HEALTH & FITNESS

Time is muscle after heart attack
Dr Upendra Kaul

A heart attack (acute myocardial infarction) is a catastrophic presentation of ischemic heart disease, which has nearly eight crore Indians in its grip. The central problem is blockages in the arteries supplying blood to the heart muscle.

  • The golden first hour

  • Early medicine

  • Treatment after two hours

  • Life after attack

Homoeopathy & you
High uric acid leads to gout
Dr Vikas Sharma

Do you have high uric acid levels in your blood? If so, then there are chances that if it goes unchecked you might end up suffering from Gout. Gout is a disease that affects the joints. In earlier days it was also called the “disease of the kings” because it was associated with over-indulgence in drinks and rich food. But it is not so nowadays. It can strike anyone, men being more at risk than women.

EYESIGHT
General tips for eye care
Dr Mahipal S. Sachdev

“Doctor, please tell my child that he should not watch TV, otherwise his glasses power will go on increasing.” Try to recollect how many of you have requested this to your eye specialist. This is a common misconception.

Health Notes
Alcoholic milk can protect infants against food allergies

WASHINGTON:
Taiwanese researchers have found that feeding babies alcoholic milk might help to protect against some food allergies.

  • Gene mutation that turns girls into boys discovered

  • Anti-depressants affect adolescents and adults differently

  • Coke addicts are easy to con

 

 

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Time is muscle after heart attack
Dr Upendra Kaul

A heart attack (acute myocardial infarction) is a catastrophic presentation of ischemic heart disease, which has nearly eight crore Indians in its grip. The central problem is blockages in the arteries supplying blood to the heart muscle.

The heart attack occurs when a partially blocked artery gets completely occluded by a blood clot. This cuts blood supply to a portion of the heart muscle, which can cause death, heart failure or severe weakening of the heart resulting in shock and related complications. The symptoms of a heart attack are the sudden onset of chest discomfort, shortness of breath, unconsciousness, often with profuse sweating and vomiting. Early recognition and prompt treatment are vital to reducing the mortality rate (20 to 25 per cent, if the treatment is inadequate or improper). Most of the deaths occur within the first hour after the onset of chest pain.

The golden first hour

The best and the easiest method to diagnose a heart attack is electrocardiography (ECG) and a few specialised blood tests, carried out at the bedside with instant results.

Once the diagnosis establishes a heart attack, the treatment should be directed towards pain relief and quickly restoring the blood flow in the blocked artery. If this is done within an hour or two of the onset of chest pain and the ECG changes, the results are excellent and the chances of death are cut to just 3 per cent. This first hour is also called the golden hour. Time decides which treatment is the best. “Time is muscle.”

Admission to a hospital with a coronary care unit (CCU) at the earliest is vital. Disorders of cardiac rhythm leading to very fast heart beat (tachy arrhythmias) or marked slowing of the heart rate (brady arrhythmias), which can lead to sudden death, can be promptly recognised and treated in a CCU. The first 24 hours after the attack are crucial and the heart needs continuous ECG monitoring in this period.

Early medicine

Aspirin (300 to 325 mg) chewed at the onset of a heart attack has been shown to lower mortality. Another oral medicine, clopidogrel, enhances the efficacy of aspirin. The sheet anchor of management, however, is a clot buster medicine or angioplasty at the earliest to clear the blocked artery.

A clot buster medicine (streptokinase, urokinase, tissue plasminogen activator, etc.) administered intravenously works well if administered within two hours of the attack. Its results at this stage are equivalent to those of angioplasty. This method is easier, more cost-effective and can be applied rapidly to a much larger patient population not able to reach specialised centres within the shortest possible time. This treatment can begin even before reaching the hospital, in properly equipped ambulances.

Treatment after two hours

The management after two or three hours becomes difficult. Angioplasty along with stent placement becomes a better way of preserving the heart muscle. Clot buster medicines can do little if the early opportunity has been lost. Angioplasty is the only way to save the heart if the delay in starting the treatment has been more than four hours, but less than 12 hours after the onset of chest pain. Angioplasty has clear superiority over clot busters in patients with low BP, very compromised heart muscle function, recent brain strokes or bleeding tendencies. Patients who arrive more than 12 hours later often have already suffered a permanent damage to the muscle.

Life after attack

Diabetics and patients with high BP need aggressive blood sugar control and blood pressure control. Dietary counselling to keep the cholesterol levels low and the intake of heart-healthy diets are essential. In uncomplicated cases with successful initial treatment, prolonged hospitalisation is not required. Patients can be discharged on day four or five after a brief period of rest. At home, they can resume their full activities.

Each patient needs a management suited to the amount of the damage to the muscle. The advice for exercise, resumption of office work, sex, travel, etc, would vary accordingly. Periodic echocardiography and nuclear scans give the doctor a good idea of recovery and further strategy. Many patients treated by clot buster medicines need coronary angiography, followed by angioplasty or bypass surgery. Heart attacks affect even the young; its early recognition and prompt treatment are essential.

The writer is Director, Cardiology, Fortis Group of Hospitals, New Delhi and NOIDA.

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Homoeopathy & you
High uric acid leads to gout
Dr Vikas Sharma

Do you have high uric acid levels in your blood? If so, then there are chances that if it goes unchecked you might end up suffering from Gout. Gout is a disease that affects the joints. In earlier days it was also called the “disease of the kings” because it was associated with over-indulgence in drinks and rich food. But it is not so nowadays. It can strike anyone, men being more at risk than women.

What is uric acid? How does uric acid levels increase in our blood and what precautions can be taken to avoid it? Uric acid is a waste product in our body and is eliminated by our kidneys. It is produced from the breakdown of a certain kind of a substance known as purine. This substance is also produced in our body and is present in some of the food that we eat.

Uric acid increases due to mainly three conditions: over-production in situations like fasting, strenuous exercising and crash dieting; if there is a decreased removal of uric acid by the kidneys; and if one takes excess food high in purine.

Foods high in purines should be avoided particularly by those who are having increased levels of uric acid among these are quite a few nonvegetarian foods, lentils (dals), whole grains, peas, cauliflower and mushroom. Alcohol intake slows down the removal of uric acid. Being overweight also adds to increased levels. A simple blood test (serum uric acid) at a local lab can be good enough for an evaluation.

What is gout and how does a high level of uric acid in blood lead to gout? Gout is an inflammatory condition of the joint. It results in an inflammation of the joint. This is due to the deposition of uric acid crystals in the joint spaces and in the connective tissue of the joints. It is a very painful condition causing swelling redness, heat pain and stiffness of the joint.

Deposits of uric acid called tophi can appear as lumps under the skin around the joints. Gout mainly affects the big toe, but it can also affect other joints like ankles, heels, knees, wrists, fingers and elbows

Increased uric acid is not a disease and by itself not dangerous. However, if excess uric acid levels lead to the formation of crystals between the joints, gout can develop. In some individuals, excess levels also lead to the formation of kidney stones.

Homoeopathic medicines can be a boon for all those who suffer from high uric acid. These medicines work by reducing uric acid’s overproduction by the body and accelerating the removal of this waste product through the kidneys. Homoeopathic medicines Benzoic Acid, Pulsatilla, Lycopodium and Urtica Urens are very effective in curing the increased levels of uric acid. Another medicine that requires special mention is Berberis Vulgaris. It is used when kidney stones form due to high levels of uric acid.

Gout is also very effectively treated by homoeopathy. Ledum Pal, Colchicum, Benzoic Acid, Bryonia and Formica Rufa are very useful in treating gout.

The writer is a homoeopath based in Chandigarh.

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EYESIGHT
General tips for eye care
Dr Mahipal S. Sachdev

“Doctor, please tell my child that he should not watch TV, otherwise his glasses power will go on increasing.” Try to recollect how many of you have requested this to your eye specialist. This is a common misconception.

The glasses are an aid to see the things clearly. The power of glasses does not increase by watching TV. It will increase if it has to even if one does not watch TV. There are also many other common misconceptions about vision:

l Using computers will damage the eyes.

l Wearing eyeglasses will make one dependent on them.

l Wearing contact lenses will stop the glass power from increasing.

These are all wrong beliefs. Computers and watching TV does not do any damage to the eyes. Working on computers for long hours causes fatigue. While looking at the screen our blinking becomes less, leading to dryness. So, while working on the computer, one should take regular breaks. One can see at far distance in between or close the eyes for a few seconds. This will help to spread the tear film properly and relax the eye muscle. In addition, one should keep computer monitor at your eye-level at an arms length from you. This reduces the neck strain. The screen illumination should be equal to the room illumination.

Wearing eyeglasses makes the vision clearer for the person who has refractive error. It does not cause any weakness in the eyes if you use glasses; rather it provides you a clear vision. It is not actually that you get dependent on them but you get used to seeing clearly with them. A person with glasses has an option of using contact lenses. Many people think using contact lenses stops the glasses power from increasing. This is also a misconception. The contact lenses also have power like glasses and you have to change if the glasses’ power increases.

One should use good illumination while reading. The ideal lighting for reading is 40 candles/sq.mt. One should adjust the light so that it will fall on the script you are reading. The good lighting will improve the contrast of the script. Older people should particularly use good lighting conditions, as retinal degeneration is common in old age. This makes your reading more comfortable.

Eating food rich in vitamin A like carrot and papaya is healthy for eyes. However, this does not mean that somebody eating vitamin-A-rich food will not get glasses. The person who has refractive error will have to wear glasses. The vitamin A keeps the eye healthy in the long run and helps in slowing down the retinal degeneration.

Eye exercises are advised in the case of muscle weakness. They strengthen the eye muscles. They maintain the alignment of the eye. One should focus on an object at a far distance and then at near for 5-10 times. This relieves the eyestrain after continuous reading or working on computers.

Use your glasses properly so that no scratches should come. Clean them with soap and water at least once in a day. Our fingers leave oily marks on glasses, causing foggy vision.

Proper care while doing day-to-day activities will keep your eyes healthy in the long run!

The writer is Chairman and Medical Director, Centre for Sight, New Delhi. E-mail: msachdev@bol.net.in 

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Health Notes
Alcoholic milk can protect infants against food allergies

WASHINGTON: Taiwanese researchers have found that feeding babies alcoholic milk might help to protect against some food allergies.

The researchers found that Kefir, a traditional fermented drink, which is often used to wean babies, as it is easily digested, has “friendly” bacteria that may play a role in blocking the pathway involved in allergic responses.

Food allergy prevalence is especially high in children under the age of three, with around 5-8 per cent of infants at risk. Avoiding the problematic food is the only treatment till now.

Kefir, which is consumed in Eastern Europe as a health food, was found to inhibit the allergen-specific antibody Immunoglobulin E (IgE) — ANI

Gene mutation that turns girls into boys discovered

LONDON: Researchers at the University of Pavia, Italy, have discovered a gene, the mutation of which can turn girls into boys.

They explain that almost all men carry two different sex chromosomes XY, while women normally have XX, but there are some very rare exceptions to this rule like having XX men.

The researchers say that female-to-male sex reversal happens when a certain gene called SRY, usually carried on the Y chromosome, ends up on the X chromosome inherited from the father.

Reporting in Nature Genetics, the researchers said they studied a family in which four brothers were each XX, who did not carry the male SRY gene. They said that all of them had a mutation in a gene called RSPO1. — ANI

Anti-depressants affect adolescents and adults differently

WASHINGTON: A new study published in the American Psychological Association (APA) shows that teenagers taking common anti-depressants may become more aggressive and commit suicide, which is a clear indication that these medications affect adult and juvenile brains differently.

Neuroscientists at the University of Texas at Austin found that juvenile hamsters given low doses of fluoxetine hydrochloride, which is sold in the United States as Prozac, became more aggressive on low doses of the drug, while those administered high doses became somewhat less aggressive. However, adult hamsters were the ones who calmed down on both high and low doses.

Doctoral student and lead author Kereshmeh Taravosh-Lahn says that their findings have confirmed that juvenile and adult brains are different. — ANI

Coke addicts are easy to con

WASHINGTON: Scientists have revealed that it is easier to dupe drug addicts for they have an impaired ability to perceive rewards and exercise control due to disruptions in the brain’s reward and control circuits.

“Our findings provide the first evidence that the brain’s threshold for responding to monetary rewards is modified in drug-addicted people, and is directly linked to changes in the responsiveness of the prefrontal cortex, a part of the brain essential for monitoring and controlling behaviour,” said Rita Goldstein, a psychologist at Brookhaven Lab.

Goldstein’s experiments were designed to test a theoretical model, called the Impaired Response Inhibition and Salience Attribution (I-RISA) model. — ANI

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