High Cholesterol

Overview

Hypercholesterolemia, or high cholesterol, is a high level of cholesterol in the blood that can cause plaque to form and accumulate leading to blockages in the arteries (atherosclerosis), increasing the risk for heart attack, stroke, circulation problems, and death.

What Is Cholesterol?
Cholesterol is a soft, waxy fat particle (lipid) that circulates in the blood. It has several important functions in the body: it is a building block for all cell membranes and many sex hormones, and is the digestive substance released by the gall bladder.

The body produces cholesterol in the liver. The liver, in fact, produces almost all of the cholesterol the body needs. However, many popular foods contain cholesterol and the substances used to produce cholesterol particles, which can increase the amount of cholesterol in the blood.

Evidence that High Cholesterol Levels are Bad
Many studies have looked at the relationship between high cholesterol levels and heart attack and death. In one study of young men without known heart disease, cholesterol levels were measured and participants were followed for 6 years. During this time, researchers recorded heart attacks and deaths that occurred in the participants.

The higher the cholesterol level, the greater the risk for having a fatal heart attack. In fact, the risk for a fatal heart attack is about 5 times higher in those with a cholesterol level of 300 mg/dL or more than in those with a cholesterol level below 200 mg/dL.

The Framingham Heart Study is probably the most famous ongoing heart study in the world. Cholesterol levels, smoking habits, heart attack rates, and deaths in the population of an entire town have been recorded for over 40 years. After 30 years, over 85% of people with cholesterol levels of 180 mg/dL or less were still alive; almost 33% of those with cholesterol levels greater than 260 mg/dL had died.

There have been many studies examining the relationship between cholesterol levels and heart attacks and death. There is overwhelming evidence that high cholesterol levels increase the risk for heart attack, circulation problems in the legs, stroke, and death.

What Cholesterol Levels Require Treatment?
There is no formula to determine what level of cholesterol is considered "safe" and what level of cholesteral requires treatment. Cholesterol experts, including those who wrote the NCEP guidelines, have come up with general recommendations based on ongoing research.

The NCEP based its recommendations, in part, on the future risk for heart attack. This makes sense, because someone who has no risk factors for coronary artery disease or heart attack can tolerate a somewhat elevated cholesterol level. In someone with established coronary artery disease, the risks for heart attack (or additional heart attacks) and death are much higher, so even a mildly elevated cholesterol level must be aggressively treated.

NCEP recommendations are based on the LDL cholesterol level because it correlates best with risk for heart attack and death, and because treatment of the LDL level has been the focus of recent studies.

All these considerations make the recommendations a little complex. Fortunately, several general guidelines have emerged. Different physicians may suggest different levels at which therapy should be started, and different goals of therapy, so it is important to discuss your levels with your doctor.

Many physicians recommend that patients without known atherosclerosis should strive to lower their LDL cholesterol level if it is above 160-190 mg/dL. The more risk factors for coronary artery disease one has (e.g., diabetes, high blood pressure, cigarette smoking, history of premature heart disease in parents or brothers and sisters), the less tolerance there should be for high LDL levels. Most physicians agree that patients with known atherosclerosis whose LDL levels are above 100-130 mg/dL should be treated.

Target LDL Cholesterol Level
There is no golden number below which an LDL level is considered "safe." Target levels vary, depending on the individual. Again, one should discuss the goals of cholesterol therapy with one's physician. The following is presented only as a general discussion.

Many physicians follow the recommendations of the NCEP and establish a target LDL level below 130-160 mg/dL for patients without known atherosclerosis. For patients with no other cardiac risk factors (e.g., diabetes, high blood pressure, cigarette smoking, family history of premature heart disease), a level below 160 may be acceptable.

For those with multiple cardiac risk factors, a level below 130 mg/dL may be considered more desirable. For those who have atherosclerosis, many physicians believe LDL should be brought down to a level below 100 mg/dL, the target level set by the NCEP

Treatment

The treatment approach to abnormal lipid levels differs depending on which lipid is high. For the purposes of simplicity, the focus here is on management of a high LDL ("bad") cholesterol level.

There are basically two ways to lower LDL cholesterol: with medication (pharmacological therapy) and without medication (nonpharmacological therapy).

Nonpharmacological Therapy
Standard nonpharmacological therapy consists primarily of modifying eating and exercise habits. This therapy often modestly reduces LDL cholesterol but is not likely to lower the LDL cholesterol level by more than about 30 mg/dL.

When can nonpharmacological therapy be used?
For people without atherosclerosis and with modestly elevated LDL cholesterol levels, the urgency to treat with medication is not great. An initial 6-12 month trial of nonpharmacological therapy may be advised by some physicians. If the LDL cholesterol has fallen to an acceptable level within that time frame, the patient can continue with these interventions only. If the level remains high, however, drug therapy should be initiated.

Changing diet can decrease the cholesterol level by about 8%-14%, which may be enough to reach the target level in some cases. However, diet and other lifestyle modifications generally do not decrease LDL levels by more than 30 mg/dL. If your LDL level is notably elevated, you may want to discuss with your doctor the possibility of adding drug therapy to your treatment plan.

People with established atherosclerosis have the incentive to significantly lower their high LDL levels. Most practitioners agree that both drug therapy and lifestyle modifications are needed, particularly because there is such good evidence that medication significantly decreases the chances of having a future heart attack or stroke and increases the chances for living longer.

What lifestyle changes can bring about lower LDL cholesterol levels?
Several are commonly accepted as positively impacting elevated cholesterol levels:

• Diet. Minimize excess cholesterol and fat intake, especially saturated fat. These fats raise cholesterol levels more than any other substances. Cholesterol and saturated fats are found primarily in foods derived from animals, such as meats and dairy products. Unwanted cholesterol and fats lurk in many foods that might never be suspected of having high amounts of these substances. Here are some dietary guidelines for reducing cholesterol and fat consumption:

1. Eat lean fish, poultry, and meat. Remove the skin from chicken and trim the fat from beef before cooking.

2. Avoid eating commercially prepared and processed food (cakes, cookies, etc.)

3. Increase the relative amount of fruits, vegetables, breads, cereals, rice, legumes, and pasta.

4. Use skim or 1% milk.

5. Avoid breaded fried foods.

6. Eat no more than 2 egg yolks (or whole eggs) per week.

7. Use cooking oils that are high in unsaturated fat (e.g., corn, olive, canola, safflower oils)

8. Use soft margarines. They contain less saturated fat.

• Weight loss. Losing modest amounts of weight (even only 5-10 lbs.) can double the reduction in LDL levels achieved through an improved diet. Weight loss should be achieved gradually by modestly decreasing calorie intake and increasing exercise.
• Exercise. Exercise can decrease LDL levels and increase HDL levels to some extent. For example, taking a brisk 30-minute walk or a low-level jaunt on a treadmill 3-4 times a week is likely to positively impact the cholesterol profile. Patients with chest pain and/or known or suspected heart disease should talk to their doctors before beginning any exercise program.

Pharmacological (Drug) Therapy
The introduction of HMG-CoA reductase inhibitors (or statins) significantly advanced the treatment of hypercholesterolemia. Statins lower LDL cholesterol levels by 20%-40%. At maximum doses, they lower LDL levels by an amazing 40%-50%. They provide the added benefit of modestly increasing HDL ("good") cholesterol levels, usually by about 5%-10%.

These agents are usually well tolerated, have few side effects, and need to be taken only once or twice a day. Because the body produces cholesterol primarily during the night, most of these medicines should be taken after dinner or during the evening. A high dose can be split and taken once in the morning and once in the evening.

Should patients already taking one of the older types of cholesterol-lowering medications switch to a statin? Several things should be kept in mind. First, some people are possibly being treated with a different type of medication because the primary lipid problem may not be a high LDL level but some other abnormality, such as a markedly high triglyceride level.

Second, if treatment with an older type of medication is working well and the patient is satisfied, there's no reason to change. However, if the person doesn't take the medication regularly because it's hard to remember to take several doses every day, because it has unpleasant side effects, or because it has failed to lower the LDL to an acceptable level, it may be worthwhile to discuss switching to one of the statins with a physician.

Statins. Commonly prescribed statins include: atorvastatin (Lipitor®), cerivastatin (Baycol®), fluvastatin (Lescol®), lovastatin (Mevacol), pravastatin (Pravachol®), and simvastatin (Zocor®).

There are two rare but potential side effects associated with these medications. The first, mild inflammation of the liver, can be detected by simple blood tests (liver function tests, or LFTs). The tests are usually performed once or twice during the first several months of therapy and then periodically (e.g., twice a year) thereafter. The second very rare side effect is muscle inflammation, soreness, pain, and weakness. Because this occurs so rarely, no routine testing is performed. However, a patient who develops diffuse muscle pain or weakness should speak with his or her doctor.

Occasionally, even with high-dose statin therapy, the LDL level may not decrease sufficiently. In this case, another cholesterol-lowering medication may be added.

Other medications. These medications, when combined with a statin, may help lower cholesterol to an acceptable level. Patients should be aware that using the combination may increase the risk for liver and/or muscle inflammation. These drugs include: cholestyramine (LoCHOLEST®, Questran®), colestipol (Colestid®), fenofibrate (Tricor®), fluvastatin (Lescol®), gemfibrozzil (Lopid®), and niacin (Niacinol®, Niacor®, Nicolar®, Slo-Niacin®).

Alternative Treatment

Most alternative medicines and therapies have not been subjected to scientific investigation, making it hard to assess their effectiveness. Some objective information, however, has emerged.

• Garlic. The medicinal properties of garlic (used by the Babylonians and other ancient peoples in their medicines) continue to be debated. The debate has instigated a number of studies examining garlic's effect on cholesterol levels. When combined, the results of some of the earlier studies suggest that garlic may lower total cholesterol levels by an average of about 9%. However, some of the recent, more well-designed studies (in which half of the group was treated with garlic and the other half with a placebo) have found no beneficial effect produced by garlic on either total cholesterol or LDL levels. What can be concluded from this? The best that can be said, from a scientific point of view, is that garlic may at most have a modest effect on cholesterol levels but should not be used instead of other interventions.
• Oat bran. Oat bran mania swept across the United States a decade ago. Research (including one report published in the New England Journal of Medicine) found that oat bran, per se, had little impact on cholesterol levels. Rather, any beneficial effects were attributable to the fact that people were eating more oat bran and less fat.
• Cholesterol-lowering margarine. The Food and Drug Administration (FDA) recently approved two of these products, Benecol® and Take Control®, for marketing. These margarines contain plant-derived substances that can decrease the absorption of cholesterol in the digestive tract. They modestly reduce cholesterol by about 7%-10%. They should not be used instead of drug therapy but can be added to a treatment plan for hypercholesterolemia.

Dental Caries

Dental Caries
Definition
A disease of the teeth resulting in damage to tooth structure.
Alternative names
Dental cavities; Tooth decay; Cavities - tooth

Causes, incidence, and risk factors
Dental caries (tooth decay) is one of the most common of all disorders, second only to the common cold. It usually occurs in children and young adults but can affect any person. It is the most important cause of tooth loss in younger people.

Bacteria are normally present in the mouth. The bacteria convert all foods-especially sugar and starch-into acids. Bacteria, acid, food debris, and saliva combine in the mouth to form a sticky substance called plaque that adheres to the teeth. It is most prominent on the grooved chewing surfaces of back molars, just above the gum line on all teeth, and at the edges of fillings. Plaque that is not removed from the teeth mineralizes into calculus (tartar). Plaque and calculus irritate the gums, resulting in gingivitis and ultimately periodontitis.

The acids in plaque dissolve the enamel surface of the tooth and create holes in the tooth (cavities). Cavities are usually painless until they grow very large inside the internal structures of the tooth (the dentin and the pulp at the core) and can cause death of the nerve and blood vessels in the tooth. If left untreated a tooth abscess can develop.

Plaque and bacteria begin to accumulate within 20 minutes after eating, the time when most bacterial activity occurs. If plaque and bacteria are left on the teeth, cavities can develop and untreated tooth decay can result in death of the internal structures of the tooth and ultimately the loss of the tooth.

Dietary sugars and starches (carbohydrates) increase the risk of tooth decay. The type of carbohydrate and the timing and frequency of ingestion are more important that the amount. Sticky foods are more harmful than nonsticky foods because they remain on the surface of the teeth. Frequent snacking increases the time that acids are in contact with the surface of the tooth.

Prevention
Oral hygiene is the primary prevention against dental caries. This consists of personal care (proper brushing at least twice a day and flossing at least daily) and professional care (regular dental examination and cleaning, every 6 months). Select X-rays may be taken yearly to detect possibily cavity development in high risk areas of the mouth.

Chewy, sticky foods (such as dried fruit or candy) are best if eaten as part of a meal rather than as a snack. If possible, brush the teeth or rinse the mouth with water after eating these foods. Minimize snacking, which creates a constant supply of acid in the mouth. Avoid constant sipping of sugary drinks or frequent sucking on candy and mints.

The use of dental sealants is a good means of cavity prevention. Sealants are thin plastic-like coating applied to the chewing surfaces of the molars. This coating prevents the accumulation of plaque in the deep grooves on these vulnerable surfaces. Sealants are usually applied on the teeth of children, shortly after the molars erupt. Older people may also benefit from the use of tooth sealants.

Fluoride is often recommended to protect against dental caries. It has been demonstrated that people who ingest fluoride in their drinking water or by fluoride supplements have fewer dental caries. Fluoride ingested when the teeth are developing is incorporated into the structure of the enamel and protects it against the action of acids.

Topical fluoride is also recommended to protect the surface of the teeth. This may include a fluoride toothpaste or mouthwash. Many dentists include application of topical (applied to a localized area of the skin) fluoride solutions as part of routine visits.

Symptoms

toothache -- particularly after sweet or hot or cold foods or drinks
visible pits or holes in the teeth
Signs and tests
An examination of the teeth reveals dental caries (cavities). Most dental caries are discovered in the early stages during routine checkups. The surface of the tooth may be soft when probed with a sharp instrument. Pain may not be present until the advanced stages of tooth decay. Dental X-rays may show some cavities before they are visible to the eye.

Treatment
Destroyed tooth structure does not regenerate. However, the progression of dental caries can be stopped by treatment. The goal of treatment is to preserve the tooth and prevent complications. Ideally proper dental education is the best weapon in preventing tooth decay.

In filling teeth, the decayed material is removed (by drilling) and replaced with a restorative material such as silver alloy, gold, porcelain, or composite resin. Porcelain and composite resin more closely match the natural tooth appearance, and may be preferred for front teeth. Many dentists consider silver amalgam (alloy) and gold as stronger and are often used on back teeth, although there is a trend to use high strength composite resin in the back teeth as well.

Crowns are used if decay is extensive and there is limited tooth structure which may cause weakened teeth. Large fillings and weak teeth increase the risk of the tooth breaking. The decayed or weakened area is removed and repaired and a covering jacket or "cap" (crown) is fitted over the remainder of the tooth. Crowns are often made of gold, porcelain or porcelain fused to metal.

A root canal is recommended if the nerve (pulp) in a tooth dies from decay or from a traumatic blow. The center of the tooth, including the nerve and vascular (blood vessel) tissue (pulp), is removed along with decayed portions of the tooth. The roots are filled with a sealing material. The tooth is filled and a crown may be placed over the tooth if needed.

PrognosisTreatment often preserves the tooth. Early treatment is less painful and less expensive than treatment of extensive decay. Anesthetics -- local, nitrous oxide (laughing gas), or other prescription medications -- may be required in some cases to relieve pain during or following drilling or other treatment of decayed teeth. For those who fear dental treatment, nitrous oxide anesthesia may be preferred.

Complications
tooth abscess
fractured tooth
discomfort or pain
tooth sensitivity
inability to bite down on tooth

Islamic Medical Tips

Honey's Nutrition & Health Facts

Honey's Nutritional Profile

Honey is a source of simple carbohydrates. Its composition on average, is 17.1 percent water, 82.4 percent total carbohydrate and 0.5 percent proteins, amino acids, vitamins and minerals. The average carbohydrate content is mainly fructose (38.5 percent) and glucose (31percent). The remaining 12.9 percent of carbohydrates is made up of maltose, sucrose and other sugars.

Source of Energy

As a carbohydrate, honey supplies energy at 64 calories per tablespoon, providing fuel to working muscles. A limited study at the University of Memphis Exercise and Sports Nutrition Laboratory found honey to be one of the most effective forms of carbohydrate gels to ingest just prior to exercise. According to Dr. Richard Kreider, the study's lead investigator, "honey appears to be a carbohydrate source that is relatively mild on its effects upon blood sugar compared to other carbohydrate sources." Continuing research is examining the effects of honey in comparison to different types of carbohydrate gels prior to weightlifting on the effect on glucose, insulin and markers of protein breakdown.

Other limited studies performed in Dr. Kreider's lab have shown that honey may comprise half of the secret to post-workout recuperation. Many post-workout products on the market combine a large amount of carbohydrates with protein. The most common carbohydrate source used is maltodextrin, a mildly sweet carbohydrate usually derived from corn. Upon comparison of a honey-protein vs. a maltodextrin-protein shake taken after a vigorous weightlifting workout, the honey-protein combination fared as well in promoting markers of muscle recuperation. The honey group's blood sugar was sustained for at least two hours post-workout. "Our data suggest that honey functions well in all of the aspects associated with post-workout recuperation and energy repletion. In addition, honey appears to stand out as perhaps a better source of carbohydrate to ingest with post-workout protein supplements. These findings support our previous study presented at the annual Experimental Biology meeting in April 2000," added Dr. Kreider.

"In addition to promoting muscle recuperation and glycogen [carbohydrates stored in muscle] restoration, honey-protein combinations also seem well suited to sustain favorable blood sugar concentrations after training."

Vitamins, Minerals and Amino Acids in Every Bite

Honey contains small amounts of a wide array of vitamins, minerals, amino acids and antioxidants. The vitamins found in honey may include (depending on floral variety) niacin, riboflavin and pantothenic acid; minerals present include calcium, copper, iron, magnesium, manganese, phosphorus, potassium and zinc. Just as the color and flavor of honey varies by floral source, so does the vitamin, mineral, antioxidant and amino acid content.

Antioxidants in Honey

In addition to the nutrients that are involved in normal metabolic activity, foods contain components that may provide additional health benefits. These nutrients are referred to as nutraceuticals. Phytochemicals are one broad category of nutraceuticals found in plants that are actively being investigated by scientists for their health-promoting potential. Honey has a phytochemical profile which includes polyphenols that can act as antioxidants.

Antioxidants perform the role of eliminating free radicals, which are reactive compounds in the body. Free radicals are created through the normal process of metabolism and contribute to many serious diseases. Researchers at the University of Illinois, led by Nicki J. Engeseth, Ph.D. and May R. Berenbaum, Ph.D., are studying the antioxidant capacity of common honey varieties.

Honey's Antimicrobial Properties and Benefits to Wound Healing

The use of honey as a wound dressing goes back to ancient times and has now been 'rediscovered' by modern medicine, according to Dr. Peter Molan of the University of Waikato, New Zealand. "It is a common observation in the many reports in medical journals that numerous benefits result from using honey to dress wounds," says Dr. Molan. The antibacterial properties of honey may help clear infection in wounds, and the anti-inflammatory action of honey may reduce pain and may improve circulation which hastens the healing process. According to Dr. Molan, "Honey stimulates the re-growth of tissue involved in healing, making healing faster and reducing scarring."

The Miracle of Honey

More than 1,400 years ago Allah and His Messenger, sallallahu alayhe wa sallam, told us that honey can heal a variety of medical problems.
Allah says in the Qur'an, "And the Lord inspired the bee, saying: Take your habitations in the mountains and in the trees and in what they erect. Then, eat of all fruits and follow the ways of your Lord made easy (for you). Then comes forth from their bellies a drink of varying color wherein is healing for men. Verily in this is indeed a sign for people who think." (16:68-69)
The Prophet, sallallahu alayhe wa sallam, has also told us of the healing found within honey for a variety of medical problems, including stomach ailments. One hadeeth reported by Bukhari, states that a man came to the Prophet sallallahu alayhe wa salaam, because his brother had stomach disorder. The Prophet, sallallahu alayhe wa sallam, said, "Let him drink honey." The man returned a second time, saying his brother had a stomach disorder, and again the Prophet, sallallahu alayhe wa sallam said, "Let him drink honey." The man returned a third time, saying again his brother had a stomach disorder. The Prophet, sallallahu alayhe wa sallam, responded again, "Let him drink honey." The man returned and said, "I have done that." The Prophet then responded, "Allah has told the truth, but your brother's stomach has told a lie. Let him drink honey." He drank it and was cured.
Tirmithi, Ibn Majah, and Baihaqi also reported that the Prophet, sallallahu alayhe wa sallam, said, "Make use of the two remedies: honey and the Qur'an."
Modern medicine is only just learning of this fact. Traditional uses of honey have included honey mixed with lemon for sore throats. Honey coats the throat and reduces throat irritation. Research has already shown that honey blocks the growth of oral bacteria. Honey has also been used for stomach pains and problems. Modern research shows that honey is effective when used in the treatment of gastric or peptic stomach ulcers. Research has also revealed that honey is effective in the treatment of various wounds and infections because of its antimicrobial (antibacterial, antiviral, and antifungal) properties.
Researchers are not absolutely sure why honey heals but they are learning new things about honey every day. We do know that honey contains a variety of sugars and minerals. Honey is also considered an antioxidant. This means it allows the blood to circulate better and provide more oxygen to areas of the body such as the brain. Honey can also be used externally to promote healing when applied to wounds, even postoperative wounds. Honey has also been effective in its use to treat burns. It has even been shown to be low in calories and useful as a sweetner for diabetics, people with heart disease or those overweight.
Although there is healing in honey for variety of medical disorders, certain precautions should also be taken. Children under the age of one year should never be give honey due to the possibility of infant botulism. This type of food poisoning can be dadly, however, it only seems to affect infants under on year of age. Also, if you have any known allergies to specific plants, then you should make sure the honey you are using is not made from that plant. People with allergies to bee stings should also be careful when using other bee-related products such as propolis or royal jelly. If these precautions are followed, then honey may provide healing for you. As Muslims, we must acknowledge and accept that Allah and His Prophet, sallallahu alayhe wa sallam, know better and have revealed the truth. We should, therefore, accept that honey can heal and make use of it. We should study the research that is available, not to confirm or deny the truth that has been revealed by Allah and His Prophet sallallahu alayhe wa sallam, but to learn of new ways we can use honey.

Benefits

MILK:
The Prophet (SAW) said thatmilk wipes away heat from the heart just as thefinger wipes away sweat from the brow. Itstrengthens the back, increases the brain, augments intelligence, renews vision and drives away forgetfulness.

HONEY:
? is considered to be the best remedy for constipation when mixed in hot water. It is the food of foods, drink of drinks and drug of drugs; gives appetite, strengthens the stomach, eliminates phlegm, can be used as a meat preservative, hair conditioner, eye salve and mouthwash. It is not only beneficial to drink in the mornings in warm water; it is also a sunnah.

OLIVE OIL:
Excellent treatment for skin and hair,delays old age, treats inflammation ofthe stomach.

MUSHROOM:
The Prophet (SAW) said that mushroom is a good cure for the eyes, it also serves as aform of birth controland arrests paralysis.

GRAPES:
The Prophet was very fond of grapes. It purifies the blood, provides vigourand health, strengthens the kidneys and clears the bowels.

DATES:
The Prophet (SAW) said thata house without dates has no food, also to be eatenat the time ofchildbirth .

FIGS:
It is afruit from paradise and a cure for piles.

BARLEY:
Good forfever in a soup form.


MELON:
Melon contains1000 blessings and 1000 mercies , the prophet SAW said 'None of your women who are pregnant and eat of watermelon will fail to produce offspring who are good in countenance and good in character.

POMEGRANATE:
The Prophet (SAW) said it cleanses you of Satan and evil aspirations for 40 days.

WATER:
The Prophet (SAW) said the best drink in this world and the next is water, when you are thirsty drink it bysips and not gulps, gulping produces sickness of the liver

--
Fi Aman Allah

with best wishes and regards
Khurram Shahzad
+92 - 333 - 5127596
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"صرف وہی چیز انسان کی قسمت میں ہے جس کے لیے وہ کوشش کرتا ہے۔ سورہ النجم آئت 39"