breathe easy

Breathe easy

http://www.telegraphindia.com/1160321/jsp/knowhow/story_75553.jsp

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Your Health - Dr. Gita Mathai

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Breathing is an involuntary action, coordinated by respiratory centres deep in the brain. It is not really possible to die by voluntarily holding your breath, as without practice and training, apnoea (not breathing) cannot be sustained for more than 1-2 minutes. This is because "breath holding" results in accumulation of carbon dioxide in the blood and a drop in the blood pH. The respiratory centre in the brain is automatically stimulated. Breathing sets in.

Sleep apnoea (cessation of breathing during sleep) can occur in adults, usually middle-aged overweight males with a thick neck. It can occur in all ages and both sexes, especially if the tonsils or adenoids are enlarged, there is a deviated nasal septum or GERD (gastro esophageal reflux disease). Sleep apnoea can cause high blood pressure, stroke, heart disease, and daytime drowsiness. Academic performance and decision making at work can suffer. There may be daytime lapses in concentration, which can cause accidents.

Mild cases of sleep apnoea respond to weight loss and exercise. Severe cases may require CPAP (Continuous Positive Airways Pressure), or surgery.

Reactive Airways Disease (old name bronchial asthma) is a condition where the smaller airways in the lungs constrict when exposed to many triggers. These may be a viral or bacterial infection, pollen, food, or odours in the air. As the breathing pipes become smaller, the outflow of air is obstructed and there is whistling sound with each breath. The person may start coughing vigorously or panic as they feel the air supply is being cut off.

This can be tackled with nebulisers, inhalers and rotahalers. These devices deliver dilating medication directly to the breathing pipes. The effect is almost instantaneous and there are practically no side effects.

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Our airways are designed to filter out dust and other harmful particles. Unfortunately our inbuilt air purification system can only filter out particles of 2·5 µm (PM2 ) in diameter. The smaller - found around us both indoors and out - can enter the lungs. Indoor pollution comes from the use of solid fuels, such as coal, wood, or charcoal (even when it is only used to heat water), burning rubbish and waste, particularly plastic. Cigarette smoke harms the smoker and the polluting particles secondarily affect others in the environment. Agarbattis release many polluting chemicals as do mosquito repelling coils, mats and liquids.

Industrialisation and urbanisation have? resulted in fossil fuels being used in factories and for transport. Smoke from factories is sent high into the sky through industrial chimneys, but that just means that the particles spread over a wider area. The petrol and diesel vehicles on the road also emit particulate material and harmful gases. Seven million deaths occur annually because of air pollution alone. Pregnant women and children are particularly vulnerable. Constant exposure to a polluted environment affects long-term growth and cognitive ability in children. If we keep polluting the environment like this, our IQ levels will be affected.

Eventually, constant exposure to pollutants over many years can also result in COPD (chronic obstructive pulmonary disease) with breathlessness with the slightest activity. This too is treated with nebulisers and inhalers.

• We all breathe but this does not mean we breathe correctly. Lungs need regular breathing exercises and correction of faulty breathing techniques. Yoga corrects the technique.

• Exercise early in morning when pollution is less or indoors in a gym.

• Keep indoor plants in your home. They reduce particulate matter and pollutants.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her atyourhealthgm@yahoo.co.in

Zika virus

http://www.telegraphindia.com/1160314/jsp/knowhow/story_74296.jsp

A strange disease

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Your Health - Dr. Gita Mathai

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The Aedes Egypti mosquito has long been spreading diseases such as chikungunya and dengue in India. It has now added another illness to its spectrum -- the Zika virus.

The Zika virus infection in itself is a mild disease. The bite of the infected mosquito is followed by a 3-7 day asymptomatic incubation period. After this, there is mild fever, red eyes, rash and joint pains. Most people recover spontaneously in a few weeks.

The problem with the infection is that, unlike dengue and chikungunya, the Zika virus can cause the Guillain-Barré syndrome. This is a rapidly occurring paralysis that can actually follow any viral infection, not necessarily Zika alone. It can also be precipitated by respiratory or gastrointestinal infections and even vaccination or surgery. The syndrome starts with a tingling and numbness in both feet and then spreads upwards. There may be pain and weakness. A person who was fine is suddenly bed ridden and paralysed within two weeks. Respiratory muscles can be affected making it difficult to breathe. Control of the bowel and bladder is lost. The heart rate may become irregular and the blood pressure may drop. The breathing problems and the heart irregularities can make the disease fatal.

It occurs because as the body tries to fight the virus causing the infection, it makes a mistake and attacks the protective myelin covering of the nerves instead. The nerves are damaged. They are no longer able to transmit signals to the brain or receive reciprocal messages. The tingling sensation signals the initial attack. This is soon followed by paralysis.

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Doctors in the emergency departments are suddenly confronted with a paralysed person who the relatives claim was previously healthy. The precipitating illness (even Zika) may have been so mild as to pass unnoticed. This means that a number of diagnoses have to be considered. It may be due to a stroke affecting both sides (very rare), a injury to the spinal cord, metabolic conditions, heavy metal poisoning, alcohol intoxication, drug overdose or vitamin deficiencies, especially B12 and folic acid.

The diagnosis is difficult. It is arrived at after blood tests, spinal fluid analysis, electromyography, nerve conduction studies and scans. It is a diagnosis of exclusion, when none of the tests yield a positive result

Guillain-Barré tends to worsen for two weeks then plateau for about a month. After that, there is slow recovery, which may take as long as three years. Eighty per cent of those affected (particularly children) recover completely. Some residual symptoms of weakness and pain may remain in the rest of the patients. About five per cent may suffer a relapse or recurrence.

The treatment is mainly supportive, with physiotherapy and strengthening exercises, mobility, pain relief and prevention of blood clots. Recovery can be speeded up with procedures like plasmapheresis and immunoglobulin therapy.

Mosquitoes spread many diseases such as the Zika virus, dengue, chikungunya, malaria, filaria and brain fever. To prevent that we need to:

• Stop stagnant water from accumulating and clear garbage to prevent mosquitoes breeding.

• Sleep in mosquito nets

• Mosquito-proof homes with nylon or metal mesh.

• Use electric "mosquito bats" to rid the house of any mosquitoes that may have entered.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her atyourhealthgm@yahoo.co.in

http://www.telegraphindia.com/1160229/jsp/knowhow/story_71810.jsp

Exercise to stay alert

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Your Health - Dr. Gita Mathai

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All our physical and mental functions and activities are controlled by a supercomputer called the brain, housed safely in the skull.

As we age, the telomeres (DNA strands) in our cells shorten. This starts in middle age and accelerates after 60. The connections between the brain cells decrease and become less efficient. The cells also begin to shrink in size, especially in the hippocampus and the prefrontal cortex.

These changes make us "slow down". We no longer talk, walk or react as fast as we used to. Learning a new skill becomes difficult. Sometimes the world around appears confusing. The personality changes and people may become unreasonable or aggressive.

These normal changes are exaggerated and accelerated in people who have dementia, Alzheimer's and Parkinson's disease or other neurodegenerative disorders. Lifestyle diseases such as diabetes, hypertension and high or deranged lipid levels can also hasten brain degeneration. Alcohol taken in excess has a permanent degenerative affect on the brain. Women should not have more than one drink a day, and men two to prevent brain changes.

As we grow older, (especially after retirement), we tend to use less of our brain. The areas responsible for swift decision-making and mathematical calculation begin to degenerate as they are not actively used.

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There are several ways to get the best of the brain. Control diabetes, hypertension and lipids. Stop smoking and control drinking. Writing down things that need to be done in a diary or the phone will help you remember. If names are a problem, repeat a person's name several times in your head when you are introduced to them. Reading a book helps develop concentration. Even watching the news channel or scientific programmes (not serials) on television helps. Try alternating your hands. Do the things that you normally do with your right hand with the left.

Mind games like chess, scrabble and cards help to keep the brain active. Video games and computer games are good for older people as they help to develop strategy and speed up reaction time. (They are not good for children though.)

The diet should be healthy, with less oil, fat, processed flour and sugar. It should contain 4-6 helpings of fruit and vegetables. Rich coloured fruits and vegetables contain protective anti-oxidants, which help prevent cell damage and deterioration.

Scientists have now discovered that physical activity like walking, jogging, running, swimming and cycling is not only good for cardiovascular fitness it also keeps the telomeres long and undamaged. It is best if you exercise for an hour everyday and then sleep for 7-8 hours to recover, but even half an hour twice a week has benefits and is better than nothing at all!

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her atyourhealthgm@yahoo.co.in