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| HEALTH TRIBUNE | Wednesday, August 27, 2003, Chandigarh, India |
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Ways to
prevent heart disease Angioplasty
preferable for heart attack victims AYURVEDA & YOU Eye
donation picking up in the North Smokers
with TB double their chances of dying Turmeric
an effective therapy Alcohol
during pregnancy harms foetus |
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Ways to prevent heart disease
CORONARY artery disease (disease of the arteries of the heart) has reached almost epidemic proportions in India. The incidence of this disease ranges from 14.8 to 65.4 per 1000 people. In Punjab, the incidence is in the upper limit of the range - mostly due to the fat-rich, predominantly non-vegetarian and milk and milk product containing staple diet, increasing stress in all walks of life and a genetic predisposition to atherosclerosis . The last factor — of a genetic predeliction and of an association of heart disease with obesity and diabetes mellitus (Syndrome X) — has recently come to light when it was found that second and third generation Indians born and brought up abroad had a higher incidence of heart disease than their Western counterparts. Syndrome X places Indians at a four-fold increased risk of heart disease, with those below 40 years of age being at a 10-fold risk. Some more hitherto unproven factors like hostility and anger have also found to be the harbingers of heart disease. Because of a combination of factors even young Punjabis are getting afflicted with heart disease. According to the WHO, by the year 2010 as many as 60 per cent of the heart patients of the world will be Indians. Every minute four Indians die of heart disease. There are various risk factors that predispose a person to get coronary artery disease. Prominent among these are high blood pressure, lack of exercise, obesity, diabetes mellitus (increased blood sugar), smoking (which causes a three-five-fold increase in heart disease) , stress and the previously mentioned genetic factor . Simple preventive measures include stopping of smoking, proper
exercise, reduction in weight, control of hypertension and diabetes and stress management. The earliest symptom of coronary artery disease is chest pain (angina). It is caused by an inadequate supply of blood to the heart muscle. It may start as heaviness in the middle of the chest and go to the left shoulder and arm. Some people may experience it as a choking sensation in the throat, or a feeling of weight on the chest, a squeezing sensation etc. It is a warning sign that the arteries to the heart are getting blocked. The problem in India is that patients or the local health workers either do not understand the seriousness of the symptom and mistake it for cervical spondylosis or acidity or gas (the so-called gas has harmed more patients because of a delay in proper treatment), or try to control the problem with inadequate medication. This can lead to serious complication. There is severe continuous chest pain occurring at rest and is associated with sweating, vomiting and a sensation of the impending disaster. Many patients die before proper medical aid can be given. There are those who survive, but a part of their heart muscle dies and the heart becomes weak. Due to this the pumping of the heart is reduced and the patient can develop difficulty in breathing on doing ordinary activity. It is imperative to start appropriate therapy as soon as possible to save the heart muscle. “Time is muscle” is the catchword if one is to improve the results in patients who have sustained a heart attack. A patient suspected of having heart disease must undergo certain tests after a thorough physical examination before treatment can be scientifically started. An ECG gives some information about any ongoing reduced blood supply or heart attack. An echocardiogram (scanning) tells about the functioning of the heart. A TMT or stress test is done with the help of a computerised machine to see what happens when the patient is made to exercise on a treadmill. These tests are an important part of a comprehensive cardiac checkup. It should be done routinely in people whose job entails a lot of stress and responsibility; also as a screening procedure in males over 40 years of age. In doubtful cases, a nuclear scan may be done - this shows whether there is a reduction in the flow of blood to the heart arteries and also if treatment for the blockage will help improve the quality of life of the patient. In patients in whom the above tests are positive or who clinically have advanced heart disease , the next final test is a coronary angiogram. This is done under local anaesthesia with the patient fully awake . A special dye is injected into the arteries and the heart and continuous X-rays are taken. These show the blockages in the arteries. This is a safe procedure and takes about 5-10 minutes to perform. The test can be done from the groin or from the arm (metro coronary screening). The metro coronary screening allows a patient to go home within one hour with a complete report — in cases performed from the groin the patient has to be admitted overnight. The angiogram decides the further line of treatment. In bypass surgery, a new tube is used to bypass the blocked arteries. This tube is either the patient’s own leg vein or an artery taken from some other part of the body. The bypass surgery may be performed in two ways — either with the heart-lung machine when the patient’s heart and lung are stopped and their function taken over by the machine or on a beating heart where a heart-lung machine is not used. The beating heart technique has been pioneered by the author who holds a world record for the first such surgeries having been done for multivessel disease — the same has been acknowledged by the medical world by a mention in the Limca Book of World Records. While Punjabis typically live life to the hilt with an inclination towards rich food and good things in life and a rare exuberance and resilience, it is time for us to take stock of the disturbing heart epidemic and take steps to reverse it. We will have to reduce our share of desi ghee, butter, parathas, gajar ka halwa , butter chicken, puris and the recent trend of eating junk food. An increase in our level of exercise and stress reduction are unavoidable. Even in rural area the level of day-to-day exercise and hard work has drastically gone down with the advent of cheap migrant labour and mechanisation. The average woman in the region is now subjected to a higher level of chronic stress and daily hassles than her mother ever was . The writer is Chairman, Cardio-Vascular Surgery, Metro Heart Institute, Noida.
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Angioplasty preferable for heart attack victims Boston: Using surgery to reopen clogged arteries should be the standard treatment for heart attack victims, the New England Journal of Medicine said as a new study showed that the technique is more effective than giving clot-busting drugs. The Danish study, published in the journal, found the surgical technique known as angioplasty was the best treatment even if patients have to travel up to two hours to get it. Angioplasty uses an inflatable balloon to get blood flowing through arteries clogged by heart disease, but its availability is limited — especially on an emergency basis. Even in the United States, most hospitals do not perform the operation, Boston University Medical Center’s Alice Jacobs said in an editorial that accompanied the study. Given the latest findings, Jacobs said, it is time for hospitals that perform angioplasty “to offer it 24 hours a day, seven days a week.” In a summary, the journal said angioplasty “should be considered the standard method” of unblocking arteries in heart attack victims. The new study found that it’s usually worth the extra time to get heart attack patients to hospitals that are ready to perform angioplasty on an emergency basis.
— Reuters
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AYURVEDA
& YOU by Dr R. Vatsyayan ASSIMILATION and elimination are the two basic needs of natural health. Conveyance of waste matter from the body takes place in two phases - propulsion from the colon and expulsion from the rectum. Interference with any aspect of this process results into constipation, which may be described as the failure to evacuate stools from the body regularly and satisfactorily. The reasons for constipation may differ from person to person. These mostly refer to three basic things: the constitution of the particular individual, his dietary pattern and lifestyle. The dietary reasons include insufficient intake of liquids and opting for food which is residue-free, dry, astringent, heavy and slow to digest. Constipation more often comes to stay as a sequel to the faulty lifestyle. People with a sitting job, doing less of physical activity and also overdoing any exercise, adopting irregular daily schedule or late night engagements, taking too much of tea and coffee and making indiscreet use of laxatives impair the natural movements of intestines. Psychological and emotional factors like anger, grief and depression also weaken the digestive process, resulting in constipation. Certain physical conditions like pregnancy, chronic illness, insomnia and old age tend to slow down the process of proper evacuation. The management of constipation should primarily be aimed at correcting the diet and life-style pattern of the patient. To start the day, ayurveda advises everybody to get up at dawn and to slowly drink a glass of water which is kept overnight in a copper vessel. Bulk and roughage producing and easily digestible food consisting of whole grains and bran, leafy vegetables, unpolished lentils, moderate use of lubricants like milk, ghee and butter and fruits such as orange, mango, papaya, pear and guava facilitate proper bowel movements. Heavy and fried food items like those made of “maida”, fruits like apple, pomegranate and unripe banana and rice often cause constipation. Prescribing a safe, effective and non-habit-forming laxative is perhaps the most difficult task for a physician. At the first stage, patients are advised not to take any “churna” available over the counter containing a herb called senna. By taking a purgative instead of laxative, they usually experience rebound constipation and gradually turn their case into a chronic one. Generally, all cases of constipation respond well to the traditional non-effervescent isapgol husk, which can be taken at bed-time with warm milk. The much talked about Triphla Churna is a drug to treat occasional constipation only. Hararh also clears the bowels but should be used after getting fried in desi ghee because otherwise, if used for long, it dries up the intestinal flora and creates dependence. Use of gulkand and a decoction of amaltas pulp is helpful in mild cases of constipation. Preparations of senna should only be opted for in severe cases. If taking a laxative at bed-time doesn’t produce the desired results, it is better to try for the same around seven p.m. or preferably an hour before dinner. Stubborn constipation and the problem of hard stools occurring in old people respond well to a few drops of desi ghee or almond oil added and given with a cup of warm milk. Those who confront constipation due to a faulty life-style and improper diet start showing signs of improvement once they make suitable changes. Laxatives should be used only as the last option. Chronic cases respond slowly and, instead of getting restive, they are advised to attentively devise a suitable diet plan for its cure. For all patients of constipation it is only the self-care which can give them the joy of satisfactory evacuation, every morning and day after day. The writer is a Ludhiana-based ayurvedic physician. |
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Eye donation picking up in the North
TILL a few years back it was Sri Lanka which was catering to the entire requirement of eye donations in India. People in the neighbouring island feel that the gesture earns a lot of goodwill in the next birth. Had it not been for religious superstitions in India, that a person whose eyes are donated would be born blind, the number of visually handicapped people getting their vision restored would be much higher. People are still hesitant about donating eyes. Though the situation as far as eye donations are concerned has improved considerably, the figure from North India is not encouraging. “Yet, as compared to the situation two decades back when about 50 eyes were donated annually, the Chandigarh Eye Bank Society is able to get 215 eyes,” informed Dr Jagat Ram of the Ophthalmology Department of the PGI. He is also the Secretary of the society. Though there are 12 million visually handicapped people in India, over 2 million of them are suffering from corneal blindness, with the majority of them being children. “We can restore the eyesight of such people with corneal transplantation if more go in for eye donation. As many as 25,000 people are losing vision every year due to corneal diseases,” according to Dr Jagat Ram. The staff at the Eye Bank cite examples of parents of two-year-old Kanishka Sehgal of Ludhiana, who after her death at PGI decided to donate her eyes. A number of people pledge their eyes by filling in the form for the purpose, but the number of actual donations is very small. Either the family members are not aware of the pledge or they forget after the death of their dear ones. “People must understand that by donating the eyes of their family member they can give the gift of vision to those unfortunate people who are living in darkness,” stresses a social worker associated with this noble cause. The waiting list at the Eye Bank runs into hundreds. So far 37,000 people have pledged their eyes with the Chandigarh Eye Bank Society. The society can be contacted at 0172-744589, and in case of immediate donation at 9814014464. National Eye Donation Fortnight is being observed from August 25.
Tips on eye donation
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Smokers
with TB double their chances of dying
New Delhi: Smokers who suffer from tuberculosis double their chances of dying from the disease as compared to non-smokers, a study says. Scientists from the Epidemiological Research Centre in Chennai working in collaboration with the University of Oxford have calculated that about half the male tuberculosis deaths in India occur due to smoking. The team compared 43,000 men who had died from various diseases in the late 1990s with the health habits of more that 35,000 living men. They found that half of these deaths were caused by smoking. More than 4,000 of the deaths were from TB — but if there had been no smoking involved, the researchers calculated that only 2,000 of these deaths would have happened, according to the study published in the science journal Lancet. “Almost 200,000 people a year in India die of TB because they smoked — and half of these are still only in their 30s, 40s or early 50s when they die," Dr Vendhan Gajalakshmi from the research centre who led the study said. “The study indicates that in rural India about 12 per cent of smokers die but only 3 per cent of non-smokers die prematurely from TB,” Richard Peto from Oxford University, another tea member, said. Smoking kills people by damaging the lung’s defence against chronic TB infection. TB could lie dormant in the lungs for a long duration — but smoking encourages an active and often fatal infection, the study aimed at analysing the rate of mortality among male tuberculosis patients between 25 and 69 years said.
— PTI
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Turmeric
an effective therapy Washington:
Dietary constituents like curcumin, a component of the spice turmeric (Curcuma longa); might have anti-inflammatory properties that can effectively treat delibitating illnesses like Crohn's disease (inflammatory bowel illness) or ulcerative colitis. According to a study carried out by researchers at the Vancouver General Hospital's Jack Bell Research Centre and at the Department of Paediatric Gastroenterology, Children and Women's Hospital in Vancouver, British Columbia, Curcumin has the potent ability to inhibit or diminish NF-B, a pro-inflammatory molecule expression. NF-B, the researchers say, helps to produce cytokines and chemokines, which can cause inflammation. The study, which appears in the July edition of the American Journal of Physiology — Gastrointestinal and Liver Physiology, claims that about two million Americans suffer from this bowel-related disorder, which is of unknown origin, but is reported to be caused by a combination of genetic, environmental and immunologic factors. Most of these debilitating illnesses are characterised by chronic recurrent ulceration of the bowel, abdominal pain, digestive problems, diarrhoea or constipation, the researchers add. The authors of the study titled “Curcumin Attenuates DNB-Induced Murine Colitis” are B. Salh, K. Assi, K. Parhar, D. Owen and A. Gsmez-Muqoz. According to the National Institutes of Health (NIH), medical researchers have estimated that several efforts have been made to establish a genetic linkage between Crohn’s disease and the NOD2 protein associated with programmed cell death and activation of NF-B. Regulation of NF-B function has been documented by several agents used in the management of Inflammatory Bowel Disease (IBD), such as corticosteroids, sulfasalazine, and 5-aminosalicylates (5-ASA).
— ANI |
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Alcohol
during pregnancy
harms foetus
Washington: Changes in fetal environment, including expectant mothers taking excessive alcohol during pregnancy, may be responsible for the high rate of heart defects or other metabolic medical disorders in children, particularly female infants, says a study. Researchers at the Chicago-based Asher Center of the Northwestern University Medical School and Jeff Schwartz of the Department of Physiology, University of Adelaide in Adelaide, Australia, found that cardiac malformations exist in children with fetal alcohol syndrome. They said that the high incidence of heart defects was an indication that alcoholism during pregnancy had to be considered a serious and preventable cause of congenital heart disease.
— ANI
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