HEALTH & FITNESS

EYESIGHT
New horizons in cataract surgery
Dr Mahipal S. Sachdev

Nowaday’s cataract surgery is becoming a form of refractive surgery. The newer intraocular lens implants have the ability to take care of your astigmatism along with clear vision for near and distance without glasses, taking care of the contrast sensitivity too.

Relook at the elderly’s diet 
Dr R. Vatsyayan

At every stage in human life, diet plays an important role to keep a person fit and healthy. Nutritious food is one that contains all the nutrients, proteins, fats, carbohydrates, vitamins and minerals. A balanced diet should contain all these in correct proportions and an adequate amount. In old age, the need for proper nutrition gains special significance because due to multiple reasons an elderly person is always at the risk of getting some problem arising out of dietary aberrations or inadequacies.

Health Notes

  • Simply moving can make you feel more positive

  • Bunk beds hazardous for kids and young adults

  • Prostate cancer: resistance  to androgen-deprivation

  • Positive attitude doesn’t  help cure cancer

Pollution may cause premature childbirth 
Dr Meenal Kumar

The inhalation of outdoor and indoor air pollutants has been found to be a major concern for the health of the unborn, newborn, young children and their mothers. The women who live in the regions with high carbon monoxide or fine-particle levels caused by vehicle traffic are 10 to 25 per cent more likely to have a pre-term baby than those who live in less polluted areas. This is especially true for women who breathe polluted air during the first trimester or during the last months and weeks of pregnancy.




 

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EYESIGHT
New horizons in cataract surgery
Dr Mahipal S. Sachdev

Nowaday’s cataract surgery is becoming a form of refractive surgery. The newer intraocular lens implants have the ability to take care of your astigmatism along with clear vision for near and distance without glasses, taking care of the contrast sensitivity too.

Surgery for a cataract involves removing the natural clouded lens of the eye (the cataract) and replacing it with an artificial lens called the intraocular lens implant (IOL). The most common form of cataract surgery is the removal of the lens with phacoemulsification.

With the use of an operating microscope, your surgeon will make a very small incision in the surface of the eye in or near the cornea. A thin ultrasound probe, which is often confused for a laser, is inserted into the eye and uses ultrasonic vibrations to dissolve (phacoemulsify) the clouded lens. These tiny fragmented pieces are then suctioned out through the same ultrasound probe.

Once the cataract is removed, an artificial lens is placed into the thin capsular bag that the cataract occupied. This lens is essential to help your eye focus after surgery. In this most modern method, cataract surgery can usually be performed in less than 20 minutes and usually requires only minimal anaesthesia in the form of eye drops, no stitches to close the wound, and no eye patch after surgery.

Monofocal versus multifocal IOL: A lot of development has taken place as far as material and design of the IOL is concerned. This has helped in getting better visual outcomes for the cataract patients. The IOLs used extensively so far have been monofocal. This implies that the power of the lens inserted in the eye is such that one can see distance without glasses but a near add is required for performing any work at near distance. So, the patients would need spectacles to focus objects at different distances.

The new multifocal and accommodating IOLs offer the possibility of seeing well at more than one distance, without glasses or contacts. Multifocal intraocular lenses are one of the latest advancements in lens technology. These lenses have a variety of regions with different power that allows some individuals to see at a variety of distances, including distance, intermediate, and near.

While promising, multifocal lenses are not for everyone. They can cause significantly more glare than monofocal and they do not correct astigmatism.

Toric IOLs: Toric IOLs are designed to correct astigmatism. Most surgeons who treat astigmatism in their cataract patients tend to use astigmatic keratotomy (AK) or limbal relaxing incisions, which involve making incisions in the cornea. But in addition to or even instead of corneal astigmatism, some patients may have lenticular astigmatism, caused by irregularity in the shape of the natural lens capsule. This can be corrected with a toric IOL.

Toric lenses have more power in one specific region in the lens to correct astigmatism as well as distance vision for many individuals. While toric lenses can improve distance vision and astigmatism, they still require corrective lenses for all near tasks, such as reading and writing.

Aspheric IOLs: Another leap in the IOL technology are the aspheric IOLs which can provide improved contrast sensitivity and visual acuity over traditional, spherical IOLs. Aspheric IOL received FDA approval for new labelling that says it can reduce postoperative spherical aberrations and, therefore, improve the ability to see in varying light conditions such as rain, snow, fog, twilight and night-time darkness.

Piggyback lens: If you have a less than optimal result from the original intraocular lens used in your cataract surgery, an additional lens over the top of the one you have currently got can be implanted. This approach, known as a “piggyback lens,” can improve vision and may be considered safer than removing and replacing the existing lens. This, according to surgeons, can be corrected with the help of wavefront guided LASIK to remove the need of any glasses. The combination of LASIK with IOL implantation, commonly termed as Bioptics, is also getting popular day by day.

As time goes by, the number of options keep on increasing, and since one type of surgery may not be the standard for all patients, let your eye specialist guide you to which one would be the best for your eyes.

The writer is Chairman and Medical Director, Centre for Sight, New Delhi. Email: [email protected]

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Relook at the elderly’s diet 
Dr R. Vatsyayan

At every stage in human life, diet plays an important role to keep a person fit and healthy. Nutritious food is one that contains all the nutrients, proteins, fats, carbohydrates, vitamins and minerals. A balanced diet should contain all these in correct proportions and an adequate amount. In old age, the need for proper nutrition gains special significance because due to multiple reasons an elderly person is always at the risk of getting some problem arising out of dietary aberrations or inadequacies.

The requirement of essential nutrients depends upon many factors like age, sex and the level of physical activity done. The energy needs decrease after the fifth or sixth decade of life. With a lowered basal metabolic rate and lessened physical activity, it is believed that the energy and strength level starts getting reduced by 8 to 10 per cent per decade in the 55 to 75 age group.

In fact, old age is a period when both the quantity and the quality of food matters the most. A good, balanced, individually suitable diet supported with proper digestion and assimilation fulfils much of the nutritional requirements of the elderly people. Ayurvedic masters have repeatedly cautioned that by giving due consideration to the above mentioned factors old people should take the food which is conducive to their internal power of digestion.

If we look from the modern point of view, protein in the diet is an important measure of the adequacy and quality of food. But due to decreased appetite and poor digestion, the elderly tend to consume less protein. Similarly, fats in the diet are a concentrated source of energy, but care must be taken to thwart any rise in cholesterol levels. In old age, the need for dietary calcium increases because it helps to prevent osteoporosis which is a very common feature among the elderly. Iron deficiency leads to anaemia and the elders must include some variety of greens in their diet every day.

Vitamins are required to keep all body tissues healthy and they also help in utilising other major nutrients in the food. The elderly people require sufficient fibre in their diet to avoid constipation but they should prefer tender fibre of the vegetables, fruits and whole grain cereals. Rough fibre is not well tolerated by the intestines of old people. The fluid intake must be at least two litres in a day for a normal elderly person.

The debate on the advantages of vegetarian or non-vegetarian food is very old. The choice depends on various factors such as religious and cultural background of a person and avoidance and restriction of certain foods because of health reasons. Whatever the case may be, a well-balanced and easily digestible diet, whether vegetarian or non-vegetarian, should always be the first choice of an old person.

The writer is a Ludhiana-based senior ayurvedic physician.

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Health Notes
Simply moving can make you feel more positive

WASHINGTON: Indiana University researchers have found that physical activity throughout the day like simply moving is linked to positive feelings.

However, they found no similar relationship between physical activity and negative moods.

“In the study, if people are more active, they tend to report a more positive mood. Really low levels of activity are related to lower levels of positive affect,” said Bryan McCormick, associate professor in IU Bloomington’s School of Health, Physical Education and Recreation. — ANI

Bunk beds hazardous for kids and young adults

WASHINGTON: Parents of young children are not the only ones who need to worry about bunk bed-related injuries, for a new study has found that young adults between the ages of 18-21 are also at risk of getting hurt because of these beds.

The 16-year study had researchers at the Centre for Injury Research and Policy of The Research Institute at Nationwide Children’s Hospital saying that “increased prevention” was needed in order to lower such injuries.

“The high rates of injury found in our study suggest the need for increased prevention efforts to lower the risks of bunk bed-related injury, especially among young children and young adults,” said study co-author Gary Smith, Director of the Centre for Injury Research and Policy at Nationwide Children’s Hospital, and an associate professor of Paediatrics at The Ohio State University College of Medicine. — ANI

Prostate cancer: resistance to androgen-deprivation

WASHINGTON: A collaborative study has uncovered what may be helpful in discerning how prostate tumours eventually become resistant to androgen-deprivation therapy — the suppression of circulating testosterone via surgical castration or medical castration with testosterone-blocking drugs. Testosterone is the hormone that fuels prostate-cancer growth.

“We found that despite the suppression of circulating androgen levels to very low or castrate levels, metastatic prostate tumours are themselves able to maintain significant levels of testosterone, which fuels the growth of the cancer,” said Dr Elahe Mostaghel, a clinical-research associate in Peter Nelson’s laboratory at Fred Hutchinson Cancer Research Centre. — ANI

Positive attitude doesn’t help cure cancer

MELBOURNE: A team of Australian specialists has debunked the theory that a positive attitude can boost the chances of surviving cancer. The researchers pointed out that they know their study findings might not impress the majority of patients who believed their outlook could help their diagnosis, but said it could be good news too.

“People often really beat themselves up and blame their attitude if their cancer relapses,” News.com.au quoted Professor Kelly-Anne Phillips, a medical oncologist at the Peter MacCallum Cancer Centre in Melbourne, as saying. — ANI

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Pollution may cause premature childbirth 
Dr Meenal Kumar

The inhalation of outdoor and indoor air pollutants has been found to be a major concern for the health of the unborn, newborn, young children and their mothers. The women who live in the regions with high carbon monoxide or fine-particle levels caused by vehicle traffic are 10 to 25 per cent more likely to have a pre-term baby than those who live in less polluted areas. This is especially true for women who breathe polluted air during the first trimester or during the last months and weeks of pregnancy.

There is an association between maternal inhalation of air pollutants and adverse birth outcomes, including an increased risk of pre-term delivery, intrauterine growth retardation, small head circumference, low birth weight, and an increased rate of malformations. Pre-term births are associated with significantly increased risks of neonatal death and illness compared with term births, a recent study indicates.

Numerous toxic agents have been detected in umbilical cord blood samples, a finding potentially significant because tissues, organs and genetic material of the unborn and the young are particularly susceptible to biologic insult. Nonsmoking pregnant women exposed to environmental tobacco smoke have an increased risk of delivering a low weight infant. Children endure greater risk of excessive tissue damage because of their underdeveloped immune systems.

Birth weight is a major predictor of later health. For example, normal-weight babies have been shown to have higher IQs in childhood and lower risk of cardiovascular disease in adulthood.

A common environmental risk factor is exposure to indoor cook smoke (i.e., the combustion contaminants generated from fuels during the cooking of foods and other indoor activities requiring fire). An estimated 90 per cent of rural households in India use biomass fuels as their primary source of energy. These fuels are plant based in origin; examples include animal dung, crop residues, wood, and charcoal.

The pollutants emanating from these burning fuels present risks to human health. A partial list includes airborne particulate matter, poly-nuclear aromatics, carbon monoxide, formaldehyde, and oxides of nitrogen and sulfur. Even humble tea can cause problems to the foetus. The reason is that caffeine in your cup of tea/coffee crosses through the placenta to the foetus, but is difficult for the foetus to metabolize because of the under-developed metabolic system.

Caffeine may also influence cell development and decrease placental blood flow, which may lead to an adverse effect on foetal development.

Poverty is a strong predictor of indoor air contamination in our country. Modest income earners rely on accessible, low-quality/low-cost fuels, and frequently reside in homes that tend to exacerbate poor air quality.

Wherever possible, efforts should be initiated to make cleaner fuels and energy-efficient stoves available to women. By introducing energy-efficient stoves, made with locally available materials, less fuel is required and less smoke is produced, thus reducing biomass collection and making more time available for the caring of young children. The result is a better quality of life.

The writer is a Chandigarh-based senior gynaecologist.

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