Author: noorali

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Nasal Polyps

Dear Dr. B: What is a polyp? I have polyps in my nose and they bleed occasionally. Could they turn into cancer?

Answer: A polyp is a growth or tumor protruding from the lining of an organ such as the nose, bladder, uterus, and intestine or from any organ of the body.

Nasal polyps are growths in the mucous secreting lining of the nose or sinuses. They are grape like, fleshy and usually inflammatory in nature. Most of the nasal polyps are benign (non-cancerous), and can be on one or both sides of the nose. Unlike polyps in the colon or bladder, most polyps in the nose are not true tumors and do not suggest an increased risk of cancer. They are merely a reflection of inflammation.

Certain types of nasal polyps have a predisposition to turn into cancer. If you have polyps and if they tend to bleed then you should have your problem fully assessed by your doctor and a specialist in ear, nose and throat surgery (otolaryngologist).

Nasal polyps are more common in adults. . Men are four times as likely to have nasal polyps as women. The most common cause of polyps is allergy, followed by chronic sinus infection. They are more common in people who have asthma or inflammation of the lining of the nose (rhinitis), and cystic fibrosis.

People with nasal polyps suffer from stuffy nose and have trouble breathing. They become mouth breathers. They have a poor sense of smell and taste. Sometimes they have runny nose.

If you have chronic symptoms of rhinitis and sinusitis then your physician will refer you to an
otolaryngologist for an endoscopy. Endoscopy uses a small, flexible, lighted scope (nasopharyngoscope) to examine your nasal passages. A nasal polyp can be visualized and diagnosed with this instrument. Also biopsy can be taken to check for cancer.

You may also have a CT scan if the number and size of the polyps cannot be assessed with an endoscope. Quite often you may have polyps in the sinuses as well.

Nasal polyps are treated with corticosteroid nasal spray or corticosteroid pills. Steroids help to slowly shrink the polyps. If you continue to take the medicine, it may prevent new polyps. If your polyps are large, you may need surgery to remove them. Nasal polyps can recur. You should discuss with your doctor how to stay on maintenance therapy to prevent recurrence of nasal polyps.

A lesson in science:

In a school science class four worms were placed into four separate jars.

The first worm was put into a jar of alcohol. The second worm was put into a jar of cigarette smoke. The third worm was put into a jar of sperms. The fourth worm was put into a jar of soil.

After one day, the first worm in alcohol died. The second worm in cigarette smoke died. The third worm in sperms died. The fourth worm in soil stayed alive.

So the science teacher asked the class – “What can you learn from this experiment?”

Little Johnny quickly raised his hand and said “As long as you drink, smoke and have sex, you won’t have worms.”

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Laptops and Male Fertility

What is a laptop?

A laptop is a portable computer small enough to use on one’s lap. The question is – is it safe to use your lap as a desk?

The Medical Post reports that male fertility may be adversely affected by using a laptop balanced on the thighs.

A study published in a European journal (Human Reproduction) found the combination of the thighs held together to form a desk for the laptop plus the heat generated by the machine raised the scrotal temperature by 2.6 to 2.8 degrees Celsius within 15 minutes.

For fertility and production of sperms, it has been found that increase in the testicular temperature between one to 2.9 degrees Celsius may adversely affect the production of sperms.

The blood flow to the testes maintains the temperature of the testes two to four degrees Celsius lower than the rectal temperature in the normal individual. If there is loss of this temperature differential then the testicular function is compromised resulting in infertility.

Sperm and testosterone production occurs in the two testicles, or testes, which are contained in the scrotal sac (the scrotum). This sac develops on the outside of the body because normal body temperature is too high to allow sperm production.

Many hormonal and environmental factors influence the production of sperms. It takes approximately 64 days to produce one sperm. There are four stages involved in this process and there are millions of sperms present in different stages of production.

Any major physical or mental stress can temporarily reduce sperm count. Some examples are: emotional stress, sexual issues, testicular overheating from high fevers, saunas, and hot tubs, substance abuse, smoking, malnutrition and nutrient deficiencies, obesity, and vigorous bicycling.

Infertility affects one in 25 North American men. More than 90 per cent of male infertility cases are due to low sperm counts, poor sperm quality, or both.

Semen is produced by clusters of tissues called seminal vesicles and prostate gland. Semen provides a safe environment for 100 to 300 million sperms delivered at the time of ejaculation. But only 15 per cent of these are good enough to impregnate a woman. However, only 40 or more sperms survive the stress of ejaculation, the chemical composition of the semen and the hostile environment of the vagina (cervical mucous is sometimes impenetrable) to find an egg and fertilize.

It can take up to four days for the sperm to reach the egg in the fallopian tube. And the egg is available only for 12 hours each month for the sperm to get there on time and fertilize. And, in the end, only one sperm gets through to fertilize the egg. What a journey! No wonder so many couples have difficulty having children. On top of that we put laptops on our thighs!

Teenagers and young men (I presume that excludes me!) are advised to use laptops on a table or desk instead of on their laps. Have pity on these poor little tadpoles. They have to be strong – as their journey is long and perilous!

Thought for the week:
“Experience teaches only the teachable.” -Aldous Huxley (1894-1963)

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About Prawns and Steam Rooms

Dear Dr. B: I have two questions:

1. I love eating prawns. Can you please clarify for me if prawns contain good cholesterol (HDL) or bad cholesterol (LDL)?

2. When I go to my local health club, I often visit the steam room. Outside the steam room there is a sign to say it may not be suitable for heart patients. I have had quadruple coronary bypass and I am not sure whether the rise in the body temperature in the steam room is dangerous for me.

Answer: Nutritional guidelines recommend eating fish three to four times a week because it contains large amount of omega-3 fatty acids. This fatty acid may substantially reduce the likelihood of irregular heart rhythm. It helps prevent heart attack and stroke. And it can reduce the risk of dying from heart disease by almost 50 percent.

Fish and seafood in general is low on cholesterol with three exceptions – prawns, squid and fish roe. The cholesterol from our food is not classified as HDL or LDL. We just call it dietary cholesterol.

HDL and LDL are measured in humans to estimate the risk of heart disease. We have to be careful what we eat as it affects our good and bad cholesterol.

A dietitian informs me that the present consensus on prawns is that the amount of omega-3 fatty acids present in prawns will offset the amount of cholesterol in it. So we are allowed to eat prawns in moderation even in the heart healthy diet. Prawns should be steamed and not fried/deep fried or in butter as these are all worse for our heart and would stimulate increased production of bad cholesterol in the body.

So, if you love to eat prawns then cut back and eat more of salmon, sardines, trout, mackerel, and herring – broiled, baked or steamed. They contain the highest levels of omega-3 fatty acids. Fish is also high in protein, vitamins and minerals. Compared to meat, it is low in calories.

About saunas and steam rooms. The heat in the sauna is a dry heat and the heat in the steam room is wet heat. These rooms are meant for relaxation. The heat makes us perspire and relaxes our muscles and relieves aches and pains.

“In a Finnish sauna the human body is exposed to higher temperature than anywhere else in natural surroundings, but only for a short time. The high temperature induces many temporary physiological changes,” says Dr. Lasse Viinikka, Chairman of the Finnish Sauna Society on one of the websites I visited.

The temperature of skin increases in a few minutes to over 40°C, but after the sweating has started – usually in three to five minutes – this temperature declines and starts to rise slowly again. Skin temperature is around 40°C after a 20 minute bath, says Dr. Viinikka.

The physiological effect of increased temperature results in dilatation of skin capillary vessels. This will drop the blood pressure. In order to maintain sufficient blood pressure the cardiac output increases two to three fold. This also considerably increases the heart rate. And this puts extra stress on our heart just as it does during brisk walking. So, talk to your doctor and check how much activity your heart can tolerate.

Sweating in saunas and steam rooms results in loss of fluid, sodium and potassium from our body. So it is important to maintain good fluid balance. Dehydration can increase the load on your heart as well.

Saunas and steam rooms have many physiological short-term effects, but have no permanent long term effects on health. It is only for pleasure and relaxation. So use it carefully.

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Bottled Water

Over one billion people around the world have no access to clean water and 2.4 billion have inadequate sanitation. Two million people world wide die every year from water related diarrheal illnesses. . The latest tsunami disaster has magnified the problem immensely.

In developed countries there is so much clean water running through our taps that we can afford to use our drinking water to flush toilets, wash ourselves, our clothes and our cars. On top of that we can afford to spend millions of dollars on bottled water.

Like cell phones, bottled water is everywhere.

Bottled water is the world’s fastest selling drink. In the last 10 to 20 years there has been 70-fold increase in the sale of bottled water in North America and Europe. We are talking in terms of billions of gallons of bottled water.

Why has bottled water become so popular in developed countries?

“Bottled water exploits our worries about what affects health in the modern world,” says an editorial in the British Medical Journal. Bottled water is seen as a natural antidote to what the consumer sees wrong with modernity.

Health Canada website says that drinking bottled water is a matter of personal taste and preference over municipal tap water. Some people think bottled water is safer than municipal tap water, but Health Canada says that there is no evidence to support this.

Bottled water is not sterile. Bacteria are found in most bottled waters sold for drinking purposes. Bottled water is usually disinfected to remove harmful organisms, but is not intended to sterilize the water. Usually, sterile water is reserved for pharmaceuticals.
In Canada, bottled water is considered to be a food and is regulated under the Food and Drug Regulations. Health Canada website has excellent information on bottled water. Here are some points of interest:
-Bottled water labeled mineral or spring water is fit for human consumption that comes from an underground source. It cannot come from a public water supply.

-Mineral and spring waters must not have their composition modified through the use of chemicals, but carbon dioxide and ozone can be added during the bottling process to protect the freshness.

-Bottled water not represented as mineral or spring water, is water from any source (municipal water, well water, etc) that can be treated to make it fit for human consumption or to modify its composition.

-Do not buy bottles that have a broken seal.

-Do not refill old bottles. It is preferable to buy newly manufactured bottled water.

-While traveling, avoid bottled water unless it is carbonated or disinfected. Buy only sealed products. Wipe off the bottle or can top before drinking or pouring from them.

-Water coolers should be cleaned regularly.

Less than one percent of earth’s total water is fresh water. There isn’t unlimited supply available to waste water. Our municipalities should do a better job of informing and educating the public that tap water is clean, pure, fat-free and about thousand times cheaper than bottled water. And water should be used carefully. There is no need to spend millions of dollars on bottled water.

Joke for the week:

Doctor: How’s that little boy?…The one who swallowed all those quarters.
Nurse: No change yet!
-Edgar Argo cartoon

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