HEALTH TRIBUNE Wednesday, June 11, 2003, Chandigarh, India

A heart disease linked to throat infection
Dr Shivpreet Singh Samra
he disease of the heart valve is one of the most common cardiac problems, and strangely a large percentage of these can start with an innocuous throat infection.

Protecting eyes with contact lenses
: New study indicates that contact lenses are no longer a protective gear for the eye and wearing them in an industrial environment does not alleviate the need for eye and face protection.

How exercise makes us healthy & happy
K.C. Kanwar
ccording to the latest WHO estimates, inactive life-style is the biggest killer worldwide. Over 70-90 per cent cases of diabetes and cardiovascular cases can be prevented if we decide against being couch potatoes. Old vernacular maxim, "harkat mein barkat hai", stays medically substantiated.

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A heart disease linked to throat infection
Dr Shivpreet Singh Samra

The disease of the heart valve is one of the most common cardiac problems, and strangely a large percentage of these can start with an innocuous throat infection. For rheumatic fever which starts with a throat infection and leads to fever and pains in the joints, usually occurring in childhood or the teenage years, leads to damage of the cardiac valve which finally shows up years later, around 30 years or so of age, when it starts hampering the working of the heart. If left unchecked it progresses to a serious valve disease by the time the patient is 50 years. The way rheumatic fever leads to heart valve damage is rather strange, and only by being aware of it can we be conscious of the danger and so take appropriate precautions to avoid it.

The bacillus, which is a streptococcus that causes rheumatic fever, first attacks the throat and causes a sore throat, cough, etc. The structure of this bacillus is strangely similar to the valves of the heart. The body’s immune system therefore cannot distinguish between the two, and while fighting the bacillus in the throat also attacks the valves of the heart, and thus damages the valves. That is why we must always be acutely aware of the danger of rheumatic fever, and immediately get it investigated by a competent doctor if we have the slightest suspicion, specially if children or teenagers are concerned. Once rheumatic fever is diagnosed and which can happen only if the doctor is alert to the possibility, the administration of special long-acting penicillin like Penidure every three weeks till the patient is 30-35 years can successfully prevent cardiac valve damage. If action is not taken right at the initial stage, then two kinds of valvular conditions occur over the years. Either the damaged valve becomes Stenotic, that is it does not allow the free flow of blood, or it becomes Re-gurgitation, that is it allows the blood to flow back so that the heart becomes inefficient and has to work harder to maintain the proper flow and which finally leads to heart failure.

When the damage to the valve is still mild, drugs like long-acting penicillin penidure can stop further damage. When the progress of the disease is moderate, then too various medical therapy drugs can check it. However, if the damage has already become severe, then surgery is the only option, which can handle the damaged valve in two ways – either by repairing it, which is done in India in 10-20% of the cases, or by replacing it with an artificial valve. In the case of a stenotic valve, which does not allow the free flow of blood usually due to the fusion of the valve leaves, the fusion can be surgically opened up. In the case of a re-gurgitant valve, which allows the blood to flow back usually due to a hole, a ring can be used to repair the valve and then it can function well enough for normal life.

When the valve is damaged beyond repair or if the patient is young and the valve has to give many years of service, then a replacement is called for. An artificial heart valve is of two kinds. A mechanical valve made of pyrolitic carbon, which needs anti-coagulation, is as hard as diamond and lasts a lifetime. The second type is a biological valve made from animal tissue. This does not need anti-coagulation and lasts for 12 – 15 years. The mechanical valve is usually recommended for younger patients with many years of life left, while the biological valve is more suited for elderly people in the age bracket of 65 to 70 years. For women in the child-bearing age, the biological valve is more suitable.

Apart from heart valve disease due to rheumatic fever, the aging process with a progressive deposit of calcium on the valve can also lead to similar damage, which is called degenerative valve disease. Then there is congenital valve disease when a baby is born with a deformed valve, many of which may lead a normal life and the valve defect showing up much later around 50 years of age. Then, at least 5% of the population suffers from mitral valve prolapse, when the leaves of the valve open up more, allowing some blood to flow back. This phenomenon occurs more in women and 90% of the so affected may go through life without facing any major difficulty. In 10% of the cases, when it affects normal functioning, it can be usually handled by valve repair, and replacement is not required.

The way to prevent the disease of the valves of the heart to progress to a stage in which major surgery and replacement is required is to have a culture of regular health check-ups which can diagnose the condition well in time. In the case of heart valve damage due to rheumatic fever, being acutely aware of the possibility, both by the patients, their family and the doctor, specially general medical practitioners who are the first to interact with the patient, would go a long way in preventing the condition progress to a critical state.

The writer is a cardiac surgeon associated with the Fortis Heart Institute, Mohali.



Protecting eyes with contact lenses

Washington: New study indicates that contact lenses are no longer a protective gear for the eye and wearing them in an industrial environment does not alleviate the need for eye and face protection.

The research conducted by the American College of Occupational and Environmental Medicine upholds that the use of contact lenses does not mean additional hazards to workers. It also harps on the fact that individuals wearing contact lenses in the workplace need to combine them with appropriate industrial eye protection.

"Individuals who wear contact lenses in the workplace must combine them with appropriate industrial safety eyewear or a respirator as required by the hazard analysis," said Bernard Blais, MD, chair of the ACOEM Eye and Vision Committee, developing the guideline.

Workers who need corrective lenses may wear full-face respirators, since the lenses do not interfere with the face piece seal. As a matter of fact, contact lenses provide the best visual ergonomics for users of full-face respirator masks.

Other recommendations listed by the study include establishing a written policy documenting general safety requirements for the wearing of contact lenses, after considering the visual requirements of individual workers wearing contact lenses. Employers should also provide training on proper contact lens use and first aid medication for wearers experiencing a chemical exposure. ANI



How exercise makes us healthy & happy
K.C. Kanwar

According to the latest WHO estimates, inactive life-style is the biggest killer worldwide. Over 70-90 per cent cases of diabetes and cardiovascular cases can be prevented if we decide against being couch potatoes. Old vernacular maxim, "harkat mein barkat hai", stays medically substantiated.

Exercise works wonders with the body. It benefits virtually all body systems. It tones up blood circulation, improves cardiac health and keeps body joints lubricated. It also helps maintain bone mass and arrests osteoporosis. Exercise improves muscle mass and muscle tone too — the latter become leaner, tighter and firmer. As one ages, muscles tend to atrophy and become weaker. We lose on an average about 150 gm of muscles every year after age 40 and concomitantly gain at least as much body fat. Once one is on regular exercise, this trend is reversed.

Besides, there are quite a few less known benefits of exercise, which lowers the villains of circulating blood like sugar, cholesterol and triglyeerides as well as improves good (HDL) and bad cholesterol (LDL) ratio — all healthy parameters. Not many people know that exercise is the best means to increase blood levels of cardio-protective HDL — good cholesterol. Persistent exercise also improves the capacity of the heart coronary arteries by acquiring collaterals — small new arteries and capillaries which emerge around the semi-blocked coronary vessels. These collaterals compensate for the impaired blood flow to heart muscles. Exercise also supresses the blood-clotting process and works as a protective against stroke.

Moderate but regular exercisers decrease the chances of having heart diseases or stroke by 50 per cent. Exercise helps to control glucose levels in the diabetics. It improves insulin sensitivity, thus reducing the risk of developing diabetes. It also improves the balancing of the body, thus minimising the risk of falls among the aged. Besides, exercise empowers brain, delays the onset of Alzheimer and mental dementia and helps reduce significantly depression and anxiety. Exercise acts as a mood elevator of no less significance inasmuch as it makes the brain release mood-elevating endorphins, the so-called "feel good" substances. Lately, exercise is known to even boost immunity, which gets dull with age. In fact, there is an endless list of exercisal benefits, which collectively increase longevity, retard ageing and improve the quality of life.

Walking is the most popular, convenient and, perhaps, an ideal aerobic exercisal mode since it involves the maximum number of the body’s muscles and joints. Further, walking is beneficial for all age groups and even the oldies, who slide into inactivity making them overweight. Besides, walking can easily be tailored as per needs of the individual.

A minimum of 20 minutes or half an hour’s aerobic exercise (read walking or jogging) three times a week is a must to keep one fit, agile and look younger (Readers Digest). Along with balanced diet, physical exercise plays a vital role in achieving a long disease-free life. Numerous studies have revealed that physically active populations have better longevity vis-a-vis those which have a sedentary and inactive life-style. Walking briskly (speed 3-4 km per hour) in the morning leaves one distressed, fresh, alert and mentally more energetic for the rest of the day.

The writer is a retired professor.



Info capsule

Food can get you hooked

Washington: Don’t be surprised, but just as coffee and chocolate, even other foods are habituating.

A new book by nutrition researcher Neal Barnard argues that foods like cheese, meats and sugar release opiate-like substances that seduce us into eating them again and again, according to a report in The book, "Breaking the Food Seduction", also reveals how industry, aided by the government, exploits these natural cravings, pushing us to eat more and more unhealthy foods, the report said.

"It’s not gluttony, weak will or an oral personality that keep some of us tied to certain foods. There’s a biochemical reason many of us feel we can’t live without our daily meat, cheese or sugar fix. Cheese, for example, contains high levels of casein, a protein that breaks apart during digestion to produce morphine-like opiate compounds called casomorphins", explained Dr Barnard.

Undetected spinal problems

Washington: Research shows that spinal health influences fertility, according to a report in

The study shows that physical, mental, chemical and emotional stress can lead to spinal problems causing vertebral subluxations. However, all the women with vertebral subluxations, misalignments or related problems of the spine became pregnant after their subluxations were detected and corrected.

One case treated was that of a 32-year-old infertile woman who had not menstruated for 12 years.

The woman had undergone a number of medical infertility treatments, but still could not conceive. After two months of chiropractic care, with attention on adjustments in the lumbar region, her menses started and after regular cycles for four months, she became pregnant.

Breakthrough in cancer treatment

Washington: Researchers have come across a combination of two drugs said to be effective in treating bronchioalveolar carcinoma (BAC), a lung cancer cell generally considered resistant to chemotherapy. This is described as an important breakthrough in cancer treatment.

The researchers from UC Davis Cancer Center reported the finding at the annual meeting of American Society for Clinical Oncology early this week, reported on Sunday.

Charcoal cures heart poisoning

Colombo: There’s good news for cardiac arrest victims as studies are on to ascertain the use of charcoal as a cheap and effective medicine for certain types of cardiac poisoning. Scientists focused on the use of charcoal to treat the effects of eating poisonous oleander seeds, a common problem in Sri Lanka, according to a report published in the BBC.

Swallowing the seeds has a severe effect on the heart and results in death in about 10% of cases. Studies point out that this can be treated by fitting a temporary pacemaker, or by the use of antibodies. Since these treatments are expensive and not widely available in rural areas, a cheaper alternative was mandatory.

Lose hair to keep bugs away

Washington: Humans may have to lose their body hair to reduce their vulnerability to fur-loving parasites, according to a report in the New Scientist.

The study shows that humans lose their hair to help them control their body temperature as they evolve. The nakedness of the human species is extremely rare among the 3000 or so living mammal species. Other naked mammals include elephants, walruses, pigs, whales and the bizarre naked mole-rat.