HEALTH & FITNESS

How to cope with heart failure
A diagnosis of heart failure sounds scary, as if your heart could stop at any moment. But the underlying heart conditions that commonly cause heart failure, such as coronary artery disease or high blood pressure, typically develop slowly over many years and can be controlled at an early stage.

Clean your tongue too while brushing teeth
Dental caries (cavities) and gum diseases are caused by the bacteria in your mouth. The difference between a disease-free mouth and one with dental disease is that in the individuals prone to dental disease the number of bacteria present is greater that in those with no disease.

Pain at back of heel
Tendoachilles is an extremely common overuse injury noticed mostly after the age of 40 years. The Achilles tendon is the largest and strongest part of the human body.

Health Notes

Infant weight gain can predict later obesity
Slow-growing TB bacteria may pave way for new drugs
Gene that suppresses skin cancer growth identified
Scientists unearth the factors that affect asthma

 

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How to cope with heart failure
Dr Harinder Singh Bedi

A diagnosis of heart failure sounds scary, as if your heart could stop at any moment. But the underlying heart conditions that commonly cause heart failure, such as coronary artery disease or high blood pressure, typically develop slowly over many years and can be controlled at an early stage.

The development of heart failure usually means that the heart's ability to pump blood has weakened, so it cannot circulate enough blood to meet the body's needs.

Over five million Indians are living with symptoms of heart failure, and between 400,000 and 700,000 new cases are diagnosed every year. About 2,50,000 people die annually of heart failure.

The possible causes

Heart failure may occur for a number of different reasons (mostly preventable at an early stage):

High blood pressure.

Blockage in the heart arteries and a previous heart attack.

Diseased heart valves.

Irregular heart rate (cardiac arrhythmia).

Cardiomyopathy due to infection, alcohol or cocaine abuse.

Managing heart failure

Heart failure cannot always be cured, but it can be successfully managed. Your healthcare team will design a plan to improve your quality of life and help you feel better. In addition to your regular doctor, your healthcare team will include a cardiologist (heart specialist) and a nurse, nutritionist (food specialist), health educator and possibly an exercise specialist. But you are the most important member of the team.

Your treatment plan

Everyone's treatment plan for heart failure is different. Your individual plan may include some or all of the following:

Medication to strengthen your heart's pumping action, help blood flow better through blood vessels by dilating them, remove excess fluid, regulate your heartbeat and sodium potassium balance

Changes in the amount of your physical activity

Setting limits on the amount of salt and fat in your diet

Increasing the potassium in your diet

Losing weight if necessary

Reducing your fluid intake, if necessary

Exercise

Graded exercise is very important. The amount of exercise depends on the severity of the heart failure.

Adjusting your diet

When you have a heart failure, what you eat and drink can definitely affect the health of your heart. Your doctor may want you to do some or all of the following:

Reduce your sodium (salt) intake. Sodium causes your body to retain fluid. We get most of our sodium from salt, though we also get it from other sources such as pickles (achar), sauces, baking soda or MSG (monosodium glutamate), a preservative used commonly in Chinese foods and pre-packaged foods.

Eat more foods rich in potassium to replace the potassium you lose when you take diuretics. Potassium is present in green leafy vegetables and most fruits, especially bananas, oranges, and dried fruit.

Eat less fat.

Control your weight.

Prevention

The best defence against heart failure is the prevention of heart disease. You can control or eliminate many of the risk factors for heart disease - high blood pressure and coronary artery disease, for example - by making lifestyle changes along with the help of any needed medications.

Self-care

Restrict the intake of sodium

Limit fats and cholesterol

Limit alcohol and fluids

Do exercise regularly

Stop smoking

Weigh yourself

Reduce stress

The writer, Head of Cardio-Vascular & Thoracic Surgery, Christian Medical College
& Hospital, Ludhian, has had his training in managing heart failure and transplant
surgery at St Vincent’s Hospital, Sydney.


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Clean your tongue too while brushing teeth
Dr H.S. Chawla

Dental caries (cavities) and gum diseases are caused by the bacteria in your mouth. The difference between a disease-free mouth and one with dental disease is that in the individuals prone to dental disease the number of bacteria present is greater that in those with no disease.

Dental diseases, to a large extent, are preventable. One of the means is to reduce the number of bacteria in your mouth. If you are able to decrease the number of bacteria, you are less likely to develop dental disease.

In order to reduce their number in your mouth, you should know where bacteria live in the mouth.

These, in fact, are present everywhere in the mouth, including your saliva. But, basically, there are three major areas of deposits of bacteria in the mouth: tooth surfaces, gingival sulcus and top /dorsal surface of the tongue.

The top surface of your tongue is studded with different types of papillae. These very small multiple projections are placed very closely on the surface of the tongue.

When carefully viewed in front of a mirror, these can be figured out with the naked eye. These are of different types and technically known as filliform, fungiform and circumvalate papillae. They perform different functions.

In between multiple papillae on the tongue, bacteria lodge in large numbers and
multiply undisturbed.

On the anterior part of the tongue the bacterial number is less and is primarily aerobic --- the ones which grow and live in an environment full of oxygen.

Their number is less because due to the friction from the chewing of food items the bacteria get dislodged and are moved into the stomach.

On the posterior part of the tongue, the bacteria are in a larger number and anaerobic --- these can live and multiply without the presence of oxygen.

The anaerobic bacteria are harmful to the dental health and contribute to the development of dental cavities as well as gum disease.

Their number is more on the posterior part of the tongue because here the tongue does not get rubbed and cleaned as a result of the chewing of food.

If you clean your tongue regularly along with the cleaning of teeth, two radical changes take place in the bacterial ecology. First, the total number of bacteria on the top surface of the tongue decreases.

Secondly, the anaerobic microbes on the posterior part of the tongue get replaced with aerobic bacteria. This shift in the bacterial population results in the bacterial ecology becoming less disease producing.

How to clean the tongue?

The tongue is cleaned with the help of a soft-bristle tooth-brush; the same tooth-brush you use for your teeth.

The tongue cleaning can be done anytime during brushing. It is best carried before completely spitting out the toothpaste after brushing your teeth.

The method consists of moving the brush backwards and forwards five to six times with a light force on the tongue.

This can be repeated with a fewer number of strokes when you are brushing your teeth for the second time, and is, in fact, recommended.

The warning note is not to exert pressure while cleaning the tongue as excessive friction causes enlargement (hypertrophy) of the papillae.

The papillae in the individuals who brush vigorously become large and white, giving it the appearance of white hair on the tongue.

This condition of the tongue is called “white hairy tongue”. If you stop applying force while cleaning the tongue, the condition itself will regress back to normal.

Can plastic tongue-cleaners be used?

Invariably, with these strips you unconsciously exert more pressure while cleaning the tongue. This causes enlargement of the papillae on the tongue.

Enlarged papillae provide more spaces in-between the papillae for the bacteria
to house and grow in large numbers. The result is that your tongue looks whitish
and dirty.

You tend to scrub the tongue more vigorously to clean the white-looking patch, which leads to a further increase in the size of the papillae, and a vicious cycle sets in. So, the tongue strips are not recommended.

Datun (green sticks)

Datun chewing has a unique effect on the cleaning of the tongue. The chewing of Datun gives automatic frictional rub to the lateral sides as well as on a part of the top surface of the tongue.

This does not mean that Datun is more effective for the cleaning of the teeth. So, along with the cleaning of the teeth, it is imperative to clean up the top surface of the tongue to reduce the overall load of the bacteria in the mouth. It can be carried out with a soft toothbrush using light pressure when you brush your teeth.

The writer, Head of the Dental Department, The Apollo Clinic, Chandigarh,
is a former Head, Oral Health Sciences Centre, PGI, Chandigarh.

Email: chawlahs@gmail.com <mailto:chawlahs@gmail.com.

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Pain at back of heel
Dr Ravinder Chadha

Tendoachilles is an extremely common overuse injury noticed mostly after the age of 40 years. The Achilles tendon is the largest and strongest part of the human body.

This tendon connects the calf muscles to the heel bone — calcaneus. The tendon transfers the energy of the calf muscles to push the foot off the ground.

This produces tension on the top of the heel bone. Individuals with flat or high-arched feet are more prone to tendoachilles.

The fact is that the entire lower limb acts as a single unit when an individual walks or runs. Weak hip muscles too exert strain on the ankle joint causing tendoachilles.

That is why the biomechanics of the foot/ lower limb while walking/ running has a lot of significance in our life.

Usual causes of tendoachilles

Overuse of Achilles tendon.

Reduced calf muscle strength or tight calf muscles is usually associated with
Achilles tendonitis

Sudden increase in exercise regimen.

Wearing ill fitting shoes.

Frequent changing of high heels and flat shoes.

Symptoms

Pain experienced at the back of the heel. The pain aggravates when the back of the heel touches the shoes repeatedly.

Redness/ swelling above the insertion of the tendon at the heel bone.

Pain and stiffness particularly in the morning which decreases on resuming activity and recurs several hours thereafter.

Pain, which is triggered during anacute phase of the injury, tends to disappear after warm up but resurfaces once training is stopped.

Eventually the injury worsens till it becomes impossible to run.The condition, if ignored in the initial stages, becomes chronic and difficult to treat.

Treatment

Identifying the cause of tendoachilles is the first step in treating tendoachilles.

Rest does bring relief but pain flares up as soon as physical activity is resumed.

Ultrasound followed by deep friction message can decrease pain and inflammation.

Taping the back of the heel and leg provides support and stops the inflammation in acute cases.

Wearing a heel pad takes off some of the strain on the Achilles tendon.

Exercises

Any form of exercise should be started after warming up for about 10 minutes (which may be walking/cycling/jogging, etc).

In the beginning, work-out should be slow in speed and intensity vis-à-vis against low resistance and small range of motion with fewer repetitions.

Gradually the speed, the range of motion and the number of repetitions should
be increased.

Stationary bicycle/swimming are excellent rehabilitation and cardiovascular activities. This should be built up to 30 minutes of continuous pain free activity.

Ankle-to-toe walks

Heel walks

One-leg knee bends

Loop-stretch the band below the toes. Turn the ankle and foot outward. Repeat 10 times twice a day.

Loop band over the top of the foot at the base of toes. Pull the foot and toes up towards the shin as far as possible. Repeat 10 times twice a day.

Achilles tendonitis is a painful and debilitating injury/ affliction with serious consequences in certain cases.

Diagnosing the cause and undertaking treatment in the early part of the course of affliction is critical.

Pursuing a correct/ effective exercise regimen is crucial for achieving success in eradicating the cause.

The writer runs a pain management clinic in Chandigarh.
Email: chadha_r 2003@yahoo.co.in.

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Health Notes
Infant weight gain can predict later obesity

WASHINGTON: Rapid changes in weight during infancy increase children's risk of later obesity, says a new study.

According to a study led by researchers in the Department of Ambulatory Care and Prevention at Harvard Medical School and Harvard Pilgrim Health Care, as well as Children's Hospital, Boston, rapid weight gain during the first six months of life may place a child at the risk for obesity by age three.

"There is increasing evidence that rapid changes in weight during infancy increase children's risk of later obesity," says lead author Elsie Taveras, assistant professor in the HMS Department of Ambulatory Care and Prevention and co-director of the One Step Ahead clinic, a paediatric overweight prevention programme at Children's Hospital, Boston. — ANI

Slow-growing TB bacteria may pave way for new drugs

WASHINGTON: Scientists have found a large number of slow-growing mycobacterium tuberculosis bacteria in the lungs of TB patients which can pave the way for new medicines for treating the disease.

Dr Simon Waddell and his colleagues from the St George's University of London and the University of Leicester point out that scientists have always thought that M. tuberculosis bacteria in the lungs of TB patients are rapidly multiplying.

However, the researchers add, when they used gene chips to look at how TB bacteria behave in different environments, they observed that the bacteria in the sputum-phlegm coughed out of the lungs of the patients with the disease resembled the bacteria that are growing very slowly or hardly at all. — ANI

Gene that suppresses skin cancer growth identified

LONDON: Scientists at the National Institutes of Health (NIH) in the US have announced the discovery of a gene that suppresses tumour growth in melanoma, the deadliest form of skin cancer.

The finding was made as part of a systematic genetic analysis of a group of enzymes implicated in skin cancer, and many other types of cancer.

According to the analysis, one-quarter of human skin cancer tumours had mutations in genes that code for matrix metalloproteinase (MMP) enzymes. — ANI

Scientists unearth the factors that affect asthma

LONDON: A study has shed some light on how an enzyme prompts an allergic reaction and how a vitamin dampens the inflammatory effect in people with asthma.

A consortium of researchers led by Baylor College of Medicine in Houston found that the allergen breathed in by asthmatics triggers the enzyme MMP7, which activates a cascade of events to prompt an allergic reaction.

Dr Farrah Kheradmand and Dr David B. Corry, both of whom are associate professors of Medicine-Pulmonary at BCM as well as senior authors of the study report, point out that MMP7 particularly activates interleukin 25, a key mediator of the allergic response in the lung. — ANI

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