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Sixtyfive roses for cystic fibrosis EYESIGHT
Health Notes
How malaria parasite impairs immune system
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Sixtyfive roses for cystic fibrosis Ratna and Ganesh had named their son Aayush, meaning “Long Lived”. Little did they know that within a year of his birth their son will be diagnosed as suffering from a disease called cystic fibrosis. Their baby had the cough problem since infancy and would often succumb to respiratory infections, needing antibiotics. He was not gaining weight properly. He had several chest x-rays and even got treatment for TB. He was correctly diagnosed after a sweat test which showed that his sweat contained an abnormally high amount of salt. Cystic fibrosis, previously thought to be a disease affecting mainly white people, is indeed the most common genetically transmitted life-shortening disease of the Caucasians. In recent times it is being increasingly found in Asians, including Indians. There was an old medieval European saying: if a child when kissed on his brow tastes salty he is cursed and must die. Although things are different in the modern times when this disease is no longer untreatable, and death is not always the end of the story, it still continues to be a dreaded disease. More so when it afflicts the children of the poor who cannot afford the expensive treatment which is needed life-long. Many times, more than one child in the family has the disease. The basic defect in this disease was delineated with advancement in the genetic techniques and biotechnology merely a decade ago. The gene, which coded for a protein called cystic fibrosis transmembrane conductance regulator (CFTR), mutates leading to this problem. The pancreatic enzyme deficiency leads to maldigestion, especially of fats, leading to fatty diarrhoea and later diabetes. Hence these children fail to thrive and are malnourished. They also develop deficiencies of fat soluble vitamins A, D and K, and due to thick respiratory secretions they suffer from severe respiratory infections having persistent cough. This infection damages their breathing tubes and they ultimately develop respiratory failure. Since the pancreatic enzyme is now available, maldigestion can be easily treated though respiratory problems are being researched upon, including the devising of gene therapy for this illness. There is a tragic story behind this phrase “sixtyfive roses for cystic fibrosis”. In 1965 Marry Weiss became a volunteer for the Cystic Fibrosis Foundation after learning that her three little boys had cystic fibrosis. Her duty was to call every civic club and a social organisation for seeking financial support for research on the disease. Her four-year-old son Richard listened every day to her mother making telephone calls. After several calls Richard came to her and said, “Mom, I know that what you are working for.” Mary was dumbstruck as Richard did not know that he had cystic fibrosis. After some trepidation Mary asked, “What am I working for, Richard?” “You are working for sixtyfive roses (cysti-fib-rosisi).” He answered sweetly. Since then the term 65 roses has been used by children of all ages to describe their disease. But making it easier to say does not necessarily make is easier to live with. All these patients and their families need help and support, moral as well as material. Organised efforts in the West by clinicians, researchers and patients have produced a good quality of life for these patients. The writer is Additional Professor, Paediatrics, PGI, Chandigarh.
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EYESIGHT With the advent of “selective laser trabeculoplasty” or SLT, the challenge of vision loss in untreatable glaucoma cases can be met. It treats glaucoma by reducing the pressure in the eye. Glaucoma is a silent killer of vision and one of the leading causes of blindness. It doesn’t always have noticeable symptoms, especially in early stages. That is warning signs can often be missed leading to irreversible damage to the eye. The shape and nutrition of eye depends on the production and drainage of a fluid called aqueous humor. In open angle glaucoma, there is either a sustained increase in fluid production or a decrease in fluid drainage. Because of this imbalance there is an increase in the pressure in the eye that decreases blood supply to the optic nerve thus destroying the nerve and leading to peripheral (side) vision loss and then visual disability and blindness. Glaucoma requires lifelong monitoring and constant treatment. As there is no permanent cure, the aim of treatment is to keep the eye pressure under control either with laser or drugs and regular follow-up. There are a few key reasons why SLT may be deemed beneficial for patients. SLT is not associated with systemic side-effects or the compliance and cost issues of medications. It utilises selective photothermolysis to target only specific cells, leaving the surrounding tissue intact. It is a non-destructive laser, thus preventing the scarring of eye tissues. SLT stimulates the body’s natural mechanisms to enhance the outflow of the fluid in your eye. The expenses on this SLT therapy are reimbursed by Mediclaim and many other insurance providers. Generally, the laser treatment does not cause pain. However, studies show that some patients experience sensation during treatment. You may see a green flash of light, and feel nothing from the laser. The lens used on your eye may cause some redness or irritation in rare cases. Successes with SLT vary with individual cases. You will need to consult your doctor to inquire about follow-up treatments. You will also require follow-up visits to monitor the success of the treatment. Does SLT work for all types of glaucoma? There are different types of glaucoma. While SLT works on most, it does not work for all. A doctor needs to assess and decide if this procedure is suitable for you. Will I still need to continue using my eyedrops following the SLT procedure? Again it is an individual variation depending on a person’s response to treatment. How long will I have to wait to experience the full treatment effect of the SLT laser? People can respond as soon as an hour after treatment, or as much as a few months later. Continued monitoring and follow-up will determine the response of therapy. With SLT, patients now have a safer option of treatment of glaucoma and prevention of the visual field loss. The writer is Chairman and Medical Director, Centre for Sight, New Delhi. E-mail: msachdev@bol.net.in
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Health Notes HOUSTON: Calorie-restricted diets appear to improve heart function and reduce two key signs of ageing — fasting insulin levels and body temperature, according to two new researches. An investigation by Professor Luigi Fontana of Washington University found that after an average of six years on calorie restriction, people’s hearts functioned like the hearts of much younger people. His research follows up previous studies that showed rats on a strict low calorie diet increased their lifespans by about 30 per cent and were less likely to develop atherosclerosis and cancer. Fontana studied members of a group called the Calorie Restriction Society who call themselves CRONies (Calorie Restriction with Optimal Nutrition), and have developed ways to eat low calorie/high nutrition diets. In a recent study published in the Journal of the American College of Cardiology, Fontana revealed that the hearts of CRONies were able to relax between beats in a way similar to the hearts of younger people.
— PTI
Mental illness depends on IQ
London: A recent study by psychiatrists from the Cambridge University suggests that people with a higher IQ are less likely to suffer from severe mental illness. The research shows that disorders such as depression and schizophrenia have lesser impact on intelligent people. “It has been known for some time that intelligence can protect you against dementia and the consequences of head injury,” the Daily Mail quoted a university spokeswoman as saying. “However...researchers at the University of Cambridge’s Department of Psychiatry have discovered that intelligence can also buffer the consequences of neuropsychiatry disorders such as schizophrenia. They have demonstrated that the symptoms of schizophrenia are less severe and the ability to function in daily living is better for those with a higher IQ.” She said the study found evidence that “cognitive reserve” intelligence made people more resilient. “Fortunately, cognitive reserve can be strengthened through education, neurocognitive activation — doing crossword or Sudoku puzzles, etc — or other treatment programmes,” she added. “It may also be possible to improve cognitive reserve through the use of cognition-enhancing drugs.”
— ANI
Stress leads to depression
Washington: A new study on mice has found that long-term exposure to stress hormone directly results in anxiety that often comes with depression, thus providing evidence that stress is linked to depression. The study was carried out on 58 mice by exposing them to both short-term and long-term durations of corticosterone, the stress hormone in rodents. As a part of the study, mice were exposed to chronic doses of the stress hormone, in which they underwent 17 to 18 days of exposure; as well as acute doses in which they underwent 24 hours of exposure. The researchers found that when compared with the mice given stress hormone for a day, the mice given stress hormone for more than two weeks were not only more fearful and were less willing to explore a new environment, but it also dulled reactions to a startling stimulus, another sign that their nervous systems were overwhelmed. The researchers say that the study shows that in people, exposure to stress hormone cortisol can cause anxiety, which appears with depression.
— ANI
Outcome of sleeping disorder
New York: Near-death experiences, described by some as a journey towards a tunnel of light and the subject of various books and movies, may afterall be an outcome of a sleeping disorder known as Rapid Eye Movement, a new study suggests. The study by a team of researchers led by Dr Kevin Nelson, a neurophysiologist at the University of Kentucky in the United States, compared the sleep pattern of 55 people who had reported unusual sensations during near-death experience to 55 people who had not. The study, being published in the Journal Neurology and quoted by ABC news, defines the near-death experience as “a time during a life-threatening episode of danger such as a car accident or heart attack when a person experienced a variety of feelings, including sense of being outside of one’s physical body, unusual alertness seeing intense light and a feeling of peace.”
— PTI
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How malaria parasite impairs immune system
LONDON: Plasmodium, the parasite responsible for malaria, impairs the ability of key cells of the immune system to trigger an efficient immune response. This could be the reason behind patients with malaria being more susceptible to a wide range of other infections and failure to respond to several vaccines. In a study published in the open access Journal of Biology, researchers show that if dendritic cells, the key cells involved in initiating immunity, are exposed to red blood cells infected with Plasmodium chabaudi, they initiate a sequence of events that result in compromised antibody responses. This is due to the presence of hemozoin, a byproduct of the digestion of hemoglobin by Plasmodium, in infected red blood cells. These observations also explain why vaccines for many diseases are so ineffective during malaria infection, and suggest that the use of preventive anti-malarial drugs before vaccination may improve vaccine-induced protection.
— ANI Two-test combination helps diabetics
Washington:
A recent research has found that a self-monitoring of blood glucose (SMBG) and more precise physician testing of hemoglobin A1c (HbA1c) can help diabetics take proper control of their blood sugar levels and successfully manage their disease. In a review published in the recent edition of The Journal of the American Medical Association (JAMA), the head of the Johns Hopkins Diabetes Center urges physicians and patients to better use the blood-testing tools at hand to manage diabetes, and prevent most of its dire impact on the heart, kidneys, nerves and vision. The disease is marked by the body’s inability to respond to insulin to break down glucose, or sugar. “The message is: we have tools that are very accurate, but they don’t work at all if they are not used properly,” says Christopher Saudek, a former president of the American Diabetes Association and lead author of the article. “If the goal of treatment is to prevent morbidity and mortality, we need to do a better job of monitoring our patients, as well as advising them.”
— ANI
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