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| HEALTH & FITNESS |
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WORLD ELDERS’ DAY fALLS ON OCTOBER 1.
Meniscus tear — try conservative treatment
Drug may improve bone density in cerebral palsy HEALTH NOTES
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WORLD ELDERS’ DAY fALLS ON OCTOBER 1. Doctor: Eat, drink and be merry, but no extravagance. Elder: What to eat, how much to eat, and what not to eat. Doctor: A balanced daily diet containing proteins, carbohydrates and fats, in appropriate proportion of four, four and two of each respectively with a caloric value of 1800 to 2000. At the age of 65 years gradually reducing it to 1500 cal a day at the age of 80 years. This should keep you fit and agile. Elder: I understand fats, but what are these proteins and carbohydrates. Doctor: All non-vegetarian items like mutton, poultry, fish, milk, curd cheese and legumes and pulses are sources of proteins. All cereals, sugars, jaggery, potatoes, beet root sources of carbohydrates. Fats are saturated or non-saturated, from animal or vegetable sources respectively. Not more than 20 per cent of your daily fat requirement may be saturated fats whose sources are butter, ghee, etc. Elder:
I don’t relish certain fruits like guava and papaya, and vegetables like brinjal and bitter gourd. Can you suggest alternatives? Doctor: You must take all seasonal fruits and vegetables. The body requirement of minerals and salts is essential for proper physiological functioning of various vital organs and enzymes. These are scattered in various fruits and vegetables. Therefore, do not have taboos and prejudices against any fruit and vegetable. Elder: I am 75 and for the last five years my problem of constipation is annoyingly increasing, in spite of daily night does of Agarol. Can you prescribe some simple remedy? Doctor:
For sluggish bowels with advancing age one needs to drink about 8-10 tumblers of fluids and water, and take plenty of fruits and vegetables. A brisk walk twice a day and yogic exercises, especially for abdominal muscles, should stimulate sluggish bowels without resort to laxatives. Elder: Doctor, you advised us to check our lipids once or twice a year. Please tell us what these lipids are. Doctor: Lipids are cholesterols derived from fats during the metabolic process in the body, specially liver. There are several types of lipids, some are friendly and some unfriendly. Total cholesterols should preferably remain below 200 mgs in the blood serum. Among the friendly lipids, the high density lipids should be around 50 - 70 mgs. Among the unfriendly lipids, the Triglycerides should not excel 170 mgs and the low density lipids not more than 130 mgs. Elder: What are the ill effects of lipids? Doctor: Excess of unfriendly lipids have a tendency to get settled in the arterial blood vessels, impede blood circulation and may even block the capillaries, the smaller end-arteries. For instance, heart attacks are due to the blockage of capillaries supplying blood to the heart muscle itself. Elder: How best can we keep the lipids within safe limits? Doctor: Low fat diet, restricted saturated fats and regular exercise to burn out the excess of fats and lipids. Elder: Please name some most notorious items of diet, which we should take with caution to keep our lipids within limits. Doctor: Saturated fats like desi ghee, butter and yolk of eggs. Elder: Do you advise extra-diet vitamins for the elders? Doctor: Low absorption of vitamins from a sluggish digestive system in some elders may need a supplement of an antacid capsule containing vitamins A, B, C, E and some minerals to neutralise the harmful radicals generated in the body during metabolism and normally not neutralised due to age. May you all score a century and more!
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Meniscus tear — try conservative treatment
Meniscus in the knee joint can be torn with a twisting injury while suddenly changing direction, especially in sports. The menisci are C- shape cartilages between the joint surface of femur and tibia. The function of the meniscus is to absorb the shock of the knee joint and transmit the load of the impact from the central part of the knee towards the periphery, thereby decreasing pressure on the articular cartilage. Medial meniscus tear is more common than lateral and often associated with anterior cruciate ligament injury. In old age, tear can also occur due to degenerative changes in the menisci. Symptoms include recurrent joint pain, swelling and locking (when a torn fragment is trapped within the joint). The patient may have difficulty in extending the knee and bending as in squatting may be painful or impossible. MRI helps in confirming the diagnosis and provides additional information regarding the ligaments and the articular cartilage. The management of meniscus tear varies depending on the severity of the condition. A small tear or degenerated meniscus can be treated conservatively. On the other hand, a large painful “buckle handle” tear causing a locked knee require arthroscopic surgery. Surgery should also be recommended for those athletes wishing to participate in a high-speed sport requiring constant change of direction and pivoting. Removal of meniscus, i.e. meniscectomy, increases stress, wear and tear within the joint, reducing the shock absorption capacity of the knee by about 20 per cent. Therefore, a trial of conservative management should be undertaken to reduce pain and swelling, increase the range of motion of the knee joint and strengthening the muscles. Non-impact conditioning like walking /stationary cycling, swimming, etc, is encouraged as soon as possible. In case it is difficult to complete a revolution in cycling, then start by rocking pedal back and forth. The exercises
Knee press — This exercise helps in stretching quadriceps muscles. Sit on the floor. Place a small pillow or rolled up towel below the knee. Press it for 15 to 20 seconds and relax. Repeat it for 20 to 25 times. Hamstring stretch — Lie on your back. Raise one leg. Grasp the back of the knee with hands. Pull the leg towards chest. Hold for 15 to 20 seconds. Repeat it five times. Weight-bearing exercises: Wall Squat, lunges, step-up, bridging (bum lift) wobble board, mini-hops, landing drill and leg swings Most meniscus tears do not require immediate surgery and should be treated conservatively. In case there is no relief in pain or locking of the knee, then arthoscopic meniscectomy is the treatment of choice followed by a proper rehabilitation programme. The writer is a former doctor/physiotherapist, Indian cricket team.
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Drug may improve bone density in cerebral palsy NEW YORK Low doses of pamidronate increase bone mineral density (BMD) in children with spastic cerebral palsy with severe movement impairment, according to the results of a preliminary study reported in Developmental Medicine and Child Neurology. All of the children had spastic quadriplegia, a severe form of cerebral palsy characterised by muscle stiffness in all four limbs, the trunk and often the mouth and tongue. These patients often have mental retardation and other problems. The decreased mobility seen in these children leads to bone loss, which puts them at a high risk for fractures. Previous studies have shown that pamidronate, sold in the US and Canada as Aredia, may benefit children with disabilities and bone thinning. However, these children run the risk of developing low calcium levels in the blood, also referred to as hypocalcemia, if dosages are based on the usual adult treatment. In one study, hypocalcemia occurred in 77 per cent of the patients. Dr Horacio Plotkin, from the University of Nebraska Medical Center in Omaha, and his associates studies 23 children with severe cerebral palsy and were unable to walk. At the beginning of the study, the patients’ bone mineral density in the lower spine and hip was well below the norman level for their age. Pamidronate, which is given intravenously, was administered every four months, starting with a low dose to minimise any severe drug reactions.
— Reuters
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HEALTH NOTES WASHINGTON: A study conducted by US scientists has shown that obese individuals suffering from diabetes are three times more at risk of developing critical illness and dying young, as compared to their non-diabetic counterparts. Katarina Slynkova and colleagues from the University of Kentucky Chandler Hospital collaborated with colleagues from Emory University School of Medicine to analyse data from 15,408 subjects aged 44 to 66, coming from four different US communities, who had originally been studied between 1986 and 1989. The authors analysed the subjects’ body mass index (BMI), presence of diabetes (either type 1 or type 2) and their history of critical illness (acute organ failure) and mortality within three years. They found that non-diabetic obese individuals did not have an increased risk of suffering from acute organ failure, and of dying young, in comparison with the non-obese individuals.
— ANI
Alcoholics have greater
decision-making impairment
WASHINGTON: Belgian researchers have found that alcoholics with certain coexisting personality disorders (PDs) have particularly impaired decision-making abilities. The study published in the October issue of Alcoholism: Clinical & Experimental Research reports that impaired decision making is regarded as one of the neurobehavioural hallmarks of addiction. “Normally, we make choices by weighing immediate benefits of different options relative to possible negative consequences in the longer term. When these abilities are impaired, people are less able to cognitively evaluate the longer-term consequences of their choices. This is reflected in real life by choices that are socially inadequate and/or related to overtly negative outcomes. Substance or polydrug use/abuse is one example,” said Geert Dom, head of treatment at the Alexian Brothers Psychiatric Centre in Boechout, Belgium.— ANI
Parents not always aware of
their kids taking drugs
WASHINGTON: A study conducted by US scientists has shown that parents are aware of drug and alcohol use by their children only half of the time, but their observations can be helpful for psychopathologists in recognising this abuse among children. Previous assessments of child psychopathology had shown that parents can be helpful in reporting symptoms of Attention Deficit Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD). But the new study examines just how helpful parents are in assessing their children’s alcohol and drug use.
— ANI
Vitamin C after heart attack improves exercise ability
NEW YORK: Vitamin C (ascorbic acid) supplements
The sympathetic nervous system is a part of the nervous system that controls heart rate and other involuntary body responses. Patients with heart disease sometimes have poor sympathetic function, the authors explain, but whether or not antioxidants can improve this complication remains unclear. Dr Kazuyo Kato and colleagues from Nippon Medical School, Tokyo, investigated whether ascorbic acid influenced the sympathetic response to exercise in 21 men who were studied at least one month after a myocardial infarction.
— Reuters
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Elder:
Doctor, give us a crisp and spicy message on geriatric health care on World Elders’ Day (October 1).