HEALTH TRIBUNE Wednesday, November 28, 2001, Chandigarh, India
 

Artificial heart makes history
Dr Achintya Moulick
F
our months ago, Dr Laman A. Gray Jr and Dr Robert D. Dowling created medical history when they implanted the world's first successful artificial heart—the AbioCor Implantable Replacement. Heart developed by ABIOMED Inc — in 59 years old Mr Robert Tool in a seven-hour procedure at the Jewish Hospital and University of Louisville, Kentucky, USA.

Eat wisely; keep cancer away
Dr Rajeev Goel
A
lot of research is being carried out for the prevention and treatment of cancer. One's eating habits can significantly reduce the risk of developing the disease. A number of scientific studies have shown that the fruits and vegetables which we consume contain natural products that possess anticarcinogenic properties.

HEALTH & AYURVEDA
Indian ginseng
Dr R. Vatsyayan, Ayurvedacharya
A
shwagandha is one of those ayurvedic herbs which have attracted worldwide attention for its salutary effect on the human body. Popularly known as asgandh and scientifically called With ania somnifera, it has been held in high esteem by the leading lights of Ayurveda.

IDEAS AND ACTIVITIES
Self-grooming  is a fine art
Chander Gupta

1.
Hands and face are usually the only exposed parts of the body. So, take great care to ensure that your face and hands look good. Nails should be properly cut. Use a good cream for the hands and the face. Take care of the facial skin. Save your face. Enhance your face value. Good shaving gadgets should be used in order to get a smooth shave.

  • Alcohol shatters

  • Skin awareness

  • "Don't do all the boss says"

 
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Artificial heart makes history
Dr Achintya Moulick

Four months ago, Dr Laman A. Gray Jr and Dr Robert D. Dowling created medical history when they implanted the world's first successful artificial heart—the AbioCor Implantable Replacement. Heart developed by ABIOMED Inc — in 59 years old Mr Robert Tool in a seven-hour procedure at the Jewish Hospital and University of Louisville, Kentucky, USA. Mr Tool has made steady progress in the months since the transplant and is even expected to be home for Christmas. Though several attempts have been made over the past 50 years or so to develop and implant an artificial heart, this was the first time that it was such a success with the recipient surviving with the implant.

Way back in 1969, Dr Denton Cooley at the Texas Heart Center implanted the first artificial heart. Though the technical aspect of the surgery was a success the machine failed the man and the recipient lived about 60 hours with the mechanical heart. Among the other projects in artificial heart was that of Dr De Bakey across the street, at the Baylor Medical Center, Texas, who had been designing the artificial heart since 1966. The perseverance of human spirit can only be gauged by the fact that the perfect heart of Dr De Bakey is finally ready and going into clinical trials. Dr De Bakey is 90 years old and still actively involved in the programme! This prompted Dr Frazier of Texas Heart Institute to comment that "it was easy to make a pump that will work for a day, but to make one work for weeks and years is miraculous." This, considering that the heart beats more than 10,000 times a day! Then there was the Jarvik-7 total artificial heart, which took the centrestage as Dr William De Vries implanted a mechanical heart inside Dr Barney Clark. Dr Clark, a dentist, lived for 112 days but was never happy with his condition.

During surgery one of the mechanical chambers broke open and soon the valve broke down. The lungs were filled with bubbles and everything looked bleak right from the onset. That he survived 112 days itself was a miracle of sorts. A series of Left Ventricular Assist (LVA) devices have been used since but the total artificial heart looked only like a distant possibility till Robert Tools happened and the rest is history. Since then four more recipients have received the AbioCor artificial heart and the fifth such person was in Philadelphia at the Hahnemann University Hospital where Dr Louis E. Samuels performed the operation on November 6.

The AbioCor artificial heart, weighing around two pounds, or less than one kilogram, is made of titanium and a polyether-based polyurethane plastic. Equipped with an internal motor, it moves blood through the lungs and to the rest of the body, simulating the rhythm of a heartbeat. It runs on an internal rechargeable battery, an internal miniaturised electronic package and an external battery pack. The internally implanted battery is continually recharged from an external console or from a basic patient-carried external battery pack.

This is achieved with an energy transfer device called TET(Transcutaneous Energy Transmission), The TETsystem consists of a set of coils, one internal and one external, which transmit power through the skin without piercing the surface. In the USA the need for artificial hearts is paramount as the number of patients with end-stage heart failure far outnumbers the number of heart donors, this despite the willingness of the people and the system to donate and procure organs after brain death.

The cost of a heart transplant is much more than that of an artificial heart. A transplant costs anything between $250,000 to $ 3,00,000 in the USA whereas an artificial heart is only $75,000 and that too in the R&D phase.

In India we have a huge population of people with end-stage heart disease, but due to various reasons, which include lack of awareness and technological factors, heart transplant has remained in single digits, even in big hospitals. We are at a stage in medical development where with adequate support from either private or governmental agencies we can be the largest heart transplanting nation and that too at a fraction of the cost that is incurred in the USA. The fact that this country has the largest number of fatalities on road, though very unfortunate, will be contributory to this growth. We are not ready for the artificial heart till we have explored all avenues to increase the number of heart transplant. In the USA, UCLA does the highest number of heart transplants a year and did over 110 transplants in the Women's Hospital and the Massachusetts General Hospital, Boston; UCLA Hospital, Los Angeles; Jewish Hospital, Louisville; and the Texas Heart Institute.

Dr Achintya Moulick is a Senior Consultant in Cardiothoracic Surgery at the Fortis Heart Institute, Mohali, Punjab.
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Eat wisely; keep cancer away
Dr Rajeev Goel

A lot of research is being carried out for the prevention and treatment of cancer. One's eating habits can significantly reduce the risk of developing the disease. Anumber of scientific studies have shown that the fruits and vegetables which we consume contain natural products that possess anticarcinogenic properties. The intake of fruits and vegetables is associated with a decreased cancer incidence and a reduced mortality rate. The chemopreventers present in our diet belong either to the macronutrient form or to the micro/non-nutrient form.

Macronutrients like fibres both soluble (highly fermented) and insoluble (poorly fermented) present in the diet are the best examples of inhibitors of cancer development in different organs, especially the colon. The fibres possessing the property of retaining water increase the stool bulk and effectively dilute the carcinogens (cancer-causing agents in the intestinal tract leading to their elimination and thereby reducing the risk of colon cancer. Whole-grain and grain products, beans, legumes, fruits (with skin), vegetables fenugreek seeds, curry leaves, guargum and gondkatira constitute fibre-containing food whereas corn, oat, wheat and rice brans and soy isolates are fibre-rich supplements. The regular intake of whole-grain cereals with bran is thought to be instrumental in lowering the risk of distal colon cancer and breast cancer too.

Several micronutrients common in the diets of human beings are suggested to be associated with reduction in the incidence of cancer. These include vitamin A, carotenoids, tocopherol (vitamin E), ascorbic acid (vitamin C), minerals and several other minor constituents known to occur in specific classes of food, especially in green and leafy vegetables. However, among the micronutrients, the most extensively studied are fat and water soluble vitamins.

Vitamin A, caretenoids, vitamin E (A-tocopherol), vitamin C (ascorbic acid), folic acid and vitamin B12 are known to be anticarcinogenic. Vitamin A is ingested from milk, egg, fish and meat and has an important physiological role to play in vision, reproduction and body growth. Carotenoids, of which @-carotene is well studied, are abundant in dark green and yellow/orange leafy vegetables and fruits. Vitamin E is derived from a wide variety of foods, especially vegetable oils and margarine. Vitamin E is also required for the formation of RBCs and certain drug metabolism and in detoxification of pollutants within the body.

Vitamin C is present in great amounts in fruits and vegetables, including citrus fruits, and its juices, green peppers, tomatoes, melons, strawberries, cabbage, broccoli and leafy green vegetables.

Besides having cancer-preventive properties, vitamin C has broad biological functions varying from the synthesis of hormones and Neuro chemicals to its role in the prevention of heart diseases and ageing. Folic acid or vitamin B12 are present relatively in large amounts in green leafy vegetables, beans, beets and oranges.

Folic acid maintains the integrity of the chromosomes. Vitamins A, E and carotenoids are all fat-soluble vitamins which accumulate in the tissues. The depletion of vitamin E takes months since it gets deposited in all tissues. Therefore, an overdose of these vitamins can prove toxic.

The dietary intake of minerals like calcium, iron, zinc, copper, magnesium and selenium affects the process of cancer development. Studies have suggested a protective effect of calcium intake in colon cancer. The intake of iron, copper, zinc and magnesium modifies the process of cancer development — especially of the large bowel, breast, ovary, lung, bladder, oral cavity and esophageal tumours.

Selenium, although a non-metallic trace mineral found in foods proportionate to the amount of the selenium content in the soil, has shown a protective role in animal models against certain types of cancer. All these minerals are required in a very low amount and a person taking a balanced diet should have the desired quantity.

The non-nutrients like flavonoids, phenols, allium compounds and tarpens are reported to be anticarginogenic. These are natural plant products. Flavonoids and phenols are well studied and are effective in preventing cancer development. The daily intake of these plant products may be as high as 1 gm/day. Fruits and vegetables are rich sources of flavonoids and phenols. The citrus fruits, berries, tomatoes, potatoes, beans, onions with red skin, radishes, grapes, tea, particularly green tea, contain a good quantity of natural flavonoids and phenols. The medicinal effect of many phenolics and flavonoids in food has been an area of active interest in the recent years because of their antioxidative, anti-inflammatory and anticarcinogenic properties and their capacity to regulate key enzymes in the body.

Latest studies have shown that flavonoids and phenols modulate the activity of certain genes responsible for the suppression of cancer. Tannin in tea, because of its antioxidative properties, is protective against the cancer of the skin, lung and forestomach in animal models. Green tea deserves special mention.

Most of the vegetables and fruits contain compounds having anti cancerous properties.

The writer is an Assistant Professor of Physiology at Dr Rajendra Prasad Government Medical College and Hospital, Kangra at Tanda (HP)

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HEALTH & AYURVEDA
Indian ginseng
Dr R. Vatsyayan, Ayurvedacharya


How Charak hated quackery

“It is better to die than to be treated by a physician ignorant of the science of medicine. Like a blind person moving with the help of his hands or like a boat being driven by the wind, a quack applies the course of treatment with apprehension because of his ignorance.”

Ashwagandha is one of those ayurvedic herbs which have attracted worldwide attention for its salutary effect on the human body. Popularly known as asgandh and scientifically called With ania somnifera, it has been held in high esteem by the leading lights of Ayurveda.

Described in ancient texts as balya (tonic), rasayan (rejuvenating) and atishukrala (potent spermatogenic), ashwagandha is sweet, bitter and astringent in taste; and light, unctuous and hot in effect. Its small plant grows wild throughout drier regions of India but to meet the increasing demand in the domestic as well as international market, better varieties of ashwagandha are favoured for cultivation. Though all parts of the plant have medicinal properties, it is the root which constitutes the main drug.

Ashwagandha is a highly acclaimed herb for its tonic effect on the brain and the nervous system. Detailed clinical investigations have shown that it acts as an anti-stress and adaptogenic medicine. Ayurvedic texts describe it as having anti-inflammatory, diuretic, analgesic, aphrodisiac, diuretic and mildly sedative properties. Modern research has found several types of alkaloids in it of which somniferin and withaniol are responsible for its multiple actions.

Ashwagandha is also a proven immune-modulator, antioxidant and hormone precursor which tends to regulate important physiological functions. It is used to cure a number of ailments like nervous and psychiatric disorders, arthritis, low backache, emaciation, impotency, hypertension and insomnia. Ashwagandha improves general alertness and prevents all types of weakness. It increases one's strength and stamina.

By virtue of its uses ashwagandha is often referred to as the Indian ginseng and assuredly prescribed by experts for all people — young but tired or old and retired.

The present-day competitive and fast lifestyle subjects us to tremendous mental and physical stress resulting in disturbed psychosomatic equilibrium, the loss of energy and reduced body resistance. Similarly, in middle age problems, the menopausal syndrome and conditions involving chronic fatigue and senile debility, there is no better natural remedy than ashwagandha. Scientific studies have found it to be endowed with anti-tumour, anti-ulcer properties and also a good adjunct in wasting diseases. The use of ashwagandha during the treatment of rheumatoid arthritis also helps one to gain fast relief from inflammation, stiffness and pain in the joints.

Ashwagandha is best used in its powder form. Readily available as a classic medicine called Ashwagandha Churna, this powder can be taken in the dose of one to three grams at bed time preferably with warm milk. This helps induce sound sleep besides giving other therapeutic benefits. In weak and emaciated children, a small dose of ashwagandha is given mixed with butter, sugar and a few pieces of peeled-off almonds.

There are several other classic ayurvedic medicines which include ashwagandha as an important ingredient. For example, in Ashwagandhadi Churna, another herb called vidhara is equally mixed with ashwagandha and it is an effective medicine for male sexual insufficiency. Ashwagandha ghrit and Ashwagandharishta are well-known medicine which have been used since ancient times. Though the therapeutic use of ashwagandha is generally safe, for its long-term utilisation patients are advised to consult a physician. (Next week: Amla: the mother of most herbs).

Dr R. Vatsyayan is an ayurvedic consultant based at the Sanjivani Ayurvedic Centre, Ludhiana. (Phones: 423500 and 431500; E-mail- sanjivni@satyam.net.in).

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IDEAS AND ACTIVITIES
Self-grooming is a fine art
Chander Gupta

1. Hands and face are usually the only exposed parts of the body. So, take great care to ensure that your face and hands look good. Nails should be properly cut. Use a good cream for the hands and the face. Take care of the facial skin. Save your face. Enhance your face value. Good shaving gadgets should be used in order to get a smooth shave.

2. You can emit smell from your mouth. Armpits are pits of foul smell. Private parts, if not properly washed, can produce bad odour. The brushing of teeth should not be a ritual which is gone through hurriedly. Brushing should be done carefully. Use a good-quality brush and paste. It helps to gargle (warm saline water is OK) after brushing your teeth. Bad breath can be controlled this way. Bad breath can repel people who come in close contact with you. In the same way, the odour emanating from the armpits can put off people, especially those of the opposite sex. Wash your armpits well while taking a bath. Let water fall directly on the armpits for a while. Apply soap. If you have time, raise your arms above your head so that the naked armpits are exposed to fresh air for some time. Likewise, keep your groin area clean. Cut off the pubic hair. Don't wear an underwear during the night. If possible, expose yourself to sun and air.

3. Keep your hair and shoes shining. Dull and dry hair give you an unseemly air. Similarly, dirty and dusty shoes spoil your personality. Well-polished shoes add to your stature.

4. Don't wear socks with holes. Undergarments having holes or stains should be replaced. You may have to take off your shoes and the holes in your socks will embarrass you.

5. We should avoid eating excessively. The problem of farting and gurgling can be tackled this way.

6. Keep your nostrils clean so that you don't have to poke your finger in to your nose. You can splash water in to your nostrils also as you do on your eyes.

7. Walk routinely for 45 minutes to an hour a day. This is good for general health. It is an effective way to balance sedentary life-style.

8. Avoid taking diuretics. You don't have to rush to the urinal time and again!

Alcohol shatters

(a) Alcoholic Fatty Liver is a condition of excess accumulation of fat in the liver cells due to increased alcohol intake.

(b) Alcohol inhibits fatty-acid oxidation to Co2 and water.

(c) It increases fatty-acid mobilisation from adipose tissue.

(d) It increases hepatic blood-flow (increased uptake of serum fatty acids by the liver).

(e) A high-fat diet with alcohol provides additional fatty acids.

— R. Talarico et al.

Skin awareness

Dr F. Handa, the godfather of Dermatology, at Faridkot — this in itself is good news.

The conference of the Indian Association of Dermotologists, Venereologists and Leprologists held there on November 24 and 25 proved very useful by way of creating public awareness.

Dermatology has gone through tremendous change in the recent past. A big boost to this branch has been given by cosmetology and dermatosurgery which give wonderful results if performed well.

A dermatologist faces a lot of practical problems when he starts using modern therapeutic techniques like chemical peeling, exfoliance, minipunch grafting and hair transplantation, says Dr Gurinderjit Singh, President of the Association (North Zone).

The pigmentation on the face of a lady may increase instead of decreasing after chemical peeling if strong concentration is used or the chemical is left on the face for a long period. The dermatologist, who is new to this field, must study a lot before attempting surgery of any kind. Once it is started, all efforts should be made to attain perfection. Young dermatosurgeons need not present a rosy picture to the patient as this raises high hope. It is better to tell the person that he or she would have to come repeatedly for the maintenance of chemical peels. It is time to remember specialists like Prof Bhushan Kumar, who leaves no stone unturned either as a clinician or as a Professor at the PGI. — TNS

"Don't do all the boss says"

A Hong Kong psychiatrist has a simple prescription for people who feel too stressed at work — do just 70 per cent of what the boss asks. "Tell yourself that you can merely fulfil 70 per cent of what your boss requires because you can never fully satisfy his wishes", Monday's Mail newspaper quoted Leo Chiu Pak-wang as saying.

"Managers will always ask willing workers to do more, leading to more stress for people who are already worried about losing their jobs in these tough economic times", he said. Hong Kong is on the brink of its second recession in less than three years after the government reported worse-than-expected second quarter growth last Friday. Many companies have announced lay-off plans and economists expect the jobless rate to rise to 5 per cent by year-end (from 4.7 per cent).

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