Cancer on the rise among youth

Youngsters in Kolkata are paying a heavy price for failing to kick the butt and spit out the pan masala. Despite a more high-pitched anti-tobacco campaign, pictorial warnings on cigarette packets and restrictions on the sale of tobacco products around educational institutions, GenNext, it seems, can't get rid of the cancer stick or the gutkha sachet.
Statistics reveal that 1,500 to 2,000 young adults in the city are diagnosed with oral or head and neck cancer every year and nearly half of them die within 12 months. The number has never been higher and ranks among the highest among metros in India
Even as smoking habit is on the wane around the country, Kolkata and the eastern region have been merrily puffing and chewing away. The consequences have been disastrous. Nearly 91% of the 25,000 oral cancer cases in the state are triggered by tobacco use.
"The worrying news is that an increasing number of young adults those in the 18 to 25 age group are now falling prey. Our data shows that it has been rising despite government-imposed restrictions on the sale of tobacco. Along with smoking, pan masala has been taking a big toll. Tobacco chewing raises the risk of oral cancer by 31 times. Unfortunately, urban youngsters are now hooked to pan masala chewing more than ever before," said Gautam Mukhopadhyay, senior oncologist, who led a study on cancer in Kolkata.
While smoking is known to trigger lung cancer and cancer of the voice box, stomach or oesophagus, pan masala-induced cancer is largely restricted to the mouth. Instances of oral cancer are now higher than smoke-induced cancers among Kolkata youngsters. "Head and neck cancer has always been the commonest form of the disease among males, followed closely by oral cancer. Among women, breast and cervical cancer top the list. Traditionally, lung and oral cancer patients would be middle-aged. But there has been an alarming drop in the age of patients over the last three years. It seems youngsters are getting hooked to tobacco even earlier than they previously did," said Subir Ganguly, senior oncologist. The study has also revealed that a majority of the tobacco addicts is addicted to alcohol which enhances the risk of cancer ten-fold.
"Smoke and alcohol is a dangerous combination. It exposes you to the risk of oral, lung and stomach cancer. Unfortunately, a strong drinking culture now exists in Kolkata. Youngsters love to puff away while they are downing a few pegs," said Mukhopadhyay. Nearly 50% of the 80,000 cancer cases in West Bengal annually are reported in the final stage of the disease. More than half of those who die of cancer in the state are tobacco users.
A survey done by the Cancer Foundation of India (CFI) among school children in Kolkata, confirms the early use of tobacco. "A surprisingly high percentage of high school students are now taking to smoking and chewing tobacco. By the time they are in their early twenties, many have had enough exposure to tobacco for cancer," said M Siddiqui, chairperson, CFI.
Experts blame the poor implementation of anti-tobacco laws and a weak awareness campaign for the alarming scenario. Youngsters, especially men, in this part of the country, they argue, still look at smoking and chewing as machismo. Early incidences of cancer among women, says the study, has more to do with an unregulated lifestyle than tobacco abuse. Indiscriminate use of contraceptives and sexual activity from an early age have been found responsible for cervical cancer among women in Kolkata.

Cops cold to smoke ban violations

KOLKATA: The city, it seems, is reluctant to root out smoking in public.
It's been five months since the mechanism for imposing fines on those who flout the ban on smoking in public was put in place. The Kolkata Police armed itself with the challans and State Tobacco Control Cell ( STCC) got ready to swing into action. A series of meetings and advocacy sessions aimed at sensitizing the police and those responsible for enforcing the prohibition were held and a list of pubs and bars that were generous about smoking drawn up. But the first penalty is yet to be imposed.
This, despite the fact that Kolkatans continue to puff at hospitals, government buildings and educational institutions. Even though most restaurants and bars have managed to stub out smoking, lighting up on the road remains unrestricted. Smoking in public was prohibited under the Cigarettes and Other Tobacco Products Act that came into force on October 1, 2008, exactly two years ago.
Cancer Foundation of India (CFI) that has been actively advocating the ban has lodged complaints against some restaurants that allow smoking late in the evening. Complaints have also been filed against offenders in public transport. But no step has been taken.
"Unfortunately, police are yet to conduct surprise raids which it had promised. There are a few prominent restobars which are still flouting the rule. As far as government buildings are concerned, they remain smokers' dens," said Sutapa Biswas, executive director, CFI. Each government department is supposed to have a designated officer authorized to slap the penalty. The police can impose a fine at any place where lighting up has been prohibited. Offenders in Kolkata and the state, it had been decided, would be fined Rs 200.
Three government hospitals in the city SSKM, Calcutta Medical College and Hospital and NRS Medical College had drawn up an action plan. They had appointed designated officers and put up no-smoking boards all over their campuses earlier this year. Their efforts, however, petered out.
"Their response was quite encouraging to begin with. But these places are too caught up with their own problems to keep up the momentum. The police must lend support," said Biswas. Coffee House at College Street, one of the city landmarks, continues to ignore the law. Even though the authorities have removed ash-trays from the tables, visitors are allowed to light up.
Institutions like Jadavpur University and Presidency College, too, have not been able to banish smoking or even restrict it. It has been officially disallowed on both campuses, but continues to be ignored.
A hookah bar in central Kolkata was recently warned by police. CFI members claimed they still allow patrons to puff away and even hold hookah parties late at night. Restaurant owners also admitted that many continue to ignore the law. "There are a few in central Kolkata which flout the ban. We'd be happy if police catch them," said S K Khullar, president of the Hotel and Restaurant Owners' Association of Eastern India.
CFI has been lodging complaints with the commissioner of police. "It's been a disappointing period for us and certainly a setback for the campaign. Ideally, we should have started by catching a few offenders to set an example. We must start all over again," said Biswas.

Kolkata men most hit by tobacco cancer

Cancers caused by tobacco is highest among men from Kolkata and least among those from Mumbai, in the four metropolitan cities.
Among women, tobacco related cancers were highest in those from Chennai and least among women in Delhi.

Cancers caused by tobacco is highest among men from Kolkata and least among those from Mumbai, in the four metropolitan cities.
Among women, tobacco related cancers were highest in those from Chennai and least among women in Delhi.
According to the Indian Council of Medical Research's "Cancer associated with the use of tobacco" report, nearly 44.4% of all cancers in men in Kolkata are because of tobacco followed by Chennai (41.4%), Delhi (39.4%) and Mumbai (39.2%).

Women from Chennai record the highest number of tobacco related cancers (15.2%) followed by Mumbai (13.5%), Kolkata (12.3%) and Delhi (11%).
Besides the four metropolitan cities, the burden of tobacco associated cancers is acute even in other cosmopolitan cities like Bangalore and Pune. Almost 35% of all cancers in men and 14.3% of all cancers in women from Bangalore are related to tobacco consumption.

In Pune, 39.3% of all cancers in men and 16.8% of all cancers in women are associated to tobacco.

However, among the 20 cancer registries surveyed, the burden of tobacco related cancers is most acute in Dibrugarh district in both men and women. Around 57% of all cancers in men here and 26.3% of all cancers in women in Dibrugarh were tobacco related.
Experts said, "In most societies smoking rates are higher for men than for women, but more men than women are giving up, and in some societies the number of female smokers is rising."
Director of medical oncology of AIIMS Dr Vinod Raina said, "One-third of all cancers in India is due to tobacco -- chewing or smoking. India needs to immediately strengthen its anti-tobacco programme and launch it across the country."
Tobacco kills nearly 5.7 million people worldwide each year, including 5.1 million people who die from their own smoking. The World Health Organisation says smoking is the world's leading cause of preventable death.
It causes 1 in 10 deaths among adults worldwide. At the current rate, the death toll is projected to reach more than 8 million annually by 2030 and a total of up to one billion deaths in the 21st century.
Second-hand tobacco smoke is equally dangerous to health.
In India, 34.6% of adults use tobacco in any form out of which 47.9% were male and 20.3% were female. There are more than 4,000 chemicals in tobacco smoke, of which at least 250 are known to be harmful and more than 50 are known to cause cancer.
Women comprise about 20% of the world's more than 1 billion smokers. Both men and women who smoke are prone to cancer, heart disease and respiratory disease.
Experts say that 90% of all lung cancer deaths in women smokers are attributable to smoking. Women who smoke have an increased risk for other cancers, including cancers of the oral cavity, pharynx, larynx (voice box), esophagus, pancreas, kidney, bladder, and uterine cervix.

Natural ways to a healthy heart

Arjuna (Kahu, Terminalia arjuna)
The bark powder of this indigenous tree is a powerful cardiac tonic. While some consume the powder (approximately 1-2 grams) with their meals, others prefer to prepare a decoction using milk and jaggery and consume first thing in the morning.

Cinnamon
It is said to be the spice for the heart. To lower cholesterol levels, consume ½ a teaspoon of cinnamon daily. It has an anti-clogging impact on the arteries and veins. Cinnamon tea is good for heart patients. To prepare, steep ½ tsp cinnamon powder in 250 ml boiled water for about six minutes or so. 

Garlic
Various studies from different parts of the world hold garlic in high esteem in preventing and healing heart related disorders. There are folks who claim two raw flakes of garlic a day keep their heart healthy and strong. 

Apples
Potassium plays an important role in the health of our heart. Ideally, it ought to be consumed via edible natural products that contain it. Apples being a rich source of both, potassium and phosphorus, make for vital heart food.

Grapes
Fruit therapists explain, “The production of energy essential for the proper functioning of heart depends on the metabolism of glucose. Thus, grapes being rich in pure glucose are extremely useful in treating heart ailments.” Besides toning up the heart, grape juice is effective in relieving cardiac pain and palpitations.

Asparagus
The following is claimed to be a trustworthy home remedy for a weak or enlarged heart.
Fresh juice of asparagus mixed with honey ought to be taken thrice a day (1 teaspoon at a time). Steam cooked asparagus consumed liberally with meals also benefits heart patients.

Karadai (Safflower seeds)
Karadai oil ranks as one of the most polyunsaturated oils. Consumption of the same is said to aid lowering of cholesterol and is beneficial for those suffering from ischaemia and hypertension.

Honey
In several cultures across the globe, honey has been upheld as nature’s wonderful cure for a range of ailments. In cases of arteriosclerosis, weak heart, cardiac pain and palpitation, honey is considered a safe home remedy. Generally, patients are advised a glass of water with honey and lemon juice at bed time.
(The write up is purely informative and not a substitute for proper medical diagnoses and treatment of heart ailments)

Natural ways to a healthy heart

Arjuna (Kahu, Terminalia arjuna)
The bark powder of this indigenous tree is a powerful cardiac tonic. While some consume the powder (approximately 1-2 grams) with their meals, others prefer to prepare a decoction using milk and jaggery and consume first thing in the morning.

Cinnamon
It is said to be the spice for the heart. To lower cholesterol levels, consume ½ a teaspoon of cinnamon daily. It has an anti-clogging impact on the arteries and veins. Cinnamon tea is good for heart patients. To prepare, steep ½ tsp cinnamon powder in 250 ml boiled water for about six minutes or so. 

Garlic
Various studies from different parts of the world hold garlic in high esteem in preventing and healing heart related disorders. There are folks who claim two raw flakes of garlic a day keep their heart healthy and strong. 

Apples
Potassium plays an important role in the health of our heart. Ideally, it ought to be consumed via edible natural products that contain it. Apples being a rich source of both, potassium and phosphorus, make for vital heart food.

Grapes
Fruit therapists explain, “The production of energy essential for the proper functioning of heart depends on the metabolism of glucose. Thus, grapes being rich in pure glucose are extremely useful in treating heart ailments.” Besides toning up the heart, grape juice is effective in relieving cardiac pain and palpitations.

Asparagus
The following is claimed to be a trustworthy home remedy for a weak or enlarged heart.
Fresh juice of asparagus mixed with honey ought to be taken thrice a day (1 teaspoon at a time). Steam cooked asparagus consumed liberally with meals also benefits heart patients.

Karadai (Safflower seeds)
Karadai oil ranks as one of the most polyunsaturated oils. Consumption of the same is said to aid lowering of cholesterol and is beneficial for those suffering from ischaemia and hypertension.

Honey
In several cultures across the globe, honey has been upheld as nature’s wonderful cure for a range of ailments. In cases of arteriosclerosis, weak heart, cardiac pain and palpitation, honey is considered a safe home remedy. Generally, patients are advised a glass of water with honey and lemon juice at bed time.
(The write up is purely informative and not a substitute for proper medical diagnoses and treatment of heart ailments)

Ten ways to prevent a heart attack

1. Eat right Avoid saturated fats and trans-fats as they raise the bad cholesterol level (LDL). Check the labels of food items before consuming them and avoid anything that is “partially hydrogenated” as this is a clear indicator that it contains trans-fat. Cut out red meat from your diet and add fruits and vegetables instead. However, not all fats are bad for the body, monounsaturated and polyunsaturated fats that include Omega-3 and Omega-6 are essential for good health and help protect against risk of heart attacks and strokes. Food items that contain good fats include almond, walnut, avocado, tuna and flax seed.
2. Choose your oil wisely
   Cooking oil needs to be chosen carefully to maintain heart health and optimum levels of cholesterol in the body. Use oils with a higher monounsaturated fat content and lower saturated fat content, such as canola oil, olive oil and groundnut oil can be used. Do not reuse your cooking oil as this can result in the creation of trans-fats.
3. Take a walk
   Exercise helps protect against heart disease and several forms of cancer. But besides regular exercise every extra step you take during the day builds up your ‘health balance’, and helps prevent disease. Try and factor in at least 30 minutes of moderate physical activity (such as walking) in your daily life. Exercise burns the excess fats in the body and helps control the blood cholesterol. It will also reduce stress and normalise the pulse rate.
   
4. Control body weight
   Studies have shown that exercise programs and healthy eating lead to improved health parameters, even in the absence of weight loss. However, these studies should not be seen to be a license to be overweight. Body weight is directly related to eating behaviours and the type of food being consumed. Depending on your height and age, it’s advisable to figure out your ideal weight and then make an effort to achieve or maintain that.
5. Be relaxed
   Stress has several negative effects on our body, and should be kept under control. While, some stress is important it is vital to not allow it to completely take over our lives. Take up a hobby that helps you relax. It could be something as simple as cooking or gardening but make sure you take some time out for yourself.
6. Blood pressure under control
   Blood pressure is an important measure for prevention of heart attacks. Your heart has to work harder to push blood through your body when your blood pressure is high. This causes your heart to enlarge and can speed up atherosclerosis (deposition of fats inside the arteries). In case you suffer from this condition, make sure you take your medications on time. Avoiding excessive consumption of sodium can also help reduce high blood pressure.
7. Stop smoking
   A smoker’s risk of having a heart attack is more than twice that of a non-smoker. Smoking speeds up the development of plaque in the arteries. It also reduces the level of the good cholesterol (known as HDL), and increases the stickiness of blood cells causing blood clots inside the arteries.
8. Sugar’s not so sweet
   If you have diabetes, keep the blood sugars under ‘tight control’. Remember, physical activity is the best way to burn off excess sugar in the blood. Those with diabetes are more prone to heart disease, especially women.
9. All in the family
   Heart disease has a strong genetic component. If your parents or siblings have had heart disease you need to be doubly careful and need to start getting yourself checked at an early age. However, just because you may have a family history does not mean you are deemed to suffer, but your risk is higher.
10. Get yourself checked
    We all feel that it will ‘never happen to me’, but heart disease is an equal opportunity killer. Unfortunately most of the risk factors for heart disease are silent – they give you no warning of their presence. You should get your blood pressure, blood sugar, cholesterol and weight checked on a regular basis. Ideally these tests should start at the age of 15, and then repeated periodically. If you have crossed 40, it’s also a good idea undergo a stress test.

Be heart-smart with almonds

Today is World Heart Day. And as cardiovascular diseases are the world's largest killers, claiming 17.1 million lives a year. The event also aims to promote preventative measures that reduce the risk of cardiovascular diseases. This year you can take a pledge to give your heart a healthy diet and

 

keep it away from all the disorders. This year on World Heart Day, keep your fist-sized vital organ healthy by giving it a healthy gift of fistful of almonds.
Almonds contain many nutrients that contribute to heart health, namely, fibre, mono-saturated fat, vitamin E and phyto-chemicals. Research has shown that these nutrients not only help reduce the risk of cardiovascular diseases, but may also protect against obesity, cancer and diabetes by promoting satiety, contributing to healthy cholesterol levels and helping regulate blood sugar.

A recent study published in the Journal of Nutrition showed that compared to controls, participants who ate almonds-containing meals lost more weight and experienced greater improvements in their cholesterol profiles, two of the major contributing factors to heart health. That same research also documented increased alpha-tocopherol (vitamin E) levels among the participants who consumed almonds. Vitamin E is thought to promote cardiovascular health by protecting against oxidative damage.

Almonds are a smart snack that offers many heart-healthy nutrients. More than 17 years of research and nine clinical studies support the role of almonds in helping maintain a healthy heart and healthy cholesterol levels. A fistful of almonds provide 6 grams of proteins and 3.5 grams of fibre and is an excellent source of vitamin E - 7.5 grams and 76 milligrams of magnesium. A handful of almonds apart from these also offer potassium, calcium and iron.

Almonds are high in several types of antioxidants. Consuming antioxidant-rich foods is thought to prevent damage to cells in your body, a mechanism implicated in the development of chronic disease. Fruits and vegetables have long been known for their antioxidant content, but more recently researcher have discovered that almonds also contain high levels of several antioxidant compounds, in amounts similar to levels found in many fruits and vegetables.

This is a heartfelt recommendation to take a positive approach to heart health. Just a handful of almonds provide several key nutrients that contribute to cardiovascular health. With all these nutrients on your platter you can enjoy each bite knowing that you are helping your heart grow stronger.

Interesting heart health trivia

Your heart is the centre of your body's cardiovascular system and can be safely called the most vital organ of your body, which pumps blood and life into you.

It has many roles to play - from transportation of oxygen, to the success of your immune system; it affects the overall health and well being of your body. Today, as we get ready to celebrate 29th September as World Heart Day 2011, Dr. Praveer Agarwal, Associate Director, Interventional Cardiology at Fortis Escorts Heart Institute tells us interesting trivia about heart health, as part of our week long heart health special. Read on...

1. The human heart beats around 35 million times in a year - The average adult heart beats 72 times a minute.

2. Even at rest, the heart muscles work twice as hard as the leg muscles of a person running.

3. The heart pumps about 1 million barrels of blood during an average - Within a minute's time, a human heart can pump blood to every cell in your body. And over the course of a day, about 100,000 heart beats shuttle 2,000 gallons of oxygen-rich blood many times.

4. Broken Heart can pilot heart attack risk- A breakup with a loved one or news of a family death can increase risk for heart attack. When you experience an emotionally difficult event, it can also activate the release of stress hormones into the bloodstream that temporarily "shock" the heart. But this type of achy heart can bounce back in days with some rest.

5. Long time smokers can benefit by refraining from cigarettes - Within three years of quitting; the heart attack risks for ex- smokers are the same as for someone who has never smoked before.

6. Taking care of your teeth can impact your heart health - Developing gum disease can increase risks of heart attack or stroke by 50%.

7. The heart creates enough energy to drive a truck 20 miles every day - That is equivalent to driving to the moon and back in a life time.

8. The obtrusive sleep apnea (OSA) condition of heavy snoring, can negatively affect the heart.

9. Your heart is about 10 ounces in weight and has four chambers: The left atrium, the left ventricle, the right atrium & the right ventricle.

10. High blood pressure is one of the most common risks linked to heart health, then comes the heart attack, heart failure or kidney failure. It is also called as the "silent killer."

Time to take care of your heart

On the occasion of World Heart Day take a pledge to keep your heart healthy and strong. If you are suffering or have suffered any heart attack, then World Heart Day is the right time to know about the various non-modifiable and modifiable risk factors, and prevent such attacks in future.

The heart, although is the strongest muscle of the body, is very vulnerable to the various factors such as eating habits, smoking, stress, obesity and cholesterol. The World Health Organization reveals shocking facts that more than 17 million people die of various heart diseases among which 80% is premature deaths. So, what causes such deaths? Definitely, unhealthy eating habits, lack of physical activity and consumption of tobacco cause the excessive number of deaths.

But the good news is that all such factors could be prevented with right information and by following certain actions. This year, the World Heart Federation and its members on World Heart Day 2011 has asked people across the world to take charge of their family's heart health and also advocate the healthy lifestyle for a healthy living.

World Heart Federation has identified four actions that can keep heart diseases at bay:
Ban smoking completely at your home : By doing so, it will improve the health of the family members and also create a healthy environment to live in.

Healthy eating tips : It advocates that a healthy diet that is rich in vegetables and fruits can prevent cardio vascular diseases (CVD).

Be Active : Organizing outdoor activities such as hiking trips or simply playing in the playground can avert the risk of heart diseases.

Know your numbers : It is very important to know about glucose or cholesterol level, blood pressure and body mass index (BMI) as based on these facts an individual can develop a strategy that would help him/her keep fit and active.

Stay safe from cardiac arrest

With youngsters becoming more prone to sudden cardiac arrest, it is advisable that everyone over the age of 30 undergo an annual preventive cardiac check. But what is sudden cardiac arrest? It is a condition in which the heart suddenly and unexpectedly stops beating. When this happens, blood stops flowing to the brain and other vital organs.

Certain tests are performed to determine if an individual is at high risk for cardiac arrest. These include:

The electrocardiogram, which records the electrical activity of the heart.

Holter monitoring uses a walkman-size recorder attached to the patient's chest for one to two days, which continuously records the heart rhythm. After the recorder is removed, the tape is analysed for signs of arrhythmia.

The event recorder is a pager-sized device that records the electrical activity of the heart over a longer period; here the patient turns on the device whenever he feel his heart is beating too chaotically.

The Echocardiogram measures the pumping ability while identifying other problems that increase the risk of a sudden cardiac arrest.

Electrophysiology study (EPS) identifies rhythm problems and pinpoints areas in the heart that may be the sources of abnormal electrical signals that trigger arrhythmias.

Cardiac catheterisation can help identify any coronary artery disease or structural abnormalities.

Certain blood tests like cardiac enzyme test, electrolyte test, drug test and hormone tests maybe suggested.

Treatment Options
Patients diagnosed at risk of sudden cardiac arrest may be advised therapies, which include:

Anti-arrhythmic drugs for emergency, long-term treatment of arrhythmias or potential arrhythmia complications maybe recommended.

Implantable cardioverter-defibrillator (ICD) maybe recommended once the patient's condition stabilises.

An ICD is a battery-powered unit that is implanted near the collarbone. If it detects a cardiac rhythm disturbance like a ventricular tachycardia or ventricular fibrillation, low or high energy shocks are sent to reset the heart to a normal rhythm.

Coronary angioplasty or a coronary bypass surgery maybe advised to open blocked coronary arteries, if the individual is suffering from coronary artery disease.

Radiofrequency catheter ablation works to block a single abnormal electrical pathway, which is the cause of arrhythmias such as Wolff-Parkinson-White syndrome.

Corrective heart surgery to deal with a congenital heart deformity, a faulty valve, and diseased heart muscle tissue due to cardiomyopathy reduces the risk of fatal arrhythmias.

Heart transplantation maybe indicated in some people with severe congestive heart failure who have experienced cardiac arrest.

In case of a sudden cardiac arrest, time is precious because the brain is sensitive to the lack of oxygen and blood flow treatment must be instituted within four to six minutes, to avoid permanent brain damage. Cardiac arrest can be reversed using an electrical shock to get the heart back into a regular rhythm.

Communities need to institute public CPR education, use of AEDs, and rapid activation of emergency medical services to help increase the survival rates from sudden cardiac arrest. If the patient survives, the reason for collapse and sudden death will need to be diagnosed. As also, the ABCs of resuscitation will be re-evaluated. Airway, breathing, and circulation (heart beat and blood pressure) will be supported, and admission to an intensive care unit is most likely. The survivors of sudden cardiac arrest are often candidates for implantable cardiac defibrillators.

Diabetes is blinding young population

Beware of rising blood sugar level, it may not only force you to give up sweets but can also make you blind. India, which already has the dubious distinction of being the diabetic capital of the world, is now witnessing a larger number of patients reporting vision-loss at an early age.
According to a recent study, nearly 18 per cent of urban working population is falling prey to retinopathy. Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness in working age group. Dr Rajiv Raman, director, vitreoretinal services at Choithram Nethralaya and also the principal investigator of this study, says, "With diabetes hitting working population aged 35 and above, more and more numbers are reporting with retinopathy. Out of 100 patients with diabetes, 18-20 are diagnosed with mild to severe retinopathy."
He attributes the rising trend of retinopathy to changing lifestyle, eating habits of young population, hypertension and diabetes being reported at early age. The study was conducted on nearly 6,000 people based on socio-economic criteria.
The study used multi-stage random sampling method. The measures included were age- and gender-adjusted prevalence of diabetes and diabetic retinopathy, and correlation of prevalence with history-based risk factors. The results found that the prevalence of diabetic retinopathy in general population was 3.5 per cent. The prevalence of diabetic retinopathy in the population with diabetes mellitus was 18.0 per cent. The duration of diabetes is the strongest predictor for diabetic retinopathy. The study also found that if the age of onset of diabetes is less than 30 years then chances of developing severe retinopathy are five times higher. The disease is more common in men.
Dr Raman said, "We found an interesting fact that though diabetes has rural/ urban difference and difference in rich or poor, diabetic retinopathy does not. Once a person has diabetes, irrespective of socio-economic difference or geographic difference, he has similar chances of getting retinopathy."
According to the World Health Organization ( WHO), India will become one of the major hubs of diabetic population during the next two decades; the number of cases of adult-onset diabetes mellitus will grow to nearly 80 million in 2030. According to doctors working in the field of diabetes in city, out of 100 cases 15-20 are found to have the problem of vision-loss or retinopathy.
Dr P G Raman, senior diabetologist, says, "The problem is becoming more common these days. There are several cases where the problem is still unknown. I recommend my patients to get an eye check-up if there is vision-loss rather than changing spectacles."
Earlier news reports say India is also home to the largest number of the blind in the world. The problem of retinopathy persists but only limited data are available on the prevalence of diabetic retinopathy in the general population. As the awareness regarding the disease is low, people usually report at a stage when severe damage is already done.
Reasons:
The possible reasons for the rising trend of diabetic retinopathy are acculturation, changing lifestyles, changing food habits and more sedentary lifestyle.
Symptoms and detection:
Often there are no symptoms in the early stages of the disease, nor is there any pain. Be sure to have a comprehensive dilated eye exam at least once a year. Blurred vision may occur when the macula-the part of the retina that provides sharp central vision-swells from leaking fluid.
Treatment and measures:
During the first three stages of diabetic retinopathy, no treatment is needed, unless you have macular edema. To prevent progression of the disease, people with diabetes should control their levels of blood sugar, blood pressure and cholesterol. Proliferate retinopathy is treated with laser surgery. This procedure is called scatter laser treatment.

These Four Things Happen Right Before a Heart Attack

Every year, approximately 785,000 Americans suffer a first heart attack. And 470,000 who’ve already had one or more heart attacks have another one. The scary thing is that 25 percent of ALL heart attacks happen “silently,” without clear or obvious symptoms.
Even when symptoms occur, they can be so mild or vague, most people don’t even realize it’s heart-related (unless they are made aware). Four things in particular are the most sinister signs of a silent heart attack.
These four things are the focus of a recent video presentation by renowned cardiovascular expert Dr. Chauncey Crandall: Silent Heart Attacks: A Special Newsmax Heart Health Report. According to Dr. Crandall, the reason silent heart attacks go untreated is because people don’t even notice the symptoms, so he created a special video presentation to show the four things to look for that may be a silent warning — before it’s too late to intervene and survive the damage.


Read more on Newsmax.com: These Four Silent Heart Attack Symptoms Happen Right Before a Heart Attack
Important: Do You Support Pres. Obama's Re-Election? Vote Here Now!

Which burns more calories, walking or running?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Friday, it's Dr. Melina Jampolis, a physician nutrition specialist.

Asked by Michael from Galesburg, Illinois:
I have read and heard from other people that running and walking a mile burns the same number of calories. I have compared the two on a treadmill and the difference is astounding! Walking = 92, running = 158. I understand that treadmills don't show an accurate count of calories burned, but these numbers are so different. Is this true?

Expert answer:
Hi Michael!
I'm not sure where you heard that running and walking one mile burns the same number of calories, but as you found out with your experiment, this statement is not correct.
Distance itself does not really determine total calories burned. How long you exercise, how fast/hard you exercise, how much you weigh, and your fitness level are the major determinants of calories burned.
According to the website www.caloriesperhour.com, a 200 pound man would burn 113 calories walking 1 mile at a pace of 4 miles per hour (total exercise duration = 15 minutes).
The same man would burn 151 calories running a mile at a pace of 6 miles per hour (total exercise duration = 10 minutes).
And if you were strolling for a mile at a pace of 2 miles per hour, you would burn 113 calories but it would take you twice as long (total exercise duration = 30 minutes).
This may be where the confusion takes place. You burn fewer calories exercising at a lower intensity, but if you exercise for a longer period of time, in some cases, as with walking at 2 miles per hour versus 4 miles per hour, you may burn the same total number of calories.
Exercising at a higher intensity burns more calories per minute, which is much more relevant than distance. In addition, if you weigh more, you burn more calories doing the same activity (this is just something to keep in mind. I'm not suggesting that you gain weight to increase the number of calories that you burn!).
Also, if you are more fit, you actually burn fewer calories doing the same activity, but the good news is that you burn more calories from fat when you are fit.
The bottom line is that more intense exercise, like running, is a more time efficient workout. However, many people, including myself, are not able to run because of injury or arthritis. In this case, exercise as intensely as you can, but realize that you will have to exercise for a longer period of time to burn the same number of calories.
This is why the physical activity recommendations for adults are either 150 minutes of moderate aerobic activity (brisk walking) per week or 75 minutes of vigorous (running or jogging) physical activity per week in addition to strength training.
You can also try walking on an incline (or hills) to increase calorie burn or alternating running and walking (interval training), which is great for people just starting a more intense exercise program or looking to improve their overall fitness level.

A Drug To Treat Diabetes Before It Begins

A new study shows that people who are high risk of developing Type 2 diabetes may be able to prevent the disease by taking pioglitazone (sold as Actos), a common drug for diabetes treatment. But experts say that doesn't mean everyone with high blood sugar levels should be taking the medication.
Diabetes often progresses from a condition of impaired insulin sensitivity to the full-blown disease. Doctors have long been eager to find medications or lifestyle changes that can slow this progression or stop it altogether. While 21 million Americans suffer from Type 2 diabetes, nearly four times as many have high blood sugar levels that put them at risk of developing the disease.
Now researchers led by Dr. Ralph DeFronzo at the Texas Diabetes Institute and University of Texas Health Science Center report in the New England Journal of Medicine that pioglitazone can be an effective tool in helping high-risk patients control their blood sugar and stop the onset of diabetes.
The drug helps diabetes patients become more sensitive to their body's insulin; in Type 2 diabetes, the amount of insulin patients make isn't sufficient to break down the sugar they consume in their diet.
Among more than 600 people with elevated blood sugar levels and at least one additional risk factor for diabetes — including a family history of diabetes, being overweight, high cholesterol levels or hypertension — 2% of those taking pioglitazone developed diabetes, compared with 7.6% of those in the placebo group, during the study's more than two year follow-up, amounting to a 72% reduction in risk for those taking pioglitazone. In addition, more of the volunteers who took pioglitazone were able to restore their glucose tolerance to normal levels than those who were on placebo.
The reduction in diabetes risk seen in the new study was greater than that of other interventions that doctors currently use to help people with pre-diabetes avoid the disease. Another drug used to treat diabetes and control blood sugar, metformin, can lower risk by 31%; other medications in pioglitazone's class have lowered risk by up to 62%; and lifestyle modifications such as diet and exercise have also reduced risk by 58%.
Still, as encouraging as the results are, the study's authors caution that the data shouldn't be a license to prescribe pioglitazone to everyone at high risk of developing diabetes. The drug belongs to the same class of anti-diabetes medications as rosiglitazone, or Avandia, which the Food and Drug Administration put on restricted use last fall after evidence that it increased patients' risk of heart attack and stroke.
Pioglitazone has not been associated with such risks, but participants in the study who took the medication gained more weight than those taking placebo. While the gain was small, becoming overweight remains a strong risk factor for developing diabetes.
That's why diabetes doctors continue to reserve drug-based treatments of pre-diabetes only for only those patients who have tried and failed to control their escalating blood sugar with non-pharmaceutical methods, such as diet and exercise. It may take longer and may not result in as dramatic a benefit as medications, but lifestyle options, experts say, are safer and potentially longer lasting.


Read more: http://healthland.time.com/2011/03/25/a-drug-to-treat-diabetes-before-it-begins/#ixzz1Yyfxx3Lq

11 Signs Cholesterol Is Harming Your Legs

Cholesterol can clog the heart's blood vessels, but it can also affect the legs, leading to peripheral arterial disease, or PAD.

Up to 12 million people in the U.S. have PAD, which is linked to a higher risk of heart disease, heart attack, and stroke, says David Slovut, MD, director of advanced interventional therapy at Montefiore Medical Center.

After five years, 20% of people with PAD will have had a nonfatal heart attack.

Here are 11 signs you could have PAD. The good news? It's treatable.

Pain in the legs

An extremely common PAD symptom is claudication, a type of leg pain or discomfort.

Because the arteries are clogged, they can't deliver enough blood to the legs to support exertion. Some people say their legs feel "heavy" or tired, or they report a burning pain, Dr. Slovut says.

The pain can be in any part of the leg, from the calf to the thigh or buttock, and it may be in one or both legs. It's also reproducible: The pain happens when walking a certain distance (like two blocks), it's relieved by rest, and then occurs again when walking the same distance

Nighttime cramps

While sleeping, people with PAD may get cramps or spasms, typically in the heel, forefoot, or toes, says Darren Schneider, MD, director of the Center for Vascular and Endovascular Surgery at New York–Presbyterian Hospital/Weill Cornell Medical Center.

The pain can often be relieved by dangling the foot off the bed or sitting in a chair, which allows gravity to assist blood flow to the feet, Dr. Schneider says.

Skin and nail changes

PAD can cause changes in the toenails and the skin on the legs.

Because the legs aren't receiving normal blood flow or nourishment, you may notice that you are losing hair on the feet and legs, or that it's growing back more slowly if you shave it.

The skin on the legs may get shiny and tight, and toenails may thicken or grow more slowly.

All of these are usually experienced together, Dr. Schneider says.

Unusual skin coloring

One of the things doctors look for is a change in the color of your legs. When raised, a leg may be white because of compromised blood flow.

Then, when the leg is dangled from the table, it can turn reddish or purplish in color, says Dr. Schneider, because the body has dilated the blood vessels to increase flow to the feet.

In some people with PAD, the feet or toes are pale or bluish when they're sitting, due to a lack of circulatation

Cold feet

Feet or legs that feel cold, or are cool to the touch, may be an indicator that you have PAD. But it's not really the best indicator, says Dr. Schneider.

That's because this is a common problem, and it can happen to anyone as he ages—even someone without PAD.

However, if you feel like one leg or foot is cold, but not the other, it could be time to talk to your doctor.

Sores that don't heal

In people with more advanced PAD, a reduction in circulation can result in foot ulcers that don't heal.

Known as ischemic ulcers, these should be treated quickly, says Dr. Schneider.

The ulcers may be brown or black, and they're often painful (as opposed to diabetic foot ulcers, which may be painless due to diabetes-related nerve damage).

Erectile dysfunction

This is not a common occurrence, but it is possible for PAD to cause erectile dysfunction, Dr. Slovut says.

The internal iliac arteries provide the blood supply for erections.

If both are closed or severely clogged, it can cause erectile dysfunction (ED).

"The number of patients who have ED on the basis of a vascular problem is a minority of them. I don't see it a lot, but it can be a vascular problem," Dr. Slovut says.

Numbness or weakness

If your legs or feet feel numb or weak while you are resting, it could be a sign of PAD.

"Some patients will just say their legs get weak and feel like they will give out, and some get numbness in their feet," says Dr. Schneider. People who have symptoms at rest, not just while walking or exercising, usually have more severe PAD, he says.

Atrophy of calf muscles

People with more advanced PAD may experience atrophy, or a reduction in the size of their calf muscle.

On the microscopic level, a lack of adequate blood flow can lead to a decline in the number and size of muscle fibers.

In fact, those with severe PAD can lose more than half of their muscle fibers in an affected area, and the remaining muscle fibers tend to atrophy or shrink in size

Tissue death

About 80% of people with PAD never progress beyond having relatively mild symptoms, says Dr. Schneider, but a small minority of people can experience extreme symptoms.

In advanced stages, the disease can cause tissue death and even gangrene, which can be limb- and life-threatening, he says.

PAD can even lead to amputation in some cases, but quitting smoking, eating healthy, taking medication, and even having bypass or angioplasty can improve circulation in the leg.

No symptoms at all

Most people with PAD have no symptoms. However, people at a greater risk for PAD may want to be tested, since the disease ups your chance of heart attack and stroke.

PAD is more likely to occur in smokers, people over 50, and those with diabetes. You're also more likely to get PAD if you have high cholesterol or blood pressure, or a strong family history of heart disease or stroke.

Gains in Muscle Mass, Not Just Weight Loss, May Help Lower Diabetes Risk

Lose weight. That's often the first advice from doctors to their pre-diabetic patients. But while losing excess fat can help reverse Type 2 diabetes risk factors like insulin resistance and high blood-sugar levels, a new study finds that increasing muscle mass may also help lower risk of the metabolic disease.
According to lead researcher, Dr. Preethi Srikanthan, this may be good news for many people with pre-diabetes — a condition that results in higher-than-normal blood sugar, but does not qualify as diabetes — who have difficulty slimming down.
"Our findings suggest that beyond focusing on losing weight to improve metabolic health, there may be a role for maintaining fitness and building muscle mass," Srikanthan, an assistant professor of medicine at the University of California, Los Angeles, David Geffen School of Medicine, said in a statement. "This is a welcome message for many overweight patients who experience difficulty in achieving weight loss, as any effort to get moving and keep fit should be seen as laudable and contributing to metabolic change."
Srikanthan and colleagues based their study on data on 13,644 adults who participated in the U.S. National Health and Nutrition Examination Survey (NHANES) III between 1988 and 1994. Looking at the participants' skeletal muscle index (SMI), a ratio of muscle mass to total body weight, researchers found an association between increasing SMI and a reduction in certain diabetes risk factors: for each 10% increase in SMI, there was an 11% decrease in insulin resistance and a 12% decrease in pre-diabetes.
The findings are in line with what is already known about the metabolic effects of muscle and fat. "Extra fat has bad effects, but more muscle has good effects. These data are also consistent with data we see on exercise, that it helps decrease diabetes risk, and that a lack of exercise and weight gain increase risk," Daniel Rubin an assistant professor of medicine at Temple University School of Medicine, told USA Today.
The research was an extension of a 2009 study by the same UCLA team that found that people with high waist-to-hip ratios were at greater risk for diabetes. The team then began examining a subset of patients who had "sarcopenic obesity," a condition marked by unusually high body fat and unusually low muscle mass.
The following year, using data from NHANES, the team was able to show that sarcopenic obesity was associated with pre-diabetes and diabetes risk. But in this latest study, the team found that the association between muscle mass and pre-diabetes held, even among those who did not suffer from sarcopenic obesity.
The study will be published in the September issue of the Journal of Clinical Endocrinology and Metabolism.


Read more: http://healthland.time.com/2011/08/02/gains-in-muscle-mass-not-just-weight-loss-may-help-lower-diabetes-risk/#ixzz1YycZm3OI

5 Ways to Avoid Diabetes — Without Medications

New research suggests that when it comes to lowering your risk of diabetes, the more changes you make to your diet and lifestyle, the better.
Led by Jared Reis at the National Heart, Lung and Blood Institute, scientists report in the Annals of Internal Medicine that people can lower their risk of developing diabetes by as much as 80% if they adhere to a combination of lifestyle changes: exercising more, not drinking as much alcohol, quitting smoking, avoiding obesity and eating high-fiber, low-fat foods.
Although the advice sounds familiar, the new study is the first to demonstrate the effect of combining all the recommendations together. Previous studies have shown that losing weight or eating healthier can independently help reduce the risk of diabetes, but this study is the first to show the potential cumulative benefits of making multiple lifestyle changes.
The study involved more than 207,000 men and women aged 50 to 71 who were enrolled in the National Institutes of Health (NIH)–AARP Diet and Health Study. The participants were all healthy and free of heart disease, cancer and diabetes at the start of the study in 1995-96. When they joined, the volunteers filled out questionnaires about their lifestyle and diet, including what they ate, how much they weighed, how physically active they were, and whether they smoked or drank alcohol. The researchers tracked them for nearly a decade to see who developed diabetes.

VIDEO: Competing in the Olympics with Type-1 Diabetes

Reis and his team then divided the volunteers into low- and high-risk groups, depending on their responses to the lifestyle questions. People included in the low-risk diet group, for example, were those who ate foods with a low glycemic index (that is, foods that don't cause a sharp a spike in blood glucose levels, which can impair the body's ability to break down the sugar with insulin), more unsaturated as opposed to saturated fats, higher fiber and lower trans fats.
Women in the low-risk alcohol group drank no more than one alcoholic beverage a day; men drank no more than two. The low-risk physical activity group got at least 20 minutes of exercise three or more times a week. People whose BMI fell into normal ranges were considered low risk in terms of weight.
Each low-risk lifestyle habit was associated with a reduction in diabetes risk. Among men, those who were normal weight had a 70% lower risk of developing diabetes over 10, compared to those were overweight or obese. For women, the reduction in risk was 78%.

For men, the next most influential factors were not smoking and exercising regularly: non-smokers had a 24% lower risk of diabetes than current smokers or those who quit less than 10 years ago, and men who reported being physically active enjoyed a similar reduction in diabetes risk, compared with more sedentary men.
MORE: Gains in Muscle Mass, Not Just Weight Loss, May Help Lower Diabetes Risk

For women, avoiding overindulgence in alcohol was an important factor in reducing diabetes risk: those who drank just one glass or less a day had a 37% lower risk, compared with women who drank more. And being physically active also helped women avoid diabetes; those who exercise regularly were 23% less likely to develop the disease than those who didn't.
What was more intriguing was how much the participants were able to lower their diabetes risk when they combined many of these healthy lifestyle habits. A man who ate a high-fiber, low-saturated fat diet and exercised regularly, for example, had a 28% lower risk of diabetes than his counterpart who ate less healthily and spent more time on the couch. If that man was also a non-smoker, his risk of diabetes dropped by 32%; if he also cut back on his alcohol, his risk fell by 39%. If he maintained a normal weight on top of everything, his overall risk of developing diabetes was 72% lower than his peers who adhered to none of the healthy lifestyle behaviors.
The numbers were even more impressive for women, who, by combining all five lifestyle factors, were able to lower their risk of developing diabetes by 84%.
While there are effective medications to treat diabetes, it's encouraging news that standard lifestyle modifications such as losing weight, eating right, exercising, quitting smoking and drinking in moderation can significantly lower the risk of the disease. Not everything, it seems, needs to be treated with a pill.


Read more: http://healthland.time.com/2011/09/07/5-ways-to-avoid-diabetes-without-medications/#ixzz1Yyb4oxaZ

10 Risk Factors Linked to 90% of Strokes

Analyzing data on 6,000 people — half of whom suffered a stroke, and half of had not — from 22 countries around the globe, researchers from Canada's McMaster University identified 10 common risk factors, including smoking, high blood pressure and belly fat, associated with 9 out of 10 strokes. The results of the INTERSTROKE study, as it it's known, are being presented this week at the World Congress of Cardiology in Beijing and will be published in The Lancet.

For the study, all participants completed detailed questionnaires about medical history and behavior and underwent a physical exam. Stroke patients were assessed by researchers within three days of hospital admission, and within five days of the first onset of stroke symptoms. Participants in the control group were matched by age and gender, and had no history of stroke themselves.

Researchers found that 80% of all strokes were associated with five common risk factors: hypertension (high blood pressure), smoking, poor diet, belly fat, and low physical activity. When researchers examined five additional risk factors — diabetes, heart disease, alcohol consumption, high cholesterol and stress or depressive symptoms — they found that together, these 10 risk factors were linked to 90% of the population-attributable risk (a measure of the population-wide impact of risk) for all strokes.
When the study authors analyzed risk factors by particular type of stroke, they found that all 10 of these major factors were strongly associated with ischemic stroke, or when a clot in a blood vessel blocks blood and oxygen supply to the brain. They found that five risk factors were more pronounced for intracerebral hemorrhage, or bleeding within the brain: high blood pressure, smoking, belly fat, poor diet and alcohol consumption.
Considering each risk factor individually, the researchers found that hypertension was the most significant risk factor for stroke, as it was associated with roughly one third of all risk for stroke.


Read more: http://healthland.time.com/2010/06/18/10-risk-factors-linked-to-90-of-strokes/#ixzz1YyZDJ9Ws