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Of older moms and Down Syndrome

India‘s urban elite has plenty of DINKs (Double Income, No Kids). These people get married later than their rural counterparts, often after they are financially and professionally independent and secure. They can afford the best, as far as pregnancy, antenatal care and delivery are concerned. Eventually, they limit their families to one or maybe two children for whom they wish to provide the best opportunities in life.

Under these circumstances, the birth of a child with Down’s Syndrome (trisomy 21 or mongolism) becomes an unbearable tragedy.

One in 800 children is born with Down’s Syndrome. Such children have a characteristic mongoloid  appearance at birth itself, irrespective of the parents’ ethnic backgrounds. The head may be smaller than normal with a sloping forehead, upward slanting eyes, a small flattened nose, low set ears, short stumpy fingers, a protuberant abdomen and a tongue which sticks out of a small mouth. Also, the palm shows just two lines instead of the usual three.

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Down’s Syndrome usually occurs spontaneously as a result of an anomaly during early embryonic cell proliferation producing an abnormal chromosome 21. During cell division it may have divided abnormally, producing three parts instead of the normal two. Sometimes a piece from the chromosome may have attached (translocated) itself to another chromosome.

These anomalies are more likely with increased maternal age at the time of the pregnancy. Many doctors and researchers consider the age 35 as the cut off.

The child shows all the typical features of Down’s Syndrome if all the cells contain the abnormal chromosomes. Sometimes the person may be a mosaic, with a mixture of normal and abnormal cells. The appearance may then be atypical.

The risk of recurrence is greater if the condition has arisen as a result of translocation. This is because one of the parents is then likely to be a carrier. The risk is around 3 per cent if the father is the carrier, and 12 per cent if the mother carries the abnormal gene. Also, a mother with a Down’s Syndrome child has a one per cent chance of producing another similarly affected child.

Life is difficult for children suffering from Down’s Syndrome as they often have subnormal intelligence. They may also have abnormalities in other organs like the heart. There may be blocks or malfunction of the gastrointestinal tract with constipation and intestinal bloating. Hearing loss or visual defects may also occur. The chromosomal abnormality causes a decreased immune response, causing frequent infections as the children grow. The incidence of leukaemia is 20 times greater than in the general population. Dementia too sets in during early adult life (around 40). All this means a lifetime of nurturing and extra care.

So does this mean that women should sacrifice education and professional careers for early marriage and childbirth?

Not really, as advances in medical science have made it possible to diagnose Down’s Syndrome during the antenatal period itself.

Ultrasound examination during the first trimester has a detection rate of approximately 95 per cent of all Down’s Syndrome cases. The measurement of nuchal translucency — the size of a collection of fluid at the base of the foetal neck  correlates with the risk of Downs Syndrome. Other markers like the size of the head, the nose, the presence or absence of heart and intestinal defects can be evaluated with a scan. The presence of several abnormal markers may be an indication of Down’s Syndrome.

Moreover, certain blood tests performed on the mother can show abnormal results if the foetus is affected. Of these, the one commonly available in India is the alpha-fetoprotein level which tends to be less than normal in Down’s Syndrome.

To confirm the diagnosis, the chromosomes of the foetus can be examined. This can be done with amniocentesis (an examination of the cells in the amniotic fluid that surrounds the baby in the uterus). The diagnosis takes two weeks.

The cells of the placenta can be also tested during the 10th and 12th weeks of pregnancy by Chorionic Villus Sampling (CVS). If a rapid diagnosis is required, Percutaneous Umbilical Blood Sampling (PUBS) can be done after 18 weeks of gestation. Each of these three tests is 98 to 99 per cent accurate in diagnosing Down’s Syndrome. However, all these tests carry a risk of miscarriage.

After birth, Down’s Syndrome is suspected because of the typical appearance of the baby. It is confirmed by karyotyping or checking the baby’s chromosomes to demonstrate the extra chromosome in the cells.

Unfortunately, much of this high-tech diagnosis is out of reach for the average Indian woman. Financial constraints, poor education and lack of facilities are major drawbacks to good antenatal care and prenatal diagnosis.
Source:Thr Telegraph (Kolkata,India)

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Laughter, the best medicine

Laughter by David Shankbone

Image via Wikipedia

If Dr Madan Kataria has his way, all IT and BPO offices in Bangalore(INDIA)will have a laugh room soon. “Instead of taking coffee and cigarette breaks, the employees will take a laughter break. It gives an equally good high, says Kataria, who runs a School for Laughter Yoga in Mumbai. (India)

Kataria is not joking. Last month, he conducted research with 30 employees in two Bangalore-based IT firms to determine the effects of laughter therapy on people suffering from work stress. We measured the stress levels of the employees before and after a laughter yoga session, says Kataria. The researchers found that stress levels reduced significantly after an hour of laughs and yogic exercise.

Kataria is still tabulating the findings of the research. Once that is done, he plans to float a proposal to start laughter yoga sessions in software firms — known for erratic hours and work stress.

Kataria believes a good guffaw a day keeps the doctor away. Laughter is a natural cure for many ailments like asthma, gastric ulcers and certain sexual disorders, he says. It helps asthmatics because laughter improves lung capacity and oxygen levels in the blood, explains Kataria. If you laugh uninhibitedly, it clears all pent-up negative emotions and helps keep the mind clear, boosting the immune system and relaxing the body, adds the laughter yoga proponent.

At a time when medical drugs and self-help literature rule, Bangalore boasts of 160 laughter clubs ” the highest in any Indian city, according to B.K. Satyanarayana, founder, Bangalore Laughter Clubs. As work related stress is on the rise in Bangalore, more and more people are heading to laughter clubs. People are realising the benefits of a simple hearty laugh, says Satyanarayana. He adds that on an average, each club has over 50 members.

Daylight is yet to break as people start streaming into an open area near Ulsoor Lake, in the heart of Bangalore. The mostly middle-aged members of the local laughter club start the session at 6 am sharp. It takes off with a prayer which is followed by a Namaste laughter — that is, laughing with folded hands.

The one-hour session is a mix of yoga and laughs. Each yogic exercise – which includes pranayam, kapalabhati and bhastrika — is followed by stimulated laughter, each of which have names like ‘one meter laughter’, ‘forgiveness laughter, ˜break dance laughter and the ˜AK-47-without-a-bullet laughter.

L.G. Vishwanath Shetty, who anchors two clubs in R.T. Nagar, Bangalore, says his club members have mastered 40 ways of laughing. “One meter laughter is when you laugh at a stretch. Forgiveness laughter is when you hold your ear lobes and laugh looking at someone, as if to say that you have forgiven and forgotten,” explains Shetty.

Newcomers to the club admit it is not easy to laugh for no reason. Madhav Swamy, who recently enrolled at a laughter yoga club, says he initially felt odd when he was asked to break into peels of laughter for no reason. “I felt awkward,” says Swamy. But I gradually grew out of my inhibitions. Watching 50 people bend backwards and laugh heartily is very infectious, he adds.

B.K. Satyanarayana feels laughter is a much-needed medicine in a world that is turning into a dreadful place to live in. Unhappy news and negative thoughts abound today. We are trying to break the seriousness of life and alleviate stress through laughter clubs, he says. Satyanarayana calls laughter the easiest form of meditation.

The physical benefits of laughter are an added plus-point. More than 70 per cent of all illness has some relation to stress. These include high blood pressure, heart disease, depression, insomnia, migraine, anxiety, allergies and peptic ulcers, says Kataria.

Researchers have found that laughing increases the count of antibodies present in the mucous membranes of the nose and respiratory passages. This means that people who laugh a lot catch fewer colds and chest and throat infections. Also, a laugh a day strengthens the human body’s immune system by increasing the count of natural killer lymphocytes, a type of white cell and raising the level of antibodies, he adds.

Laughter is also an effective pain killer, claims Kataria, adding, “Laughing increases the level of endorphins which is a natural pain killer. So it reduces the pain from migraine, spondilitis and arthritis.

There is good news for those who want to look good. Laughter tones up facial muscles and increases blood supply to the face and thus gives it a glow. Laughing can make you look younger, claims Kataria, adding, “But the biggest benefit of laughing is the bonhomie it creates among people. If people laugh together, they bond better and shed ill will.

Clearly, laughter therapy is no laughing matter
.

Source:The Telegraph (Kolkata,India)

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