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| HEALTH & FITNESS |
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‘Gutka’ chewing causing incurable disease
Hip joint arthritis: how to avoid surgery
Heart ailment: is the option stent or surgery?
Health Notes
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‘Gutka’ chewing causing incurable disease “Gutka” is a powdery mixture of arecanut (supari), lime and tobacco. Arecanut triggers the synthesis of collagen, a tough, fibrous protein that stiffens the muscles of the mouth. The mouth size shrinks. In extreme cases, only a button-size opening is left. Studies have shown that it contains a substance which can transform ordinary human cells into uncontrolled cancer. There is no record about the incidence of submucous fibrosis in India. But there is a definite increase in the number of patients suffering from submucous fibrosis. Scientific studies regarding submucous fibrosis have highlighted three points. Firstly, it has been proposed that this epidemic is spreading very fast, particularly in the younger population. Secondly, it has been established that the arecanut is the main cause of this serious disease. Once this disease develops, there is no specific cure. Thirdly, the studies show that this disease has a high association with the further development of oral cancer. Patients with mucous fibrosis have 400 times greater risk of developing oral cancer. It has been proved that the cancer of the oral cavity is the most common cancer in our country. This is because of widespread use of tobacco. In future, we may face an epidemic of oral cancer if measures are not taken urgently . There is no specific treatment for submucous fibrosis. The difficulty in opening the mouth (truisms) can be reduced to a certain extent by local injections of steroids or by surgery. The adage “Prevention is better than cure” is fully applicable in this condition. The following points are to be taken care of :
The writer is Professor and Head, Department of ENT, Government Medical College and Hospital, Sector 32,
Chandigarh.
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Hip joint arthritis: how to avoid surgery Osteoarthritis
of the hip joint is probably one of the worst conditions to be endured by any individual, as it affects the quality of life tremendously. Hip arthritis is marked by the progressive loss of articular cartilage, causing narrowing of the joint space. This leads to pain and stiffness. Putting on socks and shoes also becomes an uphill task. Rheumatoid arthritis could also affect the hip joint as could certain childhood conditions. Long-term effects include reduction in the contact area between the femur and acetabulum. This eventually causes shortening of the lower limb. Prior to this deformity, one could initially experience a bit of discomfort and stiffness in the groin, buttocks or thigh on waking up in the morning. Symptoms:
Treatment: Reversing the effects of osteoarthritis is difficult. However, early non-surgical treatment may help avoiding pain and disability and slow down the progression of the disease. Surgery is the answer if the condition is already severe and the patient feels pain even during daily activities like wearing shoes, walking, etc. Analgesics are of limited use due to their numerous side-effects like dyspepsia, ulcers and liver toxicity. However, acetaminophen (paracetamol) tablets can be taken two or three times a day. Glucosamines are useful in certain cases due to their action on articular cartilage. A cane in the opposite hand helps unload the hip significantly. The cane should reach the patient’s hip pocket while wearing shoes. Significance of limiting activity: In individuals suffering from hip arthritis, the more one walks the more the hip hurts. In due course, running, playing and eventually even walking may become impossible. Use an elevator instead of stairs, and avoid long walks that cause pain. However, “saving the joint” by becoming totally sedentary will not slow-down the progress of arthritis. Ideally, one should try remaining as active as pain permits. Aerobic activity: Walk as much as possible without inflicting excessive pain. Patients of hip arthritis (with mild symptoms can conveniently walk for 45 minutes five times a week. Individuals with moderate to severe symptoms should be encouraged to walk with a cane, walker, etc. The initial duration could be five minutes, increasing once to several times per day to 45 minutes. Ideal all-round exercise is swimming. Water relieves the stress on the hip as one “walks” about at the shallow end in the pool. Cycling (stationary or mobile) is also well tolerated. Overweight individuals on losing weight could also decrease pain. Stretching and strengthening exercises are extremely beneficial in improving the range of motion. The following exercises are crucial to stretch and strengthen the hip muscles but should not be done after hip replacement surgery. Leg
rotation: Lying on the back, straighten the affected leg with toes pointing towards the ceiling and bend the other leg. Rotate the leg/foot clockwise and anticlockwise. Repeat it 10 times with each leg. Leg
raise: Standing next to a chair for support, raise one leg to the front as far as possible. Lower it and repeat it 10 times. Then move the leg from side to side 10 times. Straight leg
lift: Lie on the back, bend the unaffected leg, and straighten the affected leg as high as possible. Return to the starting position and repeat it 10-15 times. Knee to chest
lift: Lie on your back with both knees bent. Bend the affected leg at the hip by bringing the knee as close to the chest. Return to the starting position and repeat it 10 times. Strengthening
exercises: Lie on your back and loop elastic band over the ankles. Spread your legs as apart as possible. Repeat it 5-10 times. Osteoarthritis of the hip is, in fact, a debilitating disease which should alert both the patient and the doctor to initiate early non-surgical intervention. The writer is a former doctor/physiotherapist, Indian cricket team.
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Heart ailment: is the option stent or surgery? The real dilemma starts when one is found to be having significant coronary artery disease, which requires interventional treatment. As of now, two types of interventions are available (both are invasive and require hospitalisation). There can be situations where both angioplasty and bypass surgery can be offered as treatment of course, bypass surgery is the solution in any type of situation. Angioplasty means the diseased area of coronary artery is repaired by dilating that portion with a balloon catheter, and these days to support the weak dilated wall of the artery, a stent is put in place for better long-term patency rates. Bypass surgery is where surgically the diseased part is bypassed with a new route of blood supply via a graft taken from the human body only in the form of a vein or an artery. Angioplasty is less invasive than surgery as it is done under local anaesthesia and there are no major incisions. Bypass surgery has also become less invasive in terms that it is being done on beating heart and no longer the heart is arrested to carry out these grafts. So, the stressful effect of the heart-lung machine
on the body is gone and recovery is much faster. Bypass surgery is beyond doubt a long-term, time-tested solution which improves the quality of life, prevents sudden heart attacks and freedom from a second procedure is great. In the case of angioplasty with stents also the quality of life improves but the other two factors do not hold good. If the stent fails or blocks again, it will lead to a fresh heart attack and the chances of blockages a second time are more with stents where a second procedure may be required early. Even the new generation medicated or drug-coated stents have over 9 per cent re-blockage chances during the first year only. The procedure is beneficial only on a short-term basis. The great father of interventional cardiology, Dr Andreas Gruntizg, who died prematurely in a plane crash at the age of 46, stated in 1979, “We estimate that only about 10-15 per cent of candidates for bypass surgery have lesions suitable for angioplasty. A perspective randomised trial will be necessary to evaluate the usefulness in comparison with surgical and medical management”. So, stent or surgery is not or should not be a physician’s choice. It should depend on what the disease demands, keeping in view the long-term benefits and the cost involved. Pros and cons of both procedures should be made aware to the patient in detail. Durability of treatment rather than a short stay should be the goal and an important factor for deciding the treatment. The best way to remove this dilemma is to have a multidisciplinary team consisting of a physician, a cardiologist and a
cardiac surgeon to decide about the treatment plan for the coronary artery disease in a particular patient on an individualised basis. The writer is Senior Consultant Cardiac Surgeon, Fortis,
Mohali.
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Heavy drinking increases heart attack risk As part of the study, researchers conducted a prospective cohort study of 64,338 men who participated in the 1991 China National Hypertension Survey. At baseline, all of the men were over 40 years old and free of stroke. They provided information about their demographic characteristics, medical history and lifestyle risk factors, including alcohol consumption. Those who said they consumed more than 12 drinks per year were defined as drinkers, and then quantified the number of drinks they had each month.
— ANI Why green tea helps prevent DNA damage Washington: Green tea, garlic, onions, fruits and vegetables might help prevent cancer, cardiovascular diseases, Parkinson’s and Alzheimer’s, for they contain antioxidants that neutralise DNA damage, which is often linked to these diseases, a Clemson study has found. DNA damage occurs when metal ions in the body such as iron and copper produce reactive oxygen compounds that damage human cells. As part of the study, Julia Brumaghim and colleagues showed the new mechanism for antioxidant activity, as the antioxidants bind to naturally present iron and copper in the body to prevent the formation of reactive oxygen compounds that damage DNA. “Our studies have shown that antioxidants even at low concentrations found in these foods bind to iron and copper and prevent DNA damage,” Brumaghim
said. — ANI Obese men more likely to die of prostrate cancer London: Obese people might be less likely to develop prostrate cancer but are also less likely to survive the disease, a new study has found. The study was conducted by researchers at Sweden’s Umea University who analysed 784 men as a part of their research. Exactly 392 men had been diagnosed with prostate cancer, while the other equal number were healthy men. The researchers found that obese men were not only more likely to die of prostrate cancer, but were also more likely to develop an aggressive form of the disease which was likely to spread to other parts of the body. “The suggestion that obese people are less likely to develop prostate cancer is provocative,” the BBC quoted lead researcher Dr Par Stattin, as saying.
— ANI Fruits, vegetables colouring compounds might fight cancer As part of the study researchers retrieved anthocyanins, compounds that give colour to most red, purple and blue fruits, from some relatively exotic fruits and plants, including grapes, radishes, purple corn, chokeberries, bilberries, purple carrots and elderberries and tested them on rats and on human colon cancer cells. Researchers noted that in some cases, slight alterations to the structure of anthocyanin molecules
made these compounds more potent anti-cancer agents. — ANI
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