Preventing cancer
Your Health
DR GITA MATHAI
A shot in the arm
Cancer conjures up images of mutilating surgery, chemotherapy, radiation, years with doctors and in hospitals, and — most terrible — death. It comes in many avatars and can attack any part of the body. The risk factors for the ailment are many. It has been found to have associations with infections, lifestyle, genetic factors and heredity. If an injection is available to prevent cancer, it is hard to imagine anyone opting not to take it!
Viruses have long been known to cause infections that can progress to cancer. Previously, the association was suspected but not proven. Today, with electron microscopes, DNA sequencing and other advanced techniques, the association between certain viral infections and cancer has been conclusively proven. Of these, two types of cancer — of the cervix and some cancers of the liver — can be prevented with timely immunisation.a
The statistics speak for themselves. Cervical cancer (or cancer of the neck of the uterus) accounts for 25 per cent of all cancers in women. It is commoner than breast cancer (14 per cent). Around 1,30,000 cases are detected annually in India and half of these women eventually succumb to the disease.
Cervical cancer has long been associated with certain risk factors. It is more likely to occur if the woman smokes, does not have a healthy diet with plenty of fruits and vegetables, is exposed to multiple male sexual partners, has her first sexual contact before the age of 17 years, or has multiple pregnancies. A higher incidence is also noted if the woman has other sexually transmitted infections like Chlamydia or infection with HIV.
Recently, the association between infection with HPV (Human Papilloma Virus) and cervical cancer has been conclusively established. More than 95 per cent of the women with cervical cancer have evidence of HPV infection. Although 75 per cent of normal women have evidence of HPV infection, the virus persists and goes on to cause cancer in 5-10 per cent.
There are 130 identified types of HPV. Some cause infection but produce no symptoms like fever or pain, and are harmless. The patient may remain totally unaware of the infection. Other subtypes of HPV may cause warts on the skin. Around 30-40 types of the virus is transmitted through sexual contact. They may produce no symptoms when the infection first occurs. The virus can persist in the surface mucosa of the moist ano-genital areas. It can produce disfiguring warts in these areas. It can extend into the vaginal areas and cervix. Cancerous changes occur 20-30 years after the initial infection, when the woman is in her 40s and 50s.The progression depends on the type of virus and is more likely to occur if the infection occurred with the subtypes 15-20.
Once the association between cervical cancer and HPV was established, the scientific community got to work and produced a vaccine. It has been extensively studied and is now marketed in India by two companies under the trade names “Gardasil” and “Cervarix”. This is a major scientific breakthrough and cervical cancer can now be prevented in future generations of women.
The dosage schedule advised for HPV vaccine is as follows. The first dose is given between nine and 11 years of age. The second dose is administered two months later, and the third six months after that. No booster doses are advised at present. Women who have not been immunised can have the first dose at any time up to the age of 26 years. If they have already been exposed to HPV, the vaccine will only protect them against the strains to which they have not been exposed. Immunisation is not advised in pregnancy but can be given to breast-feeding mothers. Side effects are rare and include fever and rash.
For those of us who are older and have not had access to the vaccine, a screening test called “pap smear” (Papanicolaou test) can be done to detect cervical cancer in its early stages. The test is widely used and is effective. Screening should ideally be done three years after sexual activity has started and then continued every three years after that. Many Indian women do not have access to this test or are unaware of it.
Liver cancer and chronic liver disease can occur in people who develop hepatitis B infection. This too is a viral disease which is spread by contact with infected body fluids (blood transfusions, sexual intercourse). Infection can be prevented by three doses of hepatitis B vaccine. The second dose is given a month after the first and the third six months later.
Men and women should receive immunisation against Hepatitis B. At present, HPV vaccine is advised only for girls. Perhaps we have forgotten that women get the infection from their infected male partners, making a case for non-gender specific universal immunisation of all children.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Monday, December 28, 2009
Tuesday, December 22, 2009
woman like
Breasts like a woman
Your Health
DR GITA MATHAI
Both men and women have breasts. In women they are well developed while in men they are rudimentary. Yet 60 per cent of men, at some point in their life, develop aesthetically unacceptable “gynaecomastia”, a term which in Greek means “breasts like a woman”.
Male babies may develop enlargement of one or both breasts. Sometimes, the affected breasts may also secrete a watery milk-like secretion. This is normal and occurs because the baby’s breast has been influenced by the mother’s hormones. It disappears if left alone. Pressing it to remove the milk can result in infection and abscess formation.
Thirty to 50 per cent boys in the age group 11 to 14 years suddenly develop breasts. It occurs because during this time the levels of the sex hormones, both estrogen (female hormone) and testosterone (male hormone), start to increase. Testosterone controls male traits such as muscle mass and body hair, while estrogen controls female traits, including the growth of breasts. A perfect ratio has to be maintained, or else it might lead to the development of breasts in boys. In 75 per cent of them, the breasts regress spontaneously within three years.
Breast enlargement in boys may persist because of hypogonadism (inadequate development of the male sex organs). This may be genetic — in people whose genetic profile is XXY instead of XY, owing to the failure of the testes to develop at all, or a result of artificial removal of the testes (castration). It may occur in adults as a result of kidney and thyroid diseases. Liver damage can also result in low testosterone levels and enlarged breasts.
Enzymes belonging to the cytochrome P450 group, found in fat tissue, convert testosterones to estrogens. As the fat tissue increases gynaecomastia can occur. Weight loss and exercises, like the bench press and push-ups, can correct this type of breast enlargement along with overall weight reduction.
These enzymes can be affected by medications for ulcers, anti psychotic drugs, sedatives, diuretics and some antibiotics. Long-term use of medications belonging to these groups can cause gynaecomastia. Several illicit drugs are available on the streets today. Some, such as the amphetamines, are touted as a “safe” adjuvant to long hours of studying as they prevent drowsiness. But long-term use of these not only damages the psyche but also promotes breast development.
“Nutritional supplements” are used by many bodybuilders. Many do not contain all the ingredients listed. Some are sold secretly “under the counter” or via the Internet. Many preparations are not legal or may have expired. They may not conform to safety standards. Moreover, they may contain steroids. Sometimes, they contain creatinine, natural ingredients found in the human body. However, they may be dangerous to health, and cause enlarged and sometimes lumpy breasts.
There is no short cut to a “Mr World” physique. At least two hours of workout is needed with a healthy high-protein, low-fat diet.
Gynaecomastia is not always harmless. It needs to be reviewed with all previous medical documents, and investigated with blood tests and scans. Very rarely, gynaecomastia confined to one side may be due to cancer.
Diagnosis and treatment of the underlying cause of gynaecomastia may lead to improvement. Changing the offending medication, avoiding alcohol and exercising regularly may be all that is required. Some medications which are anti estrogen, or testosterone derivatives can sometimes be used on a short-term basis under medical supervision. These medications are for treating other diseases and are not universally approved for the treatment of gynaecomastia.
Medical treatment or “waiting and watching” can be tried for two to three years. After that, the breast tissue tends to harden and then surgery is the only alternative. There are several options — liposuction, gland excision, skin sculpture, reduction mammoplasty or a combination of these techniques. Reduction surgery is a cosmetic procedure and is usually performed by plastic surgeons.
In 25 per cent of men with persistent gynaecomastia, there is no correctable cause, nor is the condition dangerous. If they do not wish to have surgery or try medications and just wish to live with the condition, the breasts can often be compressed. An elastic girdle worn by women around their abdomens can be used and works quite well. Or else, a loose thick shirt may be sufficient to hide the offending bulges.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Your Health
DR GITA MATHAI
Both men and women have breasts. In women they are well developed while in men they are rudimentary. Yet 60 per cent of men, at some point in their life, develop aesthetically unacceptable “gynaecomastia”, a term which in Greek means “breasts like a woman”.
Male babies may develop enlargement of one or both breasts. Sometimes, the affected breasts may also secrete a watery milk-like secretion. This is normal and occurs because the baby’s breast has been influenced by the mother’s hormones. It disappears if left alone. Pressing it to remove the milk can result in infection and abscess formation.
Thirty to 50 per cent boys in the age group 11 to 14 years suddenly develop breasts. It occurs because during this time the levels of the sex hormones, both estrogen (female hormone) and testosterone (male hormone), start to increase. Testosterone controls male traits such as muscle mass and body hair, while estrogen controls female traits, including the growth of breasts. A perfect ratio has to be maintained, or else it might lead to the development of breasts in boys. In 75 per cent of them, the breasts regress spontaneously within three years.
Breast enlargement in boys may persist because of hypogonadism (inadequate development of the male sex organs). This may be genetic — in people whose genetic profile is XXY instead of XY, owing to the failure of the testes to develop at all, or a result of artificial removal of the testes (castration). It may occur in adults as a result of kidney and thyroid diseases. Liver damage can also result in low testosterone levels and enlarged breasts.
Enzymes belonging to the cytochrome P450 group, found in fat tissue, convert testosterones to estrogens. As the fat tissue increases gynaecomastia can occur. Weight loss and exercises, like the bench press and push-ups, can correct this type of breast enlargement along with overall weight reduction.
These enzymes can be affected by medications for ulcers, anti psychotic drugs, sedatives, diuretics and some antibiotics. Long-term use of medications belonging to these groups can cause gynaecomastia. Several illicit drugs are available on the streets today. Some, such as the amphetamines, are touted as a “safe” adjuvant to long hours of studying as they prevent drowsiness. But long-term use of these not only damages the psyche but also promotes breast development.
“Nutritional supplements” are used by many bodybuilders. Many do not contain all the ingredients listed. Some are sold secretly “under the counter” or via the Internet. Many preparations are not legal or may have expired. They may not conform to safety standards. Moreover, they may contain steroids. Sometimes, they contain creatinine, natural ingredients found in the human body. However, they may be dangerous to health, and cause enlarged and sometimes lumpy breasts.
There is no short cut to a “Mr World” physique. At least two hours of workout is needed with a healthy high-protein, low-fat diet.
Gynaecomastia is not always harmless. It needs to be reviewed with all previous medical documents, and investigated with blood tests and scans. Very rarely, gynaecomastia confined to one side may be due to cancer.
Diagnosis and treatment of the underlying cause of gynaecomastia may lead to improvement. Changing the offending medication, avoiding alcohol and exercising regularly may be all that is required. Some medications which are anti estrogen, or testosterone derivatives can sometimes be used on a short-term basis under medical supervision. These medications are for treating other diseases and are not universally approved for the treatment of gynaecomastia.
Medical treatment or “waiting and watching” can be tried for two to three years. After that, the breast tissue tends to harden and then surgery is the only alternative. There are several options — liposuction, gland excision, skin sculpture, reduction mammoplasty or a combination of these techniques. Reduction surgery is a cosmetic procedure and is usually performed by plastic surgeons.
In 25 per cent of men with persistent gynaecomastia, there is no correctable cause, nor is the condition dangerous. If they do not wish to have surgery or try medications and just wish to live with the condition, the breasts can often be compressed. An elastic girdle worn by women around their abdomens can be used and works quite well. Or else, a loose thick shirt may be sufficient to hide the offending bulges.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Saturday, December 5, 2009
leg cramps
A painful night visitor
Your Health
DR GITA MATHAI
It is not unusual to get a sudden spasm or cramp in a muscle, causing excruciating pain and a temporary inability to move. The condition, however, has an unusual colloquial name in the US and the UK — charley horse. This may be because the pain resembles the kick of a horse. The ailment is not confined to Western nations or horse riders. It affects 70 per cent of people over the age of 50 and 50 per cent of women during pregnancy.
These leg cramps usually last less than a minute — though it may seem much longer as the pain is severe — but the contraction may take several minutes to subside. It may leave a residual dull ache. It can occur once — as a never-to-be-forgotten single incidence — or several times a month, or disturb the person’s sleep night after night.
Although any muscle can go into such cramps, it commonly occurs in bigger muscles that cross two joints, like the hamstrings and quadriceps which cross the knee and hip or calf muscles which cross the ankle and the knee. It can occur in the fingers and toes as well.
The exact reason for cramps is not known. Older people, especially post menopausal obese women, and smokers are more prone to them. Improper footwear while exercising aggravates the problem. Medications — such as statins (for high cholesterol), some drugs for high blood pressure, diuretics and steroids — may cause cramps. People of all ages can develop cramps, especially if they change their mode of exercise and suddenly increase its intensity, type and duration.
Cramps are a result of electrolyte imbalance in the body. This causes defective functioning of the muscle-nerve reflex arc. It is rather like traffic lights going out of sync and causing a jam. The electrolytes involved are sodium, potassium, magnesium, iron, zinc and calcium. Cramps occur if the ratio among these minerals changes. Proper functioning of the reflex arcs also requires biochemical reactions in the body, mediated by enzymes. The latter are affected by diseases like diabetes and malfunctioning of the thyroid gland. Deficiencies in the B group of vitamins, alcohol consumption, excessive caffeine intake and smoking also affect the enzymes.
If you have several attacks of leg cramps a month, consult your doctor. You need to tackle treatable conditions and change medication that may be aggravating it. If the cramps are due to pregnancy, they usually disappear once the baby is born.
If all the tests are normal, you may try a few simple measures:
* Try eating three to four helpings of fresh fruit and raw vegetables every day. It will correct any potassium and vitamin B deficiency.
* Eat a handful of nuts. It will take care of your requirements of magnesium and zinc.
* If you are anaemic, take iron and folic acid supplements.
* Most people do not get enough calcium from their diet and this needs to be supplemented. Around 1,200 mg of calcium needs to be taken daily, preferably at bedtime.
* Keep yourself well hydrated. Drink at least three litres of water a day and at least 250 ml before going to bed.
* Finish all your exercise at least an hour before bedtime.
* Soak the legs in warm water for 10 minutes before bedtime, and place a pillow at the end of the bed so that you sleep with your feet propped up.
* Some stretches done morning and evening prevent cramps. Stand on the floor with your feet apart. Stretch your hands up over your head and rise up on to your toes. Holding this position, rock backwards and forwards on your feet for a minute.
* Always warm up and cool down before and after exercise.
* The stretches done as a part of yoga prevent cramps.
If you develop spasms despite all this, immediately try to push the foot upwards. Massage the affected leg and apply moist heat. Sometimes, stretching the unaffected leg helps.
Leg cramps occur specifically at night. That is what distinguishes them from pain that is due to nerve disorders or damage, slipped discs or blocked blood vessels which reduce blood circulation to the legs. These diseases cause pain all the time, day and night.
“Restless legs” are different from leg cramps. This is a peculiar condition where both the legs develop pins and needles and sometimes a creeping pain several times during the night. It wakes up the person, and relief can be obtained only by moving the leg or standing up. Sleep is disturbed and inadequate. This needs to be evaluated by a doctor and treated with medication.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Your Health
DR GITA MATHAI
It is not unusual to get a sudden spasm or cramp in a muscle, causing excruciating pain and a temporary inability to move. The condition, however, has an unusual colloquial name in the US and the UK — charley horse. This may be because the pain resembles the kick of a horse. The ailment is not confined to Western nations or horse riders. It affects 70 per cent of people over the age of 50 and 50 per cent of women during pregnancy.
These leg cramps usually last less than a minute — though it may seem much longer as the pain is severe — but the contraction may take several minutes to subside. It may leave a residual dull ache. It can occur once — as a never-to-be-forgotten single incidence — or several times a month, or disturb the person’s sleep night after night.
Although any muscle can go into such cramps, it commonly occurs in bigger muscles that cross two joints, like the hamstrings and quadriceps which cross the knee and hip or calf muscles which cross the ankle and the knee. It can occur in the fingers and toes as well.
The exact reason for cramps is not known. Older people, especially post menopausal obese women, and smokers are more prone to them. Improper footwear while exercising aggravates the problem. Medications — such as statins (for high cholesterol), some drugs for high blood pressure, diuretics and steroids — may cause cramps. People of all ages can develop cramps, especially if they change their mode of exercise and suddenly increase its intensity, type and duration.
Cramps are a result of electrolyte imbalance in the body. This causes defective functioning of the muscle-nerve reflex arc. It is rather like traffic lights going out of sync and causing a jam. The electrolytes involved are sodium, potassium, magnesium, iron, zinc and calcium. Cramps occur if the ratio among these minerals changes. Proper functioning of the reflex arcs also requires biochemical reactions in the body, mediated by enzymes. The latter are affected by diseases like diabetes and malfunctioning of the thyroid gland. Deficiencies in the B group of vitamins, alcohol consumption, excessive caffeine intake and smoking also affect the enzymes.
If you have several attacks of leg cramps a month, consult your doctor. You need to tackle treatable conditions and change medication that may be aggravating it. If the cramps are due to pregnancy, they usually disappear once the baby is born.
If all the tests are normal, you may try a few simple measures:
* Try eating three to four helpings of fresh fruit and raw vegetables every day. It will correct any potassium and vitamin B deficiency.
* Eat a handful of nuts. It will take care of your requirements of magnesium and zinc.
* If you are anaemic, take iron and folic acid supplements.
* Most people do not get enough calcium from their diet and this needs to be supplemented. Around 1,200 mg of calcium needs to be taken daily, preferably at bedtime.
* Keep yourself well hydrated. Drink at least three litres of water a day and at least 250 ml before going to bed.
* Finish all your exercise at least an hour before bedtime.
* Soak the legs in warm water for 10 minutes before bedtime, and place a pillow at the end of the bed so that you sleep with your feet propped up.
* Some stretches done morning and evening prevent cramps. Stand on the floor with your feet apart. Stretch your hands up over your head and rise up on to your toes. Holding this position, rock backwards and forwards on your feet for a minute.
* Always warm up and cool down before and after exercise.
* The stretches done as a part of yoga prevent cramps.
If you develop spasms despite all this, immediately try to push the foot upwards. Massage the affected leg and apply moist heat. Sometimes, stretching the unaffected leg helps.
Leg cramps occur specifically at night. That is what distinguishes them from pain that is due to nerve disorders or damage, slipped discs or blocked blood vessels which reduce blood circulation to the legs. These diseases cause pain all the time, day and night.
“Restless legs” are different from leg cramps. This is a peculiar condition where both the legs develop pins and needles and sometimes a creeping pain several times during the night. It wakes up the person, and relief can be obtained only by moving the leg or standing up. Sleep is disturbed and inadequate. This needs to be evaluated by a doctor and treated with medication.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Sunday, November 29, 2009
feeding children
Mama, give me the right food
Your Health
DR GITA MATHAI
“My child does not eat at all. Could you prescribe a tonic?” This is a concern expressed by most parents during their visit to the paediatrician for a routine checkup. Yet, rarely do these children appear malnourished. They do not have sunken cheeks nor are the ribs plainly visible. They seem healthy and their weight is appropriate. The complaints arise probably because the amount of food they eat falls short of the parents’ expectations.
The weight of a child in the first year is determined by the birth weight. For example, a child who is 3kg at birth should be 9kg on his or her first birthday (three times the birth weight). After the first year, the growth rate slows down. The weight after the age of two can be calculated using the formula: (age +3) x 5 = weight in pounds. Divide it by 2.2 to get the value in kilograms. The BMI is calculated as weight in kilograms divided by height in metre cubed. For children up to 10 years, this should be 23.
If a child is underweight, or the weight curve has plateaued or is dropping, investigations have to be done. The problem may be treatable and correctable. Children often get worm infestation. This may cause weight loss and a perverted desire to eat chalk, toothpaste, uncooked rice or lick paint. Usually a single dose of albendazole is all that is required. It can be prescribed by the paediatrician. But if the physical examination and tests are normal, the problem may lie with faulty feeding practices.
Correct food habits have to be started at birth and continued through life. Breast milk is best for a newborn baby even if it is pre-term. The World Health Organisation has recommended that it should be the only food (exclusive) the baby receives for the first 120 days. Breast milk has a high concentration of antibodies and immunoglobulins which protect against viral and bacterial diarrhoea, cold, cough, measles, chicken pox, mumps and a variety of other infections between six and nine months. Despite extensive research and claims of superiority, baby food manufacturers have not managed to duplicate breast milk.
Weaning foods can be introduced after 120 days. Breast milk tastes bland, so unless the initial weaning food tastes similar, the baby may reject it. Natural foods like rice, wheat or ragi are best. Precooked, ready-to-eat packaged cereals have no advantage. They may (despite claims to the contrary) contain preservatives or high concentrations of electrolytes which the baby’s immature organs cannot handle.
New foods should be introduced only every two weeks. Mashed banana, stewed apple and freshly prepared juices are easily digested. Homemade string hoppers or idlies can be served with milk and sugar. A mixture of rice, pulses, potato, carrot and other vegetables can be cooked with salt, mashed properly and given to the baby.
After the age of 10 months, undiluted cow milk may be given. The total quantity a day should not exceed 400ml. But if it is given first thing in the morning, it suppresses the appetite. Milk should be served after breakfast. It contains only 60 calories per 100ml. This means that consuming large volumes will fill the stomach but not provide as much energy as the same volume of calorie-dense food. Additives and “health drinks” do not really provide nutrition. They contribute very little to the health or weight of a child unless taken in large unrealistic portions.
A sedentary child who sits in front of the television will not have a good appetite. Physical activity is essential. This has to be provided and supervised by parents as most schools today concentrate on academics. At least one hour of activity — such as running, jumping and cycling — is essential for a good appetite and good health.
Milk biscuits, cream biscuits, packaged snacks and aerated, carbonated cool drinks provide empty calories. A child who is not particular about meals but prefers to eat snacks and watch television all day will be unhealthy, develop a paunch and have a poor appetite. This may also lead to obesity. An occasional snack is a reward, not a substitute for proper meals.
Many “health tonics”, often touted as natural, are available in the market. Non- allopathic (homeopathic or aryuvedic) products may have tongue-twisting names and contain many ingredients. Their side effects are not known, nor whether they have reactions with any allopathic medication that a child is taking. Tonics containing cyproheptadine do increase the appetite. This drug is actually a potent antihistamine with many dangerous side effects, one of which is an increased appetite.
It must also be kept in mind that the apple does not fall far from the tree. If both parents are thin, it is likely that the child will also be so. This may be genetic or the result of food and exercise habits inculcated over several generations.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in.
Your Health
DR GITA MATHAI
“My child does not eat at all. Could you prescribe a tonic?” This is a concern expressed by most parents during their visit to the paediatrician for a routine checkup. Yet, rarely do these children appear malnourished. They do not have sunken cheeks nor are the ribs plainly visible. They seem healthy and their weight is appropriate. The complaints arise probably because the amount of food they eat falls short of the parents’ expectations.
The weight of a child in the first year is determined by the birth weight. For example, a child who is 3kg at birth should be 9kg on his or her first birthday (three times the birth weight). After the first year, the growth rate slows down. The weight after the age of two can be calculated using the formula: (age +3) x 5 = weight in pounds. Divide it by 2.2 to get the value in kilograms. The BMI is calculated as weight in kilograms divided by height in metre cubed. For children up to 10 years, this should be 23.
If a child is underweight, or the weight curve has plateaued or is dropping, investigations have to be done. The problem may be treatable and correctable. Children often get worm infestation. This may cause weight loss and a perverted desire to eat chalk, toothpaste, uncooked rice or lick paint. Usually a single dose of albendazole is all that is required. It can be prescribed by the paediatrician. But if the physical examination and tests are normal, the problem may lie with faulty feeding practices.
Correct food habits have to be started at birth and continued through life. Breast milk is best for a newborn baby even if it is pre-term. The World Health Organisation has recommended that it should be the only food (exclusive) the baby receives for the first 120 days. Breast milk has a high concentration of antibodies and immunoglobulins which protect against viral and bacterial diarrhoea, cold, cough, measles, chicken pox, mumps and a variety of other infections between six and nine months. Despite extensive research and claims of superiority, baby food manufacturers have not managed to duplicate breast milk.
Weaning foods can be introduced after 120 days. Breast milk tastes bland, so unless the initial weaning food tastes similar, the baby may reject it. Natural foods like rice, wheat or ragi are best. Precooked, ready-to-eat packaged cereals have no advantage. They may (despite claims to the contrary) contain preservatives or high concentrations of electrolytes which the baby’s immature organs cannot handle.
New foods should be introduced only every two weeks. Mashed banana, stewed apple and freshly prepared juices are easily digested. Homemade string hoppers or idlies can be served with milk and sugar. A mixture of rice, pulses, potato, carrot and other vegetables can be cooked with salt, mashed properly and given to the baby.
After the age of 10 months, undiluted cow milk may be given. The total quantity a day should not exceed 400ml. But if it is given first thing in the morning, it suppresses the appetite. Milk should be served after breakfast. It contains only 60 calories per 100ml. This means that consuming large volumes will fill the stomach but not provide as much energy as the same volume of calorie-dense food. Additives and “health drinks” do not really provide nutrition. They contribute very little to the health or weight of a child unless taken in large unrealistic portions.
A sedentary child who sits in front of the television will not have a good appetite. Physical activity is essential. This has to be provided and supervised by parents as most schools today concentrate on academics. At least one hour of activity — such as running, jumping and cycling — is essential for a good appetite and good health.
Milk biscuits, cream biscuits, packaged snacks and aerated, carbonated cool drinks provide empty calories. A child who is not particular about meals but prefers to eat snacks and watch television all day will be unhealthy, develop a paunch and have a poor appetite. This may also lead to obesity. An occasional snack is a reward, not a substitute for proper meals.
Many “health tonics”, often touted as natural, are available in the market. Non- allopathic (homeopathic or aryuvedic) products may have tongue-twisting names and contain many ingredients. Their side effects are not known, nor whether they have reactions with any allopathic medication that a child is taking. Tonics containing cyproheptadine do increase the appetite. This drug is actually a potent antihistamine with many dangerous side effects, one of which is an increased appetite.
It must also be kept in mind that the apple does not fall far from the tree. If both parents are thin, it is likely that the child will also be so. This may be genetic or the result of food and exercise habits inculcated over several generations.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in.
Feeding children
Mama, give me the right food
Your Health
DR GITA MATHAI | |
"My child does not eat at all. Could you prescribe a tonic?" This is a concern expressed by most parents during their visit to the paediatrician for a routine checkup. Yet, rarely do these children appear malnourished. They do not have sunken cheeks nor are the ribs plainly visible. They seem healthy and their weight is appropriate. The complaints arise probably because the amount of food they eat falls short of the parents' expectations.
The weight of a child in the first year is determined by the birth weight. For example, a child who is 3kg at birth should be 9kg on his or her first birthday (three times the birth weight). After the first year, the growth rate slows down. The weight after the age of two can be calculated using the formula: (age +3) x 5 = weight in pounds. Divide it by 2.2 to get the value in kilograms. The BMI is calculated as weight in kilograms divided by height in metre cubed. For children up to 10 years, this should be 23.
If a child is underweight, or the weight curve has plateaued or is dropping, investigations have to be done. The problem may be treatable and correctable. Children often get worm infestation. This may cause weight loss and a perverted desire to eat chalk, toothpaste, uncooked rice or lick paint. Usually a single dose of albendazole is all that is required. It can be prescribed by the paediatrician. But if the physical examination and tests are normal, the problem may lie with faulty feeding practices.
Correct food habits have to be started at birth and continued through life. Breast milk is best for a newborn baby even if it is pre-term. The World Health Organisation has recommended that it should be the only food (exclusive) the baby receives for the first 120 days. Breast milk has a high concentration of antibodies and immunoglobulins which protect against viral and bacterial diarrhoea, cold, cough, measles, chicken pox, mumps and a variety of other infections between six and nine months. Despite extensive research and claims of superiority, baby food manufacturers have not managed to duplicate breast milk.
Weaning foods can be introduced after 120 days. Breast milk tastes bland, so unless the initial weaning food tastes similar, the baby may reject it. Natural foods like rice, wheat or ragi are best. Precooked, ready-to-eat packaged cereals have no advantage. They may (despite claims to the contrary) contain preservatives or high concentrations of electrolytes which the baby's immature organs cannot handle.
New foods should be introduced only every two weeks. Mashed banana, stewed apple and freshly prepared juices are easily digested. Homemade string hoppers or idlies can be served with milk and sugar. A mixture of rice, pulses, potato, carrot and other vegetables can be cooked with salt, mashed properly and given to the baby.
After the age of 10 months, undiluted cow milk may be given. The total quantity a day should not exceed 400ml. But if it is given first thing in the morning, it suppresses the appetite. Milk should be served after breakfast. It contains only 60 calories per 100ml. This means that consuming large volumes will fill the stomach but not provide as much energy as the same volume of calorie-dense food. Additives and "health drinks" do not really provide nutrition. They contribute very little to the health or weight of a child unless taken in large unrealistic portions.
A sedentary child who sits in front of the television will not have a good appetite. Physical activity is essential. This has to be provided and supervised by parents as most schools today concentrate on academics. At least one hour of activity — such as running, jumping and cycling — is essential for a good appetite and good health.
Milk biscuits, cream biscuits, packaged snacks and aerated, carbonated cool drinks provide empty calories. A child who is not particular about meals but prefers to eat snacks and watch television all day will be unhealthy, develop a paunch and have a poor appetite. This may also lead to obesity. An occasional snack is a reward, not a substitute for proper meals.
Many "health tonics", often touted as natural, are available in the market. Non- allopathic (homeopathic or aryuvedic) products may have tongue-twisting names and contain many ingredients. Their side effects are not known, nor whether they have reactions with any allopathic medication that a child is taking. Tonics containing cyproheptadine do increase the appetite. This drug is actually a potent antihistamine with many dangerous side effects, one of which is an increased appetite.
It must also be kept in mind that the apple does not fall far from the tree. If both parents are thin, it is likely that the child will also be so. This may be genetic or the result of food and exercise habits inculcated over several generations.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in.
Sunday, November 22, 2009
preparation for pregnancy
Preparing for your baby
Your Health
DR GITA MATHAI
A painting by Dipti Chakrabarti
“My baby is small because I had typhoid / jaundice during pregnancy.” “This is my third pregnancy; I lost one child and the other was born very small.”
“I needed interventions to get pregnant. This baby cost more than a lakh.”
Common but preventable events. India has a high maternal mortality rate of 450 per 1,00,000 live births. The figure, of course, does not account for women who have a lifetime of ill health after childbirth. Our country has a high infant mortality rate as well. There are 21.76 births per 1,000 every year. Out of this 1 lakh newborns die in the first 24 hours of their life and an unknown percentage has lifelong “special needs”.
Today many women are educated, employed and self sufficient. They no longer consider home making and child bearing their primary function in life. Despite this, it is a function many eventually have to perform. Human beings, after all, live to procreate, produce children and ensure the survival of family genes. Reproduction is the prerogative of women. They must try to remain physically fit to undertake this venture. The ability to conceive, carry a healthy child to term and then deliver normally must not be taken for granted. Thought, effort and preparation has to go into this “natural” function.
All parents need to focus on the prevention of diseases that can affect the lives of their little ones. Some infectious diseases, such as German measles, can have a devastating effect on the child if acquired by the mother during pregnancy. It causes heart defects, deafness, cataract, a small head and mental retardation. Mumps, on the other hand, can cause an abortion. Chicken pox may lead to abnormal arms and legs, and eye and brain damage. All this means a lifetime of misery for the mother, who bears the brunt of caring for a child with special needs.
These common infectious diseases can be prevented by timely immunisation. The MMR (measles, mumps, rubella or German measles) vaccine should be given at the age of 15 months with a booster at 9-10 years. Chicken pox can be prevented by a single dose of Varicella vaccine administered soon after the first birthday. These vaccinations are not yet part of the National Immunisation Programme (NIP) and therefore not provided free of cost by the government.
Hepatitis B is a type of jaundice that is dangerous, can be fatal and is passed on to the baby by the mother. Hepatitis A causes jaundice that is usually mild and self limiting. During pregnancy, however, it can devastate a woman’s health as it aggravates nausea and vomiting. It affects the liver, which is more sensitive to damage during pregnancy.
Both types of jaundice are preventable with immunisation. Hepatitis B immunisation has recently been made part of the NIP. It is available free and given at birth and then along with triple antigen (DPT). Older children have not had the benefit of this programme and need to be immunised separately. Hepatitis A immunisation is not free. It is advised after the age of two years.
Typhoid is a very common infection, especially in the monsoon. Again, women who develop it can become very ill. Many medicines used to treat this infection are contraindicated during pregnancy. Striking a balance between the health of the mother and that of the unborn child becomes a tricky balancing act. Again, preventive immunisation is available and consists of a single injection every three years.
The Human Papillovirus (HPV) causes wart-like growths in the genital area, which requires delivery by caesarian section. The infection can later progress to cervical cancer. It is preventable with three doses of vaccine between the ages of 9-11 years.
Women tend to be anaemic with haemoglobin values less than the recommended 12gm/dl. Anaemic women produce low birth weight babies who have insufficient iron at birth. This can be prevented with iron supplements. It is usually available as a combination tablet with folic acid — a vitamin that prevents defects in the baby’s brain and spinal cord. This can be started (after consulting your doctor) following menarche (onset of menstruation).
Regular exercise is essential for girls. It should be started at the primary school level, with jogging, cycling or swimming for 30-40 minutes a day. Stretching and yoga help the flexibility of the joints that need to "give" during labour. Hormonal imbalances, polycystic ovarian disease and many fertility problems correct themselves if ideal body weight is maintained. This endurance training is helpful during the long exhausting hours of labour.
When your precious daughter is about to get married, make sure her immunisations are complete. And perhaps present her a treadmill or any other exercise machine in lieu of some jewels.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Your Health
DR GITA MATHAI
A painting by Dipti Chakrabarti
“My baby is small because I had typhoid / jaundice during pregnancy.” “This is my third pregnancy; I lost one child and the other was born very small.”
“I needed interventions to get pregnant. This baby cost more than a lakh.”
Common but preventable events. India has a high maternal mortality rate of 450 per 1,00,000 live births. The figure, of course, does not account for women who have a lifetime of ill health after childbirth. Our country has a high infant mortality rate as well. There are 21.76 births per 1,000 every year. Out of this 1 lakh newborns die in the first 24 hours of their life and an unknown percentage has lifelong “special needs”.
Today many women are educated, employed and self sufficient. They no longer consider home making and child bearing their primary function in life. Despite this, it is a function many eventually have to perform. Human beings, after all, live to procreate, produce children and ensure the survival of family genes. Reproduction is the prerogative of women. They must try to remain physically fit to undertake this venture. The ability to conceive, carry a healthy child to term and then deliver normally must not be taken for granted. Thought, effort and preparation has to go into this “natural” function.
All parents need to focus on the prevention of diseases that can affect the lives of their little ones. Some infectious diseases, such as German measles, can have a devastating effect on the child if acquired by the mother during pregnancy. It causes heart defects, deafness, cataract, a small head and mental retardation. Mumps, on the other hand, can cause an abortion. Chicken pox may lead to abnormal arms and legs, and eye and brain damage. All this means a lifetime of misery for the mother, who bears the brunt of caring for a child with special needs.
These common infectious diseases can be prevented by timely immunisation. The MMR (measles, mumps, rubella or German measles) vaccine should be given at the age of 15 months with a booster at 9-10 years. Chicken pox can be prevented by a single dose of Varicella vaccine administered soon after the first birthday. These vaccinations are not yet part of the National Immunisation Programme (NIP) and therefore not provided free of cost by the government.
Hepatitis B is a type of jaundice that is dangerous, can be fatal and is passed on to the baby by the mother. Hepatitis A causes jaundice that is usually mild and self limiting. During pregnancy, however, it can devastate a woman’s health as it aggravates nausea and vomiting. It affects the liver, which is more sensitive to damage during pregnancy.
Both types of jaundice are preventable with immunisation. Hepatitis B immunisation has recently been made part of the NIP. It is available free and given at birth and then along with triple antigen (DPT). Older children have not had the benefit of this programme and need to be immunised separately. Hepatitis A immunisation is not free. It is advised after the age of two years.
Typhoid is a very common infection, especially in the monsoon. Again, women who develop it can become very ill. Many medicines used to treat this infection are contraindicated during pregnancy. Striking a balance between the health of the mother and that of the unborn child becomes a tricky balancing act. Again, preventive immunisation is available and consists of a single injection every three years.
The Human Papillovirus (HPV) causes wart-like growths in the genital area, which requires delivery by caesarian section. The infection can later progress to cervical cancer. It is preventable with three doses of vaccine between the ages of 9-11 years.
Women tend to be anaemic with haemoglobin values less than the recommended 12gm/dl. Anaemic women produce low birth weight babies who have insufficient iron at birth. This can be prevented with iron supplements. It is usually available as a combination tablet with folic acid — a vitamin that prevents defects in the baby’s brain and spinal cord. This can be started (after consulting your doctor) following menarche (onset of menstruation).
Regular exercise is essential for girls. It should be started at the primary school level, with jogging, cycling or swimming for 30-40 minutes a day. Stretching and yoga help the flexibility of the joints that need to "give" during labour. Hormonal imbalances, polycystic ovarian disease and many fertility problems correct themselves if ideal body weight is maintained. This endurance training is helpful during the long exhausting hours of labour.
When your precious daughter is about to get married, make sure her immunisations are complete. And perhaps present her a treadmill or any other exercise machine in lieu of some jewels.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Preparation for pregnancy
Preparing for your baby | ||
| ||
"My baby is small because I had typhoid / jaundice during pregnancy." "This is my third pregnancy; I lost one child and the other was born very small." "I needed interventions to get pregnant. This baby cost more than a lakh." Common but preventable events. India has a high maternal mortality rate of 450 per 1,00,000 live births. The figure, of course, does not account for women who have a lifetime of ill health after childbirth. Our country has a high infant mortality rate as well. There are 21.76 births per 1,000 every year. Out of this 1 lakh newborns die in the first 24 hours of their life and an unknown percentage has lifelong "special needs". Today many women are educated, employed and self sufficient. They no longer consider home making and child bearing their primary function in life. Despite this, it is a function many eventually have to perform. Human beings, after all, live to procreate, produce children and ensure the survival of family genes. Reproduction is the prerogative of women. They must try to remain physically fit to undertake this venture. The ability to conceive, carry a healthy child to term and then deliver normally must not be taken for granted. Thought, effort and preparation has to go into this "natural" function. All parents need to focus on the prevention of diseases that can affect the lives of their little ones. Some infectious diseases, such as German measles, can have a devastating effect on the child if acquired by the mother during pregnancy. It causes heart defects, deafness, cataract, a small head and mental retardation. Mumps, on the other hand, can cause an abortion. Chicken pox may lead to abnormal arms and legs, and eye and brain damage. All this means a lifetime of misery for the mother, who bears the brunt of caring for a child with special needs. These common infectious diseases can be prevented by timely immunisation. The MMR (measles, mumps, rubella or German measles) vaccine should be given at the age of 15 months with a booster at 9-10 years. Chicken pox can be prevented by a single dose of Varicella vaccine administered soon after the first birthday. These vaccinations are not yet part of the National Immunisation Programme (NIP) and therefore not provided free of cost by the government. Hepatitis B is a type of jaundice that is dangerous, can be fatal and is passed on to the baby by the mother. Hepatitis A causes jaundice that is usually mild and self limiting. During pregnancy, however, it can devastate a woman's health as it aggravates nausea and vomiting. It affects the liver, which is more sensitive to damage during pregnancy. Both types of jaundice are preventable with immunisation. Hepatitis B immunisation has recently been made part of the NIP. It is available free and given at birth and then along with triple antigen (DPT). Older children have not had the benefit of this programme and need to be immunised separately. Hepatitis A immunisation is not free. It is advised after the age of two years. Typhoid is a very common infection, especially in the monsoon. Again, women who develop it can become very ill. Many medicines used to treat this infection are contraindicated during pregnancy. Striking a balance between the health of the mother and that of the unborn child becomes a tricky balancing act. Again, preventive immunisation is available and consists of a single injection every three years. The Human Papillovirus (HPV) causes wart-like growths in the genital area, which requires delivery by caesarian section. The infection can later progress to cervical cancer. It is preventable with three doses of vaccine between the ages of 9-11 years. Women tend to be anaemic with haemoglobin values less than the recommended 12gm/dl. Anaemic women produce low birth weight babies who have insufficient iron at birth. This can be prevented with iron supplements. It is usually available as a combination tablet with folic acid — a vitamin that prevents defects in the baby's brain and spinal cord. This can be started (after consulting your doctor) following menarche (onset of menstruation). Regular exercise is essential for girls. It should be started at the primary school level, with jogging, cycling or swimming for 30-40 minutes a day. Stretching and yoga help the flexibility of the joints that need to "give" during labour. Hormonal imbalances, polycystic ovarian disease and many fertility problems correct themselves if ideal body weight is maintained. This endurance training is helpful during the long exhausting hours of labour. When your precious daughter is about to get married, make sure her immunisations are complete. And perhaps present her a treadmill or any other exercise machine in lieu of some jewels. Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in | ||
Preparation for pregnancy
Preparing for your baby
Your Health
DR GITA MATHAI
A painting by Dipti Chakrabarti
"My baby is small because I had typhoid / jaundice during pregnancy." "This is my third pregnancy; I lost one child and the other was born very small."
"I needed interventions to get pregnant. This baby cost more than a lakh."
Common but preventable events. India has a high maternal mortality rate of 450 per 1,00,000 live births. The figure, of course, does not account for women who have a lifetime of ill health after childbirth. Our country has a high infant mortality rate as well. There are 21.76 births per 1,000 every year. Out of this 1 lakh newborns die in the first 24 hours of their life and an unknown percentage has lifelong "special needs".
Today many women are educated, employed and self sufficient. They no longer consider home making and child bearing their primary function in life. Despite this, it is a function many eventually have to perform. Human beings, after all, live to procreate, produce children and ensure the survival of family genes. Reproduction is the prerogative of women. They must try to remain physically fit to undertake this venture. The ability to conceive, carry a healthy child to term and then deliver normally must not be taken for granted. Thought, effort and preparation has to go into this "natural" function.
All parents need to focus on the prevention of diseases that can affect the lives of their little ones. Some infectious diseases, such as German measles, can have a devastating effect on the child if acquired by the mother during pregnancy. It causes heart defects, deafness, cataract, a small head and mental retardation. Mumps, on the other hand, can cause an abortion. Chicken pox may lead to abnormal arms and legs, and eye and brain damage. All this means a lifetime of misery for the mother, who bears the brunt of caring for a child with special needs.
These common infectious diseases can be prevented by timely immunisation. The MMR (measles, mumps, rubella or German measles) vaccine should be given at the age of 15 months with a booster at 9-10 years. Chicken pox can be prevented by a single dose of Varicella vaccine administered soon after the first birthday. These vaccinations are not yet part of the National Immunisation Programme (NIP) and therefore not provided free of cost by the government.
Hepatitis B is a type of jaundice that is dangerous, can be fatal and is passed on to the baby by the mother. Hepatitis A causes jaundice that is usually mild and self limiting. During pregnancy, however, it can devastate a woman's health as it aggravates nausea and vomiting. It affects the liver, which is more sensitive to damage during pregnancy.
Both types of jaundice are preventable with immunisation. Hepatitis B immunisation has recently been made part of the NIP. It is available free and given at birth and then along with triple antigen (DPT). Older children have not had the benefit of this programme and need to be immunised separately. Hepatitis A immunisation is not free. It is advised after the age of two years.
Typhoid is a very common infection, especially in the monsoon. Again, women who develop it can become very ill. Many medicines used to treat this infection are contraindicated during pregnancy. Striking a balance between the health of the mother and that of the unborn child becomes a tricky balancing act. Again, preventive immunisation is available and consists of a single injection every three years.
The Human Papillovirus (HPV) causes wart-like growths in the genital area, which requires delivery by caesarian section. The infection can later progress to cervical cancer. It is preventable with three doses of vaccine between the ages of 9-11 years.
Women tend to be anaemic with haemoglobin values less than the recommended 12gm/dl. Anaemic women produce low birth weight babies who have insufficient iron at birth. This can be prevented with iron supplements. It is usually available as a combination tablet with folic acid — a vitamin that prevents defects in the baby's brain and spinal cord. This can be started (after consulting your doctor) following menarche (onset of menstruation).
Regular exercise is essential for girls. It should be started at the primary school level, with jogging, cycling or swimming for 30-40 minutes a day. Stretching and yoga help the flexibility of the joints that need to "give" during labour. Hormonal imbalances, polycystic ovarian disease and many fertility problems correct themselves if ideal body weight is maintained. This endurance training is helpful during the long exhausting hours of labour.
When your precious daughter is about to get married, make sure her immunisations are complete. And perhaps present her a treadmill or any other exercise machine in lieu of some jewels.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Preparation for pregnancy
Preparing for your baby
Your Health
DR GITA MATHAI
A painting by Dipti Chakrabarti
"My baby is small because I had typhoid / jaundice during pregnancy." "This is my third pregnancy; I lost one child and the other was born very small."
"I needed interventions to get pregnant. This baby cost more than a lakh."
Common but preventable events. India has a high maternal mortality rate of 450 per 1,00,000 live births. The figure, of course, does not account for women who have a lifetime of ill health after childbirth. Our country has a high infant mortality rate as well. There are 21.76 births per 1,000 every year. Out of this 1 lakh newborns die in the first 24 hours of their life and an unknown percentage has lifelong "special needs".
Today many women are educated, employed and self sufficient. They no longer consider home making and child bearing their primary function in life. Despite this, it is a function many eventually have to perform. Human beings, after all, live to procreate, produce children and ensure the survival of family genes. Reproduction is the prerogative of women. They must try to remain physically fit to undertake this venture. The ability to conceive, carry a healthy child to term and then deliver normally must not be taken for granted. Thought, effort and preparation has to go into this "natural" function.
All parents need to focus on the prevention of diseases that can affect the lives of their little ones. Some infectious diseases, such as German measles, can have a devastating effect on the child if acquired by the mother during pregnancy. It causes heart defects, deafness, cataract, a small head and mental retardation. Mumps, on the other hand, can cause an abortion. Chicken pox may lead to abnormal arms and legs, and eye and brain damage. All this means a lifetime of misery for the mother, who bears the brunt of caring for a child with special needs.
These common infectious diseases can be prevented by timely immunisation. The MMR (measles, mumps, rubella or German measles) vaccine should be given at the age of 15 months with a booster at 9-10 years. Chicken pox can be prevented by a single dose of Varicella vaccine administered soon after the first birthday. These vaccinations are not yet part of the National Immunisation Programme (NIP) and therefore not provided free of cost by the government.
Hepatitis B is a type of jaundice that is dangerous, can be fatal and is passed on to the baby by the mother. Hepatitis A causes jaundice that is usually mild and self limiting. During pregnancy, however, it can devastate a woman's health as it aggravates nausea and vomiting. It affects the liver, which is more sensitive to damage during pregnancy.
Both types of jaundice are preventable with immunisation. Hepatitis B immunisation has recently been made part of the NIP. It is available free and given at birth and then along with triple antigen (DPT). Older children have not had the benefit of this programme and need to be immunised separately. Hepatitis A immunisation is not free. It is advised after the age of two years.
Typhoid is a very common infection, especially in the monsoon. Again, women who develop it can become very ill. Many medicines used to treat this infection are contraindicated during pregnancy. Striking a balance between the health of the mother and that of the unborn child becomes a tricky balancing act. Again, preventive immunisation is available and consists of a single injection every three years.
The Human Papillovirus (HPV) causes wart-like growths in the genital area, which requires delivery by caesarian section. The infection can later progress to cervical cancer. It is preventable with three doses of vaccine between the ages of 9-11 years.
Women tend to be anaemic with haemoglobin values less than the recommended 12gm/dl. Anaemic women produce low birth weight babies who have insufficient iron at birth. This can be prevented with iron supplements. It is usually available as a combination tablet with folic acid — a vitamin that prevents defects in the baby's brain and spinal cord. This can be started (after consulting your doctor) following menarche (onset of menstruation).
Regular exercise is essential for girls. It should be started at the primary school level, with jogging, cycling or swimming for 30-40 minutes a day. Stretching and yoga help the flexibility of the joints that need to "give" during labour. Hormonal imbalances, polycystic ovarian disease and many fertility problems correct themselves if ideal body weight is maintained. This endurance training is helpful during the long exhausting hours of labour.
When your precious daughter is about to get married, make sure her immunisations are complete. And perhaps present her a treadmill or any other exercise machine in lieu of some jewels.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Preparation for pregnancy
Preparing for your baby | ||
| ||
"My baby is small because I had typhoid / jaundice during pregnancy." "This is my third pregnancy; I lost one child and the other was born very small." "I needed interventions to get pregnant. This baby cost more than a lakh." Common but preventable events. India has a high maternal mortality rate of 450 per 1,00,000 live births. The figure, of course, does not account for women who have a lifetime of ill health after childbirth. Our country has a high infant mortality rate as well. There are 21.76 births per 1,000 every year. Out of this 1 lakh newborns die in the first 24 hours of their life and an unknown percentage has lifelong "special needs". Today many women are educated, employed and self sufficient. They no longer consider home making and child bearing their primary function in life. Despite this, it is a function many eventually have to perform. Human beings, after all, live to procreate, produce children and ensure the survival of family genes. Reproduction is the prerogative of women. They must try to remain physically fit to undertake this venture. The ability to conceive, carry a healthy child to term and then deliver normally must not be taken for granted. Thought, effort and preparation has to go into this "natural" function. All parents need to focus on the prevention of diseases that can affect the lives of their little ones. Some infectious diseases, such as German measles, can have a devastating effect on the child if acquired by the mother during pregnancy. It causes heart defects, deafness, cataract, a small head and mental retardation. Mumps, on the other hand, can cause an abortion. Chicken pox may lead to abnormal arms and legs, and eye and brain damage. All this means a lifetime of misery for the mother, who bears the brunt of caring for a child with special needs. These common infectious diseases can be prevented by timely immunisation. The MMR (measles, mumps, rubella or German measles) vaccine should be given at the age of 15 months with a booster at 9-10 years. Chicken pox can be prevented by a single dose of Varicella vaccine administered soon after the first birthday. These vaccinations are not yet part of the National Immunisation Programme (NIP) and therefore not provided free of cost by the government. Hepatitis B is a type of jaundice that is dangerous, can be fatal and is passed on to the baby by the mother. Hepatitis A causes jaundice that is usually mild and self limiting. During pregnancy, however, it can devastate a woman's health as it aggravates nausea and vomiting. It affects the liver, which is more sensitive to damage during pregnancy. Both types of jaundice are preventable with immunisation. Hepatitis B immunisation has recently been made part of the NIP. It is available free and given at birth and then along with triple antigen (DPT). Older children have not had the benefit of this programme and need to be immunised separately. Hepatitis A immunisation is not free. It is advised after the age of two years. Typhoid is a very common infection, especially in the monsoon. Again, women who develop it can become very ill. Many medicines used to treat this infection are contraindicated during pregnancy. Striking a balance between the health of the mother and that of the unborn child becomes a tricky balancing act. Again, preventive immunisation is available and consists of a single injection every three years. The Human Papillovirus (HPV) causes wart-like growths in the genital area, which requires delivery by caesarian section. The infection can later progress to cervical cancer. It is preventable with three doses of vaccine between the ages of 9-11 years. Women tend to be anaemic with haemoglobin values less than the recommended 12gm/dl. Anaemic women produce low birth weight babies who have insufficient iron at birth. This can be prevented with iron supplements. It is usually available as a combination tablet with folic acid — a vitamin that prevents defects in the baby's brain and spinal cord. This can be started (after consulting your doctor) following menarche (onset of menstruation). Regular exercise is essential for girls. It should be started at the primary school level, with jogging, cycling or swimming for 30-40 minutes a day. Stretching and yoga help the flexibility of the joints that need to "give" during labour. Hormonal imbalances, polycystic ovarian disease and many fertility problems correct themselves if ideal body weight is maintained. This endurance training is helpful during the long exhausting hours of labour. When your precious daughter is about to get married, make sure her immunisations are complete. And perhaps present her a treadmill or any other exercise machine in lieu of some jewels. Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in | ||
Friday, November 6, 2009
dementia
The recent elections threw up a spate of experienced “senior citizen” politicians, astute, informed and ready with verbal repartee. They are part of the 4.5 per cent of our population over the age of 65 years. They present a stark contrast to many other senior citizens who cannot remember what was said to them a few minutes ago, though the past is still very vivid and easily recollected. Questions get repeated over and over and answers are irrelevant. Words seem lost, forgotten or are inappropriate. These individuals no longer seem to follow a logical train of thought. Their personalities change for the worse and they become short-tempered and difficult to deal with.
Such people may struggle with 21st century gadgets such as microwaves, mobile phones and remote controls, which seem to make their life more complicated. Keeping track of medication becomes a logistic nightmare. Falls with injury and fractures occur as balance and co-ordination become faulty.
People fitting this description are loosely classified as suffering from dementia, a Latin word that means “deprived of mind”. Dementia may be due to many causes. Alzheimer’s disease is the commonest type of dementia and is the diagnosis in 50 per cent of the cases.
Dementia occurs in the elderly as brain cells deteriorate with age. Chemical messengers in the brain, essential for its proper functioning, become depleted and chromosomes shorten. Many of these changes are inevitable and irreversible.
Young people may develop symptoms similar to dementia, but in their case it usually occurs as a sequel to a brain infection (encephalitis or meningitis), brain trauma owing to an accident or a sport like boxing, bleeding in the brain (subdural haematoma), poisoning with lead or other heavy metals, or lack of sufficient thyroid hormone (hypothyroidism). The dementia is often cured if the underlying condition is treated successfully.
Recently, some types of dementia have been found to have a genetic basis. Many members of an affected family carry certain gene mutations that are passed on through the generations. Scientists are now beginning to identify these defects.
The risk of developing dementia increases if the lifestyle involves excessive alcohol consumption, smoking, a sustained elevated abnormal lipid profile, uncontrolled hypertension or diabetes. Heart or lung diseases, which compromise blood supply to the brain, also accelerate dementia.
The diagnosis of dementia is based on medical history and an evaluation of orientation, general intellectual, academic and language skills, memory, reasoning and judgment. Scans (computed tomography or CT and magnetic resonance imaging or MRI) and electroencephalograms (EEGs) help to evaluate changes in the brain and clinch the diagnosis.
Dementia can be treated with medications like donepezil, rivastigmine, galantamine hydrobromide and memantine. Specific symptoms and behavioural problems can be treated with sedatives and antidepressants. It is important to take the medicines exactly as prescribed in the correct dosage, which is often individualised. Many people take alternative medications such as vitamin E, omega 3 fatty acids, Coenzyme Q or extracts of ginkgo biloba (a Chinese herb). The dosage schedules are not established. There may be unwanted reactions with the regular medication.
For a long time Indian physicians thought that dementia was a “Western” disease. They felt it did not occur in India as we had longer hours of sunlight exposure. And also because our diet contained turmeric which has the protective anti aging antioxidant curcumin.
Actually earlier, life expectancy in India was only 45 years. This made cases appear few and far between. Now it has increased to 64. Still, only 4.8 per cent of our population is over the age of 65 years. This is in contrast to Western countries where 12 per cent of the population falls in this group.
Today, realisation has dawned that across the globe 0.3-0.4 per cent of the elderly suffers from dementia. We in India are not equipped to deal with it. Caretakers are expensive and family members are left with the difficult responsibility. Geriatrics is an emerging speciality and still not very popular. Old age homes are a recent phenomenon. Insurance is often not available to cover the medical care of the elderly.
Dementia occurs in a genetically predisposed individual living in a conducive environment. Age and genes cannot be changed but blood sugars, lipid levels and hypertension can be controlled. Stimulating the brain by doing puzzles, painting or learning a new skill compensates for some of the changes associated with dementia. The more frequent the activity, the more beneficial the effects. Physical activity such as walking an hour a day also helps delay dementia.
Many young adults do not exercise regularly. Old age seems far away and they feel “this cannot happen to me”. Nothing could be further from the truth.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Such people may struggle with 21st century gadgets such as microwaves, mobile phones and remote controls, which seem to make their life more complicated. Keeping track of medication becomes a logistic nightmare. Falls with injury and fractures occur as balance and co-ordination become faulty.
People fitting this description are loosely classified as suffering from dementia, a Latin word that means “deprived of mind”. Dementia may be due to many causes. Alzheimer’s disease is the commonest type of dementia and is the diagnosis in 50 per cent of the cases.
Dementia occurs in the elderly as brain cells deteriorate with age. Chemical messengers in the brain, essential for its proper functioning, become depleted and chromosomes shorten. Many of these changes are inevitable and irreversible.
Young people may develop symptoms similar to dementia, but in their case it usually occurs as a sequel to a brain infection (encephalitis or meningitis), brain trauma owing to an accident or a sport like boxing, bleeding in the brain (subdural haematoma), poisoning with lead or other heavy metals, or lack of sufficient thyroid hormone (hypothyroidism). The dementia is often cured if the underlying condition is treated successfully.
Recently, some types of dementia have been found to have a genetic basis. Many members of an affected family carry certain gene mutations that are passed on through the generations. Scientists are now beginning to identify these defects.
The risk of developing dementia increases if the lifestyle involves excessive alcohol consumption, smoking, a sustained elevated abnormal lipid profile, uncontrolled hypertension or diabetes. Heart or lung diseases, which compromise blood supply to the brain, also accelerate dementia.
The diagnosis of dementia is based on medical history and an evaluation of orientation, general intellectual, academic and language skills, memory, reasoning and judgment. Scans (computed tomography or CT and magnetic resonance imaging or MRI) and electroencephalograms (EEGs) help to evaluate changes in the brain and clinch the diagnosis.
Dementia can be treated with medications like donepezil, rivastigmine, galantamine hydrobromide and memantine. Specific symptoms and behavioural problems can be treated with sedatives and antidepressants. It is important to take the medicines exactly as prescribed in the correct dosage, which is often individualised. Many people take alternative medications such as vitamin E, omega 3 fatty acids, Coenzyme Q or extracts of ginkgo biloba (a Chinese herb). The dosage schedules are not established. There may be unwanted reactions with the regular medication.
For a long time Indian physicians thought that dementia was a “Western” disease. They felt it did not occur in India as we had longer hours of sunlight exposure. And also because our diet contained turmeric which has the protective anti aging antioxidant curcumin.
Actually earlier, life expectancy in India was only 45 years. This made cases appear few and far between. Now it has increased to 64. Still, only 4.8 per cent of our population is over the age of 65 years. This is in contrast to Western countries where 12 per cent of the population falls in this group.
Today, realisation has dawned that across the globe 0.3-0.4 per cent of the elderly suffers from dementia. We in India are not equipped to deal with it. Caretakers are expensive and family members are left with the difficult responsibility. Geriatrics is an emerging speciality and still not very popular. Old age homes are a recent phenomenon. Insurance is often not available to cover the medical care of the elderly.
Dementia occurs in a genetically predisposed individual living in a conducive environment. Age and genes cannot be changed but blood sugars, lipid levels and hypertension can be controlled. Stimulating the brain by doing puzzles, painting or learning a new skill compensates for some of the changes associated with dementia. The more frequent the activity, the more beneficial the effects. Physical activity such as walking an hour a day also helps delay dementia.
Many young adults do not exercise regularly. Old age seems far away and they feel “this cannot happen to me”. Nothing could be further from the truth.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Dementia
Old and forgetful | ||
| ||
The recent elections threw up a spate of experienced "senior citizen" politicians, astute, informed and ready with verbal repartee. They are part of the 4.5 per cent of our population over the age of 65 years. They present a stark contrast to many other senior citizens who cannot remember what was said to them a few minutes ago, though the past is still very vivid and easily recollected. Questions get repeated over and over and answers are irrelevant. Words seem lost, forgotten or are inappropriate. These individuals no longer seem to follow a logical train of thought. Their personalities change for the worse and they become short-tempered and difficult to deal with. Such people may struggle with 21st century gadgets such as microwaves, mobile phones and remote controls, which seem to make their life more complicated. Keeping track of medication becomes a logistic nightmare. Falls with injury and fractures occur as balance and co-ordination become faulty. People fitting this description are loosely classified as suffering from dementia, a Latin word that means "deprived of mind". Dementia may be due to many causes. Alzheimer's disease is the commonest type of dementia and is the diagnosis in 50 per cent of the cases. Dementia occurs in the elderly as brain cells deteriorate with age. Chemical messengers in the brain, essential for its proper functioning, become depleted and chromosomes shorten. Many of these changes are inevitable and irreversible. Young people may develop symptoms similar to dementia, but in their case it usually occurs as a sequel to a brain infection (encephalitis or meningitis), brain trauma owing to an accident or a sport like boxing, bleeding in the brain (subdural haematoma), poisoning with lead or other heavy metals, or lack of sufficient thyroid hormone (hypothyroidism). The dementia is often cured if the underlying condition is treated successfully. Recently, some types of dementia have been found to have a genetic basis. Many members of an affected family carry certain gene mutations that are passed on through the generations. Scientists are now beginning to identify these defects. The risk of developing dementia increases if the lifestyle involves excessive alcohol consumption, smoking, a sustained elevated abnormal lipid profile, uncontrolled hypertension or diabetes. Heart or lung diseases, which compromise blood supply to the brain, also accelerate dementia. The diagnosis of dementia is based on medical history and an evaluation of orientation, general intellectual, academic and language skills, memory, reasoning and judgment. Scans (computed tomography or CT and magnetic resonance imaging or MRI) and electroencephalograms (EEGs) help to evaluate changes in the brain and clinch the diagnosis. Dementia can be treated with medications like donepezil, rivastigmine, galantamine hydrobromide and memantine. Specific symptoms and behavioural problems can be treated with sedatives and antidepressants. It is important to take the medicines exactly as prescribed in the correct dosage, which is often individualised. Many people take alternative medications such as vitamin E, omega 3 fatty acids, Coenzyme Q or extracts of ginkgo biloba (a Chinese herb). The dosage schedules are not established. There may be unwanted reactions with the regular medication. For a long time Indian physicians thought that dementia was a "Western" disease. They felt it did not occur in India as we had longer hours of sunlight exposure. And also because our diet contained turmeric which has the protective anti aging antioxidant curcumin. Actually earlier, life expectancy in India was only 45 years. This made cases appear few and far between. Now it has increased to 64. Still, only 4.8 per cent of our population is over the age of 65 years. This is in contrast to Western countries where 12 per cent of the population falls in this group. Today, realisation has dawned that across the globe 0.3-0.4 per cent of the elderly suffers from dementia. We in India are not equipped to deal with it. Caretakers are expensive and family members are left with the difficult responsibility. Geriatrics is an emerging speciality and still not very popular. Old age homes are a recent phenomenon. Insurance is often not available to cover the medical care of the elderly. Dementia occurs in a genetically predisposed individual living in a conducive environment. Age and genes cannot be changed but blood sugars, lipid levels and hypertension can be controlled. Stimulating the brain by doing puzzles, painting or learning a new skill compensates for some of the changes associated with dementia. The more frequent the activity, the more beneficial the effects. Physical activity such as walking an hour a day also helps delay dementia. Many young adults do not exercise regularly. Old age seems far away and they feel "this cannot happen to me". Nothing could be further from the truth. Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in | ||
Dementia
Old and forgetful | ||
| ||
The recent elections threw up a spate of experienced "senior citizen" politicians, astute, informed and ready with verbal repartee. They are part of the 4.5 per cent of our population over the age of 65 years. They present a stark contrast to many other senior citizens who cannot remember what was said to them a few minutes ago, though the past is still very vivid and easily recollected. Questions get repeated over and over and answers are irrelevant. Words seem lost, forgotten or are inappropriate. These individuals no longer seem to follow a logical train of thought. Their personalities change for the worse and they become short-tempered and difficult to deal with. Such people may struggle with 21st century gadgets such as microwaves, mobile phones and remote controls, which seem to make their life more complicated. Keeping track of medication becomes a logistic nightmare. Falls with injury and fractures occur as balance and co-ordination become faulty. People fitting this description are loosely classified as suffering from dementia, a Latin word that means "deprived of mind". Dementia may be due to many causes. Alzheimer's disease is the commonest type of dementia and is the diagnosis in 50 per cent of the cases. Dementia occurs in the elderly as brain cells deteriorate with age. Chemical messengers in the brain, essential for its proper functioning, become depleted and chromosomes shorten. Many of these changes are inevitable and irreversible. Young people may develop symptoms similar to dementia, but in their case it usually occurs as a sequel to a brain infection (encephalitis or meningitis), brain trauma owing to an accident or a sport like boxing, bleeding in the brain (subdural haematoma), poisoning with lead or other heavy metals, or lack of sufficient thyroid hormone (hypothyroidism). The dementia is often cured if the underlying condition is treated successfully. Recently, some types of dementia have been found to have a genetic basis. Many members of an affected family carry certain gene mutations that are passed on through the generations. Scientists are now beginning to identify these defects. The risk of developing dementia increases if the lifestyle involves excessive alcohol consumption, smoking, a sustained elevated abnormal lipid profile, uncontrolled hypertension or diabetes. Heart or lung diseases, which compromise blood supply to the brain, also accelerate dementia. The diagnosis of dementia is based on medical history and an evaluation of orientation, general intellectual, academic and language skills, memory, reasoning and judgment. Scans (computed tomography or CT and magnetic resonance imaging or MRI) and electroencephalograms (EEGs) help to evaluate changes in the brain and clinch the diagnosis. Dementia can be treated with medications like donepezil, rivastigmine, galantamine hydrobromide and memantine. Specific symptoms and behavioural problems can be treated with sedatives and antidepressants. It is important to take the medicines exactly as prescribed in the correct dosage, which is often individualised. Many people take alternative medications such as vitamin E, omega 3 fatty acids, Coenzyme Q or extracts of ginkgo biloba (a Chinese herb). The dosage schedules are not established. There may be unwanted reactions with the regular medication. For a long time Indian physicians thought that dementia was a "Western" disease. They felt it did not occur in India as we had longer hours of sunlight exposure. And also because our diet contained turmeric which has the protective anti aging antioxidant curcumin. Actually earlier, life expectancy in India was only 45 years. This made cases appear few and far between. Now it has increased to 64. Still, only 4.8 per cent of our population is over the age of 65 years. This is in contrast to Western countries where 12 per cent of the population falls in this group. Today, realisation has dawned that across the globe 0.3-0.4 per cent of the elderly suffers from dementia. We in India are not equipped to deal with it. Caretakers are expensive and family members are left with the difficult responsibility. Geriatrics is an emerging speciality and still not very popular. Old age homes are a recent phenomenon. Insurance is often not available to cover the medical care of the elderly. Dementia occurs in a genetically predisposed individual living in a conducive environment. Age and genes cannot be changed but blood sugars, lipid levels and hypertension can be controlled. Stimulating the brain by doing puzzles, painting or learning a new skill compensates for some of the changes associated with dementia. The more frequent the activity, the more beneficial the effects. Physical activity such as walking an hour a day also helps delay dementia. Many young adults do not exercise regularly. Old age seems far away and they feel "this cannot happen to me". Nothing could be further from the truth. Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in | ||
Dementia
Old and forgetful | ||
| ||
The recent elections threw up a spate of experienced "senior citizen" politicians, astute, informed and ready with verbal repartee. They are part of the 4.5 per cent of our population over the age of 65 years. They present a stark contrast to many other senior citizens who cannot remember what was said to them a few minutes ago, though the past is still very vivid and easily recollected. Questions get repeated over and over and answers are irrelevant. Words seem lost, forgotten or are inappropriate. These individuals no longer seem to follow a logical train of thought. Their personalities change for the worse and they become short-tempered and difficult to deal with. Such people may struggle with 21st century gadgets such as microwaves, mobile phones and remote controls, which seem to make their life more complicated. Keeping track of medication becomes a logistic nightmare. Falls with injury and fractures occur as balance and co-ordination become faulty. People fitting this description are loosely classified as suffering from dementia, a Latin word that means "deprived of mind". Dementia may be due to many causes. Alzheimer's disease is the commonest type of dementia and is the diagnosis in 50 per cent of the cases. Dementia occurs in the elderly as brain cells deteriorate with age. Chemical messengers in the brain, essential for its proper functioning, become depleted and chromosomes shorten. Many of these changes are inevitable and irreversible. Young people may develop symptoms similar to dementia, but in their case it usually occurs as a sequel to a brain infection (encephalitis or meningitis), brain trauma owing to an accident or a sport like boxing, bleeding in the brain (subdural haematoma), poisoning with lead or other heavy metals, or lack of sufficient thyroid hormone (hypothyroidism). The dementia is often cured if the underlying condition is treated successfully. Recently, some types of dementia have been found to have a genetic basis. Many members of an affected family carry certain gene mutations that are passed on through the generations. Scientists are now beginning to identify these defects. The risk of developing dementia increases if the lifestyle involves excessive alcohol consumption, smoking, a sustained elevated abnormal lipid profile, uncontrolled hypertension or diabetes. Heart or lung diseases, which compromise blood supply to the brain, also accelerate dementia. The diagnosis of dementia is based on medical history and an evaluation of orientation, general intellectual, academic and language skills, memory, reasoning and judgment. Scans (computed tomography or CT and magnetic resonance imaging or MRI) and electroencephalograms (EEGs) help to evaluate changes in the brain and clinch the diagnosis. Dementia can be treated with medications like donepezil, rivastigmine, galantamine hydrobromide and memantine. Specific symptoms and behavioural problems can be treated with sedatives and antidepressants. It is important to take the medicines exactly as prescribed in the correct dosage, which is often individualised. Many people take alternative medications such as vitamin E, omega 3 fatty acids, Coenzyme Q or extracts of ginkgo biloba (a Chinese herb). The dosage schedules are not established. There may be unwanted reactions with the regular medication. For a long time Indian physicians thought that dementia was a "Western" disease. They felt it did not occur in India as we had longer hours of sunlight exposure. And also because our diet contained turmeric which has the protective anti aging antioxidant curcumin. Actually earlier, life expectancy in India was only 45 years. This made cases appear few and far between. Now it has increased to 64. Still, only 4.8 per cent of our population is over the age of 65 years. This is in contrast to Western countries where 12 per cent of the population falls in this group. Today, realisation has dawned that across the globe 0.3-0.4 per cent of the elderly suffers from dementia. We in India are not equipped to deal with it. Caretakers are expensive and family members are left with the difficult responsibility. Geriatrics is an emerging speciality and still not very popular. Old age homes are a recent phenomenon. Insurance is often not available to cover the medical care of the elderly. Dementia occurs in a genetically predisposed individual living in a conducive environment. Age and genes cannot be changed but blood sugars, lipid levels and hypertension can be controlled. Stimulating the brain by doing puzzles, painting or learning a new skill compensates for some of the changes associated with dementia. The more frequent the activity, the more beneficial the effects. Physical activity such as walking an hour a day also helps delay dementia. Many young adults do not exercise regularly. Old age seems far away and they feel "this cannot happen to me". Nothing could be further from the truth. Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in | ||
dementia
Old and forgetful | ||
| ||
The recent elections threw up a spate of experienced "senior citizen" politicians, astute, informed and ready with verbal repartee. They are part of the 4.5 per cent of our population over the age of 65 years. They present a stark contrast to many other senior citizens who cannot remember what was said to them a few minutes ago, though the past is still very vivid and easily recollected. Questions get repeated over and over and answers are irrelevant. Words seem lost, forgotten or are inappropriate. These individuals no longer seem to follow a logical train of thought. Their personalities change for the worse and they become short-tempered and difficult to deal with. Such people may struggle with 21st century gadgets such as microwaves, mobile phones and remote controls, which seem to make their life more complicated. Keeping track of medication becomes a logistic nightmare. Falls with injury and fractures occur as balance and co-ordination become faulty. People fitting this description are loosely classified as suffering from dementia, a Latin word that means "deprived of mind". Dementia may be due to many causes. Alzheimer's disease is the commonest type of dementia and is the diagnosis in 50 per cent of the cases. Dementia occurs in the elderly as brain cells deteriorate with age. Chemical messengers in the brain, essential for its proper functioning, become depleted and chromosomes shorten. Many of these changes are inevitable and irreversible. Young people may develop symptoms similar to dementia, but in their case it usually occurs as a sequel to a brain infection (encephalitis or meningitis), brain trauma owing to an accident or a sport like boxing, bleeding in the brain (subdural haematoma), poisoning with lead or other heavy metals, or lack of sufficient thyroid hormone (hypothyroidism). The dementia is often cured if the underlying condition is treated successfully. Recently, some types of dementia have been found to have a genetic basis. Many members of an affected family carry certain gene mutations that are passed on through the generations. Scientists are now beginning to identify these defects. The risk of developing dementia increases if the lifestyle involves excessive alcohol consumption, smoking, a sustained elevated abnormal lipid profile, uncontrolled hypertension or diabetes. Heart or lung diseases, which compromise blood supply to the brain, also accelerate dementia. The diagnosis of dementia is based on medical history and an evaluation of orientation, general intellectual, academic and language skills, memory, reasoning and judgment. Scans (computed tomography or CT and magnetic resonance imaging or MRI) and electroencephalograms (EEGs) help to evaluate changes in the brain and clinch the diagnosis. Dementia can be treated with medications like donepezil, rivastigmine, galantamine hydrobromide and memantine. Specific symptoms and behavioural problems can be treated with sedatives and antidepressants. It is important to take the medicines exactly as prescribed in the correct dosage, which is often individualised. Many people take alternative medications such as vitamin E, omega 3 fatty acids, Coenzyme Q or extracts of ginkgo biloba (a Chinese herb). The dosage schedules are not established. There may be unwanted reactions with the regular medication. For a long time Indian physicians thought that dementia was a "Western" disease. They felt it did not occur in India as we had longer hours of sunlight exposure. And also because our diet contained turmeric which has the protective anti aging antioxidant curcumin. Actually earlier, life expectancy in India was only 45 years. This made cases appear few and far between. Now it has increased to 64. Still, only 4.8 per cent of our population is over the age of 65 years. This is in contrast to Western countries where 12 per cent of the population falls in this group. Today, realisation has dawned that across the globe 0.3-0.4 per cent of the elderly suffers from dementia. We in India are not equipped to deal with it. Caretakers are expensive and family members are left with the difficult responsibility. Geriatrics is an emerging speciality and still not very popular. Old age homes are a recent phenomenon. Insurance is often not available to cover the medical care of the elderly. Dementia occurs in a genetically predisposed individual living in a conducive environment. Age and genes cannot be changed but blood sugars, lipid levels and hypertension can be controlled. Stimulating the brain by doing puzzles, painting or learning a new skill compensates for some of the changes associated with dementia. The more frequent the activity, the more beneficial the effects. Physical activity such as walking an hour a day also helps delay dementia. Many young adults do not exercise regularly. Old age seems far away and they feel "this cannot happen to me". Nothing could be further from the truth. Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in | ||
Old age
Old and forgetful | ||
| ||
The recent elections threw up a spate of experienced "senior citizen" politicians, astute, informed and ready with verbal repartee. They are part of the 4.5 per cent of our population over the age of 65 years. They present a stark contrast to many other senior citizens who cannot remember what was said to them a few minutes ago, though the past is still very vivid and easily recollected. Questions get repeated over and over and answers are irrelevant. Words seem lost, forgotten or are inappropriate. These individuals no longer seem to follow a logical train of thought. Their personalities change for the worse and they become short-tempered and difficult to deal with. Such people may struggle with 21st century gadgets such as microwaves, mobile phones and remote controls, which seem to make their life more complicated. Keeping track of medication becomes a logistic nightmare. Falls with injury and fractures occur as balance and co-ordination become faulty. People fitting this description are loosely classified as suffering from dementia, a Latin word that means "deprived of mind". Dementia may be due to many causes. Alzheimer's disease is the commonest type of dementia and is the diagnosis in 50 per cent of the cases. Dementia occurs in the elderly as brain cells deteriorate with age. Chemical messengers in the brain, essential for its proper functioning, become depleted and chromosomes shorten. Many of these changes are inevitable and irreversible. Young people may develop symptoms similar to dementia, but in their case it usually occurs as a sequel to a brain infection (encephalitis or meningitis), brain trauma owing to an accident or a sport like boxing, bleeding in the brain (subdural haematoma), poisoning with lead or other heavy metals, or lack of sufficient thyroid hormone (hypothyroidism). The dementia is often cured if the underlying condition is treated successfully. Recently, some types of dementia have been found to have a genetic basis. Many members of an affected family carry certain gene mutations that are passed on through the generations. Scientists are now beginning to identify these defects. The risk of developing dementia increases if the lifestyle involves excessive alcohol consumption, smoking, a sustained elevated abnormal lipid profile, uncontrolled hypertension or diabetes. Heart or lung diseases, which compromise blood supply to the brain, also accelerate dementia. The diagnosis of dementia is based on medical history and an evaluation of orientation, general intellectual, academic and language skills, memory, reasoning and judgment. Scans (computed tomography or CT and magnetic resonance imaging or MRI) and electroencephalograms (EEGs) help to evaluate changes in the brain and clinch the diagnosis. Dementia can be treated with medications like donepezil, rivastigmine, galantamine hydrobromide and memantine. Specific symptoms and behavioural problems can be treated with sedatives and antidepressants. It is important to take the medicines exactly as prescribed in the correct dosage, which is often individualised. Many people take alternative medications such as vitamin E, omega 3 fatty acids, Coenzyme Q or extracts of ginkgo biloba (a Chinese herb). The dosage schedules are not established. There may be unwanted reactions with the regular medication. For a long time Indian physicians thought that dementia was a "Western" disease. They felt it did not occur in India as we had longer hours of sunlight exposure. And also because our diet contained turmeric which has the protective anti aging antioxidant curcumin. Actually earlier, life expectancy in India was only 45 years. This made cases appear few and far between. Now it has increased to 64. Still, only 4.8 per cent of our population is over the age of 65 years. This is in contrast to Western countries where 12 per cent of the population falls in this group. Today, realisation has dawned that across the globe 0.3-0.4 per cent of the elderly suffers from dementia. We in India are not equipped to deal with it. Caretakers are expensive and family members are left with the difficult responsibility. Geriatrics is an emerging speciality and still not very popular. Old age homes are a recent phenomenon. Insurance is often not available to cover the medical care of the elderly. Dementia occurs in a genetically predisposed individual living in a conducive environment. Age and genes cannot be changed but blood sugars, lipid levels and hypertension can be controlled. Stimulating the brain by doing puzzles, painting or learning a new skill compensates for some of the changes associated with dementia. The more frequent the activity, the more beneficial the effects. Physical activity such as walking an hour a day also helps delay dementia. Many young adults do not exercise regularly. Old age seems far away and they feel "this cannot happen to me". Nothing could be further from the truth. Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in | ||
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