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| HEALTH & FITNESS |
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Air travel and heart patients
EYESIGHT
Chronic sinusitis and homoeopathy
Health Notes
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Air travel and heart patients
Almost 2 billion passengers embark on international and domestic air travel each year. However, the overall number of in-flight cardiac events is low — occurring in one or two patients per million during air travel. Yet some heart patients need to avoid flying, at least temporarily, because of the increased risk posed by being confined to a high-altitude (and therefore low-oxygen) compartment. Researchers at Yale University have proposed some guidelines for patients with heart diseases who wish to travel by air. These have been published in the Annals of Internal Medicine. Several mechanisms predispose travellers to heart problems during air travel. Although airline cabins are pressurised to maintain an acceptable in-flight environment, they are not pressurised to sea level — in fact they are at 10,000 feet above sea level. Acute exposure to moderate altitude results in decreased PaO2, increased sympathetic activity, and increased pulmonary artery pressure. In addition to physiologic changes resulting from altitude, many travellers experience mental stress - particularly after 9/11 -- while flying. Preflight evaluation should include a careful history and examination. Vital signs should include resting oxygen saturation, pulse and blood pressure. A resting electrocardiogram should be obtained, and a copy should be given to the patient to be carried on his person. If indicated echocardiography, stress test and angiography may be done. Patients should be queried about recent pacemaker evaluations or stress testing. All testing for new symptoms or concern for device malfunction should be performed before travel, if possible. Routine evaluation of pacemakers or Implantable Cardiac Defibrillators (ICDs) should be performed on schedule but need not delay travel. Airport security gates may detect implanted pacemakers or ICDs but not stents. Travellers with any of these three devices should carry a card identifying the type of device or verifying stent placement. Several studies have evaluated the safety of airport security systems in regard to ICDs and pacemakers. Routine in-flight oxygen is not necessary for most travellers with cardiovascular disease. There are, however, several important exceptions. Any traveller who requires supplemental oxygen at sea level will require supplemental oxygen during air travel. Oxygen should be requested well in advance. Travellers should bring an ample supply of all medications in their carry-on baggage. All travellers should carry an updated medication list with both generic and brand drug names as well as doses. Travellers with cardiovascular disease should bring a copy of their most recent ECG.
Patients should not fly if:
A preflight checklist:
The writer is Chairman, Cardiac Sciences, Sigma New Life Heart Institute, Ludhiana
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EYESIGHT
A "tumour" simply means a mass or tissue swelling. This term applies to both benign tumours and malignant tumours (also referred to as cancer).
"Benign" means that a tumour that does not have the ability to spread to other organs. "Malignant" refers to a tumour that has the ability to spread to other organs. Ocular oncology is a branch of ophthalmology, which deals with the management of both such tumours. Eye tumours are considered to be rare, but in reality they constitute quiet a significant amount of population and include all ages. Tumours can involve almost any structure in and around the eye. Tumours of the eyelid may be benign cysts, inflammation, or malignant cancers. These appear as swelling on the lids which may or may not be painful. The most common type of eyelid cancer in the Indian context is sebaceous gland carcinoma. These can be removed with surgery but if left untreated, these tumours can grow around the eye and into the orbit. Conjunctival tumours grow on the outer surface of the eye. The most common types of conjunctival tumours are squamous cell carcinoma and malignant melanoma. Malignant melanomas can start as a nevus (freckle) or can arise as newly formed pigmentation (brownish coloured pigmentation on the white portion of the eye). Small tumours can be completely removed surgically. Chemotherapy and eye drops are also needed in certain situations to treat the entire surface of the eye. Eye cancer in children, though rare, is the third leading cancer of childhood. Retinoblastoma, a cancer of the retinal eye tissue, is the most common eye cancer in children. It appears as a white spot in the eye. It affects approximately one in 18000 live births. Retinoblastoma can be a particularly distressing form of cancer as it is potentially fatal and can result in vision loss of one or both eyes. Fortunately, most of these children can now be treated successfully if diagnosis is made in time and proper medication initiated. There are a few other tumours which arise from inside of the eye. Patients with this disease often do not recognise its presence until the tumour grows to a size that impairs vision. A complete periodic eye examination is the best means of early detection. One such common tumour is choroidal melanoma; simply removing the tumour with surgery and leaving the rest of the eye is not routinely advised. As any such intervention would allow the remaining tumour cells to float around into the spaces around the eye, which could spread cancer cells to other parts of the eye. Malignant tumours from other parts of the body can also spread in and around the eye. Tumours and inflammations can occur behind the eye in the bony orbit. Apart from surgery, many tumours also need treatment with drugs (chemotherapy) or radiation. Thus, it is necessary for the people to be informed about these conditions and get treatment as soon as possible. In India, these conditions are common but only a limited number of people are trained and a few health care centres are well equipped to provide complete treatment. The writer is Chairman and Medical Director, Centre for Sight, New Delhi. Email: drmahipal@gmail.com
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Chronic sinusitis and homoeopathy
Chronic sinusitis is a condition in which the sinuses inside our skull remain inflamed for months and years together. This can considerably reduce one’s quality of life. Chronic sinusitis patients complain of difficulty in breathing from the nose, headaches, pain and tenderness in the face. Yellow greenish discharges may also be noticed from the nose and from the back of the throat.
In most cases, this kind of chronic inflammation in the sinuses is caused by underlying allergic reactions to pollens, pet dander, dust mites, smoke, etc. Homoeopathic treatment of chronic sinusitis is very effective and has a strong edge over the conventional treatments. This is because homoeopathic medicines cure the underlying allergies too. They prevent the recurrence of inflammation in the sinuses. Allergy tops the cause-list for chronic and recurrent sinusitis. Other reasons that trigger inflammation in the sinuses are infections like flu and common colds, blockages in the nose caused by a deviated nasal septum, polyps and reaction to fungus in the air. The sinuses are hollow spaces in our skull (bony structure of the head and the face). There are four pairs of sinuses in our skull. Sinusitis is the inflammation of one or more of these spaces in the skull linked with the nose for free exchange of air. It is usually when this opening gets blocked by swelling in the nose due to common cold or allergies that the symptoms of sinusitis develop. The symptoms resemble those of acute sinusitis, but usually last much longer and cause more fatigue. The main symptoms of chronic sinusitis are pain in the face and pressure in the areas of forehead, temples, cheeks and nose, and behind the eyes, a thick yellow or greenish discharge from the nose or down the back of the throat, obstructed and difficult breathing through the nose, diminished sense of smell or taste, frequent headache (especially in the morning), toothache, fatigue, cough and sore throat. As homoeopathy is a symptom-based system of medicine, the prescription is given accordingly. The main medicines used for treating chronic sinusitis are Hydrastis, kali Bichrome, Silicea and Merc Sol. At times the treatment may also require a totally different set of medicines. The writer is a Chandigarh-based homoeopath. Email: vikas@drhomeo.com
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Health Notes
Talking about her analysis of 200,000 blood test results in the Annals of Clinical Biochemistry, biochemistry expert Vanessa Thurlow said that clenching was an outdated practice. She said that the results on which her study was based belonged to blood tests requested by GPs between 2002 and 2005. The updated training was offered in September 2003, she said.
— ANI
Soyfoods have no impact on sperm count
Washington: A recent study claiming “soy products lower sperm count” has now been questioned as experts claim that soyfoods have no impact on fertility. Researchers insist that the small scale, preliminary study by Dr Jorge Chavarro was based on recollected intake of soyfoods and not on specific diets containing soyfoods. “This study is confounded by many issues, thus I feel the results should be viewed with a great deal of caution,” warned Dr Tammy Hedlund, a researcher in prostate cancer prevention from the University of Colorado Health Sciences Center, Department of Pathology.
— ANI
Meditation slows HIV progression
Washington: Scientists at the University of California, Los Angeles (UCLA), say that mindfulness meditation may help slow the progression of HIV. They say that meditation does so by relieving stress, and thereby bolster the immune system in HIV-positive patients. HIV slowly eats away at CD4 T cells to weaken the immune system, and stress can accelerate this process. Their study report in the journal Brain, Behaviour and Immunity describes mindfulness meditation as the practice of bringing an open and receptive awareness of the present moment to experiences, and avoiding thinking of the past or worrying about the future.
— ANI
Smoking worsens flu, viral infections
The study, by researchers at Yale School of Medicine, also identified the mechanism by which viruses and cigarette smoke interact to increase lung inflammation and damage. Their experiments showed that the immune systems of mice exposed to cigarette smoke from as little as two cigarettes a day for two weeks overreacted when they were also exposed to a mimic of the flu virus.
— ANI
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With air travel becoming fairly common in India, quite often patients ask their doctors: How safe is plane journey for me?
London: British researchers cautioned that getting blood donors to tightly clench their fists during the procedure may raise potassium levels in the samples, which may indicate kidney or heart problems.
Washington: A new study in mice has provided an insight into why viral infections have more severe consequences in individuals exposed to cigarette smoke than in those not exposed to it.