Creatine Kinase MB Isoenzyme and Myocardial Infarction

The proximity of patient, clinician and analyst improves the consultational opportunity for the care of patients suffering from myocardial infarctions. Very early diagnosis of myocardial infarction could be ascertained by bedside measurement of creatine kinase. The simplicity of the test procedure and the immediate availability of results make a significant contribution to the clinical diagnosis. There are many commercial kits for the bedside determination/measurement of creatine kinase (CK) and its MB coenzyme (CK-MB). Upto 40% of the creatine kinase activity of the heart muscle is CK-MB, and no other tissue contains high proportion. Marked increase in the plasma CK activity may only result in heart or skeletal muscle disease, but the plasma CK-MB increase is generally associated with heart muscle damage. The M-subunit of isoenzyme could be a derivative of MM isoenzyme of skeletal muscles or heart muscles and B-subunit could be a derivative of MB or BB forms of isoenzyme. It is well established that following myocardial infarction it may take several hours for CK and CK-MB activity to become normal. A sample of the patient should be analyzed on admission and two further samples should be obtained and analyzed at 6 and 12 hours. Smaller increases can be seen in dermatomyositis and progressive muscular atrophy but normal results are obtained in conditions such as poliomyelitis as the muscular abnormality is secondary to nerve lesions in this disease.

The test procedure uses dry-chemistry reagent slides for analytical measurement. The reagent preparation or blood sample preparation is not required. The color change is measured on a microprocessor-controlled instrument. The CK and CK-MB can be measured separately using specially prepared slides. For measuring CK activity (derivative of B-subunit of isoenzyme) M-subunit is neutralized by antibodies against M-subunit. Adenosine tri-phosphate (ATP) is formed by the action of CK on creatine phosphate and adenosine di-phosphate (ADP). Alpha-glycerophosphate is formed in the presence of glycerol and glycerol kinase. Further by the action of a-glycerophosphate oxidase, hydrogen peroxide is produced from the a-glycerophosphate. Hydrogen peroxide reacts with the peroxidase and oxidizes the colored dye, which is measured spectrophotometrically. Patients admitted within 12 hours of onset of severe chest pain, show elevated levels of CK-MB activity with 98% accuracy as compared to normal or non-infarction control subjects. As there is none or very little activity of CK in red blood cells (RBCs), so RBCs or hemolysis of blood sample does not interfere with the determination of CK-MB. The determination of CK-MB activity has been considered more sensitive investigation than aspartate transaminase or lactate dehydrogenase in myocardial infarction.

Who is God?

Different people had/have divergent views for and against the God. Modern people understand the modern words whereas the words of religious books and scriptures are beyond the understanding of many. There are certain things which have no physical shape or size but could be experienced, felt or appreciated like - cold, hot, beautiful, ugly, entertaining, painful, joyful
etc. The God is a cosmic energy without any definite size or shape and could be experienced though various techniques of meditation or self realization.

Human mind is like the pulse of a microprocessor of a computer and is powered by bioenergy attained through breathing. Inhalation and exhalation create positive and negative waves in our body and regulate various metabolic processes essential for life, emotions and desires. Ordinary human beings are overpowered by desires and run after Godmen for blessings for the fulfillment of their desires but fail to understand that the God is omnipresent and all pervading. The God is like the fragrance of a flower. The God is a positive energy and could be generated within through positive thinking and self realization. The God does not need any special prayer or sacrifice. Just trust your existence, love thyself and do good to others for attaining a positive aura. The truthfulness and kindness are two major attributes of the God and 'His' existence can be experienced through the attainment of these qualities.

Signs and Symptoms of Thyroid Disorders

Cretinism

Thyroid gland is associated with the general metabolism of all body tissues. Suboptimal activity of thyroid gland at birth leads to hypo-secretion of thyroid hormones and causes cretinism impairing the mental and physical growth of an infant or child. The child grows up a mentally retarded dwarf, unless diagnosed and treated with thyroid extract. The cretin child has a stunted body with broad face and wide nostrils. The mouth and tongue of a cretin child are so big that the mouth may not be closed properly. The affected child could have protuberant abdomen with an umbilical hernia. The child is very sluggish and cannot be taught to walk, talk and personal hygiene tips.

Hypothyroidism

Patients affected by under function of thyroid gland or hypothyroidism, develop generalized oedema called myxoedema (swelling of body). In myxoedema metabolic processes slow down with a tendency to gain weight. There is slowness of mind and speech and one feels lethargic. The skin becomes thickened and dry. The body temperature is subnormal, pulse slow and hair may fall or get thin. Treatment of hypothyroidism needs thyroid hormone as oral drugs. Pro-thyroid drugs used for treatment of hypothyroidism, increase the metabolic rate with a subsequent increase in catabolism. Self-medication of hypothyroidism is not advisable.

Hyperthyroidism

Enlargement of thyroid gland with increased secretion is termed as hyperthyroidism. In hyperthyroidism the metabolic rate is increased and the body temperature may be higher than the normal with very fast pulse rate. The patient loses weight and is nervous and excitable. The cardiac output is generally increased and cardio-vascular complications like fibrillation may develop if hyperthyroidism is not treated effectively and timely. However, enlarged thyroid gland could be associated with non-toxic or toxic goitre. Goitrous gland may have normal function or under function (hypothyroidism) or over function (hyperthyroidism). The exophthalmic goitre is known as Graves's disease and in this disease the eyeballs protrude. The effect is due to over activity of thyroid hormone and may not completely be reversed with treatment. The hyperthyroidism is treatable with anti-thyroid drugs but self-medication is not advisable as it could be harmful if other ailments like diabetes, cardiac problem or coagulopathies exist. Sometimes surgical removal of thyroid gland is also advised for the treatment of hyperthyroidism and thyrotoxicosis or the thyroid gland is bombarded with x-ray like radiations from radioactive iodine accumulated in the gland after it had administered to the patient.

Thyroid Gland and its Functions

Thyroid Gland and its Secretions

Thyroid is an endocrine gland situated in the front of neck. It consists of two lobes, lying one on each side of the trachea just below the larynx. Both the lobes are joined by narrow band of thyroid tissue called isthmus of thyroid. The gland receives very rich supply of blood and consists of a large number of vesicles formed by secreting cells grouped around the small cavities called alveoli. The thyroid alveoli contain very thick colloid or gummy substance, composed of thyroxine hormone, which is rich in iodine content. Secreting cells of the vesicles contain an internal secretion known as thyroglobulin which is broken down to thyroxine and released in the alveoli of thyroid. The thyroid gland governs the general metabolism of all body tissues. The triiodothyronine (T3) hormone is also present in the colloid of thyroid gland and blood plasma. The triiodothyronine (T3) has been found to be more active than thyroxine. Thyroxine is an iodine derivative of thyronine. Thyroxine has four iodine atoms in its molecule and could also be called T4 hormone. The function of thyroid is regulated by thyrotrophic hormone of the anterior lobe of pituitary gland. Normally thyroid is not palpable but may get enlarged where there is deficiency of iodine in water supply. Enlarged thyroid could be associated with non-toxic or toxic goitre. Goitrous gland may have normal function or under function (hypothyroidism) or over function (hyperthyroidism). Suboptimal activity of thyroid gland at birth leads to hypo-secretion of thyroid hormones and causes cretinism. Cretinism is a disorder of thyroid in which mental and physical growth are retarded.

Functions of Thyroid Gland

The thyroid gland controls the body metabolism in terms of temperature, pulse rate, respiratory rate, cardiac output, appetite, body weight, emotions, nervous temperament and intelligence. Though it looks strange to put the emotions, nervous temperament and intelligence under the metabolic functions but it is true that the metabolic changes influence all these. Thyroid gland and its iodine containing hormones play a vital role in metabolic processes of our body essential for good health.

Garlic as Herbal Antibiotic and Home Remedy

Garlic is one of the best sources of natural medicinal compounds, daily used by many as home remedy for a number of ailments. The botanical name of garlic is Allium sativa and it is a rich source of germanium, a mineral thought to strengthen the immune system. The health benefits of raw garlic are numerous, as are its uses. Use of garlic may play a big role in your overall health. It can protect you from digestive and allergic disorders, and provide prophylaxis against a wide range of infections and infestations. Garlic probably is nature's most potent immune system booster. Its aphrodisiac properties enhance the vitality and libido. Experimental studies have demonstrated that garlic has bactericidal action on over two-dozen bacteria. Though the modern physicians have bypassed the use of herbal antibiotics due to easy availability and reliability of pharmaceutical antibiotics, but the herbal antibiotics have least side effects.

The history of civilization stands testimony to the medicinal properties and use of garlic in a variety of ailments including atherosclerosis, rheumatoid arthritis, digestive disorders like dyspepsia and gastritis, stroke, cerebral aging, asthma, cough and cataract. The garlic's power as health promoter probably comes from germanium and rich variety of sulphur containing compounds, mainly allicin-an amino acid. It is a natural cholesterol buster also. Modern physicians have also appreciated its use in the treatment of cardiovascular diseases and hyperlipidemia. Some benefits of regular use of garlic are listed below:

• Garlic boosts the immune system and bone marrow.


• It provides prophylaxis against bacterial and viral infections.


• It helps lowering the blood pressure as it relaxes the smooth muscles and reduces the viscosity of blood.


• It helps to prevent and treat the cancer of digestive system.


• It is helpful in the management of hyperlipidemia as its regular intake lowers the LDL-cholesterol.


• Its regular intake can help to prevent atherosclerotic plaques in arteries.


• Regular consumption of raw or cooked garlic improves brain function and memory.

Important Tips:

• Chewing raw garlic should be avoided as it may cause very strong burning sensation on your tongue.


• Paste of raw garlic should be taken with curd, buttermilk (lassi), lemon water or hot curries.


• Paste of raw garlic and green coriander leaves with lemon juice with salt and pepper to taste is the best recipe to be taken with major meals.


• Curries and snacks cooked with garlic paste are equally beneficial.


• Daily intake of raw garlic in any recipe should not be more than 2 gram.