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Chemical in cigarette smoke may damage vision

The Kashmir Monitor





Exposure to a chemical in tobacco smoke could make it more difficult for people to see in low-contrast conditions, such as low light, fog or glare, a new study suggests.
Researchers found that higher levels of cadmium in the blood were associated with diminished contrast sensitivity, they report in JAMA Ophthalmology.
“This particular aspect of vision is really important because it affects your ability to see the end of a curb or put a key into a lock in low light,” said lead author Adam Paulson of the University of Wisconsin, Madison, School of Medicine. “It’s something that at this point in time there’s no way to correct, unlike visual acuity, which you can easily correct with glasses or contact lenses.”
Smoking can raise cadmium levels, as can consumption of leafy green vegetables and shellfish, Paulson said. It may be possible to eat greens and avoid cadmium if you can find produce that has not been treated with pesticides, he added.
For a closer look at the impact of two heavy metals, cadmium and lead, Paulson and his colleagues analyzed data from a larger study dubbed the Beaver Dam Offspring Study, which was designed to look at the aging process. Volunteers enrolled in that study between 2005 and 2008.
Both lead and cadmium accumulate in the retina, Paulsen said.
The retina is the layer of nerve cells at the back of the eye that senses light and sends signals to the brain.
Volunteers’ contrast sensitivity was examined through an eye test. Instead of making letters smaller and smaller, researchers made successive reductions in the contrast between the letters and the background. Volunteers would start with black letters against a white background. Then, with each iteration, the letters would become more and more washed out.
At the beginning of the study, all 1,983 participants had no impairment. All were retested at five and 10 years after the study started. At the 10-year mark, nearly one quarter of the study volunteers had some impairment of their contrast sensitivity, and that impairment was associated with levels of cadmium, but not lead.
That doesn’t necessarily mean that lead won’t impact contrast sensitivity. “Levels of lead in our study population were actually quite low,” Paulsen said. “It could be that in our study there wasn’t enough exposure to lead. It’s possible that another study might find an association.”
The new study suggests “that certain trace chemicals that we are exposed to in small amounts could be harming our eyes in subtle, incremental ways over time,” said Dr. Mandeep S. Singh of the Wilmer Eye Institute at Johns Hopkins Medicine. “Here, the investigators implicate cadmium, which is present at relatively high levels in cigarette smoke, but there could be other culprits which we don’t know about. But it is another good reason to avoid smoking.”
Many people don’t realize they can have good visual acuity, 20-20, and still not feel like they can see well, Singh said in an email. “Even people who can read all the way down to the smallest letters on the eye chart can have deficits in contrast sensitivity that tells us their vision is not OK.”
Cadmium is a neurotoxin, and it could be damaging the nerve cells of the vision system, Singh said.
Even those with 20-20 vision can experience problems with daily living if their contrast sensitivity is impaired, said Dr. Nicholas J. Volpe, George and Edwina Tarry Professor and chairman of the department of ophthalmology at Northwestern University’s Feinberg School of Medicine in Chicago.
Contrast sensitivity declines as we age, Volpe said. But the new study suggests there might be other factors that can affect it.
Volpe cautioned that the study has found an association, but it can’t prove that cadmium actually causes contrast sensitivity to decline. It’s possible cadmium is a marker for some other factor.
Another issue is that the researchers weren’t able to say that cadmium, independent of smoking, was associated with contrast sensitivity declines, Volpe said. So, until there are more studies, “I don’t know that we’ll be checking cadmium levels,” he said. “More often I’ll be saying, don’t smoke.”

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Hepatitis A Causes and Symptoms

The Kashmir Monitor



Generally speaking, hepatitis A is more common in parts of the planet that are developing. It’s for the fact that sanitation and food handling practices are by and large poor. However, medical experts say that living in developed countries can also put you at risk of having hepatitis A, but it’s really a rare occurrence.

Just like what’s mentioned earlier, hepatitis A is caused by the hepatitis A virus or HAV. It can be spread around by someone who has hepatitis A because he or she is a carrier of the virus behind it. It is said that a person with hepatitis A is most infectious about 2 weeks before he or she begins to experience signs and symptoms.

Here are some of the ways that hepatitis A is spread around:


Consumption of food that is prepared by a person who has hepatitis A. This is most especially true if he or she has not properly washed his or her hands.

Drinking of water that is contaminated with the hepatitis A virus.

Intake of raw or undercooked seafood obtained from contaminated water.

Close contact with someone who has hepatitis A. This includes having sexual intercourse with an infected person, especially when the rectal or anal area has been touched with the fingers, mouth or tongue.

Using illegal drugs, especially when paraphernalia contaminated with the hepatitis A virus are used.


Medical experts say that it may take a while before the various signs and symptoms associated with hepatitis A show up. They say that someone may experience them about 4 weeks after getting infected. It’s even possible for someone with hepatitis A to not experience any sign and symptom at all.

Some of the initial signs and symptoms of hepatitis A include:

Tiredness and malaise
Achy muscles and joints
Pain in the upper right section of the abdomen
Loss of appetite
Mild fever
Sore throat
Diarrhea or constipation
Hives or raised rash that’s itchy

These initial signs and symptoms associated with hepatitis A can last anywhere from a few days only to a couple of weeks. Afterwards, as the infection of the liver progresses, the following may be experienced by the individual:

Jaundice, which is the yellowing of the skin as well as the whites of the eyes (sclera)

Pale colored stools
Dark colored urine
Skin itching

Tenderness and swelling of the upper right section of the abdomen

Although it rarely happens, hepatitis A can cause liver failure. When such develops, the person who is infected may experience severe vomiting, frequent bruising, bleeding of the nose and gums, drowsiness and confusion.

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Busting myths around blood donation

The Kashmir Monitor



As per the World Health Organisation (WHO) norms, ideally, one per cent of the total population should regularly donate blood to meet the requirements, which is anywhere between 1% and 3% of country’s population that would require blood in a year.

Contrary to the myth about blood donations making a person weak or anaemic, the body replenishes the lost blood in a matter of a few days, say experts.

“A healthy bone marrow makes a constant supply of red cells, plasma and platelets, so there is no question of becoming weak, much less anaemic. It is a myth and should not deter people from donating blood,” says Dr RK Singal, chairman, internal medicine department, BLK super-speciality Hospital.


The donors can give either whole blood or specific blood components, as there is sophisticated equipment available these days that extract relevant components from blood and the rest of the blood can be transfused back to the donor.

As per the World Health Organisation (WHO) norms, ideally, one per cent of the total population should regularly donate blood to meet the requirements, which is anywhere between 1% and 3% of country’s population that would require blood in a year.

About 65% of India’s population is young and if this section donates blood regularly, chances of the country facing blood shortage will be remote. Hence, there is all the more reason for people, especially youngsters, to come forward and be regular blood donors.

How to prepare

Have enough fruit juice and water in the night and morning before you donate

Have a full meal 3 hours before donation; never on an empty stomach

Have some rest for about 10-15 minutes after donation

Have some snacks or a juice with high sugar content after donation

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Erectile dysfunction’s connection with lifestyle

The Kashmir Monitor



By Dr Anjani Kumar Agrawal

healthy-lifestyle-can-reverse-effects-of-hypertensionAll over the world, but perhaps more so in India, men are embarrassed to admit that they may have a problem getting or keeping an erection — a condition known as erectile dysfunction (ED).

All over the world, but perhaps more so in India, men are embarrassed to admit that they may have a problem getting or keeping an erection — a condition known as erectile dysfunction (ED). From my research, I have found a strong link between ED and stress. Other major causes include smoking, drinking, diabetes, hypertension or high blood pressure and cholesterol levels. My advice to these patients is — do not get even more stressed over this situation. Instead, focus on taking the right medication and making some changes to your lifestyle, so you can once again enjoy a satisfactory sexual life.



We normally diagnose ED and its underlying causes by asking the patient a few questions about his medical and sexual history. This is sometimes done by sharing a questionnaire with the patient. The questions that we ask are designed to help us understand the cause of ED in the particular patient.

We also do a physical exam, ask for certain blood tests to rule out other medical conditions responsible for erectile dysfunction, and recommend imaging tests (if required) to determine whether the person is physically able to have an erection or not.


Underlying medical conditions such as diabetes, hypertension and hypercholesterolaemia (high cholesterol levels) can cause ED. In these cases, ED can be reversed once the patient starts treatment.

In my experience, many men suffer from ED because of work stress, family pressure and anxiety. So, changes in lifestyle with regular exercise, yoga, abstaining from alcohol and smoking, and proper counselling help in treating ED. Along with this, medicines for ED are usually prescribed for about 3 to 6 months by which time lifestyle changes start to take effect and the patient is physically and mentally healthier, which helps resolve the problem.

An estimated 16% to 25% of men experience ED at some point in their lives. I would urge them not to be embarrassed about it. Seek medical help from a urologist or andrologist; get the necessary advice/medication; and go on to enjoy a healthy, fulfilling sexual life.

The author of this article is Dr Anjani Kumar Agrawal, head, andrology, department of urology sciences, Max Smart Super Speciality Hospital, Saket

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