Doctor Bari: 2014

Bogra Diagnostic Centre and Clinic

Popular Diagnostic Centre Ltd.

Thanthaniya, Sharpur Road, Bogra.

Phone : 051-69500-4,

Fax : 051-69319

Mobile : 01919-610187, 01922-072377

Doctors Clinic Unit-2

Thanthaniya, Sharpur Road, Bogra.

Phone : 051-66224

Mobile : 01716 106796

Saic General Hospital

Thanthaniya, Sharpur Road (Bhai Pagla Majar of South site), Bogra.

Phone – 051-63760, Mobile : 01936 002877, 01783 747503

SAIC General Hospital is fully equip-ed with all the latest medical technology to provide best quality medical services to the people of the country. A Competent, dedicated and highly qualified doctors team along with highly trained nurses ensure quality health care services in all area of medical facilities on both emergency and non-emergency situations.

Social Commitment:

SAIC has great feelings and social commitment to those who are deprived of modern Medical treatment. This is costly and even increasing in trend, which is out of reach of the most of the people of Bangladesh. SAIC felt need to do something for them. Thats why SAIC is offering special facilities to make the treatment affordable to them. Unlike fully commercial Medical centre. SAIC has got it's society oriented Misson. It is prime concern. Our Mission is to ensure socity good health though individual patients recovery.

Cool and peace sleep this summer

This summer get to sleep in peace. Please following below work.

Work - 1

Please take a bath before going to sleep at night. Than our body temperature and general lack of facilities in our sleep. As a result of our body temperature decreases when the bath is deep sleep. If you cannot make the bath water and soak the feet go to sleep. Able to sleep comfortably.

Some of us do not know tips- Necessaries of life

They who do not sleep at night before going to sleep with sugar eat a glass of milk. To be able to sleep any way.
Many like the fresh flowers. But it cannot be kept longer in the house. If the flowers are prone to log vases of fresh water mixed with little camphor days.
If the fruit fly cells is depredation. To avoid depredation fly home wet rope hanging in a place of light. Flies sit on the rope.

Five foods that are completely natural way to remove acne spots

One

Choose a natural bleaching agent which is lemon juice or any kind of acne is very effective in eliminating dark circles. Eat a glass of lemon juice in the morning and afternoon. If the problem cannot eat without sugar carbohydrate. This toxic substance from the body is out and the skin is bright and lively.

How long will. What are the healthy body and healthy mind possesses. Long live the way I talk.

Observe what is often:

1. The sun arise should leave a half-hour before bed. Only patients and children of different things to do these statutes.

2. Beds teeth well after leaving the ground and will have to face. Face, hands and feet must be washed thoroughly.

3. Might rise up in the morning you need to evacuate.

4. Wake up from the Mall-leaving water and ground teeth and mouth-wash hands wandering space is extremely beneficial to the body.

5. Morning tea and a biscuit to eat with unwashed hands withered face physical harm. People wake up and face washed withered tea eating habits they eat ground teeth.

6. Patients and children more than 8 hours of sleep each harmful to healthy people. 10-12 in children sleep enough hours.

7 . Evening bath is beneficial is very important. The flux can not attack.

8 . Went at once to evacuate after a good night of work . Such practice will sleep better at night if you have a healthy body.

9. Every day some need to be walking.

10. Those who sit and work, for some of them essential to the walking path.

11. Those who have their own cars, cars and office visits on behalf of them walking up and need some space.

12. Too much trouble to keep the mind cheerful . With friends or children in the house at the time of the trial with the goal of spending some time to clarify and smiles. Find the emotional enjoy.

Emotional Enjoy

13 . Regular daily bathing and eating at the same time will.

14 . Will eat like amount . Together eating more is not better.

15. Quickly so do not eat and swallow. Eat well chews.

16 . The office or on the go you should eat 1 hour ago. The taste is not good to work quickly or office.

17. Will meal the night before sleeping at night. Night meal should be very bland . You should not eat too much.

18. The morning at 7 am, noon 10 am to 12 pm, afternoon and night at 4:00 pm to 8:00 pm eating. Food should not be eaten moments.

19. The head do not let the hot water. Clean, well washed with cold water, soak a towel in hot water with a towel or wash away.

20. Will not be engaged in the activities of more than 8 hours per day. If more than 8 hours in any work to do, whatever will damage health.

21. Remember 24 hours throughout the day and night, it will have three parts. 8 hours of sleep at night. 8 hours working morning, the rest of the 8 hours of rest and activity etc..

Alcohol

22. Alcohol, marijuana, carry chewing tobacco, drink, smoke, cigarettes not eating well. If difficulties should be used very little.

23. Those who sit and toil head, some of them empty-handed exercises and yoga are essential to the seat. If it blood pressure, diabetes, indigestion can be.

Balanced Diet – In Pregnancy

A Balanced Diet is a Must! – In Pregnancy.

We are what we eat, and diet based on fresh, light, nutritional foods, such as fruit, vegetables and grains keeps the body lean, agile and the mind clear and sharp. For you, as a pregnant mother, this is even more vital as your health and vitality will determine the health and vitality of your unborn child. Your diet should contain adequate quantities of proteins, minerals and vitamins for both a healthy you and your baby.

Protein is required during pregnancy to support the growing foetus and the placenta. It can be obtained in generous amounts from lentils, peas, beans, nuts and soya products. These can be taken in combination with whole grains such as wheat, oats, corn, barley, etc. It is better to avoid red meat as it could lead to constipation. Besides, meat only adds toxins to the body.
Calcium is required at every stage of pregnancy as it helps in the development of your baby’s bones and teeth. Women should increase the intake of calcium during pregnancy in order to meet the foetus needs without compromising their own bone density. Deficiency of calcium can lead to weakness and acute pain in the bones and joints of the expectant mother, making it difficult to carry on with the pregnancy. Deficiency of calcium can ultimately lead to development of rickets in your growing child. Good sources of calcium are soya, nuts and dairy products like milk, curd, cottage cheese, soya and nuts.

Iron and Folic Acid
Iron is necessary for the development of haemoglobin- the carrier of oxygen in the blood. Haemoglobin is attached to red blood cells and it is because of this component that oxygen is able to move from the lungs to different parts of the body. Deficiency of haemoglobin results in anemia, which subsequently leads to weakness, breathlessness and fatigue. Dietary sources of iron are green leafy vegetables, egg yolk, raisins, apricots, cereals, whole grin, bread and liver. Folic acid is easily available in jiggery, pulses and dairy products.
Vitamins
Vitamins promote good eyesight, healthy teeth, clear skin, and general growth and vitality. They build resistance to infection and are very necessary during pregnancy and lactation. Natural sources of vitamins are fruits, milk and milk products and vegetables. Vitamins C and D increase resistance to infection and hold the body cells together. Vitamin C is available in citrus fruits, papaya mango, tomato, potato as also in minor amounts in other fruits and vegetables. Vitamin D is available from sunlight and natural fruits and vegetables that are full of this prana.
Fibre
A very important component in diet during this period, as pregnant women normally tends to suffer from constipation due to the extra intake of iron. Try and eat lots of fruits and vegetables, whole grains and cereals to add fibre to the diet. Fibre is rich in polyunsaturated fats that help control blood cholesterol.
Liquids
Equally important is intake of plenty of fluids. Drink lots of water and fresh juices, but limit your consumption of tea, coffee and aerated drinks. Drinking fruit juice or herbal tea is definitely preferable to drinking plain tea. We do not recommend alcohol to pregnant mothers. Not only does it get absorbed into your bloodstream, and that of your baby, you also run the risk of suffering from slower reflexes and loss of muscle coordination, thus placing both yourself and your baby at risk.

Mountain Pose or Parvatasana

This asana makes the entire body strong. The abdominal muscles are drawn toward the spine when breathing deep. It strengthens the internal organs and has a profound effect on the reproductive organs.

· Lie down on the floor on your stomach, i.e. with your face downwards. Keep your feet about 2.5 cm apart.

· Rest your palms by the side of your chest, with fingers straight out, pointing towards your head.

· Exhale. Raise your hips, lowering your head between your arms. You will be forming a triangle with your back and legs.

· Try to keep your legs stiff. Do not bend your knees but try to press your heels and the soles of your feet on the floor. Also try to bring your head towards your knees.

· Stay in this position for thirty to forty seconds while breathing deeply.

· Release the posture by lifting your head forward, stretching your torso forward and lowering your body gently down to the floor.

Shoulder Stand Pose or Sarvang Asana

This asana balances your endocrine glands to your hormonal levels. It regulates menstrual activity and also is very beneficial for women suffering from a displaced uterus.

· Lie on your back and flex your toes inward. Place your palms facing down, close to your hips. Inhale; push down on your hands and raise your legs straight up and above you.

· Left your hips off the floor and bring your legs up, over and beyond your head at an angle of about 45⁰.

· Exhale, bend your arms and support your body, holding as near the shoulders as possible, thumbs around the front of the body, fingers around the back. Push your back up and lift your legs.

· Straighten your spine and bring the legs up to a vertical position. Press your chin firmly into the base of your throat. Gradually try to get your elbows closer together and your hands further down your back, towards the shoulders, so as to straighten your back.

· Breathe normally while doing this posture and while holding it. Stay in this position 20 to 30 seconds.

· Bend your knees and pull them to your forehead or chest; then gently lower your body, releasing the position.

Take care not to jerk into the posture instead gently keep pulling your body up into the final position.

Energising your Solar Centre or Agni Sara

This exercise tones your abdominal muscles and organs. It encourages digestion and excretion. It also tones all your reproductive organs and facilitates sexual functions.

· Sit in a comfortable cross-legged position.

· Place your hands on your knees, close your eyes and relax your body for a few minutes.

· Inhale deeply. Exhale, by emptying out your lungs completely.

· Lean forward a little and straighten your elbows, pushing down on your knees.

· Lower your chin down towards your throat. Now contract and expand your stomach muscles rapidly for as long as you can hold your breath.

· Perform about five to ten contractions in this way, but do not can hold your breath.

· Slowly lift your head up, inhale slowly and deeply.

· This completes one round. Relax your body, breathe and begin the next two rounds.

Do not practice this when menstruating, or if you are suffering from heart disease, high blood pressure, hernia or an ulcer.

Yoga for Conception

So you are planning to start a family. Then you must know that the implications of bringing a child into this world are enormous- not only on you as a mother-to-be, but on your partner and on your lifestyle as well. But if the timing is right, and you are mentally prepared, then you should start preparing your body for pregnancy at least a year in advance.

Time and again it has been proven that stress is one of the biggest blocks to getting pregnant. In this busy world it becomes harder to find the inner peace that our body and mind craves for. Yoga is a mind and body exercise that enables you to recharge at all levels and allows your body and mind to work with its innate magic.

Start on a protein diet and increase your intake of green vegetables and fruits, reducing fried and junk food, thus cleaning your body of toxins. Those of you, who have been on a contraceptive pill, give yourselves three months without it to let your body get used to the new situation. Visit a gynecologist and make yourself familiar with what is going to happen. It is important that you get yourself checked for Rubella virus. Take special care of yourself so as to make your body’s stay comfortable.

The way to approach your conception is to create the correct environment for becoming pregnant, which means that as a prospective parent, your body must be in optimum health and in fit condition to facilitate conception. In addition, your mind must be calm and positive. Time and again it has been proven that stress is one of the biggest blocks to getting pregnant.

The result of a balanced yoga session will give you tranquility o mind and the body will feel rested and energized. Your internal organs will feel recharged and this will allow them to function more effectively. Therefore if you are having trouble conceiving you should give yoga a try. By starting early, you will develop all the good habits that are essential to carry, protect and nourish your unborn child when the time comes.

The regular practice of hatha yoga will help achieve hormonal balance, regulate irregular menstrual cycles and tone all the reproductive organs. Yoga postures foster awareness of feelings, both physical and emotional. They build strength and flexibility and also help in lubricating the joints and in releasing the toxins that build up in the body. The various postures also tone the muscles of the spine and strengthen the entire physical body-internally as well as externally, making it fit to carry a new life inside it for nine months.

The asanas describes in this section should be done before one decides to conceive. Once you become pregnant, you can make changes and add new asanas that will help and support you through your pregnancy.

Remember to Pregnancy

For Pregnancy

Throughout your pregnancy baby is dependent on you for all its dietary need. This means that you should pay special attention to what you eat. A poor diet during pregnancy will not only take its toll on your own health, but can also have life-long repercussions on the physical and mental well-being of your child. A pregnant woman should eat a well-balanced diet, but at the same time keep track of her weight gain. Women who experience morning sickness or nausea in the first trimester are sometimes unable to eat properly. In fact, many mothers-to-be tend to lose weight during this period. However, this should not worry the expectant mother, unless it continues even after the third month; then it becomes advisable to seek the doctor’s help. Food aversions are extremely common in pregnancy and are believed to be due to the hormonal changes taking place in the body.

From the third month on wards, when your baby starts to develop and grow, you will find a change in your appetite. Your hunger will return! This is the time to nourish you with a well-balanced and nutritious diet. It is important that women should gain weight during pregnancy. Not gaining enough weight makes for a low-weight baby who might face health problems; on the other hand, too much weight may make the delivery a bit too difficult. The ideal weight gain during your pregnancy is between 9 to 13 Kg. Any weight gain beyond this will stay with your after your delivery. Make sure not to restrict your diet during pregnancy because otherwise your diet may lack the right amount of nutrients required for the growth of the baby.

Remember to

a.       Eat small portions of food at regular intervals. Avoid consuming large quantities of food at meal times.
b.      Keep fruits, nuts and biscuits handy for those intermediate hunger pages.
c.       Avoid smoking and alcohol.
d.      Reduce your intake of tea and coffee.
e.      Avoid heavy and spicy foods as these may cause flatulence. Keep your salt intake low.
f.        Eat at least two portions of fruits and vegetables. Avoid aerated drinks as this will lead to unwanted calories. Instead, substitute with fresh fruit and vegetable juice.
g.       Add honey instead of refined sugar to your milk. And in general, limit all kinds of sugar.
h.      Eat only when you are genuinely hungry.
i.         Eat slowly and chew your food well.
j.        Avoid tranquillizers and drugs in general, unless you are prescribed one by your doctor/gynecologist. If you have an over powering need to take a drug, then consult your doctor. Just remember that drugs have serious effects on the unborn fetus.

Relaxation or Yoga Nidra

Relaxation or yoga Nidra

The state of our minds and the state of our bodies are intimately linked. If our muscles are relaxed, then our mind too is relaxed. In today’s world, we are bombarded with stimuli that leave our bodies in physical and mental tension. Such undue tension drains us of our energy and becomes the major cause of our tiredness and ill health.

Relaxation releases the muscular tension, infusing the body with serenity. To relax is to rejuvenate. To rejuvenate is the key to good health, vitality and peace of mind. Yoga nidra is a gentle relaxation technique that requires a few minutes and is very effective in our day-to-day lives.

a. Lie down in balasana and make yourself comfortable. Relax your body and focus on your breathing.

b. Relax your body physically by mentally starting from the toes and moving upwards slowly, till your entire body is relaxed.

c. Your mind can be relaxed by focusing on your rhythmic breathing and letting no other thought to creep in.

d. Stay in this position for as long as you want.

Mantra Meditation or Japa Meditation

Sound is a form of energy that is made up of vibrations and wavelengths. Mantras are Sanskrit syllables, when chanted, will take you to a higher stage of consciousness. Sincere practice and repetition of a mantra lead to birth of pure thought. Mantra meditation calms the body and mind. It induces a state of silence and stillness. The vibration of the chant has a very soothing and positive effect on you and your baby.

a. Sit in a comfortable cross-legged position with the spine held erect, or preferable still, sit against a wall, as you will be more comfortable and less distracted. Cushions and bolsters may also be used as per your needs.

b. Place your hands on your knees with palms upward and the fingers in the chin mudra, i.e. your thumb pressing the tip of your index finger. Relax your body and calm your breathing.

c. Gently focus your eyes on the point between your eye-brows –the ajna charka.

d. Feel your breath moving in and out of your body. Visualize that from this point you are sending all your energy to your baby.

e. Now chant a mantra or the cosmic sound, OM. First chant loudly for a few seconds, and then slow it down to a whisper that you only can hear. Then chant it mentally 108 times. ( You could also use a Japa mala to keep a track of the cunts)

f. Continue till you are comfortable and then lie down in balasana.

One can also use a japa meditation to keep the mind from distraction. Listening to mantra or spiritual music can be another option.

Rules of drink water

The rules are to drink water?

It depends on how much water a person needs, the weather, the amount of its activities, the status of development. Get the hypothalamus portion of the brain is the control center. When you drink water that is in the center. This is part of a functional deficiency or excess water will never do.However, any time, such as after brain surgery, the loss of control of the person's thirst is disappearing. The lack of water hazards may occur. Once again, the amount of the body through the urine from the kidneys to effectively additional water can. But if the kidneys are invalid, but the accumulation of excess water in the body can cause problems.

8 tips for drinking water.

I like the warm weather, the work is fairly typical day of work for people who drink two to three liters of water in it. The water flowed from his body, but it depends on the amount of help.
You should drink plenty of water during fever. Remove constipation is to drink plenty of water. Three in the morning on an empty stomach - drink four glasses of water problems productive. Some drugs, particularly antibiotics, some teams are asked to drink more water, so that it can be extracted quickly.
The hot weather is less than the amount of water may reduce the amount of urine, yellow or reddish color, and urinary retention may be irritation. Please understand that if such panisunyata. I will drink a lot of water.
Drinking water should be enough to keep the skin healthy and bright. The important role of appetite and other metabolic problems.
Kidney problems, high blood pressure, and respiratory problems huderaga there, you can specify the amount of water in treating patients.
Half hours before meals and at least one hour after eating half hours should drink water. Drink more water during meals is not advised.
Heavy activity or exercise three - four drink a glass of water.
Do not hurry to get to the water. There is no need to force more water to drink. You will be notified when your pipasai how much water you need.

 Department of Medicine, Shaheed Suhrawardy Medical College and Hospital.

Medication and Relaxation - Pregnancy yoga

Meditation and Relaxation

Everyone seeks peace of mind though the path adopted to achieve it may differ. Some use soft soothing music to ease that tensions of the day, some read quietly and still others find solace in prayer. The purpose of all these activities is to focus attention on any one point of concentration and still the mind, shutting away all other thoughts till the incessant internal chattering stops. As the mind calms down, and the worries get forgotten, there arises a feeling of contentment. With continued practice of meditation, you can discover a greater sense of purpose and strength of will. Your thinking becomes clearer and more concentrated, affecting all that you do.

Pregnancy is wonderful but it can be a period of strain and stress; striking a harmonious balance between the mind and the body under these circumstances can be rather difficult.

The meditation and relaxation techniques taught during the yoga class help you to cope well with the various mood swings that one suffers during pregnancy. These mood swings are due to the hormonal changes that take place during your first trimester. Hormone fluctuations are greatest in this period due to the changes in the levels of estrogen and progesterone. This causes emotional disturbances, nausea and a feeling of lethargy.

After the there-to-six month period, your placenta replaces the ovaries, which produce the harmones-oestrogen and progesterone. As these hormonal levels reach a balance, your energy levels return and your emotional swings diminish.

In the last trimester, another major change takes place in your body as it prepares itself for labor and lactation. After your baby is born, the oestrogen and progesterone and progesterone levels fall once more, causing extreme depression and fatigue.

Mediation and relaxation techniques help your cope with all these hormonal imbalances and emotional ups and downs. They also keep the mind calm, focused and well balanced, besides creating a positive state of mind. Now you are at the stage to willingly accept the changes taking place in your body and in your life.

Meditation is only a path to increasing your self-awareness and connecting to your unborn baby. It is a proven fact that mothers who practice yoga during their pregnancy give birth to babies who are of happy disposition, calm, healthy an flexible. Your nine-month journey through pregnancy will be a lot easier with meditation as you focus your energies on creating another life within you.

In order to get the maximum out of meditation, it is essential to make it a regular habit in your life. If you follow these simple instructions, you will be able to gradually train your mind to respond without delay.

a. Identify a special place for meditation, where you can be left undisturbed for a period of time.

b. Ideally the best time to meditate is early dawn or dusk, when the atmosphere is charged with spiritual energy. If neither of these times is suitable, then choose a time when you can concentrate wholly on meditation.

c. Use the same time and place each day, as this will train your mind to slow down more quickly.

d. Sit with your back, neck and head held in a straight line, facing the north or east, to benefit from the subtle effects of the earth’s magnetic field.

e. Try to keep your mind calm during the meditation sessions, by forgetting the past, the present and the future.

f. Regulate your breathing by first slowing it down and then establishing a rhythmic pattern. This will control the flow of prana and help you to still your mind.

g. Practice meditation daily, staring with twenty minutes and gradually increasing to an hour.

Womb Seal or Yoni Mudra -Pregnancy yoga

Womb Seal or Yoni Mudra

Bandha and mudra are the locks and seals that have a powerful effect on the reproductive organs of a woman. They also help in altering the mood, attitude besides enhancing awareness and concentration. We have featured two of the most important and beneficial exercises here.

This Mudra is helpful in soothing your mind and the nervous system. It helps you to withdraw yourself from the outer world and enter your inner world. This practice provides the peace needed to prepare you for your new stage of life.

a. Sit in comfortable position; relax your body and focus on your breath.

b. Raise your arms and cover your face gently.

c. Place your index finger on the eyebrow, and your middle finger on your closed eyelids. Press the tips of your ring finger on the outer side of the nostril and your little finger on your lips at the corner of your mouth. Press your thumbs on your ear-holes to withdraw from all the sounds.

d. Breathe normally and remain in this position for as long as your feel comfortable. Then ole down in balasana.

Pelvic Floor Exercise -Yoga in pregnancy

Pelvic Floor Exercise

Pelvic Floor Exercise is the locks and seals that have a powerful effect on the reproductive organs of a woman. They also help in altering the mood, attitude besides enhancing awareness and concentration. We have featured two of the most important and beneficial exercises here.

Exercising the pelvic, anal and vaginal muscles keeps them strong and flexible, as these muscles are going to stretch fully at the time of the birth of your baby. They have to withstand the pressure and the stress of birth and return to normal position, avoiding any postnatal problems.
a. Sit in a comfortable cross-legged position, with your eyes closed and your body relaxed.
b. Focus on your anal sphincter, the perinea muscles and the vaginal area.
c. Inhale. Contract these muscles. Exhale and release these muscles.
Repeat several times.

Pregnancy yoga

Ujjayi Pranayama

This pranayama increases your endurance level, soothes your nerves and tones your entire nervous system. It prepares you well for labor as it helps you to stay calm during the entire period.

a. Sit in a comfortable position with eyes closed. Relax your body and breathe.

b. Inhale deeply from both nostrils through the throat, partially keeping your glottis closed in order to produce a sound of low uniform pitch (sa).

c. Fill your lungs, but take care not to bloat your stomach. Exhale slowly and deeply until your lungs are empty. As you exhale, the air should be left on the roof of the palate and make a sound (ha). These sounds should be so silent that only you should able to hear them. This completes the first sequence of this pranayama. Wait for a few seconds to begin the next round.

Repeat 10 to 15 times.

Yoga in pregnancy and Childbirth

Alternate Nostril Breathing

In this Pranayama, the blood receives a larger supply of oxygen than in normal breathing; your mind feels relaxed and calm. It also soothes the entire nervous system.

a. Sit in a comfortable cross-legged position. Relax your entire body and keep your eyes closed.

b. Bend your right arm from the elbow. Bend the middle and index finger inward to your palms. Bring your ring finger and the little finger toward your thumb.

c. Place your right thumb on the right side of your nose and your ring and little finger on the left side of your nose. By pressing your thumb, back the right nostril.

d. Inhale slowly and deeply through your left nostril. After full inhalation, block your left nostril with your ring and little finger. Exhale, breathing out the pressure from your right nostril and releasing the air slowly, deeply and steadily.

e. Next, blocking your left nostril, inhale deeply from the right. After a full inhalation, block the right nostril and exhale, steadily. This completes one round of the pranayama. Try to do four to eight rounds at least twice a day.

f. Lie down in balasana and relax.

Pregnancy yoga

Yogic Breathing

Breath is the very essence of life. According to the yogis, there are two main functions of breathing. The first is to oxygenate the blood and the second to control the Prana or vital energy, leading to control of the mind.

Yogic breathing is very important in yoga. In the yoga sutras, the practice of pranayama and asana is considered to be the highest form of purification and self-discipline for the mind and the body. In pranayama we focus attention on the breath. Therefore, it is very important to keep an alert mind. There is no movement in the body as in the practice of asanas, but we must feel the movement of the breath within as pranayama prepares us for achieving stillness- a prerequisite of meditation.

Just as there are three stages in an asana, in pranayama there are three parts to each breath – inhalation, retention and exhalation. Unlike the general belief that inhalation is the most important part of breathing, yogic breathing focuses on prolonged retention and exhalation. Nasal inhalation maximizes the amount of prana taken in, for at the back of the nose lie the olfactory organs through which the prana passes, to reach the central nervous system and the brain.

Yoga breathing exercises teach you how to control the prana and thus control the mind. Since breathing reflects your state of mind, by controlling your breathing, you can control your state of mind. The increased intake of prana will bring you great vitality and strength. It also steadies your emotions and encourages greater clarity of mind. In order to facilitate the flow of prana, all yogic breathing exercises are performed while sitting down with the spine, neck and head held in a straight line. Always try to be aware of the breath, and focus on place in the body where we can feel or hear the breath entering and leaving the body at the nostrils. It is also possible to listen to the breath, especially if you make a slight noise.

During pregnancy, yogic breathing is extremely beneficial as you are breathing for the two of you. You need an abundant amount of oxygen to pass it on to your baby, so that it develops into a healthy, strong infant. Yogic will help control pregnancy anxieties and gestation period. It also proves beneficial during labour as it helps you cope with the painful muscular contractions and calms you, so that your delivery is smooth and natural.

During pregnancy, yogic breathing is extremely beneficial as you are breathing for the two of you. You need an abundant amount of oxygen to pass it on to your baby, so that it develops into a healthy, strong infant. Pranayama will help control pregnancy anxieties and promote a feeling of calmness and well-being during your entire gestation period. It also proves beneficial during labour as it helps you cape with the painful muscular contractions and calms you, so that your delivery is smooth and natural.

Whilst performing breathing exercises, do remember to sit up in a comfortable position, supporting yourself with cushions, keeping your facial muscles released and breath natural. Also remember not to retain your breath and stop the exercise if your feel breathless

“Breathe naturally, without forcing. No pressure, no disturbance. Nothing should interfere with the simple tide-like movement of our lungs as we breathe in and out.” – Vanda Scarvelli

Physical Activity program for heart Patient.

What is graduated physical activity program?

A graduated program of physical and self care activities can begin upon transfer from the coronary care unit. In the coronary care unit (CCU), assisted range of motion exercises can be initiated in the first 24 to 48 hours for most patients. Self care activities such as shaving, oral hygiene and sponge bathing can be undertaken in the intensive care unit. Upright posture should be encouraged as much as tolerated. Patents should walk with assistance at least twice daily. White some inpatient programs suggest walking specific distance each day; ambulation can be based upon the patient’s tolerances. Most patients will tolerance a minimum of 5 minutes of walking the first day. Walking time can be increased until patients are walking for 30 minutes twice daily. At that point, the walking sessions should include stair climbing to ensure that patients can perform that task at home. Patients able to walk unassisted for 30 minutes and climb stairs have sufficient strength and endurance for most activities of daily living.

rehabilitation after bypass surgery

Rehabilitation After Bypass Surgery

It is usually believed that heart operation is very taxing. But patient usually recover completely after the bypass operation. The patient may find himself tiring easily for a while but he must not be frustrated. Physical strength will return slowly and steadily over the coming months. Although by-pass operation is usually done for the relief of chest pain or to improve overall well being, the patient may not be fully aware of these benefits until several months after the surgery. A sensible balance of rest and activity is the keynote to a good and speedy recovery. Patient must abide by few instructions after the by pass operation:

1. It is recommended that the patient must avoid heavy exercise within one month of operation. If you an activity tiring, stop and rest.

2. Graded exercise program like walking is beneficial. It is better to walk at a comfortable pace, daily increasing the length of time according to physical condition.

3. It is better to avoid walking in very cold or hot weather and to climb uphill. Exercise in extreme of weather is discouraged.

4. Formal exercise programmes e.g. wall climbing exercise, riding a stationary bicycle, sit-ups are usually recommended. Riding a stationary bicycle is favourable. Patient can increase the daily time of exercise slowly. Other exercises are equally beneficial.

5. Heart rate increases when you climb stairs, so climb stairs slowly.

6. Patient can drive car after 2 months of discharge from the hospital.

7. Sexual activity can be started once the patient is discharged from the hospital. This is up to you and your sexual partner, when you wish to incorporate intercourse into your activities. If you hesitant or fearful about resuming sexual activity, it is helpful to discuss the feeling with your partner. The stress and fatigue of your operation may initially lessen your interest in sex but as with any activity your desire will return with your increased strength and feeling of well being. Initially it is advisable to place as little pressure on the sternal area as possible. Change of intercourse position may be beneficial. If you feel shortness of breath or chest pain during sexual activity it is better to stop there and to start again when symptoms disappear.

Non-Cardiac Chest pain- Incisional probles

Incisional problems

It is important to know that most of the patients experience non-cardiac chest pain related either to the incision on the breast bone or to ribs on either side of the midline This type of pain is usually different from the heart pain experienced by the patient in the past. It is important to distinguish between the two. Incisional pain is usually aggravated by coughing, sneezing or sudden changes in body position. Nitroglycerine tablet or spray under tongue will not relieve the pain. This pain is usually relieved by analgesic tablets like paracetamol, indomethacin etc. The patient must be informed that the incisional pain will diminish in time but may recur when there is an adverse change in the weather or when the patient overdose physically. This pain related to cut mark will become less frequent and bothersome as time goes by.

The long cut marks on legs are usually made to harvest sections of veins for using them as by pass channels during operation. There may be local pain and some swelling in the areas of these incisions. Patient may feel some sense of numbness of the skin on either side of the incisions. Patient may have some swelling around the ankle joint for time being. This will disappear in time and should not cause concern. If the patient develops swelling with redness along with discharge of watery substance or pus from the leg or chest wounds, doctor to be consulted immediately?

Coffee and heart disease

Coffee consumption and heart disease

Epidemiological studies have not yet clarified whether coffee consumption is a risk factor for coronary artery disease. Framingham study assessed the survey data on coffee consumption in relation to age, blood pressure and total cholesterol with regard to impact on coronary heart disease. The analysis did not show any association between coffee consumption and the presence of atherosclerosis. Moreover, there was no demonstrable relationship between coffee intake and subsequent coronary events in patients with coronary heart disease. The effects of coffee intake on cholesterol were gender dependent: an inverse correlation with total cholesterol and with LDL in men and a positive correlation with each of these cholesterol values in women.

Heart attacks management

Important steps in the management of heart attack

1. Oxygen inhalation

2. Aspirin is an important medicine in the treatment of heart attack. Aspirin alone in dose 160 mg per day may reduce fatality by 21% and if aspirin and streptokinase are both used mortality can be reduced by 39%. Aspirin should be started as soon as the patient is admitted and given daily until discharged from the hospital, at which time it can be continued at a dose of 75 mg to 325 mg daily in absence of any specific contraindication.

3. Nitroglycerine: either by mouth or through intravenous infusion.

4. Morphine for relief of chest pain.

5. Beta blockers for prevention of recurrent heart attack and sudden death.

6. Angiotensin converting enzyme inhibitors for prevention of ventricular remodeling (heart dilatation).

Heart Transplant, TMR, Endarterectomy, Keyhole Surgery of bypass operations

New operative techniques of Bypass Operations

1. Endarterectomy:

During surgery removal of atheroma by opening the coronary artery is called endarterectomy. This procedure is sometimes utilized with CABG operation and may ensure good results.

2. TMR:

TMR represents a novel approach to treat coronary disease. In this procedure Laser is used to create or drill 15 to 30 channels approximately 1 mm in diameter in left ventricular wall. After TMR, an oxygen-starved area of heart gets direct contact with the oxygen rich blood in the chamber.

3. Cardiac transplantation:

The first human heart transplant was performed by a South African cardiac surgeon, Dr. Christian Bernard in South Africa in 1967. Cardiac transplantation is presently the optimum surgical treatment for severe end stage heart failure. Allograft transplantation results in 90% survival at one year and 50% survival at five years with return to a near normal quality of life.

4. Cardiomyoplasty:

In this technique severely failed heart is wrapped by chest muscle named Latissimus Dorsi. This muscle is then driven electrically which helps the heart in pumping. But this operation coats around 30% mortality in the first year.

5. Reshaping the heart:

Reduction of left ventricular volume by resecting a part may increase longevity. In this technique large part of the left ventricle is removed and size of the heart is reduced. Though this operation somehow improves the quality of life but this procedure carries 15% risk of death during operation.

6. Artificial Heart:

This is a new technique which showed promise in the surgical treatment of heart failure. The Jarvik 2000, is a pump, about the size of a thumb designed to sit within the apex of the heart and silently deliver non-pulsatile flow rates up to 10 liters per minute. In animal models it has shown excellent performance.

7. Keyhole Surgery:

This technique is one of the biggest achievements in the history of cardiac surgery. By using this technique surgeons can now perform bypass surgery through a simple three-inch incision. In a standard CABG operation, surgeons sever the patient’s breastbone with a saw; open the rib cage with a steel retractor then stop the heartbeat while they reconfigure its supporting blood vessels. But in new technique surgeons make a small incision “Keyhole” between the ribs. This operation can be done when the heart is still beating and stopping the heart is optional. Patient may be discharged after three to five days and the patients are fit to play golf two weeks later. But this new technique will not eliminate open heart surgery. This procedure is intended mainly for single vessel bypass operations which are less common. So if the patient requires more than one bypass, may be possible through the keyhole operation.

8. MIDCAB and OPCAB:

These surgical strategies include surgery through small incisions or surgery without cardiopulmonary bypass or some combination of two. By pass on beating heart “off pump” bypass surgery through a small median sternotomy incision is the most widely used procedure now a day. “Off-pump” surgery through small incision is most commonly employed as a left internal mammary artery to the left anterior descending artery graft through a left anterior thoracotomy. Robotics technology, still in its infancy, offers the possibility of expanding access to coronary arteries “off-pump”.

9. Hybrid operation:

The concept of adjunctive coronary angioplasty combined with minimally invasive bypass surgery for revascularization of multivessel coronary artery disease has been developed in recent years. This minimally invasive bypass surgery has obviated the risks of median sternotomy and cardiopulmonary bypass procedure. Patients earlier considered high risk for a conventional CABG operation, are now candidates for surgical revascularization by the less invasive surgery. The hybrid operation is nothing but a combination of PTCA and CABG simultaneously on a same patient. This combined strategy of mini CABG and balloon angioplasty is extremely useful if used judiciously in appropriate high risk patients.

Treatment Coronary Artery Disease

New techniques in the treatment of coronary artery blockage

1. atherectomy2. rotational ablation3. laser balloon angioplasty

Atherectomy: This is the process of extraction of the cholesterol rich plague or blockage from the coronary artery. This is also introduced inside body through the groin and it also looks like a balloon catheter. The blockages are cut into pieces and are stored inside a small housing. The conventional balloon PTCA can not reduce the bulk of the blockage but only compress it. During atherectomy the bulk of the atheroma can be reduced, so it is a debulking procedure. There is cutting blade at the tip of the catheter and it spins at a rate 5000 rpm inside the coronary artery. Though this type of treatment can reduce the size of the blockage more effectively and produce lumen diameters better than PTCA but these new techniques have not reduced the rates of acute complications or restenosis after coronary angioplasty.

Rotational ablation: This is another approach for removing atheromatous plaque from the narrowed coronary arteries. It looks like a burr and the whole process can be compared with burring usually performed by the carpenters. This technique uses a diamond studded burr spinning at about 180000 rpm to excavate the obstruction. Though burring is associated with higher short-term success but the rates of restenosis is higher in burring patient compared to conventional PTCA.

Laser balloon angioplasty: the present technique involve the application of a continuous wave neodymium, yttrium laser irradiation transmitted through a fiberoptic system that heats up the culprit obstruction. Argon laser, Holmium laser are also used to reduce the blockage. This technique did not gain popularity as long term results are disappointing.