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.

8 tips Necessary of life.

Some of us do not know tips- Necessaries of life

1. 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.
2. 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. 
3. 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. 

Remove acne Spots with five foods

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.

Health tips (Long Live the way)

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.

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.

1. 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.
2. 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.
3. 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.
4. Drinking water should be enough to keep the skin healthy and bright. The important role of appetite and other metabolic problems.
5. Kidney problems, high blood pressure, and respiratory problems huderaga there, you can specify the amount of water in treating patients.
6. Half hours before meals and at least one hour after eating half hours should drink water. Drink more water during meals is not advised.
7. Heavy activity or exercise three - four drink a glass of water.
8. 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.

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.

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 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.  

Angioplasty stent

Is stenting superior to conventional angioplasty?

Balloon expandable stents were introduced to prevent complications and sudden closure after ordinary angioplasty. The stent was first approved by Food and Drug Administration (FDA) in 1992 for the emergency management of abrupt vessel closure after angioplasty the so called bailout indication. But few trials have proved tant routine placement of stent (not bail out stenting) may reduce the restenosis rate of angioplysty, which is a great draw back of conventional PTCA. Some studies has document that stenting may reduce the incidence of restenosis after the procedure. In one study restenosis rate was 32% in conventional angioplasty and 22% in stentiion group and in another study restenosis rate was 43% in angioplasty patients and 30% in stented patients. So it is believed that coronary stenitng may be superior to ordinary balloon angioplasty and can reduce reocclusion rate significantly.

What is stent

What is a stent?

A coronary stent is a small, stotted, stainless steel tube mounted on a balloon catheter. It looks like a spring used in ordinary ball pen. It is introduced into the artery just after balloon angioplasty into the artery just after balloon angioplasty and is positioned at the site of the obstruction. The procedure is almost lie balloon angioplasty, so the patient can not understand the difference between ordinary stenting. The stent remains wrapped around the deflated balloon. When the balloon is inflated, the stent expands and is pressed against the inner walls of the coronary artery. After the balloon is deflated and removed, the stent remains in place, keeping patients artery. It helps to old the artery open, improves blood flow and relieves symptoms of chest pain.

During the first few days of stent implantation, the daily activities well are restricted. The patient must lie flat until the day following the procedure. The patient will stay in the hospital for up to 2 to 8 days before being discharged. If the patient experienced any chest discomfort, pain or bleeding of any kind after returning home, he/she should contact the doctor or hospital immediately. After 6 months the patients may be asked to return to hospital for a follow-up stress test/check coronary angiogram.

There are many types of stent at present in use. They are Gianturco-Roubin, Palmaz-Schatz, Wallstent, Medronic- Wiktor stents, Bard XT, AVE stent etc. All stents mentioned above are made of stainless steel except Wiktor stent which is made of Tantalum. All the stents are thrombogenic so it may re-occlude after placement. So it is extremely important to follow the medication exactly after implantation of a stent. These medicines keep the blood thin and prevent re-occlusion. Within about four weeks, the lining of the artery slowly grows over the stent, incorporating it into he arterial wall. During this time the patient must be treated with medications to thin the blood and to prevent blood clogging inside the metal surface of the stent. At earlier days combination of aspirin, warfarin and dipyridamole were used to prevent stent occlusion. But now the trend has changed. Now-a-days warfarin or coumadin are not used routinely. Combination of aspirin and ticlopidine has been proved more superior than aspirin and warfarim combination. Patient is advised to take ticlopidine 250 mg twice daily and aspirin combination for 4-8 weeks then only aspirin indefinitely. Any patient taking ticlopidine must check his blood count at an interval of 2 weeks to 1 month because white cell count may fall in 1-2% of patients taking this drug. Combination of aspirin and clopidogrel (plavix) 75 mg once a day may be used instead of combination of aspirin and ticlopidine.

Cardiac Stent

Advice to a stent patient

1.     You must follow your medications erectly.

2.     Do not stop taking any of the prescribed medicines unless you are instructed to do so by the doctor who implanted the doctor who implanted the stent.

3.     If you experience any side effects of the medications, such as headaches, nauseas, vomiting or skin rash, notify your doctor immediately.

4.     After stent implantation, if you develop chest pain or dyspnea immediately report to your doctor.

5.     Keep all appointments for follow-up care including blood testing.

6.     Do not go for a magnetic resonance imaging (MIR) scan within 8 weeks of stent implantation with out clearance from your cardiologist.

7.     Do not use antacids routinely unless prescribed by your doctor, as antacid decrease the absorption of aspirin.

Aspirin for Heart attack

Can low dose aspirin prevent heart attack?

Attention has recently focused on the possible role of prophylactic low-dose aspirin in reducing the risk of heart disease. The hypothesis that platelet inhibition with low-dose aspirin reduces the risk of heart attack n apparently people have been tested in two trials of primary prevention in men. The U.S physicians Health Study of 22,071 men 40 to 84 years of age observed a statistically significant 44% reduction in the risk of first heart attack whereas the British Doctor’s Trial of 5139 men 50 to 79 years of age observed no significant reduction. However an overview of both trials of primary prevention demonstrated a 33% reduction in the risk of fatal heart attack. Although no randomized trial has been completed specifically in women, the Nurses Health Study recently reported that women who took one to six aspirin weekly were 32% less likely to have an acute myocardial infarction.

At present the data on the role of aspirin in the primary prevention of stroke and heart attack are inconclusive. But some authorities recommend routine use of aspirin in asymptomatic men and women older than 50 years to prevent first myocardial infarction. It is important to view the clear benefits of aspirin in the primary prevention of heart attack in the context of what is already known about the modification of other coronary risk factors. It would be unfortunate if a middle aged smoker took aspirin instead of quitting smoking, because the benefits from quitting far exceed any protective defect of aspirin of heart attack. Any decision to use aspirin prophylaxis should be made on an individual basis, and in general, should be considered only for those whose absolute risk of a first heart attack is sufficiently high to warrant accepting the potential adverse effects of long-term aspirin use.

Antioxidants

Antioxidants with coronary artery disease

Epidemiological studies have suggested that high intake of antioxidants may modify coronary artery disease risk. The relative impact of vitamin E, vitamin C, beta carotene and flavonoids still remains unclear. Nurses Health Study and the Health Professional’s Follow-up Study showed 34% and 36% reduction in coronary events, respectively among women and men who take vitamin E supplement regularly. Oxidized LDL (bad cholesterol particles are believed to play a key role in the atherogenesis (blockage formation). So, theoretically any oxidant is likely to prevent coronary artery narrowing by preventing oxidation of LDL. In the European Community Multicenter Study on Antioxidants, Myocardial Infarction and breast cancer trial high beta carotene intake was protective only among smokers; vitamin C intake showed no relationship with coronary artery disease.

Results from most of the observational and experimental studies consistently support an effect of vitamin E supplemental on reducing the risk of heart attack. It is suggested that supplemental intake of vitamin E at or above 100 IU/day will reduce incidence of coronary artery disease. Long-term intake of vitamin E may reduce the progression of blockage in coronary arteries.

Carnivores and Herbivores

We are Carnivores or herbivores?

Human beings basically are not carnivores. We are basically herbivores (vegetarian) but we always behave like carnivores (flesh eaters). If several characteristics of carnivores are compared, human beings clearly have more characteristics of herbivores than carnivores. The teeth of carnivores are sharp; those of herbivores, mainly flat (for grinding). The intestinal tract of carnivores is short; that of herbivores is long (the small intestine of humans is 26 feet long!). Carnivores cool their bodies by panting; herbivores by sweating (as human beings). Carnivores make their own vitamin C (like animals); herbivores obtain their vitamin C from their diet. Most human beings believe themselves to be carnivores (we eat flesh) but fundamentally our characteristics more closely resemble the herbivores. Foods intended for Homo sapiens (man) probably are only three: starches (rice, corn, potatoes, beans etc), vegetables, and fruits.

Healthy cholesterol levels

Measures to lower the blood cholesterol level

1.     Take a proper diet. Take food that is low in saturated fat and cholesterol such as fruits, vegetables, skinless poultry, lean meat, fish, rice, cereals, and vegetable oil.

2.     Maintain an appropriate weight.

3.     Exercise accordingly as advised by your doctor.

4.     If the cholesterol levels do not reach the minimum goal despite this measure, then doctor may put the patient on medication to lower cholesterol.

Vegetarian recipes

Benefits of being vegetarian

Human beings who eat exclusively a vegetarian-fruit diet for many decades infrequently have the diseases so commonly observed in meat eaters. Diseases very uncommon in vegetarians include : 

1. coronary artery disease (heart attack and angina), 

1. hypertension (high blood pressure), 

1. breast cancer, 

1. colon cancer and possibly cancer

1. prostate gland, 

1. obesity, 

1. peptic ulcer, 

1. diverticulitis and osteoporosis, 

1. gall stone, 

1. kidney stone. 

1. Bowel syndrome etc.

Saturated Fats

What is a saturated fat?

Any fat that solidifies in room temperature is a saturated fat. The saturated fat can be identified by its being solid at room temperature; the polyunsaturated and menstruated fats are fats are soft or liquid at room temperature. All three fatty acids are very high in calorie. The average American adult consumes a diet containing nearly 40% of the calories from fat, one third of which is of the saturated variety.

A reduction of the percent of calories from fat from 40% to 10% can reduce the blood cholesterol level around 150 mg/dl. This level can only be achieved by those who strictly follow the vegetarian diet. The diet of the Japanese historically has consisted of a 10% of calories from fat diet and significant ischaemic heart disease has seldom been observed. Today Japanese are consuming a diet averaging approximately 23% of calories from fat and the consequences have been a significant increase in the frequency of heart attack. Thus for diets to be very effective in lowering the blood total and LDL cholesterol levels, the percentage of calories from fat must be reduced to 20% and ideally 10%.

Types of fat

Saturated fat: Increases total and LDL cholesterol level, so, high risk.

a.      beef fat

b.     mutton fat

c.     egg yolk

d.     palm kernel oil

e.      coconut oil

Monounsaturated oil: Either lower or have a neutral effect on the total cholesterol level, so, no risk.

a.      olive oil

b.     peanut oil

Polyunsaturated oil: Decreases the total and LDL cholesterol level, so, no risk and the best oil to consume.

a.      Soyabean oil

b.     Corn oil

c.     Safflower oil

d.     Cottonseed oil

e.      Fish oil

f.       Sesame oil

Good Cholesterol

Cholesterol and heart problem

Cholesterol is a complex fatty substance produced by the liver for various functions in the body. The cholesterol in our food also contributes to the cholesterol level in our body. An excess of cholesterol results in the deposition of cholesterol in the arteries resulting in narrowing and hardening of he arteries called atherosclerosis (blockage). Too much cholesterol can slowly build up on the inner walls of arteries feeding the heart. Together with other substances, cholesterol forms plaque (early blockage) a thick bard coating that gradually clogs the artery over time. Cholesterol in the blood is carried in two main forms, low density lipoprotein (LDL) or band cholesterol and high density lipoprotein (HDL) or good cholesterol. LDL cholesterol is called bad cholesterol as it is associated with blockage formation and HDL cholesterol is called good cholesterol as it is thought to remove excess LDL (bad cholesterol) from blood. The only absolute, unequivocal, independent atherosclerotic (blockage formation) is an elevated blood level of total cholesterol or LDL cholesterol, a low HDL cholesterol level or both. What constitutes an elevated total cholesterol level is debated. If an elevated level is that minimal level above which atherosclerotic events occur, then that level would be approximately 150 mg/dl. The risk of getting heart disease substantially increases above the level of 200 mg/dl. Framingham study clearly demonstrated that higher total cholesterol or LDL Level and the lower HDL cholesterol levels are predisposing factors for the heart attack. International epidemiologic studies have shown that populations with blood cholesterol levels less than 150 mg/dl for decades have a near absence of angina or heart attack. A certain critical blood level of total cholesterol is necessary before a block approximately 150 mg/dl. As the level increases above this value, the risk of an atherosclerotic event (angina or heart attack) increases roughly proportional to the level and to the amount of time that this level has been present.

To keep a normal cholesterol level normal and to return an elevated level to normal, dietary intake of cholesterol, fat and total calories must be restricted or one or more lipid-lowering drugs must be administered or both. The average adult in the United States consumes approximately 500 mg of cholesterol daily. Nearly 50% of the direct cholesterol consumed by adults in the United States comes from the visible and no visible eggs eaten, so giving up eggs eliminates nearly half of the direct cholesterol intake. Bovine muscle (beef) accounts for nearly 30% of our direct cholesterol intake, so giving up flesh beef, mutton eliminates about one third of our direct cholesterol intake. Bovine products (butter, ghee, cheese etc) contain high amount of bad cholesterol, so they should be eliminated from the daily food. Most adults in the United States consume more than 100 gm of fat daily. Ideally men should consume no more than 60 gm and women no more than 50 gm of fat daily. There are two problems with the fat: 1. all fats possess a saturated component  2. all fats are high in calories. Saturated fat are dangerous for heart patients and their presence in the food must be curtailed.

Quit smoking

Stop smoking right now. 

Follow the following instructions to quit smoking. 

1. Get rid of all your cigarettes, discard matches and lighters.
2. Take deep breaths, when ever you feel the urge to smoke. Hold your breath for 10 secs then release slowly.
3. Exercise to relieve tension-walk instead of riding when ever possible.
4. Think of negative image. You  associate with smoking when you feel tempted. Select your worst memory connected to smoking. Think of breathlessness when running.
5. Reward yourself, with apple slices instead of smoking. Eat three meals a day.
6. spend time with friends who don't smoke.
7. Go publicly with plans to quit smoking.