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Finding a cure for itching
eYESIGHT
Leg pain — cause may be back problem
Health Notes
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Swine flu: don’t get panicky
Swine-flu, better known as H1N1 flu, is being reported from different parts of India. The tally of deaths is also increasing everyday. Undoubtedly, it is going to affect a large number of people in course of time. It is likely to stay for several months, may possibly become endemic in the long run — like many other viral illnesses such as the dengue fever or Japanese encephalitis. We need to minimise the losses and learn to live with the virus.
Hyped by the visual media reports, there is panic among the public. This is further fanned by the daily news of swine flu deaths. Most doctors are getting frantic calls, the demand for tests is increasing at an alarming rate. But do we all need this exalted version of news? This is the obvious question one should ask.
The answer is plain “no”. We are damaging ourselves and our society more by this panic than the damage which is likely to be caused by the H1N1 virus. To speak of the flu, there is plenty of information in circulation on the TV, in the newspapers and the Internet. About a third of the world’s population is likely to get infected. The main concern with this flu is the high transmission rate from humans to humans. Death from severe influenza, especially from pneumonia and respiratory failure, is another important concern. Both concerns are genuine and need to be tackled as much as is humanly possible. The mortality from swine flu is exaggerated. Small children, elderly persons of over 70 years of age, pregnant women, immuno-deficient people and other individuals suffering from concurrent illnesses (uncontrolled diabetes, cancer, organ-failures, etc) are likely to develop severer infections than their healthy counterparts. Whenever they suffer from any other disease such as a pneumonic illness or a viral fever. The rate of dying from H1N1 infection is in no way greater than the rate of dying from such illnesses. Mortality from the H1N1 virus is factually less than that from dengue fever or community-acquired pneumonias. To contain the infection, it is advisable to practice good hygienic measures, including repeated hand-washing, and avoiding coughing and spitting in the open. One should stay at home in the presence of respiratory catarrh (sneezing, nose-running, throat irritation, cough, sputum production, etc). The respiratory and hand hygiene constitute an essential part of our normal living. Wearing of masks is essential for the suspects and for high-risk healthcare workers handling such patients. It is a self-limiting disease in most cases. Treatment with Tamiflu is required in the case of only serious and sick patients. There is no need for the drug in mild cases even if positive for H1N1 infection. Some degree of immunity to the virus is already there. Soon, the community is likely to develop a collective herd immunity which will help control the flu. The vaccine is there in the pipeline, but likely to be meant for infants or other high-risk groups prone to flu. It is also feared that the risk of developing complications such as myelopathy may, in fact, be more than the risk of the flu. It will do good to everyone if we adopt an approach of living with H1N1 without an uncalled for panic, like we do with many other viruses, bacteria and parasites. Panic results in exploitation by several vested interests. This must be avoided. Good hygienic measures and better health care practices should replace the reaction of fear and
panic. The writer is Professor and Head, Department of Pulmonary Medicine, |
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Finding a cure for itching
At any given moment, an estimated 9 per cent of the worldwide population are itching. Women do it more than men, kids are the worst for giving in to the temptation for a good scratch, and like yawning it's said to be "contagious". So don't be surprised if, as you read this, you're giving in to it too.
Scientists believe itching developed through evolution as a low-level form of protective response, alerting the body to small threats such as ticks and fleas. By encouraging the scratch mechanism to kick in, humans and animals could brush off the offending insects. But we now know the itch is far more complicated than it seems.
There are three kinds of itch. The first originates in the peripheral nervous system through nerves in the skin - this is the kind that turns lying on grass into a scratch-fest. Allergens such as pollen trigger a reaction transmitted through nerves called This type of itch can be treated with antihistamines. But the other kinds of itch that originate in the central nervous system, generated psychologically or by damaged nerves, present a far bigger problem. At its best, itching (scientifically known as pruritus) is a slight irritation. But at its worst, it can be a chronically debilitating condition associated with more than 50 different diseases, ranging from eczema to cancer. Around 42 per cent of patients undergoing kidney dialysis suffer from chronic itching as a result of liver failure, and those who do are 17 per cent more likely to die, almost certainly due to a lack of sleep. Despite its prevalence and occasional severity, very little is known about the But the latest research carried out by a team at Washington University's Pain Centre in St Louis has been hailed as a "landmark study", providing new information on the causes of itch and taking scientists a step closer to treatment. Previously, scientists considered itch to be a milder form of pain sensation and believed the two were conducted along the same neural pathways. It seems a logical conclusion, as pain can stop itching, which is partly why we scratch. In 2007, the team at Washington successfully identified an "itch gene" called GRPR which only relays the itch sensation, not pain, from the spinal cord to the brain. Researchers took this further by injecting a toxin into the spinal cords of mice, killing the cells in which the GRPR gene was active and abolishing the scratch response. However, when the mice were subjected to pain, they reacted normally, proving that itch and pain signals are not related but are completely different sensations, conducted along separate nerve pathways.
— The Independent
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eYESIGHT
What exactly is cataract?
How does it affect vision? The human crystalline lens, which is clear and transparent, is part of the focusing mechanism of the eye. With age, the lens becomes cloudy and opaque, thereby hampering normal vision. Any opacity in the crystalline lens which leads to decreased division is called “CATARACT or “SAFEDMOTIA”.
How will I know if
I have cataract? Cataract causes a gradual, painless loss of vision. It can cause glares /haloes around bright light. It can also cause diplopia or multiple images. If you feel your vision is deteriorating day by day and simple tasks are becoming difficult, you probably need to be evaluated for cataract. Consult an eye specialist for a detailed eye check-up. When should I get operated upon for cataract? Cataract surgery should be performed as soon as it begins to affect your daily activities. There is no need to wait for the cataract to mature as most people think. Is it safe to get operated in summer or the rainy season? Season does not affect the outcome of cataract surgery. With sophisticated technology and expert post-operative care, one can get operated upon at any time of the year according to one’s choice. What are the treatment options for cataract? Surgery is the only treatment for cataract. Phaco-emulsification with foldable intra-ocular lens (IOL) implantation is the best and safest option. Using ultrasonic power, the cataractous lens is broken down into small pieces and suckedoutusinga vacuum base daspiration system. A new artificial lens is implanted in its place which allows you to see clearly. What are the various IOL options? There is a wide range of IOLs that you can choose from. Aspheric IOLs provide better contrast and neutralise the aberrations of the eye to provide a better quality of vision. People who want reduced dependence on glasses for both near and distance should consider multifocal
IOLs. Patients with astigmatism will benefit from Toric IOLs in which the cylindrical power is incorporated within the IOL optic. Your eye surgeon will advise you regarding the best IOL option. How long does the surgery take? The average duration of cataract surgery is 10-20 minutes. Will I have any pain during the surgery? Cataract surgery is painless and you can comfortably walk out of the operation theatre after the procedure. It can be done either by using anaesthetic eye drops or by giving a small injection to anaesthetise the area around the eye. General anaesthesia is used in certain situations like in small children. How soon after surgery will I see clearly? You may be able to see better almost immediately following the surgery, although most patients experience clear vision after two or three days. Recovery depends on various factors, including any associated eye disease and general health of the patient. Will I need glasses after cataract surgery? You may need to wear glasses to fine-tune your vision for distance and near. While multifocal lenses reduce your dependence on glasses, people who get mono-focal lenses will need glasses for near vision. When can I get my second eye operated upon? Usually, both eye surgeries are not done together. If the recovery of the first eye is good, the second eye can be operated upon even on the next day of the first eye. It is as per the comfort of the patient and the doctor. Where should I get my surgery done? Cataract surgery should be done at a centre which offers the latest technology combined with safety and expertise of the cataract surgeon. A complete eye care centre which provides comprehensive facilities for intra-operative and post-operative care and follow-up is
ideal. The writer is Chairman and Medical Director, Centre for Sight, New Delhi. |
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Leg pain — cause may be back problem
Leg pain is a common symptom which may occur due to various reasons. In case there is no direct injury then the pain can either be due to nerve or vascular affliction. In instances where pain radiates to the leg from the lower back or hips, the sciatic nerve is either pressed or irritated.
Sciatica, a term commonly used for pain radiation along the path of the sciatic nerve, is not a disorder but a symptom of numerous problems involving the nerve.
The causes of leg pain due to pressure on the sciatic nerve are: Lumbar disc prolapse: Degenerated disc disease — As age advances, the discs start to become dry, brittle and flat. The result is disc herniation, pressing on a nerve root, causing pain, numbness in the back, leg or both. Lumbar spinal stenosis: There is narrowing of one or more areas of the spinal canal, exerting pressure on the spinal cord. Spondylolisthesis often results when one vertebra slips slightly forward over another vertebra due to a fall, osteoporosis, etc. This displaced vertebra may pinch the sciatic nerve. Piriformis syndrome: Piriformis muscle is located in hip and placed directly above the sciatic nerve. Prolonged sitting or a fall on the hips can lead to muscle spasm, exerting pressure on the sciatic nerve. Trauma due to accident or a fall can compress the cord/ nerve root leading to pain.
Symptoms
Moderate to severe pain, starting in the lower back and buttocks radiating to the back of the thigh, lower leg and/or foot. Loss of movement, numbness, weakness in the affected leg. In chronic cases, the pain may gradually become localised in the lower back and buttock area. Prolonged sitting, heavy weight-lifting; sneezing, coughing or bowel movement may aggravate pain. Lying down is usually the most comfortable position. In cases of canal narrowing pain, numbness increases on standing and walking and gets alleviated on sitting. Diagnosis can be established after a clinical examination. An X-ray test can show the alignment of the vertebras, disc spaces, etc. MRI shows the extent of damage to the disc and ligaments.
Treatment
Avoiding activities like forward or backward bending which aggravates pain. Rest for 24 to 48 hours may provide relief. However, prolonged bed rest and inactivity can cause muscle weakness. Use of hot packs after a period of 48 hours is good to relax the muscles. Medication helps reduce pain and inflammation. Spinal manipulation helps relax the spine immediately and alleviate pain. Physical therapy plays a vital role in the recovery of the affliction. Exercise prompts the body to release endorphins (a chemical that prevents pain signals from reaching the brain). When the pain decreases, a rehabilitation programme which comprises exercises to improve the posture and flexibility and strengthen the muscles supporting the back is mandatory. Initially, low-impact exercises such as walking and stationary bicycle help to stay active. Regular exercises for the muscles of the abdomen and lower back are of utmost importance for proper posture and alignment.
Tips to avoid stress on the lower back
Ideally, one should lie on the back with pillows under the knees or with the hips and knees bent and the feet on a chair. Sleeping on the side with bent knees and a pillow between the knees. Using a firm mattress also helps. When standing for prolong periods of time, resting one foot on a stool helps Placing a rolled towel/ pillow behind the back when sitting is also beneficial. When lifting an object from the ground, bending the knees and squatting help considerably. Keeping the back straight and holding the object close to the body help. Lifting objects over the head or bending over too far doesn’t help. Don’t lift beyond ones capacity. When pain becomes intolerable, epidural steroid injections reduce inflammation and relieve pain. However, three injections per year are advised. Surgery is indicated when the compressed nerve causes significant weakness, The key to successful treatment lies in remaining active, avoiding activities that aggravate pain and undertaking a coordinated and proper rehabilitation programme for permanent relief. The writer runs a pain management clinic in
Chandigarh. |
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Health Notes
London: There has been a significant increase in the number of people suffering from eating disorder “orthorexia nervosa”, an obsession for healthy food, in Britain.
According to experts, sufferers with the obsession for healthy eating tend to be aged over 30, and are middle-class and well-educated. The condition, which affects equal numbers of men and women, is described as a “fixation on righteous eating”.
— ANI
New swine flu jabs may trigger brain disorder
London: The British Government has written to senior neurologists to warn them that the new swine flu vaccine may trigger a deadly brain disorder called Guillain-Barre syndrome. Medical experts have been asked to look out for cases of Guillain-Barre syndrome, which can paralyse its victims once the national vaccination programme begins. In its letter, the Health Protection Agency refers to the use of a swine flu vaccine Smokeless tobacco is also dangerous
Washington: People who think that smokeless tobacco is safe have been warned by researchers that it exposes the user to the same amount of another group of dangerous chemicals as the smoke of five cigarettes. The research on polycyclic aromatic hydrocarbons (PAH) in smokeless tobacco adds to existing evidence that smokeless contains two-dozen other carcinogens that cause oral and pancreatic cancers. “This study once again clearly shows us that smokeless tobacco is not safe. Our finding places snuff on the same list of major sources of exposure to polycyclic aromatic hydrocarbons as smoking cigarettes,” said Dr Irina Stepanov, who led the research team.
— ANI
Kissing ‘poses herpes risk’
Wellington: The next time you kiss your partner, keep this health warning in mind — the symbol of affection is a major transmitter of herpes. While kissing “demonstrates love and affection”, it also poses risks, warns the Australian Herpes Management Forum (AHMF) ahead of the roll-out of a national ad campaign. AHMF executive director Tricia Berger says that kissing poses risks to both adults and children.
— ANI
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