STREET FOODS AROUND THE WORLD

 

 

Some months back I wrote about Comfort food the world loves. If you have missed it then you can read it now bu clicking this hyperlink:

https://surajitbrainwaves.blogspot.com/2023/12/comfort-food-for-hungry-travellers.html

Almost a decade ago I wrote a blog on street foods – From a Street Food Junkie. Please click the hyperlink to refresh your memory:

https://surajitbrainwaves.blogspot.com/2015/10/from-street-food-junkie.html

One of my favorite parts of traveling is trying out all the local foods. I look forward to sampling the local cuisine and local restaurants while trying all the flavorsome street food. Although many dishes are brought to other countries, there’s nothing better than getting a genuine dish in its home territory. Here is a list of the best street food delicacies to try when you go traveling. 

Dürüm in Istanbul

This Turkish dish features a wrap made from flatbread, grilled crispy and filled with meat cooked on a vertical spit. Sometimes you will find vendors who offer chicken, beef or veal, but lamb is the typical filling. The wrap is topped with tomatoes, onions, cucumbers, lettuce, herb yogurt, and hot sauce. This dish is also highly popular in Germany, but Istanbul is the ideal city to experience this tasty treat.  

Taco al Pastor in Mexico City

This is a true marriage of two food cultures: Lebanese immigrants introduced the tradition of split roasting meats and the tender meat began being served on the local Mexican tortilla. Typically the meat, usually pork, is marinated in dried chilies, spices, and pineapple. The tortillas are served with onions and cilantro and topped with salsa or lime juice.  

Egg Waffle in Hong Kong

Called gai daan jai in Cantonese, this popular Hong Kong invented dish first appeared on the streets in the 1950s. An eggy batter is cooked between two metal plates of semi-spherical cells over a flame, giving the snack its unique form. Egg waffle is best enjoyed hot off the griddle and plain, although some vendors do add chocolate or fruit and mix the batter with green tea or ginger flavoring.  

Supplì in Rome

This finger food is native to Rome and is named after the Italian word for 'surprise', because of the unexpected mozzarella filled center. This Italian deep-fried rice ball is combined with ragù, ground beef, and tomatoes. Older recipes used to use chicken giblets. This popular city croquette can also be found in pizza parlors and grocery stores, where it is served as an antipasto.  

Bhel Puri in Mumbai

In India, a street snack is known as as chaat and while Bhel Puri is found all over the vast country, this dish is best tasted in Mumbai. The recipe includes a mix of puffed rice, vegetable, spices, chutneys, and semi-fried, vermicelli-like noodles. This flavorsome dish tastes sweet, salty, tangy and spicy all at the same time.  

Currywurst in Berlin

It's hard to believe that this iconic German dish was only invented in 1949. 800 million currywursts are consumed annually across Germany and the dish is particularly popular in Hamburg and Berlin. This hearty street food features a steamed-then-fried pork sausage with ketchup and curry, served with bread or french fries.  

Arepas in Bogotá

This popular flatbread is made from maize or flour and can be grilled, baked or fried. In neighboring Venezuela, the bread is used for sandwiches, while in Colombia arepas are topped with butter, cheese, eggs, condensed milk, chorizo, or hogao, an onion sauce. If you want to feel like a local Bogotano, eat a plain arepa with a cup of hot chocolate for breakfast.  

Ceviche in Lima

This fresh seafood appetizer is Peru's national dish. Peruvian's even hold a holiday in its honor. The recipe consists of chunks of raw sea bass, or sole, marinated in lemon juice and topped with onions and chili peppers. This dish is best served as soon as it’s prepared. It is commonly served with sweet potato, lettuce, corn or avocado. 

 

Hokkien Mee in Singapore

Among Singapore's vibrant street food culture, Hokkien Mee stands out as a winner. This dish was created by Chinese sailors from Fujian Province after the Second World War. The rice and egg noodle dish is stir-fried with pork, egg, shrimp, squid, garlic, bean sprouts and soy sauce and is often garnished with lime and chili sauce. In the past pieces of lard were drizzled on the top, but this tradition was abandoned for health reasons.  

Falafel in Tel Aviv

This delicious street food is Israel's unofficial national dish. The origins of this food remain unknown and many neighboring nations claim it as theirs too, this dish is best enjoyed in Israel. The locals enjoy the deep-fried chickpea balls served in a pita, topped with salad, pickled vegetables, tahini, hummus, and hot sauce. 

   

Crêpes in Paris

This much-loved street dish is an iconic Parisian scene. Head to Montparnasse, an area overflowing with crêpe stands. During dinner and lunch, you can enjoy a savory crêpe, typically made with buckwheat flour and filled with ham and cheese. Other savory versions include vegetables, eggs, and other meats. For dessert or breakfast, sweet crêpes are served, made with wheat flour and sugar. The sweeter crêpes are filled with fruit preserves, custards or even Nutella.  

Tagine in Marrakesh

This Berber stew is named after the earthenware pot it’s cooked in. The dish is slowly cooked over hot coals for hours and enjoys many variations. It usually features lamb, beef or chicken, vegetables and plenty of spices and herbs. Many locals add fruit and nuts and it is served with couscous or bread. You can find this dish offered in fine Moroccan restaurants, but it's best enjoyed served in a simple setting.  

Espetinho in Rio de Janeiro

These "little skewers", cooked over small charcoal grills, are found all over Brazil. Popular meats are spiced beef and chicken, but anything can be put on the skewer such as sausages, shrimp, cubes of fish or queijo coalho, a non-melting cheese. Vendors often serve the skewers with hot sauce and farinha, a crunchy flour that can be sprinkled on the meat.  

Jerk Chicken in Jamaica

Well known outside of the Caribbean, jerk chicken is best on its home island. While the marinating jerk sauce is easy to replicate, the real secret is in its grilling. The Jamaicans grill the chicken over charcoal, for a unique smoky flavor. The meat is also cooked directly on top of fresh green wood logs, so that it absorbs the woody oils and fragrances, adding to the aromatic flavor.  

Halo-Halo in the Philippines

This dessert sounds wacky when you look at the ingredients, but locals are mad for this sundae. Shaved ice and evaporated milk are the base of this dessert, but you also might find a mix of kidney beans, chickpeas, sugar palm fruit, coconut, caramelized plantains, jackfruit, tapioca, sweet potato, crushed rice, flan and ice cream in this surprising dish.

SELF CONFIDENCE AND SELF ESTEEM

 

Self-esteem refers to whether you appreciate and value yourself. Your self-esteem develops and changes as a result of your life experiences and interactions with other people.

Self-confidence is your belief in yourself and your abilities. This can change depending on the situation. It's normal to feel quite confident in some circumstances and less confident in others. A healthy amount of self-esteem is necessary to have the self-confidence to meet life's challenges and participate in things you find enjoyable and rewarding.

If you have low self-esteem or low self-confidence, you may find that individual negative or disappointing experiences affect how you feel about yourself. This can cause a self-perpetuating cycle of negative thinking where negative expectations for the future discourage you from trying. This leads to disappointing outcomes.

For example, if you're lacking self-confidence and receive a low mark for an assignment, you may think, "What else could I expect? I'm stupid. This proves it, and I might as well leave." On the other hand if you have healthy self-esteem and receive a low mark, you may think, "I wonder where I went wrong? I'll find out so that I can do better next time." Although you may feel disappointed by the low mark, you don't feel diminished as a person.

So, being confident in yourself is one of the most important, and most challenging, traits to have. Self-confidence can fuel success, while low self-esteem can impede it. Even if you struggle with self-esteem issues, it’s probably not something you’d want to broadcast or the kind of impression that you’d like to give people. 

Low self-confidence can result in:

• shyness
• communication difficulties
• social anxiety
• lack of assertiveness.

Low self-esteem may cause you to develop a strong critical internal voice (an 'inner critic') that tends to express itself loudly when you're feeling distressed, overwhelmed or judged by others. This inner critic can cause significant personal distress by contributing to 

• feelings of sadness, anxiety or anger.
• Believing your inner critic can cause you to:
• think negative things about yourself
• believe your negative thoughts are always true
• ignore your strengths and abilities
• focus on your mistakes and failings while ignoring the positive
• expect the worst
• avoid challenges or situations where you feel you could be judged by others
• think that you don't deserve to have pleasure or fun.

 

There is a certain set of behaviors, habits, and patterns that not only make you seem insecure, they also perpetuate that feeling in your mind. To start changing the way you and others perceive yourself, and raise your self-esteem, it is important to acknowledge these habits and swap them for alternative healthier ones. These are the crucial signs that can point to low self-esteem.

 1. Being overly positive

Having a sunny outlook on life is great, but being realistically optimistic is equally important. In some cases, however, the need to put a positive spin on everything is a veil for a feeling of insecurity or low self-esteem. Talking to your loved ones openly and honestly about frustrating experiences or emotions sends the message you are confident enough, and trust them enough, to admit that not everything is perfect.  Moreover, being overly positive and refusing to look at what’s not going well has a destructive downside that leads to avoiding the truth. If you numb yourself into a sense of being OK, you can’t really solve the problems in your life and raise your confidence. 

2. Excessive perfectionism

Perfection is the enemy of good. Some perceive the need to always achieve perfection, as a sign of confidence - someone with such high expectations of themselves must really believe in their abilities, right? Well, not always. Being overly perfectionist can be a manifestation of fear of failure. This will lead a person to ‘get stuck’ on a task, trying to get that perfect unattainable result, and stop them from making actual progress.  For example, if you’re about to have some friends over, you may feel stressed that the house isn’t clean enough. Instead of taking 30 minutes to tidy up and make the place look welcoming, you might spend hours on an unnecessary deep clean and have no time left to present the food beautifully on the dinner table! This in turn might take a toll on the way you feel about yourself.

3. Constantly bragging about your accomplishments

Social media has made sharing the best moments of our lives easier than ever. Every visit to a beautiful destination, a nice meal, academic achievements, and so on can be broadcast to the world at the push of a button. Constantly having to remind others how great your life is can easily defeat the purpose, and actually point to a sense of insecurity, low self-esteem, and a need for external reassurance and validation that you are, indeed, great.  Sharing the occasional celebratory moment is perfectly fine, as long as your self-worth isn’t affected by the praise or jealousy of others. Your real friends and your family love you for who you are, and impressing strangers and acquaintances don’t care much. So, a constant broadcast of your greatness is counter-productive. 

4. Trouble saying no

Those with low self-esteem have trouble believing that people will like them for who they are, so they try to ‘give’ people reasons to like them. Being a yes-man means always being available to lend a hand or do whatever others ask of you, putting their needs in front of your own. Of course, some of it comes from being nice and wanting to be helpful, but a big part of it comes from wanting to please people.  Every time you help another person, but it comes at the expense of your own needs or prior commitments, you send a message to your subconscious self that you are less important, or not important at all. Learning to say no and setting healthy boundaries is essential for building up your self-esteem.

5. Constantly seeking validation

Being anxious and indecisive about your choices, asking for your friends' opinions too frequently - those are some forms of seeking validation. It can be about simple decisions like which coat to buy, or what restaurant to go to or it can be the reassurance that something that you feel or think is appropriate. Getting ‘approval’ from others can make you feel like you’re ‘free’ from the burden of deciding, and possibly making the ‘wrong’ decision.  In the long run, however, it does the opposite of setting you free. By not trusting yourself, you signal to others and yourself that you’re unable to handle different situations. 

6. Expecting a catastrophe at the drop of a hat  

Catastrophizing can be defined as ruminating about irrational worst-case outcomes. If you have a tendency for catastrophic thinking, it is bound to affect your self-esteem, and the insecurity feeds the cycle of anxiety. “If I don’t recover quickly from this procedure, I will never get better, and I will be disabled my entire life” or “If this viva doesn’t go well, I willnever pass” are not the type of thoughts your mind should construct. Try to put your experience into perspective. When becoming aware that you’re engaged in catastrophic thinking you should counter that thinking by adopting a reasonable perspective on what’s going on. Remind yourself that there is always a Plan B up your sleeves. And of course, you can always seek the help of a professional if you feel you need it. 

7. Rejecting compliments

People with low self-esteem have the most difficulty accepting compliments. If you think you're somehow flawed, or you believe that you aren't good enough, you might have trouble understanding how others can say such kind things about you. Instead of graciously accepting the compliment you may say something like, “I was just doing what I had to do” or “It wasn’t me, sometimes things happen”. Slowly changing that habit could have a very positive effect on your self-esteem.

 

Ways to improve self confidence and self esteem

Practice self-acceptance - Becoming more accepting of yourself helps you to feel OK about yourself and other people, regardless of the situation. Everyone makes mistakes. When you practice self-acceptance you can:

• acknowledge that mistakes are part of learning
• identify ways you may be able to solve problems differently or change to get a different outcome
• be critical of your behaviour and try to change it without being critical of yourself.

Get to know yourself - Take notice of experiences or thoughts that increase or decrease your self-confidence or self-esteem. Identify your strengths, abilities and achievements. Be honest and include everything you're proud of, no matter how small. Think about what they mean to you and why they're important to you. Think about what you'd like to change or improve about yourself, and how you can do that.

Reprogramme your thinking - Pay attention to the language you use when you talk to yourself or describe yourself to others. We are often more kind and generous to other people than we are to ourselves. Recognize and challenge your inner critic. Focus on the messages that make you value yourself, and turn down those that make you think negatively about your value or ability. Reprogram your thinking with positive self-talk and affirmations.

Be more assertive - Learn to assert your needs. Don't feel guilty about asking others for what you want, or saying no to what you don't want.

Make changes in your life - You may decide you want to make changes in your life to improve your self-esteem and self-confidence. Think about what you can change that will improve how you feel about yourself. For example, you may want to make changes in your studies, job or relationships, or develop new skills. Make a plan so that you can:

• identify specific goals that will challenge you
• break each goal down into achievable steps
• build on your success after each step.

Surround yourself with positive influences - Spend time with people who are themselves achievers and who like you for who you are. Avoid people who are constantly negative or critical, but don't withdraw from genuine social contact.

Reward yourself - Celebrate your achievements as you practice building your self-esteem and self-confidence. Make time to treat yourself with experiences and activities you value.

Share with others - If you can, tell a good friend what you're doing. Their encouragement and feedback on the changes you're making could be invaluable support. You can also help other people to see themselves as capable and worthwhile.

 

Self-confidence is a person's attitude about their capabilities and skills. A person with good self-confidence feels like they have control over their lives. Self-esteem is how a person perceives their own value and self-worth. A person with high self-esteem is open to different ideas and comfortable socially. Self-confidence is closely related to self-esteem. It is more the external behaviors that stem from healthy self-esteem. Self-confidence particularly relates to believing you can be effective in the world, feeling able to handle situations and to achieve goals.

KNOWLEDGE, INTELLIGENCE, AND WISDOM

 

Knowledge is the collection of facts, information and skill. It is typically gained through books, research, and delving into facts. These can be acquired at any age. They can be acquired either through reading, education or by doing. The word knowledge is defined first as the “acquaintance with facts, truths or principles, as from study or investigation; general erudition.” 

Intelligence can be defined as the ability to think logically, to conceptualize and abstract from reality. Intelligence is something, some say, we are born with. Intelligence can be acquired naturally. Or, it can be honed through learning. It takes intelligence to apply knowledge properly. Intelligence helps in:

• Better grades at school
• Higher-paying jobs
• Ability to think critically, analytically, and rationally
• Ability to make logical decisions
• Admiration by others (something highly desirable by grandiose narcissists)
• Ability to solve complex problems, e.g., involving mathematics or inductive or deductive reasoning.
• Ability to predict future outcomes based on knowledge of the appropriate data
• Less likely to get in trouble e.g., because of an understanding of crime and punishment

 

Wisdom can be defined as the ability to grasp human nature, which is paradoxical, contradictory, and subject to continual change. Wisdom can only be acquired through experience over time. It can be learned in youth through mentoring, but it more likely comes with learning by doing over time. Wisdom is defined as “the state of being wise,” which means “having the power of discernment and judging properly as to what is true or right: possessing discernment, judgement, or discretion.” It’s older (recorded before the 900s), and joins wise and -dom, a suffix that can convey “general condition,” as in ‘freedom, kingdom. When we think of the benefits of wisdom, they are plenty:

• Ability to discern right from wrong (also called intuition)
• Ability to view adversity as an opportunity for growth
• Being more accepting of uncontrollable life’s challenges and uncertainties
• Ability to spot danger from afar and avoid it
• Better sense of direction that comes intuitively
• Developing greater patience and therefore less likely to experience anxiety
• Greater vision and leadership skills
• Knowing how to attain peace, happiness, and contentment with greater ease

 

The two constructs, intelligence and wisdom, hold potential for highlighting positive and adaptive features of development in the later years. Both are considered to increase with age, and both provide for life-long acquisition of knowledge. As humans, we make decisions. Not all decisions are good. Virtually no one can make every single decision a good one. But knowledgeable, intelligent and wise people make more good decisions than bad ones. Knowledge, intelligence and wisdom are there for the taking for most, if one has the desire. The combination of traits does not, in itself, make a good person. But how one applies each of those traits can determine the type of person one becomes.

 

Differences between Wisdom and Intelligence

#1. Wisdom grows with age, but not necessarily intelligence: You might have heard the sentiment “The older, the wiser.” And there might be some truth to it. Greater wisdom is seen in older people’s ability to use a wider range of reasoning and consider different outcomes when faced with various scenarios. Those scenarios include making choices, resolving conflicts, dealing with uncertainties, and deciding when to take risks.

#2. Wisdom comes through life experience, unlike intelligence: “Experience teacheth wisdom,” at least that’s the age-old belief. It makes sense that we learn from experience, whether the experience was pleasant or unpleasant. We are wiser if we can use the knowledge gained, especially from bad experiences, to exercise sound judgment in the future. Intelligence is something you have to consciously work on improving. In fact, a person can be extremely intelligent yet lack experience in various areas as well as wisdom.

#3. Intelligence can be willfully improved, but not wisdom: You can read a book, take a course, or read for a degree and you’ll increase intelligence and knowledge just like that. You can’t wake up one day and say, I’m going to develop or increase my wisdom today, at least not exponentially. The only fresh wisdom you’ll gain is from new or different experiences you have on that day.

#4. Wisdom leads to second-nature decisions, unlike intelligence: The use of intelligence to make decisions requires the application of facts, logic, and/or reasoning. Besides, the individual will first have to be intelligent in order to engage in the process of logical thinking and use the result to make informed decisions. They may have to look up books or Coogle for tips.  The wise person relies on past experiences, patterns, and intuition, They also lean on their ability to make quick judgments from the facts and are able to come to a decision quickly, without relying on books or googling for tips. This is because the information is already stored in the brain from previous experience, they’re able to quickly draw from it and act accordingly.  

#5. Wisdom allows for self-reflection, intelligence may not: A person, young or old, can be as smart as a whip and still conduct themselves poorly because they lack the ability to self-reflect and gain awareness of their behaviors. For example, noticing they’ve acted impulsively, aggressively, or indulged in risky behaviors. The ability to regulate our emotions and maintain emotional stability also comes with age, time, experiences, and maturity.

#6. Intelligence can be measured, but not wisdom: There are Intelligent Quotient tests such as the Wechsler Adult Intelligence Scale (WAIS).  but do you know of a Wisdom Quotient Test that exists? There are none.

#7. Intelligence does things “by the book,” wisdom asks if it’s the right thing to do: Wisdom is more of an inner sensing ability or intuition that kicks in to question what you’re about to say or do before doing so. Intelligent people who lack wisdom may act impulsively by nature. By asking, “Is this the right and proper thing to do?” wisdom essentially turns to past experiences and core values, such as honesty and morality, for advice in order to determine the proper course of action.

 

The function of intelligence is characterized as focusing on questions of how to do and accomplish necessary life-supporting tasks; the function of wisdom is characterized as provoking the individual to consider the consequences of his actions both to self and their effects on others. Wisdom, therefore, evokes questions of should one pursue a particular course of action.

Many search for ways to become wise, but few feel they have really achieved it. The Berlin Wisdom Project of the late 80s defined wisdom as:

- Spiritual knowledge

- Factual knowledge

- Excellent judgment 

- Excellent problem-solving skills

- Ability to learn from past experience

- Humility, emotional strength or ability to recover from defeat

- Openness and maturity - allowing another to see you as you really are

- A deeper understanding of human nature, including empathy for others and other cultures  

 

How to become wiser in the human experience    

1. By Being Social:   People who keep more contact with other people display higher levels of wisdom than those who remain more secluded. Some think this may be due to new people constantly giving us new ideas to think about, new information, new experiences, and this enriches the mind and gives us more wisdom. So make an effort, if not for others than for yourself. Stay in touch with old friends, go take a course, and stay in contact with those around you, it's the wise thing to do.    

2. By Adopting Open-mindedness:    Wisdom is the ability to understand all aspects of a problem, without surrendering to personal feelings. Rabindranath Tagore said ‘Where the mind is without fear and the head in held high’! The meaning of an open mind is to find true empathy and to understand that everyone has a life story that affects them in some way, and it is not our place to judge. A good habit is to write down, every day, what ails you. At the end of the day, take a look at that list and try to get a new perspective on each problem, you'll be surprised what things will come to mind.      

3. By Acknowledging that "I could be mistaken":   A smart person understands that it is impossible to know everything and that life always throws you a curve when you least expect it. Acknowledging our mistakes may, and often does, lead to greater wisdom. Remember, your ability to be wrong shouldn't damage your reputation as a wise man but should increase it because wise people know how to take responsibility for their mistakes. Nietzsche is quoted to have said: "Wisdom sets limits on knowledge, too." Only a fool thinks he knows everything. Acknowledge the limits of your knowledge and admit when you are wrong.    

4.  By Experiencing new things:   While we each have our own personal tastes in books, music, art or movies, it is important to note that getting familiar with styles unknown will broaden your horizons and introduce new world views, new ideas and new outlooks on life. So put down the novel you're reading and try a science fiction story, a history book or just a great romance. Whatever it is you almost never read, now is the time to add some real experience in things you haven't really touched on. So try something new, or learn a new skill -  it won't just make you wiser, it'll also keep you young!

5. By Self-awareness:   Many will say they have rich life experiences, but when was the last time you really stopped to think of all you've learned throughout life?   Try this exercise: Write down your three biggest failures and your three biggest successes. Next to each of them write some of the events that lead to it and the lessons you learned. Look for patterns, without pride or regret, simple patterns to teach you about how you used each experience to drive you forward. After all, knowing yourself is the biggest challenge of all.    

6. By Knowing what is going on around you:   Yes, the news is often dramatic, misrepresented or just depressing. But it's hard to make balanced decisions for yourself and others if you don't learn from the mistakes of others and, on larger scales, of your city, country, and world. Keep updated, read a newspaper, watch the news or just read a news site online from time to time. Read the articles, not just headlines, and understand how you fit into this bigger world, and where you stand. This is crucial for true wisdom.

It takes intelligence to apply knowledge properly. Wisdom can only be acquired through experience. It can be learned in youth through mentoring, but it more likely comes with learning by doing over time. One can know a lot, and not apply what he or she knows intelligently. Knowledge and wisdom are two distinct concepts that are often used interchangeably but hold different meanings. While knowledge refers to the acquisition of information and facts, wisdom involves the application of knowledge along with experience, insight, and good judgment.

REMEMBERING PROF. S. N. CHAKRABORTY BY HIS FOOT NOTES

 

 

Recently while going through my medical school class notes, I came across a very interesting lecture delivered by my late Guru and a wizard of Medicine, Prof. S.N. Chakraborty. He was a genius. He would walk inside a class early morning and ask “What do you want to study today?” and once we or his Medicine Senior Resident, Dr. Sumanta Chakraborty, who would take our attendance before his arrival, would express our choice of chapter, he would start extempore. No notes, no preparation Prof. Chakraborty was a walking talking encyclopedia of Medicine. We were mesmerized by his knowledge and were in love with his thunderous laughter.

On that day someone in our class asked him to teach us about diseases of the foot and in this blog I am trying to summarize his teachings from my lecture notes. The Professor said that although “my feet are killing me!” is one of the most overused exaggerations in the entire world, the truth is that the condition of your feet can say a lot about the overall state of your health, as well as indicate any underlying diseases you may have. Reflexologists and massage therapists have been proponents of manipulating points on the feet to improve the health of internal organs for a very long time. Although the evidence to prove this is somewhat scant, it's true that a person’s state of health can be expressed through their feet.

In addition to containing a quarter of the entire human body’s bones, the feet also bear its entire weight. There are no less than 33 joints, 100 tendons, muscles and ligaments in them, as well as countless nerves and blood vessels that link to the heart, spine and brain. Taking the above into account, it perhaps isn’t a surprise to know that if there is something wrong with someone’s feet, the likelihood is that their entire body will be affected as well. Let’s take a look at a few things about the human body that can be revealed by the condition of the feet:  

1. Foot Cramping and Spasms

If you happen to get cramps and spasms in your foot, it could be a sign of a deficiency in your body. Spasms can be caused by dehydration, which occurs as a result of the muscles not getting enough oxygen. Another reason for muscles spasms could be that there is a lack or imbalance of electrolytes or nutrients in your body. If you experience spasms specifically when walking, then this could indicate a circulatory problem. A further reason for spasms to occur is overexertion, or failing to stretch adequately prior to exercising. Last but not least, the type of shoe you’re wearing may be causing you discomfort. If you’re a lady who happens to enjoy wearing sky-high heels, for instance, you should look more closely at your choice of footwear to see if they’re to blame for the spasms.  

2. An Enlarged Big Toe

Gout is the most common type of inflammatory arthritis in men, and it can cause the big toe to become red, hot, swollen and extremely painful. Gout occurs as a result of too much uric acid building up in bodily tissues and fluids. Its normal blood level is between 3.5 to 7.2 mg%. It’s also to blame for an increased risk of developing kidney stones. This type of inflammatory arthritis usually manifests itself in the big toe because uric acid crystals tend to collect in the coolest part of the body. Overweight or obese people are more at risk of developing gout, as well as those who drink excessive amounts of alcohol and/or consume lots of meat. Furthermore, certain medication like diuretics can exacerbate the risk.

3. Cold Feet

 Do your feet to tend to be abnormally cold? If they do, it could indicate that you have poor circulation, diabetes, hypothyroidisim or anemia. In addition, if your feet change color from red, to white, to blue, it could be a sign of Raynaud’s disease, which is a narrowing of the blood vessels when nerves overreact to the cold. Primary Raynaud’s sufferers are advised to avoid the cold and smoking tobacco, however 20% of all cases stem from an underlying disease. These people tolerate the winter months poorly.

4. Swollen Feet (Pedal oedema)

Swollen feet can be indicative of numerous health problems. It could be simple nutritional deficiencies like hypo-proteinemia, anaemia and Beri-beri (Vitamin1 or Thiamine deficiency) or life-threatening like poor circulation and related heart failure, kidney or liver disease. It could also be because of deep vein thrombosis, filariasis,  a blood clot, lymphatic build-up and cellulitis, among others. Try raising your feet when sitting down, exercising your legs, reducing your salt intake and avoiding tight clothes, if you happen to have swollen feet. Investigations for the causative diseases are advisable. 

5. Spoon-Shaped Toenails

Concave-shaped toenails aren’t just unsightly – they could also be a sign of something underlying. The primary thing it’s associated with is nutritional deficiencies. They’re also associated with genetic disorders, circulatory problems, autoimmune diseases and musculoskeletal conditions.

6. Colored Toenails

Conditions such as tuberculosis, jaundice due to liver problems, thyroid gland involvement and even sinusitis could all cause the toenails to yellow. Yellowed toenails can also be symptomatic of bronchiectasis, an infective lung condition that causes breathing problems. Different nail colors and textures could also indicate a whole range of various systemic problems.  Vitamin B₁₂ deficiency present as hyperpigmentation of nails like bluish discoloration of nails, blue-black pigmentation with dark longitudinal streaks, and longitudinal and reticulate darkened streaks.

7. Deformed, infected and destroyed toe nails

Fungal infection of the toe nails or Onychomycosis, usually seen in diabetics are a common cause of deformed nails.  If the nails are peeling, brittle, or have vertical ridges, this may be vitamin D deficiency should be considered. Recurrent nail bed infections – paronechoea should always be investigated for diabetes. Brittle nail that chip and break easily is associated with iron deficiency anaemia. White spots on the nails - sometimes called Beau's lines - are one of the important signs of a zinc deficiency.

8. Pins and Needles Sensation

Circulatory problems, peripheral nervous system damage, a trapped nerve and a range of other ailments can lead to numbness or tingling in the feet. Diabetics who are exposed high blood glucose for an extended period can also experience nerve damage, which in turn leads to tingling in the feet, which is called Peripheral Neuritis. Pins and needles in the extremities can also be one of the first symptoms of multiple sclerosis.

9. Aching Toe Joints

Some 90% of people who have rheumatoid arthritis will experience aching toe joints. The disease makes the lining of the joints swollen and inflamed. As a result, the joints and supporting ligaments and tissues are damaged, which ultimately leads to decreased mobility. Antiinflammatory drugs relieve these symptoms, but have their own side effects like gastritis. Furthermore, shoe inserts can help minimize pressure and correct the shape of the foot. Some people also have braces that they wear on their feet. Gout too is a cause of painful and swollen great toe joints.  

10. Hallux valgus and Bunion

This condition is characterized by misalignment of the big toe. This leads to the big toe pushing and exerting pressure on the surrounding toes making the big toe MCP joint to stick out and point outward. Bunions at this projected site are more common in women who have diabetes and are overweight.  

11. Corns and Calluses

Corns and calluses are thick, hardened layers of skin that develop when the skin tries to protect itself against friction or pressure. They often form on feet and toes or hands and fingers. If you're healthy, you don't need treatment for corns and calluses unless they cause pain. Offloading footwear can help patients who are severely distresses. Corn caps, which have salicylic acid can be used for a long time to get rid of them. Offloading footwear can help patients who are severely distresses. 

12. Planter fasciitis

Plantar fasciitis can cause pain in the bottom of your heel or in the lower part of your middle foot. This happens when the plantar fascia becomes strained because of soft-soled footwear with poor arch support, frequent standing, long-distance running, weight gain, or other foot conditions. Stretching exercises, alternate hot and cold foot bath and corrective footwear can effectively treat this condition.

13. Foot Drop

If you have difficulty lifting the front part of your foot, this could be a sign that you have drop foot, which is normally indicative of an underlying muscular, neurological or anatomical problem. The resultant gait is called ‘steppage gait’. Foot drop can occur as a result of a leg injury, faulty plaster immobilization damaging the lateral popleteal nerve or Sciatic nerve damage during a hip operation. It can also be the result of a neurological disease such as polio, as well as a brain or spinal cord disorder. A brace or splint can be used to help maintain a normal foot position, whereas nerve stimulation can also alleviate drop foot to a certain extent. Surgery can also be undertaken to treat nerves, fuse bones or transfer tendons.

14. Persistent Sores

If you have diabetes, it’s possible that you have experience nerve damage to some extent. Nerve damage, or neuropathy, results in people being unable to feel or notice injuries such as blisters and decreased vascularity prevents early healing. Diabetics are prone to foot ulcers both because of loss of sensation and because of decreased blood flow. Nerve damage can also cause feet and toes to change shape – Charcot foot. Dry, cracked and peeling skin on the feet can also be a sign of diabetes, as can calluses and poor circulation.

15. Madura foot

Madura foot, or mycetoma, is a chronic granulomatous infection characterized by subcutaneous masses, draining sinuses, and the presence of grains or granules in exudates. This condition is caused by either fungi or aerobic filamentous bacteria.  Surgical debridement, followed by prolonged appropriate antibiotic and antifungal therapy for several months is required to save the foot.

16. Deformed foot

Deformities can be since birth like Club foot, Syndactyly of toes, Hemimelia or shortening of lower limb. Acquired deformities can be because of trauma or because of chronic diseases like diabetes and Rheumatoid Arthritis. Diabetes is the commonest cause of amputation of foot or its digits is you take trauma out of the consideration.

 

The Professor concluded with the advice that if you miss to examine the feet of your patients, you may miss the diagnosis! The feet warrant more attention than you imagined. If you are a diabetic then take care of your feet more than your face.

Friends, this was one of Prof. Chakraborty’s many extempore lectures which we have enjoyed in our college days. Always smiling, with a twinkle in his eyes he not only knew the subject thoroughly but could organize it into a captivating lecture and could convey his message almost effortlessly. With no notes, no power point presentations, the sagacious grand old man was effervescent with knowledge and his love for teaching could only be matched by his wisdom. Remembering him today with great reverence and respect!