forget the zeal which he showed while telling his profession.

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I did the thorough examination and prescribed him, some painkiller and a duplex scan as an investigation which would suggest me where exactly the problem is. While I was writing the prescription, he was talking to me about a couple of his students who are at high designations.
One heavy dialogue he told, “its a proud moment for any teacher to see their students working on high positions”
I asked him last question “sir, which subject u used to teach?”
With loud voice he told, “I was an URDU teacher.”

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After giving me blessing he left.It was a special meet, it was not the first time when I was seeing a teacher as my patient, but he was different for 2 reasons. He was a proud teacher secondly his varicose veins.
Varicose veins are a condition occurring in those who works for long in standing position. Due to blood flow against gravity, it gives ugly shape to the leg veins. This disease doesn’t develop overnight. It takes long years, hours of standing work, so much of dedication.

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This photo doesnot belong to the teacher mentioned here

It took me some time to recollect myself, but his wrinkled face and heavy voice made a strong impression on my brain. Only thought that was revolving was he got varicose in return of his heavy work, and he is still proud to be a teacher. He has no complaints against his profession, which caused him this pain.
Why he was so proud to see us achieving high ranks?
What was his contribution in our job?
Today whatever I m practicing, I learnt from my MBBS lecturers then why he is taking credits for that?
As I was thinking about him only, next patient entered inside  and gave a break to my thought process.This time I had a 4 year old boy with 5% of burn injury on his thigh. This boy accidentally spilled hot water giving him some blebs. Last 1min before I could write on prescription paper, I was calculating the doses as per baby weight back in my mind. I wanted to make sure that baby gets optimum doses of medicine, and in no case it becomes either under dose or overdose.I realized unknowingly I am making so many calculations in my mind without a calculator, that too very quickly.

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For a second, I remembered my math’s primary teacher scolding us for not memorizing tables.I continued my work thinking a lot of things back in my mind. I as a doctor do a lot of calculation. Lots of additions, fractions, ratios and algebraic equations, ratio proportions, %, etc. Can you imagine how easily a doctor divides the dose of a medicine for a patient of 24 kg who should receive 50mg/kg/day of a particular drug as 400 mg every 8 hours for 5 days. Thanks to math’s teacher who forced us learn all the tables, addition multiplication and all.
At the end of the OPD, I and my colleague were discussing about some operation, he told me all the history of the operation, how it was first done then how it modified then-new procedure replaced it. He was telling the whole story with such an interest that he was even telling me the years. I asked him with irritation “why to know all these things? Knowing about latest thing is enough”

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he told, “my history teacher used to say, Those who don’t know history are doomed to repeat it.” I was spelled bound. I don’t know how many times my history teachings helped me from trapping in trouble. Thanks to our history teachers who taught us importance of history though many of us find it boring. After long hours of hectic government hospital OPD finally, it was time to go.
While going back to my room that varicose vein teacher was still in my mind. My thought machine was working with the speed of light, and I landed in a primary school, where we see toddlers with anxious faces. They constantly look at the door for their mothers but there would be a teacher with a chalk n duster in hands, making funny faces to attract kids to teach them “one round and a small line make a and round plus big line makes b, circle broken on the right side makes c.”

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Whole day whatever we write is nothing but permutation and combinations of 26 alphabets taught by our school teachers. We never think of the efforts our school teachers put to teach A B C D when it was completely new for us.
By the time of lunch, I realized that I use so many concepts that I learned in school. Temperature, blood pressure, velocity, elasticity, solid liquid gas, calories, carbohydrate protein fat, and what not. Whatever I am using today is all learnt from my teachers.At the end of the day when I want to have some relaxation, I listen to some songs, watch movies, isn’t it what our Urdu/ language teachers created interest in? Poems, dramas, etc.

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I make diagrams to demonstrate diseases for my patients, thanks to my drawing teacher.
Physical education teacher taught us basics of exercise and fitness.
Best writer someday was a good language student, a good orator back in date was under training of some teacher.
Stage daring, writing skills, reading skills, problem-solving ability and endless qualities we learnt under guidance of our teachers.So in short whatever we are today is all because of our teachers.
Truly said, A teacher is a fruit laden trees. It’s the responsibility for a student to take maximum advantages. Teachers have the very important responsibility of shaping the lives of young, impressionable children. And yeah accepting this challenge and successfully producing achievers really gives them great pride and joy. Not every child learns the same way, nor are they interested in the same things. Even so, teachers shape the career of every single student.

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While reading this, I am sure everybody will correlate their profession and will find that whatever they know is all because of their teachers. And why not, teachers are designers of a good homeland who help us in making our mind for the true path in our life. As a student without our notice, our teachers recognize the problems we are facing and deal with it in both ways- individually and professionally. They train us to have an optimistic approach towards life.
Teachers are the most responsible and important members of society. Their professional efforts make the fate of the earth.

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Good education and good teachers are the need of the generation.All the social evil can be easily eradicated if teachers decide to tackle them because they have the best opportunity to mould the brains of newer generation. If, at the school level, they nurture young kids in such a way that in future, they remain away from corruption, terrorism, racism, castism, drugs and sexual crimes, etc.
Ever thought what we are giving back to our teachers?
We are earning name, fame, money all because of them. They don’t expect anything from us, but it’s our responsibility to give them what they deserve the most, i.e. RESPECT. And I believe the best way to give them respect is by becoming an achiever, this is what they want us to be. They are doing their job well, now its our turn. Let’s become best doctor, best engineer, best businessman, best artist, best in any field we are working, so that our teachers will automatically become teachers of best students.

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Let’s appreciate the contribution of our teachers because…
•They do work hard thats why we all are enjoying luxurious life.
•They scarify their family time for school and students that’s why nation is growing day by day.
•They suffer from profession-related diseases like varicose vein, chalk dust allergy, etc. that’s why we are doctors.
•They solve many of our problems that’s why we are good administrators.
•They shape our skills and talents that’s why we are artists.
•They lay down our foundation stone that’s why we are engineers.
•They inspire us thats why we are good leaders.
•They teach us to see dreams that’s why we are scientists.
Today on the occasion of teachers’ day, I want to thank all the teachers and not to forget our mothers because they are our first teacher.

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                     Thank you.

Kidney stones common but preventable problem…

Those who ever had an experience of kidney stone pain will probably never forget it for the lifetime. In medical books kidney stone pain is described as ‘tossing in the bed.’

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It can be so excrutiating that patient may seek emergency room.
Although kidney stones may remain silent for long time and do pass on their own without causing any major damage, if you dont take proper precautions it may occur again.

What are kidney stones?
Kidney stones are crystals of minerals, mainly calcium and oxalate, that are formed along the path of urine.
In some patients crystals of calcium in combination with oxalate, phosphate, uric acid or cystein may be formed when they are concentrated in urine.

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Credits: dilipraja.com

Sometimes stone can be large enough to block the urinary tubes to cause pain and damage due to blockage and irritation.
Patient can have pain in the abdomen and flanks which may spread to groin and thigh.
Other symptoms includes burning urination, blood in urine, vomiting.
Fever and chills occur when infection in urinary path.

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Credits: kidneyhealth365.com

Why is knowing which type of kidney stone a person has important?
Not all the kidney stones are same. Though most common types is stones made up of calcium and oxalates
There are Four major types of kidney stones.
1.calcium oxalate and calcium phosphate
2. Uric acid stones
3. Struvite stones
4. Cystine stones

It is helpful to know which type of stone patient had because the advice about what to eat is slightly different for each type of stones.

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Who are at risk of kidney stones?
Not all people develop kidney stones there are some risk factors which contributes to stone formation.

1. Drinking less water
The number one risk factor for kidney stones is not drinking enough water. It makes urine concentrated which favours kidney stone formation. Main function of kidney is to excret various wastes, if body has less water then these wastes cannot be dissolved in urine, when too much of wastes in too little liquid, then formation of stones start. If less water then less urine and the crystals aggregate and form larger stone.

2. Low Calcium in the body
Yes its true, we think that eating more calcium produces stones but recent research shows calcium binds to oxalates to in digestive tract so oxalate cannot enter into blood and urinary path where they may form kidney stones.
Important to know that im talking about natural calcium from our food NOT calcium supplements in tablet or syrup form. Calcium supplement increases chances of kidney stones.
3. Eating more oxalates
Some leafy vegetables such as spinach and others like nuts and seeds, grains, legumes, chocolate and tea, peanuts, beets and sweet potatoes are rich in oxalates which are the main culprit for stone formation if taken in excess. When ingested in large quantity they may concentrate in urinary tract and form stones.

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4. Excessive processed salts in diet.
Processed salts contain high quantity of sodium. When sodium is high in the body more calcium is excreted through urine. So indirectly it poses more chances for stone formation. There are many sources of hidden sodium such as canned or commercially processed foods as well as restaurant prepared and fast foods.

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5. Less citrus in the body
Citrus fruits such as lemon, lime lower the chances of stone formation. So eating less citrus increases chances of stones.
6. Deficiency of magnesium
For absorption and assimilation of calcium important role is played by magnesium. If calcium is ingested without adequate magnesium then overloaded calcium becomes harmful and predisposes to kidney stone formation. Magnesium is present in green leafy vegetables, beans, seeds and nuts.
7. Drinking soda
The possible reason for this is phosphorus acid presnt in the soda makes urine acidic that helps in stone formation, also sugar (fructose) present in it interfers with calcium and magnesium absorption thus increases chances of stone formation.

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8. Heriditory causes
People who have strong family history of kidney stones have more chances to have it. Cause of this can be the oxalate absorption problem which can run in family.
9. Laxative overuse
When laxatives are used for longtime it interferes with the absorption of minerals and also causes dehydration, thus concentrating urine and making favourable conditions for stone formation.
10. Obesity
Obese persons are at higher risk of kidney stones. Excessive fat in the body leads to changes in the urinary path and acidify urine thus trigerring the stone formation in urinary tract.

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11. Surgery for obesity
Though obesity increases kidney stone risk, weight loss surgery that alters digestive tract and increases the chances to have stones in kidney.
12. Vitamin B6 deficiency
Studies say that vitamine B6 deficiency is a risk factor for stone formation. 1.3milligrams of vitamin B6 is recommended.
The richest sources of this vitamin include fish, liver, potatoes and starchy vegetables, and non-citrus fruits.
13. Lack of exercise
Immobility bone resoption causing excessive calcium which increases the risk for developing kidney stones especialy in women who have achieved menopause.
14. Being male
Men are more risk of developing kidney stones.
15. Race
Caucasians have the higher stone rates as compared to other races
16. Geography
People living in hot and dry environments have more chances for stones. Don’t Underestimate Sweat. More is the sweating, the less will be the urine, which allows for stone forming minerals to settle and bond in the kidneys and urinary tract.

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17. Seasonal variation
It is obvious that Stone development is more common during the summer months due to dehydration from higher temperatures and possibly also from higher concentrations of calcium in urine resulting from increased sun exposure which can lead to higher levels of Vit D production.
18. Occupation
People who work in hot atmosphere and those who are prone for dehydration suffers more.

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19. Kidney diseases
Individuals with a diseases like medullary sponge kidney or renal tubular acidosis are prone to forming stones.
20. Urinary tract Infections
Long standing urinary tract infections can lead to the development of infection related stones such as struvite stones (a type of kidney stone).

Once passing a kidney stone doesnot mean that it will never form again. Studies have shown that having even one stone greatly increases your chances of having another.
How Can kidney stone be prevented?
Though kidney stones can be excruciatingly painful in some patients, fortunately, there are plenty of precautions that can be taken to reduce the risk…
Life style modification and some basic dietary changes reduces the risk to great extent. While these changes may not guarantee for stone formation but they can make it less likely.
1. Drinking plenty of water and other fluids
This is the most important thing a patient can do to lower the risk of getting another kidney stone.
Aim for at least 2 ½ – 3 litres of fluid each day.
If you are not used to drink this much fluid, increase it gradually.
Avoid sugary drinks, fruit juices, tea and coffee as they may increase the risk of kidney stones.

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To increase the water intake try these tips:
Always Carry a water bottle and drink it as and when possible. Add some lemon or lime to water so that it gives refreshing flavour.
Drink water before going to sleep and after getting up or if wake up during night time.
Stay hydrated especially when doing exercise or when doing some activities which causes more sweating.
It is important to have adequate water intake. As every person has different water requirment a simple method is to checkcolor of urine, if it is dark in color then your water intake is not adequate. Aim should be to have pale yellow or whitish.
People who have had cystine stones may need to drink even more as compared to other types of stones.

2.one smart way is to drink orange juice and lemonade, which are high in citric acid and which can be helpful. So both water and citrus is covered in it.

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3.making some dietery changes such as decreasing intake of salt, animal proteins and calcium supplementation may help prevent future stone formation.

A)Calcium is not the enemy. Eat calcium and oxalate rich food together maitaing balance. Both calcium and oxalate will bind each other and there should not be excess of any thus making stone formation less likely. Milk and milk products are rich in calcium.
But Be Careful with calcium Supplements.

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B)Limiting animal proteins like meat, fish, poultry and eggs will help for these patients.
Protein in the body breaks to form purine. High purine leads to a higher production of uric acid which then accumulates as crystals in the joints causing gout, or as stones in the kidneys.
To prevent uric acid stones, cut down animal proteins. 
Alcohol may also increase uric acid level in the blood.
C) Limit salt (sodium) intake
As explained earlier reducing the sodium intake especially in fast food and ‘hidden’ sodium in preservatives and other compounds as a part of preservatives can greatly help in reduction of stone formation
D)Cut back soda intake
Those who take regular soda its good idea for then to limit its consumption.
E)Make sure to get enough magnesium
Vegetable juice is an excellent source of magnesium, as are some beans, nuts like almonds, and seeds, pumpkin seeds, sunflower seeds etc are also good source of magnesium.

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F)Eat lots of fruits and vegetables.

3.Regular exercise, avoiding Overeating are important for keeping weight in check also being physically fit there is less chances of bone resoption.
4. Visit doctor if you develop severe pain in the side, back or lower abdomen, blood in urine or have difficulty urinating. Prompt diagnosis and assessment are keys to preventing complications.

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5. Maintain healthy weight. As obesity is one of the risk factor for kidney stones maintaining normal weight is essential aspect.

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If the size of stone is small it can easily pass down through the urinary tract without causing much problem but if it is large enough intervention is required to prevent harmful effects.

Available treatment options for stones are

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Medication to facilitate its easy passage.
Non surgical methods for removal of stones.
Surgery to treat or remove the stone.

Disclaimer: The topics in these pages including text, graphics, videos and other material contained are for informational purposes only and not to be substituted for professional medical advice. As the results may vary from patient to patient your doctor is best person to treat you.

Don’t kill PV Sindhu, Sania Mirza, Sakshi Malik ….

 By Dr Qazi Arif

Olympics 2016 at Rio at its full swing and people are having sports fever. While all are enjoying the bronze and silver medal moments with whole nation, somewhere at some place any future PV Sindhu, Sania Mirza, Sakshi malik is getting murderd.

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Yes im talking about Female foeticide.
While whole nation is praying in one voice for the medals some people have different thinking when it comes to their turn about their own daughter.
Indian female athelets are winning medals for us at the same time giving strong message to the society to change their view about female child.

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Since the ancient time, women in the Indian society are considered as a curse for their family and society.If u see the issue of Female foeticide the main reason for the female foeticide is very obvious and clear that couples prefer to have a male child over female child. They consider that a girl cannot do what a boy can do, and our bright female athelets are proving that they have the ability to walk shoulder to shoulder with boys.

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The reason for this shameful act lies in our own thinking. In the society it is a general perception that having a boy is benificial to the family. The boy is source of money for the family. The boy works and earns for the family so you get all your money and inputs back what you have spent on him. On the other hand parents have to spend money and efforts on a girl and in laws get the reward. It is like “watering your neighbour’s lawn.”

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One of the reason is that a male child brings name and fame for the family. He can lighten the name of the family. Looking at the career of sportswomen everytime they prove that they are no less than a boy in any field and give their best.

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Dowry is very common in india. It is the money paid by the parents to groom while he gets married to their daughter. This is one of the biggest reasons why girl is considered burden on the family. While dowry is paid mostly as gold necklaces these champions redefined the gold necklaces. Gold in their necks are much more precious than any other jewellery they can wear.

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Another reason why girl is considered a burden on her parents is the safety. Girl is considered as physically poor and weak who cannot take care of herself alone and protecting her is always a big problem. Son is considered as family asset however a daughter is a liability. Our champions proved that they can take care of themselves very well.

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It is very common to hear about the rape, sexual abuse, domestic violence and trafficking of females. Having a girl child will always keep parents at the risk of all such things where as a boy is brave enough to tackle these situations.

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With the advancement of technology, sex determination has become very easy. Using newer scientific modalities and tests parents know the gender of baby before birth and take all possible steps to destroy the new life. These athelets used technology not to kill but to uplift their own status. They taught the world that technology can be used to bring empowerment of them.

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Members of specific professions along with parents team up to make sure that female child dont see this world. They make strategy against an unborn foetus but hold on these amazing ladies showed how to team up and make strategy to make their family, relatives, their teachers and coaches and moreover whole country proud by their actions.

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They are conveying a simple and powerful message to our double standard society that “every female foetus has right to life and should enjoy this beautiful wolrd. She has right to fly high and do anything what she wants”. They are making us to re-think that all the things we are using against them to supress them, can be very well used to flourish the talent they have.

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So question is, What is common between every ones success story??
1.It is the parent’s positive thinking towards girls which can change the whole society in India. Their parents didnot kill them in the womb.
2. Society should consider females as boon not curse.
3. Girls should show their qualities and prove that they are special in their own way.

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Girls are special,they are amazing, they are awesome.
A girl child doesnot deserve to be killed, hated or disrespected. She deserves to be saved, loved and respected for the betterment of society and country. She is as equal participant in the development of country as a boy. No nation/society can grow if they neglect 50% of their strength.

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Do we have some more points for not to have a female child?? If any, then these great girls are ready to accept the challenge and to make us understand that “Daughters Are Precious”.