Medical

Travelers’ health insurance

50% of people who travel develop a travel-related illness. All travelers should be well prepared for their trip and take precautions to avoid contracting travel-related illness. This issue discusses various aspects of travel-related illness and the associated protective measures.

Travel, according to Ayurveda, vitiates the vata dosha. Vata dosha regulates all bodily functions such as digestion, respiration, excretion, nerve impulse transmission, reflexes, and body movements. When vata becomes vitiated as a result of travel, all of these normal bodily functions become imbalanced as well. Disturbances in bodily functions manifest as travel-related illness.

Severe motion sickness:

Almost every human body is prone to motion sickness. The primary unwelcome symptoms of motion sickness are fatigue, giddiness, sleep deprivation, nausea, and vomiting. While traveling, abstain from alcoholic beverages, pain relievers, spicy foods, fried foods, and junk foods. Make an effort to unwind and select a window seat. Avoid reading or conversing. Alternatively, observe someone who is motion sick.

Consume light fare. While traveling, incorporate pomegranate, ginger, and curds into your diet. As soon as you finish eating, rinse your mouth and wash your face with cold water.

Diarrhea:

Though travelers’ diarrhea is a minor inconvenience, it can be life threatening at times. Travelers frequently experience digestive upsets as a result of stress, time zone changes, irregular meal times, and new foods. However, severe diarrhea during travel is caused by bacteria, viruses, or parasites. The best course of action is to take numerous precautions.

Hands are frequently washed. Utilize sanitizing liquids, hand washes, or gels that effectively cleanse hands without the use of water. Rather than towels, always use disposable hygienically packed tissue papers. Avoid street and roadside food, as well as buffets. Choose food that is properly cooked and served hot. Generally, thick-skinned fruits that you can peel yourself are safe. Steer clear of raw or undercooked meat, fish, raw vegetables, and salads. Use unpasteurized milk and milk products with caution. Always use bottled mineral water, canned juices, and beverages that have been sealed. Never use ice cubes or bottled beverages that have not been sealed. It is safe to consume bottled beer, wine, and hot coffee or tea. Consume beverages in their original containers or in clean glasses.
If you experience mild diarrhea, consume light, soft, and semi-solid foods such as idli, soups, and so on that are easily digestible. Avoid foods that are heavy, spicy, or not vegetarian. Consume a variety of fruit juices. (canned or packaged hygienically.) Maintain adequate hydration. Consult a physician as soon as possible if diarrhea results in dehydration.

Constipation:

Constipation is a common symptom of traveling because one’s normal diet and daily routines are disrupted. Consume plenty of water and fiber-rich foods to avoid constipation.

Attempt to maintain consistent meal times.

Each morning, drink a large glass of water. Avoid excessive tea or coffee consumption. Before going to bed, taking two thriphala tablets with warm water helps to normalize bowel movements. Pregnancy should be avoided when taking these tablets.

Feet that are weary

Even healthy individuals can develop blood clots in their legs following extended periods of travel. Attempt to walk occasionally. Consume water, stretch your calf muscles while seated, and wear compression stockings.
Bathe your tired feet in a foot bath: Massage a small amount of coconut oil into your feet and soak them in warm water. To warm water, add a few drops of lavender oil, peppermint oil, or sandalwood oil. Rub your foot after a foot bath. After a foot bath, unwind.

Malaria Prevention:

Wear mosquito repellent to avoid mosquito bites and malaria.

Between dusk and dawn, remain indoors. Generally, this is when malaria-carrying mosquitoes feed. Use insect repellent on your clothing and bedding. When outdoors, wear socks, long pants, and long-sleeved shirts. While sleeping, use a mosquito net. Stay in a screened-in, air-conditioned room.

Inflight jet lag

To avoid jet lag, get plenty of rest prior to departing. Avoid excessive alcohol consumption during the flight. Consume well-balanced meals and abstain from overeating. While on your trip, get as much exercise as possible. Acclimate to a new time zone by following the local meal and sleep schedules.

Accidents:

Avoid driving in unfamiliar areas where you are unfamiliar with the regional language, road conditions, traffic rules, and vehicle condition. Choose your mode of transport carefully. Examine the transportation’s security and life-saving features. Choose a cab equipped with seat belts, a hotel equipped with a fire escape, or a ferry equipped with life preservers. Never swim in unfamiliar rivers or seas if you are unfamiliar with the sea’s currents and waves.

Sex:

Have secure sex with unfamiliar new partners. Alcohol, drugs, and sex are a lethal cocktail.

Immunization:

Immunize yourself with vaccines prior to traveling. Avoid contact with animal bites and saliva. If you are bitten by a dog, immediately wash the wound with soap and water.

Traveling while pregnant:

If you choose to travel while pregnant, the best time is during the second trimester (weeks 14–27). Consult your consulting physician prior to traveling and provide him with sufficient information about the destinations you will be visiting, the mode of transport you will be using, and so on.

Travel tips for senior citizens

Consult your physician for a checkup and to discuss your fitness level.

Consult your dentist and optometrist. Maintain a small medical kit with a spare pair of glasses and any necessary medications. If necessary, arrange for travel health insurance that includes coverage for pre-existing conditions. Ascertain that it includes provisions for emergency evacuation. Ensure that routine immunizations are completed prior to traveling. Consider your back and opt for luggage with integrated wheels. Take appropriate clothing and hats for the climate.

Additional safety precautions include the following:

Consult the regional office or the internet to determine the status of the locations you intend to visit. The destinations must be free of riots, terrorism, flooding, and other natural disasters.

Tensions in the mind:

Travel preparations elicit anxiety and tension. Here are a few relaxing tips to keep in mind before and during your travels.
1. Close your eyes and take five deep breaths through your nose, focusing solely on your breathing.
2. A hot shower helps to relax your muscles, as does a break from more stressful activities.
3. Laugh. Laughter aids in relaxation. Find people who can make you laugh and brighten your days.
4. Listen to soothing music.
5. Take a walk.
6. Obtain a hug.

A visit to your family physician, as well as some forethought and planning, will help ensure the success and enjoyment of your trip. We wish you an enjoyable, memorable, safe, and healthy travel experience.

What is the relationship between Allergic Rhinitis and Otitis Media with Effusion? (OME)

Otitis media is a condition in which the middle ear becomes inflamed. The middle ear space contains fluid that is susceptible to infection, and an infection of the middle ear is referred to as otitis media with effusion. The majority of allergic rhinitis patients develop chronic OME (otitis media with effusion) as a result of IgE-mediated allergies. IgE-mediated allergy occurs when an IgE antibody (a type of white blood cell) interacts with a mast cell. When a foreign substance from the outside of the body enters the blood via the nasal mucosal surface, the plasma cell produces IgE antibody. Once the IgE antibody binds to the mast cell surrounding the nose, this cell secretes histamine, which is the primary chemical responsible for the itching and hypersensitivity of the nose. According to a group of scentists, 50% of children with chronic OME also have nasal allergy [Acta Otolaryngol (Stockh) 1988;458(suppl):41-7]. A few groups of medical scientists have studied the effects of seasonal allergic rhinitis on Eustachian tube function and middle ear pressure. According to one study, the percentage of pollen allergic patients with obstructed Eustachian tubes increases from 15% to 60% from the start to the peak of pollen exposure. [J Allergy Asthma 1990;65:206–10]. In one study, ragweed pollen was exposed to a group of people. Ragweed pollen is a seasonal pollen. It was discovered that it triggers immune responses in the Eustachian tube and nose [Am J Rhinol 1988;2:155-61.]. Apart from this study, another reported that the house dust mite, a perennial allergen, also obstructed the Eustachian tube [ ArchOtolaryngol Head Neck Surg 1986;112:840-]. In the same study, they discovered that 55% of adults with nasal allergies developed Eustachian tube dysfunction after being exposed to house dust mites. In the subsequent study, it was discovered that Eustachian tube obstruction occurred more frequently in patients with allergic rhinitis. [Journal of Allergy and Clinical Immunology 1987;79:27–31]. Scientists discovered that nasal obstruction typically occurs prior to the development of Eustachian tube obstruction in allergen provocation studies. Individuals who participated in the allergen provocation study were exposed to allergens to elicit their nasal allergy symptom. Additionally, researchers discovered that a variety of inflammatory mediators, including histamine, were detected in the middle ear effusions of children with OME. [American Journal of Otolaryngology-Head and Neck Surgery 1988;114:1131-3]. If an obstruction in the Eustachian tube caused by persistent exposure to an allergen such as a house dust mite is left untreated for an extended period of time, it can develop into middle ear disease, particularly when the priming phenomenon occurs in the Eustachian tube. The priming effect occurs when the organ’s mucosa responds to repeated exposure to low doses of allergen. Allergic rhinitis may also exhibit priming, in which the mucosa of the nasal passage responds to a small amount of allergen inhaled through the nostril. The physiologic hyperresponsiveness of the Eustachian tube obstruction caused by seasonal exposure to allergens such as ragweed pollen may extend beyond the ragweed season.

According to studies, half of newly diagnosed otitis media are diagnosed immediately after the patient has been infected with a viral URTI (virus that causes flu and common cold). It is extremely rare for viruses to be isolated from middle ear effusions in patients with otitis media using conventional culture techniques. However, using a newly developed PCR-based molecular analysis, viruses in middle ear effusions were detected, and it was discovered that 53% of middle ear effusions are virus-positive [J Infect Dis 1995;172:1348-51]. Infection of real humans with rhinovirus-39 was used in an experiment at Children’s Hospital of Pittsburgh to determine the virus’s effect on middle ear pressure and the Eustachian tube. The results of this experiment revealed a significant increase in Eustachian tube dysfunction and also abnormal middle ear development in approximately 30% of those infected in this study. However, all of these individuals who were infected with this virus had a decreased risk of developing otitis media disease. In another study, where influenza A virus was administered intranasally to a group of people, 59 percent of those inoculated developed middle ear pressure and only 25% developed otitis media [J Infect Dis 1995;172:1348-51]. One of the participants in this study developed middle ear pressure followed by purulent otitis media. The middle ear effusion of this patient was sent for PCR analysis, which revealed positive results for influenza A and Streptococcus Pneumoniae. Streptococcus Pneumoniae is a Gram-positive, alpha-hemolytic spherical bacterium that belongs to the genus Streptococcus. Eighty percent of those inoculated with this virus developed Eustachian tube dysfunction, and eighty percent developed middle ear pressure [Ann Otol Rhinol Laryngol 1994;103:59-69]. Five of the infected individuals developed OME on the fourth day following viral exposure. One of the patients experienced dizziness and vertigo, which is primarily caused by an inner ear malfunction. All of these studies support the URTI virus as a cause of otitis media, as well as the development of Eustachian tube obstruction and abnormal middle ear pressure as a cause of otitis media. The investigator of a recent publication on a group of children with acute otitis media isolated microorganisms from the children’s middle ear fluids. They discovered that 65% of the fluid samples collected contained bacteria and viruses. These findings demonstrate that virus infection of the middle ear creates an environment conducive to bacterial growth. [New England Journal of Medicine 1999;340:260-4].

On the basis of information gathered from a few recent publications on the relationship between allergic rhinitis and OME (otitis media with effusion), we can conclude that allergic rhinitis or the common cold/flu will result in Eustachian tube obstruction and middle ear pressure. When the situation becomes out of control, otitis media with effusion develops, which may result in permanent hearing loss. As a result, allergic rhinitis and the common cold/flu should be treated immediately. This is because these common illnesses can progress to chronic sinusitis and otitis media with effusions, both of which are extremely difficult to treat.