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| HEALTH AND FITNESS |
Even killer strokes are preventable
Chest pain? Act fast Avoid back pain with correct posture
Fruit helps ward off vision problems
An indicator of nerves’ health
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Even killer strokes are preventable A
50-year-old top executive in a multinational company suddenly felt uneasy one afternoon. He then noticed that his right hand was getting weak. He tried getting up from the chair but fell down, as he had no power in his legs. He was rushed to a private hospital where he was diagnosed to have a stroke (hemiplegia). An emergency CT scan revealed an infarct in his brain (due to the lack of blood supply). Fortunately, he recovered almost completely in a few weeks. Others, including several eminent people, have not been so fortunate, and have died of a stroke. The list includes the likes of Lenin, Woodrow Wilson and Roosevelt. A Doppler study of his carotid arteries (blood vessels which supply blood to the brain) showed that his left internal carotid artery had a 90 per cent stenosis (narrowing) at its origin. Most probably, a small piece from the area had dislodged to the brain — this had caused the near-fatal stroke. A clot could get detached any moment to cause a repeat stroke, and this time he may not be so lucky: the paralysis may be permanent. The only answer was an operation — carotid endarterectomy (CEA) — wherein the narrowed artery is surgically exposed in the neck, and the offending debris cleaned. He underwent CEA which lasted about 90 minutes. He was discharged on the fifth day, and he remains asymptomatic two years after surgery. Carotid artery stenosis (CAS) is responsible for about 20 per cent of all ischemic strokes. Most of these are preventable by appropriate surgery. Unfortunately, this is not known to even a majority of the doctors. The vast majority of CAS cases result from atherosclerosis, the disease that narrows the coronary arteries causing a heart attack or angina. Obesity, hypertension, diabetes, smoking and high blood cholesterol level are the known risk factors. In fact, ischemic heart disease (IHD) and CAS often coexist. Ideally, all patients planned for coronary bypass surgery / angioplasty should be screened for asymptomatic carotid artery narrowing. A large number of CAS cases are without any symptoms and are only picked up on routine “screening” (just as mammography screens breast cancer and a “pap smear” is used for detecting the cancer of cervix). Some of these patients have a frank stroke (paralysis) and they may or may not recover. In between are patients who suffer from a “minor stroke” which are often transient (i.e. they recover fully). These are called TIA (transient ischemic attacks). A variant of this is “amarausis fugax” — temporary disturbance of vision in an eye. Classically, the patient feels as if a curtain has fallen in front of his eye. It is mandatory that all patients who have suffered from TIA or amaurosis fugax are screened for carotid artery stenosis by colour Doppler studies. If this shows a significant disease, an angiogram or an MRA (magnetic resonance angiography) is required to accurately quantify the severity of the narrowing problem. All patients with CAS have to take an antiplatelet agent (soluble aspirin) for life. A symptomatic CAS case (a patient who has suffered from TIA / amaurosis fugax / recovered stroke) and one who has a significant CAS (defined as more than 60 per cent narrowing of the artery) will benefit from CEA, as the chances of his suffering from a stroke are considerably reduced. In trained hands, this operation has a mortality/stroke rate of less than 2 per cent. The patients who have less than 60 per cent stenosis should be managed with anti-platelet drugs alone. The first carotid endarterectomy was performed in 1953 in the US. It, however, remains an uncommon operation in India even today. There are several reasons for this. Vascular disorders remain undiagnosed due to the paucity of trained vascular surgeons as also owing to a lack of awareness among general physicians. There are only a handful of trained surgeons available who perform these operations in large numbers. Facilities for this operation are available in Chennai, Bangalore, Hyderabad, Mumbai and Delhi at the Army Hospital-R&R, Gangaram Hospital, Escorts, Batra Hospital and Apollo. —
The writer, a retired Major-General, is a former Director, Medical Services, Western Command.
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Chest pain? Act fast
WASHINGTON: Aggressive new guidelines call for quick treatment of a common form of heart attack marked by chest pain and shortness of breath. The American Heart Association and American College of Cardiology have issued the joint guidelines for treating ST elevation myocardial infarction or STEMI, a severe heart attack in which an artery is completely blocked. While heart attack patients may be unsure about their symptoms and wait to call an ambulance, every minute counts in this form of heart attack. “It is not unusual for patients to wait two hours or longer before seeking treatment, when they should get help as quickly as possible to minimize damage to their hearts,” Dr. Elliott Antman of Harvard Medical School said in a statement.
— Reuters
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Avoid back pain with correct posture Owing to the computer revolution and an increasing health awareness in society, good posture has become an integral part of healthy living. Good posture entails bones being in alignment and muscles, joints and ligaments working as a single unit. Correct posture helps to place minimum stress on the body when the spine position is S-shaped. When sitting incorrectly, the spine adopts a forward C-shape. The most common postural problems are swayback and slouching. Swayback is a large curve in the back and slouching is when everything is moved forward and rolled in. Poor posture can lead to all kinds of health problems, including impaired breathing, musculoskeletal pain and fatigue. It can cause wear and tear of the joints, thereby increasing the risk of osteoarthritis. Treatment goals for correcting postural problems include restoring the range of motion, increasing flexibility and strengthening weak muscles. These goals can be accomplished through exercises and practice. Muscle relaxation techniques, massage and stretching exercises are also used to relieve pain and muscle tension. The correct posture while sitting is:
The following exercises help in improving one’s posture: Exercise 1: While sitting, allow the body to move forward to the maximum. The reverse the position until the body is at the extreme of the erect position. Repeat this rhythmically six times. Exercise 2: Standing, place the palms of the hands in the small are of the back. Keep the knees straight. Moving only from the hips, lean back over your hands. maintain the position for a few seconds. Return to the upright. Repeat 10 times, trying to go a little further each time. Exercise 3: Lie on your abdomen and raise yourself on elbows allowing the back to sag for two minutes. Exercise 4: The Bridge — lying on your back with your knees bent, lift your hips and lower back and hold for a few seconds. Exercise 5: The plank — lying flat on your stomach raises up your forearms and the tips of your toes, and holds your body straight for as long as you can. Poor positioning of the body can be improved and it is never too late to start trying to correct postural problems. — The writer is a former doctor/physiotherapist, Indian cricket team.
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Fruit helps ward off vision problems
CHICAGO: Eating fruit regularly earlier in life may help ward off macular degeneration, the leading cause of vision loss in older adults, a study said. But the report pointed out that there appeared to be no strong protective effect from vegetables, vitamins or carotenoids — the compounds that make some fruits and vegetables red, orange or yellow — as some earlier research had suggested. The study from Brigham and Women’s Hospital in Boston looked at data from 77,562 women and 40,866 men who were followed for from 12 to 18 years as part of long-term studies tracking them for a variety of health issues. It found that both men and women who consumed three or more servings of unspecified fruit a day had a 36 per cent decreased risk of developing macular degeneration. “People are living longer, healthier lives and age-related illnesses, such as blindness, can significantly impact an otherwise healthy quality of life,’’ said Eunyoung Cho, the study’s lead author. “Because there are a limited number of treatment options for age-related macular degeneration, clinicians and researchers have been focused on identifying factors that reduce risk and can ultimately save a person’s eyesight,’’ added Cho. |
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An indicator of nerves’ health
Singapore: A new study has revealed that examining a person’s fingers after soaking them could be an effective method of checking the condition of a person’s nerves. According to The Straits Times, scientists at the National University of Singapore and the National University Hospital have found that the more wrinkled the fingers get, the healthier the nerves are. They are now trying to use this information to create a simple, cheap and faster screening method. The test is based on the fact that water seeps in easily through the pores in the hand, diluting the body’s own liquids and changing the electrolyte values. This makes the nerve fibres fire up more rapidly and shrinks tiny blood vessels in the fingers. As they shrink, they pull the skin around them, causing wrinkles. Therefore, the number of wrinkles can indicate the health of the nerves. According to the scientists, this test could be used to diagnose nerve atrophy or damage resulting from conditions like diabetes or leprosy. The HIV virus, responsible for AIDS, also attacks nerves. To count the number of wrinkles, scientists have written an algorithm for software to spot, measure and count wrinkles on digital photos of fingers. The computer can compare before and after pictures and measure the wrinkles. For the test, the nerves are stimulated with anaesthetic, not water.
— ANI
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Ayurveda & you Use herbs, but wisely In olden days people depended on nature for
medication and they managed their problems very well with what it had
to offer. Today when most herbs are sold over the counter, it becomes
very important for us to take certain precautions while opting for
them.
— The writer, a Ludhiana-based ayurvedic consultant, is a member of the Chandigarh Medicinal Plants Board. |
