HEALTH & FITNESS

Surgery on the elderly: the complications
T
he incidence of various diseases, including cancer, increases with age. The number of elderly patients requiring surgical intervention can be expected to rise markedly in the coming decades.

Ignorance about brain strokes
T
hough experts have clubbed brain strokes with cancer and heart diseases as the leading causes of morbidity and mortality among the elderly, these are not rated high on the severity scale of the common people.

Vitamin E does not reduce heart disease risk
Washington:
Vitamin E supplements have been found ineffective in lowering the risk of heart disease. According to WebMD, a review of a separate research on Vitamin E in the treatment and prevention of heart disease has shown that Vitamin E has no significant effect in reducing the risk of a heart attack, a stroke or any other heart-related death.

Babies born slightly early are at risk
CHICAGO:
Babies born a few weeks prematurely are at increased risk of health problems, such as jaundice and low blood sugar. So, expectant mothers should not hasten delivery, researchers say.

Body massage for migraine
Wellington:
A soothing massage can help you keep the migraine at bay, reveals an Auckland University study. According to The New Zealand Herald, a research done by doctoral student Sheleigh Lawler has found that a regular upper body massage can reduce migraine attacks substantially.

Golf for healthy heart
Washington:
If you thought that golf was a leisure game, think again! For now, researchers have revealed that playing the sport is good for your heart and health in general. A study published in this month’s issue of the Harvard Men’s Health Watch, a publication of Harvard Medical School, says that the walking one does while playing golf is the key to securing health benefits from the game.

Ayurveda & you
Herbs in the Indian kitchen
A
part from helping proper digestion and absorption of food, herbs and spices used in our kitchen offer a number of other health benefits. Since ayurveda considers medicine and diet complimentary to each other, it becomes all the more important for us to have basic knowledge of some of the herbs we use as spices in our day-to-day life.

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Surgery on the elderly: the complications
by Dr J.D. Wig

The incidence of various diseases, including cancer, increases with age. The number of elderly patients requiring surgical intervention can be expected to rise markedly in the coming decades.

Treatment decisions are very complex as older patients may have concurrent disease, restricted physiological reserve, limitation in physical functioning, disabilities, or other age-associated problems. There is a particular need to understand in greater depth the influence of aging and old age in many important scientific areas with various age-related functional limitations.

Cormorbid illness increases with age and the presence of other life-threatening illnesses can compromise the ability of a patient to endure the stress of disease and its treatment. Adequate preoperative planning, scheduling surgery electively as opposed to emergency and improving nutritional status may be helpful. Emergency procedures are associated with a higher mortality rate and are challenging problems.

Elderly patients are more vulnerable to emergency operations because of the overall decrease in the reserve. Early surgical treatment should be considered wherever indicated. Delaying surgery just because of a patient’s age is not recommended. There may be insufficient time for preoperative improvement. The goal should be to optimise symptomatic complaints as much as possible prior to surgery.

The most common comorbidities are chronic obstructive lung disease, anaemia, cardiac conditions, hypertension, gastrointestinal problems and arthritis. They may have a number of comorbidities affecting more than one organ system. There is a close association between comorbidity and mortality — certain comorbidites like kidney failure, liver disease, and cerebrovascular disease are associated with higher mortality.

The incidence of coexisting disease rises steadily with age. Comorbid illnesses influence disease course, treatment-related side-effects, mortality, and the quality of life. Comorbid illness may cause a reduction of standard treatment during dosing and may aggravate side-effects. Treatment may place the older patient at risk for medical exacerbation of comorbid illness. Length of stay, complications and mortality rates are significantly influenced by the presence of coexisting heart or lung disease.

Treating post-surgery pain in an elderly patient requires an understanding of normal changes associated with aging and the impact on medications. These patients often require a tight balance between excessive dosing with consequent adverse effects such as respiratory depression and inadequate pain relief. Factors that directly influence pain management include cognitive functions, heart disease, pulmonary impairment and kidney and liver functions. Adverse effects of opiods such as nausea, vomiting, urinary retention and respiratory depression can lead to significant complications. Dosing in the elderly patient thus can be a real challenge.

Any local anaesthetic used to block pain transmission may result in difficulty with balance or the patient may be unable to ambulate safely. Post-operative agility is a key factor in assessing the advisability of a block for post-operative pain relief. It is important to carefully devise a post-surgery pain management plan based on the individual needs of the patient. It is advisable to start low and go slow.

Increasing age seems to have adverse effects on the outcome of surgery. Results of elective surgery in elderly patients seem largely formidable. Emergency surgery is associated with a threefold increase in morbidity and mortality. An emergency operation requires an extended hospital stay and greater need for post-operative care in elderly patients. Most deaths after emergency surgery result from the complications of co-existing heart or respiratory disease or thrombo-embolic complications.

The care of elderly patients presents significant challengers. They often do not show typical signs and symptoms of a disease, making timely and accurate diagnosis more difficult. They have the loss of physiological reserve, decreased resilience, and poor response to stresses. Comprehensive assessment may help identify new and treatable conditions, thus improving diagnostic accuracy and the quality of life. Comorbid illnesses do play a role in survival. The goal should be to maintain a good quality of life.

The writer is Professor and Head, Department of General Surgery, PGI, Chandigarh.
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Ignorance about brain strokes
Neelam Sharma
Tribune News Service

Though experts have clubbed brain strokes with cancer and heart diseases as the leading causes of morbidity and mortality among the elderly, these are not rated high on the severity scale of the common people. Neurologists, however, suggest that all those above the age of 40 years need to remain highly careful to keep the chances of brain stroke at bay.

Just to draw a comparison of severity between the brain stroke and the heart attack, neurologists prefer to call it as ``brain attack’’ as they say that in both heart attack and brain attack cases, a lot of stress is laid on early intervention and treatment.

The awareness about the disease may be low, but its prevalence is not. For, the brain stroke hotline at the PGI, Chandigarh, receives on an average 10 calls a day of suspected brain stroke cases where patients urge the hospital to keep their teams ready for prompt treatment.

``Normally persons above the age of 40 years are more susceptible to brain stroke, but those already suffering from hypertension and with high cholesterol levels need to take extra care. We have also observed that the lack of physical exercise and smoking increase the risk levels among the patients,’’ says an Assistant Professor at the PGI’s Department of Neurology, Dr Parampreet Singh Kharbanda.

Emphasising on prompt treatment, he adds, ``The first few hours in brain stroke cases are the most crucial for the control and treatment of the patient. We consider the first two hours as the golden period when the stroke can be controlled and treated. If the time lapse of more than three hours is between the stroke and the treatment, most of the damage is already done.’’

Common symptoms of a brain stroke:

l Weakness in the body on one side (hemiplegia)
l A state of confusion
l Sensory defects
l Speech and visual defects
l Dizziness

Common risk factors which can cause brain stroke:

l Hypertension
l Heart disease
l Diabetes
l Smoking
l Lack of regular physical exercise

The PGI’s stroke hotline for instant help in case of a suspect stroke (phone): 9815615600
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Vitamin E does not reduce heart disease risk

Washington: Vitamin E supplements have been found ineffective in lowering the risk of heart disease. According to WebMD, a review of a separate research on Vitamin E in the treatment and prevention of heart disease has shown that Vitamin E has no significant effect in reducing the risk of a heart attack, a stroke or any other heart-related death.

Although some previous studies have shown that eating a diet rich in antioxidants may reduce the risk of heart disease, studies on antioxidant vitamin supplements, such as Vitamin E, have produced conflicting results.

In the latest study, researchers reviewed seven large clinical trials involving more than 100,000 people on the effectiveness of Vitamin E therapy in preventing or treating heart disease and found that six out of seven studies showed no significant effect of Vitamin E on heart disease.

Researchers have said that relying on Vitamin E supplements without any proven benefits may actually keep people from adopting healthy lifestyles or using other therapies proven to reduce the risk of heart disease, such as aspirin, cholesterol-lowering statins, beta-blockers, and ACE inhibitors. — ANI
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Babies born slightly early are at risk

CHICAGO: Babies born a few weeks prematurely are at increased risk of health problems, such as jaundice and low blood sugar. So, expectant mothers should not hasten delivery, researchers say.

"Conventional wisdom has been that babies who were near-term, but still premature, would do as well as full-term babies. ... But those of us who take care of these children know from experience that they may have more jaundice or hypoglycemia than full-term infants do," said study author Dr Marvin Wang of Mass General Hospital for Children.

Researchers at the Boston hospital compared 95 full-term babies born at 37 weeks gestation or later with 90 babies born at 35 or 36 weeks gestation.

Premature babies were significantly more likely to have health problems and 18 had multiple ailments, while none of the full-term babies had more than one problem.

Among the conditions were jaundice, hypoglycemia (low blood sugar), respiratory distress, the need for intravenous feeding and difficulty in maintaining body temperature. — Reuters
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Body massage for migraine

Wellington: A soothing massage can help you keep the migraine at bay, reveals an Auckland University study. According to The New Zealand Herald, a research done by doctoral student Sheleigh Lawler has found that a regular upper body massage can reduce migraine attacks substantially.

Out of 47 migraine sufferers who took part in the study, half the group that received a 45-minute massage of the upper body and head region once a week for six weeks, in addition to their standard medication, got fewer migraines than those who didn’t receive the massage.

The study also found that those who received the massage on a regular basis did not need to take the medication as often. — ANITop


Golf for healthy heart

Washington: If you thought that golf was a leisure game, think again! For now, researchers have revealed that playing the sport is good for your heart and health in general. A study published in this month’s issue of the Harvard Men’s Health Watch, a publication of Harvard Medical School, says that the walking one does while playing golf is the key to securing health benefits from the game.

Walking 18 holes three to five times a week gives an optimal amount of endurance exercise for your heart and if you pull your clubs or carry them, you’ll end up burning more calories per round, and benefit even more, the study says. The study also warns golfers about embedded injuries. As a golf swing involves the whole body, any part of the body can be injured in the course of play, the researchers caution.

The study suggests some common workouts like stretching, warm-ups and usage of good quality equipment. — ANI
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Ayurveda & you
Herbs in the Indian kitchen
by Dr R. Vatsyayan

Apart from helping proper digestion and absorption of food, herbs and spices used in our kitchen offer a number of other health benefits. Since ayurveda considers medicine and diet complimentary to each other, it becomes all the more important for us to have basic knowledge of some of the herbs we use as spices in our day-to-day life. Here is a brief introduction of another set of spices which form an essential part of a traditional Indian kitchen.

Turmeric: Popularly known as "haldi" and in ayurvedic literature referred to as "haridra", turmeric has been used in India as a herb and spice for thousands of years. It is a digestive, carminative, blood purifier, anti-bacterial , anti-allergic and antioxidant agent which is bitter and pungent in taste and is light, dry and hot in effect. Turmeric while alleviating "kapha" and "vata", is a versatile health aid which as a home remedy is not only applied in minor cuts and wounds but is also used as a herbal cosmetic.

Clove: Though a native of South-East Asia, clove is a well -embedded herb in Indian kitchen. Known as "lavang" in Sanskrit, clove is bitter and pungent in taste and light, sharp and unctuous in action. It alleviates "kapha" and "pitta" and, contrary to the general belief, ayurveda considers it to be cold in action. Clove is an aromatic, appetizer, stomachic and anti-spasmodic herb which not only stimulates various body organs like salivary glands, skin, liver, heart and kidneys but is also regarded as a good aid to counter halitosis (bad breath) and tooth decay.

Ajwain: Of the aromatic group of plants used both as medicine and spice, ajwain is a well-documented herb of ayurveda. Bitter and pungent in taste and hot in effect, it is counted among the 10 foremost herbs known for their anti-colic or anti-spasmodic action. Besides endowed with carminative, diuretic and diaphoretic (that produces sweating) properties, ajwain is a trusted household remedy to treat indigestion, flatulence, urticaria and menstrual spasm.

Cardamom: Called "chhoti elaichi" in common parlance and refereed to as "ela" in ayurvedic literature, cardamom is at the same time pungent and sweet in taste and is light, dry and cold in effect. Famous for its expectorant properties, cardamom is relied upon to treat various types of coughs, conditions involving respiratory allergies, phlegmatic conditions and sore throat. Besides acting as a mouth purifier and deodorant, cardamom is also used to control various types of digestive upsets like excessive thirst, nausea, vomiting, indigestion and flatulence.

Hing: Used in most Indian homes and famous for its peculiar odour, "hing" is a resin of a plant which is bitter and pungent in taste and light, sharp, unctuous and hot in effect. It is reputed as a drug which dispels wind from the stomach and counteracts spasmodic disorders. While aggravating "pitta" and pacifying "vata" and "kapha", "hing" not only acts as a stimulant to the nervous and respiratory systems but is also a killer of intestinal worms and an emmanagogue (that promotes the menstrual discharge).

Methi: Popularly known as methi, fenugreek seeds are an essential spice of an Indian kitchen. Bitter in taste and light, unctuous and hot in effect, it aggravates "pitta" but pacifies "vata" and "kapha". Fenugreek seeds relieve indigestion, colic and distension and, besides having anti-diabetic action, they are useful in treating a number of other disorders like arthritis, low backache and sciatica. Being hot in effect, persons suffering from high blood pressure and haemorrhagic tendencies are advised against using "methi" seeds in a high dosage and for a long time.
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