How to stop bad breath

Have you felt awckward in a gathering due to bad breath

A bad breath always interferes in the personal, social as well as professional life, it feels disgusting when you talk with a person and the person avoid directly talking to you. Some might even offer you some mouth freshener like peppermints or any chewing gums.

Bad breath is really something which is unpleasant, there may be a yellow tinge on your teeth which also affect your look. All these lead to depressed life, cut off from gatherings and you end up brushing or cleaning your mouth.
Bad breath is also called halitosis, this is bad odor in the breath.

Causes of bad breath

There are different causes of bad breath but the most common cause is the dental hygiene. An unhygenic oral cavity leads to bad breath. Other causes are eating strongly flavored foods like onion, spices, garlic. Strong smelling beverages like tea, coffee, alcohol, or smoking.

There are some medical causes too causing bad breath which are curable and preventable. These causes are

Infection of the upper respiratory tract, bronchitis, sinusitis as these lead to secretion which may be infected and foul smelling.

Dry mouth also called xerostomia is mainly due to deficiency of Vitamin A is another important cause of bad breath.

Some chronic diseases related to metabolism may be a causative factor of bad breath like Diabetes, Liver or kidney problems, Atkins diet and Montignac diet.

Gastritis and food reflux mainly old food particles may lead to bad odor of mouth.

Diagnosis of bad breath

The diagnosis depends on self assessment or by one who is very close to you. If these are not possible, one can put some saliva on a peice of paper and let it to dry and smell that, a bad odor usually remains on the paper.

Treatment of bad breath

Maintenance of dental hygiene is the most appropiate measure to cure bad breath, apart from that the disease should be treated if there is any respiratory infection or sinisitis. Proper antibiotics with steam inhalation may be helpful in such situation. One cannot prevent taking strong smelling food, but then proper brushing and mouth washing by antiseptic mouth wash with proper rinsing will help to curb the odor.

Remaining empty stomach for long time may cause acidity and gastric reflux and these can be cured by drugs like antacids. Blood sugar should be in control which can also prevent from other diseases related to liver and kidney.

Preventive measures for bad breath

Reduce the intake of strongly flavored or spicy food, alcohol and reduce smoking as much as you can. Take plenty of fluids orally which will clean your mouth from food particles especially liquids like milk, meat and polutry which causes bad odor very quickly.Use a tongue cleaner and clean right to the back of the tongue.
Intake of vitamin A rich food like carrots, guava and tomatoes prevents from dry mouth. Avoid snacks between meals and if you take clean your mouth properly as these are the cause of growth of bacteria causing bad odor.

If all these fails,visit your dentist for a proper check up.

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Pityriasis Versicolor : A fungal infection of skin

Pityriasis versicolor is a mild, chronic, asymptomatic infection of the most superficial layers of the skin caused by fungus called Pityrosporum orbiculare. It is very common in warm and humid climate and usually affects young adults.

It is characterized by fine, scaly pigmentatation which may be hypo or hyperpigmentation. The macules may vary in size and shape and usually appear on trunk, upper arm, shoulder and neck. Macules may become confluent to form polycyclic patches



Diagnosis of pityriasis versicolor

The diagnosis is done by examination of the patches and a microscopic examination of the skin scrapping is done in a KOH preparation. This reveals short hyphae and cluster round and budding yeast cells. Scaly lesion usually show golden yellow fluorescence when examined under wood’s light.



Treatment of Pityriasis versicolor

The treatment includes selenium sulphide shampoo in 2.5% solution. Ideally it should be applied to the affected part in the night and should be washed off in the morning. Other antifungal ointments like miconazole or clotriazole can be applied twice daily and is effectrive if used regularly for 10 to 14 days. In extensive and lond standing stubborn eruptions oral antifungals like ketokonazole 200 to 400 mg per day of fluconazole 150mg weekly may be effective.

The patient may have to take treatment for 2 to 3 months in extensive lesions.

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Recovery after a hysterectomy operation

It is very important for a woman to know the details about recovery process after a hysterectomy. A woman is discharged from the hospital within a day or two if she had undergone laproscopic hysterectomy or latest by a week, but complete physical recovery from hysterectomy usually takes about 6 to 8 weeks. During this period one should know each and every steps to be taken for a well, healthy and doctor free life.

Recovery process at hospital

After surgery, for the first day, there may be a catheter inserted into the urethra for urine to be passed and total output to be measured. An intravenous drip may be on to replenish fluid lost during surgery. The doctor will prescribe some medication for pain the patient may feel, after the effect of anesthesia wear off. Some patient may feel nausea on the first day due to the effect of anesthesia.

In a day or two, the patient can get on to her feet, to go to toilet or roam in her room. This is encouraged as moving and roaming may improve blood circulation. It also relieves from the gas which collects in the abdomen. There will be slight vaginal bleeding for a few days which may soon disappear.

Holding a pillow against the stitches while getting out of bed helps in reducing the pain. Sutures given in surgery are absorbable, but some shreds may be passed off and on for 2 to 3 weeks. The doctor may probably discharge a patient on 5th to 7th day, if all is well and call her for a check up after 6 weeks. If there is any fever, vaginal discharge, which appears unhealthy, or an increase in bleeding, the patient must see the doctor immediately.

Recovery after discharge from hospital

Once out of the hospital, a woman needs to learn to take the reins of the household back in hand slowly. She must take plenty of rest and start with simpler work first. She should not lift furniture or heavy weights or do any strenuous spring cleaning. A little effort will make her tired. The time required to recover varies from patient to patient. Activity should be increased slowly. Only those works should be done which she is comfortable with.

Bathing etc is allowed, though it may leave the patient exhausted when the first time she has a bath after hysterectomy.

If a woman is going out to work, starting with part time work and only after 8 weeks, should she, slowly take over more responsibility. It must be remembered that she can only recover now. Taking care of herself will ensure healthier years later. Neglect after surgery will mean a frequent visit to the doctor, for complications and problems like backache, tiredness, fatigue and irritability.

Medication after hysterectomy

After hysterectomy for the initial stage medication may consist of antibiotics to prevent from secondary infection, pain killers as mentioned above, some doctors prescribe trypsin-chymotrypsin like chymoral forte to reduce inflammation and edema. These drugs may be off within a week if everything is well.

Some patient may feel dryness in vagina, hot flushes and irritation due to artificial menopause she had attained after hysterectomy, for this doctor may prescribe hormone replacement therapy for a few years. If there is any complication by this therapy, she should immediately report to the doctor.

Some patient may require calcium supplement throughout life to prevent from complications like osteoporosis which may be due to lack of estrogen if ovary is also removed. It is though recommended to take calcium supplement to every woman who attained natural menopause or got their ovary removed.

For vaginal dryness, estrogen cream may be prescribed by the doctor.

Thus a full recovery from hysterectomy require an active role of doctor, patient herself and her family members, a proper awareness may lead to a normal, healthier and happy life further.

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Sexual effect after hysterectomy

Sexual feeling after hysterectomy varies from woman to woman after hysterectomy. In our country it is very difficult for a woman to ask out rightly that will she able to have normal sexual life and a normal intercourse after hysterectomy. But frankly speaking this is a very relevant and important query.

Can a woman perform sex after hysterectomy

Generally the candidates for hysterectomy are of above forty years of age but the Indian psychology inhibits the woman for asking such relevant question. Well the answer to the above query is yes. Unless the hysterectomy is radical (see types of hysterectomy) where a part of vagina is also removed along with cervix, as in cases of cancer, the length of vagina is intact and is quiet stretchable to perform sexual intercourse. The lubrication is required for proper and natural, enjoyable sexual act. In hysterectomy where ovaries are also removed there may be dryness of vagina and this can make the sexual act difficult if there is no lubrication. If there is hormone replacement therapy lubrication may occur naturally due to estrogen, sometimes estrogen cream is prescribed, but in normal circumstances a petroleum jelly can work as well.

When to perform sexual act after hysterectomy

In hysterectomy there is formation of scar at the place from where the cervix is removed. The scar is initially soft and tender and may cause during intercourse. The total healing period for the internal scar is usually 6 to 8 weeks in normal circumstances and may be longer if the patient is hyperglycemic, though a strict sugar control is always advised before operation. The doctors generally advise to abstain from sexual intercourse for this duration. A little adjustment in position may lead to less pain and this adjustment depends on the partners.

Sometimes, even after 6 to 8 weeks there may be a little blood stained discharge after sexual intercourse. Though a check up by the doctor is advised, but in majority of cases this may be due to the suture remnants falling of after healing is over.

Change in libido after hysterectomy

There is a myth among majority of woman that sexuality is reduced after a hysterectomy. It is a learning process for both partner all over again on what the other wants and what causes pain and pleasure. The initial reluctance to make love comes from that everything may not be normal. Most woman experience pleasure when there is uterine contraction stimulating abdominal lining when the uterus is pushed during intercourse. Now after hysterectomy when uterus is not there the initial few times, one may not feel that pleasure as before. But if the woman learns about few things there may not be any problem in the feeling of pleasure.

As the clitoris is intact which is supposed to be specifically the erotic and pleasure giving area called the G spot inside the vagina. Thus further there is no problem is libido. The G spot is located in the front wall, midway between the symphysis and the cervix. Pressure against this gives pleasure and vaginal orgasm. There is deeper penetration in the female astride position and the G spot is also stimulated more intensely. Thus both clitoris orgasm as well as vaginal orgasm can be attained by a woman even after hysterectomy.

If the ovaries are also removed, ovarian androgens, which are supposed to be the libido hormone, are less. Some of these complaints are resolved by giving external hormone to the woman. Though these hormones are not free from side effects. Therefore it is best to relearn, rediscover and reinvent the art of love making again in this changed scenario which may come after few hours when a woman attain menopause if not by hysterectomy.

For more details please see Indiastudychannel.

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Psychological effect after hysterectomy

Uterus in a woman is a sign of feminism and so is the menstruation. When a woman looses her uterus after hysterectomy, her menstruation too ceases unnaturally and there are various psychological effect of that condition.

Depression after hysterectomy

A common after effect of hysterectomy is depression. Depression occurs more often in woman who have not been properly counseled, or in those who feel they had no other option like in the cases of cancers. Those woman who have many interests like those working outside home, adjust better to these situation. Home bound woman, who concentrate all their energies in running the house, looking after their children, feel incomplete. They feel they have lost a part of themselves, a part of womanhood. There is speculation that may be the uterus also produces some hormone like substance, which after a hysterectomy is not there hence causes depression. This speculation applies to woman in which ovaries are left intact.

When the ovaries are also removed in hysterectomy, the depression is attributed to an early artificial menopause and its related problem. Due to artificial menopause there may be hot flushes due to estrogen deficiency and this leads to insomnia and aggravate depression.

Improper counseling creates a myth in the woman’s mind that there may be loss of libido and her sexual ability may hamper and this becomes another reason for depression after hysterectomy.

How to cope up with psychological effect after hysterectomy

To combat psychological effect after hysterectomy the role of doctor, counselor, family and the woman herself is equally important.

The doctor needs to explain all the after effect of hysterectomy, its hazards, its necessity so that a woman may be mentally prepared for the operation. He should explain the how hysterectomy can be beneficial for the disease she is suffering.

The counselor which can be doctor him/herself should explain that there is no loss of womanhood at all and just a physiological process ceases which was not even present before puberty. There is no loss in the sexuality or libido of the woman as the clitoris is intact and a woman can attain full orgasm even after hysterectomy.

The family, especially the husband’s support is very important as he is the person who can make her feel that she is as normal as a woman and same as before hysterectomy.

The woman’s role is also important as she should know all the facts about hysterectomy and should know whether there is any alternative to hysterectomy, how hysterectomy can be beneficial for her disease. What if she does not undergo hysterectomy? She should ask all the questions about hysterectomy and should be completely aware of. See here Awareness about hysterectomy.

She should know all the risks of hysterectomy and also the risk if she does not perform the operation,

Hot flushes and other problems related to artificial menopause can be treated by hormone replacement therapy. Vaginal dryness sometimes occurs which can be treated by estrogen cream.

In severe depression the patient may require tranquilizers and fluoxetine for the treatment. In severe cases fluoxetine along with regular counseling and other behavioral therapy may cure this problem.

For more detail please see Indiastudychannel.

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Hysterectomy and its indications

Hysterectomy means the surgical removal of the uterus. This is of various types of hysterectomy depending upon what parts of uterus and its attachments to other structures are removed.

Types of hysterectomy

Sub total or partial hysterectomy – In this the uterus is removed leaving the cervix in place.

Total hysterectomy – Removal of entire uterus along with cervix.

Hysterectomy with unilateral salpingoophorectomy – Removal of uterus, cervix and one sided ovary along with fallopian tube.

Hysterectomy with bilateral salpingoophorectomy – Removal of uterus, cervix and both sided ovary along with fallopian tube.

Radical hysterectomy – Radical hysterectomy is usually done for cancers, this is removal of uterus, cervix, ovaries, part of vagina, the support of the uterus and lymph nodes of the area.

Indications of hysterectomy

When a hysterectomy is done to repair the pelvic floor, or tighten the support of the uterus, or to remove prolapse of the uterus along with the cervix, it is done via vaginal route, the surgeon giving a small incision in the vagina. It may involve a small incision, but is still a major surgical procedure and is called a vaginal hysterectomy.

A hysterectomy can be done by giving an incision on the abdominal wall and is called an abdominal hysterectomy. This is one used for most gynecological indications. An abdominal hysterectomy allows better visualization of the pelvic organs and greater operating area.


The indication of doing an abdominal hysterectomy are many, but now a days there are many alternatives, equally beneficial reconstructive surgical procedures, which can be considered for some conditions, for which a hysterectomy was the answer earlier.

Now a days laproscopic hysterectomy is most preferred procedure in which just two hole is made and a camera is inserted into the abdomen and the whole procedure is done by visualizing the internal abdomen in the screen.

The benefit of laproscopic hysterectomy is that the patient may be mobile within 24 hours, bleeding is less, though it may require an expert hand and total time consumed for entire operation may be more. This type of operation is more expensive.

Before undergoing hysterectomy a patient should be aware of some facts, she should know whether the operation is actually necessary or not, whether there is any alternative method, if yes is the alternative method as effective as hysterectomy etc. Please go to awareness about hysterectomy to know what a woman should ask the doctor before undergoing hysterectomy.

Absolute indications of hysterectomy

There are some conditions where there is no alternative treatment to hysterectomy and there is absolute indication for hysterectomy. These conditions are

Pelvic cancer
Uncontrolled bleeding where all other measure fails to control.
Severe fulminating pelvic infections.

There are other conditions where hysterectomy is indicated but there are alternative measures for treatment too and it depends on the condition or situation to choose between alternative treatment or hysterectomy. These conditions are

Dysfunctional uterine bleeding.
Fibroid in uterus in elderly patients
Adenomyosis with severe pelvic endometriosis.
Pelvic inflammatory disease.
Some obstetric conditions like molar pregnancy and hydatidiform mole in elderly woman where the risk of choriocarcinoma is more. Some abortions where there is chances of sepsis and in some cases of post partum hemorrhage where there is life threatening bleeding.

In some conditions like placenta accrete where placenta is completely adhered to uterine wall, hysterectomy is the only choice.

One must see the risk involved in hysterectomy before undergoing this operation and should calculate the risk versus benefit by consulting a gynecologist.

For more details see at Indiastudychannel.

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Menstrual problems in thyroid disease

Thyroid problems whether it is hyperthyroidism or hypothyroidism exert a significant effect on periods of a woman. Here Depression in thyroid abnormalities we have seen that thyroid abnormalities also leads to depression and a menstrual disorder can be additive factor to this depression. There may be various types of menstrual disorder in a case of thyroid disease.

Types of menstrual disorder in thyroid disease

The various types of menstrual disorders seen in thyroid abnormalities are

Menstrual disorder in hyperthyroidism

Amenorrhea means absent period and oligomenorrhea means scanty period. This is seen mainly in hyperthyroidism. There may also be delayed menstruation in hyperthyroidism and also the period will in irregular, infrequent and sporadic.

The girl may attain late puberty and their onset of menstruation may be late after 15 years of age or even more.

Menstrual disorder in hypothyroidism

In contrast to hyperthyroidism, there is heavy period in hypothyroidism which may last long, the feature is called menorrhagia. The duration of bleeding is more and there may be early periods means period starts before the due dates. The normal cycle of 28 days may reduce to 25 days or even 20 days in some cases.

Woman with hypothyroidism may also suffer from painful menstruation, the pain may be dull, aching associated with backache, cramps in legs, headache and often nausea and vomiting.

Management of menstrual disorder in thyroid problem

The menstrual problem in most of the cases corrects when thyroid abnormalities are corrected. Management includes a thorough investigation and treatment.

Investigations in menstrual disorder with thyroid disease

The woman with any complaints of menstrual problem should be thoroughly investigated for thyroid hormones mainly thyroid stimulating hormone (TSH), T3 and T4. In hyperthyroidism where TSH is below normal and T3 and T4 levels are elevated, while in hypothyroidism TSH level is more than normal and T3 and T4 are under normal.

Apart from investigating thyroid hormone levels, it is also necessary to get investigated for other hormones like serum prolactin level, which can be increased. Leutinizing hormone (LH) and Follicular stimulating hormone (FSH) level are also investigated and this can be also a reason for menstrual problem. Ideal time for investigating LH and FSH is 2nd or 3rd menstrual day.

Treatment of menstrual disorder with thyroid disorder

In hypothyroidism, a hormone replacement by eltroxin or thyronorm is done according to the level of thyroid hormone. Excessive bleeding may lead to anemia and iron supplement may be required. In painful menstruation symptomatic management is done by analgesics. Calcium supplement is also helpful in dysmenorrhea.

Some ayurvedic herbs is expected to be beneficial in delayed menstruation, these include parsley, ginger, yarrow, sage, and feverfew. Herbs such as chamomile, red raspberry, lemon balm, red clover, catnip, and comfrey root are helpful in dysmenorrheal as well as to curb excessive bleeding.

For more details see Indiastudychannel

For more resources on health please seeMy Resources

Dr. S. Choudhary
Health is Wealth

Healing by Yoga

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Preparing for a childbirth

This is a subject which is of most important for a woman and is much talked about not only in west but also in India. With the advent of pain relieving drugs, anesthesia, the pain of childbirth was lost somewhere, in the last 20 - 30 years. Women especially in the western countries and even in our country, now want to feel the event of having a baby and hence these are learning processes.

This article is simultaneously posted by be at Preparation of a woman for childbirth

In India the village dais or midwife and in town the grandmother, mother or mother in law in the house, generally counselled the young mother to be, so this teaching was never lost. However in India today, with more and more women of the western culture attitudes being imbibed we are where the western Countries were 20 years ago. Before we really lose out our traditiopns with friendly midwives not being around, the five star culture catching up in privately managed hospitals I hope this article may help woman all they need to know regarding preparation for childbirth.

How to prepare for a childbirth

The idea of preparing a woman for childbirth is to minimize the discomfort, the feeling of pain in labor and delivery as also to decrease potential risks to the newborn and the mother to be.

There are many regimens ann various methods applied for preparing a woman for child birth, some of them which are commonly applied are :-

Dick Real method

Dick Real method involves breaking of the fear-tension-pain cycle by teaching breathing and muscle relaxation exercises and adequate knowledge of what to expect during labor.

Lamaze method

Lamaze method also deals with specific breathing and relaxation exercises, a thorough knowledge about the delivery process and active support, of the father of the child in all the exercise programs, as well as when actual uterine contractions occur during labor. The hallmark of this is strict discipline to do the exercises and be committed to follwing all that is taught.

Sheila Kitziner program

Sheila Kitziner program is like the Dick Real method and Lamaze method with stress laid on perineal exercises. Also the entire family is interviewed and relationship is worked out.

Bradely method - Husband coached childbirth

In Bradley method the woman concentrates not on breathing exercises, but by being prepared for the pain and tuning in on it, by concentrating on what is happening to her, in this unique process of childbirth. The husband is an active participant and both feel the entire process of labor. The husband encourages the woman through the labor and tactile reassuring contact is maintained.

Hypnosis

Women are hypnotized to relate the sensation of pain in labor as pressure in labor. The mind is concentrated and fixed on something other than pain.

In the Indian context, our age-old science of yoga and meditation beats all these techniques and now gaining popularity even in Western Countries. Basically, yoga and yogic exercise lay stress on breath control and the exercises help to develop correct breathing techniques. Yoga also teaches meditation and mental relaxation. To learn yoga one must be initiated and taught by a yoga instructor, if she is not aware of fully. However, it is best to to get a thorough check up done by a doctor before starting any exercise program. In pregnancy the yogic breathing exercise helps to teach the correct ways to breathe and relax, so helpful during labor.

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