Ill? How hysterical
Your Health
DR GITA MATHAI
Some illnesses defy scientific explanation. One such has symptoms ranging from blindness to deafness to paralysis to seizures. The attacks are inconsistent and erratic, they tend to come and go. Patients are usually taken to the friendly neighbourhood physician (unexplained symptoms account for up to 40 per cent of primary care consultations) who can usually reach no medical diagnosis despite repeated visits. Patients then typically proceed to specialised tertiary care hospitals to have a battery of expensive diagnostic tests done. Even there, eventually, four per cent of illnesses remain scientifically unexplained.
These illnesses, however, are not lifestyle diseases specific to the modern age. Patients with inexplicable symptoms were present even during the time of Socrates. Greek physicians noticed that women were more likely have such symptoms. So they decided that the uterus was the root cause of all these illnesses and labelled them hysteria from the Greek word hysterus for uterus.
Hysteria has myriad manifestations. One such manifestation is called “possession” and is found all over the world. The person’s body appears to have been taken over by spirits or a demon. The voice changes and he or she may harm themselves or others. They may suddenly have the strength of 10 people. Their actions are bizarre and often frightening.
Another is “somatisation” in which various body parts develop “diseases”. There may be peppery hot sensations, loss of feeling and numbness or actual paralysis. Sometimes food may appear to stick in the throat. There are hundreds of symptoms that can be attributed to hysteria, but the symptoms overlap with some very real illnesses. Hysteria, therefore, becomes a diagnosis by exclusion.
Another symptom of hysteria — seizures — can also occur because of epilepsy, brain tumours, brain fever or even high fever in children. Some seizures may be atypical, with staring spells or repetitive twitches. Hysterical seizures can usually be distinguished as they do not fit any of these patterns. Instead, they represent what the patient thinks seizures should look like.
Today, hysterical symptoms are attributed to the brain’s attempt to protect the person from stress. It may be for gain, such as staying home from a hated job or to avoid a social requirement. It may also be to control a third person like a parent or spouse.
Recently, scientific brain scans were done on patients diagnosed with hysteria. As the person attempted to move the apparently paralysed hand, the motor cortex that controls movement did not light up. Instead, brain activity was confined to the temporal and frontal lobes, which control emotion. The person thought they she was paralysed and the brain supported her belief.
Nobody likes to be labelled hysterical. And no one wants to hear that their symptoms have no scientific basis. So a host of inoffensive synonyms for “hysteria” have appeared in medical parlance such as functional, nonorganic, psychogenic and the favourite “medically unexplained” disease. Clinicians tend to use these bland terms to retain their patients and stop doctor hopping.
A chunk of hysteria patients also visit native healers, exorcists and mediums for treatment. Some of them have excellent rates of cure. They may beat the patients, douse them with water or burn them. Some of the rituals have, in fact, ended in the death of the patient.
Fortunately, though hysteria has have not changed much through the centuries, the medical profession’s understanding of it has. Instead of beating, burning and trial by fire, medical and scientific therapy is available today. Basically, hysteria is a cry for help, often by people trapped in a “no win” situation from which there is no escape.
Many of the symptoms disappear with psychotherapy. Attention seeking symptoms, like sudden blindness or loud inappropriate belching, respond if the appropriate amount of attention is given, or when the person realises that the end no longer justifies the means. Depression, which can precipitate hysteria, responds to medication.
Segments of the population are said to be suffering from collective or mass hysteria when several people have the same symptoms — like nausea, headache, muscle weakness, rash or seizures — at the same time. One person may complain of light-headedness at a social function and the symptom may spread like wild fire. A majority of those present may be affected. There is no rational scientific reason for these occurrences. They usually peter out gradually.
Hysteria may also not be confined to illnesses. It may involve seeing aliens or God. Quite often it involves attacks on persons believed to have a “black tongue” or an “evil eye”. A crowd can be whipped up to a frenzy with devastating and often fatal consequences.
When you develop a worrisome symptom, listen to your doctor. Ask for a rational explanation. If none is forthcoming, look within. In society, before you act and blindly follow the crowd, remember you have a brain, pause and THINK.
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
Wednesday, September 21, 2011
Monday, September 12, 2011
paunches and other problems
Aerobics, to lose that paunch
Your Health
DR GITA MATHAI
“I want to lose my paunch,” announced the young woman, “It looks ugly when I wear jeans.”
A common complaint and certainly not a new one. A number of people want a miracle cure for their arms, thighs, belly, double chin — the list of problem areas is endless. Some catchy names have been made up for excess fat that can accumulate in the most inconvenient places. A paunch that spills over a tight salwar or jeans is called muffin top while a substantial round paunch that dictates where you wear your trousers is called a beer belly and the rolls of fat around your torso are called love handles. There’s of course nothing to love about any of these cutely named body parts and all of us would love to get rid of them, but without much effort.
There are advertisements galore pushing machines, diets and “body wraps” that claim to offer a miracle cure for problem areas but it would be a miracle if any of them actually work. It is just not possible to reduce fat from one particular spot, without overall weight reduction. To get rid of that paunch or those baggy upper arms, you’ll have to reach your ideal body weight first.
Whether you look fat or thin depends on height, weight and body habitus, that is, whether you are an endomorph, mesomorph and ectomorph. Being “fat” is not in the eye of the beholder. It is a measurable entity and anyone whose weight is 10 per cent more than it should be is categorised as fat.
How do you find out your ideal body weight? On life insurance charts, for one. If you are an athlete, your height cubed in inches divided by 1906 will give your ideal body weight. If your body mass index (BMI) is 23, then your body weight is ideal. You can find your BMI by dividing your weight in kg by your height in metres squared. The value should be 23; less than that is bad, but more is worse. If maths isn’t your strong point, measure your waist. You have nothing to worry about if your waist is less than 37 inches if you are a man and 32 inches if you are a woman.
But if your waist measures more than that you have a paunch, which means you have fat deposits around the organs in the abdomen and in the liver. This tends to occur with inactivity, is commoner in men and with increasing age. Abdominal fat increases the risk for diabetes, hypertension, heart disease and cancer.
The first step towards a washboard abdomen is achieving ideal body weight. Food eaten (calories consumed) minus exercise (calories expended) determines eventual weight gain or loss. To lose weight, you need to eat 20 calories /kg / day, to maintain your present weight 30 calories / kg/ day and to increase your weight you need 40 calories / kg / day. Pregnant and breast feeding women need 30-35 calories / kg / day.
A reduction of 1,600 calories a day results in the loss of 1kg. A sustainable weight-reducing diet provides about 1,200 calories a day. A diet containing 800 calories a day (or fasting) may ensure initial rapid weight loss but cannot be maintained long term.
Exercise is of two kinds. Aerobic exercise, which includes swimming, dancing, cycling, jogging, running, stair climbing and skipping, uses between 200 and 400 calories an hour, depending on the intensity and the distance. Anaerobic exercise consists of weight or resistance training and yoga.
An hour of aerobic exercise a day results in significant loss of abdominal fat. The liver is able to work more efficiently. Insulin resistance drops and blood sugar levels improve. Many young people, however, prefer to do only weight training at the gym, concentrating on the muscles that they want to improve — like the abdomen or biceps — under the guidance of a “trainer”. Such people increase their lean muscle mass and also lose a little subcutaneous fat. Their body becomes more efficient at burning calories, but their stamina and resistance power do not improve.
Also, an hour of aerobic activity burns 70 per cent more calories than weight training. Also, the chemicals released by the muscles elevate mood and reduce stress. The heart becomes conditioned and fit. Immunity improves. Best of all, aerobic activity has proven to reduce the risk of developing lung, colon, breast, prostate and endometrial cancer.
So, whatever your age, start exercising. For best results, combine an hour of aerobic exercise with a half-hour of anaerobic activity. And say goodbye to all that extra fat.
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 want to lose my paunch,” announced the young woman, “It looks ugly when I wear jeans.”
A common complaint and certainly not a new one. A number of people want a miracle cure for their arms, thighs, belly, double chin — the list of problem areas is endless. Some catchy names have been made up for excess fat that can accumulate in the most inconvenient places. A paunch that spills over a tight salwar or jeans is called muffin top while a substantial round paunch that dictates where you wear your trousers is called a beer belly and the rolls of fat around your torso are called love handles. There’s of course nothing to love about any of these cutely named body parts and all of us would love to get rid of them, but without much effort.
There are advertisements galore pushing machines, diets and “body wraps” that claim to offer a miracle cure for problem areas but it would be a miracle if any of them actually work. It is just not possible to reduce fat from one particular spot, without overall weight reduction. To get rid of that paunch or those baggy upper arms, you’ll have to reach your ideal body weight first.
Whether you look fat or thin depends on height, weight and body habitus, that is, whether you are an endomorph, mesomorph and ectomorph. Being “fat” is not in the eye of the beholder. It is a measurable entity and anyone whose weight is 10 per cent more than it should be is categorised as fat.
How do you find out your ideal body weight? On life insurance charts, for one. If you are an athlete, your height cubed in inches divided by 1906 will give your ideal body weight. If your body mass index (BMI) is 23, then your body weight is ideal. You can find your BMI by dividing your weight in kg by your height in metres squared. The value should be 23; less than that is bad, but more is worse. If maths isn’t your strong point, measure your waist. You have nothing to worry about if your waist is less than 37 inches if you are a man and 32 inches if you are a woman.
But if your waist measures more than that you have a paunch, which means you have fat deposits around the organs in the abdomen and in the liver. This tends to occur with inactivity, is commoner in men and with increasing age. Abdominal fat increases the risk for diabetes, hypertension, heart disease and cancer.
The first step towards a washboard abdomen is achieving ideal body weight. Food eaten (calories consumed) minus exercise (calories expended) determines eventual weight gain or loss. To lose weight, you need to eat 20 calories /kg / day, to maintain your present weight 30 calories / kg/ day and to increase your weight you need 40 calories / kg / day. Pregnant and breast feeding women need 30-35 calories / kg / day.
A reduction of 1,600 calories a day results in the loss of 1kg. A sustainable weight-reducing diet provides about 1,200 calories a day. A diet containing 800 calories a day (or fasting) may ensure initial rapid weight loss but cannot be maintained long term.
Exercise is of two kinds. Aerobic exercise, which includes swimming, dancing, cycling, jogging, running, stair climbing and skipping, uses between 200 and 400 calories an hour, depending on the intensity and the distance. Anaerobic exercise consists of weight or resistance training and yoga.
An hour of aerobic exercise a day results in significant loss of abdominal fat. The liver is able to work more efficiently. Insulin resistance drops and blood sugar levels improve. Many young people, however, prefer to do only weight training at the gym, concentrating on the muscles that they want to improve — like the abdomen or biceps — under the guidance of a “trainer”. Such people increase their lean muscle mass and also lose a little subcutaneous fat. Their body becomes more efficient at burning calories, but their stamina and resistance power do not improve.
Also, an hour of aerobic activity burns 70 per cent more calories than weight training. Also, the chemicals released by the muscles elevate mood and reduce stress. The heart becomes conditioned and fit. Immunity improves. Best of all, aerobic activity has proven to reduce the risk of developing lung, colon, breast, prostate and endometrial cancer.
So, whatever your age, start exercising. For best results, combine an hour of aerobic exercise with a half-hour of anaerobic activity. And say goodbye to all that extra fat.
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, September 1, 2011
delhi belly
Delhi belly
Your Health
DR GITA MATHAI
Keep diarrhoea away
• Always wash hands with soap or a hand sanitizer before eating
• Drink water that has been boiled for 5 minutes, purified through a machine or bought as “mineral water” from a reputed company
• If that is not available, add a drop of tincture iodine or a pinch or turmeric to the water
The monsoons may bring a good harvest but the stagnant rainwater, overflowing drains and flooded roads also play havoc with our health. Flooding leads to back flow in sewage drains and drinking water can become contaminated. This results in outbreaks of diarrhoea, dysentery and, occasionally, cholera epidemics.
Diarrhoea is defined as stools that are more frequent, bulkier or more watery than usual. It occurs either because a damaged intestine does not absorb fluid from the food or secretes excess fluid. If blood and mucous is present in the stool as well, then it is called dysentery. Other incidental symptoms are fever, vomiting or stomach pain.
Viruses, bacteria and parasites damage the lining of the intestines. There is “intestinal hurry” as food is rushed through it before the liquid portion can be fully absorbed.
In weddings and other functions, diarrhoea can affect a number of people, and is referred to as food poisoning. This is caused by heat stable intestine damaging toxins released by the bacteria which initially contaminated the food. Subsequent cooking destroys the bacteria, but not the toxin.
Usually diarrhoea (even infective ones) subsides on its own, without specific treatment, in 3 to 7 days. If it lasts two weeks or longer, it needs to be investigated. The diagnosis requires a detailed history, stool and blood tests and sometimes endoscopy studies.
Common causes for such diarrhoea are alcohol, coffee, tea and allergy to food, particularly the oil used, or the preservatives or colouring added. Some people are intolerant to milk and if “a little extra” is consumed, it results in diarrhoea. Even if you did not have milk intolerance in childhood, it can occur later in life. Also, the blood supply to the intestines may be inefficient because of a hernia, prior surgery, radiation treatment, diabetes or an abnormal lipid profile and this can lead to diarrhoea.
Antibiotics can also kill the friendly bacteria in the gut that help in digestion and absorption. This results in antibiotic diarrhoea. Antacids containing magnesium, painkillers and cholesterol-lowering statin group of drugs are other offenders. Sometimes people take laxatives (allopathy or homeopathy) and this can also result in chronic diarrhoea.
Painful but non-infectious diarrhoea may occur as a result of a poorly understood condition called the irritable bowel syndrome. Coeliac disease (where the person is intolerant to wheat and wheat products) responds only to a strict diet. Cancer of the intestine can result in constipation alternating with diarrhoea.
Acute diarrhoea can result in dehydration as fluids are lost from the body faster than they are replaced. It makes the person drowsy, irritable, lethargic and giddy with cold and clammy hands and feet and sunken eyes. Urine may not be passed for 6-8 hours. Dehydration is dangerous. If it is not corrected, it can lead to kidney failure and even death.
Dehydration can be prevented by taking small frequent sips of water alternating with rice gruel, watery khichdi (combination of equal quantities of rice and dal) and banana. This replaces the electrolytes lost. Commercially available ORS (oral rehydration solution) sachets can also be reconstituted and used. Tea, coffee, fruit juices and fizzy drinks are best avoided.
Loperamide and Lomotil can be used to reduce intestinal motility and stop the diarrhoea. They do not treat the disease, only its symptoms. They can cause intestinal bloating and should not be used in children or in older patients.
Antibiotics do not work in viral diarrhoea or in food poisoning. They should not be used unless there is an identified bacteria causing the diarrhoea. Single doses should not be purchased from medical shops without a prescription and taken indiscriminately, as it results in the development of resistant bacteria.
Immunisation is available to prevent diarrhoea due to the rotavirus (for children), cholera, seasonal flu and typhoid.
A doctor should be consulted if there is dehydration, the diarrhoea has persisted for more than three days, there is fever, blood and mucous in the stool, or if it follows treatment with antibiotics.
Probiotics sold as sachets and tablets have gained popularity. They are advertised widely and are reputed to check antibiotic induced and other diarrhoeas. They are “good bacteria” which normally populate the intestine and prevent overgrowth of disease producing bacteria. Potent probiotics are found in freshly prepared home-made curd. A spoon of curd every morning can prevent overgrowth of diarrhoea producing organisms.
Breast-fed babies are less likely to develop diarrhoea. This is because human milk contains white blood cells that kill germs. It also contains immunoglobulin (IgA) which gives the baby’s intestines a protective coating and prevents infections and allergies.
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
Keep diarrhoea away
• Always wash hands with soap or a hand sanitizer before eating
• Drink water that has been boiled for 5 minutes, purified through a machine or bought as “mineral water” from a reputed company
• If that is not available, add a drop of tincture iodine or a pinch or turmeric to the water
The monsoons may bring a good harvest but the stagnant rainwater, overflowing drains and flooded roads also play havoc with our health. Flooding leads to back flow in sewage drains and drinking water can become contaminated. This results in outbreaks of diarrhoea, dysentery and, occasionally, cholera epidemics.
Diarrhoea is defined as stools that are more frequent, bulkier or more watery than usual. It occurs either because a damaged intestine does not absorb fluid from the food or secretes excess fluid. If blood and mucous is present in the stool as well, then it is called dysentery. Other incidental symptoms are fever, vomiting or stomach pain.
Viruses, bacteria and parasites damage the lining of the intestines. There is “intestinal hurry” as food is rushed through it before the liquid portion can be fully absorbed.
In weddings and other functions, diarrhoea can affect a number of people, and is referred to as food poisoning. This is caused by heat stable intestine damaging toxins released by the bacteria which initially contaminated the food. Subsequent cooking destroys the bacteria, but not the toxin.
Usually diarrhoea (even infective ones) subsides on its own, without specific treatment, in 3 to 7 days. If it lasts two weeks or longer, it needs to be investigated. The diagnosis requires a detailed history, stool and blood tests and sometimes endoscopy studies.
Common causes for such diarrhoea are alcohol, coffee, tea and allergy to food, particularly the oil used, or the preservatives or colouring added. Some people are intolerant to milk and if “a little extra” is consumed, it results in diarrhoea. Even if you did not have milk intolerance in childhood, it can occur later in life. Also, the blood supply to the intestines may be inefficient because of a hernia, prior surgery, radiation treatment, diabetes or an abnormal lipid profile and this can lead to diarrhoea.
Antibiotics can also kill the friendly bacteria in the gut that help in digestion and absorption. This results in antibiotic diarrhoea. Antacids containing magnesium, painkillers and cholesterol-lowering statin group of drugs are other offenders. Sometimes people take laxatives (allopathy or homeopathy) and this can also result in chronic diarrhoea.
Painful but non-infectious diarrhoea may occur as a result of a poorly understood condition called the irritable bowel syndrome. Coeliac disease (where the person is intolerant to wheat and wheat products) responds only to a strict diet. Cancer of the intestine can result in constipation alternating with diarrhoea.
Acute diarrhoea can result in dehydration as fluids are lost from the body faster than they are replaced. It makes the person drowsy, irritable, lethargic and giddy with cold and clammy hands and feet and sunken eyes. Urine may not be passed for 6-8 hours. Dehydration is dangerous. If it is not corrected, it can lead to kidney failure and even death.
Dehydration can be prevented by taking small frequent sips of water alternating with rice gruel, watery khichdi (combination of equal quantities of rice and dal) and banana. This replaces the electrolytes lost. Commercially available ORS (oral rehydration solution) sachets can also be reconstituted and used. Tea, coffee, fruit juices and fizzy drinks are best avoided.
Loperamide and Lomotil can be used to reduce intestinal motility and stop the diarrhoea. They do not treat the disease, only its symptoms. They can cause intestinal bloating and should not be used in children or in older patients.
Antibiotics do not work in viral diarrhoea or in food poisoning. They should not be used unless there is an identified bacteria causing the diarrhoea. Single doses should not be purchased from medical shops without a prescription and taken indiscriminately, as it results in the development of resistant bacteria.
Immunisation is available to prevent diarrhoea due to the rotavirus (for children), cholera, seasonal flu and typhoid.
A doctor should be consulted if there is dehydration, the diarrhoea has persisted for more than three days, there is fever, blood and mucous in the stool, or if it follows treatment with antibiotics.
Probiotics sold as sachets and tablets have gained popularity. They are advertised widely and are reputed to check antibiotic induced and other diarrhoeas. They are “good bacteria” which normally populate the intestine and prevent overgrowth of disease producing bacteria. Potent probiotics are found in freshly prepared home-made curd. A spoon of curd every morning can prevent overgrowth of diarrhoea producing organisms.
Breast-fed babies are less likely to develop diarrhoea. This is because human milk contains white blood cells that kill germs. It also contains immunoglobulin (IgA) which gives the baby’s intestines a protective coating and prevents infections and allergies.
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, August 22, 2011
strokes
Brain attack
Your Health
DR GITA MATHAI
Keep your brain healthy by doing the crossword everyday
An elderly person’s worst nightmare is suffering a stroke. It conjures up visions of being confined to bed with the inability to move or speak and, worst of all, loss of bowel and bladder control. A cerebral stroke occurs when blood supply to a part of the brain stops for any reason. Though strokes can occur at any age, they are more common after 65 years. With the increase in life expectancy in India, the incidence of stroke has doubled from 175 to 350 per 1,00,000.
Although it is uncommon for strokes to occur in young people, it can happen in youngsters born with a malformed blood vessel in the brain, brain tumours or those who suffer severe dehydration. Also, at any age, irregular heartbeats can lead to small clots in the brain called emboli, which can block vessels. The chances of having a stroke increase in those above 65 years if they have diabetes, hypertension, obesity, elevated blood lipids (cholesterol and triglycerides), are smokers, take more than 60ml of alcohol a day and do not have an active life.
Pregnant women can also suffer a stroke because of an increase in clotting tendency . In fact, the number of such women having a stroke has increased internationally. This upsurge has been blamed on older age at first pregnancy, an inactive life prior to and during pregnancy and obesity.
The manifestations of a stroke are giddiness, weakness or paralysis of muscle groups, blurring of vision, inability to speak or loss of consciousness. This is followed by paralysis of a limb, or a side of the body. A stroke occurs when blood supply to an area of the brain is cut off, either as a result of a block or a bleed.
Usually, there are a few warning TIA (transient ischaemic attacks) before a stroke or cerebral attack. There can be sudden blurring of vision, inability to speak or weakness of a limb. These signs are due to spasm of a diseased vessel in the brain or to small amounts of blood leaking. Many people do not take these symptoms seriously since recovery is spontaneous and complete. But appropriate preventive treatment at this point can prevent a full-blown stroke.
In the absence of treatment, TIAs are soon followed by the real thing — a stroke. The devastation caused by it depends on the extent of damage to the brain. This in turn depends on the site and size of the block or leak. Thirty three percent of stroke victims recover, 33 per cent have permanent disability and another 33 per cent die. Cerebral stroke is responsible for 1.2 per cent of the recorded deaths in India.
The most common effect is paralysis of a part of the face or one side of the body. Muscles in the throat and mouth lose co-ordination, making it difficult for the person to swallow and talk. Speech may become slurred and distorted. If the speech centre in the brain is affected the person may understand everything that is said but be unable to reply. Memory loss may make recollection of present events a blur. Quite often though past memories are intact. A person may also lose the ability to make judgements, reason and understand concepts. This makes them appear unnecessarily stubborn. A strange numbness or pricking sensations may occur in the paralysed limb. Since all these effects are because of damage to the brain, they are difficult to treat with medication.
All injuries heal given time and treatment, the brain is no exception. It is capable of rewiring itself so that lost skills are regained to an extent. A person who is predominantly right handed can learn to write with his left hand. Physiotherapy makes the paralysed muscles flexible and stronger. Since a few muscle spindles may be still active, they can be retrained to enlarge and take over the function of the paralysed muscles. The bladder can be trained to empty itself every 3-4 hours. By speaking slowly and using simple sentences, it is often possible to be understood. The brain can be stimulated with puzzles and poetry to enable faster healing.
Better still, try to prevent a stroke.
• Keep diabetes and hypertension in control.
• Take medications to reduce lipid levels.
• Take aspirin and clopidogrel, usually prescribed to diabetics and those with high pressure, regularly to prevent a stroke.
• Walk, swim or cycle for at least 30 minutes a day.
• Stimulate yourself intellectually by learning new skills and doing puzzles.
When it comes to brain circuits, the correct mantra is “use it or lose it!”
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, August 14, 2011
hear hear
Hear, hear
Your Health
DR GITA MATHAI
The ears are one of our five sense organs but most of us take very little care of them. And a lot of us are gradually losing our hearing owing to neglect, misuse and wilful damage. The inability to hear properly and the consequent misinterpretation of what is heard can lead to misunderstandings with friends and social isolation. It can also be dangerous, as motor horns, bells, sirens and even warnings shouted may be missed.
Some babies are born deaf as an isolated defect or part of a complex plethora of congenital defects and syndromes. Sometimes the mother contracts measles, mumps or chicken pox during the first few months of pregnancy and deafness occurs in the baby as a result.
Hearing should be checked soon after birth. Some babies can hear, but develop post-lingual (after speech develops) hearing loss. Minor hearing loss can begin by age 20, with difficulty in hearing whispers and soft speech. By the time one reaches 65, 30 per cent have significant hearing loss while 50 per cent are quite deaf by the time they cross 75. Age related gradual degenerative deafness is called presbycusis.
The ear consists of the outer ear, middle ear and inner ear. Sound waves enter through the outer ear and cause vibrations at the eardrum. Three small bones of the middle ear amplify these vibrations as they pass to the inner ear, which contains a fluid-filled snail shaped structure called cochlea. Sound waves make the tiny hairs attached to the nerve cells in the cochlea move in different directions. This transforms the sound waves into electrical signals that are transmitted to the brain.
Continuous exposure to loud sound can damage the fine hair on the nerve cells, leading to progressive loss of hearing. This can be occupational in people who work with loud machinery. It is becoming common in teenagers who use “in ear” earphones to listen to loud music prolonged periods. Even soft piano music should not be listened to for more than two hours at a stretch.
Difficulty in hearing can also occur because of the external ear canal being blocked with wax. This can also lead to severe ear ache. It can be tackled with wax dissolving eardrops. A physician can clean it out. Ear buds tend to push hard wax further inwards, blocking the canal further. Pins and other sharp objects should never be inserted into the ear as they can damage the eardrum.
The middle ear is prone to viral and bacterial infections. Fluid and pus can collect, causing temporary hearing loss. Viral infections are unavoidable but immunisation is available against H. Influenzae and pneumococcus, the two common bacteria that cause ear infections in childhood. These injections are not part of the free national immunisation schedule; they are classified as “optional” vaccines and have to be paid for.
If left untreated, middle ear infections can result in hearing loss. The infection can spread outwards damaging the eardrum or inwards causing brain fever and meningitis. It can also damage the nerves conducting sounds to the brain.
Childhood infections such as measles, mumps and chicken pox could cause deafness as a complication. This too is preventable with immunisation. Vaccinations for all these diseases should be completed by the age of two.
Hearing loss can develop because of a defect either in the conduction pathways or in the nerve cells. It can also be a side effect of medication such as chloroquine, quinine and aspirin as well as antibiotics like gentamicin and kanamycin.
A sudden blow to the head, or a poke with a sharp object can also rupture the eardrum. Sudden loud noises can have the same effect. In war zones, there are “epidemics” of deafness where large numbers of the population cannot hear. Children are particularly vulnerable.
Once hearing loss has set in it should be evaluated professionally to assess the severity, whether one or both ears are affected and if it is reversible and curable.
Small holes in the eardrum can heal spontaneously or with medication. Larger holes require surgical repair, with skin grafts. In permanent hearing loss, a hearing aid should be considered, particularly in older individuals. Hearing aids vary in price, size and usability. The individual has to be fitted with the aid that suits him best. Cochlear implant surgery is also an effective but expensive solution.
Tips to preserve hearing:
• If occupational exposure to loud noise is inevitable, use ear mufflers.
• Turn TV and music volumes down.
• Do not place foreign objects in the ear.
• Children should be immunised against measles, mumps, German measles, chicken pox, H. influenza and pneumococcus.
• Women should complete their immunisation schedule before marriage.
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 ears are one of our five sense organs but most of us take very little care of them. And a lot of us are gradually losing our hearing owing to neglect, misuse and wilful damage. The inability to hear properly and the consequent misinterpretation of what is heard can lead to misunderstandings with friends and social isolation. It can also be dangerous, as motor horns, bells, sirens and even warnings shouted may be missed.
Some babies are born deaf as an isolated defect or part of a complex plethora of congenital defects and syndromes. Sometimes the mother contracts measles, mumps or chicken pox during the first few months of pregnancy and deafness occurs in the baby as a result.
Hearing should be checked soon after birth. Some babies can hear, but develop post-lingual (after speech develops) hearing loss. Minor hearing loss can begin by age 20, with difficulty in hearing whispers and soft speech. By the time one reaches 65, 30 per cent have significant hearing loss while 50 per cent are quite deaf by the time they cross 75. Age related gradual degenerative deafness is called presbycusis.
The ear consists of the outer ear, middle ear and inner ear. Sound waves enter through the outer ear and cause vibrations at the eardrum. Three small bones of the middle ear amplify these vibrations as they pass to the inner ear, which contains a fluid-filled snail shaped structure called cochlea. Sound waves make the tiny hairs attached to the nerve cells in the cochlea move in different directions. This transforms the sound waves into electrical signals that are transmitted to the brain.
Continuous exposure to loud sound can damage the fine hair on the nerve cells, leading to progressive loss of hearing. This can be occupational in people who work with loud machinery. It is becoming common in teenagers who use “in ear” earphones to listen to loud music prolonged periods. Even soft piano music should not be listened to for more than two hours at a stretch.
Difficulty in hearing can also occur because of the external ear canal being blocked with wax. This can also lead to severe ear ache. It can be tackled with wax dissolving eardrops. A physician can clean it out. Ear buds tend to push hard wax further inwards, blocking the canal further. Pins and other sharp objects should never be inserted into the ear as they can damage the eardrum.
The middle ear is prone to viral and bacterial infections. Fluid and pus can collect, causing temporary hearing loss. Viral infections are unavoidable but immunisation is available against H. Influenzae and pneumococcus, the two common bacteria that cause ear infections in childhood. These injections are not part of the free national immunisation schedule; they are classified as “optional” vaccines and have to be paid for.
If left untreated, middle ear infections can result in hearing loss. The infection can spread outwards damaging the eardrum or inwards causing brain fever and meningitis. It can also damage the nerves conducting sounds to the brain.
Childhood infections such as measles, mumps and chicken pox could cause deafness as a complication. This too is preventable with immunisation. Vaccinations for all these diseases should be completed by the age of two.
Hearing loss can develop because of a defect either in the conduction pathways or in the nerve cells. It can also be a side effect of medication such as chloroquine, quinine and aspirin as well as antibiotics like gentamicin and kanamycin.
A sudden blow to the head, or a poke with a sharp object can also rupture the eardrum. Sudden loud noises can have the same effect. In war zones, there are “epidemics” of deafness where large numbers of the population cannot hear. Children are particularly vulnerable.
Once hearing loss has set in it should be evaluated professionally to assess the severity, whether one or both ears are affected and if it is reversible and curable.
Small holes in the eardrum can heal spontaneously or with medication. Larger holes require surgical repair, with skin grafts. In permanent hearing loss, a hearing aid should be considered, particularly in older individuals. Hearing aids vary in price, size and usability. The individual has to be fitted with the aid that suits him best. Cochlear implant surgery is also an effective but expensive solution.
Tips to preserve hearing:
• If occupational exposure to loud noise is inevitable, use ear mufflers.
• Turn TV and music volumes down.
• Do not place foreign objects in the ear.
• Children should be immunised against measles, mumps, German measles, chicken pox, H. influenza and pneumococcus.
• Women should complete their immunisation schedule before marriage.
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
Wednesday, July 20, 2011
calcium needed
Calcium every day keeps fractures away
Your Health
DR GITA MATHAI
Debility, illness and loss of independence are assumed to be an inevitable part of ageing. In a society like ours, where there are no health benefits and minimal social security, old age can be frightening. Unfortunately, young people do not realise that if they take remedial action, some of the incapacitating changes of ageing like osteoporosis are preventable.
Osteoporosis occurs because of calcium deficiency — the bones became fragile and brittle. This means that the slightest trauma can lead to a fracture. In India, the incidence of osteoporosis is high and, with our ageing population, it will only climb.
Patients do not realise that anything is wrong until the first fracture. The trauma that caused the break need not be severe; a trivial fall may be sufficient. The commonest sites are the wrist and the hip. Treatment usually requires setting the bone surgically and screwing it into place. Healing is a long-drawn-out and painful process. Fear of surgery may lead people to native bonesetters, who set fractures with bandages and egg whites. But these ancient treatments are not successful in osteoporosis, especially when the fracture occurs in a deep-seated bone like the hip.
Apart from fractures, early signs of osteoporosis are a decrease in height as the spinal vertebrae grind into each other. This also results in a stooped appearance with a “dowager’s hump”.
The only way to avoid osteoporosis is to have enough calcium, which is necessary not only for healthy bones but also for the proper functioning of cells and enzymes. If there isn’t enough calcium in the blood, the body gets it from the bones. If this calcium is not replaced, the bones become increasingly fragile. Bones are built up in childhood, adolescence and the early twenties. So it should be ensured that the body gets enough calcium during this period. The final strength of the bones is determined by genes but diet and lifestyle can modify this.
The body gets calcium from dairy products such as milk and cheese (processed as well as cottage). Other calcium-rich foods are sardines, custard apples and green leafy vegetables. To absorb dietary calcium, the body also needs 400 IU of vitamin D, 400mg of magnesium and 110 micrograms of vitamin K. The skin can synthesise sufficient vitamin D from sunlight but the problem is that most people either work indoors or use sunscreen and umbrellas. The other source of vitamins is green leafy vegetables. However, the requisite amounts of these vitamins are usually not available in a normal diet. Therefore, you need calcium supplements, most of which contain additional vitamins and minerals to aid absorption.
Calcium supplements are best absorbed if taken after meals in 500mg doses several times a day. Other minerals such as iron and zinc interfere with calcium absorption. Even though many people need supplements of all these elements, they have to be given separately or at least 12 hours apart. A common mistake is to try and combine all these ingredients into one giant biologically ineffective capsule or tablet.
The other thing that can interfere with calcium absorption is too much protein, caffeine (coffee and cola) or alcohol in the diet. There is a demonstrated difference between the bone density of people who drink colas every day and those who drink it once a month.
Osteoporosis can also occur as a side effect of medication like corticosteroids (called secondary osteoporosis). These are prescribed for ailments such as arthritis or asthma and patients are sometimes not aware that they have been given steroids on a long-term basis. Sometimes, it is part of the unlabeled medication dispensed by practitioners of alternative medicine.
Some antacids contain aluminium, which acts as “bone poison” and interferes with the incorporation of calcium into the bones, increasing the risk of osteoporosis. Thyroid disorders or malfunctioning parathyroid glands can also increase the risk of developing the disease. Lactose (milk) intolerance results in an inadequate intake of milk and dairy products with subsequent calcium deficiency.
It is never too late to contain osteoporosis. Physical activity helps bones retain and even gain density all through life. Effective exercises are running, jogging, skipping, stair-climbing, tennis and badminton. Exercise also improves muscle strength and coordination so that falls and injuries are less. One should exercise for an hour every day, all through life. Although exercise at any age is a boon to health, to build bone strength one needs to be regular and consistent.
Daily calcium requirement
• 1-3 yr: 700mg
• 4-8 yr: 1,000mg
• 10-20 yr: 1,300mg
• 20-70 yr: 1,000mg
• Women over 50: 1,200mg
• Men over 71: 1,200mg
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
Debility, illness and loss of independence are assumed to be an inevitable part of ageing. In a society like ours, where there are no health benefits and minimal social security, old age can be frightening. Unfortunately, young people do not realise that if they take remedial action, some of the incapacitating changes of ageing like osteoporosis are preventable.
Osteoporosis occurs because of calcium deficiency — the bones became fragile and brittle. This means that the slightest trauma can lead to a fracture. In India, the incidence of osteoporosis is high and, with our ageing population, it will only climb.
Patients do not realise that anything is wrong until the first fracture. The trauma that caused the break need not be severe; a trivial fall may be sufficient. The commonest sites are the wrist and the hip. Treatment usually requires setting the bone surgically and screwing it into place. Healing is a long-drawn-out and painful process. Fear of surgery may lead people to native bonesetters, who set fractures with bandages and egg whites. But these ancient treatments are not successful in osteoporosis, especially when the fracture occurs in a deep-seated bone like the hip.
Apart from fractures, early signs of osteoporosis are a decrease in height as the spinal vertebrae grind into each other. This also results in a stooped appearance with a “dowager’s hump”.
The only way to avoid osteoporosis is to have enough calcium, which is necessary not only for healthy bones but also for the proper functioning of cells and enzymes. If there isn’t enough calcium in the blood, the body gets it from the bones. If this calcium is not replaced, the bones become increasingly fragile. Bones are built up in childhood, adolescence and the early twenties. So it should be ensured that the body gets enough calcium during this period. The final strength of the bones is determined by genes but diet and lifestyle can modify this.
The body gets calcium from dairy products such as milk and cheese (processed as well as cottage). Other calcium-rich foods are sardines, custard apples and green leafy vegetables. To absorb dietary calcium, the body also needs 400 IU of vitamin D, 400mg of magnesium and 110 micrograms of vitamin K. The skin can synthesise sufficient vitamin D from sunlight but the problem is that most people either work indoors or use sunscreen and umbrellas. The other source of vitamins is green leafy vegetables. However, the requisite amounts of these vitamins are usually not available in a normal diet. Therefore, you need calcium supplements, most of which contain additional vitamins and minerals to aid absorption.
Calcium supplements are best absorbed if taken after meals in 500mg doses several times a day. Other minerals such as iron and zinc interfere with calcium absorption. Even though many people need supplements of all these elements, they have to be given separately or at least 12 hours apart. A common mistake is to try and combine all these ingredients into one giant biologically ineffective capsule or tablet.
The other thing that can interfere with calcium absorption is too much protein, caffeine (coffee and cola) or alcohol in the diet. There is a demonstrated difference between the bone density of people who drink colas every day and those who drink it once a month.
Osteoporosis can also occur as a side effect of medication like corticosteroids (called secondary osteoporosis). These are prescribed for ailments such as arthritis or asthma and patients are sometimes not aware that they have been given steroids on a long-term basis. Sometimes, it is part of the unlabeled medication dispensed by practitioners of alternative medicine.
Some antacids contain aluminium, which acts as “bone poison” and interferes with the incorporation of calcium into the bones, increasing the risk of osteoporosis. Thyroid disorders or malfunctioning parathyroid glands can also increase the risk of developing the disease. Lactose (milk) intolerance results in an inadequate intake of milk and dairy products with subsequent calcium deficiency.
It is never too late to contain osteoporosis. Physical activity helps bones retain and even gain density all through life. Effective exercises are running, jogging, skipping, stair-climbing, tennis and badminton. Exercise also improves muscle strength and coordination so that falls and injuries are less. One should exercise for an hour every day, all through life. Although exercise at any age is a boon to health, to build bone strength one needs to be regular and consistent.
Daily calcium requirement
• 1-3 yr: 700mg
• 4-8 yr: 1,000mg
• 10-20 yr: 1,300mg
• 20-70 yr: 1,000mg
• Women over 50: 1,200mg
• Men over 71: 1,200mg
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, June 27, 2011
going grey
Colour grey
Your Health
DR GITA MATHAI
As we grow older several changes take place in our body, some visible, others not so visible. The most obvious one is the hair — and moustache in the case of men — turning grey from jet black. Unfortunately, nowadays it is not just senior citizens who are greying but also those in their twenties or early thirties. Twenty years ago, 18 per cent of adults under the age of 30 had started to grey. According to a recent report, that figure is now close to 32 per cent. Hair care brands have come up with a new mnemonic for grey haired over stressed twenty something — GHOSTS. The first grey hair stresses out GHOSTS even more as the current job market prizes youth — or at least looking youthful — over experience.
The age at which one starts to grey is determined genetically. At that age the hair cells stop producing the colouring pigment melanin. This makes the shaft of the hair transparent. Light reflects off it, giving it its white appearance. Not all hairs stop producing melanin simultaneously. The mixed white and normal black makes the hair appear grey.
People who are exposed constantly to pollution and UV rays can get grey hair even before their genetically determined age to grey. The poisonous chemicals in tobacco kill the melanocytes, making smokers go grey before their non-smoking peers. Deficiency of vitamin B12 can also cause premature greying, as can a a peculiar type of anaemia called pernicious anaemia. Thyroid malfunction can also turn hair grey.
Grey hair has been cosmetically unacceptable for centuries. People used all kinds of natural dyes such as henna, indigo, walnut, curry leaves, gooseberries, tea, coffee, hibiscus flowers and arecanut either alone or in combination to colour grey hair. These natural products are used even today. Most, if used consistently, produce a dark brown colour. They are popular as they are inexpensive, can be applied at home, and are considered safe. But some people are allergic to even herbal products.
Hair can also be dyed with commercially available colouring agents. Temporary colours last a single wash. They can be funky colours like pink, blue or green but dark hair will not take these unless it is bleached first. Repeated use of these dyes without proper conditioning can, however, make hair brittle and lustreless.
Permanent hair colouring is the one usually used to disguise grey hair. It is a two-step process. First the hair is lightened using an agent like hydrogen peroxide or ammonia. Then the dye is applied and fixed. The colouring lasts until the hair grows out. This can be anything between 4 to 6 weeks.
Some people are allergic to hair dyes. Redness, itching, burning or skin rashes can occur either immediately or within 48 hours. To prevent this, before applying a dye for the first time, or switching brands, do a patch test. Take a small quantity of dye and apply it to the skin [usually on the inside of the elbow] for a day to see if there is any reaction. Sometimes a person can turn allergic to a product that they have been using safely for many years.
If hair is being coloured at home, it is important to follow the instructions on the package implicitly. Before using the dye, apply Vaseline to the hairline and ears. This will prevent the skin from staining. Always use gloves to apply the colour. Leave it on the hair for the time specified. Then wash it off with water. Apply a conditioner and leave it on for 7-9 minutes. Shampoo the next day.
Most shampoos (particularly the anti-dandruff ones) are harsh and unsuitable for regular use on coloured hair. Special colour safe shampoos and conditioners should be used to preserve the health of hair and minimise fading.
Hair that has been damaged by excessive and improper exposure to chemicals becomes dry, rough and fragile. The only solution is to stop using chemicals and cut off the damaged bit.
Hair colour should also not be used to darken facial hair because its texture is different and also because using traditional hair dyes so close to the nose can be distressing because of the odour of ammonia and other chemicals. The best thing to use is a range of colouring products labelled “just for men”.
How to delay greying:
Avoid stress
Don’t smoke
Avoid too much exposure to ultraviolet rays
Exercise regularly
Eat at least 4-5 helpings of fruit and vegetables a day.
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
As we grow older several changes take place in our body, some visible, others not so visible. The most obvious one is the hair — and moustache in the case of men — turning grey from jet black. Unfortunately, nowadays it is not just senior citizens who are greying but also those in their twenties or early thirties. Twenty years ago, 18 per cent of adults under the age of 30 had started to grey. According to a recent report, that figure is now close to 32 per cent. Hair care brands have come up with a new mnemonic for grey haired over stressed twenty something — GHOSTS. The first grey hair stresses out GHOSTS even more as the current job market prizes youth — or at least looking youthful — over experience.
The age at which one starts to grey is determined genetically. At that age the hair cells stop producing the colouring pigment melanin. This makes the shaft of the hair transparent. Light reflects off it, giving it its white appearance. Not all hairs stop producing melanin simultaneously. The mixed white and normal black makes the hair appear grey.
People who are exposed constantly to pollution and UV rays can get grey hair even before their genetically determined age to grey. The poisonous chemicals in tobacco kill the melanocytes, making smokers go grey before their non-smoking peers. Deficiency of vitamin B12 can also cause premature greying, as can a a peculiar type of anaemia called pernicious anaemia. Thyroid malfunction can also turn hair grey.
Grey hair has been cosmetically unacceptable for centuries. People used all kinds of natural dyes such as henna, indigo, walnut, curry leaves, gooseberries, tea, coffee, hibiscus flowers and arecanut either alone or in combination to colour grey hair. These natural products are used even today. Most, if used consistently, produce a dark brown colour. They are popular as they are inexpensive, can be applied at home, and are considered safe. But some people are allergic to even herbal products.
Hair can also be dyed with commercially available colouring agents. Temporary colours last a single wash. They can be funky colours like pink, blue or green but dark hair will not take these unless it is bleached first. Repeated use of these dyes without proper conditioning can, however, make hair brittle and lustreless.
Permanent hair colouring is the one usually used to disguise grey hair. It is a two-step process. First the hair is lightened using an agent like hydrogen peroxide or ammonia. Then the dye is applied and fixed. The colouring lasts until the hair grows out. This can be anything between 4 to 6 weeks.
Some people are allergic to hair dyes. Redness, itching, burning or skin rashes can occur either immediately or within 48 hours. To prevent this, before applying a dye for the first time, or switching brands, do a patch test. Take a small quantity of dye and apply it to the skin [usually on the inside of the elbow] for a day to see if there is any reaction. Sometimes a person can turn allergic to a product that they have been using safely for many years.
If hair is being coloured at home, it is important to follow the instructions on the package implicitly. Before using the dye, apply Vaseline to the hairline and ears. This will prevent the skin from staining. Always use gloves to apply the colour. Leave it on the hair for the time specified. Then wash it off with water. Apply a conditioner and leave it on for 7-9 minutes. Shampoo the next day.
Most shampoos (particularly the anti-dandruff ones) are harsh and unsuitable for regular use on coloured hair. Special colour safe shampoos and conditioners should be used to preserve the health of hair and minimise fading.
Hair that has been damaged by excessive and improper exposure to chemicals becomes dry, rough and fragile. The only solution is to stop using chemicals and cut off the damaged bit.
Hair colour should also not be used to darken facial hair because its texture is different and also because using traditional hair dyes so close to the nose can be distressing because of the odour of ammonia and other chemicals. The best thing to use is a range of colouring products labelled “just for men”.
How to delay greying:
Avoid stress
Don’t smoke
Avoid too much exposure to ultraviolet rays
Exercise regularly
Eat at least 4-5 helpings of fruit and vegetables a day.
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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