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Gallbladder Stones: Symptoms, Causes And Risks






The little pear-shaped organ close to your liver really has an important role to play. It releases the bile pigment which helps in breaking your food down and digesting it, particularly fats. When the deposits of this fluid harden inside your gallbladder, they lead to the formation of gallstones. These stones can be as small as the size of sand-grain or as large as a golf ball. Some people may develop only one stone and some may develop too many. Usually, these stones are not harmful but in some cases they may block the passage of bile from the bladder, thereby causing inflammation and pain. This is when a gallbladder removal surgery is required. But before we proceed to that, it is important to note some signs, symptoms, causes, and risks posed by gallstones. Take a look.

Causes of gallstones

Experts are not very clear as to what causes gallstones. However, they say that the following are the major causes of gallstones.

  1. Too much cholesterol in bile

Normally, the bile has enough chemicals to dissolve the cholesterol excreted by your liver. But sometimes the liver produces too much cholesterol which cannot be broken down by bile. This extra cholesterol forms crystals and stays in your liver in the form of gallstones.

  1. Excess bilirubin in bile

When your body breaks down red blood cells, it produces bilirubin. It could be due to cirrhosis, blood disorders or biliary tract infections. This extra bilirubin may contribute to the formation of gallstones.

  1. Gallbladder is not emptying properly

When your gallbladder fails to empty properly, then bile can remain there in concentration. This can result in the formation of gallstones.

Signs and symptoms of gallstones

If the gallstones are not serious, they will not show many signs and symptoms. However, if they block the passage of the bladder, they may show symptoms like:

Intense pain in the upper part of your abdomenIntense pain in the centre of the abdomen, below the breast bonePain between shoulder bladesNauseaVomitingPain in right shoulderThe pain could be anything; from mild to severe. It could last for a few minutes to hours.

When should you see a doctor?

Certain signs and symptoms could be something you need to worry about. They could indicate a serious gallstone condition. These symptoms include:

Excruciating abdominal pain which makes it hard for you to sit comfortablyHigh feverChillsYellowing of skin and eyes
Gallstones can cause excruciating stomach ache

Risk factors for gallstones

Your diet and lifestyle have an impact on your risk of developing gallstones. These two are the controllable factors. However, there are some more uncontrollable risk factors for it. Broadly, the risk factors include:

ObesityEating a diet high in terms of fats and carbsDiabetes mellitusRapid weight loss in short period of timeFamily historyGender (women are at a higher risk of gallstones)Age (above 60)CirrhosisPregnancyHigh estrogen medicationCholesterol-lowering medication

However, you must not leave these medicines completely without your doctor’s approval.



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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June 2019
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