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Holter Monitor

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Alternative Names : Ambulatory electrocardiography; Electrocardiography – ambulatory

Definition
A Holter monitor is a machine that continuously records the heart’s rhythms. The monitor is usually worn for 24 – 48 hours during normal activity.It is a portable EKG device that records your heart rhythm over time, outside the hospital or doctor’s office.Whereas a regular EKG examines your heart’s electrical activity for a few minutes, the Holter monitor examines changes over a sustained period of time-usually a 24- to 48-hour period-while you go about your daily activities and even while you sleep. Doctors use it to evaluate symptoms that come and go and that might be related to heart-rhythm changes.

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How the Test is Performed ?
Electrodes (small conducting patches) are stuck onto your chest and attached to a small recording monitor. You carry the Holter monitor in a pocket or small pouch worn around your neck or waist. The monitor is battery operated.

While you wear the monitor, it records your heart’s electrical activity. You should keep a diary of what activities you do while wearing the monitor. After 24 – 48 hours, you return the monitor to your doctor’s office. The doctor will look at the records and see if there have been any irregular heart rhythms.

It is very important that you accurately record your symptoms and activities so that the doctor can match them with your Holter monitor findings.
Why the Test is Performed ?
Holter monitoring is used to determine how the heart responds to normal activity. The monitor may also be used:

*After a heart attack
*To diagnose heart rhythm problems
*When starting a new heart medicine

It may be used to diagnose:
*Atrial fibrillation/flutter
*Multifocal atrial tachycardia
*Palpitations
*Paroxysmal supraventricular tachycardia
*Reasons for fainting
*Slow heart rate (bradycardia)
*Ventricular tachycardia

What happens when the test is performed?
A technician in your doctor’s office or a diagnostic lab fits you with a Holter monitor and explains how to use it. Five stickers are attached to your chest.Wires snap onto each of these stickers and connect them to the monitor. The wires detect your heart’s electrical pattern throughout the day, while the monitor records and stores the data for doctors to interpret later. You can fit the monitor into a purse or jacket pocket or wear it over your shoulder by its strap.

You can go about your normal activities with two exceptions. First, you can’t take a shower or bath during the period that you’re wearing the monitor. Second, you are given a small diary in which to note any worrisome symptoms you feel and record the time when they occur. The doctor will later review both your diary and the data about your heart’s activity from the monitor, to see if any symptoms you experienced were caused by some underlying heart problem. There are no side effects from the testing.
How to Prepare for the Test ?
There is no special preparation for the test. Your doctor will start the monitor. You’ll be told how to replace the electrodes should they fall off or become loose.

Tell your doctor if you are allergic to any tape or other adhesives. Make sure you shower or bathe before you start the test. You will not be able to do so while you are wearing a Holter monitor

Men with a lot of hair on their chest will probably have to shave it.

How the Test Will Feel?
This is a painless test. However, some people may need to have their chest shaved so the electrodes can stick.

You must keep the monitor close to your body. This may make sleeping difficult for some people.

You should continue your normal activities while wearing the monitor.

Risk Factors:
There are no risks.However, you should be sure not to let the monitor get wet.

Must you do anything special after the test is over?
You need only return the Holter monitor.

Normal Results:-
Normal variations in heart rate occur with activities. A normal result is no significant changes in heart rhythms or pattern.

What Abnormal Results Mean?
Abnormal results may include various arrhythmias. Changes may mean that the heart is not getting enough oxygen.

The monitor may also detect conduction block, a condition in which the atrial electrical activity is either delayed or does not continue into the ventricles of the heart.

How long is it before the result of the test is known?
It usually takes a few days for your recording to be printed out and examined.

Considerations :-
Electrodes must be firmly attached to the chest so the machine gets an accurate recording of the heart’s activity.

While wearing the device, avoid:
*Electric blankets
*High-voltage areas
*Magnets
*Metal detectors

It is very important for you to keep a diary of symptoms. The diary should include the date, time of day, type, and duration of symptoms.

Resources:
https://www.health.harvard.edu/fhg/diagnostics/holter-monitor.shtml
http://www.nlm.nih.gov/MEDLINEPLUS/ency/imagepages/8810.htm
http://www.nlm.nih.gov/MEDLINEPLUS/ency/article/003877.htm

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FDA Cites Toxic Risk Of Popular Head-Lice Drug

Post author By Mukul
Post date February 23, 2008
2 Comments on FDA Cites Toxic Risk Of Popular Head-Lice Drug

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The sole U.S. maker of an insecticide-based treatment for head lice has stopped promoting the product after a sharply worded warning from the Food and Drug Administration that its marketing misled consumers by downplaying the rare, but serious, risks of the treatments.

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The move follows years of controversy over prescription shampoo and lotion treatments that contain the insecticide lindane, including a ban on their use in California. Lawmakers in Michigan, New York and Minnesota are considering curbing use of the products.

In a little-noticed December letter, the FDA cites concern over some of the information drugmaker Morton Grove Pharmaceuticals provided on websites and in mailed materials, including a statement by the company that treating head lice effectively requires two applications, several days apart. That is “extremely alarming given that retreatment with Lindane Shampoo can lead to increased exposure and possibly death,” the FDA says.

Millions of cases of head lice and body mites are reported each year in the USA, often among children. More than 166,000 prescriptions for lindane treatments â€” almost 10% of all prescriptions for head lice and scabies â€” were written from January to November 2007, according to the tracking firm IMS Health.

RELATED: States may restrict lice treatments:

Hospitalizations, seizures and deaths have been reported after the use of Lindane Shampoo and Lindane Lotion, according to the products’ warning label. The FDA requires the prescriptions to carry that warning. The warning label also cites “lindane toxicity, verified by autopsy” in two deaths: an infant and an adult who used the product to commit suicide.

Morton Grove was purchased by Wockhardt, an India-based company, in October. It says in a response letter that the new owners “do not believe” that the marketing materials “intended to downplay” the risks associated with the shampoo. Morton Grove President and CEO Kurt Orlofski said in an interview the firm has stopped its promotion, as requested by the FDA, until it develops new marketing materials.

“The FDA has had a number of occasions to review the safety and efficacy of product and keep it or pull it: They have kept it on the market,” Orlofski said. “It’s an important second-line therapy.”

The FDA says lindane products are useful as a last resort against head lice and scabies. “The benefit of the drug for treating scabies and lice outweigh the risk,” FDA spokeswoman Rita Chappelle said.

Several treatments for head lice are available, including combing out the lice and their nits, over-the-counter products and prescription treatments.

In 2006, the Environmental Protection Agency banned lindane as an agricultural insecticide, citing its toxicity. About 50 other countries already ban or restrict the agricultural use of lindane.

Sources:http://www.usatoday.com/news/health/2008-01-30-lindane_N.htm?csp=34

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Cough Syrup Could Harm Kids

Post author By Mukul
Post date January 22, 2008
No Comments on Cough Syrup Could Harm Kids

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The next time your child sneezes and wheezes, don’t reach out for the cough syrup bottle and a teaspoon. It not only doesn’t always work, chances are it could be dangerous for the kid. Talk to a doctor instead….>….CLICK & SEE

Though cough and cold remedies have been widely prescribed and routinely used by parents without consulting a doctor, medical experts now say these have serious side-effects and could even be lethal in certain cases.

After months of debate, the US Food and Drug Administration issued a public health advisory on Thursday warning parents against giving over-the-counter (OTC) cold and cough medicines to children under 2 years, because of “serious and potentially life-threatening side effects”. Some doctors and pharma industry experts, however, say low doses aren’t harmful but acknowledge overdose has serious side-effects. Also, decongestants mainly target symptoms, while the cause of the problem remains.

Some side-effects to watch out for are drying of the mouth, stomach problems and changes in heart rate and blood pressure.

Doctors say the FDA warning should be taken seriously here as there are few controls on sale of medicines and most, including cough syrups, are available without prescription.

There are some 200-300 cough and cold medicines in the market, including Benadryl, Cinaryl, Corex, Chericof, T-minic, Cosome, Deletus, Dristan Expectorant, Grilinctus, Phensydyl, Tixylix and Zeet Expectorant.

Companies say the FDA advisory may not affect them much. “Our label clearly says it should not be given to children below two years. We do not sell paediatric cough formulations in India,” says Anil Nayak, director of Johnson & Johnson.

Click to read …>‘Cough syrup can cause stroke’

Source: The Times Of India