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| HEALTH & FITNESS |
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Why youngsters, too, suffer from piles?
Neck pain can cause headache
Shopping tips for toothbrush
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Why youngsters, too, suffer from piles?
Benign ano-rectal conditions like piles, fissures and anal fistula are conventionally thought to be the problems of the middle-aged and elderly people. However, the situation is rapidly changing as these diseases are being seen with an increasing frequency in younger age groups. The primary reasons for this are changing food habits and an altered lifestyle. The youngsters suffer because of low roughage
(fibre) in their diet, the intake of lesser quantity of water and a lack of exercise. The increased intake of junk food, which typically is low in
fibre, is an important contributor. In the initial stages, the options are a high fibre diet, banding (rubber band), bipolar coagulation (electrotherapy), cryotherapy (liquid nitrogen), infra-red (photo coagulator), sclerothrapy (an injection) and hemorrhoidolysis (galvanic waves). These modalities do not help much in the higher stages of the disease. In advanced stages, the options are open surgery and an operation using the stapler technique. The stapler operation is done in the upper anal canal, which is insensitive to pain. A disposable stapler device is used to obliterate the blood supply to the piles and remove the excess which corrects the mucosal prolapse and restores the heamorrhoidal tissue back to its original anatomical position. The last two procedures don’t create any wound and the patient is pain-free right after the operation . Anal fissure: It is a tear in the anus causing a painful linear ulcer at the margin of the anus. It may cause itching, pain or bleeding. At least, 50 per cent of the fissures heal by sitting in plain warm water, a
high-fibre diet and using an anaesthetic ointment. Nitroglycerin and diltiazem ointment relaxes the anal sphincter and results in fissure healing in more than 80 per cent patients. The principal side-effect is headaches in 20-40 per cent cases.
Botulinum injection: Local injection relaxes anal sphincter and healing occurs in about 60 per cent patients. Surgical treatment is advised in advanced cases. Lateral internal
sphincterotomy: A small cut is made in the portion of the anal muscle. This relaxes the sphincter muscle and helps in healing. Subcutaneous
fissurectomy: This is the latest advocated method in which no sphincter cutting is done.
Anal fistula
Anal fistula is an abnormal passage (communication) between the interior of the anal canal or rectum and the skin surface. An anal fistula usually lasts until it is surgically removed. The article has been excerpted from a paper, one of the six best, presented by the writer at a meeting of the International Society of
Colo-Rectal Surgeons at San Diego, USA, on September 16. Dr Garg is a senior consultant at
Fortis, Mohali. drgargpankaj@yahoo.com
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Neck pain can cause headache
Upper neck pain is an extremely common cause of headache. This pain usually radiates to the back of the head and towards the eyes. An examination reveals pain at the occiput (upper back of the head) although the individual suffering from pain is unable to pinpoint and complains of pain felt all over. The distressing ache is experienced even by mere pressure of the pillow at night. Such patients point out the sore spot at the base of the scalp with their fingers. Sometimes there is a feeling of light-headedness, dizziness, etc. Headache can be provoked due to a wrong posture, improper neck position while sleeping or during work.
Causes
Sustained head bending (owing to an incorrect posture) or due to continuous upward head tilt or rotation. Pain is aggravated on looking upwards for a prolonged period of time e.g. when an individual lies prone and watches television by raising the head on the elbows to support the neck. Individuals who keep their head tilted sideways while talking, watching television or typing are more vulnerable to headaches. Anxious, depressed people with low tolerance threshold are more at risk to suffer such headaches. Chilling the back of the neck can contribute to the pain at the back of the head. Examination reveals restriction in the forward and sideways bending of the neck.
Treatment
Massage is extremely useful as it alleviates the muscle spasm. Manipulation relieves muscle spasm and joint stiffness instantly if performed correctly. Most of the cases are relieved of pain with two-five sessions. Trigger points are taut bands of inflammatory material present around the neck. Ultrasound therapy followed by a massage is very effective. Trigger point’s application of a hot pack or a heating pad to the sore areas, especially at the end of the working day or on retiring for the evening, relieves pain. Certain exercises also help relieve pain and stiffness. Shrugs: Standing with the arms by the side, lift shoulders up to the ears, holding for a few seconds. This is followed by pulling the shoulders back, punching the shoulders blades together. Hold for five seconds, relax and repeat 15 times. Placing the palms of the hands on the forehead, try touching the chin to the chest against the resistance of the hand for a count of 10. Placing both hands behind the back of the head, tilt the head backwards against the resistance of the hands. Placing one hand behind the ear, resisting the motion of bringing the ear to the shoulder on the same side.
Precautions
* Avoid looking upwards with the head tilted to one side. It is advisable to place documents on a vertical stand in front rather than placing it on a flat surface on the side. *
Using the cervical collar sometimes can be more irritating and annoying than helpful. The collar can aggravate pain by exerting more pressure on the affected part. *
Sitting directly under the airconditioner for extended periods causes pain in the neck and the shoulders. Use a scarf or a neck sweater. *Keep your neck warm by wearing a high-neck shirt or a pullover. *
Patients with morning headache should modify their pillow and avoid sleeping in a trouble-prone position with the neck in extreme rotation. The writer is a pain management expert.
chadha_r2003@yahoo.co.in
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Shopping tips for toothbrush
There are a variety of toothbrushes available in the market: different shapes, designs, handles and texture, bristles that are very soft, soft, medium or hard, bristle-heads that are short, medium and long. Automatic brushes are also getting popular. This plethora, coupled with attractive advertising, is confusing. Let us start with brushes for children. Like shoes, a toothbrush with small dimensions in all respects would be the best buy for little hands and mouths. There are also expensive brushes available, some with handle-ends shaped into the likeness of animals, and others that produce music when used correctly. Automatic brushes are not recommended for children, except for those who are handicapped. In general, we do not require brushes with hard bristles. The principle is: soft bristles and repeated movements. This effectively removes bacteria from the teeth without any abrasive effect. Should the bristle-head be long, medium or short? The test that a bristle-head needs to pass is the ability to reach the buccal (cheek) side of the very last tooth. Choose any size that can accomplish this. The trick is to close the mouth slightly after inserting the brush. With this method, one finds ample space to explore the terrain. The medium size is the right choice in most cases.
When to go for a new toothbrush ?
Brush bristles flare outwards in a few days, or may remain straight even after six months of regular use. This varies from individual to individual, and depends upon the style of brushing. You must change your brush when the bristles start turning outwards — days do not matter. It is a proven fact that a toothbrush with straight bristles cleans better than one with flared-out bristles. The second tip is to change the toothbrush after two-three months of use, even if it is in good shape. Are you cleaning your brush properly after use? To find out, examine the base of the bristles. It is a good idea to have two toothbrushes, one for night and the other for morning use, in order to give each brush the time it needs to dry completely before the next use.
Care of the toothbrush
Tap water should be directed under pressure through the splayed bristles of the brush in order to wash out any muck. The brush should then be left to dry, taking care that there are no house flies around. A wet brush should not be covered with a lid or cap of any sort as it will remain moist and encourage bacterial growth. Some people share tooth brushes. This is not a good idea because brushes harbour bacteria even if washed thoroughly, and cross contamination is harmful for dental health. For the same reason, brushes belonging to different individuals should not be placed with the bristles of one brush in contact with that of another.
Tooth pastes
The major function of toothpaste is to provide fluoride to the teeth. Research has shown that regular use of fluoride toothpaste can ward off the formation of new cavities to the extent of 30 per cent compared with non-fluoridated toothpaste. When buying a toothpaste, ensure that it has fluoride as one of its constituents.
Dental floss and interdental brush
Both these items are now available in the Indian market, especially in big cities. The Indian brands of both products are equally good – even better. Waxed floss should be bought, if one finds difficulty in passing through the contact points. The use of dental floss is recommended right from childhood. As inter-dental spaces gradually increase with age, interdental brushing should supplement flossing. Interdental brushes are available in different shapes — tapered and straight — and also as large, medium, fine and superfine. You should make your choice depending upon the width of the inter-dental spaces in your teeth. A pack of interdental brushes generally contains a handle together with 5-6 refills. Refills are also available separately without the handle. The writer, Head of the Dental Department, The Apollo Clinic, Chandigarh, is a former Head, Oral Health Sciences Centre PGI, Chandigarh. Email: chawlahs@gmail.com
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Health Notes London: The well-known “quick fix” jab used to ward off ugly-looking wrinkles, called as Botox, can have long-term effects on the shape of the users’ faces, a groundbreaking research has found. According to a study by cosmetic surgeons, people who regularly use the treatment for nine years or more have “significantly” higher brows than those who had rarely used the treatment, the study found. The research found that the brows of patients who repeatedly had the treatments were, on an average, more than 3 mm higher than those who did not, long after the short-term effects of the treatment to freeze wrinkles had disappeared, reports The Telegraph. —
ANI Teens’ pals can affect
their weight
Washington: Do you have a big belly? Well, one of the key reasons behind the extra flab could be your friends, says a new research, which has found that pals may affect teens’ weight. The study, published in the September issue of Journal of Health Economics found that friends’ weight is correlated with an adolescent’s own weight even after considering demographics, smoking status, birth weight, and household characteristics such as parental obesity. — ANI Mums’ ‘toxic’ behaviour can warp kids’ outlook on life
The Australian study shows that mothers who exhibit “toxic” behaviours — from being cold and indifferent to being abusive, manipulative or over-controlling — are far more likely to warp their children’s outlook on life than fathers with similar behaviour. — ANI
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Piles are a dilated “bunch” of veins in the lower anal canal. These cause episodic bleeding, itching or discomfort due to the prolapse (bulging) of piles. 
Sydney: Bad mothering has a worse effect on children than bad fathering, says a new study.