Experts explain why heart failure should be a public concern

Agencies
April 8, 2018

New Delhi, Apr 8: Heart Failure is a progressive, debilitating and potentially life-threatening condition, which is responsible for silently killing one-third of patients during hospital admission and one-fourth within 3 months of diagnosis.

On World Health Day 2018, the Cardiological Society of India (CSI) has urged the people to prioritise heart failure as a public health priority. The need of the hour is to develop a comprehensive approach to combat heart diseases in India which is on its way to becoming an epidemic in the country.

Focusing on the 'Health for all' theme of World Health Day 2018, the CSI calls for introducing programmes concentrating on screening and detection of symptoms of heart diseases amongst the rural population as such initiatives need to be scaled up across the country.

It is important that the growing incidence of heart failure should be seen as a public health challenge to further reduce mortality and morbidity due to heart failure.

'Heart failure' doesn't mean that the heart is about to stop working, but it is a potentially life-threatening condition where the heart cannot pump enough blood around the body. This, in most cases, happens because the heart muscle, which is responsible for the pumping action, weakens or stiffens over time.

According to the Non-Communicable Diseases Country Profiles released by the WHO, of the estimated 98.16 lakh deaths in India, NCDs led to nearly 6 million, which is 60 percent of the total mortality reported annually in the country.

Cardiovascular diseases (CVDs) are the leading cause of mortality, accounting for more than half of all deaths resulting from NCDs. The burden of CVDs is rising at a significantly high rate amongst middle-income and lower-income geographies.

According to Dr. K. Sarat Chandra, President, Cardiological Society of India, "Indians have all the reasons to be alarmed over matters of the heart. With the burden of heart failure snowballing in India and the associated high death rates, it is necessary to recognize heart failure as a public health priority in the country. The disease has socio-economic and emotional implications for the patient and his family, impacting the overall quality of life. The need of the hour is for all stakeholders to come together to develop a community-level approach to raise awareness about this condition."

The increased prevalence of heart diseases in India can be attributed mainly to lifestyle factors like tobacco use, unhealthy diet, physical inactivity and psychosocial stress. Heart failure is a global health problem, affecting about 26 million people worldwide. The disease burden of heart failure is around 10 million in India.

Dr Ambuj Roy, Additional Professor of Cardiology, AIIMS, New Delhi, said, "Untreated Heart Failure is a rapidly progressive and potentially fatal condition, so it is important to recognize the symptoms promptly and get treated at the earliest to prevent a rapidly downhill course. This is especially critical, since there is no way to reverse the damage already done, and treatment helps in containing further damage to the heart and other body organs. Simple medicines and in some cases implantable devices are known to benefit these patients and prolong their survival."

Data from low-income and middle-income countries like India suggested that mortality in patients with heart failure in these countries is greater than that in high-income countries. It is estimated to have cost about US$100 billion in 2012. The marked variation in mortality is attributed to low awareness, economic disparity, and ease of access to high-quality healthcare facilities, environmental and genetic factors.

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Agencies
July 8,2020

Probiotics that broaden the mix of helpful bacteria in the gut may help to ease depression, say researchers.

Foods that broaden the profile of helpful bacteria in the gut are collectively known as probiotics. These "good bacteria" can be taken as supplements, or found naturally in yoghurts or fermented foods.

For the findings, the research team from the University of Brighton in the UK searched for relevant studies published in English between 2003 and 2019, which looked at the potential therapeutic contribution of pre-and probiotics in adults with depression and/or anxiety disorders.

Out of an initial haul of 71 studies, just seven met all the criteria for inclusion. All 7 investigated at least one probiotic strain; four looked at the effect of combinations of multiple strains.In all, 12 probiotic strains featured in the selected studies, primarily Lactobacillus acidophilus, Lactobacillus casei, and Bifidobacterium bifidium.

One study looked at combined pre-probiotic treatment, while one looked at prebiotic therapy by itself. The studies varied considerably in their design, methods used, and clinical considerations, but all of them concluded that probiotic supplements either alone or in combination with prebiotics may be linked to measurable reductions in depression.

And every study showed a significant fall or improvement in anxiety symptoms and clinically relevant changes in biochemical measures of anxiety or depression with probiotic or combined pre-probiotic use.

Of the 12 different probiotics investigated, 11 were potentially useful, the findings showed.'Probiotics may help reduce the production of inflammatory chemicals, such as cytokines, as is the case in inflammatory bowel disease, the researchers suggested.

"They may help direct the action of tryptophan, a chemical thought to be important in the gut-brain axis in psychiatric disorders," they added.

In this way, with a better understanding of the mechanisms, probiotics may prove to be a useful tool across a wide range of conditions," the authors wrote.

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Agencies
February 11,2020

Using smartphone for long hours every day may do you more harm than you can probably think of. Researchers have found that spending a lot of time with the device and on social media may lead to mental distress and suicidality among adolescents.

The findings, published in the journal CMAJ (Canadian Medical Association Journal) contains guidance for physicians, parents and teachers on how to help teenagers manage smartphone and social media use for a healthy balance between sleep, academic work, social activity, interpersonal relationships and online activity.

"Physicians, teachers and families need to work together with youth to decrease possible harmful effects of smartphones and social media on their relationships, sense of self, sleep, academic performance, and emotional well-being," said lead author of the study Elia Abi-Jaoude from Toronto Western Hospital in Canada.

This review of evidence, led by the Hospital for Sick Children (SickKids), focuses on smartphone use and does not consider online gaming.

"For adolescents today, who have not known a world without social media, digital interactions are the norm, and the potential benefits of online access to productive mental health information -- including media literacy, creativity, self-expression, sense of belonging and civic engagement -- as well as low barriers to resources such as crisis lines and Internet-based talking therapies cannot be discounted," the authors wrote.

The researchers recommend that doctors should ask teenagers to reduce social media use rather than eradicate it completely and encourage parents to be part of the conversations.

Parents should discuss appropriate smartphone use with teenagers to determine together how to reduce risks and set boundaries.

A recent poll from the US indicates that 54 per cent of teenagers think they spend too much time on their smartphones and about half said they were cutting back on usage.

"Encouragingly, youth are increasingly recognising the negative impact of social media on their lives and starting to take steps to mitigate it," the authors wrote.

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News Network
February 26,2020

New York, Feb 26:  A new wearable sensor that works in conjunction with artificial intelligence (AI) technology could help doctors remotely detect critical changes in heart failure patients days before a health crisis occurs, says a study.

The researchers said the system could eventually help avert up to one in three heart failure readmissions in the weeks following initial discharge from the hospital and help patients sustain a better quality of life.

"This study shows that we can accurately predict the likelihood of hospitalisation for heart failure deterioration well before doctors and patients know that something is wrong," says the study's lead author Josef Stehlik from University of Utah in the US.

"Being able to readily detect changes in the heart sufficiently early will allow physicians to initiate prompt interventions that could prevent rehospitalisation and stave off worsening heart failure," Stehlik added.

According to the researchers, even if patients survive, they have poor functional capacity, poor exercise tolerance and low quality of life after hospitalisations.

"This patch, this new diagnostic tool, could potentially help us prevent hospitalizations and decline in patient status," Stehlik said.

For the findings, published in the journal Circulation: Heart Failure, the researchers followed 100 heart failure patients, average age 68, who were diagnosed and treated at four veterans administration (VA) hospitals in Utah, Texas, California, and Florida.

After discharge, participants wore an adhesive sensor patch on their chests 24 hours a day for up to three months.

The sensor monitored continuous electrocardiogram (ECG) and motion of each subject.

This information was transmitted from the sensor via Bluetooth to a smartphone and then passed on to an analytics platform, developed by PhysIQ, on a secure server, which derived heart rate, heart rhythm, respiratory rate, walking, sleep, body posture and other normal activities.

Using artificial intelligence, the analytics established a normal baseline for each patient. When the data deviated from normal, the platform generated an indication that the patient's heart failure was getting worse.

Overall, the system accurately predicted the impending need for hospitalization more than 80 per cent of the time.

On average, this prediction occurred 10.4 days before a readmission took place (median 6.5 days), the study said.

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