World Kidney Day

World Kidney Day is celebrated every year to raise awareness about the importance of our kidneys as amazing organs that play essential role in keeping us alive. Though kidney diseases are common and are harmful but they are mostly treatable at initial steps...

 By Dr. A. Majid Rana

The kidney day is celebrated every 2nd Thursday of March since last three years to raise awareness about the importance of our kidneys as amazing organs that play essential role in keeping us alive. Though kidney diseases are common and are harmful but they are mostly treatable at initial steps.

The main job of our kidneys, located beneath our rib cage, is to remove toxins, certain chemicals and excess water from our blood. Every day our kidneys filter and clean 200 litters of blood equivalent to 20 buckets. Beside this impressive feat, kidneys also help to control blood pressure, facilitate red blood cells formation and play a very important role to make our bones stronger.

Kidney diseases are usually divided into two main groups (a) where precautionary measure, proper and early treatment keeps the progression of kidney diseases in check (b) in which diseases can be cured by offering surgical remedy to the patients.

If the kidneys gradually start loosing their ability to function properly then it is called chronic kidney diseases (CKD), it is silent in character and often goes unnoticed. Studies of different races living in different countries worldwide have consistently shown that one out of 10 adults have some form of kidney damage.

People with chronic kidney disease are 10 times more likely than healthy individuals to die of heart attacks and brain strokes. The health of their kidneys may also progressively worsen to the point where kidneys must be replaced (this is called end stage renal disease). The patient can be kept alive either by kidney transplantation, haemodialysis through machine thrice a week or peritoneal dialysis. Other than the above mentioned methods of treatments of end stage kidney diseases all other claims are hoax, cheating and a lie with patients.

In the changing world chronic, non communicable diseases like heart diseases, hypertension, diabetes mellitus and chronic kidney diseases have now replaced the communicable disease. Death claimed by infectious diseases will decline by three percent over the next decade-in marked contrast to chronic diseases which already account for 72 percent of the total global burden of diseases and in population over 30 will increase by 17 percent.

The cost of treating the chronic kidney disease is already 80 percent of many health care budgets representing a leading threat to public health and healthcare resources worldwide. USA will spend nearly 10 billion dollars by year 2010 only to control and treat kidney diseases.

As Pakistan is a third world country, it is of paramount importance that focal point of the government health policy should be prevention of kidney and other diseases related to kidney. It is also more significant because kidney disease is a disease multiplier, rather than spending huge amounts in purchase of medical equipments and constructing building which is easy and quick way of siphoning kick backs from health budgets.

On the face of earth 500 million individuals, who makes 10 percent of the adult population have some form of kidney damage and every year millions die of heart disease linked to CKD. The main causes of CKD in order of priority are uncontrolled diabetes, uncontrolled high blood pressure, infections and stones of kidney and urinary tract while presence of stones in the renal tract is the leading cause of kidney failure in children. These kidney diseases actually contribute morbidity from cardiovascular disease in 12 million individuals worldwide each year and these numbers are multiplying rapidly due to global epidemic of types 2 diabetes.

The cost of kidney failure treatments are escalating worldwide, over 1.5 million people are kept alive through either haemo or peritoneal dialysis or transplantation and this number is expected to double within the next 10 years.

The cumulative global cost for dialysis and transplantation over the next decade is predicted to exceed US$ 1 trillion. The worst bit of this whole picture is that 80 percent of patients benefiting from renal replacement therapy live in developed countries and only 10 percent of patients in Pakistan and India are benefited by this treatment. In many African countries there is little or no access to renal replacement therapy mean to face the stark reality of death, plain and simple death.

Fortunately we can detect chronic kidney diseases early on. Simple routine tests of urine, blood, ultrasound examination, and symptoms of diabetes, uncontrolled high blood pressure and heart and vessels diseases greatly facilitate the diagnosis, but the positive outcome is that by using correct drugs, certain precautions and change of life style not only brings about control of chronic kidneys diseases but at times can get you rid of it.

Those diseases of kidney and urinary tract, which can be treated with surgical intervention, include urinary stones, congenital urinary diseases, genitourinary cancers and enlargements of prostate gland in old men.

In Pakistan 60 percent of the surgical work of all districts hospital comprises of urological diseases and most of these are with kidney, uretar and bladder stones. The most common causes of these are malnutrition, unbalanced diet, deceased intake of liquids, repeated or chronic urinary tract infection injudicious use of certain drugs especially painkillers and few genetic and familial diseases.

Most kidney and bladder stones can be diagnosed by simple x-ray and ultrasound examinations. Specialised x-ray techniques are used to identify more accurately the size and location of stone and function of the kidney, which facilitate the treatment planning few urine and blood test do help establish the cause of stone formation.

Some kidney diseases of children can be diagnosed before birth with the help of ultrasound. In about one out of 500 births, some abnormality occurs in the development of the kidneys or urinary tract. Most common among these are blockage present at the out flow of urine resulting in swelling of kidneys called pelvic ureteric function obstruction. Another common abnormality is vasico ureteral reflux. This occurs when a valve like mechanism at the point where urethra joins bladder does not work allowing the urine to flow back up in to the kidneys. Presence of posterior urethral valves in the terminal urinary passage is another congenital disease. All of these diseases can be looked after and treated by surgical intervention providing lasting protection to kidneys.

Urinary tract infections are the 3rd common cause of kidney damage and one in five women will have atleast one such incidence in her lifetime.

Are protein shakes a good idea?

 Can you get buff without adding extra protein to your diet? What are the pros and cons of protein shakes?

 By Martica Heaner

Although many women avoid lifting heavy weights because they are afraid they'll get bigger, many men who want to build bulk know that it's not easy to build muscle. The secret to getting buff boils down a simple recipe: Lift heavy weights two to three times a week, and eat more calories than normal. (Having shorter arms and legs and a genetic tendency to build muscle also helps.)

The exercise stimulus creates a sort of muscle breakdown so that when you sleep, your muscles go into an anabolic state to get bigger and stronger than before. Consuming extra calories provides the energy needed for this rebuilding process.

Many people believe that you need to eat more protein than normal to fuel muscle growth, but this is not really true for most weight lifters, according to research by Peter Lemon, a renowned protein researcher and professor at the University of Western Ontario in Canada.

More protein can lead to more body fat

The recommended daily allowance (RDA) for protein that the average person should get in their daily diet is 0.8 grams for every kilogram of body weight. Lemon's research shows that exercisers need between 0.8 grams and 1.7 grams per kilogram of body weight. Some bodybuilders take in four or five times as much as the RDA-and, according to this research, totally unnecessarily.

Extra protein does not automatically make extra muscle. In fact, if you eat more protein than your body uses, it will be stored as fat. So, bodybuilders who down six chicken breasts at time in between high-protein shakes and bars may be adding more to their waistline than their biceps.

Protein shakes can add as much as 200 grams or 300 grams of protein (800 to 1,200 calories) a day. If you don't need it, the body stores all those extra calories as fat. Also, if these shakes are taking you to the high end of the protein spectrum, you may be increasing health risks-high-protein diets may cause bone loss and kidney damage.

There is some debate about the types of protein in different shakes or supplements. But the bottom line is, you probably don't need added protein. And even if you do, it's probably healthier to get it from real foods, not processed supplements.

Deducing your protein quota

An easy way to calculate your needs is to multiply 0.36 by your body weight in pounds. So if you weigh 180 pounds, you need about 65 grams of protein per day, or about 47 grams per day if you weigh 130 pounds.

If you consider that the average chicken breast may contain 30 grams to 60 grams of protein, one slice of cheddar cheese has seven grams, and even one cup of chopped broccoli has about five grams of protein-it's very easy to get what you need from the meals and snacks in your day without making an extra effort. Beginning weight-lifters trying to build muscle need a little more protein than the RDA. If you are extremely active-such as an endurance exerciser going on long runs, for example-you may need about 50 percent more than the RDA, or 1.2 grams of protein per kilogram of body weight, but for a 135-pound woman that's still only about 70 grams per day.

So while certain exercisers may need more protein, chances are, you are getting more than enough already. It's unlikely that even a novice weightlifter will need to supplement over what they are already eating.

Timing your muscle fueling efforts

When you eat protein-and when you eat more carbohydrates-may be more important than how much and what type of protein you eat.

After a hard workout, even though you feel ready to quit, your body isn't: The muscle-building process is about to begin. Your body is most primed to refuel starting about 45 minutes after you work out, up to about two hours. So it's time to eat-ideally, carbs with a touch of protein.

In this post-workout period, muscles are most highly sensitive to insulin-and eating triggers the release of insulin. And since insulin helps shuttle the carbs-or glucose-that you eat into cells, higher levels mean that more glucose gets in. Plus insulin activates an enzyme that specifically helps store extra glucose in your muscles.

That means your muscles are better fueled for tomorrow's workout. More insulin also helps trigger protein synthesis. So if you fuel up post-workout, muscles will pack more protein into your muscle's fibers.

Research shows that your post-workout snack should consist of as much as four times as much carbs to protein, or a 2-to-1 to 4-to-1 ratio, according to John Ivy, a professor of kinesiology at the University of Texas at Austin. So after a hard workout, eat a carb- and protein-containing snack or drink.

(Some people don't feel like eating right after a hard session, so here's where having a shake or a protein-supplemented energy drink may be useful.) Foods to nibble on include a handful of almonds, walnuts, peanuts, pecans, sunflower seeds, peanut butter on bread, vegetables and fruit with yogurt.

Health update
Antibiotics little help for most sinus infections

Doctors are overprescribing antibiotics for common sinus infections and related conditions, possibly in the false belief they may help in cases where symptoms are protracted, researchers reported. Bacteria can cause rhinosinusitis - an inflammation of the sinuses - but a virus such as the common cold is often a more likely culprit so antibiotics seldom work, the researchers reported. Yet doctors still dole out the drugs more than they should. "What tends to happen in practice is when patients have had symptoms for a while and go see their family doctor, the doctor assumes they have a bacterial infection and gives them antibiotics," said James Young, a statistician at the University Hospital Basel, who led the study. "Our results show that is not a very good strategy."

Breast cancer may be deadlier

Breast cancer patients who are overweight have more aggressive disease and are likely to die sooner, researchers reported recently. A dangerous type of breast cancer, known as inflammatory breast cancer, was seen in 45 percent of obese patients, compared with 30 percent of overweight patients and 15 percent of patients of healthy weight. "The more obese a patient is, the more aggressive the disease," said Dr Massimo Cristofanilli of the University of Texas M.D. Anderson Cancer Centre, who led the study. "We are learning that the fat tissue may increase inflammation that leads to more aggressive disease." Writing in the journal Clinical Cancer Research, Cristofanilli and colleagues said they studied 606 women with breast cancer that had spread within the breast. "Obesity goes far beyond just how a person looks or any physical strain from carrying around extra weight. Particular attention should be paid to our overweight patients," Cristofanilli said.

Protein 'reverses eye diseases'

A drug to tackle two of the leading causes of blindness is a step closer after successful experiments in mice. Activating a specific protein in the eyes prevented blood vessel damage, which can cause sight loss. The research has implications for macular degeneration and diabetic retinopathy - two common conditions associated with blood vessel problems. The University of Utah study could also provide clues for treating other diseases. Both of the types of eye problems are common in older people, and involve both leakage of blood vessels within the eye, and the formation of abnormal new blood vessels. Researchers had already identified a protein called Robo4, which appeared to play an important role in the development of stable, working blood vessels. The proteins were activated in mice bred to mimic the effects of age-related macular degeneration (AMD) and diabetic retinopathy. The scientists saw that the blood vessel damage was prevented, or in some cases, reversed.

11.7 m cosmetic procedures done in 2007'

The annual report released recently by The American Society for Aesthetic Plastic Surgery indicates that 11.7 million cosmetic procedures were performed in 2007 at a cost of roughly $13.2 billion. The popularity of cosmetic procedures exploded in the last decade. Since 1997, surgical procedures have increased by 114 percent, while nonsurgical procedures rose by an impressive 754 percent, according to the report. Eighteen percent of the procedures performed in 2007 were surgical and 82 percent were nonsurgical. This is the 11th consecutive year that data from multiple specialties have been collected for cosmetic procedures. To obtain the data, more than 12,000 surveys were sent to plastic surgeons, dermatologists, and otolaryngologists. The findings were then used to generate estimates.

Top