Wednesday October 17, 2018

Going in for long-distance running? Get your heart screened first

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New Delhi: Are you in your 40s and eager to run your first half-marathon or are even contemplating entering into the 42 km heart-pounding endurance challenge?

Running_womanWell, hold the adrenaline rush. First, take some key tests–especially related to heart–before you hit the road with your running shoes.

In the past five years or so, field experts, and middle-aged Indians have picked up on the growing popularity of long-distance running, thanks to celebrity runners like Milind Soman, and are joining half-marathons or full races over the weekends in surging numbers.

However, a proper health screening is a must before any professional run, cardiologists warn, to rule out any underlying condition that may have serious consequences for your life.

According to Dr Lekha Phatak, head (cardiology) at Nanavati Super Speciality Hospital in Mumbai, running is good for the heart but middle-age people must go for a thorough cardiac check up and begin the regimen slowly.

“Nowadays, we do not guide middle-age people to run or jog. Running is good for younger people and I personally do not advise middle-aged people for long-distance running,” she told IANS.

Anyone who has run a marathon can witness the wear and tear on his body – especially heart.

“If a runner indulges in ‘chronic exercising,’ he or she needs to be extra cautious as it may have several damaging effects on the heart like irregular heartbeat, stiff heart muscles and building up of scar tissues on the heart,” cautions Dr Sanjat Chiwane, cardiology consultant from Columbia Asia Hospital in Gurgaon.

It is important not to compromise on heart health while increasing endurance.

“Take a professional consultation before preparing yourself for strenuous running activities. Many studies have suggested that marathons put unusual stress on the heart so one should not participate in it frequently,” adds Dr Chiwane.

“Those with high blood pressure, we direct them not to run or take part in any marathon,” stresses Dr Pathak.

The best precaution is to let yourself know how much is your limit.

“Assuming that for 30 years of your life, you never exercised or led an active life and suddenly you decide to go for the run. It will certainly affect your body and muscles,” explains Dr TS Kler, executive director (cardiac sciences) at Fortis Escorts Heart Institute and Research Centre in New Delhi.

There have been several deaths, mostly of people who are in their 40s, during the long-distance run in the recent past.

In July this year, a 43-year-old man collapsed and died while running for a marathon in Borivali, Mumbai. Doctors blamed existing ailments that spiked due to exercising and sudden pressure on the organs.

In February this year, a young techie lost his life due to cardiac arrest while running the half-marathon in Bengaluru.

A senior executive in a bank suffered cardiac arrest while running the Mumbai marathon in January last year. After being in comatose for nine months, he died.

marathon

In the US last year, two runners collapsed and died near the finish lines of half-marathons while a third runner collapsed and had to be resuscitated after completing the New York City half-marathon.

A study in the past has also found the link between sudden cardiac death and marathon running. Published in the Journal of the American College of Cardiology, the researchers found that marathon runners may harbour underlying and potentially lethal cardiovascular disease.

Although the risk of sudden cardiac death associated with such intense physical activity was one in 50,000, proper health screening is required to ensure that you are not that ill-fated person.

“Pre-participation medical evaluations are recommended before any strenuous sports activity to identify cardiovascular disease that has the potential to cause sudden cardiac death, stroke, angina or heart failure,” elaborates Dr S S Sibia, director of the well-known Sibia Medical Centre in Ludhiana.

Before you decide to run, tests like “ECG, treadmill, echo and a complete blood profile are required,” advises Dr Subhash Chandra, chairman (cardiology) at BLK Heart Centre in New Delhi.

“Those with abnormal lipid profile, hypertension, smokers and diabetics should be considered as having increased health risk for marathons,” adds Dr Sibia.

However, what experts recommend for a normal and healthy middle-aged person is to jog or run three km a day on five days a week.

“Sixty minutes of running is more than enough for a day. Give yourself a rest for a day in a week to calm your muscles,” stresses Dr Chiwane.

If you have made up your mind for the long-duration run, pay heed to these precautions:

First, consult the doctor to find out if your body is eligible to run marathon or not. Prepare yourself not just physically but mentally as well. Maintain your nutritional stores to keep your body fit. Take a break or two during marathons to rest your body, the experts emphasise. Keep yourself well hydrated, do not go overboard in your enthusiasm and look at the bigger picture.

Last but not the least, hire a good trainer who can give you a head start after examining your health thoroughly.

(IANS)

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C-Section Births Doubles In Number, Reaching Epidemic Proportions: Doctors

C-section is a type of major surgery, which carries risks that require careful consideration

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A newborn, one of 12 babies born by C-section, cries inside an incubator at the Bunda Hospital in Jakarta, Indonesia, Dec. 12, 2012. Several hospitals in Indonesia's main cities performed more cesareans than usual with new mothers hoping a 12-12-12 birth date will bring luck to their newborns. VOA

Worldwide cesarean section use has nearly doubled in two decades and has reached “epidemic” proportions in some countries, doctors warned Friday, highlighting a huge gap in childbirth care between rich and poor mothers.

They said millions of women each year may be putting themselves and their babies at unnecessary risk by undergoing C-sections at rates “that have virtually nothing to do with evidence-based medicine.”

In 2015, the most recent year for which complete data is available, doctors performed 29.7 million C-sections worldwide, or 21 percent of all births. This was up from 16 million in 2000, or 12 percent of all births, according to research published in The Lancet.

It is estimated that the operation, a vital surgical procedure when complications occur during birth, is necessary 10-15 percent of the time.

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The Yusuf Dantsoho Memorial Hospital has a high success rate with C-sections. Kaduna, Nigeria. Photo by Chika Oduah, VOA

Varying country rates

But the research found wildly varying country rates of C-section use, often according to economic status: In at least 15 countries, more than 40 percent births are performed using the practice, often on wealthier women in private facilities.

In Brazil, Egypt and Turkey, more than half of all births are done via C-section.

The Dominican Republic has the highest rate of any nation, with 58.1 percent of all babies delivered using the procedure.

But in close to a quarter of nations surveyed, C-section use is significantly lower than average.

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Maternal death and disability rates are higher after C-section Flickr

Reasons to opt for surgery

Authors pointed out that while the procedure is generally overused in many middle- and high-income settings, women in low-income situations often lack necessary access to what can be a life-saving procedure.

“We would not expect such differences between countries, between women by socioeconomic status or between provinces/states within countries based on obstetric need,” Ties Boerma, professor of public health at the University of Manitoba, Winnipeg, and a lead author on the study, told AFP.

Jane Sandall, professor of social science and women’s health at King’s College London and a study author, told AFP that there were a variety of reasons women were increasingly opting for surgery.

These include “a lack of midwives to prevent and detect problems, loss of medical skills to confidently and competently attend a vaginal delivery, as well as medico-legal issues.”

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It also identified an emerging gap between wealthy and poorer regions within the same country. Flickr

Doctors are often tempted to organize C-sections to ease the flow of patients through a maternity clinic, and medical professionals are generally less vulnerable to legal action if they choose an operation over a natural birth.

Sandall also said there were often “financial incentives for both doctor and hospital” to perform the procedure.

The study warned that in many settings young doctors were becoming “experts” in C-section while losing confidence in their abilities when it comes to natural birth.

Income a factor

It also identified an emerging gap between wealthy and poorer regions within the same country. In China, C-section rates diverged from 4 percent to 62 percent; in India the range was 7-49 percent.

C-sections
Worldwide, more than 11 percent of babies are born premature. Pixabay

While the U.S. saw more than a quarter of all births performed by C-section, some states used the procedure more than twice as often as others.

“It is clear that poor countries have low C-section use because access to services is a problem,” Sandall said. “In many of those countries, however, richer women who live in urban areas, have access to private facilities have much higher C-section use.”

Risks to mother, child

C-sections may be marketed by clinics as the “easy” way to give birth, but they are not without risks.

Maternal death and disability rates are higher after C-section than vaginal birth. The procedure scars the womb, which can lead to bleeding, ectopic pregnancies (where the embryo is stuck in the ovaries), as well as still- and premature future births.

 

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Doctors are often tempted to organize C-sections to ease the flow of patients through a maternity clinic. Flickr

 

The authors suggested better education, more midwifery-led care and improved labor planning as ways of ensuring C-sections are only performed when medically necessary, as well as ensuring women properly understand the risks involved with the procedure.

“C-section is a type of major surgery, which carries risks that require careful consideration,” Sandall said.

Also Read: Novel Blood Test May Predict Autism Risk In Babies During Pregnancy

In a comment accompanying the study, Gerard Visser of the University Medical Centre in the Netherlands, called the rise in C-sections “alarming.”

“The medical profession on its own cannot reverse this trend,” he said. “Joint actions are urgently needed to stop unnecessary C-sections and enable women and families to be confident of receiving the most appropriate care for their circumstances.”