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| HEALTH & FITNESS |
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Breast cancer on the rise in India
How to protect the new-born
Low back pain? Exercise can give you relief
Books An apple a day for
cancer prevention A drug combo to treat hepatitis C Suicides linked to painkillers
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Breast cancer on the rise in India Breast cancer is one of the commonest cancers affecting females. It is estimated that this disease will afflict one in eight females the US during their lifetime. The disease is not so common in India but is also not so uncommon. Statistics reveal that breast cancer is rapidly increasing in its incidence in India and it has overtaken cancer of the cervix. Indian Council of Medical Research data shows that breast cancer is the commonest cancer to affect Indian females in metropolitan cities. Although Indian data is not very reliable, it is estimated that one in 22 Indian females is likely to develop breast cancer. It has also been said that 80,000 new cases of breast cancer are detected every year in India and this is a huge number by any standard. Breast cancer is supposed to be more common among affluent people, those exposed to the modern lifestyle, as it is more prevalent in the West than in Asian and African countries. But in India the disease is also seen among poor, illiterate and backward people. Breast cancer from the point of clinical management is divided in three stages: early breast cancer, locally advanced cases and late or metastatic disease. Early breast cancer includes tumours of less than 5 cm in diameter; locally advanced tumours are more than 5 cm and secondaries from the breast tumour in other organs are included in the late stage of the disease. The common sites for secondaries are lymph nodes (at distant sites, axilla being included in early breast cancer), bones, lungs, liver, brain, skin, etc. In India, we see very few patients of early breast cancer whereas in developed countries the majority of the patients are of this group. It seems ignorance coupled with the lack of health education are important factors contributing to the growth of the disease. Quite often I have been told that the patient was aware of the large swelling in the breast but had not consulted any doctor earlier as the swelling was painless, little realising that the cancerous swelling is mostly painless in the initial stages. Unfortunately in India, a large percentage of patients depend on quacks for healthcare resulting in delayed treatment. It is really painful to note that even educated women in a modern city like Chandigarh want to try unscientific methods of cancer management. A cancer tumour can be detected in the asymptomatic stage when the patient does not have any complaint regarding the tumour and this is possible by following regular screening protocols. The screening protocol should be started at the age of 40 years: it consists of mammography, clinical examination by a specialist surgeon and self-examination of breasts by the female herself. Regular mammography of both breasts every second year and a clinical examination by a competent surgeon are supposed to decrease the deaths from breast cancer by almost 30 per cent. Breast screening is commonly practised in developing countries but unfortunately in India, because of financial constraints, it has not become common. Mammography costs only Rs 900 and it is a worthwhile investment for those women who can afford it. Self-examination of breasts ha to be learnt so that it can be practised properly. It has now been conclusively proved that a breast cancer patient not only requires operation but has to be given other forms of multimodality treatment also like chemotherapy, radiotherapy, hormone therapy and immunotherapy. A right combination of different modalities with proper planning and sequencing is important to get the maximum benefit to the patient. This depends upon the stage of the disease, the menstrual status of the patient, the histopathological findings of the excised tumour, the evaluated tumour markers and, most important, the expertise and experience of the treating surgeon. For over hundred years, radical surgery for breast cancer was being practised all over the world and this mutilating operation has been giving a lot of psychological problems to the patients. For the last 25 years it has been found that total removal of the breast is not required; the tumour can be excised along with a rim of normal breast tissue and the breast can be preserved, thus giving an excellent cosmetic look to the patient. Of course, this surgery has to be combined with the administration of other forms of treatment modalities so as to get the best results. There is an acute shortage of radiotherapy facility in India. Similarly, there is an acute shortage of trained oncologists. It is unbelievable but true that there is not a single trained medical oncologist at the PGI, Chandigarh, one of the premier medical institutes of India. This is true all over the country, resulting in the non-application of radiotherapy or chemotherapy to a majority of the patients of breast cancer. The results are obvious. The follow-up of the patient with the treating surgeon is very important not only for her rehabilitation but also for detecting the recurrence or distant metastasis. The recurrence of the cancer disease can be effectively kept under control if it is detected early and proper treatment initiated in time. This is also pathetically lacking in India. The writer is retired Professor and Head, Department of Surgery, PGI, Chandigarh
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How to protect the new-born The proper care starts with the cutting of the cord that separates the baby from the mother, which should be done only with a sterilised cutter. For this, the doctors advocate institutionalised deliveries.
In India, as many as 40 per cent of the babies are not delivered in hospitals. That is why expert care from the first day itself eludes the baby,” says Dr Ashish Mehta, Consultant neonatologist from Ahmedabad. Things to keep in mind immediately after the baby is delivered:
The new-born baby has an extremely low body resistance, and a mild variation from the ideal temperature can cause detrimental affect on the baby. “For adults, the comfortable room temperature is around 25 degrees celsius. But for a new-born, the ideal temperature should be between 36 and 37 degree celsius. This difference should be kept in mind regardless of the place at which the baby is delivered, whether it is hospital or home’’ says Dr N.B. Mathur of Maulana Azad Medical college, New Delhi. If a baby is exposed to a lower temperature for a long duration immediately after birth, he/she can die due to infections. Equally crucial is the wrapping and clothing of the baby immediately after delivery. The doctors say that as many as 35 per cent of the babies born in the country are not wrapped properly with adequate clothing, making the newborn vulnerable to infections. “The first breath taken by the baby after being separated from the mother is of extreme importance. The baby can develop asphyxia if it does not breath in after it is delivered. Making the newborn take its first breath requires expertise, as the correct breath taken can go a long way in determining the expansion of the lungs and the provision of oxygen to the brain,’’ says another expert. To make sure that the baby takes its first breath correctly, it should be positioned after being taken out of the womb and should be slowly rubbed at its back. The first feed of the baby has to be the mother’s milk, which should remain its exclusive diet for the first four months. Anything else, including honey or jaggery administered at the time of birth, should be completely avoided.
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Low back pain? Exercise can give you relief LOW back pain is as common as common cold. About 80 per cent of the adults suffer from low back pain at some point of time in their life. An attack that lasts longer than two months becomes chronic. The human backbone comprises small bones called vertebrae, which are stacked on one another in the spinal column. The lower part of the spine is called lumbar, which connects the upper body to the lower body. Lumbar spine provides mobility and strength. Mobility allows movement such as turning, twisting and bending. Strength facilitates standing, walking and lifting. This denotes the importance of lower back. Pain in the lower back can restrict one’s normal activity and also work capacity. Low back pain can be caused by various injuries and as a consequence of aging. Injuries occur due to obesity, improper usage, poor or incorrect posture, etc. Low back pain due to aging is on account of osteoporosis as there is a decrease in bone mass, strength and elasticity of muscles’ ligaments which support the spine. Nerves from the spinal cord can be irritated by the slipped disc leading to pain in the buttocks or legs and sometimes numbness, tingling and weakness in the legs. Most of the repetitive strain injuries cause chronic back pain, restricting an individual to lead a comfortable life. People usually complain of early morning pain while getting out of the bed which improves slowly during the day and re-occurs when a person goes home in the evening. The same cycle is repeated day in and day out till the individual starts to live in pain. There are certain conditions in which prompt investigations and treatment should be done.
Treatment Many a time the treatment is prescribed in the form of bed rest, analgesics, physiotherapy, etc. A common misconception regarding back pain treatment is advising bed rest for a long period. Bed rest for a short period of time reduces pain and inflammation, and light activity speeds up healing and recovery. It is not necessary to discontinue all activities, including work. Instead, one may adjust one’s activities according to one’s requirement. Activities which put a load on the lower back like lifting heavy weights and twisting one’s back should be avoided. When the pain reduces, begin with light cardiovascular training like walking and riding a stationary bicycle. Such aerobic activities increase blood flow to the back, which helps in promoting healing. For pain, ice should be applied for the first 24 to 48 hours. An ice pack should be applied for 10 to 15 minutes four to five times a day. Early intervention is essential for effective management and complete relief. There is strong evidence from long-term experiences of physicians that the spinal manipulation therapy and exercise are more effective in the management of low back pain than bed rest, analgesics, etc. Low back pain can be avoided or slowed down by following methods:
Exercises The following exercises help in conditioning and strengthening the muscles that support the spinal column. These exercises should preferably be done after cardiovascular exercises — walking, cycling, swimming, etc. An exercise that aggravates pain should immediately be stopped: 1. Pelvic tilt — Lie down on your back with knees bent. Flatten the small of your back against the floor without pushing down with the legs. Hold on for five to 10 seconds and repeat it 10 times. 2. Both knees to chest — Lie down on your back with knees bent. Feet flat on the floor. Pull both knees towards the chest. Hold on for five to 10 seconds. Slowly return to the starting position. Repeat it for 10 times. 3. Hamstring stretch — Lie down on your back. Place your left leg down with the knees straight. Bend your right hip by holding your right thigh so that your knee is pointing towards ceiling. Now move the foot towards ceiling. You will feel a stretch on your thigh. Hold on for 20 seconds and repeat it three times. 4. Partial curl — Lie down on your back with the knees bent and feet flat on the floor. Tighten your stomach muscles. Slowly curve your head and shoulder off the floor. Hold on for one or two seconds. Repeat it 10 to 15 times. 5. Lumber spine stretch — Start on your hands and knees like an animal having four legs. Move back on the heels and stretch your arms in the front as far as possible. Stay for five seconds and return. Repeat it for 10 times. It is advisable not to ignore chronic low back pain. If its treatment is deferred or delayed, activities can be severely restricted, thereby reducing a person’s work capacity. The writer is a former doctor/physiotherapist, Indian Cricket Team.
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Books BIG houses. Fast cars to get away from homes. Today, we worry about what we eat. Not about what is eating us. We worry about what we wear. Not about what is wearing us out. The style of life breeds stress and strain. These bring disease and despair. Resultantly, the modern man is afflicted with problems. Dr B.L. Manocha, in his book “Health, Disease and Hope”, suggests simple solutions for a multitude of maladies. At the outset, he asks: “Man and food. Who eats whom?” The opening chapter gives the way to health and happiness. Regular exercise, proper food, healthy habits and freedom from stress are the secrets of good health. This is the first lesson. All need to learn it. In fact, the chapter can be a part of the curriculum in our schools. The 42 chapters that follow cover almost all matters of concern. From “acne” to “warts”. Be it allergy, anaemia, angina pectoris and arthritis or obesity and osteoporosis, the book details the cause as well as the cure. Still more, the remedies are not confined to the homoeopathic system alone. The author has drawn upon his long experience and suggested solutions from different systems. To illustrate: For Anaemia, he gives Iron from the allopathic, “amla” from the Ayurvedic and ferrum metallicum from the homoeopathic systems of medicine. Such instances abound. Acupressure is useful for beautification of face and figure. Prayer can cure the “patient.” The author quotes Dr Herbert Benson of the Harvard Medical School to say, “Repeating prayer, words and sounds, and passively disregarding other thoughts, many people are able to trigger a set of p`ysiological changes. Mind works like a drug relieving AIDS symptoms, lowering high blood pressure and curing infertility.” All in all, it is a good reference book. For the layman and the learned alike. It is rich in content. Very moderately priced. The author has been giving medicines free. Through his book he is sharing his experiences free. We can use it freely to overcome our daily difficulties.
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An
apple a day for cancer prevention
NEW DELHI: An apple a day plus
a vegetable-intensive diet can help prevent many types of cancers as
the latest research show that up to one-third or cancer cases are
related to the food we eat. A chemical in apples helped prevent colon cancer in laboratory tests and animal studies, says Francis Raul, Research Director of the French Institute for Health and Medical Research in France. Three or more servings of vegetables a day — potatoes not included — reduces the risk of non-Hodgkin’s lymphoma by 40 per cent, says another researcher, Linda Kelemen, with the Mayo Clinic College of Medicine in the US. “It has been estimated that up to one-third or cancers are related to the food we eat... that’s a lot of preventable cancer,” says Kelemen in a report. Antioxidants in fruits and vegetables protect the body from damaging free radicals “like rust proofing your car,” she says. “A balanced diet of minerals, vitamins, trace elements and beta carotene can help prevent the onset of cancers in many cases” says Dr Sumir Kaul, a well-known cancer specialist here. For a lay man, this means a diet rich of fresh green vegetables with a minimum fertiliser content, tomatoes, carrots, cabbage and fruits.
— PTI
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A drug combo to treat hepatitis C
WASHINGTON: Saint Louis University School of Medicine researchers and six other American research sites have reportedly discovered a drug combination that could effectively prevent or reduce Hepatitis C viral levels better than when taken individually. According to Dr. Adrian M. Di Bisceglie, a professor of internal medicine at the university’s Department of Gastroenterology and Hepatology, using the drugs Peg-Intron(R) and Pegasys together with Ribavarin had better results than when they were taken individually. Pegasys and Peg-Intron are types of pegylated alpha interferon which is a longer lasting version of interferon, a naturally produced substance in the body that triggers the immune system. Combining these drugs with ribavirin enhances their efficacy and is the standard treatment for hepatitis C.
— ANI
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Suicides linked to painkillers
LONDON: Selling paracetamol and other painkillers in smaller pack sizes has slashed rates of suicide and damage to the liver from paracetamol poisoning, according to the British Medical Journal. The researchers also found that numbers of tablets taken in non-fatal overdoses of aspirin and paracetamol fell significantly after legislation was passed in Britain regulating the pack size of the drugs. Researchers analysed rates of suicides and non-fatal overdoses from paracetamol, salicylates (aspirin) and ibuprofen across the UK between 1993 and 2003. While overdosing from paracetamol and salicylates — both covered by the new laws — decreased, patterns of overdosing from ibuprofen, which was not targeted in the legislation, remained roughly the same.
— ANI |
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CHANDIGARH: Simple precautions taken at the time of the birth of a baby can go a long way in determining its long-term health and development. Right from maintaining the optimal temperature in the room in which the baby is delivered, to its proper wrapping and clothing can make a lot of difference so far as the chances of its survival are concerned.