The Indian Express | 1 week ago | 21-09-2022 | 05:35 pm
Comedian Raju Srivastava’s death, after suffering a cardiac arrest and collapsing on a treadmill last month, raises a key question: Should we have a limit on our exercise regimen, and are we taking out fitness mantra to extremes and over-exerting ourselves? Is our obsession with getting lean stressing the heart out? Cardiologists say that 150 minutes of any exercise regime every week are good enough and a longer routine than that does not guarantee extra benefits. In fact, it may do harm than good if the person is already prone to heart disease and suffers from markers like hypertension, anxiety or even a silent blockage that has not harmed him thus far.“All you need are 150 minutes for five days a week, or 30 minutes of exercise each day. It should be a healthy mix of aerobics, weight training (this strengthens muscles, including the heart) and stretching (yoga and breathing exercises). This rotational regime is good for both physical and mental health. Stop during exercise if you have discomfort and get yourself tested before you adopt any high-intensity regime,” advises Dr Ruchit Shah, Interventional Cardiologist, Masina Hospital, Mumbai.“Regular exercise increases your heart rate, improves your cardiac muscles and aids in enhancing your lung capacity. On the other hand, there is a phenomenon known as over-exercising. Continual over-exertion has been linked to an increased risk of ‘atrial fibrillation’, a form of irregular heart rhythm that can be fatal if left untreated. Besides, it can potentially raise the risk of cardiac abnormalities, particularly for those with hypertrophic cardiomyopathy or coronary heart disease,” says Dr Shalin Thakore, Senior Interventional Cardiologist, Shalby Hospitals Ahmedabad.What is Hypertrophic Obstructive Cardiomyopathy?Hypertrophic cardiomyopathy, usually caused by genes, is when the walls of the heart chamber (left ventricle) become thicker than normal. The thickened walls may become stiff and this can reduce the amount of blood taken in and pumped out to the body with each heartbeat. The thickened part of the heart muscle, usually the wall (septum) between the two bottom chambers (ventricles), blocks or reduces the blood flow from the left ventricle to the aorta.“This can provoke sudden cardiac arrest and a patient needs resuscitation in the first 60 seconds. In fact, we must train students in schools and colleges about CPR. All of us should know how to administer this. Besides, every public place should have defibrillators, schools and college students,” says Dr Shah.THE PRE-GYM MUST-DOS: NOT JUST A TMT TESTDr RR Kasliwal, Chairman of Clinical and Preventive Cardiology at Medanta hospital, Gurgaon, advocates a full cardiac work-up for any person going to the gym or doing any strenuous activity. “Just a TMT (treadmill test) doesn’t cut it. These days there are CT angiographies that can tell even if there is a 40 to 50 per cent blockage. Such a blockage would not show up on TMT because there is not much impairment in the patient’s capacity. Always know your heart before you take up some strenuous activity. Many people who get cardiac arrest do not live to tell the tale.”He said the same should apply to anyone who stopped working out during the pandemic and is now resuming an old routine. Such check-ups are particularly essential for diabetics and women, he said, because they might not experience a heart attack as a typical pain in the chest.Dr Kasliwal said that the Covid-19 status of the patient is also very important. “If you have had Covid-19 — and we know now that long Covid-19 is leading to sudden cardiac death — it is very important that you check your heart health. Those who have had Covid-19 also have high heart rate (tachycardia) sometimes.”Intensity and duration act as critical factors“When treadmill is done at very high speed and /or inclination, there is a double impact, that is the heart rate and blood pressure, which is a determinant of the oxygen demand in the heart. High mets (metabolic equivalent) during higher speed and for prolonged periods can cause undue stress on a compromised heart circulation in a setting of heart blockages. They cause sudden arrhythmia, undue low blood pressure or a heart attack. Such people need to be evaluated urgently with coronary angiography and should have appropriate revascularisation, for example, stenting procedure as per current guidelines,” says Dr Suman Bhandari, Visiting Consultant, Interventional Cardiology, Fortis Escorts Heart Institute.Vigorous activity makes you breathless and sweat heavily. Go for moderate-intensity workouts instead, which comprise activities that increase your heart rate, such as casual sports, brisk walking, jogging, cycling, and swimming. “Every individual must engage in 30 minutes of moderate-intensity physical activity on a daily basis in order to receive the health benefits. One must avoid testing their physical strength and physique. Whether you are a novice or a seasoned exerciser, you should not overdo it. In addition, allow sufficient time for your body to recuperate and mend. Consult a doctor if you experience any difficulties,” adds Dr Thakore.How to prevent over-exertion?Exercise has both direct and indirect beneficial effects on the heart. Direct effects include, helping the heart muscles get stronger and pump more blood per heartbeat as well as the ability to withstand abnormal heart rhythms better. Indirect effects include beneficial effects on blood pressure, sugar, cholesterol, and body fat, all of which reduce the chances of a heart attack.“It is important to keep in mind that sudden cardiac death very rarely occurs in someone with a healthy heart. Exercise may be the trigger to have a cardiac event in individuals who have undetected or silent heart disease. In terms of a single episode of exercise, there is no absolute upper limit defined, and it all depends on the individual’s training level. One should avoid high levels of unaccustomed exertion, the rule of thumb being that any given bout of exercise should not be more than a ten per cent increase compared to previous bouts. Environmental conditions should also be considered, and outdoor exercise should be avoided in extreme weather conditions; as this is one scenario where even a healthy person could suffer serious consequences,” says Dr Aashish Contractor, Director, Sports Medicine and Rehabilitation, Sir H N Reliance Foundation Hospital, Mumbai.He adds that “Another way to look at ‘too much exercise’, is the overall volume of exercise accumulated over the years. Here, the research has shown that a very large volume of exercise over several decades might cause some changes in the heart muscle, as well as accumulation of calcium in the coronary arteries. At this point, the amount of exercise has not been defined, and the consequences of these changes have not been fully understood. However, it is well known that to reap optimum health benefits, moderate exercise is the way to go. So how does one reduce the risk? In my opinion, risk can be reduced by taking care of the following:1. Pre-participation health check2. Paying heed to warning signs3. Sensible and appropriate training programmes.”Balancing fitness routine with a healthy dietIndians are genetically prone to developing heart disease 15 or 20 years earlier than their Western and Japanese counterparts. And since our genes are not modifiable, we have to look at modifiable factors like lifestyle, sleep cycles and stress. “Now stress is compounded by tobacco, tobacco-derived products and alcohol. Did you know that the effect of even a single tobacco use lasts for three to six months? By rough estimates, a cigarette shortens your life by five to seven minutes. Which means a moderate smoker can easily reduce his/her life by three to five years. Instead of ‘no smoking’ banners, we should start a ‘why you should not start smoking’ campaign,” says Dr Shah.Maintaining physical and mental health requires a good diet and regular exercise. “When people conduct high-intensity workouts and consume less, the body uses nutrition reserves, causing deficits. Following fad diets to lose weight promotes starvation, anaemia, heart disease, stroke, poor mental health, etc. Align your diet with your workout regimen. Choose healthy carbs as they power one’s brain and body. Carbohydrates recharge the body after a workout. Eating quality proteins post-workout repairs muscle microtears and boosts blood flow. Some fats are actually healthy despite being calorically dense. Polyunsaturated fat is advantageous. One can also look for sunflower oil, soybean oil, and various nuts and seedsas they contain omega fatty acids. In conclusion, the benefits of exercise should not be called into doubt; on the contrary, they should be reinforced. However, moderate activity and a healthy diet are strongly affirmed for a healthy heart,” says Dr Thakore.Dr Shah advocates the “Ek chamach kam (One teaspoon less)” campaign, which entails cutting down on our use of the three whites in our food — salt and sugar and oil. More fruits and vegetables. Minimise cakes and junk foods.”When should you get tested for cardiac fitness?Coronary Artery Disease (CAD) can start as early as your teen years. Plaque can form that early. “To prevent further build-up, your first BP, sugar test and lipid profile test should be done at age 18 and then once every three to four years. Do check your BP during every clinical visit. You need to do the ECG once a year when you turn 40 and depending on your other parameters, space out the frequency as advised by your doctor. Watch your LDL levels and for those who have not undergone intervention, maintain the level at less than 60 mg/dL less and for those with cardiac intervention like stenting, less than 30 mg/dL,” advises Dr Shah. No test is foolproof. What we need is a good alertness level.UNDERSTANDING PLAQUE RUPTUREExplaining these sudden episodes, Prof K. Srinath Reddy, a cardiologist, epidemiologist and president, Public Health Foundation of India (PHFI), says, “Chronic obstruction of 70 per cent or more in a coronary artery produces angina or chest pain on exertion, since available blood supply does not meet the increased oxygen demand of the exercising body and straining heart. However, a heart attack (acute myocardial infarction) can occur when soft plaques that form in the coronary arteries rupture and cause a large clot to form. This may come without any prior warning symptoms. Even plaques of 30 per cent can rupture and set up the formation of a large obstructive clot.”
The Covid-19 pandemic has increased the progression of complications arising from heart ailments, said Dr Sameer Dani, director, cardiology services, Apollo CVHF Heart Institute, Ahmedabad, adding that it can become a considerable risk factor if Covid-19 becomes endemic.Speaking a day before the World Heart Day on September 29, Dr Dani said, “Based on what we have observed, people who had pre-existing coronary artery diseases have more complications with Covid-19… more heart failures, more heart attacks and rapid progress of blockages.”Adding that even those who did not have pre-existing heart diseases stand higher chance to develop heart problems once they get Covid-19, Dani said, “We have seen three or four cases where a 10-20 per cent blockage before Covid-19, progressed to 90 per cent blockage in six to eight months after Covid. If it becomes endemic, then it will become important to take care of post-Covid precautions to prevent heart problems.”
New Delhi (India), September 27: NSE-listed, Libas Consumer Products Ltd is on fast track with several major diversifications whereby it has launched ‘KNG brand Organic Innerwear’ which are made of bamboo fiber, supposed to replace regular innerwear due to sustainable and non-allergic factor. KNG brand will be retailed exclusively on its website and few products of organic innerwear will be retailed through online multi-channel such as kng.ltd, Amazon, Flipkart, Myntra, Snapdeal, Meesho, Paytm Mall, Nykaa Fashion, Shopclues, etc.With the current size of the Indian inner wear or under wear market is Rs. 15,870 crores ($2.9 billion) which is expected to grow on a fast pace,KNG will be a clear winner.The company has just launched its first commercial store targetting middle class market in the hub of Bur dubai a commercial city in the middle East the company proposes to expand its foot print in the middle East with stores in Bahrain and Abu Dhabi also supplying uniform s to the 500 plus hotels opened in the after covid 2020 Libas is a lead supplier of accessories and uniform s to hotels like the AtlantisPost Covid, the wedding season in India is booming with stalled weddings for the last 2 years Riyaz Gangji Libas is all set to take advantage of all stalled weddings in Maharashtra and UP, Delhi it also retails through its website www.libasconsumerproductsltd.com and www.libasfashion.com, Amazon, Flipkart, Snapdeal, Meesho, Paytm Mall, Shopclues, whereby Libas Consumer Products ltd would gain substantially due to the wedding season .Last year ,Libas Consumer Products Ltd had announced a third bonus issue in 3 years and 2 dividends in recent years.Riyaz Gangji Libas has also signed an exclusive contract with Flex Wheeler, a bodybuilding legend, to retail in the USA and other parts of the world.With these positive developments, profitability and revenues may rise substantially.Big Renowned HNI investors are holding shares in Libas, giving a boost to its credibility.The company has proposed to raise investment to open stores across India through franchise models.The company has three production facilities in Mumbai, Delhi, Dubai .In light of the on-going COVID-19 pandemic and due to the temporary slowdown faced in the current business segment, the company is diversifying and derisking its business by venturing into Online Segment of manufacturing and selling of goods .The company’s mother brand ‘Libas’ is considered as one of the most reputed ethnic wear brands in India.The other brands of the company include Libas Riyaz Gangji, Libas Reshma Gangji, Gangji Jewels and KNG, Reshma Riyaz gangji Libas.Libas is the preferred label amongst stars in the IndianFilm Industry.Many Celebrities who have endorsed the company by wearing outfits designed Libas including, Amitabh Bachchan, Salman Khan, Zarine Khan, ZeenatAmaan, Anil Kapoor, Jacqueline Fernandes, Sonu Sood, etc. Music Maestro A.R. Rehman’s first international video makeover had clothes designed by Libas.The global ethnic wear market size was valued at USD 77.6 billion in 2020 and is anticipated to expand at a compound annual growth rate (CAGR) of 6.3% from 2021 to 2028. There has been a high demand for ethnic wear of various countries across the world because of globalisation, movement of culture & tradition in conjunction with individuals visiting and staying in numerous countries.Expansion into the international markets would expand cultural activities and wants desired by the company to serve various markets in the global world.
AHMEDABAD: The city on Monday recorded 22 new Covid cases and the death of one patient, taking the total number of active cases to 244. Gujarat registered 85 cases and active cases reduced to 981. After 111 days, the daily case count dropped below 100, and after 102 days, the active case count fell below 1,000. Five out of 33 districts recorded zero active cases.
The Gujarat government provided appointment letters and apprenticeship contract letters to 1.49 lakh youths at employment appointment letter distribution programmes held in 33 districts and seven municipalities in the state on Monday.“Providing employment opportunities to 1.49 lakh youth is historic,” said Chief Minister Bhupendra Patel as handed over the letters to 17 youths in Ahmedabad.Attributing the development in Gujarat to the strong foundation laid by Prime Minister Narendra Modi, the CM said that today Gujarat has become the growth engine of the country.“During the Covid pandemic, even major countries got tired. At that time, PM Modi gave the call of Atmanirbhar Bharat… through free vaccination, the PM got us out of Covid and made sure no one slept hungry during that time by providing free ration,” CM said.Describing the comprehensive development of the state, the CM said that Gujarat has become identical with strong development in every sector under the direction of PM Modi.“Two decades ago, the state was producing 99 MW of renewable energy that has reached 16,588 MW today and 8,750 MW power generation has reached 40,138 MW,” he said adding that 26 per cent of Narmada’s water that was taken for use has now reached 94.86 per cent.Two decades ago there were 2.74 lakh MSME industries in the state which has now increased to 8.66 lakh, he added. With the support of the state government and private institutions, 2.17 lakh students are being trained in 125 courses in the 600 ITIs in the state to create a skilled workforce, he added.Under the Mukhyamantri Apprentice Scheme, more than one lakh youth were trained in four years, he said.“More than three lakh employment have been provided to youths through rozgar melas. In the past five months, nearly 900 rozgar melas were organised. More than two lakh jobs were given through Anubandham portal that links employers and employees… and 13,000 vacancies are still available on the portal,” said principal secretary Labour, Skill Development and Employment Department Anju Sharma.
Post Covid pandemic and after a gap of two and half years, the Pune team of surgeons from Galaxy Care hospital flew to Gujarat over the weekend to carry out a record back to back uterine transplants in two women in their 20s. “Prior to the pandemic, nine uterine transplants – all in Maharashtra -were performed.Now with the Gujarat government giving permission for uterine transplant, our team decided to carry out the procedure for the women on Sunday (Sept 25),” Dr Shailesh Puntambekar, medical director at Galaxy care hospital told The Indian Express. The next state to invite the team is West Bengal where the team is already planning their next surgery.On Monday morning the entire 11 member team returned to Pune and according to Dr Puntambekar both uterine transplant procedures were completed in a span of nine hours. According to Dr Milind Telang, chief gynaecologist with Galaxy Care hospital, the two women who underwent uterine transplants are stable.“The first patient was a 28 year old woman who had a small uterus and was infertile. Her mother was 49 and as per the transplant norms were evaluated. The second woman had an absent uterus and suffered from a condition called Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome and was married for three years. She was evaluated and her mother also agreed to donate her uterus. Both patients and their families were counselled,” Dr Telang said. The incidence of MRKH syndrome is one in 5000 girls that are born.“In our Indian scenario it would approximate to nearly 1.25 lakh girls who are born with this condition,” Dr Telang said. Both cases were of absolute uterine factor infertility. The entire procedure was completed in less than 12 hours. “Starting at 9 am we finished both operations by 7.45 pm,” Dr Telang said. Both donor and recipients are stable with no blood transfusion.Both women were earlier registered with the hospital in Pune for the transplant. Pune’s Galaxy Care hospital had conducted India’s first two successful uterine transplants in May 2017 with the third one in January 2018 being completed by the team in six hours.The womb transplants were performed through laparoscopic surgery that made the surgeries painless and helped in faster recovery. After nine uterine transplants the Covid pandemic brought about a temporary stop to the procedures.While the institute awaits a formal inspection and renewal of its license as a uterine transplant centre the Gujarat government in the meantime had invited Dr Puntambekar and his qualified team members to perform the transplant in Ahmedabad. The permission from the Gujarat government was like a bonus for the families of the transplant recipients as they could stay in their home state and undergo the procedure, Dr Puntambekar said.The transplants were performed at the Institute of Kidney Diseases and Research Centre at the Ahmedabad civil hospital campus.The state authorization committee, transplantation of human organ act, government of Gujarat had granted registration of uterus transplant centre to the institute and in a letter issued recently had stated that during the first year the uterus transplantation has to be done by Dr Shailesh Puntambekar and his qualified team members.Dr Vasanthi Ramesh, Director of National Organ and Tissue Transplant Organisation (NOTTO) when contacted told The Indian Express that the registry is in the process of being updated. “Uterine transplantation is not a life saving procedure. However one can live without a uterus and hence it can be a life enhancing or life giving procedure,” Dr Ramesh said.