HEALTH & FITNESS

Gum disease can lead to heart problem
Dr H.S. Chawla
You do get worried if the teeth develop cavities. These are visible as black or brown ditches on the teeth. Gum/periodontal disease also begins early in life. Its progression is slow and painless, and thus it becomes perceptible to the individual only when the disease is in an advanced stage, manifested by pain and bleeding gums.

Shoulder injury: avoiding exercise is dangerous
Dr Ravinder Chadha
Shoulder joint injuries can occur due to varied aetiology. The afflicted individuals avoid the movement of the joint fearing pain. This results in stiffness of the joint and weakness of the muscles supporting the joint. Prolonged rest and immobilisation of the joint may lead to a condition known as frozen shoulder.

Bael: an excellent gift of nature
Prabodh Chander Sharma and Rakesh Pahwa
Bael, a fruit tree of Indian origin, is well known for its medicinal and nutritional properties. It plays an important role in protecting the environment too. The pulp of bael is very nutritious and used for making sharbat. The pulp has a detergent property also, which offers it as a herbal substitute for soaps, especially for allergy patients. Chemical studies have revealed that bael is rich in mineral and vitamin contents, and its young leaves and shoots are eaten as vegetables.

Millions at risk from fake medicines smuggled into UK
Paul Rodgers
Packets of fake pills are being smuggled into high-street chemists and sold as real medicines that prevent heart attacks or fight cancer, putting the lives of millions of British patients at risk. Criminal gangs that cut their teeth selling fake Viagra on the internet and went on to push dummy drugs in poor countries are now suspected of infiltrating the supply of medicines in the developed world.

Health Notes

n New and better anti-obesity medicine
n Bacteria can directly cause blood clotting
n Genetically modified soya bean can cut heart attack risk
n Common anti-depressant can cure motor neurone disease

 

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Gum disease can lead to heart problem
Dr H.S. Chawla

You do get worried if the teeth develop cavities. These are visible as black or brown ditches on the teeth. Gum/periodontal disease also begins early in life.

Its progression is slow and painless, and thus it becomes perceptible to the individual only when the disease is in an advanced stage, manifested by pain and bleeding gums.

Teeth normally are regarded by lay persons as the hard white structures in the mouth that contribute to a pleasant smile and are meant for chewing food, without much connection with the other parts of the body.

The hard fact is that teeth are intimately connected with the rest of the body. They are anchored in the jaws through their roots, which dig into the bone.

From the apex of the root, blood vessels enter the tooth and run all the way into the crown. It can be inferred that the health of the teeth and the surrounding gums will influence the health of the jaw bone.

Dental caries and periodontal disease are caused by bacteria. Bacterial infiltration from the gum leads to infections directly in the soft tissues surrounding a tooth. It also affects the bone around the tooth.

This infection can travel to the other parts of the body through blood. Untreated teeth infections may cause death due to cavernous sinus thrombosis, just as bacterial spread from a throat infection can cause a heart disease known as bacterial endocarditis.

Oral health means much more than healthy teeth. It is an integral part of general health. Several theories exist to explain the link between gum/periodontal disease and heart disease.

One theory is that when oral bacteria enter the blood stream, they attach to fatty plaques in the coronary arteries (heart blood vessels), thus reducing its lumen. This, in turn, hinders the normal flow of blood, restricting the amount of nutrients and oxygen required for the heart to function properly.

Although it is known that the health of the oral cavity is not a separate component of general health, proving a direct association is difficult and not completely understood.

This is because both cardiovascular and gum diseases are chronic diseases and share many common risk factors, including the age, smoking habit, socio-economic status and glycaemic control. Thus, the specificity of the association between the two is not clear-cut.

Though many studies provide evidence regarding the absence of a moderate-to-large association between gum disease (periodontitis) and coronary heart disease, a small causal association could not be ruled out.

On the other hand, researchers have found that people with gum/periodontal disease are almost twice more likely to suffer from coronary artery disease than those without periodontal disease. Periodontal disease can also exacerbate the existing heart conditions.

Bacteria-causing periodontal disease (periodontal pathogens) have been found in the fat deposits on the walls of the blood vessels supplying blood to the heart (atherosclerotic plaques). Athero-thrombogenic mediators such as C-reactive protein are elevated in periodontal disease.

There are findings of a meta-analysis that the risk of coronary artery disease may be related to the number of remaining teeth (tooth loss being the ultimate outcome of untreated gum disease). It would, therefore, be prudent to take care of oral health with a view to having a healthy heart.

The above facts add strength to the hypothesis that gum disease may be a risk factor for coronary artery disease. Given the high mortality rate among those suffering from cardiovascular diseases, and the relatively minor morbidity of periodontal therapy, maintenance of gum/periodontal health should be among the precautions for the prevention of heart disease.

When should we suspect gum disease?
(i) The bleeding from the gums as such without provocation, or upon brushing, inter-dental cleaning with floss / inter-dental brush, is an important indication of gum disease.
(ii) If the gums at the union of the tooth and the gum are loose and not well attached with the tooth. The gums are swollen at the margins with the teeth.

Many times people live in ignorance of the gum disease they harbour. A professional examination is helpful. It is recommended that dental check-up is done every six months.

The writer, who heads the Dental Department, The Apollo Clinic, Chandigarh,
is a former Head, Oral Health Sciences Centre, PGI, Chandigarh. Email:
[email protected]
.

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Shoulder injury: avoiding exercise is dangerous
Dr Ravinder Chadha

Shoulder joint injuries can occur due to varied aetiology. The afflicted individuals avoid the movement of the joint fearing pain.

This results in stiffness of the joint and weakness of the muscles supporting the joint. Prolonged rest and immobilisation of the joint may lead to a condition known as frozen shoulder.

In such cases there is complaint of experiencing discomfort in combing hair, scratching the back, locking brazier hook, etc.

Motion, strength and stability are the three important components of a healthy shoulder and these could be disrupted by any acute or chronic injury suffered by the joint. These can be treated effectively by therapeutic rehabilitation.

The most important factor that determines the success or failure of a particular shoulder rehabilitation protocol is establishing the correct diagnosis and early active mobility.

The joint capsule surrounds the joint like a watertight bag. This bag contains an small amount of fluid which lubricates the joint surfaces thereby facilitating the shoulder joint’s large range of motion.

In events of trauma, over usage, degeneration (due to aging) post-surgery and prolonged immobilisation, this fluid becomes viscid leading to contracted capsule and a frozen shoulder.

The shoulder joint is a ball and socket joint. To keep the joint healthy and fully functional, it is imperative to keep the rotation movements going, otherwise end results would be diminution of joint mobility.

In the past, the frozen shoulder problem was not so common as people undertook various activities — weaving clothes on heirlooms/charkas, drawing water from the well, spinning, cutting fodder, etc, and all of them involved rotational activities. Today’s life has taken away all this.

Symptoms

Pain while performing overhead activities
Pain during night
Dead arm
Shoulder weakness

Treatment

Shoulder injuries can be diminished by careful warm-up, stretching and strengthening of the shoulder muscles. When shoulder injury symptoms begin, early evaluation and treatment can prevent mild inflammation from becoming full-blown rotator cuff tear, frozen shoulder.

Avoidance of overhead activities, abduction and external rotation — bench press, chest fly, push-ups.

Physical therapy should be initiated in the early phase of treatment.

Electrotherapeutic modalities such as ultrasound, interferential stimulation and laser may be used.

Massage therapy in the form of digital ischaemic pressure and transverse friction massage is effective.

Injection corticosteroid is often helpful.

Most of the injuries are as a result of muscle weakness. Therefore, strengthening of the shoulder muscle is important.

Shoulder injuries/dysfunction should be diagnosed early with the initiation of effective rehabilitation in order to obtain optimum results.

The writer runs a pain management clinic in Chandigarh.
Email:[email protected]
.

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Bael: an excellent gift of nature
Prabodh Chander Sharma and Rakesh Pahwa

Bael, a fruit tree of Indian origin, is well known for its medicinal and nutritional properties. It plays an important role in protecting the environment too.

The pulp of bael is very nutritious and used for making sharbat. The pulp has a detergent property also, which offers it as a herbal substitute for soaps, especially for allergy patients. Chemical studies have revealed that bael is rich in mineral and vitamin contents, and its young leaves and shoots are eaten as vegetables.

Keeping in view its traditional importace, researchers have focused their efforts on highlighting the medicinal potential of bael.

As a result, bael has been found to possess myriad therapeutic properties to make it useful for fighting diabetes and heart diseases. It is also helpful in curing constipation, diarrhoea, dysentery, peptic ulcer and many other medical problems.

Unripe bael fruit is found to be the most effective food remedy for chronic diarrhoea and dysentery cases without fever. Recently, its utility has also been reported for the cases of amoebic dysentery.

Its leaf extract has been used in ayurveda as a medicine for diabetes. It enhances the ability to utilise the external glucose load in the body by stimulation of glucose uptake similar to insulin.

Bael extracts have been observed to be very effective in reducing levels of blood urea and cholesterol in various experiments conducted on laboratory animals.

Juice of leaves is also employed as an antidiabetic drug in the Unani system of medicine. Favourable effects of the bael leaf extract have been reported for various cardiac disorders and palpitation.

Bael has been used traditionally for fertility control in Bangladesh. Ripe fruit is regarded as best of all laxatives. It cleans and tones up the intestines.

Its regular use for two to three months helps in the evacuation of even the old accumulated faecal matter from the bowel. Hence, it is naturally a very effective remedy for constipation.

Patients with peptic ulcer can take this fruit in the form of beverage and get relieved from pain and discomfort as its mucilage forms a coating on the stomach mucosa and thus helps in the healing of ulcer.

It is also used as carminative, astringent, stomachic and for treating the irritable bowel syndrome. Bael is one of the most sacred trees of India and is valuable in several religious rituals also.

Owing to its environment-friendly nature, bael has been placed in a plant species group called “climate purifiers” which emit a greater percentage of oxygen in sunlight as compared to other plants.

Its leaves and bark act as a sink for dust and poisonous gases. It has the fragrance effect also which deodorises the bad odour of the air.

Concerted scientific research is required to explore the maximum potential of this under-utilised fruit tree.

The authors are lecturers at the Institute of Pharmaceutical Sciences, Kurukshetra University, Kurukshetra.

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Millions at risk from fake medicines smuggled into UK
Paul Rodgers

Packets of fake pills are being smuggled into high-street chemists and sold as real medicines that prevent heart attacks or fight cancer, putting the lives of millions of British patients at risk.

Criminal gangs that cut their teeth selling fake Viagra on the internet and went on to push dummy drugs in poor countries are now suspected of infiltrating the supply of medicines in the developed world.

"Counterfeit drugs could be compared to arms trafficking. It really is the same kind of dangerous crime," said Françoise Grossetête, a French MEP and member of the parliament's public health committee, at an international conference on the problem in Brussels. "It could become a form of terrorism."

The Medicines and Healthcare products Regulatory Agency (MHRA) has recalled 14 batches of counterfeit drugs in the past three years, compared with none in the previous decade.

These included fakes claiming to be the world's best-selling drug, Lipitor, which cuts cholesterol, Plavix, which helps to prevent blood clots, and Casodex, which fights prostate cancer. Criminals have also targeted Zyprexa, an anti-psychotic prescribed for schizophrenia and bipolar disorder.

The MHRA described the situation as "serious", and said its enforcement and intelligence unit was dealing with the problem.

The World Health Organisation (WHO) estimates that 1 per cent of drugs in the developed world are counterfeit. In Britain, that would mean up to seven million fake prescriptions a year, almost all of them undetected.

Illegal pills may contain little or none of the real medicine's active ingredient, and because they are manufactured in unhygienic conditions, could have dangerous contaminants. Often the fakes can be spotted only with laboratory tests.

Patients who report to their doctors that a drug isn't working are likely to be put on a higher dosage than they need, or be switched to alternatives that could be less effective or have more dangerous side effects.

No Britons have died yet because of counterfeit drugs, the MHRA claims. However, any deaths would almost certainly be attributed to the patient's illness. Medicines taken by people who appear to die of natural causes are not routinely checked.

The WHO has reported several cases where counterfeits have led to mass deaths. More than 2,000 people died during a meningitis epidemic in Niger in 1995 after being inoculated with fake vaccines.

Prescription drugs are traded throughout the EU and around the world. Often a packet of pills will pass through dozens of companies between the manufacturer and the chemist.

They are frequently repackaged, with labels and instructions in different languages. Although British drug traders need a licence from the MHRA, it has no control over who handles the pharmaceuticals elsewhere in the EU.

Many of the fakes are produced in India or African countries, and then imported into the EU. John Taylor, the head of the anti-counterfeiting team in the EU Customs Department, said national authorities seized four million fakes last year, up 50 per cent on 2006. "Once they are in the EU, they travel around freely," he said.

Aegate, a British company, has recently completed an audit of its successful system in Belgium, Greece and Italy that uses a bar code to check whether a drug is authentic. — The Independent

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Health Notes
New and better anti-obesity medicine

London: An anti-obesity medicine called tesofensine has been found to be about twice as effective as any previous diet drug.

The drug made by NeuroSearch of Copenhagen, Denmark, was tested on some people who weighed more than 100 kilograms. A research article in the journal The Lancet suggests that those who took the drug lost almost 13 kilograms in six months.

The drug makes people feel full early in a meal by increasing the pleasurable effects of three neurotransmitters.

However, larger trials to come will delay its approval, reports New Scientist magazine. — ANI

Bacteria can directly cause blood clotting

London: An international research team has found that bacteria can directly cause human blood and plasma to clot, something that has long been thought to have been lost during the course of vertebrate evolution.

The researchers believe that their new findings may help advance scientists’ understanding of coagulation during bacterial infections, which in turn may pave the way for new clinical methods for treating serious medical conditions like sepsis and anthrax.

Blood often coagulates during sepsis or bacterial infections, but this has generally been regarded as a host’s immune and inflammatory response. — ANI

Genetically modified soya bean can cut heart attack risk

London: A genetically modified soya bean, which can help to prevent heart attacks, has passed the first phase of trials in the United States.

Researchers at the University of South Dakota say that the promising results of the experiments have cleared the way for its use in foods such as spreads, yoghurts, cereal bars, and salad dressings.

The researchers said that their study had shown that oil from the GM soya could raise blood concentrations of long-chain omega3 acids, which are found chiefly in oily fish such as salmon, trout and fresh tuna. — ANI

Common anti-depressant can cure motor neurone disease

London: Scientists from King’s College London have launched a major clinical trial to test whether common antidepressant drug lithium can effectively treat motor neurone disease.

Till now, there is no effective cure or treatment for the fatal motor neuron disease, which is commonly found in men and most likely to strike between the ages of 50 and 70. — ANI

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