JULY 2013
Khaas Baat : A Publication for Indian Americans in Florida
Health & Wellness

Food Poisoning!

By M. P. Ravindra Nathan,
MD, FACC, FACP, FRCP
(London)

Summer has arrived and many of you will be traveling to various destinations such as vacation resorts, convention centers or, for family reunions, some even abroad. Often you may have to eat in restaurants, at fair stalls or rarely, from roadside stands. Beware of what you eat, lest you suffer my recent terrifying fate.

It was the final day of a national conference at a five star hotel in a big U.S. city. The fantastic cultural show was just over. The buffet line opened after 9 p.m., a bit late for my usual dinner time. While standing in line, I admired the great spread consisting of several mouth-watering vegetarian and non-vegetarian dishes, cooked by four chefs, catered by a reputable Indian restaurant and then warmed and served by the hotel staff. I scooped up spoonfuls from some of the dishes, including a delicious chicken curry. My family members and I returned to a relative’s place late at night.

About six hours after I ate, my belly started rumbling and getting painfully distended. Then ensued severe vomiting, watery diarrhea, fever and chills. “Oh, my God, is it acute food poisoning?” I wondered in dismay. Soon it turned out to be a major crisis, that too, in an unfamiliar city. I had to be hospitalized immediately and given several liters of fluids intravenously in the ICU to correct the dehydration, hypotension and shock, plus antibiotics, steroids and more. Dozens of docs checked me out. The cultures grew Campylobacter jejuni, a bacterium that is often associated with undercooked poultry but can also come from raw milk and dairy products, and contaminated produce or water. Most likely, the chicken was the culprit! The nightmare ended three days later when I was discharged, weak and skinny.

I must admit because of certain health problems, I am a bit more susceptible for infections than otherwise healthy people. However, many of my friends recounted similar stories related to eating contaminated food, often from a buffet line in chain restaurants, some getting seriously ill.

This brings me to the main point of this article. Foodborne diseases, often termed “food poisoning,” are on the increase lately in the U.S. No doubt, it is more prevalent in India and many other countries. You have heard about traveler’s diarrhea or tourista. Here is an excerpt from a recent report published in JAMA (J of Am Med Assoc): “The Foodborne Diseases Active Surveillance Network, known as Food-Net, which tracks confirmed infections, transmitted via food at 10 U.S. sites reported 19,531 infections, 4563 hospitalizations and 68 deaths from food-borne diseases in 2012. For most infections, the incidence was highest among children younger than 5 years. Hospitalizations and deaths were highest among adults 65 or older.” However, CDC estimates that “Each year, roughly 1 in 6 Americans (48 million people) gets sick, 128,000 are hospitalized, and 3,000 die of foodborne diseases.” The pathogens involved included Campylobacter, Vibrio (which live in sea water and hence associated with contaminated raw oysters), salmonella (often contaminating chicken), shigella, listeria and E-coli from undercooked hamburgers.

Don’t think fresh fruits and vegetables that you buy from reputable stores or corner stands are immune from contamination. We are all familiar with the Salmonella outbreak from fresh peppers imported from Mexico in 2008 and another similar outbreak from Mexican cantaloupes in 2000 and, the green onion Hepatitis outbreak in 2003. Even leafy vegetables like lettuce are not exempt.

Tips for prevention

CDC advises that chicken, other meats, and shellfish should be thoroughly cooked and unpasteurized milk and cheeses such as brie, goat cheeses, etc., should be avoided. Of course, when you eat home-cooked food, you hardly ever get sick; but we don’t always have that luxury. I now try to avoid buffet dining, especially from chain restaurants, and if I do go, try to eat as soon as the buffet opens, so the food will be fresher. I have never had any problems with hot vegetarian dishes from anywhere. Similarly, well-cooked fish has not given me any gastrointestinal upsets. Salads and other cold, uncooked foods often harbor germs and can give you problems. My son, who travels frequently, says: “You can pile up all the food you want in a plate and ask the hostess to ‘nuke’ it in a microwave (provided it is ‘nukable,’ unlike ice cream!) for a couple of minutes to kill the germs.” And fruits and vegetables need to be thoroughly cleaned before consumption.

As you get older, your immune system gets weaker, making you more vulnerable to infections. When eating from restaurants, one cannot be certain if the food is always prepared and served according to the strict safety standards prescribed by the CDC. Hopefully, the Food Safety Modernization Act of 2011 will strengthen the surveillance and outbreak response for foodborne illnesses in the U.S.

Dr. M. P. Ravindra Nathan is a Brooksville cardiologist.


GUEST COLUMN

LASER for CATARACT surgery Is Now a Reality!!

By DR. ARUN GULANI

Cataract surgery is one of the most frequently performed surgeries in medicine as everyone who lives long enough will have cataracts (clouding of their natural lens) and need cataract surgery eventually (Ref: Khaasbaat article).

Recently, the United States FDA approved Femtosecond Lasers for cataract surgery, heralding a new era in sophistication, accuracy, reproducibility and consistent success of cataract surgery.

In traditional cataract surgery, the eye surgeon uses a hand-held metal or diamond blade to create an incision, a special hand held device to make an opening in the lens and then ultrasound energy to remove the cataract. Many people think lasers have been doing their cataract surgery but honestly eye surgeons are tired of saying that it is not laser but high-speed ultrasound (Phacoemulsification). Until now!

With the laser approach to cataract surgery, the surgeon creates a customized surgical plan with a sophisticated 3-D image of the eye and computer-guided micron-precision to enable them to safely and consistently perform cataract surgery beyond the intricacies and precisions of the human hand.

This laser can also simultaneously correct coexisting Astigmatism (Khaasbaat article in September 2012) during cataract surgery by performing intricate incisions to change the corneal shape from a football to a basketball, beyond the accuracy of diamond blades themselves.

At the time of this article, the costs associated with Laser Assisted Cataract surgery are unlikely covered by Medicare or private health insurance. Fees vary from one cataract surgeon to another and you can do your research based on surgeon reputation and experience.

We have started designing new surgical tools to work with the Laser as the approach to cataract surgery itself has changed with it. As Lasik and cataract surgeons, we have realized that the Laser adds another layer of advantages when we combine it with high-tech, premium implants such as presbyopia-correcting multifocal IOLs and accommodating IOLs. The advantages can include better lens placement and, therefore, more accurate visual outcomes.

The Laser by virtue of being a software-driven computer action lends itself to continued refinements and improved applications.

Until then, you still need to have an eye surgeon.

Arun C. Gulani, M.D., M.S., is director and chief surgeon of Gulani Vision Institute in Jacksonville. He can be reached at gulanivision@gulani.com or visit www.gulanivision.com

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