Dr. Alin Marga, Dublin, Ireland - Medical Blog

Myocardial Infarction (MI) - Warning symptoms

7/7/2013

Myocardial infaction (MI) occurs most often in the early hours of the morning partly because of increased platelet aggregation and increased serum concentration of plasminogen activator inhibitor -1 (PAI-1) that occur after awakening.

In most situations, the onset is not associated or triggered by severe exertion. The immediate risk of MI increases 6 to 30 folds in sedentary people.

An increased suspicion for a possible MI should be maintained especially when it comes about the following groups in the presence of typical symptoms: cocaine users, elderly people, those with a history of heart failure, dementia, diabetes mellitus, hypercholesterolaemia or those with a strong family history of early coronary disease (any first-degree male relative aged 45 years or younger or any first-degree female relative aged 55 years or younger who experienced a MI).

Preceeding symptoms (within days before an acute attack):

fatigue
chest discomfort
malaise

Typical characteristics of the chest pain in MI:

intense and unremitting for 30 - 60 minutes
felt behind the sternum bone and often radiating into the jaw, neck and down to the ulnar aspect of the left arm
most commonly described as a retrosternal pressure sensation or sometimes as a squeezing, aching or burning sensation
in certain individuals the symptoms are those of an indigestion or of fulness or gas (digestive symptoms)

Accompanying symptoms and signs:

excessive anxiety (sensation of imminent death)
excessive perspiration (excessive sweating)
increased and/or irregular pulse (sometimes felt like palpitations)
increased respiratory rate
coughing, wheezing and production of aerate (bubbly) sputum (phlegm)
increased temperature (fever of around 38C) for the first 24 - 48 hours

Atrial Fibrillation (AF) - "Am I suffering from AF?"

27/6/2013

Atrial fibrillation (AF) is defined as an irregular and often rapid heart rate which commonly causes poor blood flow to the rest of the body. During an episode of AF, the heart's two upper chambers (the atria) beat chaotically and irregularly and are out of coordination with the two lower chambers of the heart (the ventricles).

AF is a condition which should be taken seriously due to it's main potential risks: atrial thrombosis (the formation of a blood clot inside the atrium chamber, as a result of the whirlpooled blood flow in the respective chambers due to the chaotic contraction of the atrial heart muscle during AF) leading frequently to stroke, heart failure (inability of the heart muscle to contract properly) and sudden death.

How do I know I suffer from Atrial Fibrillation (AF)?

AF is sometimes asymptomatic (clinically "silent") and in this case it usually goes unnoticed. If symptomatic (noticeable), here are some of the main symptoms which could indicate the presence of AF:

Irregular pulse
Shortness of breath
Palpitations
Feeling fatigued or lacking energy
Dizziness or confusion
Light-headedness or fainting
Feelings of fear or anxiousness
Chest discomfort or chest pain

Vitamin A deficiency - signs, symptoms and causes

13/6/2013

There are three forms of vitamin A: beta-carotens, retinols and carotenoids.
Deficiency of vitamin A is frequently found among the elderly, those chronically sick and the malnourished.

Among the first signs of vitamin A deficiency are: dry skin, dry hair, broken/brittle nails, impaired visual adaptation to darkness, decreased resistance to various infections (especially diarrheal and respiratory infections), infertility secondary to abnormal spermatogenesis, spontaneous abortion (due to secondary abnormal fetal development) and fatigue (excessive tiredness).

Other signs/symptoms of lack of vitamin A:

pruritus (itchiness)
keratomalacia (softening, drying and ulceration of the cornea) resulting in altered vision
xerophthalmia ("dry eyes" - reduced lacrimation)
anaemia
excessive deposition of bone at periostum level (periostum = a layer rich in very small blood vessels covering the bone structures)

Causes of vitamin A deficiency:

cystic fibrosis (a hereditary disorder affecting the exocrine glands)
cholestasis (delayed evacuation of bile from the gallblader)
certain small-bowel surgery (by-pass surgery)
fat malabsorption (reduced absorption of fat from the bowels)
pancreatic insuficiency (of the exocrine pancreas - not related to insulin production)
irritable bowel syndrome (IBS)
sprue (coeliac disease or a tropical disease of unknown cause manifested by diarrhoea and malabsorption of nutrients from the intestines)
vegan diet (containing only vegetable food)
alcoholism
young or very young persons living in poverty

Cholesterol medication & Grapefruit make a Lethal combination!

5/6/2013

Grapefruit intake during the treatment with certain cholesterol lowering medication (statins) is a life threatening combination!

This is not a myth, but pure reality. But how does it happen?
Some of the enzymes (CYP3A4) commonly present in the intestines are responsible for the breakdown of various medicines such as some of the statins. CYP3A4 regulates the intestinal absorption of ingested statins into the bloodstream thus preventing this drugs to accumulate in the organism. The fruit and also the juice of grapefruit in its turn destroy this useful enzyme and, as a result certain statins accumulate in growing amounts in the bloodstream eventually causing renal (kidney) and liver failure and ultimately death.

It is of no importance what time you consume grapefuit as long as you are taking these statins.

What are the symptoms indicating a statin accumulation in the body? The most relevant of them are: muscular pain, unexplained tiredness and fever.

Apart from the interaction with certain statins, grapefruit could also boost the concentration of other medicines in the organism up to dangerous levels. Here's a list of these medicines:

calcium channel blockers normally used to treat hypertension (Felodipine, Nifedipine)
certain statins (Atorvastatin, Simvastatin, Lovastatin)
benzodiazepines - medicines used to treat anxiety and insomnia (Diazepam, Triazolam, Midazolam, Temazepam)
immunosuppressants (Cyclosporine)
psychiatric and neurological medication (Buspirone, Carbamazepine, Sertraline)

Parsley (Petroselinum crispum) - suggested medical uses

3/6/2013

Petroselinum crispum or simply parsley, has been widely used for preparation of various food recipes.

Apart from its cuisine-related use, it is attributed numerous qualities when used as an add-on therapy for conditions such as:
kidney and bladder stones, urinary tract infections, gastrointestinal disorders, constipation, jaundice (icterus), flatulence (excessive winds), indigestion, colics, diabetes, cough, asthma, oedema (swelling of tissues), osteoarthritis, anaemia, hypertension, prostate conditions and spleen conditions.

The recommended daily dose of parsley to ensure effectiveness when used as add-on treatment is 6 grams. Its medical effects are believed to be due to its volatile oils myristicin and apiol.

Parsley was reported to have a minor interraction with Warfarin (an anticoagulant) and it is contraindicated in case of pregnancy (induces abortion). Also, it should not be used as single medication to treat oedema due to cardiovascular cause or inflammation of kidneys.

However, new studies have demonstrated that parsley (apart from its diuretic effect) is a useful natural candidate to treat some autoimmune and allergic diseases as a result of its immunomodulatory effect.

Rice water to treat diarrhoea in infants up to 5 months old

27/5/2013

Small babies are sometimes quite difficult to treat as most of the pharmaceutical drugs are contraindicated for those up to 5 - 12 months old.

Common cold, benign infections, teething or changes in babies diet can induce diarrhoea and abdominal colics (cramps) in small babies or even in older children. Those up to 5 months old are at greater risk when suffering from diarrhoea as they are most likely to develop a rapid dehydration.

Unless the cause of the loose bowel motions (diarrhoea) is a really severe one (bacterial infections of the digestive tract, a.s.o.), parents could use a very old remedy for such condition and namely the rice water.

A lot of us have heard that the rice seeds can be beneficial in stopping diarrhoea. But how to use the white seeds when it comes about the small babies?

Here is a very simple recipe that any of you could use without headaches:

Ingredients:

3 tablespoons of rice flour
4 tablespoons of glucose powder
1 liter water

Put the water to boil and then add the rice flour and the glucose powder. Simmer the mix for 25 minutes stirring from time to time. When ready, wait for the rice water to get to the room temperature and add it to the milk bottles as follows:

day one: 3 parts rice water and 1 part milk for each bottle of the day (if diarrhoea is a severe one - more than 6 or 7 watery stools per day - continue with the same proportions during the second day as well
day two and three: 1 part rice water and 1 part milk for each bottle of the day
day four: 1 part rice water and 3 parts milk for each bottle of the day (it could be continued respecting these proportions for one or more days or until diarrhoea will resolve)

Psyllium seed husks - a natural remedy for IBS

26/5/2013

Psyllium seeds (Plantago ovata seeds) are originary from India. They are indigestible, hygroscopic (they have the property of absorbing high quantities of water) and a source of soluble dietary fiber.

They are mainly used as an add-on treatment for IBS and hypercholesterolaemia. The improvement of diarrhoea, and a colon cleasing action (in those suffering from IBS) and a reduction of coronary heart disease (CHD) events (in those suffering from high cholesterol levels) are the benefits this seeds offer.

On the other hand, the long term ingestion of Psyllium seeds might give abdominal cramping, increased flatulence (increased passing of bowel wind) and constipation.
Psyllium seeds are contraindicated in case of oesophageal and gastrointestinal obstruction or difficult swallowing and also in case of fecal impaction, symptoms of appendicitis (lower right abdominal pain, nausea/vomiting, reduced/absent bowel motions, high temperature, altered general state), gastritis or gastro/duodenal ulcers, rectal bleeding.

Dosing: 1 teaspoon or tablespoon of seeds in 8 oz (~ 240 ml) of water for up to three times per day. An increased daily ingestion of water (fluids) is recommended during the treatment with these seeds.

Safety information for Ketoprofen gel users

23/5/2013

Ketoprofen is a non-steroidal anti-inflammatory drug (NSAID).

The topical formulation of ketoprofen is widely prescribed for benign conditions in traumatology and rheumatology as well. It has been used in European Union since 1978.
In 2010, the European Medicines Agency's Committee for Medicinal Products for Human Use (CHMP) has conducted a scientific review of topical ketoprofen-containing medicines on the basis of reported photosensitivity reactions and co-sensitization with octocrylene (UV filter).
CHMP has concluded that photosensitivity reactions of topical ketoprofen-containing medicines are important adverse reactions, but that the benefit/risk profile of these medicines remains favourable.

Therefore, it is important that patients should be advised on several photosensitivity preventative measures such:

Wash hands thoroughly after each application of gel
Do not expose treated areas to sun, even if cloudy, or UVA during the treatment with ketoprofen or 2 weeks after its discontinuation
Protect treated areas from sunlight by wearing clothing
Topical ketoprofen should not be used under occlusive bandage
Discontinue treatment immediately upon development of any skin reaction, including cutaneous reactions after co-application of octocrylene containing products

(source: Irish Medicines Board)

The less known uses of Cumin - traditional (herbal) medicine

17/5/2013

Just a few of us have heard of the benefits this tiny seeds could offer for a series of medical conditions. If you would ask your granny, you might find out even more about it.

Cumin is very rich in iron and magnesium and therefore could be used as an add-on natural remedy to treat conditions like iron deficiency anaemia, stress, anxiety and fatigue. The long term intake might also prevent cancer.

Cumin is famous for its effects on the digestive tract. It proves a great fighter against diarrhoea, flatulence, indigestion, nausea and vomiting.

How to use the cumin seeds?

The best way of taking advantage of its miraculous properties is to make a cumin seeds tea.

Here's my recipe:

Put to boil one or more cups (~250 - 300ml each) of water and add one heaped tablespoon of cumin seeds to each cup of water; boil them together for about 10 to 15 minutes or until the boiling liquid is turning brownish; leave it to cool down until just slightly warm and drink 1 - 2 cups of unsweetened tea per day (kids could use half of this amount). As a note: excessive use of cumin tea can promote constipation.

Polycystic ovary syndrome (PCOS) and its psychological implications

16/5/2013

Polycystic ovary syndrome (PCOS), a frequently diagnosed condition in both young and elder women can produce different effects on quality of life, psychosocial well-being and sexual satisfaction.

The major features of PCOS are obesity, excessive body hair, acne, increased serum testosterone levels, disturbed insulin metabolism, menstrual cycle disturbances and infertility.

PCOS patients show significant reductions in quality-of-life, increased psychological disturbances and a decreased sexual satisfaction compared with those undiagnosed with this condition. Among the changes mentioned above, the increased BMI (obesity) and hirsutism have been shown to cause the greatest negative impact on quality-of-life and sexual satisfaction. Metabolic and endocrine parameters along with menstrual irregularities and infertility appear to have a lower impact.
(source: European Journal of Endocrinology, 2005 Dec.)