HEALTH & FITNESS

EYESIGHT
Users of contact lens solutions, beware!
Dr Mahipal S. Sachdev

Why do we use a soft contact lens solution? We guess we all know the answer to this simple question and would promptly reply — to clean, disinfect, store and rinse our lenses. Contaminated lenses are not only a source of uncomfortable lens wear, but also pose a bigger threat of causing infections of the eye. Some of these infections can be sight threatening too. Proper

Sachin’s shoulder injury: what is it all about?
Dr Harpreet Singh Gill

The shoulder joint is a ball and socket joint, similar to the hip. However, the socket of the shoulder joint is extremely shallow and thus inherently unstable. To compensate for the shallow socket, the shoulder joint has a cuff of cartilage called labrum that forms a cup for the head of the arm bone (humerus) to move within. A comparison is made with a golf ball placed on the tee. 

Heart patients: meditation helps
CHICAGO:
Heart disease patients who practised meditation for four months showed slight improvements in blood pressure and insulin levels, a small, government-funded study found.

Health notes

  • Obesity may begin in the brain

  • Sunscreens may alter thyroid hormones

  • Bone marrow treatment to restore lost vision

  • Antibiotics: shorter course equally effective

  • Anti-depressants may increase diabetes risk

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EYESIGHT
Users of contact lens solutions, beware!
Dr Mahipal S. Sachdev

Why do we use a soft contact lens solution? We guess we all know the answer to this simple question and would promptly reply — to clean, disinfect, store and rinse our lenses. Contaminated lenses are not only a source of uncomfortable lens wear, but also pose a bigger threat of causing infections of the eye. Some of these infections can be sight threatening too. Proper disinfecting is the key to maintaining the health of the eye.

Over the years, these multipurpose solutions have shown remarkable popularity with contact lens users because of their easy usage and maintenance.

Early in March, Bausch and Lomb received a troubling phone call from a New Jersey eye doctor. A cornea specialist alerted the company that three of his recent patients had been afflicted with a microbe that caused a potentially blinding eye infection. All three of his patients had used Bausch and Lomb’s lens cleaners.

Apart from this, 35 “serious injury reports” of Fusarium Keratitis were notified from Singapore’s Ministry of Health in February 2005 that were related to Bausch and Lomb’s MOISTURELoc. As of May 12, reports of 122 confirmed cases of fusarium keratitis, 15 possible cases and 60 cases under investigation have been reported from the U.S.

When an infection in the eyes occurs due to the use of contact lens it leads to corneal ulceration. Cornea is the anterior most part of our eye, over which we put the contact lens. Once the cornea gets affected it can lead to watering, redness, intolerance to contact lens and decreased vision. Most of the infections can be treated with medicines, but the healing process itself may leave a corneal scar, which can cause visual impairment. Apart from that, some organisms that infect the cornea are so virulent that controlling the infection is very difficult and we might even lose that eye.

This is an effort to make people aware in this regard, in view of the recent controversy regarding the use of a very popular contact lens solution.

The lens cleaner of this brand has been found to have caused fungal infection of the cornea. As mentioned earlier, 35 serious injury reports of `fusarium keratitis’ have been related.

No official reports exist on the health impact of the outbreak, but a Florida-based woman has lost an eye and some other patients have undergone restoration corneal transplant surgery.

It took months for the company to figure out that the infections were caused by fusarium fungi. It was found that the fungal infections involved a complex interaction of MoistureLoc ingredients and the customer’s own lens care practice.

The FDA began an investigation of a Bausch factory in Greenville, U.S.A, where the lens cleaners involved in the outbreak were made. The investigation began to identify any possible source of `fusarium keratitis’ which has been associated with contact lens wearers who used ReNU with the MoistureLoc solution.

Since then B&L has withdrawn its ReNU with MoistureLoc product from worldwide distribution, including India. They have suggested that the lens solution formulation may be the cause of the increased risk of the fungal keratitis infection.

.If anyone of you wearing contact lenses and using this solution experiences watering, redness, decreased vision, intolerance to contact lenses, please report to an ophthalmologist immediately. Please switch over to a new pair of contact lens. The older version of ReNU solution, the multipurpose solution or any other brand of contact lens solution is safe to use.

Ophthalmologists should also culture patients whenever they present with microbial keratitis to consider the possibility of a fungal infection in contact lens users.

‘Remember eyes are the window to the world. It’s a gift to be cherished and handled with utmost care’.

The writer is Chairman and Medical Director, Centre for Sight, New Delhi. E-mail: msachdev@bol.net.in.

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Sachin’s shoulder injury: what is it all about?
Dr Harpreet Singh Gill

A view of labral tear (SLAP)
A view of labral tear (SLAP)

The shoulder joint is a ball and socket joint, similar to the hip. However, the socket of the shoulder joint is extremely shallow and thus inherently unstable. To compensate for the shallow socket, the shoulder joint has a cuff of cartilage called labrum that forms a cup for the head of the arm bone (humerus) to move within. A comparison is made with a golf ball placed on the tee. The tee represents the cup (glenoid) of the shoulder joint, and the ball represents the head of the humerus. The ring of cartilage around the tee, deepening it somewhat and offering more stability is called the labrum. It is a stabilizer for the shoulder joint.

The labral tears were classified by Snyder, who gave the acronym SLAP (Superior Labrum Anterior Posterior). The SLAP tear occurs at the point where the tendon of the biceps muscle inserts on the labrum.

How does a SLAP tear occur?

The labrum gets injured in sportsmen and especially in overhead athletes. Mechanism of injury can be a fall on an outstretched hand or due to repetitive overhead actions as in throwing. This injury is commonly seen in throwers, bowlers, tennis players and swimmers.

What is the treatment?

A patient with an acute SLAP tear is advised rest after the injury to allow the injured tissue to cool down. A period of rest will allow inflammation to subside and may help to alleviate symptoms. Anti-inflammatory medication and later on physiotherapy is prescribed.

In patients who have continued symptoms despite non-surgical treatments, arthroscopic (key-hole) surgery of the shoulder is recommended. A SLAP repair is an arthroscopic procedure that uses sutures with anchors attached to resecure the torn labrum down to the shoulder socket. A SLAP repair is best suited to patients with an otherwise healthy shoulder who want to remain athletically active.

Rehabilitation

Rehabilitation varies depending on the factors such as the strength of the SLAP repair, and the preference of the surgeon.

Through rehabilitation, the dedicated athlete can often return to sport at his previous level of performance. Various studies have shown good results of SLAP repair in 85 per cent to 95 per cent of patients. The rehabilitation protocols are individualised and return to sport is usually around three months and in some cases, it may even take six months.

Individualising Sachin Tendulkar’s case, Indian team requires his batting ability more than bowling. Hence the Indian team management has to facilitate his early return to sport. It is advisable that he follows some don’ts in the early phase of his return to play.

The writer is Consultant Orthopaedic Surgeon, SPS Apollo Hospitals, Ludhiana

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Heart patients: meditation helps

CHICAGO: Heart disease patients who practised meditation for four months showed slight improvements in blood pressure and insulin levels, a small, government-funded study found.

Patients who learned transcendental meditation did better on those measures than patients who spent the same amount of time on lectures, discussions and homework assignments about the effects of stress, diet and exercise on the heart.

The 103 heart patients participating in the study received regular medical care, including drugs for lowering cholesterol and blood pressure.

Adding meditation had “a strong enough effect that we could show a benefit over traditional health care, and traditional health care is pretty good now,” said study co-author Dr. Noel Bairey Merz of Cedars Sinai Medical Centre. “I think it’s a testimony to this  intervention that we could see anything.”

Some of the researchers involved are affiliated with the organisation that teaches transcendental meditation around the world, raising questions about potential bias, said Jim Lane of Duke University School of Medicine, who had no part in the study. — AP

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Health Notes
Obesity may begin in the brain

LONDON: Recent research suggests that being overweight may be down to more than just eating habits and may have an origin in brain chemistry.

Researchers further stated that fat is a neurobiological issue, and the brains of overweight people have more receptors for the neurotransmitter serotonin than those with normal weight. They say that genes are important in determining fat’s prevalence.

David Erritzoe and his colleagues at the Neurobiology Research Unit at Rigshospitalet, part of Copenhagen University Hospital, Denmark, used positorn emission tomography to map the brains of 47 people of normal weight and 29 overweight people.

Drugs that block the serotonin receptor are associated with weight gain, and in animals, stimulating the receptor causes weight loss, suggesting that this receptor plays a role in regulating body weight. The researchers found slightly higher concentrations of the receptor in overweight people. — ANI

Sunscreens may alter thyroid hormones

London: Sunscreens may become a necessity in summers to protect your skin from harmful UV rays but now fears are now being raised about the potential of sunscreens to disrupt the balance of thyroid hormones.

German researchers found rats exposed to the sunscreen chemical 4MBC had raised levels of thyroid stimulating hormones and heavier thyroid glands. The gland sits in the neck and produces hormones to regulate metabolism.

If thyroid levels are altered it can cause lethargy, but Charite University said more research was needed to see if this also happened in humans.

Another chemical benzophenone 2 was also found to alter thyroid hormone levels, but the effect was reversed by other chemicals present in sunscreens.

“The last thing I’d say to anyone just now is to stop using sunscreens, but less extensive direct sun exposure might be better Professor Josef Kohrle, lead researcher, said”.

“These are initial studies which show that UV (ultra-violet light)-absorbing chemicals in sunscreens have an effect on animals, so we need to test these findings in humans before coming to too many safety conclusions.” — ANI

Bone marrow treatment to restore lost vision

Washington: Scientists at the University of Florida claim that bone marrow could be used to regenerate a damaged retinal pigment epithelium (RPE), a cell layer vital for eyesight.

RPE plays a vital role in our visual health by forming the outer barrier of the retina and supporting the function of cells that receive light. RPE gets damaged due to various kinds of diseases of the retina, including age-related macular degeneration.

Researchers claim that the findings quash the earlier belief that RPE is a non-renewable source. They now believe that it may be possible to also grow new cells in the retina to replace cells lost to injury or disease.

The same belief used to be held about brain cells — people who suffered from trauma, stroke or disease formerly faced no hope of growing new cells to replace dead ones. — ANI

Antibiotics: shorter course equally effective

London: A new study has revealed that taking antibiotics for a lesser number of days than actually prescribed, can be equally as effective.

Researchers found that antibiotics taken for just three days were as effective for community-acquired pneumonia as continuing treatment for the recommended 7-10 days.

Shorter treatment can also help contain growing resistance rates. The study raises questions about the optimal duration of antibiotic therapy for common infections.

Community acquired pneumonia is one of the most important indications for antibiotic prescriptions in hospitals. But a lack of evidence to support short course therapy means it has become accepted practice to continue treatment for days after symptoms have improved.

Researchers in the Netherlands compared the effectiveness of discontinuing treatment with amoxicillin after three days or eight days in adults admitted to hospital with mild-to-moderate-severe-community-acquired -pneumonia.

These findings show that discontinuing amoxicillin treatment after three days is not inferior to discontinuing it after eight days in adults with mild-to-moderate-severe-community-acquired pneumonia who have substantially improved after an initial three days’ treatment, say the authors. — ANI

Anti-depressants may increase diabetes risk

WASHINGTON, DC: Study findings show that there is a link between the use of anti-depressant drugs and diabetes, investigators here at the 66th Scientific Sessions of the American Diabetes Association announced. This is the first report of such an association, they say.

Depression is two- to three-times higher in diabetics than in the general population. In addition, 10 per cent to 15 per cent of the US population takes anti-depressants, ‘’and the numbers are increasing,’’ Dr Richard R Rubin of The Johns Hopkins University School of Medicine in Baltimore, Maryland, told a meeting.

Dr Rubin, a co-investigator with the Diabetes Prevention Program Research Group, presented findings for 3,187 trial participants with elevated blood glucose values, indicating that they were pre-diabetic. Of these subjects, 5.7 per cent reported regular use of anti-depressants at the beginning of the study. Elevated scores on the Beck Depression Inventory, a common test used to diagnose depression, were found for 10.3 per cent. — Reuters

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