Asthma: Not a killer, but can be killing!

by Shanika Sriyananda

Little Harshi is a notable absentee in the class. Not one particular day, but day in and day out, fighting with breathing difficulties. When the condition turns worse she is given an inhaler to make her breathing easy. Still unsure of the root cause of her illness, her young mother avoids giving her ice creams and other milky foods that might aggravate her breathing difficulty.

With no family history of such an illness, the little girl is deprived of tasting sweet and milky food items.

Harshi is not the only one but there are over two million Sri Lankans including 30 per cent children are gasping for breath due to asthma.

Though there is a slight decrease in cases of asthma, it also needs equal attention like cancer, heart ailments and diabetes. The asthma victims, according to chest physicians may be due to allergic reactions and poor environmental conditions at home and outdoors.

What is Asthma?

Asthma is a chronic disease that affects the airways, which carry air in and out of the lungs. When one has asthma, the inside walls of the airways are inflamed (swollen). The inflammation makes the airways very sensitive, and they tend to react strongly to things that one is allergic to or find irritating.

When the airways react, they get narrower, and less air flows through to the lung tissue. This causes symptoms like wheezing (a whistling sound when breathing), coughing, chest tightness, and trouble breathing, especially at night and in the early morning.

Asthma cannot be cured, but most people with asthma can control it so that they have few and infrequent symptoms and can live active lives.

When asthma symptoms become worse than usual, it is called an asthma episode or attack. During an asthma attack, muscles around the airways tighten up, making the airways narrower so less air flows through.

Inflammation increases, and the airways become more swollen and even narrower. Cells in the airways may also make more mucus than usual. This extra mucus also narrows the airways. These changes make it harder to breathe.

Asthma attacks are not all the same - some are worse than others. In a severe asthma attack, the airways can close so much that not enough oxygen gets to vital organs. This condition is a medical emergency. People can die from severe asthma attacks.

What causes asthma?

Still it is not very clear exactly what makes the airways of people with asthma inflamed. The inflamed airways may be due to a combination of things like with a family history of asthma and then a person is more likely to develop it.

It has also found that exposure to tobacco smoke, infections, and some allergens in early life may increase the chances of developing asthma.

What causes asthmatic symptoms and attacks?

Remember there are things in the environment that make one asmatic and even lead to asthma attacks. The more common things include exercise, allergens, irritants, and viral infections. Some people have asthma only when they exercise or have a viral infection.

Symptoms of asthma

Allergens

* Animal dander (from the skin, hair, or feathers of animals)

* Dust mites (contained in house dust)

* Cockroaches

* Pollen from trees and grass

* Indoor and outdoor)

Irritants

* Cigarette smoke

* Air pollution

* Cold air or changes in weather

* Strong odours from painting or cooking

* Scented products

* Strong emotional expression (including crying or laughing hard) and stress

Others

* Medicines such as aspirin and beta-blockers

* Sulfites in food (dried fruit) or beverages (wine)

* A condition called gastroesophageal reflux disease that causes heartburn and can worsen asthma symptoms, especially at night

* Irritants or allergens that you may be exposed to at your work, such as special chemicals or dusts

* Infections

These symptoms are not the exact symptoms that trigger asthma, but these may be one of the causes. Identifying these asthma triggers will help to avoid these.

Who are at risk?

Mainly the victims are children and young people, In Sri Lanka out of total number of asmatics, 66 percent are between the age of 15 to 54. Asthma is closely linked to allergies. Most, but not all, people with asthma have allergies. Children with a family history of allergy and asthma are more likely to have asthma.

Although asthma affects people of all ages, it most often starts in childhood. More boys have asthma than girls, but in adulthood, more women have asthma than men. What are the signs and symptoms of asthma?

Common asthma symptoms include:

* Coughing. Coughing from asthma is often worse at night or early in the morning, making it hard to sleep.

* Wheezing. Wheezing is a whistling or squeaky sound when you breathe.

* Chest tightness. This can feel like something is squeezing or sitting on your chest.

* Shortness of breath. Some people say they can't catch their breath, or they feel breathless or out of breath. You may feel like you can't get enough air in or out of your lungs.

* Faster breathing or noisy breathing.

Not all people have these symptoms, and symptoms may vary from one asthma attack to another. Symptoms can differ on how severe they are: Sometimes symptoms can be mildly annoying, other times they can be serious enough to make one stop what he or she is doing, and sometimes symptoms can be so serious that they are life threatening.

Symptoms also differ in how often they occur. Some people with asthma have symptoms only once every few months, others have symptoms every week, and still other people have symptoms every day. With proper treatment, however, most people with asthma can expect to have few or no symptoms.

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Exercise boosts brainpower

Exercise boosts brainpower by building new brain cells in a brain region linked with memory and memory loss, U.S. researchers reported.

Tests on mice showed they grew new brain cells in a brain region called the dentate gyrus, a part of the hippocampus that is known to be affected in the age-related memory decline that begins around age 30 for most humans.

The researchers used magnetic resonance imaging scans to help document the process in mice - and then used MRIs to look at the brains of people before and after exercise.

They found the same patterns, which suggests that people also grow new brain cells when they exercise. "No previous research has systematically examined the different regions of the hippocampus and identified which region is most affected by exercise," Dr. Scott Small, a neurologist at Columbia University Medical Center in New York who led the study, said in a statement.

Writing in the Proceedings of the National Academy of Sciences, the researchers said they first tested mice. Brain expert Fred Gage, of the Salk Institute in La Jolla, California, had shown that exercise can cause the development of new brain cells in the mouse equivalent of the dentate gyrus.

The teams worked together to find a way to measure this using MRI, by tracking cerebral blood volume. "Once these findings were established in mice, we were interested in determining how exercise affects the hippocampal cerebral blood volume maps of humans," they wrote.

They of course could not dissect the brains of people to see if new neurons grew, but they could use MRI to have a peek.

They recruited 11 healthy adults and made them undergo a three-month aerobic exercise regimen.

They did MRIs of their brains before and after. They also measured the fitness of each volunteer by measuring oxygen volume before and after the training program.

Exercise generated blood flow to the dentate gyrus of the people, and the more fit a person got, the more blood flow the MRI detected, the researchers found.

"The remarkable similarities between the exercise-induced cerebral blood volume changes in the hippocampal formation of mice and humans suggest that the effect is mediated by similar mechanisms," they wrote.

"Our next step is to identify the exercise regimen that is most beneficial to improve cognition and reduce normal memory loss, so that physicians may be able to prescribe specific types of exercise to improve memory," Small said.

Exercising your finger after an injury

Why do I need to exercise my finger after an injury?

Exercising an injured finger can make it stronger and easier to move. You shouldn't start these exercises until your doctor says it is safe.

Exercise can help you straighten your finger to make it easier to move. To do this exercise, use your uninjured hand to slowly straighten and bend the injured finger. Hold it straight then slowly bend it.

Exercise makes it easier to straighten your finger. To do this exercise, put your injured hand flat, palm down, on a table. Lift each finger one at a time. Exercise can make your finger stronger. Make a fist with your injured hand and hold it a few seconds.

You can do this exercise using only your hand, or you can squeeze a ball (for example, a soft "stress" ball, a racquet ball, or a tennis ball). If you use a tennis ball, cut the side of the ball to make it easier to squeeze.

Exercise can help you do the things that you did before your injury, such as writing or tying your shoes. To do this exercise, pick up small objects such as coins, marbles, or buttons with the injured finger and the thumb.

American Family Physician

"Goo-Goo-Ga-Ga" sound helps baby's language skills

The study was designed by Japanese researchers who examined how newborns respond to adult-directed speech (ADS) and to infant-directed speech (IDS) and found that the frontal area of the babies' brains become more active in response to "baby talk."

"When the neonates heard IDS rather than ADS, (the result was increased oxygenation) in the frontal area of the brain," said the study's lead author, Yuri Saito of Hiroshima University. "This result suggests that the emotional tone of maternal utterances could have a role in activating the brains of neonates to attend to the utterances, even while sleeping."

The researchers studied 20 newborns between the ages of 2 and 9 days, with an average age of 4.4 days. Their average gestational age was 38.9 weeks, just shy of the 40 weeks considered optimal for pregnancy. All of the babies appeared normal and healthy and seemed to have normal hearing.

Two sensors were placed on either side of the babies' forehead to measure the oxygenation of the blood going to the frontal area of the brain. The device used to test the babies' brains is called near-infrared spectroscopy.

Once a newborn was sleeping, the mothers were directed to read a scene from Little Red Riding Hood in Japanese to either their baby (in baby talk) or to an adult. As the mothers read the passage, the researchers recorded their voices. The recordings were then played for the babies, and their brain oxygenation was recorded.

Saito said the main reason the researchers tested sleeping babies was to ensure that the scientists weren't recording any increase in brain oxygenation due to visual stimuli.

When the researchers compared oxygenation levels when the babies were exposed to baby talk compared to adult speech, they found that baby talk increased the blood oxygenation in the frontal area of the brain.

Concentrations of oxygenated haemoglobin rose an average of 0.25 millimoles per litre (mmol/l), while these concentrations decreased an average of 0.23 mmol/l when the babies heard their mothers reading to the adult researcher. Results of the study are published in the March issue of the Archives of Disease in Childhood.

Dr. Marilyn Augustyn, an associate professor of paediatrics and a developmental behavioral paediatrician at Boston Medical Center and the Boston University School of Medicine, wrote an accompanying editorial in the same issue of the journal.

She said that while the research was "small and preliminary, this is a compelling and well-done study that provides physiologic evidence for what we've known clinically." Saito said infants respond so well to baby talk that "they form a bond by recognizing a caring person. Also, because it is easy to hear IDS, it promotes language development."

Augustyn said the bottom line from this study is that parents need to know "it's important to talk to babies. Your babies are listening. What's important is that they hear your voice; it's not necessarily the content of what you say."

She said you could simply talk to your baby about the mundane activities of the day, such as "I'm changing your diaper now." But, when done in baby talk, it's something the baby will respond to and will help him or her begin to develop language skills.