Sunday,
September 7, 2003, Chandigarh, India
|
|
BODY & MIND
Pain, unbearable and excruciating. The inability to remain still. A feeling of doom and helplessness. The desperate desire for it to end. That is the description of a patient with a kidney stone attack. A sudden attack of “renal colic” can be spotted immediately. Victim’s face turns pale; he is usually nauseated and paces around nervously. And then, the pain returns in unannounced waves that bring tears, a moan and can even bring the victim down to his knees, crying for help. The everyday bathroom visit that we so take for granted, can turn into a traumatic experience for the kidney stone patient. Yet, for some inexplicable reason, there are no reliable statistics about kidney patients in India. In the West, it is estimated that for every 10-lakh people there are 100 patients developing advanced kidney disease each year. Even applying the same statistics to India, there are at least 1,00,000 people developing “End Stage Renal Disease (ESRD)” each year. This is not a small number. Urinary tract stone disease has been documented for thousands of years. Early Egyptian skeletons have revealed the existence of stones. These historical events along with modern scientific discoveries have determined that there are many factors that lead to formation of stones. According to Dr Rajesh Taneja, Senior Consultant Urology, Pushpawati Singhania Research Institute For Liver Renal & Digestive Diseases (PSRI), “Heredity, age, sex, environment, and various dietary excesses or deficiencies are some of the known contributing factors in stone disease. It is well-known that there is a geographic distribution of this disease. The United States, Scandinavia, Mediterranean countries and Northern India have a relatively high incidence of stone disease. Whereas, Central & South America and Africa despite its hot climate have a very low incidence of stone disease. Stones form in the kidneys under a specific set of circumstances. Initially, crystals begin to form and if the conditions are right, the process can progress to cause crystal growth and larger stones. Some of these stones may remain “silent” for many years. Others can cause pain, be a source of infection or begin to migrate down the ureter. The partial blockage of the urinary flow from the kidney to the bladder creates extreme pain. Rarely a stone can lead to a blockage without causing any pain.” Types of stones: The types of minerals that create kidney stones vary. Many are made from calcium in people who have a very high calcium diet or who have a medical condition, which causes them to have high levels of calcium in their blood, such as hyperparathyroidism. A substance called as oxalate can be found in some stones often in people who have a diet high in spinach, nuts, etc. Uric acid stones can occur as a result of gout or in certain metabolic disorders (where there is too much uric acid in the blood). A very rare component of kidney stones is a substance called cystine, which in some people can be leaked in high quantities into the urine. Causes: Highlighting the various causes of stone, Dr Rajesh Taneja said: “However, since our country is a part of geographical stone belt, more often then not no definite metabolic abnormalities could be detected. Primarily, hyperabsorption (increased absorption) of dietary calcium is the most commonly detected metabolic abnormality in children with urinary stones. Other conditions, including juvenile rheumatoid arthritis, inflammatory bowel disease, gastrointestinal disorders, urinary tract infections and hyperparathyroidism, carry enhanced risk for stone formation.” Symptoms: Dr Taneja further disclosed that very often it is possible to have a kidney stone without it causing any symptoms at all especially if it is lying stationary within the kidney. They may be related to recurrent kidney infections. However, if a stone passes down the ureter towards the bladder, it generally causes a severe colicky pain in the back just above the ribs and follows the course of the stone. Once the stone reaches the bladder, the pain subsides, but below lower urinary tract irritation begins. Stone blocking the flow of urine must be removed (endoscopically or through sound/shock waves). Microscopic hematuria (blood in urine) and abdominal pain are the presenting symptoms in majority of the cases. Treatment: “The treatment of stones is determined by the size, location, and overall medical condition of the patient. A patient with a small stone in the ureter can be managed conservatively with pain medication as long as he responds to the medication and there is no sign of infection or dehydration,” Dr Taneja added. “Should the pain become unbearable the blockage needs to be relieved. This can be done by removing the stone and inserting a stent or a “bypass” from the bladder to the kidney or by placing a tube directly into the kidney through the skin to allow the urine to be diverted. These are various techniques available to remove stones in the ureter. A small telescope is available that can allow direct visualisation of the stone and with the use of various baskets and graspers the stone can be extracted. Since more than 85% of stones are visualised on X-rays, many ureteral stones can be treated with Extracorporeal Shock Wave Lithotripsy (ESWL). ESWL can fragment a stone into smaller pieces, which hopefully will pass on their own. These are usually outpatient procedures,” he said. For very large kidney stones a tube can be placed directly into the kidney, and thereby fragmenting the stone under vision with various energy sources so it can be removed in multiple pieces. Once the stone are treated and removed, there are multiple blood and urine studies that can be performed to identify specific factors in that patient that caused the stone. This can hopefully prevent further stones from occurring in the future. Metabolic Evaluation: After appropriate diagnosis and treatment a full metabolic evaluation is indicated to help reduce the recurrence of urinary stones. Eighty-five per cent of all stones are calcium based and are radio-dense as seen on plain abdominal radiographs. This excludes: Magnesium-ammonium-phosphate stones, also referred to as infectious calculi stones. These stones are found most frequently in women. Patients should be encouraged to increase fluid intake (during the day and night) to decrease urinary supersaturation of urine. Precautions: Throughout the ages, increased water intake has been recommended for individuals with kidney stones. Common sense dictates that the higher the urinary volume the more dilute urine becomes and the less likely it is for stone crystals to develop. This logic holds today in the age of modern medicine, with doctors all over the world asking their patients to drink water in excess as a preventive measure. 1. High fluid intake (100oz/day). 2. Reduced salt intake. 3. Cut down on animal protein. 4. Avoid food with high oxalate content. Home gym Grand Slam, the quality fitness equipment provider in North India, has now launched the ‘Multi Exercise Home Gym’ for those who like to keep their bodies ship shape. Specially designed for homes, the gym offers over 20 weight training exercises in one workstation. Trauma cream Schwabe India, which specialises in providing homeopathic solutions, has now come out with with Topi Arnica - a cream for day to day traumatic problems, such as bruises rashes, sprains, muscular aches and pains. Topi Arnica is well-equipped with essential homeopathic ingredients that are clinically proven to improve the local blood supply and hasten healing. Miscarriage risks Taking headache pills, like several Non Steroidal Anti-inflammatory Drugs (NSAIDs) may dramatically increase the risk of miscarriage, warns a latest research, conducted by the US-based Kaiser Foundation Research Institute. However, it went on to say that paracetamol was found relatively safe during pregnancy. Miscarriage is defined as natural abortion before 20 weeks of gestation. The research, published in the latest issue of the British Medical Journal, was prompted by similar findings of an earlier Danish case control study. Obstetricians and gynaecologists here have taken the study seriously and feel that it can be very useful in providing guidelines of treatment protocols to prevent miscarriages. This assumes particular significance because of the fact that the incidence of miscarriages in India is very high and majority of it goes unreported. Dr Sunita Mittal, Head of the Department, Department of Obstetrics and Gynaecology at the All India Institute of Medical Sciences (AIIMS), says that an estimated 15 per cent of miscarriages take place in our country. As the study suggests, wrong medication may be linked to a higher risk of miscarriage although results need to be established on a larger scale.” Patients should avoid use of any drugs on their own especially during peri-conceptual period in the first few months of pregnancy. NSAIDs should be avoided. Usually paracetamol is the first line treatment for labour pain, fever and headache,” she says. Dr Anita G. Kaul, Senior Consultant Gynaecologist at Apollo Hospital here, concurs with the findings and says that she is surprised that such a high rate of miscarriage is because of the indiscriminate use of NSAIDs. She advises pregnant women to consult their doctors before taking any painkillers. |
Tania Sachdev sets sights on WGM New Delhi, September 6 When Tania competed in the qualifiers held at Kozhikhode in Kerala recently, not many people gave her much of a chance, as she was the lowest rated Indian in the fray. But she qualified from what was undoubtedly the toughest field in the history of Asian Women’s Chess Championship. Tania proved her critics wrong when she made the ‘cut’ by logging five-and-a-half-point out of a possible nine. “It was one of the toughest women’s Asian qualifiers,” she said. Her only prayer now is that the World Championship should not be scheduled for December as she would be busy then preparing for her pre-Board examination, though her doting mother, Anju Sachev, asserted that Tania would be playing in the World Championship, come what may. He mother hopes to persuade Tania’s school authorities (Modern School, Vasant Vihar) to allow her to sit for the pre-Board exam at a convenient date if the World Championship is held in December. Tania asserts that she requires at least a minimum of three months to fully prepare herself for the tough World Championship ahead, which will be played in a knockout format. “The loss of one game may send you crashing out of the championship,” she pointed out. Tania has come a long, long way after she finished second in the National Under-8 Championship held in Madurai (Tamil Nadu) in 1993. She caught the national spotlight when she won the 1993 British Under-8 title, which made her the youngest winner of an international chess title in the world. Tania went on to make history by annexing five titles in the following edition of the British Championship at Norwich, Scotland, and the feat earned her an entry in the Limca Book of Records, which still stands. She is the only player in the country to have finished among the top ten every time she played in a World Age-Group Championship. Her collection of medals include a bronze in the World Championship for girls under-12 in 1998, golds in the Asian Championships in the under-14 and under-19 categories, gold in the Commonwealth Championship in the under-16 category in 1999 and silver in the under-18 section in 2003. Tania’s triumph in the Asian Junior (Under-19) Championship last year earned her the title of “Woman International Master” as well as a nine-game Woman Grand Master norm. She has now set her sights on acquiring two more such norms within the next two years to realise her dream of becoming a Woman Grand Master (WGM)—a gambit, which is very much within her realm.. This confident class XII student has all the attributes to attain the WGM as she is intelligent, quick on the uptake, has the talent and the patience to train hard. She trains for five hours on holidays and three hours on school days. “It’s quite a hard grind. I don’t have time to lead the life of normal teenager,” she confessed, at a function organised by the Delhi Chess Association to felicitate her for her qualification for the World Championship. She was gracious enough to admit that she would not have reached where she has but for the help and guidance of her mentors like G. B. Joshi and International Master Varghese Koshy. Tania’s mother Anju Sachdev said her daughter’s success had come with a heavy price tag as she has to accompany wherever Tania plays. Mercifully, Tania has found a sponsor—Hughes Sofware Systems.. Though Tania has made great strides in her game, she is working hard to beat the clock. “I try hard not to come under time pressure now. I am also working on my opening game, which has been my weak spot,” she noted. Tania brushes up her chess skills at home by practising with a computer, and not against it. The 18-year-old Tania is the master of all she surveys in the chess firmament of Delhi. She has won almost all Delhi State Championships since 1995, and has qualified for the Delhi State men’s team for three consecutive years, since 2000. Tania, whose burning ambition is to become a television newscaster, is made of fine stuff, and chess fans in India, North India in particular, is eagerly looking forward to her outing in the World Championship, come December. |
Adidas signs up Zaheer Khan, Ashish
Nehra New Delhi, September 6 Zaheer Khan and Ashish Nehra will endorse the entire range of Adidas products that include sports footwear, apparel and accessories. Managing director of Adidas India Marketing Ltd Tarun Kunzru, while presenting Zaheer Khan and Ashish Nehra, said, “Zaheer Khan and Ashish Nehra’s passion and commitment are among the character traits that not only make the duo one of the fiercest competitors and exciting players to watch in cricket, but also the perfect fit for our brand. We are also associated with Sachin Tendulkar and Virender Sehwag and we feel we have the leading cricketers in India to promote our products.” Both Zaheer Khan and Ashish Nehra said, “Joining the Adidas family is an exciting step in our career. It is clear to us that Adidas has a sincere commitment to the sport of cricket. We are looking forward to working with them and doing our part in keeping the brand headed in the right direction.” Zaheer Khan, who made his international debut against Bangladesh in Dhaka in 2002, has taken 73 wickets in 24 Tests and 108 wickets in 70 One-Day Internationals. Ashish Nehra, who made his debut against Sri Lanka at Colombo, has taken 37 wickets in 13 Tests and 45 wickets in 39 One-Day Internationals. |
Promila emerges fastest Rohtak: Promila of Meham block emerged the fastest women in the District level Sports meet held at Chottu Ram Stadium here today. Sunita of the same block secured second position in the 100m race, whereas Neeraj of Rohtak block finished third. Madhu and Manju of Rohtak block stood first in the discuss throw and javelin thorw events respectively. In team games, Rohtak block won the championship in volleyball and Gymnasticks, whereas Meham won the title in Kabaddi. Following are the results: 100m: 1. Promila (Meham), 2. Sunita (Meham) 3. Neeraj (Rohtak) 200m: 1. Promila (Meham), 2. Poonam (Rohtak), 3. Seema (Rohtak) 400m:
1. Sunita (Meham), 2. Seema (Meham), 3. Poonam (Meham). OSR |
Simla Youngs win New Delhi, September 6 |
|
| Punjab | Haryana | Jammu & Kashmir | Himachal Pradesh | Regional Briefs | Nation | Editorial | | Business | Sport | World | Mailbag | Chandigarh Tribune | Ludhiana Tribune 50 years of Independence | Tercentenary Celebrations | | 123 Years of Trust | Calendar | Weather | Archive | Subscribe | Suggestion | E-mail | |