HEALTH & FITNESS

Donít sleep over it
Many medical problems are frequently seen among young adults working in jobs that have late-night shifts
Dr Amit Kumar Mandal

The age-related sleep changes that characterise the sleep of older adults begin to appear in early adulthood and progress steadily during the adult human lifespan, including the older years. The bulk of the changes seen in adult sleep patterns occur between early adulthood, beginning at age 19 through age 60, and that changes in sleep macro-architecture effectively asymptote, declining only minimally from age 60 to age 102. Not only does the quality of sleep changes across the human lifespan, but the timing also changes with ageing.

Homoeopathic cure for dengue fever 
Dr Harsh Sharma

Dengue is a potentially fatal fever that occurs due to the dengue virus. It is spread by the Aedes Egypti mosquito. Dengue fever is also sometimes known as the break-bone fever because of the intense pain that it causes in the body as if a bone has been broken.

 

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Donít sleep over it
Many medical problems are frequently seen among young adults working in jobs that have late-night shifts
Dr Amit Kumar Mandal

The age-related sleep changes that characterise the sleep of older adults begin to appear in early adulthood and progress steadily during the adult human lifespan, including the older years. The bulk of the changes seen in adult sleep patterns occur between early adulthood, beginning at age 19 through age 60, and that changes in sleep macro-architecture effectively asymptote, declining only minimally from age 60 to age 102. Not only does the quality of sleep changes across the human lifespan, but the timing also changes with ageing.

Circadian rhythms are those that occur within a period of 24 hours (from the Greek ''about [circa] a day [dies]''), such as the adult human sleep-wake cycle. Older people tend to have earlier circadian phases, with a corresponding tendency to go to and rise earlier than younger adults. Also older people have more trouble adjusting to the rapid phases of shift work and jet lag, at least in terms of sleep quality, subjective complaint and performance measures. Yet many studies suggest that sleep-related problems are frequently seen in young adults working in call centres having odd-hour shifts.

The body's clock is programmed, both genetically as well as by habit, from birth to remain active during the daytime.

BPO work culture

In, 2005 IT and BPO industries in India employed about 7,00,000 people directly and about 2.5 million indirectly. It is expected to grow as more companies adopt off shoring because of its benefits. The export revenue could be go up by $ 80 million by 2015 from $ 60 million in 2010.

BPO work schedules pertain to extreme forms of shift-work. Circadian rhythm sleep disorders (CRSD) are frequently seen among shift workers who comprise a large segment of the BPO industry. The pattern of sleep, prevalence of anxiety and depression and the overall impact of the nature of their employment on their lifestyle were studied in a segment of BPO workers employed in the call centres around New Delhi. The study, conducted by a team led by Dr J.C. Suri, head of the Indian Sleep Disorders Association in 2008, compared a group of daytime workers (aged 19 to 37) to call centre staff on night shifts. It found more than 80 per cent of staff in call centres was showing signs of depression. Their symptoms were linked to the disruption in their normal sleep patterns by working regular night shifts. While 81 per cent of call centre workers showed signs of depression, only one in six of the day workers displayed the same symptoms. The call centre workers drank more heavily and a quarter regularly took illegal drugs, compared to only four per cent of day workers. Their body clocks could not adjust to the Western time zones. The sleep pattern of BPO workers was markedly different from normal. They were sleepier. The BPO workers were also seen to suffer more from anxiety disorder. The use of stimulants (tea, coffee, and cola) and other substances (alcohol, narcotics) was also more common in this group.

Job troubles

An eight-part study tool covering various topics was used in the call centres situated in Bangalore conducted by Naveen R., Bobby Joseph (176 call handlers participated). Majority of the respondents were in the age group of 21-30 year and were males. As many as 67.6 per cent had less than a year of experience working in the call centres, 54.3 per cent respondents had rotation shift duties and 81.8 per cent worked for eight-12 hours per night. Fifty per cent of the respondents had some problems related to their vocal health, 12.5 per cent, complained of problems related to their ears and 71.6 per cent of the respondents had musculoskeletal pain; the common region being the neck and the back. Unmarried respondents were found to be significantly under more stress when compared to married respondents. Working in call centre had interfered with the call handler's interaction with family members and social life.

India is situated five hours ahead of UK, 10 hours ahead of New York and 13 hours ahead of Los Angeles. US and UK-based companies claim overnight response capability because during their night time, it is day time in India and agents in India can respond to e-mails during Indian business hours. This is known as the follow the sun model. Working at nights requires adjusting the biological clock. This is turning out to be a major cause for health-related and social problems.

About 30-40 per cent of employees working in call centres suffer from computer vision syndrome and complain of eye problems. Soreness, dryness, blurred vision, light sensitivity, headache, etc. This problem is more acute in team leaders who are required to come in early and leave late. Thirty four per cent of employees complain of digestive disorders. The problem of 'losing their voice' earlier know as the 'teacher syndrome' is also found in the young call centre workers. In chronic form it is characterised by inability to speak (dysphonia), pain, croakiness of voice, irritating cough, poor vocal power, inability to modulate and breathing problems.

BOOS syndrome (burnt out stress syndrome) is very commonly seen among young workers in call centres. The symptoms of this syndrome include chronic fatigue, insomnia and complete alteration of 24-hour biological rhythm, which become routine causes of sickness/absenteeism. Chronic levels of stress affect the heart, endocrine system and also lead to sleep disorders.

Guiding principles

The call centre processes are designed to fit the technology and not the workers. Although most of the above cases do not require treatment or medication, they need guidance on physical and mental coordination to cope with a job that requires hyper-alert efficiency. Given the intense contact between team members on a shift, there is bound to be some development of interpersonal relationships and when the shift changes, there is a sudden break-up of relations. There is a period of total isolation both within the work environment and without ó since family lives get disrupted and contacts between family members break up. The stress levels of night-shift employees and high targets may force some towards drug abuse like pep-up pills to keep them going ó especially when youngsters have money to indulge.

The writer is Additional Director, Pulmonology, Sleep and Critical Care, Fortis Hospital, Mohali

strategies for a sound Sleep

Some strategies that may help shift workers improve their sleep:

* Having a sleep environment which is dark, quiet and not too warm

* Eating a carbohydrate-rich meal before sleeping.

* Physical activity during the night shift. This may help the circadian rhythm of night shift workers adapt more quickly to sleeping during the day

* Eating food containing protein during work time may help keep the shift workers more alert.

Medical conditions

Problems commonly seen in young adults working in call centres:

* Depression

* Reduced cognitive ability - leading to mistakes while working and dangerous driving.

* High blood pressure

* Mood swings

* Eating disorders (can increase appetite or kill it, depending on how the body reacts)

* Disrupted bowel movements

* Lowering of immunity

* Irregular cardiac rhythms

* Darkening of eyes

* Premature aging of skin

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Homoeopathic cure for dengue fever 
Dr Harsh Sharma

Dengue is a potentially fatal fever that occurs due to the dengue virus. It is spread by the Aedes Egypti mosquito. Dengue fever is also sometimes known as the break-bone fever because of the intense pain that it causes in the body as if a bone has been broken.

Symptoms

The symptoms usually begin four to six days after infection. Fever generally remains high and is accompanied by aches and pains all over the body, head, eyes and even the bones. There is a type of dengue fever known as the dengue haemorrhagic fever in which blood starts oozing from the body, the skin and the eyes. This is due to a sudden fall in the platelets of the blood which are instrumental in helping the blood clot. This form of fever is quite dangerous and can even be fatal.

Preventive measures

Wearing full-sleeves clothes when going outdoors and using common mosquito repellents inside the home are effective methods. Water should not be allowed to collect in the vicinity of home.

Role of homoeopathy

While homoeopathic medicines have worked wonders in the treatment of dengue fever and the dengue haemorrhagic fever, these medicines can also play the role of a prophylactic. A brief description of the commonly used medicines are given here. But a word of caution is necessary here. Haemorrhagic fever is best handled under expert care and hospitalisation may be required.

Eupatorium Perfopliatum: The prompt action of this medicine relieves severe pains in the back, the limbs and the muscle pains. Sweating relieves all symptoms except the headache.

Belladonna: This is beneficial for relieving throbbing headache with fever. The symptoms include a red and hot face, very cold feet even with high fever and there is little thirst.

Phosphorus: It is suitable for the haemorrhagic dengue fever. There may be bleeding from some body parts. There is strong thirst but vomiting occurs soon afterwards. The patient may be unusually hungry.

Rhus Tox: There is soreness and aching all over the body and the patient feels restless. The tongue may be coated except the tip which is red in a triangular fashion.

Bryonia: Pain in all parts of the body can be felt and is aggravated by the slightest motion and therefore the patient wants to remain still. There is intense thirst and the patient feels that his mouth is getting dry every now and then.

The writer is a Mohali-based homoeopath 

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