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Bleeding in the eye can obliterate your vision! Managing painful menstrual periods Regular exercise lowers depression risk by up to 30 per cent Health Notes
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Bleeding in the eye can obliterate your vision! It was a bad day for Dr Kapoor (70) in the operation theatre (OT) where he went for his own cataract eye surgery but was wheeled back un-operated after he developed swelling in the face at the site of local anaesthesia injection. While coming back, the eye surgeon enquired if he was taking low dose aspirin (LDA), and the reply was “yes”. Kapoor was panicked by the prospect of bleeding near the eye that may extend into the eye ball. He wondered, “Could the bleeding occur in the retina or vitreous and lead to blindness?” Some time ago when he referred a case of vitreous hemorrhage to an eye specialist the doctor told him to stop aspirin first of all. Recently two of his patients, who were taking LDA as a preventive to heart ailment were wheeled into OT for major surgeries and had harrowing experiences — Gupta underwent gasterectomy when he developed sudden vomiting with blood and Saini was put on the OT table for prostate surgery when he suddenly started bleeding in the urine. Both spent good two weeks each in the hospital with huge costs. Could withdrawal of aspirin alone have saved them from the risks of surgery and the lakhs of rupees spent? Was surgery avoidable? Was it frivolous or life saving? Can aspirin be so nasty that one can develop spontaneous bleeding from any of the orifices/ cavities of the body and one has to undergo major surgery as a life-saving measure? Kapoor had recently read in a medical journal that “many physicians had stopped recommending aspirin for the prevention of heart disease. The evidence in support of aspirin has always been quite weak, and over the last decade it has become even weaker.” Why he did not heed that warning first of all and stopped the use of LDA and why he did not disclose to the eye surgeon about its use as he cursed himself?
Can aspirin be harmful?
A Japanese study found “More than 10 per cent of patients taking LDA-developed peptic ulcers. The risk of bleeding is particularly pronounced in the elderly. Clopidogrel and aspirin in combination are widely used following unstable angina and coronary artery stenting, also called angioplasty. Among these patients, those with BT (bleeding time) 24 min presented with increased bleeding episodes (oral bleeding, epistaxis, hematuria, uterine bleed, eye bleed and rectal bleed). Scientists also found that those who take aspirin on a regular basis are much more likely to develop macular degeneration ('wet AMD', a blinding condition) than those who do not. Other risks include bleeding in the brain, asthma attacks in one in 10 adults, increased risk of breast cancer in women, increased risk of kidney failure, cataracts, hearing loss and tinnitus, etc. All products containing acetaminophen appear on the latest watch list of FDA because of reports of severe skin reactions, according to Medscape.
What is eye haemorrhage?
An eye haemorrhage is a discharge of blood within the eye. The bleeding under conjunctiva, cornea, retina or vitreous and choroid has been described with the use of aspirin and other anticoagulants. A conjunctival haemorrhage may be spontaneous or brought by a minor blow or trauma, or even by straining, sneezing, or coughing. The most serious eye haemorrhages take place in the retina. Vitreous or retinal haemorrhages may be initiated by diabetes or high blood pressure or by an injury to the retina. Most subconjunctival haemorrhages require no treatment and subside in 7-10 days, but vitreous haemorrhages must be watched because they may form bands that obscure vision and can result in a detached retina, a serious problem. If the vitreous humor has become clouded by blood, an operation called vitrectomy may be necessary to replace the natural fluid with a clear, saline solution.
Rationalise aspirin use
Seeing a large number of side-effects and risks, uses of aspirin should be rationalised and minimised. The dose of 50 mg daily may be enough when the use is a must. Other blood thinners may be considered. Regular testing of bleeding time (BT) and clotting time( CT) is required in such cases to assess the prospects of aspirin-related bleeding; the simple and inexpensive tests are at present missing even in the best of the centres. The withdrawal of aspirin should be the first step in the management of bleeding anywhere in the body in such cases. Emergency surgery or any other surgery should be planned after withdrawing the use of aspirin and other anticoagulants and as a last resort. Regular check-ups of the retina is necessary in those who are on anticoagulants since most of these cases would also be suffering from diabetes and hypertension and are prone to bleeding in the
retina. The writer is a senior eye specialist based in Chandigarh. E-mail:
drrkumar16@gmail.com |
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Managing painful
menstrual periods Almost every adult female knows what it is like to have a painful menstrual cycle. Every female suffers menstrual pain at least once, if not more, during her lifetime, ranging from mild discomfort to violent crampy, colicky pain. At times, the pain is almost disabling, forcing one to avoid all sorts of activities. This pain may be accompanied by nausea, vomiting or diarrhoea. There may be irritability, headache and even loss of appetite as the acompanying symptoms. The pain is felt usually in the abdomen and the back but it may be in the stomach and legs also. The pain may start along with the onset of the periods or in some cases it may start even a few days before the flow starts. It is more severe on the first day and the intensity abates in the following days. Often the pain is severe enough to incapacitate an individual for a day or two. Some females get relief from the pain by hot fomentation or even by bending double on the stomach. The pain may start at the age of puberty as the first menses appear, known as primary dysmenorrhoea or it may start later in life known as secondary dysmenorrhoea. Primary dysmenorrhoea is purely functional in the sense that it involves no structural or pathological abnormality, but the pain is there all the same. The pain is a result of severe uterine contractions that are meant to force out the contents of the uterus. The uterus is a large mass of muscle. Like all other muscles, it contracts and relaxes. When it contracts more forcefully than normal, the arteries supplying blood to the uterus get contracted. The blood supply is reduced or even stopped temporarily causing a deficiency of oxygen. This causes pain. Functionally, it is somewhat similar to angina though much less harmful and not at all life-threatening. In secondary dysmenorrhoea, there is usually a cause of the pain which can be diagnosed by a trained physician. The pain may be due to endometriosis or uterine fibroids or a simple pelvic infection. Even if no reason is found for the excruciating pain in most of the patients, it is important to search thoroughly for any pathological cause. It is more so if there are some other disturbances in the menstrual cycle like irregular periods or excessive bleeding or discharge of clots along with the liquid blood. In case any such pathological condition is diagnosed, it is imperative that it be treated immediately as short-term measures like pain-killers will not be able to cure the trouble.
Useful tips
Role of homoeopathy
Homoeopathic medicines are able to cure this problem of painful menses easily and completely, leaving no chance for recurrence. In the acute stage, medicines like colocynth, pulsatilla, mag phos, belladonna and arsenic album are very helpful in relieving the pain. To be able to cure this problem and to avoid any recurrence, it is required that all symptoms are taken into consideration and a suitable medicine
prescribed. — The writer is a Mohali- based homoeopathic practitioner. Email:
drharshsharma@gmail.com |
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Regular exercise lowers depression risk by up to 30 per cent
LONDON: Just 10 minutes’ brisk walking can improve your emotional state, according to a report being released by the Mental Health Foundation to mark the start of Mental Health Awareness Week. Taking part in regular physical activity can both increase self-esteem and reduce stress and anxiety, according to the report. And it can act as both prevention and treatment for various mental illnesses, including depression and anxiety.
“One way to enhance our mental well-being and protect our mental health is through participating in physical activity,” it states. And people who exercise regularly have a 20-30 per cent lower risk for depression and dementia. The report suggests using physical activity to “regulate mood during the day” but warns against overdoing it - for this could result in “short-lived negative effects” such as “low mood and irritability”. “People should choose a type of physical activity based on what they enjoy doing,” it adds. But it warns that most people are not doing anywhere near enough exercise, with just 40 per cent of men and 28 per cent of women in the UK managing the two and a half hours a week recommended by the
NHS. — The Independent
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Health Notes London: Addiction to games is being blamed for increase in the number of young kids being hospitalised with serious sleep disorders. NHS' latest figures show that there were 5,992 appointments for kids to see a sleep specialist last year, which amounted to more than 100 every week, the Daily Express reported. The data covered kids who had trouble sleeping as well as those suffering from sleep apnoea, where breathing stops momentarily, or severe
snoring. The effects of a sleeping disorder on a kid can be severe with a suggested link to attention deficit hyperactivity disorder and poor grades at school.
— ANI Eating fewer calories a day may help stave off cancer
London: Cutting 100 calories from your diet could be the key to keeping cancer at bay. The simple calorie cutting, which equals to eating just one and a half digestive biscuits less, can prevent people from piling on weight in just a year, the Daily Express reported. Kate Mendoza, head of health information at World Cancer Research Fund (WCRF), said that this strategy of small changes might prevent additional weight gain and help reduce cancer risk.
— ANI Obesity may increase the
risk of dementia
London: The increase in waistlines could fuel a big rise in the number of people with dementia in the future, researchers have warned. According to data presented at the European Congress on Obesity, stemming the rise in obesity will cut down the risk of dementia, the BBC reported. The Alzheimer's Society charity has suggested that regular exercise and a healthy weight are important for reducing the risk. One study conducted on 8,500 Swedish twins showed that people with a body mass index (BMI) greater than 30 — who are classified as obese — were almost four times as likely to develop dementia as those with a normal BMI.
— ANI Chronic pain sufferers often experience anxiety as well
Washington: Researchers have suggested that patients coping with chronic pain should also be evaluated for anxiety disorders. Lead author Kurt Kroenke, professor of medicine at Indiana University in Indianapolis, noted that health care providers are more aware of the common occurrence of depression in patients with chronic pain, and there has been less of an emphasis on anxiety. In the new study, researchers evaluated 250 primary care patients who were being treated at a Veterans Medical Center in the Midwest. All patients had moderate to severe chronic joint or back pain that had lasted at least three months despite trying pain medications.
— ANI
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It was a bad day for Dr Kapoor (70) in the operation theatre (OT) where he went for his own cataract eye surgery but was wheeled back un-operated after he developed swelling in the face at the site of local anaesthesia injection. While coming back, the eye surgeon enquired if he was taking low dose aspirin (LDA), and the reply was “yes”. Kapoor was panicked by the prospect of bleeding near the eye that may extend into the eye ball. He wondered, “Could the bleeding occur in the retina or vitreous and lead to blindness?”
