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| HEALTH & FITNESS |
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Advantages of robotic surgery
Squint can lead to loss of vision
Chronic cough leads to depression
Heart talk: count your risks on fingertips
Weight gain linked to early aging
Kids: lack of sleep doubles obesity risk!
Ayurveda & you
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Advantages of robotic surgery
A soldier at Siachen sustains a serious head injury and develops a clot compressing his brain every minute. An early surgical treatment is essential to save his life. The weather and ground conditions do not permit evacuation for surgery at a super speciality centre. Today, unfortunately, he has no help.
A slave telerobot is stationed at Siachen that has a satellite link to its master console at a specialised centre. The slave robot carries out the surgery in an operating room at a far-flung location such as Siachen, taking commands from the master console, being operated by a super specialist at the centre. The clot is removed in time and the soldier is alive to see another day and fight another war. Just as this situation is not entirely fictional, the use of robotics in performing surgeries is also a reality today. Extrapolate this situation to any remote location in India; a farmer in the Tenga valley in Arunachal Pradesh requires an urgent repair of the vessel supplying blood to his right leg or he would lose his limb; and you have a requirement for telerobotic surgery. In order to perform a remote surgery operation, the system requires two functioning worksites: one for the surgeon and one for the robotic devices actually operating on the patient. Remote surgery is based on a master-slave robotics model in which a controller manipulates the robot from a distance by using two joysticks that control the tracking of the robotic devices. The worksite on the patient’s end contains the robotic devices, which perform the surgical procedures. The field of robotics provides an opportunity for the enhancement of human performance, projecting surgical expertise to remote and distance places, and recreation of a patient in a “virtual” form. Robotics takes the surgeon’s motions and changes them into electronic signals which through a computer can be enhanced. The result is performing a procedure with greater accuracy and precision. Robotics allows doctors to perform the most delicate of operations with little risk and post-operative discomfort. To the uninitiated, “robots” have often been thought of as machines that replace humans. In fact, they are machines that help man. These machines have been used in manufacturing, space exploration and other areas. However, they can also be used as surgical tools. They are already used as surgical tools and to complement human surgeons. Many medical specialities are using these technologies to extend and enhance human capabilities. Neurosurgery, orthopaedics, ophthalmology, dentistry, urology, general surgery, gynaecology, radiation oncology and many more fields are relying on robotics for a wide range of uses. Robotic surgery has also been used in many delicate procedures, including heart surgery. The first coronary bypass surgery in a human patient using robotic arms manipulated by the surgeon was performed by Dr Ralph Daminano, Jr Chief of cardiothoracic surgery at the Milton S. Hershey Medical Centre at Penn State College of Medicine in Hershey, Pennsylvania. If robotic surgery continues to be safe and successful, it could mean that doctors may need to cut across the chest and crack the rib cage to perform open-heart surgery only in rare cases. This procedure is regularly being performed in India. Despite certain difficulties, many experts believe that remote surgery will be a reality in a few years. While surgical robots offer some advantages over the human hand, we are still a long way from the day when autonomous robots will operate on people without human interaction. But, with advances in computer power and artificial intelligence, it could be that in this century a robot will be designed that can locate abnormalities in the human body, analyse them and operate to correct those problems without any human guidance. — The writer is Executive Director, Escorts Hospital and
Research Centre, Faridabad.
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EYESIGHT
Glaucoma or kala-motia is a silent killer of vision. By the time one becomes aware of it, usually a lot a damage to the optic nerve has already been done.
Glaucoma cannot be cured. But it can be controlled and further damage to the optic nerve can be slowed down or halted. This control can only be sustained through very disciplined and regular treatment as advised by the ophthalmologist. It is a life-long process. Early detection of glaucoma is most important as timely treatment will prevent further loss of vision and preserve the existing vision. Regular eye checkups are particularly important for people whose risk of glaucoma is higher than average. This includes the following:
How is glaucoma controlled? The goal of treating open-angle glaucoma is to preserve vision by lowering intraocular pressure and preventing further optic nerve damage. Here are some facts about the main forms of treatment in use today: Medical management:
Drugs for open angle glaucoma are the most widely used method of treating this disease. These medications are taken as eye drops or pills. Some improve fluid drainage, while others lower pressure by inhibiting fluid formation. Most cases of glaucoma can be controlled with one or more medications, and a majority of the patients tolerate these drugs well. However, in a few patients intraocular pressure is not adequately controlled by medications. Also, some people find that the drugs’ side-effects — such as stinging in the eye, blurred vision, or headache — do not go away after the first few weeks of use but continue to be a problem. Surgical management: Now ophthalmologists generally reserve surgery for the patients whose glaucoma cannot be controlled by medications and for those who are unable to tolerate the side-effects of these drugs. During the operation, the surgeon makes an opening to create a new drainage pathway so that aqueous can leave the eye more easily. After surgery, a few patients still need to use medication to keep their pressure under control and avoid loss of vision. And if the new drainage opening closes, a second operation may be needed. Lasers: Certain types of lasers can control open angle glaucoma. The procedure is called ALT (Argon Laser Trabeculoplasty). It is helpful in 50-60 per cent patients to lower the IOP. But, usually, people who have this surgery must continue taking some glaucoma medication afterwards, although they may be able to lower the dosage and still keep intraocular pressure under control. However, the pressure lowering effect of the laser treatment may wear off eventually, and for this reason patients sometimes have a second or third treatment session. In angle closure glaucoma YAG laser is used to do peripheral iridotomy. This prevents further attacks of acute congestive glaucoma. The treatment option chosen to control glaucoma depends on the type of glaucoma, the severity of the damage which has already occurred, patient compliance, convenience and affordability. The control of glaucoma can only be effective if the patients adhere to the treatment schedule prescribed by their ophthalmologist. Remember that it is your vision, and you must do your part in maintaining it. Early detection is the only way to manage the glaucoma. So, immediately get in touch with a dependable doctor if you experience any of the following:
— The writer is Chairman and Medical Director, Centre for Sight, New Delhi.
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Squint can lead to loss of vision
Chandigarh: Squint isn’t just cosmetic blemish on the face, capable of inviting ending taunts. It also amounts to loss of vision if not treated early.
Ophthalmologists describe squint as that disorder in which there is misalignment in both eyes. There is a deviation in the eyes, which is either “inward” or “outward”. Squints are more common among children and doctors say that a child may have a squint right from birth or can develop it within six to eight months after birth. Usually, squints which are noticed within the first seven days of the birth of a child (due to the child’s searching vision) can later go away, but the squints that continue to remain after a week of the birth require medical attention. ‘’A lot of people have a misconception that even if a newborn has a squint it can get corrected on its own with age. But this is not true. In fact, parents must notice that their child has a squint and then consult a doctor immediately so that the treatment is started early,’’ says city-based ophthalmologist Dr Rajan Chugh. If not corrected in time, squints can lead to a decrease in vision, called
amblyopia, and even lead to a permanent loss of vision. ``Though there is no known cause of squint in the eyes, less vision in either of the eyes itself can be one of the reasons of development of a squint. It means that if a child has a squint, it is likely that he has a lesser vision in one of the eyes,’’ explains Dr
R.K. Bansal of the Government Medical College and Hospital, (GMCH), Sector 32. Squints are readily treatable but the patient needs to consult the doctor early otherwise, it can be too late. ``The squints should be treated during childhood only, otherwise the damage can be permanent. Later in life, only cosmetic treatment of squint would be possible, but vision would not be corrected,’’ adds Dr Bansal. Eye exercises and wearing of glasses are the treatments prescribed for the correction of squint. But surgery remains the ultimate treatment. ``Surgery is the definite solution for removing a squint. Even a child as young as three-month-old can be operated upon for squint correction,’’ says Dr Chugh. But what is most important in the treatment of squint is the subsequent follow-ups to make sure that vision is corrected and the eyes do not develop a squint again.
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Chronic cough leads to depression
WASHINGTON: Most people having a chronic cough (which can last for months or even years) suffer from depressive symptoms, a new study has revealed.
According to Dr. Dicpinigaitis, a professor of Clinical Medicine at Albert Einstein College of Medicine and director of the ICU at Montefiore Medical Center, “A lot of people don’t realise that cough is the single most common complaint for which patients seek medical attention in the US alone.” A first of its kind, the study carried on 100 people with chronic cough that had lasted an average of nine years found that 53 per cent suffered from depressive symptoms. The percentage of men and women with chronic cough who suffered from depressive symptoms was similar, said Peter V. Dicpinigaitis, the author and director of the Montefiore Cough Centre in the Bronx, New York. In the study, it was found that those whose cough had improved had significant reduction in depressive symptoms, while those whose cough did not improve did not have any corresponding improvement in their depressive symptoms. “They are socially isolated and miserable. They are afraid to go out in public, go to church or to a restaurant. Their cough affects their relationship and their jobs. Since cough doesn’t kill people it doesn’t get the attention that other conditions get, but it is a tremendous quality of life issue,” said Dicpinigaitis. “My message for patients with chronic cough is not to give up. Continue to seek out help. Once the cause of the cough is diagnosed, it can be treated, Dicpinigaitis concluded.
— ANI
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Heart talk: count your risks on fingertips
New Delhi:
No more complicated medical jargon on the state of your heart. A simple risk score scale can tell you whether you are likely to have a heart attack in the next 10 years.
“Do you smoke? Are you diabetic? Is your blood pressure high? Does your ECG show any abnormal graph?” If yes, then according to the risk scale, you are most likely to get the coronary artery disease (CAD) in the next 10 years, says a new book “Heart Talk: Roadmap to a Healthy Heart”. The risk score scale is different for both men and women and works on a simple logic — with each risk factor, the chances of having a heart attack or dying of heart disease over the next 10 years increases, says authors Dr Yatish Agarwal and Dr Rekha Agarwal. Smoking, high blood cholesterol, blood pressure, diabetes, obesity, physical inactivity, Syndrome X, emotional stress all make up the risk factors, authors say. Over the past three decades, cases of coronary artery disease in India have risen three-fold. An estimated 12 out of 100 people living in cities and seven out of 100 in rural India suffer from the heart disease. “With the structure of India’s age pyramid undergoing a metamorphosis and more people coming under the age bracket where the disease may strike, the number of coronary patients is growing at a worrying pace,” says Dr Agarwal, a senior physician at Safdarjang Hospital in New Delhi.
— PTI
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Weight gain linked to early aging
WASHINGTON: Tulane University researchers have demonstrated a biological link between insulin resistance, weight gain and signs of early aging, according to a study published in the latest issue of Circulation.
According to the researchers, people with insulin resistance and weight gain also have prematurely shortened white blood cell telomeres — a widely recognized sign of aging. This means that as their body weight and insulin resistance increase, they are more likely to get old at a younger age. Insulin resistance is a reduced sensitivity in the tissues of the body to the action of insulin, a hormone that brings blood sugar to those tissues to be used as a source of energy. To compensate, the body works harder to produce more insulin while at the same time failing to lower blood sugar levels. “We know that obesity and insulin resistance place a physical burden on the body, leading to inflammation, the production of more blood to feed the body, and oxidative stress, all of which are important factors in the biology of aging. It makes sense that we would see other signs of aging, like shortening of the white blood cell telomeres, as well,” said cardiologist Gerald Berenson, co-author of the study. The researchers analysed blood drawn from 49 adults who participated in the Bogalusa Heart Study at least twice between 1988 and 2001. They also studied data related to weight, blood pressure and diet and lifestyle factors and found that as people’s weight and insulin resistance increased, they also experienced a shortening of the telomeres of their white blood cells.
— ANI
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Kids: lack of sleep doubles obesity risk!
LONDON: Kids who sleep less than 10.5 hours a night are twice as likely to pile on weight as other children of their age, a new study has revealed.
According to the study published in the online edition of British Medical Journal (BMJ), short sleep duration at the age of three can harm children’s health. Duration of night time sleep may affect growth hormone secretion or reduce the child’s exposure to food intake in the evening. Alternatively, children who are more physically active may sleep longer at night, researchers said. The study also found that high birth weight, parental obesity, rapid weight gain in the first year, rapid growth up to two years and high pre-school body-fat levels, are some other factors which put children at obesity risk. “Most interventions to prevent obesity have tried to change lifestyles of children and adolescents and have been unsuccessful. Future interventions might focus on environmental changes targeted at relatively short periods in early life, attempting to modify factors during pregnancy, in infancy, or in early childhood.”
— ANI
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Ayurveda & you
Of the countless herbs and herbal combinations used in the ayurvedic system of medicine, triphala holds as exalted status as no other drug does. Deeply embedded in the Indian ethos, it was trusted as a multi-purpose medicine by the ancient people and is relied upon by millions even today. Known as “phalatrik”and “vara” in Sanskrit, triphala is a combination of the pulp of three famous fruits or herbs — amla (emblica officinalis), harad (terminalia chebula) and baheda (terminalia bellirica).
If we analyse each ingredient separately, amla is famous as the richest natural source of Vitamin C. Besides this, it contains tannic acid, resinous matter, glucose, protein, cellulose and calcium. Amla has cooling, astringent, digestive, carminative, diuretic, anti-pyretic, aphrodisiac and anti-oxidant properties. It is considered useful in tackling a vast array of diseases like acid dyspeptic disease, urinary anomalies, skin problems, chest diseases, jaundice, hemorrhagic conditions, emaciation, hair and eye diseases. It is also regarded as a tonic. Harad, the other constituent of triphala, is dry, light and hot in effect and has carminative, digestive, anti-inflammatory, anthelmentic, cardiotonic, aphrodisiac and restorative properties. It is said to be endowed with the same healing effects as those of amla, but is additionally beneficial in flatulence, constipation, piles, cough and colds. Harad is also a drug of choice in sinus allergies, lung diseases, liver and splenic enlargements and obesity. The last among this triad is baheda. Slightly hot in effect and pungent, acrid and bitter in taste, it has astringent, digestive, expectorant, antiemetic and rejuvenating properties. Modern research has proved it to be an anti-histaminic, bronco-dilator, anti-stress, anti-viral and endurance promoting herb. Baheda is very useful in disorders of the respiratory tract like cough, bronchitis and asthma and is also given to treat insomnia and general debility. In totality, triphala is a unique combination having dual properties of a medicine and a rejuvenating agent. Its recommended use helps alleviate all vitiated doshas — the vata, the pitta and the kapha and detoxify the body of various undesirable accumulations. Besides nourishing the tissues by improving absorption, digestion and assimilation of the food, it corrects the body, metabolism, strengthens all physiological systems and acts as an excellent anti-oxidant. Though generally triphala is used to treat conditions involving indigestion, bowel toxicity and constipation, its numerous other therapeutic uses make it a distinct medicine in the ayurvedic pharmocopeia. It is a drug of choice to treat anaemia, eye problems, premature graying of hair, disorders of the urinary and genital tract, chronic skin and lung diseases, metabolic disorders like obesity and raised uric acid and cholesterol. The average daily dose of triphala powder varies from two to five gm, but can be individualised according to the need and suitability of the patient. —
The writer is a Ludhiana-based senior ayurvedic consultant.
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