HEALTH TRIBUNE Wednesday, March 12, 2003, Chandigarh, India

Respiratory health: the warning triad
he symptoms of cough, sputum and breathlessness, either individually or in combinations, are almost "normally" present in milder forms. It is not uncommon for a healthy individual to cough and even produce some degree of sputum on a winter morning. 

High and dry ‘vata’ personality
enturies ago, Acharya Vagabhatta, one of the leading lights of ayurveda, while compiling the principles and practices of this ancient system, wrote the famous line, "tatra ruksho laghu sheetah, khara suksmo chalo anilah".

Orthodontics for you and me




Respiratory health: the warning triad
Dr S.K. Jindal

The symptoms of cough, sputum and breathlessness, either individually or in combinations, are almost "normally" present in milder forms. It is not uncommon for a healthy individual to cough and even produce some degree of sputum on a winter morning. All of us also get breathless when an unaccustomed activity is performed. One generally tends to ignore these symptoms attributing their origin to a seasonal change, inhalation of dust and smoke, old age or cold exposure. But this symptom triad may reflect the status of the respiratory health — normal or abnormal.

Cough of common cold is of short duration and often accompanied by symptoms of coryza such as malaise, fever, sneezing and the running nose. It is usually viral in origin and needs no specific treatment. Dry cough may also follow the inhalation of irritant gases, fumes, dusts and smokes.

Tobacco smoke is one of the most important causes of chronic cough. It induces cough by both irritant and chemical actions on the airways. Smokers' cough is a nuisance symptom. It is common to see a smoker inhaling smoke and coughing repeatedly. In fact, both the smoker and those in his close company get so habituated to the noise of coughing that it is unnoticed and often denied.

Chronic cough may indicate the presence of chronic brochitis (chronic inflammation of the airways) and/or emphysema which are about 10 to 20 times more frequently prevalent in smokers. Collectively called as the chronic obstructive lung disease, it is an important cause of chronic respiratory disability, failure and death.

When accompanied by sputum production (expectoration), cough is said to be productive. While small quantities of sputum may arise from hyper-secretion of the mucous glands, large and thick or tenacious sputum is more serious. This may follow an episode of severe pneumonia or other lung infections. Formation of a cavity or an abscess is a common sequela of a poorly or inappropriately treated lung infection. A severe childhood infection can damage the airways and become a chronic source of cough and expectoration — a condition known as bronchiectasis. Tuberculosis is an important cause of unrelieved cough persisting for several weeks. But all cough is not tuberculosis, and tuberculosis may not always manifest with cough.

Another mechanism of smoking causing coughing is more serious. It is the lung cancer which occurs in smokers, more than 20 times frequent than in non-smokers. Any aggravation of coughing as change in its behaviour in an elderly smoker should always alarm the patient, as well as the doctor about the possibility of such a complication.

Patients with bronchial asthma may also complain of cough with or without breathlessness and and wheezing. This can be suspected when the cough does not respond to treatment with routine cough sedatives and expectorants unless anti-asthmatic drugs are also instituted. Asthma remains an important cause of episodic breathlessness throughout life. In the middle aged and the elderly people, however, attacks of breathlessness can occur due to the presence of heart failure or other serious problems. The patient is generally more seriously ill in such a condition.

Chronic obstructive lung disease is another common problem which causes difficulty in breathing in adults. Often ignored in the beginning, it gradually progresses and leads to early respiratory disability and failure. In later stages, it makes the person a respiratory cripple who is constantly gasping for breaths. Most other diffuse lung diseases may also present similarly. In fact, it represents one of those helpless situations for a doctor where even palliation with anti-anxiety drugs or sleeping pills cannot be offered. The sedative drugs may prove to be risky.

Breathlessness need not be associated with serious illness even if it is chronic. Simple obesity is an important cause. Breathlessness of obesity is akin to that of a person with an optimum weight carrying an extra load all the time. Besides posing limitation on activities, it leads to serious health problems after a few years. Marked obesity is a recognised cause of respiratory failure which again is preventable and partially reversible.

Breathlessness may also occur due to the deficiency of blood in conditions of anaemia. Improvement of haemoglobin will be associated with relief from dyspnoea.

In the absence of an organic illness, breathlessness can occur in a highly anxious and tense individual. Getting out of breath during an episode of acute anxiety is experienced by every individual. But it may manifest as a symptom of hidden anxiety. An individual with a more dependent personality, especially a child, is known to develop episodes of fast and apparently laboured respiration. Like most other hysterical phenomenon, this is generally meant to achieve a secondary gain and can be relatively easily handled.

It is a common misconception that all types of breathing difficulties are potentially treatable by exercise It is tricky situation. Exercise, no doubt, is of paramount importance for a healthy, sedentary or obese individual who needs to increase his breathing capacity. On the other hand, any undue exertion for a person with an underlying cardiac or lung disease should be undertaken only great caution. It may over-burden the already strained system. Even breathing exercises may compromise the lung function and aggravate the problem.

Treatment of any or all of these symptoms depends upon the underlying cause. Their presence need not cause panic, but their persistence should certainly signal the need to seek medical attention — the earlier the better.

The writer is Professor and Head, Department of Pulmonary Medicine, PGI, Chandigarh.


High and dry ‘vata’ personality
Dr Ravindra Vatsyayan

Centuries ago, Acharya Vagabhatta, one of the leading lights of ayurveda, while compiling the principles and practices of this ancient system, wrote the famous line, "tatra ruksho laghu sheetah, khara suksmo chalo anilah". This Sanskrit verse lists the main qualities of vata as dry, light, cool, rough, subtle and mobile. A combination of air and space elements, vata is the most important of the three body humors.

According to ayurvedic physiology, vata is the psychosomatic force of initiation and transmission. It supports mind, heart, the nervous system, sense organs and intelligence and governs the process of respiration. Besides regulating enthusiasm, it initiates the thought process and sends impulses to body organs. As a symbol of kinetic energy, vata is also responsible for body movements, transportation of food even to the minutest cell. It also segregates and expels wastes from the body.

Vata prakriti means that the qualities of vata are predominantly expressed in the mental and physical make-up of a person. Vata people are usually light and lean individuals with thin, dry and cold skin and prominent veins. They have thin, dry and cracking joints and tend to have a variable and erratic appetite. The cold quality of vata manifests itself in making them feel cold more easily with a craving for warmth. Talkativeness, inconsistency and low endurance are their other hallmarks.

The vata mental frame also typically represents its qualities. However, three gunas — satva, rajas and tamas — give good and bad bent to these qualities. Generally, vata people are mentally changeable, enthusiastic, excitable and indecisive. They are quick both at attachment and detachment and are fast at getting emotional and revealing secrets. They also have a light sleep pattern with flying, moving and restless dreams. With a good but selective memory and subtle thought process, they make good artists, critics and writers. The mobile quality of vata makes them to weave many fantasies, besides giving them an impulse to do a hundred jobs at a single time. Due to the lack of courage and consistency and a tendency towards cowardice, vata people do not make good leaders.

Vata persons are easily exposed to diseases which are identical to the qualities of vata as a body humor. Their most problems revolve around constipation and abdominal gas. However, vata people are more prone to getting dryness of the skin, migraine, arthritis, brittleness of bones, weakness of limbs, palpitation, sleeplessness and exhaustion. Vata ladies experience irregularity of the menstrual cycle with frequent body cramps. The majority of vata personalities also suffer from anxiety, restlessness and nervousness. Stress easily catches on them and adds to other allied problems.

Ayurveda, while discussing regimes and routines for each body type, has elaborated a specific diet plan and lifestyle modifications for the vata people. They are advised to prefer food items having sweet, sour and salty tastes and should take less of the eatables having pungent, bitter and astringent tastes. Vata individuals do well to have a warm, unctuous and freshly cooked food and can use butter or ghee in moderation. To avoid constipation, they are advised to choose whole meal cereals and fibre-rich diet , but should shun food which is sticky or dry. It is usually seen that fruits rather than fruit juice suit them. Ashwagandha, amla, sonth and triphla powder are best recommended herbs for the system of vata people.

Since vata persons have a low stamina and a weak immune system, they are advised not to overindulge in any activity which may leave them drained and exhausted. Going for a small walk or doing a mild exercise or adopting easy yoga postures followed by a body massage with sesame oil is the best way to start their day. Irregularity of routine and late night engagements should always be avoided as these activities create rebound vitiation of the vata humor in them. They should practice to control their emotions by not over-reacting to situations. (Next fortnight - Characteristics of pitta prakriti).

The writer is a senior ayurvedic consultant based at Ludhiana. Phones - 2423500, 2431500. E mail -

Orthodontics for you and me
Dr Sarabjeet Singh

What can orthodontics do for you?

  • Increase self-esteem by improving appearance.

  • Decrease the likelihood of gum disease and premature loss of teeth by relieving stress on gums and bones which results when teeth do not meet properly.

  • Eliminate speech problems caused by protruding or malaligned teen.

  • Help reduce and treat jaw joint difficulties — TMJ.

  • Lower the incidence of decay in crowded, overlapping teeth which can become food trap areas.

  • Help correct poorly grown jaws in adults with a combination of orthodontics and jaw surgery.

  • You may avoid developing a breathing problem — sleep apnea.

When in the best time to start orthodontic

Although there is not a universal best age to begin orthodontic treatment, the American Association of Orthodontics (AAO) recommends that all children see an orthodontist by age seven. This does not mean all children will need treatment at this age, but this allows an orthodontist to assess individual cases to determine who could benefit from early intervention.

What about the treatment for adults?

Braces aren’t just for kids anymore. Today, more than one out of every four orthodontic patients is an adult. However, because an adult’s facial bones are no longer growing, certain conditions cannot be resolved with braces alone. Sometimes surgery is required to obtain the correct result.

Health concerns are often the primary consideration for adult treatment. Orthodontic treatment may help prevent many serious potential problems such as tooth decay, gum disease and eventual tooth loss. Contrary to popular belief, wearing braces will not interfere with an adult lifestyle. For patients where appearance is of paramount importance, clear braces are available.

How long does orthodontic treatment take?

Treatment time depends on the severity of the problem, the cooperation of the patient and the growth of the patient’s facial structures. It will take longer if the patient does not do what the orthodontist tells him to do or if there is something unusual about his bite.

Do braces hurt?

It matters what kind of braces you use. Old-fashioned braces will hurt a lot. However, if you get modern braces, they will not hurt except when they are first put in or when your braces are tightened and that too for a very short time.

What kinds of braces are there?

Braces come in lots of different sizes and colours. First, there are old-fashioned braces which are big and clunky. They can cut your lips and are generally uncomfortable. Then there are modern braces, which are smaller and more comfortable than old-fashioned ones. They have what is called a low-profile design, which is less irritating to your lips. They also have special contours to make your orthodontic treatment go faster and be less painful.

Are there any dietary restrictions with braces?

The patient is advised to have soft diet for the first few days after putting braces, because of slight discomfort and mild pain. Later on, except for biting very hard things (nuts) the patient can have a normal diet without any problem.

The writer is a Chandigarh-based orthodontist and a former Senior Resident, PGI.



Like master, like dog

LONDON: The old saying that dogs tend to look like their masters could finally be proved right as obesity has now been declared the biggest health problem for British canines.

Obesity has been declared an epidemic in the USA and is also reaching huge proportions in Europe. In South Africa it is estimated that two-fifths of all adults are obese. Unhealthy lifestyles seem to be rubbing off on our furry friends too, according to a report in News

A study conducted by the Chartered Society of Physiotherapy (which deals with both canines and humans) found that obesity was the number one health problem faced by dogs in Britain, followed by traffic and disc problems. ANI

Deadly combination

WASHINGTON: Eating fast food and watching TV might do more bad than good. A new study has found that the combination adds up to a high risk for obesity and diabetes.

"Fast food consumption in this country has increased dramatically. The association between eating fast food and the incidence of obesity and abnormal glucose control has not been thoroughly examined before", said Mark Pereira, Assistant Professor of Pediatrics at Harvard Medical School and children's hospital in Boston.

Researchers found that eating fast food meals more than twice a week was associated with double the risk of abnormal glucose control and a 50 per cent increase in the risk of obesity. In addition, frequent fast food meals and hours spent watching TV combined to increase the odds of obesity and abnormal glucose metabolism. ANI

‘Missing eye’ in babies

LONDON: Researchers at the Human Genetics Unit in Edinburg have found that mutations in a particular gene may be the cause of a devastating condition that leads to babies being born without eyes.

Bilateral Anophthalmia is rare, affecting approximately one in every 100,000 births. It happens when the foetus simply does not develop eyes in the normal way during the first 28 days of pregnancy. The babies are born with empty eye sockets and are often fitted with prosthetic eyes to allow normal facial development, according to a BBC report.

According to the researchers, at least some cases may have their roots in a mutation of a gene called SOX2. The research, published in the journal Nature Genetics, will reassure parents who fear that the blindness could have been their fault. ANI

Gout on the rise in UK

LONDON: Once dubbed the "disease of kings", gout is now becoming more prevalent among the commoners. However, despite the fact that 250,000 people in the UK are thought to have gout, a recent survey showed that fewer than 2 per cent understood key facts about it and only 1 per cent knew it was a form of arthritis, according to a BBC report.

Consultant rheumatologist Dr Michael Snaith said gout was definitely on the increase but warned that the type of sufferers was changing. "In the 17th, 18th and 19th century you had the wealthy people who were over-indulging. Now it is the less wealthy who over-indulge. They eat more and they drink more, but it is the better educated who look after their health better", Snaith said.

He also said that those who ate healthy diets were less likely to suffer from gout, unless their was a family history of the condition. ANI