Wealth of Health : 5 Tips

Merely an absence of disease does not necessarily mean that you are healthy. It’s true that sometimes diseases strike us when we least expect it even when we do everything right as far as staying healthy is concerned. Indeed, a wise man once truly said “Health is Wealth”, for there is nothing worse than feeling ill at ease. Illness and diseases not only make you dependent on others, they also rob you of your zest for life. Why not take measures to ensure a long, happy, self sufficient and healthy life? Here are a few tips to help you do just that!

Regular Checks

Never underestimate the power of monitoring your health. A major part of staying well is consistency in health and that can only be figured out if the indicators of your health are regularly monitored. These indicators are Sugar Levels, Blood Pressure, Haemoglobin Count, Urine Analysis, Cholesterol and Lipid Profile, Liver Function Test, ECG, and Chest X-Ray. Many hospitals such as Apollo Hospitals have comprehensive health check-ups that cover all these tests and more. These tests become all the more important as you age.

Sweat It

There is no alternative to exercising and you don’t just need to do it when you gain a few extra pounds. Exercise keeps you active and energetic and it is great for the joints. However, be careful of over-straining yourself. Consult a physician or fitness trainer to figure out a fitness plan that is best suited for you. And do remember to wear the right outfit and footwear while exercising, else you may injure yourself. Keep moving and don’t allow yourself to be glued to a chair all day.

Follow the Pyramid

Not the pyramids in Egypt, we mean the food pyramid. A food pyramid basically tells you what to eat most and what to scrimp on. At the base of the pyramid are things that you should consume the most like cereals and pulses. As the pyramid tapers off to its peak, it tells you about the things you should eat sparingly like oils and fats. In the middle of the pyramid are food items to be consumed moderately like fruits and veggies followed by milk and meat products. Keep this in mind when you eat or plan your meals.

Relax

Stress leads to many physical and mental disorders. Keep it at bay with deep breathing, leisurely strolls, meditation, chanting, and listening to music. Other ways to relax include socializing, traveling, talking to friends, or basically doing anything that pleases you and makes you feel good.

Water Rules!

Keep your body well-hydrated by drinking a lot of water throughout the day. Water is actually a miracle drink that aids many of your bodily functions like getting rid of toxins, eliminating wastes, regulating body temperature, lubrication of body joints, assisting in digestion processes, and much more. This is one drink you should indulge in all day and every day!

Eczema Treatments for Kids

Eczema or Atopic Dermatitis, is a common and frustrating condition for parents and their children. In addition to there not being a cure, it can be difficult to treat and parents often get different advice about how to treat it.

Eczema Symptoms

The main symptom of eczema is an itchy rash, which may be red, rough or irritated, scaly, and oozing. The rash typically begins in early infancy and almost always by 5 years. Although the rash does usually come under control and go away with proper treatment, it will likely come back at times.

Diagnosis of Eczema

Eczema is usually diagnosed based on the appearance of the itchy rash in typical areas, including the forehead, cheeks, arms and legs in infants, and the creases or insides of the elbows, knees, and ankles in older children.

Eczema is sometimes mistaken for other itchy rashes, including contact dermatitis, heat rash, seborrheic dermatitis, and psoriasis. The timing of when the rash started, where your child has the rash, and the pattern of when it flares up can help your pediatrician figure out if he has eczema or another skin rash.

Preventing Eczema Flares

The basics of preventing eczema flares (periods of time when your child's eczema gets worse) includes avoiding known triggers, such as harsh soaps, bubble baths, dust mites, food allergies, overheating and sweating, wool and polyester clothing, and keeping your child's skin well-moisturized. Since it is often hard to identify and avoid triggers, moisturizers can be the most helpful way to avoid eczema flares.

To help avoid dry skin, you should give your child a daily bath using lukewarm water and a mild, moisturizing soap or soap substitute. Afterwards, cover him with a moisturizer as soon as possible to seal the moisture into his skin.

Although there are many types of moisturizers, a greasy ointment will likely work best. These can include Vaseline and Aquaphor, although creams may also work well. Avoid lotions and oils. When choosing a moisturizer, you may have to try several and just see what works best for your child and be sure to reapply the moisturizer at least two or three times a throughout the day.

Nonsteroidal prescription creams and lotions can also be used instead of an over-the-counter moisturizer. These include Hylira, Mimyx, and Atopiclair.

Treatments for Eczema

When your child's eczema flares, the typical treatments include topical steroids and the newer non-steroidal medications like Elidel (pimecrolimus) and Protopic (tacrolimus). Keep in mind that there are warnings about using Elidel and Protopic in children who are under two years old or for continuous use over long periods of time.

Topical steroids can range from over the counter hydrocortisone creams, which are very mild and may even be used on the face, to stronger mid- and super-potent steroids that require a prescription. In general, super-potent steroids are avoided in children, and intermediate or mid-potency steroids are more commonly prescribed, such as Cutivate (Fluticasone), Dermatop (prednicarbate), Elocon (mometasone), Locoid Lipocream (hydrocortisone butyrate) , and 0.1 percent triamcinolone. Even these can cause side effects, including skin thinning and stretch marks if they are used for to long in the same place though. They should also not be used on a child's face or under occlusion, like under a diaper.

Newer immunomodulators or steroid-free topical medications are also available to treat children with eczema, including Elidel and Protopic. They are generally used twice a day in children over age two and can be applied to all areas where your child has eczema, including his face. They may also help avoid flares if you then begin using them at the first sign of itching or a rash.

Antihistamines are also often used as part of a good treatment regimen for eczema. They are particularly helpful if itching is interfering with your child's sleep, in which case a sedating antihistamine, like Benadryl (diphenhydramine hydrochloride) or Atarax (hydroxyzine hydrochloride), may work well. Cold compresses can also be effective at helping your child control his scratching when his skin itches.

Other treatments are also available for very difficult to treat cases of eczema, including using wet dressings, oral steroids, ultraviolet light therapy, and immunosuppressive drugs, like cylcosporin.

What You Need To Know

• Although there is no cure, many children either outgrow their eczema, or it at least gets better as they get older.

• Eczema does run in certain families and can be associated with other 'allergic'-type disorders, like allergic rhinitis and asthma.

• You should apply moisturizers on top of your child's other topical medications during eczema flares.

• Most experts now recommend that your child take a daily, 10-minute bath to help moisturize his skin. As long as you place a moisturizer or lubricant on his skin within two or three minutes after his bath, it should keep his skin healthy and well hydrated.

• Be ready for times when your child's eczema may get worse, including the winter, when your house may be dry, and summertime, when he may be swimming or getting overheated outside.

• Keep in mind that skin infections often accompany difficult to treat eczema flares and your child may sometimes require an antibiotic, in addition to his usual eczema treatments.

• If your child's eczema isn't improving with standard treatments, see a pediatric dermatologist for further help and treatment advice.

Source:
Habif: Clinical Dermatology, 4th ed. Dry skin and Xerosis.

Basic Information About Diabetes

Diabetes refers to a group of metabolic disorders (which are quite common and becoming commoner or increasing in incidence) which share a common sign i.e. high blood sugar level or hyperglycemia. There are several types of diabetes and all of these are characterized by hyperglycemia and develop signs and symptoms of hyperglycemia. The cause of diabetes is complex and generally genetic and environmental factors play a role in its causation.

The cause of hyperglycemia in diabetes can be due to reduced insulin secretion, insulin resistance in presence of normal or near normal insulin secretion, decreased utilization of glucose by the diabetic individual or it may be due to increased production of glucose. The cause of decreased insulin secretion or insulin resistance can be different in different type of diabetes.

Broadly diabetes can be divided into type-I diabetes, type-II diabetes, MODY (maturity onset diabetes of the young), gestational diabetes (occurs during pregnancy only) and other types. Out of all these, type-II is the commonest type of diabetes and has strong genetic factor involvement.

Diabetes can cause secondary pathophysiologic changes in multiple organ systems due to metabolic disorders which are associated with diabetes. Due to secondary pathophysiological changes in multiple organ systems, the involved organ systems may not function to the optimal state and lead to several complications of diabetes. The common complications of diabetes involve eye (cataract, diabetic retinopathy etc. and cause blindness), kidney and urinary system, heart and cardiovascular system, central nervous system, increased incidences of infection, gastrointestinal problems, delayed healing of injuries etc.

Allergy

Introduction 

Allergy is a condition characterised by a level of sensitivity greater than normal to a specific substance or group of substances. These substances, called allergens, trigger a response in susceptible individuals. They can enter the body through various routes like inhalation, ingestion, injection, and external skin contact. They react with antibodies in a susceptible person, causing the release of histamine (a chemical mediator in allergic reactions) and other chemical substances that cause various symptoms, thus creating a chain response known as the allergic response. 

Cause and Pathogenesis 

Allergic reactions may be caused by a multitude of factors. These include the most common allergy 'triggers' like pollen grains, dust, moulds and foodstuffs. Other triggers include animal proteins from hair, and fur and substances that cause skin allergic reactions such as certain oils found in plants, drugs, cosmetics, chemicals etc.

The allergies can be classified as seasonal allergies and perennial allergies. 

Seasonal Allergies

Seasonal allergies occur during certain seasons of the year. They are caused by inhaling microscopic particles in the air and substances like pollen released by plants, grasses and weeds. It can lead to a sustained allergic response. 

Perennial Allergies

Perennial allergies occur throughout the year. They occur due to mould, fungi and dust found indoors. Perennial Allergies can be caused due to fur from cats and dogs and other pets.

An exaggerated response to specific food allergens is termed food allergy or hypersensitivity and such foods include milk, eggs, chocolate, nuts, corn, pork and beef. Histamine and its related substances are responsible for mediating the allergic response and causing the characteristic symptoms of allergy. 

Symptoms and Signs 

Breathing problems and skin irritations are the common allergic responses. Sneezing, running nose, watery eyes, wheezing, skin redness, and skin itching and rashes are common symptoms. Allergic Rhinitis is a term that is used to describe a thin, watery trickle from the nose accompanied by sneezing, as in common colds. Severe allergies can cause anaphylactic shock, a life threatening reaction to some allergens where there may be a sudden and dramatic drop in blood pressure. Anaphylactic shock may also cause closure of air passages and result in death. Anaphylactic reactions may be caused by bee stings, drugs like penicillin and also some types of food substances. When an individual's allergies are triggered, there is swelling of the nasal linings, which results in sinus blockage and infection. 

Investigations and Diagnosis 

A family history of allergy and allergy-related diseases is important in the assessment of allergies. Reactions occurring with regularity at certain times each year may be due to seasonal allergies, while those that manifest throughout the year are perennial. If the symptoms improve with anti-allergy drugs, then an allergic component to the problems is believed to be present.

There are also a variety of tests that help in the diagnosis of allergies. One method of testing is In-Vivo Testing. The basic principle in this method is to demonstrate an actual allergic reaction in the patient by using micro doses of the suspected allergen. Various allergens are injected into the skin by a scratch, a prick, or an injection, and the skin is monitored for a reaction. A positive response can be noted when significant redness or swelling occurs at the site of the test. While these tests can accurately identify actual allergic sensitivities, there is the risk of triggering a full-blown allergic response. Another requirement of In-Vivo Testing is that the patient must stay off anti-allergy drugs for several days prior to testing so as not to negate the response. Additionally, this test involves the timely and sometimes painful process of injecting numerous allergens, usually on the back or the arms. Skin tests are difficult to perform on infants and young children. Allergic individuals who have skin rashes or hypersensitive skin, which might interfere with test results, are not suitable for skin testing.

Another method is In-Vitro Testing. It is based on identifying the antibody proteins (chemicals produced in the body due to an immune response) produced by the individual during an allergic reaction. A blood sample is collected from the patient, and the amount of specific antibodies present is measured (there are a variety of antibodies, each of which reacts to a specific allergen). The Radio-Allergo-Sorbent Test (RAST) requires only a sample of the patient's blood. Blood serum can then be tested against common allergens. However, RAST is useful in infants and young children unable to undergo the In-Vivo Test, and in individuals with extensive skin rashes or skin hypersensitivity where injection may stimulate an over-response.

In Nasal Smear Testing, a sample of nasal secretions is collected and analysed in a laboratory. Substances called Eosinophils (a type of cell present in the body) are produced during an allergic reaction, and these are observed under a microscope in the nasal specimens obtained. This test does not identify the specific substances that cause the allergy but indicates if the nasal problems are caused due to allergy. 

Treatment and Prognosis 

Avoiding the causative factor is essential to prevent allergies. Since the allergic reaction is due to histamine and its related substances that trigger the full-blown allergic reaction, drugs called Antihistaminics are used to treat allergies. They block the activity of histamine and relieve symptoms. Their most common side effect is drowsiness. Some antihistamines are non-sedating, and do not cause drowsiness. Antihistaminics in the form of nasal sprays work relatively rapidly once sprayed into the nose. Antihistaminic sprays avoid some of the unpleasant side effects of oral antihistamines. Antihistamine-Decongestant combinations are useful in allergic patients who have a strong degree of nasal congestion. While the antihistamine component minimises sneezing and dripping, the decongestant contracts the lining of the nose, resulting in improvement in breathing. The decongestant component tends to cause an increasing wakefulness, which counteracts the sedating aspects of antihistamines.

Steroids are the most potent drugs for allergies. They help by decreasing the inflammation seen in the allergic reaction. Prolonged use of steroids can have serious adverse effects, so they should be taken on a limited, short-term basis to provide relief. Steroid sprays are relatively safer than oral steroids. Other intranasal sprays used include cromolyn sodium that acts by preventing the release of histamine. It is most effective if used prior to allergen exposure. Another spray called Ipratropium acts directly on the glands of the nasal lining to decrease the watery trickle that occurs with allergies and other conditions. Anaphylaxis should be treated by immediate administration of Epinephrine.

If environmental controls and medications have failed to provide adequate relief, allergy shots (Allergen Immunotherapy or Desensitization) can be used. Shots are more useful for year-round allergies rather than those lasting a short period each year. The basic principle is to inject increasing doses of allergens into the allergic patient to sensitise him. The shot is made up of an extract based on results of the skin test or a RAST. Usually, shots are given once to twice every week, with increased dosage each week. Once a maintenance level is reached, the shots can be given at reduced frequency. Significant improvement should be seen within three to six months of initiating Immunotherapy. If successful, the treatment should be given for two to five years. 

Prevention 

The best way to avoid symptoms of allergy is prevention. This means avoiding exposure to agents that trigger the allergic response. Being aware of common allergens like pollen, dust, fur, drugs, specific foods etc, and avoiding them is absolutely essential in preventing an allergic reaction. Patients, who have suffered from an anaphylactic reaction in the past should carry an injectable shot of a drug called Epinephrine that can be administered in an emergency. Prompt treatment of severe allergic reactions, especially anaphylactic reactions, is essential.