Contact Us
Mental Health
Financial advice
Youth Matters
Techno Corner

M. P. Ravindra Nathan

The recent death of Tim Russert, the reputed NBC TV journalist, of a "sudden heart attack" at the young age of 58 was shocking and saddening. An autopsy found that Russert had an enlarged heart and significant coronary artery disease.

One wonders if this tragedy could have been prevented. Hopefully, this will raise public consciousness of a problem - sudden cardiac death - which claims more than 300,000 lives every year in USA. It is for this reason that during the recent four-day annual scientific sessions of the American College of Cardiology (ACC) in Chicago, "Take Action against heart attack" campaign was launched officially.

"Beating a heart attack is not a fantasy - it is within our reach," said Jack Lewin, MD, ACC - CEO. This is a comprehensive new effort to tackle heart disease, acute heart attacks in particular, at every stage of care from prevention to intervention to discharge and into secondary prevention. An extensive awareness campaign is being launched to educate the public. ACC has most definitely set its sight on an important target.

The Windy City was an appropriate venue to host this premier convention as the winds of change blew throughout the major scientific sessions. Over the years, this convention has been dispensing inspiring advice for physicians and their patients. Daily 'late-breaking clinical trials' sessions provided a rich variety of cutting-edge science from a host of studies, relevant to the modern medical practice.

For four days, about 30,000 people, including more than 10,000 physicians, scientists, nurses, nutritionists, industry participants, international guests and other health care providers gathered at the McCormick Convention Center and adjacent hotels to listen and learn from some of the most compelling figures in cardiovascular medicine today - like speakers from Harvard and NIH and leading authorities from all over the world. Some of the hot-button issues in cardiology - quality, health care reforms, defining best practices, new insights in the management of complex heart diseases, etc., were presented in an updated track format for easy comprehension.

Many sessions were held simultaneously, so the attendees could pick their choice, depending on their special interests in practice and research. Case studies were utilized with 'real world' patients showcasing clinical problems and giving enough time for audience feedback. The main emphasis was on quality in clinical practice because of the ever-increasing gaps in health care quality received by various sections in the society.

"The time has come to stop talking and start the transformation," said ACC President Dr. James T. Dove, MD, in his presidential address. "Redefining health care is a priority now. The newly developed ACC Appropriateness Criteria will guide our use of testing and procedures…Physicians must use health care dollars wisely and remain open to new techniques and tools. We have an opportunity to proactively lead social change."

On the first day, data presented from at least two clinical trials indicated that PCI (percutaneous coronary intervention - like balloon angioplasty/stent placement, etc.) can be performed successfully and safely in medical centers without onsite cardiac surgical back up, provided such programs are well organized and committed to quality. This certainly makes the life of patients who present to the suburban community hospitals a lot easier. There was considerable discussion on the latest 'coronary stent' advances. Currently, the major challenge is 'stent thrombosis' resulting in re-blockage. Newer bioengineered stents coated with antibody and biodegradable stents are in the pipeline.

Risk factors for heart attacks were critically analyzed and studied. "The persistence of tobacco smoking is the most powerful predictor of a heart attack," concluded a Greek study. Those first heart attack victims who continued to smoke had a 50 percent higher chance for recurrent heart attacks. Obesity, anxiety levels etc also posed high risk for heart attacks. Take home message? Pay attention to your emotional well being as well. If you have anxiety or depression, don't be shy, get treatment.

But if you were unfortunate to develop a heart attack, "The balloon is still riding high," meaning emergency opening of the occluded coronary artery by balloon angioplasty (with or without stent placement) is still the best treatment. The earlier you do this, the better the outcome. Every hospital that offers this procedure is trying to reduce the 'door-to-balloon time' to 90 minutes or less. So, if you get chest pains or symptoms suggestive of a possible heart attack, or if you are not sure what is happening, call 911 immediately. Always remember time is so precious during the first few minutes of a heart attack.

To be continued …

Cardiologist Dr. M. P. Ravindra Nathan, director of Hernando Heart Clinic in Brooksville, lives in Brooksville.



TV journalist Tim Russert has left us during a critical political season. His death refreshed sad memories in many Americans' hearts of loss caused by their loved one's heart failure. It certainly refreshed memory of my father's last night. He passed away before arrival of help.

There are 1.1 million people who are suffering with coronary artery disease in America and more than 300,000 people die of heart attack before help arrives. Sedentary (inactive) lifestyle is one of the top risk factors for heart disease. Fortunately, you can take some steps to reduce the risk factor. What can you do to minimize your risk factor for heart disease?

" Strengthen your heart and cardiovascular system.
" Improve your circulation and help your body use oxygen better.
" Improve your heart failure symptoms.
" Increase energy levels so you can do more activities without becoming tired or short of breath.
" Increase endurance.
" Lower blood pressure.
" Improve muscle tone and strength.
" Improve balance and joint flexibility.
" Strengthen bones.
" Help reduce body fat and reach a healthy weight.
" Help reduce stress, tension, anxiety and depression.
" Boost self-image and self-esteem.
" Improve sleep.
" Make you feel more relaxed and rested.
" Make you look fit and feel healthy.

How to put this long list in practice? The answer is an exercise program with healthy diet and regular medical checkup.

Regular exercise, especially aerobic exercise, has many benefits. Always start with stretching routines followed by the cardiovascular or aerobic exercises.

Stretching the arms and legs before exercising helps prepare the muscles for activity and helps prevent injury and muscle strain. Regular stretching also increases your range of motion and flexibility.

Cardiovascular or aerobic is a steady physical activity using large muscle groups. This type of exercise strengthens the heart and lungs and improves the body's ability to use oxygen. Aerobic exercise has the most benefits for your heart. Over time, aerobic exercise can help decrease your heart rate and blood pressure and improve breathing.

Again, regularity in your exercise is the key to any results. Regular walking in a neighborhood or on treadmill can be a starting point of your exercise program. Then improve exercise by adding bicycling, jumping, jogging or a few aerobic exercises such as steps, squats, lunges and crunches. Exercise will help you sleep better. Every one has way to relieve their stress physically. Some let go their stress, anger, frustration, sadness and negativity by running, some by kicking, etc. Exercise is the most positive way to cope with stress and anger. It fills the body with energy and empty the unwanted body garbage, including, excess fat, excess cholesterol and carbohydrate, stress, etc.

Our life pump is designed to last a lifetime. Preventive actions are the key to fight coronary artery disease. We need to educate our growing generation to take care of their health from childhood. Physical activities such as field sports and regular activities like running, jogging and bicycling can help kids to develop a healthy heart, which will help them to lead to a long and healthy life.

Achut Mashruwala of Fitness Guru Inc. can be reached at (813) 857-5103 or e-mail

Payal Patel

In the last part of my article, I would like to be more specific in my food choices as to better the choices for the whole family. After all, being healthy should be a family goal, as I had stressed in my prior article. Since food choices are extensive, here are some examples of the right food choices.

Starting with the morning, never skip breakfast. It is true that breakfast is the most important meal of the day; so start off with a healthy breakfast such as low-sugar cereals such as Total, All Bran or Kashi. When choosing cereal in the grocery aisle, look up on the top shelf, where the healthy cereals are put away. More sugary and artificial cereals are on the lower aisles (that's where the kids can see it and can demand it).

Incorporate oatmeal or cream of wheat (not instant) in the idlis, upmas, etc. If drinking tea or coffee, use decaffeinated if possible, and limit it to one cup per day. For children older than 2 years of age as well as adults, 2 percent, 1 percent or skim milk should be used. The older we get, the lower the percentage of milk fat we need.

If eating eggs, a great source of protein, use the egg whites instead of the yolk. When choosing breads or bagels, stay away from the white breads, which is made of enriched white flour and is deficient of any nutritional value. Choose 100 percent wheat or whole grain breads, which are a better source of nutrition and more filling. Avoid chevdas (fast food snacks), fried foods, etc.

Try to snack in between breakfast and lunch as well as between lunch and dinner on a piece of fruit such as a banana, apple, an orange, a cup of strawberries, or the best, blueberries (high in antioxidants). Plain yogurt is a good choice with some fresh fruit added for taste. Avoid eating flavored yogurt, which taste great but are loaded with sugar, and artificial sweeteners, and flavors.

Try a protein bar, found at GNC or even your grocery stores, which are great to curb appetite, especially if you have a time where you tend to snack or overeat, especially after coming home from work. Grab a handful of almonds, walnuts, pecans, etc., which also are great as a snack and a source of nutrition (provides essential fatty acids such as Omega 3 and Omega 6).

At dinner time, get the kids involved in making a salad - incorporate spinach, beets, tomatoes, bell peppers, beans such as garbanzos, etc. Use low-fat dressing; otherwise, stick to extra virgin olive oil mixed with some salt and pepper. When making chappatis, use whole wheat flour from your American grocery store mixed in with the Indian atta (flour), half of each to give it more nutritional value.

One medium size roti has about 80 calories without ghee (butter) vs. 130 calories with ghee. Avoid puris that are deep fried or even high in fat parathas with paneer, and loads of oil. Use more fresh vegetables to make parathas such as spinach, cauliflower, onions, garlic, etc. and use half the oil to cook it to avoid extra fat and calories. Use canola oil or olive oil to cook vegetables, dals, etc. Incorporate beans such as rajma (kidney beans), cholay (chick peas, Moong, and best of all, small red beans found only in American grocery stores.

This is a good source of protein, especially for vegetarians as well as a wonderful source of fiber. It aids in constipation and weight loss. For meat eaters, grill or bake meats rather than fry. Also, eat less red meat, which tends to be high in fat as well as cholesterol. Incorporate more vegetables into your cooking and stay away from fattening sauces, curries such as the ones used in Punjabi food.

Limit sodas, caffeinated drinks, juices, sports drinks, etc., and drink at least 8-10 glasses of water. If you crave for dessert, have a fresh fruit instead of fatty desserts such as cakes, cookies, etc. Instead of ice-cream, eat real fruit sorbets, bars, or choose frozen yogurt.

If you make sweets, use non-calorie sweetener or ¼ the amount of sugar called for in a recipe and add the rest with non-calorie sweetener. Eat half the amount you would otherwise. Use low-fat or fat-free evaporated milk and unsweetened condensed milk in a recipe that calls for condensed milk.

In conclusion, eat wholesome foods and avoid foods that are a source of empty calories, which can lead to weight gain. Grill or bake instead of frying, such as samosas, egg rolls, vegetables meats. Replace chips, fried snacks with fresh vegetable snacks or baked chips, etc. Learn to read food labels and understand how to incorporate it into your diet.

I hope that this four-part series has led to a more educated decision when it comes to lifestyle as a family.

I would like to thank Bhavi Patel, a registered dietitian in assisting me with this series on obesity. We wish you a healthy and active lifestyle to better the future of not only you but your children as well.

Dr. Payal Patel is a board-certified pediatrician at Sunshine Pediatrics, 18928 N. Dale Mabry Highway, Suite 102, Lutz. For information, call (813) 948-2679.

Contact Information
The Editor:
Send mail to with questions or comments about this web site. Copyright © 2004 Khaas Baat.

Anything that appears in Khaas Baat cannot be reproduced, whether wholly or in part, without permission. Opinions expressed by Khaas Baat contributors are their own and do not reflect the publisher's opinion.

Khaas Baat reserves the right to edit and/or reject any advertising. Khaas Baat is not responsible for errors in advertising or for the validity of any claims made by its advertisers. Khaas Baat is published by Khaas Baat Communications.