Monthly Archives: June 2015

Treatment less effective in asthma patients over 30

Older patients with asthma are at increased risk for treatment failure, particularly those patients being treated with inhaled steroids, says a new study.

“Asthma morbidity and mortality are known to be increased in middle-aged and older patients, and gender may also affect the incidence and course of the disease, but the impact of age and gender on asthma treatment response is not well understood.

“In our study of 1,200 patients with mild-to-moderate asthma, the risk of treatment failure was increased in patients aged 30 and above, and these failure rates increased proportionally with increasing age above age 30 across our study cohort,” said study author Michael Wechsler, professor of medicine at the National Jewish Health in Denver, US.

“We also found that the rate of treatment failure did not significantly differ between males and females,” Wechsler said.

The findings were published online in the American Journal of Respiratory and Critical Care Medicine.

The researchers used Asthma Clinical Research Network data on patients participating in 10 trials from 1993 to 2003.

Treatment failures were observed in 17.3 percent of patients 30 years old and above, compared with 10.3 percent of those under age 30.

Lower lung function measurements and longer duration of asthma were associated with a higher risk of treatment failure.

When stratified by specific treatment, failures increased consistently for every year above age 30 among those patients using inhaled corticosteroids.

Patients aged 30 and older who were treated with inhaled corticosteroids, either alone or in combination, had more than twice the risk of experiencing a treatment failure compared with patients younger than 30.

Males and females had similar asthma control measures and treatment failure rates.

Source Article from http://indianexpress.com/article/lifestyle/health/treatment-less-effective-in-asthma-patients-over-30/

The Interpreter of Maladies: An anaesthetist opens up about what ails the medical industry in India

A week after his post, “Why I will never allow my child to become a doctor in India,” was published on his blog on godyears.net, Dr Roshan Radhakrishnan quit his job. The 34-year-old anaesthetist decided to leave his post at a private hospital in Palakkad and return to his native Kannur. “I am looking for a job in Kannur so I can take care of my parents,’’ he says. Readers of the blog post shouldn’t be too surprised, the young doctor knows full well how his career choice will cost him, but it is a price he is willing to pay.

In his blog post, Radhakrishnan writes a letter to his imaginary son, warning him about the perils of entering the medical industry in India, where he will have to tackle a multitude of issues — the skewed doctor-patient ratio (0.7 doctors per 1,000 Indians), the insufficient salary in rural government hospitals, the better pay at private hospitals but the soul-crushing hours that must be clocked, the violence doctors have to face from patients’ families, how pharmaceutical companies are never hauled up for selling faulty medicines and more.

“Erring doctors should be punished. But there are several unreported incidents of attacks on doctors. The hospital management wants to cover up assaults as they fear reporting of such incidents would impair the image of the hospital,’’ says Radhakrishnan, who decided to write the post after reading media reports about doctors being attacked in various parts of the country by patients’ relatives.

The son of a retired public relations officer with a shipping firm in Dubai, Radhakrishnan completed his MBBS from Bharati Vidhyapeeth Medical College in Pune. He started his career as an assistant professor with a private medical college in Mangalore and after two years there, he moved to another private hospital in Palakkad. For the first few years in the hospital, he worked round-the-clock. “Many of us lived on the hospital campus; some lived away from their families,” he says.

Since Radhakrishnan posted the article on his blog on May 15, it has attracted more than 20,000 shares, over 2 lakh hits and has been published on news media sites as well. Taken aback at the avalanche of responses the post has generated, Radhakrishnan says that his arguments have resonated significantly with the medical community, from “first year medicos to senior doctors”.

Radhakrishnan argues that the hospital management are responsible for the growing distrust among the stakeholders of the health sector. “Some hospitals in the country have started appointing bouncers as security guards. This shows the complete breakdown of doctor-patient relationship,” he says. But one of the most alarming issues is India’s dismal healthcare budget. “We spend a mere …continued »

Source Article from http://indianexpress.com/article/lifestyle/health/the-interpreter-of-maladies-an-anaesthetist-opens-up-about-what-ails-the-medical-industry-in-india/

You can include pork in recipe to lower blood pressure

If you are following a diet to lower blood pressure, you may expand your protein options to include lean, unprocessed pork, new research suggests.

The Dietary Approaches to Stop Hypertension (DASH) diet is recommended to reduce blood pressure and is focused on the increased consumption of fruits and vegetables, whole-grains, low-fat dairy products, nuts, poultry and fish, while reducing fats, red meats, including pork, and added sugars.

“If people have to rely only on fish and chicken their diet choices can be limited and our results support that lean pork may be a viable option for people who are consuming a DASH diet without compromising the effectiveness of the diet plan,” said co-author Drew Sayer, doctoral student in nutrition science at Purdue University in the US.

The study that appeared in American Journal of Clinical Nutrition compared lean, unprocessed pork with chicken and fish as the predominant protein source in a DASH-style diet.

The consumption of these DASH-style diets for six weeks reduced all measures of blood pressure with no differences in responses between DASH with chicken and fish and DASH with pork, the study found.

“This study supports that the DASH diet can include lean and unprocessed red meats in the appropriate serving sizes,” Wayne Campbell, professor of nutrition science at Purdue University, said.

Source Article from http://indianexpress.com/article/lifestyle/health/you-can-include-pork-in-recipe-to-lower-blood-pressure/

Urine test may detect breast cancer early, says researchers

A new test that identifies changes in cell metabolism through urine samples may detect breast cancer early, scientists say.

Researchers at the University of Freiburg in Germany have developed a method that involves determining the concentration of molecules that regulate cell metabolism which are often dysregulated in cancer cells.

These molecules, referred to as microRNAs, enter into the urine over the blood. By determining the composition of microRNAs in the urine, the scientists succeeded in establishing with 91 per cent accuracy whether a test subject was healthy or diseased.

The measurement was possible through the detection of only four microRNAs.

If the effectiveness of the method is confirmed in further studies, it could serve in the future as a means of monitoring the success of treatment and potentially also of making an early diagnosis of breast cancer, researchers said.

Currently, doctors have made breast cancer diagnosis by mammography or ultrasound and confirmed it with tissue samples.

However, these methods have been subject to recurring criticism due to radiation exposure, erroneous results, and the fact that they involve an invasive intervention.

In the study, Dr Elmar Stickeler, medical director of Senology at the Department of Obstetrics and Gynecology and head of the Breast Center at the Medical Center and his team measured the concentrations of nine microRNAs in the urine, short genetic sequences that regulate cell metabolism.

Four of the nine molecules exhibited significant differences in concentration between healthy and diseased test subjects.

“We discovered that the microRNA profile in the urine is modified in a characteristic way in the urine of test subjects with breast cancer,” said Stickeler.

“MicroRNAs should thus be suitable in principle for a breast cancer test,” Stickeler said.

The findings are published in the journal BMC Cancer.

Source Article from http://indianexpress.com/article/lifestyle/health/urine-test-may-detect-breast-cancer-early-says-researchers/

Diet diary: The dreaded vacation pounds- how to not bring them back home

Be it a cruise, hill holiday or beach vacation, most people end up taking home some extra kilos after a vacation. Feeling sluggish, sloppy, sleepy and tired as a result of over indulgence in food and alcohol are common. A relaxed mind and plenty of good food and wine can take its toll.

Ideally, a vacation is meant to recharge our energies and refresh us to return to routine and cope with work pressures. Also, recognising the potential long-term effects that holiday weight gain can have on your body is important. Excessive weight can lead to health problems such as diabetes, heart disease and high blood pressure. Gaining unnecessary kilos now, makes it harder to shed them later.

According to studies, most people gain approximately one to two kilograms every holiday. Research shows that extra weight often gained during the holidays tends to build up over the years, contributing to long-term obesity.Some checks and balances are all that is needed to avoid gaining those extra kilos and making the most of our vacation. Following a few simple healthy habits can go a long way to energise us and save us from gaining those extra kilos.

Be active: If you exercise regularly, don’t stop, continue to exercise over the holidays. If a holiday party includes dancing, join in. Check if the hotel you book has a gym or else go for walks, run, swim, play sports or cycle outdoors

Schedule feasting times: If possible, schedule holiday dinners at normal meal time. Having meals during odd hours contributes to overeating, particularly large meals late into the night.

Watch your drink: Avoid sweetened beverages, fruit juices, mocktails and cocktails. It is best to drink water whenever possible. Diet beverages made with artificial sweeteners can help control calories at celebrations, although drinking them on a regular basis may not help with long-term weight control.

Count your alcohol: Alcohol can be a major source of hidden calories as well. A single shot of liquor, about 30 ml, is nearly 125 calories. A 150 ml glass of wine or a 350 ml glass of beer is about 160. Sweet mixed drinks have even more calories. Ginger ale has 120 calories. Beer guzzling too can be dangerous. Simple things like having a tomato juice rather than a bloody mary can help.

Food choices: Choose food that are lower in energy density. You’ll feel fuller sooner and take in fewer calories. For example, start out your meal with a salad or soup. Skip the second helping of oily gravies, fried food and bread. Ask for vegetables instead of potatoes or fries. A fibre supplement pre-meals is useful to cut back on richer food later.

Avoid high-fat food: Fat in itself may not be the key to weight control as people once thought, but in excess it does have …continued »

Source Article from http://indianexpress.com/article/lifestyle/health/diet-diary-the-dreaded-vacation-pounds-how-to-not-bring-them-back-home/

On The Loose: Instant Mess

All along the two hour route from Manali to Rohtang Pass, a circuitous and bumpy highway with spectacular views of snow capped peaks and the Beas, tourists break for the only form of sustenance available: tea, and Maggi noodles. It’s something of a tradition. The minute you reach snow point and the winds are icy, there’s bound to be a stall selling a steaming plate of Maggi. Trekkers, in fact, just lost one half of their menu. Will be just as well for those currently on a mountain if they conduct checks on Heinz baked beans after climbing season is over.

When we were growing up in the ’80s, there used to be this product, Fry-ems. Little round things something like the Mercedes logo, you had to dump them in hot oil and they would become crunchy, salty, balls. I don’t see them anymore. That was the extent of packaged foods we ate, rarely, on occasions. Now, there are Smileys at kids’ birthday parties. Smiling potato wedges that you can pull out of a deep freeze months after purchase and serve. It’s best not to think about what goes into making it edible for so long. My 12-year-old son was calculating, he’s probably consumed about a 100 packets of Maggi so far. He listens, agog, to the information pouring in, much more seriously now. The Maggi fallout is that it has started an important dialogue on how we in cities live, what we eat, and our relaxed attitudes to our children eating out of a packet.

Irrespective of whether Madhuri Dixit proclaims a junk food as healthy or Preity Zinta models for chips or Dhoni for a cola brand, the educated middle class in India has been well aware that all these products have no nutritional value whatsoever. This is not news to us, though, of course, we weren’t expecting to get poisoned by instant noodles. But we can’t claim we were fooled by celebrity endorsements.

Our kids have been merrily tucking into these items entirely with our knowledge and if not exactly active, with our passive encouragement. In the incredibly versatile culinary expanse that is India, and in light of these new facts, the city parent needs to take stock of why our kids are indulged so much, to their detriment. It’s a wake-up call to figure out ways to improve their diets and systematically stunt the new proclivity to burgers, pizzas and chocolate.

It’s not going to be easy. Outings in cities are to malls, not parks. Kids play on computer devices more than outdoors. In the TV show Man Vs Food, the host participates in food challenges that involve him eating copious amounts to the point of sickness. It’s a runaway hit. …continued »

Source Article from http://indianexpress.com/article/lifestyle/health/on-the-loose-instant-mess/

Diet diary: Is your daily plate of rice putting you at major health risk?

Rice, a staple for many across the world, has been considered one of the safest and easily digestible nutritious foods. It is also an important alternate grain for those who are gluten or wheat intolerant and those suffering from celiac disease. However, some recent reports on its toxicity, specifically related to arsenic have been a cause for concern.

In a consumer report in the US, analysis of US federal health data found that people who ate rice had arsenic levels that were 44 per cent greater than those who did not. Certain ethnic groups like Asians and Mexicans were more affected.

A study by the European Food Safety Authority found cereal products could account for more than half of dietary exposure to inorganic arsenic, mainly because of rice. Rice absorbs arsenic from soil or water much more effectively than most plants. That’s in part because it is one of the only major crops grown in water-flooded conditions, which allows arsenic to be more easily taken up by its roots and stored in the grains.

Arsenic is found in water, air, food and soil in organic and inorganic form. These together are referred to as “total arsenic”. The US Food and Drug Administration (USFDA) has found arsenic content in over 30 samples of Indian basmati rice in its preliminary analysis. USFDA is in the process of collecting and analysing a total of approximately 1,200 samples of rice from different countries including India to examine the issue thoroughly. This data collection will be completed by the end of 2012. Once the data collection is completed, FDA will analyse these results and determine whether or not to issue further recommendations.

Arsenic not only is a potent human carcinogen but also can cause other health problems in children later life. Long-term exposure to high levels of arsenic is associated with higher rates of skin, bladder, and lung cancers, as well as heart disease.

Author is a clinical nutritionist and founder of http://www.theweightmonitor.com and Whole Foods India.

Source Article from http://indianexpress.com/article/lifestyle/health/diet-diary-rice-arsenic/

Exercise during pregnancy curbs diabetes risk

A little exercise during pregnancy can bring in huge benefits for you and the baby.

Researchers have found that women who engage in moderate physical activity during pregnancy are less likely to have gestational diabetes, and the exercise also helps to reduce maternal weight gain.

“Exercise is not something to be feared during pregnancy – the moderate levels of exercise used in these studies had significantly positive effects on health and were found to be safe for both mother and baby,” said lead author of the study Gema Sanabria-Martinez from Virgen de la Luz Hospital in Spain.

Gestational diabetes is one of the most frequent complications of pregnancy. It is associated with an increased risk of serious disorders such as hypertension, preterm birth, and with induced or caesarean birth.

It can have long term effects on the mother including long term impaired glucose tolerance and Type-2 diabetes.

The children of mothers with gestational diabetes are more likely to become overweight or obese and have a higher risk of developing diabetes themselves.

Gaining more weight than is recommended during pregnancy carries similar risks, and these women are also less likely to lose the excess weight after the baby is born.

In this study, analysis of 13 trials, involving more than 2,800 women, found that exercise reduced the risk of gestational diabetes by more than 30 percent – for women who exercised throughout pregnancy this was even greater (36 percent).

This effect was strongest for women who combined toning, strength, flexibility and aerobic exercise.

Exercise was also helpful in reducing excessive weight gain — those who exercised were on average a kilogram lighter.

This held true for the weight gain even if the exercise programme was started in the second trimester of pregnancy.

The study was published in BJOG: An International Journal of Obstetrics and Gynaecology.

Source Article from http://indianexpress.com/article/lifestyle/health/exercise-during-pregnancy-curbs-diabetes-risk/

Beware! Your toothbrush may transmit diseases

If you are using a ‘shared’ bathroom, be careful about where and how you store your toothbrush. Researchers have found that toothbrushes can serve as a vector for transmission of potentially pathogenic organisms.

The researchers found evidence of transmission of fecal coliform bacteria in communal bathrooms.

“The main concern is not with the presence of your own fecal matter on your toothbrush, but rather when a toothbrush is contaminated with fecal matter from someone else, which contains bacteria, viruses or parasites that are not part of your normal flora,” said Lauren Aber from Quinnipiac University in the US.

For the study, all toothbrushes were collected from participants using communal bathrooms, with an average of 9.4 occupants per bathroom in Quinnipiac University.

At least 60 percent of the toothbrushes were found to be contaminated with fecal coliforms.

“Using a toothbrush cover does not protect a toothbrush from bacterial growth, but actually creates an environment where bacteria are better suited to grow by keeping the bristles moist and not allowing the head of the toothbrush to dry out between uses,” Aber said.

“Better hygiene practices are recommended for students, who share bathrooms both in the storage of their toothbrush but also in personal hygiene,” Aber added.

Toothbrushes are a known source of contamination. Scientists have suspected since the 1920s that the re-use of toothbrushes could be a possible source of infection in the oral cavity.

There are several potential sources of contamination of one’s toothbrush — toothbrushes stored open in the bathroom are especially vulnerable to contamination with material from the toilet or contamination from other occupants.

This research was presented at the annual meeting of the American Society for Microbiology in New Orleans, Louisiana.

Source Article from http://indianexpress.com/article/lifestyle/health/beware-your-toothbrush-may-transmit-diseases/

Why people die of heat stroke? All you need to know about the illness

There was a 61% increase in the number of deaths due to heat stroke across India between 2004 to 2013, according to National Crime Records Bureau (NCRB) data, with indications that these numbers represent a vast under-reporting and often misdiagnosed.

Heat illness may be viewed as a range of ailments related to the body’s inability to cope with heat. It includes minor problems such as heat rash (prickly heat), heat cramps, and heat exhaustion. Heat stroke is the most severe form and is defined as a body temperature higher than 41.1°C (106°F) associated with neurological (brain) dysfunction.

Exertional heat stroke (EHS) generally occurs in young individuals who engage in strenuous physical activity for a prolonged period of time in a hot and sometimes even in a not-so-hot environment. It can start as heat cramps that can be completely disabling and typically occur during or after hard work and are caused by electrolyte deficiencies that result from extended periods of intense sweating. Symptoms include painful spasms of leg, arm or abdominal muscles, heavy sweating and thirst. Drinking plenty of water or electrolyte fluids are the suitable first aid.

EHS happens when the individual’s capacity to dissipate or drive away the heat produced by overactive muscles falls short. The temperature rises to such high that the body becomes a pressure cooker and starts (am tempted to say) cooking our internal organs, inflicting severe tissue damage resulting into multi-organ failure. We frequently read news about young men (and women) collapsing and dying with no apparent reason when made to undergo severe physical excretion for endurance tests during recruitment in the Indian police force or military.

High (body) core temperatures damage the internal organs, especially the brain. The main reason is the fluid loss in the form of sweat, sometimes even ‘one and half’ liter in one hour and three liters in two hours. Along with sweat we also lose electrolytes. Enormous fluid loss can also lead to dangerously low blood volume and lead to dangerously low blood pressure. This can break down the body’s cooling system that demands increased blood flow to the skin to take away the heat from body’s core. Electrolyte imbalance adds insult to injury, causing irregularities in heart function. Most people who are killed by heat stroke die when their heart stops pumping effectively (mostly the cause of death is written as ‘heart failure, or cardiac arrest and that is why heatstroke death numbers seem so low). Even people who survive are likely to have permanent brain damage if their core temperature has been over 40.6°C (105°F) for more than an hour or two.

The risk factors for EHS in such young men and women depend on the number of active sweat-glands, acclimatization, outside temperature, humidity, hydration status and activity-related factors (duration of exercise). Acclimatization means gradual introduction of a sportsperson or a worker to the ‘outdoor’ task. …continued »

Source Article from http://indianexpress.com/article/lifestyle/health/why-people-die-of-heat-stroke-all-you-need-to-know-about-the-illness/