HEALTH TRIBUNE Wednesday, September 24, 2003, Chandigarh, India
 


WORLD
HEART DAY FALLS ON SEPT 28
WORLD HEART DAY FALLS ON SEPT 28Heart attack: prevention through intervention
 by Dr H.S. Wasir
H
eart attack is a major cause of death and disability among the young and the elderly in most countries, including India. 

Simple method to save lives at public places
by Dr G.S. Kochhar
R
eports are often received of people dying of heart attack at golf courses or public places.

Lack of exercise hurts women more than men
WASHINGTON

A woman's health tends to suffer more than a man's due to lack of exercise, says a new US study. 

Steroids: beware of the side-effects
by Pratibha Chauhan
W
ith a large number of patients suffering from serious complications arising out of steroid intake being admitted to hospitals, there is growing concern over the excess use of steroids.

What's wrong with fertility tests? 
Alok Jha
L
eading fertility experts say some tests based around the immune system may be unscientific and therefore unreliable. In fact, the Royal College of Obstetrics and Gynaecology said this week that couples should be made more aware of possible problems with the tests before paying for expensive treatment.

Cell phones shelter bacteria
WASHINGTON

New research presented at the 43rd annual Interscience Conference on Antimicrobial Agents and Chemotherapy in Chicago revealed that cell phones can harbour a stubborn bacteria.

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WORLD HEART DAY FALLS ON SEPT 28
Heart attack: prevention through intervention
by Dr H.S. Wasir

Heart attack is a major cause of death and disability among the young and the elderly in most countries, including India. The main risk factors are uncontrolled high blood pressure, diabetes, high blood cholesterol and other lipids, cigarette smoking and lack of physical exercise.

The prevention and control of this heart disease epidemic lies in timely intervention through early detection and effective management of hypertension and diabetes, avoiding smoking, control of blood lipids with diet, exercise and, if need be, drugs like statins and making physical exercise a habit.

Apart from these primary preventive measures, routine heart check-up with ECG, stress testing (TMT/Thallium), and angiography in persons with an abnormal stress test will go a long way in detecting serous heart disease and thereby doing timely intervention with ballooning or bypass surgery so as to prevent serious heart attacks and the catastrophic event of sudden cardiac death.

The writer is Chief Cardiologist & Medical Adviser, Batra Hospital, New Delhi
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Simple method to save lives at public places
by Dr G.S. Kochhar

Reports are often received of people dying of heart attack at golf courses or public places. Mr B.S. Danewalia, IGP (retd), Punjab, had a severe heart attack and died at the Chandigarh Golf Club two weeks back.

This is the third heart attack case there. In America an estimated 225,000 sudden cardiac arrests occur outside hospitals every year. Out of these, only 5 per cent survive.

At least 50 per cent of them could have been saved if fellow golfers or the public knew how to apply a simple life support technique of cardiopulmonary resuscitation (CPR).

CPR is the ability to use one’s hands and mouth to help someone start breathing or restore a pulse beat until he can be given professional emergency medical assistance.

Anyone who is 13 years or older is capable of doing CPR. This is a first aid technique used to keep cardiopulmonary arrest alive and prevent brain damage. It has two goals:

  • Keeps blood flowing throughout the body.

  • Keeps air flowing in and out of the lungs.

So, CPR is the resuscitation of the heart (by chest compression) and lungs (by mouth-to-mouth breathing).

Mouth-to-mouth breathing

The patient lies flat on the ground. The airway must be maintained by extending the neck and pushing the jaw (mandible) upwards. The nares are occluded and the operator expires (breathes out) his air directly into the mouth of the patient.

This action should be repeated 10-15 times per minute. There has never been a case of HIV transmission by mouth-to-mouth CPR.

Chest compression

In the meantime, another golfer compresses the patient’s chest so that the heart is compressed against the backbone (vertebral bodies).

About 60 times per minute pressure is applied to the lower sternum.

CPR is not only useful in gold courses. It is also helpful in cases of drowning, shock, electrocution, people suffering from respiratory problems and sudden cardiac arrest anywhere outside hospitals.

The writer is a former Assistant Professor, Department of Anaesthesia, PGI, Chandigarh.Top

Lack of exercise hurts women more than men

WASHINGTON
A woman's health tends to suffer more than a man's due to lack of exercise, says a new US study.

According to the researchers, the results suggest that a person's physical fitness level may be a more accurate predictor of death risk than other commonly used measures that are based on sex, cholesterol, age, blood pressure, and smoking status.

"Earlier studies showed an association between poor exercise capacity and poor survival in men with or without heart disease, but this is the first study large enough to examine the issue in a cross-section of healthy women," WebMD quoted researcher Martha Gulati, an assistant professor of medicine and preventive medicine at Rush Presbyterian St. Luke's Medical Centre in Chicago, as saying in a release.

In the study, the researchers followed 5,721 women with an average age of 52 from 1992 until 2000. None of the women had heart disease, but many of them had high blood pressure, high cholesterol, diabetes, or other risk factors for heart disease.

Each woman completed a physical fitness test on a treadmill, which measured their exercise capacity in metabolic equivalents (METs), at the start of the study.

Researchers found that for every 1 MET increase in exercise capacity at the beginning of the study, there was a 17 per cent decrease in the risk of death over the next eight years.

The risk of death doubled for those women with reduced fitness in the medium range of physical fitness (5 MET to 8 MET range) and the risk of death tripled for women in the lowest category of fitness compared with those in the highest (above 8 METs).

"Currently, no one recommends routine exercise testing in healthy individuals. Our study has demonstrated a clear clinical rationale for routine stress testing in asymptomatic women," said Gulati. — ANITop

 

Steroids: beware of the side-effects
by Pratibha Chauhan
Tribune News Service

With a large number of patients suffering from serious complications arising out of steroid intake being admitted to hospitals, there is growing concern over the excess use of steroids. If not taken under strict medical supervision, steroids can prove to be very harmful for the body.

Though the introduction of steroids nearly 50 years ago revolutionised the treatment of many diseases, its use can also lead to serious side-effects. “Steroids are like a double-edged weapon. If taken in a controlled quantity it can be healing, and if taken in excess it can lead to serious side-effects," says Dr Surjit Singh of the Internal Medicine Department at the PGI.

Doctors point out that the use of steroids is a must for the treatment of certain diseases like asthma, arthritis and allergies, but its misuse, mostly by quacks and other unqualified people, is a serious health hazard.

They say many patients seek help when they start suffering from serious side-effects, but with the damage already done there is little hope of recovery.

Since steroids give instant relief, their use leads to a feeling of well-being and the patient thinks the medicine is proving to be very effective.

Dr J.D. Wig, Head, Department of Surgery, PGI explains that steroid therapy depends on the clinical setting. The decision to initiate this therapy is taken in an emergency situation.

But the patients who receive substantial doses for prolonged periods suffer from serious adverse effects, although all side-effects may not show up in every patient.

Possible side-effects

1. Weight gain and redistribution of the body fat with a peculiar rounding of the face — “moon face” — fat on the abdomen, the upper back and the back of the neck.

2. High blood sugar or steroid-induced diabetes.

3. High blood pressure, fluid retention and atheroschlerosis.

4. Cataract can develop due to the prolonged use of steroids, for which surgery has to be done.

5. Increased susceptibility to infections as body immunity becomes very low.

6. Bone-thinning called osteoporosis, as the process of bone loss is accelerated. The person is prone to falling, leading to fractures.

7. Thin skin as a result of which patients bruise easily and wounds do not heal up fast.

8. Muscular weakness in the arms, legs, shoulders and pelvic muscles.

9. Peptic ulcers and abdominal stripes.

Self-help measures

1. Take your dose in the morning with breakfast or with meals.

2. Good appetite stimulant so that weight gain can be avoided. Eat more salads and restrict the salt intake.

3. Increase physical activity while keeping a close watch on blood sugar and blood pressure.

4. Wear a necklace or bracelet indicating the quantity and duration of steroid use because if a patient falls unconscious, the doctor will know he is on steroids.

5. Steroid therapy needs to be closely monitored and supervised by a physician, in case a person develops fever or any infection.

6. Never stop taking steroid medicines unless the doctor tells you to do so.

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What's wrong with fertility tests? 
Alok Jha

Leading fertility experts say some tests based around the immune system may be unscientific and therefore unreliable. In fact, the Royal College of Obstetrics and Gynaecology said this week that couples should be made more aware of possible problems with the tests before paying for expensive treatment.

"This reflects a growing concern that there are many patients who are going off to have these tests," says Lesley Regan, a professor of obstetrics and gynaecology at Imperial College and an author of the report.

Unexplained reproductive failure affects a fifth of couples looking for treatment and some researchers believe that it could be because of abnormalities in the immune system.

Several treatments and screening tests have been developed in recent years that claim to examine whether antibodies are responsible for the infertility.

The Royal College says there is not enough evidence to support the idea that reproductive failure is due to immunological abnormalities, such as those potentially caused by the natural killer cell.

Regan cites the example of testing for thyroid antibodies. "For years and years people thought that this was a problem, particularly since women who have thyroid disease often can't get pregnant," she says. "Having thyroid antibodies doesn't actually affect the outcome of the pregnancy, hence screening for thyroid antibodies doesn't seem to be very sensible."

Apart from a test for antiphospholipid syndrome in women who have recurrent miscarriages, the RCOG says immunological tests are not yet reliable. "They're not bad tests necessarily, they just haven't been researched sufficiently to be considered as evidence-based," says Regan.

Jinan Bekir, Medical Director of the London Women's Clinic, says doctors tend to use fertility tests only as part of a wider consultation for couples. "These tests are not routinely done," she says. "There must be a good indication to suggest to the patients to go and have them."

Bekir says her clinic takes the RCOG's issues seriously and is working to improve the situation.

— The Guardian
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Cell phones shelter bacteria

WASHINGTON
New research presented at the 43rd annual Interscience Conference on Antimicrobial Agents and Chemotherapy in Chicago revealed that cell phones can harbour a stubborn bacteria.

According to the researchers, Acinetobacter baumannii, a stubborn bacterium, can become resistant to almost any available antibiotic and can survive on inanimate objects, like cell phones for long periods.

The bacteria can be passed on to patients from the staff carrying cell phones.

Israeli researchers cultured bacteria found on the hands and cell phones of 124 employees at Soroka University Medical Center in Beer-Sheva in Israel and found acinetobacter on 12 per cent of cell phones and 24 per cent of hands.

"It wasn't that surprising. But it is alarming," lead researcher Jacob Gilad, MD, an investigator in the infection control unit of Soraka University Medical Center in Beer-Sheva, was quoted by webMD as saying.

Banning cell phones in hospitals can be effective as an administrative decision. — ANI Top