24 April, 2013

Indian hip fracture patients at high mortality risk

An Indian study has found that 30.4 per cent of hip fracture patients died within one year, with the majority of deaths occurring within the first six months after fracture, and survivors had high rates of functional impairment.

In various studies across different countries the reported one year mortality risks after hip fracture can vary anywhere from 5 to 50 per cent. In India, however, there has been little research on the risk of mortality and functional impairment following hip fracture.

In an oral presentation held during the European Congress on Osteoporosis and Osteoarthritis in Rome, Italy, held from April 17 to 20 in Rome, Italy, researchers from Maulana Azad Medical College, New Delhi, India presented findings from a prospective study which found that patients had a high rate of one-year mortality and functional impairment.

The study included 188 patients (mean age 64.67, 60 per cent women) with fragility hip fracture admitted to the hospital over a three and half-year period.

The follow up on 174 of these patients showed that 30.4 per cent had died within one year, with the majority of deaths occurring within the first six months after fracture.

Only around one-fifth of the patients were able to return to normal motor function. The remaining needed assistance for their daily life activities: 13.7 per cent were bed ridden, 14.9 per cent could only walk with a cane, and 19.5 per cent required a walker (zimmer frame).

The findings have been published in `Osteoporosis International.

Source: www.timesofindia.com

24.04.2013

Mushrooms superior than Vitamin D

Mushrooms are a good source of vitamin D2 and is as effective as taking vitamin D supplements.

Vitamin D intake is crucial to the process of calcium absorption and maintaining healthy bones.

Vitamin D helps the body in maintaining bone density thus reducing the risk of fracture, osteomalacia, osteoarthritis and osteoporosis. The nutrient also plays an integral role in modulating the immune system to help fight infections like the flu and reduces the risk of many common diseases including cancer, cardiovascular disease, depression and diabetes.

For the study, researchers from Boston University School of Medicine (BUSM) studied the data obtained from 30 healthy adult participants who were asked to take vitamin D supplements or vitamin D2 mushroom powder. The participants were randomly selected to take either vitamin D2, vitamin D3 or the mushroom powder for 12 weeks. At the end of the study, there was no difference in the amount of vitmamin D found among the paricipants.

"These results provide evidence that ingesting mushrooms which have been exposed to ultraviolet light and contain vitamin D2, are a good source of vitamin D that can improve the vitamin D status of healthy adults. Furthermore we found ingesting mushrooms containing vitamin D2 was as effective in raising and maintaining a healthy adult''s vitamin D status as ingesting a supplement that contained either vitamin D2 or vitamin D3," said Michael F. Holick, PhD, MD, the principal investigator of the abstract.

According to Holick and his coauthors, ingesting mushrooms containing vitamin D2 can be an effective strategy to enhance a persons'' vitamin D status. "The observation that some mushrooms when exposed to UVB light also produce vitamin D3 and vitamin D4 can also provide the consumer with at least two additional vitamin Ds," he added.

In a second poster presentation, the researchers were able to determine how mushrooms make vitamin D2 and found that the process is similar to what occurs in humanskin after sun exposure. They were also able to show that mushrooms not only produce vitamin D2, but can produce vitamin D3 and vitamin D4.

"Although it has been previously reported that mushrooms have the ability to produce both vitamin D2 and vitamin D4, through our own research we were able to detect several types of vitamin Ds and provitamin Ds in mushroom samples including vitamin D3 which is also made in human skin," added Holick.

The study will be presented at the American Society for Biochemistry and Microbiology annual meeting in Boston.

Source: www.timesofindia.com

24.04.2013

The loss of enemies does not compensate for the loss of friends

Abraham Lincoln

22 April, 2013

How to prevent kidney stones in summer

In India, approximately 5 to 7 million patients suffer from kidney stone disease and at least 1/1000 of Indian population needs hospitalisation due to kidney stone disease.

We rarely associate kidney stones with the rise in temperature and humidity. "The incidence of kidney stone cases rises by 40% during summer due to rise in temperature. Climate, temperature and humidity are important factors that contribute to kidney stones," points Dr. Abhinandan Sadlalge, Chief Urologist, RG Stone Urology and Laparoscopy hospital.

People who work in a hot environment or have a work routine that does not allow them to have enough water are prone to develop stones. Specifically a 5 to 7 degree temperature rise due to climate change could yield a 30% increase in kidney stone problems. When people relocate from areas of moderate temperature to areas with warmer climates, a rapid increase in stone formation has been observed. There is a known geographic variation in stone disease that has been attributed to regional differences in temperature. The incidence of kidney stone disease is particularly high in areas with dry, hot climate.

Dr. Abhinandan chalks out 9 steps to prevent kidney stones

1. Drink plenty of water during the day and at night before bed so that your body stays hydrated throughout each 24-hour period.

2. Drink lemonade as this has been shown to reduce the risk of kidney stones

3. Cut back on products with large amounts of oxalate - an acid that can lead to the formation of calcium oxalate kidney stones. These include products like drinking soda, iced tea, chocolate, rhubarb, strawberries and nuts.

4. Cut down the intake of caffeine as it leaves you dehydrated even though you think you are taking in plenty of liquids.

5. Reduce the salt intake and make that a regular habit

6. Ask your physician about medications that can help prevent kidney stones. Medications include those that control the amount of acid, alkali or cystine in the urine - factors that can cause kidney stones to develop.

7. Check your intake of animal protein, including meat, eggs, and fish. These foods contain purines, which are natural substances that metabolise or break down into uric acid.

8. Have more salads as it maintains the coolness levels.

9. Exercise and lose weight and stay healthy

Source: www.timesofindia.com

22.04.2013

Now a special course on family medicine: Health Ministry

In an effort to bridge the gap between the need and availability of doctors, the health ministry is promoting courses in family medicine for medical practitioners, an official said. ‘There is a gap between the need and availability of doctors,’ T. Sundaraman, executive director of the National Health Systems Resource Centre (NHSRC), told reporters at a two-day National Rural Health Mission-sponsored conference that began here Saturday.

The conference will give information about a two-year diploma and a three-year degree course in family medicine for medical practitioners, he added. Delegates from India, Nepal, Pakistan and Sri Lanka are participating in the conference. ‘While there are very few doctors available in rural areas, in urban areas it is mostly specialists. There are very few practitioners of good old family health care,’ Sundaraman said.

‘The hospitals are for people who are rich and can afford it. People in small cities and rural areas go to quacks.’

Raman Kumar, president of Academy of Family Physicians of India, said: ‘India is moving towards Universal Health Coverage (UHC) and National Health Mission (NHM). Multi-skilled and competent primary care providers and their knowledge figure prominently in the evolving schemes, themes and initiatives of our health care systems’.

‘Current health care scenario in India is staring at a crisis, as patients face increasing health care expenses due to the skewed emphasis on hospitals and super-speciality care,’ said Santanu Chattopadhyay, founder and CEO of NationWide Primary Healthcare Services Pvt Ltd. ‘Much of this expense can be avoided if the primary care provision is strengthened, which can only happen when we have a robust system for training and producing more family physicians,’ he added.

Source: http://health.india.com

22.04.2013

When it is not necessary to change, it is necessary not to change

Lucius Cary Falkland

17 April, 2013

Ice therapy can treat lung cancer?

Frozen balls of ice can safely kill cancerous tumours that have spread to the lungs, according to the first prospective multicenter trial of cryoablation.  Cryoablation is a process that uses extreme cold to destroy or damage tissue.

"Cryoablation has potential as a treatment for cancer that has spread to the lungs from other parts of the body and could prolong the lives of patients who are running out of options," said David A Woodrum, author of the study and interventional radiologist at the Mayo Clinic in Rochester.

"We may not be able to cure the cancer, but with cryoablation we can at least slow it down significantly and allow patients to enjoy greater quality of life longer," he added.

Metastatic lung disease is difficult to treat and often signals a poor prognosis for patients.

In the initial results of the study trial, 22 subjects with a total of 36 tumours were treated with 27 cryoablation sessions.  Cryoablation was 100 per cent effective in killing those tumours at three-month follow-up. Follow-up at six months on 5 of the 22 patients (23 per cent) showed the treated tumours to still be dead.

Cryoablation is performed by an interventional radiologist using a small needle-like probe guided through a nick in the skin to cancerous tumors inside the lung under medical imaging guidance.  These tumours have spread - or metastasised - to the lung from primary cancers in other areas of the body. Once in position, the tip of the instrument is cooled with gas to as low as minus 100 degrees Celsius.

The resulting halo of ice crystals can destroy cancer by interrupting its cellular function, protecting nearby healthy, delicate lung tissue. Lung cryoablation has been promising in part due to the low periprocedural morbidity.

"Most of these patients can go home the day after their cryoablation treatment and resume their normal activities," Woodrum said, noting that researchers plan to continue to follow patients for up to five years.

While cryoablation is being developed for the treatment of metastatic lung cancer, the future looks brighter for individuals who once had nowhere else to turn, said Woodrum.

Source: www.indianexpress.com

17.04.2013

'Too much sugar in diet can make you look older'

Increase in blood sugar levels can make you look way older than you actually are, a new study has claimed. According to the study, published in the journal Age, blood glucose levels are directly related to how old a person looks.

Researchers studied 670 people between aged between 50 and 70, and found that for every increase in blood glucose levels of 1 millimole per litre, the participants looked about 5 months older, 'MyHealthNewsDaily' reported.

Another study looked at glycation - a process in which blood sugars attach to proteins and form undesirable molecules called Advanced Glycation End-products (AGEs).

It found that glycation is linked with visible signs of ageing, the report said. An earlier study, published in the British Journal of Dermatology, found that the collagen and elastin proteins that keep skin looking supple and youthful are the most susceptible to damage from the glycation process.

Experts say if you want to keep your youthful appearance, it's time to cut back on your sugar consumption.

However, that does not mean that sugar is evil. It is just a carbohydrate. It's how we use, or overuse, that carbohydrate that matters, they say.

Source: www.indianexpress.com

17.04.2013

To be ready to fail is to be prepared for success

José Bergamín

16 April, 2013

What to avoid daily for high blood pressure?

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High blood is serious issue and should not be ignored. There are several reasons why you have high BP in the first place - the most prominent is stress and unhealthy habits.

Mental health therapy can fight stress and healthy habits can control and reduce high BP. In order manage and control high blood pressure, Dr. Arvind Agarwal, Senior Consultant with Internal Medicine from Sri Balaji Action Medical Institute shares a brief list of dos and don'ts for high blood pressurepatients.

When it comes to a healthy and right diet, Dr. Arvind recommends, "Diet should be rich in fruits, vegetables, whole grains and low dairy products. Food can include meat, fish, poultry, nuts and beans." This diet seems feasible but find out what you need to avoid control and reduce high blood pressure. Dr. Arvind also adds, "People should avoid red meat, sugar-sweetened beverages, processed food."

Interestingly if you follow a strict diet to control and reduce high blood pressure to can minus the effect drastically, "If this diet regimen is followed it can reduce systolic BP by 11 and 6 mm Hg in hypertensive population."

Another way to reduce high blood pressure is to up the level of physical fitness. "Exercise is very essential for high BP patients", says the doctor. "It is recommended that one should go for brisk walks for 30 minutes every day for 5 days a week. Also, one should take the stairs whenever possible instead of using the elevator," suggests Dr. Arvind.

In case you are a regular gym-goer or plan to exercise at the gym then this is what he says, "It is advisable that a high BP patient should avoid any form of weightlifting exercises." Inform your trainer of your physical condition, and if you feel uneasy or dizzy stop your workout immediately.

Dedication plus discipline equals success when it comes to lowering high blood pressure.

Source: www.timesofindia.com

16.04.2013

UK surgeon warns India about increasing heart disease risk

Professor Sir Roger Boyle, a former Director of Heart Disease for the UK Government, warned a meeting of India’s leading cardiologist in Kolkata on Sunday that their country faces ‘a tsunami of heart disease’ unless they urgently implement effective measures for prevention and treatment. Heart disease is the number one killer in India, currently accounting for a fifth of all deaths; by 2020, this figure is predicted to rise to a third¸ making India ‘the heart disease capital of the world’. Worse still, many of those dying are relatively young: heart disease in India is occurring 10 to 15 years earlier than in the West.

The policies championed by Prof Boyle in the UK were instrumental in halving deaths due to heart disease over an eight-year period. Whilst acknowledging the differences in healthcare systems between India and the UK, he believes that many of the policies for which he was responsible for implementing in the UK could also be applied here to significant effect. Most importantly, medical professionals need to engage government at both a national and local level to agree on a concerted plan of action for both the prevention and treatment of heart disease.

There should also be good quality data monitoring put in place to accurately track its success. Prevention of heart disease needs to be achieved through promoting the adoption of more healthy lifestyles (a diet involving less fat and more fibre; increased amounts of exercise; less tobacco chewing); and routine screening of everyone over 40 with suspected risk factors (a family history of heart disease; overweight; high blood pressure; high cholesterol). Treatment of established heart disease needs to include effective lowering of both blood pressure and cholesterol, which could be cost-effectively achieved with the use of relatively cheap generic drugs.

‘India is facing a tsunami of heart disease in the very near future unless effective action is taken to reduce both the prevention and treatment of this condition over the long term’, commented Prof Boyle. ‘Quite a apart from the human cost, this makes a lot of sense economically: in the UK, the cost of effectively promoting the concept of lifetime risk assessment has proved to be only a fifth of the resulting savings due to improved economic productivity and reduced chronic treatment plus social care costs.’ Professor Boyle has been supported on his visit to India with an educational grant from Biosensors International, a global medical device company specialising in interventional cardiology.

Source: http://health.india.com

16.04.2013

The secret of happiness is to admire without desiring

Bradley

15 April, 2013

Indian-American doctors seek end to physician shortage in the US

An influential group of Indian-American doctors has proposed a comprehensive legislative agenda to end the shortage of physicians in the US, which would need a staggering 130,000 doctors by 2025. Members of the American Association of Physicians of Indian Origin (AAPI), representing thousands of Indian-American doctors, spent Thursday in the Capitol Hill meeting lawmakers to press their agenda. This includes a provision for green cards for physicians graduating from accredited US residency programmes in the proposed comprehensive immigration reform bill.

The Association of American Medical Colleges (AAMC) predicts that America will need 90,000 physicians by 2020 and a staggering 130,000 by 2025. Among other things AAPI urged the lawmakers to support two bills in the house and the senate introduced by Democrat House member Joe Crowley and Democrat Senator Bill Nelson to address the shortage of physicians. Crowley, co-chair of the Congressional India Caucus, who has sponsored the ‘Resident Physician Shortage Reduction Act of 2013,’ assured AAPI members that he would work for their legislative agenda.

Other lawmakers who addressed the doctors’ conclave included Republicans Phil Gingrey and Phil Roe and Democrats Jim McDermott, Frank Pallone, and Zoe Lofgren. AAPI has also suggested making the J-1 visa waiver programme — that allows international medical graduates to do their medical training and residency in the US — permanent; an increase in residency positions and the enrollment in medical schools and providing a permanent fix to the medicare sustainable growth rate (SGR) formula.

Source: http://health.india.com

15.04.2013

Pakistani girl undergoes liver transplant procedure in India

Madhia Tariq, 16, had no hope of survival when she slipped into a coma after collapsing in her Lahore school in January due to acute liver failure. An air ambulance from Delhi brought the young Pakistani student to India — and back to life. Madhia underwent a liver transplant at the capital’s Indraprastha Apollo hospital where a team of 18 doctors operated upon her. Her brother Rizwan donated almost half his liver to her Feb 3.

Madhia had developed acute liver failure due to Hepatitis A. She was off the ventilator within 24-hours after the surgery and started eating the next day. Over the following weeks, her condition improved and she is now ready to fly home to Pakistan. ‘The process of sending an air ambulance to Pakistan, arranging visas for the entire family and taking a decision on the transplant took just 48 hours, which were very crucial,’ said Anupam Sibal, senior paediatric gastro-enterologist, at the Apollo Hospitals.

He said it was the first time that Apollo Hospitals had sent an air ambulance to any foreign country to pick up a liver transplant patient. ‘The entire government machinery in both India and Pakistan was extremely helpful,’ he said. Neerav Goyal, who operated upon Madhia’s brother Rizwan, 25, said undergoing a donor surgery is also very major. It is usually the family members who are the donors.

According to Madhia, her experience in Delhi has strengthened her desire to become a doctor. The Pakistani teenager and her mother and brother are grateful to the Indian doctors for giving her a second life. With this transplant, the Indraprastha Apollo hospitals has completed 350 liver transplant cases of Pakistani patients, Sibal said. ‘Pakistani patients form the second largest chunk of patients from any country after India, who have undergone successful liver transplants in our hospital,’ he said.

The hospital has conducted 1,281 liver transplants in children and adults since the first one in 1998, he added.

Source: http://health.india.com

15.04.2013

Your future is created by what you do today, not tomorrow

Robert Kiyosaki

13 April, 2013

Stem cell jab could help cure heart disease

For the first time, scientists have successfully tested a revolutionary new treatment in heart patients, paving way for a stem cell jab to treat heart diseases.

The heart failure breakthrough involves injecting patients with their own stem cells.

In a quick and easy procedure, doctors take bone marrow from the patients' hips before injecting them directly into the heart to strengthen the muscle, the media report said.

With the new ground-breaking treatment at the Mayo Clinic's Centre for Regenerative Medicine in Rochester, Minnesota, heart pumping function improved within six months for every patient.

The patients also enjoyed improved fitness and could walk longer distances, researchers said.

"I think it's an exciting time where regenerative medicine is no longer science fiction. This study is providing clinical evidence for a new approach in cardiovascular regenerative medicine," Dr Andre Terzic, lead researcher of the study, said.

During the trial, 45 heart failure patients were treated with a special type of stem cell harvested from the top of the patient's hip.

Researchers used proteins to instruct the stem cells to behave like heart cells and then injected them into the patient's heart.

All the patients saw greater improvement in their heart health than another group given the standard treatments for heart failure. The amount of blood pumped out with each heartbeat increased by a dramatic seven per cent.

The study was published in the Journal of the American College of Cardiology.

Source: www.indianexpress.com

13.04.2013

People with apple-shaped bodies at risk of kidney disease

High blood pressure in the kidneys of people with apple-shaped bodies may put them at an increased risk of developing kidney disease later in life, according to a new study.

The study published in the Journal of the American Society of Nephrology (JASN) suggests that these individuals may benefit from treatments that reduce kidney blood pressure.

People with "apple-shaped" bodies - when fat is concentrated mostly in the abdominal area - are more likely than those with "pear-shaped" bodies to develop kidney disease.

To study the issue, Arjan Kwakernaak, from University Medical Center Groningen, in The Netherlands and his colleagues looked for links between waist-to-hip ratio, which reflects central body fat distribution, and kidney measures in 315 healthy individuals with an average body mass index of 24.9 kg per square metre.

Higher waist-to-hip ratios were associated with lower kidney function, lower kidney blood flow, and higher blood pressure within the kidneys.

"We found that apple-shaped persons - even if totally healthy and with a normal blood pressure - have an elevated blood pressure in their kidneys. When they are also overweight or obese, this is even worse," said Kwakernaak.

This suggests that elevated blood pressure in the kidneys of individuals with apple-shaped bodies may be responsible for their increased risk of developing kidney disease later in life.

Previous studies have shown that high blood pressure in the kidneys can be treated through salt restriction or with drugs that block what is known as the renin-angiotensin-aldosterone system.

"Our current data suggest that such interventions could be particularly useful in subjects with a central body fat distribution," said Kwakernaak.

Source: www.indianexpress.com

                                                     13.04.2013       

Criticism is always easier than constructive solutions

Jaron Lanier

12 April, 2013

Father of IVF Robert Edwards passes away

British scientist Robert Edwards, known as ‘father’ of world’s first test-tube baby breathed his last on Wednesday, the Cambridge University announced. The 87-year-old died following prolonged illness. Edwards, who was awarded Nobel Prize for his pioneering work in developing in vitro fertilisation (IVF) along with his colleague Patrick Steptoe, led to the birth of the first ‘test-tube baby’ Louise Brown in 1978, Xinhua reported.

The invention made millions of childless couples’ dream come true worldwide, as figures show about four million babies have been born with the help of IVF treatment. In India, IVF was popularised last year thanks to Aamir Khan and Kiran Rao opting for the procedure and publicly admitting it.

‘It is with deep sadness the family announces that Professor Sir Robert Edwards, Nobel prize winner, scientist and co-pioneer of IVF, passed away peacefully in his sleep April 10, 2013 after a long illness,’ a statement from Cambridge university said.

Born in Yorkshire in northern England Sep 27, 1925, into a working-class family, Edwards served in the British army during World War II before returning home to study first agricultural sciences and then animal genetics. Building on earlier research which showed that egg cells from rabbits could be fertilised in test tubes when sperm was added, Edwards developed the same technique for humans.

In a laboratory in Cambridge, eastern England, in 1968, he first saw life created outside the womb in the form of a human blastocyst, an embryo that has developed for five to six days after fertilisation. He was made a Fellow of the Royal Society, Britain’s foremost science institution, in 1984. He was also appointed an emeritus professor at Cambridge in 1989.

Source: http://health.india.com

12.04.2013

This gen adults less healthy than previous

Despite their greater life expectancy, the adults of today are less "metabolically" healthy than their counterparts of previous generations, according to a new study from the Netherlands.

Assessing the trends, the investigators concluded that "the more recently born generations are doing worse", and warn "that the prevalence of metabolic risk factors and the lifelong exposure to them have increased and probably will continue to increase".

The study analysed data on more than 6,000 individuals in the Doetinchem Cohort Study, which began in 1987 with follow-up examinations after six, 11, and 16 years.(1,2) The principal risk factors measured were body weight, blood pressure, total cholesterol levels (for hypercholesterolaemia) and levels of high-density lipoprotein (HDL) cholesterol, which is considered "protective".

The subjects were stratified by sex and generation at baseline into ten-year age groups (20, 30, 40, and 50 years); the follow-up analyses aimed to determine whether one generation had a different risk profile from a generation born ten years earlier - what the investigators called a "generation shift".

Results showed that the prevalence of overweight, obesity, and hypertension increased with age in all generations, but in general the more recently born generations had a higher prevalence of these risk factors than generations born ten years earlier.

For example, 40 per cent of the males who were in their 30s at baseline were classified as overweight; 11 years later the prevalence of overweight among the second generation of men in their 30s had increased to 52 per cent (a statistically significant generational shift). In women these unfavourable changes in weight were only evident between the most recently born generations, in which the prevalence of obesity doubled in just 10 years.

The study was recently presented in the European Journal of Preventive Cardiology.

Source: www.timesofindia.com

12.04.2013

Most people fail in life because they major in minor things

Anthony Robbins