Health Wise

With Christmas almost upon us, the season of merry making is in full swing. It’s party time for the young and old, male and female, and dance halls, bars, clubs and wherever else people socialise have been booked well ahead of Christmas and the New Year next week.

But take care: for amidst this merrymaking lurks dangers that can seriously undermine your health - such as binging or indulging in excessive drinking of alcohol.

Last week, this page carried an article cautioning readers on the adverse effects that drugs can have on especially young people who get their first taste of hard drugs such as cannabis and heroin during this season and are thereafter hooked for life, by the Head of the Toxicology Unit at the National Hospital, Dr Waruna Gunathilake.

This week the Sunday Observer talked to him again to find out what he had to say about consuming too much alcohol which is common among those who are already addicted to liquor, during this season of festivity.

Question: Last week you warned merry makers, especially young persons, against using substances such as heroin and cannabis during a festive season as they could lead to other unhealthy and dangerous habits. What are your views on alcohol which is also consumed in larger quantities during the coming festive season?

Answer: Alcohol has been often called the ‘gateway drug' to dependence on other drugs. Almost all heroin dependent young people are tobacco smokers and the vast majority are also habitual alcohol drinkers.

A. Like heroin, the effects are wide ranging. Alchohol causes high blood pressure, peptic ulcer, oesophageal cancer, lung cancer, gastritis and cirrhosis.

A. Because it contains ethanol which is a drug frequently co-ingested (ingested simultaneously with another agent) with other drugs in suicide attempts.

You find ethanol in commercial beer, wine and liquors contain various amounts of ethanol.

Ethanol also is found in a variety of colognes, perfumes, aftershaves, and mouthwashes, some rubbing alcohols, many food flavourings (e.g. vanilla, almond, and lemon extracts) pharmaceutical preparations (e.g. elixirs) hand sanitisers, and many other products.

It affects the central nervous system and the entire body if taken in excessive doses. Ethanol is frequently co-ingested with other drugs in suicide attempts.

A. Central nervous system (CNS) depression is the principal effect of acute ethanol intoxication.

Ethanol has additive effects with other CNS depressants, such as barbiturates, benzodiazepines, opioids (opium like substance) antidepressants and anti-psychotics.

Ethanol intoxication and chronic alcoholism also predispose patients to trauma, exposure - induced low body temperature, injurious effects of alcohol on the Gl tract and nervous system, and a number of nutritional disorders and metabolic derangements.

Ethanol is readily absorbed (peak, 30-120 minutes) and distributed into the body water (volume of distribution, 0.5- 0.7 L/kg or 50L in the average adult.) Elimination is mainly by oxidation in the liver and follows zero-order kinetics. The average adult can metabolise about 7-10 g of alcohol per hour, or about 12-25 mg/dl/h.

A. Generally, 0.7 g/ kg of pure ethanol (approximately 3-4 drinks) will produce a blood ethanol concentration of 100 mg/dl (0.1 g/ dl) A level of 100 mg/dl decreases reaction time and judgement and may be enough to inhibit gluconeogenessis (glycogen breakdown to glucose) and cause low sugar level in children and patients with liver disease, but by itself it is not enough to cause coma. However the level sufficient to cause deep coma or respiratory depression is highly variable, depending on the individual's degree of tolerance to ethanol.

Although levels above 300mg/ dl usually cause coma in novice drinkers, persons with chronic alcoholism may be awake with levels of 500-600 mg/dl or higher.

Effects of smoking

This season will also see an increase in smoking, with many young persons taking their first puff of cigarette smoke at a night club. Cigarette smoking is toxic and dangerous as there are 4,000 chemical components found in cigarettes - at least 250 of them harmful to human health. They can cause leukaemia, lung cancer, chronic lung and respiratory diseases. Cigarettes expose smokers to polonium, a radioactive element inhaled directly to the airway. Studies show those who smoke a pack and a half of cigarettes a day are receiving the same radiation they’d get from 300-plus X-rays per year! Cigarettes also contain Cadmium which can interfere with the repair of damaged DNA and damage the kidneys and lining of arteries.

With mild to moderate intoxication, patients exhibit euphoria, mild in-coordination, unsteady gait dancing eyes, and impaired judgement and reflexes.

Social inhibitions are loosened, and boisterous or aggressive behaviour is common. Low sugar level may occur, especially in children and persons with reduced hepatic glycogen stores.

With deep intoxication, coma, respiratory depression, and lung aspiration may occur. In these patients, the pupils are usually small, and the temperature, blood pressure, and pulse rate are often decreased. Muscle fibre breakdown may result from prolonged immobility.

Q. Once a person becomes addicted to it, how does the ethanol factor affect his health?

1. Hepatic toxicity includes fatty infiltration of the liver, alcoholic hepatitis and eventually cirrhosis.

Liver scarring leads to fluid retention, and bacterial infections in tummy. Production of clotting factors is impaired, leading to prolonged prothrombin time-liver function assessment tests to evaluate blood clotting efficacy or capability. Hepatic metabolism of drugs and endogenous toxins is impaired and may contribute to hepatic encephalopathy.(liver failure.)

2. Gastrointestinal bleeding may result from alcohol-induced gastritis. Other causes of massive bleeding include tears of the oesophagus and oesophageal varices.

3. Cardiac disorders include various rhythm disorders of the heart, such as atrial (heart chamber) fibrillation, that may be associated with potassium and magnesium depletion and poor caloric intake and excessive intake of alcohol during weekends and holidays - (‘holiday heart.’) Cardiomyopathy (enlargement of the heart) has been associated with long-term alcohol use, and was also historically associated with ingestion of cobalt used to stabilise beer.

4. Neurologic toxicity includes brain shrinkage, and peripheral stocking (glove type sensory impairment). Nutritional disorders such as thiamine (vitamin B) deficiency can cause jeopardise normal brain functions.

A. Drinking alcohol at any time as I said is dangerous. But you are particularly vulnerable to health risks when you drink while having the following health conditions: High triglyceride (lipids) Blood pressure, liver problems, pregnant or trying to get pregnant, breast feeding, planning to drive or engage in other activities that require attention and skill, taking meditation drugs.

Limits

Q. Are there limits with regard to the amount consumed, to keep in mind when drinking alcohol?

The limits include the following: No more than 100ml per day for man. No more than 50ml per day for women.

Q. Any other important guidelines to bear in mind associated with alcohol consumption?

A. Remember that liquors, sweet wine and dessert wine, contains high sugar that can lead to diabetes. Diabetics must also be warned that if they are using insulin, they should be aware that low blood sugar can occur up to 14 hour after drinking alcohol.

Diabetic patients must also be extra cautious when consuming alcohol with medications, as this too can lead to low blood sugar.

A. A popular custom is to eat a lot of ‘bites’ while drinking alcohol e.g. - fried meat, salted nuts, chips. These ‘bites’ which are often deep fried, contain high fat / oil content or salt which causes high lipid levels, leading to heart attacks and high blood pressure.

Q. If an alcoholic or habitual drinker wants to stop this habit, will he /she experience worrying symptoms?

A. They are called ‘alcohol withdrawal symptoms.’ Sudden discontinuation after chronic high-level alcohol use often causes headache, tremulousness, anxiety, thumping heart, and lack of sleep.

Brief, generalised seizures may occur, usually within 6-12 hours of decreased ethanol consumption. Sympathetic nervous system over-activity may progress to delirium tremens, a life - threatening syndrome characterised by raised heart rate, hyperthermia, and delirium, which usually manifests 48-72 hours after cessation of heavy alcohol use.

Treatment

1) To protect the airway to prevent aspiration and assist ventilation if needed.
2) Give glucose and thiamine and treat coma and seizures if they occur at hospital setting,
3) To correct low body temperature with gradual re-warming Most patients will recover within 4 - 6 hours.

Decontamination. Because ethanol is rapidly absorbed, gastric decontamination is usually not indicated unless other drug ingestion is suspected.

Consider aspirating gastric contents with a small, flexible tube if the alcohol ingestion was massive and recent (within 30-45 minutes).

Activated charcoal does not effectively adsorb ethanol but may be given if other drugs or toxins were ingested.

A. Stop taking any form of alcohol. Remember that the belief about taking small doses of alcohol will not undermine your health is a MYTH. Ingesting even the smallest amount of liquor is toxic and can seriously harm all your organs, especially the liver.

Vitamin pills offer no health benefits and could be harmful, says study

Evidence from the study suggested that ‘supplementing the diet of well-nourished adults...has no clear benefit and might even be harmful’.

A study of nearly 500,000 people, carried out by academics from the University of Warwick and the Johns Hopkins School of Medicine in Baltimore, USA, has delivered a damning verdict on the claims made by the vitamin supplement industry.

Evidence from the study suggested that “supplementing the diet of well-nourished adults...has no clear benefit and might even be harmful”, despite one in three Britons taking vitamins or mineral pills.

According to The Times, scientists involved in the study, which was published in the Annals of Internal Medicine, concluded that companies selling supplements were fuelling false health anxieties to offer unnecessary cures. The industry in the UK is thought to be worth more than £650 million annually.

Researchers declared ‘case closed’ on the vitamin and mineral pills after making their conclusion based on the study of half-a-million people along with three separate research papers.

One of the research papers involved the retrospective study of 24 previous trials. In total 450,000 people were involved in the trials and the paper concluded that there was no beneficial effect on mortality from taking vitamins.

Another examined 6,000 elderly men and found no improvement on cognitive decline after 12 years of taking supplements, while a third saw no advantage of supplements among 1,700 men and women with heart problems over an average study of five years.

The experts said most supplements should be avoided as their use is not justified, writing: “These vitamins should not be used for chronic disease prevention. Enough is enough.”

The scientists argued that the average Western diet is sufficient to provide the necessary vitamins the body needs.

Edgar Miller, of the Johns Hopkins School of Medicine, said: “There are some that advocate we have many nutritional deficiencies in our diet. The truth is though we are in general overfed, our diet is completely adequate.”

He said: “These companies are marketing products to us based on perceptions of deficiencies. They make us think our diet is unhealthy, and that they can help us make up for these deficiencies and stop chronic illnesses.

“The group that needs these is very small. It's not the general population.”

Dr Miller continued: “There's something for everything: preventing joint pains, stopping heart disease. If you're going to spend your money on something every month, is this really the best option?”

The NHS advised recently that other than women taking folic acid to help them conceive and the elderly and children under five benefiting from vitamin D, supplementary vitamins would be surplus to that already gained through diet, The Times said.

- The Independent

British scientists ‘print’ eye cells in world’s first

The new development in bio-printing technology could be used in the future to restore lost vision

An inkjet printer has been used to “print” cells from the eye for the first time, British scientists have said, in a striking demonstration of how technology could aid the search for a cure to blindness.

The breakthrough is the first step towards using printer technology to create artificial tissue that might be used in complex retina repair procedures.

Scientists from the University of Cambridge printed two types of cells from the retina of rats. It is the latest application of bio-printing technology, which is being used by to create ever-more complex cellular structures, including organs, but this is the first time that mature central nervous system cells have been printed.

Co-authors of the study Prof Keith Martin and Dr Barbara Lorber, said that though the results were preliminary, they provided “proof of principle”.

The ultimate aim was to develop the technology for potential medical applications, the authors.

“The loss of nerve cells in the retina is a feature is a feature of many blinding eye diseases,” they said. “The retina is an exquisitely organised structure where the precise arrangement of cells in relation to one another is critical for effective visual function.”

Cells printed this way remained healthy and were able to survive and grow, the scientists said.

The cells that were printed were retinal ganglion cells, which transmit information from the eye to parts of the brain, and glial cells, which protect neurons.

The next step will be to investigate whether the same or similar technology can be used to create light-sensitive photoreceptor cells - which convert light into biological signals and are essential for sight.

The team also hope to develop the printing process to be suitable for commercial, multi-nozzle print heads, Prof Martin said.

- The Independent

Many liars prove honest in their dishonesty

Does everybody lie? We are taught that this is common sense and that most people tell little white lies. But perhaps this isn't true. A recent paper published in Human Communication Research found that many people are honest most of the time, that many are honest about their lying, and that some lie a lot.

Rony Halevy, Bruno Verschuere (University of Amsterdam), and Shaul Shalvi (Ben-Gurion University), surveyed 527 people to find out how often they had lied over the past 24 hours. 41 percent of the respondents indicated that they had not lied at all, whereas just five percent turned out to be accountable for 40 percent of all of the lies told.

To find out whether the respondents were honest about the frequency of their lying, they were invited to take part in an additional lab test.

They were asked to roll dice and received a sum of money depending on the number they reported having rolled.

Because the researchers were unable to see the actual numbers rolled, participants were free to cheat and report higher numbers. Participants who had already admitted to lying more frequently also had higher winnings in this dice test, indicating that participants, who said they lie often, did indeed lie often. Statistically, their scores were so implausible that they are likely to have lied about the numbers they rolled, rather enjoying a series of lucky rolls.

Previous studies found that, on average, survey participants admitted to lying twice a day. According to the study, this does not permit the conclusion that everyone lies. Because this is an average, it gives a distorted picture of individual differences in lying behaviour.

“The fact that participants who indicated lying often actually did lie more often in the dice test demonstrates that they were honest about their dishonesty,” said Verschuere. It may be that frequent liars show more psychopathic traits and therefore have no trouble admitting to lying frequently.”

Beware of excessive drinking this festive season

Limits

Treatment

Vitamin pills offer no health benefits and could be harmful, says study

- The Independent

British scientists ‘print’ eye cells in world’s first

- The Independent

Many liars prove honest in their dishonesty

- MNT