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EYESIGHT
Hormone therapy in menopausal zone
Heel spur not the cause of heel pain
Ayurveda and You
Health Notes
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EYESIGHT
‘VISION 2020: The Right to Sight’ is a global initiative for the elimination of avoidable blindness worldwide by the year 2020. It is coordinated jointly by the World Health Organisation (WHO) and the International Agency for the Prevention of Blindness and has an international membership of NGOs, professional associations, eye care institutions and corporations. Approximately, 314 million people suffer serious vision impairment. Of these, 45 million people are blind and 124 million have low vision. Yet, 75 per cent of blindness is avoidable — i.e. treatable and/or preventable. 90 per cent of vision impaired people live in developing countries and 153 million people’s vision impairment is due to uncorrected refractive errors. In most cases, normal vision could be restored with eyeglasses. Aging populations and lifestyle changes mean that chronic blinding conditions such as diabetic retinopathy are now rising. However, without proper interventions, the number of people who are blind is likely to increase to 75 million by 2020 as per WHO. World Sight Day 2008 focusses on the impact of vision loss and blindness for the people aged 40 and above. The vision for aging population is:
l
They have the best possible vision to last their lifetime Healthy eyes are important for having good sight. It is important for everyone to have regular eye examinations. How frequently one should have, the routine eye check depends on the age and general health. The people with a family history of eye problems and, if already diagnosed or treated for any eye conditions, should check the eyes at regular intervals as specified by their eye specialist. Children should be examined before they enter school to be sure that there are no undetected vision problems that might affect learning. The frequency of their examinations will depend on the family history and any specific vision problems or complaints. Good sight at old age is still more important. So one should be aware about the age-related macular degenerations, cataract and glaucoma. These can be managed better if detected in time. Patients with systemic illnesses like diabetes should be aware about the eye problems associated with it and at least approach an eye specialist in time so that the vision can be maintained well. Healthy eyes make a person independent and earning member of society. It reduces the financial burden on society. Eyes are windows of our body, which make us see this world. Timely examination by an eye specialist is essential to ensure good health of the eyes to see this world as beautiful as it is! The writer is Chairman and Medical Director, Centre for Sight, New Delhi. Email:
msachdev@bol.net.in
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Hormone therapy in menopausal zone
Many women go through menopause with few or no symptoms, but during menopause vasomotor symptoms (hot flashes and night sweats) and vaginal dryness are frequently reported. The most effective treatment of vasomotor symptoms is estrogen. Compared with placebo, oral hormone therapy (estrogens, progestogens, or combination therapy) is highly effective in relieving hot flashes and night sweats.
Nonestrogen drugs may be considered for vasomotor symptoms when estrogen is contraindicated. These include progestogens, selective serotonin reuptake inhibitors and other antidepressants, anticonvulsants and alpha-blockers. Because of its excellent efficacy, local estrogen is the preferred treatment of vulvo-vaginal symptoms. Preparations include vaginal cream, tablets, or ring, and specific agents include conjugated estrogens, 17-beta-estradiol and estradiol hemihydrate. All women over 65 years should undergo bone mineral density screening. For menopausal women, recommended immunisations are influenza vaccine once yearly, tetanus and diphtheria toxoid booster once every 10 years, and a 1-time pneumococcal vaccine after age 65 years. To maintain bone health, all postmenopausal women should consume adequate amounts of calcium (1000-1500 mg of elemental calcium per day) and Vitamin D (800 - 1000 IU per day) (level of evidence, C).
Chandigarh study
The findings and recommendations in our study at the Chandigarh centre in 300 patients in the last seven years agree with the findings of the American study. In our study, 270 women were started HRT in mid-forties and continued from 3-5 years. More than 80 per cent had relief from symptoms. Only 30 women aged 60 or more were given HRT on their request — only 20 per cent of them had some relief in vaginal dryness and/or irritability. The therapy was halted after six months. The writer is a Chandigarh-based senior gynaecologist
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Heel spur not the cause of heel pain
In day-to-day practice, heel spur is claimed to be the culprit for heel pain. The fact is the heel pain is usually the result of plantar fascitis.
The myth, however, persists as it is deeply engraved in the minds of public and doctors too that heel spur which appears on X-ray is usually considered the reason for heel pain. There is a deposition of calcium at the site where plantar fascia is attached to the heel with progression of age and this is what comprises the spur. The body responds to inflammation by scar tissue formation and bone deposition at insertion site. This effectively shortens the fascia and forms heel spur. The heel is attached to the foot by a strong ligament i.e. plantar fascia. In individuals afflicted with it, there is partial tearing and inflammation at its attachment at heel causing pain. Most people have heel spurs but do not experience pain. It is actually easier to pronounce heel spur than plantar fascitis as the reason for pain. Normally a patient describes the pain due to bone growth. Pain and spur occurs due to stress exerted on the plantar fascia leading to irritation, inflammation and heel pain. The pain is most severe and could be extremely excruciating when getting out of bed or after prolonged rest. Causes: l Increased/ change/ start in activity Treatment: l Rest is crucial. Advisable not to walk through pain
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Ayurveda and You
In the present era, the average increase in life expectancy resulting into the rising population of the elderly has brought the geriatric health care to the forefront of the medical practice. Like many other diseases, the chances of occurrence of diabetes also swell with age.
According to a rough estimate, about 10 per cent of the urban Indian population who have attained the age of 65 or more has diabetes. The history of diabetes or madhumeha can be traced back to the centuries-old ayurvedic literature. Modern medicine on the basis of their response to the treatment divides the diabetic patients into two categories — Type I and Type II. The first one is the insulin dependent diabetes. Type II diabetes is more common in adults and the older people. Being overweight and obese and leading a sedentary lifestyle, stress and family history of diabetes are some of its major risk factors. Elderly people who are at risk of developing diabetes, or who have already developed this disease may not exhibit its classic symptoms and many age related changes can mask or make these indicators difficult to spot. Many times the diagnosis of diabetes is made only after patient complains of its complications such as infections and pruritis at the genitals, neuropathy and the kidney related problems, though there are many conditions which should alert the doctor to suspect diabetes in the aged people. In old age, more often it is not the diabetes which causes concern about the health of the patient rather these are its complications which are difficult to cure. Right from the cognitive impairments, dementia and raised risk of stroke, common diabetic micro-vascular complications include the diseases of the retina of the eye (retinopathy), a combination of nervous system disorders (neuropathy) and the diabetic kidney disease (nephropathy). In peripheral neuropathies the patient complains of sensory loss in the lower extremities with the absence of heat, cold and touch or sometimes reverse conditions like feeling of extreme pain or burning sensation in legs and feet. Many elderly patients encounter these complications by the involvement of gastrointestinal tract manifesting the development of either esophageal dysfunction or diabetic enteropathy with symptoms of diarrhoea or constipation, gas, flatulence. Though most elderly diabetic patients require multidisciplinary but individualised medical approach, they can chose ayurvedic help as an adjunct to their mainstream treatment. A large number of diabetic patients can feel better if they adopt low fat diet and follow an exercise schedule depending upon their physical strength and the cardiovascular status. A too ‘tight’ control should be avoided because elderly patients are prone to get hypoglycemic attacks. Smoking and diabetes are synergistic risk factors for many of the diseases of old age. It is the regular compliance of the treatment which is the cornerstone of successful management of elderly diabetic patients. The writer is a Ludhiana-based senior ayurvedic physician. Email: yourhealth
@rediffmail.com.
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Health Notes
The sting of the Middle Eastern scorpion Leiurus quinquestriatus unleashes a cocktail of neurotoxins containing a peptide that is non-toxic to humans but binds to tumour cells. In tests, the peptide has invaded tumours in breast, skin, brain and lung tissue while leaving healthy cells untouched. “It’s as if the tumours collect it,” New Scientist quoted Michael Egan of the company TransMolecular in Cambridge, Massachusetts, as saying.
— ANI
Sick leave may affect longevity
LONDON: Employees who take long spells of sick leave for circulatory or psychiatric problems or for surgery are at an increased risk of dying early, says a new study. The study suggests that specific reasons for absence such as psychiatric problems or heart disease may improve the prediction of premature death. Jenny Head from University College London analysed the sickness absence records of 6,478 British civil servants between 1985 and 1988 and analysed associations with death until 2004.
— ANI
Brain pathway behind obesity
WASHINGTON: While conducting a study on mice, researchers at the University of Wisconsin-Madison discovered a messaging system in the brain that directly affects food intake and body weight. When Dongsheng Cai, an assistant professor of physiology at the UW School of Medicine and Public Health, and colleagues looked for this same pathway in the hypothalamus — the part of the brain that regulates appetite and energy balance — they found it also influenced how much mice eat.
— ANI
Critical health risks from plastic
In a critical new research on environmental contaminants and adverse reproductive and behavioural effects, it was found that exposure to Bisphenol A (BPA), phthalates and flame retardants (PBDEs) could lead to many adverse health effects. Plastic products contain endocrine disrupting chemicals” that can block the production of the male sex hormone testosterone (phthalates used in PVC plastic) and mimic the action of the sex hormone estrogen.
— ANI |
World Sight Day is held annually on the second Thursday of October to focus attention on the issue of avoidable blindness and visual impairment. World Sight Day 2008 focuses on the ageing eye, and vision impairment in older people.
LONDON: It may sound like the ultimate poison, but radioactive scorpion venom is being tested as a treatment for malignant brain cancer.
WASHINGTON: Plastic bottles, cans and other products have extremely harmful effects on humans and laboratory animals, according to six environmental studies.