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High blood cholesterol is one of the most known risk factors of coronary heart disease. Previously cholesterol was supposed to be the most important cause of heart artery blockages but with more and more research data coming in, it has become one of the first three risk factors.Cholesterol is a type of fat particle present in the blood in small quantities. This waxy particle is made up of a single chain of fatty acid with 27 carbon atoms. The structure is so complex that this fatty acid is rotated in four rings – in combination called cyclo-pentano-perhydro-phenantherene ring. It is one of the most decorated molecules known to medical science. Cholesterol has very important functions in the body as it forms a part of the cell wall, nerve coverings and the brain cells. We cannot imagine life without this molecule. So important is the requirement of cholesterol in the body that the liver has a manufacturing capacity of the minimum amount of cholesterol required by the body.But if this molecule is present in a high quantity in the body or blood, the excess can be deposited to create coronary blockages. Not only is the heart affected; high cholesterol can also get deposited inside the brain arteries, leg arteries and also in the skin below the eyes.Cholesterol carried in the blood is in free form, which is very dangerous and it can be also carried in combination of proteins (known as lipo-proteins). There is a strong relationship of blood level of free cholesterol and the rate of deposition of blockages in the heart arteries.Previously it was presumed that a cholesterol level of 250mg/100ml of blood was normal and safe. This was about 20 years back. After further research, it was found that a level less than 220mg/100ml was okay in the next ten years. But the latest scientific research has now proved that any level more than 200mg/100ml is definitely not good. The normal range of this fat is now considered between 130 and 200mg/100ml of blood. Blood levels of cholesterol are high in those people whose diet is rich in cholesterol. Foods that contain high cholesterol are egg yolk, meat of any kind (mutton, beef, chicken, pork – red meat and white meat, fish). Another rich source is milk and its products like ghee, cream, butter, ice cream, chocolates, paneer, curd etc. This becomes the culprit in vegetarians, who depend heavily on milk. Any other fat, especially the saturated fatty acids are used in the liver to manufacture cholesterol.Cholesterol is mostly deposited in the heart arteries, after it is converted into LDL cholesterol, the so-called bad ‘low density lipo-protein cholesterol’.It is recommended very low cholesterol (130-160mg/ 100ml) in the blood. The total intake of cholesterol in the diet of a person should be as low as l0 mg/day. A vegetarian on milk diet consumes as high as 200-500mg cholesterol while a non-vegetarian consumes as high as l000 mg per day.In most of the developed countries it is compulsory to put a display on the food labels – the exact content of cholesterol in every food. Regular physical exercise, stress management, stopping of smoking can also lead to lowering of the cholesterol in the blood, besides control of diet.*12/283/5*
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Anybody can snore—great and near great, famous and infamous. Among the American presidents who shook the walls of the White House were Adams (both of them), Van Buren, Fillmore, Pierce, Buchanan, Lincoln, Andrew Johnson, Grant, Hayes, Arthur, Cleveland, Harrison, McKinley, Roosevelt (both of them), Taft, Harding, and Hoover. (Washington snored too, but he never lived in the White House.) Teddy Roosevelt once so disturbed the hospital where he was being treated that nearly every patient in the wing filed a complaint. Other historical noisemakers include Emperor Otho, Cato, King George (II and IV), Lord Chesterfield, Beau Brummel, Winston Churchill, and Benito Mussolini. And although snoring is rarely fatal, the nineteenth-century gunman John Wesley Hardin is reported to have been so annoyed by the noise generated by a guest sleeping in the same hotel that he went into the room and shot him to death.One patient told me his wife complained that she couldn’t hear the phone when he snored. Another was referred for treatment because his wife, a musician, couldn’t bear his off-pitch nocturnes. In Cincinnati a man who had been sentenced to three months in jail was released after only a few days; the other prisoners complained that his snoring constituted cruel and unusual punishment, and the warden agreed.(And humans are not the only players in this nighttime symphony. Among the animals who have been found to snore are buffaloes, camels, cats, chimpanzees, cows, dogs, elands, elephants, gorillas, horses, leopards, mules, oxen, sheep, tigers, and zebras.)One writer, motivated by complaints about his own nighttime noise, researched the topic and devised a classification system identifying eleven different types of snoring, to which he gave the names laryngeal, nasal, obesial, neurotic, pathologic, physiologic, functional, lateral, supine, prone, and pseudosnoring— noise which is made to add verisimilitude to the pretense of sleep. I must confess, however, I find that most of these labels fall far short of having any practical value in the management of sleep apnea.*142\226\8*
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Facial migraineIn some patients the pain of migraine is felt in the face, either in a distribution similar to that found in cluster headaches or lower down the cheek. In these cases, the pain is less severe, less sharp, and may last for a much longer time than in a classical or common migraine attack.
Basilar migraineThis usually occurs in young women. The headache is commonly over the back of the head and, besides nausea; the symptoms may include giddiness, double vision, unsteadiness, and slurred speech. Perhaps the most alarming symptom is loss of consciousness. These symptoms are due to a diminished blood supply to parts of the brain supplied by the basilar artery, a blood vessel at the base of the brain which goes into spasm to produce an attack.
Hemiplegic migraineThis is a very rare form in which there is a paralysis of the arm and leg on one side of the body. Fortunately the paralysis is temporary but it may be repeated. There is often a strong family history of similar attacks.
Ophthalmologic migraineThis, too, is rare and occurs particularly in children. During the attack, the eyelid droops, the pupil dilates, and the eye squints outward. Again these features are temporary and usually go when the headache stops.
Abdominal migraineThis occurs more commonly in women and its onset is usually in childhood. The pain is often over the upper part of the abdomen and lasts a few hours. The diagnosis is revealed by the family history of migraine and the occasional attacks in which the pain is preceded by about an hour of migraine, more commonly classical than common.
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