http://www.telegraphindia.com/1150525/jsp/knowhow/story_21859.jsp

delhi belly

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Your Health - Dr. Gita Mathai

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India is on the move, professionally and for recreation. Vacations for many no longer mean a visit to the grandparents and the native village. Tours, (in India and abroad), timeshares and exotic holidays are becoming common. The speed of air travel means that no corner of the globe is more than 24 hours away.

While travelling, the intestinal tract has to acclimatise itself with a shift in circadian rhythm (where there is a day night shift due to time differences) and the body clock has to reset. The normal viruses and bacteria present in food and water may be the same species as the ones at home but of different subtypes. The commonest ailment this causes is "traveller's diarrhoea".

In order for motion to be considered diarrhoea, it should be more frequent than normal (more than three times a day) and of a consistency less formed than usual. Diarrhoea may be accompanied by fever, vomiting and abdominal pain. There may be tenesmus - a desire to pass motion constantly even when the rectum is empty. If there is blood and mucous in the motion then it is more likely to be dysentery.

The commonest organism causing travellers diarrhoea is the bacteriaE.coli. The infection is usually acquired as a result of eating raw food (fruits and vegetables) or items which are not piping hot, drinking water or using ice cubes contaminated by bacteria. (Purchased bottled water sometimes may not really be as "pure" as advertised.)

The diarrhoea sets in 3-7 days after the initial exposure. There may be low-grade fever, but the usual symptoms are nausea, bloating, urgency and explosive diarrhoea. The disease is usually self-limiting and subsides on its own in another 3-4 days.

Giardia is another common parasite found all over the world. The symptoms are similar but take longer to set in. The discomfort progressively worsens. Eventually it may become a chronic diarrhoea which persists even after returning home.

Various viruses can also cause diarrhoea. Bacteria belonging to the salmonella or shigella group can also lead to diarrhoea though these infections produce fever and blood in the stool. Amoebae cause long-standing diarrhoea without fever but with tenesmus, abdominal pain, blood and mucous. Untreated, it can become chronic. It can also cause cysts in other organs like the liver.

Diarrhoea can often be treated without going to the hospital by replacing the fluid lost. ORS (oral rehydration solution) can be used as desired after it is reconstituted. In case ORS sachets are not available, homemade solutions of either half a teaspoon of salt and six level teaspoons of sugar dissolved in one litre of safe water, or lightly-salted rice gruel or even sips of plain water can be used. Bananas also help to reduce the frequency of stool. A tablespoon of home made curd on an empty stomach everyday will help to repopulate the intestines with "good" bacteria that fight infective agents. This works in the same way as the expensive sachets of probiotics with minimal expenditure.

Anti-motility agents like lomotil or imodium (lomofen) can reduce the frequency of stool. They do not have any effect on the organism causing the diarrhoea. They can cause bloating of the abdomen in adults. They are contraindicated in children under four years of age.

Diarrhoea needs to be taken seriously and a physician consulted if it persists for two weeks if the heart rate increases, a headache develops urine volume decreases, becomes dark coloured or is not passed at all confusion and disorientation occur there is fever blood is present there is documented weight loss.

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

http://www.telegraphindia.com/1150511/jsp/knowhow/story_19277.jsp

Do not sit still

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Your Health - Dr. Gita Mathai

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All age groups should exercise. The minimum recommended varies (depending on different agencies) from 30-40 minutes a day of aerobic activity, 10 minutes of stair climbing to walking at least 10,000 steps a day. At least 400 calories should be expended with each session of exercise. At least once a week, double that (800-1,000 calories) should ideally be used. Unless you are actually training for a sporting event, the exercise can be spaced out during the day and split into multiple sessions.

Despite assiduously following these recommendations, people are often not as fit as expected.
Sitting still at a desk means your lifestyle is sedentary, even if you go to the gym or run. It negates the effects of the activity that you have put in. It is almost as bad as smoking!

The enforced inactivity may be inadvertent in people because their jobs entail sitting down (IT professionals, bankers, corporate employees) or because television sets have gained a stranglehold on lifestyle. As the inactive lifestyle becomes habitual, it becomes easier to telephone co workers or do a computer chat rather than walk a few steps. Many buildings, flats and even private houses have lifts. Climbing up even one flight of steps becomes unnecessary and tedious. Even children may be encouraged to “sit down and watch television” rather than “run around being a nuisance.”

You not only need to exercise but also try to not be sedentary. It often poses a real challenge. Many fit CEOs internationally use the stairs (if they do not have time to go to the gym) even if it means climbing 14 floors in a hotel!

Sitting slows the metabolism. When we sit, the large skeletal muscles in the legs and back are very still. They do not utilise glucose, as they require very little energy to be still. This is why “fidgety” children do not gain weight, even if they eat more than their sedentary, TV-viewing counterparts.

Food eaten is not efficiently utilised. The blood sugars become elevated. The excess sugar is converted to fat. This accumulates in the blood and then gets deposited in other organs such as the liver (fatty liver) and heart. The blood pressure too starts to rise. The risk for diabetes, heart disease and death is elevated by nearly 100 per cent. In short, excessive sitting has strong associations with becoming obese, developing type 2 diabetes and premature death.

Physical activity throughout the day — even simple standing — increases the levels of the body’s own insulin. At the same time, it lowers the levels of biologically available sex hormones. This has a cascading effect and reduces the incidence of cancers of the uterus, ovary, breast and prostrate. The body’s overall immune system improves. This decreases the number of infections and shortens the time spent with illness. The body’s ability to cope is vastly improved.

Exercise has a plateau effect. Those who exercised a little more than an hour a day every day reduced their chance of premature death by 40 per cent. The reduction in mortality and health benefits did not increase at levels of exercise beyond this. The additional hours at the gym or training added no significant benefit unless they were training for competitions. The chances of injury on the other hand almost quadrupled. Everything has to be done in moderation.

Quick look

• The highest risk of early death is in people who do not exercise at all.
• Those who exercised for at least 150 minutes every week (the bare minimum recommended) reduced their risk of dying by 40 per cent compared with those who never exercised.
• Physical inactivity increased the risk of premature death by 7 per cent
• Frank obesity with a BMI greater than 30 increased the risk by 4 per cent. This statistic is independent of other risk factors like sex, education, smoking and alcohol intake.

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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summer RASHES

Summer rashes

http://www.telegraphindia.com/1150504/jsp/knowhow/story_17975.jsp

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Your Health - Dr. Gita Mathai

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Summer means unrelenting sunshine, rising temperatures, power cuts and sweating. The sweat pours down our face and our bodies. It carries dead cells and bacteria with it. These can enter pores in the skin and block them. As more sweat forms, it is unable to escape onto the surface of the skin. It gets trapped and forms bumps (prickly heat) under the skin.

Prickly heat or miliria (as it is scientifically known) can be mild and confined to the surface of the skin. These bumps and blisters are filled with clear fluid. If the sweat glands deeper down are blocked, the little bumps may be red in colour. They can itch and the whole skin may have a pricking feeling.

Prickly heat usually subsides if left alone. Friction from clothing and rubbing and scratching for relief may cause the rash to become secondarily infected. The rashes then look like pustules. There may be fever. The local lymph nodes may be enlarged.

It is possible to control and treat prickly heat at home. Water and soap can be used to wash off dead cells and sweat - and to cool the body. Take a mild, non irritating soap and apply it on a wet face towel or a loofah. Use it to lather the body, do not use the soap directly. Bathe twice a day.

Wear clothes made of cotton or a mixture of 60 per cent cotton and 40 per cent polyester. Wear clothes made of the newer cotton wicking material during exercising. Avoid wearing synthetic clothes as far as possible.

Talcum powder is very popular as a "cure" for prickly heat but contrary to the advertisements on TV, (where miraculous relief occurs in seconds), it actually aggravates prickly heat.

Talc is made up of finely powdered zinc stearate, silicates and perfume additives. The fine particles block the skin pores. Heat causes sweating. The blocked pores cannot release the sweat. It builds up in the sweat glands. This aggravates the prickly heat.

Talc causes other medical problems as well. Inhaling the air-borne particles of talc can cause inflammation and swelling of the airways. Eventually it can cause a type of aspiration pneumonia. Long-term treatment may be needed. Aspiration can be fatal in babies and young children.

And there is no such thing as "baby powder".

IF YOU HAVE PRICKLY HEAT:

•  Stay indoors between 10am and 6pm. Ifyou must go out, wear a cap or carry an umbrella. Stay away from the direct heat of the sun as far as possible.
• Wear loose and airy cotton clothes.
• Do not scratch. Prickly heat causes an overwhelming desire to scratch. The more you scratch the more it will itch.
• Take a mild antihistamine after con sulting your physician.
• Do not apply oil-based creams or ointments. They will only block the pores and aggravate the condition.
• Bathe two or three times a day in tepid water. Add a teaspoon of sodium bicarbonate and a teaspoon of salt to a bucket of water before bathing.
• Use soap containing trichlorhexi- dine (Dial, Neko) or a mild, non-irritating soap.
• Do not apply soap directly to the skin. Use a moist piece of towelling, a herbal scrubber or a loofah.
• Lightly moisturise the itchy skin with baby oil or a water-based aloe vera lotion.
• If prickly heat becomes red or yellow and pustular, changes appearance, or if the temperature rises, consult a doctor immediately.

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