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| HEALTH & FITNESS |
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Pregnancy: summer calls for extra care
EYESIGHT
More exercise leads to less obesity — often, but not always
Reducing intake of niacin can prevent obesity
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Pregnancy: summer calls for extra care
Sangeeta is due next month, but is doubly distressed since the load of the baby and the oppression of summer heat have tied her down to the bedroom. Worried about the health of the baby, she calls her doctor and asks, “Can summer heat lead to an adverse outcome for me or my baby?” “Dehydration can be especially dangerous because it can cause your baby’s heart to beat too quickly and increase your risk of preterm labour. The likelihood of preterm labour increases because dehydration decreases your blood volume, thereby increasing the concentration of oxytocin, the hormone responsible for uterine contractions. Take the following precautions”: *
Avoid direct mid-day sun because pregnant women are more prone to sunburn than non-pregnant women. *
Drink one glass of water for each hour you are outdoors in hot weather. *
Avoid vigorous outdoor activities during the hot hours of the day. * Use a high SPF sunscreen. If you have fair skin, use SPF 30 or 45. (Increased melanin production can lead to the “mask of pregnancy”; so make sure your time in the sun is limited and don’t head out without sunscreen.) *
Get indoors at the first sign of weakness, fatigue, dizziness, lightheadedness, or excessive thirst. Lie down and drink some cold water or electrolyte replacement liquid. Call your doctor.
When to go to the doctor routinely in pregnancy?
Your first visit will be when you are 6 to 8 weeks pregnant. Your doctor will start with your medical history. You’ll be weighed and have your blood pressure taken. On your first visit, you’ll also have to undergo a pelvic examination to check the size and shape of your uterus and a Pap smear to check for abnormalities of the cervix. Urine and blood test samples will be taken. Urine is tested to check for bacteria, high sugar levels and high protein levels (which can put you at risk for preeclampsia, a type of high blood pressure during pregnancy). Blood is tested to check for hemoglobin, infectious diseases (sexually transmitted diseases and hepatitis) and blood group. Ultrasound may be done to check your baby’s growth and position in your uterus. Most women gain about 12 kg. If you don’t weigh enough when you get pregnant, you may need to gain more. If you’re overweight when you get pregnant, you may need to gain less. A monthly check-up is advised initially.
Diet and other factors
Meat, eggs and fish that are not fully cooked may put you at risk for an infection. Fish sometimes has high levels of mercury, which may hurt your baby. Wash all fruit and vegetables properly. Eat four or more servings of dairy foods each day. This will give you enough calcium for you and your baby. Avoid tea or coffee or other drinks with caffeine; do not have more than one or two cups each day. You should take 1,000 mcg (1 mg) of folic acid every day during your pregnancy. Folic acid can help prevent problems with your baby’s brain and spinal cord. Avoid all kinds of medicines, which may cause birth defects, especially during the first three months of pregnancy. Lifting heavy objects or standing for long periods can be hard on your body. Radiation, lead and other heavy metals, such as copper and mercury can be damaging. Avoiding foetal heat stress is especially important during the first trimester when your babys major body systems are developing. Hyperthermia may be associated with some birth defects, including heart problems, abdominal wall defects and nervous system malformation. Try to get at least 30 minutes for exercise each day. Walking and swimming are great choices. If you didn’t exercise before pregnancy, start slowly. Don’t overdo while exercising. Call your doctor if you have symptoms such as blurred vision, dizziness, chest pain or abdominal pain while you are exercising. It is okay to have sex. The writer is a Chandigarh-based senior gynaecologist and author of several books on women’s health.
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EYESIGHT
Dry eye is a multi-factorial disease of the tears and the surface of the eye that results in symptoms of discomfort, visual disturbance and tear film instability. During the hot season, dry eye problems increase and tend to become worse. The tear film gets evaporated faster because of higher temperature and increased use of airconditioning. The use of the airconditioner actually dehumidifies the air which increases dry eye symptoms like foreign body sensation in the eye or irritation or feeling of discomfort. The need for lubricants increases with the hot season setting in. Yet, in a very severe dry eye case, preservation of tears by a procedure called “lacrimal punctal occlusion” may be needed. In this procedure, the draining channels of tears (puncta and canaliculus) are blocked. This helps in reducing the rate of tear clearance (the rate at which tears drain out of the eye) and increases the availability of tears on the surface of the eye. Reversible occlusion of lacrimal punctum or canaliculus: This can be achieved by simple OPD procedures that use inserts or plugs in the punctum. There are many types of plugs available in the market. Your ophthalmologist will do an extensive evaluation of your dry eye status to determine which type of plug will suit you. Absorbable material Collagen plugs — They come in various sizes, ranging from 1.5-3.0 mm in length and 0.2-1.0 mm in diameter. Their effect lasts from a few days to several weeks. Catgut — Another absorbable material is chromic-catgut suture. This is an easily available absorbable material that can be used for temporary occlusion. Their effect lasts up to three weeks. Non-absorbable material Silicone — These are more permanent since they are non-absorbable. The Herrick Lacrimal Plug consists of a silicone golf-tee-shaped implant that is inserted into the canaliculus with the help of a fine probe. These can be removed at a later date if required. Acrylic — Sometimes it becomes difficult to chose the right size of the punctal plug because of anatomical differences in the puncta and lacrimal passage. This problem has led to the development of Smart Plug which is a thermosensitive hydrophobic acrylic polymer. That means it changes its thickness with an increase in the temperature. At room temperature and up to 32 degree C the plug consists of a cylinder with the diameter of 0.4mm and length of 9mm. On insertion into the canaliculus, the plug is heated to around 36 degree C which causes significant shrinkage. The diameter increases to about 1mm and the length gets reduced to about 2mm, thereby blocking the canaliculus. Temporary vs permanent occlusion For patients with very severe dry eyes, a more permanent method may be needed. This can be done with the help of passing a very fine current into the canaliculus and burning it. This is done by means of punctal cautery. This simple and inexpensive technique is a quick and painless procedure and gives long-term relief to the patient. Lacrimal punctal occlusion has been reported to be a simple, safe and effective procedure for treating severe dry eyes. Lacrimal punctal occlusion may also help by maximising the time that essential tear components are in contact with the ocular surface. The substances present in tears and the transforming growth factor help in maintaining a normal corneal and conjunctival surface. Lacrimal punctal occlusion is of great benefit for the management of ocular surface disease in severe dry eye cases. Punctal occlusion is associated not only with the improvement in ocular surface health parameters but also in vision as it provides an optically better corneal surface and a stable tear film. The writer is Chairman & Medical Director, Centre for Sight, New Delhi. Email: drmahipal@gmail.com
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More exercise leads to less obesity — often, but not always
Washington: Contrary to the popular belief that more exercise is more beneficial for being fit, an Indiana University study has found that this conventional wisdom applies primarily to white women. The study not only highlights factors like racial, ethnic and gender differences regarding exercise but also the role work can play. Obesity expert Dong-Chul Seo conducted a study amongst more than 12,000 people and found that obesity rates in general declined as the amount of weekly leisure-time physical activity (LTPA) increased. "For the majority of health professionals, even health researchers, they say the more leisure-time physical activity you engage in, the less likely you'll get obese," said Seo, associate professor at the School of Health, Physical Education and Recreation's Department of Applied Health Science. "This is true, but it's probably only applicable to white women and some of the white men." To solve the mystery, Seo conducted another analysis and found that men and Hispanic women are more likely to have manually demanding jobs than white women, which could affect the amount of LTPA they accumulate. For Hispanic women, their obesity rates dropped as their amount of occupational physical activity (OPA) increased. However, a different pattern was seen for men. "This illustrates to me the importance of physical activity in the workplace," Seo said. "Workplace wellness programs should really be emphasized, especially for people who do sedentary work. To enhance their health, maybe employers could offer workout spaces and incentives to do physical activity during the work hours or right after. They can make it easier." The study sample of 12,227 people was drawn from National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2006. —
ANI
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Reducing intake of niacin can prevent obesity
Washington: Scientists in China have suggested that reducing the intake of niacin, also known as vitamin B3 or nicotinic acid, can prevent obesity. Dietary factors have long been known to play a major role in the development of obesity. The global increasing prevalence of obesity suggests that there should be some common changes in diet worldwide. In fact, a significant yet often-neglected worldwide change in the dietary factor in the past few decades is the food fortification-induced marked increase in the content of niacin. However, the effect of long-term exposure to excess niacin on human health remains to be unclear. Now, a research team from China has examined the role of excess nicotinamide in glucose metabolism using co-loading of glucose and nicotinamide test. They have proved that excess niacin intake-induced biphasic response, i.e., insulin resistance in the early phase and hypoglycemia in the late phase, may be a primary cause for the increased appetite in obesity.
— ANI
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Health Notes Washington: People who have type-2 diabetes are at increased risk for developing 24 types of cancer, according to a new study. Kari Hemminki of DKFZ collaborated with colleagues in Sweden and the United States to carry out the largest study ever on cancer risks of people with type-2 diabetes. The study included 125,126 Swedish citizens who had been hospitalised due to problems associated with type-2 diabetes. The epidemiologists compared the cancer incidence in these patients with that of the general population in Sweden. — ANI
Spicing the meat makes it safer
Washington: Applying spices to beef not just enhances its taste but can also cut down your risk of cancer, suggests a new study. J. Scott Smith, a Kansas State University food chemistry professor, has pursued different projects in recent years seeking ways to reduce heterocyclic amines (HCAs). HCAs are the carcinogenic compounds that are produced when muscle foods, such as ground beef patties, are barbecued, grilled, boiled or fried. Consuming HCAs through meat increases risk factors for colorectal, stomach, lung, pancreatic, mammary and prostate cancers. —
ANI
Removing HIV's 'invisibility cloak' may help defeat virus
London: A new research has suggested that removing a chemical 'invisibility cloak' that makes HIV-infected cells look healthy might be the key to defeating the virus. Human cells defend themselves against immune attack by displaying proteins on their surface that mark them as "self". When the immune system detects these proteins, it holds back. One way HIV evades immune attack is by hijacking one of these proteins — CD59 — and using it to disguise itself and the cells it infects as healthy, human cells. — ANI
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The doctor replied, “Generally, only those who don’t get adequate care during pregnancy run the risk of complications. Heat can be dangerous for you and your baby if you become overheated, dehydrated, or develop hyperthermia.
The management of dry eyes includes supplementation of tears by lubricating eye drops, gel and ointments, decreasing lacrimal gland and surface inflammation by local steroids and cyclosporine.