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| HEALTH TRIBUNE |
Role of first aid in spinal injury cases
How to control excessive menstrual bleeding
Spinach is good for health
Health-giving herbs
Ayurveda
& you
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Role of first aid in spinal injury cases It has been estimated that between 8000-10,000 traumatic spinal cord injuries occur each year in the US. Its true incidence in India is not known, but it is expected to be higher due to a larger population and poor driving conditions. Trauma is the leading cause of death in individuals between 20-35 years of age. Of these deaths, 3-5 per cent are directly the result of spinal cord injuries from trauma. The incidence of spinal cord injuries is five times more in males than females. Most spinal cord injuries are caused by automobile accidents, falls and in sports events. Common sites of injuries to the vertebral column (spine) are the region of maximum mobility (neck) and junctions between relatively fixed and mobile segments like the thoraco-lumber junction (junction of the middle and lower spine). Accident victims of any sort should be assumed to have an unstable spine until proven otherwise. Neck pain or deformity, wound on head and an inability to move limbs increase the suspicion of a spinal cord injury. First aid to such patients is usually lacking in our country due to the shortage of trained paramedical staff. Great care is required to immobilise the spine during the transport of these patients from the site of trauma to a hospital. The spinal cord injury can be worsened if proper precautions are not taken during transfer. Patients of cervical (neck) injuries should be transported supine with the head supported between sandbags, which may also be used to anchor a towel passed across the forehead. In moving the patient, flexion, particularly rotation of the neck, should be avoided by an attendant who is made responsible for controlling this alone. If available, a hard cervical collar (Philadelphia Collar) is ideal for immobilising the neck of the patient. Proper care of a person with suspected cervical spine injury must begin at the accident site with adequate immobilisation of the head and the neck along with attention to the first priorities of ABC of trauma resuscitation: airway, breathing and circulation. Because aspiration and shock are the primary cause of death in spinal cord injury victims before they arrive in the emergency room, respiratory and circulatory management at the scene of the accident is critical. If airway is adequate on initial assessment, the patient’s head should be immobilised and secured. Supplemental oxygen should be administered by a face mask or nasal cannula. Patients of dorsal and lumber spine (upper and
lower back) injuries should never be moved except by at least two attendants, one being responsible for the pelvis and the other for shoulders; the two being kept parallel and the patient effectively rolled like a log of wood. The patient may be transported either prone or supine, depending upon other injuries in a backboard. Paediatric patients present a unique problem for immobilisation. If the patient is found in water and has a suspected spinal injury, all efforts should be made to keep the patient floating on the surface, with support for the head and the neck. The common error of carrying the patient to dry ground usually allows the head to dangle unsupported, Instead, extrication in water can be relatively easily accomplished by securing the floating patient to a long board while the patient is still in water. A motorcyclist, bicyclist or athlete may be found at an accident scene with a helmet still in place. Inline traction should be applied for removal with a second rescuer supporting the head and the neck. If the helmet cannot be removed easily, it can be left in place during transport as long as the patient’s airway is not compromised. If the patient is seated in a vehicle or otherwise in a position of difficult access, a rigid cervical collar can be placed for some support. While still in the vehicle, the patient should be immobilised on a half-board for removal from the vehicle. Before transportation, the patient must be secured and fastened to the transport device and be able to withstand complete inversion without loss of immobilisation. The ambulance transporting these patients should be required with oxygen supply, suction machines, life-saving drugs, ventilators and above all, trained paramedical staff. Due to the lack of trained paramedical staff, poor practical training to undergraduate doctors and the lack of availability of well-equipped ambulances in our country, most patients are not provided proper immobilisation, first aid and transportation. The critical issue of training of paramedics in resuscitation of spinal cord injury patients needs to be addressed on an urgent basis.
— The writer is a Jalandhar-based neurosurgeon.
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How to control excessive menstrual bleeding Neerja has been suffering from depression since her uterus was surgically removed one year back. She believes that the uterus and menses are signs of feminity. Moreover, she feels that her reproductive organ was needlessly sacrificed due to the doctor’s negligence. On the other hand, Jeeto is enthused in narrating her tale, “I am hale and hearty after the operation since the organ had become useless anyway after I finished my child-births. More so, the monthly blood loss could threaten my life since the uterus used to pour excessively. My doctor saved my life by getting me rid of the troubling organ.” Notwithstanding the tales of the two women, thousands of hysterectomies are performed daily to treat excessive uterine bleeding; many are essential. One of the most common menstrual disorders is “Excessive bleeding” called menorrhagia, which affects more than a third of all women. A patient who bleeds for more than seven days or loses more than 80
cc of blood, or a woman who routinely uses more than 10 pads a day during her period is usually diagnosed with menorrhagia. It is a chronic condition that may occur as early as a woman’s first menstrual cycle, or it may be noted with the beginning of the menopausal zone at 40 years of age, and can severely compromise the health and quality of life of the women who suffer from it. Causes: (I) Hormonal imbalance causes dysfunctional uterine bleeding (DUB) and accounts for approximately 20 per cent of hysterectomies. (ii) Fibroids and polyps cause structural uterine bleeding, and account for 30 per cent of the hysterectomies performed. (iii) Infection of the uterus or cervix and certain types of cancer, such as the cancer of the uterus, cervix or vagina, can cause uterine bleeding. Most women who lose excessive blood during menstruation develop anaemia. It leads to time missed from job/ work, social activities and a lack of ability to care for family. There is also an emotional toll, which can include stress, embarrassment and depression. Several health problems arise due to the loss of blood. This requires active management. Dysfunctional uterine bleeding is abnormal uterine bleeding caused by the interruption of the normal ovarian function that produces eggs called ovulation. The right choice for correction is based on the cause of bleeding, and the preferences of the patient. Hysterectomy is the surgical removal of the uterus and remains one of the most common surgeries performed on women in India. It is used in the management of abnormal uterine bleeding, symptomatic uterine fibroids, pelvic relaxation, gynaecologic cancer and pelvic pain. In some cases, the uterus can be saved when the doctor and the patient both approach the problem patiently. In some cases, only the endometrial lining needs to be removed, or perhaps the portion of the uterus responsible for bleeding and cramping. How is diagnosis made? A pelvic exam is the first step to determine the cause of menorrhagia, including a Pap smear and blood tests to check for any underlying causes, as well as a pregnancy test when appropriate. An ultrasound is often performed to check for any abnormalities such as fibroids and an endometrial biopsy, D&C, or hysteroscopy may also be performed to further evaluate the condition of your uterus. How is excessive bleeding treated? Women who are not pregnant and who experience a single episode of heavy bleeding usually require no medical treatment. Getting sufficient rest often reduces the amount of blood flow. However, all women who experience heavy bleeding for over 24 hours should seek the advice of their doctor. Relief from menorrhagia is achieved by treating the medical or physical (as in the case of an IUD) cause. Abnormal bleeding which does not appear to be related to another underlying cause is often successfully treated with progesterone or a combination of progesterone and estrogen, many times given in the form of an oral contraceptive. —
The writer, a senior gynaecologist based at Chandigarh, is the author of |
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Spinach is good for health
Washington: Popeye was right, spinach is good for you and contains antioxidants, which help fight formation of free radicals, says a newly certified report. The National Institute of Standards and Technology
(NIST) recently published their Standard Reference Material (SRM) 2385 consisting of small jars of slurried spinach, pure spinach that's been blanched, pureed and passed through filter screens. The concentrations of vitamins and other constituents have been measured and certified, so that the food industry can use the SRM to validate analytical methods and provide accurate nutritional information for its products. An analytical method is also evaluated by using it to measure constituents in the SRM and then comparing the results to the
NIST-certified values. The NIST values confirm that spinach is rich in antioxidants-- both beta-carotene and
lutein. Although the actual amounts look relatively small, spinach contains far more of the two combined than most other fruits or vegetables, concludes the report. Antioxidants help fight formation of free radicals, highly reactive molecules that can damage DNA and are responsible for the development of certain diseases.
— ANI
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Health-giving herbs The book has been divided into three parts. These together cover the following: Body constitution and ayurvedic herbs. Holistic and preventive herbs. Herbs which improve memory and intelligence. Herbs which promote rejuvenation and longevity. Herbs which strengthen the heart and prevent heart ailments. Herbs which strengthen the body's defence system. Herbs which help in managing gastric and respiratory problems. Herbs which activate the nervous system and alleviate depression and anxiety. Herbs useful in the prevention and management of diseases like AIDS and cancer.
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AYURVEDA & YOU In
our day-to-day life, we come across people who look younger than their
actual age. While there are others who appear to have aged well before
the time. Medical science is putting a lot of efforts to find out the
causes influencing aging and at the same time determining our
lifespan. Ayurveda believes that human beings have an in-built “biological clock” which can run for 100-odd years if no disease affects the body. If we talk in philosophical terms, it is the “kaal” or the time which runs the whole of the universe. For a set period, everything on earth is following the same principle — it comes, grows, declines and then vanishes. But the momentum and manner in which a person ages may depend upon many factors. The longer life-span of the offspring of parents who live long makes us believe that, perhaps, heredity is the foremost factor which determines longevity. Though sometimes the opposite is also true, but mostly long life seems to be related to some genetic code. While referring to the genesis of serious diseases, many ayurvedic texts have pointed out that inherited health problems are most difficult to treat, and they have more of a negative effect on the life-span of a person. Acharya Charaka has written about the environmental factors like place and climate playing an important role in this regard. It is observed that people living in certain regions of the world have a longer life-span. Climate by itself doesn’t seem to have much effect on longevity, but shorter lifespan of many people living in tropics seems to depend upon their relatively poor hygiene and nutritional discrepancies. Nowadays environmental pollution is increasingly considered a factor which weakens our vitality, thus speeding the aging process. While much of the ayurvedic approach regarding aging is attributed to the lifestyle of a person, improper or unwholesome diet has been thought to be equally responsible for the fast and early decay of health. A good, balanced and individually suitable diet, supported with proper digestion and assimilation, fulfils much of the desired requirements of good health. In ayurvedic terminology, when “ama” (post-digestive impurities or endotoxins) gets absorbed in the system, it lowers the body immunity, aggravates the cellular wear and tear to bring disease and fastens aging. Physical activity is another important factor which is related to the overall well-being of our body. Many elderly people display remarkable physical fitness and endurance despite their high fat intake. Ayurveda believes that people who lead an active life and never shirk from physical effort remain healthy and have a longer life-span. Reasonable exercise not only increases stamina and endurance but also helps clear the body channels, leading to the strengthening of the immune system. Ayurveda discusses certain psycho-social factors known to accelerate the pace of aging. Most noticeable of these, are excessive stress and anxiety, which are proven health risks and have the potential to affect every system. Overindulgence in vices, lack of body and mind discipline and the adoption of a neglectful attitude towards health also hastens the aging process. Persons of a weak mental frame confronted with prolonged loneliness, adverse social conditions and a lack of family support also start their downhill journey quite early. Aging is a complex issue, and people who have lived longer are seen attributing the secret of their longevity to the will of God. But modern experts also seem to echo the ayurvedic viewpoint in this regard. The main factors to guard against speedy aging and the shortening of the life-span are the lack of dietary caution, less of physical exertion and an abundance of worries. —
The writer is a Ludhiana-based ayurvedic consultant.
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India has been known the world over for its ancient herb-based system of medicine — Ayurveda. These herbs play a dual role, in curing diseases as well as maintaining health. There are herbs greatly useful in rejuvenation and promoting longevity. One can get the details in Dr Chander Mohan Ghai's well-researched book.