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| HEALTH & FITNESS |
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Bipolar disorder or manic depressive illness
A few undesirable habits of patients
Cataract surgery with femtosecond laser
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Bipolar disorder or manic depressive illness
All of us undergo normal mood changes in our daily life, but in some cases these are quite intense and are at a pathological level when the person concerned undergoes a roller coaster ride of mood variations. They are accompanied with many behavioural abnormalities and need definite psychiatric treatment. This illness often starts in a person’s late teen or early adult years. Some may develop these phases late in life; occasionally, children may also suffer from this illness. These patients may vacillate between phases of being very high and very low. When they are high the phase is called manic phase, and when they feel down they pass through a depressive phase. Such patients are diagnosed to be suffering from bipolar disorder or manic depressive illness. These phases may or may not follow any distinct or cyclical pattern. Some cases may show seasonal pattern. They may have a manic phase during summer months and a depressive phase during winter and vice versa. During the manic phase a person feels over-energetic and overactive and overly happy. He may feel extremely irritated, agitated and aggressive. He becomes over-talkative and has racing thoughts. He becomes extremely confident and takes up new projects and at times appears unrealistic. He sleeps less and does not feel tired. He may go on a spending spree, may take impulsive and wrong decisions and may have increased sex desire. He becomes very argumentative and does not listen to any suggestions and arguments. During such periods a patient does not feel anything wrong with him; rather he may find faults with other family members and friends. Symptoms of the depressive phase are just the opposite of the manic phase. The person feels sad, pessimistic, withdrawn and inactive. He expresses negative ideas and may become even suicidal. He may have much anxiety and becomes restless. He may show changes in sleeping, eating and other daily routine activities. He may fear taking a decision and may limit or stop doing daily routine activities. During severe depression he may feel completely ruined. Some people experience hypomanic phases. These phases are of much lesser versions of manic periods. The person concerned may have increased activities and energy level but these phases are not as bad as manic phases. He may feel very good and may show increased work output. He may tend to finish his incomplete tasks. If not treated in time he may develop a full-blown manic problem. What are rapid-cyclers? When a patient may have four or more episodes of major depression or mania within one year he is called a rapid-cycler. Some people may experience more than one episode in a week or a month. Rapid-cyclers show poor response to medical treatment. What illnesses can co-exist with bipolar disorder? Alcohol and other such substance abuse is very common with bipolar disorder. In some cases, a sudden start or increase in alcohol use is the early sign of the onset of the illness. Some cases of bipolar illness may tend to suppress or treat their symptoms with alcohol and addictive drugs. It is commonly observed that substance abuse may trigger or prolong the illness. Other coexisting illnesses are anxiety disorder, post-traumatic stress disorders, social phobias and attention deficit hyperactivity disorder. Bipolar patients are more prone to thyroid disease, migraine, diabetes, hypertension, obesity and other physical illnesses. What causes bipolar disorder? There is no single cause for bipolar disorder. Rather it is the result of the interaction of a number of factors. Bipolar disorder tends to run in families. Children of bipolar patients have a higher risk of developing the illness. Many patients do not have a family history of bipolar illness. Stress has a definite role in precipitating the disorder. Scientists believe that the illness results from the interaction of genes with the environment. Treatment These patients are managed with a number of medicines like mood stabilisers, atypical antipsychotics and antidepressants. Counselling is needed to provide an insight into the various aspects of the disease and have a better understanding and relationship among the family members. One of the key family members has to take an active role in the management of the illness because many patients, particularly the manic ones, are quite averse to medical treatment. It is important to remember that bipolar illness is a chronic illness like diabetes and hypertension, and needs prolonged expert treatment extending up to many years. An irregular or on-and-off approach to the treatment often worsens the situation. Proper treatment is a must to bring the situation under control. The writer is a Ludhiana-based psychiatrist and de-addiction specialist. E-mail - happymind@rediffmail.com
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A few undesirable habits of patients
Often many persons ask for a medicine for a symptom without caring for the underlying disease. They continue to use the same for quite some time till the disease advances, such as in generalised weakness, cough, recurrent fevers, hoarse voice, headache, difficulty in swallowing, swelling feet, giddiness, muscular and joint pains, low vision, etc. This symptomatic casual approach to a serious underlying disease can put you in great trouble later on while to nip the same in the very beginning is a wise approach. Proper follow-up is a casualty among our patients. Once symptoms are relieved, medicines are stopped. In many such cases, diseases get suppressed but resurface after sometime. So, taking a proper dose of medicines and for the recommended period, as in the case of antibiotics, is of great importance. Many patients, especially in the rural areas, do not come forward to tell the complaints they are suffering from due to the fear that they may be having some serious disease. In the case of sexually transmitted diseases, patients are too ashamed or embarrassed to seek medical attention because of cultural taboos. Delay in handling such cases results in harmful effects. Patients often want quick relief. They frequently change the doctor, even the system of medicine. Chronic diseases such as diabetes, BP and heart problems take a long time to tame with regular and prolonged treatment. Irregular treatment for such diseases is harmful. Self-medication must be avoided. Often patients accept the substitutes of the medicines on the written prescription that may be cheap, but sometimes these may be substandard or even fake. It is better to have the same brand even if you have to go from one chemist shop to another. The writer is a former CMO, Multi-Speciality Hospital, Sector 16, Chandigarh
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Cataract surgery with femtosecond laser
The biggest single cause of blindness is cataract, also known as ‘Safed motia’. Nearly 9 million people are blind from cataract in our country while 32 million are moderately visually impaired because of this factor. There have been tremendous advancements in cataract surgery both qualitatively and quantitatively. Surgical techniques have evolved over the last few decades and now it has become a fairly smooth, safe and sophisticated procedure. Suture-less phaco-emulsification with foldable intra-ocular lens (IOL) implantation has become the norm, and is commonly performed in most well-equipped centres across the country. During the last two years, another revolutionary change is happening in the technique of cataract surgery. This has been brought about by the introduction of the femto-second laser. The laser technique eliminates the human element to a great extent and makes nearly the entire procedure pre-planned, mechanised and regulated down to the micron level. In this technology, a high resolution image of the eye provides guidance for the laser. The corneal incisions are planned and created by the laser with exact precision. A well-centred, optimum-sized, smooth opening is made in the anterior lens capsule (known as a capsulorhexis). The lens is then softened and liquefied using the laser rays and broken down into small particles. This allows the surgeon to skip the technically difficult steps like sculpting and chopping the lens which could lead to complications. The phaco-emulsification energy is reduced by 43 per cent and the phaco-time is reduced by 51 per cent. This reduces the overall inflammation and hastens the recovery of the eye. The stable wound architecture minimises the infection rate. It also gives a better visual outcome as the surgery is more precise and accurate. The other significant advantage this technology offers is that it gives far better results with the premium IOLs like accommodative lenses (Crystalens) and multifocal lenses. Overall visual quality with these lenses is improved with the precise laser technique. Also co-existing problems like astigmatism can be tackled simultaneously by planning the LRI’s or limbal relaxing incisions. This makes the entire surgery ‘customised’ to fulfil the patient’s needs and give him the best quality vision possible. With the use of this ‘all laser’ procedure, we can now give faster healing, better visual outcome, minimal risk of infection and other complications, stable wound construction, precise IOL insertion, correction of the co-existing problems like astigmatism and an overall smooth recovery to each of our patients. Though this technology is still not available commercially in India, it should be there in the near future. The increased costing of the procedure of cataract surgery being done with the femtosecond laser can well be compensated by value addition in the qualitative outcomes, and the enhancement of the safety profile of the procedure further. The writer is Chairman & Medical Director, Centre for Sight Group of Eye Hospitals, New Delhi. Email:
drmahipal@gmail.com
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Health Notes LONDON: In the growing concern over childhood obesity, the British government has issued new guidelines to parents, recommending three hours of daily exercise for children under the age of five. Babies should stretch and roll on activity mats and be taken for swimming while toddlers should walk for at least 15 minutes for any routine journey, such as trips to a nursery or the shops, according to the government’s chief medical officers, reports the Daily Mail. However, the guidance, which will also include recommendations for older children and adults, is bound to lead to accusations of nanny-state meddling. The advice was issued by England’s chief medical officer Professor Dame Sally Davies and her counterparts across Britain. — ANI
Getting fat? Blame it on ‘chemical calories’
LONDON : A new study has found that the reason most of us are unable to shed the fat in our body is because of the “chemical calories” present in beauty products such as shampoo, body lotions and soap that we use. Doctors at the Mount Sinai Medical Center in New York claim that phthalates, chemical ingredients in 70 per cent of cosmetics as well as many household cleaning products, are responsible for throwing the body’s natural weight control system, a delicate balance of hormones, off kilter. The researchers suggested that once exposed to phthalates through daily use of such beauty products, the chances of childhood obesity and weight problems in adults become high. The researchers meted out the study on girls living in the inner city area of East Harlem, by measuring their exposure to phthalates and analysing the children’s urine. “The heaviest girls have the highest levels of phthalates in their urine,” the Daily Mail quoted Professor Philip Landrigan, a paediatrician and the study author, as saying. —ANI
Replace salt with seaweed granules to prevent strokes
LONDON: Scientists have claimed that high blood pressure, strokes and early deaths could be prevented by replacing salt with seaweed granules in bread and processed foods. The granules deliver a strong flavour but are low in salt, which is blamed for thousands of early deaths every year. It also contains a vast array of vital micronutrients while consumption is said to make consumers feel full, which means it could be useful in reducing obesity levels. The study by the government-funded Food Innovation Project discovered that consumers find it almost impossible to tell when seaweed granules replaced salt in baked goods. The granules are healthier because their sodium level is just 3.5 per cent compared with the 40 per cent in salt used by the food industry. — ANI
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Instructions and preventive measures along with the needed medicine, explained by the doctor, are commonly ignored by many. Steam inhalation in allergic bronchitis, proper rest and good diet in viral infections, vocal rest in voice changes, low salt intake in blood pressure and washing of hands properly before meals can keep local infections at bay. If a child is suffering from diarrhoea, etc, parents are advised not to give milk and sweets for a few days, but the mother does not feel satisfied till she feeds the child with sweetened milk though along with medicines — thus not giving the desirable results. With due precautions while working on the computer, eye stains, headache and cervical pain can well be avoided.