Ask Dr. Rachna Pande

I like adding salt to everything I eat, but recently I was diagnosed with high blood pressure and told not to take raw salt again. What makes raw salt dangerous?


Dear Doctor,


I have a habit of chewing gum, especially after taking my meals. Is this harmful to my health in any way?




Dear Lydia,

People take up chewing gums for various reasons. For many it becomes a habit and compulsion to take it. But it is not a healthy habit and it is better to give it up as soon as possible.

Some persons take up chewing gum to reduce food cravings and avoid junk food. But in this process, they incur more harm than good. Chewing gum by itself does not provide any nutrition and a person may lose out on necessary nutrients while taking it. This happens because when it is placed in the mouth for a long time, it can give a sense of satiety, thus reducing intake of food necessary for nutrition of the body and providing energy.

The minty flavor of a chewing gum may make fruits and vegetables taste bitter when eaten after. Thus a person may opt to eat more unhealthy foods like chips, instead of fruits and vegetables.

The jaw muscles of one or other side are constantly put to use in the process of chewing the gum. This can lead to chronic pain in the jaw and even headache and toothache. Chewing gums have also been linked to tension headache and migraine in teenagers. If good dental hygiene is not observed, chewing gum used regularly can cause dental problems as well.

Excess air can be swallowed in the process of chewing gum, which can cause an uncomfortable bloating sensation in the abdomen and even flatulence. Gastric acid and juices are released in the stomach during the process of chewing without any food actually reaching the stomach. When the person actually eats food, juices may not be available in sufficient quantity to digest the food.

The net result of this is, he may suffer from burning pain in the stomach, chest and or nausea and vomiting. Chronic dyspepsia impairs appetite thus reducing overall food intake of a person, affecting nutrition.

Mercury present in dental fillings can be released in the blood stream due to chewing gum and cause toxic effects like neuropathy, damage to kidneys, heart, lungs and the immune system.

Although one does not swallow a chewing gum and throws it away, yet its ingredients are absorbed directly in the blood stream. Chemicals used for flavour and softness in a chewing gum can cause allergic reaction in susceptible people. Some of them are known toxins for liver and kidney. Aspartame used as artificial sweetener is known to cause weight gain, birth defects and even cancers.



Dear Doctor,

I am 2-months pregnant. When is the right time for me to go for an ultrasound and can I know the gender of the child at this age?


Dear Nadege,

Congratulations for your pregnancy. Ultrasound is a safe, non-invasive, painless technique which helps in confirming pregnancy, state of the fetus, the umbilical cord, any genetic abnormalities and even gender of the baby. Usually, ultrasound is done by 18-20 weeks.

However, in very early pregnancy it can be done by putting the transducer in the vagina. The gender of the baby is usually visualised clearly by 18-20 weeks, when the body is formed by conventional 2D ultrasound machines. With latest 3D machines, the gender can be seen as early as 11-14 weeks.

You can now go for an ultrasound examination. Accuracy of seeing gender depends on the position of the baby and body weight of the mother.

All genetic abnormalities cannot be picked by ultrasound, hence if that is suspected, a woman may need specific genetic marker tests done with maternal blood.



Dear Doctor,

I recently completed my medication for malaria, but it left me feeling very weak and drained. How can I know if I am having side effects of using certain drugs?


Dear Michelle,

If you are diagnosed with malaria (positive blood test) and given ambulatory treatment, most certainly you would have been given coartem. Coartem tablet is combination of 2 pills, artemether and lumefantrine. Like any other medication, it is beneficial but also has adverse effects. It can cause nausea, vomiting, lethargy, loss of appetite and muscular pains.

One can have one or more adverse effects. Paracetamol if used for controlling fever can also cause nausea, vomiting, anorexia as side effects. Loss of appetite, nausea and lethargy can also be due to residual effects of malaria. These residual effects depend on severity of malaria and how many days after infestation, treatment was taken. If the problems you face are side effects of drugs, they should improve gradually after stopping drugs.

Take frequent small meals which are nutritious. This should help you to regain energy. If symptoms persist or there is relapse of fever, possibilities are, either it is malaria which has not cleared with the treatment or there is some other infection which needs to be investigated.



Dear Doctor,

I like adding salt to everything I eat, but recently I was diagnosed with high blood pressure and told not to take raw salt again. What makes raw salt dangerous?


Dear Solomon,

High blood pressure occurs due to narrowing of the blood vessels of the body, forcing the blood to flow with greater pressure inside arteries. This process is enhanced due to increased salt intake, which increases high blood pressure.

The arteries also get more thickened with salt load. Gradually with increased pressure and turbulence of the blood flow, the inner lining of some blood vessels may be damaged, leading to formation of a clot to help it heal. Part of this clot may break up and go via the blood to the heart or brain, causing heart attack or stroke.

Normally, extra fluid and salt are removed from the body by the kidneys. Taking extra salt puts a heavy load on kidneys and they find it difficult to remove this extra salt and water. This can gradually lead to impaired functioning of the kidneys. Increase in salt and fluid inside the body also increases burden on the heart, affecting its functioning which gradually leads to heart failure.

Almost all natural food substances like most of the fruits and vegetables have inherent salt present in them.

Therefore, it is said that it is not necessary to add table salt to the food. For a normal person, recommended daily intake of salt should not exceed 2gms per day and for a person with high blood pressure, it should not exceed 1.5gm per day. An experienced dietician can advise a person as to how much salt he/she can take and in which form. As such, taking extra salt is not good.

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