KEEP AN EYE ON YOUR CHILD’S VISION

Weak eyesight has nothing to do with age anymore. An increasing number of children are complaining of it     Have you noticed a substantial rise in the number of children wearing glasses? Well, there's a reason for it. Experts say kids these days have more eye-related problems since the load placed on the eye has significantly increased.  Not only has the quantum of school work increased, new technology has also led to massive eye strain. Says Ophthalmic surgeon Dr Keiki Mehta, "Ideally, for a growing child, nearpoint application, which includes reading on computers and tablets, should be restricted to two to four hours per day. However, the increasing emphasis on competition, at an even earlier age, has led to excess pressure on their developing system."      Consultant cataract and refractive surgeon Dr Nikhil Nasta says many problems leading to visual loss are related to lifestyle. "Vision depends on a clear lens and rich microcirculation to the retina and the visual nerve cells of the retina called rods and cones. These are adversely affected when exposed to toxins and oxygen-free radicals. Poor dietary habits can also be harmful," he says.  COMMON EYE PROBLEMS IN CHILDREN Near and far sightedness:  Dr Nasta says refractive errors (spectacle number) account for 80% of visual impairment in kids. "This includes Myopia or nearsightedness, where distance vision is blurred, but a child can usually see well enough to read or do other such tasks. This occurs most often in school-going children. The prescription for glasses will indicate a minus sign before the power (for example, -2.00). Another problem is Hyperopia (far-sightedness), because of which crossing of the eyes, blurred vision or discomfort may develop. Most children are far-sighted early in life and it becomes a concern only in extreme cases where the focusing muscles are not able to keep the vision clear. A prescription for hyperopia will be preceded by a plus sign (+3.00)," he says.  Astigmatism:  This is commonly caused by a difference in the surface curve of the eye. Instead of being shaped like a perfect sphere (like a basketball), the eye is shaped with a greater curve in one axis (like a rugby ball). This causes fine details to look blurred or distorted. Prescribed glasses have greater strength in one direction of the lens than in the opposite      direction.      Anisometropia:  This problem causes children to have a different prescription in each eye. This can create a condition called lazy eye, where the vision in one eye does not develop normally. Glasses (and sometimes patching) are needed to ensure that both eyes can see clearly. Lazy eye or Amblyopia:      Seen only in one per cent children, it is a failure of the eye to connect to the brain due to lack of use of one eye during infancy and childhood. Therefore, the vision in the amblyopic eye remains poorer than in the normal one.      To solve this, the weaker eye is forced to be used by patching the other one. Treatment also includes using glasses if necessary. Amblyopia must be corrected by nine years of age, by when it becomes permanent. To detect and treat amblyopia, it is necessary to examine preschool age children.  Squint or Strabismus  "Also called crossed-eyes, this means that the eyes are not aligned but are pointing in different directions. They may either point inwards towards the nose (esotropia), outwards to the ear (exotropia) or up or down (vertical strabismus). The problem can be constant or intermittent. However, intermittent strabismus occur in the first few months of infancy, especially when the baby is tired, since they are still learning to focus their eyes and to move them in a coordinated fashion. Most babies outgrow this by the age of three months. For others, various treatment options are available, including exercises for the eyes called orthoptics. Other common eye problems in kids include cataract, glaucoma and retinal problems," adds Dr Nasta.  SIMPLE THINGS MAKE A DIFFERENCE  • All children need the same nutrients, no matter what their age. A healthy diet with an emphasis on fresh vegetables, fruits, whole grains, beans, seeds and nuts is a must. For non-vegetarians, add eggs and a small amount of fish. Avoid addictive sweets as well as junk food. Natural, unprocessed foods help preserve circulation to the retina, rods, cones and lens.  • Regular exercise helps maintain low blood pressure and preserves blood vessels, which the retina is rich in. It also helps support the health of endothelium, the cells that line the arteries. These cells relax blood vessel muscles and maintain blood flow.  • Lens and retina are damaged when exposed to ultraviolet light. However, moderate sun exposure is healthy. Widebrimmed hats and UV filtering sunglasses (in older children) protect the eyes.  • In India, over 25% of childhood blindness is due to Vitamin A deficiency. Many dietary supplements improve vision and protect the macula (the area of the retina with the sharpest vision) and the lens. These are vitamins E and C, and the trace minerals Selenium and Zinc. Others are amino acid Taurine, carotenoids such as betacarotene, lycopene (found in tomatoes), lutein (from spinach) and anthocyanosides (found in grapes).      — Dr Keiki Mehta  WHAT TO DO  • Increase rest periods and emphasise on ocular hygiene. Reading in good light and keeping the book at a minimum distance of 12 to 14 inches are basic requirements. • Playing sports is one of the best ways to increase blood circulation to the eye and end point mobility.  • A child should study in an area where he/she does not face the wall. It is preferable if they sit near an open window or in one corner of a big room — this way, when they look up, they can look into the distance and relax.  • While taking breaks in between studies, the eyes need to be relaxed. Reading a comic book or playing on a computer or cell phone defeats this purpose.  • Yearly eye check-ups are recommended for children.  Eye examination in children  A pediatrician should examine a newborn's eyes. An ophthalmologist should examine all premature infants. Vision screening should be done between three and threeand-a-half years of age. Detailed eye examination is a must if there aresymptoms of visual impairment.

Eye, throat infections spike in muggy weather

Increased humidity, fairly high temperatures and sporadic rainfall are forcing Mumbaikars to pay frequent visits to the doctor. Experts say humidity increases the virus load in the air, which in turn makes people vulnerable to conjunctivitis, upper respiratory tract infections and skin infections. If the weather continues to be the way it is for long, viral infections are likely to increase, doctors warn.      Ophthalmologists say conjunctivitis is common in the post-monsoon months. It has been only about 10 days since the monsoon has withdrawn and already quite a few cases have been reported. "When people suffer from cold, they may touch their eyes and thus transfer infection. We see that most patients with conjunctivitis also suffer from cough and cold," said Dr Hemant Thacker, who consults at Jaslok and Breach Candy hospitals.      "We have several patients with cough and cold. Though fever subsides in a few days, body ache and a low platelet count persists, thus causing weakness," Dr Thacker said.      Dr Khusrav Bajan, intensivist at Hinduja Hospital, said patients have reported four types of viral infections. "Dengue has been present since the start of the monsoon. But of late, the number of patients suffering from lower respiratory tract infections has increased. They come with high-grade fever and cough that refuses to go for 10 days. Besides, viral gastroenteritis and conjunctivitis, along with skin reactions, are also common," Dr Bajan said.      What happens is that the body is unable to adapt to weather changes, explain doctors. "The cilia, or the protective hair within the respiratory tract, are not able to adapt to changes in the weather outside. Even the immunity system becomes weak, which results in cough and cold. This may go on till weather conditions settle," said Dr Bajan.

Watch your food habits, not all coughs come from the lungs

Do you have a cough that is not responding to routine measures? Do you getunexplained hoarseness of voice? Do you have trouble with your throat early in the morning which clears up during the day?      Then this may be for you. GERD— gastro esophageal reflux disorder—is a condition wherein food remnants and gastric acid contents creep up the food pipe into the oropharynx (common receptacle for the food pipe and wind pipe) and spill into the windpipe passively.      In these patients, the gastro-esophageal sphinctervalve between the food pipe and the stomach, is defective and allows regurgitation (backward flow) of stomach contents.      At night during sleep, when the horizontal posture aids the backward flow, the stomach remnants find their way up and soil the respiratory tree. The chemical nature of the contents cause inflammation of the vocal chords and as they trickle down the trachea, they irritate the respiratory lining. When this occurs with periodic regularity almost every night, the tracheal inflammation becomes chronic which the normal body response is unable to ward off. Chronic dry cough and a stubborn hoarseness of voice is the result. The cough is often likened to the short sharp barking of a dog.      Standard therapy directed towards the respiratory track proves ineffective and symptoms continue unabated. The patient goes from family physician to chestconsultant to ENT specialist, with no avail. Clinical examination is near normal and blood tests and X-rays of the chest draw a blank.      Some even get CT scans of their lungs. By then they have consumed antibiotics, cough syrups, antihistamines and sometimes even inhalers and nebulizers. Grandma and home remedies have failed.      GERD is more common in obese patients, those individuals who lie down soon after meals and those who eat heavy, large meals late at night. The content of the spicy, often alcohol-containing meal, the late timing and the lax tone of the abdominal muscles, tend to open up the sphincter and permit leakage up the food pipe. In addition to these bizarre respiratory symptoms, such patients tend to have water brash and heartburn owing to the gastric hyperacidity.      While treatment lies in changing the lifestyle and eating habits, drugs are available to increase the tone of the sphincter, neutralize the hyperacidity and blunt the hypersecretion.      In fact, the treatment of GERD focuses on the GI tract and the respiratory symptoms are seen to vanish— all coughs do not emanate from the lungs! While a lax sphincter may be due to a primary disorder, more often than not it is bad lifestyle that is the culprit.      With Diwali round the corner and parties dime a dozen, those vulnerable should take heed about late night dinners for "lungs se ooper" stomach is the "Boss" when it comes to a teasing cough.      (Dr Hemant Thacker is a consultant physician and cardio metabolic specialist in south Mumbai Hospitals. Email: dochpt@gmail.com)

735 dengue patients in city this month: BMC

Mumbai:The extent to which dengue has spread in the city became clear on Tuesday when BMC officials gave out, for the first time, figures of patients treated in both private and public hospitals. As against 578 dengue patients treated in public hospitals from January to September, BMC officers on Tuesday revealed that this month had seen 735 patients. 

    The dengue outbreak in the city has cost 11 lives so far, prompting the BMC to call in experts from Delhi's National Vector Borne Disease Control Programme and the National Institute of Malarial Research from Goa. 
    Till Tuesday this month, 615 dengue patients were treated in private hospitals and 120 in public hospitals. 
    "An analysis of our data shows that 50% cases are reported from non-slum areas and over 90% of the (mosquito) breeding was found in patients' homes or surroundings," municipal commissioner Sitaram Kunte said. 
    Two of the newest patients are assistant municipal commissioner (estates and markets department) Chandrashekhar Chore and his eight-year-old daughter. Both are in Jaslok Hospital. 
    Chore is the same officer against whom a departmental inquiry was initiated after the Mazgaon building collapse that killed 61 people. 
    Additional commissioner Manisha Mhaiskar said the BMC was clearing up outdoor breeding sites, but people should ensure that their homes were free of denguecausing mosquitoes. 
    The BMC also plans to make the dengue test—the NS1 antigen test—available at 50 dispensaries within the next three days. It is so far available only in the major public hospitals. 
    The BMC has also served notices to 570 housing societies found responsible for failing to prevent mosquitobreeding sites. It has already begun collecting blood samples of dengue patients admitted to Sion and Kasturba hospitals. These will be sent to the National Institute of Virology in Pune to ascertain if there is any mutation in the virus.

Complaints of throat infection and pain radiating to ears flood doctors

Mumbai: The increasing pollution levels accompanying the gradual change in weather is pulling Mumbaikars down. The spike in allergic as well as viral infections can be partly blamed on the haze and rising pollution levels.      Suspended particulate matter causes grief to the respiratory tracts of Mumbaikars, especially those who suffer from chronic problems. The situation is aggravated by the particulate matter trapped in the haze.      "The viruses thriving due to increase in humidity may be an additional reason for throat infections," said Dr Shahid Barmare, who consults at Kohinoor Hospital, Kurla. A primary viral infection, if untreated, may be followed by a bacterial infection. "Most patients are coming with throat pain and often it is radiating to the ears as well," he said.      Doctors say children and those already suffering from chronic respiratory problems such as asthma or chronic obstructive respiratory disorder (COPD) are more at risk.      "Most patients are coming with throat infection. There is hardly any fever, but the patients get dog-like barks and weakness in the limbs," said Dr Hemant Thacker, who consults with Jaslok and Breach Candy Hospitals.      Different sizes of particles may affect different parts of the respiratory system. "Small particles (5-15 microns in size) affect the upper parts of the respiratory tract like nose, sinuses, throat, bronchii (small airways). Since these particles are big, they are stopped by the hair lining the inside of the nasal tract. However, particles 1-5 microns in size manage to reach the deeper parts of the lungs," said Dr Ashok Mahasur, chest physician at Hinduja Hospital.      While the body has its own mechanism to combat even the smallest particles, in areas where construction is a continuous process, these particles are abundant and a beyond-the-limit quantity in the body may cause serious health hazards.      "The white blood cells present in the alveoli can eat up these particles. But there is a limit to it. When a person stays near a construction site, the particles get accumulated in the lungs over time and stay there. Prolonged accumulation of these particles may cause chronic cold, allergies, pharynxitis, bronchitis, an increase in asthma or trigger pneumonia along with the dreaded COPD," said Dr Neelam Rane, professor of physiology at D Y Patil Medical College.      Doctors advise Mumbaikars to start preparing for a worse onslaught of upper respiratory track infections. "Winter is round the corner and so is Diwali. There will be smog in the mornings and the crackers are not going to help matters. Those suffering from respiratory problems such as asthma should take precautions and increase their doses," said Thacker.

3 Indians suffer a stroke every min, don’t know it

Mumbai: Three adults suffer from a stroke every minute in India and around 5 million people are disabled globally due to the brain attack each year. Yet, half the residents of metros in India are unaware of strokes and their link to the brain. 

    A survey carried out across six metros in the country has revealed that awareness of astroke is abysmally low. More shocking is the fact that increasingly younger people are becoming vulnerable to strokes, reasons for which vary from lifestyle to ignorance about the problem itself. "Most people think that stroke is related to the heart," Dr Shirish M Hastak, neurologist and former president of the Indian Stroke Association, said. 
    A stroke occurs when a blood vessel taking blood and oxygen to the brain gets blocked or ruptured. When this happens, brain cells don't get the required blood. 
MEGA BLOCK WORLDWIDE 20m suffer strokes each year 
5m die, 5m left disabled/yr 
1 in 6 suffers stroke in lifetime IN INDIA 1.5m suffer strokes each year 
3,000-4,000 hit every day 
Strokes kill more than TB, HIV and malaria put together 42% Mumbaikars ignorant of strokes 
Brain Disease Affects 1.5mn Indians: Study 
Mumbai: Younger people are increasingly suffering strokes, but knowledge about the problem is shockingly low in most Indian cities, a survey shows. 
    Astroke occurs when brain cells do not get the blood they require. Deprived of oxygen, nerve cells stop working and die within minutes, so the part of the body they control can't function either. "It is extremely difficult for a person to seek immediate medical help if one does not even know about a problem," Dr Dr Shirish M Hastak, a neurologist, said. 
    The survey covered 1,507 people aged between 25 and 50 years in Mumbai, Delhi, Kolkata, Bangalore, and Chennai. It mainly captured the respondents' awareness and understanding of the term stroke, its symptoms, perceived causes, the prevailing knowledge about treatment options, and their experiences with stroke sufferers. 
    Worldwide, 20 million people suffer from stroke each year, five million die and another five million are disabled. In India, 1.5 million suffer from stroke every year and 3,000 to 4,000 are affected each day. According to the survey, 48% of people did not know what stroke meant. 
    "Bangalore scored fairly well with 68% aware of what a brain stroke is. Mumbai's performance was average with 58% aware that stroke is associated with the brain, followed by Kolkata. Delhi and Hyderabad had the lowest levels of awareness, with 36% and 27% respectively," said Dr Hastak. 
    The survey showed younger people were getting vulnerable to strokes. Doctors said it had to do with their lifestyle and eating habits. "I've observed an about 15-20% increase in the 25-40 age group reporting a stroke or unmistakable symptoms of it," said Dr P P Ashok, head of neurology, Hinduja Hospital. 
KNOW WARNING SIGNS, SEEK IMMEDIATE HELP 
STROKE | A stroke occurs when blood supply to part of the brain is disrupted, causing brain cells to die as oxygen and glucose cannot be delivered to the brain 
SYMPTOMS 
Sudden numbness or weakness of the face, arm or leg (especially on one side of the body) 
Loss of voluntary movement and/or sensation may be complete or partial. 
Sudden trouble speaking or understanding speech, seeing and walking. 
IF SOMEONE SUFFERS A STROKE 
Emergency medical care should be sought 
The affected person should be made to lie flat to promote optimal blood flow to the brain 
If drowsiness, unresponsiveness, or nausea are present, the person should be placed in the rescue position on their side to prevent choking if vomiting occurs 
While aspirin plays a major role in stroke prevention, once symptoms of a stroke begin, doctors say additional aspirin should not be taken till the patient receives medical attention

RUN RIGHT THE THIRD IN A 5-PART SERIES WHERE TOP ORTHOPAEDIC DR ARUN MULLAJI PREPS YOU FOR JANUARY’S MUMBAI MARATHON

TEMPERATURE CONTROL

The before and after are as important as the middle. Know the art of warming up and cooling down correctly to avoid injury

    Warming up before a run, whether it a half hour session or a half marathon, is crucial to avoid injury and sore muscles. Warming up ensures that your muscles get blood flowing through them, your heart rate ups, and you are placed in the right mental and physical state to train. Warming up is far more effective than cooling down in preventing muscle soreness the next day. 
    Do not start running right away — you will risk pulling your muscles. Allocate time as follows: Warm up for 5 minutes, perform dynamic stretches for 10 minutes, begin your training session running leisurely for the first 5 minutes, then cool down, and follow it up with a few minutes of stationary stretches. 
WARMING UP 
First, slow walk for a few minutes before you ease into a brisk walk, and follow it up with light jogging. Do this for about five minutes. Once your muscles are warmed up, start with stretches. 
COOLING DOWN 
The most important benefit of cooling down is to allow your circulatory system to return to normal. In other words, it prevents blood from pooling in your legs and causing dizziness or light-headedness from decreased blood flow to your brain. Cooling down is best accomplished by jogging at a slow pace, and moving into a brisk walk till you are breathing normally. Once your breathing pattern is normal, end your session with stretches for your calves, hamstrings, quads, glutes, hip flexors. Finish it off with side stretches. The key to correct stretching is to hold a stretch for 15-30 seconds and repeat it several times. As far as easing muscle soreness goes, research has proved that performing easy low-impact aerobic exercises is more effective than stretches. 
LET YOUR BODY RECOVER 
Recovering after a run is important in preventing injury. When you first set out to run, do not run on consecutive days. You must rest for at least two days in a week. This not only prevents overtraining, but injuries too. It lets the muscle tears heal. You can cross-train on days when you don't run. This can include going to the gym to strengthen your core muscles, using a cross-trainer, rower, cycling, swimming and spinning. On your rest days, perform stretches, or build strength with yoga and pilates. 
    As you get fitter, resist the temptation to rapidly speed up and increase your mileage. Instead, aim to increase the time or distance by about 10 per cent on your longest run each week. 
STRETCHES 
These can be stationary or dynamic. Dynamic stretches involve actively moving at high speed into a particular pose. They have a greater value than stationary stretches which involve holding a muscle in an elongated and fixed position for 30 seconds or so. I'd suggest stationary stretches for cooling down. The idea behind stretching is to get your joints and muscles primed for the functional range of motion that will be demanded of them during running. Stretches help quickly loosen stiff and cold muscles, and up body temperature and blood flow. Here are three effective dynamic stretches: 
LEG LIFTS 
Performed by standing on one leg and swinging the other leg sideways — away from your body as much as you can — and then swinging it the other way across your body. Hold onto a support if you need to. 
LUNGE WALKING 
This involves walking with a long stride, keeping the front knee over your toes while lowering your body by bending your rear knee till it almost touches the ground. 
QUAD STRETCHES 
Done while walking. When 
    you swing 
    your leg back, continue the motion so your heels come close to your buttocks. Repeat with the other leg. 
HAMSTRING AND CALF STRETCHES 
Done while walking forward with your back and knees straight, and lifting your legs straight out in front of you as much as you can; try to touch your toes with the opposite hand.

Way to suppress appetite found Brain Cells Can Help In Diet Control

Washington: Scientists have used genetic engineering to identify a population of neurons that tell the brain to shut off appetite. Researchers have also identified neurons in other brain regions that can stimulate the appetite of mice that are not hungry, paving way for therapies that promote or decrease appetite.      To identify these neurons, or cells that process and transmit information in the brain, researchers at the University of Washington first considered what makes an animal lose its appetite. There are a number of natural reasons, including infection, nausea, pain or simply having eaten too much already.      Nerves within the gut that are distressed or insulted send information to the brain through the vagus nerve.      Appetite is suppressed when these messages activate specific neurons - ones that contain CGRP, (calcitonin gene-related peptide) in a region of the brain called the parabrachial nucleus. In mouse trials, researchers used genetic techniques and viruses to introduce light-activatable proteins into CGRP neurons.      Activation of these proteins excites the cells to transmit chemical signals to other regions of the brain.      When they activated the CGRP neurons with a laser, the hungry mice immediately lost their appetite and walked away from their liquid diet (Ensure); when the laser was turned off, the mice resumed drinking the liquid diet. "These results demonstrate that activation of the CGRP-expressing neurons regulates appetite. This is a nice example of how the brain responds to unfavourable conditions in the body, such as nausea caused by food poisoning," said Richard Palmiter, UW professor of biochemistry and investigator of the Howard Hughes Medical Institute.      Using a similar approach, neurons in other brain regions have been identified that can stimulate the appetite of mice that are not hungry.      Researchers hope to identify the complete neural circuit in the brain that regulates feeding behaviour. PTI NOW YOU CAN STAVE OFF HUNGER

Cutting-edge tech brings cheer to patients

When 71-year-old Krishna Natrajan of Chembur was told that his heart, already operated upon a decade ago, needed surgery again, he decided to wait for a hi-tech alternative: biodegradable stents.      He waited four months for the launch till December 2012, pooled his medical insurance and his savings and bought four stents. The stents alone cost Rs 12 lakh, but his cardiologist V T Shah believes the cost was worth on two counts: redo heart surgeries are very complex and his patient's recovery took lesser time than a surgery would.      Advanced technological solutions carry a premium tag, but they offer an edge to patients. They translate into quicker exits from dreary hospitals, fewer tears and, mostly, a quicker recovery.      Technology has changed health-care delivery in many ways. Knee-replacement patients literally start walking within 24 hours of surgery. Patients who have half of their stomachs carved out, walk out of hospital within 24 to 36 hours. Most private eye hospitals don't bother with overnight facilities as most of the procedures are done as out-patient procedures. 'Hi-tech has helped better treatments'  Higher Costs Spark Debate, But Most Docs See Advantage      A day after TOI highlighted how insurance companies are receiving higher bills due to toptech surgeries, experts said hi-tech medical solutions offered greater comfort to patients. "Technology has helped us gain perfection. We are close to eliminating human error in orthopaedic surgery," said orthopaedic surgeon Dr Vijay Shetty.      Eye surgeons feel the same. "In the last decade or so, we have managed to reduce the size of the incision for eye surgery to 0.7mm. This is one-seventh of what we did before," said retina surgeon Dr S Natrajan to highlight the contribution of hi-tech to the world of surgery.      Thanks to minimally invasive heart surgery with newly-devised probes and clips, heart surgeon Mahesh Singh said "we can now offer patients supra-heart surgery with the promise to discharge them after two days in hospitals".      Old-timers like Dr Lalit Kapoor, a surgeon and founding member of the Association of Medical Consultants, believe that technology is being overused. "Hi-tech has become an excuse to hike the bill," said the doctor who has been part of many dialogues with insurance companies. "Relatives of patients want to offer the best or they carry guilt. The costs are so high, I wonder how people raise the money," he added.      But senior heart surgeon Dr Ramakanta Panda felt the contribution of technology cannot be underestimated. "Advancements in technology are improving the quality of treatments available. So what looks like an increase in the insurance claim amount could actually be a whole new treatment made available to the patient, or an opportunity to save his life that was not available earlier," he said.      The main issue, he felt, was the initial cost of research on any new technology. "Only if there's wide acceptance of the procedure and usage will the cost get lower," he said.      Insurance companies could use "information therapy" to help patients, felt Aniruddha Malpani, who heads the HELP Library for patients. "It has been researched extensively and accepted that patients don't care if someone else is paying the bill. When they are paying, they will say that they don't want an expensive drug-coated stent and would be happier with bare metal," he said.      A solution for insurance companies against unnecessary splurging on top tech would be to educate buyers about health options. "If a patient runs a check on Google about robotic surgery, which is still comparatively new, he is not likely to find the adverse advice until they reach the fourth or fifth page of the search. If an insurance company offers information to patients on their website or mail such booklets to patients, it would help both the patients and the insurance companies," Malpani added.