Traditional eating habits prevent heart diseases

In patients suffering from ischemic heart disease the flow of blood to the heart is obstructed and thus the heart is deprived of oxygen. This leads to death if not attended to immediately.

By Syed Akbar

Aping the West in food habits and lifestyle is proving
to be dear to people in Andhra Pradesh with heart diseases linked to food habits
emerging as the leading cause of death.
According to a recent survey published by the Central Bureau of Health
Intelligence, ischemic heart disease characterised by reduced blood supply to
the heart has been killing 13.21 per cent of people in Andhra Pradesh. It is
the cause of death in 12.2 per cent of women and 14.08 per cent of men.
Incidentally ischemic heart disease tops the 10 important causes of death in
people of the State.
Doctors link the disease to smoking, diabetes, hypertension, obesity,
excessive use of hydrogenated fats (vanaspathi) and foods containing high
cholesterol levels. So far, ischemic heart disease has been the major
cause of death in the US and Europe.
That it has emerged as the top killer in Andhra
Pradesh is a cause for concern, says senior cardiologist Dr PC Rath.
In patients suffering from ischemic heart disease the flow of blood to the
heart is obstructed and thus the heart is deprived of oxygen. This leads to
death if not attended to immediately. According to Dr Rath, a little
change in lifestyle and food habits will help in controlling cardiovascular diseases.
Cerebrovascular disease (bleeding in brain or cutting supply of blood or
oxygen to the brain) is the second leading cause of death in Andhra Pradesh,
though it is the third leading cause of death in the West. Cancer or
malignancy, which is the second leading cause of death in the West, is
incidentally the 10th cause of death in Andhra Pradesh.
While lower respiratory (lung) infections is the third over all leading
killer in the State, diarrhoeal diseases occupy the third position in case of women and
tuberculosis in case of men. Self-inflected injury is the seventh leading
killer both among men and women while asthma and stomach cancer is the eighth
major cause of death among men and women respectively, according to the
CBHI report.
Road accidents occupy the 10th slot in case of men and dementia (group of
disorders relating to brain) is the 10th cause of deaths among women.
Cirrhosis of the liver is the cause of 2.19 per cent of deaths among men but
incidentally it is absent among women. Cirrhosis is linked to alcohol.
Women tend to be more prone to unintentional injuries than men. Statistics
show that 4.09 per cent of deaths in women and 3.81 per cent of deaths in
men are attributed to unintentional injuries.

Eat health to live healthy: Avoid hydrogenated fats, smoking, diabetes, hypertension for a heart free of troubles

Doctors link the heart diseases to smoking, diabetes, hypertension, obesity,
excessive use of hydrogenated fats (vanaspathi) and foods containing high
cholesterol levels

By Syed Akbar
Hyderabad: Aping the West in food habits and lifestyle is proving
to be dear to people in Andhra Pradesh with heart diseases linked to food habits
emerging as the leading cause of death.
According to a survey published by the Central Bureau of Health
Intelligence, ischemic heart disease characterised by reduced blood supply to
the heart has been killing 13.21 per cent of people in Andhra Pradesh. It is
the cause of death in 12.2 per cent of women and 14.08 per cent of men.
Incidentally ischemic heart disease tops the 10 important causes of death in
people of the State.
Doctors link the disease to smoking, diabetes, hypertension, obesity,
excessive use of hydrogenated fats (vanaspathi) and foods containing high
cholesterol levels. So far, ischemic heart disease has been the major
cause of
death in the US and Europe. That it has emerged as the top killer in Andhra
Pradesh is a cause for concern, says senior cardiologist Dr PC Rath.
In patients suffering from ischemic heart disease the flow of blood to the
heart is obstructed and thus the heart is deprived of oxygen. This leads to
death if not attended to immediately. According to Dr Rath, a little
change in
lifestyle and food habits will help in controlling cardiovascular diseases.
Cerebrovascular disease (bleeding in brain or cutting supply of blood or
oxygen to the brain) is the second leading cause of death in Andhra Pradesh,
though it is the third leading cause of death in the West. Cancer or
malignancy, which is the second leading cause of death in the West, is
incidentally the 10th cause of death in Andhra Pradesh.
While lower respiratory (lung) infections is the third over all leading
killer in
the State, diarrhoeal diseases occupy the third position in case of women and
tuberculosis in case of men. Self-inflected injury is the seventh leading
killer
both among men and women while asthma and stomach cancer is the eighth
major cause of death among men and women respectively, according to the
CBHI report.
Road accidents occupy the 10th slot in case of men and dementia (group of
disorders relating to brain) is the 10th cause of deaths among women.
Cirrhosis of the liver is the cause of 2.19 per cent of deaths among men but
incidentally it is absent among women. Cirrhosis is linked to alcohol.
Women tend to be more prone to unintentional injuries than men. Statistics
show that 4.09 per cent of deaths in women and 3.81 per cent of deaths in
men are attributed to unintentional injuries.

Myocardial infarction or death of heart muscle is one of the major reasons for heart attacks. However, the damage to the heart tissue can now be repaired using stem cell technology: Prof Stephen Minger

Syed Akbar
Hyderabad:  Myocardial infarction or death of heart muscle is
one of the major reasons for heart attacks. However, the damage to the
heart tissue can now be repaired using stem cell technology.

According to eminent scientist Prof Stephen Minger, stem cell
technology has made it possible to repair heart tissue damaged by
myocardial infarction. There is no need to cut open the chest to gain
access to the heart muscle. Heart cells, cultured in laboratory using
stem cells, can be implanted in the heart through a catheter from one
of the arms. The patient can go home the same day.

Myocardial infarction takes place if blood supply to the heart is
stopped for a long time. The damaged tissue can be repaired using the
stem cell technology. India, with a billion-plus people, is all set to
play a key role in stem cells and regenerative medicine, he says
adding, “If India and China could bank even one per cent of their
annual births, they could supply stem cells to the whole world”.

Prof Stephen Minger, who heads the global research and development at
GE Healthcare, UK, told this correspondent “in about five year’s time
it would be possible to repair heart tissue damaged by myocardial
infarction and to replace neuronal cells lost in Parkinson’s and
Alzheimer’s diseases”.

Heart cells derived from stem cells of bone marrow have been implanted
successfully in a patient. Animal studies are on with regard to heart
cells generated from umbilical cord. The stem cell technology is also
helpful to transplant new insulin producing cells for diabetics and
myelinating cells for individuals afflicted with multiple sclerosis,
and to replace bone and cartilage lost through aging and inflammatory
disease.

“The generation of specific populations of defined subtypes of human
cells has tremendous potential to revolutionise the fields of drug
discovery and investigation into the cellular bases of human disease,”
Prof Stephen Minger pointed out. He is currently in Hyderabad to
create awareness for public banking of cord blood.

Prof Stephen Minger is known worldwide for his research in growing
cells, not in a petri dish, but at an industrial scale that could one
day supply zillions of stem cells to millions of people to repair
diseased organs.

“The newly emerging field of regenerative medicine will fundamentally
alter clinical medicine and significantly influence our perceptions of
aging, health and disease, with a myriad of consequences for society,”
he added.

Three new embryonic stem cell lines, including one that encodes the
most common genetic mutation resulting in cystic fibrosis, have been
generated. He said the Stem Cell Biology Laboratory of GE is focused
on the generation of a number of therapeutically relevant human
somatic stem cell populations from embryonic stem cells. These include
cardiac, vascular, retinal, and neural stem/progenitor cell
populations and pancreatic Beta cells.

Stem cells the only alternative in end stage heart failure

By Syed Akbar
Hyderabad:  Patients with end stage heart failure need not
despair any longer. A team of cardiologists led by eminent heart
specialist Dr KM Cherian has successfully improved the heart condition
of dozens of patients, who otherwise did not respond to any kind of
treatment.

In the last three years as many as 56 patients with end stage heart
failure received stem cell therapy. The functioning of their heart
showed considerable improvement and many of them are leading a normal
life, doing their daily chores.

The medical breakthrough achieved by Dr Cherian and his team was
presented at the ongoing international conference on stem cells and
regenerative medicine at the Indian School of Business here. Dr
Cherian, who could not attend the conference, is the founding chairman
of Frontier Lifeline Hospital and Dr KM Cherian Heart Foundation in
Chennai. He is credited with performing India’s first coronary artery
bypass surgery 37 years ago.

The patients, who underwent stem cell therapy, were not fit for
maximal medical therapy, angioplasty, ventricular remodeling, coronary
artery bypass or cardiac resynchronization Therapy (CRT) devices. The
only alternative left for them was to undergo heart transplant. As the
need for transplantable heart far outweighs the availability supply,
the patients opted for stem cell therapy, which had improved their
lives.

According to the presentation, post stem cell therapy follow-ups were
performed with echocardiography (ECG) and revaluations of B-type
Natriuretic Peptide (BNP) levels and signs and symptoms after three
months, six months and one year. There was no procedural mortality or
complications.

Three patients, who were suffering from severely deranged cardiac
function and single or double graftable coronary arteries, underwent
mesenchymal stem cell injection into the myocardium. Seven patients
had endothelial progenitor cell injection into the coronary or into
the myocardium directly, by catheter or by surgery respectively. A
large group of 42 patients received autologous bone marrow mononuclear
cells (MNC) in their heart by catheter or surgical interventions.

“All patients tolerated the procedure well. Viability of MNCs was
about 99 per cent. Ejection fraction increased in 97 per cent of
patients. Symptomatically all the patients did fairly well. In seven
patients post therapy first follow up showed regression in Mitral
regurgitation, and the mitral annular size. All these improvement
showed a slow rise till the sixth month after which improvement in13
patients declined,” the presentation said.

The team noted that cardiac stem cell therapy is a safe therapeutic
tool for the no-option cardiac failure patients. It can be a tool for
bridge to transplant. Monitoring of all the patients’ data shows that
repeated therapy at an interval of six months may be a practiced
modality of treatment.

Consume more fruits, vegetables and keep coronary artery disease at bay

Syed Akbar
Hyderabad: Coronary artery disease (CAD) in Indians below 30
years is mainly due to inadequate consumption of fruits, vegetable
salads and foods rich in folate and vitamin B 12 rather than mutations
in certain genes.

A team of city researchers has found that a majority of young heart
patients examined as part of the study consumed inadequate quantity of
fruits and salads and foods fortified with vitamin B12 and folate or
folic acid.

When their genetic makeup was studied to find out whether any mutation
in genes was responsible for CAD, only a few patients showed such
mutation. A majority of the young heart patients studied had no
genetic mutations, and yet they got coronary artery disease mainly
because of low intake of B12 and folate-rich foods, particularly
vegetables and fruits.

The team comprised doctors from the Institute of Genetics and Hospital
for Genetic Diseases, Apollo Hospital, Care Hospital and Gandhi
Hospital. Coronary artery disease is linked to high levels of an amino
acid (homocysteine) and this is linked to mutations in genes known as
MTHFR and MS. But in 100 young heart patients examined, only a handful
had the mutation, while a majority of them had low levels of B12 and
folate. The quantum of homocysteine also goes up if dietary intake of
B12 and folate is insufficient. Smoking, intake of tobacco products
and lack of physical exercise added to the problem.

Young Indians are three times at higher risk of heart diseases than
people living in the West. "Though high levels of homocysteine have
been widely linked to the early onset of heart diseases in other
populations, a definite proof among Indians is lacking," the team
pointed out adding that high levels of this amino acid is linked
mainly to the diet rather than the genes.

The study gains significance as about 25 per cent of heart attacks
among men and women in India occur when they are younger than 40.
"This is unheard of in other populations," the researchers observed.
They said prolonged cooking and frying of vegetables results in loss
of 90 per cent of folate content.

Heart Diseases: Aping the West proves costly for people in Andhra Pradesh

By Syed Akbar
Hyderabad: Aping the West in food and lifestyle is proving to be dear to people in Andhra Pradesh with heart diseases linked to food habits emerging as the leading cause of death.
According to a recent survey published by the Central Bureau of Health Intelligence, ischemic heart disease characterised by reduced blood supply to the heart has been killing 13.21 per cent of people in Andhra Pradesh. It is the cause of death in 12.2 per cent of women and 14.08 per cent of men.
Incidentally ischemic heart disease tops the 10 important causes of death in people of the State.
Doctors link the disease to smoking, diabetes, hypertension, obesity, excessive use of hydrogenated fats (vanaspathi) and foods containing high cholesterol levels. So far, ischemic heart disease has been the major cause of death in the US and Europe. That it has emerged as the top killer in Andhra Pradesh is a cause for concern, says senior cardiologist Dr PC Rath.
In patients suffering from ischemic heart disease the flow of blood to the heart is obstructed and thus the heart is deprived of oxygen. This leads to death if not attended to immediately. According to Dr Rath, a little change in lifestyle and food habits will help in controlling cardiovascular diseases.
Cerebrovascular disease (bleeding in brain or cutting supply of blood or oxygen to the brain) is the second leading cause of death in Andhra Pradesh, though it is the third leading cause of death in the West. Cancer or malignancy, which is the second leading cause of death in the West, is incidentally the 10th cause of death in Andhra Pradesh.
While lower respiratory (lung) infections is the third over all leading killer in the State, diarrhoeal diseases occupy the third position in case of women and tuberculosis in case of men. Self-inflected injury is the seventh leading killer both among men and women while asthma and stomach cancer is the eighth major cause of death among men and women respectively, according to the CBHI report.
Road accidents occupy the 10th slot in case of men and dementia (group of disorders relating to brain) is the 10th cause of deaths among women. Cirrhosis of the liver is the cause of 2.19 per cent of deaths among men but incidentally it is absent among women. Cirrhosis is linked to alcohol.
Women tend to be more prone to unintentional injuries than men. Statistics show that 4.09 per cent of deaths in women and 3.81 per cent of deaths in men are attributed to unintentional injuries.

Andhra Pradesh plays a role model: Screening for children with heart ailments

By Syed Akbar
Andhra Pradesh is going to add yet another feather in its cap. This time for 
taking up the gigantic task of providing medicare and conducting heart 
surgeries free of cost to around 5000 children, mostly from the lower strata of 
society.
The second phase screening of heart diseases in children, under an innovative 
scheme launched by the State government in August 2004, is currently on in 
the State. Already 3,200 children have been identified for surgery in medical 
camps held in September. Another round of medical camps is scheduled for 
October 8 at 44 centres across the State. Once the screening process is 
completed, heart surgeries will be performed on these children in about 50 
corporate, private and government hospitals.
In the first phase screening held in 2004, over 5500 children were identified 
for surgeries and of them 4700 underwent heart operations. The remaining 
700 children could not make their way to the operation theatre for want of 
infrastructure. These children will now be included in the list of fresh 
beneficiaries in the second phase.
Andhra Pradesh is the first and so far the only State in the country where 
children under 12 years of age are provided free heart treatment in the state-
of-the-art corporate hospitals. They are also provided with free follow up 
treatment. Only the neighbouring Karnataka State has a health insurance 
scheme for children belonging to below the poverty families. Unlike the 
cardiac programme in Andhra Pradesh, the scheme in Karnataka provides for 
general health problems. A CM’s Children Relief Fund was exclusively set 
up for the purpose. 

How the Scheme Began:

It was August 7, 2004. The new Congress government was just settling 
down. Hundreds of children suffering from heart diseases gathered in 
Hyderabad to press for their demand for free medical treatment. The 
Mahajana Sangarshna Samithi had organised the demonstration by 
mobilising poor children and their parents from all most all the rural areas of 
the State.
Tragedy struck the demonstration. One of the children, T Sobhan (12), of 
Shanigaram of Karimnagar district, collapsed on the Lower Tank Bund road 
apparently unable to bear the stress of walking and standing for long under 
the hot sun. A couple of days later, two more children, Rajasekhar from 
Prakasam district and Konda Saidulu from Nalgonda district succumbed to 
heart ailments. Incidentally, these two children too had participated in the 
demonstration.
This moved the new Congress government and Chief Minister YS Rajasekhar 
Reddy announced a special package for children suffering from cardiac 
ailments which includes free heart surgery. Andhra Pradesh thus became the 
first State in the country to introduce free heart treatment for children below 
12 years of age.
In the first year the government conducted screening tests for 5500 children 
and of them about 2000 children underwent surgeries. Another 2700 children 
were operated upon in 2005. The government has initially allocated Rs 8 
crore for the project and announced that it would be a continuous 
programme. Keeping its assurance, the government has now called for the 
second phase of screening tests in all the 23 districts to identify new patients.
The government has also taken up an ambitious programme to strengthen 
facilities in government hospitals so that state-of-the-art medicare is provided 
to poor children. The government has also roped in children specialists to 
perform surgeries.
Now buoyed by the success of the cardiac programme, the government has 
decided to introduce a universal health insurance scheme to take care of the 
health needs of children suffering from various ailments. Children below 12 
years and belonging to below poverty line families will be covered under the 
proposed scheme. According to a rough estimate, two lakh children under 12 
years are suffering from heart problems in the State and about 20,000 
children add to this number every year.

How It Works:

Unlike in other States where free treatment is provided to the poor only in 
government hospitals, the Andhra Pradesh government has made a provision 
for treatment of poor children even in corporate and top class hospitals. The 
provides financial aid to corporate hospitals towards these surgeries and other 
follow up treatment if any.
These private hospitals charge 20 per cent less than the rates fixed by the 
State-controlled Nizam’s Institute of Medical Sciences. The payment is  
made by the Director of Medical Education to the hospital concerned after 
getting scrutiny of bills by a committee constituted for the purpose. 
The State government has divided heart diseases into various categories for 
purpose of treatment. The category I covers PDA interruption 
pericardiectomy, closed mitral valvotomy and PA banding, while category II 
covers BT shunt coarctaion of aorta repair. Under category II, surgeries like 
ASD closure, VSD closure and AP window repair.
The other categories are: category IV: Intracardiac repair of TOF, 
intracardiac repair of TAPVC; Category V: Intracardiac repair of TGA, 
DORV, tricuspid atresia, trunkus arteriosus etc., and other surgeries needing 
special conduits like pulmonary atresia; Category VI: Valve repair, mitrial 
valve repair, tricuspid valve repair; Category VII:  Mitral valve replacements, 
aortic valve replacements, tricuspid valve replacements; Category VIII: 
double valve replacements (mitral valve replacement and aotric valve 
replacement); Category IX: Interventional procedures like percutaneous 
balloon valvuloplasties, balloon septostomy including cardiac catheterization 
and cine angiograms. 
Initially there was no provision for permanent pacemaker implantation (PPI) 
but now the government has included this category also. A new category - 
Category X - has been included to provide for permanent pacemaker 
implantation. Other cardiac problems not included in the above categories, 
whenever they come up would be examined and put in appropriate category 
on a case to case basis by the central cell at Gandhi Hospital in consultation 
with the Director of Medical Education.

Special Cardiac Cells

Moreover, special cardiac cells have been created in seven government 
teaching hospitals, which will treat, operate or refer patients to other 
hospitals. These cells are located at Osmania General Hospital, Hyderabad, 
King George Hospital, Visakhapatnam, Mahatma Gandhi Memorial Hospital, 
Warangal, Gandhi Hospital, Secunderabad, Government General Hospital, 
Kurnool, Government General Hospital, Guntur and Government General 
Hospital, Kakinada. 
On being approached by a child cardiac patient, the cardiac cell in the 
Teaching Hospital will conduct necessary screening and render advice to the 
child patients and his/her parents/attendants. The cardiac cell will undertake 
treatment of the paediatric cardiac ailments at the same teaching hospital 
including surgeries. 
If the surgeries for which facilities are not available or the required expert 
cardiac surgeon personnel are not available in the teaching hospital, then the 
cardiac cell of the teaching hospital will first enquire with the other 
government teaching hospitals as to whether they can handle the required 
type of surgeries.
If any of the other teaching hospitals in the State have such spare capacity, 
the case will be referred to there. If not, it will be referred to the nearest 
private hospital that can perform such surgery. An identification card is 
issued to the patient for this purpose, by the government cardiac cell of the 
teaching hospital.
In case, the patient comes back to the hospital concerned at a later date, 
where surgery is performed, the hospital should have to take proper care of 
the patient. It should not insist reference from the cardiac cell.
Congress MP V Hanumantha Rao demands that the Central government bear 
the cost of operations. "Thousands of children are in a critical condition for 
lack of medical facilities. The State government does not have the resources 
to fund the critical heart operations of children who are waiting for months 
for heart operations. Many children are also dying while they wait for heart 
operations in Andhra Pradesh. The Central government should pay attention 
to this critical problem," he pointed out.

Heart diseases are responsible for about one-third of all deaths in rural India

2006
By Syed Akbar
Hyderabad, Oct 3: Heart diseases are responsible for about one-third of all deaths in rural India while only 13 per cent of deaths are related to accidents including suicide.
An international research study conducted jointly by the George Institute for International Health and the University of Queensland revealed that heart related problems constituted the "major killer" of human beings in the countryside. The findings were published in the International Journal of Epidemiology and the research was carried out in East and West Godavari districts of Andhra Pradesh. The study emphasised the need for India to improve its health services besides creating new health avenues to fight against chronic ailments.
While the incidence of diseases related to heart are on the rise in the country, interestingly enough cases of infectious diseases are on the decline. This, according to the study, is the result of change in social and economic scenario in villages.
The study pointed out that death from injury, both accidents and self-inflicted as in suicide, was the second most common cause of death in rural India contributing to 13 per cent of total deaths. Infectious diseases, including tuberculosis, intestinal infections and HIV/AIDS, are responsible for 12 per cent of deaths, while cancer is contributing to 7 per cent of deaths.
According to Dr Rohina Joshi, the data on the causes of death is an indicator of the health problems now facing the rural India. The spurt in heart related diseases is linked to high rate of smoking, diabetes and high blood pressure among villagers.
The study was conducted in 45 villages spread over East and West Godavari districts covering a total population of 1.80 lakh.

Indians suffer from cardiac ailments 10 years earlier

2006
By Syed Akbar
Hyderabad, Sept 22: Indians suffer from cardiac ailments 10 years before people of other countries develop them. And if the World Health Organisation report is any indication, about 60 per cent of all heart patients in the world will be in India in the next six years.
A research study has now been taken up to find out the reasons for the high prevalence of heart diseases in Asian countries, particularly India. Scientists and researchers have thus far been baffled by the mystery behind heart attacks in people who are not bracketed under high risk groups and who do not have "social vices" like smoking and drinking.
Apollo Hospitals have tied up with John Hopkins to identify the causes responsible for cardiac risk among Indians. The study will find out whether a particular gene is behind heart attacks.
Apollo Hospitals chairman Dr Pratap C Reddy told reporters here on Friday said there was possibly a genetic predisposition to heart diseases among Indian, but the precise cause was still elusive.
"Risk factors that are often associated with heart diseases like hypertension, smoking, high total serum cholesterol and high fat diet do not seem to fully account for the high incidence of the disease in Indians. The disease process also differs in Indians as the coronary vessels are diffusely affected while in other ethnic groups the coronary arteries are more discretely affected. High incidence of diabetes and low levels of good cholesterol with high levels of triglycerides may partially address the high risk of heart diseases in Indians but there is something beyond," Dr Reddy pointed out.