|
|
|
|
| HEALTH & FITNESS |
|
|
|
Lung tumours: facts and fiction
Why laparoscopic surgery in pregnancy
Tips to prevent neck pain
|
|
Lung tumours: facts and fiction The diagnosis that cricketer Yuvraj had a lung tumour caused a nationwide concern resulting in numerous conflicting reports on the cause and nature of the tumour, varying from a benign one to a semisoma, or a cancer. It is not my intention to discuss about the illness of the beloved hero. The subject of lung tumours, however, needs to be brought into sharp focus. Tumour is the presence of an “abnormal” mass of tissue in one or more body parts. Often considered as synonymous with cancer, it creates anxiety whenever detected. It may be visible even when it is of superficial nature under the skin, or is hidden involving an internal organ (such as the lung). Anxiety about a tumour is always a good thing; it makes you seek medical opinion and do efforts to reach a conclusion about the nature of the tumour. After all, it is the nature of the tumour which makes all the difference in matters of treatment. Therefore, no tumour should ever be ignored without establishing a diagnosis; good medical consultation must always be sought, at least. Like in most other body parts, the lungs can also develop tumours of most benign nature compatible with normal lifestyle. There can also be highly malignant tumours with a rapidly downhill course, leading to death in a matter of months. Then there are slowly-growing, limited or localised and potentially malignant tumours. This group includes a wide variety of tumours with variable courses of progression. They are most amenable to treatment and should be diagnosed and managed appropriately as early as feasible. Unfortunately, these tumours are most commonly missed in the early stages and often ignored by the patients as well. Both symptomatology and diagnosis of a lung tumour depend on not only its nature but also on the location within the respiratory system. Even a relatively benign tumour near the trachea causing compressive symptoms such as breathlessness and choking is likely to be more troublesome than a deep tumour embedded in the lung tissue. Similarly, tumours causing frank haemoptysis (blood in sputum) are suspected and detected early than those presenting only with cough and other general symptoms. Considering that cancer is the most fearsome type of lung tumour, it is a fair dictum that the onset of haemoptysis, persistent cough and/or breathlessness for the first time in life in an individual of over 40 years of age, especially in a smoker, must never be ignored. It may not necessarily be cancer, but certainly it calls for medical attention. Tobacco smoking is an important issue whenever one talks of cancer in general and lung cancer in particular. It remains the single most common cause of lung cancer. Unfortunately, quitting smoking after the diagnosis of cancer does not help much; it has to be done much earlier before the development of cancer. Factually speaking, the risk of development of lung cancer in an ex-smoker never reaches the level as we find in a nonsmoker, even after years of smoking cessation. Prevention, of course, is important, but what to do for treatment remains an enigmatic question. Detected early, most lung tumours, including the cancerous ones, require a surgical approach. Almost all benign tumours as well as localised ones can be removed through surgery. This may not always be possible or only partially possible. So, in the later stages one has to go in for alternative approaches with chemo and/or radiotherapy. It is rather unfortunate that the availability of thoracic surgery facilities is highly inadequate in India. Most cardiothoracic surgeons are busy and hard-pressed with cardiac surgical work. Thoracic surgery has, therefore, remained ignored. It is time to rethink and develop programmes for this purpose to facilitate surgical treatment for lung tumours and other thoracic disorders. Actually, it is the fear of cancer which is more dreadful than cancer. It is rightly said that “a cancer is not only a physical disease, it is also a state of mind”. It needs to be fought with courage and conviction. “The enemy is not pain or even death, which will come for us in any eventuality. The enemy is cancer, and we want it defeated and destroyed (George Zimmer)”. The writer is Professor &Head, Department of Pulmonary Medicine, PGI, Chandigarh.
|
|
Why laparoscopic surgery in pregnancy The use of laparoscopy both as a diagnostic and therapeutic tool has become common over the recent past. It is increasingly being applied for many conditions during pregnancy as well. Approximately 2% of pregnant women may require some type of surgical intervention at some point during gestation, resulting in more than 80,000 operations performed annually in the United States alone. This is mainly because the incidence of non-obstetric-related conditions in women of childbearing age is unaffected by pregnancy. In this regard, the most common non-pregnancy-related indications for operative intervention during pregnancy are appendicitis (0.1 0.3%), gall bladder infection or cholecystitis (0.1%) and bowel obstruction. Other conditions that may require an operation during pregnancy include ovarian cysts, masses or torsion, symptomatic gall stones, adrenal tumours, disorders of the spleen, symptomatic hernias, complications of inflammatory bowel diseases, and abdominal pain of unknown etiology. Laparoscopic treatment of acute abdominal disease has the same indications in pregnant and non-pregnant patients. One needs to investigate such problems before deciding the need for surgical options. Ultrasonographic imaging during pregnancy is safe and useful in identifying the etiology of abdominal pain in the pregnant patient. Expeditious and accurate diagnosis should take precedence over concerns for ionizing radiation. In pregnant women with abdominal pain or pathology, foetal outcome depends on the outcome of the mother. MR Imaging without the use of intravenous Gadolinium, can be performed at any stage of pregnancy. Diagnostic laparoscopy is safe and effective when used selectively in the treatment of acute abdominal processes in pregnancy, etc. Laparoscopy can be safely performed during any trimester of pregnancy. There are many advantages of laparoscopy in the pregnant patient. These include decreased foetal respiratory depression due to diminished postoperative narcotic requirements, lower risk of wound complications, diminished postoperative maternal hypoventilation, shorter hospital stays, and decreased risk of thrombo-embolic events. The improved visualisation in laparoscopy may reduce the risk of uterine irritability by decreasing the need for uterine manipulation. Decreased uterine irritability results in lower rates of spontaneous abortion and preterm delivery. There are a number of surgical issues involved like difficult access to the abdomen, very little working space due the enlarged uterus and altered physiology of pregnancy which makes the surgery demanding. Then there are risks of anaesthesia as well as safety of the baby which needs to be kept in mind all the time. In such cases it is not only the mother and the child but also the whole family which needs to be taken care of. The desire to minimise maternal and foetal stress entails that the surgical intervention should be as minimally invasive as possible. The benefits of laparoscopy for such patients are well established. Suggested recommendations for laparoscopy during pregnancy: 1. Pre-operative obstetrical assessment. 2. When and If possible, operative intervention may be deferred until the second trimester, though it can be carried out at any time. 3. Take steps to avoid venous thrombosis during and after surgery. 4. Foetal and uterine status needs to be monitored during surgery. 5. Excellent intra and post-operative care in a facility. The writer is associated with Fortis Hospital, Mohali.
|
|
Tips to prevent neck pain People working in offices normally complain of pain in the neck and upper back region. This occurs due to the tendency to move the head and the neck forwards followed by the rounding up of the shoulders and thereby putting extra pressure on the neck and upper back muscles. Slumping while sitting exerts a weight of approximately 16 kg on the neck while the head actually weighs approximately 5 kg. This extra weight means muscles of the neck and the back have to work much harder, thereby tiring quickly. Neck pain can be manifested as headache, pain in the upper back area or the whole arm. Headache originating in the neck causes restriction in neck movements. The following tips can help in avoiding neck pain: While concentrating on the computer screen, reading material should always be about 15-30 degrees below from the head position or at the eye-level contact to avoid sustained bending of the head/neck. To confirm, close your eyes first and then open slowly. If the gaze is at the centre of the computer screen, then the level is perfect, otherwise this needs to be raised or lowered suitably. Those who have intensive computer or desk jobs to do should get up and stretch themselves while turning off the buzzer, and reset the timer placed across the room. Some computers have alarm clock functions which can be set to remind you to get up. This can relieve muscle tension. The keyboard and the mouse should be operated with relaxed shoulders and bent elbows. The keyboard should be kept close to the lap. If no keyboard table is available, then it is better to have the keyboard on the knees so that your arms and shoulders are not raised to put strain on the upper back muscles. While typing, writing, reading, etc, it is advisable to keep the arms vertical with the elbow behind the plane of the chest, and not projected forward. Arm-rest of the chair helps in taking off the load from the shoulder and the neck. When we sit behind a table, the chair height should be such that the forearms rest comfortably on the table without hunching the shoulders up or down. People wearing eye-glasses while reading should place the head in an erect balanced position by adjusting the frame of the eye-glasses on the nose in such a way that neck bending is avoided. Near-sightedness should be corrected since it causes the head forward posture which leads to neck pain. Eye-glasses with adequate focal length should be used so that a person can see clearly with the head in a balanced position. An awkward posture used for a long time at office or on a computer tends to develop a round-shoulder posture. Correction requires a gentle movement of the head backwards to bring the ears in line with the shoulders. People with a long supple neck should strengthen their neck muscles as they are more prone to developing pain in the neck than those with a short stocky neck because of the greater leverage and demand placed on the muscles. Swinging the head around at a full range of motion — head rolling — should be avoided as this can cause pain, dizziness and vertigo. Side-bending neck exercise — by bringing the ear to the shoulder first on one side and then on the other side — helps in improving flexibility of the neck. Holding your head with hands while doing sit-ups can cause neck pain. Alternatively, one should place the hands either across the chest or on the temple to avoid neck strain. Excessive neck extension while sleeping can be corrected by using a small, soft pillow that supports the normal cervical curve. Individuals who prefer sleeping on the side should tuck the side pillow between the shoulder and the chin and not under the shoulder to avoid pain in neck muscles. Neck pain can occur while reading when the bed lamp is placed at one side of the bed. The reading light should fall directly on the book. While typing from a copy, it is important to place the copy at eye level and as near as possible to the centre of the line of vision. Placing a copy at the sides involves neck rotation and can cause stiffness/pain of the neck. A tight shirt collar and clinching the necktie too tightly can cause neck pain. While selecting a shirt, a finger should fit comfortably inside the collar not only when looking straight but also when looking at the sides. While talking on the telephone for a prolonged period of time, one should change one’s hand to hold the receiver. Use of a headset is recommended in such cases. People suffering from vertigo and dizziness should avoid hyperextension of the neck while sleeping, sitting in a beauty parlour or at a dentist’s chair. The writer is a former doctor/physiotherapist, Indian Cricket Team. E-mail — chadhar587@gmail.com
|
|
An hour of exercise daily can help improve memory, learning
LONDON: Doing exercise for up to an hour a day can improve memory and learning in children and the elderly, say scientists. The researchers found that walking or cycling regularly for between six months to a year can improve memory and problem solving skills in the elderly by between 15 and 20 per cent. They have shown that such exercise can also increase the size of crucial parts of the brain. The scientists have also discovered that children who are fit also tend to be better at multitasking and performing difficult mental tasks than unfit friends, The Telegraph reported. Professor Art Kramer, director of the Beckman Institute for Advanced Science and Technology at the University of Illinois, who led the research, said their findings could have major implications for improving children’s performance at school.
— ANI
Nuts, beans and seeds can boost health
WASHINGTON: Adding nuts, beans and seeds in your diet can give you an ample amount of nutrients, say experts. In the February 2012 issue of Food Technology magazine, published by the Institute of Food Technologists (IFT), Contributing Editor Linda Milo Ohr writes that heart health, weight management, healthy cholesterol levels, and cognitive health are just some of the benefits that these foods can offer. Almonds are low in saturated fatty acids, rich in unsaturated fatty acids, and contain fiber, phytosterols and plant protein. In a scientific review, Berryman et al. (2011) showed that consuming a breakfast containing almonds aids in stabilising blood glucose levels for most of the day and provides a lasting feeling of fullness. Pistachios are also considered a part of a heart-healthy diet and may also lower cholesterol. In addition, some research has shown that walnuts may have been linked to benefits related to brain health and cancer.
— ANI
Fasting on and off can help you ‘live longer’
LONDON: Starving yourself on alternate days can boost brainpower, help to lose weight and make you live longer, say American scientists. Scientists at The National Institutes for Aging said their research was based on giving animals the bare minimum of calories required to keep them alive, and results showed they lived up to twice as long. The diet has since been tested on humans and appears to protect the heart, circulatory system and brain against age-related diseases like Alzheimer’s. “Dietery energy restriction extends lifespan and protects the brain and cardiovascular system against age-related disease,” the Daily Mail quoted Mark Mattson, head of the laboratory of neurosciences at the NIA and professor of neuroscience at John Hopkins University in Baltimore, as saying.
— ANI
|
