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Is yours white coat or masked hypertension?

In white coat hypertension, blood pressure shows an increase in doctors office and becomes normal at other places. In masked hypertension, except at office, the candidates BP levels are highly elevated due to stress, anxiety and other factors. One in 10 people in their 20s and 30s, five in 10 people in their 50s suffer from hypertension. Take charge before it is too late
NAGA SUNDARI xperts of hypertension felt 24 hour home blood pressure monitoring (24 hr ABPM) service is regarded as the gold standard for blood pressure measurement. It helps identify different patterns of blood pressure like white coat hypertension, masked hypertension etc. They said proper measuring of blood pressure is not followed by number of medical practitioners in the hospitals. And repeat blood pressure measurement provides more accurate readings for administering accurate treatment procedures for the patients.

Startling facts
l Nearly half of patients with hypertension do not take medications as prescribed by their physicians. l Majority do not know they suffer from hypertension until they visit the clinic for some other illness leading to more deaths every year. l 95% patients with hypertension have primary hyper-

tension one that develops with age. Secondary hypertension, which develops at a young age, is attributed to tumours, arterial disease like renal artery stenosis etc. l The theme of World Health Day this year is Preventing Hypertension. As per World Health Organization data, High Blood Pressure (HBP) affects every third person above the age of 18 years. The number of patients in India with high blood pressure is likely to rise about 140 million in 2008 to nearly 215 million by 2030. The proportion increases with age, from 1 in 10 people in their 20s and 30s, 5 in 10 people in their 50s. Among senior citizens especially at the age of 75, almost 95 per cent of people suffer from hypertension. Stiffening of arteries can lead to hypertension and result in heart or stroke attacks also. High intake of salt , cholesterol and smoking can cause stiffing of the ar-

teries. Hence low fat food, low salt intake, plenty of fruits and vegetables, avoiding red meat a n d

measurement provides more accurate readings of the individual. At least once a week, measure your blood pressure at home in the morning and night. Keep a record of the readings and show it to your physician for review. It is the correct way to come for an understanding of blood

Blood Pressure Control Targets

Patients with hypertension with no other health problems
Office blood pressure (performed based on expert recommendations): <140/90 mmHg Home blood pressure (performed based on expert recommendations): <135/85 mmHg

Patients with hypertension and diabetes or kidney disease

processed food, regular physical exercises (daily walk of at least 45 minutes per day) can help control hypertension, obesity and diabetes In one word, lifestyle modifications make our lives go on a healthy track said Dr Mohammed A Rafey, renowned hypertension specialist and nephrologist. Repeated blood pressure Office blood pressure (performed based on expert recommendations) : <130/80 mmHg There are two types of hypertension - primary and secondary. 95 per cent of hypertensives have primary hyper tension. It occurs as the arteries stiffen and kidneys are not able to maintain

pressure levels of any patient in their body accurately. Patients should remember that while high blood pressure is bad, very low blood pressure is even worse. Especially in summer, dehydration or starvation can also lead to low blood pressure, warned Dr Rafey.

optimal blood pressure. Many diseases can occur due to secondary hypertension in which blood pressure levels get highly elevated. Different patterns of blood pressure can be observed. In normal blood pressure, BP is normal when measured in physicians office as well as at other places. Whereas in white Coat hypertension, BP shows an increase in doctors office and becomes normal at other places. In masked hypertension, except at office, the candidates BP levels are highly elevated everywhere due to stress, anxiety and other factors. Many young men in their 20s approach us with complaints of high blood pressures and high cholesterol which happens because they are into junk food, sit for prolonged hours either at workplaces or at home. Another starling fact is that nearly 60 per cent of hypertensive patients stop their BP medication after one year of treatment assuming that the BP is under control. This can be dangerous, he warns.

esearchers have claimed that a potent sleep hormone could hold the key to beating diabetes. They believe that by taking a daily supplement containing melatonin, people could help protect themselves against the devastating condition. The supplement is already available on prescription to treat insomnia. Researchers from a Boston hospital found that women with low levels of melatonin in their body were more than twice as likely to develop Type 2 diabetes as those with high levels. Melatonin is produced naturally in the body by the pineal gland, a pea-shaped organ inside the brain that is sensitive to light. When it gets dark, the hormone is released, as the bodies signal that it is time to fall asleep. Dr Ciaran McMullan and colleagues at the Brigham and Women's Hospital said previous studies have suggested that melatonin may

Drug to insomnia may avert diabetes R

play a role in maintaining healthy blood sugar levels by helping to metabolise glucose. They took blood and urine samples from hundreds of women in 2000. Of these, 370 had developed Type 2 diabetes by last year. The research team found that there were twice as many cases among those with the lowest melatonin levels even when factors such as family history of diabetes and high blood pressure were taken into account. In their research, the team wrote that melatonin receptors have been found throughout the body including in pancreatic cells. This reflected "the widespread effects of melatonin on physiological functions such as energy metabolism and the regulation of body weight," they said. However, mutations in the receptors were associated with lowering sensitivity to insulin and Type 2 diabetes. - ANI


Dos and Donts for PCOS

Dr Janaki, Nutritionist Irregular menstrual periods l Hair growth on the face, chest, stomach, back, thumbs or toes l Acne, oily skin and dandruff l Weight gain l Weakness or excess hunger l Hair loss l Infertility because of lack of ovulation l Depression due to appearance and/or infertility Women with any of these symptoms in combination may be heading towards Polycystic Ovarian

Syndrome - PCOS. Five to 10 percent of young women have this hormonal disorder. Women with PCOS often have insulin resistance resulting in too

Changing eating habits and getting more exercise helps to manage PCOS
nal glands. The result being with all the symptoms above!

foods, fruits, vegetables, lean meats and low-fat or fat-free milk, cheese or yogurt. These foods help lower your blood sugar, improve your bodys use of insulin and normalize hormone levels.

Three important diet tips for PCOS:



Diet for PCOS

Changing eating habits and getting more exercise helps to manage PCOS. By just losing 510 percent of weight get normal menstrual cycles blood sugar chances of conceiving a baby

Fat-free milk Vegetables much insulin in the blood. Excess insulin has been related to an increase in production of androgen, a

male hormone made in fat cells, ovaries and adre-

Eat more whole-grain

Dont skip meals. Eat three major meals with snacks in between. Change the composition of each meal by including fruit and vegetable Protein source in every meal is a must. Protein sources are egg whites, lean meat, fish, whole grains, low fat cheese/paneer and whey protein. Go for regular physical activity , it will alleviate many symptoms of PCOS and improves lean mass in the body.

Sun stroke is a medical emergency

High body temperature but no sweat Dry and hot skin with rapid pulse Breathing difficulty, disorientation and seizure Nausea, vomiting, weakness, headache, muscle cramps In rare cases, the patient goes into coma

Faster, safer OArm spine surgeries now in Hyderabad

rishna Institute of Medical Sciences (KIMS), Secunderabad, claims to have become Indias first private hospital to offer neurospine surgery using 3D fluoroscopy and image guided neuro and spine navigation, increasing the safety of complex spinal procedures. KIMS is the second hospital in the country, after All India Institute of Medical Sciences (AIIMS), Delhi. According to doctors, a bulk of these procedures had to be performed to address age-related spinal pathologies in addition to spinal tumours and trauma. A typical spine surgery involves accessing and operating on highly delicate parts of the anatomy, such as the spinal cord, and nerves that provide sensory and motor function to our arms and legs, said Dr Manas Panigrahi. Spine surgery in India is rapidly evolving as the more traditional large open spine surgeries continue to give way to Minimally Invasive Spine (MIS) surgical tech-

Dr. Srirang Abkari Sr General Physician Aware Global Hospital he season of heat waves has already begun. Extreme heat is the prime reason for triggering cases of heat strokes which should be treated as a medical emergency. Large number of sun stroke cases, often fatal, gets reported every year between March and May in twin cities. Heat strokes occur when the body temperatures rises abnormally due to hot weather con-

ditions. In extreme hot conditions the body loses its ability to dissipate the heat and this leads to rise in body temperatures. Heat strokes are also caused due to dehydration when the body does not sweat quickly and dissipate heat. This leads to rise in body temperature and causes heat stroke. It would be better if public avoid venturing out between 2 pm and 4 pm. The common symptoms presented by sun stroke victims include high body tem-

Immediate treatment should be given to victims to avoid organ damage The patient should be cooled immediately. Transfer the victim to a shady area, remove clothing and spray water on the body. The patient can be kept under a fan; ice packs can be used to cool the body. Alert the emergency immediately.


Avoid going out in the sun between 2 pm and 4 pm Wear hats, carry an umbrella, wear loose and light coloured clothing Avoid alcohol and consumption of caffeine Children, pregnant women and the elderly are more vulnerable

perature, rapid pulse, difficulty in breathing vomiting fatigue, headache muscle cramps and aches and dizziness. It is very important for public to keep themselves hydrated and avoid physical exertion when the sun is hot .

niques. MIS surgery is typically performed through small portals that pass through muscle without destroying it. These minimally invasive approaches can be equally effective while being much less disruptive to the supporting tissues of the spine, reducing intra-operative blood loss and post-operative deformities. As a new imaging system for spinal surgery, the O-Arm is similar to Computed Tomography (CT) scan. However, in the O-Arm, 3D imaging equipment is placed around a patient on the operating table itself. Before surgery, doctors use the O-Arm to capture 3D images of the patient that help them develop a precise surgical plan. During surgery, the O-Arm images allow surgeons to confirm proper placement of implants and instruments without having to move the patient out of the operating room. After the implants are placed, surgeons use the OArm again to reconfirm correct placement in the spine and address anything further

that needs to be done. Conventionally, prior to the release of the O-Arm technology, patients would have an MRI or CT scan before surgery and doctors would use 1- or 2-Dimensional images to guide them, Dr Panigrahi said. While improving outcomes for the patient, the OArm improves safety for surgeons and staff members also through reduced radiation exposure. Spinal problems can be chronic and debilitating. The O-Arm gives patients a great opportunity for excellent results. Image guidance provides 3D visualisation of the spine, which can be used for pre-operative planning and highly accurate intra-operative navigation and also post-operative confirmation before the patient leaves the operating theatre, which increases the safety of complex spinal procedures, especially in critical regions with small pedicles, such as the cervical spine and the upper and middle thoracic spine, and advanced minimally invasive procedures.