|
|
|
|
| HEALTH & FITNESS |
|
|
|
Eye strain with headache? See your doctor, don’t panic
Common shoulder injury
Millions at risk as main malaria drug loses potency
Health Notes
|
|
Eye strain with headache? See your doctor, don’t panic
The doctor raised several questions and proceeded with his eye examination, refraction and retina examination. “Does the pain get worsened with watching TV or working at your laptop or reading your morning papers? Did you get your glasses checked in the recent past? Any difficulty in night driving, reading paper in dim light, seeing two or more moons instead of one, frequent change in glasses, glares or halos around the light, inability to open one eye in the sun and reduction of power for near vision?” When Seth nodded his head in the affirmative, the doctor pronounced, “You are developing early cataract changes, which has caused change of power of your glasses. You have to strain your eyes to see clearly, all the time, which results in eye strain and headache. You may not be having any brain tumour! You may be helped with the spectacles alone”, counseled the doctor while pushing back the plethora of investigations back to Seth. Common causes of eye pain with headache Glaucoma, an important cause, entails increased pressure in the eye, and can cause headache and eye pain. Inflammations and infections in and around the eye can also produce eye pain. Iritis or uveitis is one such condition. The pains may also be related to stress, depression, anxiety, a head injury, or holding your head and neck in an abnormal position. The pain may feel dull or squeezing, like a tight band. Your shoulders, neck, or jaw may feel tight or sore. Migraine headaches are severe that usually occur with other symptoms such as vision changes or nausea. The pain may be throbbing, pounding, or pulsating. It tends to begin on one side of your head. You may have warning symptoms that start before your headache. Sinus headaches cause pain in the front of your head and face, and may involve one eye. They are due to swelling in the sinus passages behind the cheeks, nose, and eyes. The pain tends to be worse when you bend forward and when you first wake up in the morning. Headaches may occur if you have a cold, flu or fever. Headache may rarely be a sign of a serious cause such as brain infection like meningitis or encephalitis, or abscess, brain tumour, very high blood pressure, etc. When to see your doctor/ eye physician:
l
The all cases of vision complaints and headache, consult an eye specialist first. l
When headache interferes with your daily activities. l
Your headache comes on suddenly and is explosive or violent. l
You describe this episode of headache as “your worst ever.” l
You also have slurred speech, a change in vision, problems moving your arms or legs, loss of balance, confusion, or memory loss with your headache. l
Your headache gets worse over a 24-hour period. l
You also have a fever, stiff neck nausea and vomiting with your headache. l
Your headache occurs with a head injury or any associated ailment like hypertension, diabetes, etc. l
Your headache is severe and just in one eye, with redness in that eye. l
You are over age 50, especially if you also have vision problems, and severe and persistent pain in one or both eyes. The writer is a Chandigarh-based eye specialist. |
|
Common shoulder injury
Supraspinatus tendonitis is a common injury of the shoulder joint. Supraspinatus is an integral part of the rotator cuff muscle group.
The rotator cuff is a group of four muscles which not only stabilise the shoulder joint but also help lift the arm over the head and rotate it towards/away from the body. Supraspinatus effectively facilitates lifting of the arm sideways — away from the body. This tendon, when inflamed/swollen, gets repeatedly trapped by movements of the shoulder. Therefore, moving the arm outward and upward is not only painful but also makes the condition worse by increasing inflammation in the tendon. Causes l
Supraspinatus muscle injury can occur due to a fall. l
It can also occur as a result of repetitive, high-velocity overhead motion (throwing) as in cricket, swimming, etc. l
Doing repetitive overhead exercises with heavy weights in the gym can also cause this kind of injury. l
The most common reason for supraspinatus tendon injury is a rapid increase in the intensity and volume of exercises in the early stages of the strengthening
programme. l
Supraspinatus injury can also occur by carrying heavy objects such as a suitcase, briefcase or a package with the arm hanging by the side or walking a large dog that pulls hard on the leash. l
Supraspinatus tendon injury is very common in old age. Symptoms There is pain (night pain) in the front and outer part of the shoulder. Referred pain is felt as deep ache in the mid-deltoid region of the shoulder and usually extends down the arm. There is weakness in the muscles supporting the joint. One feels difficulty in reaching the head to comb one’s hair, to brush teeth, to doing shaving, etc. There is limitation of active motion, especially overhead activities such as serving a tennis ball, throwing, etc. Clicking sound is felt during certain shoulder movements due to slipping in or out of the inflamed tendon. Diagnosis Pain occurs with the abduction of the arm — movement away from the midline. Mouth wrap test-patient is asked to bring the hand and the forearm behind the head and take the hand as forward as possible, trying to cover the mouth. Normally, fingertips can cover almost till the midline of the face. A patient with supraspinatus injury has difficulty in performing this test as the muscle is unable to lift the weight of the arm. A shoulder MRI examination confirms the tear and its size. Treatment Non-operative management is often effective in the treatment of supraspinatus injuries and a supervised programme of physical therapy is the mainstay of treatment. Arthroscopic/ surgical treatment is indicated if the patient fails to show progress after a minimum of two months of physical therapy. Avoid overloading of the supraspinatus muscle too rapidly and increase the workload to less than 10 per cent per week. Acute stage management Take rest from aggravating activities. Take anti-inflammatory medication/ICE Go in for electrotherapies — TENS/ultrasound. Take the Injection Corticosteroid. REHABILITATION The Main aim of rehabilitation is to re-establish the full range of motion of the shoulder joint and improve muscle strength. Acute phase — Wall walking. — Pendulum exercises — Passive joint/scapular mobilisation/manipulation relieves pain and increases the range of motion. Second phase l
Rope and pulley exercises. l
Push up – Knee push-up/wall push-up. l
Posterior capsule stretching — by moving the hand towards the opposite shoulder and pressing backwards through the elbow. l
Isolated rotator cuff exercises with weights — side lying external/internal rotation. l
Rowing (with a stretch band) Final phase When shoulder movements become pain-free, walk on your arms while the trunk is supported by a Swiss ball or a low stool. l
Ball exercises (throwing and catching ball against wall with a bend arm) l
The throwing technique should be evaluated by the coach and appropriate changes should be integrated into the rehabilitation programme. Shoulder injuries can be decreased by careful warm-up, stretching and strengthening of the shoulder muscles. Whenever there are symptoms of shoulder injury, start early evaluation and treatment which can prevent mild inflammation from becoming rotator cuff tear. The writer is a former dctor/pysiotherapist, Indian cricket team. E-mail-chadhar587@gmail.com |
|
Millions at risk as main malaria drug loses potency The world’s most effective malaria drug is losing its power, threatening the lives of millions of people around the globe. Tests on the border between Thailand and Burma show that the most deadly form of the malaria parasite has developed resistance to artemesinin, the gold standard treatment for the disease for more than a decade. Experts described the development as “very worrying indeed” and warned the effects could be “devastating”. Malaria claimed the lives of 655,000 people, mainly children, in 2010, according to the World Health Organisation, which warned that figure could rise “dramatically”. However, some estimates put the actual annual death toll at more than one million. The development almost certainly puts the global strategy to end malaria deaths by the UN’s target date of 2015 beyond reach. The world has been striving to eliminate the disease for 50 years and a huge global effort in the past five years, galvanised by the intervention of Bill Gates, has seen rates halved in many countries. Those gains are now in danger of being reversed. Artemesinin has long been regarded as a miracle cure for malaria because it works so quickly, has few side-effects and, up to now, has been almost 100 per cent effective. Resistance to it was first detected in western Cambodia in 2009, but has now spread 800km to the west. Efforts to contain the resistant parasites and wipe them out were made following the earlier discovery but the latest findings suggest it may have been too little, too late. Experts are alarmed because, twice before, resistance to the then gold standard anti-malarial drugs – chloroquine and sulfadoxine-pyrimethamine – has started in the same region before spreading to South-east Asia and Africa, leading to the deaths of millions of children. Chloroquine, once given routinely to anyone with symptoms of malaria, is now frequently ineffective against the disease. The latest findings, published in The Lancet, come from the Shoklo Malaria Research Unit which has been monitoring the disease on the Thai-Burmese border for more than a decade. Studies in more than 3,000 patients show that artemesinin is taking a third longer to clear malaria parasites from the blood than it did in 2001 (from 2.6 to 3.7 hours) – a clear sign it is becoming less effective. Professor François Nosten, director of the unit, said: “We have now seen the emergence of malaria resistant to our best drugs, and these resistant parasites are not confined to western Cambodia. This is very worrying indeed and suggests that we are in a race against time to control malaria in these regions before drug resistance worsens, develops and spreads further. “The effect of that happening could be devastating. Malaria already kills hundreds of thousands of people a year. If our drugs become ineffective, this figure will rise dramatically.” Professor Nick White, chairman of the Worldwide Antimalarial Resistance Network, added: “Initially, we hoped we might prevent this serious problem spreading by trying to eliminate all Plasmodium falciparum [the most lethal malaria parasite] from western Cambodia. While this could still be beneficial, this new study suggests that containing the spread of resistance is going to be even more challenging.” The researchers said there was “compelling evidence” that genetic changes underlay the emergence of resistance, based on a separate analysis of the genetic make up of the parasites. Artemesinin is derived from an ancient Chinese herbal remedy. It is usually given in combination with other medicines that last longer in the bloodstream. — The Independent
|
|
Health Notes
London: Two out of three appendix removal operations may be unnecessary and could be avoided by simply administering antibiotics, a new study has revealed. Doctors often wrongly believe that surgery is the only way to treat appendicitis, researchers said. In cases of uncomplicated appendicitis, where the organ has not become infected or perforated, antibiotics are actually better than surgery, the study found.
A Nottingham University team studied 900 patients with appendicitis. About half were given antibiotics while the rest underwent operations.The study reported a 63 per cent success rate among patients who were given antibiotics. Just 20 per cent of cases require an operation, the researchers said. “The role of antibiotic treatment in acute uncomplicated appendicitis may have been overlooked mainly on the basis of tradition rather than evidence,” the Sun quoted the report. “Antibiotics are both effective and safe as primary treatment for patients with uncomplicated acute appendicitis,” the report said. An infected or inflamed appendix has to be treated or removed before it bursts and causes a potentially deadly infection. —
ANI
Pesticides `may reduce pregnancy length and birth weight`
New
Delhi: Exposure of pregnant women to organophosphate (OP) pesticides may be associated with decreased gestational age and lower birth weight, a new study has claimed. OP is a widely used class of pesticides in North American agriculture. The new study, conducted by Vancouver-based Simon Fraser University (SFU) researchers, finds that the decrement in birth weight for OP pesticide exposure was comparable with the decrement seen for women who smoke cigarettes.
Although the findings need to be confirmed, it again raises people’s concern about the harmful effects of low-level exposures to environmental toxicants. “For an individual child, a decrement of 150-gram reduction in birth weight is of little consequence, but this is just one of many risk factors that a pregnant woman might encounter,” English.news.cn quoted Bruce Lanphear, the study’s senior author as saying. —
ANI |
Seth, 66, entered an eye specialist’s chamber with anguish on his face. “I have a really severe pain on right side of my head. I couldn’t sleep last night. Every thing I do bothers me and my right eye ball hurts some times. It feels my head is going to explode. Can you tell me doctor why the neurologist has referred me to an eye specialist instead of a neurosurgeon, when I feel it could be a brain tumour?” questioned Seth while pushing a bundle of MRI, CT and lumber puncture reports on the doctor’s table.