Sweet disease
Your Health
DR GITA MATHAI
A waist-hip ratio (the narrowest part of your waist divided by the widest part of your hips) greater than 1 in men and 0.8 in women is risky
Vellore recently hosted an endocrinology conference that was attended by almost 1,000 physicians. The experts discussed health issues linked to various hormones, but more than half the conference was devoted to diabetes. This was not surprising. After all, we are in the midst of a global epidemic. The physicians talked about new issues, the latest advances, pancreatic islet cell transplant surgery and hopes of an eventual cure. Exciting new developments were discussed. An eminent professor has actually managed to modify insulin so that it can be injected just once a month for good sugar control. Of course, only mice have benefitted thus far, but everyone is hopeful of successful human trials in the near future.
Diabetes has affected 11 per cent of India’s urban population and 3 per cent of the rural population above the age of 15. This may be an underestimation as 30 to 40 per cent of diabetics in India go undiagnosed until complications set in.
But why do we have this predisposition to diabetes? One theory is that India survived several famines, and in the process we evolved genetically and developed a “thrifty” gene. This conserves calories and converts food into fat which is then deposited in various parts of the body. That is why Indians, even thin individuals, tend to have a “tummy”. The first place we put on weight is around the middle.
Metabolic syndrome usually occurs in people who have a close relative like a parent or sibling with diabetes. Women at risk may have polycystic ovarian syndrome (PCOS) or develop diabetes during pregnancy (gestational diabetes).
It is possible to determine if a person is at risk for developing diabetes by recording certain biometric criteria. Such an individual has elevated fasting blood sugar levels of more than 125mg/dL or a random sugar value of more than 200mg/dL. The glucose tolerance test may be impaired. The lipid profile is deranged with triglycerides greater than 150 mg/dL, and HDL cholesterol less than 40mgdL in men and 50 mg/dL in women. The blood pressure is also higher than 135/85. Those who exhibit these abnormalities are said to suffer from “metabolic syndrome” or “syndrome X”.
It is also possible to evaluate yourself using a weighing scale and measuring tape. Risk factors are a BMI (body mass index) more than 30 (BMI = weight in kilogram divided by height in metre squared), a waist to hip ratio greater than 1 in men and 0.8 in women (this is the narrowest part of your waist divided by the widest part of your hips), and a waist measurement greater than 102cm in men and 88 cm in women. These anthropometric measurements do not require medical expertise.
If three or more of the above criteria are present, the person suffers from metabolic syndrome. When checking a cross section of the population, a staggering 40 per cent of those above the age of 15 were found to be affected.
Does this mean the majority of us are doomed to become diabetic?
To prevent syndrome X, and later its progression to diabetes, first the biochemical abnormalities have to be corrected. The abnormalities occur because of insulin resistance. Normally, the food we eat is converted into glucose which enters the cells of the body to provide them with energy. In people with syndrome X, the cells are resistant to insulin. Higher amounts of insulin have to be secreted to force the glucose to enter the cells. Eventually, the body is unable to produce enough insulin to do this and diabetes sets in.
Tackling the insulin resistance attacks the beginning of syndrome X. The most effective way to do this is to achieve and maintain the ideal body weight or a BMI of 23.
Aerobic activities like walking as little as 30 minutes every day will reduce insulin resistance. This has to be at a brisk pace, fast enough to prevent conversation except in short bursts. Ideally a pace of 4km/hr should be maintained. Although this is just about sufficient for fitness, an hour of walking, combined with caloric restriction (1,500 calories), is ideal. Cycling or swimming can be done instead.
If time is a constraint, climb stairs for 20 minutes. Weight lifting and other gym exercises increase strength and flexibility but do not help control syndrome X unless they are combined with aerobic activity. Also, exercises for spot reduction of abdominal fat alone, attempting to correct an abnormal waist-hip ratio, without overall weight loss do not work.
Caloric restriction can be achieved by reducing the amount eaten during each meal by 25 per cent. Reading, watching television and other mind diverting activities during meal times increases caloric intake. Also, fill up on fruits and vegetables and avoid snacking. Oils add hidden calories to food. Consumption should be restricted to 500 ml per person a month.
Healthy eating and the habit of regular exercise should be ingrained in children by parents.
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, December 28, 2010
Monday, December 13, 2010
coughs and colds
eason of coughs and colds
YOUR HEALTH
DR GITA MATHAI
Self medication can be harmful, consult a doctor when your child is sick
In India, we enjoy four seasons — winter (January and February), summer (March to May), monsoon (June to September) and a post-monsoon period (October to December) with unseasonal rains causing an overlap amongst them. Each season has its own set of illnesses.
During winter and the rains, we often suffer from colds and coughs. People blame it on the weather — getting caught in an unexpected shower or going about on a grey, chilly day. These are unproven theories and fall in the category of urban legends.
Colds are infections caused by 200 types of viruses. With so many subtypes around, immunity is poor and infections are common.
Infection occurs when the cold virus reaches the nose. It is transported to the back of the throat in 10-15 minutes. The nasal mucous membrane attempts to wash out the virus by swelling up and increasing its secretions. This causes sneezing and a characteristic drippy nose.
Sneezing and coughing expel the viruses into the environment to infect others. The viruses can temporarily survive on furniture, walls and clothing. Hands placed on contaminated walls or furniture and then on the nose can cause infection.
During the monsoon and winter, people tend to keep windows and doors shut. As they sit close together with inadequate ventilation, colds spread rapidly.
Children under the age of one year are most susceptible. They have a little immunity passed on by their mothers while in the uterus and also through breast milk. This wanes in about six months. Later, as they come in contact with many others, especially in a closed environment like a poorly ventilated classroom, the number of initial infections proportionately increases. This causes a dramatic increase in the number of fevers, colds and “lost school days”.
Children may develop eight to 10 infections a year. Each cold lasts seven to 10 days. This means around 60 days of ill health due to colds alone, leading parents to feel the child is always sick. They begin to fear the child is suffering not from recurrent illnesses due to different viruses but something more sinister like primary complex or tuberculosis. (These illnesses do not have a symptom free interval — the child is continuously sick.)
The classic symptoms of a cold are mild fever, watery or slightly yellow nasal discharge, a scratchy feeling in the throat, cough and body ache. It is best tackled with rest. If the temperature rises above 100.5° F, or if the body ache is severe, paracetamol may be taken. Adults do not require more than 500mg and children 10-15mg/kg body weight per dose. The medicine can be repeated every four to six hours. Sore throat can be tackled with salt water gargles. Saline nose drops can be administered in each nostril every three hours. It is better to avoid decongestant chemical nose drops as they can cause rebound nasal congestion, habituation and, if used frequently for prolonged periods, atrophy of the nasal mucosa.
Anti histamines can cause drowsiness. Both anti histamines and cough suppressants can cause side effects. The prescribed dose should not be exceeded. Nor should they be used without medical supervision.
Traditional remedies like ginger tea, rasam, rice gruel and chicken soup help soothe the throat, relieve congestion and maintain hydration and nutrition.
Consult a doctor if:
■ The fever lasts more than five days
■ There are chills
■ The headache is continuous
■ There is abdominal pain or vomiting
■ There is earache
■ Breathing becomes difficult
■ There is a persistent cough
■ There is drowsiness.
In children, continuous crying or grunting must be taken seriously. Antibiotics will not shorten the course of a cold or prevent one from appearing. They need to be used if there are complications like an ear infection, sinusitis, bronchitis or pneumonia. They need to be taken in the prescribed dose. The medication should not repeated every time there is a cold without a medical opinion.
The ability to cope with a cold is better in people who keep themselves fit with regular physical aerobic exercise and breathing asanas.
Not all colds are infective. Some may be allergic rhinitis, a watery discharge from the nasal mucosa as a response to allergens like pollen, crackers, mosquito repellents, room fresheners, incense and chalk dust. Allergies are difficult to treat if the cause is not determined. The newer anti allergic nasal sprays if used regularly as directed cause the hypertrophied mucosa to shrink and the allergy to subside.
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
Self medication can be harmful, consult a doctor when your child is sick
In India, we enjoy four seasons — winter (January and February), summer (March to May), monsoon (June to September) and a post-monsoon period (October to December) with unseasonal rains causing an overlap amongst them. Each season has its own set of illnesses.
During winter and the rains, we often suffer from colds and coughs. People blame it on the weather — getting caught in an unexpected shower or going about on a grey, chilly day. These are unproven theories and fall in the category of urban legends.
Colds are infections caused by 200 types of viruses. With so many subtypes around, immunity is poor and infections are common.
Infection occurs when the cold virus reaches the nose. It is transported to the back of the throat in 10-15 minutes. The nasal mucous membrane attempts to wash out the virus by swelling up and increasing its secretions. This causes sneezing and a characteristic drippy nose.
Sneezing and coughing expel the viruses into the environment to infect others. The viruses can temporarily survive on furniture, walls and clothing. Hands placed on contaminated walls or furniture and then on the nose can cause infection.
During the monsoon and winter, people tend to keep windows and doors shut. As they sit close together with inadequate ventilation, colds spread rapidly.
Children under the age of one year are most susceptible. They have a little immunity passed on by their mothers while in the uterus and also through breast milk. This wanes in about six months. Later, as they come in contact with many others, especially in a closed environment like a poorly ventilated classroom, the number of initial infections proportionately increases. This causes a dramatic increase in the number of fevers, colds and “lost school days”.
Children may develop eight to 10 infections a year. Each cold lasts seven to 10 days. This means around 60 days of ill health due to colds alone, leading parents to feel the child is always sick. They begin to fear the child is suffering not from recurrent illnesses due to different viruses but something more sinister like primary complex or tuberculosis. (These illnesses do not have a symptom free interval — the child is continuously sick.)
The classic symptoms of a cold are mild fever, watery or slightly yellow nasal discharge, a scratchy feeling in the throat, cough and body ache. It is best tackled with rest. If the temperature rises above 100.5° F, or if the body ache is severe, paracetamol may be taken. Adults do not require more than 500mg and children 10-15mg/kg body weight per dose. The medicine can be repeated every four to six hours. Sore throat can be tackled with salt water gargles. Saline nose drops can be administered in each nostril every three hours. It is better to avoid decongestant chemical nose drops as they can cause rebound nasal congestion, habituation and, if used frequently for prolonged periods, atrophy of the nasal mucosa.
Anti histamines can cause drowsiness. Both anti histamines and cough suppressants can cause side effects. The prescribed dose should not be exceeded. Nor should they be used without medical supervision.
Traditional remedies like ginger tea, rasam, rice gruel and chicken soup help soothe the throat, relieve congestion and maintain hydration and nutrition.
Consult a doctor if:
■ The fever lasts more than five days
■ There are chills
■ The headache is continuous
■ There is abdominal pain or vomiting
■ There is earache
■ Breathing becomes difficult
■ There is a persistent cough
■ There is drowsiness.
In children, continuous crying or grunting must be taken seriously. Antibiotics will not shorten the course of a cold or prevent one from appearing. They need to be used if there are complications like an ear infection, sinusitis, bronchitis or pneumonia. They need to be taken in the prescribed dose. The medication should not repeated every time there is a cold without a medical opinion.
The ability to cope with a cold is better in people who keep themselves fit with regular physical aerobic exercise and breathing asanas.
Not all colds are infective. Some may be allergic rhinitis, a watery discharge from the nasal mucosa as a response to allergens like pollen, crackers, mosquito repellents, room fresheners, incense and chalk dust. Allergies are difficult to treat if the cause is not determined. The newer anti allergic nasal sprays if used regularly as directed cause the hypertrophied mucosa to shrink and the allergy to subside.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Saturday, December 11, 2010
don't get pregnant
Don’t get pregnant
Your Health
DR GITA MATHAI
I have done something wrong,” said the young woman. No, it was not theft or murder she was confessing to but unprotected sex. An unguarded passionate moment with her boyfriend had made her pregnant. She was terrified of the stigma — the boyfriend was still a student, there was no way they could get married right away.
This is quite a common scenario in urban as well as rural India. Women increasingly face the problems of unplanned and unwanted pregnancies. It’s most important that they know how to take care of themselves, married or single.
First, women need to be in control of their bodies, especially when it comes to sexual intercourse, pregnancy and childbirth. Many safe women-oriented contraceptive methods are available.
Women become pregnant only on certain days of the month. The ovum or egg of a fertile woman is released 14 days before her next period. The egg survives 12 to 24 hours after release and the sperm for up to 72 hours. Couples may refrain from intercourse on these days if they wish to avoid pregnancy. This method, however, is not reliable as many women do not menstruate with clockwork precision.
Women may use contraceptive creams containing nonoxynol-9 in the vagina. These substances increase the effectiveness of the safe period. They are effective for about an hour. But they do not suit everyone and may cause vaginal irritation or allergic reactions. They are available in pharmacies without a prescription.
Diaphragms can be inserted prior to intercourse. These come in various sizes and need to be combined with a spermicide. An initial medical examination is needed to confirm the size. The device has to be left in the vagina for eight to 12 hours after intercourse but should be removed within 24 hours.
Women can also opt for an intrauterine contraceptive device (IUCD), popularly known as a “copper T”. These need to be inserted by a medical professional. They can work for three, five or 10 years, depending on the type and manufacturer’s recommendations. Imported devices can be purchased from the pharmacy. Also, free IUCDs are distributed by the government.
“Depo” injections of long-acting progesterone are available. A woman needs to have an injection every 12 weeks. They can cause weight gain, irregular cycles, breakthrough bleeding or spotting. The irregular periods can raise the spectre of an unwanted pregnancy.
Oral contraceptive pills (OCP) prevent pregnancy if taken regularly. There are combination pills containing estrogen and progesterone with different trade names. They are also provided free by the government (Mala D). The active ingredient is given for 21 days. Then there is a pill-free interval of seven days after which the next lot needs to be started. Sometimes placebo pills are administered during the pill-free period. They prevent pregnancy as well as regularise the cycle. They do not increase the risk of cancer.
Breast feeding women can opt for “progesterone only” pills. These are taken without a pill-free interval.
There’s a new contraceptive in the market — a plastic ring impregnated with estrogen and progesterone. The ring needs to be inserted in the vagina and left there for three weeks followed by a one week ring-free interval. A woman can purchase and insert the ring herself. An advantage of this over the pill is that the question of forgetting the latter does not arise.
Condoms can be used by the male partner. These have to be used from the beginning to the end of intercourse, and can be combined with a spermicidal cream.
Casual sex and multiple partners can result in sexually transmitted diseases. Some like Hepatitis B and HIV can eventually be fatal. Only condoms can prevent these diseases.
Even if you have had unplanned and unprotected sex, you can use emergency contraception (morning after) pills. Although theoretically these pills should be dispensed only by prescription, in many places they are available over the counter (OTC). The tablet should be taken after intercourse as soon as possible. It is 80 per cent effective if taken within 72 hours.
The morning after pill contains either progesterone or a combination of estrogen and progesterone in higher doses than in the 21 or 28-day packs of OCPs. An alternative is to take four low-dose or two “standard-dose” OCPs, and then take an equal dose 12 hours later.
If an unwanted pregnancy occurs, do not buy medicine OTC or rush to an unqualified quack out of shame or fear. Medical abortion pills are available and effective. They work up to the 49th day after the last period.
The last two are stopgap emergency measures. They are not to be considered regular methods of contraception. They are detrimental to health if repeatedly used.
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 have done something wrong,” said the young woman. No, it was not theft or murder she was confessing to but unprotected sex. An unguarded passionate moment with her boyfriend had made her pregnant. She was terrified of the stigma — the boyfriend was still a student, there was no way they could get married right away.
This is quite a common scenario in urban as well as rural India. Women increasingly face the problems of unplanned and unwanted pregnancies. It’s most important that they know how to take care of themselves, married or single.
First, women need to be in control of their bodies, especially when it comes to sexual intercourse, pregnancy and childbirth. Many safe women-oriented contraceptive methods are available.
Women become pregnant only on certain days of the month. The ovum or egg of a fertile woman is released 14 days before her next period. The egg survives 12 to 24 hours after release and the sperm for up to 72 hours. Couples may refrain from intercourse on these days if they wish to avoid pregnancy. This method, however, is not reliable as many women do not menstruate with clockwork precision.
Women may use contraceptive creams containing nonoxynol-9 in the vagina. These substances increase the effectiveness of the safe period. They are effective for about an hour. But they do not suit everyone and may cause vaginal irritation or allergic reactions. They are available in pharmacies without a prescription.
Diaphragms can be inserted prior to intercourse. These come in various sizes and need to be combined with a spermicide. An initial medical examination is needed to confirm the size. The device has to be left in the vagina for eight to 12 hours after intercourse but should be removed within 24 hours.
Women can also opt for an intrauterine contraceptive device (IUCD), popularly known as a “copper T”. These need to be inserted by a medical professional. They can work for three, five or 10 years, depending on the type and manufacturer’s recommendations. Imported devices can be purchased from the pharmacy. Also, free IUCDs are distributed by the government.
“Depo” injections of long-acting progesterone are available. A woman needs to have an injection every 12 weeks. They can cause weight gain, irregular cycles, breakthrough bleeding or spotting. The irregular periods can raise the spectre of an unwanted pregnancy.
Oral contraceptive pills (OCP) prevent pregnancy if taken regularly. There are combination pills containing estrogen and progesterone with different trade names. They are also provided free by the government (Mala D). The active ingredient is given for 21 days. Then there is a pill-free interval of seven days after which the next lot needs to be started. Sometimes placebo pills are administered during the pill-free period. They prevent pregnancy as well as regularise the cycle. They do not increase the risk of cancer.
Breast feeding women can opt for “progesterone only” pills. These are taken without a pill-free interval.
There’s a new contraceptive in the market — a plastic ring impregnated with estrogen and progesterone. The ring needs to be inserted in the vagina and left there for three weeks followed by a one week ring-free interval. A woman can purchase and insert the ring herself. An advantage of this over the pill is that the question of forgetting the latter does not arise.
Condoms can be used by the male partner. These have to be used from the beginning to the end of intercourse, and can be combined with a spermicidal cream.
Casual sex and multiple partners can result in sexually transmitted diseases. Some like Hepatitis B and HIV can eventually be fatal. Only condoms can prevent these diseases.
Even if you have had unplanned and unprotected sex, you can use emergency contraception (morning after) pills. Although theoretically these pills should be dispensed only by prescription, in many places they are available over the counter (OTC). The tablet should be taken after intercourse as soon as possible. It is 80 per cent effective if taken within 72 hours.
The morning after pill contains either progesterone or a combination of estrogen and progesterone in higher doses than in the 21 or 28-day packs of OCPs. An alternative is to take four low-dose or two “standard-dose” OCPs, and then take an equal dose 12 hours later.
If an unwanted pregnancy occurs, do not buy medicine OTC or rush to an unqualified quack out of shame or fear. Medical abortion pills are available and effective. They work up to the 49th day after the last period.
The last two are stopgap emergency measures. They are not to be considered regular methods of contraception. They are detrimental to health if repeatedly used.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Saturday, November 20, 2010
red eye
Watch your eye
Your Health
DR GITA MATHAI
What do people fear most? When do they rush to a doctor? Apparently the greatest fear is death, followed by loss of vision and cancer, probably in that order. This is the reason why people rush to a doctor when anything goes wrong with their eyes.
The current epidemic of conjunctivitis (also called Madras / Delhi eye, pink / red eye, or joybangla) has people really worried. Not only is the infection uncomfortable — the eyes are red, itchy and swollen — but also it spreads like wildfire.
Conjunctivitis occurs when the transparent membrane that lines the eyelids and part of the eyeball becomes inflamed and red. This may be due to an allergy, infection, a foreign body or blocked tear duct. The redness appears because the small blood vessels in the conjunctiva react to it. If the infection is severe the conjunctiva may be swollen. The eye may then feel gritty and itchy, shed tears and have a yellow or white discharge.
Infection is often due to a seasonal bug — an adeno or influenza virus. It may be associated with a cold or sore throat. These infections are self-limiting. Cold or warm compresses applied to the eyes can be soothing. It does not really require any treatment with eye drops and clears up spontaneously in three or four days.
The discharge in bacterial conjunctivitis can be yellow and purulent (containing pus). This requires antibiotic eye drops. These are effective when applied every two or three hours. An eye ointment may be applied at night.
Infectious conjunctivitis (viral or bacterial) can spread rapidly within a classroom, home or community. Contrary to popular belief, just looking at an affected person does not cause the infection to spread. The virus or bacteria gets transferred from the infected person’s eyes on to table tops, books and other frequently used items. If an uninfected person touches a contaminated surface, and then his or her eyes, the infection is transferred. Wearing dark glasses reduces photophobia due to the infection and prevents people from touching and rubbing their own eyes.
If you develop conjunctivitis:
• Don’t touch your eyes. Don’t itch or scratch
• Wash your hands often
• Use a clean towel which must be changed daily. Don’t share towels
• Change your pillow cases everyday
• Don’t share eye cosmetics or personal eye-care items (like mascara and kajal)
• Apply a compress to your eyes by soaking a clean cloth in water and applying it gently to your closed eyelids. Don’t touch both eyes with the same cloth. This reduces the risk of spreading red eye from one eye to the other
• Clean the crusts from the eyelids with a solution of 1 part of baby shampoo to 10 parts of warm water
• Stop wearing contact lenses until the infection completely clears up.
Children with viral conjunctivitis rapidly transmit the infection to their classmates. They should stay at home if infected and return to school only when the eyes no longer have a discharge. This may take around a week.
During the process of birth, a baby’s eyes can become contaminated by organisms present in the birth canal. An antibiotic ointment or drops are usually applied soon after birth to the infant’s eyes to prevent infection. In ancient civilisations, these infections were recognised and treated by applying a few drops of expressed breast milk to the baby’s eyes. Breast milk contains high concentrations of immunoglobulin which can protect against infection.
Sometimes, the tear ducts in babies are blocked. This occurs because either they are not yet fully developed or have been partially blocked by debris during the process of birth. This causes constant tearing of the affected eye and can result in a secondary infection. It usually clears up spontaneously by the age of one year.
All cases of conjunctivitis are not caused by infection. Allergy to substances like pollen, dust or chemicals can also cause the mucous lining of the eyes and airways to respond by releasing chemicals like histamine. This can result in itchy, red and watery eyes, a running nose and sneezing.
Non-steroidal anti allergy eye drops containing sodium chromoglycate are usually all that is needed to clear this. The eyes may respond faster to over-the-counter steroid eye drops but if the diagnosis is wrong, they can cause a flare up of the infection.
Chemicals like chlorine in swimming pools or detergents in soap and shampoo can cause a conjunctivitis-like response. Flushing the eye with clean water usually cures the problem within a day.
Dust particles, saw dust and other foreign bodies can be accidentally imbedded in the eye. An eyelash may also grow inwards. Both these cause constant irritation, redness and watering. If this occurs, you need to consult an ophthalmologist.
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
What do people fear most? When do they rush to a doctor? Apparently the greatest fear is death, followed by loss of vision and cancer, probably in that order. This is the reason why people rush to a doctor when anything goes wrong with their eyes.
The current epidemic of conjunctivitis (also called Madras / Delhi eye, pink / red eye, or joybangla) has people really worried. Not only is the infection uncomfortable — the eyes are red, itchy and swollen — but also it spreads like wildfire.
Conjunctivitis occurs when the transparent membrane that lines the eyelids and part of the eyeball becomes inflamed and red. This may be due to an allergy, infection, a foreign body or blocked tear duct. The redness appears because the small blood vessels in the conjunctiva react to it. If the infection is severe the conjunctiva may be swollen. The eye may then feel gritty and itchy, shed tears and have a yellow or white discharge.
Infection is often due to a seasonal bug — an adeno or influenza virus. It may be associated with a cold or sore throat. These infections are self-limiting. Cold or warm compresses applied to the eyes can be soothing. It does not really require any treatment with eye drops and clears up spontaneously in three or four days.
The discharge in bacterial conjunctivitis can be yellow and purulent (containing pus). This requires antibiotic eye drops. These are effective when applied every two or three hours. An eye ointment may be applied at night.
Infectious conjunctivitis (viral or bacterial) can spread rapidly within a classroom, home or community. Contrary to popular belief, just looking at an affected person does not cause the infection to spread. The virus or bacteria gets transferred from the infected person’s eyes on to table tops, books and other frequently used items. If an uninfected person touches a contaminated surface, and then his or her eyes, the infection is transferred. Wearing dark glasses reduces photophobia due to the infection and prevents people from touching and rubbing their own eyes.
If you develop conjunctivitis:
• Don’t touch your eyes. Don’t itch or scratch
• Wash your hands often
• Use a clean towel which must be changed daily. Don’t share towels
• Change your pillow cases everyday
• Don’t share eye cosmetics or personal eye-care items (like mascara and kajal)
• Apply a compress to your eyes by soaking a clean cloth in water and applying it gently to your closed eyelids. Don’t touch both eyes with the same cloth. This reduces the risk of spreading red eye from one eye to the other
• Clean the crusts from the eyelids with a solution of 1 part of baby shampoo to 10 parts of warm water
• Stop wearing contact lenses until the infection completely clears up.
Children with viral conjunctivitis rapidly transmit the infection to their classmates. They should stay at home if infected and return to school only when the eyes no longer have a discharge. This may take around a week.
During the process of birth, a baby’s eyes can become contaminated by organisms present in the birth canal. An antibiotic ointment or drops are usually applied soon after birth to the infant’s eyes to prevent infection. In ancient civilisations, these infections were recognised and treated by applying a few drops of expressed breast milk to the baby’s eyes. Breast milk contains high concentrations of immunoglobulin which can protect against infection.
Sometimes, the tear ducts in babies are blocked. This occurs because either they are not yet fully developed or have been partially blocked by debris during the process of birth. This causes constant tearing of the affected eye and can result in a secondary infection. It usually clears up spontaneously by the age of one year.
All cases of conjunctivitis are not caused by infection. Allergy to substances like pollen, dust or chemicals can also cause the mucous lining of the eyes and airways to respond by releasing chemicals like histamine. This can result in itchy, red and watery eyes, a running nose and sneezing.
Non-steroidal anti allergy eye drops containing sodium chromoglycate are usually all that is needed to clear this. The eyes may respond faster to over-the-counter steroid eye drops but if the diagnosis is wrong, they can cause a flare up of the infection.
Chemicals like chlorine in swimming pools or detergents in soap and shampoo can cause a conjunctivitis-like response. Flushing the eye with clean water usually cures the problem within a day.
Dust particles, saw dust and other foreign bodies can be accidentally imbedded in the eye. An eyelash may also grow inwards. Both these cause constant irritation, redness and watering. If this occurs, you need to consult an ophthalmologist.
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, October 25, 2010
10 steps for health
10 steps to a long life
YOUR HEALTH
--------------------------------------------------------------------------------
DR GITA MATHAI
As we grow older and mature, the habit of reading the newspaper too grows. Everyday we find a wealth of information on health in newspapers, books and magazines, and wonder: what do we really need to do to stay fit?
1 Body weight
Body weight is a dynamic equation between the calories consumed and the level of activity. At all ages, we need to maintain our BMI (body mass index) — which is calculated by dividing the weight in kilograms by the height in metre squared — at 23.
Obesity (BMI over 30) is associated with a host of diseases like arthritis, diabetes, hypertension and cancer. It can be tackled by reducing the food intake and increasing the amount of exercise.
Being “size zero” with a BMI of 20 or less (underweight) may be fashionable if you are a model, but actually it’s a sign of ill health. It is associated with menstrual irregularities, poor pregnancy outcome and weak bones. Such a condition is often due to inadequate food intake. Correction of the diet will cause a weight gain. It may also be due to caries in the teeth, diabetes, thyroid problems, malabsorption, cancer and other chronic illnesses.
The number of calories needed a day varies from person to person. For weight loss it is 20 calories / kg, maintenance requires 30 calories / kg and for weight gain it is 40 calories / kg. These are approximate values and need to be adjusted according to activity levels.
2. Heart disease
Heart disease now affects men even in their thirties. Women are protected by their hormones till menopause. After that there is no difference between the sexes. You can take charge of your heart by not smoking as well as preventing exposure to second hand smoke. Include at least an hour of walking, jogging or running every day. Reduce stress with yoga or meditation.
3. Diet
The diet should be rich in vegetables, fruits, whole grains, fibre and fish (in the case of non-vegetarians). Snacking on readymade foods high in saturated fat and sodium is unhealthy.
4. Exercise
The current recommendations are an hour of aerobic activity like jogging, walking or swimming and 20 minutes of stretching or yoga every day.
5. The big C
Prevention and early detection of cancer can increase the lifespan considerably. Correct weight, regular exercise, a healthy diet, not smoking, and drinking in moderation contributes to the prevention of cancer. Hepatitis B immunisation protects against liver cancer, and HPV (human papillovirus virus) vaccine against cervical cancer. Regular “pap smear” tests, breast self examination and mammography detect cancers early in women. For men over 50, colonoscopy (in high-risk individuals) and PSA (prostate specific antigen) test should be regularly done.
6. Injuries
In India, over 80,000 persons die in road accidents annually, over 1.2 million get injured seriously and about 3,00,000 disabled permanently. Many motorbike accidents can be prevented if both the rider and pillion rider use crash helmets. While travelling in a car, everyone should use seat belts, not just on the highway but even for short distances within the city.
In the house, falls can occur on staircases and in bathrooms. These areas should be well lit. In addition, bars should be fixed in the toilet so that older people can grasp it firmly for support.
7. Master health checkups
A physical examination should be done every year, recording the height, weight, blood pressure, general condition of the heart, lungs and abdomen. The eyes and teeth should also be evaluated annually. Routine master health checkups offered by laboratories often have tests that are not required for a particular person. Some of the “package deals” may be unnecessarily expensive. It is best to go to your physician and do the tests you require. Some tests like haemoglobin, blood sugars and a lipid profile have to be repeated every year.
8. Chronic disease
If you have diabetes, kidney disease or some other chronic ailment, adhere to your diet and take your pills regularly. Keep all your follow-up appointments and do the blood tests on schedule. Complications of disease set in when patients are non-compliant.
9. Immunisations
Older people need influenza injections in September-October. The vaccine protects against the strain causing “flu” that year. When there is a pandemic (as there is this year of swine flu), that particular vaccine should also be taken. For those over 65, pneumococcal vaccine needs to be taken as a single dose.
10. Health supplements
Bone loss occurs in older people, in both men and women. Calcium supplements (around 1,200 mg a day) are needed to prevent this.
Tonics and protein supplements are not needed.
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 and mature, the habit of reading the newspaper too grows. Everyday we find a wealth of information on health in newspapers, books and magazines, and wonder: what do we really need to do to stay fit?
1 Body weight
Body weight is a dynamic equation between the calories consumed and the level of activity. At all ages, we need to maintain our BMI (body mass index) — which is calculated by dividing the weight in kilograms by the height in metre squared — at 23.
Obesity (BMI over 30) is associated with a host of diseases like arthritis, diabetes, hypertension and cancer. It can be tackled by reducing the food intake and increasing the amount of exercise.
Being “size zero” with a BMI of 20 or less (underweight) may be fashionable if you are a model, but actually it’s a sign of ill health. It is associated with menstrual irregularities, poor pregnancy outcome and weak bones. Such a condition is often due to inadequate food intake. Correction of the diet will cause a weight gain. It may also be due to caries in the teeth, diabetes, thyroid problems, malabsorption, cancer and other chronic illnesses.
The number of calories needed a day varies from person to person. For weight loss it is 20 calories / kg, maintenance requires 30 calories / kg and for weight gain it is 40 calories / kg. These are approximate values and need to be adjusted according to activity levels.
2. Heart disease
Heart disease now affects men even in their thirties. Women are protected by their hormones till menopause. After that there is no difference between the sexes. You can take charge of your heart by not smoking as well as preventing exposure to second hand smoke. Include at least an hour of walking, jogging or running every day. Reduce stress with yoga or meditation.
3. Diet
The diet should be rich in vegetables, fruits, whole grains, fibre and fish (in the case of non-vegetarians). Snacking on readymade foods high in saturated fat and sodium is unhealthy.
4. Exercise
The current recommendations are an hour of aerobic activity like jogging, walking or swimming and 20 minutes of stretching or yoga every day.
5. The big C
Prevention and early detection of cancer can increase the lifespan considerably. Correct weight, regular exercise, a healthy diet, not smoking, and drinking in moderation contributes to the prevention of cancer. Hepatitis B immunisation protects against liver cancer, and HPV (human papillovirus virus) vaccine against cervical cancer. Regular “pap smear” tests, breast self examination and mammography detect cancers early in women. For men over 50, colonoscopy (in high-risk individuals) and PSA (prostate specific antigen) test should be regularly done.
6. Injuries
In India, over 80,000 persons die in road accidents annually, over 1.2 million get injured seriously and about 3,00,000 disabled permanently. Many motorbike accidents can be prevented if both the rider and pillion rider use crash helmets. While travelling in a car, everyone should use seat belts, not just on the highway but even for short distances within the city.
In the house, falls can occur on staircases and in bathrooms. These areas should be well lit. In addition, bars should be fixed in the toilet so that older people can grasp it firmly for support.
7. Master health checkups
A physical examination should be done every year, recording the height, weight, blood pressure, general condition of the heart, lungs and abdomen. The eyes and teeth should also be evaluated annually. Routine master health checkups offered by laboratories often have tests that are not required for a particular person. Some of the “package deals” may be unnecessarily expensive. It is best to go to your physician and do the tests you require. Some tests like haemoglobin, blood sugars and a lipid profile have to be repeated every year.
8. Chronic disease
If you have diabetes, kidney disease or some other chronic ailment, adhere to your diet and take your pills regularly. Keep all your follow-up appointments and do the blood tests on schedule. Complications of disease set in when patients are non-compliant.
9. Immunisations
Older people need influenza injections in September-October. The vaccine protects against the strain causing “flu” that year. When there is a pandemic (as there is this year of swine flu), that particular vaccine should also be taken. For those over 65, pneumococcal vaccine needs to be taken as a single dose.
10. Health supplements
Bone loss occurs in older people, in both men and women. Calcium supplements (around 1,200 mg a day) are needed to prevent this.
Tonics and protein supplements are not needed.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Saturday, October 9, 2010
stop dengue
Stop dengue in its tracks
Your Health
--------------------------------------------------------------------------------
DR GITA MATHAI
India has had a good monsoon this year. Rivers are flooded and stagnant water can be seen everywhere. Urbanisation has resulted in a proliferation of improperly planned cities — with slums, and poor sanitation and sewage. This has provided mosquitoes with excellent breeding grounds. The population explosion in the insects has resulted in epidemics such as dengue.
Dengue fever is caused by the Aedes egypti mosquito. Culex and Anopheles mosquitoes (which cause diseases like malaria and filaria) are nocturnal — that is, they emerge and bite at night. They can be effectively kept at bay by using mosquito nets while sleeping at night. Aedes egypti, however, is a daytime urban insect. It cannot live above 1,220m or fly more than a hundred metres. It is easily identifiable — its body is striped like that of a tiger. It lives in houses and breeds in stagnant water. This could be in flower vases, old tyres, upturned bottle caps, and even water that collects on leaves and plants.
Eradication of their breeding grounds is, therefore, a Herculean task, which cannot be achieved by the government alone. Citizens need to do their bit, awaken their civic sense and keep their neighbourhood garbage free. At home, flower vases, water cooler trays, and all sorts of open containers — including broken mugs and bottle caps — should be emptied.
The government often uses “fogs” or sprays of insecticides to reduce the population of Aedes egypti in populated areas. The sprays need to be used every eight to 10 days to interrupt the cycle of virus transmission. Also, people must leave their doors and windows open so that the insecticide can penetrate indoors, into the nooks and crannies where the mosquitoes rest. We often close all openings to prevent the “harmful chemicals” from entering inside. This negates the effects of spraying.
Once an infected mosquito bites, there is an asymptomatic incubation period of five to six days. After this, dengue sets in abruptly with headache and high fever. There is pain behind the eyes and on moving the eyes. Severe body ache makes it difficult for the person to move, giving dengue the nickname “back breaking” fever. There may be rashes on the skin and inside the mouth. There may also be bleeding into the conjunctiva of the eyes, making them appear blood shot.
After three or four days, the temperature returns to normal. But this is only a temporary respite; the fever returns a few days later with all the previous symptoms but in a milder form. Dengue is, therefore, also called “saddle back” fever.
Unfortunately, there is no specific treatment for dengue. There is no vaccination (as yet) to prevent infection or specific antiviral medication to combat the condition. Affected persons have to ride out the disease with supportive treatment, hoping for the best. Treatment is symptomatic with paracetamol for lowering the fever and fluids for hydration. Aspirin and non-steroidal anti-inflammatory agents like brufen must be avoided. Blood transfusions may have to be given if there is bleeding and shock.
The first attack of dengue usually takes a few weeks to completely recover from. Overall, the disease has a five per cent mortality. It is especially dangerous in children. The dangerous form, called dengue haemorrhagic fever, which is accompanied by shock and bleeding, occurs with subsequent infections with the virus, especially if they are of a different “serotype”.
Humans are infective during the first three days when the virus is multiplying in the blood. During this period, it’s important they lie inside a mosquito net all day and night. This is to prevent them from infecting other members of the household.
The diagnosis is made by excluding other causes of fever. Blood tests may show a low white cell count and platelets. There are, however, some confirmatory tests, like complement fixation, Elisa and an increasing number of antibodies.
Dengue is a self-limited disease. The severity of the symptoms depends on the serotype of the virus, immunological status of the host and, to some extent, genetics.
Herbal products — such as fresh leaves and extracts of neem and tulasi — are being investigated for their anti viral and immune boosting properties. The results are not conclusive. Claims and counterclaims about the efficacy of herbal products are difficult to evaluate. Double blind control studies have not yet been done to prove or disprove their efficacy.
One can prevent mosquito bites to a certain extent by wearing long-sleeved clothing, sleeping inside a mosquito net, and using mosquito meshes for windows and doors. Water should not be allowed to stagnate in containers in and around residential areas. Adding a handful of rock salt or pouring kerosene into stagnant water prevents mosquitoes from breeding.
Remember, no vaccine or specific treatment exists — the only way to escape dengue is to prevent being stung by these pesky insects.
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
India has had a good monsoon this year. Rivers are flooded and stagnant water can be seen everywhere. Urbanisation has resulted in a proliferation of improperly planned cities — with slums, and poor sanitation and sewage. This has provided mosquitoes with excellent breeding grounds. The population explosion in the insects has resulted in epidemics such as dengue.
Dengue fever is caused by the Aedes egypti mosquito. Culex and Anopheles mosquitoes (which cause diseases like malaria and filaria) are nocturnal — that is, they emerge and bite at night. They can be effectively kept at bay by using mosquito nets while sleeping at night. Aedes egypti, however, is a daytime urban insect. It cannot live above 1,220m or fly more than a hundred metres. It is easily identifiable — its body is striped like that of a tiger. It lives in houses and breeds in stagnant water. This could be in flower vases, old tyres, upturned bottle caps, and even water that collects on leaves and plants.
Eradication of their breeding grounds is, therefore, a Herculean task, which cannot be achieved by the government alone. Citizens need to do their bit, awaken their civic sense and keep their neighbourhood garbage free. At home, flower vases, water cooler trays, and all sorts of open containers — including broken mugs and bottle caps — should be emptied.
The government often uses “fogs” or sprays of insecticides to reduce the population of Aedes egypti in populated areas. The sprays need to be used every eight to 10 days to interrupt the cycle of virus transmission. Also, people must leave their doors and windows open so that the insecticide can penetrate indoors, into the nooks and crannies where the mosquitoes rest. We often close all openings to prevent the “harmful chemicals” from entering inside. This negates the effects of spraying.
Once an infected mosquito bites, there is an asymptomatic incubation period of five to six days. After this, dengue sets in abruptly with headache and high fever. There is pain behind the eyes and on moving the eyes. Severe body ache makes it difficult for the person to move, giving dengue the nickname “back breaking” fever. There may be rashes on the skin and inside the mouth. There may also be bleeding into the conjunctiva of the eyes, making them appear blood shot.
After three or four days, the temperature returns to normal. But this is only a temporary respite; the fever returns a few days later with all the previous symptoms but in a milder form. Dengue is, therefore, also called “saddle back” fever.
Unfortunately, there is no specific treatment for dengue. There is no vaccination (as yet) to prevent infection or specific antiviral medication to combat the condition. Affected persons have to ride out the disease with supportive treatment, hoping for the best. Treatment is symptomatic with paracetamol for lowering the fever and fluids for hydration. Aspirin and non-steroidal anti-inflammatory agents like brufen must be avoided. Blood transfusions may have to be given if there is bleeding and shock.
The first attack of dengue usually takes a few weeks to completely recover from. Overall, the disease has a five per cent mortality. It is especially dangerous in children. The dangerous form, called dengue haemorrhagic fever, which is accompanied by shock and bleeding, occurs with subsequent infections with the virus, especially if they are of a different “serotype”.
Humans are infective during the first three days when the virus is multiplying in the blood. During this period, it’s important they lie inside a mosquito net all day and night. This is to prevent them from infecting other members of the household.
The diagnosis is made by excluding other causes of fever. Blood tests may show a low white cell count and platelets. There are, however, some confirmatory tests, like complement fixation, Elisa and an increasing number of antibodies.
Dengue is a self-limited disease. The severity of the symptoms depends on the serotype of the virus, immunological status of the host and, to some extent, genetics.
Herbal products — such as fresh leaves and extracts of neem and tulasi — are being investigated for their anti viral and immune boosting properties. The results are not conclusive. Claims and counterclaims about the efficacy of herbal products are difficult to evaluate. Double blind control studies have not yet been done to prove or disprove their efficacy.
One can prevent mosquito bites to a certain extent by wearing long-sleeved clothing, sleeping inside a mosquito net, and using mosquito meshes for windows and doors. Water should not be allowed to stagnate in containers in and around residential areas. Adding a handful of rock salt or pouring kerosene into stagnant water prevents mosquitoes from breeding.
Remember, no vaccine or specific treatment exists — the only way to escape dengue is to prevent being stung by these pesky insects.
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, September 28, 2010
hypertension
Don’t worry, get moving
YOUR HEALTH
DR GITA MATHAI
Hypertension or high blood pressure (BP) is like a thief who creeps in without warning in the dead of the night. That’s because the disease produces practically no symptoms.
People rarely develop giddiness, headaches or nose bleeds until the hypertension is very high. The first sign that there is something wrong may be a complication like a heart attack, stroke or ruptured aneurysm.
Blood pressure is optimal when it is 120/80 mmHg (millimetres of mercury) or less. It is considered normal even if it is 130/90 and high when it is 140/90 or more. Values of 130-140/85-99 are considered in the prehypertension category. Blood pressure needs to be monitored every two years after the age of 20 and yearly after 40.
Some kidney and adrenal gland diseases and diabetes can cause a rise in BP. It can also occur with certain medications like the oral contraceptive pill, some pain relieving medications and even decongestant cough syrups. Pregnancy may cause a peculiar type of hypertension called pre-eclampsia. In these patients, hypertension can revert to normal if the aggravating condition is tackled.
Doctors, too, can precipitate hypertension in normal people. The mere thought of a medical check-up and sight of the blood pressure apparatus can set the heart racing and blood pressure soaring. This is called “white coat hypertension”. If these people are monitored for 24 hours as they go about their daily activities, their BP is found to be normal. They do not require treatment.
Hypertension usually sets in during middle age. The exact reason is not known. Genes, the environment and upbringing count. Though it is not due to a single inherited gene, it’s more likely to occur if one or both parents are hypertensive.
Ideally, those with hypertension should monitor their BP at home to make sure it is under control. This way, they can immediately consult a doctor if it seems to be fluctuating or elevated. Wrist and cuff apparatuses are available that show automatic readings. The arm should be straight and on level with the heart while doing this.
Though a reading of 120/80 is ideal, doctors may set a target that is slightly higher in older people.
High BP should not be ignored. It must be treated and kept under control. Untreated, it makes the blood vessels thicken and less pliable. The blood supply to the brain is then affected. This can lead to loss of memory, balance, reasoning and other changes of dementia. It can cause a stroke with paralysis of parts of the body. The heart, unable to pump against high resistance, may fail or there may be a heart attack.
There are several groups of medicines to control hypertension. They should be taken exactly as advised. Timing is important – they pills should be swallowed as per schedule, even on fasts. They should not be taken in the morning one day and in the evening the next.
To prevent hypertension, and help lower the pressure once it has set in, the diet should have no high calorie snacks or junk food, be low in fat and dairy products, and rich in fruits and vegetables.
Fruits and nuts contain potassium and magnesium. The minerals balance the effect of sodium or salt in the diet. Salt causes the body to retain water and this elevates the BP. Salt consumption should be 2.5gm (1/2 tsp) per person a day. The “hidden salt” in aerated drinks, health supplements and preserved food should be taken into account. The taste for salt is developed at a very young age and depends on one’s cooking and eating habits.
A sedentary lifestyle results in a tendency to gain weight. The BMI (or body mass index — weight divided by height in metre squared) should be 23. Obesity (BMI greater than 30) increases the work of the heart and blood vessels. At least 40 to 60 minutes of active exercise should be incorporated into the every day schedule.
Tobacco in any form (gutkha, chewing tobacco, snuff, beedis and cigarettes) aggravates hypertension. When it comes to tobacco, there can be no halfway measures. Use has to be completely stopped. Alcohol, too, raises the BP. If you must drink, consumption should be limited to 60ml a day for men (two drinks) and 30ml a day for women.
Sustained stress, at home or in the workplace, also elevates the BP. Worry has never provided a solution to a problem. It just produces further problems. Exercise, deep breathing, yoga and meditation are good stress busters. Try them.
And for those who are not affected and want to remain that way, get up and get moving. Now.
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
Hypertension or high blood pressure (BP) is like a thief who creeps in without warning in the dead of the night. That’s because the disease produces practically no symptoms.
People rarely develop giddiness, headaches or nose bleeds until the hypertension is very high. The first sign that there is something wrong may be a complication like a heart attack, stroke or ruptured aneurysm.
Blood pressure is optimal when it is 120/80 mmHg (millimetres of mercury) or less. It is considered normal even if it is 130/90 and high when it is 140/90 or more. Values of 130-140/85-99 are considered in the prehypertension category. Blood pressure needs to be monitored every two years after the age of 20 and yearly after 40.
Some kidney and adrenal gland diseases and diabetes can cause a rise in BP. It can also occur with certain medications like the oral contraceptive pill, some pain relieving medications and even decongestant cough syrups. Pregnancy may cause a peculiar type of hypertension called pre-eclampsia. In these patients, hypertension can revert to normal if the aggravating condition is tackled.
Doctors, too, can precipitate hypertension in normal people. The mere thought of a medical check-up and sight of the blood pressure apparatus can set the heart racing and blood pressure soaring. This is called “white coat hypertension”. If these people are monitored for 24 hours as they go about their daily activities, their BP is found to be normal. They do not require treatment.
Hypertension usually sets in during middle age. The exact reason is not known. Genes, the environment and upbringing count. Though it is not due to a single inherited gene, it’s more likely to occur if one or both parents are hypertensive.
Ideally, those with hypertension should monitor their BP at home to make sure it is under control. This way, they can immediately consult a doctor if it seems to be fluctuating or elevated. Wrist and cuff apparatuses are available that show automatic readings. The arm should be straight and on level with the heart while doing this.
Though a reading of 120/80 is ideal, doctors may set a target that is slightly higher in older people.
High BP should not be ignored. It must be treated and kept under control. Untreated, it makes the blood vessels thicken and less pliable. The blood supply to the brain is then affected. This can lead to loss of memory, balance, reasoning and other changes of dementia. It can cause a stroke with paralysis of parts of the body. The heart, unable to pump against high resistance, may fail or there may be a heart attack.
There are several groups of medicines to control hypertension. They should be taken exactly as advised. Timing is important – they pills should be swallowed as per schedule, even on fasts. They should not be taken in the morning one day and in the evening the next.
To prevent hypertension, and help lower the pressure once it has set in, the diet should have no high calorie snacks or junk food, be low in fat and dairy products, and rich in fruits and vegetables.
Fruits and nuts contain potassium and magnesium. The minerals balance the effect of sodium or salt in the diet. Salt causes the body to retain water and this elevates the BP. Salt consumption should be 2.5gm (1/2 tsp) per person a day. The “hidden salt” in aerated drinks, health supplements and preserved food should be taken into account. The taste for salt is developed at a very young age and depends on one’s cooking and eating habits.
A sedentary lifestyle results in a tendency to gain weight. The BMI (or body mass index — weight divided by height in metre squared) should be 23. Obesity (BMI greater than 30) increases the work of the heart and blood vessels. At least 40 to 60 minutes of active exercise should be incorporated into the every day schedule.
Tobacco in any form (gutkha, chewing tobacco, snuff, beedis and cigarettes) aggravates hypertension. When it comes to tobacco, there can be no halfway measures. Use has to be completely stopped. Alcohol, too, raises the BP. If you must drink, consumption should be limited to 60ml a day for men (two drinks) and 30ml a day for women.
Sustained stress, at home or in the workplace, also elevates the BP. Worry has never provided a solution to a problem. It just produces further problems. Exercise, deep breathing, yoga and meditation are good stress busters. Try them.
And for those who are not affected and want to remain that way, get up and get moving. Now.
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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