HEALTH & FITNESS

 

When hearty laugh is not possible
Dr R. P. Sapru
Heart failure is a serious illness at any time. Therefore, the very mention of such a diagnosis by the doctor gives rise to a great deal of understandable alarm. In medical parlance, heart failure is said to be present when the heart is not able to pump enough blood to meet the requirements of the body. Contrary to a popular belief, it does not indicate “stoppage” of the heart beat.

How to prevent wrist injuries
Dr Ravinder Chadha

In clinical practice, patients with wrist pain present with either an acute injury or pain that develops gradually as a result of overuse.
Acute injuries occur as a result of fall on the out-stretched hand or a violent twist to the wrist at work or in swinging a bat or a racquet. 

Women’s desire to become thin causes boom in cosmetic surgery
By Jeremy Laurance

Women weary of pumping iron or eating hamster food are turning in growing numbers to liposuction, the short cut to a svelte figure in which fat is sucked from the abdomen, bottom, thighs, or under the chin.

Health Notes
Fruit juices as beneficial as fruits and veggies

Washington: A European study has revealed that 100 per cent fruit and vegetable juices are as effective as their whole fruit/vegetable counterparts in reducing risk factors related to certain diseases.

 

 

 

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When hearty laugh is not possible
Dr R. P. Sapru

Heart failure is a serious illness at any time. Therefore, the very mention of such a diagnosis by the doctor gives rise to a great deal of understandable alarm. In medical parlance, heart failure is said to be present when the heart is not able to pump enough blood to meet the requirements of the body. Contrary to a popular belief, it does not indicate “stoppage” of the heart beat.

The usual symptoms are shortness of breath (initially with increased effort progressing in time to appear even at rest; some patients may be woken up at night with shortness of breath), cough (sometimes with frothy sputum), palpitations, swelling in the legs, weakness, loss of appetite, disturbed sleep, confusion or impaired memory, etc. Of course, a number of other conditions may mimic heart failure which is why a doctor needs to be consulted at the earliest.

There are, however, a small number of patients of heart failure in whom the cause cannot be found or removed whether for technical reasons or because of an uncertain or unacceptable risk of definitive treatment. These patients require treatment on a long-term basis. The first line of treatment for these patients is with drugs, usually a combination of various medicines. Treatment inevitably is life long.

Of these, a small number of patients may not respond to treatment or stop responding to treatment after having been suitably controlled for short or long periods. It is this small number of patients in whom medical treatment fails to provide sufficient relief in spite of the best efforts with medications (under the supervision of experts). For such patients there is only one procedure that can possibly offer a cure and that is cardiac transplantation. There are many logistic and technical reasons why this procedure cannot be offered to more than a very small number who could be possible beneficiaries (constraints of space do not permit a detailed consideration of these).

The next best solution that has the potential of providing sustained relief but is still an experimental procedure is that of seeding in the heart very special cells called “stem cells” taken from the patient himself. This treatment is not available as yet for patients but is mentioned because it has been receiving media coverage. Incidentally, one of the institutions engaged in researching the subject is the PGI, Chandigarh.

The next option is a surgical procedure that tries to reconstruct the major chamber of the heart (the left ventricle) in an attempt to restore the geometry of the chamber as close to normal as possible (the Batista operation). The procedure, however, carries a substantial risk with uncertain benefits.

It has been known for several years that the sequence of activation of heart muscle plays an important role in ensuring optimum function of the heart. Some patients at an advanced stage of heart failure may also show abnormal spread of the normal electrical activity that controls the sequence of activation of the heart. About 15 years ago a new procedure was attempted to try and restore towards normal, as far as possible, the sequence of electrical activation of the heart. This procedure, known as Cardiac Resynchronisation Therapy (CRT), has come to gain acceptance all over the world because it provides some relief in symptoms to these patients. It, however, cannot be called a miracle treatment since it does not offer a cure for the disease. It does not supplant medical treatment but may supplement it.

A recent dissertation estimates that only about 4 per cent patients of heart failure would be eligible for treatment with CRT according to the currently accepted criteria. Unfortunately, about a third of the patients who are offered the treatment may not show significant improvement. Even in those who do, improvement in symptoms is estimated at 24 per cent.

The writer was earlier associated with the PGI, Chandigarh.


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How to prevent wrist injuries
Dr Ravinder Chadha

In clinical practice, patients with wrist pain present with either an acute injury or pain that develops gradually as a result of overuse.

Acute injuries occur as a result of fall on the out-stretched hand or a violent twist to the wrist at work or in swinging a bat or a racquet. The most common injury can be fracture, dislocation of the bones (carpal bones instability), inflammation of the tendons and injury to the nerves (carpal tunnel syndrome). If not diagnosed and treated properly it can lead to long-term disability.

Enquiring regarding the history of an injury, any abnormal sound or sensation associated with wrist motion is of great importance. Patients describing grinding sensation represent synovitis while clunking, and clicks are due to carpal instability. A snap usually represents a subluxing tendon.

The location of the wrist pain helps in diagnosing its cause. The pain can be on the front, back, inner or outer side of the wrist.

Pain associated with repetitive movements along with stiffness after a period of rest suggests an inflammatory condition such as tenosynovitis.

Morning stiffness can be due to inflammatory arthropathy.

Pain aggravated by weight-bearing activities suggests bone or joint involvement.

Characteristic night pain with or without numbness is found in the carpal tunnel syndrome.

People who are suffering from osteoarthritis, rheumatoid arthritis or injuries of the wrist should perform their daily activities with minimal pain and stress to the joints and take the following precautions:

l It is advisable to stop any activity which brings discomfort or fatigue. In case one feels pain or discomfort that persists for one hour after stopping the activity, one should either modify or discontinue that activity.

l During the active phase of the disease one should perform minimal activity and take rest intermittently.

l Avoid using strong grasping activities as these increase discomfort like opening jars, pinching grip movements, etc.

l Avoid carrying anything in the hands. Use a shoulder bag for the purpose.

The following exercises can be started when there is a decrease in the wrist pain:

Bend the wrist forward as far as possible and try to touch the fingers to the wrist. Hold it for five seconds. Repeat 10 times.

Bend the wrist backward as far as possible. Hold it for five seconds. Repeat 10 times. Do three sets.

With the palm up, apply pressure on the fingers with the other hand to bend the hand and the fingers backward.

Standing at a table with the palms down and the elbows straight, lean your body weight forward for 15 to 30 seconds.

Wrist curls — Sit in a chair with the arm resting on a table and the hand over the table edge. Hold weight (1-4 pounds) and slowly raise and lower the hand by flexing the wrist. Repeat 10 to 15 times.

The complexity of the wrist makes the diagnosis difficult, but knowledge of the wrist joint and awareness of these common injuries will help in making a specific diagnosis. Treatment is according to the injury that will allow a patient to return to normal activity in a timely manner and help prevent chronic, debilitating wrist pain.

The writer is a former doctor/physiotherapist, Indian cricket team. 

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Women’s desire to become thin causes boom in cosmetic surgery
By Jeremy Laurance

Women weary of pumping iron or eating hamster food are turning in growing numbers to liposuction, the short cut to a svelte figure in which fat is sucked from the abdomen, bottom, thighs, or under the chin.

The demand for liposuction rose by almost 90 per cent in 2006, according to the figures released by the British Association of Aesthetic Plastic Surgeons (Baaps). Almost 3,500 women and 500 men chose to have their excess fat hoovered up at a cost of £3,000 to £5,000 each.

The clash between the obesity epidemic and the 21st century search for bodily perfection is behind the boom, surgeons say.

Douglas McGeorge, the President of Baaps, said: "People don't feel as bad about having cosmetic surgery as they did. The techniques are tried and tested and the results are predictable."

But he warned that liposuction was not a quick fix for the obese.

"It is not desperately difficult; I could teach a four-year-old to do it. The skill comes in resculpting the body. It is not an alternative to dieting. It works best on someone who is happy with his/her tummy, but has jodhpur thighs which you can reshape."

He added:"If someone is three stone overweight and wants liposuction to deal with the problem, I tell them to go away."

Mr McGeorge, a consultant plastic surgeon at the private Countess of Chester hospital, Cheshire, said the procedure had become more acceptable as average waistlines had expanded. "We live in a society where people carry a pound or two more than they would like and want to do something about it," he said.

The growth in demand is part of an overall beautification frenzy sweeping the globe.

— The Independent

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Health Notes
Fruit juices as beneficial as fruits and veggies

Washington: A European study has revealed that 100 per cent fruit and vegetable juices are as effective as their whole fruit/vegetable counterparts in reducing risk factors related to certain diseases.

The conclusion is the result of the study designed to question traditional thinking that 100 per cent juices play a less significant role in reducing risk for both cancer and cardiovascular disease than whole fruits and vegetables.

Juices are comparable in their ability to reduce risk compared to their whole fruit/vegetable counterparts, according to several researchers in the United Kingdom who conducted the literature review. — ANI

Chemical that may help insomniacs sleep

London: Swiss experts have identified a chemical that may help promote sleep in insomniacs.

The new approach, they say, targets brain hormones called orexins, known to be linked to sleepiness.

Patients with a sleeping disorder have low levels of these hormones, and are chronically sleepy during the day, sometimes falling asleep on the job or while driving. — ANI

Vaccines that exploit natural alarm bells to fight diseases

London: A team of researchers at Oxford University are developing a new generation of vaccines that exploit natural “alarm bells” in the immune system which could help fight killer diseases such as tuberculosis, malaria and HIV.

The vaccines use adjuvants — substances that put the immune system on alert, making it more likely to notice the vaccine. Some vaccine injections are already augmented with adjuvant chemicals such as aluminium hydroxide, but the new vaccines have built-in genes for making their own adjuvants — ANI

A blast of sunshine helps fight skin diseases

LONDON: According to a new study by researchers at Stanford University, California, a blast of sunshine could help fight skin diseases and cancer by 
attracting immune cells to the skin surface.

Eugene Butcher at Stanford University in California and colleagues discovered an interesting immune process in human skin.

The researchers noted that sunshine regulates immune cells in the skin called dendritic cells, which convert vitamin D3 (produced in exposed skin in response to sunlight) into its active form. — ANI


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