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| Sunday, 24 November 2002 |
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| News Business Features Editorial
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Health When your Eyes get RED Compiled by Carol Aloysius 'Conjunctiva' is the thin transparent membrane covering the front of the eye and inner side of eyelids. Any inflammation of this layer is called Conjunctivitis. There are many causes for it. Invasion by bacteria, virus and other germs; allergy and trauma. Every year we see more than one Epidemic of conjunctivitis in different districts affecting thousands of adults and schoolchildren. Very often these epidemics are caused by certain viruses. The infection spreads from person to person, usually by Droplets of patient's secretions. It is very contagious. It affects one eye first and by personal contact spreads to the other as well. Sharing items that touch the eye, such as face make-ups, towels etc. can spread the disease. Washing your hands frequently and avoiding rubbing your eyes are good ways of reducing the risk of spreading. When sore eyes occurs, the blood vessels in the eye become congested, giving the eye a 'Pink-Red Appearance.' 'Red Eyes' are the result of a wide range of other eye problems too. Some of them are serious enough to threaten your eyesight and go blind. Remember all red eyes are not conjunctivitis. When you have sore eyes, there may be watering or discharge from the affected eye. You do not feel pain as such. You get a gritty feeling under the eyelids - like sand in the eye. If you have a genuine pain, it may be some other dangerous disease such as Glaucoma. Symptoms Itching of the eye is a convincing sign. One may feel blurred vision that clears with blinking. Swelling of the eyelids and the conjunctival membrane are not uncommon. There maybe an alarming looking large red patch seen on the white of the eye. This is a collection of blood from a ruptured small blood vessel behind the conjunctiva which is a harmless condition requiring no treatment at all. The viral conjunctivitis is a self-limiting condition which clears off in a few days time. No drug treatment is required. What you really need is to take a rest, in a semi-dark room, avoid contact with the others in order to prevent spread. Drug treatment is only indicated if there is suspected secondary infection by bacteria or the condition continues for more than four to five days, because prolonged infection can damage the adjacent delicate tissues of the eye. Self medication with eye drops is very dangerous, because some eye preparations can reduce your own immunity process in the eye, thereby helping to spread the already existing viruses. Bacterial Conjunctivitis is more common in children. The eyes are red, there is a yellow sticky discharge. Often the eyelids are stuck together in the morning and may have to be forced open. Bacteria can come from your own skin, the environment (such as contaminated water) or from contact lenses if they aren't properly cleaned and disinfected. Allergic - Conjunctivitis is commonly characterised by itching and can be caused by a number of trigger factors such as, cosmetics, hair dyes, and environmental allergies like dust, smoke and other pollutants. Patients are therefore advised not to self medicate their Red Eye. If you have severe pain or blurred vision in addition, it is unlikely to be a simple conjunctivitis and you should see your Doctor immediately. For Conjunctivitis rest is the best cure. ***** Health alert on Sore Eyes Are your eyes red and tearing? Are your eyelids pasted together on awakening? If so the chances are you have sore eyes. Sore eyes or Conjunctivitis has re-surfaced again and is now spreading to various parts of the island. Health authorities have warned the public to be on the alert and avoid close contact with any person who shows symptoms of this highly contagious disease, which is spread by droplet infection. According to them, travelling in overcrowded buses and sitting next to a patient with sore eyes can lead to contracting conjunctivitis. Dr. Sampath N. Nanayakkara discusses the symptoms and treatment of conjunctivitis. ***** Conjunctivitis Early symptoms . Red, teary eyes . Feeling of sand under upper eyelid . Eyelids will paste together on awakening . A small lymph gland in front of the ear enlarges and could be painful to touch. . Children may develop fever resulting in virus infection (the virus does not respond to treatment) Treatment . Wash face repeatedly with clean water . Use an antibiotic to prevent bacterial infection of the eye on doctor's advice . Plenty of rest in a darkened room. You & Your Doctor "Sprain and Strain" Q: What is a sprain? Is it same as strain of a part of the body? How to manage a sprain and strain in an emergency situation where medical help is not immediately available, specially in a situation like sports event. - An athlete A: A Sprain is an injury to the soft tissues around a joint, causing swelling, pain, and bruising of that area. A Strain on the other hand, is an injury to a muscle or tendon (tendon is that part of the muscle attached to the bone) causing pain, swelling and stiffness of the area involved. Therefore a sprain can only occur around a joint. All sprains and strains are due to physical exercise, over-use, wrong positioning of a joint, in sports or may result from ordinary daily activity, whatever their cause, sprains and strains can lead to discomfort and inconvenience. We all have experienced sprains and strains some time in our life; it is, therefore, useful to know how to treat such a condition in an emergency situation. The formula is very simple. It is called RICE treatment. R - Rest The injured part of the arm or leg should be rested for some time depending on the extent of the injury. This would prevent further damage of the part. I - Ice Ice packs or cold water-soaked cloth to be applied to the injured area for the first 24 hrs. C - Compression The area to be compressed ideally with a crape bandage. E - Elevation The injured area should be kept raised to encourage blood circulation and help to decrease the swelling. The affected area of the limb needs support by a bandage. Although a little expensive, Grip Type Tubular bandages (knee guard ankle guard etc.) are ideal. - Dr. Sampath Nanayakkara News Flash : Dengue warning! A Dengue epidemic has broken out according to health authorities, with a large number of cases being reported in the South and North Central parts of the island. The public has been advised to immediately seek medical aid if they have the following symptoms: High Fever Headache Rash in face, trunk and extremities Nausea and vomiting Note: These symptoms usually subside in about 3-4 days and the patient recovers. But if neglected it may lead to Dengue Haemorrhagic Fever (DHF) which could be fatal. Symptoms of DHF are similar to dengue fever but accompanied by bleeding from nose, gums, brown coloured vomit or faeces and severe stomach pain. If these symptoms appear rush the patient to hospital immediately. Until microwave invasion takes over . . . : Minimum Access Surgery on the rise by Lalith Edrisinha This report is based on material presented at a scientific seminar held in Singapore recently. Focussing on the theme "Towards Surgical Excellence" a panel of distinguished surgeons and specialists from Singapore's Mount Elizabeth Hospital as well as overseas shared their insights on the science and art of Minimal Access Surgery. The occasion was graced by Dr. Balaji Sadasivan, Minister of State for Health & Environment who declared open two new state-of-the-art operating theatres Stryker's Endosuite and Storz's ORI at Mount Elizabeth Hospital. Minimal Access Surgery (MAS) is a surgical technique that has now been accepted based on clinical data to provide mid and long-term survival benefit to the patient. Initial scepticism about its role has been replaced by wide acceptance of the clinical advantages conferred by the technique, making it the surgery of choice among surgeons and patients alike. MAS offers a multiplicity of benefits. Traditional surgery often requires a lengthy hospital stay and weeks of recovery due to large incisions. With MAS, the age-old goals of surgery are being accomplished with small incisions and decreased psychological traumas. A clear benefit for the patient who goes through MAS is reduced postoperative pain. This is because operations traditionally done through large incisions can be completed through "keyhole" incisions due to technological advances that have brought superior optics and higher resolution camera systems into the operating theatre. The development of new and effective instruments, techniques and energy modalities have now allowed major procedures to be done by MAS when before the only way was open surgery. This ensures an added benefit to patients in the form of lower infection and complication rates. Consultant General Surgeon Dr. T. Ravinatharan of Mount Elizabeth Medical Centre (MEMC), Singapore referring to advances in MAS for abdominal conditions said: "Advances in energy sources needed to cut, coagulate blood vessels have improved to the point that large blood vessels can be sealed with special instruments and energy modalities like the Ultrasound dissectors and Bipolar instruments, like the Ligasure. Dissection of solid organs now can also be done with the above methods. Conventional diathermy machines have been made safer by computer-control, which reduce injury. Special instruments have been developed to allow safe manipulation of the organs without trauma and to allow stitching. Others like staplers have been used for creation of anastamosis and for division of vascular pedicles. Still others like the balloon dissector allow us to expose areas of the pre-peritoneal cavity for surgery. Such patients were previously considered as not suitable for MAS procedures but with these recent advances, can be selected for laparoscopic surgery. This brings the advantages of MAS to as many types of patients allowing better recovery and less morbidity". An essential corollary to less postoperative pain and reduced infection is a shorter hospital stay. One of the reasons attributed to this welcome benefit to patients is the use of high-tech instruments in MAS. Consultant Obstetrician and Gynaecologist MEMC Dr. Alex K. H. Ooi commenting on the use of the harmonic scalpel in gynaecologic minimal access surgery said, "The use of the 5mm Laparosonic Coagulating Sheares (LCS) is demonstrated for a range of surgery, including hysterectomy, myomectomy, cystectomy and adhesiolysis of bowel and endometriosis. Ultrasound is a safe mechanical and contact energy modality. It is convenient in terms of delivery and set-up. One can adapt to using it efficiently after a short learning curve and recognising its limitations. It helps to separate tissue planes and obviates fogging. Further, the 5mm LCS has grasping, coagulating and incision properties altogether in one small diameter instrument, optimising manoeuvres and reducing duration of surgery. It also appears to give less recovery morbidity." Another significant benefit of MAS has been highlighted as less scarring. This is specially so of those who undergo Appendicectomy, Cholecystectomy and other forms of abdominal surgery. Dr. Teoh Tiong Ann, Consultant Colorectal and General Surgeon MEMC in a paper submitted at the seminar: However, two of the most common abdominal operations are almost routinely performed with the minimal access technique. Cholecystectomy (Gall Bladder Removal) is now routinely performed. Previously with conventional surgery, gallbladder removal requires a surgical incision about 10 cm long and 2-3 day stay in hospital. With Laparoscopic Cholecystectomy, it can be performed with 4 small incisions (ranging from 3 mm to 1 cm) and the patient can be discharged usually after an overnight stay. Appendicitis is a very common problem. This operation is also being performed in the minimal access approach. Laparoscopic Appendicectomy has the advantage of superior cosmesis and shorter post operative recovery. It is also possible to deal with other problems e.g. from the ovaries at the same operation without having the need to make a longer incision. This has ensured for patients the ability to return to their normal daily activities earlier than when traditional surgery was resorted to. The consensus then is that MAS ensures many benefits to patients. It was also accepted that inevitably the cost of surgical care is on the rise the challenge in Healthcare in the 21st century is to reduce costs whilst maintaining the highest standards of honesty and professional integrity. (Ceylinco Parkway Medical Referral Centre (CPMRC) now handles all
matters connected with treatment at Mount Elizabeth Hospital, Singapore) Health risks of high protein diets There is a misconception among some people that consumption of a high protein diet (consisting of plenty of meat and fish) and very low carbohydrate helps obese (overweight) people to trim their waist line. But when you take a high protein diet and eliminate starchy food such as rice, bread, pasta, potatoes and sugary food such as fruits, your body has no choice but to live off its fats when a metabolic state known as ketosis occurs. One disadvantage of consuming food items containing high protein such as meat is that high protein dietary items are loaded with cholesterol and saturated fat which elevate your blood level of atherogenic or L.D.L. cholesterol which is a well-known risk factor for heart attacks and strokes. Another disadvantage of consuming a high animal protein diet is that these diets are dangerously low in fibre and other protective nutrients. Unlike healthy vegetarian diets, which reduce the risk of cancer, heart disease and other problems, high protein, high fat diets are associated with increased risk of the following diseases Colorectal Cancer. This is one of the most common forms of cancer in meat eaters. Long term increased intake of meat, especially, red meat is associated with high incidence of colorectal cancer. High protein diets especially those containing meat and fish are also low in dietary fibre which helps to protect against cancer. Heart Disease High protein diets are also loaded with cholesterol and saturated fats which elevate your atherogenic or LDL cholesterol. High fat diets also reduce compliance of arteries increasing the risk of heart attacks immediately after meals. Impaired kidney function People who consume large amounts of animal protein have a risk of significant kidney damage. The American Academy of Family Physicians notes that high animal protein intake is responsible in a large measure for high prevalence of kidney stones in the USA and other developed countries and recommends protein restriction for the prevention of recurrent kidney stones. Diabetes complications In diabetes kidney and heart problems are particularly common. The use of diets that may further tax the kidneys and may reduce arterial compliance is not recommended. Osteoporosis Very high protein intake is known to increase urinary calcium losses and has been linked to increased fracture risk in research studies. - Dr. D. P. Atukorale Painful menstruation Are you one of those unfortunate women who develop cramps and severe discomfort before your periods? If you are, this article is for you.... Painful menstruation is also known as Dysmenorrhoea. It is characterised by cramp-like discomfort that may be mild to severe and is usually located in the lower abdomen or sometimes in the back and thighs. The pain may begin just before menstruation and persist for a few hours or through the menstrual period. Often there are other symptoms: Urinary frequency, nausea, diarrhoea, backache, headache, pelvic soreness etc. When it begins at puberty we called it as Primary Dysmenorrhoea; the cause is unknown. Secondary Dysmenorrhoea, which begins later in life, is usually associated with an organic cause such as pelvic inflammation, cervical stricture, abnormal position of the uterus, endometriosis (the presence of uterine tissue outside the uterus) or tumour of the uterus or ovary. In many cases of Primary Dysmenorrhoea, Aspirin, Paracetamol or a painkiller is helpful. Magnesia Phosphoric is successfully used in the Homoeopathic system of medicines. For Secondary Dysmenorrhoea, a thorough medical examination is warranted. In this stage, avoid taking medicines yourself as mentioned in the Primary Dysmenorrhoea and consult a qualified Physician. Homeopathically there are a lot of remedies used in the treatment of Dysmenorrhoea, such as Colocynthis, Pulsatilla, Sabina etc. - Dr. Y. M. Mousoom. |
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