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Health & Wellness

Scalpel and intuition

Random notes on the surgical symphony that thrives on the cusp of intellect, instinct, and intuition.

Dr Vishal Rao



Scalpel has always been defined by science and never by intuition. If one broadly looks at the tenets and principles of surgery, the art and science of it have always been spoken about, but the role of intuition has not been emphasised much. In my formative student years, I used to hang around the vintage racks of my college library, in the archival section wherein outdated books were stored, nay dumped. The disregarded corridors led me to a unique treasure trove of archaic books and journals. The primary fuel of my offbeat voyage was the long list of unanswered questions to which some of my professors like Prof. Humbarwadi would ask me to consult these secluded corners of the old sections from time to time.

 I knew the answers were there to be found in history, if one cared to dig them out, like how in the Egyptian mythology where some of the secrets are believed to have been mummified. One of my great discoveries in the library was this brilliant book by Dr Milton T Edgerton called the ‘The Art of Surgical Technique’. Dr Edgerton was a renowned plastic surgeon and one of the founding professors at John Hopkins University. His book was a wealth of great insights, adorned with beautiful hand sketches by the author himself. This book spoke about the art and science of surgery while hinting at the role of intuition.

 The earliest editions of the books by another prolific surgeon Dr Hamilton Bailey were thankfully part of my curriculum. The newer editions have unfortunately focused only on the technological and clinical advancements, leaving out many profound questions posed by the original edition. Presumably, some authority at some point had taken the liberty to overlook certain truisms as having been dealt with and spoken about at length and hence omitted from the subsequent versions. Consequently, many beautiful aspects of art and intuition were disconnected from the science of it.

 As science evolves, there is a transition that happens, wherein many aspects of science are wrongly assumed to have lost their relevance for future generations. For instance, the first edition of ‘Harrison’s Principles of Internal Medicine’ had a beautiful elaboration by Dr Judah Folkman, Father of Angiogenesis, which was omitted in the subsequent editions. He alluded to the possibility of reaching a point in time when we can co-exist with our tumours. This would imply harmony, not conflict, between normal cells and cancer cells. The former would not be affected by the aftermath of the latter, and the latter would stop growing. In this first edition, Dr Folkman also put forth the theory that if we cut off the blood supply to the tumour, it will be paralysed, thereby losing the propensity to grow and spread further. Given the seminal significance of his words, the omission from subsequent versions was needless and heedless.   

 In the context of this loss in transition, I recall the amusing experiences of Stan Lee, creator of ‘Spiderman’, which he shared in a BBC Radio interview. His publisher had rejected the idea of a teenage Spiderman superhero calling it the ‘worst idea ever heard’. His hardcoded logic was simple: people hate spiders and teenagers can never be heroes, they can only play sidekicks. Lee was dejected and decided to give up on the idea with a fleeting tribute to Spiderman in the last issue of the loss-making ‘Amazing fantasy’ comic series. The spider superhero went on to become an instant hit, and it made the fading comic series a resounding bestseller. Needless to say, the publisher came back to say how much he always liked Spiderman as an idea, and the rest of course is history. Stan’s superhero was simple and likeable due to the inherent contradictions— a superhero with spider skills but inflicted with glaring insecurities: a child raised by his grandparents, bullied at school, and hugely awkward in the presence of the opposite gender. 

 Coming back to science, it is not often dictated by the stalwarts; at times, the business of it takes precedence, led by the need for market creation. These forces let go of what they presume as foregone conclusions or arguments no longer valid. This popular view disregards the fact that people need to know certain slices of history which provide a deep connection to the future. The intuition of science can be found as much in history as on the way forward. Art and intuition are extremely intermingled as they both have creativity in them, and science stands tall between them. We talk of science, and we talk of art, but we don’t often think about where they meet. Either our thoughts gravitate towards a ‘no’ or lean towards a ‘yes’ when it comes to acknowledging the power of intuition, but we are never able to strike a balance. In the whole spectrum of science, intuition has been largely sidelined.

 I was always drawn to the role of intuition in surgery. Although extremely difficult to define in verbal terms, I make a feeble attempt to put scientific intuition in perspective. We have always been taught about the importance of instruments and equipment, their designs, precision, and purpose; how they cut; how they retract a tissue; how a tumour is opened; how the surgical area is approached and accessed and the like. Of course, these are highly significant aspects beyond doubt integral to surgery. But in Milton’s book, the foreword began with gratitude to his wife, for the time she allotted him in the kitchen to learn some sewing skills. Elaborating on the art of surgery, he writes, “A surgeon needs to know his ten important instruments — his own fingers.”

 Today we talk of robots, machines and gadgets, but in the ultimate analysis, only these fingers are running the machines. Milton brings out the essence of science to underline the fact that fingers decide how the scalpel or retractor will be used. Milton’s words couldn’t have rung truer. These fingers, I feel, run a surgical symphony in the operating room. This aspect has to have an intuition to it, like how Mozart composed his music. Had Mozart followed a book and not his intuition, he would not have been Mozart today.

 All through my student and practice years, I have been instinctively driven towards unanswered questions like what exactly drives certain indications. Whenever I read about a surgical procedure, I always wonder what exactly drove the surgeon to adopt a particular technique on the operating table at a particular point in time. There are instances when the surgeon was reprimanded for the proposed choice of technique or approach, which must have perhaps been ahead of its times, and yet he backed his intuition. There would have been some strong reason for the surgeon’s conviction, which has to be something more than science.

 For instance, it was historically believed in the earliest scientific literature that a surgeon attempting thyroid surgery was playing with fire, and the errors he would commit in the surgery were unpardonable given the risk of torrential bleeding and even life. Today, it has become a lifesaving surgery with several instances of successful operations across the globe. Now, if the slice of history related to this bit is omitted from the annals of medicine, the whole context of surgical advancement is lost. What would have gone through the minds of the surgeons who dared to think different, risking their reputations in the event of adverse consequences, and how did they back themselves and their fingers – all of that would be lost in the missing notes. The very purpose driving the ambition would be lost. 

 For example, we always say we keep checking the calcium in the blood. We say calcification can occur in the body, which can cause certain conditions in the parathyroid gland. When this gland creates a tumour, we have been taught to perform a parathyroidectomy surgery if the condition is accompanied by hypercalcemia or excess calcification in the blood. What is intriguing is that we were never taught why calcium doesn’t calcify in the blood under normal circumstances. None of the books would answer that question. But this was addressed in the old books in the library.

 I remember one late evening at the library when the librarian, a kind-hearted, middle-aged lady, came to remind me that it was time to close the doors and put the lights off. I requested her to give me five more minutes as I was in the midst of poring over some invaluable information in the old racks. She conceded to my request but asked me a favour. She asked me to prescribe some medication for her chronic sinus headache. I asked her how she was so sure that it was a case of sinusitis. She told me she had been on medication for quite some time and knew her diagnosis well. Out of curiosity, I asked her how often she caught a common cold in a year, and when did she have it last? She promptly told me she had never had a common cold as far as she could remember.

 Her answer left me puzzled, and the next question I asked her on an impulse was whether she had any issues. She again replied in the negative and told me that she was infertile. Now, this was my first accidental but intuitive diagnosis of a condition called Immotile Cilia syndrome, wherein the little cilia nerves in our sinuses and elsewhere do not move, and this disorder is accompanied by infertility. I advised her to meet the physician for appropriate treatment.

 The moot point here was tapping into that particular aspect of intuition that paves the way for discovery and direction. You may have all the algorithms, but you need a peripheral intuition to set you on the right path. I remember a monk who once told me about the miracle of the healing touch or ‘kaiguna’ as we call it in Kannada. He told me that a physician or faith healer who wholeheartedly treats his or her patients gets innumerable blessings from the patients and their near and dear ones, which manifest themselves in the physician’s hands. This positive healing energy can’t ever be used for self-benefit, it can only be transferred to other patients undergoing treatment. This is like distributing your dividends to those in need. Mother Teresa was the epitome of this healing touch.

These healing hands, he said, are blessed with intuitive powers. I have no doubt in my mind that these powers guide the hands towards the right approaches and therapies. The universe helps you bring about a surgical symphony.

 The monk insisted that I touch each patient, even those at a stage of no return or inflicted with a supposedly incurable disease, as things could possibly turn for good amid all adverse circumstances. I got a first-hand experience of this truism many a time. Once during my ICU rounds, I encountered a patient who was recovering well but suffered a psychiatric spell all of a sudden during the wee hours of the morning. He turned violent and tried to physically harm those around him before falling unconscious out of breathlessness. I made it a point to touch him and in that touch, there was as much science as was an earnest plea to help me pass on the dividend of the healing touch. At the same time, I shared my helplessness with his wife, openly telling her about the futility of the treatment being extended to her husband. Both contradictory acts—one to the patient and the other to his wife—were guided by intuition, I did not initiate them, I was led to them.         

 The symphony I talk of is the symphony of nature. During the 2004 Tsumani wave, elephants, dolphins, dogs, deer, foxes, and rabbits got intuitive signals of the impending danger beforehand. Many among them could plan evasive action well in advance. Similarly, we need to balance the art and science of any discipline using our intuition. This intuition can only be found with purpose and love. One can define and refine intuition only when a deep sense of intent and benevolence is developed within. I call intuition a fusion of passion and compassion; the former is not to be confused with pride, and the latter is not to be confused with pity.

The writer is on the advisory of the Prime Minister‘s scientific team and heads the Karnataka health Covid task force.

We need to balance the art and science of any discipline using our intuition. This intuition can only be found with purpose and love. One can define and refine intuition only when a deep sense of intent and benevolence is developed within.

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Health & Wellness

Conducting an Internet Search For ‘Optical Shop Near Me?’ Get these 7 Pair Of Glasses Instead



Shopping for personal items be it apparel, or accessories has become increasingly accessible and easy with ecommerce websites that offer door-step delivery. You have the luxury of browsing through endless options, sizes, brands, colours and even styles from the comfort of your home. The extent to which online services have evolved can almost seem unfathomable to the casual shopper, especially when one talks about online shopping for eyeglasses.

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When you have eye care needs or might need to invest in new eyewear, you might search for ‘an optical shop near me’ to go to for an appointment, repair, or purchase. What if you had an option to look through endless options for eyewear and other eye care essentials, all from the comfort of your home? Instead of searching for ‘an optical shop near me’ you can through the range of eyewear offered by reputed brands like Titan on their website. To understand the kind of options and customizations you can have access to, let us go through the glasses below before you search for an ‘optical shop near me.’

The Classic Rectangles

Looking for “spectacles shop near me ”is a search that mostly ends in vain, where lack of trust and navigation difficulties can get in the way. Investing in this pair of glasses, however, can be a solution to your problems from the comfort of your home. The design of these glasses is the standard, and conventional rectangles which are meant to flatter most face shapes and not hinder any power needs for the eyesight requirements within the glasses.

The Daily Wayfarers

Before going online and searching for daily-wear ‘spectacles near me’, it always helps to look at options closer to home, on your mobile or desktop. This pair of Wayfarers is the symbol of simplicity with a spirited aura. While the spunk of a Wayfarer is more subdued in its eyeglass counterpart, it still retains its versatility when it comes to being donned diverse types of face shapes and genders. These glasses are great for a first time investment or purchase, as they are fit to flatter everyone.

The Round and Classy

Some eyeglasses wearers lean towards eccentric get classy designs when they look for a nearest optical shop, but their needs might be left unsatisfied as the places may have limited options for them to look through. These round and classy eyeglasses are available to be bought online, where your lenses can also be customised to your power requirements. These glasses are great for everyday looks, making you look like the chic and intellectual person you are.

Break Away in Grey

Navigators are rare finds, and one will most certainly not find this pair of grey navigators when they search for an ‘optical shop near me’. These glasses are exclusively for the adventurous and the disruptors, where they embody the spirit of thinking outside the box. These glasses are more angular when compared to most eyewear designs on the market, which makes them a perfect fit for those with round features and jawlines that can be balanced out with these eyeglasses.

Painted in Purple

Cateye lenses are often considered a ‘blind buy’ for most first-time customers when it comes to online ‘spectacles near me’, as they are one of the most universally flattering styles on women. The upswept look given by a good pair of Cateye eyeglasses is incomparable, as it can make you look youthful and chic at the same time. These glasses are a must-have for your eyewear collection, for your daily needs and slight makeovers when innovative designs become an eyesore. 

Bold in Gold

The combination of gold and rimless is one that you will not find when you are looking for ‘an optical shop near me’. These glasses encapsulate many of the new-age trends along with the old ones, especially the sleek glasses with a rimless twist. The gold accents on this pair of eyeglasses make them even more memorable, as they have become synonymous with those achievers who mean business and have every aspect of their life in control. 

Novelty in Hexagons

Urban trends often take time to find their way to local stores and opticians. Therefore, when you look for an ‘optician near me’, you might set yourself up for disappointment when they do not have the wide range of hexagonal eyeglasses that have slowly made an incredible place for themselves in eyewear collections across the globe. The playful symphony of angles and large lenses make them a perfect pair for the spontaneous and easy-going.

Searches like ‘an optical shop near me’ can often lead you to a dead end, or dicey shops that might not even have trustworthy reviews. Since eyewear can often be a long-term and pricey investment, it is important to seek out trusted brands that offer a guarantee of the best products at reasonable prices. Therefore, reputed brands like Titan Eyeplus are the best place to start when looking to buy eyewear online. From curated collections and eyewear essentials being available at the same place, to reviews that ensure complete customer satisfaction; Titan Eyeplus is the place to be. 

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Health & Wellness

How to Handle a Stressful Schedule



Life can be hard. You’re trying to handle everything that comes your way, but, no matter how hard you try, things still keep piling up more and more. There always seems to be a never-ending list of things you need to do or should have already done, acan as you are able to check several things off of the top of your list, more to-do’s are added to the bottom. It’s like having a Mary Poppin’s bag of to-do lists. Does this sound familiar? While staying moving and productive can be a good thing, if not handled with intention, a stressful schedule can easily become too much. Burn-out is all too common and it can happen to anyone. Keep reading, however, for some effective and easy ways to avoid burnout and handle that stressful schedule with care.

Morning Routine

How you start your day is incredibly important. If you wake up and feel instantly bombarded with a barrage of thoughts and anxiety about all of the things you have to do that day, instantly that puts you in a fight or flight mode. Staying calm and present is vital to staying level-headed and focused regarding your schedule. Taking time in the mornings, even if it’s just a few minutes, to center yourself and calm your mind can make you more efficient and honestly just happier, throughout the day. Instead of rushing immediately to your to-do list, take a few minutes and meditate, journal or even just some deep breaths while you do your skincare routine. Intentionally setting up a little bit of time to do this will set you up to make your day even better.


Prioritization is key when trying to tackle the stressful day before you. Figure out what needs to happen first before letting the number of things you have to do overwhelm you. For example, if you need to do a few loads of laundry, you’ll need to clean your room first. If you get home from work and your kitchen is flooded, that should most likely be taken care of before figuring out dinner. If you have a presentation from work a week from now, work backward to figure out what steps you need to take to be ready. You have to walk before you can run.

Lists Are Your Friend

One of the best ways to prioritize the things on your schedule is to make a list. You can even start out by just writing frantically on a piece of paper all of the things that pop into your head that need to get done. From there, take a step back, and look at the list as a whole. If it’s May and you’re already thinking about buying Christmas presents, move that down to the bottom of the list. If your in-laws are coming to stay this coming weekend, maybe move your grocery shopping up to the top of the list. Remember, think small to big. What do I need to do first in order to make all of these other, bigger things, happen smoothly?

Keep Track of Your Time

If you are first starting out with all of this and need a little practice, take a week or so and keep a rough estimate of how long everything you do takes you. Time spent at work? Forty hours every week. Commute time? Thirty minutes every day. Grocery shopping? An hour and a half every week. Keep track of everything as best you can. This will help you plan your schedule in the future, as well as being an excellent way to keep track of if, and how, you may be wasting any idle time throughout the day or week.


You have to take time for yourself! Going non-stop only works for so long. Just like taking a few minutes in the morning is important, so is unwinding at the end of the day. What’s something feasible you can do, that you enjoy, that will help you? Can you watch an hour of your favorite show every night? Can you get a massage every other week? Whatever it is, make sure you get enough time for just you.

Making little tweaks here and there to your schedule can make a world of difference. You don’t have to be perfect right away and you don’t have to do everything right away either. Just slowly build that awareness by incorporating some of these small tricks and, over time, it will get easier.

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Health & Wellness




You’ve probably heard of this popular herb’s energy-boosting properties, but what’s its other function? In this article, we’ll look at its effects on anxiety, pain, and sobriety. Kratom is an herbal supplement that contains a high-quality, non-psychoactive chemical known as ketamine. Known for its calming and soothing effects, kratom helps to reduce anxiety and enhance mood.

Mood Boost

If you have depression, you might be wondering if you  use Kratom powder, was it  good for a mood boost? Depression is a serious medical problem that affects a person’s mood, thoughts, and actions. Symptoms can range from feeling tired to loss of interest in various activities. Kratom is a popular supplement for both of these conditions. Here are a few ways to use this herb to improve your mood.

Green Malay is one of the best varieties for people looking for a mood boost. It’s known to reduce anxiety and depression while increasing overall well-being. It also promotes a regular sleeping pattern, which is a key benefit for people with depression and anxiety. Additionally, it can be used as a natural pick-me-up and can help people feel more energetic without caffeine. Regardless of the specific strain, you can find Kratom that works for you.

Pain Relief

While there is little scientific evidence that kratom is good for pain relief, heaps of anecdotal evidence point to its effectiveness. Typically, dosages of one to five grams are taken for pain relief in Southeast Asia. The primary effects of kratom are a mild energy boost and an improved sense of focus. However, as with any drug, a higher dosage can have negative side effects.

In Southeast Asia, kratom is used for many medical conditions, including the treatment of opioid addiction. In fact, kratom has been used for decades as a method for treatment of opioid withdrawal. 85% of those who reported using kratom did so without taking prescription opioids or heroin. Other reasons people use kratom include anxiety and depression. Moreover, joint pain is common, particularly of the shoulder and knee.

Anxiety Relief

If you suffer from stress and anxiety, you’ve probably wondered whether Kratom is good for anxiety relief. Kratom is a tropical tree that is widely used as a remedy. It is not a true opioid, but its effects are comparable. The best thing about Kratom is that it doesn’t have a high risk of dependence or abuse. It can be taken as a supplement if you want to reduce your anxiety, or as a standalone treatment.

When it comes to anxiety and depression, bali kratom capsules have a lot to offer. A high-quality strain can act as an analgesic, reducing pain throughout the day. Besides pain relief, this herb can help you sleep better, allowing you to enjoy a restful sleep at night. In addition, kratom’s strong sedative effect can help you get a good night’s sleep and set a healthier sleep schedule.


Using kratom is not a substitute for drug rehab. Depending on the intensity of withdrawal symptoms, it is important to go through a medical detox. Once a patient has ceased using kratom, they can go on to work towards regaining sobriety. During withdrawal, they may experience intense cravings. However, these cravings can often be suppressed by engaging in other activities, such as participating in 12-step programs or joining a support group.

While Kratom can be used to combat cravings for narcotics, it is not a substitute for opiates. The main alkaloids in kratom bind to opioid receptors in the brain, so it can produce euphoric, stimulatory effects similar to those of cocaine or alcohol. Users may also feel an analgesic effect. Regardless of its use, it is important to know that the drug may be addictive, and it is not recommended for use by those who are not sober.


If you’re struggling with an addiction, you may have considered trying a detox program that includes Kratom. While this type of treatment isn’t always recommended, there are some proven benefits of kratom. While Kratom has a relaxing and energizing effect at low doses, its effects can range from anxiety to depression after using it. In addition to addiction, you may experience side effects such as aching muscles, jerky limb movements, and excessive tearing. Although research is still needed, some treatment programs use behavioral therapy as an effective method.

Kratom is a naturally occurring substance derived from a tree in Southeast Asia. It contains two active compounds, Mitragynine and 7-a-hydroxymitragynine. Both of these compounds interact with opioid receptors in the brain. In higher doses, the plant produces feelings of pleasure and decreased pain, while lower doses produce an increase in energy and sociability. It is also known to be safe in small doses and may be effective for individuals struggling with addictions to heroin and other opioids.

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Health & Wellness

What are the Facts about STDs and heart health?



Prioritizing heart health is crucial because, even though many heart illnesses are preventable, they are the leading cause of death worldwide. Syphilis and chlamydia, two prevalent STDs, may affect your heart health, influencing your overall health.

In this article, we’ll examine some facts related to heart health and STDs, as well as the relationship between the two. Let’s start by reviewing the STDs facts.

What are the Facts about STDs?

Contrary to what many believe, STDs are significantly more prevalent, and their symptoms are much less noticeable. Let’s look at some of the facts about STDs you might never know.

  • Condoms aren’t 100 % foolproof.

They are not entirely immune to genital herpes, even when used correctly. Any sexual interaction puts you at risk since the virus might exist in locations other than those protected by a condom.

  • You might not be aware that you have an STD.

Most those between the ages of 15 and 49 have genital herpes, which is preventable but not curable, but most individuals are unaware of it. Since the symptoms are minor, people may not seek treatment or realize they are sick. Even if you are not feeling any symptoms, it is always preferable to get tested for STDs.

  • Anyone who engages in sexual activity is susceptible to STDs.

Ages 14 to 24 account for a significant portion of new STD infections, putting senior persons at risk. Sexual activity raises the risk of STDs at any age, so it’s critical to be aware of your status and take precautions constantly.

  • Untreated STDs can be fatal.

Medical severe issues can develop due to untreated STDs, including cancer, pelvic inflammatory disease, and heart disease. Syphilis has the potential to be fatal and can cause irreparable organ damage. HIV decreases immunity and can lead to AIDS when the immune system of the body as a whole is seriously weakened.

What are the facts about heart disease you should know?

The following are some heart disease facts: 

  • One in five patients will experience a heart attack without ever knowing it.

Most individuals believe that heart attacks often occur, as shown in movies and television shows. Milder signs of a cardiac event, such as shortness of breath and chest discomfort, are more prevalent than expected.

  • Heart failure can be detected by chest pressure, discomfort, and slight neck pain.

Cardiopulmonary resuscitation (CPR) must be administered to the patient in the case of cardiac arrest as a first aid measure before seeking advanced medical treatment to save his life.

Top risk factors include diabetes, high cholesterol, and high blood pressure.

You may be more likely to develop heart disease if you have diabetes, high blood pressure, or high cholesterol. Staying active and eating a nutritious diet are the most significant ways to preserve your health and manage these chronic diseases.

What is the relationship between heart health and STDs?

The following section focuses on the conditions that can arise due to STD infections which may lead to heart-related concerns.

  • Stress and heart health.

Finding out you have an STD is worrying and might make you more stressed out. Stress can exacerbate inflammation in the body, which is connected to heart-harming variables, including high blood pressure.

  • Depression and heart health.

Finding out you have an STD can be emotionally trying and increase your risk of depression. Your heart rate and blood pressure increase when you’re depressed, which lowers the amount of blood getting to your heart, and heart disease results from these impacts over time.


You should be aware of any warning symptoms of STDs by working with your doctor to discover when you are infected to avoid situations of worry and stress leading to depression, which is the main cause of heart-related disorders.

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Health & Wellness




Retinoblastoma is one of the most common eye cancers in infants and young children. It arises from the retina of the eye that is responsible for visual perception in the eye. In most cases, it occurs in one eye, known as unilateral retinoblastoma, and in some instances, both eyes can be affected, which is known as bilateral retinoblastoma. Retinoblastoma has the risk of spreading to the brain and the whole body through the optic nerve of the eye and the bloodstream, respectively. The myths and misconceptions along with the late diagnosis are the biggest reasons why we come across advanced cases in India, reducing the chances of survival. Otherwise, it is a completely curable eye cancer if detected early and treated in the right way.


Some variations in the genes or genetic mutations are the risk factors for retinoblastoma. In about 40% of the cases, the genetic form is responsible for this type of cancer and affects very young children, especially those who are 1 year old or younger. The gene responsible for this rare form of cancer is known as RB1, which happens to be the link when retinoblastoma occurs in both eyes. However, the genetic form rarely results in damage to only one eye. Despite that, only 10-20% of the children with the disease have a family history associated with retinoblastoma. Another risk factor for retinoblastoma happens to be a young age. Most children diagnosed with the disease are below the age of five years, and several of them are even infants. Children of any race can develop this condition. However, the underserved communities face the worst outcomes due to inadequate healthcare facilities. 


As the disease is most prevalent in young children and infants, the symptoms go unnoticed. Here are a few signs that one may look out for:

White Pupillary Reflex—In normal eyes, the pupil appears to be red when light is focused on it. However, in eyes with retinoblastoma, the pupil mostly appears white, which in actual is a white tumour, retinoblastoma.

Squint eye—the eye can be seen as squinting, turned inwards or outwards

Some other common symptoms are redness, pain, affected eyes appearing bigger, vision loss, bulging of the eyes, bleeding in the front of the eyes, and shrunken eyeballs.

Precautions and Treatment for Retinoblastoma

Retinoblastoma is not preventable. However, its severity can be reduced by regular eye examinations, especially among children who have a family history of the disease. This helps in the detection of the condition earlier and significantly increases the chances of saving the eye and survival. The treatment varies for different stages of the disease. The common treatments include:

Cryotherapy: During this procedure, an extremely cold liquid and instruments are used to freeze and destroy the abnormal tissue and tumour.

Laser therapy includes thermotherapy, where doctors use lasers to destroy cancer tumours with heat.

Chemotherapy: These drugs are mild and can be tolerated by children; they are injected through a vein or artery. The advancement in treatment modalities recently also includes injecting chemotherapy drugs directly into the arteries connected with tumour. 

Radiation Therapy: This therapy kills the cancer cells and prevents them from multiplying. Doctors also recommend a type of radiation therapy called radioactive plaque therapy, where the radiation device is directly applied on top of the eye to treat the tumour.

Retinoblastoma is a curable childhood eye cancer if detected on time. It is important to take the symptoms seriously, undergo eye examinations, and consult an eye specialist in the event of any white reflex in the eye. The doctors, pediatricians, physicians, and general ophthalmologists should be trained and educated to be able to diagnose the condition on time, and referring the patients to retinoblastoma specialists and treatment centers makes it possible to give appropriate care, thereby improving the outcome. 

The author is Head, Ocular Oncology, Dr Shroff Charity Eye Hospital

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Health & Wellness

How to fix your sleep routine



Our body has its own GPS to rotate between sleep and wakefulness. This 24-hour sleep-wake cycle is called the circadian rhythm. Any dysfunction in this internal clock will inhibit our restful sleep, leading to decreased productivity, stress, high cortisol levels, and metabolic diseases.

It’s important to have a straight, 8-hour sound and undisturbed sleep cycle to lead a normal, functioning day.

The Hypothalamus, a part of the brain, responds to some external cues that tell our body to sleep and go to bed. Sometimes, your circadian rhythm can get thrown off due to

• Night shifts

• Jet lag

• Traveling across time zones

• Late-night coffee shots

• Late-night TV or mobile use

Deficiencies of potassium, iron, magnesium, zinc, Vitamin B12, Vitamin D, 

Luckily, there are multiple tips to take care of your sleep cycle and reset your internal clock. Switch off your mobile phones and regulate your exposure to blue light two hours before bedtime.

Avoid electronic screens from TVs, computers, or smartphones because blue light initiates the “fight or flight” response in the body. When you’re exposed to light, your brain stops producing melatonin, the sleep hormone. This makes you feel awake and alert.

Cover your curtains and any blinking red light from A/C transformers or digital displays on A/C panels that are enough to disrupt the hormonal balance at night.


Try to meditate and do breathing exercises. Practice yoga, stretching, or journaling. Avoid caffeine at night. Reducing stress will help bring down cortisol levels, which will help relax your brain to promote restful sleep.


If your sleep is disrupted, it’s better to avoid naps in the daytime. If you wish to, you can take a short nap of 30 minutes. Do household chores, and increase NEAT (Non-exercise activity thermogenesis), which can give some fatigue and induce restful sleep.


Muscle responds by aligning our circadian rhythm and promoting melatonin production. Thirty minutes of cardiovascular fitness can improve our sleep cycle. Aim for 150 minutes of physical exercise per week to get the best results. Keep in mind that even exercise can cause your body to over stimulate. If you want to exercise at night, do it at least one to two hours before bedtime.


Loud distracting noises can be a big culprit in disturbed sleep routines. Better still is to take the TV out of your room. Turn down the volume of the TV as our brain processes all kinds of sounds even while sleeping. White noise is a soothing, steady sound that masks environmental noise. You can create white noise by using a

• fan

• Air conditioner

• Humidifier

• Air purifier

• White noise machine

You can also wear earplugs to block out outside sounds.


Just before bedtime, your body temperature drops to prepare for sleep. A cool bedroom temperature of 60 to 67°F (15 to 19°C) will help you relax and sleep. The temperature of the room where you sleep is one of the most important factors in achieving quality sleep. Anything below 54°F (12°C) or above 75°F (24°C) may disturb your sleep, so make sure to adjust your thermostat. You can also use an air conditioner or fan during warmer weather or a heater during cold weather. These offer the extra benefit of creating white noise.


A comfortable bed is the best sleeping environment for a good night’s rest. If your mattress is more than ten years old, please replace it because mattresses and pillows generally absorb the impressions of those sleeping on them, resulting in an uneven level with lumps or depressions that may cause back aches and pains. Replace it after every 10 years, and pillows after 2 years.


Your circadian rhythm also responds to your eating habits. A late dinner can delay sleep, so eat your last meal two to three hours before bed.

This will give your body enough time to digest the meal. It matters what you eat, too. Heavy, high-fat meals might disrupt sleep because they take a while to digest.


At times, when our diet is deficient in some micronutrients like magnesium and zinc, problems with having sufficient sleep occur. Include nuts and pumpkin seeds, legumes, grains, yogurt, and soybeans to have enough magnesium and zinc in your diet to avoid sleep issues.


Melatonin is a hormone that regulates your sleep cycle and is made by the pineal gland in the brain, but it’s also available as a supplement. It can promote relaxation.

The writer is Dietician & Nutritionist and founder of Nutrifybypoonam Diet & Wellness Clinic

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