High blood pressure: investigation & treatment
Dr H.S. Wasir
Anybody who is found to have high blood pressure must get the following investigations done which help (a) to find a possible cause or causes and thereby give a specific treatment for the disease in the form of ballooning (angioplasty) or surgery, and (b) to know the extent of damage done by high blood pressure to vital organs such as brain, eyes, heart and kidneys.

Therapeutic benefits of honey
Dr John Briffa
Before the advent of modern medicine, traditional methods of healing using food and herbs were all the rage. Despite the fact that such folk medicine has become overrun by hi-tech and drug-oriented health care, a few homespun remedies survive, such as honey and lemon — an elixir reputed to relieve sore throats.

AYURVEDA & YOU
When the belly is on fire
Dr. R. Vatsyayan
Of the numerous diseases attributed to modern lifestyle, acidity is one which all of us might have suffered from at different times. To a large number of people, it is a regular phenomenon. In a majority of homes one can easily find strips of antacid tablets or liquids adoring the dining tables and drawers of bedrooms.

INFO CAPSULE

High blood pressure: investigation & treatment
Dr H.S. Wasir

Anybody who is found to have high blood pressure must get the following investigations done which help (a) to find a possible cause or causes and thereby give a specific treatment for the disease in the form of ballooning (angioplasty) or surgery, and (b) to know the extent of damage done by high blood pressure to vital organs such as brain, eyes, heart and kidneys. The investigations include: (1) Blood tests for haemorgram, urea, sugar, uric acid, electrolytes (Na+ k+) and lipid profile, i.e. cholesterol, triglycerides and lipoproteins like LDL, HDL and VLDL. (ii) Urine analysis for albumin and microscopy (iii) X-rays of chest and abdomen (iv) ECG. (v) Ultrasound of abdomen for kidneys and adrenal glands (vi) Eye check-up (fundoscopy). (7) CT scan or MRI is advised in a few cases suspecting a tumour as a cause of high blood pressure or vascular complications due to high blood pressure.

Treatment of high blood pressure comprises of (1) non-drug measures, (2) drugs for high blood pressure, (3) angioplasty with stents (ballooning), and (4) surgery.

Weight reduction in those who are overweight. Doing regular physical exercise specially brisk walks, swimming and other dynamic exercises. Avoiding excess salt and spirits (alcohol). Avoiding smoking. Practice of mental relaxation through meditation, music and yoga, study of religious scriptures and attending to religious congregations.

There are excellent drugs available at present for the control of high blood pressure. It is not possible to describe these in detail here, but it will suffice to state that the doctor should use such drugs or drug combinations as do not cause any disturbances in blood glucose, cholesterol and electrolytes. One common side-effect of some of the blood pressure lowering drugs is impotence or adverse effects on male erectile function. In case the patient experiences such a side-effect it should be brought to the notice of the treating doctor so that alternative medicines can be prescribed as there is a large list available to choose from.

While treating high blood pressure in elderly patients, we must start with the smaller doses of any drug and preferably give one drug. The elderly cannot tolerate sudden falls in blood pressure and may get symptoms due to a sudden decrease in blood supply to the brain if their blood pressure is brought down suddenly. The elderly are also more prone to postural hypotensions, i.e. sudden fall in blood pressure on standing. They should, therefore, be instructed to gradually adopt the standing posture from the lying down supine position, preferably sitting in the bed with legs hanging down for a few seconds before standing up and walking.

Unlike the old concept that once blood pressure drugs are started one had to take them life long, this is not always so. If the drug treatment is started early, it is possible to reduce drugs and at times even stop these while continuing the life-style modifications enlisted above under non-drug measures. Any reduction in drug therapy or its stopping should be done under medical supervision.

Some patients whose high blood pressure is due to narrowing or blocked arteries, especially the renal (kidney) arteries, can be successfully treated by angioplasty procedures, i.e. ballooning and using metallic coils called stents to prevent a recurrence of the narrowing. This procedure can be done at any age, including the adults and even elderly where the narrowing of the renal arteries is due to the process of atherosclerosis.

It is rare that high blood pressure is due to some tumours in the kidneys or in the neighbouring organs called adrenal glands. Such patients can be cured of their high blood pressure by operations. The earlier the treatment is given, the better are the results.

Precise prevention of a disease is possible when its exact cause is known, which in the case of high blood pressure we do not know. We, therefore, do not have any vaccination against high blood pressure as the causative agent is not known. The various preventive measures for the disease are targeted against the risk factors which either initiate or aggravate high blood pressure. These are:

1. Avoid obesity and lose weight if overweight.

2. Regular physical exercise not only keeps the weight down but is also the best means for mental relaxation and keeps the blood pressure and blood cholesterol down. Regular physical exercise adds not only years to life but also life to years.

3. Not to consume too much salt. Diet should contain enough citrus fruits to keep the blood potassium up and sodium low. Banana is a rich source of potassium.

4. Alcohol consumption more than two ounces of whisky or two glasses of beer or wine in a day should be strongly discouraged.

5. Regular practice of meditation and yoga asanas, including padamasana and shavasana, are proven ways to give mental relaxation and to prevent high blood pressure.

Lying flat on the ground with the face upwards, in the manner of a dead body, is shavasana. It removes tiredness and enables the mind and whole body to relax. Shavasana practised for 15 to 20 minutes daily is helpful in prevention and treatment of high blood pressure.

The writer is the Chief Cardiologist and Medical Adviser, Batra Hospital & Medical Research Centre, New Delhi. Mobile Phone: 98110-26116. e-mail:hsw.dlf@ hotmail.com

Therapeutic benefits of honey
Dr John Briffa

Before the advent of modern medicine, traditional methods of healing using food and herbs were all the rage. Despite the fact that such folk medicine has become overrun by hi-tech and drug-oriented health care, a few homespun remedies survive, such as honey and lemon — an elixir reputed to relieve sore throats.

The presence of lemon juice in this brew makes sense, as vitamin C is known to have immune-stimulating and anti-infective effects in the body. But, at first sight, the honey component is harder to make a case for. However, the fact that honey’s use as a remedy dates back to the ancient Egyptians suggests there might be something in it. Recent scientific evidence also suggests that honey has real medicinal power, and may help to ease sore throats and other infections.

Sore throats can be caused by both viral and bacterial organisms. Most start out as viral infections, against which antibiotics are quite ineffectual. Antibiotics do have their use, however, for bacterial organisms. Bacteria might be the first germ to take up residence at the back of the throat, though commonly they superimpose themselves on top of a viral contamination. The most common bacterium known to cause sore throats is Streptococcus pyogenes. Because this germ can lead on to problems such as rheumatic fever and inflammation of the kidneys, treatment with antibiotics is important. However, laboratory experiments have found that honey can inhibit Streptococcus pyogenes. So, it is not beyond the realm of possibility that sipping honey and lemon at the first sign of a sore throat may help keep the potentially hazardous streptococcal bug at bay.

Another organism that honey has been shown to help combat is Helicobacter pylori (H pylori). This bacterium was discovered 20 years ago and is now well-recognised as a causative factor in ulcers. Manuka honey, from New Zealand, has been shown to kill H pylori in the test tube. While conventional treatments exist, taking 2-3 teaspoons of Manuka honey daily can only help to rid the body of H pylori and reduce the risk of re-infection. Opt for a brand labelled UMF 10+. UMF stands for ‘uniqueManuka factor’, which is believed to give it its bacteria-killing potential. Comvita and Medi-Bee are two good brands.

The therapeutic benefits of honey appear to have applications not just inside the body, but outside, too. Scientific studies have found that the application of honey can help a variety of wounds, including burns. Honey appears to have the ability to ward off wound infections, reduce inflammation and promote healing. In one case report in the scientific literature, honey was used successfully to treat a wound infected with the antibiotic-resistant superbug MRSA (methicillin-resistant Staphylococcus arueus). The evidence suggests that as far as folk remedies go, honey really is the bee’s knees.

Guardian Newspapers Limited

AYURVEDA & YOU
When the belly is on fire
Dr. R. Vatsyayan

Of the numerous diseases attributed to modern lifestyle, acidity is one which all of us might have suffered from at different times. To a large number of people, it is a regular phenomenon. In a majority of homes one can easily find strips of antacid tablets or liquids adoring the dining tables and drawers of bedrooms. It is also not uncommon to see many patients who suffer from some other chronic ailment start their day by taking a bunch of tablets and capsules which invariably include one antacid. Incidence of acidity is almost equal in persons of different sections of society whether men or women, young or old, and rich or poor.

Ancient ayurvedic texts didn’t discuss acidity as such. There are only oblique references about this disease in the works of Charaka and Sushruta. Later-day ayurvedic scholars like Pandit Madhava Mishra, while explaining the etiology and pathogenesis of acidity, termed it as “amla-pitta”. As the name suggests, amla is sour or putrid and pitta is a body humor which itself is hot, bitter, smelly and sharp in nature.

Types of acidity

Ayurveda describes acidity as of two types: urdhwaga with upward pressure, and adhoga which though has downward force also exhibits systemic effects on other parts of the body. According to the doshic imbalance, it has been described as of three types: one due to the intervention of vata, another due to kapha and the third one is attributed to the involvement of both of them.

Causative factors

There is a wide range of reasons which contribute to the occurrence of acidity. Foremost among them is the indiscretion in taking food which incorporates its quality, quantity and timing. Frequent intake of incompatible and sweet, sour and spicy food, eatables which are fried and heavy in digestion, eating even simple but more food than one’s capacity to digest and taking meals at irregular hours or before the previous meal is digested result in the vitiation of pitta in the stomach. Smoking and too much intake of tea or coffee add to many of its other causative factors.

Ayurveda also considers psychological reasons like anger, grief, anxiety and depression as potential reasons to trigger the onset of acidity. Intake of any unsuitable food item and medicines like antibiotics, steroids and pain-killers can cause gastric irritation and enhance acid secretions. Acidity can also result due to some organic disorders like the inflammation of gall bladder, stone formation, hiatus hernia and due to the malfunctioning of the stomach-esophageal valves more commonly known as gastro-esophageal reflux disorder (GERD). Vata-dominated acidity is seen occurring in many aged and elderly people due to the destruction or atrophy of mucous membrane of the stomach.

Signs and symptoms

Depending upon the severity, acuteness and chronicity of the problem, patients suffering from acidity or amla-pitta present a variety of signs and symptoms. Initially, almost all of them complain of burning in the throat, chest and upper abdomen accompanied by sour and fuming eructations. All this may be accompanied by nausea or vomiting during the digestion of food or on empty stomach. The sticky and thin vomit material has been described in ayurveda as of different colours like green, yellow or red and sometime resembling the mutton wash (a symptom found in peptic ulcer). Other symptoms include bloating and uneasiness in the abdomen, headache, loss of appetite and restlessness.

The adhoga or the acidity with downward tendency presents more systemic features and many of them resemble the symptoms of chronic sprue or of irritable bowel syndrome. There may be diarrhoea or, alternatively, constipation, passing of very foul smelling semisolid stool, excessive thirst, giddiness, fainting and a heightened state of anxiety. Poor digestion, malabsorption, anemia, rashes on the skin are some other symptoms which ayurvedic texts have attributed to the chronic and more severe type of acidity.

The writer is a senior Ayurvedic Consultant based at Ludhiana. Phones 2423500, 2431500. E-mail: sanjivni@satyam.net.in

INFO CAPSULE

Oxygen deprivation

WASHINGTON: US researchers have found that even minor oxygen deprivation at or immediately after birth may put premature babies at increased risk of developing cognitive and language problems, according to a report in Neuropsychology.

The study, published by the American Psychological Association APA), reports that biochemical signs of reduced blood oxygen levels (hypoxia) soon after birth are associated with lower IQs and language skills and also reveal how the risk threshold for rain damage in preterm babies could be lower than thought. Psychologists compared the intellectual and language development of five- and six- year olds, all of whom had been born prematurely. ANI

From one woman to another

JOHANNESBURG: Lesbian sex can transmit HIV, according to a report in the journal of Clinical Infectious Diseases. This was confirmed after a 20-year-old woman from Philadelphia tested positive for HIV following relationship with another women.

According to doctors, this is the first scientifically confirmed case where the HIV virus was transmitted from one woman to another. It is believed that the virus was transmitted through sex toys, the experts were quoted by the journal. ANI

Leukaemia in Vietnam veterans

WASHINGTON: Resear-chers have found that Agent Orange, a defoliant used by the US forces during the Vietnam War, triggered a chronic form of leukaemia suffered by former soldiers — thus prompting US Veterans Affairs to extend benefits to Vietnam veterans with chronic lymphocytic leukaemia. The experts reassessed six studies on exposure to herbicides sprayed in Vietnam, reports The Age. Their conclusions, released in a report, hinted at extending compensation to the victims.

The ruling means that veterans with the disease will not have to prove that their illness is related to their military service to qualify for compensation. ANI