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Clinton case: some important aspects of heart disease
Lithium can prevent radiation-linked memory loss
Teens with insulin resistance more
prone to BP
Antibiotic that switches off cancer gene!
Mentally ill face higher brain and lung cancer risks
Books
Ayurveda & you
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Clinton case: some important aspects of heart disease
On September 6 former US President Bill
Clinton had a complex quadruple bypass procedure. Conduits were used to
bypass his clogged arteries as he was in imminent danger of a heart
attack. His case brings to the forefront some very important aspects of
heart disease. We must take lessons from his case study.
1. How could
heart disease have been missed in a "vulnerable" patient with
access to the best possible diagnostic and preventive measures in the
world? Are any better modalities of detection available? 2. How safe is
heart surgery? 3. What sort of life do the former President and the
thousands of others who undergo heart surgery everyday expect from the
moment they open their eyes after the effect of anaesthesia wears
off? DETECTION Mr Clinton’s case illustrates the serious gap that
exists between the scientific understanding of the heart attack causes
and the traditional medical practice for the prevention of heart
disease. Traditional tests are inadequate and leave millions of people
with the mistaken impression that they are not at the risk when they
actually are. The former US President’s heart disease was not detected
in his regular checkups with traditional methods like finding out the
blood cholesterol level and a treadmill test, which was done regularly
on him. The current guidelines used to detect those at the risk of a
heart attack fail to detect many high-risk individuals. This fact is
well known to all cardiologists — what we call a false negative test.
A recent study published in the Journal of the American College of
Cardiology (JACC) reports that 88 per cent of heart attack victims would
have been considered low-to-moderate risk cases if they were treated
with current national guidelines the prior day. The traditional risk
factors are not sufficiently reliable to be an acceptable end-point for
middle-aged persons. We have to seek direct anatomical evidence of the
diposition of cholesterol-using non-invasive imaging technology as part
of a comprehensive vascular health assessment. Physicians have to be
able to identify "vulnerable patients" like Mr Clinton. It is
imperative to assess the structure and function of the arteries to
identify those which need immediate medical attention, including an
aggressive treatment and lifestyle modification. The two methods which
could be used more aggressively are: 1. Coronary calcium score through
a CAT scan which is used to determine the burden of plaque build-up in
coronary arteries. 2. Thickness of the carotid arteries measured with
ultrasound which correlates with an individual’s total arterial plaque
build-up for atherosclerosis. Both tests are not expensive (as compared
to a coronary angiogram) and should be covered by medical insurance or
be a part of executive health checkups. It is quite absurd for insurance
companies to only cover periodic screening for a range of ailments such
as breast cancer and colon cancer. They fail to cover the screening of
patients for the number one killer of Indians. (It is a fact that every
minute four Indians die of a heart attack, and according to the WHO
projections, by 2010 India will have 60 per cent of the world’s heart
disease patients.) HOW SAFE IS HEART SURGERY? It is a tribute to
modern technology as well as the innovation of cardiac surgeons that
what was once the most major surgery is being regarded today as a
routine procedure. The advent of the beating heart technique (pioneered
by this writer, who published one of the world’s first papers on
multi-vessel beating heart surgery in the most prestigious Annals of
Thoracic Surgery, USA, and finds a mention in the Limca Book of World
Records) has revolutionised the concept of bypass surgery. NO LONGER
IS HEART SURGERY A HEART STOPPING EXPERIENCE. Now the surgeon is able to
perform a precise reproducible anastomosis without having to resort to
the heart-lung machine which damaged the patients’ blood and organ
systems, and also drained the country of valuable foreign exchange as
these machines are imported. The risk of elective major open-heart
surgery in most good centres is now under 1 per cent. The patient is
weaned off all life-support machines within a few hours of surgery, is
mobilised the next day and can go home on the third day. With a midline
sternotomy (the usual approach), there is hardly any pain and only a
mild soreness for a couple of days. A number of large trials have
confirmed the superiority of surgery over the so-called simpler
"ballooning and stenting" procedures — in terms of safety,
longevity and the cost. Further refinements in the technique will help
us to reach the stage where a hospital visit for cardiac surgery may be
just like visiting your dentist. The writer, who was earlier
associated with the Fortis Heart Institute, Mohali, is Executive
Director and Chairman, Cardiac Sciences, Sigma Newlife Heart Institute,
Ludhiana.
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Lithium can prevent radiation-linked memory loss
Washington: Patients who undergo radiation for the treatment of brain
tumours might survive their cancer only to have lasting memory and
learning deficiencies, the impact of which can be particularly
devastating on children, Vanderbilt-Ingram Cancer Center researchers
have discovered.
The researchers are saying that in order to avoid
this, patients should take lithium, a drug commonly used to treat
bipolar disorder and other mental illnesses, as it can protect brain
cells involved in learning and memory from radiation damage. The
research, which was presented at the 46th annual meeting of the American
Society for Therapeutic Radiology and Oncology, said that in addition to
killing cancer cells, radiation can cause cell death also called
"apoptosis" in normal cells as well. It is particularly
harmful for neurons in the hippocampus, the part of the brain that plays
a crucial role in learning and memory. Lithium, however, can protect
neurons from a variety of cytotoxic damage, including Alzheimer’s
disease, which leads to progressive and profound memory loss. The
researchers carried out studies on animals and found that animals
pre-treated with lithium performed better than those who did not receive
lithium prior to radiation. The team further noted that lithium did
not appear to protect other types of brain cells studied, suggesting
that its effects may be selective for neurons. "Lithium may
therefore provide a means of attenuating long-term cognitive deficits in
patients treated with cranial irradiation," the researchers wrote
in their study. — ANI
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Teens with insulin resistance more
prone to BP
Washington:
Teenagers, whose bodies are resistant to
insulin, face a greater risk of suffering from high blood pressure and
obesity later in life, claims a new research. “The results
indicate that one of the keys to preventing high blood pressure is to
start thinking about it in childhood. If insulin resistance in
childhood is related to risk factors in adulthood, we ought to be
thinking about this problem at an early age. By the time people are in
their 20s and 30s, a lot of the risk is already set, and we are
treating the disease instead of preventing it,” Alan Sinaiko,
professor of paediatrics at the University of Minnesota, said. The
study not only documents the independent association of insulin
resistance to heart risk factors, but also provides information about
the origin of the condition. The findings also reveal that along
with high blood pressure, insulin resistance is also linked with
obesity. “There is no question that obesity in some people is
significantly related to insulin resistance. What we’re showing is
that insulin resistance has an effect on systolic blood pressure that
is independent of fatness and obesity,”Sinaiko said. —ANI
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Antibiotic that switches off cancer gene!
Washington:
A new research conducted by scientists at the Stanford University School of Medicine suggests that turning off just one cancer-causing gene is enough to eliminate aggressive, incurable liver tumours in mice in just four weeks.
The researchers led by Dan Felsher studied mice whose liver cells he had altered to carry a modified Myc gene. Myc protein acts as a cellular conductor, orchestrating messages that tell a cell to divide. The myc gene churns out the Myc protein until it is turned off by feeding mice the antibiotic doxycycline. The mice remained cancer-free as long as they maintained their diet of the antibiotic. But as soon as doxycycline was withheld, the gene was back on; Myc protein accumulated in the liver cells, and the animals developed aggressive liver cancer within an average of 12 weeks. The doxycycline diet again turned off the production of Myc protein and eliminated the cancer in mice that was confirmed by the appearance of normal liver cells. The researchers found that turning the Myc gene on and off acted like a tap, releasing the cancerous cells to divide uncontrollably then shutting off their cancerous progression. “The exciting thing is that you can turn cancer cells into something that appears to be normal,” Felsher said.
— ANI
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Mentally ill face higher brain and lung cancer risks
Washington:
Indiana University School of Medicine researchers have suggested that men and women with mental disorders have higher odds of being diagnosed with brain tumours and lung cancer.
Led by Caroline Carney, the researchers looked at insurance claims data from over 700,000 adults aged between 18 and 64. “It is known that people with mental illness smoke more than the general population, so the higher incidence of lung cancer was not surprising. The association between mental health problems and brain tumours, was less expected but is explained by the likelihood that brain tumours cause mental symptoms prior to other symptoms like neurological symptoms. Our data showed the new diagnosis of mental symptoms up to one year prior to brain tumour diagnosis,” Carney said. —
ANI
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Books
The human body must be kept in proper form if the mind
should function well. Yoga is considered a key to physical and mental
fitness. The "Textbook of Yoga" by Dr Yogeshwar tells you how
to practice asanas the right way, and how to have the maximum benefit of
the same in a simple language. It should better be titled "Yoga for
all".
It also tells how best to get relief from common health
problems —headache, colds, backaches, diabetes, arthritis and others.
Penguin has brought out this book in paperback, with beautiful pictures,
and the text is free from the printer’s devil. It would be prudent to
know that yoga does not mean the exercises alone. It comprises eight
limbs: 1. Yama —- (Ahimsa -non-injury), Satya (truth), Asteya
(non-covetousness), Brahmacharya (continence) and Aparagriha (abstinence
from avarice); 2. Niyama; 3. Asan; 4. Pranayama; 5. Pratyashar; 6.
Dharana; 7. Dhyana and 8. Samadhi. Concentration is a necessary part of
yoga. Anyone above 14 years of age can do Yogasanas. Sick people may
also do them. Pregnant women must discontinue the practice after the
third month of conception. People suffering from heart disease must be
careful and take up yogic practices only under expert supervision.
Generally, too, these asanas are best learnt from a competent teacher.
Padmasana is an excellent posture for all meditative and pranayamic
practices. It loosens the joint in the lower parts of the body and
removes rheumatism. It tones up the three humors (wind, phlegm and bile)
in the system, harmonising their functions. It strengthens the nerves
and muscles of the legs and thighs. Asanas are best performed in the
morning on an empty stomach. Where time does not permit they can be done
in the evening, but at least three hours should elapse after the last
meal. Regular practice at the same place and time gives good results
soon. Judicious and progressive follow-up of yogic practices results in
greater conditioning of the limbic system, which is thought to be
responsible for the regulation of the autonomic nervous system and the
endocrinal system. The sadhak gradually begins experiencing greater
volitional control over the metabolic and autonomic functions of the
body, which leads to the recovery of homeostatic dysfunction in the case
of the sick and the perfection of the biological equilibrium in the case
of normal persons. How such changes are brought about is still not
very clear and requires further investigation regarding the mechanism
through which yogic exercises produce physiological and mental effects.
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Ayurveda & you
The treatment of constipation largely depends upon
the type, severity and chronicity of the problem. Although patient’s
lifestyle, food habits and history of medication help in deciding the
course of treatment, here are some of the salient points which should
be kept in mind while treating constipation:
Diet — A diet
with enough fibre and liquids helps in forming soft and bulky stool.
High fibre foods include whole grains, bran cereals, fresh fruits,
salads and green leafy vegetables. When an increasing amount of fibre
is used, it is recommended that a large amount of water should also be
consumed. Slowly drinking one or two glasses of warm water with an
empty stomach stimulates natural bowel movements in the
morning. Ayurveda believes that reasonable use of ghee, butter and
milk make the digestive system unctuous and helps in relieving
constipation. Refined foods and eatables which are heavy and dry and
made of "maida" or are non-vegetarian in origin are usually
constipating. Light and easily digestible food sprinkled with a little
of carminative and digestive spices is the best bet for people who
suffer from chronic constipation, gas and bloating in the abdomen. Lifestyle
modifications — People who lead a sedentary life are more
frequently constipated than people who are active. Regular walking and
yogic exercises help tone up the whole body, including the digestive
system. Proper daily routine with a focus on having meals at a fixed
time and avoiding late night engagements is also beneficial to the
patients of constipation. Ayurveda recommends that one should never
suppress the urge to have a bowel movement. Psychological problems of
anxiety and depression many times aggravate constipation and should be
appropriately addressed to. Laxatives — Most of the people
who are mildly constipated do not need laxatives. However, for those
who have made dietary and lifestyle changes and are still constipated,
ayurveda prescribes many types of laxatives. These can be bulk forming
laxatives, lubricant and emollient laxatives or stool softeners and
stimulant laxatives having mild-to-hard properties. Isabgol husk acts
as a fibre supplement and increases the bulk and form of the stool.
Taking two spoonful of it with warm milk at bed-time generally helps
in relieving constipation arising due to dietary indiscretions and
faulty lifestyle. Gulkand is a mild laxative and so is the
pulp of amaltas fruit. Five or 10 gm of its fresh pulp should be
soaked in a glass of water for an hour and strained to be taken at
bed-time. Almond oil is the best among emollient lubricants which
grease the stool enabling it move through the intestines more easily.
A few drops of it taken with warm milk softens the stool and makes
defecation easier, specially for elderly people. Castor oil is an
intestinal irritant and is known to cause rebound constipation. Hararh
is a moderately stimulant laxative which should be taken only after
being fried in desi ghee and that too for a short period. As a
laxative triphla churna acts well but can cause dependence.
Two-to-five gm of the famous Avipattikar Churna coupled with two
tablets of Arogyavardhini Vati corrects constipation arising due to
poor digestion and sluggish liver. Shivakshar Pachan Churna should be
used where constipation is accompanied by gas and distension.
Preparations of senna leaves like Panchsakar Churna are a bit hard
medicines and should be the last choice among the laxatives. Caution
— Normal bowel habits and patterns vary from person to person. Many
people think they are constipated whereas they are not. Physicians
find this imaginary constipation the most difficult disease to be
treated. The choice of stimulant laxatives should be made very
carefully and a hard laxative should never be used where a soft one
can help. With acute constipation or the constipation that is
worsening, it is necessary to assess the cause early, so as not to
overlook any serious illness. The writer is a Ludhiana-based
ayurvedic consultant.
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