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Pregnancy after
age 35 may cause complications Cocaine-addiction
a major threat to health Nocturnal cramps
in legs Health Notes
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Pregnancy after age 35 may cause complications
l Many women delay childbirth to concentrate on professional education or building up a career. They find at difficult to take time out for marriage and children. It is a known fact that 35 is a turning point for an increase in infertility, miscarriage, premature delivery, stillbirth, placenta previa, birth defects, high blood pressure, diabetes as well as complications during labour in an expectant mother. As fertility levels fall, the odds of having twins also increase. Since chromosomal abnormalities are the most common reason for miscarriage, the risk of miscarriage also increases with age. It has been suggested that higher rates of stillbirth for women over 35 could be attributable in some part to chromosomal abnormalities. Also an increased incidence of induction of labour, instrumental delivery and delivery by caesarean section has been found for women over 35. According to a new research, females making attempts to have a baby after 35 are six times more likely to face infertility problems as compared to those 10 years younger. Delay entails grave medical problems for both the mother and the infant. Men's fertility also drops speedily from 25 onwards. The main risks: The risk of miscarriage increases. Fertility levels do start to drop drastically after 35. Health problems for a woman after 35 include gestational diabetes, hypertension as well as endometriosis and fibroids. The need for caesarian section increases. There is an increased risk of down syndrome. An aged woman has about nine times higher chance of having a baby with a chromosomal defect than a young woman. What to do if pregnancy is after 35? l
Take a daily vitamin supplement that contains folic acid (a vitamin that reduces the chance of some birth defects), calcium, iodine and iron, but not a high content of vitamin A. You may need extra care during pregnancy if you have the following: a sexually transmitted disease (STD), diabetes, high blood pressure, or other chronic health problems, especially heart or lung disease. Complete your family when still younger than 35. But there is no need to panic. Many women over 35 can have normal deliveries. Adolescent pregnancy is also unsafe. Similar to the risks involved in the case of a mother in her 35 plus, a teenager pregnancy can cause extra health risks to the mother and the baby. The body and reproductive organs of the teenagers are not developed enough to bear the pregnancy. They have a greater risk of a pregnancy-related high blood pressure and other complications. The baby has the risks of low birth weight and premature birth. Therefore, it is better for the teenagers to apply some preventive measures and avoid pregnancy. The writer is a Chandigarh-based senior
gynaecologist.
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Cocaine-addiction a major threat to health Drug
addiction continues to play havoc with the health of people in Punjab’s both rural and urban areas. Use of opium, alcohol, sleeping pills, tranquillisers, narcotic pain killers codeine containing cough syrups, smack and heroin have already harmed lives of millions of Punjabis and created a major psycho-social problem in the state. Parental use of narcotic injections have contributed to the vast reservoir of patients with Hepatitis B, C and HIV. Cocaine is the new entrant to the lethal arsenal of the addictive substances being used in the state. It is the most expensive intoxicant and costs Rs 3500-Rs 6000 a gramme. Addicts may use upto one gramme a day. Cocaine is a naturally occurring alkaloid extracted from the leaves of the coca shrub. It is known with its many street names like flake, “snow”, nose, candy, etc. It is commonly known as coke. Its use has been known to mankind for the past 5000 years. It resembles white powder. Unlike other drugs, cocaine does not cause physical dependence but leads to severe psychological dependence. Its dependence is much more severe than any other drug or chemical substance. A chronic cocaine user needs an increased dose of cocaine to “chase the high” which he felt at first use and he is unable to cut down its use. When the use of cocaine stops after binge use, it is followed by a “crash” or extremely low state. Thus, a cocaine addict is always on a roller coaster ride. A cocaine addict starts ignoring other aspects of his life. Once the addict stops using cocaine he feels tired, lethargic, exhausted and panicky, and gets insomnia. People who try cocaine often get hooked to the feeling of increased energy level. The quick high keeps the user feeling energetic and able to endure longer in physical activities. As the time passes he starts lying and stealing, and remaining absent at work. He also ignores his family. Cocaine effects are extremely detrimental on the body and the consequences can be disastrous. Cocaine use complicates pregnancy and affects the foetus directly. There is an increased risk of miscarriage, placental separation and still-birth. It can also cause many congenital abnormalities. Management of cocaine dependence: Cocaine treatment has two components: detoxification and rehabilitation. The first step is to stop the use of cocaine and an addict may experience anxiety, restlessness, intense craving and depression during withdrawal, which is symptomatically managed. Following detoxification the patient has to be adequately rehabilitated. There is no proven pharmacological treatment for cocaine dependence. A combination of drug treatment and counseling is used in most cases. Recently a new vaccine for cocaine dependence has shown positive results. The vaccine makes the body produce antibodies to cocaine, which later on deactivate the cocaine molecules in the blood before it gets to the brain. The writer is a Ludhiana-based psychiatrist and deaddiction specialist. Email —
happymind@rediffmail.com
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Nocturnal cramps in legs Idiopathic
leg cramps, also known as benign nocturnal leg cramps or “charley horses”, constitute an important and common cause of painful disabling symptom usually found in the post-middle aged individuals. Typically, during the change of posture of the leg while asleep, there is sudden painful contraction of the calf muscles, resulting in severe pain in the leg that gets relieved in a few minutes. Rarely the contraction may be so severe that the residual pain is felt for the next couple of days during the movements of the ankle and the foot. The exact cause of nocturnal muscle cramps has still not been unveiled. While some of cases can be attributed to an underlying and sometimes treatable cause like peripheral vascular disease, diabetes, electrolyte imbalance, Parkinson's disease, hypoglycemia, tetany, thyroid disorders pregnancy and anemia; the majority of the cases have no known etiology or trigger. Certain drugs such as diuretics have also been cited as a cause for leg cramps mainly due to the causation of electrolyte disturbance. Dialysis patients again due to the problem of electrolyte disturbance may often complain of leg cramps. Although, there is no universal cure available for the condition, the following measures have been found to be useful: Quinine: The quinine, which is traditionally used as an anti-malaria drug, has been used as a preventive and curative therapy for nocturnal leg cramps. In spite of some efficacy in the treatment of cramps, the risk of serious complications like potentially fatal hypersensitivity reactions, thrombocytopenia and cardiac arrhythmia, observed over a period of time, outweigh its benefits. Due to these risks, the drug was banned by the Food and Drug Administration (FDA), US, for over-the-counter use in 1994. If quinine is, however, used to treat serious and disabling type of cramps, side-effects should be closely monitored. Other sources of quinine: Tonic water contains small amounts of quinine. Thus, the use of tonic water in patients with leg cramps also has the potential to cause serious adverse effects such as thrombocytopenia indicating the same caution to be used as for the use of quinine. Magnesium or Vitamin E supplementation: Although these drugs, mainly due to their safety, are most frequently prescribed for the treatment of cramps, there is no data from clinical trials that has concluding evidence of their role in the treatment of cramps in terms of improvement in cramp frequency or sleep disturbance. Other drugs: Calcium-channel blockers such as diltiazem have been used to treat nocturnal leg cramps. Vitamin B complex (including 30-mg vitamin B6) has also shown some effectiveness. But again there is no concluding evidence to show that they can provide universal relief. Homoeopathic remedies: Some of the homoeopathic remedies claim to provide sure treatment of the cramps. One must, however, ensure that these remedies are not containing the traces of quinine. Herbal remedies: Some herbal products such as ginkgo and ginger have been shown to be of benefit for leg cramps. However, there is no clinical evidence in support of any herbal products because clinical trials are not available. Salt supplementation or “A Banana A Day”: As a general remedy, there are sporadic reports of use of bananas or other foods/supplements for leg cramps without any scientific basis. Some useful, harmless measures: Although non-pharmacologic therapy is not well-established, may warrant an initial trial before the treatment with medication begins. The following measures may be useful: Hydration: Plenty of fluid intake in the form of lime water/tea/coffee/soups may provide relief to some patients. Hot and cold compresses: Warm or cold compresses may be useful to some patients It should be applied for 10-20 minutes before going to bed. Calf stretches: Exhausting the stretch reflex before going to bed by stretching the calf muscles with wall pushups can also be a useful preventive remedy. When cramping has actually occurred, one should try to walk on the cramped leg. Subsequently, one should elevate it while keeping over a pillow. Hot and cold compresses as well as calf stretches as mentioned earlier can also be tried once the cramping is over before going to sleep again. Calcium, magnesium and vitamin E supplements, being without any side-effect, are the most frequently prescribed agents that can provide relief to some patients. General measures like hot and cold compresses and stretching exercises are also useful. Quinine-containing products should be used only as a last resort and that too under the supervision of a physician. The writer is Associate Professor, Orthopaedics, Government Medical College and Hospital,
Chandigarh.
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Health Notes Washington: A study on the benefits of exercising while pregnant has found that moms-to-be who do so help their children to have healthy hearts after birth. When it was reported a couple of years back that exercising strengthens a foetus' heart control, many pregnant women took heed and hit the ground running, literally. Some signed up for prenatal yoga classes, while others found new ways to incorporate low-impact aerobic activities into their daily lives. Linda E. May, an exercise physiologist and anatomist at Kansas City University of Medicine and Biosciences, has been heading up a series of studies on foetal heart development for the past four years. "It is my hope that these findings will show that efforts focused on improving health need to start during pregnancy rather than in childhood," she said.
— ANI
Caffeine contributes to
development of diabetes
Washington: A study has suggested that caffeine disrupts glucose metabolism and may contribute to the development and poor control of type 2 diabetes, which is a major public health problem. The study examines the latest evidence, contradicting earlier studies, suggesting a protective effect of caffeine. James Lane, Duke University, describes numerous studies that have demonstrated caffeine's potential for increasing insulin resistance (impaired glucose tolerance) in adults that do not have diabetes, an effect that could make susceptible individuals more likely to develop the disease. In adults with type 2 diabetes, studies have shown that the increase in blood glucose levels that occurs after they eat carbohydrates is exaggerated if they also consume a caffeinated beverage such as coffee.
— ANI
Green tea improves quality of life in post-menopausal women
Washington: Previous studies have shown that people who consume the highest levels of green tea tend to have lower risks of several chronic degenerative diseases such as cardiovascular disease and osteoporosis. Now, a new study has suggested that drinking green tea and practising "tai chi" may promote bone health as well as reduce the risk of inflammation in post-menopausal women. Researcher Chwan-Li Shen, an associate professor and a researcher at the Laura W. Bush Institute for Women's Health at the Texas Tech University Health Sciences Center, focused on post-menopausal women and investigated the potential for green tea to work synergistically with "tai chi" in enhancing bone strength.
— ANI
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