When women’s mental health is threatened
Dr Meenal Kumar

One in four women aged between 45 and 65 now experience some form of mental disorder. This decline in mental health is greater than any other age or gender group, according to a research study. In another study in Scotland, 85 per cent women experienced psychological problems. In India, such complaints are almost common, but most women suffer silently until their condition deteriorates.

Recently, when Dayalo, 55, was brought to me in a state of total desperation for symptoms of mental depression, headaches, sleeplessness and having lost interest in everything for the last 10 years, she did not know that her problem was related to her entry into the menopausal zone. The high prevalence of symptoms in middle-aged women could be attributed to age, hormonal influence as well as personality. The stigma surrounding mental health may be preventing women from getting help.

"It is worrying that we have seen such a large increase in the number of middle aged women experiencing mental health problems such as depression and anxiety," one expert said. “Women may be finding it difficult to take time out for themselves to take care of their own mental well-being but it's vital that they take their mental health just as seriously as they would their physical health."

Work-related factors such as unemployment and job strain and circumstances within their private sphere such as social network/support system seem equally important for middle-aged women's health status. These findings ought to have important policy implications and also to be of major importance in a primary health care setting.

On their part, the middle-aged women passing through menopausal symptoms like hot flashes, loss of sleep and dry vagina should go to their gynaecologists regularly and should not be worried only about children and husbands. Marital satisfaction, nutrition and inter-personal relations, in particular, cannot be ignored.

There is a four-fold rise in stroke incidence in middle-aged women. This is blamed on increases in their abdominal fat levels, body mass index (a ratio of height and weight that is often used as an indicator of obesity) and blood sugar levels.

Recommendations

l To maintain bone health, all post-menopausal women should consume adequate amounts of calcium (1000 - 1500 mg of elemental calcium per day) and vitamin D (800 - 1000 IU per day).

l For women at a high risk for coronary heart disease, aspirin chemoprophylaxis is recommended.

l Beginning at 40 years of age, women should be screened for breast cancer every one or two years.

l Women who are or who have been sexually active and who have a cervix should be routinely screened for cervical cancer.

l Beginning at age 50, women should be screened for colorectal cancer.

l Regular visit to your gynaecologist is unavoidable.

The writer is a Chandigarh-based senior gynaecologist.

Prolonged numbness — a cause for concern
Dr Ravinder Chadha

Early morning numbness and tingling sensation in the feet and hands are common symptoms which occur due to the pressing of nerves and blood vessels. This usually happens due to a wrong posture while sleeping. Movement, exercises of the feet and hands overcome these symptoms in the usual course.

In the event of persistence of numbness/ tingling sensation, treatment must be sought at the earliest to avoid disability. Peripheral neuropathy is an entity where there is a failure of the nerves to carry information to and from the brain and the spinal cord. These nerves are damaged as a result of diabetes, spinal problems, rheumatoid arthritis, injuries, etc. Symptomatic presentation in such cases is in the form of pain, loss of sensation and inability to control muscles. Neuropathies are essentially multifactorial in aetiology, and determining the exact cause is difficult.

The nerves going to the feet are the longest in the body and are often the first to be affected. However, pain, numbness and muscle weakness can be felt in hips, thighs and buttocks rendering walking difficult. Numbness, though perceived as a benign condition, could be the cause for gangrene requiring amputation in certain cases.

Causes

Diabetes mellitus (diabetic neuropathy).

Dietary deficiencies (especially vitamin B-12).

Spine injuries, canal stenosis, disc prolapsed, etc.

Excessive alcohol usage (alcoholic neuropathy)

Ischemia (decreased blood flow)

Prolonged exposure to cold temperature.

Rheumatoid arthritis, etc.

Symptoms depend on type of nerves affected. Neuropathy can affect any nerve separately or in combination (involving all three types of nerves).

l Tingling / burning in toes, feet, legs, fingers, hands/ arms.

l Numbness or loss of sensation.

l Sensitivity to heat and cold?

l Sensitivity to light touch.

l Loss of coordination or balance while walking.

l Pain / cramping/muscle weakness.

l Loss of muscle bulk.

Treatment

Remaining safe is a priority in cases of individuals afflicted by neuropathy. Reduced sensation and muscle control increase the risk of falls and other injuries. It is advisable to check feet or other affected areas regularly for bruises, raw areas, or other injuries, which might go unnoticed (due to decreased pain/ sensation)

Medications in the form of analgesics do ameliorate acute pain.

Exercises

Help maintain muscle strength, joint mobility and blood circulation to the affected areas. Stretching and strengthening exercises help maintain length, tone and flexibility of the muscles.

Cycling, swimming exert the minimal impact on feet/ legs. These are good exercises. In individuals who can tolerate some mild impact only, walking can promote aerobic fitness, circulation, etc.

While sitting one can perform various exercises:

l Toe clawing with the heel forward and then extending the toes.

l Foot shortening (arch raised) while the toes are still on the floor.

l Picking up duster/marbles.

l Tower curls — place a wet towel on the floor and then curl the toes to pull the towel towards the heel.

Calf stretch: Keep the injured leg back and place hands against the wall. Lean forward towards the wall until you feel a stretch at the back of the calf. Hold for a count of 15. Repeat three times.

These exercises can be followed by strengthening exercises with a stretch band.

Due to numbness it is difficult to appreciate blisters/injuries which could be inflicted by ill-fitting shoes. The importance of well-fitted shoes to prevent any injury or infection cannot be undermined.

To prevent neuropathy, it is advisable to be disciplined in life. A well-balanced diet, drinking alcohol in moderation and keeping diabetes, hypertension and weight under control go a long way in cutting down the risks manifold.

The writer runs a pain management clinic in Chandigarh. E-mail-chadha_r2003@yahoo.co.in

How to handle a stuttering child
Dr Vivek Sharma

Stuttering, or stammering as it is also known, is a speech that is interrupted by stoppages and disruptions in fluency. The stoppages sometimes take the form of repetitions of words, sounds or syllables, or sometimes complete silence when the next word just won’t come out.

Fluent speech requires timely synchronisation of phonetary and articulatory muscle groups. Stuttering often leads to frustration and avoidance of speaking situations.

Stuttering usually begins at three or four years of age and is seen more often in males. Approximately 3-5 per cent of pre-school children stutter to some degree. Young adults who stutter are very few. The problem of stuttering is hereditary and tends to run in families.

Females and those with a history of recovery in the family are most likely to have spontaneous recovery by adolescence. This recovery is not related to the severity of stuttering.

Identifying signs

Stuttering must be differentiated from the normal developmental dysfluency among pre-school children.

In normal developmental dysfluency, the frequency of syllable repetitions, vocal tension and normal tension are absent. There is no reaction to stress, and the articulating posture is normal. Frustration is not there and eye contact is normal.

But in stuttering, the frequency of syllable or word repetition is faster than normal, vocal tension is often apparent, and normal tension is present during talking. More broken words can be noticed during stress, and the articulating posture may be inappropriate. Frustration may also be present and eye contact may waiver.

Some tips

l Slow down your own speech so that your child feels less rushed.

l Slow down your replies to your child — have a short pause before launching into an answer.

l Look at your child as he/she speaks and show that you are interested in what he/she is saying. Make sure that you keep eye contact going even if his/her speech is slow.

l Don’t madly question your child like when he or she comes home from school and you are keen to know what happened during the day. Too many questions can put pressure on a child. So, given him/her time to answer everything thoroughly, without having to rush.

l Make sure that your child gets a good night’s sleep as stuttering can be made worse by lack of sleep.

l Don’t treat a child who stutters differently from his/her siblings. If he misbehaves, give the same punishment that you’d give to other children.

l Remember to praise your child when he/she achieves anything and let him/her know that you love them.

The writer is a Consultant Paediatrician at Rungta Hospital, Jaipur. Email drvivek_sharma@rediffmail.com

Exercise and stop smoking to ‘stay sharp’
John von Radowitz

A recipe for staying sharp in old age has been uncovered by scientists who studied more than 2,000 men and women through their seventies and eighties.

The four key factors involved in preventing mental decline were found to be exercise, education, social activity and not smoking.

Researchers carried out a series of memory and mental tests on 2,500 men and women aged 70 to 79 over a period of eight years.

Just over half the participants showed a normal rate of age-related decline while 16% suffered a major reduction in their mental faculties.

However, 30% of the study volunteers remained unchanged and in some cases even showed an improvement in performance over the years.

The researchers then examined what lifestyle factors stood out among those people who were able to remain quick-witted in old age.

Study leader Dr Alexandra Fiocco, from the University of California at San Francisco, said: "To this day, the majority of past research has focused on factors that put people at greater risk to lose their cognitive skills over time, but much less is known about what factors help people maintain their skills."

The research, published in the journal Neurology, revealed a unique profile that distinguished people who avoided mental decline with the passing years.

Those who exercised moderately or vigorously at least once a week were 30% more likely to "stay sharp" than people who did not.

Individuals with a good education were nearly three times more likely to maintain their mental faculties than those with less education. Likewise, high levels of literacy were associated with a five-fold better chance of side-stepping age-related mental decline.

Non-smokers were nearly twice as likely to remain mentally fit than smokers. And people who were socially active — either by working or volunteering, or by living with someone — were 24% more likely to avoid mental deterioration in later life.

"Some of these factors such as exercise and smoking are behaviours that people can change," said Dr Fiocco. "Discovering factors associated with cognitive maintenance may be very useful in prevention strategies that guard against or slow the onset of dementia. These results will also help us understand the mechanisms that are involved in successful ageing.

— The Independent

Health Notes
Cigarette smoking does not affect everyone
in same way

London: Cigarette smoking induced COPD, or chronic obstructive pulmonary disease, does not progress in the same way in all smokers, a new study has found.

COPD, a disease that results in severe breathing difficulty, is the fourth leading killer worldwide, according to the World Health Organization (WHO).

However, the mechanisms responsible for some smokers developing COPD and others evading the disease have not been well understood. — ANI

New nanoparticle may revolutionise heart disease treatment

Washington: Scientists in America have developed a nanoparticle that may prove very helpful in treating cardiovascular disease. Scientists and engineers at UC Santa Barbara, who have done this work with researchers from other places, say that the novel nanoparticle can attack plaque, a major cause of cardiovascular disease.

In a research article, published in the Proceedings of the National Academy of Sciences, the researchers have revealed that the focus of their study was atherosclerosis, in which plaque builds up on the walls of arteries and can cause heart attack and stroke. — ANI

Blacks at higher obesity risk associated with short sleep

Washington: Blacks are at greater risk of obesity associated with short sleep than whites, according to a new study. The study showed that short sleep was associated with obesity, with the adjusted odds ratios for black Americans (1.78) and white Americans (1.43) showing that blacks had a 35 per cent greater risk than whites of obesity associated with short sleep.

The prevalence of obesity (body mass index of 30 or higher) was 52 per cent for blacks and 38 per cent for whites. The prevalence of short sleep (5 hours or less) was 12 per cent for blacks and 8 per cent for whites. — ANI