HEART AND ITS FUNCTIONS

Heart is the organ whose function is to keep up the circulation of the blood. At birth the heart beats about 130 times a minute, gradually diminishing to 100 at 6 years, 90 at 10 years, 85 at 15 years, and, among adults, anywhere from 60 to 80. Sixty to 65 beats per minute is exceedingly slow but has been noted, particularly in long-distance runners. The heart beats more than two billion times during a lifetime and pumps millions of gallons of fluid. The heart lies inside a sac, called the pericardium, a little to the left of the breastbone, at about the fifth rib. It is essentially a muscle about as big as a fist. It beats from before birth until death and seldom rests, even by diminishing its rate. It is an involuntary muscle that responds to excitement, effort, and other activities by beating fast.You can give it rest by lying down so as to slow the beat a little and decrease its force.
Coronary ArteriesThe heart gets its own nourishment from small blood vessels that pass into its muscle tissue from the large blood vessels that carry the blood away from the heart. Blocking of these coronary arteries is called coronary thrombosis; the symptoms that follow such blocking are known as coronary disease. In hardening of the arteries, blocking of the coronary blood vessels is more frequent than otherwise. Associated with temporary spasms of these vessels or temporary lack of blood supply to the heart is angina pectoris.
Heart FailureFailure of the heart to carry on its work is serious because the whole body depends on the blood. Failure may be due to inability of the muscle to pump, inability of the pump to force out enough blood at one time, or failure of the pump to force the blood all the way around and back again. If any of these failures occur, fluid collects in the feet and in the abdomen; the brain gets insufficient nourishment; occasionally the heart muscle will enlarge in an attempt to do what it cannot. Signs of heart failure are shortness of breath, and a blue tinge to the skin resulting from lack of oxygen in the blood.
Heart DiseaseHeart disease is not a single illness but may be one of several, such as that resulting from rheumatic fever, one of the foremost foes of health in children, which is related frequently to streptococcus infections of the throat.People of advanced years sometimes suffer breakdown of the heart; death may be prevented by seeing to it that the victim avoids stress and strain.
Coronary ThrombosisCoronary thrombosis is the forming of a clot or clots in the coronary arteries. The moment an attack occurs, the victim should be put immediately at complete rest in bed. Then, by careful study involving the use of the electrocardiograph, the doctor will determine the nature and scope of the condition and take the necessary measures to relieve pain and, if possible, bring about improvement. Any attack of acute indigestion in a person past forty-five years may actually be the beginning of coronary thrombosis and should not be regarded lightly.*16/318/5*

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WHY YOU CAN’T STAY AWAKE: NARCOLEPSY

After apnea, narcolepsy is the next most frequent cause of excessive daytime sleepiness. People with this disorder are prone to transient, overpowering attacks of sleepiness lasting from a few seconds up to thirty minutes, with the average spell lasting about two minutes. Narcoleptics may have up to two hundred such attacks in a single day, even if they have slept well the night before. During an attack the victim’s jaw may grow slack, or the head may drop forward onto the chest. In some cases victims may completely black out, appearing to be asleep or unaware of their actions. In less severe attacks, they are alert but may experience some form of muscle paralysis—their knees may buckle, or they may lose all control over their voluntary muscles. (Some people mistakenly refer to narcolepsy as sleeping sickness. The two are by no means the same: sleeping sickness is a parasitic infection transmitted by insects, including the tsetse fly and the kissing bug. Narcolepsy is also distinguished from seizure disorders like epilepsy in that such symptoms as repetitive movements (lip smacking, for example) and perceived visual auras are rarely present.The term “narcolepsy” was first used more than a century ago,1940s. Today an estimated 250,000 Americans suffer from the condition—more than the number of people afflicted with multiple sclerosis. Although narcolepsy accounts for less than 1 percent of all cases of sleep disorders, sleep laboratories report that narcoleptics make up the second largest group of patients who come to them for help.*150\226\8*

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WHAT IS THE DIFFERENCE OF STIMULI, TO WHICH MALE AND FEMALE RESPOND?

Husband is excited by his wife’s body while she depends on tactile stimulation alone to get excitement. Thus husband likes to keep the light on but she prefers dark and even closes her eyes so that the sights which are stimuli to husband causes destructions to wife. Darkness may mean for her modesty, secrecy or safety.What is the common complaint of wife against husband?Wife thinks that she is being taken as granted and husband does not give due importance to arouse her showing his selfishness. A wife may want to prolong coitus after orgasm and feel disappointed when her husband turns away and goes to sleep.
What can be the normal frequency of sex?It depends on the couples health, desire, sexual brought up, education and need. No normal limit can be defined. Kinsey in his survey from the age of adolescence to the age of 85 calculated and it came out to be 3 orgasms per week, including masturbation for men.
What is the frequency Of orgasm a woman gets?In the Kinsey sample about a third of the single females between the ages of 16 and 20, 26 and 30, 46 and 50 experienced one orgasm every other week. Among married females between 21 to 25 about one third had one orgasm. More than 5 percent averaged 3 orgasm a week. 20 percent had one orgasm every other week. Between 36 to 40 one of four women had no more than one orgasm every other week.
Does morals permit girls to masturbate?Society has negative feelings about masturbation by girls. If boy can masturbate why not girls. It is not an unusual practice, it does not cause mental deterioration or physical decay but it has certain advantages that girls who mastrubated to orgasm were more likely to enjoy intercourse later in married life. Masturbation to orgasm can also relieve premenstrual tension and dysmenorrhoea.
When woman feels more sexy?
Wife’s sensual interests are somewhat closer to the surface immediately before, during and after menstruation. Second day of menstruation gives a peak to female according to one survey. On second day some pelvic congestion1 still persists and wife gets orgasm with little bit of man’s effort. A second rise of sex desire coincides with ovulation. There is no reason why people should not concentrate on these days to have orgasms satisfactorily.*101\301\2*

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TYPES OF HEART DISEASE: HEART FAILURE DUE TO CARDIOMYOPATHY – HYPERTROPHIC CARDIOMYOPATHY

Hypertrophic cardiomyopathy is sometimes called idiopathic hypertrophic subaortic (beneath the aorta) stenosis, abbreviated IHSS. This overgrowth creates a bulge that protudes into the ventricular chamber and impedes the flow of blood from your heart to the aorta and the res body.When this obstruction is present, the cardiomyopathy is also called hypertrophic obstructive cardiomyopathy (HOCM, often pronounced HO-kum”). In this condition, the problem is not that the heart muscle but that the overgrown heart impedes the flow of blood through and out of the heart.If the example of the plastic bottle is used, the sides of the bottle have thickened, especially near the opening. The thickening decreases the space inside the bottle and gets way of the opening.With HOCM, one of the leaflets of the mitral valve between the left and the left atrium ventricle moves forward during contraction, and this, with the thicker septum between the  ventricles, obstructs blood flow. Ironically, the obstruction to blood flow may worsen the harder the heart squeezes, because the thickened septum protrudes even farther into the pathway of the blood trying to flow out of the heart.Hypertrophic cardiomyopathy not always affect the area beneath the  aortic valve. Sometimes the condition occurs down near the apex (tip) of the heart, and in other individuals overgrowth is distributed more or evenly throughout the heart muscle. These cases can be likened to the plastic walls of the bottle becoming thickened all over and making squeezing less effective. In those situations, problem is not due to obstruction. The thickened muscle is simply inefficient at pumping and especially at relaxing. The blood flow can decrease because of this, and heart rhythms are a problem as well.*94\252\8*

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PAIN TREATMENT: TESTING THERAPY FOR EFFECTIVENESS

The aim of these tests is to reveal the consistent action of the therapy liberated from the bias of patients and therapists who think it ought to work. The major bias is the placebo response, which is surprisingly powerful.The standard test for efficiency is the randomized double-blind placebo-controlled trial. ‘Randomized’ means that patients with a particular condition have been chosen at random in order to avoid choosing some special types who might tilt the result. ‘Double-blind’ means that neither the patient nor the people running the trial know if the real therapy or a mock therapy has been given. ‘Placebo-controlled’ means that the true therapy and a mock imitation of the true therapy have been given.To give an example, suppose that a pharmaceutical company wishes to market a new analgesic and that they have completed all the preliminary trials for safety and apparent beneficial effect. They are then required by law to submit their new tablet to this rigorous type of trial. A group of patients with some definite problems, a wisdom-tooth extraction for example, are asked to volunteer for a trial. They are told they will either receive the new tablet or a blank one that looks exactly the same. Then the patient, who does not know which tablet he received, tells an observer, who is also unaware of the nature of the tablet, whether the tablet reduced his pain. Finally, after all the data have been collected, the code is broken and it is calculated whether the new drug is superior to the placebo.This type of trial sounds simple, even if it is elaborate and costly, but there are severe problems. The first problem is that the tested group never includes all the types of people who might use the therapy: a test group in New York is unlikely to contain many Inuits. The group is usually deliberately restricted, to healthy young adult men, for example. This means that the results do not necessarily apply to Inuits, women, children, old people and so on.Much more serious is the famous difficulty in keeping a secret. A tested drug may have side effects such as drowsiness so it is obvious to patients and observers who has received the active therapy. There are ways around this particular problem by deliberately giving a sedative that is not believed to be an analgesic to compare with the tested analgesic that has sedative side effects. It will be seen that the crucial element of keeping patients and staff ignorant becomes more and more difficult as the therapy becomes more elaborate. Take the problem of subjecting acupuncture to a rigorous trial. What would be the placebo arm of the trial? The problems escalate to an extreme with surgical therapy, where it would be quite unethical to subject a patient to a general anaesthetic and a mock operation in order to test the true efficiency of the surgery.There are subtle ways around these problems, which we will discuss with particular therapies. However, no one should forget that the background for these trials is based on the powerful assumption that all people are the same and that individual psycho-social factors are irrelevant. This leads to the present vogue for ‘evidence-based medicine’, driven partly by the tradition of academic medicine and partly by the financiers’ need to identify proven therapy whose cost is justified by trial.The trials are designed to identify a class of pains, medicines and patients who respond reliably and to exclude a class where personal individuality is a factor. The separation of these two classes is itself an artefact because they interact.*52\219\2*

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DIET IN DIABETES

Introduction : Diet plays a vital role in control of diabetes. In India, people generally tell, “what to do! When somebody offers sweet etc, I have to accept as a courtesy, so there should not be any shame being a diabetes patient and to tell I am a diabetes patient and will not take sweets or other avoidable things at social function or other occasions”.It is mandatory to have a proper knowledge of food and its constituents in relation to caloric requirement by each diabetes patient for a good control of diabetes. The person who cooks and serves the food also must know what food has to be served to diabetes patient.GOALS OF DIETARY MANAGEMENT1. Restoration of normal blood glucose and optimal levels; maintenance of blood level as close to physiological levels as possible, to :a. Prevent hyperglycaemia and / or hypoglycaemiab. prevent or delay the long term complications of diabetes, c. Contribution to a normal outcome pregnancy for a woman with diabetes.2. Maintenance of normal growth rate in children and adolescents with attainment of body weight in adults (BMI, W/H ratio, height-weight charts)3. Provision of adequate nutrition for the pregnant woman, foetus and lactation.4. Consistency in the timing of meals to prevent swings in blood glucose.5. Determination of a meal plan appropriate for the individual’s life style.6. Management of weight for obese people with NIDDM.7. Improvement in the overall health of people with DM. 9. Reduction in requirement of Oral Hypoglycaemic Agents. lO.Diet to be altered according to complication of DM.In order to ensure dietary compliance diet prescribed should be individualised. It must be depending upon patients liking and disliking, realistic, flexible and must suit the life style of diabetes patients.*26\329\8*

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HIV INFECTION AND ITS EFFECTS ON THE EMOTIONS: ANGER AND ENERGY-IF YOU’RE A CAREGIVER

If you are taking care of someone with the virus, understand that the disease is the target and you are not. The person you’re caring for is feeling anger, not hatred; they do not blame you. Lisa said, “The anger and rage my husband felt were his issues and not in my control. I knew it was just his guilt for bringing the virus into our lives. It’s easier to deal with his annoyance over something understandable than it is to deal with the feeling of being unloved.”     Allow the person with HIV infection to express the anger, though that can be difficult when, as Lisa said, “they’re shouting at you.” Dean did a certain amount of yelling in the presence of his partner; his partner told him, “Go ahead and get it over with. Get it out of your system. It’s understandable.” Try not to judge the person or to confront him or her: judgment and confrontation will only further misdirect the anger toward you.     Acknowledge the struggle the person is having. Try saying, “I know it is hard for you. Cold oatmeal really does not taste good, and I’ll heat it up again.” This may help the angry person dissipate the anger and understand its true target.     Still, you need not try to achieve sainthood during your lifetime. No caregiver is neutral; often caregivers have long histories with the people they are caring for, and many old sources of anger get confused with the new ones. Nor is letting them talk about their anger the same as letting them take it out on you. Remind them that their anger is difficult for you to hear, and difficult to separate out from old problems. Dean’s partner not only told him to get it over with, but also said, “Thank goodness you don’t go blowing up all the time.” When Dean’s partner felt he had taken too much abuse, he would pull away. Dean said he noticed this, calmed down, and worked to recover his perspective.
*65\191\2*

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SMART DRUGS FOR MAXIMUM MENTAL PERFORMANCE: IDEBENONE (AVAN)

Idebenone is a smart drug that is structurally related to the smart nutrient coenzyme Q10 (CoQ10). CoQ10 plays a vital role in the creation of ATP, the primary energy molecule in the body. It has been used in Japan as a treatment for various types of cardiovascular diseases and has been used successfully in the United States as a treatment for gingivitis (inflammatory gum disease).Several studies have shown that CoQ10 can be metabolized in the body in such a way as to create damaging compounds with free radical-like activity, although if the body is supplied with sufficient antioxidant smart nutrients, such as vitamin C, ascorbyl palmitate (fat-soluble vitamin C), beta-carotene, and vitamin E, CoQ10 should be able to exert its beneficial effects without causing free-radical damage. Idebenone does not seem to share this problem.Studies have found that idebenone is relatively nontoxic. No biochemical abnormalities have been noted in people taking idebenone, and no studies I have found report suspicious clinical laboratory values that could be directly related to the use of idebenone.Dosage commonly used: 100 mg per day.*55\244\2*

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AROUSAL IN THE FEMALE: ENVIRONMENTAL FACTORS

These play an important part in turning on a female, unlike the male who can usually perform anywhere, as long as he is not disturbed. A woman on the other hand is turned on by the right ‘atmosphere’—moonlight, a rainy or cloudy day, soft music, enchanting scenery, the sound of the sea, dancing with her partner or even by a situation of extreme grief or danger, such as bombing during a war. She likes to be protected from danger by the male. Strange as it may seem, the secret desire “of some women is to be raped and they often dream about being sexually molested!CULTURAL CONDITIONING: This shapes the sexuality of a woman. She is usually guided by society mores. If she has lived in a society where free sex is practised, she will indulge in it when she grows up without any pangs of conscience. On the other hand, if she has grown up in a culture where sex is taboo and even touching a male is not permitted before marriage, she may ultimately develop a guilt complex which may affect her arousal.*97\262\8*

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HIV INFECTION AND ITS EFFECTS ON THE BODY: AIDS-RELATED COMPLEX, OR ARC-IDIOPATHIC THROMBOCYTOPENIC PURPURA (ITP)

When a person has idiopathic thrombocytopenic purpura, or ITP, the body for some reason produces antibodies which attack the platelets that allow the blood to clot. Thus, the symptoms of ITP are excessive bruising and bleeding. ITP is a relatively unusual medical condition that can occur in people without HIV infection, but it is far more common in those with the infection. Most people are unaware of this condition; it is usually discovered with routine laboratory testing. Several forms of treatment are considered effective.     Whether ITP means that HIV infection is progressing is unclear. Many studies have shown that people with HIV-related ITP do not go on to get AIDS any faster than people with HIV infection who do not have ITP. Other studies have shown that people with HIV-related ITP develop AIDS more quickly than people who have HIV infection but do not have ITP.
*48\191\2*

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