Effect of dietary phytoestrogens on human growth regulation: imprinting in health & disease.

This group has advocated a return to the notional Palæolithic diet with fruits, vegetables, roots, leaves, seeds, phytochemical antioxidants and proteins, etc. Phytoestrogens, viz. lignans, isoflavonoids and flavonoids are weak oestrogenic constituents of such a diet and may have a considerable impact on human health and disease. The aim of this paper was to conduct a preliminary overview of about 2000 research-led studies from the 1930s to the present time reported in the literature on flavonoids/isoflavonoids/lignans and to assemble evidence for a future strictly formal literature review on the health benefits and risks of flavonoids in a variety of diseases.

Pulmonary Capillary Haemangiomatosis: A Rare Cause of Pulmonary.

Pulmonary capillary haemangiomatosis (PCH) is a rare disorder of unknown aetiology, characterised by proliferating capillaries that invade the pulmonary interstitium, alveolar septae and the pulmonary vasculature. It is often mis-diagnosed as primary pulmonary hypertension and pulmonary veno-occlusive disease. Pulmonary capillary haemangiomatosis is a locally aggressive benign vascular neoplasm of the lung. We report the case of a 19-year-old female who was referred to us in the early post-partum period with severe pulmonary artery hypertension, which was diagnosed as PCH by open lung biopsy.

The Adverse Effects of Wealth on Cardiovascular Health: A Scientific Statement of the International College of Cardiology.

Background and Aims: Increase in economic status may be associated with increased consumption of Western type of foods and sedentary behaviour. In the present review, we discuss that increase in wealth may be associated with adverse effects on health behaviour Study Design and Methods: Internet search and discussion with colleagues. Results: Review of studies indicate that with increase in wealth, there is increased consumption of high fat, ready prepared foods and decrease in physical activity in most of the countries resulting in obesity and metabolic syndrome, leading to cardiovascular diseases (CVDs) and other chronic conditions. Many experts during the United Nations High Level Meeting in Sept 2011, misinterpreted the WHO estimates and proposed that, of total deaths, 22·4 million arise in the poorest countries, and 13.7 million in high-income and upper-middle-income countries and therefore poverty may be the major cause of deaths due to non-communicable diseases (NCDs). A recent study shows that 57.0 % of deaths in adults (aged 25-64 years) were due to CVDs and other chronic diseases, 25.5% due to communicable diseases and 15.9% due to injury and accidents. The deaths due to NCDs were highly prevalent among higher social classes compared to lower social classes who had greater deaths due to communicable diseases. It is interesting to know from new data from United States, that there is ‘Wealth’ without cardiovascular health in America. The whole world is likely to have the same scenario in the near future. Conclusions: Increase in wealth may be associated with altered health behaviour; greater consumption of unhealthy foods, tobacco consumption, mental load and sedentary behaviour resulting in increased risk of deaths due to CVDs and other chronic diseases which may change with knowledge about health education. Wealth may cause extension in life by buying of expensive drug therapy, intervention and surgery which are known to add income and employment in the west.

Structure of aldobiouronic acid and glucuronic acid from Agathis australis degraded gum polysaccharide.

Agathis australis gum on acid hydrolysis with sulphuric acid yielded L-arabinose and D-galactose in 1:4 molar ratio with traces of L-fucose. The components of aldobiouronic acid and glucuronic acid were obtained by graded hydrolysis of degraded gum polysaccharide. The derivatives of aldobiouronic acid was obtained as methyl ester methyl glycoside.

Polysaccharide structure of degraded glucomannan from Abrus precatorius Linn. seeds.

Degraded glucomannan was isolated from Abrus precatorius Linn. seed polysaccharide (Papilionaceae). Acid hydrolysis and methylation studies produced certain degraded methyl sugars as, 2, 3, 6-tri-O-methyl-D-glucose and 2, 3, 6-tri-O-methyl-D-mannose in 1:4 molar ratio. On the basis of hydrolysis and methylation experiments, a polysaccharide structure has been assigned to the degraded glucomannan and to the parent glucomannan of Abrus precatorius Linn. seed.

How brain influences neuro-cardiovascular dysfunction.

Mechanisms that may explain the association between brain-heart connection leading to abnormal heart rate variability (HRV) and blood pressure variability (BVP) resulting into increased morbidity and mortality due to cardiovascular diseases (CVD), are reviewed. Medline search till December, 2001 and articles published in various national and international journals were reviewed. Experts working in the field were also consulted. There is compelling evidence that saturated and total fat and sedentary behaviour can enhance sympathetic activity and increase the secretion of catecholamine, cortisol and serotonin, whereas omega-3 fatty acid supplementation may enhance parasympathetic activity and increase the secretion of acetylcholine in the hippocampus. While increased sympathetic activity has adverse effects on HRV and BPV, increased parasympathetic activity has beneficial effects and can directly inhibit sympathetic tone. A large body of evidence is available demonstrating that abnormal HRV measured over a 24-hour period, or for 7 days, provides information on the risk of subsequent death in subjects with and without heart disease. Meditation, beta blockers, ACE inhibitors, n-3 fatty acids, trimetazidine and oestrogen may have a beneficial influence on HRV. However, no definite and specific therapy is currently available to improve the prognosis for patients with abnormal HRV and blood pressure variability (BPV). Low HRV has been most commonly associated with a risk of arrhythmias and arrhythmic death, unstable angina, myocardial infarction, progression of heart failure and atherosclerosis. There is a need to develop a consensus on the measure of HRV for clinical purposes and whether 7-day record is necessary and practical. New analysis methods based on nonlinear dynamics may be more useful in risk stratification. More precise insight into the patho-physiological link between HRV and nutrition may be applied to clinical practice and used to direct therapy for prevention of disease risk.

New insights into circadian aspects of health and disease.

Early awakening and early to bed as well as good conduct, thought, diet, interpersonal dealings and physical activity have been suggested for healthy life in Ayurveda. Circadian rhythms, coordinated in part by the parietal hypothalamic-pituitary and adrenal mechanisms, have been reported in almost all variables examined thus far, including the circulation. It is possible that all metabolic functions undergo circadian rhythms. It remains to be explored whether these rhythms may be optimized by Ayurvedic practices. The onsets of myocardial ischemia, unstable angina, acute myocardial infarction, sudden cardiac death, and strokes have been reported to exhibit a circadian variation, with increased frequency in the second quarter of the day. An increased physical and mental load caused by an attempt to prepare for the day may be important in triggering acute cardiovascular events. Depending on their timing, meditation (Ayurvedic practice), n-3 fatty acids, coenzyme Q10, beta-blockers and estrogens may have beneficial effects, whereas progestins and mental load may have adverse effects on heart rate and blood pressure variability, which may be expressed by different circadian patterns. Around the clock serial recordings of blood pressure and heart rate during usual activities and lifestyles may be recorded and may be analyzed by computer-implemented curve fitting to assess the about 24-hour (circadian) variation, among other rhythmic, chaotic, and trend components of the time structure (chronome) of these variables. The new disease risk syndrome circadian hyper-amplitude-tension (CHAT), a condition characterized by an excessive circadian amplitude of blood pressure, cannot be ascertained on the basis of single casual blood pressure measurements. The International Chronome Ecological Study of Heart Rate (and blood pressure) Variability in various ethnic groups aims at collecting further evidence regarding the role of blood pressure and heart rate variability in the pathogenesis of cardiovascular events, while also examining any role played by ethnicity and lifestyle-associated factors.

Genetic variation and nutrition in relation to coronary artery disease.

There is evidence that coronary artery disease (CAD), hypertension, diabetes mellitus (DM) and hyperlipidemia develop due to interaction of genetic and environmental factors during transition from poverty to affluence. Rapid transition in diet and lifestyle factors may influence heritability of the variant phenotypes that are dependent on the nutrient environment for their expression. We are beginning to recognize the interaction of specific nutrients with the genetic code possessed by all nucleated cells. In the next millennium, the physician may be able to make nutrient intake recommendations not on physical characteristics but on the basis of the individual's phenotypic expression for health while suppressing his phenotypic expression for disease. We have demonstrated an increased susceptibility to CAD, diabetes, central obesity, hyperinsulinemia and lipoprotein(a) excess in Indians in younger age groups indicating a genetic predisposition to these problems due to interaction of gene and environment. Lipoprotein(a) is a genetic risk factor for CAD, diabetes and stroke and it is higher in South Indians than North Indians. Antioxidant vitamins, coenzyme Q10 and n-3 fatty acids may have a beneficial influence whereas linoleic acid, saturated fat and sugars may have adverse effects on phenotypic expression. There is significant evidence that genes are involved in determining enzymes, receptors, cofactors, structural components involved in regulation of blood pressure, the metabolism of lipids, lipoproteins and inflammatory and coagulation factors that are involved in determining an individual's risk. Majority of these genes are polymorphic. While some genes respond to nutritional modulation, others may not indicate any response.

Pulmonary sarcoidosis in a south Indian hospital: clinical and lung function profile.

Twenty-two histopathologically proven cases of sarcoidosis were analyzed to determine the clinical presentation, lung function and the response to treatment. Laboratory data, chest x-ray and pulmonary function tests (PFT) were analyzed. Sarcoidosis was found to be more common in females in this study. Cough, breathlessness and weight loss were the predominant symptoms. Serum angiotensin converting enzyme (SACE) was elevated in 50% patients. Comparison of chest radiographs and PFT at the time of diagnosis revealed that stage I disease was associated with normal pulmonary function, 50% patients with stage II disease had mildly impaired PFT and 75% patient with stage III disease had severely impaired PFT. The indication for oral steroid treatment was respiratory symptoms in 58.8% of cases. Of the 13 patients who were available for follow up 10 (76.9%) had subjective improvement in symptoms. Majority of patients showed regression on chest radiograph but one patient progressed to stage IV disease. Pulmonary function data of the patients who were followed up showed improvement but this was not significant statistically. Oral corticosteroids improved symptoms but changes in pulmonary function seemed to be independent of steroid therapy. Further study of a larger number of patients over a longer period would be necessary.

L-carnitine administration in coronary artery disease and cardiomyopathy.

Myocardial ischaemia may be defined as a deficiency in cardiac energy supply relative to energy demand. In coronary artery disease (CAD), oxygen supply is limited due to coronary obstruction so energy production is not enough to meet the energy demands for work. Several reports involving about 2500 patients of CAD where carnitine was administered for upto 1 year indicate some beneficial effects. There is reduction in ischaemia showing reduced ST-segment depression and angina, greater effort tolerance and decreased need of cardiac drugs. Carnitine can cause overall improvement in cardiac performance in patients with CAD as well as in cardiomyopathy. More studies are necessary to demonstrate where carnitine can scavenge free radicals apart from its beneficial effect on fatty acid metabolism. Side effects of carnitine are mild nausea and vomiting and dose upto 2 g/day in 3 divided doses may not have any side effects. Intravenous L-carnitine acts rapidly and has no side effects.

Validation of tobacco and alcohol intake questionnaire in relation to food intakes for the Five City Study and a proposed classification for Indians.

Cross-sectional survey was conducted among 1806 subjects (904 men and 902 women) between 25-64 years of age. The survey instruments were questionnaires according to guidelines of WHO and other Indian studies and based on scores of various attributes of tobacco and alcohol consumption. All subjects with tobacco and alcohol consumption were classified separately into mild, moderate and heavy consumption and previous consumptions were also recorded. The overall prevalence of tobacco consumption was significantly higher in men compared to women (27.5 vs 11.6%), while mild tobacco intakes were comparable (2.0 vs 1.6%), moderate (22.2 vs 7.7%) and heavy (3.3 vs 2.2%) tobacco consumptions were significantly higher in men compared to women. The overall prevalence of alcohol consumption was 10.4% in men without any subject among women. The prevalence of moderate (6.6%) alcohol intakes was significantly higher compared to mild (1.2%) and heavy (2.5%) alcohol consumption. Whisky and country liquor were most commonly consumed alcoholic beverages. Smoking (20.7 vs 1.6%) and tobacco chewing (13.3 vs 10.7%) in men and women respectively were common modes of tobacco consumption. Tobacco consumption was significantly associated with lower consumption of vitamin C and beta-carotene and lower body mass index. These findings suggest that tobacco and alcohol consumption assessed by scores constructed on the basis of various attributes appear to be accurate and the questionnaires may be used with precision for classification and assessment in other population groups.

Coenzyme Q in cardiovascular disease.

Coenzyme Q10 or ubiquinone normally present in many plant and animal cells is an antioxidant. Coenzyme Q10 deficiency has been observed in patients with congestive heart failure, angina pectoris, coronary artery disease, cardiomyopathy, hypertension, mitral valve prolapse and after coronary revascularization. Coenzyme Q10 is involved in the synthesis of ATP and hence is useful in preventing cellular damage during ischaemia-reperfusion injury. The clinical benefits are mainly due to its ability to improve energy production, antioxidant activity, and membrane stabilizing properties. Several studies showed that coenzyme Q could be useful in patients with congestive heart failure, angina pectoris, cardiomyopathy, coronary artery disease and in the preservation of myocardium. Coenzyme Q10 is normally present in the low density lipoprotein cholesterol fraction and inhibits its oxidation. It can also regenerate vitamin E. Coenzyme Q10 is known for producing minor gastrointestinal discomfort and elevation in SGOT and LDH when used.

Civilian vascular trauma: an experience of 54 cases.

Fifty-four patients with civilian vascular injuries of the extremities caused by blunt trauma in 41 patients and by penetrating trauma in 13 patients were evaluated. Twenty-nine patients (53.7%) had associated fractures/dislocations and 19 sustained concomitant venous injuries. Twenty-nine patients (53.7%) came with a lagging period of more than 12 hours. Vascular injuries were diagnosed both clinically and by Doppler examination. In patients with equivocal findings, arteriography was performed. Arterial repair was done in 19 patients and saphenous vein interposition grafting was done in 2 patients. Fifteen patients required fasciotomy. Amputation was done in 13 patients (24.07%). It is concluded that the time lag, incorrect and incomplete assessment, and the reluctance to perform fasciotomy early and completely are some of the factors responsible for poor results.