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Smog: How it affects the eye

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First, it was the irritation, later, Debiparna Chakraborty saw that her eyes were red and swollen. The 28-year-old media professional has been living in Delhi for four years now and of late, the time during and after Diwali has become extremely trying for her. This year was no better. “My eyes have been itchy and irritable since the smog set in. Some days I wake up with swollen red eyes. I have to splash it with water several times a day,” she says. “Sometimes even that doesn’t help. Nor does air purifiers,” she adds. At present on antibiotics, Chakraborty says the medicines have helped in curbing the itchiness.

Anjali Nayar, another media professional says, “Post Diwali, I would experience irritation in my eyes after a bike ride or if I spent too much time outside. My eyes used to irritate and then they would become watery. Sometimes it occurred in just one eye, at other times in both”. The cause of discomfort was the same as Chakraborty’s – smog.

A thick haze of smog has enveloped the city for days now. On Tuesday (November 13) a PTI report stated that the air quality in the capital remained severe. According to the same report, the level of PM2.5 (particles in the air with a diameter of less than 2.5 micrometres) and PM10 (particles in the air with a diameter of less than 10 micrometres) in was recorded at 238 and 399 respectively in Delhi.

 

The pollution has severe health hazards and affects the eye as well. Dr Sudipto Pakrasi, who leads the Ophthalmology division at Medanta, Gurgaon, admits that the frequency of patients complaining of eye soreness, redness, burning sensation increases significantly post Diwali every year.

“Post-Diwali we see a huge increase in the number of people coming with these symptoms. These are related to commonly found air pollutants like carbon monoxide, sulphur dioxide, nitrogen dioxide, arsenic, asbestos, benzene, lead, chlorofluorocarbons, particulate matters, and dioxin,” he says.

“During Diwali, the most common conditions which people experience and come to an eye specialist for is allergic conjunctivitis. This causes redness in the eye and watering. The increase in the dust level leads to blurry vision,” says Dr Radhi Malar, Ophthalmologist at the Fortis Malar Hospital.

At such times, taking basic preventive measures go a long way. “Try to wear glasses during this time. They act as a barrier. However, do avoid contact lenses as they tend to aggravate allergy,” says Dr Parul Sharma, Ophthalmologist at Max Multi Speciality Centre Panchsheel Park and Max Hospital Gurgaon.

“General hygiene is a must when it comes to avoiding eye problems. Washing of hands, wearing protective eye wear like polarized sunglasses while travelling outside and maintaining a good and healthy lifestyle is important,” Malar says. However, Pakrasi maintains that in case redness in the eye persists, or there is a prolonged burning sensation in the eyes for some time, consulting a doctor is a must.

The effect of smog is not a recent phenomenon. Milap Kashyap, a 25-year-old who works at a corporate bank, recollects the scare he faced last year. “Last year during Diwali, my eyes reddened and after four days, a thin blue line appeared along with the redness. Panicking, I went to consult a doctor. He gave me some medicines and suggested that I do some tests,” he says. “However, things quickly worsened and my eyesight in my left eye became blurred. I visited Center for Sight in Safdurjung where I had to undergo a couple of more tests. After some doctor consultation, I was finally given spectacles with cylindrical numbers. I wore it for 10 days and then gradually recovered,” he added.

The problem, clearly, has become a fixture with the festive season. Long after the spark from the crackers has been put out, a dark cloud of gloom surrounds us and it refuses to subside.


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Health

Beware of the silent killer

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By Dr Sudhir Koganti

One may wonder what all this fuss about high blood pressure is. Hypertension causes many cardiovascular diseases that include stroke, heart attack, kidney failure and dementia, thus putting a huge burden on healthcare globally due to morbidity, mortality and associated costs. Last but not least, the public need to be aware of the correct treatment for high blood pressure.
Every year, the World Hypertension Day is celebrated on the 17th of May to increase awareness about this silent killer among general public. International Society of Hypertension along with World Hypertension League has designated the month of May as “May Measurement Month.”
The aim of this initiative is to screen as many people as possible that are over the age of 18 years for suspected hypertension. This strategy would greatly enhance in identifying silent or undiagnosed hypertensives so that they can be targeted with guideline directed lifestyle, dietary advice and treatment.
Awareness on the lower threshold of blood pressure reading required to label an individual as hypertensive is also required. American Heart Association guidelines released in 2017 clearly stipulate that a blood pressure reading of over 130/80 is now considered as stage 1 hypertension. However, the job of a cardiologist doesn’t stop with diagnosis but actually starts there. Once someone is labelled as hypertensive, it needs to be established if it is true or an entity called white coat hypertension.
Furthermore, investigations may have to be carried out to see if hypertension is secondary to a cause. Once diagnosed, a decision needs to be taken if lifestyle modification can be adopted or treatment needs to be initiated early.
Lifestyle modifications include six key steps and they are:
• Get expert advice from your doctor to help you understand your results;
• Lower salt/sodium to prevent excess fluid in the blood, which strains blood vessels;
• Eat more fruits and veggies – particularly potassium-rich ones – to balance out sodium in the blood;
• Exercise – it makes the heart stronger, putting less strain on blood vessels;
• Quit smoking – constituents of tobacco smoke damages blood vessel linings; and
• Monitor your blood pressure at home
As per studies and data, thousands of people are on wrong treatment for hypertension with a class of drugs called Betablockers (Atenolol, Metoprolol etc) being prescribed as first line or second line agent.
Betablockers have been phased out as first line or second line drugs to treat hypertension a while ago, unless there is concomitant coronary artery disease or heart failure. In fact, the same holds for other concomitant conditions too such as kidney disease, stroke etc.
Essentially, the key message is one prescription does not fit all and it need to be tailored to the individual in a dedicated specialist clinic. People need to actively undergo blood pressure screening of themselves.
They need to nudge their relatives and friends in the month of May and seek expert advice on how to manage and monitor this silent killer over the long run to lead an active and healthy life. (Writer is Consultant Cardiologist, Citizens Hospitals, Nallagandla, Serilingampally)
Dr Sudhir Koganti

 
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Health

Jawless fish may hold key to effective brain cancer treatment

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A chemical found in jawless parasitic fish can be used to deliver anti-cancer drugs directly to brain tumours, as well as lead to more effective treatments for trauma and stroke, a study has found.
The research, published in the journal Science Advances, found that molecules from the immune system of the parasitic sea lamprey may also be combined with a wide array of other therapies, offering hope to treat disorders like multiple sclerosis, Alzheimer’s disease or even traumatic injuries.
“We believe it could be applied as a platform technology across multiple conditions,” said Eric Shusta, a professor at the University of Wisconsin-Madison in the US.
When injected into the bloodstream, many drugs cannot reach targets in the brain as the blood-brain barrier prevents large molecules from leaving the blood vessels in the brain, researchers said.
In conditions such as brain cancer, stroke, trauma and multiple sclerosis, however, the barrier becomes leaky in and around the disease locations, researchers said.
The study found that leaky barrier offers a unique point of entry, allowing molecules to access the brain and deliver drugs precisely on target.
“Molecules like this normally couldn’t ferry cargo into the brain, but anywhere there’s a blood-brain barrier disruption, they can deliver drugs right to the site of pathology,” Shusta said in a statement.
Researchers said that the technology takes advantage of the fact that many diseases disrupt body’s natural defense mechanism – the blood-brain barrier, which lines the blood vessels of the central nervous system, protecting the brain from circulating toxins or pathogens.
They also linked the molecules to a chemotherapy called doxorubicin. The treatment prolonged survival in mouse models of glioblastoma, an incurable cancer.
“This could be a way to hold therapies in place that don’t otherwise accumulate well in the brain so they can be more effective,” said Ben Umlauf from the University of Wisconsin-Madison.
“There are several disease processes that disrupt the blood-brain barrier and we could conceive of delivering a variety of different therapies with these molecules,” said John Kuo from the University of Texas in the US.

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Health

Life expectancy linked to a person’s walking speed

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People who walk slowly have a lower life expectancy than those who walk fast, a recent study has claimed. According to the study published in the Journal of Mayo Clinic Proceedings, those with a habitually fast walking pace have a long life expectancy across all levels of weight status – from underweight to morbidly obese.
Underweight individuals with a slow walking pace had the lowest life expectancy (an average of 64.8 years for men, 72.4 years for women). The same pattern of results was found for waist circumference measurements.
Professor Tom Yates, the lead author of the study, said, “Our findings could help clarify the relative importance of physical fitness compared to body weight on the life expectancy of individuals. In other words, the findings suggest that perhaps physical fitness is a better indicator of life expectancy than body mass index (BMI) and that encouraging the population to engage in brisk walking may add years to their lives.”
Dr Francesco Zaccardi, co-author of the study, said, “Studies published so far have mainly shown the impact of body weight and physical fitness on mortality in terms of relative risk, for example, a 20 per cent relative increase of risk of death for every 5 kilograms per metres squared increase, compared to a reference value of a BMI of 25 kilograms per metres squared (the threshold BMI between normal weight and overweight).”
Last year, Professor Yates and his team showed that middle-aged people who reported that they are slow walkers were at higher risk of heart-related disease compared to the general population.

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