The kidneys are a pair of bean-shaped organs located in the upper-posterior part of the abdomen. Its main function is to filter the blood, eliminating toxins and excess salt and water from the bloodstream.
The proper functioning of the body depends a lot on the kidneys. Therefore, it is necessary to take special care to avoid possible kidney problems, which can lead to failure and the need for dialysis or hemodialysis.
Chronic kidney disease (CKD) is a slow, progressive and irreversible loss of renal structures that affect the glomerular, tubular and endocrine functions of the kidneys, leading to the body’s inability to maintain metabolic and electrolyte balance.
Characterized by the presence of functional and/or structural changes in the kidneys, for a period longer than three months, with a glomerular filtration rate (GFR) lower than 60 mL/min./1.73m.
CKD has been considered a public health problem worldwide due to its high rates of morbidity and mortality and its impact on physical and biopsychosocial aspects, drastically affecting the quality of life of patients, says the best nephrologist in Delhi.
With that in mind, nephrologist in Delhi prepared this article with the main types of treatment for Chronic Kidney Disease. Keep reading and learn more about them!
Treatment for Chronic Kidney Disease
Treatment for Chronic Kidney Disease aims to help the kidneys maintain homeostasis for as long as possible.
With the deterioration of renal function, dietary intervention is necessary with careful control of protein intake (allowed must be of high biological value – dairy, eggs, meat – to provide essential amino acids), fluid intake (quantity of fluid allowed is 500 to 600 ml more than the 24-hour urine output) to counteract fluid losses, sodium intake to counteract sodium losses, and a certain potassium and phosphate restriction.
At the same time, adequate caloric intake and vitamin supplementation must be ensured.
In general, dialysis in Delhi is started as a form of treatment for Chronic Kidney Disease when the patient cannot maintain the usual lifestyle with the conservative method.
Unfortunately, not all patients are candidates for dialysis or transplantation due to severe psychological problems, ischemia, vascular complications from diabetes and old age, says kidney specialist in Delhi.
Types of dialysis
There are two types of dialysis – hemodialysis (HD) and peritoneal dialysis (PD), both types involve the use of a fluid used to filter impurities in the blood, toxins and fluids passing from the blood through a semi-permeable membrane.
Physiological principles of dialysis
Dialysis is a process of treatment for Chronic Kidney Disease whereby the composition of solutes in a solution A is changed by exposing solution A to a second solution B through a semipermeable membrane.
Water molecules and low molecular weight solutes from the two solutions can pass through the pores of the membrane and therefore mix, while larger solutes (such as proteins) cannot pass through this semi-permeable membrane and thus the amounts of high molecular weight solutes on either side of the membrane will remain unmodified.
The transport of solutes will take place in two ways:
Diffusion: transport of solutes through a semi-permeable membrane, obeying the concentration gradient and the molecular weight of the solute;
Ultrafiltration: transport of water through the transmembrane pressure gradient with the passage of water from the higher side to the lower pressure.
Peritoneal dialysis uses the peritoneum as a natural permeable membrane to balance water and solutes.
The technique is less physiologically stressful for the patient, does not require vascular access that can present numerous complications, it can be performed at home and, for this reason, allows patients greater flexibility in its performance.
Although, with so many advantages, the technique requires much more patient involvement than in a hemodialysis at dialysis centre in Delhi, it needs to be performed carefully and sterile maintenance is of great importance.
Peritoneal dialysis can be done manually or using an automatic device (periodic, overnight, or continuous), and in general, the dialysate is instilled through a catheter into the peritoneal space, remains for a period, and then drains. In the double bag technique, the patient drains the fluid instilled into the abdomen into one bag and then infuses fluid from another bag into the peritoneal cavity.
Quality of life of patients
Although the different dialysis methods of treatment for Chronic Kidney Disease are equivalent in issues related to patients’ rehabilitation and mortality, the quality of life needs to be evaluated.
In a study, it was possible to observe that PD was more favorable to a better quality of life for the patient, as it presents three significant variables (work, patient satisfaction and less contact with the team – less likely to experience situations of stress), while HD presented two significant variables (emotional and physical function).
However, it should be taken into account that the two significant items in HD are more relevant to the daily quality of life of the patient outside the clinic.
Kidney replacement therapies, hemodialysis and peritoneal dialysis, as a treatment for Chronic Kidney Disease represent, in most cases, a life expectancy for those who undergo it, since the disease is characterized as an irreversible process.
Conservative treatment (medicines, changes in diet and lifestyle) can be used to delay the worsening of renal function or stabilize its progression, reduce symptoms (malaise and fatigue, itching and dry skin, headache, loss of unintentional weight, loss of appetite and nausea), prevent complications and improve the quality of life of these patients.
Adapting to this new reality is not an easy process, nor is it a very smooth process, the health professionals involved in the patient’s treatment must understand and help the individual in all aspects, as well as his family, says the kidney doctor in Delhi.
They are hard formations (hence the term used, “stones”) resulting from the aggregation of minerals and salts present in the urine.
In fact, the correct technical designation is kidney stones. The existence of kidney stones gives rise to a condition known as Renal Lithiasis.
Although they form in the kidneys, the stones can move to another part of the urinary tract, namely the ureters and bladder.
They may have different biochemical compositions, which distinguish them: calcium (such as calcium oxalate, the most common or calcium phosphate, for example), uric acid, struvite and cystine, among others, explains the urologist in Dwarka.
It is not always possible to identify the cause of the problem, but there are some risk factors related to kidney stones that seem to increase the probability of its occurrence, such as:
Family history of urinary lithiasis;
Insufficient fluid intake;
Unhealthy diets (mostly high in salt, sugar and protein);
Low urinary output;
Pathologies in certain glands or kidneys;
Certain medications and supplements;
Low urinary concentration of protective elements such as citrate or magnesium (which help to inhibit stone formation).
How do they manifest?
When lodged in the kidneys, kidney stones may not cause symptoms.
However, if they move along the urinary tract, the first warning sign appears – a sudden, intense pain, usually near the flank or lumbar region, which may radiate to the abdomen or other areas such as the groin.
Known as renal colic, this pain is extremely disabling and has no relief position. It is one of the most intense pains that human beings can experience, says the urologist in Hari Nagar.
These stones may also be at the origin of other symptoms:
Nausea and vomiting;
Increased voiding frequency, burning when urinating or sudden urge (especially when the stone is close to the bladder);
Bloody urine (haematuria);
Fever (which is usually an indicator of infection).
Incidence of Renal Lithiasis
It is estimated that this pathology affects between 2 to 3% of the world population, predominantly white men.
The probability of having an episode of renal colic, in patients with stones, up to 45 years of age, is around 9%, explains the urologist in Hari Nagar.
How to Treat Kidney Stones
The basis of correct treatment is making an accurate diagnosis, as kidney stone treatment in Dwarka depends on information such as the location and size of the kidney stone.
Thus, it is necessary to know the clinical history, perform an objective exam and resort to some complementary exams, namely imaging.
This assessment is essential because there are other diseases with similar symptoms, and it is essential to exclude them.
When the stone is small and the pain is tolerable/controllable, it is possible to expect it to be spontaneously eliminated through the urethra. Various medications can be used, either to control pain or to facilitate the elimination of the stone.
When the dimensions are larger or the stones is closer to the kidneys and does not progress along the ureter, it is necessary to resort to other methods – namely surgical, even if minimally invasive.
One of the options is to carry out Extracorporeal Lithotripsy by Shockwaves (LEOC), which promotes the fragmentation of the stones, which then are naturally eliminated. Although efficient, it has some contraindications, limiting its performance.
Another method, used in most cases, is Endoscopic Surgery, which consists of ureterorenoscopy or retrograde intrarenal surgery.
Through a semi-rigid or flexible ureteroscope, which is inserted into the urethra and bladder, the ureter is accessed, and the ureteral/kidney stones are fragmented with a laser guided by an optical fiber and removed using surgical instruments.
These procedures are extremely precise and controlled, thanks to the use of video surgery, with a camera included or attached to the ureteroscope, says the urologist in Uttam Nagar.
Endoscope procedures may vary depending on the type of calculation:
Inside the kidney: with a flexible ureterorenoscope, through which the laser fiber passes and very small instruments (“baskets” or tweezers, for example), to remove the stones;
In the ureter: with a semi-rigid ureteroscope, with the same type of instruments, although larger;
Percutaneous nephrolithotomy: in some cases, namely for very large stones that cannot be removed with the equipment and instruments mentioned above, the kidney is punctured from the skin of the lumbar area to introduce devices that fragment and remove the stones.
As females, we all are born feminine. But somehow, somewhere down the line in the quandary of daily life, we lose touch with our feminine energy. After all, the modern age demands us, women, to be strong and independent just like our male counterparts.
And in an effort to be accepted and acknowledged at the workplace and in public life, we often lose the echo of our feminine side. So, if you too as a girl or a woman feel less feminine as you want to, don’t lose heart. There are a lot of ways of how to become more feminine and feel good in your skin.
To get you started here are six simple tips to be more feminine in your daily life without sacrificing any career opportunities or feel like being at the receiving end.
Wear red lipstick
Want to look more feminine?
Wear red lipstick.
No matter what clothes you are wearing, how’s your hair-do and footwear, once you put on red lipstick you will instantly transform yourself into a diva!
Yes, that is the magic of red lips on a woman. So, girls swipe on your red lipstick and carry it with you all the time because you never know what you may run into.
Nothing speaks more feminine than a woman who smells nice. But this doesn’t mean you go overboard with it or apply any scent to your body. Wearing perfume is an art. Check out this post to learn how you can find the right fragrance and then use it to your advantage as a great femininity infuser or a beautifying tool.
Keep your hair healthy and clean
Studies suggest that women with shiny, clean and lush hair look undeniably more feminine than women with dry, limp or over-styled hair. So girls take care of your hair. Keep them clean and healthy by eating well, using good-quality hair-care products and choosing the right hairstyle.
Getting dressed in an attractive manner doesn’t mean you start prancing around in frou-frou dresses. True, skirts, frills, ruffles and laces look feminine on women and you can dress up in attractive clothes occasionally from time to time.
But you can look as attractive and feminine in a business suit or simple jeans & tee as in an evening gown if you choose to wear clothes that fit you properly and enhance your natural silhouette.
If you are one of those women, who would make big investments in buying expensive outfits and accessories but pay no attention to their undergarments, this one is for you.
Yes girls, never underestimate the power of underwear to lift up both your confidence and attraction quotient. Feeling like a woman is as important as looking like one. Your underwear may not necessarily be seen by anyone but you know what you are wearing inside.
And if you’re wearing dated and ragged underwear from five years ago, it’s definitely not going to add any value to make you feel good about yourself and worse still can make you feel less confident or less of a woman inside.
Now imagine yourself wearing nice lingerie set underneath your clothes with feminine details like lace or silk. Doesn’t this feel empowering delightful?
If yes, then you must check out this online boutique MarieMur.com for investing in some high-quality lingerie pieces. From handmade custom leather lingerie to any strappy or kinky women’s accessory, the store is chock-full of masterful lingerie items that appeal to your authentic feminine self.
Have you ever wondered why all the beautiful cool women in the show-biz wear high heels?
Because heels make women look ultra-sassy, glamorous, classy and feminine.
So, if you also want to look more feminine and stylish, wear high heels. And if you find it difficult to walk in high-heeled shoes, consider buying shoes with kitten heels.
Even a little heel to your shoes is enough to lift you up a little, add oomph to your silhouette and make that magical sound while you’re walking.
So, girls, you see it’s not enough to be born a female to feel yourself a woman. To really feel feminine and confident in your skin you not only need to take care of your looks but also of your mindset.
Agreed, modern women are required to be strong and decisive. But this doesn’t mean that if a woman is tender and soft in nature she is weak and vulnerable. A truly feminine woman is one who is not afraid to express her authentic self.
In fact, she is someone who is caring and receptive to others’ needs just like what nature expects in the female gender. So my dear peeps stop pondering over how to become more feminine and just start being you!
Miyar Valley, unknown to many – even in the most ardent Himalaya lovers’ circle, is a stunning little corner of the world. Given that it is extremely remote and mostly inaccessible, the valley hasn’t gained its fair share of following. Yet. Miyar has it all – limitless meadows, stunning carpets of unique flowers, glacial streams. Located in the north-west of the Lahaul district – Miyar covers over 100 KMs and is a beautiful amalgamation of landscapes of both Himachal and Ladakh!
Given its remoteness, this valley is accessible to those who trek! Since there are no defined routes, the treks can be as short as a day or two to as long as 10 days or more. The beauty is in the eye of the beholder as they say, and Miyar keeps unfolding into some of the most stunning, cascading views!
The locals like to refer to the valley as the “Valley of Flowers” and this trek will take you through grasslands, flower beds, mountain streams, moraine and boulders.
About Miyar Valley
Miyar Nala, as it is often known, is an exceptionally long S-shaped valley, which lies between Zanskar and Chamba. Covering a massive distance of nearly 100 KMs, with the Miyar River running into Chandra Bhaga River at Udaipur. This in itself covers over 50 kms distance from the Miyar Glacier. The glacier itself is nearly 36 km long all the way till Kang La (17,600 ft.) and beyond into the Zanskar Valley.
What’s beautiful is that a narrow gorge near the bottom of the valley is home to 12 little farming villages. All lying between 9,300 and 11,500 ft., with about 3,000 current inhabitants in total. The villagers are mostly of Buddhist faith and, thus, you’ll come across small Gompas (the one in Urgos is stunning!)
Locals of Miyar Valley
Cultivation of peas and grains, the main occupation in these villages – ceases at about 12,000 ft. Post this, you’ll be greeted by the most surreal of meadows! What boggled my mind, particularly, was a cricket field here! Isn’t the love for cricket in our nation beyond all belief? No matter where you are, no matter what you’re doing – if there is a field large enough – it will be converted into a cricket ground. So special! Oh I must mention, though a bit unnecessarily, that the views from the cricket ground are exceptionally jaw-dropping. With nearly 15 snow covered peaks visible at all times, you’ll be hard pressed to move forward!
Geography of Miyar Valley
The Valley is unique, it has some of the most beautiful landscapes and the presence of high-altitude Himalayan flora just adds to the magic. Along with the flora, you’ll be mesmerized by the meadows and the steep rocky side valleys. It almost becomes a game, a task to look for the beautiful flowers and wonder what they can be used for (a lot of these plants have medicinal purposes!)
Near the snout of the Miyar Glacier, at Phalpu, you’ll be welcomed into the Kesariyong Chu, seven icy sacred pools. These pools are highly revered in the Buddhist culture and you are allowed to bathe/dip in them for prosperity and prayers. On all sides snow-covered peaks abound, many of them unclimbed.
Thriving Flora and Fauna of the region
This is a huge selling point for me. To get to experience stunning, unseen, thriving vegetation is such a blessing! The journey will have you witness Juniper trees, Willow, Pine, Cedars, birch, Alder, Poplar trees along with some exceptionally colorful Orchids. In the summer and post-summer months, you’ll get to hear and spot many a migratory bird as well! I encourage you to interact with the local shepherds (gaddi) – they can share insights on the medicinal properties and help you recognize some of the herbs you’ll see. If you’re lucky, they will also share stories of how leopards attacked sheep in the recent times and other such folklore, synonymous with the nomadic life. Keep your eyes peeled for the blue sheep near Zardong.
A confluence of rivers and farming villages
What is surreal about this region, of course, is that the Miyar river forms an integral part of life here. Obviously. However, the confluence with the Chandra Bhaga river near Udaipr is an important pilgrimage in Lahaul. Further, revered peaks of Never seen Tower and Castle Peak are within a 2 km radius from the Miyar Glacier.
Introduction to the Miyar Valley TREK
The Trek in itself begins right after Udaipur in Lahaul. You reach the stunning, untouched, unexplored village of Shukto and then the magic awaits. The trail will take you through some of the most unbelievable views and terrains of Central Himalayas.
When in the valley, you will get to witness flora and fauna in all their natural glory! Wildlife here includes snow leopards, Himalayan bears as well as many flocks of migratory birds. Rocks akin to ruby and sapphire, crystal green glacial lakes are all awaiting you to visit.
The route in general will take you through vast meadows well above plantation levels, adjacent to rivers, grasslands and glacial streams. Combine this with sleeping underneath the stars in idyllic locations. Some of the key features of this trek include –
Multiples of River Crossings and boulder patches
An extremely thrilling addition, setting this unknown trek apart from most, is the multiples of river crossings! Throughout our journey, you’ll cross many a wooden bridge, with the Miyar river flowing beneath you in full force. Now if that is not a feeling of full living, I don’t know what is! There are two sections, in particular, where there are no bridges – you’ll be crossing the river itself. Not to fret, it is manageable, just keep your wits about you!
Rare Mountain Views
Since not many people are aware of the , even in the trekkers’ circle, a lot of the views are uncaptured still. Rarely seen mountains such as the Menthosa Peak, Tharang I, II, III and the castle peak will be your accompaniments.
Best time to visit Miyar Valley
June to October is the best time to visit the area and embark upon the trek. The weather is supportive, the journey is easier and you’ll have access to more of the area. Winter months are a no-go as the entire region is covered in a thick blanket of snow.
The Route for Miyar Valley Trek
The route is scenic and will take you through some stunning routes. In essence, you’ll be covering the following journey.
Day 1: Drive from Manali (6,725 ft.) to Udaipur (9000 ft.) Distance – 110 Kms, Total Time taken – 3 hours (via Atal Tunnel) Acclimatization Day.
Day 2: Drive from Udaipur (9000 ft.) to Shukto. Trek to Doksa (12080 ft.) Drive Distance – 22 km, Time Taken- 50 minutes, Trek Distance – 2 km, time taken – 1.5 hours
Day 3: Doksa (12080 ft.) to Yoling (12,388 ft.) Trek distance: 7.5 km, Time Taken – 5 hours
Day 4: Yoling (12,388 ft.) to Zardong (12,782 ft.) Trek distance – 12 km, time taken – 6-7 hours
Day 5: Zardong (12,782 ft.) to Phalpu (13,008 ft.) Trek distance – 7 km, time taken – 3-4 hours
Day 6: Phalpu (13,008 ft.) to Gumba (12,732 ft.) via Miyar glacier snout (14,599 ft.) Trek distance – 15 km, Time taken – 7-8 hours
Day 7: Gumba (12,732 ft.) to Doksa (12080 ft.) Trek distance – 12 km, Time taken – 7-8 hours
Day 8: Doksa (12080 ft.) to Shukto (11400 ft.). Drive from Shukto to Manali Trek distance – 2 km, Time taken – 1 hour, Drive distance: 150 km, time taken – 5 hours
Day 9: Return home!
Detailed Itinerary for Miyar Valley Trek
Combined with above, here’s a detailed description of what to expect when you’re out in the Miyar Valley!
Day 1: Reaching Udaipur from Manali
The journey is slightly modified now, thanks to the Atal Tunnel. I have covered an extensive guide on Lahaul Valley and important things to cover previously, so I will refrain from discussing the route too much. One thing I want to highlight here is that you’ll see a stark change in the terrain and landscapes as you cross the Atal Tunnel!
A beautiful highlight will, of course, be the Sissu waterfall. Also, Tandi is an important point in your trip to fill up on fuel. From Tandi, you’ll take the diversion towards Udaipur.
Spend the night in Udaipur, acclimatize and relax. Enjoy the thrilling joy of being in a secluded valley!
Day 2: Head towards Shukto, then trek to Doksa
Shukto is the last stop on road. Once you reach Shukto, you’re starting your journey off in earnest! From the village, you’ll cross a suspension bridge to enter the village of Kanjer, roughly 30 Kms from Udaipur. This village will mesmerize you no bounds. With cultivation only occurring from June to September, you’ll be awed by the sheer will and hard work of the villagers. Crops include – iceberg lettuce, seed potatoes, apples, sea buckthorns, cauliflowers, barley, asafetida, and some medicinal plants including Kuth (Saucerrea lappa), mannu (Innu Racemosa).
After you cross the village, your trail will take you through many a farms all the way up to your first campsite on the journey – Doksa. This place is a slice of heaven. What’s wonderful is coming across the meadow-cum-cricket-field that is often used by locals. The mountains are also particularly disposed to rock-climbers, given the steep rock-faces. Spend the night here, where your view includes staring in Menthosa – the second highest peak of Lahaul and the crown of Miyar Valley!
Day 3: Journey on to Yoling
The trail today will take you through multiple villages and farms. You get to cross a river bridge as well! Initially you’ll descend and get to the bridge. After these, a series of descends and ascends takes you through a well-defined path. You’ll be crossing a Stupa today, for which the climb might be steeper, but only for about half an hour. After you cross the Stupa you’re in Thanpattan. From here on out, you’ll be on fairly easy trekking, with flat meadows surrounded by stunning views.
Today’s journey is stunning, with multiple sections of stunning flowers, all of different hues. Particularly beautiful is the path post Tharang massif where you’ll spot a beautiful growth of purple flowers – aka Lupins!
Your stay for the night is Yoling, which has a water crossing nearby, adding to the eclectic charm. I hope you get a clear evening when here- because the sunsets just paint different colors across the mountains for hours on end!
Day 4: Head on to Zardong
About 7 Kms of overall distance to be covered today, with a very level walk and then a steep climb for about half hour. Today you’ll be experiencing an undulating boulder section, followed by an open valley with the views of Miyar River!
The day, overall, is a bit challenging, though, it starts off easy. After a levelled walk of about 15 minutes, you will be descending for the same time to reach a bridge. Upon crossing the bridge, there is a steep climb to reach the Gompa. A little way ahead, you’ll come across a hut, very close to the Gompa lake. Fill up your water supplies here. After the shepherd’s hut, you will be descending to some respite of a flat meadow patch.
But, the route ahead has some trickiness, requiring presence of mind. You reach a section of boulders, which will take you through multiples of ascends and descends, walking over edges in certain places. This particular patch is tiring, for sure. Eventually, you’ll reach the river, which feels like a well-earned, well deserved ease! Almost beach like with sandy shores of the river, and walking right along the gushing water – you’ll be making headway into the valley. The more you walk, the wider the river gets, majestic it becomes! To add beauty atop exquisiteness – you’ll be blessed with bountiful of flowers
Sleeping at the most exquisite campsites
The entire day will have you surrounded by flowers abound! The gradient change is not too heavy on the body and you’ll be ascending gradually throughout the day. The carpet of flower, however, will be a definite headline and a memory you won’t soon forget! Enroute today, you’ll be crossing the Gumba Nala, from where you’ll continue to follow the Miyar Nalla (by taking a north-west turn). Home for the night is Zardung – another show-stopper campsite. I can’t say this enough, but, the night skies from here will not let you sleep and you will be in a Zen-like stance for most of the night! The entire day, the colors, the visuals and the experience in itself is enough to leave even the most accomplished Yogis spellbound!
Day 5: Move from the stunning beauty of Zardong to Phalpu
Covering a mighty distance of 15 KMs today, the trail, thankfully, is a level walk by the steam. However, you will be crossing a few patches with many massive boulders. One of the most iconic places enroute today is Chhudong, which is a massive meadow. And, to top off the beauty – this patch is right next to the river. Though the day is long and never-ending, I would definitely spend some time here, soak in the views and remember the moment of belonging! The river in itself, is wider than anywhere else on the trek and the feeling is especially restful!
Due to the active river running right through the valley, the easiest route for this trek is alongside the river itself. This makes the route well-marked and easily noticeable – keeping you fairly safe! After you’ve had your fill of your heart’s desire of Chhudong, the gorge embraces you through boulder reinforcements. Subsequently, you’ll be on flatter grounds again and begin your rendezvous with the river! This will again be followed by a tiring journey through the boulders with an added challenge of some water streams. Your home for the night is Phalpu, located near Castle peak. Another very beautiful campsite with some gorgeous views of Tharang Peaks as well as the Menthosa peak.
Day 6: Phalpu to Gumba via Miyar glacier snout
The day is finally here, you’ll be touching the glacier snout! The journey is a bit laborious and moderately difficult, though, not unmanageable. After about 5 days of walking deep in the hills, you’ll be well prepared for the route. Key highlights include crossing 3 icy-cold river crossings along with the now staple patches of boulders.
Covering a total distance of 12 Kms is still mammoth. Though, not as challenging as your previous day on the trail, this is the epitome of your journey! After you get to the snout, I highly recommend spending quality time here to marvel at the stunning beauty of being in the vicinity of a glacier, with almost no one around. The last meadow on your journey is located about 30 minutes from the snout, near the seven icy ponds – Kesar Yon Chu. This is also the spot where the glacier begins.
Your return is from the same route, whereupon you’ll be crossing two more river crossings. Post Chhudong, you’ll touch a tricky spot with multiple boulders to manage. Then you reach your final campsite for the journey. Your vantage point today allows you views of both sides of the valley. Pure bliss.
Day 7: Gumba to Doksa
The return journey has finally begun. The end of a trek is usually so bittersweet. It is akin to gaining so much, yet not having absorbed all the changes in you, all the additions! Yet, the feeling of leaving a part of you behind is so strong!
The journey is quite dramatic today and it will definitely be easier and you’ll be in a trance like state for the most part! Enjoy your final night at Doksa.
Day 8: Doksa to Shukto. Drive from Shukto to Manali
Only 2 KMs on foot and you’re back in Shukto. From here, head on back to Manali and enjoy re-adjusting to being surrounded by civilization!
I highly recommend keeping a buffer day (or two) handy. This can come in handy if the weather is not that great for you to embark on a leg of your trek. If not used, you can always enjoy spending a couple of days at the end of the trip in Manali and enjoy all it has to offer.
The trek can be done solo. The route is fairly well defined. However, this is only so for seasoned trekkers with an exceptional understanding of routes and paths in the Himalayas. If you’re new to the hills, I highly recommend getting a local guide to accompany you. Also, this is especially helpful to ensure you have access to sufficient food and supplies.
There is no electricity throughout the trek, obviously! The only place you’ll find a plug to charge your phone or camera batteries will be Udaipur (in Himachal Pradesh) before and after the trek. So, use your electronic equipment wisely! Do remember, the batteries drain faster in colder weather! Keep backup banks!
It is hard to imagine a place so untouched by humans. With no one around, there is a sense of belonging that not many have felt before. As a lover of the hills, I can’t tell you of the sheer joy you’ll experience in this valley.
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This gentle and easy yoga class is perfect for anyone that has suffered from back pain and is looking to strengthen and stretch the lower and upper areas of their back. A rehabilitating yoga class that mixes strengthening exercises and gentle stretches that will help you along the journey of maintaining a healthy spine.
Make sure to listen to your body throughout this class. Never pushing through any pain in the back, and if you have suffered through any severe spinal injuries please advise with your doctor first if you’re ready to incorporate yoga as part of your rehabilitation process.
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What is Benign Prostatic Hyperplasia (BPH) or prostate adenoma?
Benign Prostatic Hyperplasia (or prostate adenoma) is the non-malignant growth of prostate tissue that occurs in middle-aged men onwards. In a young individual, the prostate gland is rudimentary, almost undetectable, and spreads like a cluster of seeds over the lining of the urinary tract. However, at puberty, this anatomy begins to change due to the high production of the hormones testosterone and dihydrotestosterone, explains the Best Urologist in Delhi.
Testosterone causes “seeds”, called acini, to germinate and grow. Thus, in adult life, and due to their growth and proliferation, these small glandular structures can cause obstructive symptoms associated with urinary flow disorders.
Benign Prostate Hyperplasia is one of the most common diseases in men and is considered part of the physiological aging process. The incidence of this disease is 51% in men 60 to 69 years of age and 75 to 90% in the eighth decade, says the Best Urologist in Delhi.
Although the concept of BPH encompasses an enlarged prostate and mechanical obstruction to voiding flow, there is not always a direct relationship between the volume of hyperplasia and the intensity of symptoms. Very enlarged prostates may not cause symptoms and minor ones can be a source of intense discomfort, explains the Urologist in Delhi.
The symptoms of Benign Prostate Hyperplasia can be divided into obstructive and irritative.
Weak and / or intermittent urine flow.
Decrease in the force and calibre of urine.
Feeling of incomplete emptying of the bladder.
Double urination (urinating a second time in a 2-hour period).
Post void drip.
Difficulty or delay in starting urination.
Polyakiuria, or increased frequency with which you urinate.
Nocturia, or the need to urinate frequently at night.
Urge urinary incontinence.
Causes of benign prostate hyperplasia
Prostate hyperplasia is related to age, so that over 80 years of age, 9 out of 10 men have it, and may or may not produce symptoms depending on the magnitude of their growth, says the Urologist in Delhi.
How is benign prostate hyperplasia diagnosed?
Although prostate hyperplasia is a benign disease, in the presence of symptoms such as those mentioned in the previous section, prostate cancer must always be ruled out. To do this, it is necessary to perform a digital rectal examination, determine the concentration of PSA (prostate specific antigen) in a blood test, and perform an ultrasound of the prostate, says the Kidney Specialist in Pitampura.
In those cases where the PSA value is high, it is necessary to perform a prostate biopsy. The biopsy is done transrectally, that is, inserting a needle into the anus and puncturing through the rectum. For this, the biopsy is guided by rectal ultrasound.
An ultrasound probe is inserted through the anus and several biopsies are obtained with a fine needle. About 6 biopsies are usually obtained so as not to leave any area of the prostate without evaluating, explains the Urologist in Delhi.
What care does it require?
Patients with this disease require periodic check-ups to assess the possibility of developing cancer. However, having benign prostatic hyperplasia does not imply that there is a higher risk of developing cancer.
How to treat benign prostate hyperplasia?
Early diagnosis of Benign Prostate Hyperplasia is essential to avoid complications such as urinary tract infections, kidney or bladder damage, bladder stones, or incontinence.
The possible existence of these secondary processes derived from urinary obstruction, together with the degree of discomfort of the patient, will determine the treatment against BPH.
The indications for Prostate treatment in Rohini, depends on the discomfort that the disease is producing. These discomforts are generally related to difficulty urinating, subsequent dripping and the permanent feeling of wanting to urinate, mainly at night. If there are no discomforts, no treatment is indicated, says the Kidney Specialist in Pitampura.
5α reductase inhibitors. These drugs block the effect of male sex hormones (androgens) on the prostate, which prevents it from continuing to grow and even favours its reduction in size, with subsequent improvement in symptoms. A typical drug in this group is finasteride.
Α-adrenergic blockers. They relax the urethra and facilitate urine output. They do not modify the evolution of the disease or the size of the prostate. Drugs in this group are doxazosin, tamsulosin, and terazosin.
The prostate surgery in Rohini involves removing the prostate, which is called a prostatectomy. Prostatectomy can be done through the urethra (transurethral route) or by opening the abdomen and directly accessing the pelvis. The decision to perform one technique or another depends on the size of the prostate, the patient’s health status and their preferences.
The most used are transurethral resection techniques. These techniques are done through the urethra (the hole in the penis where urine comes out) and can be done with general anaesthesia, spinal anaesthesia, or epidural anaesthesia (leaving the lower half of the body asleep after puncturing the anaesthesia in the spine) or with local anaesthesia and sedation. There are different ways to remove the prostate transurethrally:
Prostate Urethral Lift (PUL): This procedure uses permanent implants to lift and keep enlarged prostate tissue out of the way, so it no longer blocks the urethra.
Transurethral resection of the prostate (TURP): This procedure involves the use of a heated wire to cut the prostate tissue and has been used for years to treat an enlarged prostate.
Transurethral Incision of the Prostate (TUIP): One or two small cuts are made in the prostate gland, making it easier for urine to pass through the urethra.
Transurethral Microwave Thermotherapy (TUMT): Microwave energy from the electrode destroys the inner portion of the enlarged prostate gland, reducing it and facilitating the flow of urine.
Transurethral needle ablation (TUNA): An endoscope is passed into the urethra to place needles into the prostate gland. Radio waves pass through the needles, heating and destroying excess prostate tissue that blocks the flow of urine.
Ready to start using your air fryer for breakfast? Today I’ll show you 10 different ways you can whip up breakfast in your air fryer!
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① Breakfast Bowl
Preheat air fryer. Add 5-6 chicken nuggets and 10ish frozen tater tots and cook at 400F/200C for 6 minutes. Whisk 4 eggs and 1/4 cup milk together then chop up chicken and tots into bite sized pieces. Pour into lightly greased 7″ cake barrel (or any air fryer safe dish) and air fry for 7 minutes at 350F/176C. Stir up eggs and cook for 3-4 minutes more. Top with shredded cheese and cook for 1 more minute to melt cheese.
② Air Fryer Bacon and Sausage
place bacon and sausage in air fryer and cook at 320F/160C for 8 minutes, flip bacon, and cook for an additional 5 minutes at 370F/187C. To clean up bacon grease, let it cool and harden, then wipe out with a paper towel.
③ Eggs in a Hole
Preheat air fryer. Lightly spray 2 slices of bread and use a cup or cookie cutter to cut a hole from the center. Place parchment paper in basket (AFTER preheating) and lay bread over the top. Crack an egg and drop into bread hole. Lightly season with salt, peper, fresh thyme, and other desired toppings. Air Fry for 6-7 minutes at 330F/165F. Then carefully flip the toast/egg to crisp up other side and cook for an additional 2-5 minutes, depending on how done you prefer your eggs.
④ Air Fryer Bagels
Find full recipe here:
⑤ Sausage Balls
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⑥ Breakfast Egg Bake
Mix in your faves in a greased 6-8oz ramekin dish. Bake 350˚F/175˚C for approx 15 minutes, stirring 2x PRINT:
⑦ Hashbrowns – 400F/200C for 8 minutes, flipping 1x half way through.
⑧ French Toast Sticks
Dry bread out at 350˚F/175˚C for 2 minutes. Batter breadsticks and cook at 350˚F/175˚C degrees for 8 minutes, flipping the sticks halfway through.
Sausage (I decased 4 links) – cook in air fryer for 3 min @ 350f/176c then 3 more minutes @ 370f/187c. Steam about 3 ounces spinach in microwave & 1 tablespoon water for two minutes in microwave (covered). small handful of your favorite cheese(s)
1/3 cup milk added to 3-4 beaten eggs with a 1/4 teaspoon salt & dash of pepper, pinch of nutmeg. Place cooked sausage on air fryer pan (approx 7″ wide), then top with spinach & cheese. Mix up eggs, milk, & seasonings & pour on top of sausage/spinach/chs.
Cook at for 350f/176c for 12 minutes or until toothpick comes out clean
⑩ Air Fryer Eggs
Preheat 270F/132C for 5 minutes.
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0:00 Air Fryer Breakfast Ideas
0:24 Breakfast Bowl
1:50 Air Fryer Bacon and Sausage
2:59 Eggs in a Hole
4:41 Air Fryer Bagels
7:07 Sausage Balls
7:57 Breakfast Egg Bake
9:08 French Toast Sticks
11:03 Crustless Quiche
13:02 Air Fryer Eggs
If you feel pain in your joints, it may be due to osteoarthritis. But, to clear up any doubts, perhaps the time has come to look for the best rheumatologist in Delhi. Rheumatologists are the specialists in charge of treating this and other diseases of the bones and muscles.
Osteoarthritis is a painful joint disease that is frequently disabling and affects more than 10% of the population in our country. In fact, although it is believed to be a pathology related to the elderly, the reality is that more and more people are suffering from osteoarthritis problems in India. This ailment affects the joints, as a consequence of the progressive wear of the cartilage located at the beginning or at the end of the bones. Therefore, age is an obvious risk factor for the development of osteoarthritis. But not the only one.
There are genetic factors that are transmitted between descendants. That is, if your father, your mother or your grandparents have suffered this disease, you run a greater risk of having it at some point in your life. Sex —although it occurs in both men and women, it tends to appear earlier in them— and, especially, being overweight, are elements that powerfully influence their condition.
Given that bone wear is the cause that produces it, the passage of time and the effort that is required on the bones, to bear the additional load that an excessive weight produces, accelerate this deterioration and generate, much earlier, swelling, pain and reduced mobility in the joints that characterize this problem.
The appearance of this ailment can degenerate into a deformation of these parts of the body. Therefore, and given that prevention is the only effective way to combat it, it is essential to anticipate and detect the risk of suffering it as soon as possible, to apply palliative remedies as soon as possible.
Organs involved in rheumatic diseases
Surely you know that a rheumatologist in Delhi is the professional who treats diseases that affect the joints, resulting in inflammation and pain and requiring treatment. However, there are several pathologies of this nature that also involve very disparate organs.
Therefore, a rheumatologist in Delhi is not limited to comprehensive examinations to take care of your skeleton. If you go for the joint pain treatment in Delhi, it is most likely that, depending on your case, the rheumatologist will be interested in evaluating other aspects of your health. Autoimmune diseases make up a large group with more than 200 clinical entities. The common denominator of most of the diseases grouped in this category is the alteration of the immune system. As a consequence, the defense mechanisms that the body’s foreign molecules and cells should fight back against your tissues, inflaming and injuring them.
It is not uncommon for some of them to affect the tissues of the eye, triggering what is called uveitis. At the level of the cardiovascular system, these conditions can lead to injuries to the heart valves, the inner lining of the arteries or the pericardium, a fibrous tunic that surrounds the heart, causing pericarditis. In all these cases, you can also suffer from arteriosclerosis, which leads to premature coronary disease.
Another organ that is often damaged is the liver, which can suffer from autoimmune hepatitis exclusively related to this organ. It can also be damaged by a clinical entity such as lupus, which is generalized. Other organs that are involved in the evolution of several of these diseases are the pancreas, kidneys, skin and the membrane that covers the lungs, generating pleurisy, explains the rheumatologist in Delhi.
Symptoms of osteoarthritis
Osteoarthritis is one of the most common degenerative diseases affecting a large number of the population. The symptoms appear and are noticed little by little and with the passage of the years they increase. For this reason, it is very important that at the first signs and problems of osteoarthritis you go to consult a specialized rheumatologist in Delhi who will analyze your situation, determine the degree of osteoarthritis and decide on the best possible treatment.
At the beginning, osteoarthritis always manifests itself with pain, since when moving the joints the patient experiences discomfort, such as an uncomfortable pinch that prevents him from flexing with normality and customary functionality. Suddenly, something as normal as getting up from a sofa, reaching for a saucepan of water or simply getting out of bed becomes a problem because of the pain they cause. The joints that suffer the most from this disease are the hip, knee and hands.
Most of the patients who go to a joint pain specialist in Delhi to treat their osteoarthritis problems, they complain that staying in the same position for a long time, for example, going to the movies, taking a car trip or at bedtime, becomes an ordeal. Pain is often accompanied by swelling and numbness. Thus, patients with osteoarthritis usually notice the affected parts more swollen and more rigid. Sometimes when osteoarthritis is very advanced, the fingers or the affected joint begin to deform.
It is very important that, if you think you may suffer from osteoarthritis, at the first symptoms you go to a top rheumatologist in Delhi.
Causes of osteoarthritis
First of all, it must be clarified that the word osteoarthritis designates a disease caused by the wear and tear of the joints, which leads to inflammation, pain and inability to carry out certain tasks or even move in a general way. It is a chronic disease that affects all joints from the cartilage to the synovium. Likewise, osteoarthritis doctors in Delhi will tell you that you should not confuse osteoarthritis with arthritis, as this is nothing more than an inflammation of the joints, explains the rheumatologist in Delhi.
But what are the causes of osteoarthritis? Not only age influences, but also genetics, overweight, some diseases and the overload of the affected areas. At the beginning of the disease, the joints suffer pain due to one of the aforementioned causes, which, over time, causes dehydration, causing inflammation that ends with the degeneration of cartilage. This destruction causes friction between the bones causing their final wear.
The growth of this pathology in younger and younger people has alerted specialists. This increase in injuries to the locomotor system is due to the increase in the practice of sport in a massive way in recent times. The impact that athletes exert on their body often causes wear and tear on the joints that evolves into acute or chronic pain if we do not treat it in time. If this pathology is uncomfortable and painful in general, in the case of athletes it is aggravated by being limiting and disabling in their sporting exercise and even in their daily life. The disease affects more females than males. In addition, there is a tendency to mistakenly think that it is a disease of the elderly and that it has no cure, says the rheumatologist in Delhi.
Treatment of osteoarthritis
Treatments to relieve symptoms range from anti-inflammatory drugs to a series of physical exercises through physical therapy. In the most serious cases, an operation should be performed to avoid incapacitation of the patient.
Also, you can follow some tips that will ease your pain. For example, exercise moderately, use insoles, canes or shoes with soft and thick soles so that the joints rest better, eat a balanced diet and, when you feel pain, apply heat to the area.
The important thing, above all, is to receive adequate treatment early. So, if you feel pain in any of your joints, it is best to receive the opinion of a specialist rheumatologist in Delhi.
The rheumatologist in Delhi can make a proper diagnosis and indicate the best treatment to follow, if necessary. Likewise, he will give you some indications to alleviate those symptoms of pain or stiffness, so annoying in this type of disease.
Sex is the most important and vital part of a couple. It’s a wonderful moment that fun has to be complete. If this does not happen and the person does not enjoy it, it will cause problems for the couple.
Given this, it is important to seek help as soon as possible to prevent such problems from ending the relationship. However, there are many people who have difficulty realizing that they have a sexual problem and do not want to go to a sex therapist.
A sex specialist in Delhishould be a priority when relationships are at risk due to sexual intercourse with a partner. If pleasure is replaced by problems and worries, there is something wrong and a solution must be found as soon as possible. Here are some of the reasons why it’s important to go to a sexologist doctor in Delhi:
Remember that the moment you have sex with your partner should be fun, so if you have any of the problems described above, you should immediately go to the best sexologist in Delhi, India who can help solve such a problem.
There are some cases where it is advisable to contact a specialist:
Doubts about different forms of contraception.
Common symptoms of sexually transmitted infections.
Today and even though you are in the XXI century, there are still many people who are reluctant to go to a consultation with a sexologist in Delhi. However, going to a specialist is the key to being able to speak openly without any problems with the sexual problem that the person may have.
The best sexologist in Delhi must always ask what the cause of the sexual problem is. From here, the top sexologist in Delhi will have to put in place other strategies to help solve the problem. The number of programs will always depend on the type of problem to be treated and the individual’s participation. With the right sex treatment in Delhi the problem should disappear and make sex more enjoyable for couples.
In short, going to a sexologist in Delhi is an issue that needs to be overcome. Today there are many men and women who find it difficult to believe that they have a sexual problem and it is not easy for them to talk about something intimately with someone they do not know. Home sex education is inadequate or desirable, which is a bad thing when it comes to talking openly about sex. Therefore, it is important to know that a sexologist in Delhi is a professional who will help solve a problem that may be at risk for your partner.