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If winter comes, can heart disease be far behind?
Why regular visit to a dentist is unavoidable
Knee arthritis: medicine’s limitations
Health Notes
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If winter comes, can heart disease be far behind?
The risks of having a heart attack during the winter months are twice as high as in summer — and the winter attack is also more likely to be fatal. Cold weather poses a threat to those with a heart disease for a variety of reasons. Heart attacks usually occur in people with a build-up of fatty plaque in their arteries. In a study carried in Circulation, the journal of the American Heart Association, researchers have found that the rate of heart disease-related deaths rose sharply between December 25 and January 7. There is a combination of factors that increase the heart attack risk in winter. When a person gets exposed to cold weather, the body’s automatic response is to narrow the blood vessels to the skin so that heat is retained. But for people who already have arteries filled with plaque, the narrowing of the blood vessels raises the risk that it will become blocked, triggering a heart attack. The problem is higher in India as we do not live in artificially regulated temperatures as in the West. The other factors include: Increased blood pressure, thicker blood, holiday feasting, snow
shovelling, stressful season, less daylight, flu (influenza), delay in seeking treatment. So, does this mean you have to fear winter and huddle indoors all the time? Not at all. The message is not to be afraid of cold weather but to know that winter is a period of increased risk. There is need to look for ways to minimise that risk. Pointers for healthy heart Try to keep your heart healthy with the help of the following: Stick to your normal exercise plan Avoid very early morning walks — wait for sunrise Start slow — the cardiovascular system can adapt to slow and progressive changes, but it has a much more difficult time adapting to sudden changes. Have a proper trained gym instructor chart a graded exercise programme for you. Don’t aim for a SRK six pack in a short time . Eat a prudent diet, low in saturated fats and calories. Nuts and dry fruits can Avoid tobacco, coffee, tea or alcohol just to “warm you up” — the additional nicotine and caffeine put a stress on the heart. “Holiday spirits” also increase blood pressure and rhythm irregularity. Skip the frantic shopping last minute trip to the mall for gifts to give for New Year. Plan well in time — gifting online is a good option. Stop and smell the roses. Don’t get stressed out about preparations — make time to enjoy celebrations with family and friends. Avoid gambling on New Year — it can be stressful, both financially and on the heart! Know and manage your blood pressure Don’t ignore symptoms if you are feeling unwell — doctors on duty will not mind. Take rest if you are sick. Sit in the sun. This improves your levels of Vit D Take your medication as recommended Get a flu shot (vaccine) to lower your risk of getting flu The writer, Chairman, Cardiac Sciences, Sigma New Life Heart Institute,
Ludhiana, was earlier associated with Fortis, Mohali, and Escorts, New Delhi. |
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Why regular visit to a dentist is unavoidable
Should you visit a dentist periodically even if you have no tooth problem? To comprehend this you should know that the common dental diseases — dental caries and the gum disease — are bacterial in nature.
When you eat, particularly sugar in any form, the bacteria — “dental plaque” — present on the teeth metabolise this almost immediately and the result is the production of acid. Dental plaque is nothing but the collection of bacteria on teeth. Though these are present in everybody’s mouth, the bacterial numbers are much more and of different types in individuals who do not effectively brush their teeth compared to the ones who are particular with their oral hygiene. The bacteria, being very small and microscopic, need a very small amount of eats containing sugar to instantly produce acid. The acid thus produced, as a result of the interaction of bacteria and food, lowers the local pH of the dental plaque surrounding the tooth. The acid erodes the enamel and leads to a localised microscopic ditch. The enamel is the outer hardest layer of the tooth. The repeated attacks of acid formed each time when food containing sugar is taken results in a cavity visible to the naked eye. The contacting sides of the teeth, firstly, are more vulnerable to the development of cavities as these commonly are not reached with the routine brushing of teeth; flossing and interdental brushing are required to clean these surfaces. Secondly, these surfaces are not visible to the naked eye. These surfaces of teeth may have cavities, but go unnoticed and progress unknowingly. There is another type of caries — sub-surface caries — where the outer surface of enamel remains intact, but inwardly the cavity keeps progressing. This on examination gives a grayish-to-blackish hue to the tooth. These also get missed in self-detection. The production of a cavity in a tooth is a slow process as initially acid causes a microscopic ditch in the enamel. Numerous such attacks of acid are needed for the development of a macroscopic cavity. In between these attacks, there is also protective
re-mineralisation of the microscopically ditched or demineralised enamel through the calcium and other salts present in the saliva. It is only when the balance tilts towards destruction i.e., when the sugar is taken more than three times a day, the demineralisation crosses the limit of natural repair, i.e.,
re-mineralisation affected through saliva; and a dental caries/cavity is produced. The above mentioned process of the development of a cavity in a tooth is trouble-free. The progression of dental caries is without any pain. The pain occurs only when the dental caries reach the pulp. The pulp constitutes the arteries and nerves that enter through the opening at the tip of the root of a tooth and run throughout the root and also a part of the crown. So, a cavity may exist without your knowledge and can easily skip your notice. What happens in gum disease? Like dental caries, periodontal or gum disease begins trouble-free and is also painless when it progresses. Pain is not a symptom even in advanced disease. Initial symptoms like bleeding from the gums may vary in different patients, occurring early in some and late in others. The process of development of gum disease is unproblematic. It is most likely to completely skip your attention. In fact, sometimes both the hidden cavities and gum disease can be missed by the dentist himself. In order to diagnose he takes radiographs to ascertain the existence of dental disease. It is indeed very essential to visit the dentist every six months otherwise you may live with a false perception that you have no disease, whereas you may be having a dental disease. When the alarming symptoms of pain occur, both diseases will have reached quite an advanced stage. The writer, Head of the Dental Department, The Apollo Clinic,
Chandigarh, is a former Head, Oral Health Sciences Centre, PGI,
Chandigarh. |
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Knee arthritis: medicine’s limitations
As knee arthritis sets in with advancing age, those affected usually initiate treatment with analgesics to alleviate pain.
This is also supplemented with cartilage rebuilding drugs vis-à-vis
glucosamine/diacerein. However, the effect of these drugs tapers off after some time and may produce side-effects like hyperacidity. Knee arthritis occurs due to degenerative changes in the cartilage, bones,
synovium, etc. Cartilage becomes thin and roughens, and synovium swells producing extra fluid thereby swelling the joint. Muscles weaken/thin out and get wasted, leading to a feeling of “give away”. Due to these changes the space between the bones, particularly on the inner side of the joint, decreases leading to a reduction in the mobility of the knee joint. This results in crackling sound from the joint, or locking it, etc. Pain in knee arthritis is due to the inflammation of the synovium, from diminished blood flow, stretching of the nerve endings, small fractures under cartilage, etc. Obese females are more vulnerable to knee arthritis. Fat gets accumulated in the hips, resulting in an increase in the angle between the hip and the knee joint. This exerts more load on the knee. To make matters worse, osteoporosis sets in after menopause, increasing the fragility of the bones. Medication only helps relieve pain. Factors like bio-mechanics of the lower limb, muscle weakness and motion of the knee joint are not affected. This is only part of the job done as the knee movements become more restricted and also painful. Such individuals cut down on physical activity for fear of pain, thus gaining weight which becomes the root cause of innumerable medical complications. Doctors are left with no option but to advocate knee replacement surgery. Patients, however, take their time to commit to expensive surgery for fear of various complications and also certain compulsive conditions like diabetes and obesity. Symptoms Pain/difficulty in walking. Swelling and restricted movement. Crackling sound in the joint. “Gel phenomenon”, i.e. stiffness with rest and inactivity that resolves within a few minutes of activity. Locking due to intra-articular loose bodies. Deformities e.g. bow legs. X-ray has limited relevance as 50-75 per cent people above 65 years and100 per cent people older than 75 have evidence of osteoarthritis. Avoid the following: Sitting for long periods of time. Squatting, climbing. If required, then climb stairs with the good leg first and downstairs with the affected leg first. Standing for more than 10 minutes. Low bed, chair and toilet - elevate them at the waist level. Treatment Weight reduction is essential. Wearing sports shoes. Walking/swimming/stationary cycling frequently. Knee support to provide stability to the joint. Walking aid, e.g. cane and on soft regular surface. The damaged cartilage lacks the ability to produce the lubricating fluid, rendering the joint dry, stiff and painful. Hyaluronic acid injections dramatically alleviate the symptoms of pain, stiffness, etc. Ultrasound / diathermy/ TENS have limited role. Exercises As the muscles and ligaments hold the knee together, it is mandatory to stretch and strengthen the muscles on the front and back of the thigh vis-à-vis (Quadriceps and Hamstring). The following exercises are very useful: Place a round pillow or a rolled towel under the knee. Tighten the muscles of the leg without moving the knee. Repeat 15 times. Sitting against the wall, lift the affected leg 6” above the floor and stay for a count of 10. Repeat 10 times. Advanced exercises with stretch-band is very safe and improve muscle strength and knee mobility. Tie a sandbag or a purse filled up with coins over the ankle. Lie with the face downwards and lift the lower leg by bending the knee 6-12 from the floor. Repeat 10 times. Treatment is effective if initiated at the early stage of arthritis, and an exercise regime is conscientiously adhered to. Surgical intervention should be viewed as the last resort. The writer runs a pain management clinic in
Chandigarh. |
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Health Notes
LONDON: A group of neuroscientists, psychiatrists and ethicists have suggested that society should be more open to the use of drugs that boost brain power rather than staying away from them.
And
the students routinely buy these drugs on black markets to boost memory
and concentration. The stimulant Modafinil has also been touted as a mind
enhancer. — ANI
UK’s binge drinking culture harmful
for liver
LONDON: Liver disease could become one of the biggest killers in the UK as a result of the country’s binge drinking culture, according to a new study. The survey, commissioned by the London Clinic in Harley Street, shows that half of Britain’s young adults first got drunk before the age of 15. It found that 48 per cent of those in the 18 to 24 age group were between the ages of 13 and 15 when they first got drunk, while 6 per cent were aged under 12.
— ANI
Moderate exercise is good in peripheral artery disease
WASHINGTON: A new study has shown that regular, moderate exercise may help relieve the symptoms of peripheral artery disease (PAD) via some unexpected mechanisms. PAD is characterised by dangerous deposits of fatty plaques in arteries resulting from poor diet and lack of exercise. However, the disease not only affects the heart, but also blocks the blood flow to the legs, leading to pain when walking, immobility and, even in extreme cases, amputation. The risk factors of PAD include smoking, diabetes, obesity and high blood pressure. Surgical intervention can sometimes help, but the prognosis is not good.
— ANI
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Brain-boosting drugs should be welcomed, not feared
Eating sarson ka saag and makki ki roti with a dollop of butter,
gazak, rewari and groundnuts, sitting around the fire, cuddling up in a warm blanket and — guess what — having a heart attack, all have something in common: You’re more likely to experience them in winter.
In a recent survey, it was found that almost 25 per cent of students at US universities bought Ritalin or Adderall — prescription drugs to treat attention-deficit hyperactivity disorder.