So that all may hear
Dr U.S. Bansal

LOSS of hearing is one of the largest yet least recognised physical ailments in India. Statistics show that one out of every 12 persons in this country is affected by this problem to some degree. Yet we pay less attention to hearing loss.

Despite the magnitude of the problem, it is not given as much importance as other disabilities. Perhaps, this is because hearing loss is invisible and painless. But for those who are deaf and actually live in this world of silence, the emotional pain is devastating. Hearing loss is also India’s least understood problem because it is a hurt that does not show. Among the infirm and defectives, the deaf mutes are the most short-lived as they suffer in silence, are less expressive and the least understood.

Today there are many unsolved problems related to hearing and balance disorders, and there are indications that the size of the problem is growing. Though the opportunities to do something about these problems today are better than ever before, the many unsolved mysteries of hearing and balance disorders still persist. Each year brings new and promising research leads that someday will bring solutions to hearing problems. Research is a challenge that involves not only doctors but also their patients and all of us.

If you are suffering from deafness, a complete otologic examination by a ear specialist is necessary to determine what type of hearing impairment is present, its probable cause and recommended treatment. If your hearing can be improved by medical or surgical means it should be got done. Where medical or surgical means do not help much, the use of a hearing aid may be of great help.

The ear is divided into three parts: the external ear, the middle ear and the inner ear. The middle ear is connected to the back of the nose by the eustachian tube which serves as a pressure equalising valve for the ear. Each part of the ear performs an important function in the process of hearing. The external ear and the middle ear conduct sound while the inner ear receives it. Any disease affecting the eardrum or the three small ear bones in the middle ear may cause a conductive hearing loss by interfering with the transmission of sound to the inner ear. Such hearing impairment is mostly due to perforation in the eardrum or infection in the middle ear.

Middle ear infection occurs more frequently in children in connection with an upper respiratory infection or throat infection and develops an infected or abscessed ear. The eardrum may rupture, resulting in perforation. The infection in the middle ear usually subsides and the perforation heals with the proper treatment from the specialist concerned at this stage. Unfortunately, not all patients with ear problems consult an ear specialist — many of them are seen by unqualified doctors or qualified but not ENT specialists. If a child does not get proper and adequate treatment at this stage, the infection in the middle ear does not subside; the perforation fails to heal and hearing loss occurs with intermittent or constant ear discharge. General health factors are particularly important in regard to the child’s resistance to infection.

If perforation is present, you should not allow water to get into your ear canal. This may be avoided when showering or washing the hair by placing cotton in the external ear canal. If you desire to swim, use cotton-covered vaseline or a tight fitting swimming cap. You should avoid blowing your nose in order to prevent any infection in your nose from spreading to the ear through the eustachian tube. Any nasal secretion preferably should be drawn backwards and expectorated. If it is absolutely necessary to blow your nose, do not occlude or compress one nostril while blowing the other. In the presence of ear discharge the ear canal should be kept clean by means of a small cotton tipped applicator. Medication as prescribed should be used if discharge is present or when discharge occurs.

In recent years changes in surgical techniques have made it possible to reconstruct the diseased hearing mechanism in most of the cases. With surgical techniques, most ear infections subside and the structures of the middle ear heal almost completely. If you do not have surgery performed at this time, it is advisable to have frequent examinations, especially if the ear is draining. Should you develop dull pain in or around the ear, increased discharge, dizziness or twitching or weakness of the face, you should immediately consult a specialist.

Any disease of inner ear results in nerve or sensor neural deafness. The most common cause is an ageing change in the nerves, commonly in old persons. Speech is audible but not clear to him. He is having difficulties in understanding what is being said to him. Unfortunately, this type of deafness is not correctable so far. But if the hearing level has dropped below the point of serviceable hearing, perhaps the greatest assistance is a carefully selected hearing aid. It is estimated that with a hearing aid alone comprehension is approximately 50-60 per cent. It is most important for the persons with impaired hearing to avail himself of this opportunity for maximum understanding. Much of the strain, fatigue and tension can be reduced and perception and understanding enhanced.

The writer is an ENT surgeon and former CMO in charge, ENT Department, General Hospital, Sector 16, Chandigarh.

Osteoarthritis and Ayurvedic rejuvenation therapy
Dr Harish Verma

OSTEOARTHRITIS is the most common condition, affecting the weight bearing joints (e.g. knees, lower back, hips, etc.), often described as “wear and tear” arthritis.

In human body the ends of the bones in normal joints are covered with a smooth, slippery tissue called cartilage, which provides protection to our bones. Joints also contain a substance called synovial fluid, which acts as a cushion or “shock absorber” and lubricates the joint. In people with osteoarthritis, the synovial fluid becomes thinner and loses its elasticity. The thinner synovial fluid does not provide a good cushion. For this reason, the cartilage covering the ends of the bones begins to break, which leads to pain and stiffness in the joint.

Osteoarthritis is also known as degenerative joint disorder, because of degeneration of cartilage covering the ends of the bones. In Ayurveda, this condition is called Sandhighat Vata.

This condition can be a very mild disease or a severe disease that greatly limits everyday activity. For example, if a patient has Osteoarthritis of the knee, he may feel pain and swelling in the knee area and pain gets worse during the movement of the knee. The patient may feel or hear crunching or cracking sounds on the movement of joints. X-rays usually confirm the diagnosis.

Ayurveda has been practised for thousands of years in India. Ayurvedic therapy in osteoarthritis not only prevents further deterioration in the joints but also rejuvenates the damaged cartilages. As acute pain may not be felt in every case of degeneration, one must think of starting treatment at the very initial stage.

Ayurvedic science is based on the principles of bio-energy. There are three types of bio-energies or Doshas called Vata, Pitta and Kapha, which control metabolism and all other functions of human body. The equilibrium of the Doshas provide complete health. An imbalance of these Doshas leads to various disorders. Osteoarthritis (Sandhighat Vata) is a Vata disorder in which excessive Vata energy causes dryness in the joints followed by pain, swelling and stiffness of affected joints.

According to Ayurvedic principles, before starting the treatment of any chronic disease, detoxification of the body is essential. Panchakarma is a detoxification process that is to be administered along with essential pre-procedural and post-procedural methods under strict supervision of qualified Ayurvedic doctors. The Panchakarma process allows the body to achieve the equilibrium of the bio-energies — Vata, Pitta and Kapha.

In my private practice I have seen, after the Panchakarma process, people report a feeling of lightness in the body and clarity of mind, the weight naturally balances. The seven days of detox involves a daily approximate by two-hour treatment consisting of a warm, nurturing oil massage given by experienced therapists. This is followed by a relaxing steam, which enables the oils to penetrate and lubricate the tender body tissues.

After detoxification of the body the following rejuvenating Ayurvedic herbal supplements are recommended for six months to one year: ashwagandha, guggul and shilajit, one capsule or tablet each twice a day with a large glass of water. Ayurvedic diets and life styles are selected as per constitution of the individual. One should avoid being overweight, because excess weight increases the load on the joints. Regular exercises of knee joints help the patient to remain fit. Research evidence on the effectiveness of Ayurvedic rejuvenation therapy is lacking, but many patients find it greatly helpful.

The writer is Chief Consultant, Sushruta Ayurvedic Therapy Centre, Delhi, and the author of ‘Secrets of Ayurveda’, published in the UK.

INFO CAPSULE
Sleep and children

Washington
A new study by researchers at the Baylor College of Medicine has revealed that sleep apnea may not only affect children’s sleep but also have more severe conditions like impairing a child’s performance on tests of intelligence, memory, academic performance, social skills and even attention.

These findings and others raise the possibility that attention deficit hyperactivity disorder, or ADHD, and other behavioural and learning problems may sometimes be a symptom of obstructive sleep apnea syndrome (OSAS). Apnea signifies breathing problem during sleep. ANI

Soap-and-water handwashing

JOHANNESBURG: A new research by the London School of Hygiene and Tropical Medicine has found that widespread handwashing with soap could reduce infection and cut by 50 per cent the number of deaths from diarrhoea-related diseases worldwide.

Diarrhoeal diseases kill 200 children an hour — more than either AIDS or malaria. While most households in the world have soap and water, very few use them together to wash their hands after going to the toilet or cleaning something dirty. ANI

Fighting insulin resistance

WASHINGTON: A new study has concluded that reducing or preventing insulin resistance, possibly through exercise, weight loss and drugs, may help people with type 1 diabetes avoid nephropathy, a lethal complication of the kidney.

Insulin resistance, a condition commonly associated with the development of type 2 diabetes, is likely to be a major cause of nephropathy in people with type 1 diabetes, according to study results published by University of Pittsburgh Graduate School of Public Health (GSPH) researchers in the September issue of Kidney International a journal of the International Society of Nephrology. ANI

Device for diabetics

WASHINGTON: Scientists are developing a “smart” tattoo that would tell diabetics when their glucose levels are dangerously low. Once perfected, the tattoo will allow glucose levels to be monitored round the clock and could permit an alarm system that would warn the diabetic if their glucose levels were to fall dangerously.

It would also mean that diabetics would no longer have to subject themselves to the finger-stick devices, which currently they must use everyday. ANI