HEALTH & FITNESS

EYESIGHT
Glaucoma: Be cautious about water overload
Dr Mahipal Sachdev

Glaucoma, or “Kala Motia” as commonly known, is a disease where eye pressure increases to a level that is not safe for the optic nerve. The balance between the fluid produced inside the eye and drained out from the eye is disturbed, resulting in an increased pressure and damage to the optic nerve.

Sudden asthma deaths are preventable
Dr S.K. Jindal

It is rather uncommon to encounter death in a patient of asthma, which is otherwise considered a benign problem. Deaths are expected in cases of chronic obstructive pulmonary disease (COPD), which also is misunderstood as “asthma”. But COPD is a progressive and fatal disorder of the old who are mostly smokers. Asthma, on the other hand, is an allergic problem of the children and young adults.

How a sweet tooth leads to senior moments
John von Radowitz

Raised blood sugar levels may be to blame for memory lapses that commonly occur with increasing age, according to a study by Columbia University Medical Centre in New York.

Life ‘meaningless’ for one in 10 young adults
Alan Jones

LONDON: One in 10 young people believed life was not worth living or was meaningless, according to an “alarming” new report. A survey of 16- to 25-year-olds by the Prince’s Trust found a “significant core” for whom life had little or no purpose, especially among those not in education, work or training.

Health Notes

 

 

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EYESIGHT
Glaucoma: Be cautious about water overload overload
Dr Mahipal Sachdev

Glaucoma, or “Kala Motia” as commonly known, is a disease where eye pressure increases to a level that is not safe for the optic nerve. The balance between the fluid produced inside the eye and drained out from the eye is disturbed, resulting in an increased pressure and damage to the optic nerve.

Mr R.K., a 65-year-old person suffering from glaucoma, had his problem well controlled for four years with a group of eye-drops. Suddenly, we found that despite his pressure being controlled, the field of vision was deteriorating. We checked the medication and a detailed eye examination could not pinpoint the cause. The diurnal variation of the eye was also normal. However, on detailed questioning, we came across the fact that he had started yoga and water therapy six months ago. When we advised him to stop the water therapy, the field deterioration stabilised and the patient is again controlled well with original medications.

In this era of fitness everyone is concerned about what he/she is eating. Everyone is calorie-conscious and prefers drinking a lot of water/fluids. This intake of excess water is good for an ordinary person, but not for a glaucoma patient.

Glaucoma is the second most common cause of blindness worldwide. It is estimated that 4.5 million persons globally are blind due to Glaucoma, and that this number will rise to 11.2 million by 2020. Glaucoma is the name for a group of eye conditions where the pressure within your eye is raised to such a degree that the optic nerve becomes damaged and you begin to lose your vision. The increase in pressure usually happens when fluid (the aqueous humor) in the front part of the eye (the anterior chamber) doesn’t drain away properly. Normally, the amount of fluid produced is balanced by the amount draining away, so the pressure in the front part of the eye stays constant.

Glaucoma presents in different forms like open angle glaucoma, angle closure glaucoma and secondary glaucoma. Also there are various factors which affect the progression of glaucoma.

Water therapy and different shuddhi-kriyas as per yoga are commonly practiced in our country. There is a belief that taking a large quantity of water in early morning helps in bowel movement and flushes the body clean. In this water therapy the person drinks almost 4-6 glasses of water at a time in the morning empty-stomach. This may do well for his/her digestive system but may create problems for the eye of the glaucoma patient. But many people are not aware of this.

Anything which overloads our body fluid will increase the load on the drainage system. When one drinks a large amount of water in a short time like this, it gets absorbed in the fluid spaces of the body. So, fluid in the eye is produced in excess quantity. This increases the load on the drainage system of the eye. In glaucoma, the drainage system is affected and so will lead to a rise in the eye pressure. Thus, such intake of a large quantity of fluids in a short span will give rise to short spikes of increase in the eye pressure that may be missed on an examination by eye specialist. This type of glaucoma may get presented or aggravated if one drinks a lot of water in a short span.

Every patient of glaucoma or having a family history of glaucoma should be cautious about the water therapy. Such patients, if continue the water therapy habit, may have the disease progressing in spite of the best treatment. This should not be practiced in families with glaucoma . It is a multifactorial disease and one needs to control all factors as far as possible.

The water drinking test is commonly used to detect such cases of glaucoma based on similar observations. During this test, we check the eye pressure after drinking one litre of water in a short time. The eye pressures are checked every half an hour for two hours. Persons with a positive water drinking test should avoid large quantities of fluid empty stomach in the morning.

According to the World Health Organisation’s estimate, India has a 1 per cent prevalence of blindness. The problem is expected to reach alarming proportions soon.

Some facts related to glaucoma:

  • Glaucoma is one of the leading causes of blindness in our country, second only to cataract.
  • There is no cure (yet) for glaucoma, but it can be controlled.
  • Everyone is at risk for glaucoma.
  • There may be no symptoms to warn you.
  • It can occur at any age, but it generally affects people above 40 years of age.
  • People over 60 years of age are six times more at risk.
  • Preventing blindness from glaucoma requires a regular eye check-up and treatment.
  • Those with diabetes, hypertension, thyroid disease and myopia are more prone to develop glaucoma. Also, especially prone are the family members of glaucoma patients. These people need yearly check ups with glaucoma specialists.

Be careful and watch for your glass of water!

The writer is Chairman and Medical Director, Centre for Sight, New Delhi. Email: drmahipal@gmail.com


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Sudden asthma deaths are preventable
Dr S.K. Jindal

It is rather uncommon to encounter death in a patient of asthma, which is otherwise considered a benign problem. Deaths are expected in cases of chronic obstructive pulmonary disease (COPD), which also is misunderstood as “asthma”. But COPD is a progressive and fatal disorder of the old who are mostly smokers. Asthma, on the other hand, is an allergic problem of the children and young adults.

Theoretically, no individual should die of asthma provided an appropriate threatment plan is in place. In any case, an asthmatic patient should not die prematurely. It was, therefore, shocking to know of the three deaths from asthma of young individuals happening at different places within the last few months. All of them belonged to educated and well-to-do families and should not have died so young.

The clinical story of each of the three patients which I came to know later was different. But all of them had been apparently well, attending to their normal duties. The asthma attacks occurred at home or at work-place, progressed rapidly to the state of collapse before they could be shifted to hospital. Little could actually be done later after the irreversible damage to the brain had already occurred following the respiratory arrest.

Almost sudden respiratory arrest leading to severe suffocation and inability to breathe is typical of this kind of “fatal” or “near-fatal” asthma. Several different medical terms have been used to describe this condition. But “brittle” or “labile” asthma is perhaps the most appropriate term to understand the problem. Sudden and marked fluctuations in the severity of the symptoms are characteristically seen.

Truly speaking, the apparent suddenness is not all that sudden. Often, there is a prodrome of ill health and worsening of symptoms of a few days’ duration preceding the sudden suffocating attack. The occurrence of this prodrome is usually ignored by the patient, and/or his family. It is somewhat sad to know that the patients described above had similar histories.

Unfortunately, asthma is considered as somewhat stigmatic by the lay man. Therefore, the patients and their parents have a general tendency to avoid the diagnosis and downplay the symptoms. They also tend to omit and ignore the treatment.

I know of several examples of young and newly married patients, especially girls who would hide their regular inhalalational treatment and skip their doses for fear of being exposed to their in-laws. That is almost suicidal. This amounts to a collective sin of society which must be remedied.

In the past, there had been an epidemic-like occurrence of asthma deaths in several Western countries, including in the United Kingdom, Switzerland and New Zealand. Under-use of the controller-inhalers and over-use of rapidly acting reliever drugs were the two most important medical causes of sudden asthma deaths. A controller drug essentially required for the treatment of asthma should be regularly continued while a reliever drug is meant for temporary use. One wishes that a similar scene does not develop in this country.

It was the knowledge and guided management of asthma which changed the scene in the West. We in India similarly need to educate our society about asthma and accept the problem as purely medical, without an associated stigma.

Asthma is a completely livable disease, affecting up to 2 to 5 per cent of general population. One can control one’s asthma well with the regular use of controller-drugs and live a normal happy life. Any deterioration of symptoms must be immediately recognised and carefully managed. It is the reliance on controller inhalers which matters.

The dose of controller drugs can be immediately doubled the moment one notices deterioration. Over-use of rapid reliever inhalers must be avoided. In such a situation, the underlying disease status continues to worsen. Moreover, the overuse of such drugs results in toxic symptoms. Most asthma deterioration and deaths can be prevented. There is no reason to run away from the diagnosis or from acute exacerbations. A positive approach is the best method of management. One should also remember the adage, “A stitch in time, saves nine”.

The writer is Professor & Head, Department of Pulmonary Medicine, PGI, Chandigarh.


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How a sweet tooth leads to senior moments
John von Radowitz

Raised blood sugar levels may be to blame for memory lapses that commonly occur with increasing age, according to a study by Columbia University Medical Centre in New York.

The research suggests that, even in healthy individuals with no hint of diabetes, keeping blood sugar under control could be the key to preventing so-called “senior moments”. Taking regular physical exercise and eating the right foods are two strategies that may help achieve this, say the scientists. If necessary, blood sugar levels can be lowered with drugs.

Some degree of mental decline, marked by episodes of forgetfulness, is a part of normal ageing and does not always herald the onset of Alzheimer’s disease or other forms of dementia. Both the problems of normal ageing and Alzheimer’s involve the hippocampus, the centre of memory and learning in the brain.

Earlier research led by Dr Scott Small, from Columbia University Medical Centre, showed that one area of the hippocampus called the dentate gyrus is mainly responsible for normal age-related memory decline. In the new study, published in the journal Annals Of Neurology, his team conducted brain scans of human volunteers and animals to find out what was affecting the dentate gyrus. The scientists discovered that reduced activity in this part of the brain was closely correlated with higher levels of blood sugar.

Dr Small said: “Showing for the first time that blood glucose selectively targets the dentate gyrus is not only our most conclusive finding, but it is the most important for ‘normal’ ageing – that is, hippocampal dysfunction that occurs in the absence of any disease states. There have been many proposed reasons for age-related hippocampal decline. This new study suggests that we may now know one of them.

“Whether with physical exercise, diet or through the development of potential pharmacological interventions, our research suggests that improving glucose metabolism could be a clinically viable approach for improving the cognitive slide that occurs in many of us as we age.”

—— The Independent

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Life ‘meaningless’ for one in 10 young adults
Alan Jones

LONDON: One in 10 young people believed life was not worth living or was meaningless, according to an “alarming” new report.

A survey of 16- to 25-year-olds by the Prince’s Trust found a “significant core” for whom life had little or no purpose, especially among those not in education, work or training.

The poll of over 2,000 showed that more than a quarter felt depressed and were less happy than when they were younger.

Almost half said they were regularly stressed and many did not have anything to look forward to or someone they could talk to about their problems.

The trust, which aims to help vulnerable young people, said its study revealed an increasingly vulnerable generation.

Chief executive Martina Milburn said: “Young people tell us that family is key to their happiness, yet too often we find they don’t have this crucial support.”

The survey, described as the first large scale study of its kind, showed that young people who had left school but did not have a job or a place on a training course, were twice as likely to feel that their life had no purpose.

Relationships with family and friends were found to be the key to levels of happiness, although health, money and work were also important.

Paul Brow, director of communications at the Prince’s Trust, said the study showed there were thousands of young people who “desperately” needed support.

“Often, young people who feel they have reached rock bottom don’t know where to turn for help.”

Ross Hendry, head of public policy at Action for Children, said the report highlighted “serious issues” which must be tackled.

“Otherwise, we risk allowing a generation of vulnerable children to be lost to anger, depression and subsequent mental health problems,” he said.

“Our own research shows that young people often feel confused, frustrated and misrepresented when they are not empowered to play a positive part in society.

“Children must be given the chance to speak out, be heard and participate in setting the political agenda about issues affecting their lives, if we are to build stronger, safer and more inclusive communities.”

A spokesman for the Department for Children, Schools and Families said: “In a survey of 110,000 pupils last year 93 per cent of children said that they felt happy about life. But we know childhood isn’t good for every child and we will continue to focus on the problems that exist for some.”

The Independent



Health Notes
Most New Year smoking quitters fail in their resolve

MELBOURNE: Most smokers who make New Year’s resolutions to kick the butt are unlikely to last more than 24 hours, according to a new study.

Nine out of 10 people who vow to quit smoking break their resolution in the first few months, with a majority failing on the first day itself.

“Tying your quit attempt to an event such as New Year’s Eve is usually not enough on its own to ensure success,” the Daily Telegraph quoted GP and smoking cessation expert Dr Colin Mendelsohn as saying. — ANI

Low-carb diets can help control type-2 diabetes

Washington: After conducting a comparison of low-carb diets for six months, Duke University Medical Center researchers have found that diets that encourage eating carbohydrates with the lowest-possible rating on the glycemic index lead to greater improvement in blood sugar control.

Dr Eric Westman, director of Duke’s Lifestyle Medicine Program, revealed that patients who followed the no-glycemic diet experienced more frequent reductions, and in some cases elimination, of their need for medication to control type-2 diabetes.

“Low glycemic diets are good, but our work shows a no-glycemic diet is even better at improving blood sugar control. We found you can get a three-fold improvement in type-2 diabetes as evidenced by a standard test of the amount of sugar in the blood. That’s an important distinction because as a physician who is faced with the choice of drugs or diet, I want a strong diet that’s shown to improve type-2 diabetes and minimise medication use,” he said. — ANI

Heart failure drug may help treat cancer too

Washington: Scientists at the Johns Hopkins University School of Medicine say that digitalis-based drugs like digoxin, which have been used to treat patients with irregular heart rhythms and heart failure for centuries, may prove helpful in treating cancer too.

The researchers came to this conclusion while researching into the existing drugs that might slow or stop cancer progression.

“This is really exciting, to find that a drug already deemed safe by the FDA also can inhibit a protein crucial for cancer cell survival,” says Dr. Gregg L. Semenza, director of the vascular program at the Johns Hopkins Institute for Cell Engineering and a member of the McKusick-Nathans Institute of Genetic Medicine. — ANI

Understanding extinct microbes

Washington: University of Oklahoma researchers in the US say that researching into extinct microbes may have significant implications for the state of modern human health, for such studies raise questions about the microbes living on and within people.

Within the gut, microbes are known to assist in human digestion, improve energy intake, produce vitamins and even help in the development of a healthy immune system. — ANI






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