HEALTH TRIBUNE
 

Deadly implications of drug abuse
by Dr Rajeev Gupta
D
RUG abuse takes a heavy toll of its users. As the number of drug addicts is fast rising in the country, it is important for their families and general practitioners to understand the physical problems caused by regular drug abuse. Some of the physical complications are life-threatening and need urgent attention.

Bleeding after menopause can spell disaster
by Dr Meenal Kumar
P
OST-menopausal bleeding represents one of the most common reasons to suspect an underlying cancer in the uterus. Cancer of the reproductive tract is present in approximately 30% to 50% of the patients coming with this complaint. So, this symptom can’t be neglected either by the patient or the doctor.

Partial breast radiation therapy
WASHINGTON:
Partial-breast irradiation is yet to become a sure shot therapy for cancer patients. A paucity of data acts as a hindrance in promising alternative treatment for breast cancer patients, recovering from a lumpectomy.

New test for rheumatoid arthritis
LONDON:
By developing a test to give early warning signals about the onset of rheumatoid arthritis, researchers from Umea University in Sweden have increased the chances that the condition that affects millions of people worldwide can be treated successfully.

Racial bias impairs cognitive performance
WASHINGTON:
A new University of Dartmouth study reveals that inter-racial contact has a profound impact on a person's attention span and performance.

 

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Deadly implications of drug abuse
by Dr Rajeev Gupta

DRUG abuse takes a heavy toll of its users. As the number of drug addicts is fast rising in the country, it is important for their families and general practitioners to understand the physical problems caused by regular drug abuse. Some of the physical complications are life-threatening and need urgent attention. Since the number of drugs or addictive substances used by the addicts is manifold, for the present article, I shall be focussing on important general medical complications caused by their prolonged misuse.

Malnutrition: Most of the drug addicts suffer from moderate-to-severe malnutrition. Their dietary intake is quite poor. They suffer from anaemia and other nutritional disorders. Their poor nutritional status makes them prone to a number of infections, including tuberculosis.

Liver illness: All drugs are metabolised in liver. Regular drug abuse becomes quite stressful for human liver cells. Gradually, they become inflamed and turn dysfunctional at a later stage.

Alcoholics are very prone to developing alcoholic liver disease and finally end up with liver cirrhosis and liver failure. Female alcoholics are more vulnerable to developing alcoholic cirrhosis.

A routine blood check-up of addicts generally shows raised SGOT, SGPT and GGT levels (liver enzymes).

Convulsions: Drug addicts are known to suffer from epileptic attacks. During such attacks they get severe body jerks and may become unconscious and can injure themselves. Convulsions are commonly seen during the drug withdrawal phase.

Unsupervised sudden withdrawal of the drugs can cause serious complications like status epilepticus.

During this state one keeps on getting epileptic fits without regaining consciousness in between. If unattended to it can also turn fatal.

Neuropathy: Drug addicts are known to develop severe neuropathy and complain of numbness of limbs, tingling sensation of hands and feet, and even complain of muscle weakness.

Opium is often contaminated by arsenic, which is known to damage nerve cells.

Sexual dysfunction: Drugs are commonly misused to increase sexual potency, but their regular use causes premature ejaculation, poor erection and complete loss of erection.

Thus, their family life often remains disturbed and become miserable. Finally, many drug addicts become impotent and have severe marital problems.

Kidney failure: Kidney specialists often blame the chronic use of painkillers for causing kidney failure. Many painkillers, narcotic and non-narcotic, are being regularly misused for addiction.

AIDS: Addicts using intravenous or intramuscular injections fall victim to HIV infection because of the use of the contaminated needles and syringes. Drug addicts often share their needles and syringes among themselves.

Sudden death: Death often curtails the life of many drug addicts. In Punjab, drug addiction is becoming an important cause of death among youth. Death can be caused because of overdose of the drug or by an anaphylactic (allergic) reaction. It can also result from sudden cardiac arrest for unknown reasons.

Many drug addicts have a false confidence that they are very strong and will not develop any physical complications. But they should realise that drugs are toxic substances and spare none in the long run.

The writer, a Ludhiana-based psychiatrist, runs a de-addiction centre.
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Bleeding after menopause can spell disaster
by Dr Meenal Kumar

POST-menopausal bleeding (PMB) represents one of the most common reasons to suspect an underlying cancer in the uterus. Cancer of the reproductive tract is present in approximately 30% to 50% of the patients coming with this complaint. So, this symptom can’t be neglected either by the patient or the doctor.

Earlier, the only means of investigation was by dilatation and curettage (D&C), but now newer methods such as outpatient endometrial biopsy, transvaginal ultrasonography and hysteroscopy have come to make the task easier and better.

The family doctor often fails to differentiate the post-menopausal from the peri-menopausal or the patient with dysfunctional uterine bleeding. Many a time excessive bleeding or irregular bleeding after menopause is interpreted as a sign of normal menopause by the patient. This can spell disaster. Consult a gynaecologist. Most patients understand that the investigation of vaginal bleeding at this stage aims to identify cancer.

However, benign conditions like inflammations, benign tumours, polyps, etc, are also frequent causes of bleeding and thus detailed investigations in each case are a must. A negative test should not be taken as a guarantee of normality by the patient.

It is suggested that there are potential risk groups —Hormone users, obese patients with diabetes; women with hypertension; a past history of excess oestrogenism. Examples of the latter include women with early menarche and late menopause. Those who do not bear children are more likely to develop tumours. All women presenting with PMB require a pelvic examination during their assessment. Thickening of the endometrium on ultrasound test indicates the presence of pathology. In general, the thicker the endometrium, the higher the likelihood of cancer.

Any abnormal feature would require further investigation irrespective of the endometrial thickness.

Other methods of endometrial assessment such as transvaginal doppler ultrasonography, three-dimensional ultrasonography, saline enhanced transvaginal ultrasonography and endometrial texture and margin analysis can help further.

Endometrial biopsy can be undertaken using biopsy curette or endometrial samplers. Hysteroscopy and biopsy (curettage) is the preferred diagnostic technique to detect polyps and other benign lesions.

Here are some frequently asked questions

* What is PMB?

Post-menopausal bleeding involves vaginal bleeding following a woman’s last menstrual period. (Bleeding 12 months or more after the last period).

* Why does it need investigation?

In the majority of cases no serious problem will be found, but there are times when bleeding is the first symptom of a serious disease including cancer. If it is diagnosed early, there is a very good chance that the disease can be cured.

* What causes PMB?

The commonest cause is atrophic vaginitis (inflammation of the lining of the vagina due to the lower levels of the circulating hormone oestrogen at this time). Cervical and endometrial polyps are other common findings and they are usually benign. In many cases, PMB will be associated with endometrial (uterine) or cervical cancer.

* How is PMB investigated?

Transvaginal ultrasonography (TVUS) is non-invasive and quite informative. Hysteroscopy uses a thin telescope that is inserted through the cervix into the uterus. They are fitted with small video cameras to allow the operator to visualize the inside of the uterus. Biopsy involves removing a small sample of the womb lining for pathological analysis.

* How accurate are the test results?

TVUS measures the thickness of the lining of the womb and your gynaecologist can interpret the test results. Some cases will require hysteroscopy and endometrial biopsy.

Besides preventive measures, early detection and prompt treatment hold the key to success.

The writer is a senior gynaecologist and menopause consultant, based in Chandigarh.
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Partial breast radiation therapy

WASHINGTON: Partial-breast irradiation is yet to become a sure shot therapy for cancer patients.

A paucity of data acts as a hindrance in promising alternative treatment for breast cancer patients, recovering from a lumpectomy.

According to a report in Health Day News, although many women have already sought out the therapy, its long-term benefits remain unproven.

The therapy requires just a week or less of radiation after breast cancer is diagnosed, instead of the six or seven weeks required for whole-breast irradiation.

Dr Gary Freedman, a radiation oncologist at the Fox Chase Cancer Center in Philadelphia, has urged a cautious approach to tackle the problem.

Although some studies looking at the benefits of partial-breast irradiation five years after treatment have produced acceptable results, the results needed to be tested for some more time.

Bearing radioactive seeds, the therapy is implanted after a lumpectomy into the site from which the tumour has been removed and then delivers radiation to that area only, not the entire breast.

The therapy is proving popular with women who find the short timetable far more convenient and is based on the idea that most recurrences of cancer appear at the site of the original tumour, not other parts of the same breast. — ANI
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New test for rheumatoid arthritis

LONDON: By developing a test to give early warning signals about the onset of rheumatoid arthritis, researchers from Umea University in Sweden have increased the chances that the condition that affects millions of people worldwide can be treated successfully.

Rheumatoid arthritis is caused by the body's immune system attacking the cartilage in its own joints. In many cases, it leads to severe pain and crippled joints, predominantly the hands and fingers. Hereditary factors have been shown to be important in how the disease develops.

The test is based on detecting antibodies produced by patients before they develop symptoms of the disease, says a report in BBC.The test looks for the presence of antibodies produced by the body in response to the presence of proteins. — ANI
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Racial bias impairs cognitive performance

WASHINGTON: A new University of Dartmouth study reveals that inter-racial contact has a profound impact on a person's attention span and performance.

Using brain imaging, the researchers have discovered that white individuals attempt to control racial bias when exposed to black individuals and that this act of suppressing bias exhausts mental resources. Published in the online edition of Nature Neuroscience, the study combines the use of functional magnetic resonance imaging (FMRI), which measures brain activity, with other behavioural tests common to research in social and cognitive psychology to determine how white individuals respond to black individuals. — ANI
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