19th Jul 2014, 07:03 AM #1281
Re: Health Bulletin
FFR, Intravascular Imaging have improved treatment for heart blocks: Experts
Now there is no need to fret if you have a block in your heart as doctors say that not every block needs an open heart surgery or a stent.
Experts say that several new technologies and better imaging tools like the Fractional Flow Reserve and Intravascular Imaging have helped them get a closer view of the heart and decide whether a surgery or stent is required to correct the defect.
Earlier, doctors did an exercise test and angiography to assess blocks but the techniques had some limitations. "An exercise test is not useful when there are multiple blocks and an angiography can sometimes underestimate or overestimate blocks. So now a new technology called FFR is becoming popular," said Dr S Vijayakumar of Madras Medical Mission.
In the FFR technology, doctors introduce a guide wire into the artery of the patient and reach the block in the heart. The wire, which has a device attached to it, measures the pressure levels above and below the block and calculates the flow and feeds the data to a monitor.
"We just have to calculate the ratio of the two flows and if the result ranges between 1 - .8, then it is normal and the block is harmless. But if the result is below .8, then the block is significant and requires a surgery or stent," said the doctor. Another new technology that has changed the way blocks are diagnosed is Intravascular Imaging. "While angiography helps us ascertain a block only from outside the blood vessel, new imaging techniques enable us to capture images from inside the coronary artery and understand the severity of the block," said Dr S Mullasari Ajit.
He said MMM has established new modalities like intravascular ultrasound and optical coherence tomography (OCT) and 3D OCT Ilumien Optis to benefit the patients. "The 3D OCT imaging technique allows the doctor to have a 3D view of the blood vessel which helps us get accurate results and take a call on the way to treat the block," he added.
The doctor said MMM was also setting up the first 'core lab' for coronary and structural interventions in angiography and imaging for research purposes.
Dr Ajit added that a four-day symposium on advanced cardiovascular therapeutics would be held at the hospital on July 19 and 20 and on July 26 and 27 which would focus on Intravascular Imaging and transcatheter congenital and structural cardiac interventions.
19th Jul 2014, 07:03 AM #1282
Re: Health Bulletin
Gene that mediates ageing identified
In what could point towards the possibility of one day using therapeutics to combat ageing, researchers have found in animal models that a single gene plays a surprising role in ageing that can be detected early in development.
"We believe that a previously uncharacterized developmental gene known as Spns1 may mediate the ageing process," said Shuji Kishi, an assistant professor at The Scripps Research Institute (TSRI) in the US.
"Even a partial loss of Spns1 function can speed ageing," Kishi noted.
Using various genetic approaches to disturb Spns1 during the embryonic or larval stages of zebrafish, the scientists were able to produce some models with a shortened life span that lived long lives.
While most studies of "senescence" — declines in a cell's power of division and growth — have focused on later stages of life, the study is intriguing in exploring this phenomenon in early stages.
"Mutations to Spns1 disturbs developmental senescence and badly affects the long-term bio-chronological ageing process," Kishi said.
The new study shows that Spns1, in conjunction with another pair of tumour suppressor genes, beclin 1 and p53 can, influences developmental senescence through two differential mechanisms: the Spns1 defect was enhanced by Beclin 1 but suppressed by 'basal' p53.
In addition to affecting senescence, Spns1 impedes autophagy, the process whereby cells remove unwanted or destructive proteins and balance energy needs during various life stages.
The study appeared in the journal PLOS Genetics.
19th Jul 2014, 03:43 PM #1283
Re: Health Bulletin
Milk teeth stem cells help treat chronic diseases
Stem cells, which have the potential to protect from life threatening diseases, can be 'locked' within your family teeth. Now, dentists have introduced process to send milk teeth to Mumbai-based labs to harvest milk teeth for future use of stem cells.
Dentists claim that though only two samples have been collected by the Mumbai-based lab from the city but there has been a steep rise in the queries being raised by parents about the facility in the past three to four months.
With the discovery of stem cells in milk teeth, dentists claim that an accessible and available source of stem cells has been identified. A child's stem cells can be preserved from the milk teeth and can even be collected from impacted third molars till the age of 22.
Dr Om Shankar of Institute of Medical Science, BHU, maintained that stem cells can be obtained from any bone of the body and it can also be obtained from pulp (milk teeth) as well as blood. He said that a large number of stem cells were found in bone marrow and the number of less stem cells were found in blood.
He claimed that stem cell taken from pulp of teeth has many advantages as it could be transformed in different cells.
Ortho dentist Dr Abha Vishnoi Kesarwani said that parents have become aware about the fact that stem cells can be obtained from the pulp of milk teeth. Parents of new born and children ask about the course of action and expenditure needed for the process.
Research involving stem cells in teeth has exploded during last four and five years and the laboratories that will bank the cells in a deep-freezer have since began operating. Experts say that dental stem cells have the potential to treat different diseases including heart disease and leukemia In the near future, dental stem cells could grow new teeth and jaw bone.
Professor and head of the department of Forensic Medicine & Toxicology, MLN Medical College, Allahabad, U S Sinha said that stem cells can be taken from milk teeth for preservation. Preserving milk teeth is highly recommended as an all-time asset that can be used for treating a person or his/her siblings anytime."
As a Mumbai laboratory is providing special kits for preserving stem cell from milk teeth, city dentists have started harvesting milk teeth for stem cell preservation. City based dental surgeon Dr Vaibhav Shukla has collected milk teeth of two children aged about seven and nine years and sent to the Mumbai laboratory for preservation.
The deciduous tooth which has been extracted can be cut with a cryo knife to collect stem cells. This facility was not available in India till a few years back, but a medical lab at Mumbai has introduced the facility for preserving stem cell.
If experts use any other instrument instead of cryo knife, it produces heat that subsequently leads to destruction of stem cells. The stem cells contained within teeth are capable of replicating themselves and can be readily recovered at the time of a planned dental procedure.
Apart from being the most convenient stem cells to access, dental stem cells have significant medical benefits in the development of new medical therapies. Using one's own stem cells for medical treatment means a much lower risk of rejection by the body and decreases the need for powerful drugs that weaken the immune system.
The stem cells from teeth have been observed in research studies to be among the most powerful in the human body. Stem cells from teeth replicate at a faster rate and for a longer period of time than cells harvested from other tissues of the body.
Recently, parents of a boy suffering from muscular dystrophy approached the doctors to get his stem cell preserved. After the process, his treatment was started which is showing positive results.
Dr A K Santhani said that parents may not see the benefits of dental stem cell banking immediately, but it is the best investment and gift from parents to their children. Most of the families regret when their children face some chronic disease and their stem cells are not preserved at the time of birth. But now, stem cell preservation through milk teeth is offering a new hope.
It is a costly exercise and around Rs 85,000 is required for preserving stem cell from milk teeth. Doctors said that stem cells have shown potential in treating cardiovascular diseases, diabetes, Parkinson's disease, cancer, spinal cord injuries, retinal diseases, endocrinal disorders, renal disease, liver disorders, muscular dystrophy and many incurable diseases.
19th Jul 2014, 03:49 PM #1284
Re: Health Bulletin
Doctors prescribe stem cell cure for tumours
After extensively using stem cell therapy for treatment of leukemia, doctors are now pushing for using it to help cure solid tumours.
Doctors from various countries have congregated in the city to deliberate on the efficacy of using stem cells to treat the side-effects of chemotherapy, which, if given in high dosage, kills healthy cells as well.
"In several patients we have observed that the white blood cell count plummets following chemotherapy. This brings down the person's resistance to infections. By transplanting stem cells we could counter that," said Dr Ranjan Kumar Mohapatra, oncologist at Global Cancer Institute which is organising the two-day convention that begins on Saturday.
Doctors from various centres in Europe that specialise in stem cell therapy are participating in the convention.
Stem cells are produced in the bone marrow and can develop into cells with different skills. Stem cell transplants help people with severe blood or immune system illnesses. They can also help people with non-cancerous diseases, such as serious immune deficiency problems, autoimmune diseases (like lupus), or blood disorders (thalassemia or sickle cell disease for example).
However, stem cell transplant to help fight solid tumours is still at its nascent stage in India, say a section of doctors. "We are working on using this treatment for helping cure breast cancer," said Dr Giovanni Rosti, director of a medical oncology unit in Treviso, Italy. "We need to do more research on this line, but to do that doctors need to sit up and realise the importance of this therapy," he said.
Doctors say the procedure is reserved for patients who are critical. "It is commonly administered to patients who are already resistant to standard forms of therapy such as chemotherapy," said Dr Mohapatra.
At the conference, oncologists from Europe and India will share their expertise and insights. As the treatment is still at its nascent stage, the cost incurred can go up to Rs 10 lakh. Doctors say with more studies on this line, the treatment would become cheaper.
20th Jul 2014, 02:12 PM #1285
Re: Health Bulletin
Doctors back right to die, want say in Supreme Court hearing
The Indian Society of Critical Care Medicine (ISCCM) has filed a petition in the Supreme Court to be impleaded as a party in the case on withdrawal of life support to terminally ill patients. The petition will be taken up at the next hearing of the case.
"Doctors have to be a part of this debate as this is primarily between doctors and patients. As doctors we cannot let our patients' rights be scuttled. We are denying people a fundamental right to manage their death according to their wishes. This time we will not sit passively; we will reach out to the public and explain to them how legal opinions have been skewed," said Dr RK Mani, former president of ISCCM and lead author of its position paper on end of life and palliative care in intensive care units.
The Supreme Court is hearing a plea by NGO Common Cause that a person afflicted with a terminal disease should be given relief from agony by withdrawing artificial medical support provided to him. A five-judge bench issued notice to all states and Union territories, widening the debate on the issue.
"Our position is that if it is a terminal illness and there is suffering, there might be no point in continuing aggressive treatment. Of course, this is dependent on the advice of doctors and also depends on the age of the patient, the kind of illness and so on. It is a complex issue that cannot be simplified in a mathematical formula. We are asking for the right to die with dignity and to die without suffering, just as people have the right to live with dignity," said senior advocate Shekhar Naphade, who has filed the petition on behalf of ISCCM.
Dr Mani said that the right terminology was end-of-life decisions and not euthanasia, whether passive or active. "We need to get rid of this word euthanasia which has a Nazi hangover. The word is complicating matters. What we are debating is not euthanasia of any kind as that term is only applicable to a conscious person who is very ill who is asking a doctor to inject him because he feels it is intolerable," explained Dr Mani.
In 2012, a paper published in Indian Journal of Critical Care Medicine suggested detailed guidelines on end-of-life decisions. The paper was meant "to develop an ethical framework and practical procedure for limiting inappropriate therapeutic interventions to improve the quality of care of the dying in the intensive care unit through a professional consensus process".
"We don't need to reinvent the wheel. We just need to look at all the material on the subject published by medical experts and respected medical bodies across the world," sai
20th Jul 2014, 02:19 PM #1286
Re: Health Bulletin
High-fat diets get popular as science turns love on saturated fats
Gautam John's breakfast this morning consisted of four eggs, scrambled and piled with generous portions of butter and cream, and a dash of pesto. Dinner will be chicken curry, which he'll top with a "lot of fat", preferably ghee. The gravy preparation will be teamed with a scant helping of green, leafy vegetables.
The 35-year-old Bangalorean isn't looking to bust the weighing scale. In fact, thanks to this diet (yes, you can call it that) rich in saturated fats, animal products and dairy, he is almost 30 kg lighter than he was 18 months ago.
The 5 ft 10' Gautam, who now weighs 80kg, is one of a small but growing club of Indians who have taken to the revolutionary Ketogenic diet which raises a toast to high-fat (darker meats, oily fish, butter, cream, cheese and nuts), turning traditional dietary norms on its head. It advocates that the consumption of carbohydrates be kept at 'low' or 'no' (no more than 5% of daily intake).
Is fat then the new diet fad?
The Keto way is topping popularity charts in the West, most notably in the United States. The diet — high-fat, adequate-protein and low/no carbs — first used to treat paediatric epilepsy, is now the go-to fare for weight watchers. When starved of carbohydrates, the body is forced to burn fat, which is broken into fatty acids, replacing glucose as the primary energy source.
Gautam, who works at the Akshara Foundation, says he has suffered no adverse side-effects from the diet. He is quick to caution, however, that some people go down with 'Keto flu' characterized by headaches, brain fog, an upset stomach and a general feeling of lethargy in the early days of following the diet, when the body is still getting used to burning ketones instead of glucose.
While diets dominate coffee table discussions in urban India and the fads are all given their due, the traditional route with some variations is what most folks like to tango with. Dieticians too like to harp on the "if grandma said it was good and if they ate it in their time, then it will work for you too" premise.
Gautam says he decided on Keto as the time-tested method of 'eat less, work more' wasn't working for him. "How on earth does one have the energy to exercise more when he eats less?" he asked, "There's only so much of the green, leafy stuff that I'm willing to eat in a day. That's a really boring plan and I'm hungry in no time at all. I don't feel hungry all day when I follow the Keto diet."
Performance nutritionist Ryan Fernando, whose client list includes Olympic medalist wrestler Sushil Kumar and India opening batsman Shikhar Dhawan, wonders if the Keto diet would work extensively for Indians whose genetic make-up, by and large, doesn't take kindly to fat. Fernando explains that APOE (cholesterol gene) is very prevalent among Indians, pointing out that the three avatars of the gene determine how the body metabolizes fat, deciding whether or not it works for the individual. While some people metabolize even bad fats (like fried food) there are others for whom fatty foods (red meat and dairy) simply don't work.
The other popular diet — in this age of revolutionary recommendations — is the Paleo diet, also known as the Stone Age or caveman diet, and not far removed from Keto. It is based on the premise that if our Paleolithic ancestors didn't eat something, we shouldn't either. The belief is human digestions hasn't evolved enough to digest foods such as grains, legumes and dairy, more so the highly processed and high-calorie food that came with the advent of agriculture and domestication of animals.
The anti-argument to that is: Many new-age scientists believe one reason why human brains have developed to such an extent is because of food being cooked — it took less energy for the body to break cooked food down and resulted in an energy saving, which was spent in the brain being developed.
The diet with many takers this summer is the 'raw food' fix, tipped as the best detox. The diet is based on the belief that uncooked food recharges the body. Although most of the food must be eaten raw, heating is acceptable as long as the temperature stays below 104 to 118 degrees Fahrenheit. The food chart includes raw animal products such as milk, cheese (made from raw milk), sashimi or ceviche (raw fish, marinated with the juices of lime and spice). The fruit and vegetable options make the diet easy for vegetarians to follow. Some people eat only raw foods, while others include cooked food for variety and convenience. The percentage of raw food is usually 70% or more of the diet.
Detox diets are generally followed for three to 21 days. Duchess of Cambridge Kate Middleton reportedly goes for a detox once or twice a week, which is believed to be the reason for her fabulous figure.
It's sugar, not fat then, that's the new enemy. Sugar is being blamed for everything from diabetes to heart disease and weight-related issues. On the other hand, epic apologies are being written out to saturated fat. When consumed in moderate portions it doesn't clog arteries or break hearts, it is in fact beneficial to the heart.
Earlier this year, reports came in saying researchers have reviewed 72 different studies on more than 600,000 people from around the globe, and found little evidence to support medical guidelines that recommend people limit their consumption of saturated fats in order to prevent heart disease. Celebrated food writer Michael Pollan busted the 'saturated fats are evil' myth in his book In Defense of Food.
Dr Sheela Krishnaswamy, nutrition and wellness consultant, says high-fat, high-protein diets work when the goal is to lose weight. The Bangalore-based doctor, however, warns, "These kind of diets don't offer long-term solutions. It might work for a while, but it runs its course eventually. As a race Indians follow a high-carbohydrate diet, while in the West they feast on fat and protein. We definitely need to decrease our intake of sugar and starch, but I'm not sure swinging the other way is the answer. It's about eating right. I also stress on quantity. Very often, especially given sedentary modern lifestyles, we eat more than we burn."
Raksha Satish, a 37-year-old IT professional who has been on a diet all her life, says she's done it all from the week-long GM detox to cabbage soup.
"I'm a vegetarian and I haven't tried the Keto diet yet," she says. "What works best for me is eating right and eating just enough to get me through the day. I know that some people who follow the Keto diet usually consume some form of sugar just before they exercise because they need the glucose. I run three days a week and gym the other three so I definitely need a reasonable amount of carbohydrates in my diet." She says that outside of keeping her consumption of carbohydrates low (or just enough) she doesn't over- or under-use any other food group. "I find this hassle -free, especially when I go out for a meal with family and friends. I can eat what I want."
American TV personality Kim Kardashian, who is reported to have lost 50 pounds of her pregnancy weight following the Keto diet, raised its profile. Interestingly, no athlete has come forward to hail this course correction as the way forward.
Fernando points out that sportspersons or even those of us who exercise hard every day, need to consume a certain amount of fat. "One of the key molecules in the body is testosterone, which is formed from cholesterol. If you limit fat, you hinder production of cholesterol," he said, "One of the functions of fat is that it works as an anti-inflammatory substance. Muscles can undergo microscopic trauma which leads to inflammation at the core level, not seen by the human eye. A good Omega 3 diet will ensure better anti-inflammatory action."
Even if the Keto diet — bring the butter to the table, but keep the bread in the tray — is the titan of the time in this watch-what-you-eat world, good health is all about a healthy balance. "Carbohydrates, protein and fat are all a daily requirement as are micro nutrients. It's important to get the balance right," stresses Krishnaswamy.
20th Jul 2014, 08:46 PM #1287
Re: Health Bulletin
Researchers make in vitro fertilisation safer for women
Researchers could have just made IVF — an assisted fertilisation therapy — treatment safer for women after successfully using a new method to stimulate ovulation.
"Our study has shown that natural hormone 'kisspeptin' can be used as a physiological trigger for egg maturation in IVF therapy, said Waljit Dhillo, a professor in endocrinology and metabolism at London's Imperial College.
The team have given the gift of life to 12 couples using a new injection of the natural hormone 'kisspeptin' to make their eggs mature.
Currently doctors use the hormone called human chorionic gonadotropin (hCG) for in vitro fertilisation (IVF), but there is a risk that this can over-stimulate the ovaries and threaten the mother's life.
Ovarian hyperstimulation syndrome (OHSS) affects around a third of IVF patients in a mild form, causing symptoms such as nausea and vomiting.
Less than 10 percent of patients experience moderate or severe OHSS which can cause kidney failure.
"OHSS is a major medical problem. It can be fatal in severe cases and it occurs in women undergoing IVF treatment who are otherwise very healthy. We really need more effective natural triggers for egg maturation during IVF treatment, and the results of this trial are very promising," Dhillo explained.
Kisspeptin is broken down more quickly inside the body, meaning the risk of over-stimulation is lower.
According to Alison Harper, one of the mothers who participated in the study, "I went through several cycles of IVF previously but the one in the trial was the least uncomfortable — it was less painful and I felt less swollen."
The study was published in the Journal of Clinical Investigation.
21st Jul 2014, 12:43 PM #1288
Re: Health Bulletin
69% people found deficient in vitamin D: Study
Deficiency of sunshine Vitamin D is found prevalent in around 69 per cent of the population.
SRL Diagnostics a leading healthcare diagnostics player in India, conducted an extensive analysis of vitamin D reports from 37,010 people from four zones across India, only to discover that Vitamin D deficiency was prevalent in around 69 per cent of the population.
Meanwhile, 15 per cent more were found to be vitamin D insufficient, taking the total proportion of risk-prone Indians to 84 per cent.
"There are diagnostic tests to determine Vitamin D levels in the body. It is extremely essential to keep a check on the levels of deficiency in the body as it helps retain calcium. Sufficient vitamin D levels assist the body in reducing bad cholesterol and increasing good cholesterol, besides helping in the essential repair and maintenance activities in the body. It is directly linked to knee pains and osteoporosis," said B R Das, president (research and innovation), SRL Diagnostics Limited.
Doctors also point out that vitamin D directly benefits patients with diabetes and cardiovascular ailments. A sizeable body of evidence proves the link between vitamin D and people with diabetes and heart ailments. The human body's ideal dose of Vitamin D ranges between 1,000 and 2,000 IU (International Units) per day.
21st Jul 2014, 12:48 PM #1289
Re: Health Bulletin
That we use 10% of our brain is an urban myth?
In a sombre and authoritative academic tone, Morgan Freeman's latest movie character delivers the following line: "It is estimated most human beings only use 10 per cent of the brain's capacity. Imagine if we could access 100 per cent. Interesting things begin to happen".
As a conceit for the director Luc Besson's new sci-fi thriller Lucy, this often-quoted idea has obvious Hollywood potential. It also drove the plot of the 2011 thriller Limitless, starring Bradley Cooper. But according to leading neuroscientists, the idea that we only use a fraction of our brain's computing power is nothing more than an urban myth.
Lucy, which is released next month, stars Scarlett Johansson as a woman who is kidnapped and implanted with a drug that unleashes her untapped brainpower, allowing her to control time, execute bad guys with worrying ease, and deliver some vicious beatings.
But according to Barbara Sahakian, professor of clinical neuropsychology at the University of Cambridge, the idea that we only use a small percentage of our brain "doesn't make any sense".
"It's impossible to work out how much of our brain we are using quantitatively. However, it is definitely much more than 10 per cent," Professor Sahakian said.
The 10 per cent figure, she explains, is purely "artificial" and was first widely circulated in Dale Carnegie's 1936 best-selling book, How to Win Friends and Influence People. It is thought that Carnegie simply made up a figure, to substantiate a point in his book.
The erroneous percentage could also come from a misunderstanding about how most of our brain cells work. According to neuroscientists, 90 per cent of the cells in our brains are support cells, called glial cells, which provide nutrients to the other 10 per cent, which are the neurons. Neurons are the cells which produce thoughts. In short, they are our grey matter.
Professor Sahakian does agree that we don't always use our brains to their full potential, however: "Most of the time we are operating far below our maximum brain capacity due to various factors, including tiredness." She points to a recent study of school-age children which found "their maths and reading improved with exercise".
She added: "It is not just the brain's productivity improving; the brain is also doing better."
Sahakian also explains how so-called "smart drugs" could play an important role in the future. She said, "Currently, we can enhance our cognition with smart drugs, we can enhance our alertness, attention, memory and executive functions such as planning and problem solving. In the future, we will have drugs that can produce even greater enhancements with no, or low, side effects. It is highly likely that at that time, smart drugs will be in common use."
The "10 per cent" myth is apparently still widely held among the American public, with a survey last year by the Michael J Fox Foundation for Parkinson's Research finding that 65 per cent of Americans believe it to be true - 5 per cent more than believe in evolution.
According to Barry Gordon, a neurologist at John Hopkins University in Baltimore, people like to believe the 10 per cent myth so they can blame their shortcomings on supposed useless parts of their own brain.
21st Jul 2014, 07:10 PM #1290
Re: Health Bulletin
Oral cancer claims one life every six hours in India
One person dies every six hours due to oral cancer in the country, signalling an alarming rise in the incidence of the disease, according to a top orthodontist.
The situation could be still graver as many cases of the disease went unreported, Secretary-General of the Indian Dental Association Dr Ashok Dhoble told PTI from Mumbai.
"Cases of the disease and deaths resulting from it in rural areas and among the poorer sections of society are hardly registered," he noted.
He pointed out that with the high prevalence of smokers and widespread use of other chewable tobacco products, India has seen a steep growth in the number of oral cancer patients in the past decade.
In fact, Dr Dhoble said, oral cancer approximated to 40 per cent of all cancer-related disease in the country with the Northeastern states mostly affected.
"All Northeastern states are badly affected by the disease. The states like West Bengal, Andhra Pradesh, Gujarat and Tamil Nadu are also affected," he said, adding every third person in these states used tobacco-related products.
Talking about measures to curb the prevalence of the deadly disease, he said that nothing short of a total ban on the use of tobacco was the only way.
"There is no other way to curb oral cancer... You have to ban tobacco in its every form," Dr Dhoble said, pointing out that it was the nicotine present in the tobacco which made it addictive and difficult to kick the habit.
"Our government also understands the problem... But the huge number of people employed with the tobacco industry is the problem... The government has to provide them with an alternative livelihood and then ban tobacco totally," he said.
He said a dentist was the first person to diagnose it since oral cancer was not just limited to teeth, but mouth, tongue and integral part of pharynx and gums as well.
The orthodontist explained that oral cancer was 100 per cent curable only if it was reported in the first stage. But once it slips into the second stage, the patient is left with a life span of just five years.
"I will advise people to visit a dentist and not to ignore even if there is a slight problem in the mouth... But above all they have to give up using tobacco in every form. That's the best medicine," Dr Dhoble said
Stressing the need to educate people on the disease, he said that the Indian Dental Association, which will hold the FDI Annual World Dental Congress in Delhi in September, had been conducting awareness camps and counselling people for the last five years.