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Did I just step on a nail? The pain in the sole of the foot

The Kashmir Monitor





By Kamal Singh

Completing a half marathon was always on Tanvi’s bucket list. When her doctor told her that she needed to start an exercise program, Tanvi plunged into the running lifestyle, bought the latest running shoes etc. Everything was going fine till she started to get a dull ache in the sole of her left foot, first thing in the morning. She ignored the pain and continued her running. Then one morning she woke up and tried standing up, the pain was so sharp that she thought she had stepped on a nail. She nixed the idea of her morning run as she could barely walk. She was better by the afternoon, but she did go see her doctor.

The diagnosis


The doctor examined her and said she had a case of Plantar fasciitis. The foot has a thick band of fibrous tissue, which extends from the heel to the toes. This band can get overstretched, inflamed and develop tiny tears, leading to pain and tenderness. The pain could be worse in the morning, or if standing for too long. Runners are particularly prone to Plantar Fasciitis if they suddenly up their mileage, or buy new shoes and simultaneously up their mileage. Amongst the inactive population, overweight middle-aged women are most likely to develop Plantar Fasciitis.

Possible Causes of Plantar Fasciitis

•Sudden increase in bodyweight. This would be a no-brainer as most of the increase in bodyweight directly affects the lower extremities.

•Sudden increase in activity. Runners and walkers increasing their mileage abruptly in a desire to quickly achieve their fitness goals. This is especially true of the new over-enthusiastic runner, who wants to go from couch to a marathon in a month!

•Calf muscles becoming stiff and tight. This can be the result of wearing high heels.

•People with flat feet or high arches are also at risk for developing Plantar fasciitis.

The cure – prevention

•Keep your bodyweight in check! Keeping bodyweight down has a positive impact on almost all aspects of a person’s life.

•We need to learn to hurry slowly with our fitness programs. You cannot improve your fitness over night by doing more. This usually leads to overuse issues. I highly recommend joining a running club if you intend pursuing running as your preferred activity. Most of these clubs have members who have running for a long time and they can easily guide the newbie.

Stretch and strengthen

•Foam roll the calf muscles.

•Stretch the calf muscles.

•Toe stretch and massage for the sole of the affected foot eases Plantar Fasciitis quickly. Sit with with your affected foot on the other knee. With one hand pull the toes back. Hold this stretch for 15 seconds. While doing the stretch, massage the sole of the foot. Do the toe stretch and massage for 10 repetitions. Do this three times in a day, till the pain goes away.

Plantar fasciitis can be resistant to treatment and can lead to loss of training days for the active person. Thus in this case prevention is definitely better than cure. So if starting a running get assessed by a competent physiotherapist and get a running program from a seasoned coach.

(A strength and conditioning coach for the last 15 years, Kamal Singh, CSCS, specialises in post rehabilitation training and functional training.)

Courtesy Hindustan Times



Hepatitis A Causes and Symptoms

The Kashmir Monitor



Generally speaking, hepatitis A is more common in parts of the planet that are developing. It’s for the fact that sanitation and food handling practices are by and large poor. However, medical experts say that living in developed countries can also put you at risk of having hepatitis A, but it’s really a rare occurrence.

Just like what’s mentioned earlier, hepatitis A is caused by the hepatitis A virus or HAV. It can be spread around by someone who has hepatitis A because he or she is a carrier of the virus behind it. It is said that a person with hepatitis A is most infectious about 2 weeks before he or she begins to experience signs and symptoms.

Here are some of the ways that hepatitis A is spread around:


Consumption of food that is prepared by a person who has hepatitis A. This is most especially true if he or she has not properly washed his or her hands.

Drinking of water that is contaminated with the hepatitis A virus.

Intake of raw or undercooked seafood obtained from contaminated water.

Close contact with someone who has hepatitis A. This includes having sexual intercourse with an infected person, especially when the rectal or anal area has been touched with the fingers, mouth or tongue.

Using illegal drugs, especially when paraphernalia contaminated with the hepatitis A virus are used.


Medical experts say that it may take a while before the various signs and symptoms associated with hepatitis A show up. They say that someone may experience them about 4 weeks after getting infected. It’s even possible for someone with hepatitis A to not experience any sign and symptom at all.

Some of the initial signs and symptoms of hepatitis A include:

Tiredness and malaise
Achy muscles and joints
Pain in the upper right section of the abdomen
Loss of appetite
Mild fever
Sore throat
Diarrhea or constipation
Hives or raised rash that’s itchy

These initial signs and symptoms associated with hepatitis A can last anywhere from a few days only to a couple of weeks. Afterwards, as the infection of the liver progresses, the following may be experienced by the individual:

Jaundice, which is the yellowing of the skin as well as the whites of the eyes (sclera)

Pale colored stools
Dark colored urine
Skin itching

Tenderness and swelling of the upper right section of the abdomen

Although it rarely happens, hepatitis A can cause liver failure. When such develops, the person who is infected may experience severe vomiting, frequent bruising, bleeding of the nose and gums, drowsiness and confusion.

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Busting myths around blood donation

The Kashmir Monitor



As per the World Health Organisation (WHO) norms, ideally, one per cent of the total population should regularly donate blood to meet the requirements, which is anywhere between 1% and 3% of country’s population that would require blood in a year.

Contrary to the myth about blood donations making a person weak or anaemic, the body replenishes the lost blood in a matter of a few days, say experts.

“A healthy bone marrow makes a constant supply of red cells, plasma and platelets, so there is no question of becoming weak, much less anaemic. It is a myth and should not deter people from donating blood,” says Dr RK Singal, chairman, internal medicine department, BLK super-speciality Hospital.


The donors can give either whole blood or specific blood components, as there is sophisticated equipment available these days that extract relevant components from blood and the rest of the blood can be transfused back to the donor.

As per the World Health Organisation (WHO) norms, ideally, one per cent of the total population should regularly donate blood to meet the requirements, which is anywhere between 1% and 3% of country’s population that would require blood in a year.

About 65% of India’s population is young and if this section donates blood regularly, chances of the country facing blood shortage will be remote. Hence, there is all the more reason for people, especially youngsters, to come forward and be regular blood donors.

How to prepare

Have enough fruit juice and water in the night and morning before you donate

Have a full meal 3 hours before donation; never on an empty stomach

Have some rest for about 10-15 minutes after donation

Have some snacks or a juice with high sugar content after donation

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Erectile dysfunction’s connection with lifestyle

The Kashmir Monitor



By Dr Anjani Kumar Agrawal

healthy-lifestyle-can-reverse-effects-of-hypertensionAll over the world, but perhaps more so in India, men are embarrassed to admit that they may have a problem getting or keeping an erection — a condition known as erectile dysfunction (ED).

All over the world, but perhaps more so in India, men are embarrassed to admit that they may have a problem getting or keeping an erection — a condition known as erectile dysfunction (ED). From my research, I have found a strong link between ED and stress. Other major causes include smoking, drinking, diabetes, hypertension or high blood pressure and cholesterol levels. My advice to these patients is — do not get even more stressed over this situation. Instead, focus on taking the right medication and making some changes to your lifestyle, so you can once again enjoy a satisfactory sexual life.



We normally diagnose ED and its underlying causes by asking the patient a few questions about his medical and sexual history. This is sometimes done by sharing a questionnaire with the patient. The questions that we ask are designed to help us understand the cause of ED in the particular patient.

We also do a physical exam, ask for certain blood tests to rule out other medical conditions responsible for erectile dysfunction, and recommend imaging tests (if required) to determine whether the person is physically able to have an erection or not.


Underlying medical conditions such as diabetes, hypertension and hypercholesterolaemia (high cholesterol levels) can cause ED. In these cases, ED can be reversed once the patient starts treatment.

In my experience, many men suffer from ED because of work stress, family pressure and anxiety. So, changes in lifestyle with regular exercise, yoga, abstaining from alcohol and smoking, and proper counselling help in treating ED. Along with this, medicines for ED are usually prescribed for about 3 to 6 months by which time lifestyle changes start to take effect and the patient is physically and mentally healthier, which helps resolve the problem.

An estimated 16% to 25% of men experience ED at some point in their lives. I would urge them not to be embarrassed about it. Seek medical help from a urologist or andrologist; get the necessary advice/medication; and go on to enjoy a healthy, fulfilling sexual life.

The author of this article is Dr Anjani Kumar Agrawal, head, andrology, department of urology sciences, Max Smart Super Speciality Hospital, Saket

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