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Practical tips for asthma
and allergy management Breast cancer in the elderly: Surgical complications Handling recurrent throat infections in children Health Notes
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Practical tips for asthma and allergy management Allergies and asthma are affecting an increasing number of persons worldwide. Management of asthma can improve if allergies are identified by proper scientific methods. The field of allergy has developed tremendously in the last few years, making tests and treatment patient friendly. Asthmatics can enjoy life to its fullest with the help of a few practical tips. 1. Wheezing, cough, choking, nose block or runny nose, excessive sneezes, eye irritation, indigestion, abdominal discomfort , bloating, chronic diarrhoea, itchy skin with or without rashes and swelling of lips are typical symptoms of allergy. Allergy can affect each system of the body. 2. Allergy diagnosis is done after getting a detailed history and examination of the patient and is highly individualised. It should never be done as a remote test just by sending blood to a laboratory. Tests are simple and helpful provided they are done by a qualified doctor, and minor and major allergens are pinpointed, rather than giving a vast list to the patient making his life difficult! 3. Inhalers are the cornerstone of asthma management. An inhaler is just a device; which salts should be used will depend upon the doctor’s wisdom. Patients ought to understand the difference between preventive inhalers and rescue inhalers. It’s not wise to keep nebulising Asthalin as this can result in strain on the heart besides many other complications. It’s wise to consult a doctor; you need a preventive inhaler. Asthalin is only a rescue medicine. 4. Inhalers are safe and the surest method of making the drug reach in the airways where the effect is needed. They should be taken regularly and with proper technique for adequate drug delivery. 5. It is not uncommon to find the co-existence of food allergy and asthma in the same patient. As part of the atopic march, many food allergy patients may develop asthma later in life. Each can adversely affect the other. Food allergy patients with asthma have a higher risk of developing life-threatening food-induced reactions. An asthmatic patient with food allergy may have higher rates of morbidity and mortality associated with asthma. It is wise to modify food only if it is detected on tests rather than based on myths. Many people stop taking milk, curd, cheese, eggs and nuts just due to myths whereas these are calcium, protein and vitamin A& D-rich foods, absolutely essential for the health of the young as well as the elderly. 6. Exercises are good and should be encouraged. Of course, exercises are also prescribed scientifically. Walking in fresh air and exposure to sun is best for Vitamin D and the improvement of immunity. 7. Now with winter setting in, even minor coryza and cold can trigger asthma attacks. To prevent such misery, please follow scientific advice, visit a doctor, eat well and walk in fresh air. People with asthma and allergies have even won medals in Olympics. Let us attack asthma by all scientific means. The writer, a former President of the Indian Academy of
Paediatrics, is a Chandigarh-based allergy specialist. Email — slavasa@gmail.com |
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Breast cancer in the elderly: Surgical complications
Worldwide nearly a third of breast cancer (BC) cases occur in women over the age of 65 years. Age is an important factor for BC. This proportion is likely to grow because life expectancy continues to increase. Planning therapy is not always straightforward because older patients may present with the kind of illnesses that limit therapeutic choices. One characteristic of BC in the elderly is that it is diagnosed at an advanced stage as a result of negligence. Family members have an important role to play in helping elderly women. It is important to assist elderly women to go to the doctor when they find something abnormal in their breast. What need to be observed are changes in the size or shape and skin texture such as puckering or dimpling, inverted nipple, a lump or thickening of breast tissue, redness or a rash on the skin and the nipple, discharge from one or both nipples, constant pain in the breast or armpit, or swelling in the armpit. The question frequently asked is: Should one screen elderly women for breast cancer? A Dutch breast cancer screening programme has shown that screening mammography of high quality is effective and appropriate up to 75 years of age. The results of this study strongly suggested that screening women aged 70-75 years has a positive impact on breast cancer mortality. The biological characteristics of breast cancer change with increasing age. Tumours in older patients are more likely to be of low grade, have lower proliferation indices, and tend to be hormone-receptor positive and node negative. Breast cancer may follow a less aggressive course in older women. Older patients are frequently undertreated, resulting in poor survival. Healthy elders should be managed like younger patients and should be considered for the state-of-the-art treatment programme. Outcomes are compromised in whom less than complete combined modality treatment is undertaken. Multimodality therapy should not be routinely withheld in this group in view of the demonstrated safety. The oncological management of breast cancer has evolved from radical surgery to modern-day preservation of breast structures. Surgery is the primary treatment of choice. Older patients who do not undergo surgical removal of the tumour are at an increased risk of breast cancer progression and mortality. Breast-conserving therapy has become a primary management option among elderly patients. Breast-conserving surgery, whenever possible, is preferred by most elderly patients. It is offered to patients with small tumours that have not spread. A mastectomy is done for large tumours, and cancer that is in more than one part of the breast. Breast-conserving surgery without radiation treatment results in a significant increase in local recurrence. The elderly patients can be treated with surgery and radiotherapy in accordance with the accepted recommendations for the stage of the disease. Studies have shown the potential benefits as it decreases the risk of local recurrence. Breast cancer surgery-related mortality is low for the elderly population. Careful pre-surgical evaluation can identify patients at high risk. Hormone therapy is widely used in the treatment of breast cancer because the proportion of hormone-receptor positive tumours increases with age. Elderly patients in good clinical health gain benefit from adjuvant chemotherapy. However, chemotherapy decisions are complex because of comorbidity and toxicity. Treatment thus should be individualised based on the type of comorbidities. Other options should be considered in accordance with the circumstances when standard treatment is not possible. Endocrine therapy is justifiable in a patient who is unfit for surgery. Adjuvant therapies should be considered weighing the risks and benefits for each patient. A significant controversy remains regarding what constitutes appropriate care for elderly patients. Elderly women who are completely and correctly treated with realistic treatment options that are based on surgery and adjuvant therapy have a similar chance of being curved as younger patients. More clinical trials are needed for older women if the benefits of recent advances in the management of this disease are to be extended to these patients. The writer is retired Professor and Head, Department of Surgery, PGI. |
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Handling recurrent throat infections in children It is very common for a homoeopath to see a lot of anxious parents seeking treatment for their children who suffer from recurrent throat or upper respiratory infections. Believe me, these young anxious parents are tougher to handle than their young ones. The children who have recurrent upper respiratory infections usually develop symptoms which start with cold and can very fast lead to bad chesty or dry cough, fever and even difficult breathing. The bigger problem is the kind of recurrence that is noticed in some cases. I have personally seen children developing infections every 15 days and seem to be perpetually living on antibiotics. This affects their quality of life and education in many ways. Now, the big question is whether homoeopathy has an effective remedy for preventing the recurrence. The answer is a big “yes”. Before we get to the actual homoeopathic solution let us try to understand why these kids fall sick so
frequently. We are born with an immune system (body’s own defence system) which inherits some antibodies from the mother during gestation and with breast feed. Quite a bit of immunity is developed later in life. The cells that fight infection in our body are called antibodies. Our body has a very intelligent immune system and can recognise a micro-organism as new or one that it has previously encountered, and respond accordingly. The response in the previously encountered micro-organism is to send the already developed antibodies to fight that organism. In the case of a new type of micro-organism, the body creates specific antibodies and once they are made, they are replicated in the body in great numbers and stay in there for long. They keep on providing cover against that specific kind of organism henceforth. This is one of the reasons why grown-up persons don’t have infections that frequently. The biggest reason for the recurrence of infections is that the young body within the immature immune system is not getting a chance to develop natural immunity. The reason is that these kids, at the slightest sign of infections, are being over-medicated by anxious parents and unscrupulous physicians. As paediatricians would agree, quite a few of these infections are viral in nature, which means that they require very less treatment and are self-limiting in nature. Bacterial infections are not that common and are the ones that can require antibiotics. It is very commonly seen in India that at the slightest sign of any infection (even viral infections) antibiotics are given to kids. This injudicious use of antibiotics is what leads to the body not getting a chance to develop its own antibodies. This leads to the recurrence of infections. No doubt, antibiotics are life-saving medicines, but parents have to realise that these should be given only when there is a bacterial infection and the body is showing no signs of fighting it. If the overuse of antibiotics can lead to an impaired immune system, why would homoeopathic medicines help in restoring immunity? The answer lies in the basic principle around which homoeopathy works — “Like cures like”. Homoeopathic medicines work by giving a similar impetus to the body (like that of the disease) causing the body’s immune system to get activated and fight infections. Timing is very important while taking homoeopathic treatment. Infections respond much faster when homoeopathy is started at the initial stages of infection — within 24- 36 hours. Gradual improvement in immunity occurs with homoeopathic treatment once a couple of infections are managed well with medicines. The writer is a Chandigarh-based practising homoeopath. Email- vikas@drhomeo.com
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Health Notes WASHINGTON: Commuting by car or public transport, compared to walking or cycling, is associated with negative effects on health, a new research has revealed. Researchers from Lund University looked at 21,000 people, aged between 18 and 65, who worked more than 30 hours a week and commuted either by car, train or bus, or were active commuters, who travelled by walking or cycling. “One way” journey time was compared to the volunteer’s perceived general health, including sleep quality, exhaustion and everyday stress. “Generally car and public transport users suffered more everyday stress, poorer sleep quality, exhaustion and, on a seven-point scale, felt that they struggled with their health compared to the active commuters” said Erik Hansson from the Faculty of Medicine at Lund University.
— ANI Unlocking insects’ physiology may lead to advances in health
WASHINGTON: Understanding insect physiology may lead to advances in human health and welfare, a US researcher says. Michael Kanost, distinguished professor and head of the department of biochemistry at Kansas State University, has claimed that understanding this physiology may help in controlling diseases, curbing insect-caused crop loss and developing new durable, lighter-weight medical equipment and prosthetics. “Insects are really interesting because there’s so much variety that occurs in this huge group of animals,” Newswise quoted him as saying. “Ultimately we want to understand them better.”
— ANI Thyroid surgery may reduce sleep apnea symptoms
WASHINGTON: Surgical removal or reduction of an enlarged thyroid gland could help reduce sleep apnoea symptoms like snoring, a new study has suggested. Obstructive Sleep Apnoea (OSA) affects about 20 per cent of the population and is caused by narrowing or blockage of the airways when a person is asleep. If not treated, OSA can even increase the chances of a person’s death. To evaluate the impact of an enlarged thyroid gland, known as goitre, on OSA, Alexandra Reiher and colleagues from the University of Wisconsin, Madison, assessed OSA symptoms such as snoring before and after thyroidectomy to remove all or part of and enlarged thyroid gland, Newswise reported. The patients who reported symptoms of OSA, including snoring, were asked to fill up a questionnaire before and eight weeks after undergoing thyroidectomy.
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Allergies and asthma are affecting an increasing number of persons worldwide.
Management of asthma can improve if allergies are identified by proper scientific methods. The field of allergy has developed tremendously in the last few years, making tests and treatment patient friendly. Asthmatics can enjoy life to its fullest with the help of a few practical tips.
1. Wheezing, cough, choking, nose block or runny nose, excessive sneezes, eye irritation, indigestion, abdominal discomfort , bloating, chronic
diarrhoea, itchy skin with or without rashes and swelling of lips are typical symptoms of allergy. Allergy can affect each system of the body.
