Dr. Turin Chowdhury

Hypertension is of different types. Some types are described according to their causes and some according to their distinctive features. When blood pressure in our body is above the normal level then it is defined as hypertension or high blood pressure.
   People having the problem of hypertension are more likely to develop heart disease or have a stroke than people with normal blood pressure levels. Uncontrolled hypertension can also lead to complications such as kidney failure, eye damage, etc. Today we are going to discuss various types of hypertension, which are commonly known to us.
   
   What is hypertension?
   Blood flows through the blood vessels in the body. The force blood creates against the inner walls of the arteries is called blood pressure.
   Let us think of a simple example from our daily life. If we take a rubber made hosepipe which is used for watering the garden and then try to squeeze close the pipe by pressing it with our fingertips, we will be able to do it easily. Now connect the pipe to water tap and open the tap. Water will start running through the pipe. Now if we try to do the same as before it will be nearly impossible to squeeze the pipe with our finger tips. This is due to the pressure forced by the flowing water on the inner wall of the rubber hosepipe If we close the water tap now and the water stops flowing through the hosepipe, then we will again be able to squeeze close the water hosepipe with our fingertips. As there is no flowing water so there is no force of pressure. In the same way flowing blood also puts pressure on the walls of the arteries in the body.
   Pre-hypertension: Pre-hypertension is the circumstance in which the blood pressure level is higher than normal, but not high enough to be classified as hypertension. Before developing hypertension, people almost always have this asymptomatic condition. In pre-hypertension systolic blood pressure is in between 120 and 139 or diastolic blood pressure is in between 80 and 89 on multiple readings.
   Essential Hypertension: Essential hypertension or primary hypertension means that the condition has no identifiable source. About 90 to 95 per cent of people with high blood pressure have this type of hypertension. The cause behind the disease is unknown in these people.
   Isolated Systolic Hypertension: As people grow older, their arteries tend to lose elasticity and become less able to accommodate blood surges due to hardening of the arteries. This can elevate systolic blood pressure, while diastolic pressure stays in the normal range.
   A systolic pressure of 140 or greater together with a diastolic reading of 89 or below is called isolated systolic hypertension. This is the most common form of high blood pressure in the elderly people.
   Secondary Hypertension: This results due to other health problems or disease conditions. Such as, renal artery disease, thyroid problem, etc. If the underlying causes can be treated properly then the secondary hypertension problem improves.
   White Coat Hypertension: This is a phenomenon in which patients show elevated blood pressure in a clinical setting, such as physicians' chambers or hospitals, but blood pressure is normal when recorded at home by themselves. It is believed to happen due to the anxiety some people experience during a visit to health professionals. The clinicians should remember that it is much easier to suspect the diagnosis of white-coat hypertension, as patients will usually state that their BP is normal at home. At that time the initiative to measure BP properly at home should be taken to rule out hypertension problem is present or not.
   Masked Hypertension: This phenomenon is some what opposite to the white coat hypertension circumstances. People with masked hypertension have tendency to have normal blood pressure level in clinic measurements, but elevated levels according to ambulatory monitoring. Masked hypertension is a similarly high-risk condition to sustained hypertension. The problem in this situation is that, the high blood pressure remains unidentified thus untreated putting the patient in the risk of disasters.
   Resistant Hypertension: In the treatment goal of the hypertension situation we want to achieve the treatment goal in terms of controlling the blood pressure always, but sometimes it seems the blood pressure just simply comes under control. It is still higher than it should be.
   Patients are considered to have resistant hypertension when their blood pressure remains elevated despite use of multiple anti-hypertensive medications. Estimated 10 per cent of the hypertensive patients appear resistant to therapy. Various factors can contribute to resistance, so every patient should undergo a thorough, orderly, and carefully directed evaluation.
   Labile Hypertension: In the case of this hypertension blood pressure fluctuates more than usual. Labile means ever-changing, and in labile hypertension, blood pressure might soar from normal range to abnormal range without any notice.
   Malignant Hypertension: Malignant hypertension is a complication of high blood pressure characterised by extremely elevated blood pressure and organ damage.
   The eyes, brain, lungs or kidneys are considered the end organs. The main characteristic of malignant hypertension apart from the elevated blood pressure level is the swelling of the optic nerve behind the eye, called 'papilledema'.
   E-mail: dr.turin@gmail.com

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Cultural Hegemony

Rayyan Kamal

I read a very interesting op-ed piece in the New York Times a few weeks ago. "The Odyssey Years" by David Brooks discusses the addition of two common life phases in America. Whereas in the past the phases were childhood, adolescence, adulthood and old age, the progression is now childhood, adolescence, odyssey, adulthood, active retirement and old age. Odyssey, the "decade of wandering that frequently occurs between adolescence and adulthood," is definitely the more nebulous of the two new phases.
   During this period, these travelers spend time discovering themselves - trying out new and unconventional jobs, lifestyles and, of course, partners. You have people running off to join the circus, taking road trips across Europe and starting rock bands. It's increasingly acceptable for today's youth to lack a sense of direction. Perhaps the logic is that you shouldn't expect to be the one finding your calling in life. Rather, it will show itself to you when the time is right. Until then, you have free reign to experiment and give your anxious parents a few more gray hairs.
   People born before 1964 set benchmarks to indicate one's entry into adulthood - "moving away from home, becoming financially independent, getting married and starting a family." In 1960, approximately 70 per cent of 30-year-olds had passed this test. By 2000, the percentage had fallen below 40 per cent.
   This shift is merely a reflection of the times. Having grown up in "tightly structured childhoods," today's youth are thrown into a world characterized by "uncertainty, diversity, searching and tinkering." What worked for their parents doesn't necessarily guarantee them success in this new order that itself is yet to be fully established. "Everything seems to give way to a less permanent version of itself."
   Typical of this new system is the fluid job market. Graduating seniors no longer have companies offering them jobs that will take them, step-by-step, all the way to retirement. Instead, all career options appear to be a stepping stone to something else, though no one's quite sure what. The "something else" will reveal itself in due course.
   And let's not forget the shifting balance of power between the sexes. 36 per cent of females workers in their 20's have college degrees while only 23 per cent of their male counterparts can make the same claim. At the same time, female wages have grown much more rapidly than male wages over the past few decades. Among the results is a decrease in the number of women getting married and an increase in the age at which those getting married tie the knot. In the past, women sought marriage due to financial and social factors. These days both these pressures are dwindling.
   However, the odyssey years is not about being lazy and unproductive. "There are intense competitive pressures as a result of the vast numbers of people chasing relatively few opportunities." As well, it appears that these people still have traditional goals. For example, surveys indicate that they rate parenthood more highly than their own parents did.
   Brooks seems to think that this phase, currently in its early stages, will become more firmly institutionalized in the future. He referred to Europe, which he feels is ahead of the States in this process. Europeans marry even later than Americans and spend more years making the transition from higher education to the job market.
   I know what my father would say if I shared this article with him: "This is where we'll end up if we're not careful!"
   Rayyan Kamal is a sophomore at Yale University.

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How to prevent heatstroke

Louise Chang, MD and Star Lawrence

When atmospheric heat combines humidity it becomes scorching. The temperature may be 100 degrees, but combined with humidity (which inhibits sweat from evaporating off the skin and cooling the body), the heat index may climb into the danger zone at 105 degrees or higher.
   By danger zone, they mean: danger of vomiting in public, collapsing, or even dying.
   
   Who's likely to suffer?
   According to the CDC, the elderly, children under 4, people who are overweight, those who become dehydrated, the mentally ill, or people with medical conditions, or who are on certain medications seem to be the most susceptible targets of a heat wave.
   "You know who we see a lot?" asks Bruce Bonanno, MD, an emergency medicine physician in the New York and New Jersey areas. "We see young people coming in. One place I work is a beach community. They drink the night before and think their fancy little drinks are hydrating them, when they are doing the exact opposite. Then they go to the beach the next day, fall asleep, bake in the sun, and each day get a little more behind on their fluids."
   
   Heat exhaustion
   People suffer a heat-related illness when the body's temperature system is overloaded. The body is sweating, but the sweat is not evaporating due to humidity. Eventually, like a runny egg white, the brain begins to "cook."
   The most common heat-related illness is heat exhaustion. This usually builds up over several days of activities in a hot environment, without proper replacement of fluids. Wham, it can hit you. The symptoms are:
   a. Heavy sweating
   b. Turning pale
   c. Muscle cramps
   d. Weakness
   e. Dizziness
   f. Nausea or vomiting
   g. Fainting
   h. Cool, clammy skin
   i. Fast breathing
   j. Headache
   
   Cool fluids
   To help the person, provide cool fluids immediately, anything nonalcoholic, but preferably water. Have the person lie down inside or take a cool bath or shower and then rest.
   If the person's symptoms are severe or there are pre-existing medical problems, such as high blood pressureor heart disease, then you need to get medical attention right away.
   
   Heatstroke
   If someone experiencing heat exhaustion isn't treated (see below), it can progress to heatstroke, also known as sunstroke. This is very serious. Heatstroke occurs when the body simply cannot control its temperature anymore and the body's temp rockets to 106 degrees or higher within 10 minutes to 15 minutes. This can cause permanent brain damage or death if not treated immediately.
   
   Symptoms
   * Extremely high body temperature of 103 degrees (by oral thermometer) or more
   * Red, hot, dry skin (lack of sweating)
   * Rapid, pounding pulse
   * Throbbing headache
   * Nausea
   * Confusion
   * Unconsciousness
   
   - If someone faints or stops making sense near you, get the victim to a shady area or inside.
   - Get the person cool immediately.
   - Do whatever you have to-wet compresses, a cool shower, spray them with water from a hose, wrap in a cool, wet sheet and fan them.
   - If vomiting occurs, turn the person on the side.
   
   Heat cramps
   Heat cramps are due to muscle spasms, usually in the abdomen, arms, or legs. This is usually a result of so much sweating that the body is low on sodium. People on a low-sodium diet have to watch for this.
   > People with heart problems or who are on¼ low-sodium diets need to seek medical attention right away for heat cramps. If you or someone you know gets heat cramps, stop all activity and get inside.
   > Drink a clear juice (if you are on a low-sodium diet, check with the doctor first).
   > Do not go back outside for several hours, even if the cramps subside, because further exertion could lead to heat exhaustion or heatstroke. If the cramps last more than an hour, check with a doctor.

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Plastic products may cause reproductive disorders

Dr. Joseph Mercola

An estrogen-like compound widely used in plastic products is thought to be causing serious reproductive disorders, according to a statement by several dozen scientists, including four from federal health agencies.
   The compound, Bisphenol A (BPA), is one of the most-produced chemicals in the world, and almost everyone has traces of it-or more-in their bodies.
   After reviewing about 700 studies, the scientists concluded that people are exposed to levels of BPA in excess of those that have harmed lab animals. Among the most vulnerable are infants and fetuses, who are still developing.
   BPA is used to make hard plastic that's used in numerous products including:
   Polycarbonate plastic baby bottles
   Large water-cooler containers and sports bottles
   Microwave-oven dishes Canned-food liners
   Some dental sealants for children
   The statement appeared alongside five accompanying scientific reviews and a new study by the National Institutes of Health that found newborn animals exposed to BPA suffered from uterine damage. The damage could indicate that the chemical causes reproductive disorders in women ranging from fibroids to endometriosis to cancer.
   While studies have yet to be conducted to directly examine BPA's influence on humans, past animal studies have found low doses of the chemical to be associated with early-stage prostate and *** cancers and decreased sperm count.
   No governmental agency worldwide has restricted the use of BPA, but a U.S. expert panel is meeting to discuss whether the chemical should be declared a human reproductive toxin, which could lead to regulatory action.
   The chemical industry maintains that BPA is safe, and has called the scientists' statement "alarmist and biased."

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The Nobel Prize for Literature: "Ohh! Christ!"

Saad Quasem

A Nobel Prize sprinkles a dust of prestige and joy on anyone; some remain subtle with the award and some make the days to come extra-breathtaking.  Most spectacularly this year the world saw Doris Lessing walking in with an artichoke and a bag of onions when she received news of her winning the Nobel Prize in Literature. According to Lessing, the prize has been pending for thirty years. She gleefully accepts this honor, but implies that she had been the right recipient for decades now.
   Lessing was born in Kermanshah, Iran to British parents in 1919. She spent her childhood in Southern Rhodesia, where she finished formal schooling at the age of fourteen. Since a very young age, Lessing has been actively involved in Marxist politics and her experiences were later reflected in her writing. She has been twice divorced; right after her second divorce she moved to London from Rhodesia, where her writing career began to throb with the release of The Grass is Singing in 1950, which provides a taste of apartheid in South Africa.
   The masterpiece she is most well known for is The Golden Notebook. "The burgeoning feminist movement saw it as a pioneering work and it belongs to the handful of books that informed the 20th-century view of the male-female relationship. It used a more complex narrative technique to reveal how political and emotion conflicts are intertwined. The style levels of differing documents and experiences mix: newspaper cuttings, news items, films, dreams and diaries. Anna Wulf, the main character, has five notebooks for her thoughts about Africa, politics and the communist party, her relationship to men and sex, Jungian analysis and dream interpretation. The disjointed form reflects that of the main character's mind. There is no single perspective from which to capture the entirety of her life experience." This is how the Nobel Committee describes Lessing's debut novel.
   Along the years she has been rewarded several other novels and articles, enriching the feminist movement and campaigning for the end of apartheid. Of course she will be remembered in history for her rebellious nature. Nevertheless, when the Nobel Committee announced the award to Lessing, she was out grocery shopping. The eighty eight year old stepped down from a Black Cab in London, asked the press what they were filming for, received answer of her victory and then replied "Oh Christ!" Her modesty was determined by her haggard dress plus the interview she held sitting on her front step to remark about the prize.
   On her acceptance speech, she recalled that about forty years ago she met a member of the Nobel Committee at a party in Stockholm. That member had only attended the function to convey to Lessing, that the Nobel Committee hates her and thus she would never even be nominated for the prize. "I was dying of embarrassment, because it was so graceless and stupid. I mean, I could have died. I wished the bloody earth would swallow him, certainly, and me too" said, Lessing. The table must have turned onto the guy, who (if still alive) should be engrossed with the same embarrassment.
   There is controversy that too many have been awarded for the fight against apartheid (Lessing, Mandela and Bishop Tutu). Lessing has been a symbol of the feminist movement, so she is much broader than the fight for apartheid, which was though necessary. Therefore, the Nobel Prize for Literature in 2007 is well justified. Hopefully in the years to come we shall receive recipients that parallel the intellect, livelihood and modesty of Doris Lessing.

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