Heatstroke can be dangerous

Dr. Turin Chowdhury

Summer can bring heat waves with unusually high temperatures that last for days and sometimes weeks. The soaring heat of these heat wave episodes come with the possibilities of heat related disease conditions such as dehydration, sunburn, heat rash, heat exhaustion, heat cramps, heat stroke, etc. Among them heat stroke is the most extreme one and can lead to very fatal outcome. Heat stroke is a true medical emergency that can be fatal if not properly and promptly treated.
   Heat stroke is a form of abnormally high body temperature (hyperthermia) with accompanying physical and neurological symptoms. Hyperthermia means overheating. The word is made up of "hyper" that means high and "thermia" from the Greek word "thermes" that means heat.
   
   Causes
   Generally our body generates heat as a result of metabolism, and the body is usually able to disperse the heat by either emission through the skin or by evaporation of sweat. The body normally cools itself by sweating. But under some conditions, sweating just isn't enough. In such cases, a person's body temperature rises rapidly. However, in extreme heat, high humidity, or vigorous exertion under the sun, the body may not be able to disperse the heat and the body temperature rises, sometimes up to 106 degrees Fahrenheit or higher leading to episode of heat stroke.
   Another cause of heat stroke is dehydration. A dehydrated person may not be able to sweat fast enough to dissipate heat, which causes the body temperature to rise. A person can be dehydrated due to loss of water from body due to diarrhoea or excessive sweating due to the surrounding environmental conditions.
   
   Who are at risk?
   Anybody in a given physical condition in a hot humid day can be at risk for a heat stroke episode. But the people most susceptible to heat strokes are infants and the elderly who are having a fragile physical status, as well as athletes or outdoor workers who physically exert themselves under the heat and sun. Worker indoors but in hot and humid conditions are also susceptible to heat stroke.
   Overweight people may be prone to heat sickness because of their tendency to retain more body heat. Any health condition that causes dehydration makes the body more susceptible to heat sickness.
   
   Warning signs
   Sometimes a person experiences symptoms of exhaustion before progressing to heat strokes. These symptoms are usually mild and these are taken as the warning signs of the preceding emergency condition of heat stroke. The warning signs may include nausea, vomiting, fatigue, weakness, headache, muscle cramps and aches, and dizziness. However some individuals can develop symptoms of heat stroke suddenly and rapidly without warning.
   
   Symptoms
   Different people may have different symptoms and signs of heat stroke. But common symptoms and signs of heat stroke include:
   * Extremely high body temperature
   * Absence of sweating, so the skin feels very dry with hot red or flushed appearance.
   * Rapid pulse rate.
   * Difficulty in breathing
   * Sometimes affected person shows strange behaviour, such as hallucinations, or confused, or agitated, or disoriented.
   * Sometimes seizure appears,
   * Affected person may develop sudden coma condition, etc.
   Treatment
   It is very important to treat heat stroke immediately. And treatment is most effective when given promptly. The longer treatment is delayed the dimmer is the prognosis. These emergency managements should take place in health facilities by health professionals. So it is very important to take the heat stroke patient to the hospitals as soon as possible. Victims of heat stroke must receive immediate treatment to avoid permanent organ damage.
   First aid: During the time of waiting for medical help or moving the affected person to an emergency facility we should take some steps which will be helpful in reducing the intensity of the episode. First and foremost, cool the victim. Get the victim to a shady area away from sun, remove clothing, and apply cool or tepid water to the skin. For example we can spray the victim with cool water, fan the victim to promote sweating and evaporation, place ice packs under armpits and groins. If possible we should monitor body temperature with a thermometer and continue cooling efforts until the body temperature drops to 101-102 degrees.
   
   Prevention
   To protect our health when temperatures are extremely high the following steps might prove helpful.
   Drink plenty of fluid: avoid dehydration - During hot weather, we should drink more liquid than our thirst indicates. This is especially true for people aged 65 years and older who often have a decreased physical ability to respond to external temperature changes. Drinking plenty of liquids during exercise in a hot weather is also especially important.
   Reinstate salt and minerals - Heavy sweating removes salt and minerals from the body. These are necessary for your body and must be replaced. The easiest and safest way to replace salt and minerals is through your diet. Drink fruit juice or a sports beverage during exercise or any work in the heat. But we also should avoid hot foods and heavy meals, because these add heat to our body.
   Wear appropriate clothing - Choose lightweight, light-coloured, loose-fitting clothing. In the hot sun, a wide-brimmed hat will provide shade and keep the head cool. During moving outside a shade giving umbrella will be very helpful.
   In extreme hot conditions stay indoors - If the outside temperature is extremely high then the most efficient way to beat the heat is to stay indoors. A cool shower or bath is an effective way to cool off.
   Schedule outdoor activities carefully - If it is a must to be out in the heat, we should try to plan the activities so that we have to move outdoors either before noon or in the evening. While outdoors we should take frequent rest in shaded areas. Resting periodically will give our body thermostat a chance to recover.
   Start work slowly: pace yourself - If unaccustomed in working or exercising in a hot environment, start slowly and pick up the pace gradually. If exertion in the heat makes heart pound and leaves gasping for breath, STOP all activity immediately. Instantly get into a cool area, or at least in the shade, and rest.
   Those at high risk - Those at greatest risk of heat-related illness include:
   * Infants, toddlers and children up to four years of age: Infants and children up to four years of age are sensitive to the effects of high temperatures and rely on others to regulate their environments and provide adequate liquids.
   * People 65 years of age or older: People 65 years of age or older may not compensate for heat stress efficiently, and are less likely to sense and respond to changes in temperature. Some more they are less able to take care of themselves during an acute episode.
   * Overweight people.
   * People who have ill health, or are suffering from chronic disease conditions, or are on certain medications
   
   Common sense
   The most important measures to prevent heat strokes are to avoid becoming dehydrated and to avoid vigorous physical activities. So we should take measures according to that. To beat the heat and to reduce the risk of heat stroke you will have to take simple steps based on common sense.

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Dow Jones Newswires

Rayyan Kamal

Singapore: The city where chewing gum is forbidden and where there are signs on escalators telling you to stand on the left side to facilitate traffic. The city that Westerners come to if they want to get a taste of Asia without really getting a taste of Asia, with its pollution and chaos. The city that is to be my home for the next two months.
   Yale's undergraduate career services organizes a program called International Bulldogs in honour of the university mascot. Internships in countries from India to England to Ghana to Argentina are made available to students. I chose to take the journalism internship offered at Dow Jones Newswires in Singapore, so now I'm here. I'm living with six other Yalies interning at various firms in an apartment procured - but not paid for - by Yale.
   At work they don't make me do much yet. I'm still in training, after all. To gain practice writing in the style of journalists rapidly churning out financial news reports for its corporate clients I am given long articles to summarize. At the end of each workday I help my boss write up the summary of the happenings of the Singapore Stock Exchange. "The STI moved up xx points, or yy per cent, to end at zz points today. Gainers beat losers aa to bb. The volume of trading was cccc."
   I really like my boss. I still haven't figured out where he's from, but his accent constrains him to Western Europe. It is evident that he doesn't pay too much attention to what he wears, which is fine with me because I don't either. He is quite gruff, swearing often, sometimes for no reason and to no one in particular. But he makes sure I'm not idle. At times he will assign me a task every ten minutes, the end result being that none of them get completed. Fortunately, he doesn't seem to mind.
   Boss says that he'll send me out to the field next week. There is a mobile phone exposition scheduled then and he wants me to go with another journalist to interview the representative from Nokia. I'll get a press pass and the license to ask annoying questions like those journalists do on television when the victim of their attack is averting his eyes and saying "no comment" or not saying anything at all, but simply trying to flee. "Nokia really puts on a show, but you got to learn to see through all their glitz and glamour," Boss told me.
   The corporate world, or the desk-job world of journalism, is not as soul-sucking or spirit-enervating as I had expected it to be. I actually like following the trajectory of stocks with the single-minded attention of a hen following her chicks. And reading the Wall Street Journal and the Business section of the Singapore daily is nowhere near as painful as I had previously feared. Then again, I've been working for only two days so far and as someone once observed, monotony is the bane of life.
   Rayyan Kamal is a sophomore at Yale University

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The Summer Delight, Lost and Found

Saad Quasem

The summer heat in Philadelphia has increased drastically, although the swap is a pleasant different from the rigid winters. This type of weather has set in motion a gamut of different activities and the natives are enjoying all summer has in store. However, my summer feels devoid. As a Bangalee, my summers are synonymous of aam and lichu as well as the sultry cum scorching weather. It is only nature that makes the summer in Bangladesh (as well as the rest of South Asia) excruciating, but provides aam to refresh and cool, the victims of such heat. Aam has no substitute, the fruit or the name. Mangoes remind me of the rubbery, bland and dull food I get to buy at local groceries. I find it rather demeaning to even translate mangoes to aam, because it extracts the palate and the cultural significance of the mass-adored fruit.
   aam is a staple delight for South Asians. America imports its aam or mangoes from South America and Mexico. The taste is "rubbery, bland and dull" as I described before, even taking a bite seems to be an insult. Therefore mangoes remind me of this beefy substance and aam of paradise. Throughout my stay in America, a few bites of mangoes have sickened me and therefore I learned to refrain from such tasteless matter. I restricted to live in a world here aam had been lost somewhere in the infinite and looked forward to bite the luscious fruit, in a decade or so when I could make it back to my roots over the summer. That was the story till last week.
   Last Thursday, I received a voice message from the local Indian grocery store. "Saad Bhaiya, there is some good news in stock. Alphonso aam has arrived in JFK, we are requesting orders as soon as possible. Let us know how much you want it is selling better than fresh samosas." Alphonso, known as the "aam ka Raja" and Kesar the "aam ki rani," the pieces of which I had bitten on as a child, just the thought is succulent enough; the sticky juice trickling from all sides, the silky-smooth texture, the squashy composure alone in tangy orangy colors. There are absolutely no words to describe the flavor. I got lost in the thought, but was rather confused. So I made it a point to visit the store and meet with the manager soon enough. Upon my arrival, I was welcomed by an enormous queue waiting to order some aam. The savories, desi folk have not tasted for years or decades perhaps.
   I figured that the time spent in queue, was worth a sacrifice. In line, I discovered the whole story. We had been deprived of aam, officially since 1989. That year India had shown willingness to export aam to the United States. However, the US then felt vulnerable to weevil pest, which is common in Indian fruits. Since then, several Indian expatriates and many left leaning bureaucrats have been trying to cut deals to allow this blessed wonder to enter the US. In 2006, President Bush visited India and signed a nuclear pact treaty with his hosts. Nonetheless, his return gift was to sanction aam into his country. They arrived a season late in JFK airport on the 27thof April. The primary testers of the first crate had been the lobbyists who worked to allow this fruit.
   I learnt on this standing in line for about 45 minutes, when the manager called out to say he had run out of Alphonsos and that we must wait till the next shipment. Since I had resisted it for so long, I could live for a week or two more. Nevertheless, I filled out a form to order the mangoes and have them delivered to my house, to avoid the line. While signing the bill, I see that the bill comes to $ 90. Shocked, I ask the manager who had called me earlier. He said "Bhaiya, its $ 30 a dozen," you know what we have gone through to get them here. Shocked, but interested enough, I signed the bill. Soon, I will take pleasure in the tastes that I have missed out on for so long.
   I am not certain if President Bush has been politically correct, while making aam available in America. For once I know a President has been able to meet my demands, I might have never called for it, but it has been heard from somewhere. He has helped me ease my taste buds. As I look forward to indulging in aam, I must say thank you, George.

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Holiday Desk

Refugee and Migratory Movements Research Unit (RMMRU) of University of Dhaka arranged a day-long message development workshop entitled 'Safe Labour Migration', with the support of Manusher Jonno Foundation on May 31 2007. The workshop was organised to develop message for the awareness campaign under Capacity Building and Ensuring Safe Labour Migration (CABSLAM) project. Shaikh Altaf Ali, Secretary in-Charge, Ministry of Civil Aviation and Tourism, Govt. of Bangladesh was the chief guest. The inaugural session was chaired by Dr. C R Abrar, Coordinator of RMMRU. Fayazuddin Ahmed, Programme Manager of Manusher Jonyo Foundation, highlighted the importance of mass campaign to protect the rights of migrants.
   On her keynote address, Dr Tasneem Siddiqui, Professor, Dept. of Political Science, University of Dhaka, identified 7 areas for information dissemination on safe migration. These are: planning of migration, processing of work permit and visa, processing of travel including embarkation and disembarkation, social and cultural adjustment in the receiving country, work conditions, accidents, security of female migrants, and opportunities of reintegration of returnee migrants. All these aspects were highlighted in the workshop in order to come up with messages for different segments of audience.
   Shaikh Altaf Ali in his speech requested the organisers to prepare short documentary on airport processing which could be shown in the monitor at the entrance of airport. He stressed the significance of the campaign saying it would not only assist the migrants at great measure, it will help the airport operation as well.
   Dr. Nurul Islam, Director of Research, Monitoring and Computer, Bureau of Manpower, Employment and Training (BMET), pointed in his paper that the migrants are not informed about the services currently available from BMET and Airport, under the Ministry of Expatriate Welfare and Overseas Employment. The mass campaign can aware the migrants about these services. He also emphasised on conduction of the cost benefit analysis by migrants and their family at deciding the migration.
   Md. Selim Reza, Director of Emigration and Protocol, Bureau of Manpower, Employment & Training (BMET), spoke on 'Information Required to Avoid Problems in the receiving Countries'. He stressed the need for mental preparedness of the migrants for harsh weather, tough job, and difference in culture, religious values, food and residential pattern in the destination country. He also discussed on the available facilities abroad from Embassy and Local Labour Office.
   The workshop participants identified male and female migrants, prospective migrants, their families, and returnee migrants as the target audience for information campaign and identified messages for TV and Radio PSAs, Talk Show, Drama Serial, Brochures, Billboards, Posters, Activation as channels information dissemination.
   The participants were comprised of experts from all sectors, including the communication stakeholders, Partnering NGOs of RMMRU - YPSA, BASTOB, RPDO, and AHRDT, Returnee Migrant Workers from Chittagong, Dhaka, Tangail, and Comilla. Ministry of Expatriate Welfare and Overseas Employment officials, Ministry of Civil Aviation and Tourism officials, BMET officials, Ministry of Foreign Affairs officials, Ministry of Information officials also participated on the Workshop.

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