Moles birthmarks and angel kisses
Your Health
--------------------------------------------------------------------------------
DR GITA MATHAI
Mikhail Gorbachev is easily identified in photographs by a distinctive large red mark on his head. The patch is actually a birthmark — a capillary naevus — which is present from birth. One in 10 children has birthmarks on his or her body.
These marks have fascinated people down the ages. In the 16th and 17th centuries, there developed a branch of astrology called moleoscopy. Specialists interpreted the “occult significance” of birthmarks and their “effect” on one’s character and destiny. The positions of the moles were linked with astrological signs. Hippocrates, the father of medicine, wrote a treatise on the link between birthmarks and health. He had the right idea. Health is a strong determinant of the future. We now know that the birthmarks are a coincidence.
Birthmarks that are red in colour are called strawberry marks, angel kisses or stork bites. They are usually present on the eyelids, forehead or nape of the neck. They may be flat or appear slightly raised or bumpy. They are caused by an overgrowth of the small blood vessels (capillaries). They are not hereditary or cancerous and usually disappear without treatment by the age of two.
Gorbachev’s large red naevus is called a port wine stain. Such marks too are present at birth, but are much larger, do not cross the midline and unlike strawberry marks do not fade with age. Sometimes they may be associated with seizures and glaucoma in later life.
Dark slate grey or bluish marks can be present over the areas of the buttocks or back in 80 per cent of Indian babies. These are called “mongoloid spots” and to the untrained eye can be mistaken for bruises. They occur because melanocytes (pigment producing cells in the skin) get caught in the deeper layers of the skin during the development process. The marks may last till adolescence.
Café au lait spots are so called because they are a shade of brown that looks like milky coffee. They may be present at birth or appear in early childhood. If they are very large, or four or more are present, the child may be carrying the gene for neurofibromatosis. This is a condition where multiple painless bumps appear all over the face and body in adult life.
Birthmarks that are large (the size of a fist), black and sometimes hairy are called congenital naevi. They have to be watched carefully as 10 per cent can turn cancerous.
Older children may develop pigmented areas on the skin called moles. These are also called beauty marks. Marilyn Monroe and Madhubala had attractive facial moles. In the last century, moles were a fashion statement for both men and women.
A real mole is an area of skin where there is an increase in the number of melanocytes which then form a cluster. They can be flat or raised. Some may have hair growing in it. The number present increases with age and most adults have 20-40 moles. They also increase during times of hormonal change like adolescence and pregnancy. They can darken when exposed to sunlight. Some fade away with age.
Moles rarely can become cancerous. The danger signals are —
* If the mole suddenly appears after the age of 20 and seems to be increasing in size
* If the diameter is larger than the end of a pencil
* If it suddenly changes in colour
* If it itches, oozes or bleeds.
A dermatologist can remove a mole which shows any of these signs and send it for testing. Removal of a cancerous mole in the early stages is curative.
Not all pigmentations on the skin are moles. They may be “lentigenes” or brown spots that appear on the face and hands in older people, especially after exposure to sunlight. They resemble freckles. They are harmless and can be prevented by avoiding the sun.
Black spots may appear on the chest and back as people get older. They look like blobs of dirt stuck on the skin, but cannot be picked off. These are barnacles or seborrheic keratosis. The condition may run in families. They occur because keratin, a strong natural protein normally formed in the skin, increases and forms circular whorls. They are harmless and can be left alone. Some may be cosmetically disfiguring. Others may get caught in clothing and become irritated, red and start bleeding. These can be removed by a dermatologist.
The skin, especially in older overweight women, can form tags — small flaps of tissue that hang off the skin. These are not painful or dangerous. If they get snagged frequently on jewellery or clothing, they can be easily removed.
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, May 10, 2010
Monday, April 12, 2010
sweet dangers
Sweet danger
YOUR HEALTH
DR GITA MATHAI
“I cannot have diabetes,” exclaimed the middle-aged gentleman. “The laboratory results are wrong. My parents did not have diabetes, I am a vegetarian, and I do not even eat sweets.”
Well, this man is living in a soap bubble that is about to burst. None of the reasons cited protects from the onset of diabetes. As far as family history is concerned, awareness and routine laboratory tests for metabolic diseases are a relatively new phenomenon. His parents may have had diabetes and may have died quietly of an undiagnosed complication like a heart attack.
India has 30 million known diabetics, the largest number in the world. The figure is mounting daily and is slated to escalate by 200 per cent. Most of the affected will be in the economically productive age group of 30-60. We have to find out ways to combat this epidemic, halt it and prevent our children from falling prey to it.
Studies have shown that the possibility of developing diabetes depends on one’s genes, which are inherited from both parents, and the nurturing environment provided first in the womb and later by the mother.
To begin with, women should have the correct BMI (body mass index — weight divided by height in metre squared) of 23 before they become pregnant. Some women are undernourished and eat poorly. Their calorie intake is only 70 per cent of the required amount (2,000-2,200 calories for an active adult female). The protein content may be less than the recommended 075-1gm/kg. Both these situations result in poor foetal growth and an SFD (small for dates) baby.
Compensatory mechanisms come into play in SFD babies and they develop relative insulin resistance so as to maintain normal blood glucose concentrations. Vital organs like the brain and heart receive sufficient nutrition, but it is diverted away from the muscles.
These small babies exhibit a phenomenon called “catch up growth”. If fed adequately after birth, they attain normal weight for age and height within three years. In the process, they can develop impaired glucose tolerance as early as seven years of age.
Today’s teens have a different story. They are becoming obese on a diet of fast food and “time pass” television. Many girls are overweight when they get married. Pregnancy and well meaning advice to “rest and eat for two” do not help matters. Those who are obese (BMI more than 29) or diabetic during pregnancy can produce large babies (LFD or large for dates). These babies are exposed to excess nutrition in the womb. They secrete excess insulin, can develop insulin resistance and eventually diabetes. The problem is compounded if they are growing up in a family with faulty eating habits and little or no regular exercise.
Since we now know that the majority of us carries a gene which predisposes us to develop diabetes, it makes sense to thwart the march to disease.
Check your blood sugars once a year after the age of 25, even if you are asymptomatic, to be sure you don’t fall in the “prediabetic” category. Those who are prediabetic have a fasting blood sugar between 100 and 126mg/dl and a two-hour post prandial or oral glucose tolerance test value between 140 and 200mg/dl. Abnormal values may occur 15 years before the onset of overt diabetes. Without active intervention eventually 35 per cent go on to develop the disease. With effort and a change in lifestyle, 45 per cent can revert to normal.
Medical complications — which cause heart disease, stroke, peripheral vascular diseases, and eye and kidney problems – begin to set in during the prediabetic stage. Early identification and treatment can reduce the damage.
The BMI should be maintained at 23. This can be done by keeping the caloric intake between 1,500-2,000 calories a day. The diet should be low in fat, and contain four to six helpings of fruit and vegetables. But dieting alone will not help, as weight loss through starvation cannot be sustained. Food restriction should be combined with physical activity for 60 minutes every day. A brisk walk (five kilometres), or one hour of swimming or cycling will do the trick.
Blood pressure should be maintained at 130/80 or less. Salt restriction and weight loss alone may be sufficient to achieve this. If not, medication may be needed.
Lipid levels also need to be monitored in prediabetes as dyslpidaemia and altered glucose tolerance go hand in hand. Elevated lipid levels predispose to a stroke and heart attack. LDL should be below 100 mg/dl, HDL above 40mg/dl (above 50 mg/dl for women), and triglycerides below 150mg/dl. Reducing the total oil intake to 500 ml a month, checking labels for hidden fats in processed foods, and eating more soluble fibre (beans and oats) will help. If levels remain high the statin group of medications can be started.
If parents adopt a healthy lifestyle, children will soon follow suit. Perhaps this way we can reduce the impact of this devastating disease in the next generation.
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
“I cannot have diabetes,” exclaimed the middle-aged gentleman. “The laboratory results are wrong. My parents did not have diabetes, I am a vegetarian, and I do not even eat sweets.”
Well, this man is living in a soap bubble that is about to burst. None of the reasons cited protects from the onset of diabetes. As far as family history is concerned, awareness and routine laboratory tests for metabolic diseases are a relatively new phenomenon. His parents may have had diabetes and may have died quietly of an undiagnosed complication like a heart attack.
India has 30 million known diabetics, the largest number in the world. The figure is mounting daily and is slated to escalate by 200 per cent. Most of the affected will be in the economically productive age group of 30-60. We have to find out ways to combat this epidemic, halt it and prevent our children from falling prey to it.
Studies have shown that the possibility of developing diabetes depends on one’s genes, which are inherited from both parents, and the nurturing environment provided first in the womb and later by the mother.
To begin with, women should have the correct BMI (body mass index — weight divided by height in metre squared) of 23 before they become pregnant. Some women are undernourished and eat poorly. Their calorie intake is only 70 per cent of the required amount (2,000-2,200 calories for an active adult female). The protein content may be less than the recommended 075-1gm/kg. Both these situations result in poor foetal growth and an SFD (small for dates) baby.
Compensatory mechanisms come into play in SFD babies and they develop relative insulin resistance so as to maintain normal blood glucose concentrations. Vital organs like the brain and heart receive sufficient nutrition, but it is diverted away from the muscles.
These small babies exhibit a phenomenon called “catch up growth”. If fed adequately after birth, they attain normal weight for age and height within three years. In the process, they can develop impaired glucose tolerance as early as seven years of age.
Today’s teens have a different story. They are becoming obese on a diet of fast food and “time pass” television. Many girls are overweight when they get married. Pregnancy and well meaning advice to “rest and eat for two” do not help matters. Those who are obese (BMI more than 29) or diabetic during pregnancy can produce large babies (LFD or large for dates). These babies are exposed to excess nutrition in the womb. They secrete excess insulin, can develop insulin resistance and eventually diabetes. The problem is compounded if they are growing up in a family with faulty eating habits and little or no regular exercise.
Since we now know that the majority of us carries a gene which predisposes us to develop diabetes, it makes sense to thwart the march to disease.
Check your blood sugars once a year after the age of 25, even if you are asymptomatic, to be sure you don’t fall in the “prediabetic” category. Those who are prediabetic have a fasting blood sugar between 100 and 126mg/dl and a two-hour post prandial or oral glucose tolerance test value between 140 and 200mg/dl. Abnormal values may occur 15 years before the onset of overt diabetes. Without active intervention eventually 35 per cent go on to develop the disease. With effort and a change in lifestyle, 45 per cent can revert to normal.
Medical complications — which cause heart disease, stroke, peripheral vascular diseases, and eye and kidney problems – begin to set in during the prediabetic stage. Early identification and treatment can reduce the damage.
The BMI should be maintained at 23. This can be done by keeping the caloric intake between 1,500-2,000 calories a day. The diet should be low in fat, and contain four to six helpings of fruit and vegetables. But dieting alone will not help, as weight loss through starvation cannot be sustained. Food restriction should be combined with physical activity for 60 minutes every day. A brisk walk (five kilometres), or one hour of swimming or cycling will do the trick.
Blood pressure should be maintained at 130/80 or less. Salt restriction and weight loss alone may be sufficient to achieve this. If not, medication may be needed.
Lipid levels also need to be monitored in prediabetes as dyslpidaemia and altered glucose tolerance go hand in hand. Elevated lipid levels predispose to a stroke and heart attack. LDL should be below 100 mg/dl, HDL above 40mg/dl (above 50 mg/dl for women), and triglycerides below 150mg/dl. Reducing the total oil intake to 500 ml a month, checking labels for hidden fats in processed foods, and eating more soluble fibre (beans and oats) will help. If levels remain high the statin group of medications can be started.
If parents adopt a healthy lifestyle, children will soon follow suit. Perhaps this way we can reduce the impact of this devastating disease in the next generation.
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, April 11, 2010
bent and twisted
Bent and twisted
Your Health
DR GITA MATHAI
The hunchback of Notre Dame (Quasimodo), immortalised by the novelist Victor Hugo, was so deformed that he never ventured out of the cathedral. He suffered from scoliosis, a condition where his spine was bent “idiopathically” (for no known reason). He was not alone. The condition affects 2-3 per cent of the population. Some illustrious people who have not been spared by scoliosis are Hrithik Roshan, the Malayalam movie star Mohanlal and Eleanor Roosevelt. More girls than boys suffer from it. It is distributed across society, with both the rich and the poor being afflicted. The difference is that the rich can afford treatment while the poor cannot.
Normally, spines are elongated, elegant and mildly S-shaped, rather like a swan’s neck. In people with scoliosis it forms a “C” or an exaggerated “S”. Man stands upright defying gravity. Once the basic support system of the spine is bent, the person faces various problems. The appearance becomes grotesque. Other physical and neurologic problems may also arise.
The deviation in the spine may be so mild that it may remain undetected unless specifically searched for. The mother may merely feel that the child’s spine is not straight because of bad posture. Constant nagging, with the refrain “sit up, stand straight, don’t slouch” may begin. Others may blame scoliosis on food faddism, bad diet, over exertion, or carrying heavy back packs to school. Attempted correction of these variables produces no improvement. Parents don’t regard it as a disease process as the child usually does not have any associated symptoms like fever or pain.
In less than 0.1 per cent of people, scoliosis may actually have a cause. It may appear after an accident. It may also be associated with fever and eventually diagnosed as an infection of the bones of the vertebral column. It may be part of a generalised musculo-skeletal disease, in which case bones, joints and muscles other than those of the spine may be affected.
There is a genetic predisposition to scoliosis and several members of a family may be inexplicably affected over generations. These people do not suffer from any disease which could be responsible for this bent spine. It is idiopathic.
Scoliosis can be present from birth. More often it appears in childhood or adolescence as a painless rib “hump” or a prominent shoulder blade visible under a T-shirt. The uneven appearance may deter the person from wearing tight fitting clothes. The muscles on one side of the spine may develop abnormally. This may result in the shoulder and hip being at different levels on the two sides. The gait then becomes lurching.
In girls, scoliosis may cause one breast to appear unaccountably larger and more prominent than the other. Worried and puzzled parents doctor shop as they search for an answer and a cure.
Mild scoliosis may be detected only if the person is asked to lean forwards. Scoliosis is considered mild when the angle measured by the orthopaedic surgeon is less than 10 degrees. Eighty per cent of the cases in India fall in this category. These people have no symptoms and can lead a normal active life. In some, however, the curvature progresses and the angle gradually increases to 45 degrees or more. Symptoms usually begin to appear at this time. Pressure may be exerted on the contents of the chest. The heart and lungs may get displaced, leading to cardiac problems and breathing difficulties. Teenage girls with asymptomatic but visible scoliosis are distressed by their body image. They may withdraw from contact with peers and become depressed and isolated. In some people, like Quasimodo, the hump is so large that the person appears misshapen and grotesque.
There are several scientifically proven treatment options for scoliosis. Mild cases can be watched. Severe cases need braces, followed by surgery. Bracing techniques have improved greatly. Earlier braces were made of steel. Now they are made of lightweight synthetic materials. Modern braces are of the underarm type, which can be worn under the clothing. This means that the braces are comfortable and well tolerated, increasing compliance. In 75 per cent of the cases progression of the deformity can be prevented.
After the bony growth ceases, corrective surgery can halt the progressive deformity and produce a normal looking spine.
Unfortunately, in India, children with idiopathic scoliosis are not offered corrective therapy. Parents are fearful and reluctant. Naturopathy, massages, ayurveda, stretching, biofeedback, electrical stimulation and bizarre exercises are tried one after another. These have no proven benefit, and some are positively harmful. Poorly performed physical therapy, stretching machines and hot massages used intermittently can even cause neurological damage.
Scoliosis is correctable and treatable. Ignorance and financial constraints prevent many of our young people from accessing corrective braces and surgery. Eventually, like Quasimodo, they have to hide forever from society.
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
The hunchback of Notre Dame (Quasimodo), immortalised by the novelist Victor Hugo, was so deformed that he never ventured out of the cathedral. He suffered from scoliosis, a condition where his spine was bent “idiopathically” (for no known reason). He was not alone. The condition affects 2-3 per cent of the population. Some illustrious people who have not been spared by scoliosis are Hrithik Roshan, the Malayalam movie star Mohanlal and Eleanor Roosevelt. More girls than boys suffer from it. It is distributed across society, with both the rich and the poor being afflicted. The difference is that the rich can afford treatment while the poor cannot.
Normally, spines are elongated, elegant and mildly S-shaped, rather like a swan’s neck. In people with scoliosis it forms a “C” or an exaggerated “S”. Man stands upright defying gravity. Once the basic support system of the spine is bent, the person faces various problems. The appearance becomes grotesque. Other physical and neurologic problems may also arise.
The deviation in the spine may be so mild that it may remain undetected unless specifically searched for. The mother may merely feel that the child’s spine is not straight because of bad posture. Constant nagging, with the refrain “sit up, stand straight, don’t slouch” may begin. Others may blame scoliosis on food faddism, bad diet, over exertion, or carrying heavy back packs to school. Attempted correction of these variables produces no improvement. Parents don’t regard it as a disease process as the child usually does not have any associated symptoms like fever or pain.
In less than 0.1 per cent of people, scoliosis may actually have a cause. It may appear after an accident. It may also be associated with fever and eventually diagnosed as an infection of the bones of the vertebral column. It may be part of a generalised musculo-skeletal disease, in which case bones, joints and muscles other than those of the spine may be affected.
There is a genetic predisposition to scoliosis and several members of a family may be inexplicably affected over generations. These people do not suffer from any disease which could be responsible for this bent spine. It is idiopathic.
Scoliosis can be present from birth. More often it appears in childhood or adolescence as a painless rib “hump” or a prominent shoulder blade visible under a T-shirt. The uneven appearance may deter the person from wearing tight fitting clothes. The muscles on one side of the spine may develop abnormally. This may result in the shoulder and hip being at different levels on the two sides. The gait then becomes lurching.
In girls, scoliosis may cause one breast to appear unaccountably larger and more prominent than the other. Worried and puzzled parents doctor shop as they search for an answer and a cure.
Mild scoliosis may be detected only if the person is asked to lean forwards. Scoliosis is considered mild when the angle measured by the orthopaedic surgeon is less than 10 degrees. Eighty per cent of the cases in India fall in this category. These people have no symptoms and can lead a normal active life. In some, however, the curvature progresses and the angle gradually increases to 45 degrees or more. Symptoms usually begin to appear at this time. Pressure may be exerted on the contents of the chest. The heart and lungs may get displaced, leading to cardiac problems and breathing difficulties. Teenage girls with asymptomatic but visible scoliosis are distressed by their body image. They may withdraw from contact with peers and become depressed and isolated. In some people, like Quasimodo, the hump is so large that the person appears misshapen and grotesque.
There are several scientifically proven treatment options for scoliosis. Mild cases can be watched. Severe cases need braces, followed by surgery. Bracing techniques have improved greatly. Earlier braces were made of steel. Now they are made of lightweight synthetic materials. Modern braces are of the underarm type, which can be worn under the clothing. This means that the braces are comfortable and well tolerated, increasing compliance. In 75 per cent of the cases progression of the deformity can be prevented.
After the bony growth ceases, corrective surgery can halt the progressive deformity and produce a normal looking spine.
Unfortunately, in India, children with idiopathic scoliosis are not offered corrective therapy. Parents are fearful and reluctant. Naturopathy, massages, ayurveda, stretching, biofeedback, electrical stimulation and bizarre exercises are tried one after another. These have no proven benefit, and some are positively harmful. Poorly performed physical therapy, stretching machines and hot massages used intermittently can even cause neurological damage.
Scoliosis is correctable and treatable. Ignorance and financial constraints prevent many of our young people from accessing corrective braces and surgery. Eventually, like Quasimodo, they have to hide forever from society.
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
scoliosis
Bent and twisted
Your Health
DR GITA MATHAI
The hunchback of Notre Dame (Quasimodo), immortalised by the novelist Victor Hugo, was so deformed that he never ventured out of the cathedral. He suffered from scoliosis, a condition where his spine was bent "idiopathically" (for no known reason). He was not alone. The condition affects 2-3 per cent of the population. Some illustrious people who have not been spared by scoliosis are Hrithik Roshan, the Malayalam movie star Mohanlal and Eleanor Roosevelt. More girls than boys suffer from it. It is distributed across society, with both the rich and the poor being afflicted. The difference is that the rich can afford treatment while the poor cannot.
Normally, spines are elongated, elegant and mildly S-shaped, rather like a swan's neck. In people with scoliosis it forms a "C" or an exaggerated "S". Man stands upright defying gravity. Once the basic support system of the spine is bent, the person faces various problems. The appearance becomes grotesque. Other physical and neurologic problems may also arise.
The deviation in the spine may be so mild that it may remain undetected unless specifically searched for. The mother may merely feel that the child's spine is not straight because of bad posture. Constant nagging, with the refrain "sit up, stand straight, don't slouch" may begin. Others may blame scoliosis on food faddism, bad diet, over exertion, or carrying heavy back packs to school. Attempted correction of these variables produces no improvement. Parents don't regard it as a disease process as the child usually does not have any associated symptoms like fever or pain.
In less than 0.1 per cent of people, scoliosis may actually have a cause. It may appear after an accident. It may also be associated with fever and eventually diagnosed as an infection of the bones of the vertebral column. It may be part of a generalised musculo-skeletal disease, in which case bones, joints and muscles other than those of the spine may be affected.
There is a genetic predisposition to scoliosis and several members of a family may be inexplicably affected over generations. These people do not suffer from any disease which could be responsible for this bent spine. It is idiopathic.
Scoliosis can be present from birth. More often it appears in childhood or adolescence as a painless rib "hump" or a prominent shoulder blade visible under a T-shirt. The uneven appearance may deter the person from wearing tight fitting clothes. The muscles on one side of the spine may develop abnormally. This may result in the shoulder and hip being at different levels on the two sides. The gait then becomes lurching.
In girls, scoliosis may cause one breast to appear unaccountably larger and more prominent than the other. Worried and puzzled parents doctor shop as they search for an answer and a cure.
Mild scoliosis may be detected only if the person is asked to lean forwards. Scoliosis is considered mild when the angle measured by the orthopaedic surgeon is less than 10 degrees. Eighty per cent of the cases in India fall in this category. These people have no symptoms and can lead a normal active life. In some, however, the curvature progresses and the angle gradually increases to 45 degrees or more. Symptoms usually begin to appear at this time. Pressure may be exerted on the contents of the chest. The heart and lungs may get displaced, leading to cardiac problems and breathing difficulties. Teenage girls with asymptomatic but visible scoliosis are distressed by their body image. They may withdraw from contact with peers and become depressed and isolated. In some people, like Quasimodo, the hump is so large that the person appears misshapen and grotesque.
There are several scientifically proven treatment options for scoliosis. Mild cases can be watched. Severe cases need braces, followed by surgery. Bracing techniques have improved greatly. Earlier braces were made of steel. Now they are made of lightweight synthetic materials. Modern braces are of the underarm type, which can be worn under the clothing. This means that the braces are comfortable and well tolerated, increasing compliance. In 75 per cent of the cases progression of the deformity can be prevented.
After the bony growth ceases, corrective surgery can halt the progressive deformity and produce a normal looking spine.
Unfortunately, in India, children with idiopathic scoliosis are not offered corrective therapy. Parents are fearful and reluctant. Naturopathy, massages, ayurveda, stretching, biofeedback, electrical stimulation and bizarre exercises are tried one after another. These have no proven benefit, and some are positively harmful. Poorly performed physical therapy, stretching machines and hot massages used intermittently can even cause neurological damage.
Scoliosis is correctable and treatable. Ignorance and financial constraints prevent many of our young people from accessing corrective braces and surgery. Eventually, like Quasimodo, they have to hide forever from society.
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, March 29, 2010
medical palmistry
our Health
DR GITA MATHAI
Rogue, fraud, charlatan. Words we often use to describe the roadside palmist. Can anyone say what the creases, lines and stars etched on our palms mean? Or if they do mean anything at all?
Some people, it seems, can say much about your life by “reading” your palm.
Welcome to the world of medical palmistry, a branch of science based on documented and proven scientific observations.
A detailed examination of the palm does provide valuable clues to a person’s medical history, lifestyle, diseases and life expectancy. Palms and fingers have characteristic creases, whorls, arches and loops. These are unique in each individual and never identical, even in twins. One of the oldest biometric methods of establishing positive identity is by using fingerprints.
“Palmar creases” form in an unborn baby as it holds its hands tightly clenched during the 12th week. Normally this forms three palmar creases or lines. Any physical, medical or drug-induced injury to the foetus during the first three months is reflected permanently as abnormal palmar creases. This can be picked up on ultrasound examination after the 12th week. If the creases are abnormal, the foetus should be closely monitored for associated abnormalities in the kidney, heart and other organs.
Sometimes the upper two lines fuse to form a single palmar crease or simian line that stretches across the open palm. A single palmar crease can be present in one out of 30 apparently normal people. It is more common in males and is usually present only on one hand. One or both parents of these children may have the abnormal crease on one hand. This is a minor aberration and warrants monitoring as these children may reveal mild abnormalities in other organs in later life. It is also associated with certain chromosomal anomalies, the most common of which is Down’s Syndrome (Trisomy 21).
Not all abnormal palmar creases are hereditary or genetic. Alcoholic women who continue to drink during pregnancy can produce children with “foetal alcohol syndrome” and a single palmar crease.
People with mental illnesses have more open loops and fewer whorls on their finger tips. Those prone to chronic diseases like leprosy and tuberculosis also tend to have only two lines on the palm, with the abnormal line just above the thumb.
Normally, a person has 10 fingers and toes. In one in 1,000 births, there may be extra digits, separate, complete, incomplete or fused. These defects can be associated with other internal congenital malformations, and so a detailed examination must be done for any affected newborn.
Marfans syndrome is a genetic disorder in which the person has “arachnodactyly” or abnormally long fingers like spider legs. This can be diagnosed before birth through ultrasound.
Congenital hypothyroidism, certain renal diseases and some forms of dwarfism are linked with a “tripartiate” hand — where the index, middle and ring fingers are the same length.
Cigarette smokers, people suffering from chronic respiratory ailments, and those with congenital heart disease may have blue nails. Some lung diseases like bronchiectasis, and chronic intestinal diseases may bend the nail like a convex parrot beak, a condition called “clubbing”. Jaundice causes the skin of the palms to turn yellow. Carotenemia produces a similar appearance. It is a harmless condition and is caused by an excess consumption of yellow carotene containing fruits and vegetables.
Hormone levels in the uterus also influences finger length. A person (irrespective of sex) with the index finger shorter than the ring finger will have had more testosterone (male hormone) while in the womb, and a person with an index finger longer than the ring finger will have had more eostrogen (female hormone). Professional women, especially women scientists, tend to have higher levels of testosterone vis-a-vis their oestrogen level, making their brains closer to those of men in general. The converse is true with men working in the fine arts and social sciences.
The position in which we hold our palms is a reflection of the body mass index or BMI (weight in kilogram divided by height in metre squared). A BMI more than 30 is diagnostic of obesity. Such people tend to hold their hands with the thumbs facing backwards as they stand. Overweight people with a BMI between 25 and 30 hold their arms with the thumb facing sideways. People of normal weight with a BMI between 20 and 25 stand with their palms facing forwards.
So, remember, your palms will reveal a lot about your health, but only if you go to a medical palmist.
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
DR GITA MATHAI
Rogue, fraud, charlatan. Words we often use to describe the roadside palmist. Can anyone say what the creases, lines and stars etched on our palms mean? Or if they do mean anything at all?
Some people, it seems, can say much about your life by “reading” your palm.
Welcome to the world of medical palmistry, a branch of science based on documented and proven scientific observations.
A detailed examination of the palm does provide valuable clues to a person’s medical history, lifestyle, diseases and life expectancy. Palms and fingers have characteristic creases, whorls, arches and loops. These are unique in each individual and never identical, even in twins. One of the oldest biometric methods of establishing positive identity is by using fingerprints.
“Palmar creases” form in an unborn baby as it holds its hands tightly clenched during the 12th week. Normally this forms three palmar creases or lines. Any physical, medical or drug-induced injury to the foetus during the first three months is reflected permanently as abnormal palmar creases. This can be picked up on ultrasound examination after the 12th week. If the creases are abnormal, the foetus should be closely monitored for associated abnormalities in the kidney, heart and other organs.
Sometimes the upper two lines fuse to form a single palmar crease or simian line that stretches across the open palm. A single palmar crease can be present in one out of 30 apparently normal people. It is more common in males and is usually present only on one hand. One or both parents of these children may have the abnormal crease on one hand. This is a minor aberration and warrants monitoring as these children may reveal mild abnormalities in other organs in later life. It is also associated with certain chromosomal anomalies, the most common of which is Down’s Syndrome (Trisomy 21).
Not all abnormal palmar creases are hereditary or genetic. Alcoholic women who continue to drink during pregnancy can produce children with “foetal alcohol syndrome” and a single palmar crease.
People with mental illnesses have more open loops and fewer whorls on their finger tips. Those prone to chronic diseases like leprosy and tuberculosis also tend to have only two lines on the palm, with the abnormal line just above the thumb.
Normally, a person has 10 fingers and toes. In one in 1,000 births, there may be extra digits, separate, complete, incomplete or fused. These defects can be associated with other internal congenital malformations, and so a detailed examination must be done for any affected newborn.
Marfans syndrome is a genetic disorder in which the person has “arachnodactyly” or abnormally long fingers like spider legs. This can be diagnosed before birth through ultrasound.
Congenital hypothyroidism, certain renal diseases and some forms of dwarfism are linked with a “tripartiate” hand — where the index, middle and ring fingers are the same length.
Cigarette smokers, people suffering from chronic respiratory ailments, and those with congenital heart disease may have blue nails. Some lung diseases like bronchiectasis, and chronic intestinal diseases may bend the nail like a convex parrot beak, a condition called “clubbing”. Jaundice causes the skin of the palms to turn yellow. Carotenemia produces a similar appearance. It is a harmless condition and is caused by an excess consumption of yellow carotene containing fruits and vegetables.
Hormone levels in the uterus also influences finger length. A person (irrespective of sex) with the index finger shorter than the ring finger will have had more testosterone (male hormone) while in the womb, and a person with an index finger longer than the ring finger will have had more eostrogen (female hormone). Professional women, especially women scientists, tend to have higher levels of testosterone vis-a-vis their oestrogen level, making their brains closer to those of men in general. The converse is true with men working in the fine arts and social sciences.
The position in which we hold our palms is a reflection of the body mass index or BMI (weight in kilogram divided by height in metre squared). A BMI more than 30 is diagnostic of obesity. Such people tend to hold their hands with the thumbs facing backwards as they stand. Overweight people with a BMI between 25 and 30 hold their arms with the thumb facing sideways. People of normal weight with a BMI between 20 and 25 stand with their palms facing forwards.
So, remember, your palms will reveal a lot about your health, but only if you go to a medical palmist.
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, March 20, 2010
Can't get the words out
Stutter and stammer
Your Health
DR GITA MATHAI
“Honey should be applied to a baby’s tongue soon after birth. The child then goes on to develop sweet speech with no stammering.”
This was the practice a century ago. Medically, the honey did nothing to prevent stammering. But if it was contaminated with bacteria, it did cause fatal botulinium poisoning with flaccid paralysis in a significant percentage of children.
Around 10 million people in India stammer. The speech disorder affects 3-5 per cent of children, of which one per cent continues to stammer into adult life. About 80 per cent of the affected children are boys, and first-born males are more likely to be affected. Around 65 per cent of them have a family history of stammering. In most cases, it is the father who stammers or has rapid staccato speech.
Speech is a complex process. A person decides what he or she wants to say, and electro chemical signals are triggered in the brain’s speech area. These signals have to reach the muscle groups in the pharynx, larynx and tongue. If the speed of the thought and the release of the chemicals are not perfectly co-ordinated, stammering occurs. Words or syllables are repeated or prolonged, speech suddenly stops and no sound emerges. The speech becomes blocked in spasms, resulting in repetitive sounds or no sound at all. Even in normal people, emotions can trigger such a condition. In those who stammer, anxiety anticipation of stammering, and embarrassment can trigger tics and spasms of the facial muscles as well.
Children start to stammer before the age of five. It may first become evident when they start school. Many recover spontaneously, while others require treatment. If the stammering continues beyond the age of seven, it is likely to persist into adult life.
Many famous people like Winston Churchill stammered. It didn’t prevent them from scaling great heights. In most cases, however, the sufferer fails to achieve his or her potential. Such people fail in job interviews and viva voce presentations, as stress worsens the stammer. Society often pokes fun at these individuals. In films too comedians are often shown to stammer. As a result, these otherwise intelligent and sensitive people become withdrawn and isolated.
When in contact with a person who stammers:
• Try not to show your embarrassment or look away. Do not reassure them just wait patiently and they will complete what they want to say
• Do not try to complete their sentences for them
• Maintain eye contact
• Many of those who stammer find answering the phone an ordeal. So if the phone rings and there is silence, wait till the person is able to speak.
Stammering is not due to tongue-tie, so surgery does not help. Since it is aggravated by stress, and the affected individuals appear distressed, antiaxiolytic medications like alpraxolam and valium, tranquillisers and antidepressants were initially tried. But they were not very useful. In short, there is no magic pill to cure stammering.
If a child’s stammer lasts more than six months, causes psychological problems in school, or continues beyond the age of five, it needs to be evaluated.
Children cannot voluntarily control stammering. Ridicule, asking him or her to speak slowly, or forcing him or her to repeat the words wont help. The only way parents can help is by providing a relaxed and supportive environment where the child is allowed to speak without feeling self-conscious.
Speech therapists can work with people who stammer, and by using a variety of techniques, can improve the speech. They can also help improve communication skills and create self awareness and confidence. Newer auditory feedback devices and computer assisted speech training can also be tried out. Many people do not have access to speech therapists and are forced to handle their child’s stammering as best they can.
A person may stammer while talking but not while singing. Asking him or her to formulate thoughts in the mind and then speak in a singsong way often helps. Speaking slowly, syllable by syllable instead of complete words, gets rid of the repetitive “th th th” sounds. Asking the person to follow the speech of the therapist or parent also helps. Sometimes using a gesture as the stammer sets in takes the concentration away from the speech and the stammer disappears.
Universal tips
• Sing the words
• Visualise the words in your head first
• Take a deep breath before speaking
• Speak slowly and break up the words into smaller components
• Speaking loudly or in a whisper makes stammering less obvious
If your child stammers, encourage him or her to do physical activity. This gives confidence which helps the anxiety and depression caused by stammering. Yoga calms the mind and corrects faulty breathing. It also improves speech in those who stammer.
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
“Honey should be applied to a baby’s tongue soon after birth. The child then goes on to develop sweet speech with no stammering.”
This was the practice a century ago. Medically, the honey did nothing to prevent stammering. But if it was contaminated with bacteria, it did cause fatal botulinium poisoning with flaccid paralysis in a significant percentage of children.
Around 10 million people in India stammer. The speech disorder affects 3-5 per cent of children, of which one per cent continues to stammer into adult life. About 80 per cent of the affected children are boys, and first-born males are more likely to be affected. Around 65 per cent of them have a family history of stammering. In most cases, it is the father who stammers or has rapid staccato speech.
Speech is a complex process. A person decides what he or she wants to say, and electro chemical signals are triggered in the brain’s speech area. These signals have to reach the muscle groups in the pharynx, larynx and tongue. If the speed of the thought and the release of the chemicals are not perfectly co-ordinated, stammering occurs. Words or syllables are repeated or prolonged, speech suddenly stops and no sound emerges. The speech becomes blocked in spasms, resulting in repetitive sounds or no sound at all. Even in normal people, emotions can trigger such a condition. In those who stammer, anxiety anticipation of stammering, and embarrassment can trigger tics and spasms of the facial muscles as well.
Children start to stammer before the age of five. It may first become evident when they start school. Many recover spontaneously, while others require treatment. If the stammering continues beyond the age of seven, it is likely to persist into adult life.
Many famous people like Winston Churchill stammered. It didn’t prevent them from scaling great heights. In most cases, however, the sufferer fails to achieve his or her potential. Such people fail in job interviews and viva voce presentations, as stress worsens the stammer. Society often pokes fun at these individuals. In films too comedians are often shown to stammer. As a result, these otherwise intelligent and sensitive people become withdrawn and isolated.
When in contact with a person who stammers:
• Try not to show your embarrassment or look away. Do not reassure them just wait patiently and they will complete what they want to say
• Do not try to complete their sentences for them
• Maintain eye contact
• Many of those who stammer find answering the phone an ordeal. So if the phone rings and there is silence, wait till the person is able to speak.
Stammering is not due to tongue-tie, so surgery does not help. Since it is aggravated by stress, and the affected individuals appear distressed, antiaxiolytic medications like alpraxolam and valium, tranquillisers and antidepressants were initially tried. But they were not very useful. In short, there is no magic pill to cure stammering.
If a child’s stammer lasts more than six months, causes psychological problems in school, or continues beyond the age of five, it needs to be evaluated.
Children cannot voluntarily control stammering. Ridicule, asking him or her to speak slowly, or forcing him or her to repeat the words wont help. The only way parents can help is by providing a relaxed and supportive environment where the child is allowed to speak without feeling self-conscious.
Speech therapists can work with people who stammer, and by using a variety of techniques, can improve the speech. They can also help improve communication skills and create self awareness and confidence. Newer auditory feedback devices and computer assisted speech training can also be tried out. Many people do not have access to speech therapists and are forced to handle their child’s stammering as best they can.
A person may stammer while talking but not while singing. Asking him or her to formulate thoughts in the mind and then speak in a singsong way often helps. Speaking slowly, syllable by syllable instead of complete words, gets rid of the repetitive “th th th” sounds. Asking the person to follow the speech of the therapist or parent also helps. Sometimes using a gesture as the stammer sets in takes the concentration away from the speech and the stammer disappears.
Universal tips
• Sing the words
• Visualise the words in your head first
• Take a deep breath before speaking
• Speak slowly and break up the words into smaller components
• Speaking loudly or in a whisper makes stammering less obvious
If your child stammers, encourage him or her to do physical activity. This gives confidence which helps the anxiety and depression caused by stammering. Yoga calms the mind and corrects faulty breathing. It also improves speech in those who stammer.
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
Tuesday, March 9, 2010
i can't breathe
Hunger for air
YOUR HEALTH
DR GITA MATHAI
“I can’t breathe,” said the woman, panic stricken and one hand clutched at her chest. Her forehead was lined with sweat and fear of death etched on her face. Breathing, after all, is essential for life.
We take breathing or respiration for granted. It is an involuntary, autonomous and automatic reflex that is present from birth to death. We can consciously take deep or shallow breaths, but we cannot stop breathing at will. In short, you cannot commit suicide by voluntarily ceasing to breathe.
Breathing difficulty is a perception. Some people may have fairly severe lung restriction, but be able to continue their normal activities. Others may feel breathless with the slightest unaccustomed exertion. This is more likely to occur if the person is unfit, obese and unaccustomed to exercise. A sudden “panic attack” owing to an external factor can be “breath stopping”. High altitudes and high temperature can also cause similar problems.
Breathing difficulty can occur suddenly because of a foreign body like a peanut which has got lodged in the food pipe. This then becomes a medical emergency. Immediately stand behind the person, make a fist with both hands and exert a sudden forceful upward thrust in the stomach area below the chest bone (sternum). This is called a “Heimlich maneuver” and it has saved many lives.
Mucous secretions — watery in case of viral infections and allergy, and thick and viscous in case of secondary bacterial infection — can clog the nasal passages and bronchi. Some of these secretions can drip backwards into the throat, causing a post nasal drip with a sense of suffocation.
The nasal passages can be cleared with nose drops. It is important to use saline nasal drops. This is commercially manufactured by many companies. It needs to be used every two hours. Nasal drops containing chemicals may provide faster relief. But as the effect wears off, they may cause “rebound congestion” with worse blockage. Long-term frequent usage of chemical nose drops may cause habituation, wherein the body stops responding to the medication. If the nasal block is due to an allergy, prescribed locally acting steroid nasal sprays are very effective.
The bronchi can narrow in response to exposure to ingested allergens like peanuts and food colour, or inhaled ones like cigarette or wood smoke, room fresheners and mosquito repellents. This is called reactive airways disease or asthma.
Smokers may have damaged their lungs structure permanently, causing a disease called COAD (chronic obstructive airways disease). This sets in around 20-30 years after the first puff. It attacks people in their 40s and 50s. They become breathless with exertion and sometimes even at rest. Some require continuous artificial oxygen supply.
Initially — that is, before damage sets in — airway constriction is reversible. Inhalers or rotahalers deliver relief producing bronchodilating medication directly to the bronchi. The respite is immediate and sustained if the medication is “puffed” as prescribed. Direct delivery systems make medication more effective and are less likely to cause side effects.
The rate of breathing increases during pregnancy because of the oxygen demand of the baby. Moreover, pregnancy causes the uterus to enlarge which pushes the abdominal contents upwards. This may cause a feeling of inadequacy while breathing. This is self-limited and disappears with delivery.
Congenital heart disease, heart failure and myocarditis (disease of the heart muscles) can cause difficulty in breathing and a feeling of air hunger. This is because a failing heart provides inefficient circulation of blood and insufficient oxygenation to the tissues of the body. The blood carrying capacity of the body itself may be compromised because of anaemia. Specific medication for the diseases will help with the problem.
Breathlessness needs to be evaluated if:
The difficulty occurred suddenly for no apparent reason
• It was accompanied by chest discomfort, pain or pressure
• It comes with a slight exertion or at rest
• There is an inability to lie down flat and sleep
• It is accompanied by fever
• There is pressure, fullness or a squeezing pain in the chest.
Good breathing techniques require the co-ordinated use of intercostals (groups of muscles that run between the ribs, and help form and move the chest wall), diaphragm and stomach muscles. As the breath goes in, the intercostals and stomach expand and the latter moves outwards. And as we breathe out, the chest contracts, the diaphragm moves up and the stomach moves in. Breathing is a natural response and occurs normally and naturally in children. As age advances, we tend to lose the ability to breathe efficiently.
Long hours at work seated in a sloppy posture, obesity or an inactive life without the mandatory one hour of aerobic activity (running, swimming, jogging or cycling) results in inefficient and inadequate breathing, even in a normal individual.
Place a hand on your abdomen, stand in front of a mirror and breathe in and out to check if your breathing is correct. Consciously correct deficiencies and practise breathing exercises (yoga pranayam) for a healthier tomorrow.
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
“I can’t breathe,” said the woman, panic stricken and one hand clutched at her chest. Her forehead was lined with sweat and fear of death etched on her face. Breathing, after all, is essential for life.
We take breathing or respiration for granted. It is an involuntary, autonomous and automatic reflex that is present from birth to death. We can consciously take deep or shallow breaths, but we cannot stop breathing at will. In short, you cannot commit suicide by voluntarily ceasing to breathe.
Breathing difficulty is a perception. Some people may have fairly severe lung restriction, but be able to continue their normal activities. Others may feel breathless with the slightest unaccustomed exertion. This is more likely to occur if the person is unfit, obese and unaccustomed to exercise. A sudden “panic attack” owing to an external factor can be “breath stopping”. High altitudes and high temperature can also cause similar problems.
Breathing difficulty can occur suddenly because of a foreign body like a peanut which has got lodged in the food pipe. This then becomes a medical emergency. Immediately stand behind the person, make a fist with both hands and exert a sudden forceful upward thrust in the stomach area below the chest bone (sternum). This is called a “Heimlich maneuver” and it has saved many lives.
Mucous secretions — watery in case of viral infections and allergy, and thick and viscous in case of secondary bacterial infection — can clog the nasal passages and bronchi. Some of these secretions can drip backwards into the throat, causing a post nasal drip with a sense of suffocation.
The nasal passages can be cleared with nose drops. It is important to use saline nasal drops. This is commercially manufactured by many companies. It needs to be used every two hours. Nasal drops containing chemicals may provide faster relief. But as the effect wears off, they may cause “rebound congestion” with worse blockage. Long-term frequent usage of chemical nose drops may cause habituation, wherein the body stops responding to the medication. If the nasal block is due to an allergy, prescribed locally acting steroid nasal sprays are very effective.
The bronchi can narrow in response to exposure to ingested allergens like peanuts and food colour, or inhaled ones like cigarette or wood smoke, room fresheners and mosquito repellents. This is called reactive airways disease or asthma.
Smokers may have damaged their lungs structure permanently, causing a disease called COAD (chronic obstructive airways disease). This sets in around 20-30 years after the first puff. It attacks people in their 40s and 50s. They become breathless with exertion and sometimes even at rest. Some require continuous artificial oxygen supply.
Initially — that is, before damage sets in — airway constriction is reversible. Inhalers or rotahalers deliver relief producing bronchodilating medication directly to the bronchi. The respite is immediate and sustained if the medication is “puffed” as prescribed. Direct delivery systems make medication more effective and are less likely to cause side effects.
The rate of breathing increases during pregnancy because of the oxygen demand of the baby. Moreover, pregnancy causes the uterus to enlarge which pushes the abdominal contents upwards. This may cause a feeling of inadequacy while breathing. This is self-limited and disappears with delivery.
Congenital heart disease, heart failure and myocarditis (disease of the heart muscles) can cause difficulty in breathing and a feeling of air hunger. This is because a failing heart provides inefficient circulation of blood and insufficient oxygenation to the tissues of the body. The blood carrying capacity of the body itself may be compromised because of anaemia. Specific medication for the diseases will help with the problem.
Breathlessness needs to be evaluated if:
The difficulty occurred suddenly for no apparent reason
• It was accompanied by chest discomfort, pain or pressure
• It comes with a slight exertion or at rest
• There is an inability to lie down flat and sleep
• It is accompanied by fever
• There is pressure, fullness or a squeezing pain in the chest.
Good breathing techniques require the co-ordinated use of intercostals (groups of muscles that run between the ribs, and help form and move the chest wall), diaphragm and stomach muscles. As the breath goes in, the intercostals and stomach expand and the latter moves outwards. And as we breathe out, the chest contracts, the diaphragm moves up and the stomach moves in. Breathing is a natural response and occurs normally and naturally in children. As age advances, we tend to lose the ability to breathe efficiently.
Long hours at work seated in a sloppy posture, obesity or an inactive life without the mandatory one hour of aerobic activity (running, swimming, jogging or cycling) results in inefficient and inadequate breathing, even in a normal individual.
Place a hand on your abdomen, stand in front of a mirror and breathe in and out to check if your breathing is correct. Consciously correct deficiencies and practise breathing exercises (yoga pranayam) for a healthier tomorrow.
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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