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| HEALTH & FITNESS |
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Prolonged fever
in a child indicates Kawasaki Holi colours can
play havoc with skin, hair Laugh regularly
for healthy heart Headache: neck
can be hidden source Eat yoghurt to
stay slim! Key to
immortality may lie in cancer cells!
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Prolonged fever in a child indicates Kawasaki Kawasaki
disease (KD), which is becoming common, afflicts young children and can lead to devastating consequences if diagnosis is not done in time and treatment gets delayed. KD was first reported from the Japanese Red Cross Hospital in Tokyo in 1967 by Dr Tomisaku Kawasaki. He found it in 50 children who showed a high-grade fever lasting a week or so and had other characteristic clinical findings in the form of red lips, red eyes and lymph node enlargement in the neck. As the clinical features of this condition appeared to be unique and unlike those of any known medical disorder, he planned a new name: mucocutaneous lymph node syndrome. KD has been reported from all over the world, and in many developed countries it has become the commonest cause of acquired heart disease in children. KD is also the commonest cause of myocardial infarction in children. The illness starts with a high grade fever that continues beyond one week. This fever is accompanies by the development of red lips, red tongue and red eyes. Unlike the usual cases of viral conjunctivitis, where the eyes are red and moist, in children having KD the eyes are never wet. Most children have marked irritability and are extremely fretful. In fact, from the paediatrician’s point of view, this irritability is often the first clinical clue to considering a diagnosis of KD in a child with fever. Enlargement of lymph nodes in the neck is also seen in KD but this may not be very obvious unless specifically looked for. A rash often accompanies these clinical features and this may superficially look similar to the rash of measles, but there are important differences that the doctor can recognise.
When should you suspect KD a child? KD is a disease of young children with 80 per cent cases being below the age of five years. Any child in this age group whose fever does not subside within five-seven days and has no discernible cause for the fever, should be a cause for concern and a diagnosis of KD should be considered as one of the possibilities. In simple terms, KD should be thought of in all children below five years whose fever has persisted for five days without an adequate explanation.
Usual clinical features High grade fever that is unresponsive to antipyretics and antimicrobials, extreme irritability, red lips, red tongue, red palms, fingers and toes, rash and a peculiar swelling on the back of hands and over the feet are the usual clinical features of KD in the first 10 days. Later, the child may show peeling of his skin from the tips of fingers and toes.
Why is it difficult to diagnose? Fever and rash can occur in a number of other illnesses in childhood. It may, therefore, be difficult to differentiate KD from such conditions. Moreover, all clinical features of KD may not be present together at a given point of time. Rather, they evolve sequentially over a few days. So, it is quite possible that the clinical findings may change from day to day. And if he parents opt to change their doctor in a between, some of the signs may get totally missed as these may have disappeared by that time. In our experience, this indeed happens quite frequently. The difficulty is further compounded by the fact that there is no laboratory test to confirm a diagnosis of KD. The doctor has to base the diagnosis on clinical findings alone.
Why is it important to make a diagnosis? Approximately one-fifth of children who have KD develop complications related to coronary arteries in the form of dilatation, blockage or aneurysms. These children are at risk of myocardial infarction (heart attack) later in life. A small number of children can also die during the acute episode.
Is there any treatment available? Yes, there is a lot that one can do for such patients if the diagnosis is made in time. Intravenous immunoglobulin (IVIG) is life saving in such situations and can prevent the dreaded complications associated with KD. Treatment with IVIG is undoubtedly expensive but has no alternative. IVIG, however, is effective only when given early in the illness.
Is KD a very rare medical condition? It is a myth that KD is a rare medical condition. In fact, it is quite common. The reason that these children are not being diagnosed frequently is because of the fact that sequence of typical clinical features is not recognised in time. After the first 10 days, there may indeed be no recognisable clinical features suggestive of KD. To summarise, KD is a febrile illness of young children. Early diagnosis and prompt treatment is essential. Serious cardiac complications can occur in on-fifth of such cases if proper treatment is not given at the right time. The writer is Additional Professor of Surgery and Immunology, Dept of Paediatrics, PGI, Chandigarh.
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Holi colours can play havoc with skin, hair
CHANDIGARH: The festival of colours, Holi, is all set to bring exuberance in our lives once again. But Holi-lovers need to watch out for the chemical- laden colours that can play havoc with their skin and hair, if left unprotected. Dermatologists say that dry skin leaves a lot of scope for the harmful chemicals in the colours used in Holi as the skin layer allows the colour to penetrate easily. If this happens, it could easily lead to irritation and allergies on the outer layer. “If the skin is dry, the chemicals in the colours can enter the body and cause rashes, irritation and reactions on the skin. The bright colours especially attain the specific hue with the addition of the harmful chemicals which should be avoided,’’ says skin specialist Swami Dass Mehta. While the application of very little amount of colours should be an ideal solution to avoid any kind of allergy, the option of application of a body oil, like coconut oil, also serves as a protective layer for the skin. “If the oil is applied on the body before playing with colours, it can prevent allergies and irritation. However, if the colours react or irritate the skin, they should be immediately washed away with running water,’’ adds the dermatologist. Equally prone is the hair, which can turn brittle and extremely dry if the Holi colours remain unwashed for a long time. Doctors say that it happens because of the chemicals in the colours and the dust present outside. Oiling of the hair thoroughly before jumping into the playing arena can go a long way in taking care of this common problem. “Though no damage is done on the roots or scalp, the hair begins to break,’’ says the doctor adding that hair should be washed thoroughly so that the entire colour is gone. Care need to be taken for the eyes, and colours and water should not be splashed hard into the eyes. Redness of the eyes and irritation can be the common consequence if the colour enters the eye. “The best option for keeping the eyes safe is to avoid splashing the colour into the eyes directly. If the colour enters the eyes then they should be washed with clean water,’’ recommends doctors.
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Laugh regularly for healthy heart NEW DELHI: Hard to believe but watching a “Munnabhai MBBS” or a David Dhawan potboiler can actually help reduce the risk of cardiovascular disease. According to a study conducted by the University of Maryland Medical Centre, watching a funny movie has a healthy effect on blood vessel function while watching a mentally stressful movie can cause the lining of the blood vessels to narrow and restrict blood flow. “The endothelium is the first line in the development of arthosclerosis or hardening of the arteries, so given the results of our study, it is conceivable that laughing may be important to maintain a healthy endothelium and reduce the risk of cardiovascular disease,” says Dr Michael Miller of the university in an online report. “Laughter offsets the impact of mental stress, which is harmful to the endothelium,” says Miller, who presented the results of his study recently at the scientific session of the American College of Cardiology. A
physician and heart specialist, Dr S.P. Bijotra, Vice-Chairperson, Department of Medicine, Sir Ganga Ram Hospital here, says “humour is an essential part of psychotherapy treatment we give to heart patients. We advocate that five minutes of laughter is good enough to rejuvenate the body for 12 hours.” The ability to laugh — either naturally or as learned behaviour — may have important implications for India where heart disease remains the number one killer,” says Dr K.K. Agarwal, Vice-President, Heart Care Foundation of India. “Humour therapy is used extensively in Yoga and other alternative therapies. Joggers having a hearty laugh early morning in parks is a common sight. However, more and more hospitals too are waking up to the fact and even plan to have humour specialists and separate humour therapy departments in hospitals,” says Dr Bijotra. But Dr Agarwal says people with heart disease are less likely to recognise humour or use it to get out of uncomfortable situations. They generally laugh less, even in positive situations and display more anger and hostility.
— PTI
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Headache: neck can be hidden source THERE is a long list of diseases that cause “headache” and sometimes it becomes a problem for the physician to reach at the diagnosis. Headache is a serious problem as it can affect the day-to-day functioning of a person and his quality of life. The prevalence of headache is an common as diabetes, hypertension and arthritis. Therefore, cases of headache should be diagnosed and treated properly. Headache may be secondary to certain problems like fever, diseases involving sinuses, eyes, teeth, etc. Primarily, headache may be due to migraine or tension. It may be cluster headache when it is the main problem and not just a symptom of some other disease. Common headache mostly has a psycho-social origin called tension headache, which comes with stiffness of the muscles of the neck, upper back, shoulders, etc. Headache originating in the cervical region is quite common if not the most common cause. Neck could be the culprit many a times. In the case of cervicogenic headache, the primary cause is the cervical spine. Such headache leads to the referred pain to the posterior region of the head, forehead or around the eyes. Neck movements may be restricted and limited. The basis of proper treatment entails a detailed physical examination employing various methods. Most common cause of cervical headache is the involvement of upper cervical spine. This is, in all probability, related to a disorder pertaining to the first and second cervical vertebrae. Headache due to the cervical spine entails the involvement of pain sensitive structures like disc, joints, muscles or ligament. Diseases stimulating pain like osteoarthritis and rheumatoid arthritis can also lead to headache. Cervical headache can manifest in the following different forms.
Treatment: The cardinal symptom is pain and therefore, providing pain relief is the priority.
Exercises: It is necessary to warm up before starting the resistance exercises for the neck. Move your neck forward and backward, side to side 15 to 20 times to warm up. Place the heel of your hand on your forehead, apply pressure with your hand and resist with the neck. Press as hard as you can for about 20 seconds. Similarly, place the heel of your hand at the back and both sides of the neck, and press against the resistance of your neck. Shrugging of shoulders: Start by looking straight ahead, and slowly raise both shoulders up. Hold for seven seconds and then return to the starting position. Do 10 repetitions. People suffering from headache consume a lot of medicines, which have numerous side-effects. Headache associated with neck pain responds immediately to manipulation, massage, etc. These procedures provide immediate relief and, above all, reduce the dose of medicines. The writer is a former doctor/physiotherapist, Indian cricket team.
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WASHINGTON: A new study conducted by researchers at the University of Tennessee suggests that eating youghurt helps fat loss in the body. The researchers found that obese adults who ate three servings of fat-free yoghurt a day as part of a reduced-calorie diet lost 22 per cent more weight and 61per cent more body fat than those who simply cut calories and didn’t bone up on calcium. Yoghurt eaters also lost 81per cent more fat in the stomach area than non-yogurt eaters. “Not only did yoghurt help the study participants lose more weight — the average weight loss was 14 pounds — they were about twice as effective at maintaining lean muscle mass. This is a critical issue when dieting — you want to lose fat, not muscle. Muscle helps burn calories, but it is often compromised during weight loss,” lead researcher Michael Zemel said. In the study, researchers compared the effects of adding yoghurt to a reduced-calorie diet on weight loss in 34 healthy obese adults who were divided into two groups. For 12 weeks, the first group ate three 6-ounce servings of fat- free yoghurt providing about 1,100 milligrams of calcium per day. The other group ate only one serving of the dairy product, providing 400-500 milligrams of calcium per day. Both groups ate a controlled diet that contained 500 fewer calories than normal to stimulate weight.
— ANI
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Key to immortality may lie in cancer cells! SYDNEY: In a new study researchers at the University of Sydney believe they may be able to significantly increase people’s lifespans by learning why cancer cells are immortal. “They never die. They’ll go on forever. Cancer cells survive at the expense of every other cell in the body. The cancer cells take all the nutrients and the rest of the body goes through organ failure and death,” lead researcher Brian Morris was quoted by Sydney morning Herald as saying. He added that a molecule in cancer cells called tolomerase which prevented the degradation of tolemeres — or protective caps at the end of chromosomes — was believed responsible for keeping the cells alive. “Some people suggest that by overexpressing tolomerase in all cells in the body, maybe we could make humans ... immortal. If it an be applied in a totally regulated, controlled manner to all ells of the body, we could massively extend the human lifespan,” he added.
— ANI |
