 |
|
| HEALTH & FITNESS |
|
|
|
Prevent extreme drug-resistant TB
Life after knee replacement surgery
|
|
Prevent extreme drug-resistant TB A recent World Health Organization report on the emergence of an extremely drug-resistant virulent form of tuberculosis in certain parts of the world — notably some African and formerly Soviet Union nations — has shaken the confidence of both the scientific community and the administration involved in management and control of tuberculosis. The type of tuberculosis has been
labeled as XDR-TB to differentiate from MDR-TB — multi-drug resistant tuberculosis — already known for over 15-20 years. Tuberculosis is recognised to have affected human beings for over 5000 years. Bone lesions, which mimic caries (or tuberculosis) of the spine, have been identified in the Egyptian mummies. But tuberculosis gained notoriety as a killer disease in medieval Europe when it started afflicting kings and celebrities. Both the WHO and the US Centre for Disease Control and Prevention (CDC) have described XDR-TB as resistant to three or more of the six classes of second-line drugs. On the other hand, MDR-TB is resistant to two or more first-line drugs. In practical terms, as of today, there is hardly any drug which can be effective or used against XDR-TB. We do not have any specific data on XDR-TB from India. It is likely to be there to some extent. Probably, it is not as yet a major issue. But this situation cannot remain for long. We have got all the potential for a much higher problem in India because of the presence of enormous numbers of MDR-TB and HIV-infected patients. Above all, the indiscriminate use of anti-tubercular drugs adds fuel to the fire. Resistance of organisms to any anti-infection drug is caused and promoted by the inappropriate and irrational use of antibiotics. Many effective drugs are lost to the community in this fashion. The same problem has happened in the case of anti-tuberculosis drugs — perhaps at much higher cumulative costs. It was observed in several studies that the TB treatment strategies in India were not only variable, but highly erratic and inadequate. The compliance of patients with treatment was very poor. In India, the treatment-related factors were far more significant in the persistence and enormity of TB than the presence of HIV infection. Tuberculosis, being a common man’s disease, is handled and managed at all levels by different kinds of doctors and practitioners. Even the second-line anti-tubercular drugs are being added for no rhyme or reason. Unfortunately, these factors continue to persist in spite of the country-wide implementation of the Revised National TB Control Programme (RNTCP) and the strategy of the Directly Observed Therapy, Short Course (DOTS). The only way to contain the threat of XDR-TB is to prevent the spread and diminish the pool of MDR-TB. This can be achieved through more effective implementation of RNTCP and radical treatment of patients. A uniform and forceful policy of supervised treatment is bound to ensure the compliance of patients minimising the number of defaulters with treatment. In the long run, this can achieve the goal of curbing the menace of TB. Treatment of individual patients with XDR-TB is non-existent at present. Even if one of more new drugs become available in the future, a patient is unlikely to benefit significantly. It will be more appropriate to save drugs from the development of resistance than to discover new drugs and loose them very soon. This can be best attained with the judicious use of first-line anti-tubercular drugs utilising the DOTs strategy. It is also worth mentioning that tuberculosis spreads like a smouldering fire. It does not cause flames to be obvious and visible, but it goes on and on to consume not only the individual but the community as a whole. That is why tuberculosis has been described as “consumption” in ancient Indian and Greek literature. The writer is Professor and Head, Department of Pulmonary Medicine,
PGI, Chandigarh.
|
|
Life after knee replacement surgery For the success of total knee replacement surgery, it is imperative that postoperative physical activity is undertaken seriously and religiously. Non-compliance could lead to disability, thereby defeating the very purpose of the surgery. A regular exercise regimen helps restore knee mobility and strengthen the surrounding muscles and ligaments, facilitating a gradual return to normal activity. Important tips to be followed after knee-replacement surgery:
Soon after surgery one should walk short distances in the hospital room with the help of a walker or crutches. The best way is to stand comfortably with weight balanced on the walker or crutches. Advance short distances and then reach forward with the operated leg with knees straightened.
Stair climbing and descending
The ability to go up and down stairs requires strength and flexibility. At first use a handrail for support and go only one step at a time. Always lead up the stairs with the good knee and down the stairs with the operated knee. Remember, “up with the good” and “down with the bad”. Early post-operative exercises:
People undergoing knee replacement surgery should continue with their physical activities and undertake appropriate exercises so that the huge amount spent by them for replacement may not go down the drain. Secondly, replacing the knee again, a process called “revision”, is much harder and has more potential complications and is less likely to be successful. The writer is a former doctor/physiotherapist, Indian cricket team.
|
|
Slower heartbeat at rest could mean longer life
PARIS: Slowing down heartbeat when at rest can increase the chances of living longer, according to a French survey carried out on more than 4,000 men over two decades. The study by the National Health and Medical Research Institute (INSERM) at Paris’ Georges Pompidou hospital showed that middle-aged men whose resting heart rate increased over five years had a much higher risk of death during the 20-year period. Men whose pulse while at rest decreased by more than seven beats a minute in five years had a decrease in mortality of 18 per cent compared to those whose heartbeat remained stable. An increase of more than seven beats a minute, on the other hand, meant a 47 per cent increase in mortality. Heartbeat when at rest indicates how hard the heart works to maintain adequate blood flow. A resting heart rate of 60-80 beats per minute is considered normal, while athletes or people in excellent physical condition typically have 40-50 beats per minute when at rest.
— AFP
Women harder hit by
post-traumatic stress disorder
Washington: Based on a meta-analysis of researches conducted over the last 25 years, University of Pennsylvania researchers have come to the conclusion that though men experience more traumatic events than women, the latter are diagnosed with Posttraumatic Stress Disorder (PTSD) more than their male counterparts. For the study, published in the journal Psychological Bulletin, the authors reviewed 290 studies conducted between 1980 and 2005. Their aim was to determine who among women and men is more at risk for potentially traumatic events (PTE), and posttraumatic stress disorder (PTSD). The analysis showed that while men had a higher risk for traumatic events, women suffered from higher PTSD rates.
— ANI
Call centre employees at
‘hearing risk’
London: A new study has found that call centre employees are at risk of injuries and illnesses caused by acoustic shock and other noise-related problems. Two-thirds of UK call centres fail to protect their workers against hearing damage from noise, a report warns. Experts in an acoustic safety conference in Glasgow say many of the 900,000 call centre staff in the UK are at risk. Over 700 people have so far suffered acoustic shock, with the compensation paid out so far
totaling #2.5m. Around 300 further cases are pending, according to the Acoustic Safety Programme, an independent body which aims to protect the hearing of call centre workers, reports the BBC. Acoustic shocks are defined as “any temporary or permanent disturbance of the functioning of the ear, or of the nervous system, which may be caused to the user of a telephone earphone by a sudden sharp rise in the acoustic pressure produced by it”.
— ANI
|
A recent World Health Organization report on the emergence of an extremely drug-resistant virulent form of tuberculosis in certain parts of the world — notably some African and formerly Soviet Union nations — has shaken the confidence of both the scientific community and the administration involved in management and control of tuberculosis. The type of tuberculosis has been
labeled as XDR-TB to differentiate from MDR-TB — multi-drug resistant tuberculosis — already known for over 15-20 years.
