MAY 2013
Khaas Baat : A Publication for Indian Americans in Florida
Health & Wellness

ACC 13 Reporting from San Francisco
Improving Heart Health - Part I

By M. P. Ravindra Nathan,

This year, the Annual Scientific Session of the American College of Cardiology (ACC) was held in San Francisco. “Discovery to Delivery” for the improvement of Cardiovascular Health was the promotional tag line with which ACC greeted participants. The three-day international conference was a true intellectual feast featuring cutting-edge science presentations, practice management seminars, networking opportunities, hands-on learning instructions and, much more. Attending the ACC convention has become an annual pilgrimage for many practicing cardiologists.

William Zoghbi, MD, ACC president, reflected on some of the exciting efforts over the past year aimed at improving heart health. He stressed the growing role of data registries, proper use of diagnostic modalities and interventions and collaborations aimed at dealing with public health challenges both locally and globally. “The time is now for us to act. Together, we will conquer cardiovascular disease in the world,” said Zoghbi.

Valentine Fuster, MD, Director of Cardiology, Mount Sinai, N.Y., kicked off the program with the Simon Dack Lecture. “We have to promote health rather than just prevent disease, on a global basis. And this should start at a young age,” he said. Between the ages of 3 and 5, we develop our behavior as adults and hence it is important to raise health awareness in them. Already, such efforts are filtering into children’s TV programs like ‘Sesame Street’ thanks to the recommendations from ACC. The college has started a new initiative called ‘Cardio Smart,’ the focus of which is spreading the word about healthy living and healthy choices in the community.

Global CV Challenges

Industrialization, urbanization and rapid population growth have contributed to the high prevalence of CV diseases in many of the developing countries. Incidence of heart disease in India and among Indians abroad has gone up significantly. A special three-part series symposia on the first day provided a close-up look at many of these challenges with presentation of case studies from countries such as Brazil, India, China and Mexico. The panel noted that the real world practices especially in rural areas in many countries differ widely and there are considerable societal challenges in health care coverage and delivery, especially in the implementation of evidence based guidelines as practiced in the United States.

Public education campaigns will be a key strategy for improving outcomes. To solve the issue of poor compliance with medications, countries such as India and some in Europe are turning to the ‘poly pill’ concept. By combining a small dose of Lisinopril that will reduce high BP and retard the onset of diabetes, a generic Statin drug to reduce the blood cholesterol and Aspirin that keeps the blood thin and helps to prevent heart attacks, researchers noted we can achieve significant control of these common diseases at a low cost.

Stem Cell therapy

Texas Heart Institute conducted an excellent symposium on the ‘Future Direction of Stem Cells’ in CV disease. Stem cells, the mother cells that have the potential to become any type of cell in the body, will play a major role in the future of medicine. Adult stem cells can be harvested from the bone marrow and many groups are doing active research using stem cells for the repair of damaged heart muscle. Unlike previous thinking, we now know that heart is a regenerating organ. And the stem cells you inject can stimulate formation of new myocardial cells in the heart. Combined with genomic medicine arriving shortly, there is hope for seriously ill heart patients.

The patients with refractory angina who have already undergone the entire spectrum of therapy, including interventions such as angioplasty and bypass surgery, are most difficult to manage. Preliminary data presented showed those who received injections of autologous stem cells (CD34) into the heart experienced dramatic improvement in the frequency of their chest pains and exercise tolerance. A new study called ‘RENEW’ is being launched from many centers in USA recruiting eligible patients for stem cell therapy.

To be continued …


Spring clear of Eye Allergies!


We are at the onset of spring: beautiful climate, blooming flowers and chirping birds. However, about 1 in 5 Americans may have a different opinion of this season since they suffer from eye allergies.

We have seen the commercials for stuffy nose and scratchy throats but what about itchy, scratchy, red eyes? The eyes can also suffer from allergies.

Allergic eye reactions occur when a person is sensitive to an allergen. Eye allergies often affect the conjunctiva, the clear covering that covers the front white part of the eyeball. It is the same type of material that lines the inside surface of the nose. Because the two areas are so similar, allergens can trigger an allergic response in both areas. Therefore, people with nasal allergies may also suffer from eye allergies

When your eyes are exposed to anything to which you are allergic, histamine is released and the blood vessels in the conjunctiva become swollen. Reddening of the eyes develops quickly, along with itching and tearing

The most common symptoms patients may report (and may even be seasonal) can include:

Allergens can range from indoor allergens such as dust mites, mold and pets to outdoor allergens like pollen (a fine powdery substance, typically yellow, consisting of microscopic grains released into the air by trees, grass and weeds). 

Pollen is the most common culprit in spring and once pollen is inhaled into the nose or gets in the eyes of a person who is allergic, the immune system overcompensates; creating the irritable symptoms those sufferers must bear.

The pollens that cause symptoms vary from person to person and from area to area. Tiny, hard-to-see pollens that may cause hay fever include grasses, ragweed and trees.

The amount of pollen in the air can affect whether you develop symptoms. There is more likely to be increased amounts of pollen in the air on hot, dry, windy days. On cool, damp, rainy days most pollen is washed to the ground.

To confirm diagnosis, your eye doctor may conduct a thorough eye exam to determine the presence of conjunctival and eyelid swelling (papillae) and dilated blood vessels, which would confirm the diagnosis. In some cases, the doctor may use an instrument to scrape the conjunctiva to check for the presence of eosinophils – cells that are present in severe cases of eye allergies.

They may also corroborate with your allergist and primary care providers to rule out any systemic associations (diseases) and even ask for skin testing (patch tests) and new generation serum analysis.

Some basic steps that can be taken to provide relief or decrease impact and keep your eyes healthy during allergy season include:

  1. Minimize exposure to known allergens: This may include staying indoors when pollen counts are high, wearing sunglasses to prevent pollens from entering the eyes, reducing the amount of dust present in the home, and cleaning floors with a damp mop instead of a dry sweeper. Those suffering from eye allergies may try avoiding irritants such as cigarette smoke, air pollution and strong odors.

  2. Replacing your contact lenses with daily disposables lessens the opportunity for pollen to gather on the lens surface resulting in reduced eye irritation. Avoid wearing contact lenses altogether if possible during peak season.

  3. Treat associated dry eyes and use artificial tears to flush away the allergens and dilute the impact.

  4. Medications eye drops:

A: Over-the-counter (OTC) medications can be beneficial to those suffering from eye allergies. OTC artificial tears, decongestants and antihistamines can be effective in treating short-term symptoms. Decongestant eye drops are available without a prescription to help alleviate eye redness.

B: Prescription medications are highly effective in relieving symptoms. Antihistamines reduce itching, redness and swelling, usually rather quickly. Mast cell stabilizers may be used to help prevent the release of histamines, thus reducing symptoms.

  1. Oral medications: To help with symptoms of generalized allergies, including associated conditions.

Arun C. Gulani, M.D., M.S., is director and chief surgeon of Gulani Vision Institute in Jacksonville. He can be reached at or visit

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