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| HEALTH & FITNESS |
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Aids: the pandemic is on the decline
Diabetes closely linked to kidney disease
Weak muscles cause low back pain
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Aids: the pandemic is on the decline
THE HIV pandemic, which started 28 years ago, is officially on the decline, two of the world's leading health organisations have said. The number of new HIV infections peaked in the mid-1990s and has since declined by almost a third, according to the annual update on the pandemic for 2009, published by the Joint United Nations programme on HIV/Aids (UNAids) and the World Health Organisation. It is the first time that UNAids and the WHO have confirmed that the pandemic is on a downward trend and represents a landmark in the history of the disease. In their 2008 report, they said suggestions the epidemic had peaked were "speculation" and that it was "difficult to predict the epidemic's future course". That report warned: "The HIV epidemic has repeatedly defied predictions... HIV is likely to have additional surprises in store that the world must be prepared to address." But the 2009 update throws scientific caution to the winds and instead states clearly that the pandemic has passed its zenith: "The latest epidemiological data indicate that globally the spread of HIV appears to have peaked in 1996 when 3.5 million new infections occurred. In 2008 the estimated number of new HIV infections was approximately 30 per cent lower than at the epidemic's peak 12 years earlier." It says that, in sub-Saharan Africa — the worst-affected region — new infections in 2008 were "approximately 25 per cent lower than at the epidemic's peak in the region in 1995". It adds: "Asia's epidemic peaked in the mid-1990s and annual HIV incidence has subsequently declined by more than half. Regionally, the epidemic has remained somewhat stable since 2000." The annual report from UNAids and the WHO is the official record of the progress of HIV/Aids, and confirmation that the worst disease of modern times is in decline will be widely welcomed. Two years ago the organisations admitted that they had overestimated the numbers affected and revised the total down from 40 million to 33 million. Despite the fall in new infections, the number living with HIV increased last year to 33.4 million as people are surviving longer with the roll-out of antiretroviral drug treatment. Greater access to drugs has helped cut the death toll by 10 per cent over the past five years. There are now 4 million people on the drugs worldwide, a 10-fold increase in five years. The report says 2.9 million lives have been saved since effective treatment became available in 1996 but less than half the patients who need them are currently getting them. The reasons for the decline in new infections are disputed. UNAids said prevention programmes involving sex education, HIV awareness campaigns and distributing condoms had had an impact. Critics said the pandemic was already in decline before prevention programmes were widely implemented and the disease was burning itself out. Ties Boerma, a WHO statistics expert, said countries whose HIV prevalence declined dramatically, like Zimbabwe, were not always those that got the most HIV cash. — The Independent
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Diabetes closely linked to kidney disease Symptoms Albumin (protein) in the urine. High blood pressure. Ankle and leg swelling. Decreased urination. High levels of blood urea and creatinine. Less need for insulin or antidiabetic medications. Reduced appetite, nausea and vomiting. Weakness and anaemia. Itching. Complications Severe hypertension. High level of serum potassium. Anaemia. Hypoglycemia (low blood sugar). Infections. Chronic kidney failure (rarely rapidly gets worse). Dietary advice for patients It is important to maintain a low-sodium diet in diabetic nephropathy. Many diabetics are salt-sensitive, and minimising salt intake can help in reaching blood pressure goals, with secondary benefits of decreased stroke risk, regression of left ventricular hypertrophy, and reduction in proteinuria. Lifestyle modification By modification of lifestyle, the following changes can be made: Weight loss. Reduction in salt intake. Avoidance of alcohol and tobacco. Regular exercise. Avoidance of kidney toxins and drugs It is important to avoid pain-killers in patients with diabetic nephropathy. Daily low-dosage aspirin is safe in diabetics. However, aspirin in higher dosages should be avoided. Apart from this, frequent CT scans and angiography using contrast in the presence of raised creatinine should also be avoided. Metaformin, the most commonly used anti-diabetic drug, should not be used in the presence of deranged kidney functions. Prevention Annual check-up of urine protein. Consult medical professionals before using any drug. Control of high blood sugar and elevated blood pressure, including regular use of ACE inhibitors. Treatment
Challenges in blood pressure control, hyperkalemia or the rising creatinine level on angiotensin blockade prompt a referral to specialist. Is diabetic nephropathy curable? There is need for intensive use of ACE inhibitors or ARB with tight control of blood pressure and blood sugar. With this type of treatment, long-term research has shown that diabetic nephropathy can be cured in early stages. Pregnancy and diabetic nephropathy ACE inhibitors during pregnancy with diabetic nephropathy should be avoided as they cause congenital malformations and other birth defects. The key lies in the strict control of blood glucose (HbA1C<7.0%) and blood pressure (BP<130/80) including regular use of ACE inhibitors and/ ARB like Ramipril/ Telmisartan. The writer is Senior Consultant (Endocrinology), Fortis Hospital, Mohali. E-mail:
(k.singh@fortishealthcare.com)
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Weak muscles cause low back pain Everybody
suffers from low back pain at one time or the other. In most cases, the cause attributed is weak muscles. As the muscles of the back, abdomen and buttocks support the spine, hence the nomenclature core muscles. Muscles, if shortened, tend to throw the spine out of alignment leading to back pain. A tight (constricted) back, buttocks and even the back of the thigh muscles (hamstrings) can alter the alignment of the spine. Stretching exercises enhance the mobility of the joints of the spine and lengthen the shortened (constricted) muscles, alleviating back pain. Strong and flexible muscles enable an individual to maintain the correct posture. The spine is bestowed with a natural inward curve at the lower back. A neutral spine distributes the load equally throughout the lower back. This helps the prevention of injury and facilitates efficient mobilit. Movements of the back are a combination of the forward, backward and rotational movements. As these movements entail coordinated action of different muscles, forward bending requires rectus abdominis, internal and external oblique and hip flexors muscles to act in tandem. Although general awareness regarding fitness is increasing all around, but if along with aerobic activity for heart and lungs, yoga exercises for flexibility, addition of strengthening exercises of the abdomen and back muscles go a long way in cutting down the incidence of low back pain drastically. Learning and effectively managing to maintain a neutral position should be the focus of most “core stability” exercises.
Exercise regimen It is imperative that exercises should be specific, and initiating all exercises at one go is not a wise thing to do. Certain basic exercises in order to train stomach and low
back muscles should be initiated:
Once the basic exercises have been initiated, the following exercises can be included:
The spine is an integral part of an individual’s stability and muscles the main defence against gravity. Therefore, the importance of strengthening the muscles with proper exercises can prevent or reduce back pain. The writer runs a pain management clinic in Chandigarh. E-mail-chadha_r2003@yahoo.co.in
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Diabetes cases to double in the next 25 years Washington: The number of diabetes cases is estimated to almost double in the next 25 years, suggests a new US study. The study led by researchers from University of Chicago has revealed that the number of Americans living with diabetes is likely to increase from 23.7 million in 2009 to 44.1 million in 2034. Moreover, the money spend on diabetes will almost triple, rising from 113 billion dollars to 336 billion dollars in the same period.
— ANI
Dog owners get more exercise than gym members Washington:
For those who want to stay fit but low on motivation, a personal trainer is often the best option. However, the human version may not be the most effective. A new study has shown that having a dog can successfully fill that requirement. A survey of 5,000 Britons, conducted by pet healthcare company Bob Martin, showed that dog owners get more exercise walking their pet than people who go to gyms. Two dog walks a day each lasting 24 minutes and three longer walks a week each lasting 30 minutes give pet owners seven hours' exercise a week, reports the Daily Express.
— ANI
Exercising too much in middle age 'can lead to arthritis' Washington: Too much exercise can cause arthritis in middle-aged people, according to a new study. The research led by University of California, San Francisco, has shown that middle-aged men and women who engage in high levels of physical activity may be unknowingly causing damage to their knees. "Our data suggest that people with higher physical activity levels may be at greater risk for developing knee abnormalities and, thus, at higher risk for developing osteoarthritis," said Dr Christoph Stehling, research fellow in the Department of Radiology and Biomedical Imaging at the University of California, San Francisco, and radiology resident in the Department of Clinical Radiology, University of Muenster, Germany.
— ANI
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Complications