World No-Tobacco Day: What Works In Controlling Tobacco

World No Tobacco Day is observed on 31^st May each year. The main objective of this day is to make people aware about the harming effects of tobacco and to encourage people to give up this bad habit. The hazardous effects associated with tobacco are well known. Still, a lot of young ones try tobacco or its by-products either out of peer pressure or just out of curiosity. Cigarette, bidi, ghutka and hookah are some of the common forms in which tobacco is consumed. Tobacco contains nicotine which gives you a high for sometime but in longer run can harm your heart, lungs, stomach as well as your nervous system. In the wake of rising tobacco use, there is a need to curb its use. Therefore, we all need to know what needs to be done when it comes to controlling tobacco use.

All across the world the quest for smoking cessation policies that work is a daily occupation for thousands of technocrats in governments. The constant need for effective interventions is partly driven by the pressure mounted by the tobacco industry itself which is constantly developing new strategies to permanently hold on to its market share. For instance, in recent years it’s been observed that bid tobacco is now exploiting the internet loophole to reach a younger audience by posting tobacco videos on social network sites. Vigorous marketing strategies have now been targeted at women and the youth.

In thinking about what works in tobacco control, experts consider both the demand interventions and supply interventions of the entire tobacco industry matrix. Therefore what works must effectively reduce demand and also effectively control supply. Demand for tobacco products lies in the hands and power of the consumer. Supply lies in the hands of the tobacco companies themselves. In the middle to regulate is government through the various policy interventions.

Typically controlling the demand side of things in tobacco control involves education. This particularly refers to education campaigns on the dangers of smoking and its general effects of the individual and society at large. Legislation is yet another method of controlling demand. In this category governments will effectively ban smoking in public places, for example. The government also has the power to regulate the way the industry advertises it products thereby curtailing its access to the market. Enforcement of regulations including implementation and sanctions such as fines and court appearances are an important aspect of tobacco control.

To reduce supply of tobacco products on to the market, the government can also over economic alternatives to key cogs that drive and sustain the entire tobacco industry. These cogs includes farmers of the tobacco leaf themselves and the vendors that sell the product. This side of things is particularly visible in developing countries were tobacco growing is a major source of income better than other cash crops. Governments can find ways and means to replace these economic benefits from tobacco growing in order to drive farmers away from tobacco growing. On the other hand generating alternative employment opportunities will also limit the number of vendors supporting the industry.

Other interventions that work in tobacco control involves interventions at the community level such as programs empowering people more so vulnerable sections with knowledge that is necessary for them to abandon the use of tobacco. What will further be needed us a creation of suitable environments to stimulate, support and sustain a healthy lifestyle which is tobacco free. At the individual level behavioural change will need to be encouraged that is aimed at smoking cessation. This is supported by counselling and de-addiction therapies as well as access to stop smoking products.

When is the right time to consult a sexologist?

It’s ironic that a country like India which has a deep-rooted history of sex is amongst those where sex is talked about in an inhibited manner. Because it’s considered breaking a law to mention sex-not just in the villages but big, metropolitan cities as well- there are people who suffer from this taboo, both males and females.

Is the significance of sex exaggerated?

Not really. The reticence on sex means our approach is that sex is a crime or an act meant only for pleasure but that’s only half truth. It goes beyond that and if you look at our ancient scriptures you’ll find enough evidence. Sex was looked upon as a path towards spirituality and more. In layman terms, sex is like any other body function-just as body requires, food, water, sleep, air, it needs sex too. Homo sapiens are glued to this approach and it affects our overall health and mind.

Do you suffer from a sex problem? Stay Mum…

The jaw-dropping element of this mentality is that health problems involving sex are flushed down the gutter. These issues include premature ejaculation, erectile dysfunction, discomfort during intercourse, vaginismus, low libido etc. Even though treatable to a great extent, issues related to sexual dysfunction needs to be addressed by a sexologist first, which is where people are reluctant. They either feel it’s not serious or too embarrassed to discuss.

How do we detect a problem?

Some of the problems men face includes low sex drive, inability to achieve orgasm, lack of ejaculation, recurring erection. Sexual dysfunction in women unfolds in the form of reduced desire to have sex, pain during intercourse, lack of orgasm etc.

What is the potential cause of sexual dysfunction?

Sexologists explain that in men, erectile dysfunction occurs when blood flow gets disrupted, stress, performance anxiety and nerve disorders. Diabetes, high blood pressure and certain medication are linked to loss of libido. There are other causes as well, but these are common. In females, changes in hormonal activity like after birth or post-menopause are linked to sexual dysfunction.

When and why you require professional opinion?

The answer’s simple; when your sex life is in trouble and hinders with other aspects of life. You may not get to know about the problem, so it is important to discuss with a sex therapist no matter how small the issue seems to be. It’s unfortunate that in India, sexual problems are given a low preference but it’s quintessential to understand that it can affect you in multiple ways.

Treatment

The treatment commences with normal tests and examinations. In males, treatment may involve medications such as Viagra, hormonal assistance, penile implant and psychological therapy. For women, treatment may involve hormonal replacement therapy, topical oestrogen and surgery.

Not all treatments are suited to everyone and they possess some risk. Hence, it’s better to put up the right questions before your sexologist to get a clear view. Besides regular treatment, couple therapy is known to be equally effective.

Can I contribute in making my sex life healthy?

Of course you can. The fitter you are the better sex life you enjoy. In broader terms, this means no smoking, limited alcohol consumption, taking appropriate sleep, exercising regularly and following a healthy diet.  

World Multiple Sclerosis Day: Watch out for these crucial signs

World Multiple Sclerosis Day is observed every year on 27^th May. The objective of this day is to create public awareness on Multiple Sclerosis and to make life less difficult for people affected by Multiple Sclerosis (MS). However, detecting early signs of MS may help in the treatment that follows. But detecting multiple sclerosis during the early stages is a difficult task. This is because the symptoms may vary from one person to another, and also from time to time. Multiple sclerosis warning signs may come and go, and the person may not experience any symptom for longer intervals. Most of the signs and symptoms of this medical condition may not be related to each other and may appear strange. Given below are some of the common symptoms associated with this medical condition in its initial stages.

• Numbness and tingling in the limbs. In some cases, this symptom may be concentrated on one side of the body. Sometimes, numbness may be accompanied with pain too.
• Early stages of the disease may also be characterized by vertigo and dizziness. While some people feel light-headedness, others experience a spinning sensation.
• One of the common multiple sclerosis warning signs is painful eye movements that may cause partial or complete loss of vision for some time. Even blurred vision, double vision, and black spots are considered as early symptoms of multiple sclerosis.
• The affected person may experience a loss of strength in the limbs, and an overall weakness that can make him/her easily tired.
• Some people describe the early signs as shock-like sensations inside the head.
• The affected people may also experience difficulty in speaking, tremors, lack of coordination, muscle spasms, urinary incontinence, frequent memory loss, and learning problems.
• Emotional outbursts and mood swings are also considered as the warning signs of this disease.

These are some of the early symptoms of multiple sclerosis, which is mainly seen in women. Usually, such symptoms appear between the age of 20 and 40. It is said that the risk of multiple sclerosis decreases after the age of 50. The early signs of this disease may go unnoticed, or may be attributed to other health problems. These signs may disappear and relapse. It has been observed that the relapse of the symptoms is often preceded by stress, strenuous physical activity, trauma, or infection.

However, these symptoms are not considered as a conclusive proof for the disease. While some of the affected people experience many of these symptoms, others may not have even a single one. That is why the diagnosis of this disease is very difficult. So, if you experience more than one of these symptoms, that too for a long duration, it is better to consult your neurologist. Early diagnosis is always helpful in tackling this disease.

In order to manage multiple sclerosis effectively, you should take plenty of rest; exercise daily to enhance muscle tone, balance and coordination; avoid going in the sunlight as rising temperature may worsen the symptoms; eat a balanced diet and practice Yoga and meditation.   

Common eye problems in older age

Eye problems are common in older age and can seriously affect your quality of life. Many eye conditions are treatable, and some require urgent action. Here are some of the more common eye conditions:

1. Age-related cataracts: A cataract is a clouding of the lens in the front bit of your eye. The causes are unknown. However, certain factors like smoking, overexposing your eyes to sunlight, taking steroid drugs for a long time, a history of cataracts in your family or poor diet may all play a role. When you develop cataracts, you may notice a ‘glare’ in bright light or when you drive at night and you may have difficulty differentiating objects in low light.
2. Age-related macular degeneration: This condition affects an area in the back of your eye called the macula. You’re at higher risk of developing it if, among other factors, you smoke, drink more than four units of alcohol a day or have been exposed to lots of sunlight in your life. You may find that straight edges such as bookshelves or door frames look distorted, or that your vision is generally more blurred. You may also develop blind spots. Consult your ophthalmologist for more details.
3. Chronic glaucoma: In this condition you have an increased pressure in one or both of your eyes – often caused by fluid within your eye not draining away freely. You may not notice this problem at first, but if left for too long, glaucoma may permanently affect your vision (which is why the condition is known as ‘the thief of sight’).
4. Diabetes: Too much sugar in your blood can lead to chronic eye problems, with damage to the back of your eye (called diabetic retinopathy) being an important one.
5. Dry eyes: In dry eye syndrome (or keratoconjunctivitis sicca), your tears drain away or evaporate too fast. You may notice grittiness, tearing of your eyes and redness. We don’t know what causes dry eyes, but ageing, hormonal changes, illnesses and medicines are all thought to play a role. 

If you suffer from eye problems, consulting your eye specialist is usually best. Seek medical advice immediately if you notice any of these symptoms:

• You suddenly lose your vision fully or partially.
• You have a headache in addition to any visual symptoms.
• You can’t think straight in connection with your eye problem.
• You have a painful eye at the same time as loss of vision.

How to keep your hair healthy

In the process of caring for our hair, we do many damaging things to it, from combing it the wrong way to colouring it with harsh chemicals or subjecting it to strong sunlight. If you’re starting to lose your hair, it’s important to take the best possible care of the hair you still have. Here are few of the worst things you can do to your hair.

• Never back comb your hair: It damages the hair shaft.
• Don’t rub your hair dry with a towel.
• Don’t over dry your hair with a blow dryer; stop before your hair is completely dry.
• Select the right shampoo and conditioner for your hair type.

Whether you are a male or a female, losing your precious hair doesn't mean you have to present a bald head to the world; in most cases, your options range from the simple, like plopping a department store wig on your head, to the more complicated (and expensive), like pricey hair systems or hair transplant surgery.

Minimizing Hair Loss

In a society used to chemical fixes and instant gratification, your first response to falling hair may be to search the drug-store shelves for a tonic that will replace lost hair - or at least preserve what you still have. You want to consider that these tonics will do the job and restore your head to its former glory. There are medications that can help save your hair, but you may not want to resort to medication.

Pharmaceutical, laser, and topical treatments

If hair loss looks like it’s going to be a permanent part of your life, you may be ready to turn to prescription medications or treatments to minimize your losses. The good news is that treatments are available to help slow hair loss caused by inherited male pattern baldness.

For many women, hair loss may also respond to medication, or, if a specific disease process is causing the loss, by addressing the health issue.

They can be used in addition to surgical procedures, such as hair transplant, to help slow continuing hair loss (yes, you still lose hair after a transplant — not the transplanted hair, but hair in balding areas) or to help you keep your hair as long as possible.

Considering hair restoration surgery

Hair transplants were an option out of reach for many men until fairly recently. With new advances in technology and better access to well-trained surgeons who work with modern techniques, the option of transplant is more accessible-and more men are taking advantage of it.

The difficulties of transplants in the past — the pluggy look — have been largely overcome with better technologies and well trained dermatologists. The main objection to a hair transplant is the cost, which is why it’s vitally important that you pick a hair transplant surgeon who will give you the most for your money in terms of positive, long-lasting results.

Looking ahead at Hair Loss Prevention

The future of hair loss prevention is bright. Surgical procedures are improving all the time and new medications are being developed to slow or at times reverse hair loss. Gene manipulation and hair cloning may not be too far down the road to give you an unlimited amount of hair to work with.

In the meantime, hair replacement systems are better looking than ever, and more research has been done on hair care products and treatments and ways to enhance the hair you have. Dermatologists are already on their way to discovering newer techniques! 

Important Ayurvedic Tips to be safe this Monsoon Season

You must be eagerly waiting for the arrival of monsoon as the hot, dry months of summer take a toll on our daily lives. But the season is the perfect breeding time for lot of bacteria and viruses. Some of the common ailments during this season are indigestion, diarrhoea, arthritis, asthma, nasal congestion, body aches, sneezing, cough and cold, gastrointestinal problems and many more. Ayurveda believes in getting to the root cause of the problem and then devising a treatment for it. Ayurvedic doctor in recommends certain easy but crucial changes in lifestyle to keep you and your family safe from diseases this monsoon.

Important Ayurvedic Tips 

• Fresh fruits and vegetables are definitely YES for this season. Since microbial activities increase in monsoon, always wash them properly before eating.
• Dairy products are considered heavier to digest. So lessen your consumption of yoghurt, cheese, buttermilk etc.
• Have foods that have a drying nature to encounter the water retention in your body including corn, oats, chickpea and flour.
• Mustard oil, sesame oil and peanut oil all are heavy in nature and should be avoided. Because of their nature, they increase the chances of causing infection. Replace them with corn or olive oil.
• Say goodbye to chutneys and pickles. They are fermented foods which lead to water retention in the body.
• Monitor your stomach’s digestive abilities during the monsoon season. You can aid your digestive system by consuming garlic and ginger.
• Vegetables such as bitter gourd and herbal alternatives like turmeric and fenugreek act as natural antibiotics.
• It’s no rocket science to understand that you should refrain from junk or roadside food as they are loaded with harmful bacteria.
• Drink plenty of water. Boil it before consuming to make it germ free.

Lifestyle changes directed by Ayurvedic doctors

• Don’t go for heavy exercises. Instead indulge in walking, yoga and meditation.
• Keep away from wet walls as they tend to accommodate fungus leading to infection.
• Wash your water coolers regularly and do not allow water to stagnate.
• Use fumes of neem leaves to keep mosquitoes away.  

Follow these tips provided by experienced Ayurvedic doctors and you can have a happy monsoon. 

Understanding The Stages Of Menopause

Menopause, the permanent pause in your periods (menses), is one of those things that you aren't sure has happened until long after it’s over. Like the first time you met your best friend: You probably had no idea that you’d become so close. You only realized how special that occasion really was when you were able to look back on it. Okay, maybe menopause isn't a warmed- fuzzy-greeting-card occasion, but it is a passage worth noting.

Are you or aren't you menopausal? You can answer that question only after the fact — after you've gone a year without your period. Many of the annoying symptoms assigned to menopause actually are much worse prior to menopause in the phase known as perimenopause. During perimenopause, you get both the annoying symptoms (hot flashes, irritability, mood swings, and so on) and your period.

Previewing perimenopause

For many women, perimenopause is a big case of déjà vu. Remember puberty (vaguely)? Remember the crying jags, the mood swings, and the “what’s wrong with my skin!” traumas? Well, guess what? They’re back. Once again your hormones are ready to wreak havoc on your body, your emotions, and your mental faculties. This time around, however, you’re a bit wiser, you have experience dealing with change, and you realize that this too shall pass.

Some gynaecologists advise women who are still experiencing periods not to worry about “menopausal” symptoms. But you know that the symptoms folks often attribute to menopause are usually felt as intensely or more intensely during perimenopause. And perimenopause can last for ten years before a woman stops menstruating altogether and becomes truly menopausal.

Experiencing periodic periods

During perimenopause, things change. If you welcomed your period on the same day as the full moon for 20 years, you may wake up to find the planets suddenly out of alignment.

The hormonal shift is due to changes happening in your ovaries. Your ovaries hold little oocytes (seeds), and each month, some of these seeds develop into follicles (little sacs that hold an egg). One or two lucky follicles mature and release an egg. That’s when you ovulate. The oocytes in your ovaries are held together by a substance called stroma. The stroma produces testosterone, and the follicles produce oestrogen. When you’re very young, you have hundreds of thousands of these little seeds. As you age, you have fewer seeds and more stroma. As the mix of seeds and stroma in your ovaries changes, so does hormone production. Your ovaries decrease their production of oestrogen but continue to produce testosterone.

Sometimes you ovulate during your cycle; sometimes you don’t. Sometimes the FSH just doesn’t get the follicles producing oestrogen right off the bat. Oestrogen levels are low at the beginning of your cycle when they should be high. Your brain responds to this lack of get-up-and-go by sending another surge of FSH. Finally getting the message, your ovaries become a little frantic and go into double-time production of oestrogen. Right at the time when you should be ovulating and producing progesterone, your ovaries are just kicking into gear developing a follicle. That means you won’t ovulate when you usually do and your period will be late.

Your menstrual cycle is all messed up. Your oestrogen shoots up, and then it drops down. You get hot flashes and maybe even heart palpitations (a racing heart) when oestrogen plunges. But just when you’re convinced that something is seriously wrong and you need to schedule a gynaecologist’s appointment, you get your period and everything returns to normal. You wonder why you were so worried and cancel the appointment (if you made one) until the next weird thing happens.

This is all perfectly fine (maybe not with you, but with Mother Nature) — it’s all part of perimenopause. 

Follow these tips before and after cosmetic surgery

In the yester years, we didn’t have a slightest idea of what people will be thronging upon today to look at their best. We have packed ourselves so much in our daily lives that we have totally given up on physical exercises and a balanced diet. Now, people have found a shortcut of sorts (easy solution) to enhance their looks with cosmetic surgeries. What was believed to be impossible yesterday now has become a source to regain youth and stop ageing effects. Not surprisingly, people are readily selecting cosmetic surgeries for weight loss and skin adornment.

Going under the knife for breast enlargement, liposuction, and rhinoplasty is not an option anymore. It’s a necessity now. However, you should always know the precautions to take before and after a cosmetic surgery. So here are some vital tips just in case you give your nod to the doctor:

• Be it workplace or home, people have realized that facial looks matter a lot. In order to get those perfect looks, individuals are going under the knife for nose correction or plastic surgery. But once you are over with the surgery, strictly avoid applying any sort of cosmetics in the operated area. It can lead to infection or allergies. The area should be kept clean and washed regularly.
• Limit your exposure to the sun as the UV rays can prove to be damaging for the surgical stitches and the operated area. Applying sunscreen will not help. Consult with your doctor for antibiotics and ointments.
• Antibiotics can create gastric issues. A proper diet comprising fruits, light milk and food must be followed. You might face some difficulty consuming solid food after a facial surgery. In such case, liquid diet could be followed. Consumption of alcohol and cigarettes must be restricted before and after the procedure. 
• Aloe Vera has been known for its healing powers. Intake of aloe vera juice helps in healing damaged cells from inside and also developing glowing skin. Facial surgery generally leads to loss of skin glow. Aloe vera helps in retaining the glow but should be consumed after doctor’s consultation.
• Before choosing cosmetic surgery, one should do an extensive research on the doctor. Knowing the doctor in advance before visiting him helps in judging whether he/she is the right person for the job. For instance, a facial surgery cannot be performed by someone who is a liposuction specialist. One should also discuss his/her medical background with the doctor as it helps in the procedure. 

Complexities of Laparoscopic Surgery

What are the issues related to laparoscopic surgeries?

As with any surgical procedure, laparoscopy too possesses probable risk of anaesthesia overdose and operation. Contrary to popular belief, it would be an understatement that laparoscopic procedures are completely risk free. Complexities of laparoscopy may be classified according to multiple phases of the procedure. Issues related to introduction of pneumoperitoneum and placing of laparoscope involves cardiac arrhythmias, perforation of a hollow viscus, and piercing of solid organ, bleeding, and subcutaneous emphysema. However, the probability of complications arising in a laparoscopic procedure is very less.

What is the most common impediment post laparoscopic surgery?

Infection is a prevalent issue regarding any surgical procedure. In laparoscopic procedure, the chances of getting an infection is close to negligible but studies have shown it can happen after the laparoscopic surgery is over. This issue is not related to the laparoscopic technique but much depends on the hospital environment and settings. Bowel injury is the second most common cause of despair after laparoscopic surgery.

What are laparoscopic surgery specific complications?

Damage to bowel and blood vessels is specifically related to the technique of laparoscopic surgery. There is a minute chance of getting injury to intestines, abdominal organs, and urinary bladder. Inexperience on the part of the surgeon is a major cause of such medical accidents. If the problem is stern, another surgery may be required with larger incision either to control blood flow or repair an injury that cannot be fixed by laparoscopy. In case of mild complications, antibiotic medication is sufficient to overcome the problem. Issues will happen even with experienced surgeons, but the frequency is less.

When you should realize that there is something wrong?

If patient suffers from fever, puking, chills, unable to pass urine, develops redness near the injected area, or if the discomfort is deteriorating, soreness of abdomen, patient must contact their surgeon immediately.

In which conditions laparoscopic surgery is inadvisable?

Although laparoscopy has come up leaps and bounds overtime, factors like non-cooperative patient, non-correctable defects, heart failure, respiratory problems or presence of distended bowel make it highly imprudent. Most surgeons would not suggest laparoscopy for patients with pre-existing disease conditions. Moreover, patients with cardiovascular diseases and COPD should not be considered good candidates for laparoscopy. Also, people with abdominal surgery done in the past should not go for laparoscopy. Old age people are at greater risk of developing complications with local anaesthesia.

What precautions a patient should take?

• A patient should not eat or drink at least 6-8 hours before the operation.
• Test reports of all the examinations such as blood, urine, x-ray etc. should be present as they may be required by the surgeon.
• A detailed discussion is required if the patient is on certain medications. For e.g. if you take aspirin, ibuprofen, blood thinners, you must consult your doctor first.   

Skin Care Is Important In More Ways than You Think

How our skin looks is important to many of us. At the same time, your skin performs special tasks that support life. Skin protects your internal organs from injury, bacteria, and viruses. It also helps in normalizing body temperature. You can take different steps to keep your skin healthy and replenished. As a reward, good skin care will help you to feel motivated.

Caring for your skin 

Follow these simple methods to keep your skin healthy and radiant:

• Take bathe in warm but not hot water using sensible cleansers that do not create rashes. Wash gently and don’t scrub.
• Keep skin from drying by consuming plenty of water and using moisturisers, lotions or creams.
• Practice sun safety to avoid skin cancer. Exposure to sun puts you at higher risk of skin cancer, regardless of your skin colour.
• Check your skin for sun burns. Contact your skin specialist and tell him/her regarding any unusual developments like a soar that does not heal or a change in an old growth. Ask him whether you require a clinical examination.
• Ask your skin specialist if medicines you are taking can affect your skin. For example, some antibiotics and vitamins contribute towards sun burns.   

Prevailing skin problems

• Sensitive Skin: Women with sensitive skin may have itching, burning sensation, or tightness after using soaps or make-up. Women of colour are vulnerable to sensitive skin. Search for products that are specifically made for sensitive skin. Talk with your skin specialist if these products don’t help.
• Pimples: Pimples form when hair follicles under your skin jumble up. They are recurrent in the teen years but many women get pimples in the latter stages of their lives. Acne also is rampant during pregnancy and menopause, when hormones undergo changes. Medicines, such as birth control pills, can also lead to breakouts. However, the cause of acne is still unknown. Stress, certain foods, chocolate can make symptoms worse. It can be associated with genes. To care for acne, use mild soaps, evade touching your skin, and go for oil-free make-up.
• Dry Skin: Skin can dry out and become rough and itchy for obvious reasons. Dry skin is usually a result because of dry air, overuse of soaps & perfumes, not drinking enough water, stress, smoking and the sun.
• Cellulite: Cellulite is fat that collects just below the surface of your skin. Woman of all sizes can get it. Once formed, it is very difficult to get rid of cellulite. Weight loss, exercise or massages are of no help either. Liposuction makes it look even worse. To prevent cellulite, try adopting healthy diet, stay active, and do not smoke.
• Stretch Marks: Rapid growth and weight gain such as with puberty and pregnancy; can stretch your skin, leaving pinkish or reddish streaks on your breasts, stomach, hips, buttocks and thighs. Medicines like cortisones and diseases such as diabetes can cause stretch marks. Cosmetic creams are of little or no help. Yet stretch marks often fade over time. 

Urinary incontinence in women is curable

Urinary incontinence is an unintentional or accidental passing of urine that usually occurs when a person laughs, coughs, sneezes or runs. Elderly people are known to having bladder controlling issues. They usually don’t harm the body but can have a dampening effect on the quality of life. It is a short-term issue caused by a medicine, urinary tract infection or constipation. It can be cures, when treated properly.

After years of perseverance, gynaecologists have found 3 main kinds of chronic incontinence:

• Stress Incontinence: It happens when a person sneezes, coughs, laughs and other things that put pressure on the bladder. It is the most common form of incontinence in women.
• Urge Incontinence: It happens when a person needs to pee but can’t reach the wash-room on time. Some women inadvertently leak urine without prior warning. Others may do so by just hearing or touching water.
• A combination of above two: Mixed incontinence is a blend of bladder control issues. Older women are known to be hampered with these problems. A gynaecologist may be the right person to consult for such issues. 

Factors involved

Women generally ask questions with gynaecologists as to why these problems occur. They say these issues are born because of weak muscles in the lower urinary tract or damage to the nerves that control urination. Stress Incontinence may be result of child birth, excessive weight or any other activity that causes pelvic floor muscles to stretch. Urge Incontinence may be the result of over-active bladder muscles that pushes urine out of the bladder.

Treatment involves

Most bladder control problems possess a cure. Treatment for incontinence consists of: 

• Performing Kegel exercises which strengthen the pelvic floor muscles. It is one of the best ways performed only after consultation with a gynaecologist.
• Medicines can be taken but they usually carry side-effects.
• Surgery can be performed to support the bladder or move it back to the normal position. 

Dr R K Caroli - cardiologist in New Friends colony, south delhi, India

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