A heart attack is a condition when the arteries supplying blood to the heart (one or more) are blocked by a clot formation, cutting off the blood supply to part of the heart it is supplying. This results in a shortage of oxygen and other nutrients that lead to the death of the muscle cells of the heart. Actress Mandira Bedi’s husband, filmmaker/producer Raj Kaushal recently passed away after suffering a cardiac arrest, he was only 49. It is pertinent to mention that middle-aged men and women indeed have an increased risk of heart disease, therefore, they should follow a heart-healthy lifestyle. Here, we will discuss how people, who are in their 40s, can prevent heart-related problems.
At 40 years of age one is at the twilight of youth and steps into middle age. There are hormonal changes in both the sexes as a part of ageing which has a complex relationship with the body’s metabolism that is affected leading to several changes in the body.
Forty is an age where most are at an important stage of their professional career along with added responsibilities in their family life. The peer pressures of performance at work along with various other difficulties makes it a very vulnerable period of ones’ life. This is an age where diseases like Type II Diabetes, High BP, dyslipidemia and various other diseases manifest or are detected. The psychological pressures push people into excessive stress resulting in lack of sleep, unhealthy eating, increased alcohol consumption and smoking. Due to scarcity of time, there is a lack of physical exercise too. All these contribute to weight gain, high BP, high blood sugar, high cholesterol which pushes a person into the vicious cycle of bad health with a very high risk of life-threatening heart attack and stroke. 20% of people who have a heart attack are 40 or younger and this rate has risen by 2% every year in the last decade.
SYMPTOMS OF HEART ATTACK
It’s crucial to be aware of the symptoms of a heart attack. Some of these are:
• Chest pain perceived as a feeling of pressure or tightness
• Pain in the centre of the chest with radiation to the left arm, shoulder and jaw associated with sweating
• Shortness of breath
• Excessive unexplained sweating
• Feeling dizzy and fainting
• Pain in the upper abdomen radiating upwards to the chest and back with nausea and vomiting
SMOKING AND HEART DISEASE
Every cigarette smoked makes you more likely to get a heart attack or stroke. Roughly one out of five deaths from heart disease are directly related to smoking. People who smoke are two to four times more likely to get heart disease. The risk is even greater in women who smoke and also take birth control pills.
How does cigarette smoke harm your heart and blood vessels?
1. It causes endothelial activation and dysfunction by reducing vascular NO availability, biomolecule oxidation and endothelial damage. The endothelium is the innermost layer of a blood vessel
2. It causes pathogenic alterations in lipid profile and lipid oxidation
3. It induces a local and systemic proinflammatory status leading to injury to the endothelium
4. It causes a procoagulative environment leading to thrombus formation (blood clotting)
5. Smoking causes the heart rate to rise and also increases blood pressure
There are 7000 toxic substances found in cigarette smoke.
The cardiovascular diseases caused by smoking are: coronary artery disease (arteries of the heart), hypertension, heart attack, stroke (brain), aortic aneurysm (dilation due to thinning of the walls of the vessel), and peripheral vascular disease (affect the vessels of the limbs).
HOW DOES QUITTING SMOKING HELP?
Twenty minutes after you quit smoking your heart rate drops.Just twelve hours after quitting the carbon monoxide level in blood drops to normal, allowing more oxygen to vital organs.Within four years of quitting, your risk of stroke drops to that of lifetime non-smokers.
HOW TO PROTECT YOUR HEART?
Get moving: Aim for at least 30 to 60 min of activity per day. Regular or daily physical activity can lower your risk of heart disease by reducing your weight, blood sugar, cholesterol and BP. It can be 150 minutes a week of moderate aerobic exercise like walking, cycling or jogging or a 75 minutes of vigorous aerobic activity or two or more strength training sessions a week.
Eat a Heart-Healthy diet: A healthy diet will protect your heart by reducing your weight, controlling BP, cholesterol, and diabetes. A heart-healthy diet includes vegetables and fruits, beans or other legumes, lean meats and fish, low fat or fat-free dairy products, whole grains, and healthy fats like Olive oil. Limit the intake of salt, sugar, alcohol, saturated fat (found in red meat and full-fat dairy products), trans fat (found in fried fast food, chips and baked food).
Maintain a Healthy weight: A BMI of 25 and above is considered overweight. Overweight especially around the middle part of the body increases the chance of developing heart disease, hypertension, dyslipidemia, and Type II Diabetes.
Waist circumference is a useful tool to measure abdominal fat. 40 inches for men and 35 inches for women are considered the cut-off point. Reducing your weight by just 3% to 5% can be beneficial as it can decrease certain fats (triglycerides), blood sugar, BP, and cholesterol.
Get good quality sleep: Lack of sleep leads to a higher risk of obesity, high BP, heart attack, diabetes, and depression. Most adults need seven hours of sound sleep. Make sleep a priority in your life by setting a schedule and sticking to it. Thus going to sleep and getting up at the same time every day. If you feel tired throughout the day or have a disturbed sleep where you wake up several times at night then get yourself evaluated for obstructive sleep apnoea, which manifest as snoring, stopping of breath, and waking up gasping. This is treated with a CPAP continuous positive airway pressure and weight reduction. This is one of the reasons for high BP, heart failure, and sudden cardiac death.
Stress management: Cope with stress properly and not by indulging in smoking, eating unhealthy food, and drinking alcohol. Exercise and sports are good ways to reduce stress. Meditation and yoga are the best but getting counselled by a Clinical Psychologist is helpful.
Regular Screening tests: Regular screening help you identify your risk for heart disease, especially if have a strong family history of one.
BP screening should begin from the age of 18 and measured at least once in two years. For people in their 40s, who are not hypertensive, should have their BP screened at least annually.
Cholesterol screening should also begin at the age of 20 and done annually for people with a family history of hypertension or heart disease. Once detected to have abnormal levels, tests should be repeated every six months or else annually.
Screening for diabetes: If one has a strong family history of diabetes or is overweight then screening should begin early. But for those, who have neither, screening should begin at 45.
Electrocardiogram: People with a family history of sudden cardiac death should be screened in their teens. Several familial and sporadic diseases cause a sudden increase in heart rate resulting in cardiac arrest and death. They have certain characteristic ECG by which they are diagnosed. A 24 Hr Holter (ECG) monitoring is also advised to them.
Imaging: Ultrasonographic (Echocardiography) imaging helps identify certain familial and congenital conditions which can cause sudden death. Hence, it is advised for people with a family history of premature deaths.
The writer is Consultant – Senior Interventional Cardiologist, Cardiac Science, HCMCT Manipal Hospital, Dwarka.
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HOW MEDITATION CAN HELP YOU HANDLE EVERYDAY STRESS
In recent years, meditation has gained popularity. It has somewhat become a sign of a person “taking care of themselves” and their mental health and rightfully so. With on-growing connectivity and constant digital reach, our traditional boundaries of ‘working hours’ have become blurred. With no sense of working hours and stretched responsibility, many of us find ourselves anxious and confused at times. Thus, our stress response, one of our innate physiological mechanisms that should only be triggered in life-threatening situations, is triggered constantly and we find ourselves in constant despair. In today’s time, on-standing traditional fears have been replaced with fear of traffic jams, lagging behind or never-ending pending work piles.
It may come as a surprise to some but the WHO predicts burnout will become a global pandemic within a decade and suffering through one, we can all assess the severity of this prediction. In a world where ‘off’ or a ‘pause’ button has ceased to exist, meditation can act as a circuit breaker for this non-stop lifestyle, giving the mind and the body a chance to recharge. Meditation is the practice of thinking deeply or focusing on one’s mind for some time. This can be done in silence or with the help of chanting and is done for several reasons. The primary aim of this practice is to attain mental peace and calmness. Different forms of meditation gives everybody a chance to choose what works for them and is suited to their aim and desires. Here are few of the meditation techniques:
Guided Meditation: It is also called guided imagery or visualisation. With this method of meditation, you form mental images of places or situations you find relaxing. You try to imagine yourself in a situation or a time that is particularly relaxing to you, it can be some smell that is pleasant to you or a sound or a place you associate with happier times. Anything that brings you joy. You may be led through this process by a guide or teacher.
Mantra Meditation: You silently repeat a calming word, thought or phrase to prevent distracting thoughts. ‘Om’ is a common mantra people recite over and over. The idea is to let the outer vibration beat within and find oneness with body and mind.
Mindfulness Meditation: This type of meditation is based on being mindful or having an increased awareness and acceptance of living in the present moment. You broaden your conscious awareness and focus on what you experience during meditation such as the flow of your breath. You can observe your thoughts and emotions, but let them pass without judgment.
Yoga: In today’s time, everyone is familiar with yoga. As you move through poses that require balance and concentration, you’re encouraged to focus less on your busy day and more on the moment.
It is a common reluctance or misconception about meditation that its effect is short reached but that is simply not true. Meditation, at its very core, is a practice of conquering or rather composing your mental being in a way that no sudden seen or unseen actions can rattle you easily. The benefits don’t end when your meditation session ends. Meditation can help carry you more calmly through your day and may help you manage symptoms of certain medical conditions. When you meditate, you clear away the information overload that builds up every day and contributes to stress. The many benefits of meditation include:
• Attaining a positive perspective
• Gaining tools to manage stress
• Heightened self-awareness
• Present becomes priority
• Helps to navigate negative thoughts
• Increasing patience and tolerance
As modern life becomes more and more entangled with exaggerated details of success, meditation can be the branch you need to hold on to in this raging current of development. The fiercely competitive environment coupled with the pressure to meet deadlines may keep people on their toes but only through meditation can we regain proper footing in this world.
The writer is an author & digital marketer.
CASE STUDY: 11-YEAR-OLD GIRL GETS NEW LIFE AFTER HEART TRANSPLANTATION
This is a story of an 11-year-old girl who was diagnosed with dilated cardiomyopathy at 5 years of age. Dilated cardiomyopathy is a life-threatening condition where the heart enlarges and is unable to pump blood effectively. She had undergone a heart valve repair surgery five years back for the same and was being managed with medications. But her condition deteriorated, requiring heart transplantation for survival. Luckily, a matching paediatric donor heart was found just in time, saving her life.
In January 2021, unfortunately, she developed a clot in the heart which obstructed the blood flow to one of the blood vessels of the brain, producing an acute brain stroke. She was rushed to the hospital, and within hours, the clot was removed by the Neurological team, and she recovered almost completely. In December 2020, she was allocated two potential heart donors, but due to the positive crossmatch (pre-existing antibodies against the donor, or the recipient and the donor are incompatible), this did not materialize. Finally, on 19 May 2021, she had a paediatric heart (the donor was of the same age and weight) which matched her perfectly. She underwent successful transplantation and was discharged after 3 weeks of mandatory hospital stay.
There are several children suffering from congenital cardiomyopathy or viral dilated cardiomyopathy or other myocarditis that result in the development of severe heart dysfunction needing heart transplantation. But, unfortunately, the donor pool in this segment is very limited. Especially, during the pandemic when there is a lack of organ donors, we are very lucky to get a suitable heart donor for this child. We have still many children waiting for transplantation, but she was lucky enough to get a matching donor. She is our first paediatric heart transplant recipient at our hospital while all nine previous patients were adults.
Paediatric Heart Transplantation Carries Multiple Challenges at Multiple Levels
• Very few parents of unfortunate brain-dead children come forward to donate the organ. Hence, many times, nearly matching adult donors by weight and height are used. Finding such a compatible match often takes time.
• Managing their post-operative care like immunosuppression can be challenging compared to adults.
WINNING AGAINST ALL ODDS
This is the first-ever paediatric heart transplant performed at our hospital and a successful one. Heart transplantation in a child always poses extra challenges. Moreover, in this case, it was the child’s second heart operation. We made sure that the child’s body was able to accept the new heart, and she was monitored continuously for any post-surgical complications. “We are happy the transplantation was a successful one, and we were able to return the child back to her parents safely.
DONATIONS POURED IN
Heart transplantation is also an expensive surgery. Not all patients can afford it. In this case, too, the child’s parents were unable to bear the entire expenses of the surgery. Thanks to the timely help from NGOs and the child’s well-wishers, the surgery was possible. Expressing his gratitude, Dr Devananda NS appreciated the online donations and Pranic healing trust for their contributions in raising funds for this transplantation.
The writer is HOD & Consultant – Cardiothoracic Vascular Surgery, Heart and Lung transplant surgery, Manipal Hospitals Old Airport Road.
SIX WAYS STRESS CAN AFFECT YOUR DENTAL HEALTH
Stress is the biggest devil in today’s time it affects our overall health physical and social wellbeing. But unfortunately, it has blanketed us like never before. We had not heard of the stress word when we were kids may because we grew up in a healthier environment or because we were not too open to talk about it or maybe it was a combination of both. But not anymore today stress is a part of our lives and is affecting every part of our body so how will oral health be spared.
Stress contributes to teeth grinding, gum disease, dry mouth Canker sores, ulcers, and bad breath. It may impact your dental health routine and diet increases the risk of tooth decay stress makes it harder for your body to fight any kind of infection. So any infection in the oral cavity then takes longer to heal resulting in a poor prognosis
HOW CAN STRESS IMPACT YOUR DENTAL HEALTH
1. Grinding of teeth
Stress leads to grinding your teeth it is a very common health problem. One probably does grinding or clenching at night and gets up with an ache in the morning commonly headache, sore jaw and ache in the temporomandibular joint. Too much clenching and grinding can damage your tooth structure causing loose teeth, broken teeth and loss of teeth as well. Stress and anxiety are the major reasons for this and later it becomes a habit.
Treatment plan: Nightguard appliance, meditation, counselling and yoga
2. T M J Disorders
Stress grinding leads to TMJ disorders. TMJ is the joint that helps in the movement of the lower jaw. Stiffness and the swelling of this joint due to stress can lead to pain in the joint. It’s very common in young adults just before exams and interview.
Treatment plan: Laser physiotherapy, soft diet, meditation, and face yoga
3. Dry/burning mouth
Stress leads to dehydration even the use of anti-anxiety pills cause dry mouth that’s a condition where the saliva of the mouth reduces and the mouth becomes very sticky. This leads to cavities and bad breath, actually, saliva helps flush out all bacterias and food particles from the oral cavity when the amount of saliva reduces the problems increase.
Treatment plan: Drink a lot of water, meditate, and visit a dentist for saliva substitutes
Stress also leads to acidity. Acidity leads to acidic reflux with come as a bout and badly effects inside of the lower anterior. They get eroded much before time also the saliva becomes more acidic and one suffers from bad breath.
Treatment plan: Guards to protect teeth, small frequent meals, and meditation
5. Nail Biting
Nail-biting, chewing on a pencil/pen are manifestations of stress, and cause severe damage to the teeth and overall health it can move your teeth out of position and also cause wearing of tooth enamel. It is a very unhygienic practice and can lead to a lot of bacterial infections in the oral cavity and beyond that.
Treatment plan: Itincludes habit breaking appliances, counselling, and meditation
6. Mouth Ulcers
Stress can lead to digestive issues leading to constipation which is one of the major reasons for oral and peptic ulcers. These ulcers can be very painful further leading to the inability to eat anything.
Treatment plan: Visit your dentist
The writer is a practising Cosmetic and Laser dental surgeon for 20 years, Director at Dentem & is an Associate Consultant to Sir Ganga Ram Hospital.
A HEALTH GUIDE TO WADE THROUGH MONSOON MESS
Here are some tips by a healthcare expert to ward off diseases in the monsoon.
Every year, we welcome monsoon with utmost delight. This season brings much-needed relief from the scorching summer heat. Monsoon give a sudden flip to extreme temperatures, replenish the water reservoirs and groundwater levels, bring delight to the areas suffering from water scarcity and plays an important role in the GDP for our country being primarily agriculture-dependent. Because of this, the monsoon season in India is very much awaited across all states.
However, rains also bring woes in the form of floods and various diseases. This year when we are grappling with the Covid-19 pandemic, our worries are more profound as rains may drain our already overburdened healthcare system. During rains we have a sudden surge in a plethora of diseases, be it seasonal flu, waterborne or vector-borne and they do have many overlapping symptoms.
There is going to be a huge diagnostic dilemma in front of physicians, even for mild illnesses like simple seasonal flu or viral fever where we may need to subject those patients to Covid-19 screening as the spectrum of Covid-related illness is very varied from asymptomatic to life-threatening complications.
The incidence of vector-borne diseases such as dengue fever, malaria, and chikungunya rises exponentially during monsoon, all these diseases are associated with high-grade fever, myalgias, headache, and joint pain necessitating to rule out Covid-19 illness. On top of that, if there is co-infection with these pathogens and Covid-19, the outcome could have serious implications. Take an example of dengue where a patient may be in shock and if he lands up in respiratory failure because of Covid-19 the combination could be disastrous.
Food and water-borne diseases like gastroenteritis, cholera, typhoid, and hepatitis increase during this season as a humid and wet environment with ideal temperatures provide optimal conditions for micro-organisms to grow and multiply. These diseases will certainly have an impact on the ongoing pandemic in an adverse way, increasing both morbidity and mortality.
Whatever are the circumstances, we must prepare and guard ourselves against the imminent multi-pronged attack at the individual level as well as helping the authorities in overcoming adversaries. We are currently battling with the pandemic and have done well also but we cannot ignore our fight with dengue, malaria, and other infectious diseases and this fight is in no way smaller.
Precautions for the rainy season diseases albeit difficult but are practical and all of us must contribute towards them. Here are few ways to protect yourself in monsoon:
Maintain proper hygiene and sanitation and using clean water will ward off most of these illnesses.
For mosquito-borne diseases, their breeding is to be prevented by keeping clogged areas clean and preventing yourself from mosquito bites by using repellents and covering up.
More than any other time, these times demand us to keep yourself healthy by strengthening the immunity via a nutritious diet, healthy sleeping habits, and regular exercise. Monsoon is the perfect time for the senior citizens to sit back, spend time with your loved ones, and relax at home. Their digestive capacity is said to be at the lowest point. So, it’s important to avoid street junk food and include fruits, vegetables, and increase fibre intake. Fruits such as apples, bananas, and pears can improve digestion.In addition to a healthy diet, senior citizens need to take extra care while walking on wet surfaces like balcony, terrace, porch, garden etc. It is recommended that you use walking support aid to be on the safe side. You could also consider patching these surfaces with anti-slip rubber mats to avoid accidents.
The writer is a Senior Consultant, Internal Medicine at Fortis Hospital Vasant Kunj.
REASONS TO MAKE THE SWITCH TO MENSTRUAL CUP
Q. How menstrual cups are better than sanitary pads?
A. Menstrual cups are new and safe as compared to sanitary pads. They collect the period blood instead of absorbing the blood and hence there are no chances of vaginal infection. Depending on the flow, one cup can last for four to 12 hours. With lesser chances of leakage, one can sleepy freely with menstrual cups. Sanitary pads tend to give you rashes. They are cost-effective as well, as one cup sanitised the right way, can last for years.
Q. What are the benefits of using menstrual cups for both females and the environment?
A. Menstrual cups are safe and effective as they are cost-effective as well. As cups collect the blood and do not absorb them, so there are no chances of vaginal infection. In terms of environment, Menstrual cups are environment friendly as well as they reduce waste and water usage. Women can reduce plastic waster by using a menstrual cup. One cup produces an estimated 0.4% of the plastic waste that single pads build up or 6% of them is created by tampons in 10 years.
Q. Tell us about the change in the consumer demands of the menstrual cups?
A. With women understanding the usage of menstrual cups and their benefits, there has been a considerable increase in the demand for menstrual cups. A cup could cost roughly five to seven per cent of the cost of using 12 pads (on average $ 0.31 each) or tampons (on average $ 0.21 each) per period.
Q. What are the things one should keep in mind while buying the cup?
A. Here are the key factors which one should keep in mind while buying the cups:
• The material of menstrual cups, as to what it is made of. Is it medical grade silicone, latex, plastic or rubber? Cups made of medical-grade silicone are the best ones
• Thesize of the cupas per your requirement is small or large. Small-sized cups are good for women below the age of 30 and large size cups are recommended for above 30 women
• Functionalities of the cup in terms of stem, firmness, shape, and seams
Stem: Most menstrual cups have a stem on the bottom. It acts as a guide, which helps you to locate your cup easier while removal.
Firmness: Finding the right firmness for your body, makes a huge difference in comfort and effectiveness.
Shape: Determine the shape of the cup depends on the cervix height as everybody is different.
Seams:In some cups, the seams are around the rim, some have a seam running from stem to rim, while some are seamless. It is important to understand the seam as in some cases a rough seam can cause irritation or scratch in the vaginal wall.
Q. Share some tips to keep the cup clean and sanitised?
A. Tips to keep the cup clean and sanitised:
1. Wash your hands properly before touching the cup.
2. Since silicone cups are bacteria resistant, you don’t need to wash yours every time you empty them. Simply rinsing it in the sink is enough to clean it out before reinserting. To avoid stains, you can initially rinse with cold water, then follow it up with a hot rinse to disinfect.
3. Once your period is over, you might want to give your cup a good clean before you store it, both for peace of mind and to remove any stains.
4. Boil three cups of clean water on the stove. (Tap water is fine if you’re in a place with safe water but if not, use bottled water instead.) Submerge your cup but make sure the cup isn’t touching the bottom or sides of the pot. One way to do this is to put your cup inside a whisk to hold it away from the sides. Boil for five to eight minutes then drain the cup and let it air dry. It is completely safe to boil the cups, but don’t boil the pot dry as this will destroy the silicone. If you feel strange about using a pot you cook with, you can buy a small one specifically for boiling your cup and store it separately.
5. Sterilising tablets for baby bottles isgreat because you can use them in cold water so they’re ideal if you live in a dorm room with no access to a stove or just don’t feel comfortable boiling your cup in a shared kitchen. Follow the manufacturer’s instructions. These tablets are also great at removing stains.
The writer is Director, Namyaa Skincare.
COMMON MYTHS ABOUT PROTEIN YOU SHOULD STOP BELIEVING
Protein is an essential nutrient present in every single cell in our body and is required for the growth and repair of the body. Approximately one-fifth of our body weight is protein. The protein requirement for an adult is 0.8g per kg body weight per day for adults. You have to eat protein every day. The body can’t store protein like it can store carbohydrates and fats. The Protein Week is observed from 24 to 30 July to spread awareness about the need to incorporate protein in our daily diet.
There are many myths around protein consumption. The most common myth is protein is only for muscle development and not so important for the general population. On the contrary, protein is an essential nutrient that is key to building immunity and for growth and immunity. It is required not only for muscle but also for bone, joints, tendons, ligaments, hair, antibodies, hormones, and enzymes. The body is made of muscle mass, fat mass, bone and water. A healthy body should have more muscle mass and less fat mass. And replacing our diet with healthy proteins instead of fats and carbohydrates is the ideal way to have a healthy body.
The other common myth is intake of protein can lead to kidney damage. Most believe that taking a protein-rich diet puts loads on the kidney and damages it. On the contrary, protein is an essential macronutrient and is needed for survival. Also, the common perception is that with age one should reduce protein intake as it can damage the kidneys. Muscle loss is a natural part of ageing, and if one doesn’t take adequate proteins, it leads to reduced energy levels and low muscle strength. The recommended dietary allowance is 0.8 to 1 g /kg body weight, for a healthy adult which is around 50g to 60g per day grams daily, whereas the daily need increases during illness or increased activity level. Deficiency of protein can lead to impaired physical development, oedema, low immunity, and low muscle mass. One can meet the daily needs of protein by eating eggs, fish, dairy, legumes, meat, poultry, and nuts.
Another very common myth is intake of protein leads to weight gain. Proteins are the key to losing weight the healthy way. Taking good amounts of good quality proteins like eggs and poultry can help healthy weight loss, by increasing satiety, boost up metabolism and loss of fat mass and build-up of muscle mass. Consuming insufficient protein on the other hand can actually make it harder to lose weight. Even if one loses weight by cutting the protein, chances are that its muscle — not fat — will lose. Not eating enough protein can lead to side effects including fatigue, weakness, and a low immune system. Including protein in daily diet is essential and 10% to 15% of the total calories should come from protein. So let’s pledge this Protein Week that we all will make protein a part of our diet plan.
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