HEALTH & FITNESS

Screen your baby at birth for healthy tomorrow
Dr B.S. Chavan & Dr Gurjit Kaur

All parents desire to have a healthy baby. Most of the babies are healthy, but some may have a disorder likely to lead to a life-threatening situation. Some babies may develop physical and mental disability.

Piles: exploding the myths
Dr Pankaj Garg

Though piles (haemorrhoids) is one of the most common diseases afflicting the human race, a satisfactory treatment has been largely unavailable for most of the times. Due to the absence of a convincing treatment, the number of treatment options available today exceeds the number of myths associated with the disease.

EYESIGHT
Freedom from glasses after cataract surgery

Dr Mahipal S. Sachdev
Cataract surgery has evolved a great deal over the last 20 years. I remember as a kid, when my grandmother went through the surgery. She had been in hospital for over three days. The healing process then took over two weeks.

Health Notes
Coffee can prevent memory loss
LONDON:
Your daily cup of coffee can not only rejuvenate you but also lead to ways of preventing memory loss in old age.
Scientists have discovered that the caffeine present in strong coffee alters the brain’s electrical activity. By boosting gamma rhythms, produced by the synchronised firing of nerve cells 40 times a second, it aids memory and learning.


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Screen your baby at birth for healthy tomorrow
Dr B.S. Chavan &  Dr Gurjit Kaur

All parents desire to have a healthy baby. Most of the babies are healthy, but some may have a disorder likely to lead to a life-threatening situation. Some babies may develop physical and mental disability. With the advancement in medical science, it is possible to detect a large number of genetic and metabolic disorders through antenatal and neonatal screening. Early detection through antenatal screening of high-risk mothers helps in the prevention of a disability.

The new-born screening programme has been made mandatory in all developed countries. It is now possible to screen your baby for some disorders. Let this be your gift to your new-born for a bright tomorrow.

Here are answers to some of the general questions people may like to know:

What is the purpose of the new-born screening programme?

The purpose is to test a new-born for selected disorders which are prevalent in Indian population. Early diagnosis and treatment can prevent serious medical and neurological disorders which may pose a threat to life or can lead to a physical and mental handicap.

Are the tests necessary even when a baby looks normal at birth?

Yes, these tests are necessary because most infants with metabolic disorders show no obvious sign of disease immediately after birth. In a metabolic disorder, there is an invisible problem in one of the metabolites which are produced in the body during normal metabolic processes. These defects may later lead to disease symptoms a few days or weeks after birth.

How are the tests done?

After birth within 48-72 hours two-three drops of blood are collected from the heel of the baby on a filter paper for the necessary tests.

How much does the screening cost?

The cost of this test will not be more than the cost of a few toys you buy for your baby. The tests are very economical.

Which disorders will be screened?

In this programme, four commonly existing disorders will be screened. They are phenylketonuria, congenital hypothyroidism, glucose-6-phosphate dehydrogenase deficiency, and congenital adrenal hyperplasia.

Phenylketonuria is caused by a baby’s inability to break down the amino acid phenylalanine, which is found in the protein of foods we eat routinely. If the new-born with this defect is detected early and given a special low-phenylalanine diet, mental retardation can be prevented.

Congenital hypothyroidism is caused by the lack of thyroid hormone, which leads to poor physical and mental growth (mental retardation). The devastating effects of this disorder can be prevented if diagnosis is done early and treatment is started before two-three weeks of age. The frequency of this problem in India is estimated to be 1:2000 births.

Glucose-6-phosphate dehydro-genase deficiency:

A defect in this enzyme reduces the ability of the body to protect red blood cells. It results in anaemia or jaundice, which in the neonatal periods can damage the brain. Severe jaundice may occur with the intake of medications such as sulpha drugs, and this can affect the brain irreversibly. This can be prevented by early treatment. The frequency of this disorder is 1:20 to 1:10 births.

Congenital adrenal hyperplasia is caused by the absence of an enzyme in the cholesterol pathway. If left untreated, it results in a life-threatening crisis within the first weeks of life and abnormal sexual growth. These complications can be prevented by timely detection and treatment. The frequency of this problem is about 1:3000 newborns.

What needs to be done if the screening test is positive?

The babies detected positive in the screening programme will be subjected to confirmatory tests. Once the diagnosis is confirmed, the child will be referred to the concerned doctor for treatment. In Chandigarh, counselling is provided for by the Genetic Centre at Government Medical College and Hospital, (GMCH}, Sector 32.

The writers are associated with GMCH, Chandigarh.

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Piles: exploding the myths
Dr Pankaj Garg

Though piles (haemorrhoids) is one of the most common diseases afflicting the human race, a satisfactory treatment has been largely unavailable for most of the times. Due to the absence of a convincing treatment, the number of treatment options available today exceeds the number of myths associated with the disease.

MYTH 1: Cure of piles is not possible.

The high recurrence rate of the conventional modes of treatment led to this belief. This is not true today. The latest method (stapler haemorrhoidectomy) has decreased the recurrence rate to the lowest level.

MYTH 2: Surgery of piles is painful and prolonged.

This was true with conventional surgery, but with stapler surgery, the treatment is virtually painless and can be done on a day-care basis (i.e. the patient goes home the same day).

MYTH 3: Piles always bleed.

This is not true. A significant percentage of piles patients hardly bleed. They just feel the small masses (piles) in their anal area after motions. These masses gradually increase in size over the years and may lead to complications.

MYTH 4: Piles can lead to cancer.

Piles does not increase the risk of cancer, but what is important to understand is that symptoms of piles and rectal cancer are the same — bleeding off and on. So, the symptoms of piles can mask the presence of underlying rectal cancer. Piles should always be treated even if it is causing no symptoms other than occasional bleeding.

MYTH 5: Piles is a taboo.

Many people, including educated ones, consider piles to be a taboo and do not come out openly with their problem. This can be dangerous. Piles is a simple disease, but consultations should be sought with a good surgeon.

MYTH 6: Piles treatment is a domain of quacks.

As earlier mentioned, because of the lack of satisfactory treatment the people suffering from piles mostly consult quacks. The result is that so many simple cases of piles get complicated.

The latest research has changed the way we look at piles. Earlier, piles was thought to be a dilated bunch of veins, but now it has become clear that the basic defect in the piles along with the dilatation of veins is mucosal prolapse — the inner covering layer (mucosa) of the rectum becomes loose and that is why it protrudes out.

This understanding of the disease process has led to a improved treatment.

Earlier, all treatments of piles, including the conventional surgery, removed or treated the bunch of dilated veins (piles) without addressing the basic cause — the mucosal prolapse. Stapler haemorrhoidectomy is the only treatment modality available today which by removing 1-2 cm of mucosal cuff corrects the underlying basic pathology while giving painless relief to the patient.

The writer is a senior consultant surgeon, Fortis Hospital, Mohali. 

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EYESIGHT
Freedom from glasses after cataract surgery
Dr Mahipal S. Sachdev

Cataract surgery has evolved a great deal over the last 20 years. I remember as a kid, when my grandmother went through the surgery. She had been in hospital for over three days. The healing process then took over two weeks. Finally the sutures were removed and she came home with a thick (very thick!) pair of glasses. She was able to see, but her vision was never the same again. She could not read fine print and could not do fine embroidery work that we were all so fond of.

However, technique and technology have evolved, phacoemulsification is now done routinely and a lens (Intra-Ocular Lens/ IOL) is now implanted in the eye after the natural lens has been explanted. The post-operative visual outcomes are now much better. A patient can carry out most day-to-day activities with near-normalcy. Despite this advancement, there are still a few limitations with the most commonly used IOLs. The biggest one of these limitations is the lack of accommodation in the implanted IOL.

What is accommodation? In layman’s terms , it is the ability of the eye (and the natural lens) to change focus to accommodate objects that are very close or are very far. Nature has bestowed this ability to the natural lens. The power of the lens decreases to see things that are near and the power increases to see things that are far. The artificial IOL that is implanted in the eye has only one focal power. Your surgeon will predetermine this power and you have to live with it for the rest of your life. So, it is possible that you might have excellent distance vision and a compromised near vision for which you will have to wear reading glasses. The reverse of this situation can also occur

With the evolution of IOL manufacturing technology, it is now possible to correct to a great extent the above mentioned situation, through the use of Multifocal IOLs ( MIOL) . It is now possible for you to have appropriate distance as well as near vision after cataract surgery. This helps eliminate the need for glasses or at the minimum, reducing dependence on glasses considerably.

The MIOL works in a manner that at any given time when one focus is used, the other focus becomes so blurred that it becomes imperceptible. Therefore, at any given time, the brain visualises only one image, either for distance or for near.

The currently commercially available MIOLS from AMO, namely Rezoom & Technis Multi Focal, are approved by the FDA in the US and are CE-certified in Europe.These lenses are also available in India and are being implanted at leading eye centres.

As a patient wanting to undergo cataract surgery, you should certainly discuss this option with your ophthalmologist. An expert will advise you of the use of these lenses depending upon your clinical condition and appropriateness of this technology to your lifestyle requirements.

For best results, it is important that the IOL power be calculated correctly and the surgery be conducted by a surgeon with expertise in the technique of phacoemulsifaction. Also patients with no or low cylindrical power tend to have better outcomes post-operatively. For patients with higher cylindrical power, any residual power after the cataract surgery can be corrected accurately with a lasik laser. This will ensure best results of the Multifocal IOLs

With the emergence of Multifocal IOLs, “getting rid of glasses” rather than “getting rid of cataract” can now become a stated clinical objective. Go and ask your ophthalmologist about this exciting new technology today.

The writer is Chairman and Medical Director, Centre for Sight, New Delhi. E-mail: msachdev@bol.net.in


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Health Notes
Coffee can prevent memory loss

LONDON: Your daily cup of coffee can not only rejuvenate you but also lead to ways of preventing memory loss in old age.

Scientists have discovered that the caffeine present in strong coffee alters the brain’s electrical activity. By boosting gamma rhythms, produced by the synchronised firing of nerve cells 40 times a second, it aids memory and learning.

The process involves a brain chemical called adenosine, which is present in especially high levels in the elderly.

When adenosine binds to a molecular receptor on brain cells called A1, it reduces the activity of neurons and lessens the strength of gamma rhythms.

Synchronised nerve cell activity plays a key role in information processing, which is why gamma rhythms increase when people attempt to solve complex mental problems.

Caffeine prevents adenosine binding to the A1 receptor, thereby blocking its effects and boosting gamma rhythms. — ANI

Snail venom for relief from pain

LONDON: A new painkiller based on the venom of a deadly tropical sea snail has gone on sale in Britain, offering hope to patients with chronic pain.

The drug, called Prialt, is designed only to be used to tackle constant pain such as that suffered by cancer patients and other serious conditions linked to severe pain.

The researchers took their inspiration from a predatory cone snail Conus Magus, found off the Philippines.

They produced a man-made version of the snail’s venom, which works by blocking the calcium channels on the nerves responsible for transmitting pain signals.

When the channels on these nerve cells are blocked, calcium cannot enter them. Without calcium, the pain signals are stopped from travelling from nerve cell to nerve cell, reports the Scotsman. — ANI

Obesity links depression, BP

NEW YORK: Research suggests there is a significant association, mediated through obesity, between symptoms of depression and high blood pressure.

Psychological factors are known to be related to high blood pressure and heart disease, lead researcher Dr Azad Alamgir Kabir commented to Reuters Health. “This study shows a probable pathway between depression and development of (high blood pressure). If we know the causal pathways, we can develop effective prevention techniques,” the researcher added.

The researchers studied 1,017 individuals, between 12 and 62 years old, from 561 families participating in the Bogalusa Heart Study. Sixty per cent were white and 52 per cent were women. On average, the subjects were overweight, but not obese. Roughly, one-third were presumed to have depression and 13.4 per cent had high blood pressure.

In the American Jouension, Kabir from Louisiana State University Health Science Center in Shreveport and colleagues report that symptoms of depression were associated with high blood pressure indirectly through an association with increased body weight in both whites and African-Americans.— Reuters

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