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| HEALTH & FITNESS |
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Fatal asthma is preventable
Scorching heat calls for special eye care
Health Notes
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Fatal asthma is preventable
ASTHMA, a chronic lung problem, is always there afflicting a large number of people all the time, but it attracts greater attention during the seasons of worsening. Of particular importance is fatal asthma which happens now and then and raises the alarm in the media. The sudden death of a young cricketer recently due to a sudden asthma attack at Patiala, widely reported in the media, has been a matter of grave concern for everybody, especially the families of the patient, the health personnel, the school authorities and the sports administrators. “Sudden asthma attacks” do usually provide a time-interval of progressive deterioration and worsening of symptoms of a few hours to a day or so. The early symptoms are either missed or ignored as “mild” or casual. The missed “chances” of administration of therapy during this period finally result in an unexpected tragic outcome. The key to the management, therefore, lies in the early identification of the risk and the institution of appropriate treatment. Symptoms of asthma occur from the narrowing of the respiratory tubes which normally conduct air from outside the atmosphere into the lungs, to provide oxygen to the blood for supply to all other organs. Narrowing results in an obstructed and reduced airflow responsible for symptoms of breathlessness, cough, chest pain, “congestion,” etc. The greater the narrowing, the more the symptoms. Occasionally, the narrowing is widespread and involves even the major and central airways. This causes a choking sensation almost mimicking, throttling, posing the risk of complete cessation of airflow, and hence the suddenness of the problem. There are also some other medical mechanisms and scientific explanations for the problem. We are not concerned with those details here. More importantly, one needs to understand the treatment of the problem and the potential dangers of ignoring the need of an early interference. The most critical point for prevention is the maintenance of the continued asthma management plan and the availability of emergency-kits for acute episodes. As of today, there is no better remedy for asthma than inhalational steroids. It is natural that people have all kinds of doubts and fears about inhalers such as the risk of habit-formation and side-effects of steroids. There is also a kind of stigma attached to this form of therapy and the disease — asthma. Almost all these doubts are misfounded and wrong. The only two problems with inhalers are the complexity and difficulty of administration and relatively higher costs. If properly used, the inhalational treatment is more safe, least toxic and also affordable in the long run. Inhalation therapy is also most effective for an urgent effect. The drug administered in this fashion acts immediately almost like an injection given intravenously. Therefore, it is almost mandatory that all patients of asthma are properly educated to recognise the warning symptoms and use the inhalers immediately as the need arises. One must carry the emergency inhaler in one’s pocket wherever travelling or away from the place of stay. Similarly, the inhalers should constitute the essential component of an emergency kit in schools, sport-complexes and other similar institutions. Self-medication is always despised by doctors to save their patients from the unwanted risks of side-effects and masking of disease severity. An impending attack of asthma is one situation where self-medication is advocated all over the world. The writer is Professor and Head, Department of Pulmonary Medicine, PGI, Chandigarh. Email —
dr.skjindal@gmail.com
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Scorching heat calls for special eye care
Eyes are one of the most wonderful and free gifts of God to us. Most of us take this gift for granted and ignore the fact that the eyes are one of the most sensitive organs of our body. During summer, protection of the eyes from harmful sunrays and the dusty environment should be given utmost importance. Ultra- violet (UV) rays of the sun can damage the long-term health of the eyes. UV radiation can play a contributory role in the development of various ocular disorders, including age-related cataract, pterygium, cancer of the skin around the eyelids and photokeratitis. In fact, the eye may be at a greater risk from the sun than the skin. During summer, allergy problems are on the rise. The pollengrains and duststorms flare up the allergies in the eyes. Vernal conjunctivitis, usually occurring in children, is most common during warm weather. Most often, it affects both eyes and may be recurrent. It is characterised by severe itching and thick mucous discharge. It occurs every year in the same season till the age of 10-12 years. Other allergies are also on the increase and itching/ irritation and redness of the eyes are common in summers. One should consult an eye specialist for the same. During the hot season, dry eye problems increase and tend to become worse. The tear film gets evaporated faster because of higher temperature and the increased use of airconditioning. Air conditioning actually dehumidifies the air which increases the dry eye symptoms like foreign body sensation in the eye or irritation or discomfort in the eyes. The need for lubricants increases with the hot season setting in. During summer holidays it is advisable for parents to take children for a regular eye checkup. Many children will have undetected refractive errors and by this they can have proper eye check-up and glass prescription. Children also may have squint (crossed eyes) which can be detected by an eye specialist and early treatment will prevent the loss of vision.
Eye-protection wears
Appropriate eyewear and hats are not just fashion accessories but are essential. It is important to ensure that one invests in good quality eyewear that blocks 100 per cent UV radiation. People who wear prescription glasses need not fret. Today, the market has photochromatic lenses (variable tint) which automatically adjust to the level of UV light they are exposed to, going from exceptionally clear indoors to sunglass dark outdoors. While most prescription lenses offer some UV ray protection, not all are equally effective. Wear plastic photochromatic lenses that block 100 per cent UV radiation and enhance visual comfort by preventing eye fatigue by reducing glare. Plastic photochromatic lenses optimize visual clarity by allowing just the right amount of light to reach the eye. These lenses transition from clear to dark quickly when you move from indoor to outdoor and fade back just as fast when you move indoors from outdoors.
Precautions during summer
* Take a glass of water before going out * Avoid direct air currents *
Wear protective glasses while going out * Avoid rubbing of eyes * Frequent washing of eyes with cold compress *
Avoid walking in dusty areas * It’s good to wear protective good quality eye glasses with an umbrella or a cap or a hat while stepping out *
Use of any eye-drop under medical supervision is useful * Use plastic photochromatic lenses that block 100 per cent UV radiation The writer is Chairman and Medical Director, Centre for Sight, New Delhi. Email: drmahipal@gmail.com
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Health Notes Washington: A study has found that women who survive early-stage breast cancer have an increased chance of developing a new second cancer in their other breast or elsewhere if they smoke. Investigators from The Cancer Institute of New Jersey (CINJ) are releasing these findings at an oral presentation during the 92nd Annual Meeting of the American Radium Society taking place this week in Cancun, Mexico. It has been shown that women who survive breast cancer have two to six times increased risk of developing cancer in their other breast, compared with women who have never had breast cancer. — ANI
How to identify masked hypertension in kids
Washington: A study has suggested that a parent’s blood pressure, waist and hip circumference are the keys to identifying masked hypertension in their kids. According to data unveiled at the American Society of Hypertension Inc.’s 25th Annual Scientific Meeting and Exposition (ASH 2010), children and adolescents who have parents with hypertension and larger waist (WC) and hip circumference (HC) should be evaluated for hypertension even if they exhibit normal blood pressure (BP) levels in the doctor’s office. Investigators found that these patients exhibited masked hypertension, which occurs when BP levels are normal when measured inside the doctor’s office but increase when measured outside the doctor’s office, when evaluated with ambulatory blood pressure monitoring (ABPM). — ANI
Getting little sleep raises stroke risk in elderly BP patients
Washington: A new research has shown a link between short cycles of sleep, stroke and silent cerebral infarct (SCI), or “silent strokes,” in elderly hypertensive patients. Although data suggest SCI to be more prevalent among patients with a longer duration of sleep, patients who experienced both SCI and short-sleep duration were at the greatest risk of stroke. “Stroke is extremely debilitating to patients and our healthcare system. Therefore, it is important that we learn as much about these events as possible,” said lead author of the study, Kazuo Eguchi, Division of Cardiovascular Medicine, Jichi Medical University School of Medicine in Tochigi, Japan.
— ANI
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The gravity of a fit of asthma has been known for centuries. The early details in modern medicine characterised asthma as a terrible disease. Asthma fits are almost like accidents — they are sudden, often expected, but largely preventable. Unfortunately, a fit like an accident can occasionally be fatal. They always leave behind a feeling of guilt, remorse and helplessness. It might not have happened had this been done or thought before!” Precisely so. Most of the accidents, including deaths from asthma, can at least be partly attributed to negligence, and hence avoidable.