Author Archives: Mukul

EECP Therapy

Enhanced external counterpulsation (EECP) is a mechanical form of treatment for angina. While several clinical studies appear to show that this treatment can be helpful in reducing symptoms of angina in patients with coronary artery disease (CAD), EECP has yet to be accepted by most cardiologists, and has not entered the mainstream of cardiology practice.

What is EECP?
EECP is a mechanical procedure in which long inflatable cuffs (like blood pressure cuffs) are wrapped around both of the patient’s legs. While the patient lies on a bed, the leg cuffs are inflated and deflated synchronously with each heartbeat. The inflation and deflation are controlled by a computer, which uses the patient’s ECG to trigger inflation early in diastole (when the heart relaxes and is filled with blood), and deflation just as systole (heart contraction) begins. The inflation of the cuffs occurs sequentially, from the lower part of the legs to the upper, so that the blood in the legs is “milked” upwards, toward the heart.

EECP has at least two potentially beneficial actions on the heart. First, the milking action of the leg cuffs increases the blood flow to the coronary arteries during diastole. (The coronary arteries, unlike other arteries in the body, receive their blood flow in between heartbeats, instead of during each heartbeat.) Second, by its deflating action just as the heart begins to beat, EECP creates something like a sudden vacuum in the arteries, which reduces the work the heart muscle has to perform in pumping blood. It is also speculated that EECP may help reduce endothelial dysfunction.

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EECP is administered as a series of outpatient treatments. Patients receive 5 one-hour sessions per week, for 7 weeks (for a total of 35 sessions). The 35 one-hour sessions are aimed at provoking long lasting beneficial changes in the circulatory system.

How Effective Is EECP?
Several studies suggest that EECP can be quite effective in treating chronic stable angina. A small randomized trial showed that EECP significantly improved both the symptoms of angina (a subjective measurement) and exercise tolerance (a more objective measurement) in patients with CAD. EECP also significantly improved “quality of life” measures, as compared to placebo therapy. Other studies have shown that the improvement in symptoms following a course of EECP seems to persist for up to five years (though 1 in 5 patients may require another course of EECP to maintain their improvement).

How Does EECP Work?
The mechanism for the apparent sustained benefits seen with EECP is unknown. There is some evidence suggesting that EECP can help induce the formation of collateral vessels in the coronary artery tree, by stimulating the release of nitric oxide and other growth factors in within the coronary arteries. There is also evidence that EECP may act as a form of “passive” exercise, leading to the same sorts of persistent beneficial changes in the autonomic nervous system that are seen with real exercise.

Can EECP Be Harmful?
EECP can be somewhat uncomfortable, but is generally not painful. In studies, the large majority of patients have tolerated the procedure quite well.

But not everyone can have EECP. People probably should not have EECP if they have aortic insufficiency, or if they have had a recent cardiac catheterization, an irregular heart rhythm such as atrial fibrillation, severe hypertension, peripheral artery disease involving the legs, or a history of deep venous thrombosis. For anyone else, however, the procedure appears to be safe.

When Is EECP Recommended?
Based on what we know today, EECP should be considered in anybody who still has angina despite maximal medical therapy, and in whom stents or bypass surgery are deemed not to be good options. Medicare has approved coverage for EECP for patients with angina who have exhausted all their other choices.

In 2014, several professional organizations (the American College of Cardiology, American Heart Association, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons) finally agreed in a focused update that EECP ought to be considered for patients with angina refractory to other treatments.

Why Isn’t EECP Used More Often?
In general, the cardiology community has largely chosen to ignore such an outlandish form of therapy, and many cardiologists fail to to even consider offering EECP as a therapeutic option. Consequently, most patients who have angina never hear about it.

Indeed, EECP is a little outlandish. It certainly does not look like cardiology. Nobody can really explain how it works. And, from a cardiologist/s viewpoint, when you compare the relative effort and relative reimbursement of EECP to something like inserting a stent (35 sessions over 7 weeks vs. a 30-minute procedure) there is no contest. To expect cardiologists to embrace EECP with any enthusiasm simply ignores human nature.

Still, when a noninvasive treatment for angina exists that is safe and well tolerated, when available evidence (as imperfect as it may be) strongly suggests the treatment is quite effective in many patients, and when the patient being treated will be able to tell pretty definitively whether or not the treatment has helped in their own individual case (by the presence or absence of a substantial reduction in angina symptoms), it does not seem unreasonable to allow patients with stable angina to opt for a trial of that noninvasive therapy, perhaps even before they are pushed into invasive therapy.

If you are being treated for stable angina and still have symptoms despite therapy, it is entirely reasonable for you to bring up the possibility of trying EECP. Your doctor should be quite willing to discuss this possibility with you, objectively and without prejudice.

Resources:
https://www.verywellhealth.com/enhanced-external-counterpulsation-eecp-1745293

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Treat Leg Pain With RICE

As we age, one or both of our legs can pain. A slip or fall or even an awkward step can sprain the ankle. It bears half the weight of the upright body but is a relatively weak joint. If the ligaments are strained, swelling and pain occur. If the ligaments are torn, there may be bruising as well. The R.I.C.E. treatment (rest, application of ice every 20 minutes, compression with an elastocrepe bandage and elevation ) for 2-3 days will usually work. Medication such as paracetamol and ibuprofen help relieve the pain. If there is no improvement after three days, then it is advised to consult a doctor.

Now what exactly the RICE method of healing injury:-

Step 1: Rest
Pain is your body’s signal that something is wrong. As soon as you’re hurt, stop your activity, and rest as much as possible for the first 2 days. Don’t try to follow the “no pain, no gain” philosophy. Doing so with certain injuries, like a moderate to severe ankle sprain, can make the damage worse and delay your recovery. Doctors say you should avoid putting weight on the injured area for 24 to 48 hours. Resting also helps prevent further bruising.

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Step 2: Ice
Ice is a tried-and-true tool for reducing pain and swelling. Apply an ice pack (covered with a light, absorbent towel to help prevent frostbite) for 10 minutes, then remove for 10 minutes. Repeat this as often as possible for the first 24 to 48 hours after your injury. Don’t have an ice pack? A bag of frozen peas or corn will work just fine.

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Step 3: Compression
This means wrapping the injured area to prevent swelling. Wrap the affected area with an elastic medical bandage (like an ACE bandage). You want it to be snug but not too tight — if it’s too tight, it’ll interrupt blood flow. If the skin below the wrap turns blue or feels cold, numb, or tingly, loosen the bandage. If these symptoms don’t disappear right away, seek immediate medical help.

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Step 4: Elevation
This means raising the sore body part above the level of your heart. Doing so reduces pain, throbbing, and any internal bleeding that can lead to bruises. It’s not as tricky to do as you might think. For example, if you have an ankle sprain, you can prop your leg up on pillows while sitting on the sofa. The CDC recommends you keep the injured area raised whenever possible, even when you’re not icing it.

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Black Grapes

Description:
Black grapes, also sometimes known as Concord grapes or slipskin grapes, are sold fresh or made into fresh juice, jams or jellies. They are rich in a number of nutrients, including natural antioxidants, and can be part of a healthy diet that reduces the number of calories you consume, helping you lose weight.

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Food Value:

Calorie Content:
Fresh black grapes are low in calories, with a 1-cup serving containing only 62 calories and less than 1/2 gram of total fat. While you can eat the grapes whole and raw, making a fresh juice from them by blending 1 cup of grapes with 1/2 cup of fresh water will give you 1 cup of fresh juice that is lower in calories than a commercially produced grape juice, even if unsweetened. One cup of commercial grape juice has 152 calories per serving and also less than 1/2 gram of total fat. Substituting whole grapes or fresh grape juice for a 12-ounce can of grape soda once a week can reduce your caloric intake by over 5,000 calories, or roughly 1.5 pounds of body weight, in the space of one year.

Dietary Fiber Content:
Black grapes are a good source of dietary fiber, which gives bulk to your diet, helping you eat less.Dietary fiber can also help reduce the symptoms of constipation as well as lower your blood cholesterol levels. A serving of black grapes has 0.8 gram of dietary fiber, a high amount for the small serving size. This provides 2 to 3 percent of the recommended dietary intake and can help you meet the daily recommendation, which is important as most Americans have a diet that is too low in fiber.

Sugar Content:
Black grapes are naturally sweet, with almost 15 grams per cup. The American Heart Association recommends you choose natural sugars, such as those found in grapes, over added sugars because natural sugars have greater nutritive impact. Because of their natural sweetness, you can use grapes as a healthy way to satisfy a sweet tooth or sugar craving. In addition to eating them fresh, you can also freeze grapes and eat them as a refreshing, low-calorie and sweet dessert, substituting them for other foods, such as ice cream or cake, that are often high in added sugar.

Antioxidants and Fruit Intake:
The U.S. Department of Agriculture recommends eating between 1 1/2 and 2 cups of fruit each day as part of a balanced diet, which is important for healthy weight loss. Black grapes are also a rich source of the natural antioxidant resveratrol, a type of flavonoid. In 2011, the “Annals of the New York Academy of Sciences” published a report that stated that diets high in resveratrol led to overall reduced body fat levels as well as a decrease in overall weight gain.

Vitamin Contents:

The U.S. Department of Agriculture recommends that healthy adult men and women consume 2 cups of fruit each day. A cup of most sliced or chopped raw fruits fulfills half of this requirement, including 1 cup of whole grapes – equivalent to about 32 whole seedless grapes. Both the red and green varieties are low in fat, high in fiber and a source of essential vitamins.

Vitamin K:
Each 1-cup serving of fresh grapes contains 22 micrograms of vitamin K. For a man, this amount supplies 18 percent of his recommended daily allowance; for a woman, a cup of grapes fulfills 24 percent of her vitamin K requirement per day. Your body needs adequate vitamin K to build strong bones and to synthesize several of the proteins required for blood coagulation. If your diet lacks foods rich in vitamin K, you may be more likely to develop osteoporosis or bleed too much when injured.

Vitamin B-6:
As an adult, you should get at least 1.3 milligrams of vitamin B-6 each day. Grapes contain 0.13 milligrams of vitamin B-6 in every cup, supplying 10 percent of the required daily intake. Also known as pyridoxine, vitamin B-6 is necessary for the production of neurotransmitters and hormones such as serotonin. Along with other B vitamins, it helps you metabolize the protein, fats and carbohydrates in your diet. People who consume plenty of vitamin B-6 may have a lower risk of depression, heart disease and rheumatoid arthritis, according to University of Maryland Medical Center.

Thiamin Source:
Every 1-cup serving of fresh grapes supplies 0.1 milligram of thiamin, or vitamin B-1. Consuming this amount of grapes would fulfill 8.3 percent of a man’s daily requirement of the nutrient and 9 percent of a woman’s recommended intake. Because this isn’t a very good source of the vitamin, you can’t get your daily recommended intake from grapes alone. Thiamin supports the health of your immune system and aids in the production of adenosine triphosphate, the primary compound your cells use for energy. Most Americans aren’t severely deficient in thiamin, says UMMC, but if you regularly don’t get enough, you may have a higher risk of developing cataracts.

Riboflavin Needs:
Riboflavin, another member of the B family of vitamins, is needed to synthesize red blood cells, to support nervous system function and to help prevent free radical compounds from damaging DNA or cellular tissue. You may have a higher risk of cataracts if your diet doesn’t contain enough riboflavin. You may also suffer from digestive disorders or fatigue. A 1-cup serving of grapes contains approximately 0.1 milligram of riboflavin, or about 7.6 percent of a man’s recommended daily intake and 9 percent of a woman’s. Consume additional sources of riboflavin to meet your DRI.

Health Benefits:
Black grapes, velvety colored and deliciously sweet and juicy, can be consumed fresh and raw, dried as raisins or as a juice. Rich in nutrients, black seedless grapes are similar in taste and texture to red or green grapes, but because of their skin color, they have a higher antioxidant content. The U.S. Department of Agriculture recommends between 1 1/2 and 2 cups of fruit each day as part of a balanced diet, and eating black grapes will help you meet that goal.

Anthocyanins are the flavonoid compound that gives black grapes their dark color; the darker the fruit, the higher the anthocyanin content. A natural antioxidant, anthocyanins protect your body from damage from free radicals, produced as your body breaks down food, reducing the risk of cell damage and death and potentially slowing down the aging process. A study published in the 2010 “Annual Review of Food Science and Technology” found that anthocyanins may help reduce inflammation and cancer activity, alleviate diabetes and control obesity.

Polyphenols also are present in high concentrations in black grapes. One of the most widely found and consumed natural antioxidants, they occur mainly in fruits and plant-based drinks, including juices and red wine made from black grapes. A 2005 publication of the American Society for Clinical Nutrition cites polyphenols as preventing cardiovascular diseases, cancers and osteoporosis. They may also help prevent neurodegenerative diseases and certain types of diabetes. Most of the studies were in vitro or animal experiments, however, so the research isn’t conclusive.

According to “A History of Food,” black grapes have a lower glycemic index than other grapes. While “Harvard Health Publications” cites the average GI for all grapes as 59, black grapes, according to “A History of Food,” have a GI of 43 to 53. The lower the GI is, the less effect the food has on your blood sugar and insulin levels. This means grapes won’t cause your blood sugar levels to spike, which, in addition to being dangerous for diabetics, can lead to energy highs and crashes.

Resveratrol Content:

A phytonutrient, resveratrol is present in high concentrations in all grapes, including black grapes. A natural antioxidant, resveratrol may be useful in increasing lifespan and preventing the growth and development of cancer cells. But the majority of studies of the substance have been done on yeast, insects and animals, so the effect of resveratrol in humans isn’t yet understood. Some scientists believe it may be the resveratrol content of red wine that makes the “French Paradox” possible — low levels of cardiovascular disease among the French despite high levels of cigarette smoking and saturated fat in the typical French diet.

Resources:
https://www.livestrong.com/article/277286-benefits-of-black-grapes-in-weight-loss/

Yogurt The best food stuff that everyone should eat


A new study suggests, it could lower the risk of stroke, Victoria Lambert looks at the benefits of this superfood.

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Could a pot of full-fat yogurt for breakfast be an alternative to a daily aspirin to prevent strokes? New research published in the American Journal of Clinical Nutrition suggests that a fatty acid found in dairy could lower the risk of death from cardiovascular disease — and strokes in particular.

Moreover, the University of Texas scientists, who analysed nearly 3,000 adults aged over 65 for 22 years, reported that they had found no significant link between dairy fats and heart disease and stroke, two of the biggest killers associated with a diet high in saturated fat.

The report follows another US study which found that men and women who already have high blood pressure are at lower risk of developing cardiovascular disease if they eat more than two servings of yogurt a week. Scientists from the Boston University School of Medicine, Massachusetts, looked at two large cohorts (55,898 females from the Nurses’ Health Study, and 18,232 males from the Health Professionals Follow-Up Study) and found that eating yogurt as part of a healthy diet reduced the risk by 17 per cent in women and 21 per cent in men.

But is yogurt, with its balance of protein, carbohydrates and fat that’s rich in calcium and Vitamin D, really such a “superfood”? Or is it time to rethink everything we thought we knew about its health benefits?

Dieter’s best friend:

Time was when dieters were advised to reach for a yogurt to take the edge off their appetite. Not any more.
“Not if you are opting for a low-fat yogurt which is high in sugar,” says Kim Pearson, a nutritionist based in London. “Some well-known brands contain 20g (five teaspoons) of sugar per serving.”

The NHS recommends that all adults limit sugar consumption to 30g a day. In the new study, the low-fat yogurts contained 17g of sugar and researchers noted that those “seeking to increase yogurt intake should be advised to maintain a healthful eating pattern”.

Triggers asthma :

A study from the University of Wisconsin-Madison published in the Journal of Nutrition last month found that eating 8oz (226gm) of yogurt before a meal improved metabolism and dampened down inflammation, which is associated with chronic conditions like asthma, arthritis and inflammatory bowel disease.

The scientists behind the study, supported by the American National Dairy Council, claim the key is yogurt’s ability to calm chronic inflammation by improving levels of healthy bacteria in the gut.

The news will be of interest to anyone with an allergy-related condition, such as asthma, who may have eschewed dairy thinking it could trigger an attack.

“Calcium-rich dairy products are essential for healthy bones, especially for children and adolescents. And people with asthma can be at higher risk of bone disease osteoporosis because of the use of steroid medication. So, only avoid dairy products if necessary, ensuring you replace them with other sources of calcium.”

Probiotic power :

“Yogurts contain probiotics which can improve a range of gut conditions,” says Dr Foster. “But the dose in the brands you find in supermarkets is so low, it is of negligible benefit. The probiotics get broken down by stomach acid long before they get a chance to be useful.”

An independent Canadian study published in Nutrients in 2017 agrees. Scientists from the University of Toronto looked at 31 studies which found probiotics were associated with “decreased diarrhoea and constipation, improved digestive symptoms, glycaemic control, antioxidant status, blood lipids, oral health and infant breastfeeding outcomes, as well as enhanced immunity and support for Helicobacter pylori [which causes ulcers] eradication.”

But they warned that many of the studies had been funded by the food industry and tested dosages that were up to 25 times the dosage found in most food products. “Many dosages are too low to provide the benefits demonstrated in clinical trials,” warned Dr Mary Scourboutakos, the lead researcher. “Further research is needed to enable more effective use of these functional foods.”

Pearson says: “Consuming probiotics in food is great as everyday maintenance but if it was for a specific purpose — such as after taking a course of antibiotics — I would recommend a high-strength supplement instead.”

Go dairy-free :

Non-dairy yogurts — those made with soya beans or coconut milk — can be among the most highly processed varieties, and are often laden with sugar; Alpro’s Go On Strawberry, for instance, contains two teaspoons per 100g.

However, Pearson singles out one dairy-free variety for praise. “This yogurt contains just four ingredients: coconut milk, vanilla bean paste, tapioca starch and live cultures. (The plain version contains just three — no vanilla). It’s relatively high in fat, but they are healthy fats, so that’s no bad thing as long as it’s in moderation.”

Resources:
https://www.telegraphindia.com/health/yogurt-myths-248965?ref=health-new-stry

Labeo calbasu


Binomial name :Labeo calbasu
ingdom: Animalia
Phylum: Chordata
Class: Actinopterygii
Order: Cypriniformes
Family: Cyprinidae
Subfamily: Labeoninae
Genus: Labeo

Other Names: Kalbasu, Baus, Kalia, Black Rahu

Bengali Name: Kalbose

Habitat:Labeo calbasu is native to Bangladesh; China; India; Myanmar; Nepal; Pakistan; Thailand

Description:
The labeos appear fairly similar to the “freshwater sharks” of the genus Epalzeorhynchos, which is also part of the Labeoninae (or Labeonini), but is not very closely related. Labeos are larger, and have a more spindle-shaped body, as they are mostly free-swimming rather than benthic like Epalzeorhynchos. Their mouths look very different, too; they have a pronounced rostral cap, which covers the upper lip except when feeding. The lips are expanded into thick, sausage-shaped pads which have keratinized edges. Thus, their mouth parts are moderately apomorphic; not as little-developed as in barbs or in Epalzeorhynchos, but neither as extensive as in, for example, Garra or Ptychidio. The genus name Labeo is Latin for “one who has large lips”.

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Labeos have the two barbels on the rostrum which are common among the Cyprinidae, and also another pair of barbels at the rear edges of the lower maxilla, which has been lost in some of their relatives. They have a well-developed vomeropalatine organ. In the Weberian apparatus, the posterior supraneural bone is elongated and contacts the skull at the forward end.

Food Value:This fish has very high protein content and very tasty fry or curry can be made from the flesh of the fish.

Resources:
https://en.wikipedia.org/wiki/Labeo

Kalbasu: Labeo calbasu