Glaucoma is the leading cause of irreversible blindness around the world and, as per the National Programme for Control of Blindness, the third leading cause of blindness in India. Glaucoma, popularly known as ‘kaala motiya’ is asymptomatic in its early stages and leads insidiously to an irreversible visual impairment. However, early detection can halt the progress of the condition and prevent loss of vision.
WHAT IS GLAUCOMA?
Glaucoma refers to a condition of the eye where an increased pressure (unrelated to blood pressure) leads to the damage of the optic nerve. This damage is irreversible and once lost, vision cannot be restored by medication or surgery.
The real challenge in the diagnosis of this disease is its symptomatology and its slow progression. It is usually asymptomatic in the early stages, although a patient may complain of increased problems with near vision, occasional headache and loss of peripheral vision. In India, where the majority of visual complaints is still managed by the shorter route of getting a fancy new pair of glasses from the nearest optical shop, a thorough eye examination is often missed. The diagnosis of glaucoma, a condition which is usually picked up by an ophthalmologist in a routine eye examination, gets delayed. Asymptomatic glaucoma is thus allowed to follow its relentless course towards severe visual loss before medical attention is sought. A patient may even ignore glaucoma-induced blindness in one eye as long as the other eye remains functional, not realising that the same fate is slowly unfolding for the better eye.
DO I HAVE AN INCREASED RISK OF DEVELOPING GLAUCOMA?
There are various known risk factors for the development of glaucoma, with age being one of them. People over 40 years are at a relatively higher risk of developing glaucoma. With a strong genetic linkage, a positive family history also increases the risk of developing glaucoma by up to ten times. So, if someone has glaucoma, they must get blood relatives tested as well.
Apart from age and genetics, myopia, migraine, diabetes, hypertension, thyroid and trauma to the eye also increase the risk of developing glaucoma.
WHAT SHOULD I DO AFTER THE DOCTOR TELLS ME I HAVE GLAUCOMA?
Remember that damage caused by glaucoma is permanent and irreversible. Once glaucoma is detected, the treating ophthalmologist performs certain tests to quantify the visual impairment and find the subtype of glaucoma. Subsequently, patients are advised medication, laser therapy, surgery in advanced cases, or a combination of these. The treatment given aims to halt the progression of the disease by bringing down the eye pressure, but it cannot reverse the visual loss which has already occurred.
Treating glaucoma successfully requires the team effort of the treating doctor and the patient. It is imperative that the patient does not discontinue medication without consulting the doctor. Compliance with the prescribed medication is extremely important as any spike in eye pressure can have deleterious effects on a glaucomatous eye.
The diagnosis of glaucoma is often shocking for the patient who perhaps went prepared only for being prescribed new glasses. The possibility of having a chronic, potentially blinding disease is difficult for the patient to accept, hence communicating clearly for better understanding and laying out a clear plan of action are important. Even when glaucoma has already delivered a harsh lesson, careful education is still needed to help the patient understand the nature of the disease, the rationale for treatment and the importance of compliance.
For a patient affected by glaucoma, the impact can be profound, which can include difficulty with mobility, driving, employment and depression. A high level of awareness and knowledge of this silent killer of the eye is the need of the hour. For public awareness and patient education, there are various portals and websites by numerous ophthalmological societies across India. A timely diagnosis, initiation of treatment and compliance with treatment lifelong can conquer this potentially blinding disease.
So, the next time you have any symptoms related to your eyes, book an appointment with an ophthalmologist without delay and kick this devil out before it knocks you out.
The writer is Consultant Ophthalmologist, NKS Hospital, Delhi.
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CANCER SURVIVORS MAY EXPERIENCE AGEING SOONER
A new research indicated that cancer survivors, especially older people, are more likely to experience accelerated functional decline as they age, compared with those without a history of cancer.
The research was published in the ‘Journal of the American Geriatrics Society’. As per the research, between 2006 to 2019, 1728 men and women (aged 22 to 100 years) were evaluated, with 359 of these adults reporting a history of cancer.
Among all participants, a history of cancer was associated with a 1.42 greater odds of weak grip strength. Among participants older than 65 years of age, those with a history of cancer had a 1.61 greater odds of slow gait speed than those with no cancer history, and they had lower physical performance scores.
Also, older individuals with a history of cancer experienced steeper declines in grip strength and gait speed compared with older adults with no history of cancer.
“Findings from our study add to the evidence that cancer and its treatment may have adverse effects on ageing-related processes, putting cancer survivors at risk for accelerated functional decline,” said senior author Lisa Gallicchio, PhD, of the National Cancer Institute.
“Understanding which cancer survivors are at highest risk, and when the accelerated decline in physical functioning is most likely to begin, is important in developing interventions to prevent, mitigate, or reverse the adverse ageing-related effects of cancer and its treatment,” concluded Gallicchio.
Dos and Don’ts for new mothers during pandemic
During the current times of the Covid-19 pandemic where every one of us is trying to be perfect in adhering to the Covid-19 precautions and following hygiene regimes like never before, but there is still a lot of information out there which people are still discovering. From washing our hands numerous times in a day to the usage of disinfectants and sanitisers, we are trying to do whatever it takes to keep ourselves and our loved ones safe and protected from infections and diseases. Talking about precautions, there are basic steps that everyone is aware of and must be following as per the advisories of health experts.
We understand that the outbreak of this pandemic and subsequent lockdowns have been tough and stressful for everyone, especially for new mothers who are breastfeeding and concerned about their baby’s health. In usual times, new parents could seek out social support and external help — but in current times given the restricted movements and social distancing, they have a lot of doubts and questions in their minds regarding breastfeeding and possible infections.
Here are some do’s and don’ts to get every new mom started on the right foot to safely breastfeed during the pandemic.
• First and foremost, breastfeed the baby: As soon as the child is delivered, the child must be breastfed within the very first hour. This is because Colostrum, that is the milk secreted during the first three days by the mother is rich in proteins and anti-infective nutrients that help build the child’s immunity and is essential for his healthy growth & development.
• Practice simple yet crucial hygiene measures while breastfeeding: to ensure that cleanliness and keeping viruses/infections at bay, it is essential to practice the basic hygiene steps such as washing hands thoroughly with soap and water before and after touching your baby.
• Wearing a face mask: It has been seen that some moms also wear a face mask while nursing especially if someone else is sick in the house. Therefore, to protect the baby fully, mothers may choose to wear a mask during feeding as a routine.
• Regular Disinfection of baby utilities: Apart from following the basic hygiene practices, new mothers must regularly and thoroughly clean and sterilise all baby feeding products after every use. If using a disinfectant for cleaning the products or surfaces, it is advisable to use a disinfecting liquid specially formulated for cleaning baby products or one must use sterilisers for cleaning baby utilities.
• Mothers must pay attention to their health: The challenges of new mothers can certainly feel overwhelming sometimes. Rest as much as you can — try sleeping when the baby does. Find time for yourself and relax when your partner or other caring adult watches the baby.
• Connect with family and friends: We understand that social distancing during the ongoing Covid-19 pandemic can be isolating. Try video chats or social media to stay in touch with relatives and friends. This can help new mothers with emotional and social support.
• Precautions: While being sick, it is essential to take extra precautions like keeping distance from the baby, cleaning the breast pumps or spoons used to feed the baby, avoid touching the baby’s face, eyes, nose, or mouth with unwashed hands etc. Also, be sure to clean visibly dirty or possibly contaminated surfaces your infant may touch.
Every new mom can be considerably worried to keep their newborn safe during the Covid-19 pandemic, but they should remember that Breastfeeding has many important health benefits for babies and mothers both and must be continued with precautions and guidance from the paediatrician or the doctor whenever necessary.
The writer is CEO, Artsana India (Chicco), in assistance with Chicco Research Centre.
We understand that social distancing during the ongoing Covid-19 pandemic can be isolating. Try video chats or social media to stay in touch with relatives and friends. This can help new mothers with emotional and social support.
COVID-19 RECOVERED INDIVIDUALS WITH 2 COVISHIELD DOSES HAVE HIGHER IMMUNITY AGAINST DELTA VARIANT
A study conducted by the Indian Council of Medical Research (ICMR) and National Institute of Virology (NIV), Pune, has found that Covid-19-recovered individuals with both doses of Covishield have higher immunity against the Delta variant.
The study titled ‘Neutralisation Of Delta Variant With Sera of Covishield Vaccines And Covid-19 Recovered Vaccinated Individuals’ have assessed the neutralising antibody (NAb) response of individuals immunised with Covishield vaccine (first dose and second dose), Covid-19 recovered individuals who were vaccinated (first dose and second dose) and breakthrough infections (due to Kappa and the Delta variant). Delta variant has further mutated to Delta plus also known as AY.1.
It read, “The breakthrough cases and the Covid-recovered individuals with one or two doses of Covishield vaccine had relatively higher neutralising responses against the Delta variant in comparison to the participants who were administered either one or two doses of Covishield.”
Moreover, the study suggests that there should be tracking of ‘immune escape mutants’.
A comparative assessment of Covishield vaccinated individuals’ (n=116) sera in different categories was performed against prototype strain B.1 (D614G) and Delta variant.
Sera, under this study, were grouped into five categories: I. One dose (n=31), II. Two doses (n=31), III. Covid-19 recovered plus one dose (n=15), IV. Covid-19 recovered plus two doses (n=19) and V. Breakthrough Covid-19 cases (n=20).
All the sera were collected from the participants of the first four categories four weeks after vaccination. For the participants under the “breakthrough Covid-19 cases” category, the sera were collected two weeks after inoculating both doses, the study observes.
Currently, the vaccine appears to induce a robust hormonal and cellular immune response against the SARS-CoV 2 spike protein.
The earlier investigations demonstrated a reduction in NAb titers in the sera of Covishield vaccinees against the Kappa variant.
The study has found that it significantly lowers NAb titers for the Delta relative to B.1 variant.
However, it added that NAbs in breakthrough participants and the Covid-19 recovered individuals, who administered single or both doses, had relatively higher protection against Delta in comparison with individuals who took one or two-dose of Covishield.
Titer is a test that measures the presence and amount of antibodies in the blood. Through titer test the presence and amount of antibodies in the blood is measured.
BARIATRIC SURGERY IN COVID TIMES
With the ongoing pandemic and coronavirus mutating, is this the right time for a Bariatric surgery? Let’s find out.
Rahul Misra (name changed), who was always on the heavier side, became excessively overweight because of his lockdown-infused sedentary lifestyle. When his day-to-day life activity started getting affected because of his poor health condition, he decided to shed the weight through excessive exercise. But, as a result, he developed spine and joint injuries. When he visited a doctor, he was suggested to undergo bariatric surgery or weight loss surgery. The delay in surgery led to prolonged recovery and unnecessary ICU admission.
Health experts across the globe recommend that one shouldn’t delay bariatric surgery once indications and needs have been established. Weight gain and worsening of related diseases while awaiting surgery leads to poor quality of life and also slow recovery rates. Our sedentary lifestyle has contributed to many health problems and obesity is one of them. It has been quite dismal to see how the remote working and staying at home during the pandemic and has led to a rise in obesity in children of Delhi by 51% as per a recent report. The situation is not grim only in the national capital; the National family health survey of India has shown an increase in obesity in all of the Indian states.
COVID AND BARIATRIC SURGERY
The surge in obesity cases could be mainly due to the lifestyle and a change in diet pattern as people are mostly consuming processed food, which is causing a disturbance in metabolism and insulin resistance in their bodies. As the government has now lifted the restrictions on elective surgeries, it’s just the apt moment to go for it. This surgery is done when diet and exercise haven’t worked or when somebody has serious health problems because of the weight. Robotic surgery and endoscopic bariatrics are examples of how new technology has given us more options. Also, the industry has come up with improved stapling and suturing devices. Even the hospitals are adhering to all the Covid safety guidelines with their healthcare staff vaccinated; patients should get their bariatric surgery done without any hesitation. It is advisable that people who had decided to undergo bariatric surgery before the start of the pandemic should consider having it done sooner rather than later to avoid any further adverse health outcomes.
PROCEDURES OF BARIATRIC SURGERY: ROBOTIC SURGERY IS THE WAY AHEAD
One can opt for bariatric surgery if he/she has a BMI of 32.5, with specific significant health problems like Type 2 diabetes, sleep apnea or high blood pressure. A BMI of 37.5 or higher also is a qualifying criterion for the surgery. Depending on the BMI and patient requirements, endoscopic/laparoscopic/robotic surgery is offered. Endoscopic is preferred when a small amount of weight loss is needed and robotic is the choice in extreme cases. In robotic bariatric surgery, the latest in the field, the surgeon operates the procedures through a master console and the robotic patient cart operates through tiny holes on the patient similar to laparoscopy with much ease and precision. This procedure has many definite advantages over conventional laparoscopic surgery due to its 3D vision and precise intuitive multi-range instruments that add more safety to the patients. It also helps in better suturing skills and reduces post-operative pain and recovery time after surgery. Post-bariatric surgery, nutritional deficiencies can be a problem. However, it can be prevented by staying in close touch with the hospital team and following the dietary guidelines as suggested by the dietician.
The writer is Senior Gastrointestinal & Bariatric Surgeon, Apollo Hospitals, New Delhi.
Love Nature To Lessen Covid Anxiety
Young but fragile Himalaya is blessed with rich Biodiversity.Its valuable resources have traditionally served as the foundation for economic and cultural life of vast & vibrant population.
A few attitudinal differences and climate change developments coupled with variation in soil conservation create striking changes in the terrain having fabulous flora and fauna.Such a unique bio diversity not only encompasses ecological, scientific or economic values,it is a capital of inheritance,passed down generations, stressing the need for Sustainable Development.
2) Developments of past and present indicate ,however, extremes of biotic interference.Making wise use of bio diversity inheritance should not be tutored.It has to be felt ,imbibed and carried forward when one is confronted with the tentacles of Corona Auntie And whims & fancies of the Covid Uncle.Without entering into realm of discussion on the origin of the virus,one should believe that SARS II virus is an off shoot of the prevailing environment.An environment throttled by one and all..
Fauna Such As Elephants Need Fresh Look
3) Coming to judicious utilisation rather than exploitation of floral & faunal wealth, there may be a need for a fresh approach.Not only farming communities near forests have to be sensitized to extract forest and non forest timber products properly but they also have to be briefed to leave ENOUGH scope for growth and sustenance of grass,shrubs,water bodies etc, vital for life of animals,such as,Lions,Elephants,Tigers, Deer etc.While saying so,one is not aiming to touch upon the crucial Food Chain,
rather the purpose is to prick our mind specifically about the plight of gentle Elephants,who,being vegetarian,show full loyalty towards their masters.
Of 27,000 Asian Elephants in India,21% reside in Assam.Due to loss of forest habitat, they are increasingly coming face to face with humans.Every year,around 100 of them, unfortunately, get killed.They are also misused in the Tourism industry.The Wildlife Protection Act,1972 bans the sale of captive & unregistered elephants.
The mere fact that they live,eat and move in groups or clusters,goes on to show their strong family instincts,something reflected glaringly in:
A) Episode of 18 elephants in Nagaon,Assam in May,2021 crushed by lightening And
B) Freak,directionless walk of over 500 kms by 15 elephants in Kunming area of Yunan province of China in June,2021.
Sympathy Is Necessary
4) Despite the inherent friendly attitude of the elephants and many other animals often the reports of Entry into the human habitations, hit the head lines.There has to be some reason for such an entry.What they get in return is hectic,irrational and merciless action.The facial expression of the fauna in such a situation shows their State of helplessness. The onlookers, never the less ,get sarcastic pleasure in having an exciting glimpse.Whether it is a case of entry by the loveable Monkeys.,Leopards,Tigers or the Elephants into towns of different states, these should not be considered as an intrusion by the animals.
Assertion of Rights
5) It is felt that such a behavior has to be viewed as a valiant act of ASSERTION of rights by certain species to counter the actual intrusion into their bonafide habitat by the shrewd human beings.There should be no justification to suppress or subjugate the innocent animals either by mechanical or muscle power.
Will our Forest Service friends wake up and take requisite action especially during the current wave of Covid,when almost two dozen “positive” tigers and couple of similar infected lions have already left the world ?
.Lingering threat to pets & domestic animals who soothen our feelings when we are tired & exhausted, also fill the atmosphere,time and again.
5) Having stated so,I may humbly submit :
“When the animal instinct among the humans crosses conceivable limits,the actual and bonafide sons and daughters of mother earth are left with no alternative but to react vehemently or justifiably”.
6) It is not only the competition or tussle factor for a habitat between the animals and human beings, But it is a question of displaying adequate love and care for the natural endowments,indiscriminately gifted by the Almighty.
7) It may not be out of context to remind ourselves about the basic Hindu philosophy of emphasizing reverence to the flora and fauna right from childhood.For generations, plants, such as,Peepal,Banyan,Tulsi,Banana,Mango, etc.and the animals,namely,Cow,Bull,Lion,Tiger,Elephant,Monkey,Rat,Cobra snakes etc were being worshipped. Also the morning ritual of offering water to Sun God, Tulsi plant and Peepal tree not only has given the requisite faith & confidence to the worshippers but it can also teach us again the forgotten lesson to do everything possible to Preserve Flora & Fauna.
8) To Sum Up:
If we are mandated to avoid Social Interaction due to Corona virus and more lethal Third Wave, how can we afford to undermine similar “social” instinct among the animals?
Their state of hunger and helpless facial expressios during last two rounds of Lock Downs, calls for improving our overall attitude towards them. Timely food intake and sound health of fauna not only can improve their internal social behavior but it may also ensure a refined attitude towards their human handlers, caretakers or masters.
Even if we get rid of COVIDITY clinically, the love and affection displayed by the pets may prove much more valuable if not decisive in reducing our anxiety and depression. It may Ultimately Facilitate Satisfactory Healing of the Community.
VITAMIN D SUPPLEMENTS ARE INEFFECTIVE FOR TREATING PAINFUL IBS SYMPTOMS
A new study from the University of Sheffield has revealed that Vitamin D supplements are not an effective treatment for easing painful symptoms of Irritable Bowel Syndrome (IBS).
The findings of the study appeared in the European Journal of Nutrition. Scientists from the University’s Department of Oncology and Metabolism – in conjunction with a health supplement company, BetterYou – carried out trials on participants who suffer from the chronic condition of the digestive system to assess whether vitamin D reduced the severity of their symptoms and whether it could improve their quality of life.
Results of the study found that despite an improvement in vitamin D status in the participants in response to a vitamin D3 oral spray supplementation over a 12-week trial, there was no difference to their IBS symptom severity over the same period, nor a reported change in the participants’ quality of life.IBS is a common functional bowel disorder, characterized by chronically relapsing perturbed bowel habits. It causes symptoms such as stomach cramps, bloating, diarrhea and constipation.
For some, symptoms will come and go, but for others, it can severely affect their quality of life, often causing embarrassment leading to many living with the condition undiagnosed, affecting both mental health and wellbeing.
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