GUEST COLUMN
The aspects of health, education and nutrition (HEN) are the basic pillars of development and it is unfortunate that both the government and society are ignoring these basic principles, due to which the country is paying a heavy price. Health is not only an asset but also a resource which must be nurtured by all. It is also important that those associated with this sector should not work with the sole purpose of commercial benefit, their action should be based on human ethos. Health, as defined by World Health Organisation is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Every person has a desire to be happy and we believe that only a healthy person can be happy. A healthy person can do not only his work but the work of others as well. The ability of any healthy person will be higher than an unhealthy person in every way.
Screening plays a crucial role in maintaining health by enabling early identification of potential health issues, often before symptoms appear. Regular screening and early detection can lead to more effective treatment, better disease management, predicted outcomes and improved quality of life. Screening is important as many diseases, such as cancer, diabetes and heart disease, are easier to treat when caught at an early stage. Early detection often leads to better outcomes and lower mortality rates. Screening can identify risk factors (such as high blood pressure or high cholesterol) that, if left unaddressed, may lead to severe conditions. Early intervention after screening can help prevent the onset of diseases. Treating diseases in their early stages is usually less expensive than managing advanced illnesses, thus preventive measures taken after screening can also reduce the economic burden on the healthcare system. Early intervention can prevent complications and chronic pain-related issues associated with untreated conditions. The screening tests vary by age, gender, and risk factors. General screening includes height, weight, skin thickness, waist size, pulse, temperature, respiration, blood pressure, ECG, SpO2, haemoglobin, bone density, blood type etc. Liver function tests and blood alcohol concentration, especially in alcoholics; HbA1c and serum creatinine, particularly in diabetics; thyroid function tests, especially in women with fluctuating weight; kidney function tests, especially in diabetics, hypertensive individuals and those prone to kidney stones. Pulmonary function tests are conducted especially for those with asthma, chronic smokers and individuals with other chronic obstructive pulmonary diseases. By adding regular screening in healthcare routines, individuals can better protect their health and maintain long-term well-being. A general check-up should be conducted in minimal clothing, or preferably naked, if possible, to detect lumps, deformities, changes in body weight and skin colour alterations.
Measuring height and weight can indicate the relationship between the two during children’s development. In adults, it reflects the body mass index (BMI). A simple formula for determining ideal weight entails subtracting 100 from height in centimetres and the remaining value is the ideal weight in kilogrammes. For example, if an individual is 5 feet 5 inches (165 cm) tall, their ideal weight should be 165-100 = 65 kilogrammes. Similarly, BMI can be measured by dividing weight in kilogramme by the square of height in metres. A healthy BMI is generally considered between 18.5 and 24.9. Below 18.5 indicates underweight, 25 to 29.9 indicates overweight and above 30 is considered obese. Regular weight measurements and maintaining an ideal weight can help detect many lifestyle-related diseases as obesity is considered the root cause of many illnesses.
Skinfold thickness measurement is used in children to understand the protein-fat ratio and in detecting signs of malnutrition and anaemia. Waist and hip measurements indicate the severity of obesity, which may predispose individuals to diabetes, hypertension, coronary heart disease, hypercholesterolemia and arthritis etc. All obese persons should undergo regular body checks. Bone marrow density (BMD) is a simple test for detecting bone health and early identification of osteoporosis. Regular BMD screening can help detect osteoporosis, leading to preventive measures and preventing bone fractures and their complications.
Cancer symptoms vary widely. Some patients may experience abnormal lumps, fever, involuntary weight loss, unbearable pain, unusual bleeding or discharge, coughing, voice hoarseness, wounds that don’t heal and changes in urinary or bowel habits. A PET (positron emission tomography) scan is a medical imaging procedure that creates 3D pictures of the inside of the whole body in a go. PET scan is an important and advanced test that helps detect tumour growth and spread, but it is expensive and available only in some hospitals. If any abnormality is noticed, a thorough check-up should be conducted. In addition to physical examinations, a general blood test should also be done. Further tests should be based on the symptoms and the specific organ or system involved.
Screening tests are highly beneficial for general health, particularly in cancer cases. Early detection and treatment can make cancer treatable, such as prostate, thyroid, testicular and melanoma cancers. However, some cancers, like lung, pancreatic, liver, ovarian, and colorectal cancers are very aggressive. It is observed that the patient suffering from lung cancer, irrespective of any kind of treatment, usually dies within nine months from the date of diagnosis in severe cases. Screening tests are an effective tool for reducing the severity of disease and can prevent fatal outcomes in disease like diabetes, hypertension, heart disease, hypothyroidism and hyperthyroidism. Maintaining and measuring the ideal body weight can help prevent lifestyle diseases like hypertension, diabetes, heart disease, smoking and alcohol consumption.
Anaemia is a common issue in the underprivileged population. Anaemia refers to low haemoglobin levels in the blood. Maintaining an ideal haemoglobin level can improve a person’s functional capacity. Haemoglobin is responsible for oxygen transport throughout the body and increasing haemoglobin levels requires consuming iron-rich foods, which are an essential component of haemoglobin. Inexpensive iron supplements are also available in the market when needed. Rickets is a common issue among the poor, resulting from calcium and vitamin D deficiency, causing bones, especially leg bones, to become soft and leading to various deformities. Another common problem is vision issues, especially among teenagers and the elderly. These eye problems can be diagnosed through simple refraction tests and funduscopy, and can easily be managed with glasses.
Screening gives individuals the opportunity to take proactive steps for their health. Regular screening encourages individuals to stay informed about their health and adopt a healthy lifestyle. Screening tests are essential for early identification of health problems and maintaining overall well-being.
(Padma Shri recipient Dr BKS Sanjay and Dr Gaurav Sanjay are orthopaedic surgeons based in Dehradun; views expressed are personal)
