Fast track to healthy living
Your Health
DR GITA MATHAI
Anna Hazare during his fast in New Delhi
Fasting is common in India. Hindus fast on certain days of the week, Jains after six in the evening, Muslims during the month of Ramadan and Christians during Lent. Politicians and activists have traditionally used it as a means to an end.
Some fasts involve total avoidance of all food and water. In some others, food is avoided at specific times of the day. Yet others restrict the type of food. Fasting is different from involuntary starvation due to famine or illness. Voluntary fasting isn’t advisable for people under 15, over 70, pregnant women, people involved in outdoor or heavy labour, and those suffering from illnesses. Some medicines dangerously accelerate the biochemical effects of fasting.
Any food that we eat is digested and broken down into its components — glucose, fatty acids and amino acids. Glucose is the body’s main source of energy and is required by all tissues. When the body is deprived of food, any excess glucose stored in the body is accessed and utilised to get energy. Once these stores are depleted, the body starts to break down fat and use it. This is around 7 per cent of the body weight of males and 10 per cent in females. When is used up, there is an intense craving for food. If this is still not enough, the muscles in the body start to get metabolised. The person develops a wasted and emaciated appearance.
Deprived of food and water, a healthy adult can survive about 10-12 days. With water, survival can extend to 50-60 days. Children and the elderly succumb more rapidly. Women and obese individuals (both sexes) are able to withstand starvation better as they have more body fat reserves. Extremes of temperature (heat or cold) accelerate the ill effects of starvation.
Stopping food and water abruptly causes changes of “acute starvation” in the body within 24 hours. Thirst and hunger pains set in. The mouth gets parched, the saliva thickens and the urine is high coloured and scanty. After 48 hours, the voice becomes feeble, the pulse weakens, the temperature drops and dehydration sets in. As the days pass by, the blood pressure and temperature drop, the hair and nails become brittle, the eyes sink and the pupils dilate. Constipation is usual, but diarrhoea may occur. The intellect can remain clear and unclouded, but delirium and convulsions may precede death.
The medical complications associated with prolonged fasting are electrolyte imbalances, cardiac arrhythmia and kidney failure. Death can occur if fasting is pursued to the point of complete starvation.
Some medical tests have to be done upon “fasting” or on an “empty stomach”. There is often ambiguity and confusion between these two terms. Medically, fasting usually means an overnight fast of eight to 12 hours. That’s because metabolic adjustments occur in the body during fasting. The normal values of the results of some tests like lipid profile and sugar tests are standardised for fasting conditions. “On an empty stomach” typically means three to five hours after a meal, when the meal has left the stomach and digestion is complete.
Extended, intermittent, regular fasting has been recommended from the ancient times to preserve health. Today we know fasting improves the blood lipid profile and reduces total cholesterol. Research done on human volunteers at the US National Institute on Aging suggests that fasting every alternate day offers major health benefits. The cumulative calorific restriction reduces the risk of cancer, cardiovascular diseases, diabetes, insulin resistance and immune disorders. It also actually slows the aging process, and seems to have the potential to increase the life span. People do tend to lose weight with alternate day fasting, but on the negative side they tend to be irritable on the fasting day. Also, repeated fasts can result in the body going into a “conserve mode” and the metabolism slowing down to conserve energy. There will be no weight loss despite repeated intermittent fasting.
It is possible to “starve in the midst of plenty”. This occurs in diabetics who are unable to utilise the food they eat. In some others, the food may be unhealthy (just fat and sugar) and lacking essential proteins, vitamins and minerals.
Teenagers may resort to excessive fasting to prevent obesity. This can result in mental changes and anorexia nervosa.
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, April 19, 2011
Tuesday, April 12, 2011
PS its PMS
It’s PMS, stupid
Your Health
DR GITA MATHAI
Women are often maligned and labelled as “unreasonable, unrealistic, illogical and hysterical”, even when their statements are reasonable and logical. “Blame it on the hormones” is the usual explanation from a male-dominated society. Physicians (mostly male) in the 19th century, unaware of hormone levels, concluded that somehow all this behaviour was connected to the presence of a uterus (from the Greek word hystera which means womb). They sometimes recommended hysterectomy to remove the root cause of these problems and render these women “normal”.
Unfortunately, some surgeons today, too, subscribe to this view. Women in the reproductive age are advised a hysterectomy to remove the uterus, once it has finished its reproductive function, to relieve them of all their physical and psychological symptoms.
Yet 15 per cent of women suffer from unreasonable anger, excessive sensitivity, paranoid thoughts, anxiety, depression, uncontrollable crying spells, and bizarre food cravings during the pre-menstrual period. In 0.4 per cent, the symptoms may be severe enough to be labelled psychotic. These symptoms are called pre-menstrual syndrome (PMS). They are not because of the presence of the uterus, but are attributed to the body’s response to normal changes in the hormonal (oestrogen and progesterone) ratios during the course of a menstrual cycle.
In PMS sufferers, there’s a lack of perfect synchronisation in the hormone levels, both at the pituitary-hypothalamic level in the brain and at the level of the ovaries (not uterus). Surges and dips cause changes in the biochemical neurotransmitters (serotonin) and precipitate the depressed “low feeling”. Attempts to alleviate the depression and push up neurotransmitter levels lead to food cravings and binge eating.
The mental changes can be disruptive to the family and in the workplace. By the time the distraught family persuades the woman to seek medical help, the onset of menstruation has restored the woman’s Jekyll-and-Hyde personality to normal. Unfortunately, the menstrual cycle and mood swings repeat themselves month after month.
PMS is commoner between the ages of 30 and 45. This led to the erroneous belief that it was in some way connected with approaching menopause. This isn’t true. However, this is the time when women experience the maximum stress in both their family life and career. They often fail to cope with the combination of stress and hormonal imbalances.
Some physical changes can be produced as a result of the hormones. Fluid retention can result in a measurable weight gain (1-2kg). This can make clothes tighter. There may be backache, joint pain, breast tenderness and palpitations.
Treatment becomes imperative when the mood swings make women depressed and suicidal, or psychotic and murderous. (Most murderesses committed their crime during their pre-menstrual phase). Also, job efficiency and interpersonal relationships may be affected because of tiredness, fatigue, sensitivity and ill temper.
It is difficult to convince women with PMS that they need help, especially since they are normal for around 20 days in a month. Also, the sensitivity varies from woman to woman. Some with mild forms may be acutely conscious of their problem, while others with severe degrees of PMS may rationalise their behaviour. To avoid PMS,
Try to maintain a body mass index (weight divided by height in metre squared) as close to 23 as possible
Instead of three large meals, eat six small meals at regular three-hour intervals. Add at least six helpings of fresh fruits and vegetables, one with each meal. These are high in fibre and beneficial antioxidants. Fibres delay digestion and absorption, helping to maintain a steady blood glucose level with no depression-inducing dips
Reduce the salt intake in cooked food to one teaspoon a day
Avoid fried, salted snacks and chocolate
Reduce the use of caffeine by cutting down on carbonated colas, tea and coffee
Do regular aerobic exercise such as an hour of walking, jogging, cycling, climbing stairs or swimming to reduce stress. Exercise improves blood circulation and reduces bloating and fatigue. It produces a sense of well being. It boosts the body’s natural production of endorphins, which acts as a mood elevator
Daily supplements of vitamins and minerals may be administered to relieve some PMS symptoms. A multivitamin capsule with B6 (100 mcg), B complex, vitamin E (400 IU) and vitamin C (100mg) and calcium (1,000mg) supplementation is beneficial
Capsules of evening primrose oil, oral contraceptive pills, low dose diuretic therapy, mild antidepressants and tranquilisers have been tried and have anecdotally helped some sufferers.
PMS tends to run in families. This may be because the hormone ratios are inherited, leading to similar behaviour. This becomes more likely because of a comparable lifestyle, with improper diet and inadequate physical activity.
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
Women are often maligned and labelled as “unreasonable, unrealistic, illogical and hysterical”, even when their statements are reasonable and logical. “Blame it on the hormones” is the usual explanation from a male-dominated society. Physicians (mostly male) in the 19th century, unaware of hormone levels, concluded that somehow all this behaviour was connected to the presence of a uterus (from the Greek word hystera which means womb). They sometimes recommended hysterectomy to remove the root cause of these problems and render these women “normal”.
Unfortunately, some surgeons today, too, subscribe to this view. Women in the reproductive age are advised a hysterectomy to remove the uterus, once it has finished its reproductive function, to relieve them of all their physical and psychological symptoms.
Yet 15 per cent of women suffer from unreasonable anger, excessive sensitivity, paranoid thoughts, anxiety, depression, uncontrollable crying spells, and bizarre food cravings during the pre-menstrual period. In 0.4 per cent, the symptoms may be severe enough to be labelled psychotic. These symptoms are called pre-menstrual syndrome (PMS). They are not because of the presence of the uterus, but are attributed to the body’s response to normal changes in the hormonal (oestrogen and progesterone) ratios during the course of a menstrual cycle.
In PMS sufferers, there’s a lack of perfect synchronisation in the hormone levels, both at the pituitary-hypothalamic level in the brain and at the level of the ovaries (not uterus). Surges and dips cause changes in the biochemical neurotransmitters (serotonin) and precipitate the depressed “low feeling”. Attempts to alleviate the depression and push up neurotransmitter levels lead to food cravings and binge eating.
The mental changes can be disruptive to the family and in the workplace. By the time the distraught family persuades the woman to seek medical help, the onset of menstruation has restored the woman’s Jekyll-and-Hyde personality to normal. Unfortunately, the menstrual cycle and mood swings repeat themselves month after month.
PMS is commoner between the ages of 30 and 45. This led to the erroneous belief that it was in some way connected with approaching menopause. This isn’t true. However, this is the time when women experience the maximum stress in both their family life and career. They often fail to cope with the combination of stress and hormonal imbalances.
Some physical changes can be produced as a result of the hormones. Fluid retention can result in a measurable weight gain (1-2kg). This can make clothes tighter. There may be backache, joint pain, breast tenderness and palpitations.
Treatment becomes imperative when the mood swings make women depressed and suicidal, or psychotic and murderous. (Most murderesses committed their crime during their pre-menstrual phase). Also, job efficiency and interpersonal relationships may be affected because of tiredness, fatigue, sensitivity and ill temper.
It is difficult to convince women with PMS that they need help, especially since they are normal for around 20 days in a month. Also, the sensitivity varies from woman to woman. Some with mild forms may be acutely conscious of their problem, while others with severe degrees of PMS may rationalise their behaviour. To avoid PMS,
Try to maintain a body mass index (weight divided by height in metre squared) as close to 23 as possible
Instead of three large meals, eat six small meals at regular three-hour intervals. Add at least six helpings of fresh fruits and vegetables, one with each meal. These are high in fibre and beneficial antioxidants. Fibres delay digestion and absorption, helping to maintain a steady blood glucose level with no depression-inducing dips
Reduce the salt intake in cooked food to one teaspoon a day
Avoid fried, salted snacks and chocolate
Reduce the use of caffeine by cutting down on carbonated colas, tea and coffee
Do regular aerobic exercise such as an hour of walking, jogging, cycling, climbing stairs or swimming to reduce stress. Exercise improves blood circulation and reduces bloating and fatigue. It produces a sense of well being. It boosts the body’s natural production of endorphins, which acts as a mood elevator
Daily supplements of vitamins and minerals may be administered to relieve some PMS symptoms. A multivitamin capsule with B6 (100 mcg), B complex, vitamin E (400 IU) and vitamin C (100mg) and calcium (1,000mg) supplementation is beneficial
Capsules of evening primrose oil, oral contraceptive pills, low dose diuretic therapy, mild antidepressants and tranquilisers have been tried and have anecdotally helped some sufferers.
PMS tends to run in families. This may be because the hormone ratios are inherited, leading to similar behaviour. This becomes more likely because of a comparable lifestyle, with improper diet and inadequate physical activity.
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
Thursday, March 31, 2011
painful knees
Ouch, my knees pain
Your Health
DR GITA MATHAI
We often take our knees for granted. They may be hidden under clothing and seem inconspicuous but are, in fact, most important as they balance the entire weight of the body. This makes them prone to injury and malfunction at all ages.
One of the commonest symptoms of any knee problem is pain. This may be acute following a fall. It may occur as a result of an unexpected unbalanced twisting movement in a game of basketball or football. Or the knee may be affected as a result of degenerative osteoarthritis. In autoimmune diseases such as rheumatoid arthritis, generally small joints of the hands and feet are affected. At times, one or both knees may also be swollen. Conditions like gout and pseudogout — which occur when crystals are deposited in the joint space — usually affect the big toe, but again the knee may be affected.
The bones of the knee joint are cushioned by cartilage. Bits of the latter can suddenly break away and form loose bodies inside the joint space. These can get wedged during movement of the knee. There is excruciating pain, and the joint gets “stuck”. It cannot be bent or straightened.
The cartilage may also become worn down and degenerate with constant wear and tear. This exposes the bones. They then tend to grind against each other and produce pain.
Problems in areas like the spine, hip and ankle can produce a change in gait. The person may not balance properly on both feet and may limp. This puts more pressure on one knee. This too can result in pain.
The patella is a triangular bone that sits on top of the knee. Degeneration of the patella or strain of the ligaments that attach it to the bone may cause pain. This is common in children, older people and particularly women athletes.
Bacterial infections which start in other parts of the body can spread via the bloodstream and localise in the knee. This causes an acute infection with redness, pain and fever.
Knee pain can usually be tackled at home. It often disappears with 48 hours of rest. Pain and swelling can be reduced with the application of an ice pack. The pack, however, should not be applied for more than 20 minutes. Ointments containing Capsicain are often effective. They should be applied on the affected joint, followed by an ice pack. Lidnocaine (a local anaesthetic) ointment may also provide relief. Ointments are particularly effective if combined with tablets of paracetamol, ibubrufen or nalidixic acid. Compression of the joint with an “elastocrepe” bandage or a “knee cap” prevents swelling. Elevation of the foot also helps.
Accupressure and acupuncture have been shown to be effective. The first involves application of pressure to specific points around the knee while in the second, needles are inserted into them.
A doctor needs to be consulted if the joint pain is accompanied by fever, there is obvious swelling, it is impossible to bear weight on that knee, or if it cannot be flexed or extended fully.
By examining the knee thoroughly and performing some diagnostic manoeuvres, it is usually possible for the doctor to arrive at a tentative diagnosis. Blood tests may be done to rule out gout or rheumatoid arthritis. X-rays, magnetic resonance imaging (MRI), computed tomography (CT) scans and ultrasound may be needed to clinch the diagnosis.
A combination of physical therapy and medication usually provides great relief. Injections of steroids and other chemicals into the joint space may reduce inflammation and pain. If the problem persists, surgery may be required. Arthroscopy may be done to remove loose bodies and repair tears to the ligaments inside the joint. Surgery for knee replacement — complete or partial — is now common and done in many centres. There are very few contraindications. More and more older people are opting for it and enjoying productive and pain-free lives.
Some knee problems — particularly those resulting from an injury or a systemic disease — may be inevitable and require long-term treatment. The painful arthritis of old age can, however, be prevented with a few lifestyle modifications.
Obesity increases the pressure on the knees. Many years of being overweight take their toll, resulting in degenerative changes. Try to remain as close to your ideal body weight as possible.
Physical activity maintains muscle tone and helps keep the knee joint aligned. Repetitive high impact activity can cause tears in ligaments and cause pain. Runners in particular can develop pain in the ligaments around the joint. This is particularly true if physical activity is not preceded and followed by stretching and strengthening exercises. Cross training helps balance joints and reduce strain and injury. A combination of cycling, swimming, jogging or walking, and yoga is ideal.
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
We often take our knees for granted. They may be hidden under clothing and seem inconspicuous but are, in fact, most important as they balance the entire weight of the body. This makes them prone to injury and malfunction at all ages.
One of the commonest symptoms of any knee problem is pain. This may be acute following a fall. It may occur as a result of an unexpected unbalanced twisting movement in a game of basketball or football. Or the knee may be affected as a result of degenerative osteoarthritis. In autoimmune diseases such as rheumatoid arthritis, generally small joints of the hands and feet are affected. At times, one or both knees may also be swollen. Conditions like gout and pseudogout — which occur when crystals are deposited in the joint space — usually affect the big toe, but again the knee may be affected.
The bones of the knee joint are cushioned by cartilage. Bits of the latter can suddenly break away and form loose bodies inside the joint space. These can get wedged during movement of the knee. There is excruciating pain, and the joint gets “stuck”. It cannot be bent or straightened.
The cartilage may also become worn down and degenerate with constant wear and tear. This exposes the bones. They then tend to grind against each other and produce pain.
Problems in areas like the spine, hip and ankle can produce a change in gait. The person may not balance properly on both feet and may limp. This puts more pressure on one knee. This too can result in pain.
The patella is a triangular bone that sits on top of the knee. Degeneration of the patella or strain of the ligaments that attach it to the bone may cause pain. This is common in children, older people and particularly women athletes.
Bacterial infections which start in other parts of the body can spread via the bloodstream and localise in the knee. This causes an acute infection with redness, pain and fever.
Knee pain can usually be tackled at home. It often disappears with 48 hours of rest. Pain and swelling can be reduced with the application of an ice pack. The pack, however, should not be applied for more than 20 minutes. Ointments containing Capsicain are often effective. They should be applied on the affected joint, followed by an ice pack. Lidnocaine (a local anaesthetic) ointment may also provide relief. Ointments are particularly effective if combined with tablets of paracetamol, ibubrufen or nalidixic acid. Compression of the joint with an “elastocrepe” bandage or a “knee cap” prevents swelling. Elevation of the foot also helps.
Accupressure and acupuncture have been shown to be effective. The first involves application of pressure to specific points around the knee while in the second, needles are inserted into them.
A doctor needs to be consulted if the joint pain is accompanied by fever, there is obvious swelling, it is impossible to bear weight on that knee, or if it cannot be flexed or extended fully.
By examining the knee thoroughly and performing some diagnostic manoeuvres, it is usually possible for the doctor to arrive at a tentative diagnosis. Blood tests may be done to rule out gout or rheumatoid arthritis. X-rays, magnetic resonance imaging (MRI), computed tomography (CT) scans and ultrasound may be needed to clinch the diagnosis.
A combination of physical therapy and medication usually provides great relief. Injections of steroids and other chemicals into the joint space may reduce inflammation and pain. If the problem persists, surgery may be required. Arthroscopy may be done to remove loose bodies and repair tears to the ligaments inside the joint. Surgery for knee replacement — complete or partial — is now common and done in many centres. There are very few contraindications. More and more older people are opting for it and enjoying productive and pain-free lives.
Some knee problems — particularly those resulting from an injury or a systemic disease — may be inevitable and require long-term treatment. The painful arthritis of old age can, however, be prevented with a few lifestyle modifications.
Obesity increases the pressure on the knees. Many years of being overweight take their toll, resulting in degenerative changes. Try to remain as close to your ideal body weight as possible.
Physical activity maintains muscle tone and helps keep the knee joint aligned. Repetitive high impact activity can cause tears in ligaments and cause pain. Runners in particular can develop pain in the ligaments around the joint. This is particularly true if physical activity is not preceded and followed by stretching and strengthening exercises. Cross training helps balance joints and reduce strain and injury. A combination of cycling, swimming, jogging or walking, and yoga is ideal.
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, March 13, 2011
fungus
Fungus on my skin
YOUR HEALTH
DR GITA MATHAI
The word fungus conjures up visions of mold and dirty, damp unhygienic surroundings. Many of us may cringe at the thought of developing a fungal infection. But these infections are common and most people suffer from several attacks during the course of a lifetime.
In babies, small curd-like white patches can form in the mouth. These are difficult to remove. If scraped off, a raw red area is exposed. This is commonly called “thrush” and is caused by a fungal specie called candida. It may occur if the child is bottle fed, uses a pacifier or has recently had a course of antibiotics. It may make the child irritable while feeding.
Oral thrush may occur in adults too if they have ill-fitting dentures, suffer from diabetes, have had a course of antibiotics, consumed steroids, are on anti-cancer drugs, are smokers, or are immuno compromised as a result of medicines or HIV infection.
In adults as well as children, oral thrush can be treated with applications of anti-fungal medication like clotrimazole two or three times a day. Dentures must be cleaned regularly. Feeding bottles and artificial nipples should ideally not be used. If thrush has occurred, they must be rinsed with a solution of equal parts of vinegar and water and air dried prior to sterilisation.
Candida and some bacteria like lactobacillus normally live in perfect harmony in the vagina. The lactobacillus produces acid, which prevents the overgrowth of candida. If this balance is disrupted, candida can overgrow, resulting in infection. Imbalance occurs as a result of diabetes, pregnancy, hormonal tablets, antibiotics, steroids or immuno suppression. Frequent douching or using “feminine hygiene sprays” may also lead to infection. Vaginal fungal infections owing to candida affect almost all women. It causes redness, an uncontrollable itch and an odourless white discharge.
Treatment involves the application of creams or insertion of vaginal tablets for one, three or six days. Sometimes oral medicines have to be taken. The bacteria-fungus balance in the vagina can be restored by eating lactobacillus. This is found in homemade curd. A tablespoon a day usually restores the balance.
Men can develop candida infection on the foreskin, especially if they are diabetic. The skin is itchy and may develop fissures. Topical anti-fungal creams work well.
Men are also prone to developing “jock itch” (or dhobi’s itch), an infection of the groin area where the skin is usually warm and moist. Infection is precipitated by wearing tight undergarments, or not changing sweaty exercise clothes promptly. Treatment involves bathing regularly, wearing loose-fitting clothes and application of anti-fungal creams.
The warm moist areas between the toes may also develop a fungal infection called Tinea pedis or athlete’s foot. It causes itching, burning, cracking and at times blisters. It occurs with wearing damp socks and tight airless shoes, especially of a non-porous material like plastic.
To prevent Tinea pedis, the feet need to be aired and socks changed regularly. Once infection has developed, the feet should be soaked in equal quantities of water and vinegar for 10 minutes a day. After wiping them dry, an anti-fungal cream needs to be applied. The infection may take two to four weeks to clear up.
The warm and moist areas of the inner thighs, genitalia, armpits, under the breasts, and waist may also develop fungal infection and become red, itchy, oozy and sore. This is common in overweight individuals and those with diabetes. Treatment is by bathing regularly and keeping the area dry. Talcum powder aggravates the problem. Instead, the area should be patted dry after a bath and a combination of a “diaper rash” cream containing zinc oxide and an anti-fungal medication must be applied.
Toe nails and fingernails can also get infected by fungus. The nail then hurts, breaks easily and becomes discoloured. This occurs if the nails are constantly exposed to moisture or are immersed in water, if non-absorbent socks or shoes are used, or if the person has diabetes. Treatment is with applications and medications for one and a half to six months. Soaking the feet in a solution of one part vinegar and two parts water for 10 minutes daily and then applying Vicks VapoRub has anecdotally been shown to be effective.
The outer layers of the skin can develop scaly white patches of Tinea versicolor infection. Moist climates, sweating, humidity and hormonal changes have been blamed for this. The infection responds well to Selinium sulphide (Selsun) or Ketoconazole (Nizral) shampoo.
Ringworm causes round, hairless patches on the scalp and skin. They are contagious and spread by contact with infected humans or animals. Medicines have to be taken for six weeks. Topical agents are not effective.
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 word fungus conjures up visions of mold and dirty, damp unhygienic surroundings. Many of us may cringe at the thought of developing a fungal infection. But these infections are common and most people suffer from several attacks during the course of a lifetime.
In babies, small curd-like white patches can form in the mouth. These are difficult to remove. If scraped off, a raw red area is exposed. This is commonly called “thrush” and is caused by a fungal specie called candida. It may occur if the child is bottle fed, uses a pacifier or has recently had a course of antibiotics. It may make the child irritable while feeding.
Oral thrush may occur in adults too if they have ill-fitting dentures, suffer from diabetes, have had a course of antibiotics, consumed steroids, are on anti-cancer drugs, are smokers, or are immuno compromised as a result of medicines or HIV infection.
In adults as well as children, oral thrush can be treated with applications of anti-fungal medication like clotrimazole two or three times a day. Dentures must be cleaned regularly. Feeding bottles and artificial nipples should ideally not be used. If thrush has occurred, they must be rinsed with a solution of equal parts of vinegar and water and air dried prior to sterilisation.
Candida and some bacteria like lactobacillus normally live in perfect harmony in the vagina. The lactobacillus produces acid, which prevents the overgrowth of candida. If this balance is disrupted, candida can overgrow, resulting in infection. Imbalance occurs as a result of diabetes, pregnancy, hormonal tablets, antibiotics, steroids or immuno suppression. Frequent douching or using “feminine hygiene sprays” may also lead to infection. Vaginal fungal infections owing to candida affect almost all women. It causes redness, an uncontrollable itch and an odourless white discharge.
Treatment involves the application of creams or insertion of vaginal tablets for one, three or six days. Sometimes oral medicines have to be taken. The bacteria-fungus balance in the vagina can be restored by eating lactobacillus. This is found in homemade curd. A tablespoon a day usually restores the balance.
Men can develop candida infection on the foreskin, especially if they are diabetic. The skin is itchy and may develop fissures. Topical anti-fungal creams work well.
Men are also prone to developing “jock itch” (or dhobi’s itch), an infection of the groin area where the skin is usually warm and moist. Infection is precipitated by wearing tight undergarments, or not changing sweaty exercise clothes promptly. Treatment involves bathing regularly, wearing loose-fitting clothes and application of anti-fungal creams.
The warm moist areas between the toes may also develop a fungal infection called Tinea pedis or athlete’s foot. It causes itching, burning, cracking and at times blisters. It occurs with wearing damp socks and tight airless shoes, especially of a non-porous material like plastic.
To prevent Tinea pedis, the feet need to be aired and socks changed regularly. Once infection has developed, the feet should be soaked in equal quantities of water and vinegar for 10 minutes a day. After wiping them dry, an anti-fungal cream needs to be applied. The infection may take two to four weeks to clear up.
The warm and moist areas of the inner thighs, genitalia, armpits, under the breasts, and waist may also develop fungal infection and become red, itchy, oozy and sore. This is common in overweight individuals and those with diabetes. Treatment is by bathing regularly and keeping the area dry. Talcum powder aggravates the problem. Instead, the area should be patted dry after a bath and a combination of a “diaper rash” cream containing zinc oxide and an anti-fungal medication must be applied.
Toe nails and fingernails can also get infected by fungus. The nail then hurts, breaks easily and becomes discoloured. This occurs if the nails are constantly exposed to moisture or are immersed in water, if non-absorbent socks or shoes are used, or if the person has diabetes. Treatment is with applications and medications for one and a half to six months. Soaking the feet in a solution of one part vinegar and two parts water for 10 minutes daily and then applying Vicks VapoRub has anecdotally been shown to be effective.
The outer layers of the skin can develop scaly white patches of Tinea versicolor infection. Moist climates, sweating, humidity and hormonal changes have been blamed for this. The infection responds well to Selinium sulphide (Selsun) or Ketoconazole (Nizral) shampoo.
Ringworm causes round, hairless patches on the scalp and skin. They are contagious and spread by contact with infected humans or animals. Medicines have to be taken for six weeks. Topical agents are not effective.
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, February 28, 2011
breaqthing easy
Help, I can’t breathe…
Your Health
DR GITA MATHAI
More and more people today are complaining thus, be it summer, monsoon or winter. And it’s not surprising ; the global incidence of asthma is steadily rising. In India, between 5 and 25 per cent of the population is affected. The wide variation is because statistics are difficult to come by. There is very little unbiased documentation about the true incidence of asthma using instruments and lung function tests.
Asthma — now called reactive airways disease — tends to run in families prone to allergy. Some members wheeze, some sneeze while others may have itchy, red skin lesions. Wheezing may be present all the year round with varying degrees of severity. Attacks may also come and go, precipitated by cigarette smoke, chemicals in the air (mosquito repellents, room fresheners), infections (particularly viral), medication (aspirin, ibubrufen) or food additives (dyes, preservatives), with symptom-free intervals.
Air enters the body through the main air vessels — the bronchi, which branch out into the lungs as bronchioles. If they are irritated, they secrete mucous which narrows them. In normal people, the bronchioles relax when this occurs so a slight cough expels the obstructing plugs of mucous. In allergic people, the bronchioles constrict further, trapping the mucous and causing a feeling of suffocation.
Symptoms usually start with a tight feeling around the chest and a cough. But there is no sputum, the cough is ineffective and fails to relieve the feeling of breathlessness and suffocation. More severe, hacking and ineffective cough then sets in.
Doctors do not like to tell a patient or a parent that there is “wheezing” — the latter tend to equate it with asthma and fear chronic lifetime debility. Others confuse it with tuberculosis or primary complex. Neither is true. Wheezing is treatable and the person can lead a normal life.
The mainstay of treatment is bronchodilators, which open up the narrowed bronchi. If a direct delivery system is used, the drug goes straight into the lungs. Nebulisers, inhalers and rotahalors are freely available and efficient. Nebulisers require electricity to work and are not portable. Inhalers and rotahalors can be carried around. Inhalers, unlike rotahalors, require a certain amount of breathing co-ordination to be affective. In young children and the elderly, they become efficient only when combined with a spacer and facemask.
For an acute attack, salbutamol is usually sufficient. If there are repeated attacks, interfering with sleep at night, long-term treatment is needed. There are long-acting medications like salmeterol. When delivered to the lungs, it opens up the airways. This must be combined with a steroid like fluticosone. It prevents the local inflammatory reaction, decreases mucous secretion and helps keep the airways open.
Tablets and syrups do work eventually to control wheezing. They need to reach the stomach, get absorbed, reach the blood and eventually the lungs. They are more likely to produce side effects like nausea, vomiting and tremors. The onset of action is also slow.
Some lifestyle modifications may help to control the disease. Obesity contributes to the severity and frequency of attacks. The “pot belly” reduces the capacity of the lungs, as it tends to push them upwards. The BMI (body mass index) — weight divided by the height in metre squared — must be as close to 23 as possible.
Aerobic exercises like fast walking, jogging, swimming, skipping or stair climbing improve lung function and capacity.
Avoid known allergens that are likely to precipitate attacks. It may be airborne chemicals, like those in mosquito mats, coils and liquids. These should not be used anywhere in the house, as the smoke tends to permeate easily. Some allergens may be present in food or medication. If an attack seems to be precipitated by ingestion of a particular substance, it’s better to avoid it than search for a cure. Desensitisation is offered in some clinics but it’s a laborious and expensive process.
Stop smoking and as far as possible stay away from smokers.
People with reactive airways have poor breathing technique. This can be improved with exercises taught by physiotherapists and yoga teachers. Videos are available on the Internet. Proper breathing techniques go a long way towards improving lung capacity and reducing the duration, frequency and severity of attacks.
Hand-held devices called spirometers are available to measure the amount of air you breathe in and out. These are inexpensive. By documenting the readings daily, it is possible to anticipate an attack and take prophylactic action.
Always use the nebuliser, inhaler or rotahalor as directed. Sometimes a single dose at night may prevent lung damage and keep the lung capacity at a satisfactory level.
Your Health
DR GITA MATHAI
More and more people today are complaining thus, be it summer, monsoon or winter. And it’s not surprising ; the global incidence of asthma is steadily rising. In India, between 5 and 25 per cent of the population is affected. The wide variation is because statistics are difficult to come by. There is very little unbiased documentation about the true incidence of asthma using instruments and lung function tests.
Asthma — now called reactive airways disease — tends to run in families prone to allergy. Some members wheeze, some sneeze while others may have itchy, red skin lesions. Wheezing may be present all the year round with varying degrees of severity. Attacks may also come and go, precipitated by cigarette smoke, chemicals in the air (mosquito repellents, room fresheners), infections (particularly viral), medication (aspirin, ibubrufen) or food additives (dyes, preservatives), with symptom-free intervals.
Air enters the body through the main air vessels — the bronchi, which branch out into the lungs as bronchioles. If they are irritated, they secrete mucous which narrows them. In normal people, the bronchioles relax when this occurs so a slight cough expels the obstructing plugs of mucous. In allergic people, the bronchioles constrict further, trapping the mucous and causing a feeling of suffocation.
Symptoms usually start with a tight feeling around the chest and a cough. But there is no sputum, the cough is ineffective and fails to relieve the feeling of breathlessness and suffocation. More severe, hacking and ineffective cough then sets in.
Doctors do not like to tell a patient or a parent that there is “wheezing” — the latter tend to equate it with asthma and fear chronic lifetime debility. Others confuse it with tuberculosis or primary complex. Neither is true. Wheezing is treatable and the person can lead a normal life.
The mainstay of treatment is bronchodilators, which open up the narrowed bronchi. If a direct delivery system is used, the drug goes straight into the lungs. Nebulisers, inhalers and rotahalors are freely available and efficient. Nebulisers require electricity to work and are not portable. Inhalers and rotahalors can be carried around. Inhalers, unlike rotahalors, require a certain amount of breathing co-ordination to be affective. In young children and the elderly, they become efficient only when combined with a spacer and facemask.
For an acute attack, salbutamol is usually sufficient. If there are repeated attacks, interfering with sleep at night, long-term treatment is needed. There are long-acting medications like salmeterol. When delivered to the lungs, it opens up the airways. This must be combined with a steroid like fluticosone. It prevents the local inflammatory reaction, decreases mucous secretion and helps keep the airways open.
Tablets and syrups do work eventually to control wheezing. They need to reach the stomach, get absorbed, reach the blood and eventually the lungs. They are more likely to produce side effects like nausea, vomiting and tremors. The onset of action is also slow.
Some lifestyle modifications may help to control the disease. Obesity contributes to the severity and frequency of attacks. The “pot belly” reduces the capacity of the lungs, as it tends to push them upwards. The BMI (body mass index) — weight divided by the height in metre squared — must be as close to 23 as possible.
Aerobic exercises like fast walking, jogging, swimming, skipping or stair climbing improve lung function and capacity.
Avoid known allergens that are likely to precipitate attacks. It may be airborne chemicals, like those in mosquito mats, coils and liquids. These should not be used anywhere in the house, as the smoke tends to permeate easily. Some allergens may be present in food or medication. If an attack seems to be precipitated by ingestion of a particular substance, it’s better to avoid it than search for a cure. Desensitisation is offered in some clinics but it’s a laborious and expensive process.
Stop smoking and as far as possible stay away from smokers.
People with reactive airways have poor breathing technique. This can be improved with exercises taught by physiotherapists and yoga teachers. Videos are available on the Internet. Proper breathing techniques go a long way towards improving lung capacity and reducing the duration, frequency and severity of attacks.
Hand-held devices called spirometers are available to measure the amount of air you breathe in and out. These are inexpensive. By documenting the readings daily, it is possible to anticipate an attack and take prophylactic action.
Always use the nebuliser, inhaler or rotahalor as directed. Sometimes a single dose at night may prevent lung damage and keep the lung capacity at a satisfactory level.
Monday, February 14, 2011
control BP live longer
Lower your BP, live longer
Your Health
DR GITA MATHAI
In western countries, the number of people affected by high blood pressure (BP) or hypertension is decreasing. In India, however, the figure is creeping up, albeit marginally (2-3 per cent). This is worrying because, untreated, hypertension may result in complications like a heart attack, heart or kidney failure, tearing of the blood vessels and loss of vision. It can also cause subtle loss of memory and the ability to think clearly.
BP indicates the force with which the heart pumps blood against the blood vessel. It has two values — an upper or systolic and a lower or diastolic. Values of 120/80 are normal, while 139/89 indicates pre-hypertension and 140/90 or above hypertension. With age, the blood vessels tend to harden, decreasing their pliability. This causes a peculiar type of hypertension where only the upper value is high. About 70 per cent of the population over the age of 60 has this type of systolic hypertension. BP should be measured every two years after the age of 20 and yearly after 40.
The risk of hypertension increases with age, obesity, a family history of high BP, kidney diseases, diabetes, endocrine diseases, smoking, alcohol consumption, medications like corticosteroids, birth control pills or those for losing weight. Narrow abnormally placed blood vessels present from birth can also lead to high BP. If no cause can be detected, it’s called “essential hypertension” and requires medication to prevent complications. Even isolated systolic hypertension requires treatment.
BP is linked to salt intake. A high salt intake results in elevated BP. The effect is even more pronounced in people (around 20 per cent of the population) who are “salt sensitive”.
The recommended salt intake for a normal person is 5gm or 1 teaspoon a day. But the “hidden salt” must also be considered. All food and even drinking water contains varying amounts of natural salt. Sodium (a component of salt) is added to food products in the form of monosodium glutamate, sodium nitrite, sodium saccharin, baking soda (sodium bicarbonate) or sodium benzoate. These are ingredients in condiments and seasonings like tomato sauce, soy sauce and pickles. Processed meats such as bacon, sausage and ham, and fast foods like burgers and pizzas are high in sodium content.
Medications belonging to groups such as diuretics, alpha blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta blockers, calcium channel blockers and rennin inhibitors are available to control blood pressure. The pharmaceutical industry also introduces “new and improved” drugs in the market with monotonous regularity. Control remains unsatisfactory in many patients who are then dosed with two or more anti hypertensives. The older, long-acting diuretics, surprisingly, remain one of the most effective medications, either as an adjuvant to existing medicine or alone.
Better control of BP with lower doses of medication can often be achieved if the person is willing to make certain lifestyle changes. Weight needs to be ideal. As weight increases, so does the pressure on your artery walls. To calculate your ideal body weight, multiply your height in meter squared by 23.
Inactive people have a faster heart rate, forcing the heart to work harder for longer periods of time. Aerobic exercise like walking, jogging, swimming or running needs to be done daily. It should be started at the age of around six with 20 minutes of running. Gradually this should be increased to an hour by the age of 18 years.
Smoking (even second-hand smoke), using snuff or chewing tobacco releases chemicals into the body which damage the blood vessels, making them narrow and thus increasing the BP.
Salt makes the body retain fluid, which in turn increases the BP. Limit your intake to 5gm a day. Sodium can be balanced by potassium found in fresh fruits and vegetables. Eat four to six helpings of this a day.
Vitamin D obtained through the diet and by exposure to sunlight affects the levels of a BP-regulating enzyme in the kidneys. Inadequate levels can indirectly elevate the BP.
Heavy drinking can cause permanent heart damage. Even two or three drinks in a single sitting can cause the release of chemicals that temporarily elevate the BP.
Stress can elevate the BP. It needs to tackled with meditation and yoga. Chronic diseases like diabetes, high cholesterol, kidney disease and sleep apnoea need to be controlled as they contribute to the risk of high BP.
Children too are at risk from as early as six or eight years if they are obese, inactive and eat high sodium snacks. These lifestyle changes, therefore, need to be initiated from a young age.
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
In western countries, the number of people affected by high blood pressure (BP) or hypertension is decreasing. In India, however, the figure is creeping up, albeit marginally (2-3 per cent). This is worrying because, untreated, hypertension may result in complications like a heart attack, heart or kidney failure, tearing of the blood vessels and loss of vision. It can also cause subtle loss of memory and the ability to think clearly.
BP indicates the force with which the heart pumps blood against the blood vessel. It has two values — an upper or systolic and a lower or diastolic. Values of 120/80 are normal, while 139/89 indicates pre-hypertension and 140/90 or above hypertension. With age, the blood vessels tend to harden, decreasing their pliability. This causes a peculiar type of hypertension where only the upper value is high. About 70 per cent of the population over the age of 60 has this type of systolic hypertension. BP should be measured every two years after the age of 20 and yearly after 40.
The risk of hypertension increases with age, obesity, a family history of high BP, kidney diseases, diabetes, endocrine diseases, smoking, alcohol consumption, medications like corticosteroids, birth control pills or those for losing weight. Narrow abnormally placed blood vessels present from birth can also lead to high BP. If no cause can be detected, it’s called “essential hypertension” and requires medication to prevent complications. Even isolated systolic hypertension requires treatment.
BP is linked to salt intake. A high salt intake results in elevated BP. The effect is even more pronounced in people (around 20 per cent of the population) who are “salt sensitive”.
The recommended salt intake for a normal person is 5gm or 1 teaspoon a day. But the “hidden salt” must also be considered. All food and even drinking water contains varying amounts of natural salt. Sodium (a component of salt) is added to food products in the form of monosodium glutamate, sodium nitrite, sodium saccharin, baking soda (sodium bicarbonate) or sodium benzoate. These are ingredients in condiments and seasonings like tomato sauce, soy sauce and pickles. Processed meats such as bacon, sausage and ham, and fast foods like burgers and pizzas are high in sodium content.
Medications belonging to groups such as diuretics, alpha blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta blockers, calcium channel blockers and rennin inhibitors are available to control blood pressure. The pharmaceutical industry also introduces “new and improved” drugs in the market with monotonous regularity. Control remains unsatisfactory in many patients who are then dosed with two or more anti hypertensives. The older, long-acting diuretics, surprisingly, remain one of the most effective medications, either as an adjuvant to existing medicine or alone.
Better control of BP with lower doses of medication can often be achieved if the person is willing to make certain lifestyle changes. Weight needs to be ideal. As weight increases, so does the pressure on your artery walls. To calculate your ideal body weight, multiply your height in meter squared by 23.
Inactive people have a faster heart rate, forcing the heart to work harder for longer periods of time. Aerobic exercise like walking, jogging, swimming or running needs to be done daily. It should be started at the age of around six with 20 minutes of running. Gradually this should be increased to an hour by the age of 18 years.
Smoking (even second-hand smoke), using snuff or chewing tobacco releases chemicals into the body which damage the blood vessels, making them narrow and thus increasing the BP.
Salt makes the body retain fluid, which in turn increases the BP. Limit your intake to 5gm a day. Sodium can be balanced by potassium found in fresh fruits and vegetables. Eat four to six helpings of this a day.
Vitamin D obtained through the diet and by exposure to sunlight affects the levels of a BP-regulating enzyme in the kidneys. Inadequate levels can indirectly elevate the BP.
Heavy drinking can cause permanent heart damage. Even two or three drinks in a single sitting can cause the release of chemicals that temporarily elevate the BP.
Stress can elevate the BP. It needs to tackled with meditation and yoga. Chronic diseases like diabetes, high cholesterol, kidney disease and sleep apnoea need to be controlled as they contribute to the risk of high BP.
Children too are at risk from as early as six or eight years if they are obese, inactive and eat high sodium snacks. These lifestyle changes, therefore, need to be initiated from a young age.
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
Thursday, February 10, 2011
facts about the nose
Nose job
YOUR HEALTH
DR GITA MATHAI
To most people a nose is just an organ in the centre of our face. It may be straight and aquiline (enhancing perceptions of classical beauty), snub or button-shaped, flat or crooked. Some of us do not like the way our nose is structured and try to change its appearance. Elderly relatives may pull a baby’s nose several times a day in an attempt to make it grow longer. Others may grab a wallet and head to the nearest plastic surgeon for a “nose job” (rhinoplasy).
Whatever the shape, the nose warms and humidifies the air that enters our body. It is lined with fine hair that prevents dust from going into the lungs. This acts as a first line of defence against viral and bacterial infections. On contact with an organism or a noxious chemical, it secretes fluid that washes out the offending material (causing a dripping nose).
Sometimes violent sneezing is triggered which expels these substances far away from the body.
Until the age of 18 years, the nose grows and changes in shape and size. As we get older, the nasal cartilage loses its elasticity. This causes the tip of the nose to lengthen and droop. This makes the nose appear larger in older people.
The nose enables us to smell. This helps us identify substances and distinguish between pleasant harmless odours and noxious harmful ones. Like other animals, man once had a keenly developed sense of smell. This helped him identify potentially dangerous animals as well as warring strangers from other regions and tribes. We adults have lost this ability with evolution. However, smell is the best developed of all the five senses in a baby. Infants can distinguish between their mothers, other lactating women and strangers.
The sense of smell contributes to the taste of our food. People suffering from anosmia, or loss of the sense of smell, do not find food palatable. This causes them to lose weight. Anosmia may be a temporary phenomenon when the nose is blocked as a result of a cold. It may occur when the “smell centre” in the brain is damaged, or if the person has Parkinson’s disease. Attempts to relieve a blocked nose with repeated use of nasal sprays can damage the lining of the nose sufficiently to cause a permanent loss of smell.
Some people tend to pick their noses using their fingers. This is an unsavoury, socially unacceptable habit. It may also result in damage to the lining of the nose and bleeding. Constant trauma to the nostrils can cause infection of the hair follicles in the nose. This can result in fever, swelling and pus formation.
A pierced nose is perceived to enhance the beauty of a woman. It is a common practice in India from ancient times and was believed to ease the pains of childbirth. The area that should be pierced is just below the cartilage. If the nose cartilage is accidentally pierced instead, serious complications like bleeding, infection and permanent deformity can occur. Even otherwise, infection, redness, swelling and scar formation may occur.
The jewellery used may cause problems. It may come loose and be accidentally swallowed. The back of the stud can become embedded in the skin, or nose rings can get caught in clothing and violently pulled out. Also, once you have pierced your nose, even if you change your mind and decide against jewellery, there will always be a little hole.
About 60 per cent of people experience nose bleed (epistaxis) at some time in their lives. It occurs most often under the age of 10 and over the age of 60 years. This is usually due to a local problem in the nose like a cold, nose picking, a foreign body, irritants like cigarette smoke, or an injury. Less often it may be due to a systemic disease like high blood pressure or clotting disorders like haemophilia. It can also occur owing to blood thinning medicines such as aspirin, clopidogrel, heparin or warfarin. The patient may have purchased medicines over the counter, or may be taking non-allopathic drugs and may be unaware of their side effects.
Most nosebleeds can be tackled at home:
Make the person sit up. This prevents blood from filling up in the throat and choking the person
Pinch the nostrils firmly and maintain steady pressure for 10 minutes
Instill a decongestant nasal spray containing oxymetazoline (Nasivion or Otrivin).
Most nosebleeds are harmless. Very rarely, they can be fatal. You need to seek medical help if the bleeding has lasted for more than 20 minutes, or if it followed a fall, a blow to the head or an accident.
Recurrent nosebleeds with no identifiable or correctable cause need to be tackled by an ENT surgeon.
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
To most people a nose is just an organ in the centre of our face. It may be straight and aquiline (enhancing perceptions of classical beauty), snub or button-shaped, flat or crooked. Some of us do not like the way our nose is structured and try to change its appearance. Elderly relatives may pull a baby’s nose several times a day in an attempt to make it grow longer. Others may grab a wallet and head to the nearest plastic surgeon for a “nose job” (rhinoplasy).
Whatever the shape, the nose warms and humidifies the air that enters our body. It is lined with fine hair that prevents dust from going into the lungs. This acts as a first line of defence against viral and bacterial infections. On contact with an organism or a noxious chemical, it secretes fluid that washes out the offending material (causing a dripping nose).
Sometimes violent sneezing is triggered which expels these substances far away from the body.
Until the age of 18 years, the nose grows and changes in shape and size. As we get older, the nasal cartilage loses its elasticity. This causes the tip of the nose to lengthen and droop. This makes the nose appear larger in older people.
The nose enables us to smell. This helps us identify substances and distinguish between pleasant harmless odours and noxious harmful ones. Like other animals, man once had a keenly developed sense of smell. This helped him identify potentially dangerous animals as well as warring strangers from other regions and tribes. We adults have lost this ability with evolution. However, smell is the best developed of all the five senses in a baby. Infants can distinguish between their mothers, other lactating women and strangers.
The sense of smell contributes to the taste of our food. People suffering from anosmia, or loss of the sense of smell, do not find food palatable. This causes them to lose weight. Anosmia may be a temporary phenomenon when the nose is blocked as a result of a cold. It may occur when the “smell centre” in the brain is damaged, or if the person has Parkinson’s disease. Attempts to relieve a blocked nose with repeated use of nasal sprays can damage the lining of the nose sufficiently to cause a permanent loss of smell.
Some people tend to pick their noses using their fingers. This is an unsavoury, socially unacceptable habit. It may also result in damage to the lining of the nose and bleeding. Constant trauma to the nostrils can cause infection of the hair follicles in the nose. This can result in fever, swelling and pus formation.
A pierced nose is perceived to enhance the beauty of a woman. It is a common practice in India from ancient times and was believed to ease the pains of childbirth. The area that should be pierced is just below the cartilage. If the nose cartilage is accidentally pierced instead, serious complications like bleeding, infection and permanent deformity can occur. Even otherwise, infection, redness, swelling and scar formation may occur.
The jewellery used may cause problems. It may come loose and be accidentally swallowed. The back of the stud can become embedded in the skin, or nose rings can get caught in clothing and violently pulled out. Also, once you have pierced your nose, even if you change your mind and decide against jewellery, there will always be a little hole.
About 60 per cent of people experience nose bleed (epistaxis) at some time in their lives. It occurs most often under the age of 10 and over the age of 60 years. This is usually due to a local problem in the nose like a cold, nose picking, a foreign body, irritants like cigarette smoke, or an injury. Less often it may be due to a systemic disease like high blood pressure or clotting disorders like haemophilia. It can also occur owing to blood thinning medicines such as aspirin, clopidogrel, heparin or warfarin. The patient may have purchased medicines over the counter, or may be taking non-allopathic drugs and may be unaware of their side effects.
Most nosebleeds can be tackled at home:
Make the person sit up. This prevents blood from filling up in the throat and choking the person
Pinch the nostrils firmly and maintain steady pressure for 10 minutes
Instill a decongestant nasal spray containing oxymetazoline (Nasivion or Otrivin).
Most nosebleeds are harmless. Very rarely, they can be fatal. You need to seek medical help if the bleeding has lasted for more than 20 minutes, or if it followed a fall, a blow to the head or an accident.
Recurrent nosebleeds with no identifiable or correctable cause need to be tackled by an ENT surgeon.
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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