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Herbs & Plants

Gotu kola (Hemidesmus indicus)

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Botanical Name : Hemidesmus indicus
Family:Apocynaceae
Subfamily:Asclepiadoideae
Genus:Hemidesmus
Species:H. indicus
Kingdom: Plantae
Order:Gentianales

Synonyms: Hydrocotyle asiatica – L.

Common Names:Gotu Kola,Centella, March Pennywort, Indian Pennywort, Hydrocotyle, Brahmi (Sanskrit), Luei Gong Gen (Chinese)(Note: Gotu kola should not be confused with kola nut.)

In South Asia, other common names of centella include:

Thalkudi in Oriya;  Sarswathi aku in Telugu;  Kudavan, (Muththil), or  Kudangal  in Malayalam;   Thankuni  in Bengali;  Gotu kola  in Sinhala;  Brahmi  in Marathi:  Ondelaga  in Kannada;   Vallaarai  in Tamil; Brahmi booti in Hindi; Perook in Manipuri;   Manimuni  in  Assamese;Timare in Tulu; Tangkuanteh in Paite;   Brahmabuti or  Ghod-tapre  in Nepali; and  Kholcha ghyan  in Newari  Nepal Bhasa.

Habitat :Centella asiatica is native to E. Asia – India, China and Japan. Australia. Grows on Old stone walls and rocky sunny places in lowland hills and especially by the coast in central and southern Japan. Shady, damp and wet places such as paddy fields, and in grass thickets

Description:
Centella asiatica is an evergreen Perennial plant growing to 0.2m by 1m.
It is hardy to zone 8 and is frost tender.

click to see the picture..

The stems are slender, creeping stolons, green to reddish-green in color, connecting plants to each other. It has long-stalked, green, reniform leaves with rounded apices which have smooth texture with palmately netted veins. It is in leaf all year, in flower from July to August, and the seeds ripen from August to September. The flowers are hermaphrodite (have both male and female organs) and are pollinated by Insects.

The flowers are pinkish to red in color, born in small, rounded bunches (umbels) near the surface of the soil. Each flower is partly enclosed in two green bracts. The hermaphrodite flowers are minute in size (less than 3 mm), with 5-6 corolla lobes per flower. Each flower bears five stamens and two styles. The fruit are densely reticulate, distinguishing it from species of Hydrocotyle which have smooth, ribbed or warty fruit. The plant is self-fertile. The leaves are borne on pericladial petioles, around 2 cm. The rootstock consists of rhizomes, growing vertically down. They are creamish in color and covered with root hairs.

Cultivation:
Prefers a moist to wet soil in sun or partial shade. Plants also grow on walls in the wild and so should tolerate drier conditions[K]. This species is not hardy in the colder areas of the country, it tolerates temperatures down to between -5 and -10°c. It grows and spreads very well outdoors during the summer in most parts of the country and is very easy to increase by division. It can therefore be grown as a summer crop with divisions being taken during the growing season and overwintered in a greenhouse in case the outdoor plants are killed by winter cold.

Propagation:
Seed – sow spring in a greenhouse. Prick out the seedlings into individual pots when they are large enough to handle and grow them on in a greenhouse for their first winter. Plant them out in late spring or early summer of the following year, after the last expected frosts[K]. Division is simple at any time in the growing season, though the spring is probably best[K]. We find that it is best to pot up the divisions until they are rooting away well, though in selected mild gardens it should be possible to plant the divisions out directly into their permanent positions

Edible Uses:
Edible Parts: Leaves.

Leaves – raw or cooked. Used in salads and in curries. Cooked as a vegetable. An aromatic flavour, we have found them to be rather overpowering in salads when used in any but small quantities.

Medicinal Uses:
Adaptogen; Antiinflammatory; Cardiac; Depurative; Diuretic; Febrifuge; Hypotensive; Nervine; Sedative; Skin; Tonic.

Gotu kola is an outstandingly important medicinal herb that is widely used in the Orient and is becoming increasingly popular in the West. Its Indian name is ‘Brahmi’ which means ‘bringing knowledge of the Supreme Reality’ and it has long been used there medicinally and as an aid to meditation. It is a useful tonic and cleansing herb for skin problems and digestive disorders. In India it is chiefly valued as a revitalizing herb that strengthens nervous function and memory. The whole plant is alterative, cardio-depressant, hypotensive, weakly sedative and tonic. It is a rejuvenating diuretic herb that clears toxins, reduces inflammations and fevers, improves healing and immunity, improves the memory and has a balancing effect on the nervous system. It has been suggested that regular use of the herb can rejuvenate the nervous system and it therefore deserves attention as a possible cure for a wide range of nervous disorders including multiple sclerosis[K]. Recent research has shown that gotu kola reduces scarring, improves circulatory problems in the lower limbs and speeds the healing process. It is used internally in the treatment of wounds, chronic skin conditions (including leprosy), venereal diseases, malaria, varicose veins, ulcers, nervous disorders and senility. Caution should be observed since excess doses cause headaches and transient unconsciousness. Externally, the herb is applied to wounds, haemorrhoids and rheumatic joints. The plant can be harvested at any time of the year and is used fresh or dried. Another report says that the dried herb quickly loses its medicinal properties and so is best used fresh.

Medicinal Uses and Indications

Treatment :

Wound Healing and Skin Lesions
Gotu kola contains triterpenoids, compounds that have been shown to aid in wound healing. For example, animal studies indicate that triterpenoids strengthen the skin, increase the concentration of antioxidants in wounds, and restore inflamed tissues by increasing blood supply. Because of these properties, gotu kola has been used externally for burns, psoriasis, prevention of scar formation following surgery, recovery from an episiotomy following vaginal delivery of a newborn, and treatment of external fistulas (a tear at or near the anus).

Venous Insufficiency and Varicose Veins
When blood vessels lose their elasticity, blood pools in the legs and fluid leaks out of the blood vessels, causing the legs to swell (venous insufficiency). In a study of 94 people with venous insufficiency, those who took gotu kola reported a significant improvement in symptoms compared to those who took placebo. In another study of people with varicose veins, ultrasound examination revealed improvements in the vascular tone of those who took gotu cola.

High Blood Pressure

In a study of people with heart disease and high blood pressure, those who took abana (an Ayurvedic herbal mixture containing gotu kola) experienced a significant reduction in diastolic blood pressure (pressure on blood vessels when the heart is at rest) compared to those who took placebo. Further studies are needed to determine whether gotu kola alone, some other herb in the Ayurvedic mixture, or the particular combination of all the herbs in the remedy is responsible for the beneficial effect.
Anxiety
Triterpenoids (active compounds in gotu kola) have been shown to soothe anxiety and boost mental function in mice. A recent study found that people who took gotu kola were less likely to be startled by a novel noise (a potential indicator of anxiety) than those who took placebo. Although the results of this study are somewhat promising, the dose used in this study was extremely high, making it difficult to draw any conclusions about how gotu kola might be used by people with anxiety.

Scleroderma
One study involving 13 females with scleroderma found that gotu kola decreased joint pain, skin hardening, and improved finger movement.

Insomnia

Because of sedative effects demonstrated in animals, gotu kola has been used to help people with insomnia.

Dosage and Administration :
Gotu kola is available in teas, as dried herbs, tinctures, capsules, tablets, and ointments. It should be stored in a cool, dry play and used before the expiration date on the label.

Pediatric :
There is currently no information in the scientific literature about the use of gotu kola for children. Therefore, it is not recommended for those under 18 years old.

Adult
The adult dosage of gotu kola may vary depending on the condition being treated. An appropriately trained and certified herbalist, such as a naturopath, can provide the necessary guidance.

The standard dose of gotu kola varies depending on the form:

Dried herb  to make tea, add ¼ to ½ tsp dried herb to a cup of boiling water (150 mL) for 10 minutes, 3 times a day
Powdered herb (available in capsules)  1,000 to 4,000 mg, 3 times a day
Tincture (1:2, 30% alcohol) 30 to 60 drops (equivalent to 1.5 to 3 mL – there are 5 mL in a teaspoon), 3 times a day
Standardized extract—60 to 120 mg per day; standardized extracts should contain 40% asiaticoside, 29% to 30% asiatic acid, 29% to 30% madecassic acid, and 1% to 2% madecassoside; doses used in studies mentioned in the treatment section range from 20 mg (for scleroderma) up to 180 mg (in one study for venous insufficiency; although, most of the studies for this latter condition were conducted using 90 mg to 120 mg per day).
The recommended dosage for people with insomnia is ½ tsp of dried herb in a cup of water taken for no more than 4 to 6 weeks.

Precautions
The use of gotu kola for more than 6 weeks is not recommended. People taking the herb for an extended period of time (up to 6 weeks) should take a 2-week break before taking the herb again.

Asiaticoside, a major component of gotu kola, has also been associated with tumor growth in mice. Though more studies are needed, it is wise for anyone with a history of precancerous or cancerous skin lesions   such as squamous cell, basal cell skin cancer, or melanoma  to refrain from taking this herb.

Side Effects
Side effects are rare but may include skin allergy and burning sensations (with external use), headache, stomach upset, nausea, dizziness, and extreme drowsiness. These side effects tend to occur with high doses of gotu kola.

Pregnancy and Breastfeeding
Pregnant women should not take gotu kola because it may cause spontaneous abortion. There is little or no information regarding the safety of this herb during breastfeeding, so nursing mothers should refrain from taking this herb.

Geriatric Use
People older than 65 years should take gotu kola at a lower than standard dose. The strength of the dosage can be increased slowly over time to reduce symptoms. This is best accomplished under the guidance of an appropriately trained and certified herbalist such as a naturopathic doctor.

Interactions and Depletions
There have been no reports documenting negative interactions between gotu kola and medications to date. Since high doses of gotu kola can cause sedation, individuals should refrain from taking this herb with medications that promote sleep or reduce anxiety.

Disclaimer:
The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplements, it is always advisable to consult with your own health care provider.

Resources:

http://en.wikipedia.org/wiki/Centella_asiatica

http://digedibles.com/database/plants.php?Centella+asiatica

www.umm.edu/altmed/ConsHerbs

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Ailmemts & Remedies

Takotsubo cardiomyopathy

  1. Other Names: Broken-heart syndrome, Transient apical ballooning syndrome, Apical ballooning cardiomyopathy,Stress-induced cardiomyopathy, Gebrochenes-Herz-Syndrom, and Stress cardiomyopathy.
    Definition:
    Takotsubo cardiomyopathy is a type of non-ischaemic cardiomyopathy in which there is a sudden temporary weakening of the myocardium. Because this weakening can be triggered by emotional stress, It occurs as the response of the heart to sudden, intense emotional stress such as the death of a spouse; rejection at the workplace; acute fear; or uncontrolled anger. These intense emotions can cause immediate breathlessness or strokes. The broken heart can occur simultaneously or a few minutes later. Stress cardiomyopathy is a well-recognized cause of acute heart failure, lethal ventricular arrhythmias, and ventricular rupture.

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Around ten years ago, there were a few high profile deaths in young people. They were diagnosed as having died from a “broken heart”. Now, a broken heart or stunned myocardium syndrome is a documented condition.
Symptoms:
Takotsubo cardiomyopathy or Broken heart syndrome symptoms can mimic a heart attack.The symptoms are similar to a heart attack – chest pain, sweating, giddiness or dizziness, nausea, vomiting, weakness and palpitations. Blood pressure may drop. Heart failure may develop.

Any long-lasting or persistent chest pain could be a sign of a heart attack, so it’s important to take it seriously and call your doctor if you experience chest pain.

Causes:
The exact cause of Takotsubo cardiomyopathy is not very clear. It is thought that a surge of stress hormones, such as adrenaline, might temporarily damage the hearts of some people. How these hormones might hurt the heart or whether something else is responsible isn’t completely clear. A temporary constriction of the large or small arteries of the heart may play a role.

Takotsubo cardiomyopathy is often preceded by an intense physical or emotional event. Some potential triggers are:

*News of an unexpected death of a loved one
*A frightening medical diagnosis
*Domestic abuse
*Losing a lot of money
*Natural disasters
*A surprise party
*Having to perform publicly
*Job loss
*Divorce
*Physical stressors, such as an asthma attack, a car accident or major surgery

It’s also possible that some drugs, rarely, may cause broken heart syndrome by causing a surge of stress hormones. Drugs that may contribute to broken heart syndrome include:

*Epinephrine (EpiPen, EpiPen Jr), which is used to treat severe allergic reactions or a severe asthma attack
*Duloxetine (Cymbalta), a medication given to treat nerve problems in people with diabetes, or as a treatment for depression
*Venlafaxine (Effexor XR), which is a treatment for depression
*Levothyroxine (Synthroid, Levoxyl), a drug given to people whose thyroid glands don’t work properly
Differances between Takotsubo cardiomyopathy and hear attack are:

Heart attacks are generally caused by a complete or near complete blockage of a heart artery. This blockage is due to a blood clot forming at the site of narrowing from fatty buildup (atherosclerosis) in the wall of the artery. In Takotsubo cardiomyopathy, the heart arteries are not blocked, although blood flow in the arteries of the heart may be reduced.
Diagnosis:
Takotsubo cardiomyopathy or Transient apical ballooning syndrome is found in 1.7–2.2% of patients presenting with acute coronary syndrome. While the original case studies reported on individuals in Japan, Takotsubo cardiomyopathy has been noted more recently in the United States and Western Europe. It is likely that the syndrome went previously undiagnosed before it was described in detail in the Japanese literature.

The diagnosis of Takotsubo cardiomyopathy may be difficult upon presentation. The ECG findings are often confused with those found during an acute anterior wall myocardial infarction. It classically mimics ST-segment elevation myocardial infarction, and is characterised by acute onset of transient ventricular apical wall motion abnormalities (ballooning) accompanied by chest pain, dyspnea, ST-segment elevation, T-wave inversion or QT-interval prolongation on ECG. Elevation of myocardial enzymes is moderate at worst and there is absence of significant coronary artery disease.

The diagnosis is made by the pathognomonic wall motion abnormalities, in which the base of the left ventricle is contracting normally or is hyperkinetic while the remainder of the left ventricle is akinetic or dyskinetic. This is accompanied by the lack of significant coronary artery disease that would explain the wall motion abnormalities. Although apical ballooning has been classically described as the angiographic manifestation of takotsubo, it has been shown that left ventricular dysfunction in this syndrome includes not only the classic apical ballooning, but also different angiographic morphologies such as mid-ventricular ballooning and rarely local ballooning of other segments.

The ballooning patterns were classified by Shimizu et al. as takotsubo type for apical akinesia and basal hyperkinesia, reverse takotsubo for basal akinesia and apical hyperkinesia, mid-ventricular type for mid-ventricular ballooning accompanied by basal and apical hyperkinesia and localised type for any other segmental left ventricular ballooning with clinical characteristics of takotsubo-like left ventricular dysfunction.

The ECG changes are atypical, with imprecise changes in the ST segment and T waves. They are “suspicious of but non conclusive” of myocardial infraction. Blood tests for the enzyme creatine kinase and proteins troponin should be done. These are elevated in a heart attack. In a stunned heart, these results too are inconclusive. The echocardiogram is the clincher. The heart is ballooned out. This change occurs typically at the apex of the heart. It is important to make a distinction between heart attack and takotsubo as the medication is different.

Treatment:
The treatment for takotsubo is mainly supportive. Medication is given to remove fluid from the lungs and prevent clots. Recovery occurs within a few days.

About two per cent of people who were thought to have a heart attack actually had broken hearts. In the case of women, this increases to seven per cent. Women, mainly menopausal ones (60-75 years), have “broken hearts” eight to nine times more often than men. Some people are genetically prone to “broken hearts.” Depression plays a role in susceptibility to this condition. Recurrences can occur in 10 per cent of people.

People who are in poor physical condition do not need severe emotional stress to suffer a broken heart. An episode may be precipitated by a minor event like rejection, or even a lecture or talk before an audience.

In order to never develop this condition; it is important to develop metal and physical toughness. Walking for 40-60 minutes a day at a brisk pace exposes the heart to small doses of adrenaline and nor adrenaline in a controlled manner. The heart gets conditioned and is immune to sudden chemical surges. Meditation and yoga provide calmness and the mental strength to cope with good days and bad.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://en.wikipedia.org/wiki/Takotsubo_cardiomyopathy
http://www.mayoclinic.org/diseases-conditions/broken-heart-syndrome/basics/causes/con-20034635
http://www.telegraphindia.com/1141208/jsp/knowhow/story_2612.jsp

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Healthy Tips News on Health & Science

Foods That Cleans Arteries

1.Avocados:
People often think they shouldn’t eat avocado because it is a “fatty” fruit. But this creamy teardrop-shaped fruit contains oleic acid, the same monounsaturated fat found in olive oil and known to lower LDL (bad) cholesterol. A study published in the Archives of Medical Research showed that people with moderately high cholesterol levels who ate a diet high in avocados increased their levels of HDL (good) cholesterol by 11% and decreased their levels of LDL (bad) cholesterol and total cholesterol.http://myhealingkitchen.com/medical-conditions/heart-disease/heart-disease-healing-food/arteries-love-avocado/

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2.Whole Grains.
The soluble fiber found in whole grains such as whole-wheat bread, brown rice, and oatmeal binds the cholesterol in your meal and drags it out of your body, Madden says. “And, when your body needs to utilize cholesterol in the future, it draws on your blood cholesterol supply, effectively lowering your total blood cholesterol level and your risk for heart disease.” And oatmeal isn’t just for breakfast; you can enjoy it any time of day with these easy recipes.

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3.Olive Oil  :
A 2011 study found that people ages 65 or older who regularly used olive oil (for both cooking and as a dressing) were 41 percent less likely to have a stroke compared to those who never use olive oil in their diet. Use a little olive oil instead of butter or drizzle some over pasta, salad, or veggies to take advantage of its high mono- and polyunsaturated fats, Madden says. “And although it’s a healthier option, remember to use these oils sparingly, as all fats still contain the same number of calories.”

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4.Nuts:
Grabbing a handful of nuts is a heart-healthy way to beat the afternoon itch for a cookie, Madden says. “Almonds are very high in heart-healthy monounsaturated fats, vitamin E, and fiber, while walnuts are a great plant-based source of an omega-3 fatty acid called alpha-linolenic acid.” According to the American Heart Association, monounsaturated fats can help reduce levels of bad cholesterol in your blood and lower your risk of heart disease and stroke.

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5.Plant Sterols:
Sterols are compounds that compete with the cholesterol in your food for absorption within your digestive tract, Madden says. “Sterols have been shown to lower both total and LDL cholesterol and can be found in certain brands of fortified orange juice, margarine spreads, and milk.” Just be sure to check the label—make sure the margarine is trans fat-free and that “partially hydrogenated oil” does NOT appear on the ingredient list.

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6.Salmon (or Other Fatty Fish)
Fatty fish such as mackerel, herring, tuna, and salmon are chock full of omega-3 fatty acids, Madden says. “Eating fish twice a week can reduce your risk of developing heart disease by decreasing inflammation and lowering triglyceride levels, and it may even help boost your HDL levels.” Try any of these heart healthy and delicious salmon recipes for dinner tonight.

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7.Asparagus:
Asparagus is one of the best, natural artery-clearing foods around, says Shane Ellison, an organic chemist and author of Over-The-Counter Natural Cures. “Asparagus works within the 100,000 miles of veins and arteries to release pressure, thereby allowing the body to accommodate for inflammation that has accumulated over the years.” It also helps ward off deadly clots, Ellison says. We just love the versatile vegetable’s crunch in this salad recipe.

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8.Pomegranate:
Pomegranate contains phytochemicals that act as antioxidants to protect the lining of the arteries from damage, explains Dr. Gregg Schneider, a nutritionally oriented dentist and expert on alternative medicine. A 2005 study published in the Proceedings of the National Academy of Sciences found that antioxidant-rich pomegranate juice stimulated the body’s production of nitric oxide, which helps keep blood flowing and arteries open.

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9.Broccoli:
Broccoli is rich in vitamin K, which is needed for bone formation and helps to keep calcium from damaging the arteries, Dr. Schneider says. Not to mention, broccoli is full of fiber, and studies show a high-fiber diet can also help to lower blood pressure and cholesterol levels. Enjoy this veggie for dinner tonight with this side dish recipe.

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10.Turmeric:
The spice turmeric is a powerful anti-inflammatory,” Dr. Schneider says. “It contains curcumin which lowers inflammation—a major cause of arteriosclerosis (hardening of the arteries.” A 2009 study found that curcumin helps reduce the fatty deposits in arteries by as much as 26 percent. Sounds like a good reason to try some in this delicious recipe for spicy chicken soup from pop star Rihanna.

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11. Persimmons:
Forget the old ‘an apple a day’ adage—it seems eating a daily persimmon is a better way to keep the doctor away. Research shows the polyphenols found in this fruit (which has twice as much fiber and more antioxidants than an apple) can help decrease levels of LDL cholesterol and triglycerides.

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12. Orange Juice.
A 2011 study published online in the American Journal of Clinical Nutrition found that drinking two daily cups of 100-percent orange juice can help reduce diastolic (resting) blood pressure. OJ contains an antioxidant that has been found to help improve blood vessel function.

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13. Spirulina.
A daily 4,500mg dose of this blue-green algae (usually found in supplement or powder form) can help relax artery walls and normalize blood pressure. It may also help your liver balance your blood fat levels—decreasing your LDL cholesterol by 10 percent and raising HDL cholesterol by 15 percent, according a recent study.

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14.Cinnamon.
Just one teaspoon a day of antioxidant-rich cinnamon can help reduce fats in the bloodstream, helping to prevent plaque build up in the arteries and lower bad cholesterol levels by as much as 26 percent, according to recent research. Sprinkle some on your morning coffee or on these delicious crepes.

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15.Cranberries.
Research shows that potassium-rich cranberries can help reduce LDL cholesterol levels and help raise the good HDL levels in your body, and regular consumption of the holiday favorite may help reduce your overall risk of heart disease by as much as 40 percent.

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16.Coffee.
According to researchers in The Netherlands, people who drank more than two, but no more than four, cups of coffee a day for 13 years had about a 20 percent lower risk of heart disease than people who drank more or less coffee or no coffee at all. Moderation is the key to coffee’s heart-health benefits—the caffeine is a stimulant which can cause a temporary increase in blood pressure, and in excess, can lead to irregular heart beat.

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17.Cheese.
Believe it or not, cheese could help lower your blood pressure! A recent study from Brigham and Women’s Hospital and Harvard Medical School found that people who eat three servings a day of low-fat dairy have lower (three points less) systolic blood pressure than those who eat less. Here are some tasty, low fat picks to start snacking on today.

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18.Green Tea.
Green tea is rich in catechins, compounds that have been shown to decrease cholesterol absorption in your body. Another bonus? It may help prevent cancer and weight gain, too!

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19.Watermelon.
Talk about a perfect snack—watermelon is not only a diet-friendly food, but it can help protect your heart too! A Florida State University study found that people given a 4,000mg supplement of L-citrulline (an amino acid found in watermelon) lowered their blood pressure in just six weeks. Researchers say the amino acid helps your body produce nitric oxide, which widens blood vessels.

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20.  Cucumber.
The flesh of cucumbers is primarily composed of water but also contains vitamin C and caffeic acid, both of which help soothe skin irritations and reduce swelling—which is why cucumbers are often used to help swollen eyes and sunburn.

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Resources: The Times Of India

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Metabolic Syndrome

Alternative Names: metabolic syndrome X, cardiometabolic syndrome, syndrome X, insulin resistance syndrome, Reaven’s syndrome (named for Gerald Reaven), and CHAOS (in Australia).

Definition:
Suddenly, it’s a health condition that everyone’s talking about. While it was only identified less than 20 years ago, metabolic syndrome is as widespread as pimples and the common cold. According to the American Heart Association, 47 million Americans have it. That’s almost a staggering one out of every six people.

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Indeed, metabolic syndrome seems to be a condition that many people have, but no one knows very much about. It’s also debated by the experts — not all doctors agree that metabolic syndrome should be viewed as a distinct condition.

So what is this mysterious syndrome — which also goes by the scary-sounding name Syndrome X — and should you be worried about it?

Understanding Metabolic Syndrome
Metabolic syndrome is not a disease in itself. Instead, it’s a group of risk factors — high blood pressure, high blood sugar, unhealthy cholesterol levels, and abdominal fat.

Obviously, having any one of these risk factors isn’t good. But when they’re combined, they set the stage for grave problems. These risk factors double your risk of blood vessel and heart disease, which can lead to heart attacks and strokes. They increase your risk of diabetes by five times.

Many people who have either diabetes, high blood pressure or obesity also have one or more of the other conditions, although it may have gone unrecognised.

Individually, each of these conditions can lead to damage to the blood vessels, but together they’re far more likely to do harm. People with these conditions in combination become much more likely to experience heart disease, stroke and other conditions related to problems with the blood vessels.

When a person has such a combination, they’re said to have metabolic syndrome. This is also sometimes called insulin-resistance syndrome (because one of the features is a very high level of the hormone insulin in the blood, which the body doesn’t react to or is ‘resistant’ to) or syndrome X.

There are currently two major definitions for metabolic syndrome provided by the International Diabetes Federation  and the revised National Cholesterol Education Program, respectively. The revised NCEP and IDF definitions of metabolic syndrome are very similar and it can be expected that they will identify many of the same individuals as having metabolic syndrome. The two differences are that IDF state that if BMI > 30 kg/m2, central obesity can be assumed, and waist circumference does not need to be measured. However, this potentially excludes any subject without increased waist circumference if BMI < 30, whereas, in the NCEP definition, metabolic syndrome can be diagnosed based on other criteria, and the IDF uses geography-specific cut points for waist circumference, while NCEP uses only one set of cut points for waist circumference, regardless of geography. These two definitions are much closer to each other than the original NCEP and WHO definitions.

Metabolic syndrome is also becoming more common. But the good news is that it can be controlled, largely with changes to your lifestyle.

Symptoms:
The problems found in metabolic syndrome include:

 

•Central obesity – fat is laid down around the abdomen rather than spread evenly around the body

•Abnormal fat levels in the blood – specifically, high levels of triglycerides and low levels of HDL (or ‘good’) cholesterol, which can lead to arteriosclerosis (fatty plaques) on the walls of blood vessels

•High blood pressure

•Insulin resistance or glucose intolerance – an inability to use insulin properly or control blood sugar levels very well, which is a very important factor in metabolic syndrome

•Prothrombotic state – an increased tendency to make tiny clots in the blood

•Proinflammatory state – an increased tendency to inflammation

Having one component of metabolic syndrome means you’re more likely to have others. And the more components you have, the greater are the risks to your health.

Causes:
Experts aren’t sure why metabolic syndrome develops. It’s a collection of risk factors, not a single disease. So it probably has many different causes. Some risk factors are:

*Insulin resistance. Insulin is a hormone that helps your body use glucose — a simple sugar made from the food you eat — as energy. In people with insulin resistance, the insulin doesn’t work as well so your body keeps making more and more of it to cope with the rising level of glucose. Eventually, this can lead to diabetes. Insulin resistance is closely connected to having excess weight in the belly.

*Obesity — especially abdominal obesity. Experts say that metabolic syndrome is becoming more common because of rising obesity rates. In addition, having extra fat in the belly — as opposed to elsewhere in the body — seems to increase your risk.

*Unhealthy lifestyle. Eating a diet high in fats and not getting enough physical activity can play a role.

*Hormonal imbalance. Hormones may play a role. For instance, polycystic ovary syndrome (PCOS) — a condition that affects fertility — is related to hormonal imbalance and metabolic syndrome.

If you’ve just been diagnosed with metabolic syndrome, you might be anxious. But think of it as a wake-up call. It’s time to get serious about improving your health. Making simple changes to your habits now can prevent serious illness in the future.

Risk Factors:
The following factors increase your chances of having metabolic syndrome:

*Age. The risk of metabolic syndrome increases with age, affecting less than 10 percent of people in their 20s and 40 percent of people in their 60s. However, warning signs of metabolic syndrome can appear in childhood.

*Race. Hispanics and Asians seem to be at greater risk of metabolic syndrome than other races are.

*Obesity. A body mass index (BMI) — a measure of your percentage of body fat based on height and weight — greater than 25 increases your risk of metabolic syndrome. So does abdominal obesity — having an apple shape rather than a pear shape.

*History of diabetes. You’re more likely to have metabolic syndrome if you have a family history of type 2 diabetes or a history of diabetes during pregnancy (gestational diabetes).

*Other diseases.A diagnosis of high blood pressure, cardiovascular disease or polycystic ovary syndrome — a similar type of metabolic problem that affects a woman’s hormones and reproductive system — also increases your risk of metabolic syndrome.

Complications:
Having metabolic syndrome can increase your risk of developing these conditions:

*Diabetes. If you don’t make lifestyle changes to control your insulin resistance, your glucose levels will continue to increase. You may develop diabetes as a result of metabolic syndrome.

*Cardiovascular disease.High cholesterol and high blood pressure can contribute to the buildup of plaques in your arteries. These plaques can cause your arteries to narrow and harden, which can lead to a heart attack or stroke.

Diagnosis:
Although  doctor does not typically look  for metabolic syndrome, the label may apply if you have three or more of the traits associated with this condition.

Several organizations have criteria for diagnosing metabolic syndrome. These guidelines were created by the National Cholesterol Education Program (NCEP) with modifications by the American Heart Association. According to these guidelines, you have metabolic syndrome if you have three or more of these traits:

*Large waist circumference, greater than 35 inches (89 centimeters, or cm) for women and 40 inches (102 cm) for men. Certain genetic risk factors, such as having a family history of diabetes or being of Asian descent — which increases your risk of insulin resistance — lower the waist circumference limit. If you have one of these genetic risk factors, waist circumference limits are 31 to 35 inches (79 to 89 cm) for women and 37 to 39 inches (94 to 99 cm) for men.

*A triglyceride level higher than 150 milligrams per deciliter (mg/dL), or 1.7 millimoles per liter (mmol/L), or you’re receiving treatment for high triglycerides.

*Reduced HDL (“good”) cholesterol — less than 40 mg/dL (1 mmol/L) in men or less than 50 mg/dL (1.3 mmol/L) in women — or you’re receiving treatment for low HDL.

*Blood pressure higher than 120 millimeters of mercury (mm Hg) systolic or higher than 80 mm Hg diastolic, or you’re receiving treatment for high blood pressure.

*Elevated fasting blood sugar (blood glucose) of 100 mg/dL (5.6 mmol/L) or higher, or you’re receiving treatment for high blood sugar.

Treatment:
The first line treatment is change of lifestyle (e.g., Dietary Guidelines for Americans and physical activity). However, if in three to six months of efforts at remedying risk factors prove insufficient, then drug treatment is frequently required. Generally, the individual disorders that comprise the metabolic syndrome are treated separately. Diuretics and ACE inhibitors may be used to treat hypertension. Cholesterol drugs may be used to lower LDL cholesterol and triglyceride levels, if they are elevated, and to raise HDL levels if they are low. Use of drugs that decrease insulin resistance, e.g., metformin and thiazolidinediones, is controversial; this treatment is not approved by the U.S. Food and Drug Administration.

A 2003 study indicated that cardiovascular exercise was therapeutic in approximately 31% of cases. The most probable benefit was to triglyceride levels, with 43% showing improvement; but fasting plasma glucose and insulin resistance of 91% of test subjects did not improve.   Many other studies have supported the value of increased physical activity and restricted caloric intake (exercise and diet) to treat metabolic syndrome.

Restricting the overall dietary carbohydrate intake is more effective in reducing the most common symptoms of metabolic syndrome than the more commonly prescribed reduction in dietary fat intake

Controversy:
The clinical value of using “metabolic syndrome” as a diagnosis has recently come under fire. It is asserted that different sets of conflicting and incomplete diagnostic criteria are in existence, and that when confounding factors such as obesity are accounted for, diagnosis of the metabolic syndrome has a negligible association with the risk of heart disease.

These concerns have led to the American Diabetes Association and the European Association for the Study of Diabetes to issue a joint statement identifying eight major concerns on the clinical utility of the metabolic syndrome.

It is not contested that cardiovascular risk factors tend to cluster together, but what is contested is the assertion that the metabolic syndrome is anything more than the sum of its constituent parts.

Lifestyle and home remedies:
You can do something about your risk of metabolic syndrome and its complications — diabetes, stroke and heart disease. Start by making these lifestyle changes:

Lose weight. Losing as little as 5 to 10 percent of your body weight can reduce insulin levels and blood pressure, and decrease your risk of diabetes.

Exercise. Doctors recommend getting 30 to 60 minutes of moderate-intensity exercise, such as brisk walking, every day.

Doing Yoga :Doing Yoga exercise, meditation etc. under the guideline of a good yoga teacher

Stop smoking.Smoking cigarettes increases insulin resistance and worsens the health consequences of metabolic syndrome. Talk to your doctor if you need help kicking the cigarette habit.

Eat fiber-rich foods. Make sure you include whole grains, beans, fruits and vegetables in your grocery cart. These items are packed with dietary fiber, which can lower your insulin levels.

Prevention:
Various strategies have been proposed to prevent the development of metabolic syndrome. These include increased physical activity (such as walking 30 minutes every day),   and a healthy, reduced calorie diet.   There are many studies that support the value of a healthy lifestyle as above. However, one study stated that these potentially beneficial measures are effective in only a minority of people, primarily due to a lack of compliance with lifestyle and diet changes.   The International Obesity Taskforce states that interventions on a sociopolitical level are required to reduce development of the metabolic syndrome in populations.

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Although much more research has to be done to work out the relationship between different factors in metabolic syndrome, and how drug treatments might be used to help people, there are steps you can take to reduce your risk.

Lifestyle changes can make a big difference, preventing or delaying the development of serious disease. Losing weight and getting active are the top priority. But make sure you get proper advice and support – research has shown that people who join a weight-loss group, for example, are more likely to lose weight and keep it off.

In terms of getting fit, join a gym or find a sport you enjoy. You’re more likely to stick at it if you like what you’re doing.

Some preventive treatments are also available from your GP. It’s important to keep your blood pressure under control, and blood fat (cholesterol) and blood sugar (glucose) at healthy levels. But some blood pressure treatments, such as diuretics and beta blockers, can actually make metabolic syndrome worse.

A 2007 study of 2,375 male subjects over 20 years suggested that daily intake of a pint (~568 ml) of milk or equivalent dairy products more than halved the risk of metabolic syndrome. Some subsequent studies support the authors’ findings, while others dispute them.

Check with your doctor if you’re concerned. Drugs to control blood fat and cholesterol levels, and blood glucose levels, are often needed.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/metabolicsyndrome1.shtml
http://www.webmd.com/heart/metabolic-syndrome/metabolic-syndrome-what-is-it
http://www.mayoclinic.com/health/metabolic%20syndrome/DS00522
http://en.wikipedia.org/wiki/Metabolic_syndrome
http://www.healthfocus.net.au/what-is-metabolic-syndrome/

http://www.myoptumhealth.com/portal/ADAM/item/Weight+control+and+diet

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Long QT Syndrome

Definition:
The long QT syndrome (LQTS) is a rare inborn heart condition in which delayed repolarization of the heart following a heartbeat increases the risk of episodes of torsade de pointes (TDP, a form of irregular heartbeat that originates from the ventricles). These episodes may lead to palpitations, fainting and sudden death due to ventricular fibrillation. Episodes may be provoked by various stimuli, depending on the subtype of the condition.
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You can be born with a genetic mutation that puts you at risk of long QT syndrome. In addition, certain medications and medical conditions may cause long QT syndrome.

The condition is so named because of the appearances of the electrocardiogram (ECG/EKG), on which there is prolongation of the QT interval.

Long QT syndrome is treatable. You may need to limit your physical activity, avoid medications known to cause prolonged Q-T intervals or take medications to prevent a chaotic heart rhythm. Some people with long QT syndrome need surgery or an implantable device.

Symptoms :
Many people with long QT syndrome don’t have any signs or symptoms. They may be aware of their condition only from results of an electrocardiogram (ECG) performed for an unrelated reason, because they have a family history of long QT syndrome or because of genetic testing results.

For people who do experience signs and symptoms of long QT syndrome, the most common symptoms include:

*Fainting. This is the most common sign of long QT syndrome. In people with long QT syndrome, fainting spells (syncope) are caused by the heart temporarily beating in an erratic way. These fainting spells may happen when you’re excited, angry or scared, or during exercise. Fainting in people with long QT syndrome can occur without warning, such as losing consciousness after being startled by a ringing telephone.

Signs and symptoms that you’re about to faint include lightheadedness, heart palpitations or irregular heartbeat, weakness and blurred vision. However, in long QT syndrome, such warning signs before fainting are unusual.

*Seizures. If the heart continues to beat erratically, the brain becomes increasingly deprived of oxygen. This can then cause generalized seizures.

*Sudden death. Normally, the heart returns to its normal rhythm. If this doesn’t happen spontaneously and paramedics don’t arrive in time to convert the rhythm back to normal with an external defibrillator, sudden death will occur.Signs and symptoms of inherited long QT syndrome may start during the first months of life, or as late as middle age. Most people who experience signs or symptoms from long QT syndrome have their first episode by the time they reach age 40.

Rarely, signs and symptoms of long QT syndrome may occur during sleep or arousal from sleep.

Causes:
Your heart beats about 100,000 times a day to circulate blood throughout your body. To pump blood, your heart’s chambers contract and relax. These actions are controlled by electrical impulses created in the sinus node, a group of cells in the upper right chamber of your heart. These impulses travel through your heart and cause it to beat.

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After each heartbeat, your heart’s electrical system recharges itself in preparation for the next heartbeat. This process is known as repolarization. In long QT syndrome, your heart muscle takes longer than normal to recharge between beats. This electrical disturbance, which often can be seen on an electrocardiogram (ECG), is called a prolonged Q-T interval.

Prolonged Q-T interval
An electrocardiogram (ECG, also called an EKG) measures electrical impulses as they travel through your heart. Patches with wires attached to your skin measure these impulses, which are displayed on a monitor or printed on paper as waves of electrical activity.

An ECG measures electrical impulses as five distinct waves. Doctors label these five waves using the letters P, Q, R, S and T. The waves labeled Q through T show electrical activity in your heart’s lower chambers.

The space between the start of the Q wave and the end of the T wave (Q-T interval) corresponds to the time it takes for your heart to contract and then refill with blood before beginning the next contraction.

By measuring the Q-T interval, doctors can tell whether it occurs in a normal amount of time. If it takes longer than normal, it’s called a prolonged Q-T interval. The upper limit of a normal Q-T interval takes into account age, sex, and regularity and speed of the heart rate.

Long QT syndrome results from abnormalities in the heart’s electrical recharging system. However, the heart’s structure is normal. Abnormalities in your heart’s electrical system may be inherited or acquired due to an underlying medical condition or a medication.

Inherited long QT syndrome
At least 12 genes associated with long QT syndrome have been discovered so far, and hundreds of mutations within these genes have been identified. Mutations in three of these genes account for about 70 to 75 percent of long QT syndrome, and cause the forms referred to as LQT1, LQT2 and LQT3.

Doctors have described two forms of inherited long QT syndrome:

*Romano-Ward syndrome. This more common form occurs in people who inherit only a single genetic variant from one of their parents.

*Jervell and Lange-Nielsen syndrome. Signs and symptoms of this rare form usually occur earlier and are more severe than in Romano-Ward syndrome. It’s seen in children who are born deaf and have long QT syndrome because they inherited genetic variants from each parent.

Additionally, scientists have been investigating a possible link between SIDS and long QT syndrome and have discovered that about 10 percent of babies with SIDS had a genetic defect or mutation for long QT syndrome.

Acquired long QT syndrome
More than 50 medications, many of them common, can lengthen the Q-T interval in otherwise healthy people and cause a form of acquired long QT syndrome known as drug-induced long QT syndrome.

Medications that can lengthen the Q-T interval and upset heart rhythm include certain antibiotics, antidepressants, antihistamines, diuretics, heart medications, cholesterol-lowering drugs, diabetes medications, as well as some antifungal and antipsychotic drugs.

People who develop drug-induced long QT syndrome may also have some subtle genetic defects in their hearts, making them more susceptible to disruptions in heart rhythm from taking drugs that can cause prolonged Q-T intervals.

Risk Factors:
People at risk of long QT syndrome include:

*Children, teenagers and young adults with unexplained fainting, unexplained near drownings or other accidents, unexplained seizures, or a history of cardiac arrest

*Family members of children, teenagers and young adults with unexplained fainting, unexplained near drownings or other accidents, unexplained seizures, or a history of cardiac arrest

*Blood relatives of people with known long QT syndrome

*People taking medications known to cause prolonged Q-T intervals

Long QT syndrome often goes undiagnosed or is misdiagnosed as a seizure disorder, such as epilepsy. However, researchers believe that long QT syndrome may be responsible for some otherwise unexplained deaths in children and young adults. For example, an unexplained drowning of a young person may be the first clue to inherited long QT syndrome in a family.

People with low potassium, magnesium or calcium blood levels — such as those with the eating disorder anorexia nervosa — may be susceptible to prolonged Q-T intervals. Potassium, magnesium and calcium are all important minerals for the health of your heart’s electrical system.

Diagnosis:
The diagnosis of LQTS is not easy since 2.5% of the healthy population have prolonged QT interval, and 10–15% of LQTS patients have a normal QT interval. A commonly used criterion to diagnose LQTS is the LQTS “diagnostic score”. The score is calculated by assigning different points to various criteria (listed below). With four or more points, the probability is high for LQTS; with one point or less, the probability is low. A score of two or three points indicates intermediate probability.

*QTc (Defined as QT interval / square root of RR interval)
#>= 480 msec – 3 points
#460-470 msec – 2 points
#450 msec and male gender – 1 point

*Torsades de pointes ventricular tachycardia – 2 points

*T wave alternans – 1 point

*Notched T wave in at least 3 leads – 1 point

*Low heart rate for age (children) – 0.5 points

*Syncope (one cannot receive points both for syncope and torsades de pointes)
#With stress – 2 points
#Without stress – 1 point

*Congenital deafness – 0.5 points

*Family history (the same family member cannot be counted for LQTS and sudden death)
#Other family members with definite LQTS – 1 point
#Sudden death in immediate family (members before the age 30) – 0.5 points
Treatment options:
Those diagnosed with long QT syndrome are usually advised to avoid drugs that would prolong the QT interval further or lower the threshold for TDP.  In addition to this, there are two intervention options for individuals with LQTS: arrhythmia prevention and arrhythmia termination.

Arrhythmia prevention:
Arrhythmia suppression involves the use of medications or surgical procedures that attack the underlying cause of the arrhythmias associated with LQTS. Since the cause of arrhythmias in LQTS is after depolarizations, and these after depolarizations are increased in states of adrenergic stimulation, steps can be taken to blunt adrenergic stimulation in these individuals. These include:

*Administration of beta receptor blocking agents which decreases the risk of stress induced arrhythmias. Beta blockers are the first choice in treating Long QT syndrome.
In 2004 it has been shown that genotype and QT interval duration are independent predictors of recurrence of life-threatening events during beta-blockers therapy. Specifically the presence of QTc >500ms and LQT2 and LQT3 genotype are associated with the highest incidence of recurrence. In these patients primary prevention with ICD (Implantable cardioverter-defibrillator) implantation can be considered.

*Potassium supplementation. If the potassium content in the blood rises, the action potential shortens and due to this reason it is believed that increasing potassium concentration could minimize the occurrence of arrhythmias. It should work best in LQT2 since the HERG channel is especially sensitive to potassium concentration, but the use is experimental and not evidence based.

*Mexiletine. A sodium channel blocker. In LQT3 the problem is that the sodium channel does not close properly. Mexiletine closes these channels and is believed to be usable when other therapies fail. It should be especially effective in LQT3 but there is no evidence based documentation.

*Amputation of the cervical sympathetic chain (left stellectomy). This may be used as an add-on therapy to beta blockers but modern therapy mostly favors ICD implantation if beta blocker therapy fails.

Arrhythmia termination:
Arrhythmia termination involves stopping a life-threatening arrhythmia once it has already occurred. One effective form of arrhythmia termination in individuals with LQTS is placement of an implantable cardioverter-defibrillator (ICD). Alternatively, external defibrillation can be used to restore sinus rhythm. ICDs are commonly used in patients with syncopes despite beta blocker therapy, and in patients who have experienced a cardiac arrest.

It is hoped that with better knowledge of the genetics underlying the long QT syndrome, more precise treatments will become available.
Prognosis:
The risk for untreated LQTS patients having events (syncopes or cardiac arrest) can be predicted from their genotype (LQT1-8), gender and corrected QT interval.

*High risk (>50%)
QTc>500 msec LQT1 & LQT2 & LQT3 (males)

*Intermediate risk (30-50%)
QTc>500 msec LQT3 (females)

QTc<500 msec LQT2 (females) & LQT3

*Low risk (<30%)
QTc<500 msec LQT1 & LQT2 (males)

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/longqt1.shtml
http://www.mayoclinic.com/health/long-qt-syndrome/DS00434
http://en.wikipedia.org/wiki/Long_QT_syndrome
http://paramedicine101.blogspot.com/2009/09/long-qt-syndrome-part-iii.html
http://www.itriagehealth.com/disease/long-qt-syndrome-(qt-prolongation)

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