|HEALTH & FITNESS|
Try immunotherapy in allergic disorders
Arthritis: pills unhelpful in beating pain
Blindness can soon be switched off
Eye problems in thyroid patients
Sleeping can keep you
Ayurveda & you
Try immunotherapy in allergic disorders
Successful treatment of allergic disorders is based upon three principles: avoidance of allergen if possible, pharmacotherapy, and immunotherapy desensitisation. In spite of identification of relevant allergen, avoidance may not be feasible due to many reasons. Pharmacological treatment is effective for symptom control. Immunotherapy (IT) is useful only for allergic disorders mediated by IgE antigen antibody mechanism.
Immunotherapy for the treatment of allergic respiratory diseases with orally administered pollen extract was first described in 1890. The basic principle of IT is to inject the patient with increasing doses of allergen to which he is sensitive, until a maintenance level is reached, where his symptoms are effectively controlled. Thereafter regular maintenance injections are given.
Band T cells mount the immune response to antigens and other extrinsic agents and their subsets to produce specific antibodies. Hum oral as well as cellular mechanism are involved.
According to one well accepted hypothesis, patients develop IgG antibodies, these antibodies have high avidity for the antigen than do the IgE antibodies and are able to compete successfully for the antigen sites on the allergen. These IgG antibodies are referred to as blocking antibodies. There is change in the response. There is change in the sensitivity of basophils which do not release histamine on exposure to allergen.
The exact mechanism s is yet to be known. IT may induce many other suppressive mechanisms that ultimately down regulate IgE biosynthesis. Thus, there is almost a defence barrier.
The benefits from immunotherapy depend on several factors such as accuracy in allergy tests, allergen selection for IT, its specificity, purity, storage, dosage and modification of IT schedule based on the patients’ condition. Representation of allergenic fraction in allergenic extract is very important. Therefore, purified allergens should be proffered. When an individual is more sensitive to minor allergen, which may not be present in adequate amount in the extract, the IT with routine allergens will not be beneficial.
Thus, the diagnostic criterion for the detection of allergen and knowledge of the person practicing IT are most critical factors. It is common to see in practice that people with inadequate knowledge do allergy tests and do IT putting this science in disrepute.
IT has now established itself on firm scientific grounds. The possibility of prevention of the late phase of IgE production in the lung by IT provides further rationale for its use. In a convincing double blind trial, IT with Bee venom in patients with anaphylactic sensitivity to bee venom antigen has shown to protect against anaphylaxis upon subsequent sting. IT is not indicated in food allergy and skin allergy.
In conclusion, it can be said that properly conducted immunotherapy by a qualified physician after accurate allergy diagnosis based upon in-vitro and in-vivo tests is safe and beneficial for the patients of respiratory allergies. Except for the local reactions no short-term or long-term adverse reactions are known.
The writer is is consultant paediatrician and allergy specialist Chandigarh.
London: Painkillers taken by millions of arthritis sufferers worldwide are actually of limited use in relieving symptoms, Norwegian scientists said. Researchers from the University of Bergen said their findings suggested the drugs should be used only on a short-term basis and be prescribed much more critically in future.
Current guidelines in many countries recommend using non-steroidal anti-inflammatory drugs (NSAIDs), including so-called COX-2 inhibitors, for treating patients with osteoarthritis.
But there are mounting concerns about their safety, following the withdrawal of Merck & Co Inc’s COX-2 drug Vioxx in September due to heart attack risk. At the same time, many older NSAIDs, such as naproxen and ibuprofen, can cause gastrointestinal problems.
Jan Magnus Bjordal and colleagues pooled the results of 23 previous clinical trials to find out just how useful all types of NSAIDs and COX-2 drugs were in relieving pain in patients with knee osteoarthritis, the most common form of the disease.
Their findings, published online by the British Medical Journal, showed that the drugs reduced pain in the short term only slightly better than placebo.
"We were surprised that the effects were so small. These drugs are very commonly used but their effect is below what many patients report as clinically relevant for them," Bjordal told Reuters.
Washington: Scientists at the University of California have developed a technique which enables the nerve cells to detect light, thus paving the way for an innovative therapy that could restore sight to those who have lost it through disease.
In a report published in journal Nature Neuroscience, a University of California team, lead by neurobiologist Richard H. Kramer, UC Berkeley and Dirk Trauner, has suceeded in inserting a light-activated switch into brain cells which are normally insensitive to light, thus enabling the cells to turn on with green light and turn off with ultraviolet light.
This trick could potentially help those who have lost the light-sensitive rods and cones in their eyes because of nerve damage or diseases such as retinitis pigmentosa or age-related macular degeneration.
"We may be able to use laser scanning to trace on and off patterns on the retina and allow people to see visual patterns," Kramer said.
"With this technique, you also could confer light sensitivity on organisms that normally don’t have vision, such as the nematode worm C. elegans.
Taking this from a chemical novelty to showing that it works in a biological system is a real breakthrough," Trauner added.
Eye problems in thyroid patients
The incidence of eye signs (change in eye appearance) in patients with thyroid disease varies from 40 to 90 per cent (serious ocular problems occur in 5 per cent). It is, therefore, important that thyroid patients with or without eye problems have an eye check-up. It most frequently strikes between the ages of 20 and 40 years.
Broadly, the following symptoms are noticed when thyroid is working in excess of normal (hyper): nervousness, insomnia, emotional swings, sweating, tremors and shakes, Increased heart rate, frequent bowel movements, weight loss, sensitivity to warm temperatures (feeling hot all the time), muscle weakness, shortness of breath, palpitations, etc.
In women, menstrual periods may become less frequent or stop altogether. In older patients, there may be heart failure or heart-related chest pain called angina. Eye symptoms and hyperthyroidism symptoms typically appear within 18 months of each other.
When thyroid is working less than normal (hypo), there is a long list of symptoms that can occur. Among these are fatigue, irritability, hair loss, low sex drive, dry skin, arthritis, muscle aches, acid reflux, gray hair, stress, blocked arteries, puffy eyes and face, dyslexia, etc.
In the case of hypothyroid, the only symptoms reported are puffiness of eyes, dry eye and vision blurring. In hyperthyroid, a number of symptoms have been reported, most notable being protrusion of eyeballs, also called exophthalmos or graves’ ophthalmopathy. This patient has the protrusion of the eyes and eyelid retraction.
Some of the eye symptoms of hyperthyroid are lid retraction, a condition in which the upper eyelid is retracted upwards, exposing a greater area of the eye. This may create the appearance of wonder, anger, staring, day-dreaming, etc., and may also create the appearance of large prominent eyes. Lid retraction may cause drying and irritation of the eye. Poor lid closure may allow exposure of the cornea. This may result in the drying of the eye causing redness, irritation, and sensitivity to light. Proptosis, the protrusion of the eyeballs, a condition in which the eyes are pushed forward due to the accumulation of fluid and cells within the orbit and behind the eyes. Depending upon the degree of forward displacement, it may result in the exposure of the cornea leading to drying, irritation, photophobia, tearing, pain, and, in some cases, decreased vision.
Treatment: Early eye symptoms — which may include dryness, redness, itching, swelling of the lids and inability to wear contact lenses — are usually mild. Some patients find these symptoms to be particularly irritating at night, and in the environment with airconditioning, hot-air heating and windy days tend to be particularly troublesome. Since most patients develop mild symptoms, they are often misdiagnosed with an ocular allergy in the beginning.
Treatment can be divided into two groups: minor and major. Minor treatment includes the use of glasses, warm compresses, elevation of the head of the bed, and lubricating eye drops. Glasses often provide a cosmetic improvement and they also protect the exposed eye from dust, wind, etc.
There are three main categories of major treatment: (a) Systemic medications such as steroids, cyclophosphamide; (b) surgery; (c) radiotherapy. The general indication for major treatment is any condition which may lead to permanent damage to vision. Such treatment is instituted under specialised care.
London: If you thought that lying in the bed for too long may make you fat, think again. A new research has revealed that a good amount of sound sleep prevents weight gain.
A Columbia University study has found that people who slept for four hours or less per night were 73 per cent more likely to be obese, possibly because of effects on their appetite hormones.
The study also found that even after factors such as depression, physical activity, alcohol consumption, ethnicity, level of education, age and gender had been taken into account, people who slept less were more likely to be obese.
"The results are somewhat counterintuitive, since people who sleep less are naturally burning more calories. But we think it has more to do with what happens to your body when you deprive it of sleep as opposed to the amount of physical activity that you get,"Dr James Gangwisch, who led the research team, was quoted by the BBC, as saying. — ANI
Ayurveda & you
By virtue of its weight and surface area, the skin is not only the largest organ of our body, but is also the foremost marker of our physical identity. As its Sanskrit name "twacha" is derived from a root word, meaning to cover the body, the skin is our first protective wrap which mediates between us and the environment.
The skin acts as a caring cover to our body and is a busy frontier handling a number of physiological functions. It provides a defensive shield against bacteria and protects the body from the vagaries of nature. Skin is also involved in temperature regulation. In hot conditions it produces sweat to cool the body whereas it conserves the body heat by constricting the blood vessels when it is cold. Vitamin D is also synthesized by the sunlight in the skin and it protects the body from the bad effects of ultra violet rays.
Ayurvedic seers described the skin as a subsidiary tissue of the "mamsa dhatu" or flesh. Sushruta has mentioned seven types of skin layers, and as a sense organ it has been considered a seat of the "vata" of which the sense of touch is an attribute. The skin is also a functioning entity of a subtype of "pitta" which is responsible for local metabolism and its pigmentation. It is interesting to note that thousands of years ago, while classifying body types or "prakritis", ayurveda highlighted various tones and textures of the skin as a major characteristic of different persons.
The skin of the "vata" -dominated persons is in general dry, thin and cool to touch and has dry hair. When balanced it glows with a delicate lightness and refinement, but in a dry and windy weather or in certain adverse conditions it is prone to excessive dryness and may even become rough and flaky. "Vata" skin has a tendency to disorders such as itching, pruritis, dry eczema and fungus afflictions. Mental stress and worries and lack of sleep and rest have a powerful debilitating effect on it by making to look tired and lifeless.
The "pitta" skin is fair, beaming, soft , warm and of medium thickness having fine and straight hair. Under normal conditions, it has a pinkish or reddish tinge and is invariably prone to excessive sweating and copious moles and freckles. It is the most sensitive skin having a tendency to develop rashes, pimples, furuncles and pigment disorders. With oily undertones, it has least tolerance for sun, is photosensitive and gets its problems aggravated by the consumption of hot, oily and spicy food.
The "kapha" type of skin is thick, soft, moist and unctuous in nature. With hair that are characteristically thick and wavy, "kapha" people have adequate muscles and fats under their skin and are fortunate to develop wrinkles much later in life. If their skin becomes sick, it can show up as dull, congested, having nodular enlargements and looking like having water retention. "Kapha" skin is more prone to clogging, and consumption of heavy and hard to digest food, application of oily and greasy substances and undermining of body hygiene can give it problems like fungal infections and wet and oozing afflictions.
It is usually seen that many people at the same time have both dry and oily skin or have certain zones which are different in appearance and nature. Most noticeable of these is the T zone which separates the skin of forehead and nose from the rest of the face. Ayurveda, too, has described dual "prakriti" having characteristics of two body types. Certain other factors like the hormonal status, nutritional support, genetic predisposition and systemic health problems can also effect normal quality and consistency of the skin.
The writer is a senior ayurvedic consultant based at Ludhiana.