Holistic Health Articles and Research Related to Herbal Medicines, Foods and Phytochemicals

Sunday, 1 December 2013

Hydrocephalus - The Causes and risk factors

Hydrocephalus, also known as "water in the brain" is defined as complex and multifactorial neurological disorders of accumulation of cerebrospinal fluid (CSF) in the cavity of brain of that can lead to intracranial pressure inside the side, resulting of brain trauma, stroke, infection, tumor, etc.
The Causes and risk factors
A. Causes
Although the actual causes of Hydrocephalus is unknown, some researchers suggested that
1. Genetic defect
Congenital hydrocephalus id associated with dysfunctional motile cilia represent the underlying pathogenetic mechanism in 8 of the 12 lines (Ulk4, Nme5, Nme7, Kif27, Stk36, Dpcd, Ak7, and Ak8).(3). Other researchers suggested that Although hydrocephalus is usually a sporadic disorder, there exist some rare but well delineated syndroms, in which recurrence is to be expected. The here presented Bickers-Adams-Syndrome of sex-linked hydrocephalus is caused by congenital aqueductal stenosis(4).

2. Meningitis
Hydrocephalus is associated with the complications of tuberculous meningitis (TBM) occurred in up to 85% of children with the disease. It is more severe in children than in adults. It could be either of the communicating type or the obstructive type with the former being more frequently seen(5).

3. Neural tube defect
Congenital hydrocephalus is a relatively uncommon abnormality in population malformation surveys accounting for between four and ten out of every 10,000 births. In the review of Sixty cases of 28 with NTD (group 1) and 32 without NTD (group 2). The groups were similar in terms of maternal and child variables at birth and hospitalization days during the 1st year of life. The mortality (including intrauterine deaths and deaths of babies with malformations incompatible with life that characterize a very poor prognosis) until 1 year of age was 36% in group 1 and 59% in group 2 (p = 0.077). The rate of cardiac malformations was higher in the group without NTD (p = 0.015). The length of hospital stay after birth (1st admission) was significantly higher in the group with NTD (p = 0.007)(6).

5. Intraventricular hemorrhage
Intraventricular hemorrhage and posthemorrhagic hydrocephalus are common causes of neonatal morbidity and mortality among preterm and low-birth weight infants (PT-LBWIs), but Intraventricular hemorrhage in PT-LBWIs remains a significant problem, particularly when it is associated with PHH leading to long-term neurological impairment and decreased survival rate(7).

6. PTB Deficiency
Polypyrimidine tract-binding protein (PTB) is a well-characterized RNA-binding protein and known to be preferentially expressed in neural stem cells (NSCs) in the central nervous system. Dr. Shibasaki T and the research team at the Center for Experimental Medicine and Systems Biology. showed that PTB depletion in the dorsal telencephalon is causally involved in the development of HC and that PTB is important for the maintenance of AJs in the NSCs of the dorsal telencephalon(8).

6. Tumors
Tumor-associated hydrocephalus is common in primary pediatric brain tumors. In the study of a total of 56.7% of cases presented hydrocephalus, including hydrocephalus that occurred at tumor diagnosis (51.5%), and hydrocephalus developed after tumor diagnosis (5.1%). At tumor diagnosis, the hydrocephalus was mainly obstructive type (98%) and rarely communicating type (1.9%). Definite shunting procedures in this series comprised of ventriculoperitoneal (VP) shunt in 54.4%, endoscopic third ventriculostomy (ETV) in 10.9%, subduroperitoneal (SP) shunt in 4.8%, septostomy in 0.7%, lumboperitoneal shunt in 0.6%, and ventriculoatrial shunt in 0.1% of patients with hydrocephalus(9).

7. Traumatic head injury
Post-traumatic hydrocephalus (PTH) is considered a frequent complication after severe head injury (HI). External hydrocephalus is a well-established entity in infants which is benign and usually resolves without shunting [1, 2]. The term “External Hydrocephalus” has also been used to describe the presence of extra ventricular cerebrospinal fluid (CSF) collections accompanied by hydrocephalus, particularly in cases of adults suffering from aneurysmal subarachnoid hemorrhage and severe head injuries [3–6]. Several other terms have been used to describe this entity [7] which has lead to confusion about this disease(10).

8. Subarachnoid hemorrhage
Acute hydrocephalus as a consequence of subarachnoid hemorrhage is a relatively frequent problem. Dr. Suarez-Rivera O. at the National Institute of Neurology and Neurosurgery, Mexico City, indicated that that acute hydrocephalus is present in 20% of patients with subarachnoid hemorrhage. One third of them may be asymptomatic on admission; 50% of those who have clinical hydrocephalus recover spontaneously within the first 24 h(11)

9. Etc.

B. Risk factors
1. Family history

Family studies suggested that the risk to siblings of a child with uncomplicated congenital hydrocephalus, where the anatomical site is not specified, is about 1 in 50 (1 in 40 for males, 1 in 80 for females). With aqueduct stenosis, the risk to brothers of affected boys is 1 in 22, to sisters only 1 in 50. The risks to siblings of sisters is less. Probably less than 2% of uncomplicated hydrocephalus has an X-linked basis and such an aetiology should be suspected if the special clinical features are present, there is more than one male sibling affected, or there are affected male relatives on the mother's side(12).

2. Nontumoral aqueductal stenosis, nontectal tumor and tectal glioma
Hydrocephalus was most commonly due to nontumoral aqueductal stenosis (43%), nontectal tumor (25%), or tectal glioma (13%). Five patients (16%) had multicystic/loculated hydrocephalus(13).

3. Preterm and low-birth weight infants
Preterm and low-birth weight infants are associated with increased risk of intraventricular and/or periventricular hemorrhage (IVH and PVH, respectively) of that can lead to Hydrocephalus(14).

4. Other factors
Although the precise nature of the neuropsychological deficits in hydrocephalus are not completely known, several factors such as etiology, raised intracranial pressure, ventricular size, and changes in gray and white matter tissue composition as well as shunt treatment complications have been shown to influence cognition. In fact, the presence of complications and other brain abnormalities in addition to hydrocephalus such as infections, trauma, intraventricular hemorrhage, low birthweight, and asphyxia are important determinants of the ultimate cognitive status, placing the child at a high risk of cognitive impairment(15).

5. Etc.
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Sources
(4) http://www.ncbi.nlm.nih.gov/pubmed/3907171
(5) http://www.ncbi.nlm.nih.gov/pubmed/19770534
(6) http://www.ncbi.nlm.nih.gov/pubmed/17934294
(7) http://www.ncbi.nlm.nih.gov/pubmed/16256848
(8) http://www.ncbi.nlm.nih.gov/pubmed/22705452
(9) http://www.ncbi.nlm.nih.gov/pubmed/21928036
(10) http://www.hindawi.com/journals/crim/2010/743784/
(11) http://www.ncbi.nlm.nih.gov/pubmed/9586937
(12) http://www.ncbi.nlm.nih.gov/pubmed/6524107
(13) http://www.ncbi.nlm.nih.gov/pubmed/22702328
(14) http://www.ncbi.nlm.nih.gov/pubmed/22116446
(15) http://www.ncbi.nlm.nih.gov/pubmed/11883667

Hydrocephalus - The Types

Hydrocephalus, also known as "water in the brain" is defined as complex and multifactorial neurological disorders of accumulation of cerebrospinal fluid (CSF) in the cavity of brain of that can lead to intracranial pressure inside the side, resulting of brain trauma, stroke, infection, tumor, etc.

I. Types of Hydrocephalus
1. Congenital hydrocephalus
Congenital hydrocephalus is a condition presented at birth as a result of genetic defect or abnormal fetal development. In the study to illustrate the value of knockout mice in identifying genetic factors involved in the development of congenital hydrocephalus, showed that dysfunctional motile cilia represent the underlying pathogenetic mechanism in 8 of the 12 lines (Ulk4, Nme5, Nme7, Kif27, Stk36, Dpcd, Ak7, and Ak8)... characterization of mouse models can enhance understanding of important cell signaling and developmental pathways involved in the pathogenesis of hydrocephalus(1). At least 43 mutants/loci linked to hereditary hydrocephalus have been identified in animal models and humans. Up to date, 9 genes associated with hydrocephalus have been identified in animal models. In contrast, only one such gene has been identified in humans. Most of known hydrocephalus gene products are the important cytokines, growth factors or related molecules in the cellular signal pathways during early brain development(2).

2. Acquired hydrocephalus
Acquired hydrocephalus is a condition developed after birth as a result of injure or diseases.

3. Communicating hydrocephalus or non-obstructive hydrocephalus,
Communicating hydrocephalus is defined as condition as the cerebrospinal fluid (CSF) can still flow between the ventricles.

4. Non communicating hydrocephalus or obstructive hydrocephalus
Non communicating hydrocephalus is defined as a condition as the cerebrospinal fluid (CSF) is blocked and can not flow between the ventricles.

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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/21746835
(2) http://www.ncbi.nlm.nih.gov/pubmed/16773266

The Article and Polycystic Ovarian Syndrome's research

Permanently Eliminate All Types of Ovarian Cysts and PCOs Within 2 Month, Click here

I. The article
Polycystic Ovarian Syndrome is defined as endocrinologic diseases caused by undeveloped follicles clumping on the ovaries that interferes with the function of the normal ovaries as resulting of enlarged ovaries, leading to hormone imbalance( excessive androgen), resulting in male pattern hair development, acne,irregular period or absence of period, weight gain and effecting fertility. It effects over 5% of women population or 1 in 20 women.

Ovarian cysts affect women of all ages, especially during a woman's childbearing years. Most ovarian cysts are functional and benign but some can become cancerous. Some ovarian cysts can cause bleeding and pain such as endometriomas/chocolate cysts and surgery is required for any cyst larger than 5 cms in diameter or if the cyst has interfered with the extruding of mature follicle. Traditional Chinese medicine defines ovarian cyst is a medical condition caused by excess- dampness (caused by blood and fluid stasis) accumulated in the abdomen and gradually coalesces into phlegm, that can manifest as that can manifest as ovarian cysts or various kinds, including chocolate cysts. In conventional medicine, ovarian cysts is defined as a collection of fluid, surrounded by a very thin wall, within an ovary.

Over the years as health article writer and researcher, I have received hundreds if not thousand of enquiry from women who have suffered from the affects of Ovarian cysts and Polycystic Ovarian Syndrome. Through the extensive research, some articles were written(1-5)) with an aim to help enquirers to understand more about the diseases, how they can manage the symptoms as well as treatments in conventional and holistic medicine perspective. Many recommendations have been given in herbal treatments from traditional Chinese and herbal medicine with medical studies proofs(6 -10). Unfortunately, all these types of treatment are required the correct differentiation of the diseases with specialists. Women who listened to these approaches have complained that they ended up with thousands of dollars expenses and spent lengthy time in the herbal specialist office before the diseases were cured. Women with less financial secure were recommended to a self help holistic treatment, the Ovarian Cyst Miracle written by Carol Foster with the same successful result.
Many women who know me through their friends recommendation and have tried the approaches insisted that the self help holistic treatment is the best as it is less financial burden (only $40) but to get rid of the Ovarian Cysts and and PCOs within 2 months, determination to follow the recommendations of the book is absolutely necessary. I, therefore recommend this book to all women who have suffered from the affects of Ovarian Cysts and PCOs to follow the approaches to eliminate all Ovarian Cysts and PCOS issues safely and naturally and regain the quality of life. Kyle J. Norton

All right reserves. Any reproduction of the article must have all link intact.

Sources
Polycystic Ovarian Syndrome
1. In Conventional Medicine Perspective
2.In Traditional Chinese Medicine Perspective
3. In Weight Loss Perspective
Ovarian Cysts
4. Ovarian Cysts In Conventional Medicine Perspective
5. Ovarian Cysts In Traditional Chinese Medicine Perspective
6. [Clinical observation on treatment of 43 women with polycystic ovary syndrome based on syndrome differentiation]
7. [Observation on therapeutic effect of acupuncture combined with chinese herbs on polycystic ovary syndrome of kidney deficiency and phlegm stasis type].
8. Treating adolescent ovarian cysts with Chinese herbs: a case report
9. Treating ovarian cysts with Chinese herbs: a case report.
10. Progress of integrative Chinese and Western medicine in treating polycystic ovarian syndrome caused infertility

II. The research
Permanently Eliminate All Types of Ovarian Cysts and PCOs Within 2 Month, Click here

Polycystic Ovarian Syndrome is defined as endocrinologic diseases caused by undeveloped follicles clumping on the ovaries that interferes with the function of the normal ovaries as resulting of enlarged ovaries, leading to hormone imbalance( excessive androgen), resulting in male pattern hair development, acne,irregular period or absence of period, weight gain and effecting fertility. It effects over 5% of women population or 1 in 20 women.

Angina pectoris - Treatments In Traditional Chinese medicine perspective

Angina pectoris, also known as Angina, a symptoms of Ischemic heart disease, is defined as a condition of chest pain caused by poor blood flow through the blood vessels due to obstruction or spasm of the coronary arteries resulting of lack of blood that lead to lack of oxygen supply and waste removal.
Treatments
In traditional Chinese medicine perspective

Traditional Chinese medicine defines angina as a diseases as a result of Ischemic heart disease (belongs to the categories of "xiong bi", "xin tong", "xin ji", "jue xin tong" and "zhen xin tong)either caused by Stagnation of Heart Blood of which leads to symptoms of localized stabbing chest pain aggravated at night, palpitation,restlessness, dark purple tongue, etc. in most cases or Heart Yin Deficiency of which lead to symptoms of chest pain and oppression, restlessness, insomnia, palpitation, night sweating, lumbago, weak waist and knees, dizziness, tinnitus. etc., in most cases

C.1. Formula(61)(62)

1. Jing Zhi Guan Xin Pian used for coronary heart disease, angina pectoris due to stagnation of heart blood

2. Ingredients

a. Radix Salviae Miltiorrhizae (Dan Shen)

b. Radix Rubra (Chi Shao)

c. Chuanxiong rhizome (Chuan Xion)

d. Flos Carthami. (Hong Hua)

e. Lignum Dalbergiae Odoriferae (Jiang Xiang0

C.2. Heart Yin Deficiency
1. Tian Wang Bu Xin Wan used for coronary heart disease, angina pectoris due to heart Yin Deficiency
2. Ingredients
a. Radix Salviae Miltiorrhizae (Dan Shen)
b. Rhizoma Acori Tatarinowii (Shi Chang Pu)
c. Radix Rehmanniae Glutinosae (Di Huang)
d. Radix Angelica Sinensis (Dang Gui)
e. Fructus Schisandrae Chinensis (Wu Wei Zi)
f. Tuber Ophiopogonis Japonici (Mai Men Dong)
g. Semen Ziziphi Spinosae (Suan Zao Ren)
h. Semen Biotae Orientalis (Semen Platycladi) (Bai Zi Ren)
i. Radix Codonopsis Pilosulae (Dang Shen)
j. Sclerotium Poriae Cocos (Fu Ling)
k. Radix Scrophulariae Ningpoensis (Xuan Shen)
l. Radix Polygalae Tenuifoliae (Yuan Zhi)
m. Radix Platycodi Grandiflori (Jie Geng)
n. Radix Glycyrrhizae Uralensis (Gan Cao)

Please consult with your doctor or related field specialist before applying

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Sources

(61) http://www.herbsbuy360.com/tongrentang-jing-zhi-guan-xin-pianfor-chd-p-1367.html#.UpvfX-Ja-QI

(62) http://www.activeherb.com/tianwang/

Angina pectoris - Treatments In Herbal medicine perspective

1. Organic Soybean is the genus Glycine, belonging to the family Fabaceae, one of the legumes that contains twice as much protein per acre as any other major vegetable or grain crop, native to Southeast Asia. Now, it is grown worldwide with suitable climate for commercial profit and a a healthy foods. The herb has been used in traditional medicine for the proper functioning of the bowels, heart, kidney, liver, stomach. etc.
a. Insulin sensitive
Soybean helps to normalize plasma glucose and insulin homeostasis, according to "Increased insulin sensitivity and changes in the expression profile of key insulin regulatory genes and beta cell transcription factors in diabetic KKAy-mice after feeding with a soy bean protein rich diet high in isoflavone content" by Nordentoft I, Jeppesen PB, Hong J, Abudula R, Hermansen K.(50)

b. Cardiovascular diseases
Soy protein reduces reduces the levels of serum lipoprotein, decrease in low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), LDL-C/high-density lipoprotein cholesterol (HDL-C), triacylglycerol/HDL-C and TC/HDL-Cpostmenopausal women are at risk of cardiovascular disease, according to "Effects of soy bean on serum paraoxonase 1 activity and lipoproteins in hyperlipidemic postmenopausal women" by Shidfar F, Ehramphosh E, Heydari I, Haghighi L, Hosseini S, Shidfar S.(51)

2. Garlic (Allium sativum) is a species in the onion genus, belonging to family Amaryllidaceae, native to central Asia. It has been used popularly in traditional and Chinese medicine in treating common cold and flu to the Plague, blood pressure cholesterol levels, natural antibiotic, etc.
a. Cholesterol

Eating 4 cloves of garlic a day can cut total CHOLESTEROL by 70%(Fresh or Supplement). The member of the allium family fights poor circulation.The sulfur compound in garlic keep your platelets from clumping together. It helps UNCLOG your Arteries but check with your Doctor if you are taking Blood thinning medications. Cook with both Garlic and onion to fight high blood pressure effectively. Try to take them everyday if you have high blood pressure and Cholesterol.

b. Blood pressure
In the assessment of garlic extract and its effect of hypertension. found that Aged garlic extract was generally well tolerated and acceptability of trial treatment was high (92%) and aged garlic extract is superior to placebo in lowering systolic blood pressure similarly to current first line medications in patients with treated but uncontrolled hypertension, according to "Aged garlic extract lowers blood pressure in patients with treated but uncontrolled hypertension: a randomised controlled trial" by Ried K, Frank OR, Stocks NP.(52)

7. Atherosclerosis
In the demonstration of aged garlic extract therapy with supplements (AGE+S) and theirs effect on cardiovascular diseases found that CAC progression was significantly lower and TR significantly higher in the AGE+S compared to the placebo group after adjustment of cardiovascular risk factors (p<0.05). Total cholesterol, LDL-C, homocysteine, IgG and IgM autoantibodies to MDA-LDL and apoB-immune complexes were decreased, whereas HDL, OxPL/apoB, and Lp (a) were significantly increased in AGE+S to placebo and concluded that AGE+S is associated with a favorable improvement in oxidative biomarkers, vascular function, and reduced progression of atherosclerosis., according to "Aged garlic extract supplemented with B vitamins, folic acid and L-arginine retards the progression of subclinical atherosclerosis: a randomized clinical trial" by Budoff MJ, Ahmadi N, Gul KM, Liu ST, Flores FR, Tiano J, Takasu J, Miller E, Tsimikas S.(53)

3. Alfalfa
a. Antioxidant
In a study of measurements of pH, water holding capacity, color, oxymyoglobin content, TBARS and oxidation-reduction potential in evaluating the effects of a dietary protein-xanthophylls (PX) concentrate of alfalfa to turkey diets conducted by University of Life Sciences in Lublin, Skromna 8, 20-704 Lublin, (54), researchers found that TBARS and oxidation-reduction potential values suggested that the inclusion of the concentrate to turkey diets acts as an antioxidant in the raw meat.

2. Cholesterol
In a study to test the effect of Alfalfa used in traditional medicine to treat high blood cholesterol conducted by Malinow MR, McLaughlin P, Stafford C.(55), in 3 human volunteers during ingestion of diets containing alfalfa seeds (AS) for 3 weeks, researchers found that Plasma cholesterol concentrations were reduced and No signs of toxicity were detected through serum determinations of multiple parameters. The ingestion of AS in rats decreased the concentration of plasma cholesterol, reduced intestinal absorption of exogenous and endogenous cholesterol, and increased fecal biliary excretion.

3. Hyperlipoproteinemia
In a study of Fifteen patients with hyperlipoproteinemia (HLP), types IIA (n = 8), IIB (n = 3) and IV (n = 4) were given 40 g of heat prepared alfalfa seeds 3 times daily at mealtimes for 8 weeks with otherwise unchanged diet, conducted by Mölgaard J, von Schenck H, Olsson AG.(3), found that patients with type II HLP alfalfa treatment caused after 8 weeks a maximal lowering of pretreatment median values of total plasma cholesterol from 9.58 to 8.00 mmol/l (P less than 0.001) and low density lipoprotein (LDL) cholesterol from 7.69 to 6.33 mmol/l (P less than 0.01), which corresponds to decreases of 17% and 18%, respectively. Maximal decrease was 26% in total cholesterol and 30% in LDL cholesterol. In two patients with hypercholesterolemia the LDL cholesterol decreased less than 5%. Apolipoprotein B decreased in the same period from 2.17 to 1.43 g/l (P less than 0.05) in type II HLP, corresponding to 34% decrease, whereas apolipoprotein A-I did not change. Body weight increased slightly during the first 4 weeks of alfalfa treatment (P less than 0.001) probably because of the caloric content in the alfalfa seeds. After cessation of treatment, all lipoprotein concentrations returned to pretreatment levels. We conclude that alfalfa seeds can be added to the diet to help normalize serum cholesterol concentrations in patients with type II HLP.

4. Ginkgo biloba
a. Hypertension
Ginkgo enhanced endothelium-dependent vasodilation and elevation of the endothelial intracellular Ca(2+) level in SHR, resulting in hypotension, according to the study of "Effects of Ginkgo biloba extract on blood pressure and vascular endothelial response by acetylcholine in spontaneously hypertensive rats" by Kubota Y, Tanaka N, Kagota S, Nakamura K, Kunitomo M, Umegaki K, Shinozuka K.(56)

b. Cardiovascular tissues
Ginkgo biloba extract (EGb) has shown the protection of the cardiovascular tissues against HgCl(2)-induced oxidative damage, according to the study of "Protective effects of Ginkgo biloba extract against mercury(II)-induced cardiovascular oxidative damage in rats" by Tunali-Akbay T, Sener G, Salvarli H, Sehirli O, Yarat A.(57)

c. Hyperlipidemia
Ginkgo biloba leaves (EGB) has demonstrated the activities of limitation of the absorption of cholesterol, inactivation of HMGCoA and favorable regulation of profiles of essential polyunsaturated fatty acid (EFA), according to the study of "Application of GC/MS-based metabonomic profiling in studying the lipid-regulating effects of Ginkgo biloba extract on diet-induced hyperlipidemia in rats" by Zhang Q, Wang GJ, A JY, Wu D, Zhu LL, Ma B,(58)

5. Grape seed extract
Grape Seed Extract is the commercial extracts from whole grape seeds that contains many concentrations, including vitamin E, flavonoids, linoleic acid, oligomeric proanthocyanidins(OPCs), etc..The herb has been used in traditional medicine as antioxidant, anti-inflammatory agents and to treat skin wounds with less scarring, allergies, macular degeneration, arthritis, enhance circulation of blood vessels, lower cholesterol, etc.
a. Antioxidant Activity
in the assessment of phenolic content, antioxidant activity of White and red wines spiked with green tea extract and grape seed extract found that the green tea extract and grape seed extract increased antioxidant activity dose-dependently and the CRTs varied considerably between the Korean and Australian groups, with Koreans preferring wines spiked with green tea extract and Australians showing a preference for wines spiked with grape seed extract, according to "Total Phenolic Content, Antioxidant Activity and Cross-Cultural Consumer Rejection Threshold in White and Red Wines Functionally Enhanced with Catechin-Rich" by Yoo YJ, Saliba A, Prenzler PD, Ryan DM.(59)

b. Atherosclerosis
in the association of consumption of red wine and other polyphenolic compounds and prevention of cardiovascular diseases found that aortic atherosclerosis evaluated as the cholesterol content in aortic tissue was comparable in the control and GSE-dosed females, but it was significantly reduced in the abdominal part of GSE-dosed male compared to the controls (P < 0.05). In conclusion, feeding GSE extract to Watanabe heritable hyperlipidemic (WHHL) rabbits had no significant effects in females but was associated with transient less hypercholesterolemic response to semisynthetic diet, according to "Effects of red grape skin and seed extract supplementation on atherosclerosis in Watanabe heritable hyperlipidemic rabbits" by Frederiksen H, Mortensen A, Schrøder M, Frandsen H, Bysted A, Knuthsen P, Rasmussen SE.(60).
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight

Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer

Back to General health http://kylejnorton.blogspot.ca/p/general-health.html

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Sources
(50) http://www.ncbi.nlm.nih.gov/pubmed/18522411
(51) http://www.ncbi.nlm.nih.gov/pubmed/18608549
(52) http://www.ncbi.nlm.nih.gov/pubmed/20594781
(53) http://www.ncbi.nlm.nih.gov/pubmed/19573556
(54) http://www.ncbi.nlm.nih.gov/pubmed/20580166
(55) http://www.ncbi.nlm.nih.gov/pubmed/7379953
(56) http://www.ncbi.nlm.nih.gov/pubmed/16451753
(57) http://www.ncbi.nlm.nih.gov/pubmed/17072828
(58) http://www.ncbi.nlm.nih.gov/pubmed/19960012
(59) http://www.ncbi.nlm.nih.gov/pubmed/22133028
(60) http://www.ncbi.nlm.nih.gov/pubmed/17441214

Angina pectoris - Treatments In conventional medicine perspective

Treatments

A. In conventional medicine perspective

In the summation of the evidences of angina pectoris' optimal treatment, Dr. Jánosi A. at the Fovárosi Onkormányzat Szent János Kórház-Rendelointézet III. Belgyógyászat, indicated that the first steps of therapy are - after the diagnosis - the influence of risk factors, life-style changes and optimal medical therapy. The optimal medical therapy consists of statin, aspirin and ACE inhibitor treatment besides antianginal therapy, where the beta blockers are regarded as first drugs of choice. Percutaneous interventions as initial treatment option are not recommended because we have no evidences that this intervention prolongs life and prevents myocardial infarction. If the patient remains symptomatic after medical treatment, it is necessary to perform revascularization(43a).

A.1. Medical treatments
1. 1. Nitroglycerin
a. Nitroglycerin is used to treat ischemic cardiac pain. and improve blood flow to the heart. Transdermal nitrate delivery systems improve the quality of life in ambulant patients: anginal attacks are reduced with a minimum of side effects. The widespread acceptance of this novel form of drug delivery has stimulated its application in other therapeutic avenues. The efficacy of transdermal nitroglycerin in the suppression of silent ischemic attacks has been demonstrated(43)
b. Side effects are not limit to
b.1. Dizziness
b.2. Lightheadedness, or fainting when sitting up or standing
b.3. Flushing of face and neck
b.4. Headache
b.5. Irritation
b.6. Nausea
b.7. Vomiting
b.8. Etc.

1.2. Beta-blockers
a. Beta blocker has been used to lower heart rate, blood pressure, and enhance oxygen to the heart. In the study of The 248 cases presented with new coronary heart disease from 1982 through 1984, and the 737 controls were a probability sample of health maintenance organization patients free of coronary heart disease. A withdrawal syndrome immediately following the cessation of beta-blocker use may be an acute precipitant of angina and myocardial infarction in hypertensive patients who have no prior history of coronary heart disease(44).
b. Side effects are not limit to
b.1. the medicine can cause allergic reaction to certain people, such as: rash, itching, swelling, dizziness, trouble breathing.
b.2. Easy bruising or bleeding,
b.3. Swollen hands or feet,
b.4. Confusion,
b.5. Depression
b.6. Etc.

1.3. Calcium channel blockers
a. The medicine used to relax arteries, lower blood pressure, and reduce strain on the heart. Researchers suggested that Compared with clopidogrel without calcium-channel blockers (CCBs), clopidogrel with CCB does not increase the mortality or composite thromboembolic events in elderly CAD patients, but clopidogrel combined with nondihydropyridine CCB is associated with significantly increased composite thromboembolic events in comparison with dihydropyridine CCB(45).
b. Side effects are not limit to
b.1. Stomach pain
b.2. Constipation
b.3. Drowsiness
b.4. Fatigue Feelings of a rapidly or forcefully beating heart (palpitations)
b.5. Flushing or hot flashes
b.6. Headaches
b.7. Nausea
b.8. Etc.

1.4. Statins
a. The medicine used to lower cholesterol. Dr. Biasucci LM, and the scientists at the Sacro Cuore University, in the study of Statins and coronary artery disease:clinical evidence and future perspective said "The introduction of more powerful statins in the market offered the opportunity to study whether an intensive lipid lowering treatment could yields even better cardiovascular outcomes than a moderate statin therapy and several clinical trial confirmed this hypothesis. Statins have also pleiotropic effect behind their lipid lowering function: they reduce inflammation, which plays an important role in the atherosclerotic process"(46).
b. Side effects are limit to
b.1. Headache
b.2. Nausea
b.3. Vomiting
b.4. Constipation
b.5. Diarrhea
b.6. Weakness
b.7. Muscle pain
b.8. Etc.

1.5. Aspirin
a. Many researchers believe that daily intake aspirin can reduce the risk of blood clots from forming in your arteries. In the study to determine the cardiovascular and coronary risk thresholds at which aspirin for primary prevention of coronary heart disease is safe and worthwhile, Dr. Sanmuganathan PS and the research team at the Royal Hallamshire Hospital, indicated that Aspirin treatment for primary prevention is safe and worthwhile at coronary event risk >/= 1.5%/year; safe but of limited value at coronary risk 1%/year; and unsafe at coronary event risk 0.5%/year. Advice on aspirin for primary prevention requires formal accurate estimation of absolute coronary event risk(47).
b. Side effects are not limit to
b.1. Stomach pains
b.2. Feelings of nausea
b.3. Vomiting.
b.4. Allergic reaction to some people
b.5. Aspirin may interact with other medicine, such as blood thinning medicine
b.6. Etc.

2. If the underline causes of Angina is a result of Ischemic heart disease, then
a. Percutaneous Coronary Intervention (PCI )
Percutaneous Coronary Intervention (PCI ) is one therapeutic treatment used to treat the narrowed coronary arteries of the heart found in coronary heart disease and Ischemic heart disease. In study of a total of 282 patients (74.1% females) with mean age of 57.0±3.2 years were studied. Most of the patients (89.7%) underwent elective PCI. Angiographic and procedure success rates were 95.7% and 94.6%, respectively. In-hospital MACE included two cases of death (0.7%) and one MI (0.3%); 2/29 (6.9%) of the emergent PCI and 1/253 (0.4%) of the elective PCI cases. MACE during follow-up included three cases of death (1.0%) and two MI (0.7%); 2/252 (0.8%) of the elective PCI and 1/28 (3.5%) of the emergent PCI cases. The overall MACE was calculated as 8 cases (2.8%) which included 5/29 (17.2%) of the emergent and 3/253 (1.1%) of the elective cases; P<0.001, concluded that PCI is performed with an acceptable success rate in our center in Isfahan and mortality and complications are within the range reported by other highly specialized centers in IRAN. Further studies with larger sample size are needed to find predictive factors(48).

b. Coronary revascularisation
Coronary artery bypass grafting (CABG)
Coronary artery bypass grafting (CABG) is a surgical procedure performed to reduce the risk of death from coronary artery disease by bypass atherosclerotic narrowings as arteries or veins from elsewhere in the patient's body are grafted to the coronary arteries to improve the blood supply to the heart muscle. some researchers suggested that transthoracic echocardiography(TEE) prior to coronary artery bypass surgery can provides higher resolution images than transthoracic echocardiography (TTE). Therefore one can conclude that TEE is the imaging modality of choice for detecting aortic atheromatous plaques but in patients with low risk for stroke and aortic atheromas, a detailed TTE may be sufficient for the pre-operative assessment(49).
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Sources
(43a) http://www.ncbi.nlm.nih.gov/pubmed/18258559
(43) http://www.ncbi.nlm.nih.gov/pubmed/3088957
(44) http://www.ncbi.nlm.nih.gov/pubmed/1968518
(45) http://www.ncbi.nlm.nih.gov/pubmed/22543122
(46) http://www.ncbi.nlm.nih.gov/pubmed/22495163
(47) http://www.ncbi.nlm.nih.gov/pubmed/11179262
(48) http://www.ncbi.nlm.nih.gov/pubmed/22577441
(49) http://www.ncbi.nlm.nih.gov/pubmed/22614701

Angina pectoris - The Antioxidants

1. Nitric oxide (NO)
Nitric oxide (NO), one of the antioxidant and peroxynitrite can inhibit pathways of oxygen radical generation, and, in turn, oxidants can inhibit NO synthesis from NOS.

2. Glutathione and vitamin E
Reduced form of glutathione may act as a first line of defense against oxidative stress during ischemia–reperfusion while vitamin E may act later on during severe oxidative stress by rendering resistance to the heart against the ischemic–reperfusion injury

3. 2-dithiole-3-thione (D3T)
Researcher found that in rat cardiac H9c2 cells, D3T and time-dependent induction of a number of cellular antioxidants and phase 2 enzymes, including catalase, reduced glutathione (GSH), GSH peroxidase, glutathione reductase (GR), GSH S-transferase (GST), and NADH:quinone oxidoreduc- tase-1 (NQO1) help to protect against H9c2 cell injury caused by various oxidants and simulated ischemia-reperfusion. D3T pretreatment also resulted in decreased intracellular accumulation of reactive oxygen in H9c2 cells after exposure to the oxidants as well as simulated ischemia-reperfusion.

4. Selenium
Deficiency of of a co-enzyme selenium, which is required in maintaining the glutathione redox cycle, also promote more susceptible to oxidative injure.

5. Etc.