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| HEALTH TRIBUNE |
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Tackling
eye ailments among infants Rising
cases of cervical cancer Drug
abuse: the dangers Ayurveda
& you Fish can
cause marine organism disease Practise
yoga and remain active Lung
cancer in women Cinnamon
can fight diabetes too! |
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Tackling eye ailments among
infants The
changes in the life-style of the people, the increasing longevity, the use and abuse of medical aids, self-medication and prescribing of drugs for eye ailments by all and sundry have complicated the situation with regard to eye problems. This confuses the doctor to come to a proper assessment of the disease and diagnosis and thus delays the correct line of management. What is actually happening is that before a patient really consults a specialist, he goes to a chemist, who gives him free consultation and doles out medicines, antibiotic drops and so on (of course, on payment). For vision correction, the patient goes to a spectacle shop (optician), who prescribes him glasses and even eye-drops, which the person concerned may or may not need. The optician rarely refers his clients to a specialist. There is no regulation, prohibiting him from prescribing eye-drops, etc. However, there are several brands with catching names which the patient prescribes himself/herself. Only after his failure to get relief, the patient goes to a doctor and, most of the times, conceals the history of his past treatment. He is free to put the blame on the eye-specialist in the case of delay in relief. To begin with the real eye problems, let me start with the young and infants. There is an increased prevalence rate of watering and “gidd” discharge in the eyes of the new-born, specially so in the first-born babies; nearly 10 per cent of them suffer from this problem. It is caused either by the congenital obstruction of the nasolacrimal duct or is an acquired infection during birth. It is curable in 90 per cent or more cases by the use of suitable antibiotic drops and demonstrating the correct method of instillation and massage and the frequency of application. The rest 10 per cent may require surgical opening of the drainage passages called syringing and probing, but one can delay this procedure till the baby is one-year old. The second paediatric problem of the modern times is the higher incidence of premature births and low birth-weight — less than 1500 gms. Such neonates are now reared in incubators with the administration of oxygen. These babies have retinal complications — the so-called “retinopathy of prematurity” (ROP). This leads to the late onset of myopia called “myopia of prematurity”. Retinal complications are dealt with through laser treatment of major retinal surgery. Modern mothers have less patience and interest in taking care of their babies; they mostly employ “ayas” for this purpose. If the baby cries and disturbs their sleep at night for the change of diapers or feed, they drug them to sleep or even spank them, causing injuries to their eyes, etc. This is more common in the West and this form of child abuse is called “battered baby syndrome” or “shaken baby syndrome”. The assessment of vision in a child at that stage cannot be accurate, but an idea can be obtained by checking pupillary reaction, visual reflexes, retinoscopy and fundus examination. As the child gets ready to enter school, visual acuity can be recorded for future reference. Figures tell that nearly 8-10 per cent of children need glasses by the age of six-seven years. If such cases are left untreated, their
acquisition of knowledge suffers and personality problems develop. If the power is unequal in the two eyes, one may develop squint and the eye may become lazy. There is, therefore, urgent need to educate parents and teachers for a change in their attitude so that they do not resist proper wearing of glasses by their wards. My experience tells me that teachers of kindergarten and other classes are the first one to detect a visual defect among the children and they inform the parents to get their wards’ eyes checked. This has indeed led to an early correction of their vision and also saved the eyes from becoming amblyopic. The question that arises is whether there is any alternative to glasses. Yes, there is, after a certain age, say 13-14 years in the case of girls and 16 or so in boys, when they become more responsible for taking care of their health and eyes — use of contact lenses can be recommended. Today there is a variety of contact lenses available in the market — semisoft, soft, daily wear, extended wear and disposable — which one can change every month. Even cosmetic lenses are also available in different shades. However, contact lenses do not stabilise the power of the eye nor does the number of the lenses get reduced. There is no scientific truth in it. The wearers soon get tired of the daily care, putting on and taking off at night and then preserving the glasses in a solution. They sometimes sleep with these glasses overnight and invite complications leading to pain, infection, etc. For such cases of contact lens intolerance, there are two alternatives called “refractive surgery”, altering the curvature of the cornea and thus correcting the refractive error, myopia, hypermetropia or astigmatism. Radial keratotomy was the procedure of choice started nearly two decades ago and held the forte till lately but now it is obsolete. Replaced by Excimer laser surgery (PRK or LASIK Laser), the latter is quite safe, predictable and lasting. More than five years of follow-up of cases in this part of the country is quite satisfying and encouraging. However, every new procedure has its own problems. People are warned not to expect miracles and should follow the post-operative instructions meticulously. A spate of advertisements in the lay Press has so much confused the people as they do not know which procedure to follow. Commercial twist has made the modern practice of medicine a trade. Restoration of the eyesight without glasses is becoming a craze, as it absolves the person of all the hassle of care of glasses, contact lens, etc. Secondly, it helps the marriageable girls and boys in the matrimonial market. There is a vast market as nearly 30-40 per cent of the boys and girls in the 18-35 years age group are in need of glasses. The new technique is getting acceptance, though slowly, among the people in India. However, in the West nearly 1.5 million procedures are done yearly. Another important point which needs mention is whether TV viewing and working on computers harms the eyes. There is as yet no scientific evidence to show its negative effect, except ansthenopia (eye strain) and relative dry eyes. Palming of eyes and frequent use of artificial tears
help. The writer is Emeritus Professor, Department of Ophthalmology, PGI, Chandigarh
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Rising cases of cervical
cancer
Reshma
(42) was leading an active life when suddenly she was gripped with panic after coital bleeding following one of those sexual encounters. She was not overwhelmed either by the phrase “burhi ghori lal lagam” or the underlying gravity of the symptom, and followed it up boldly with a gynaecological check-up, PAP test and colposcopy. Her fear was real, but her prompt action detected her cancer cervix early leading to its cure. On the other hand, her sister Pammi, employed as an executive in a private company, was not so lucky. Pammi (not her real name) was too busy in her official duties and boy friends to spare time to go to a gynaecologist, despite warning symptom like foul-smelling discharge and discomfort. She continued trying treatment by taking advice on the phone until her condition worsened: weight loss, fever, bloody discharge, excessive and irregular vaginal bleeding, etc. Her cancer cervix had spread and the consequences of early painful death loomed large. She had to pay the price for undue sexual permissiveness and neglect Cervical cancer is the commonest cancer among women in the menopausal zone in India. The incidence starts to rise in her early thirties and reaches its peak at 40-50 years. In India, the age is 10 years lower than that in the West. While early marriage, poor sexual hygiene and growing extramarital and pre-marital contacts and multiple sexual partners make the occurrence of this cancer common, fortunately it can be detected early. The tests are colposcopy and PAP test, which are easy to perform and are painless and inexpensive. The tests should be performed regularly every year in all females who are sexually active at or after the age of 18 years. Where history is suggestive of early, excessive and varied sexual activity and smoking/drug abuse, etc, she must be examined and investigated properly at a young age. For that matter, one is never too young to ignore colposcopy and PAP smear tests if the conditions are suggestive.
What is colposcopy? Colposcopy is an examination of the cervix and the walls of the vagina through a speculum. Your doctor uses an instrument called colposcope to detect cervical problems. Colposcopy is always necessary as a part of a gynaecological check-up in the menopausal zone and more so after an abnormal PAP smear has been found, even in a young woman. One may see white opaque areas or fiery-red bleeding and fragile or hardened areas on colposcopy after the cervix has been washed with diluted acetic acid. In fact, it will be better if colposcopy is made a part of the routine examination of the cervix, at least in suspicious/higher than normal risk cases. Pre-cancerous conditions of the cervix, seldom cause symptoms. When cancer is present in the cervix the most common symptom is abnormal bleeding. Bleeding may start and stop between regular menstrual periods, or it may occur after sexual intercourse. Abnormal vaginal discharge is another symptom. Pain is not an early symptom of the disease. Don’t skip important yearly examinations that may save your life! Early detection and adequate treatment means a difference between life and death.
What is PAP smear? PAP smear is a simple test, which any gynaecologist can perform. During a PAP smear some cells are scraped or brushed off the cervix, and put on a slide that is examined through a microscope. The purpose of the PAP test is to detect changes that may lead to cervical cancer long before the cancer develops. Pre-cancer of the cervix is easily treated, and almost always prevents cancer from developing. The test will be reported as “normal, suspicious, pre-cancerous or invasive cancer”. In the case of a normal report, no further action is required and the person can get it repeated after one year or two as per the advice and circumstances. An abnormal PAP smear does not necessarily mean that cancer was found. There are many causes for abnormal PAP smear results. A repeat PAP smear may be necessary if you had an infection at the time of the test or if there were not enough cells collected during the test. Treatment of a lesion with the help of drugs, cautry, laser, surgery, etc, after early detection can lead to complete
cure. The writer is a Chandigarh-based senior gynaecologist and menopausal consultant
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Drug abuse: the dangers The
very purpose of this article is not to create an alarm but to inform the public about its responsibility towards society with a view to reducing the appalling drug abuse that goes on in our midst. One must remember that there is nothing like a safe drug and every chemical entering our body may be potentially harmful. It is the duty and the right of the patient to request the doctor for such information as the nature of his illness and the usefulness of the drug prescribed with its possible side-effects. One should avoid taking medicines on the advice of “well-meaning” friends and relatives. A person spends hours selecting a sari or a pair of shoes but not much thought is given while consuming a new medicine. A person taking a normal diet gets sufficient amounts of vitamins naturally. It is a myth that additional quantities can be had in the form of pills, syrups (available in fancy-looking bottles) and injections for extra benefit. In fact, these extras are quickly
excreted by the body. We are often confronted with an overfed individual complaining of fatigue or tiredness and demanding that a tonic should be prescribed to cure the problem. Clearly, the answer is not additional vitamins but a reduction in weight with life-style changes.
Role of Government Drug advertisements issued to the newspapers, the radio and TV networks or displayed on roadsides for the public should be banned. This practice, to a large extent, is responsible for the sale of many useless tonics and drugs without any medical practitioner’s prescription. One reason for wrong or over-medication is that the decision as to which medicine should be employed in a given situation often falls on the chemist, who obviously is not qualified or trained for this purpose. This should be prevented to help cut down the indiscriminate use or sale of drugs. Another area of crucial importance is that of quality control. Tragedies can occur with the use of a substandard drug. It is, therefore, important that the government agencies in charge of looking after this aspect of healthcare should be more vigilant and take harsh corrective
measures.
The writer is a former CMO, Health Department, Chandigarh.
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What to do when going out in summer By Dr R. VATSYAYAN Depending
upon the positioning of the earth towards the sun, ancient ayurvedic scholars have divided the year into two six-month periods. Summer or the “grishma ritu” forms the peak of the “adaan kaal”; the phase when the sun and the wind become powerful to reduce “kapha” and take away the strength of the body and evaporate the moisture of the earth. Many diseases are peculiar to this particular season. The Charak Samhita describes two distinct types of summer ailments – “anshughat jwar” or the heat fever or the heat exhaustion and the “anshughat sannipat”, better known as sunstroke. The heat fever occurs as a result of being exposed to high temperature and is a milder form whereas sunstroke is the most deadly of the heat-related illnesses. If we look at the effect of heat on the human physiology, we find that sweat is the most helpful defence mechanism for cooling our body. The production of sweat and its subsequent evaporation cools the skin, the blood and eventually the entire body. In hot weather when the moisture on the outer surface of the skin doesn’t evaporate swiftly, it makes the body sweat more profusely. The increased body temperature and loss of electrolytes and water lead to heat exhaustion or the heat-stroke. Heat exhaustion usually occurs over a span of a few days, when a person works for longer period in summer heat. Failing to take enough liquids to maintain the electrolyte balance and exposure to the heat over the course of time produces a host of symptoms in human body. These include nausea, headache, muscle cramps, general weakness, and confusion followed by an accelerated pulse rate and raised temperature. In heat stroke all these symptoms are more severe and follow in quick succession which eventually becomes a medical emergency. Our ability to cope up with heat varies according to age and physical condition. The young and very old are more vulnerable to heat related illnesses. People who are overweight and are given to a sedentary lifestyle, drink too much alcohol, suffer from heart conditions and hypertension and those who are not used to hot weather conditions may be at a greater risk of heat stress. By adopting a strenuous exercise schedule, one may also experience the same symptoms as that of heat exhaustion or heat stroke. With a few precautions and helpful tactics, incidence of heat exhaustion and sunstroke can be avoided. Since water represents “kapha” in the body which gives strength to all the physiological systems, one should take plenty of it in the summer season. Clean drinking water is the safest liquid to take in heat emergencies. The electrolyte balance can be restored by taking simply one glass of water or two mixed with lemon juice, a little of sugar and a pinch of table salt. It is advisable to take one glass of plain water or two before setting out in summer. Staying in cool places and wearing light weight and light-coloured clothing is always helpful in summer. Cotton clothes have a lot more breathing space to allow sweat to evaporate and they should be preferred over the synthetic ones. People who are not used to working in heat wave conditions should avoid strenuous activity in the sun. If possible they should try to work in the coolest part of the day. When out in heat, take care to keep your head and back of the neck covered. Sunstroke or fainting associated with other symptoms of heat exhaustion could be described as a serious situation. The patient should be immediately taken to the nearby hospital.
The writer is a Ludhiana-based ayurvedic physician
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Fish can cause marine organism disease
WASHINGTON: A long term study by Cornell University and the National Center for Ecological Analysis and Synthesis in Santa Barbara, California has shown that fish are no exception to an overall increase in marine disease. The report finds that the rate of disease is increasing in some sea animals such as turtles, mammals, mollusks, and urchins, but declining in fish. However, Jessica Ward, a Cornell doctoral student in ecology and evolutionary biology and lead author of the published study has said, “Disease in fish populations is decreasing only because their numbers are decreasing, due to over-fishing and other factors. Undoubtedly, there are fewer and fewer cases of pneumonia among veterans of World War I, but that doesn’t mean the veterans are becoming healthier. They are becoming fewer in number, and so are populations of wild fish.” The study was conducted by the 15-member Marine Disease Working Group of the National Center for Ecological Analysis and Synthesis, an ecology think tank. Heading the marine disease group is C. Drew Harvell, a Cornell Professor of Ecology and Evolutionary Biology. “This is the first quantitative study to provide solid evidence that rates of disease do seem to be increasing in the ocean. It has been hard to tell if disease is increasing because we didn’t have proper baselines. It’s been much tougher to understand the frequency of marine disease than it is to monitor for SARS, for example, because the ocean is out of sight and out of mind,” she said. Marine mammals have a variety of viral and bacterial ailments, some of which also seem linked to human activities. Mollusks, such as commercially farmed oysters, could be experiencing increasing stresses from both climate and aquaculture practices. Only sea grasses and sharks display no apparent increases in disease levels. Ward has, nevertheless, noted that one future application of the study method might be as a management tool for marine ecosystems in need of conservation, or as an aid for trend spotting and finding underwater populations that needs to be studied. “We are seeing so many emerging diseases that it can be overwhelming, and certainly we have to be careful about how dire we make the risk out to be.
— ANI
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Practise yoga and remain active The
word “YOGA” comes from the Sanskrit word “YUJ”, which means “to join” or “to yoke”. Thus, yoga means joining the individual soul with the universal soul. The practice of yoga asanas and pranayama improves the functioning of the internal organs, — liver, pancreas, intestine, lungs, heart, brain and glands like thyroid, parathyroid, pituitary, etc. Regular practice of yoga helps in the smooth functioning of the circulatory, respiratory, elementary genital-urinary and nervous systems. It benefits each body part. The importance of yoga has increased in today’s fast-paced life. Regular practice of yoga makes one feel energetic and active. Good health is one’s greatest asset without which one can hardly expect success in life. There are numerous modern methods of exercise that lead to rapid energy loss and develop sport muscles. Yogic exercises, on other hand, lead to harmonious development of all the muscles of the body. The movement, in yoga are gentle and rhythmic, thus energy is conserved. Yoga may not seem very difficult to do. But it should be performed under proper guidance. Movements of yoga must be performed very slowly and smoothly. Thus, a slower and more controlled movement is more beneficial. Proper breathing is also an important part of yoga. Breathing has to be slow and controlled. Correct breathing makes it more beneficial. Yoga helps sportsperson a great deal. The main ingredients are observation, courage, presence and peace of mind, physical fitness and mental alertness. Yoga helps to leave aside all tensions and worries. This gives you a more relaxed feeling as well as a more focused, concentrated workout. Yoga helps in achieving all this.
The writer is a physical education teacher |
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Lung cancer in women
LONDON: A team at Northwestern University, Illinois have said that lung cancer is a different disease in women than it is in men and they blame the female hormone oestrogen partly for this difference. According to the BBC, rates of lung cancer in women have increased significantly in recent decades while those for men have remained stable. The research in the Journal of the American Medical Association also noted the effect of more women smoking. Female smokers have a greater chance of developing lung cancer, and a higher risk of developing adenocarcinoma, which is the most common form of the disease. But women also have better survival rates, the researchers said. Numbers of women smoking continue to increase, while rates among men are falling.
— ANI |
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Cinnamon can fight diabetes too!
WASHINGTON: Cinnamon may be more than a spice because it has a medical application in preventing and combating diabetes. According to cellular and molecular studies carried out at the University of California, Santa Barbara, Iowa State University and the US Department of Agriculture, cinnamon can play the role of an insulin substitute in Type II diabetes. “Cinnamon itself has insulin-like activity and also can potentiate the activity of insulin. The latter could be quite important in treating those with type II diabetes. Cinnamon has a bio-active component that we believe has the potential to prevent or overcome diabetes,” said Don Graves of the University of California (UC). The beneficial effects of cinnamon on mice with diabetes are being studied in a joint project at the UC and the Sansum Diabetes Research Institute in Santa Barbara. The researchers have been studying the effects of cinnamon on obese mice, which have been fed water laced with cinnamon at Sansum’s lab. When the trials are completed, 60 diabetic mice will have been studied. The study began six months ago and final results are expected in about six months.
— ANI |
