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| HEALTH & FITNESS |
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The truth about
skin allergies
Heart attack and its complications
Headache — your neck can be the cause
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The truth about skin allergies There are about six million chemical agents in our immediate environment. Of these, approximately 3000 act as allergens (agents causing allergy) to the skin. Skin allergy occurs when these allergens bind to carrier proteins in our skin and present them to the immune system of the skin and the body The main reason for allergic reaction to some substances or food is the response of over-active immune system. Normally, the immune system acts as the body’s defence against invading agents such as bacteria and viruses. But in the case of an allergic reaction, the immune system is responding to a false alarm. In different people substances that may cause an allergic reaction are different. In some they are unavoidable as they encounter them daily in their routine life; some have them in relation to their occupation. Most are sensitive not to one but many (numerous) allergens. The allergy tests are suggestive to a certain extent only and since the cross-reactivity between the common allergens is so much that if the tests detect one or two, there is a likelihood that they might miss some more allergens to which a patient might be sensitive. So, the treatment approach is to not only avoid the suspected allergens but also to stabilise the hyperactive skin cells. The most common among these is house dust —- the main culprit in the dust is the presence of invisible (to the naked eye) house dust mite. This house dust mite not only causes allergic reactions in a few but also makes them susceptible to develop allergic reactions to numerous other allergens in the environment. The other unavoidable skin allergen is nickel. We will discuss mainly about nickel, which is now emerging as the most common cause of allergic contact dermatitis. Nickel is one of the most common metals used by humans. It is not only found in belts, buckles, watches, rings, etc, but also in hip replacements and endovascular stents. Personal accessories For personal accessories, titanium is a great choice if you have multiple metal allergies or are unsure of the specific metal/alloy you are allergic to. For example, newer orthodontic wires and endovascular stents are now often made with titanium. Although, extremely rare, some individuals may react to the metals used in bio-medical devices such as nickel. Current data suggests a metal allergy may increase the risk of stent restenosis. What should you do? 1. Be proactive! Tell all your health care providers that you have or suspect a nickel or metal allergy. 2. Dermatologists or allergists specialising in patch testing can diagnosis what specific metal(s) you are allergic to. 3. Alternatives are available for most devices, including the titanium. 4. When a procedure is required, verify that the metal(s) you are allergic to are not in the device being implanted, especially if an alloy is being used. 5. Remember a reaction is extremely rare, but be proactive. Typically, the inexpensive jewellery and accessories used by most people are laden with nickel because it is durable and cheap. Items that may contain nickel: Belts and buckles Bracelets Earrings Eye-glass frames Gold, especially white and yellow (10k and 14k) Necklaces Rings Watches Zippers If you are unsure that an item contains nickel, there is a test to detect nickel in various items. Within 15 seconds, you can tell if your jewellery contains nickel. Simply place a few drops of the dimethylglyoxime (dmg) solution onto a cotton swab and rub the metal area that will come in contact with your skin. If the swab turns into a pink/red colour one, then it is clear that nickel is present and you should take protective measures. This nickel test is so sensitive that it detects nickel below the threshold of even the most severely nickel allergic individual. Individuals who have severe nickel allergy and have hand eczema (hand dermatitis) may do well to reduce the following foods known to be high in nickel: Almonds Asparagus Baking powder Brown lentils Beans Cabbage Canned foods Chocolate Mushrooms Peanuts Peas Cookware should also be tested for nickel to determine nickel content. Lately there have been reports about cell phone rash caused by nickel in phones. People who are allergic to nickel may have a difficult time with trendier cell phones. After using these cell phones, a rash (dermatitis) appears on the face and the ear where nickel makes contact with the skin. We all should be aware of potential skin allergen sources in our environment and try to avoid their direct contact with the skin. In case of some unavoidable allergens, barrier creams and shielding lotions over the skin are greatly helpful.
The writer is Chief Consultant Dermatologist & Dermato-Laser Surgeon, National Skin Hospital, Mansa Devi Complex, Panchkula. E-mail: drvikas.nscindia
@gmail.com
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Heart attack and its complications The diagnosis can be finalised keeping in view the clinical scenario of sudden deterioration in breathing or when sudden fall in BP occurs in a patient with heart attack. This may happen in first three days or after the first week. The trained ear of a cardiologist can pick up a murmur (purring) with a stethoscope placed on the precordium (heart area on the chest). Once suspected, heart catheterization with angiography should be promptly done in addition to an echocardiography. Previously, the surgical results of these mechanical complications were significantly poor (more than 60 per cent mortality in our country). A 65-year-old woman without a previous history of heart disease presented herself with the sudden onset of chest pain followed by breathlessness which was medically managed at a local hospital. On recurrence of chest pain she came to the hospital’s emergency ward, and her ECG showed evidence of a heart attack with heart failure. Urgent angiography revealed that it was a 90 per cent blockage in one vital artery of the heart, but permanent damage had resulted in the muscle supplied by it which had ballooned out. The family opted for not going in for stenting of the blocked artery. After her discharge she continued to do well at home till she had sudden relentless breathlessness seven days later. She was shifted back to another hospital where left and right heart failure with kidney damage was detected. Echo tests showed that in addition to aneurysm, she had now developed internal rupture of the muscle curtain dividing the two main pumping chambers of the heart (ventricle septal rupture). After consent for high-risk surgery a special balloon pump was placed in the main artery of the body (aorta) to augment the failing blood circulation to the most vital organs — the brain, the heart and the lungs in that order. Statistics show a success rate of surgery to the tune of 60-65 per cent, with 40-45 per cent patients succumbing to death. Often this has been termed a thankless operation. Due to THE RAREST NATURE of the disease, a new surgical technique was used to put the torn and damaged pieces of the heart muscle together and make it beat again normally. This technique, developed at several top heart centres in the world only recently, was applied for the first time in the region. This innovative approach helped and the patient was removed from the breathing machine after 12 hours, and from the balloon pump in 24 hours. She became mobile in two days and was discharged in eight days to go back home. The problem she suffered from was a grave complication and most often the efforts to save such patients are futile. The lucky few who develop it during admission to a hospital after a heart attack need immediate operation without angiography, with heart-and-lung- bypass-machine support. The writer is associated with Ivy Heart & Superspeciality Hospital,
Mohali.
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Headache — your neck can be the cause Headache originating in the cervical region is quite common, if not the most common health problem. Neck could be the culprit many a times. Cervicogenic headache implies headache where the primary cause is the cervical spine. Such headache leads to referred pain to the posterior region of the head, forehead or around the eyes. Neck movements may be restricted and limited. An examination reveals pain in the upper back of the head although individuals suffering from pain are unable to pinpoint the complaints of pain felt all over. Distressing ache is experienced even by mere pressure of the pillow at night. Such patients point out the sore spot at the base of the scalp with their fingers. Sometimes there is the feeling of light-headedness, dizziness, etc. Causes Mostly associated with whiplash injury. Headache can be caused by a wrong posture, improper neck position while sleeping or during work, sustained head bending (owing to an incorrect posture) or due to continuous upward head tilt or rotation. Pain is aggravated on looking upwards for a prolonged period of time — when an individual lies prone and watches television by raising his or her head on elbows to support the neck. Individuals who keep their head tilted sideways while talking, watching television and typing are more vulnerable to headaches. Anxious, depressed individuals having low tolerance threshold are also candidates for such headaches. Similarly, various digestive and menstrual diseases can initiate headache. An examination reveals restriction in the forward and sideways bending of the neck. Patients suffering from tension headache have bilateral symptoms whereas in cervical headache there is pain only at one side of the neck, shoulder or arm. Cervical headache can manifest in the following different forms: 1) Occipital: Pain in the back of the scalp. 2) Supra-orbital: Pain at the eyebrows. Pinching eyebrows between the thumb and index finger, rolling it like a cigarette. If it is of cervical origin, the eyebrows fold is painful and often thickens. 3) Frontal: Pain originating from behind the ears, upper and outer part of face and below ears. Treatment Massage is extremely useful as it alleviates the muscle spasm. Manipulation relieves muscle spasm and joint stiffness instantly if performed correctly. Trigger points are taut bands of inflammatory material present around the neck. Ultrasound therapy followed by massage is very effective. Chilling the back of the neck can contribute to the pain at the back of the head. Trigger point’s application of hot pack or a heating pad to the sore areas, especially on retiring for the evening, relieves pain. Certain exercises also help relieve pain and stiffness. Among the exercises are: Shrugs — Standing with the arms by the side, lift your shoulders up to the ears, holding for a count of 10. This is followed by pulling the shoulders back and punching the shoulder blades together. Hold for a count of five, relax and repeat 10 to 15 times. Placing palms of the hands on the forehead, try touching the chin to the chest against the resistance of the hand for a count of 10. Placing both hands behind the back of the head, tilt the head backwards against the resistance of the hands. Placing one hand behind the ear, resisting the motion of bringing the ear to the shoulder on the same side. Precautions Avoid looking upwards with head tilt to one side. It is advisable to place documents on a vertical stand in front rather than placing it on a flat surface on the side. Using cervical collar sometimes can be more irritating and annoying than helpful. The collar can aggravate pain by exerting more pressure at the side of pain. Sitting directly under an airconditioner for extended periods cause pain in the neck and shoulders. Keep your neck warm by wearing a high-neck shirt or pullover. Patients with morning headache should modify the pillow and avoid sleeping in the prone position with the neck in extreme rotation.
The writer runs a pain management clinic in
Chandigarh. chadha_r2003@yahoo.co.in
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Health Notes Washington: Activities other than exercise that get you moving in your everyday life – taking the stairs instead of the elevator, doing a little bit more work around the house, or walking down the hall to speak with a co-worker – can improve your fitness significantly, according to a new research. In the study, the more time people spent on incidental physical activities, and the more intense the activity was, the better their cardio-respiratory fitness, a measure of their aerobic fitness level. Most of the benefit was attributed to moderate physical activity such as brisk walking or climbing stairs rather than light physical activity such as cooking or window-shopping, said study researcher Ashlee McGuire, a kinesiology graduate student at Queen’s University in Canada. — ANI
Unhealthy lifestyle leads to ‘liver disease epidemic’
London: According to a top liver expert, hundreds of thousands of children are exposed to liver disease epidemic due to their poor diets and lack of physical activity. Prof Martin Lombard warned that as many as half a million under-15s face liver disease associated with alcoholics because of their unhealthy lifestyles. The rising level of obesity means these youngsters could have an early form of fatty liver disease, which can lead to cancer, strokes and heart problems, he explained. However, Lombard has been criticised for basing his figures on the average number of obese adults who develop fatty liver disease rather than clinical evidence. “I’m wary about making assumptions without hard clinical evidence. We risk scaring parents unnecessarily,” the Daily Mail quoted Conservative MP Dan Poulter, a former doctor, as saying. – ANI
Air pollution claiming tens of thousands of lives every year
London: Experts have revealed that air pollution is killing tens of thousands of people in Britain every year. The global challenge is also responsible for shortening the lives of nearly 200,000 people. Experts warn that the new threat is far less obvious than the visible levels of smog of the early 20th century. Although, they are not seen to the naked eye, tiny particles of pollutants known as particulate matter can be deadly. According to professor Frank Kelly of the Environmental Research Group at King’s College, London, nearly 30,000 people died from air pollution in Britain in 2008. “We have this new problem that we cannot see: it is tiny particles of nitrogen dioxide,” The Independent quoted him as saying. “If we consider the air pollution component ... then probably those individuals are losing on an average three years of their life.” – ANI |
A heart attack can lead to life-threatening consequences even during the prime of one’s life. It is also the leading cause of death in our country. It is, therefore, imperative that a “complicated heart attack” should be clearly differentiated by the people (or patients) in general and the discerning physician (looking after them) in particular from an “uncomplicated heart attack”.
The diagnosis can be finalised keeping in view the clinical scenario of sudden deterioration in breathing or when sudden fall in BP occurs in a patient with heart attack.
A heart attack can lead to life-threatening consequences even during the prime of one’s life. It is also the leading cause of death in our country. It is, therefore, imperative that a “complicated heart attack” should be clearly differentiated by the people (or patients) in general and the discerning physician (looking after them) in particular from an “uncomplicated heart attack”.