Wednesday, October 13, 2010


What is Osteoporosis?

Osteoporosis mean 'Porous Bone'.

This happens when your bone loses too much calcium and become weak. This is very hard to detect and is usually discovered only after a fracture occurs, or if person shows reduced height or a humping of the back, or suffers low back pain.

A person with osteoporosis has bones that are brittle and fragile. These fragile bones can break very easily with a simple slip or fall, or even with no injury at all.

Both men and women can suffer from osteoporosis, but it is most common in women after menopause (when the monthly period ends).

How common is Osteoporosis?

Osteoporosis is a common problem in India.

• 1 out of 8 males and l out of 3 females in India suffers from osteoporosis, making India one of the largest affected countries in the world.

• Expert groups peg the number of osteoporosis patients at approximately 26 million (2003 figures) with the numbers projected to increase to 36 million by 2013.

• Two points worth noting about osteoporosis in India - the high incidence among men and the lower age of peak incidence compared to Western countries.

• The incidence of hip fracture is 1 woman to 1 man in India.

• In most Western countries, while the peak incidence of osteoporosis occurs at about 70-86 years of age, in India it may afflict those 10-20 years younger, at age 50-60.

What causes Osteoporosis?

The bone is a living tissue. When we are young, any loss of bone is easily replaced. At around the age of 30, our bones are at their strongest. However, as we age, less bone is made and more bone is lost. After menopause your body's supply of estrogen decreases and the rate of bone loss increases even further. This is why postmenopausal women are more likely to suffer from osteoporosis. There are also many other factors that contribute to bone loss such as illnesses, medications and lifestyle choices.
Signs & Symptoms of Osteoporosis

Sometimes nothing happens. Osteoporosis can be a silent disease. This is where the danger lies. Most people do not know they have osteoporosis until it is too late. Their bones become so fragile that even the smallest amount of stress can cause a break or fracture.

The bones in your hip, wrist and spine are at greatest risk of breaking. If the bones in your upper back are fractured, your spine may curve to form a hump.

Osteoporosis may result in chronic pain, decrease your mobility and affect your quality of life. In severe cases, hip fractures due to osteoporosis may lead to death.

How much risk are you at?

All men and women could be at risk. Some are at a higher risk than others. The risk factors include:

• A previous non-violent fracture.

• Early menopause before age 45 years, whether natural or through surgery.

• A member of your immediate family who. Has osteoporosis.

• Being underweight or undernourished.

• Being frail due to long-term illness.

• Smoking.

• Drinking too much alcohol.

• Not exercising much or not being able to move for a long period of time.

• A diet that does not have enough calcium or vitamin D.

• Certain illnesses e.q rheumatoid arthritis.

• Certain medicines e.g. corticosteroids, thyroid medication.

Check if you have Osteoporosis?

The OSTA test helps you to find out if you are likely to get osteoporosis, but how do you know if you already have it? Osteoporosis does not usually show any symptoms or signs until the bones are so weak that a fracture occurs .

Osteoporosis can be easily detected through a painless procedure called dual- energy x-ray absorptiometry (DEXA). This test measures the density or solid ness of the bones, known as the bone mineral density or BMD.
In general, the lower your BMD, the higher your risk of fracture. Your doctor can then advise you on what needs to be done.
BMD testing is especially important for people who have a number of risk factors for osteoporosis. Your family doctor will be able to arrange for this test to be done.

Can Osteoporosis be treated or prevented?

Yes, osteoporosis can be treated. There are medicines available that help strengthen bones and reduce the incidences of fractures.

However, the best way to deal with osteoporosis is to prevent it from happening in the first place. There are many things you can do to lower your chances of developing osteoporosis.

• If you have a number of risk factors and are quite likely to develop osteoporosis in the future, your doctor can prescribe medicines that will help prevent osteoporosis from developing.

How can Diet help?
• To build and keep bones strong, the food you eat must contain enough calcium and vitamin D.
• Calcium is found in dairy products such as milk and cheese which is lacking in the Indian diet.
• However, calcium alone. May not be enough to prevent bone loss and osteoporosis after menopause.

Minimum total daily calcium and vitamin D intake

Category Calcium Vitamin D

Male 11 – 18 years old 1,000 mg 4001U
Female 11 – 18 years old 800mg 4001U
All adults 19 – 65 years old 700mg 4001U
All adults above 65 years 700mg 8001U
Lactation1, 200mg 4001U

Prevention of Osteoporosis through active lifestyle

• Regular weight-bearing exercises are important throughout life. They are the best way to keep your bones strong and healthy.

• Exercises that increase muscle strength, improve flexibility and balance, build up endurance and co-ordination, will help prevent falls.

• Everyone should try to exercise regularly at least 3 times a week for 30-40 minutes each time. Some recommended exercises are brisk walking, low impact aerobics and tai chi.

• Always remember to do proper warming up and cooling down exercises before and after each exercise session.

Smoking &Alcohol.

• Do not smoke. Smoking causes many other diseases besides increasing your risk of osteoporosis.

• It is fine to drink some alcohol, but if you drink too much you may have a higher risk of osteoporosis.

Take care of your steps

We should take steps to reduce the occurrence of falls which may lead to bone injuries.

This is very important for elderly people who are likely to have weakened bones. Start with these steps:

• Always anchor rugs and carpets.

• All rooms should be well-lit.

• Hide all electrical and telephone cords to avoid tripping over them.

• A flashlight by your bed is helpful at night.

• Reduce spacing & check Alignment

Do check the batteries often.

• Stairways should have railings and non - slip surfaces.

• Grab bars and other aids, such as nightlights, are especially helpful in bathrooms.

• Use non-slip mats or adhesive strips in your tub or on your shower floor.

• Make sure chairs and couches are easy to get in and out of.

• For more advice, consult an occupational therapist.

Although exercise, calcium and vitamin D are important, they cannot totally stop bone loss after menopause.

Need to know

You can check your risk for osteoporosis with OSTA.

If you think you are at risk of developing osteoporosis, or if you think you may already have it, see your family doctor as soon as possible.

He or she can arrange for BMD testing, and give advice and medicines if needed.

Prevention is best - stop osteoporosis before it happens. There are effective medicines to treat osteoporosis.

If you are already taking medicines to treat osteoporosis but have questions or concerns about them, your doctor is the best person to talk to.

Saturday, October 09, 2010



1. Kidneys: The key functions
2. 10 Critical functions of Kidneys
3. Ways to keep your Kidneys healthy………
4. What happens when kidney fails
5. Detect Kidney Disease early
6. Symptoms of kidney disease
7. Kidney Diseases
8. Treatments of Kidney Diseases
9. Dialysis Methods
10. Kidney Transplantation


The kidneys are bean-shaped organs, each about the size of a fist. They are located near the middle of the back, just below the rib cage, one on each side of the spine. The kidneys are sophisticated reprocessing machines. Everyday, a person's kidneys process about 200 quarts of blood to sift out about 2 quarts of waste products and extra water. The wastes and extra water become urine, which flows to the bladder through tubes called ureters. The bladder stores urine until releasing it through urination.

Wastes in the blood come from the normal breakdown of active tissues, such as muscles, and from food. The body uses food for energy and self- repairs. After the body has taken what it needs from food, wastes are sent to the blood. If the kidneys did not remove them, these wastes would build up in the blood and damage the body.

The actual removal of wastes occurs in tiny units inside the kidneys called nephrons. Each kidney has about a million nephrons. In the nephron, a glomerulus, which is a tiny blood vessel, or capillary, intertwines with a tiny urine-collecting tube called a tubule. The glomerulus acts as a filtering unit, or sieve, and keeps normal proteins and cells in the bloodstream, allowing extra fluid and wastes to pass through. A complicated chemical exchange takes place, as waste materials and water leave the blood and enter the urinary system.

In addition to removing wastes, the kidneys release three important hormones:

• Erythropoietin, or EPO, which stimulates the bone marrow to make red blood cells.
• Renin, which regulates blood pressure.
• Calcitriol, the active form of D, which help to maintain calcium for bones and for normal chemical balance in body.


1. Filter 200 liters of blood a day, removing two liters of toxins, wastes and water

2. Regulate the body's water balance

3. Regulate blood pressure by controlling fluid levels and making the hormone that causes blood vessels to constrict

4. Support healthy bones & tissues by producing the active form of vitamin D

5. Produce the hormone that stimulates bone marrow to manufacture red blood cells.

6. Keep blood minerals in balance.

7. Keep electrolytes in balance .

8. Regulate blood acid levels.

9. Remove drugs from the blood.

10. Retrieve essential nutrients so that the body can reabsorb them.


Here are some simple changes in lifestyle which you can easily adopt:

1. Keep fit and active. This may sound like a clichi, keeping fit help to reduce your blood pressure and therefore reduces the risk of Chronic Kidney Disease. The concept "on the move for kidney health" is a world-wide collective march involving the public, celebrities and professionals moving across a public area by walking, running, cycling. Why not join them- by whatever means that you prefer.

2. Although many people may be aware that high blood pressure can lead to a stroke or heart attack, few know that it can also cause kidney damage. We should educate people to "Keep the Pressure Down", highlighting the importance of keeping blood pressure low, as it can be a key symptom and cause of Chronic Kidney Disease. If you already have high blood pressure to protect yourself from kidney disease monitor your blood pressure regularly, maintain a low fat, low salt diet and keep a healthy body weight

3. Do not smoke: Cigarette smoking slows the flow of blood to the kidneys. When less blood reaches the kidneys, it impairs their ability to function properly. Smoking also increases the risk of kidney cancer by about 50 percent.

4. Do not take over-the-counter pills on a regular basis: Common drugs such non-steroidal anti-inflammatory drugs are known to cause kidney damage and disease if taken regularly. Such medications probably do not pose significant
danger if your kidneys are relatively healthy and you use them for emergencies only, but if you are dealing with chronic pain, such as arthritis, work with your doctor to find a way to control your pain without putting your kidneys at risk.

5. About half of those people who have diabetes develop early signs of kidney damage, so it is important for people with diabetes to have regular tests to check their kidney functions. It is important to keep control of blood sugar levels with the help of doctors or pharmacists.

6. Checking kidney function must be a high priority for people considered to be at risk of kidney disease. Early detection is essential and allows suitable treatment before kidney damage or deterioration manifests itself through other complications.

7. Keep your weight in check: This can help prevent diabetes, heart
disease and other conditions associated with chronic Kidney Disease.

8. Know your kidney function: If anyone in your family has suffered from Kidney disease, it is particularly important to get your kidney function checked.

It is important to encourage everyone to learn more about their amazing kidneys and to raise awareness of the fact that that kidney disease is common, harmful, but treatable.


Just one kidney, working at 20% capacity, can keep a person healthy. Below that level, you begin to feel tired or weak, and lose your appetite. This is because toxic wastes starts to build up in the blood, Fluid collects, causing tissue swelling, lung congestion and high blood pressure. To stay healthy, a method is needed to replace lost kidney function.


Kidney disease is often 'silent', causing few symptoms, especially in the early stages. If left unchecked the disease can progress or lead to kidney failure. It can severely impact quality of life and ultimately can cost lives. Very often it comes along with other health threatening conditions, such as cardiovascular disease and diabetes.

If kidney disease is detected early, appropriate treatment can delay or even stop chronic kidney disease. It is easy to detect early signs of kidney problems by using simple tests performed by your General Practitioner.


• Frequent headache and urination.
• Itching.
• Poor appetite and fatigue.
• Burning sensation during urination.
• Nausea and vomiting.
• Swollen / numb hands or feet.
• Darkened skin.

Kidney disease is any disorder that affects how the kidneys function. Some of these disorders include:

• Diabetes.
• Hypertension.
• Nephritis
• Infection.
• Injury.
• Stones.


Treatment of kidney disease is complex and depends on the type of disease, the underlying cause and duration of the disease. It can be treated by:

1) Medicines: Healthy kidneys remove waste products of metabolism, but when kidneys' function diminishes, these go up in the blood, as indicated by raised creatinine levels. Early detection leads to early treatment, preventing it from advancing to more serious stages. Diabetes is the leading cause of chronic kidney disease, followed by hypertension. See your physician regularly and follow the prescribed drug treatment to control blood sugar levels and blood pressure. Treatments for conditions which can lead to kidney disease include numerous
prescription drugs and treatment protocols.
2) Dialysis: Kidney dialysis is a medical treatment used to filter out waste products from the blood. Dialysis treatment permits the patients to live relatively normal live within the limitations of their disease.


Peritoneal & Haemodialysis. Appropriate method is administered to the patient in consultation with medical professionals.

Peritonial Dialysis:
This form of dialysis occurs inside the body. It uses your peritoneal membrane (serous membrane lining the walls of the abdominal and pelvic cavities) in the abdomen as the filter, For this treatment, a tube called a catheter is surgically placed through the wall of your abdomen.

Blood is pumped outside the body to an artificial kidney machine. The machine cleanses the blood and returns it to the body. Access to IV is made by fistula (permanent abnormal passageway between two organs in the body or between an organ and the
exterior of the body) or graft. A fistula provides access to blood vessels.


Transplantation is one of the solutions to kidney failure. During this operation, a healthy donated kidney is placed deep under your skin near your hip bone. In some cases, the non working kidneys may be removed to control infection or high blood pressure.

Treat your kidneys right, and they should look after you!

Friday, October 08, 2010

Safety Tips for Senior Citizen


Falls are the leading cause of injury in people 65 and older.

Falls can happen anytime and anyplace to people of any age, but most falls by people age 65 and older occur in the home during every day activities. However, many falls can be prevented. Here are some prevention tips.

• Provide enough light to clearly see steps.
• Keep stairs free of clutter.
• Cover stairs with tightly woven carpet or non slip treads.
• Install sturdy handrails on both sides of the stairway.

• Keep a night-light on in the bathroom.
• Use bathroom rugs with nonskid backing.
• Install handrails in the bathtub and toilet areas.
• Place a rubber mat or nonskid strips on the bathtub/shower floor.
• Leave the bathroom door unlocked, so it can be opened from both sides

• Avoid climbing and reaching for high shelves.
• Use a stable step stool with handrails.
• Arrange storage at counter level.
• Clean up spills as soon as they happen and don't wax floors.

Living Area
• Arrange furniture to provide an open path-way between rooms.
• Remove low tables, footrests and other items from the pathway.
• Keep electrical and telephone cords out of the pathway.

• Remove throw rugs, extension cords and other floor clutter.
• Install a bedroom night-light.
• Use a normal - height bed.
• Before leaving your bed, sit on the edge for a while to make sure you are not dizzy.

• Wear low heeled or flat shoes with nonskid soles.
• Tie shoes, with a fairly snug fit are preferred and keep laces tied.
• Avoid shoes with thick, heavy soles.

• Don't panic. Assess the situation and determine if you are hurt.
• Slide or crawl along the floor to the nearest couch or chair and try to get up.
• If you can't get up, call for help.

Wednesday, October 06, 2010

Darjeeling Historical & Heritage Buildings


Darjeeling long recognized as “Queen of the Himalayas” can also boast of a number of historical buildings, manifestations of the British Raj’s interest in this hill station.

In 1839 there were only ten huts and a hundred people in Darjeeling. But as the British realized its potential as an ideal summer retreat and health resort, things began to move fast. The Lt. General GA Lloyd recommended that a building project be undertaken to develop Darjeeling into a home away from home, complete with snow and mist.

Lord Napier of Royal Engineers laid out architectural plans and by 1843 Darjeeling flaunted thirty grand buildings. There was ‘Mount Pleasant’ the house of Lt General Llyod, ‘Bryan Stone’ where Sir Joseph Hooker lived, ‘Oak Lodge’, ‘Vernon Lodge’ etc. the Town Hall, which now hosts the present municipality of Darjeeling, was established in 1850.

The 19th century indeed saw hectic constructional and engineering activity in Darjeeling and some of the most beautiful heritage buildings date from that era. The Renaissance philosophy and Greek-Roman architectural designs dominated, skillfully adapted to local geographic and climatic conditions.

The public works department, formed in 1862, started constructing with new zeal. Among its best achievements were the Secretariat Building, Thorn Cottage, Raj Bhavan, Kutchery, Richmondhill, Rivershill, Old Kutchery Building, The Natural History Museum, Bloom Field Barrack, Eden Hospital Louis Jubilee Sanatorium, Dowhill and Victoria School.

Many of these buildings though recognized as heritage sites are still in use.

Take for example the Bengal Secretariat Building. It is easy to locate this three-storied building west of the Bandstand on the Chowk. It was erected in 1898 and houses the following offices: Ground floor – Offices of the chief secretary to the government, under secretary of political appointment departments and secretariat library. First Floor – offices of secretary of consulting architect to government and revenue department. Second Floor – offices of secretary and under secretary of financial and municipality department.

The Thorn Cottage, built in 1868, initially formed a meeting spot for the Planters Club. Later for a while it functioned as a PWD office. It now serves as staff quarters of various government departments.

Government College: Miss Roby’s School was built in the 19th century, just beyond the old cemetery on Lebong Cart Road. In 1904 the clewer sisters turned it into the Diocesan Girls High School. But in 1948 the Government took over this building for higher education. Presently it is a college known simply as Government College.

Government House: The site was granted to Edward Hepper around 1840. It then passed on to Brine and Martin, contractors, who sold it to Sir Thomas E Turton.

Turton built Solitaire on the site, which soon became one of the houses of the Maharaja of Cooch Behar. On 31 October 1877 the British Government purchased this building from the Maharaja.

And it subsequently functioned as the residence of successive governors of Bengal. It was renamed The Shrubbery in the summer of 1880. Many additions and alterations were made to the building during the tenure of each Governor. Sir Ashley Eden for example added a porch and tower. Sir George King (who had earlier given shape to the Royal Botanical Garden, Calcutta), artistically redesigned the garden in 1878. The Durbar Hall was built during the tenure of Sir C Elliott.

Sir Ashley Eden established Victoria Boys School in 1879 for the education of the children of government servants. Situated at an altitude 6000 ft, on a hundred acres plot.

Dowhill School was also established by Sir Ashley Eden in 1898. But this school was meant only for the daughters of persons of European descent and those employed in any branch of government service. There were 120 resident pupils on its roll when it started. Today it has some 207 residential girls and boys in the junior class and about 400 day-scholars.

LORETTO Covent established in 1846, is administered by the Sister of the Institute of Blessed Virgin Mary, a congregation of Catholic Sisters. It was founded for the education of Catholic students but today it extends its services to members of all communities, irrespective of caste or creed.

St. Joseph’s School was established in 1877, for Catholic boys by the Capuchin Fathers, in a bungalow called ‘Sunny Bank’ (probably close to what is known as Bishop’s House today).

In 1879 the school got a new building and was renamed St. Joseph’s Seminary under the Rectorship of Father Joseph Peacock assisted by five assistant-masters. This was presumably the predecessor of North Point. By 1881 the school was enlarged to a building measuring 150 X 40 ft, a very large structure for the Darjeeling of those days.

St. Paul’s School was established in 1864, for the education of the children of government staff. It is situated at an altitude of more than 6000 ft.

The Natural History Museum is a three-storied ferroconcrete structure (including basement). It was constructed in the year 1915. Lord Carmichael allotted funds for this building and the design was conceived by Crouch.

Windamere Hotel was originally a 19th century boarding house, built for bachelors and British and Scottish tea planters. It was converted into a hotel only in 1939.

A complete list of historical buildings in Darjeeling would be impossibly long but one can’t but mention a couple more. There is Park Hotel, which has now been converted in to St. Robert’s School, there is Bishop’s House, Loreto College etc. All of these replicate Scottish and English architectural styles. When travelers to England and Scotland see historical buildings like Winchester Castle, Clifton Terrace, Callendar House, Blackness Castle, Battle of Falkirk memorial etc they cannot but be reminded of the buildings they see everyday in Darjeeling.

Many historic buildings have also been destroyed in fires. It is certainly important to ensure fire protection to occupants of historic building but steps should be taken to protect the structure as well.

The Public Works Department (PWD) has made an effort to preserve historic architectural documents in a special museum. Documents, photographs, instruments, original plans, blue prints and other related materials are displayed here. They represent the cumulative engineering skill, sincerity and sacrifice of all those who have worked on this hilly terrain in the hundred years from Napier to John Chamber. The museum is located inside the PWD Inspection Bungalow, Darjeeling.