Showing posts with label Health. Show all posts
Showing posts with label Health. Show all posts

Saturday, May 16, 2009

ડાયાબિટીસની આંખ પર થતી અસર

આપણા દેશમાં ડાયાબિટીસ એક સામાન્ય રોગ છે. ડાયાબિટીસને કારણે શરીરમાં અનેક રોગો થઈ શકે છે. એક સર્વે મુજબ દુનિયાની કુલ વસ્તીના ૪.૫% લોકોને ડાયાબિટીસ હોય છે. પરંતુ ભારતમાં આ પ્રમાણ ઘણું વધારે છે અને દર વર્ષે વધતું જાય છે. આથી ૪૦ વર્ષથી ઉપરનાં લોકોએ ડાયાબિટીસની લોહી તપાસ નિયમિત કરાવવી ખૂબ જ જરૂરી છે.
ડાયાબિટીસની આંખ પર ઘણી અસર થાય છે. આંખના પડદા પર ડાયાબિટીસની અસર થવાથી એક અથવા બન્ને આંખોમાં દ્રષ્ટિ ઓછી થાય છે, જે અંતે અંધાપામાં પરિણમે છે. આમ અંધાપાના કારણોમાં ડાયાબિટીસ એક અગત્યનું કારણ છે. આંખની તથા પડદાની નિયમિત તપાસ અને સમયસર સારવારથી ડાયાબિટીસથી થતું અંધત્વ નિવારી અને અટકાવી શકાય છે.
ડાયાબિટીસથી આંખમાં થતી તકલીફોઃ

  • ચશ્માના નંબરમાં વારંવાર ફેરફાર થવો
  • ઝડપથી મોતિયો આવવો
  • ઝામર
  • આંખના સ્નાયુઓનો લકવો
  • આંખની નસ પર અસર થવી
  • આંખના પડદા પર સોજો આવવો/લોહી આવવુ
  • આંખમાં લોહી આવવુ
  • નજર ઓછી થવી
  • અજવાળામાંથી અંધારામાં ગયા પછી આંખને ટેવાવામાં સામાન્ય કરતાં વધુ સમય લાગવો
  • પડદો ખસી જવો

પડદા પર ક્યારે વિશેષ અસર થાય ?

  • લાંબા ગાળાનો ડાયાબિટીસ-૧૦ વર્ષથી વધુ
  • બાળપણમાં થતો ડાયાબિટીસ-૭ વર્ષથી વધુ
  • ઈન્સ્યુલીન લેતાં દર્દીઓ
  • સગર્ભાવસ્થાનો ડાયાબિટીસ
  • ડાયાબિટીસને કારણે કિડની પર અસર થઈ હોય તેવા દર્દીઓ
  • નજર ખૂબ ઓછી હોય ત્યારે

પડદા પર શું અસર થાય ?
ડાયાબિટીસને કારણે આંખના પડદાની લોહીની નળીઓ સૂકાય છે જેને કારણે પડદાને ઓક્સિજન ઓછા પ્રમાણમાં પહોંચે છે. પરિણામે પડદા પર સોજો આવે છે કે લોહી આવે છે. લાંબાગાળે લોહીની નળીઓ બંધ થઈ જાય છે અને તે ભાગનો પડદો કામ કરતો બંધ થાય છે. નવી લોહીની નળીઓ પડદામાં, પડદા ઉપર, નસ ઉપર અને વિટ્રિયસમાં વિકસે છે. આ નળીઓ પૂર્ણવિકસિત તંદુરસ્ત નળીઓ ન હોવાના કારણે આંખના સામાન્ય દબાણથી, જોરથી છીંક ખાવાથી કે ઝડપથી માથું ફેરવવાથી પણ ખુલી જાય છે અને આંખમાં લોહી આવી જાય છે તથા એકાએક નજર ઓછી થઈ જાય છે.
આંખની વિવિધ તપાસઃ

  • નજરનું માપ
  • આંખનું દબાણ માપવું
  • સ્લીટ લૅમ્પથી આંખના ભાગની ઝીણવટભરી તપાસ તથાપડદાની તપાસ
  • અલ્ટ્રાસોનોગ્રાફી
  • ફ્લોરેસીન એન્જીઓગ્રાફી
  • O.C.T. SCAN

સારવારઃ

  • ડાયાબિટીસ કાબુમાં રાખવો.
  • આંખની નિયમિત તપાસ આંખના નિષ્ણાંત ડૉક્ટર પાસે કરાવવી.
  • પડદા પર અસર જણાય તો ડૉક્ટર આરગન લેસર કે ઑપરેશનની સલાહ આપશે.
  • આરગન લેસરઃ લેસર સારવારનું મુખ્ય ધ્યેય પડદાનો સોજો કરવાનું છે જેથી નજર જળવાઈ રહે અથવા તો સુધરે. તદુપરાંત નવી લોહીની નળીઓને બંધ કરવામાં આવે છે, જેથી પડદા પર અને આંખોમાં લોહી આવતું અટકે અને નજર જાળવી શકાય. નજરમાં સુધારો ધીમેધીમે થતો હોય છે, જેમાં છ મહિના જેવો સમય લાગે છે. અગત્યની વાત એ છે કે પૂરતી સારવાર લીધા પછી પણ ઘણાં દર્દીઓને વારંવાર લોહી આવતું હોય છે અથવા પડદા પરની અસર આગળ વધતી રહે છે અને અંતે અંધાપો આવે છે. લેસરની સારવાર લેવાથી રોગ સંપૂર્ણપણે મટી જતો નથી. ડાયાબિટીસની સાથે અન્ય રોગો જેવા કે હાઈ બ્લડ પ્રેશર, હૃદય રોગ, ધમનીના રોગ કે કિડનીના રોગ હોય તો તેની સારવાર પણ જરુરી છે.
  • ઑપરેશનઃ જો આંખમાં આવેલું લોહી તેની જાતે ઓગળે નહીં, પડદા પર ખેંચાણ હોય અથવા તો પડદો ખસી જાય તો તેવા દર્દીઓને ઑપરેશનની જરુર પડે છે.


ડાયાબિટીસના દર્દીઓએ તેમની આંખની તપાસ દર છ મહિને કરાવવી ખૂબ જ આવશ્યક છે, જેથી ડાયાબિટીસને લીધે પડદા પર થતી અસરોનું વહેલું નિદાન અને સારવાર થઈ શકે.

Thursday, May 7, 2009

Do you suffer from Haemorrhoids(piles) ?

What are haemorrhoids ?

Haemorrhoids are bundle of veins in the rectum, which get swollen and bleed. Haemorrhoids may form on the inside or just at the opening of the anal canal. Accordingly, they are called internal or external haemorrhoids

What cause them ?
Haemorrhoids, which are normal structures present at the upper part of the anal canal are supported by two tissues: anchoring tissue & Park's ligament. Constant pressure on these tissues (e.g. straining when constipated or due to age) tends to degenerate the tissues. As a result the haemorrhoids tend to distend. Because of lack of support the haemorrhoids become swollen (like a balloon filled with water) and are now sensitive to injury. Constant rubbing by the hard faecal matter leads to bursting of the capillaries and thus leads to bleeding. As the condition progresses the connective tissue ruptures and the haemorrhoids become permanently protruded.

Symptoms of haemorrhoids:
  • bleeding while passing the stool
  • itching & soreness around anus
  • lump feeling around anus
  • discharge
  • pain
What are the factors leading to haemorrhoids ?
  • Constipation: Straining during constipation puts pressure on the veins which either bleed or protrude outside the rectum.
  • Pregnancy: Pregnancy is a common cause for haemorrhoids in women. There is increased pressure in the veins due to the enlarging womb and increased blood volume.
  • Standing or sitting for a long periods: People who tend to stand (e.g. teachers, factory workers) or sit (e.g. office workers) for a long periods tend to accumulate blood in the veins, which can lead to haemorrhoids.
  • Overweight: Being overweight puts extra pressure on the haemorrhoidal veins.
Grades of haemorrhoids:
Grade 1:
  • Symptoms: Bleeding, discomfort
  • Signs: Haemorrhoids visible by proctoscopy, which may protrude while straining but which are not prolapsed.
Grade 2:
  • Symptoms: Bleeding, discomfort, itching
  • Signs: Prolapse visible at anal opening during straining efforts, but with spontaneous return to normal place when straining ends.
Grade 3:
  • Symptoms: Bleeding, discomfort, itching, soiling
  • Signs: Prolapse requires manual replacement with finger.
Grade 4:
  • Symptoms: Bleeding, pain, soiling, discharge pruritus
  • Signs: Irreducible prolapse
What is the cause of concern in haemorrhoids ?

Haemorrhoids are very common. One out of four adults suffer from this condition. In fact, half the population over 50 years of age suffer from haemorrhoids. Most haemorrhoids attacks are self curing and symptoms disappears within 7 to 10 days. As the condition worsens, one may suffer 4 to 6 episodes in a year. This cause considerable blood loss and may lead to anaemia, specially in women. Sometimes, haemorrhoids protrude out of the anal canal and in such cases, doctors might recommend surgery.

What is the treatment ?
  • Regularise bowel movement: Increase fibre in your diet and drink plenty of water. This will help relieve constipation. Bulk laxatives like isapghol, bran are also helpful to relieve constipation if diet does not work.
  • Medication: Flavanoid derivatives bring about rapid and marked relief in acute episodes and chronic symptomatology of haemorrhoids along with anti-inflammatory & hemostatic medication. Analgesics, antipruritic drugs & local soothing & anaesthetic agents may be used to relieve acute symptoms.
  • Surgery: When the haemorrhoids are prolapsed, they require surgery. Band ligation, sclerotherapy, coagulation, haemorrhoidectomy are some of the surgical methods used.
How to prevent haemorrhoids ?
  • Drink lots of water, at least 1.5 to 2 litres daily.
  • Eat a balanced diet: food rich in fibres, cereals, fruits and vegetables.
  • Take regular exercise such as walking, jogging, running, swimming, cycling etc.
  • Avoid spicy food, alcohol, excessive tea or coffee, tobacco.

Thursday, April 30, 2009

SRESS!

STRESS: BODY'S NATURAL RESPONSE TO STIMULI:

Deadlines, traffic, long queues, noise, financial pressure, family worries, health concerns. We're all familiar with these common stresses of modern living and know it's important to relax. But what exactly is stress? And how does one relax? Simply put, stress is the body's natural response to environmental & social stimuli. As external conditions change, body's internal systems react to allow you to adapt to those changes & survive. These internal reactions are often called the "fight or flight response".

You're sitting in your most comfortable chair, engrossed in a novel when you hear a strange noise. Your senses come to attention. Where is that noise coming from? What is it? Your muscles tense, your heart is pounding, and you begin to perspire. You try to quiet your heavy breathing and notice that you're gripping that novel like a weapon, ready to strike out. Should you fight or run & hide? 

The fight or flight response is nature's way of protecting you in times of danger. That same response also helps you to meet challenges and achieve goals ( for example, some tension before the "big game" helps a team by preparing mentally & physically to reach peak performance).The problem comes when the stress is chronic & unrelieved. Your body is constantly on alert, and the protective changes brought on by stress can have harmful effect on your mental & physical well-being, and even make you sick.

PHYSICAL CHANGES CAUSED BY STRESS:

When your brain perceives a stress situation, it alerts the nerve centres in the spinal cord and the pituitary gland. The sympathetic and parasympathetic nerves stimulate your organs, and the pituitary gland signals the adrenal gland to produce adrenaline. The result:
  • Heart rate increases and blood pressure rises.
  • Respiration rate increases as oxygen consumption rises.
  • Adrenaline, other hormones, and fatty acids are released into the bloodstream.
  • The liver releases stored sugar.
  • The muscles tense, particularly thighs, hips, back, shoulders, arms, and face.
  • Blood flow to the digestive organs and extremities is constricted.
  • Blood flow to the brain & major muscles increases.
  • The body perspires to cool itself, since increased metabolism creates heat.

EFFECTS OF LONG-TERM STRESS:

Every day your body reacts to 20 to 30 short-term stresses. Usually, there's time to recover in between, but sometimes these minor stresses are unrelenting. Other stresses (the illness of a relative, divorce, or worries about your career) may stay with you over long periods of time. When stress accumulates, your body and emotions feel the strain. Eventually, the brain's stimulation threshold actually drops, and even minor stresses cause big physical reaction.

Doctors recognize a definite link between stress and heart disease, respiratory conditions like asthma, intestinal problems, and menstrual difficulties. Common headaches and migraines can be brought on or worsened by stress. Stress can also aggravate existing health problems. For example, it often exaggerates the symptoms of multiple sclerosis and diabetes. Emotional problems like anxiety and depression are frequently stress-related. Evidence is growing that chronic stress wears down the immune system and increases your chance of getting sick. The constant presence of stress hormones in the bloodstream blunts the response of lymphocytes, weakening the body's ability to combat diseases.

HOW EXERCISE RELIEVES STRESS:

Stretching, moving, and lifting provide immediate relief from the physical symptoms of stress in several ways:
  • Stretching and moving relax tense muscles.
  • Exercise uses up the excess hormones, sugar, and fatty acids dumped into the bloodstream by the flight or fight response.
  • During exercise, the body produces endorphins, neuroinhibitors that calm the stress response and create a peaceful, euphoric state (the "runner's high").
  • Relaxation gained through exercise lasts many hours after the workout session.
  • People who exercise and play sports are better at finding ways to relax and are more able to relax under pressure.

SPECIAL PROGRAMMES:

Try taking an exercise break instead of a coffee break at work. Include some exercise (even just a stroll) in your lunch hour. You'll find that some stretching and moving are much more refreshing, and ultimately more healthful, than ingesting caffeine and sugar! If you can exercise to relieve the physical and emotional symptoms of stress as they arise, you'll be calmer, more alert, and more comfortable, and you'll have less accumulated stress at the end of the day.

GOOD STRESS/BAD STRESS:

Physical challenges like lifting weights or playing a tough game of tennis allow you to feel the stress reaction in your body and recognize it. Often in stressful situations, when your mind is absorbed by the problems at hand, you may not notice the reactions in your body- like higher blood pressure, faster heart rate, and tension in the muscles. But during exercise you're more attuned to your body. Once you're familiar with how your body reacts to stress during exercise, it's easier to recognize in everyday stress situations. And then you can take control and do something about it. Remember, the flight or fight response is your body's way of protecting you- it's how you manage the response that makes it beneficial or harmful.

Stress experts agree that how you perceive a stressful situation and your characteristic emotional reaction often determine how will your body copes with the stress response. If you see new situations as an interesting challenge, the stress response stays at an appropriate level and can aid you in meeting that challenge. If, however, new situations make you feel uncertain, doubtful, and out of control, physical stress responses are extreme and put the body on "full alert" many times a day, often with no relief. Exercise can improve your ability to cope with stress by giving you more self-confidence and a better self-image. The physical strength and courage you develop through exercise will carry over into your everyday life.

HOW TO EXERCISE:

Of course, how relaxing it is to exercise depends on your attitude. If you approach your workouts like a competition or a chore, they'll just increase your stress. As researcher Dr. John Yacenda says, "If you go out and run to 'work off' tension, but the work of 'working off' the tension exceeds the pleasure of running, you are not inducing relaxation." Exercise should, above all, be fun! By setting exercise goals that are attainable, you'll experience real success and personal fulfillment.

Exercising at a gym or with friends can provide relaxed social interaction and encouragement. Working out with others relieves the feelings of isolation that so often accompany stress. Enjoyment and laughter are proven stress busters!

Friday, April 17, 2009

ડાયાબિટીસમાં પગમાં થતાં રોગો

  • પગના નખમાં ફૂગનો ચેપ (Onychonychia)
  • પગના અંગૂઠા તથા આંગળીઓનો આકાર બદલાવો અને સાંધામાં જટિલતા આવવી (Hammer toe, crowding of toes, bunion toe)
  • પગની આંગળીઓના ટેરવાં કે તળિયામાં કણી અથવા કપાસી થવી (Corn & Calluses)
  • પગના તળિયાની ચામડી સુકી થઈ જવી તથા તેમાં ચીરા પડવા (Fissures)
  • પગની આંગળીઓ વચ્ચેની જગ્યા ફોગાઈ જવી તથા ફૂગનો ચેપ લાગવો (Web space maceration)
  • પગની બન્ને કમાન સપાટ થઈ જવી (Flat Foot)
  • પગની અંદરની કમાન વધુ ઘેરી બનવી તથા તળિયાના હાડકા ઉપસી આવવા (High Arched Foot)
  • પગના અગ્રભાગમાં ચાંદુ પડવું/ ચેપ લાગવો/ ન રૂઝાતો ઘા પડવો ( Fore Foot Ulceration/ Infection)
  • પગના મધ્યભાગમાં ચાંદુ પડવું/ ચેપ લાગવો/ ન રૂઝાતો ઘા પડવો ( Mid Foot Ulceration/ Infection)
  • પગની એડીના ભાગમાં ચાંદુ પડવું/ ચેપ લાગવો/ ન રૂઝાતો ઘા પડવો ( Hind Foot Ulceration/ Infection)
  • ચેપ (Infection) અથવા લોહીના અપૂરતા ભ્રમણ (vasculopathy) ના લીધે પગ કાળો પડવો(Gangrene)
  • પગના અગ્ર તથા મધ્યભાગમાંના હાડકાનો ભૂકો થવો (Destruction) / હાડકા ગળી જવા(Resorption) / સાંધા છૂટા પડી જવા / પગના આકારમાં સંપૂર્ણ બદલાવ થઈ જવો (Charcot's Foot)

વિશ્વમાં દર ૩૦ સેકન્ડે કોઈક ને કોઈક વ્યક્તિ ડાયાબિટીસને લીધે તેનો પગ ગુમાવે છે.વિશ્વભરમાં થતા પગ કપાવવાના કુલ ઓપરેશનમાં ૭૦% થી વધુ ડાયાબિટીસને લીધે થાય છે.

Saturday, April 4, 2009

Reducing Dietary Sodium(salt) Intake

[Adapted by the World Medical Association(WMA) General Assembly, Seoul, South Korea, October 2008]
Cardiovascular diseases(CVD) remain a leading cause of mortality throughout the world. Risk factors include high blood cholesterol, hypertension, smoking, physical inactivity, obesity and diabetes. These risk factors are largely preventable and modifiable.
Globally, about 25% of all deaths from CVD are due to hypertension. This figure may underestimate the true impact of the elevated blood pressure since the blood pressure cardiovascular risk continuum begins at 115/75 mm Hg. There is overwhelming evidence that excessive sodium intake is a risk factor for the development or worsening of hypertension and it may also be an independent risk factor for CVD as well as all-cause mortality.
Substantial overall benefits can accrue from even small reductions in the population's blood pressure. Depending upon an individual's salt sensitivity, sodium may cause great damage to both normotensive and hypertensive populations. Therefore, populationwide efforts to reduce dietary sodium intake are a cost-effective way to reduce overall hypertension levels and subsequent cardiovascular disease.
In acculturated populations, the level of blood pressure, the incremental rise in blood pressure with age and the prevalence of hypertension are related to salt intake. Observational studies and randomized controlled trials document a clear and consistent effect of salt consumption on increased blood pressure. Blood pressure is also affected by other foods and nutrients and reduced salt intake should be only one component of a comprehensive strategy to lower blood pressure. Increasing physical activity, consuming a diet high in fruits and vegetables and low in saturated and total fats, maintenance of ideal body weight and moderation of alcohol intake are also recommended life style approaches to preventing and managing hypertension and reducing its impact on cardiovascular disease.
WHO recommends that average daily sodium consumption in adults should be less than 2000mg (5 g salt). Epidemiologic evidence, including the marked reduction of either hypertension or of a progressive rise in blood pressure with advancing age in populations with an average sodium ingestion less than 1500mg (3.8 mg salt) per day, supports the concept of such a threshold, above which the risk of the harmful cardiovascular disease consequences begin to increase. The world's population consumes 2300-4600 mg of sodium (5.8 g-11.5 g salt) per day per 2000 calories. In developed countries, it is estimated that 75% to 80% of the daily intake of sodium comes from processed foods and foods that are prepared outside of the home (e.g. fast food or restaurant meals). Therefore, any meaningful strategy to reduce population salt intake must rely on food manufacturers and preparers to reduce the amount added during preparation as well as on nutritional education programmes. The largest impact in sodium in the food supply of developed countries may derive from the stepwise lowering of sodium in foods that are most commonly eaten and are large contributors to sodium intake. In less developed countries, reductions in sodium are more likely to be achieved by adding less salt during cooking inside the home.
[Courtesy:JIMA, VOL 107, NO. 3, MARCH 2009, PAGE 185]