The Health Cafe

A bit of Crunchy Coolness and a whole lot more!

2012-10-16T21:48:00.000+05:30

Thinking of ways to beat the heat this summer? The cooling crunchy cucumber could be the ideal solution! This refreshingly wonderful vegetable with its unique flavor is one of the oldest cultivated crops and is believed to have originated in the plains of northern India. Currently, it’s the fourth most commonly grown vegetable in the world, after tomatoes, onions and cabbage. And the perfect cucumber is best harvested when it is tender and sweet, just short of reaching maturity.
Cucumbers are not just a wonderful way of replenishing water and electrolytes in your body, they are also a storehouse of essential vitamins and nutrients, so keep reading on to see what cucumbers have to offer us…
Cucumbers are amazingly low in calories, just 16 calories per cup, and have no sodium, fat or cholesterol to boot! The 3g of carbohydrates that come with a serving of cucumbers is just enough to give you a perk -without the side-effects of weighty issues! Aside from this, cucumbers are also rich in fiber content (when consumed unpeeled), which when combined with the 1g of protein in it, serves as a fat burner.
A single serving of cucumber will give you vitamins A, C, K, B1, B6, B9 as well as potassium, calcium, manganese, iron, selenium and zinc. However, it’s important to note that cucumbers do not contain large quantities of these vitamins and minerals. But a cup of this vegetable does provide you with small doses of nearly all essential vitamins and minerals. So what we are essentially saying is that though cucumbers aren’t nutritional rock stars, the fact remains that they are a great way of boosting your daily vitamin and nutritional intake.
Health Benefits Cucumbers are no longer considered just as a refreshing salad accoutrement, they have emerged as a bona fide tasty and healthy vegetable in their own right. Usually eaten along with other things, here are some reasons to honor the humble cucumber and elevate them to essential veggie status.
Cucumber for Eyes: They are used the world over as eye pads for treating dark under-eye circles or for refreshing tired eyes after a long days work. Cucumber also helps in reducing swelling around the eyes.• Cucumber for Skincare: Cucumbers are the proverbial magic wands when it comes to skin care. Due to its high water content and vitamins and minerals, cucumbers are an integral part of many skincare products, face packs and facials and can be used for skin tightening as well as cleansing; cucumber skin is a great antidote to caring for sunburns and windburns. • Cucumber for Anti-Aging: Cucumbers contain a great combination of anti-oxidants such as alpha-carotenes, beta-carotenes, vitamin A, vitamin C, zea-zanthin and lutein. These natural compounds act as protective scavengers -flushing out free oxygen radicals and reactive oxygen species (ROS), which are the villains in the aging process and other disease conditions.• Cucumbers for Hydration: Cucumbers have a water content of over 90% which is more nutritious than regular water; this makes it a great way of keeping the body hydrated and regulating the body temperature. It helps in flushing out harmful toxins from the body too.• Cucumbers as Diuretics: The water content of the cucumber acts as a diuretic and promotes the elimination of toxic waste products from the body through urination. It’s believed that regular intake of cucumbers can result in dissolving bladder or kidney stones.• Cucumbers for Blood Pressure: Cucumbers can be used for controlling both low and high blood pressure by virtue of their potassium and magnesium content. A cup of cucumber contains about 181mg of potassium and 16mcg of magnesium- both minerals are essential to controlling and reducing blood pressure. The potassium is a heart-friendly mineral and also reduces heart rates by countering the effects of sodium. • Cucumbers for Bone Strength: The high content of vitamin K in cucumbers has been found to play a potential role in controlling bone loss and increasing bone mass. A cup of cucumber can provide up to 17mcg of vitamin K.• Cucumber for Gout and Arthritis Relief: Blended cucumber and carrot juice are great in relieving pain caused by arthritis or gout, as they lower the uric acid levels. The rich vitamin A, B1, B6, C, D and K as well as calcium, magnesium and folates present in cucumber are responsible for this action. Cucumbers are also an excellent source of silica, which is well known for promoting connective tissue strengthening and improving general joint health. Those on the wrong side of 40’s, please take note.• Cucumber for Healthy Teeth and Gums: Cucumbers are a good source of crisp dietary fiber that is great for massaging gums and maintaining teeth hygiene. • Cucumber for Hair and Nails: The high silica content also helps prevent chipping and splitting of finger and toenails. The high silicon and sulfur content promote growth of beautiful healthy hair. • Cucumber for Digestion: The high water and dietary fiber content of cucumbers are very effective in throwing out toxins from the digestive system and aiding in digestion as well as constipation. Other digestive disorders like acidity, heartburn and even ulcers can be soothed by consuming cucumber juice.• Cucumber for Weight Loss: By virtue of its low calorie count as well as its high water content, cucumbers are an ideal food for those looking to lose a few unwanted kilos.• Cucumber for Tapeworms: With their rich content of vitamin E, cucumber seeds are a natural remedy for getting rid of tapeworms.• Cucumber for Cancer: Cucumbers are known to contain some amazing chemicals such as lariciresinol, pinoresinol and secoisolariciresinol; these three lignans have been proven repeatedly in numerous researches to be responsible for reducing cancer risks. These cancers include breast cancer, prostate cancer, uterine cancer and ovarian cancer.• Cucumber for Diabetes: Cucumbers have also been implicated in helping to control sugar levels in chronic diseases like diabetes. The juice contains a hormone–like chemical that is needed by the pancreas for producing insulin.
So adding a little cucumber to your daily diet can boost your health and increase your fat burning efforts in earnest, so go ahead and make your day!

For glowing skin

1. Peel and deseed cucumber.2. Add 4-5 mint leaves to it and puree.3. Add beaten egg white to the puree.4. Apply on face for 20 minutes before rinsing off…and witness a newer you with a glowing complexion!

Juice it, dice it

Though cucumbers are seen to have so many amazing benefits to the human body, you must keep in mind that these molecules are not present in such large quantities as to be of therapeutic value and be used in place of medications. However, that’s not reason enough not to indulge in cucumbers whenever possible and here are some great ideas on how to enjoy their health benefits:
1. Grind a cup of cucumber for a refreshing glass of juice; just add a dash of lime juice for additional flavor and enjoy your nutritious drink2. Dice cucumbers and onions and add to yogurt as a quick sandwich topper or a cooling raita to add to your meal.3. Try dicing cucumbers and melons with a dash of lime juice and mint leaves for a scrumptious summer salad!4. Or just cut them into sticks and enjoy as a snack.

Sugars: Some more Lethal than Others

2012-10-16T21:31:00.000+05:30

http://healthcafe.in/focus.php?artid=296

Our bodies cannot do without sugar. One of the most basic units of energy that feeds our cells is glucose. That means we need glucose in order for our body to work. Glucose is a type of sugar. Cutting the sugars out o our diet completely might be a tall order for many of us. So the wisest thing to do may be to understand what are the healthy limits, and try to stick to that. Forty pounds of sugar per person per year, beyond what we get from the fruits and vegetables – was what the FDA stated was safe. That translates to 200 calories of ‘added sugars’ per day, which is almost the amount you get from one can of Coke. So if you want to keep to a healthy amount of sugar, and if you have a soft drink, that means, no breads, no sauce, no additional fries or chips, no burgers, nothing that adds any more carbs whatsoever on the same day. Could you do that?
If you really want to stick to this and protect yourself and your family from diabetes, heart disease and obesity, this is what you have to do, says Dr.Lustig, childhood obesity expert.
1 Eliminate all sugared drinks – drink only water and milk.
2 Make sure you eat fiber with the carbohydrates you eat (if you eat only simple carbohydrates that are immediately broken down, it makes your glucose levels shoot up, resulting in more fat being stored. The fiber makes sure that the breakdown process is steadier)
3. Wait 20 minutes before you go for a second helping ( so your body gets time to discern if you are full or if you are having a metabolic malfunction or a craving.)
4. Increase physical activity (it’s improves your insulin sensitivity, and reduces stress- which diminishes your appetite.)
Here is a guide to understanding what the sugars that are commonly found in our food stuff really are:
Glucose: Also known as dextrose. A simple sugar that is metabolized by most every cell in the body. Also called blood sugar because it circulates in your blood. Most carbohydrates contain glucose. It is 20% less sweet than sugar.
Sucrose: The chemical name for granulated white table sugar; a mixture of 50% fructose and 50% glucose. Sulfur dioxide is added before evaporation to bleach the sugar.
Fructose: Fruit sugar that occurs naturally in honey, dates, raisins, grapes, apples, etc. Nowadays fructose is mostly produced from corn syrup. Fructose is metabolized by the liver, and when more quantities are eaten quickly the liver becomes stressed and turns most of the fructose to fat. This increases triglycerides in the blood, which increases the risk of heart disease. Fructose also increases levels of uric acid in the body.
Granulated White Sugar: Also known as table sugar, or pure crystallized sucrose, made by processing raw sugar from sugar cane or sugar beets.
High Fructose Corn Syrup: A combination of fructose and glucose made by processing corn syrup. Processing converts some of the corn syrup’s glucose into fructose to produce a desired sweetness. The resulting syrup is sweeter and more soluble. Possibly the worst kind of fructose, suspected to be one of the leading reasons for the diabetes and obesity epidemics worldwide.
Agave: The highly processed pulp of a desert-dwelling succulent plant. Agave is high in fructose, different brands range from 56-92% fructose. It is about 33 percent sweeter than sugar. Very high fructose.  Brown Sugar: White sugar in disguise – this is refined white sugar with a bit of molasses added back into it.    Confectioners’ Sugar: Also called icing sugar, this is granulated white sugar ground into a fine powder, sometimes with a bit of cornstarch to keep it dry.   Fruit Juice Concentrate: These are syrups high in fructose – made by heating fruit juices to remove their water, then treating with enzymes and filtering, then re-adding fruit flavors.
High Maltose Corn Syrup: A highly processed corn syrup with a high maltose content. Maltose is two bonded units of glucose. No fructose is present at all, and it is very easy for the body to break down. Our bodies create an enzyme, maltase that easily breaks down maltose into glucose.
Maltodextrin: A highly processed powdered sweetener enzymatically derived from any starch, resulting in a mixture of Glucose, Maltose, Oligosaccharides and Polysaccharides. In the US, the starch is usually corn, rice or potato; in Europe, it is commonly wheat. Maltodextrin is easily digestible, being absorbed as rapidly as glucose.
The better ones Maple Syrup: Boiled down maple tree sap. Barely processed, pure maple syrup is a good source of minerals like manganese and zinc. Look at the label when you buy this – Grade B gives you more minerals than Grade A.

Demerara: Pressed sugar cane water evaporated, resulting in large and coarse crystals.

Lactose: Sugar that occurs naturally in milk. Derived from whey. Lactose is about 20% as sweet as sugar.
Honey: A mix of glucose, fructose and sucrose created from nectar made by bees. Honey usually has a fructose/glucose ratio similar to HFCS. Has other nutrients too.
Molasses: The thick, dark syrup that’s left over when sugar beets or sugar cane are processed into granulated sugar. Black strap is loaded with vitamins, minerals and trace elements naturally present in the sugar cane plant and is a good source of iron, vitamin B6, potassium, calcium and magnesium. Jaggery: Is unrefined sugarcane or palm sap heated to 200 °C. It contains up to 50% sucrose, up to 20% invert sugars, up to 20% moisture, and the remainder is made up of other insoluble matter such as wood ash, proteins and fibers. It is called Palm Sugar when made from the date palm or sugar date palm.

Coconut Palm Sugar: One of the lowest glycemic index sweeteners on the market, organic coconut palm sugar is high nutritious. It has low levels of naturally occurring glucose and fructose, in addition to the presence of inulin (a zero glycemic prebiotic that aids digestive health.)    Muscovado: Unrefined. Made by pressing sugarcane and then cooking it slightly before allowing it to dry. Full of molasses and minerals.
Stevia : A sugarleaf. Stevia plants are dried and the water is taken out. 300 times sweeter than sugar with zero calories; but has a bitter aftertaste.
Artificial sugars
Aspartame: Sold under the names Equal, NutraSweet, AminoSweet. 100% artificial chemicals. This is the most used artificial sweetener in the world, many studies have been reporting adverse effects. Saccharin: Artificial sweetener that is basically a chemical called benzoic sulfilimine. It has effectively no food energy. Much sweeter than sucrose.     So the next time you see a carbohydrate or a read the label of a processed food, take time to understand what you are putting into your body. Choose the healthier option and be aware of how much is in a serving.
Best option of all? Stick to traditional, home cooked food combinations – they seem to have it all complex carbs, healthy combinations as well as healthy sugars!

Transplants: A New lease on life

2011-11-03T09:16:00.004+05:30

Reba Paul

Organ transplantation is hailed as one of the greatest advances of modern science in this century, giving millions of people a new chance at life.

Organ transplantation was a confusing, even horrific prospect for people living a few centuries ago to ponder. All of the ethical, moral issues that the concept brings up in many communities have been allayed over the past few decades, and transplants are now widely considered by doctors and the public alike to be the best medical option for many diseases. In cases involving end stage kidney failure, this is the only solution that can ensure the patient a good quality of life. Organ transplantation is hailed as one of the greatest advances of modern science in this century, giving millions of people a new chance at life.

Based on human physiology, the heart, kidneys, eyes, liver, lungs, pancreas, intestine and the thymus can be transplanted. Tissues can also be transplanted – like bones, the cornea, skin, heart valves. In fact, musculoskeletal and corneal transplants are ten times more prevalent than organ transplants. In the organ transplant area, the kidneys are the most transplanted organs, followed by the liver and then the heart.

What does it entail?

Moving an organ from one body to another for the purpose of replacing the recipient’s damaged or absent organ, is a complicated endeavor. Previously it was a prerequisite that the donor and the recipient have matching or compatible blood groups. This is becoming increasingly flexible now, due to the new drugs in the market. Higher degrees of tissue compatibility are thought to help the success rate of the transplant. The first successful organ transplant happened when a kidney was transplanted between twin brothers in 1954. The main problem faced after a transplant is that the recipients’ body tries to get rid of the foreign organ. Every body’s immune system clearly knows what belongs in the body and what is a foreign object. So after a new organ is transplanted, the immune system sees it as ‘foreign’ and keeps trying to get rid of it. This is what causes organ rejection. This problem is tackled by giving the recipient medicines that suppress this instinctive response of his immune system – these are called immunosuppressants.

Organ Donation

Any healthy adult who wishes to donate his organ is free to do so. Also, any healthy adult who wishes to bequeath his organs for transplantation after death can also do so. This is one way to positively impact the life of a fellow being even after your time on the planet is done. In case of a natural death, only a few organs can be ‘harvested’ – like the cornea, bone, skin and blood vessels. However, if a person is ‘brain dead’, then many more organs can be successfully harvested to benefit the life of other people – technically almost 37 different organs and tissues can be put to this worthy use.

The Indian Scenario

Generally speaking, chronic organ failure is still not being seen as the serious problem it really is. In India, thanks to improving mortality rates and disease management, most of the attention in the medical scenario is primarily focused on heart disease, diabetes and other such diseases. What we are failing to understand is that a huge chunk of the present population is going down the road that will inevitably lead to organ failure.

The rise in the incidence of organ failure globally has impacted India in many ways. At the time when transplants began to be commercially executed and were becoming popular, India had the rare combination of having trained transplant personnel, good medical facilities, a large impoverished population and lack of legal governance on organ transplantation. This made the country a quagmire of organ transplant activity from the late 1980s onwards. India got a lot of attention globally due to a multitude of reports regarding large-scale transplants being done with kidneys sourced from poor, illiterate donors under questionable circumstances. Following all the media criticism, the Government of India enacted the Transplantation of Human Organs Act (THOA) banning payment for human organ donation.

The Loophole

Despite this, most of the transplants happening in the country are from live donors who get paid for giving their organs. This is due to a loophole in the Act, which says that a donor can give his organs ‘for the reason of affection or attachment towards the recipient or for any other special reason’. It is estimated that India has approximately 3500–4000 kidney transplants and 150–200 liver transplants happening every year. The main source is live or unrelated donors.

India’s Human Organ Transplantation Act says that a father, mother, brother, or sister can donate organs to the patient. Other live donors go through a screening process by a state transplantation authorization committee to make sure that they are donating organs purely due to emotional attachment to the patient and not for monetary or material gain. The fact that there are so many live, unrelated donors providing organs for the majority of the transplants seem to point to the fact that there is collusion between the agents who source the donors and the authorization committee. Several ‘kidney rackets’ have been busted which have had doctors working with kidney agents to get donors. These donors would have documents fabricated regarding their relationship with the patient, and would be eventually sanctioned by the screening committee. The worst part is that since the whole process is illegal, after the various cuts are taken by the agents and others involved, the donor actually gets only a fraction the amount that the patient pays for the organ. But the question is, when such a huge need for organs exists, should we not have a better solution?

The Multi Organ Harvesting Aid Network Foundation (MOHAN)is a non-governmental organization that has, among many others, been campaigning for more cadaveric transplants. Doctors connected to this organization say that less than 600 cadaveric transplants have been performed in India since the THOA came into being. But the annual number of kidney transplants is over 2000. They point out that ‘there doesn’t have to be a shortage of cadaver organs in India- most relatives of brain dead persons are willing to donate, but there is no system in place in most hospitals to counsel relatives and harvest organs.’

The foundation has written to the health ministry requesting that the government take steps to promote cadaveric transplantation and also enforce stricter scrutiny of live, unrelated donors. They are still waiting for a response. Meanwhile, kidney and other organ rackets flourish in the country. Stray reports surface in the media regarding these from almost all major Indian cities, but no long term official solution seems to be in sight.

The cadaver donation solution

The urgency of the situation is due to the fact that the number of people who need a transplant to save their lives far outnumbers the number of live donors. The only viable solution we are left with is to promote cadaver transplants – which can be done only through people agreeing to donate their organs after death. Oddly enough, most public surveys show that organ donation has high support from the general public. The fact that this is not becoming a reality, is most probably due to the fact that after a patient dies, their relatives are either not aware of this, or are against it, and so the individual’s wishes are not carried out. Statistics say that as many as half of all families decline to donate the organs of their recently deceased loved ones.

In a country populated by more than 1 billion people, the pool for cadaver harvest is understandably high. But in India, the number of cadaver transplants is miniscule in comparison to live donation. Every year, almost 100,000 Indians suffer from kidney failure. Of these about 3,000 actually get a donor kidney, with a very small percentage being from cadavers. In the eight year span between 1995 and 2003, only 524 cadaver transplants were done. The critical shortage of available organs is only getting worse as more people succumb to kidney and liver failure.

The issue gets even more important as we consider that India has an ever increasing number of end stage liver failure patients. Patients who have kidney failure can be helped with therapies like dialysis. But liver failure has no such therapy, and transplant is the only solution. Of the majority of liver failure patients, only a handful get timely transplants that save their lives. The same is the issue with heart-lung transplants. Unlike the kidney, which a donor could give one and still survive well on the functioning of the remaining one, no one except a cadaver can donate his heart and lungs.

Cadaver Donor Program

It would not be an exaggeration to say that unless India develops a good cadaver donation program, we will remain right where we are now, with many of our citizens dying for lack of organs. This problem has to be addressed from the side of the government and policy makers, if any significant change is to take place.

Awareness has to be created about the existing problem, and the public has to be encouraged to be cadaver donors. The family unit has to be informed, and there has to be a way of ensuring that the individual who wishes to donate will have his wishes honored after his death. There should also be a practical and efficient organ retrieval mechanism that is implemented on a national level.

Well trained staff should be present in hospitals to educate and inform families about cadaver donation – in a way that this sensitive issue is handled impeccably without compromising on the optimum time for organ retrieval. One brain dead patient can help seven patients in critical stages, to lead normal lives. Another option to consider is that a national policy could be created whereby every patient in a hospital who becomes brain dead will have his organs harvested, unless otherwise clearly specified to hospital authorities. This way more organs can be made available for the living. Infrastructure should be created for harvesting, storing, biochemical work that will facilitate the best organ-recipient match. Organ donation is possibly the last and most noble act that any human being could undertake; don’t make it so hard to do.

Paid Donation – No good for Donor?

A group of independent American researchers, who tracked down over 300 individuals who had sold a kidney in Chennai, India, found that:

• The donors received far less money than what had been promised to them during the process of initial bargaining

• Instead of improving, their family income declined by about one-third after donation, and the number of participants living below the poverty line increased by about 20%

• 75% of the participants who chose to sell their kidney to get out of debt, continued to be in debt

• More than 95% of the sellers admitted that the desire to help a gravely ill patient with kidney disease was not a factor in their decision

• Almost 90% of them reported significant decline in their health status

• In many cases, women had been forced to donate against their wishes because the husbands needed money.

When asked what advice they would give to others thinking of selling a kidney, more than 80% said that they would not recommend such a step. The authors concluded that the Authorization Committee failed in its duty, shattering the myth that the money earned by selling an organ helps the donor to improve their financial standard and get a fresh start in life.

Iranian Model of Organ Donation

The Iranian model of transplants is seen as the one that is the most fair to the recipient as well as the donor. It is a state supported program – the compensation and regulation are done by the state. This program started functioning in 1988, and gives financial incentives to living donors who volunteer their organs. These living unrelated donors get a sum of money, without having to go through any middlemen. Anyone who needs a kidney gets it. However, there are regulations in place that ensure that transplant tourism does not get the benefit of this. So foreigners cannot have a renal transplant from an Iranian national in Iran, nor can they be a donor.

After this system was in place, renal transplants increased so much that by 1999, the waiting list was eliminated. Right now, there is no renal transplant waiting list in Iran. The advantage of this model is that many of the ethical issues surrounding live, unrelated donation are eliminated, since the donor is directly connecting to the government for his compensation. Also, he will not know who is going to get his kidney, since it going to an organ pool and given to the patient who is the best match for it.

All hospital expenses are also paid for by the government, so even poorer patients can afford to have a transplant. The transplants are only performed in government hospitals that are affiliated to universities. The transplantation teams, including the doctors, have no connection with identifying possible donors and no middlemen are involved. More than 50% of Iranians who had end stage kidney failure are living with a functioning transplanted kidney. It is the only country that has successfully eliminated a transplant waiting list in this manner.

mail to rebekaah.paul@gmail.com the author of this article published in the Novemebr 2011 Issue of THE HEALTH CAFE'. Sign in for the health cafe newsletter for a complimentary annual e-subscription.

Appendix : Cut it or Keep it....

2011-11-01T12:57:00.000+05:30

Is the appendix just a useless evolutionary vestige, or does it have a role to play in our health. New evidence suggests that it may be persisting in our systems for a purpose!

Case 1: My 40-year-old friend collapsed with a sudden abdominal pain one morning. With no prior warning, she came close to an absolute blackout. In minutes, the pain was gone completely. Nevertheless, she went to a hospital to get it checked out. Routine scans were done to check if her appendix was to blame, but the technician saw no problems with her ‘evolutionary vestige’. All through the morning, one thought kept coming back to mind. Her IUD was long past removal date – maybe that was to blame. The doctor she met later, however, insisted that she be admitted immediately for an appendectomy. She ventured that she felt totally fine, and that she would check with a gynecologist about the IUD first…the doctor immediately proposed that she could be admitted, have an appendectomy and also have the IUD removed by his wife, who was a gynecologist. Deeply troubled by that option, my friend insisted on going back home, despite dire predictions of doom by the doctor. The next day, she got the IUD removed, and has had no ailments since. She says, “I understand that the appendix is considered unnecessary…but it’s something that’s inside my body that wasn’t giving me any trouble! Why should he insist on removing it even when it is fine? I was being pushed to do a surgery that was totally unnecessary!”

Case 2: A patient comes into the hospital complaining of acute abdominal pain. The doctor diagnoses acute appendicitis and surgery is immediately scheduled. Later, the patient finds out that his appendix was on the verge of rupturing and that the timeliness of the operation had saved his life. “It was such unbelievable pain! I am so relieved that it could be solved by such a simple procedure – and thankfully we don’t need the appendix, so it’s not going to affect my life!”

Yes, it’s true that the appendix is considered a remnant of an evolutionary process by evolutionists. But is it a ‘useless’ mass of tissue in our body? The human body is a super-intelligent mechanism that harmoniously conducts millions of processes in every second. If something was really useless, why would the body still have it inside? Is it right of us to see the appendix and the tonsils so lightly – and choose to throw them out at the slightest provocation? Does it all come down to a comparative decision? Or does the appendix only function as a source of financial support for surgeons? Let’s find out.

The Unwanted Appendix

Till some time ago, science on the whole considered that the appendix was a part of us that the body missed out or forgot to discard when we evolved into homo sapiens. However, it has always been the focus of a lot of discussion and debate. It is understood that the appendix may have had a big role to play in the past, but after our bodies evolved to what they are now, their role diminished.

It has been widely considered that the appendix is a shrunken remainder of a large intestinal tube, from which our intestines evolved to their current state. Inside the body, the appendix is a small, finger-sized projection attached to the large intestine in the lower right area of the abdomen. It is usually between two to eight inches long. The appendix is longest in childhood and gradually shrinks through adult life.

Scientists’ view of the appendix is changing from what they believed in the past. A growing consensus is that the most likely function of the human appendix is as a part of the gastrointestinal immune system. Some opine that reasonable arguments exist for suspecting that the appendix may have a function in immunity as the appendix is highly vascular, is lymphoid-rich, and produces immune cells normally involved with the gut-associated lymphoid tissue. It’s also known to be a storehouse for the ‘good’ bacteria also.

Appendicitis

Appendicitis is a painful inflammation of the appendix. The condition starts as a pain in the centre of the abdomen. It then travels to the lower right-hand side and gradually gets worse.

Appendicitis is a medical emergency that usually requires urgent surgery to remove the appendix. If left untreated, the appendix can burst and cause potentially life-threatening infections. It’s not exactly clear what the causes of appendicitis are, although it’s thought to occur when something, usually a small piece of faeces, blocks the entrance of the appendix, causing it to swell.

Symptoms

Appendicitis typically starts with a pain in the middle of your abdomen that may come and go. Within hours the pain travels to the lower right-hand side, where the appendix lies, and becomes constant and severe.

Pressing the appendix area, coughing or walking, may make the pain worse. You may lose your appetite, feel sick and suffer from constipation, diarrhoea, vomiting and high fever.

Go for Surgery

An inflamed appendix will most probably rupture if not removed. Rupturing spreads the infection throughout the abdomen, creating a potentially fatal situation. In most cases, the appendix will have to be surgically removed. This is one of the most common operations and its success rate is excellent.

Surgery is most commonly performed as keyhole surgery (consisting of three small cuts). Open surgery (a single large cut over the appendix area) is usually carried out if the appendix has burst.

Are there any other ‘spare parts’ in the human body?

Male nipples

Men have nipples and mammary tissue which can be stimulated to produce milk. They can also get breast cancer.

Wisdom teeth

Early humans had an extra row of molars to help with the vast quantity of vegetable fibre they had to chew. Now, about 35% of the population does not develop wisdom teeth at all.

Coccyx

The remains of a tail lost long before man began to walk upright six million years ago.

Spare ribs

Humans have 12 ribs but about 8% of humans have an extra pair, as do chimps and gorillas. They live with that extra pair of ribs!

The appendix does have a use: Re-booting the gut

For generations medical orthodoxy has maintained that the appendix is useless, warranting attention only for its tendency to becomepainfully inflamed and requiring swift removal. But now the reputation of this unwanted little sac in the human gut has beenrehabilitated by a theory from a team of immunologists.

Scientists have found that the appendix acts as a “good safe house” for bacteria that are essential for healthy digestion. In effect, theappendix ‘re-boots’ the digestive system after a bout of amoebic dysentery or cholera or any case of extreme diarrhea that purges thegut.

This function has been made obsolete by modern, industrialised society; in dense populations, people pick up essential bacteria fromeach other, allowing gut organisms to re-grow without help from the appendix, the researchers said.

But in earlier times, when land were more sparsely populated and whole regions could be wiped out by an epidemic of cholera, theappendix provided survivors with a vital individual stockpile of suitable bacteria.

“The function of the appendix seems related to the massive amount of bacteria that populates the human digestive system,” said BillParker, a professor of surgery and one of the scientists responsible for establishing its status as a useful organ. “The location of theappendix, just below the normal one-way flow of food and germs in the large intestine, helps support the theory.”

New Ways To Battle The bulge

2011-11-01T12:52:00.001+05:30

Thanks to changing lifestyles, poor eating habits and sedentary jobs, an increasing number of people are hitting the overweight mark. As a result, they are busy lightening their pockets in an effort to lighten their bodies and get rid of those unsightly bulges and flab. Plastic surgery is steadily becoming a way of life to a certain section of urban upper middle class individuals.

One of the most popular procedures for fat reduction is liposuction. However, its main drawback is that it is mostly done on patients who are only within five to ten pounds in excess of their ideal weight. This is where people start to look for a backup plan for getting rid of that unsightly fat! Would topical creams effectively remove or lessen specific fatty areas? Many non-prescription creams, lotions and pills declare that they will be absorbed into the layer of fat and make it vanish. You wish!

Getting rid of unwanted fat is a booming business, and naturally has numerous bogus solutions that ‘desperately seeking to lose weight’ people flock to. So, what is the world to do? Is there no other answer in sight? Something that’s non-invasive, nonsurgical, and less expensive, which would help to improve our thighs, abs and hips…

People looking for a safe procedure for liposuction…rejoice! You can now get rid of your fat without anesthesia risks, without invasive surgery! It’s called Ultrasound assisted Laser Fat Reduction, and is now available in India. The process has been developed and utilized in several countries all over the world as an alternative to conventional liposuction.

Like most plastic surgeries, the technique is continually changing, expanding, and improving each year.

The basic challenge of any fat reduction procedure is:

To remove the right amount of fat

To cause the least disturbance of neighboring tissue, such as blood vessels and connective tissue

To leave the person’s fluid balance undisturbed

To cause the least discomfort to both patient and surgeon

As techniques have been refined, many ideas have emerged that have brought conventional liposuction closer to being safer, easier, less uncomfortable, and more effective. The marketing that goes on however, makes it harder for the consumer to distinguish truth from exaggeration.

The good news about Ultrasound Assisted Laser Liposuction is that such complications can be avoided. It causes less discomfort for the patient, both during the procedure and afterwards; decreases blood loss and can access larger areas. This new technology focuses on only the target fat cells in the body and essentially melts away the fat. The broken down fat cells are moved through the body through the body’s metabolic system and discarded naturally.

How it works:

The reason this is preferred by many is that there is more precision to the removal of fat, and it is non-invasive. Carefully calibrated energy is directed into the skin. The fat cells in our body absorb the ultrasound energy, whereas the other tissue around the fat deposits will reflect the ultrasound. This helps the surgeon to target the fat cells clearly, without posing a risk to the other tissue surrounding it. The fat is liquefied, and can be naturally expelled by the body, or is sometimes suctioned out with a small suctioning cannula.

This procedure works best in removing small to medium fat buildup – like behind the knees, around the neck or chin or arm fat. When larger areas are targeted, you will need to have some device invading your skin to suction out the larger amounts of fat being liquefied. This kind of a procedure can also be effectively used to remove deep seated tumors, which may be under many fat layers. The cost of the procedure will depend on how many sessions are required, how much fat has accumulated, you age etc.

So, thanks to advances in technology, you can lay your fears to rest. There are several back up plans available to get rid of the hideous results of our dietary indulgences. Of course, all this is possible only if we are ready to dig deep into our pockets, so weigh your options and decide what’s best for you!

Mobile mania To Be or not to Be?

2011-10-25T12:46:00.000+05:30

Article by Reba Paul

Click name to email the author

The jury’s still out on whether mobile phones are dangerous to the human body. Firmly in the clutches of today’s mobile phone culture, we are at a point where we need to understand it better, and figure out how to use it in a way that minimizes possible harm.

It’s hardly been here two decades and we already can’t imagine life without it! Many people are mulling over whether they should continue using it extensively or curb usage. Needless to say, the question of doing away with the cell phone altogether will never arise. We have already crossed that point – they have become gadgets that most of us cannot do without – even though we’ve been hearing that radiation is bad for us. So all that’s left to be done is figure out how we can use it with least damage to ourselves.

Technically speaking, the ‘real’ killing that mobile phone use is responsible for, has mostly happened on the road – with drivers using the phone while driving, causing fatalities. Statistics say that drivers on the phone are four times more likely to crash their vehicles. Many countries have made it illegal to use mobile phones while driving – and killing someone else or yourself because you were using the phone on the road, is the greatest health hazard that this instrument poses.

Unfortunately, many suspect that this is not the only risk that this small handy instrument places upon the human race. Ever since the mobile phone has been in use, people have been voicing their concerns about the dangers that its electromagnetic radiation could bring. Of course, it would take us close scrutiny of a whole generation to really know the benefits and harm of any new thing. So we stand at a very interesting juncture – it could be terrible for us, but we love it too much, and it’s much too early to really tell. All we can do now is to take stock of what early studies are showing, and use our own guidance system to decide how we want to approach the issue individually.

We would like to believe that science has all the answers. Unfortunately, since the very foundation of science is that it pursues answers, most often it raises as many questions as the answers it provides. This is an inevitable part of the process of getting to the bottom of any truth.

Most of the larger studies about the harms of mobile phone radiation state that they have been unable to find a link between cell phone radiation and cancer. Interestingly, many of the studies have connections with phone companies themselves, so the skepticism regarding the findings is understandable. Many other smaller studies have been consistently showing that radiation seems to have harmful effects on life on the cellular level. This may be why major studies done on groups of adults using cell phones did not throw up any conclusive evidence. When damage is done in minor quantities on the cellular level, it takes a lot more time to cumulatively show up in the body. Most of the studies use words like ‘there are implications’ – which means that a link between DNA degeneration and radiation is suspected, but they are unable to state this conclusively. Here are some study findings:

•…. In 1995, in the journal Bioelectromagnetics, Henry Lai and Narenda P. Singh reported damaged DNA after two hours of microwave radiation at levels considered safe according to government standards.

•…. In December 2004, a study done across Europe called REFLEX, covered evidence from 12 collaborating laboratories. They found compelling evidence that there was DNA damage in cells in in-vitro cultures. These were exposed to 0.3 – 2 watts/kg. There were also indications of chromosome damage, changes in some genes and a higher rate of cell division.

•…. In Athens, a team studied the effects of radiation on fruit flies – and saw a reduction in the reproductive capacity of these little creatures when they were exposed to six minutes of 900 MHz for a period of five days.

•…. Studies suggest that rats exposed to microwaves similar to mobile phone radiation displayed breaks in their DNA. Mice exposed to radiation for eighteen months developed brain tumors.

•…. A study conducted at the University of Montpellier in France exposed 6000 chick embryos to radiation. They found that the heavily exposed chick eggs were five times less likely to survive than the control group. This raises questions about possible effects that excessive radiation could have on fetuses.

•…. In 2009, Australian research subjected in vitro samples of human sperm to radio-frequency radiation. They saw that sperm that were put under a higher absorption rate had a decrease in motility and vitality, had an increase in oxidative stress, and increased DNA fragmentation.

Studies also indicate that radiation interferes with the chemicals in the human body – inhibiting the production of melatonin, which in turn inhibits estrogen production, and could cause cancer. Most of these studies are yet to be ‘peer-reviewed’ but they have all been done by smaller, independent teams. Your own research will help you draw conclusions about their validity and honesty. These are all early indications that it may be harmful to overuse or over expose yourself to cell phone radiation.

Interestingly, the WHO has classified mobile phone radiation as being ‘possibly carcinogenic’ – saying that there could be ‘some risk’ and strongly advises additional research into the long-term dangers this could bring. So, we stand at a point where we have no hard evidence that cell phones cause cancer or other disease, but are increasingly getting evidence that they could. What’s most unnerving is that the radiation that could cause such harm is invisible – entering and leaving our bodies without us even knowing about it.

It’s not just our bodies that are impacted by the radiation changes through the handsets and the telecommunications towers. Scientists say that the towers could be responsible for disrupting the internal navigation systems of insects like bees. Over a period of time, this could cause a disruption in our food chain and the agriculture industry, since bees are responsible for a lot of pollination of crops.

Advocacy groups and concerned scientists and doctors have initiated many movements in the USA and Europe that urge lawmakers to reconsider how and where cell phone towers are located, and to revise policies about keeping schools, retirement homes and healthcare institutions free from this kind of radiation.

Until there is more conclusive evidence, it may be wise to adopt a ‘better safe than sorry’ policy on the almighty cell phone – especially in the case of children. Their smaller heads, thinner skulls and higher tissue conductivity, make them prone to absorbing more energy from a cell phone. There are some products on the market that say they can reduce the impact of mobile phone radiation. You could check these out and investigate the usefulness of these for yourself. If you feel that there is enough evidence to be wary of cell phone radiation, you can start changing things by limiting your phone usage starting today.

Help! I’m addicted to my Phone!

Here are some tips that decrease your radiation exposure:

• Limit the use of cell phones- keep calls short.

• Text instead of talking whenever you can.

• Wear an air tube headset (not regular wired headset). The regular wired headset has been found to intensify radiation into the ear canal – serving as an antenna, attracting electromagnetic frequencies from the surroundings.

• Do not put the cell phone in a pocket or a belt while in use or while it is on. The body tissue in the lower body area has good conductivity and absorbs radiation more quickly than the head. One study shows that men who wear cell phones near their groin could have their sperm count dropping by as much as 30%.

• After dialling, wait for the call to connect before placing the phone next to the ear.

• Do not use the cell phone in enclosed metal spaces such as vehicles or elevators, where devices may use more power to establish connection.

• Do not make a call when the signal strength is weak (1 bar or less), because stronger radiation is emitted by the phone.

• Purchase a phone with a low SAR. Most phones have a SAR level listed in its instruction manual. The SAR level is a way of measuring the quantity of RF energy that is absorbed by the body.

• Be a little old fashioned – use landlines.

• Keep cell phone off most of the time. Ask people to leave messages and then call them back from a landline.

Safety First!

1. A small chip-like cell phone microwave radiation protection device is available, which absorbs electromagnetic energy waves from your mobile phone, protecting the body from these emissions.

2. Use your cell phone for emergencies, not long rambling conversations

3. DO NOT allow your children to use or play with mobile phones. Their bones are less dense than ours so they can be affected by radiation faster than an adult. Make it a rule that children use a cell phone only during emergencies.

4. Do not use your cell phone when you drive. This has been the cause of many fatal road accidents. If you absolutely HAVE to, use a hands free mobile car kit, so you can keep your hands on the steering wheel at all times.

5. Do not use the cell phone when you drive – for another reason than the previous – when you are moving, your phone is constantly trying to get the best signal – which means that radiation is intensified!

6. Some companies have developed materials and gadgets that act as radiation shields, so check these out and if you are convinced, then use them.

7. Keep your phone out of the bedroom at night. This is the time when your pineal gland and other chemical processes are working to heal and rejuvenate your body. The worst thing you could do is place EM radiation at close quarters to your body at this time.

To Subscribe to THE HEALTH CAFE' click the link.

Mail comments on this article to the author by clicking the author's name.

The Health Cafe' - Team

The Heart that Isn’t

2011-10-25T09:43:00.000+05:30

Cardiology could be on the verge of a revolutionary breakthrough – a mechanical device that works as well as a human heart is just around the corner! But would that make the recipient a semi-robot…?

For most people, the mention of ‘heart’ brings to mind the symbol of love – the famed and much loved cherry red symbol that bombards you on Valentine’s Day. This symbol of the heart is reportedly a representation of a 6th century B.C. aphrodisiac found in Africa.

In real life, the heart looks quite a bit different from its symbolic representation. Weighing in at about 5 ounces, the human heart beats roughly once per second – that’s roughly 2.5 billion times in a life time. On an average, it pumps 74 liters of blood every hour through the adult body.

Working constantly from the minute we take human form, with many additional stresses loaded onto it during our adult life, it’s no wonder the heart is usually the first of our organs to give out. Since human beings are not very good at changing their lifestyle to sustain healthy bodies or healthy hearts – doctors have been trying for more than four decades to develop an artificial device that can take over the pumping function of the heart. The search has been to develop a machine that does not wear out, break down or cause clots and infections.

The Artificial Heart

An artificial heart is a mechanical device that replaces the heart. Artificial hearts are typically used as a temporary device that works in your body till a real heart transplant is possible; or to permanently replace the heart in case transplantation is impossible. The first artificial heart was the Jarvik-7, designed by Robert Jarvik.

The first time an artificial heart was successfully transplanted into a human was in 1969 in Houston. This was to act as a bridge for a transplant. The patient died later due to complications of an unrelated acute pulmonary infection following the heart transplant. In 2004, the FDA in the USA approved the SynCardia temporary Total Artificial Heart. Originally designed as a permanent replacement heart, it is currently approved as a bridge to human heart transplant. There have been more than 900 implants of the Total Artificial Heart, accounting for more than 210 patient years of life on this device.

Another device – the AbioCor has also been recently approved for use in severe biventricular end-stage heart disease patients, who are not eligible for heart transplant and have no other viable treatment options. As of April 2011, 14 patients had been implanted with the AbioCor, with one patient living for 512 days with the AbioCor. This device is fully implantable, meaning that there are no wires or tubes penetrating the skin, which mean there are less chances of infection.

Heart with No Beat Offers New Lease on Life

Of late, radical advances are being made, with Dr. Billy Cohn and Dr. Bud Frazier of the Texas Heart Institute announcing that they have developed a machine that can function as a heart. The device is a set of simple whirling rotors — which means people may soon get a heart that has no beat!
Inside the Institute’s animal research laboratory is an 8-month-old calf with a soft brown coat named Abigail. Cohn and Frazier removed Abigail’s heart and replaced it with two centrifugal pumps.”If you listen to her chest with a stethoscope, you wouldn’t hear a heartbeat,” says Cohn. “If you examined her arteries, there’s no pulse. If you hooked her up to an EKG, she’d be flat-lined.” But she is a fully active, healthy calf!

They took two medical implants known as’ ventricular assist devices’ and hooked them together. A ventricular assist device has a screw-like rotor of blades, which pushes the blood forward in a continuous flow. The doctors say the continuous-flow pump should last longer than other artificial hearts and cause fewer problems. That’s because each side has just one moving part: the constantly whirling rotor.

In Queensland’s University of Technology, a new counter-flow heart pump is being developed which is based on a double-output centrifugal model – it pushes the blood in such a way that correct flow happens through both sides of the heart. This means that the left and right sides of the heart are supported at the same time – much like a real heart! Lead researcher Associate Professor Andy Tan says “what’s so groundbreaking is that it is the first device to combine the function of two pumps into one unit.”

Finding a technology that can serve as a replacement heart is crucial – especially because the number of people suffering from heart failure is increasing and the numbers of heart donors are not rising. So the only way to reduce the number of deaths is to find another solution.

The stages of final design and patenting are yet to be negotiated before these devices reach the chest cavities of heart patients. The world will be watching to see how effective these devices are as a solution to replacing the human heart. And even if it does, will this mean that the person having it will be semi-robot? Will they lose out on feelings and emotions? All that remains to be seen, but we can be sure of one thing. If it does work, many artificial heart recipients will be thanking their surgeons, ‘from the bottom of their hearts’!

Subscribe to The Health Cafe magazine by Clicking the LINK

For comments to the articles published on the health cafe' mail us - healthcafeam@gmail.com

Check for microalbuminuria

2011-10-24T19:57:00.000+05:30

Your pee can give you clues about your risk for heart or kidney disease.

Breakthroughs in the technology of medical testing offer a new and incredibly effective new way of catching heart disease in the bud. Testing for microalbuminurea in your urine can now predict how prone you are to heart disease!

When an individual’s urine has small but abnormal amounts of protein, this is referred to as microalbuminurea. This is measured at a time when the amounts are so small that they do not show up in the conventional dipstick method. (30-300mg of albumin excretion by the kidneys over a period of 24 hours.)

The dipstick method of measuring albumin in the urine, only detects protein excretion that exceeds 300 mg per 24 hours. This is the standard range that is currently denoted as macroalbuminuria, or gross proteinuria(high levels of protein in the urine). With new testing, even smaller levels of protein in urine can be spotted, which means that conditions like kidney and cardiac disease can be spotted at a very early stage and steps can be taken that may even be able to reverse the condition!

‘Albumin’ is the most common protein found in blood. In people with normal blood levels, the kidneys will not allow albumin to be excreted. So when there is albumin in the urine, it’s a sign that something may be wrong. Microalbumin in the urine is an early indicator of kidney disease. Microalbuminuria is almost unheard of in childhood and before adolescence. Factors that contribute to the incidence of microalbuminuria are: duration of diabetes, high blood pressure, genetic susceptibility.

Microalbuminuria is most commonly associated with diabetic nephropathy (kidney disease setting in as a result of diabetes), but there are other causes, which include glomerulonephritis, amyloidosis and other forms of kidney disease. Detecting microalbuminuria early is important because it is often a sign that the patient may be at risk of developing overt proteinuria (macroalbuminuria) and renal failure. It is also a risk factor for cardiovascular disease.

Nephrologists and diabetologists have been measuring microalbuminuria in their patients to check for the development and progression of kidney disease. But urine is also being increasingly recognized as a sensitive predictor for cardiovascular risk. Studies show a clear relationship between microalbuminuria and cardiovascular events. If this is identified early, medication can be used to work against the condition and have a beneficial effect on the cardiovascular system.

At present the incidence of type 2 diabetes is increasing world-wide, with half the population unaware that they are diabetic. The result is an increase in deaths that are caused by end-stage renal disease and cardiovascular disease. Type 2 diabetes mellitus is a silent killer, bringing with it many life-threatening complications on different organs like the kidney and heart. So there is a need for early identification of patients who are at greatest risk. By spotting the risk early, patients can start on renal and cardiovascular protective treatments early and have better quality of life.

As with every test, microalbuminuria too has the drawback of having false positive results. False positive reports happen when the patient has done strenuous exercise or has urinary tract infection, or severe hypertension, or some prolonged illness. But the chances of false positive in microalbuminuria are minimal. The best part of this new finding is that now, we can spot the onset of two potentially lethal conditions right when they start, and that too with something as simple as a urine test!

Pranayama

2011-10-24T19:37:00.000+05:30

Breath. It’s the first thing we take when we come into this world. It’s the one thing we continue to take constantly throughout our life – without even noticing it. Human beings can live without food and water for several days, but will die if deprived of air for more than a few minutes.

The breath is the all-important element in sustaining life. Our breath cleanses our bodies, brings balance to our chemical processes – regulates our hormones and can help us recover from a multitude of illnesses. Every breath that we take in, brings in cleansing oxygen to our bodies and every exhalation throws out carbon dioxide and a host of toxins. Almost 70% of toxins leave our bodies through our breath. Small wonder then, that ancient Indian knowledge focused on ways to control and sustain this vital force in our bodies in the best way possible. The Indian systems of Yoga and Ayurveda have constantly recommended breathing exercises for good health and longevity. Referred to as ‘Pranayama’, – there are several types of these breathing exercises that Yoga masters have formulated.

‘Pranayama’ means ‘extension/control of the Life Force’ (Prana – Life force; Ayama – to draw out, extend or control). The Yoga Sutras say that pranayama is a way to attain higher states of awareness. By doing pranayama, one achieves a balance in the upward and downward flowing energy in the human body – which brings a balance of good health to the mind as well as body. Generally our inward and outward breath flows through our bodies involuntarily – it’s something we do thoughtlessly. The tradition of Yoga says that when this activity is done with more awareness and various techniques of control, then our vital life force can be made more balanced.

Studies have shown that the way we breathe contributes to our bodily functions. We are told to take long deep breaths when we are disturbed or anxious. Deep breaths calm us down when we are angry. Our breath is directly connected with influencing our mental states. Pranayama exercises have been designed with one intention in mind – to inspire, infuse, control, regulate and balance the ‘prana’ (vital life force) that keeps our bodies alive. It is the one exercise that can improve all life processes.

There are about seventy types of pranayamas mentioned in traditional texts. The tradition of Hatha Yoga focuses on eight types of Pranayama – Kapalbhati, Agnisar, Bhastrika, Ujjayee, Bhramari, Nadi Shodhana (Anuloma-Viloma), Sheetali, Sheetakari and Surya Bhedan. If you have been to a yoga class, it is very likely that you have done two of these – Kapalbhati and Nadi Shodhana. This is probably because these two done in tandem, can bring about the best healing results with regards to chronic diseases.
Article by Reba Paul @ The Health cafe " Lets Talk Health" - October 2011.

Kapalbhati – Lustre to the Face
Popularized by Baba Ramdev in recent times – this is the breathing exercise where you take a deep breath and then forcefully expel it by strongly contracting your diaphragm repeatedly. Oxygen consumption increases, carbon dioxide is flushed out. Kapalbhati has been found to de-stress the mind, and bring calmness and clarity to the practitioner. Found to be extremely beneficial for warding off respiratory illnesses from colds to tuberculosis and emphysema; remedies stomach ailments, strengthens circulatory system; stimulates and regulates hormones; invigorates, cleanses and revitalizes brain cells. It also helps in weight loss and counteracts depression.To be done twice daily for best results.
Warning: To be practiced on an empty stomach, to be done gently and increased gradually by chronic disease patients; should only be done with expert supervision by patients suffering from heart disease, high B.P., spondylosis, slip disc and hernia; should be avoided during pregnancy and periods.

Agnisar – The Essence of Fire
In Agnisar – the stomach is withdrawn towards the backbone as far as possible repeatedly. This is done after all of the breath has been expelled from the lungs. The practitioner holds the breath while doing several such contractions. This cleansing pranayama strengthens the fire within our bodies – which is crucial to the functioning of the digestive system. It improves vitality in the body, awakening our inner energy and strengthening the internal organs. It is said to cure asthma and tuberculosis as well as a host of phlegm-related problems. Healthy women are advised to do this pranayama after childbirth as it helps to tighten up the abdominal and pelvic muscles and bring the internal organs back to their initial condition. Agnisar makes our digestive organs function optimally – ensuring that the foundation for good health is strong within our bodies.
Warning: Not to be done on a full stomach; not to be done by people with high B.P., heart problems, ulcers and hernia; pregnant women should also avoid this, as should people with ear, nose and eye problems.

Bhastrika – Bellows Breath
As the name suggests – the Bellows Breath is where you intake and expel the air from your lungs forcefully – similar to the air pushed in and out of the bellows. This is a powerful exercise that is basically a state of controlled hyperventilation. Bhastrika increases warmth in the body;destroys phlegm (thus working against asthma, sinusitis etc.); it eliminates wind, bile and phlegm related diseases; it activates and invigorates the liver, pancreas and spleen and also stimulates the metabolic rate.
Warning: Not to be done if you are pregnant or suffering from high B.P.

Ujjayi – Victorious Breath
In the Ujjayi, one’s throat is constricted and the breath is inhaled through the nose, with a hissing sound – like a sigh with the mouth closed; holding the breath for a few seconds before exhaling deeply. According to B.K.S. Iyengar, “this pranayama aerates the lungs, removes phlegm, gives endurance, soothes the nerves and tones the entire system. Ujjayi done in a reclining position, is ideal for persons suffering from high blood pressure and coronary troubles.” This pranayama is said to be a miracle remedy for thyroid problems, cures snoring, is beneficial in healing throat problems – including asthma, tonsils, colds and coughs.

Bhramari – Humming Bee Breath
This pranayama exercise has the practitioner making a sound while inhaling and exhaling – usually an ‘Om’ is chanted with the ‘m’ drawn out. This exercise is said to work miracles in healing throat problems. It calms the mind, elevates the mood and reduces stress; it is also beneficial in reducing anger, anxiety, insomnia and blood pressure. Practitioners experience a speeding up of healing and great post-surgery benefits from this breathing.

Nadi Shodhana/ Anuloma-Viloma – Alternate Nostril Breathing
One of the most popular pranayama exercises – the practitioner breathes in through the right nostril, holds the breath and then exhales through the left, repeating the process through the other nostril. It is only recently that scientists have discovered a connection between the nasal cycle and brain function. Yogis have known this for years. It is to bring a balance to the left and right brain hemispheres that this pranayama was designed. This is reputedly one of the most beneficial of all breathing exercises – infusing the blood with oxygen, revitalizing and purifying the body. The practitioner feels clear headed and calm. It detoxifies the blood, calms the mind and soothes anxieties. The millions of nerves or ‘nadis’ contained in our body are purified with this technique. The main purpose of this pranayama is to balance the dual forces of physical and mental energy in the practitioner’s body.
It is highly recommended for individuals who suffer from depression, insomnia, hypertension, high B.P., heart problems, fits of anger and Parkinsons.

Sheetali and Sheetakari – Beat the Heat
These pranayamas are the cooling breath, used during the hot Indian summers to cool and calm the body and mind. Sheetali is done by sticking the tongue out, curling up the sides like a tube and breathing in through this appendage, and breathing out through the nose. In Sheetkari the tongue is placed at the base of the upper teeth, with jaw gently closed and lips slightly parted – inhaling through the teeth, with a hissing sound. Apart from regulating the temperature of the body, these techniques also reduce emotional excitation and tensions. Sheetali refreshes the body, mind and also aids blood purification. It is good for combating high B.P., constipation, indigestion, acidity, ulcer, skin disease and spleen enlargement. It is said that a regular practitioner will be safe from poison and viral infections. Sheetkari improves the disposition – keeping you agile, in high spirits and active throughout the day. It relieves hunger and thirst and clears the complexion – slowing down the appearance of wrinkles and blemishes.
Warning: Avoid this exercise during cold weather, and when you have a cold, cough and other respiratory illnesses. Arthritis or low B.P. and heart patients should consult a doctor or yoga expert before doing this.

Surya Bheda – Activating the Sun
This pranayama technique focuses on breathing exclusively through the right nostril. The right nostril is considered to be the doorway to the Sun energy in our body. By activating this energy, the body is supported to fight against ‘Vata’ diseases; gas in the abdomen, rhinitis and different kinds of neuralgia. It awakens Kundalini and steadies the concentration of the mind. It increases the digestive fire and appetite and purifies the nerves.
Warning: Should be avoided if one is suffering from fever or diarrhea. People with heart disease, epilepsy, hypertension and high Pitta or acidity should not do this pranayama.
As you can see, incorporating pranayama into your daily routine can be extremely beneficial to long term health. It can be used to correct a variety of ailments. More importantly, if you are healthy right now, starting a breathing routine can be crucial in safeguarding you from going the usual route of ‘decaying with age’.

Pranayama helps you regularize and lower your breathing rate – which is supposed to determine how long you live. The understanding is that the less number of breath you take, the longer you live. It improves blood circulation, meaning that more oxygen is available in your body. This ensures vitality, high immunity and quick healing. More oxygen in the blood also means more oxygen to the heart muscles – making a healthy heart! All of the internal organs benefit from breathing exercises – the lungs, abdomen, intestines, kidneys and pancreas. But the trump card lies in the fact that something so simple as breathing can play such a huge role in mental health. Studies show that pranayama is helpful in treating a wide range of stress related disorders.
A pranayama practitioner develops a steady mind, better judgement and perception and a healthy life. A daily routine can be started at any age, provided the lessons are given by a trained professional. So what are you waiting for? Find a good yoga teacher, and start breathing your way to good health!

To Subscribe to The Health Cafe click the link.
To email the author Reba Paul - rebekaah.paul@gmail.com

Easy Breezy Breath of Health!

2011-10-24T19:15:00.000+05:30

Did you know that almost 70% of the toxins produced in your body actually leave through your breath? So when you don’t breathe right, most of the toxins don’t leave; they accumulate in different parts of your body, and over time cause disease. So, how about trying to breathe your way to a cleaner, fresher body?
Your nose holds far more than just mucus and nasal hair. It holds the potential to energizing and calming your body and mind.

Left, Right

The breath through the left nostril calms the body and the breath through the right nostril energizes you. When you breathe in through the left nostril, the right hemisphere of your brain is activated. This side of your brain is the ‘feeling’ side, which holds your creativity, emotions etc. Breathing through the right nostril activates the right side of your brain – which is the ‘thinking’ side. It holds your logic, linearity, mechanical and technical perception etc. You need both sides of your brain to work in a complementary and harmonious way, without one overshadowing the other. The alternate breathing technique is the best way to ensure this. When you do this breathing, you calm down your overworked left brain and awaken your ignored right brain.

The Purifying Breath

While you are doing this breathing exercise, you need to hold your right hand in a certain manner. Make a loose fist with your right hand. Now, open up your thumb from the fist, then open up the ring and little finger. You should have your index and middle finger touching your palm somewhere below the base of the thumb. Hold this position without straining your fingers, be easy and gentle. As you do the exercise, you may manipulate the fingers a bit for better comfort. As far as possible, do this exercise on an empty stomach, or three hours after a meal.

1.. Place your right thumb against the right nostril and gently close the nostril. Do not push hard against your nose.

2.. Inhale – a long and gentle breath- through your left nostril

3.. Pause for a second.

4.. With your thumb still holding the right nostril closed, bring your ring finger to your left nostril and close it. Release the thumb from the right nostril.

5.. Exhale through the right nostril.

6.. Holding your hand in the same position, inhale through the right nostril.

7.. Pause for a second.

8.. With the ring finger still holding the left nostril closed, bring thumb up to close the right nostril. Release the left nostril.

9.. Exhale through the left nostril.

You have finished one round of alternate nostril breathing. When you start, do 1-3 rounds. If you are feeling comfortable with this pace, gradually increase the number of rounds. Remember to never force your breath – gentleness and ease of breathing will give you far better results than forcefulness. When you finish the exercise, sit with your eyes closed for a few minutes and breathe normally. Observe your mind.

There are certain variations to the technique that you can try when you get used to the routine. If you breathe in for a count of 4, hold your breath for a count of 8 and then exhale for a count of 8. As you progress, you can try to hold your breath for a count of 16, and then exhale in 8 counts. Do not hold your breath for a long count if you have a history of high blood pressure. Just do the exercise as it has been described, allow your blood pressure to stabilize and get to normal and then proceed to the more intense practice.

Benefits of Alternate Nostril Breathing

As with any exercise, you will get maximum benefits from this practice when you do it regularly. This is a great way to revitalize your system. So anytime during the day when you feel ‘low’, get to a quiet corner and do a few rounds of this to get your mood up! A few minutes of alternate breathing, gets you prepped up and calms your mind down to face an interview or an exam.

Regular practice of alternate nostril breath has also been found to improve brain function. It improves clarity and enhances focus, bringing in equal amounts of oxygen to both hemispheres of the brain. People who suffer from anxiety or are easily agitated, report that this kind of breathing helps them to naturally and easily calm their minds. No wonder the yogis used to say that regulating the breath helps to control the mind!

Perhaps the greatest benefit that this pranayama brings is the harmonizing of the two sides of our brain. Bringing our brain to its full use and potential could be revolutionary in our lives! Of course, breathing in through just one nostril can also be done to activate a specific brain hemisphere. Try this out for yourself – the next time you want to calm down and relax, try breathing in only through your left nostril and see what happens. Alternately, when you are driving or focusing on something, breathe in through only the right nostril for a minute and notice the difference.

This technique is excellent for cleansing the lungs. Just a five minute practice every morning, will get rid of the stale air loaded with impurities from the bottom of the lungs. Most of us do not use our whole lungs for breathing – we take shallow breaths, using only the top part of the lungs. This is why stale air that if full of toxins and impurities stays collected in the lower lungs. This technique also helps you sleep better – calming down your nervous system and slowing down your heart rate. If you have trouble falling asleep, try lying on your right side, and breathe in only through the left nostril.

So there you have it. One easy way to address many problems. Try it out for yourself, and do it for at least a week regularly to experience the benefits. All you have to gain is better energy flow throughout your body, more oxygen helping all of your systems to work right, and in the long run, protection from many illnesses – which means that you save money too! Don’t forget to tell us how it goes!

To subscribe to THE HEALTH CAFE click on the link the health cafe team.

For comments on this post mail us healthcafeam@gmail.com

ROBOTS AS SURGEONS

2011-09-02T23:18:00.000+05:30

Many years ago, when writers wrote about a world where machines would assist humans in daily life, it was called science fiction. As the years went by, and technology advanced, so many things that were fiction turned into fact. As recent as twenty years ago, cardiac operations were a big deal, a ‘serious’ operation, and you would not have believed it if someone had told you machines would be doing the job much better in a few years.

But this is now true, and H.G.Wells is probably saying ‘I told you so’. One of the latest approaches to cardiac surgery involves a recent innovation that uses robotic instrumentation to allow cardiothoracic surgeons to operate through a smaller opening for a minimally invasive surgery. It’s called the da Vinci Surgical System.

For many heart patients, when medication and catheter-based treatments do not relieve the symptoms, surgery may be the only option for treatment. But just hearing about the procedures of traditional or open heart surgeries can make even the most stout-hearted among us to feel queasy. “First, your chest is cut open, then your breastbone is cracked open, then we reach in to your chest cavity…” you get the picture.

Thankfully, there have been major advances in surgical technology, which now brings to us minimally invasive surgery and unmanned surgery. Initially, the purpose of having a machine perform surgery was to facilitate remotely performed surgery in battlefields and other remote environments. But it was soon clear that the telesurgical robot was more useful for minimally invasive on-site surgery.

Robots as surgeons

Robotic surgery and research on this has been going on for some time. In 1988, the PROBOT was used to perform prostatic surgery. The ROBODOC was introduced in 1992 to ensure precise fittings in the thigh bone for hip replacement surgeries. These were the forefathers of the da Vinci Surgical System.

The da Vinci Surgical System provides surgeons and patients with the most effective, least invasive treatment alternative for even the most complex procedures, such as mitral valve repair. The best news for the patient who takes this option is that this process offers the potential for a better clinical outcome. Patients who choose this surgery have shorter recovery times than those who have open heart surgery.

How the da Vinci system works

In this process, instead of cutting open the chest, and parting the breastbone, a small working incision and three to five small incisions (ports) are made in the spaces between the ribs. The incisions are about the size of a fingertip. The surgical instruments (attached to the robotic arms) and one tiny camera are inserted through these ports. Motion sensors are attached to the robotic “wrist,” so the surgeon can control the movement and placement of the surgical instruments to perform the procedure.

The spirits of the sci-fi writers and scientific visionaries need to put the brakes on their celebrations though – the da Vinci still needs a surgeon to be in control of the robot. The system is an extremely sophisticated tool that enables the surgeon to perform the surgery with greater precision and control as well as minimal invasion on the body.

Apart from the advantage that the body does not need to take a severe trauma for the procedure, the da Vinci system also gives surgeons the option of performing the surgery on a ‘beating heart,’ in which case the patient is not placed on the heart-lung bypass machine (this is called“off-pump” surgery).

The Process

During the Robotic cardiac surgery procedure, the surgeon sits in a console to the left of the da Vinci console. The robotic arms are directly above the patient, and function as an extension of the surgeon’s hands, directed through the controls in the console.

A tiny camera attached to a robotic arm gives the surgeon a very detailed, 3D view of the operating space inside the chest. The robotic arms are very agile, and so the surgeon gets a greater range of motion than is possible with hand-manipulated moves in standard procedures.

Benefits of Minimally Invasive Surgery

Quicker return to normal activities: Rather than waiting several weeks to heal, patients can return to work or other activities much more quickly–usually within 10 days.
Shorter hospital stay: Time spent in the hospital can sometimes be reduced by as much at 50 percent, compared to traditional procedures.
No splitting of the breastbone (“cracking the chest”): Keeping the breastbone intact reduces the chance for post-surgical complications and infection.
Smaller incisions: Depending upon the case, the operation may be performed through four to five fingertip-size incisions or through a 3- to 5-inch incision at the side of the chest. Traditional open-heart procedures demand a longer incision down the center of the chest.
Much less pain: Decreased destruction to tissue and muscle results in less pain. Tylenol or aspirin are usually enough to manage pain after some procedures.
Elimination of the heart-lung bypass machine: In most cases, avoiding the bypass machine decreases the risks for neurological complications and stroke.
Minimal blood loss and less need for transfusion
A reduced risk of infection
Small scarring: Instead of a long chest scar, only a few tiny scars or a small, 3- to 5-inch scar remains.

Robotic heart surgery in India

Doctors at the Chettinad Health City, Chennai have successfully performed a rare robotic heart surgery on a 23- year-old patient. Dr. R. Ravi Kumar, the Director of the Institute of Cardiovascular Disease at the hospital, said that the robotically assisted procedure involved replacing both the mitral and the aortal valve simultaneously. Although the procedure is quite new in India, Dr. Ravi Kumar was positive about the system being used for a variety of procedures.

Just like for any successful surgery, minimally invasive procedures also need well qualified, trained hands. Since the procedure is very different from operating through a large chest incision, it requires doctors to be trained in a different manner. Even highly experienced surgeons must devote dozens of hours to learning how to use the techniques and equipment for minimally invasive surgery.

There are already several surgeons in India who are well trained in robotic surgery. Since the procedure has only advantages to offer, it is sure to be increasingly in demand in the future. Remember to research as well as discuss all of your surgical options with your doctor if you need surgery.

A healthier YOU in just one WEEK

2011-09-02T23:05:00.000+05:30

Contrary to what you might believe, getting healthier with each passing week can be easier and cheaper than you think. Drinking more water, doing some exercises and breathing properly can make a lot of difference. Try these simple but very crucial practices to ease your way into the good health zone.

Drink more Water The human body is 75% water and a human brain is 85% water. This liquid is one of the key elements that ensure that our metabolic processes are going smoothly – think of the body as a vehicle that needs all of the lubricants at optimum levels. Even a mild instance of dehydration slows down the body’s metabolism by 3%! The lack of water is the single biggest contributor to daytime fatigue. So the biggest and easiest single step you could take to making yourself healthier is to consume more water. Research shows that almost 75% of people are chronically dehydrated. And almost 37% have such weak thirst perception that it is mistaken for hunger. Could you be one of them?

We have all heard the 8-12 glasses a day mantra. It is important to remember that this is the amount that the body absolutely MUST have for good functioning. For optimum replenishment, it is ideal to have 2-3 liters every day. This will ensure that all your cells are well hydrated. If you are not used to drinking these amounts, you will need to consciously enforce this on yourself for about three days. After that, your body’s natural thirst indicators will begin functioning again, and you will automatically feel thirstier.

How to do it: When you wake up in the morning, measure out 12 glasses of water, and pour it into a glass bottle or jug. (Avoid using plastics wherever possible). Make sure that you drink this water throughout the day. This way, you will be reminded of the amount of water you are drinking. Try drinking one glass of water every hour. Increase the amount to 2 or 3 litres steadily over the course of the week.

Breathe with awareness

Your breath is what keeps you alive -Oxygen is the most important nutrient that the human body needs. A few minutes of oxygen deprivation could kill you. Our breath is also the primary medium of toxin elimination. Close to 70% of toxin elimination happens through exhalation. Little wonder that pranayama practitioners usually enjoy better health than others! All of us breathe automatically, and do not use even half of our lung capacity. What results is that our bodies are forced to function on far lesser oxygen than it needs. Oxygen purifies the bloodstream, and is a major source of the energy that we utilize to stay alive. If you observe your own breathing, you may be surprised at how shallow and irregular your breath is. A lot of us even hold our breaths for long periods of time without noticing it!

Apart from throwing out toxins, breathing well can improve energy production, lower blood pressure, reduce stress, and strengthen the immune system. In fact, there are a lot of studies being done which show that the lack of oxygen could be a major cause for heart disease, stroke and cancer. It is of utmost importance that people with sedentary jobs breathe better – this can make all the difference in their metabolism, immunity and even sleep.

How to do it: First of all practice breathing correctly. When you inhale, your stomach should inflate like a balloon – this is how you know that the air is filling even the lower part of your lungs, utilizing your breathing apparatus fully. Most of us push the air into the top part of our chest – moving the shoulders or upper chest as we inhale. This limits oxygen intake. Every time you take a bathroom break, take a few seconds to place your hands on your stomach and inhale, pushing your stomach out. It should take you just a few tries, or ask anyone who practices yoga to help you figure it out.

Every time you have a glass of water, every time you sit down to eat something, or if you are watching TV and a commercial comes on – remind yourself that it is time to breathe correctly. Relax your shoulders, straighten the small of your back and focus your attention on your breath. Breathe easily, gently with long breaths into your stomach. Exhale gently. Repeat at least 5-10 times. Make it a point to do this as often as you can.

Exercise Most of us know that exercise is important to burn off extra calories, but its benefits in maintaining good blood circulation and working your heart and lungs make it an essential part of keeping your body healthy.

How to do it: Decide what you can incorporate into your schedule, and DO IT! Make sure you move your body every day – walk to the neighborhood store for the groceries, take the stairs instead of the lift (if you’re not going too far up), go for an evening or even late night walk, put on your favorite songs and dance, do some simple flexes or stretches every time you are talking on the cell phone.

Eat Dinner early Our digestive system starts winding down when the sun sets. This means that the later you eat, the more strain you are placing on your system. Most of us make it worse by eating just before we hit the bed. This means that we have lots of food in our system and a body that is asleep before it is digested – making for poor digestion and toxin accumulation. Worst of all, this practice forces our body to focus most of its energy on digesting the food, when it should actually be using the time we sleep to repair, heal and energize our complete system. This is why we wake up sluggish and lethargic most of the time.

How to do it: Eat your dinner before 8.00 p.m. Don’t worry about getting hungry later. Go to sleep only by 10 or 10.30 p.m. If you feel hungry at bed time, drink a glass of water or have some fruit. It may take you about three or four days to hold to this routine, but if you persevere, the benefits that you feel will help you to make this a welcome, even effortless shift in your nightly routine.

Vegetarianism

Studies show that the human body is basically herbivorous in nature, and functions better on an alkaline diet of primarily vegetables. When we consume non vegetarian food on a constant basis, our blood becomes more acidic than alkaline, setting up the scene for illnesses and diseases to thrive. Decreasing non-vegetarian foods also means decreasing the toxin burden on your internal organs, especially the kidneys.Toxins from a vegetarian diet are fewer and easier to expel. Overall, vegetarians enjoy better health and have lesser chances of suffering from cancer, high blood pressure and heart problems.

How to do it: A good way of improving your health is to decide that you will consume only vegetarian food on certain days of the week. This can provide radical benefits to your digestive system, sleep patterns and immunity. You can add the number of vegetarian days in the coming weeks, depending on how you feel about it.

It would be ideal to incorporate all of the things listed above into your routine, but it is important not to overwhelm yourself with change. Decide for yourself what it is you will focus on this week, stick to it and then add more things to it, if that is what works for you. The key lies in figuring out how these practices can be incorporated into your life, and also in having the perseverance to stick with a change for a few days. It is always the first few days that seem hard – this is the window period where you are resisting change from the old routine. After that, any practice that is good for your body will be welcomed by your system, and will be easy to stick to.

A candid chat with Padmashri Dr. Marthanda Pillai

2011-09-02T22:59:00.000+05:30

By Reba Paul

I waited among very patient patients outside Dr. A. Marthanda Pillai’s consulting room. The recent recipient of the Padma Shri award, who lives in Trivadrum and heads the team at Ananthapuri Hospitals and Research Institute, had a packed waiting room. I wondered what it would be like to meet a Padma Shri recipient- would I need to be extra polite and respectful? Surely a man who was respected for the huge amount of medical service given freely to thousands poor patients, wouldn’t be too hard to talk to. Inside the doctor’s room, behind a large table sat a bespectacled man in his early seventies, wearing an army style bristle- brush moustache. Just as I started wondering whether I should be nervous, a polite smile appeared. Clad in a simple brown shirt, sleeves rolled up to the elbows – Dr.Pillai looked like the kind of doctor who was ready to get into action at the shortest notice. Exactly how I would want my neurosurgeon to be if I needed one

Dr Marthanda Pillai (Former Head Neurology Department. Govt. Medical College-Thiruvananthapuram, Presently Chairman & Managing Director, Ananthapuri Hospitals & Research Institute, Thiruvananthapuram) graduated from Medical College Trivandrum and then went on to CMC Vellore to specialize in Neurology, after which he practiced there until 1978. He joined the Medical College service in the department of Neurosurgery after this, following which he worked at Kottayam for some time. Later on he went to England for a few years of further specialization and training, and returned to Medical College. Dr. Pillai was awarded the Padma Shri award in 2011 in recognition of his work in the field of neurosurgery and his service in performing brain and spinal operations for poor patients free of cost. When Dr. Pillai served in the government Health Service he oversaw the improvement of the neurosurgical services, taking it to one of the best at the national level.

H.C: “Going to CMC – was that a part of your initial plan?

“CMC was the foremost centre in the field of neurosurgery at that time and had the first center established under Dr.Jacob Chandy. Being there has greatly impacted who I am as a doctor and my career. It was more a place of worship than a hospital – there was that kind of a reverent attitude… and everyone was committed, service minded. Their day started at 7 o’clock, and went on till 11 or 12 at night, depending upon the workload. Absolute dedication and service – that’s what I saw there. My Professor was Prof.Mathai, who was a role model – his attitude and concern towards the patient, his work culture, punctuality, and meticulousness- were all inspiring to me. Seeing and being with senior doctors who were like this has really influenced my attitude towards this profession.

H.C: Has studying abroad played a part in shaping your career?

“Yes. That too has influenced my thought process, work culture etc. It was more or less similar to what I was seeing at CMC Vellore – their commitment to the patient. For instance, if a doctor is the MO of the Casualty, they just don’t pack up and leave after duty hours. After duty hours, they come back to the ward to check on the patient and see if their diagnosis in the causality was the right one, and would also follow up on the patient until discharged. Another thing would be - an approach of critical thinking about the patients as well as the medical approach taken – that was always there.

H.C: Would you say that this kind of an approach is lacking in our practice of medicine here, in Kerala?Could be, but there are various reasons for that – one is that we are not tuned to that sort of a situation. When we look at modern medicine, most of the diseases, particularly neurological diseases as we know them now, were all described by doctors in the West. They are the ones who documented and began studying it in the current manner and form. We are more bookish – if something is put down on paper, we do not look any further than that. They are not like that – their thought goes beyond what is in the book. They don’t accept the status quo – there is a scientific curiosity to know more about things. That is why they constantly try to find out newer medicines, or define new scientific processes.

But they have much lesser patients than a doctor here has – so there is more time to pursue research and experiment. Also, over here, this profession is a way of making a living. This is our only means of security. In the UK, they do not have to worry about social security. On another angle, they also do not have the concept of amassing wealth for their future generations like we do here. All of these social factors count in how our attitude is formed. Things are different here – there is competition, it’s a mad race for existence and survival. So for many of the people, the time you spend on the real profession becomes much lesser.

H.C: So it was very important that you could have this experience?

Yes. It is very important to have this exposure. Especially after you pass a certain stage in your profession, it is always good to look at the approach of professionals in other places. For example in Vellore, which is considered one of the best teaching centers, we used to have postings in other medical institutions – in Madras or Bangalore or Karnataka… you would visit four other centers. The purpose was to understand that one situation or problem could be approached in different ways – you would see different people approaching similar situations with different perspectives. We lack this element in our teaching programs here. In my case, you can say that I got the opportunity by chance.

H.C: So would you say these are certain things that should change in the way our system works now?

You know, one very good thing about how the system works in the West is that right from the undergraduate level, there is a teacher to gauge the aptitude and skills of the student, and effort is taken to develop these skills. And ultimately the student will choose a profession for which he has more skills. It is not so over here – most of the time the parents decide that the child should go for MBBS. And there are many students who stop their course midway, especially in the private professional course sector. That is because without considering the child’s aptitude, the ambition of the parent is directly planted onto the child.

Of course the system is changing, but you can’t keep taking a lot of time to do this…even after so many years of realizing this is a problem, we are still ‘thinking’ about how and where to bring about change. We should be taking a little more of an active approach. I think the human resources department is focusing on this now.

H.C: Why is the human brain such a challenging topic to you?

Looking at it as an organ in your body – no other organ can match it , in terms of its physiological function. It constitutes only about 2% of your body mass, but almost 15% of the blood pumped out of the heart reaches the brain for its proper functioning. About 20-25% of the oxygen that we breathe is supplied to the brain. So you can understand how active the brain is. If we look at the functions- unlike other tissues like skin or the lining of our stomach etc. which looks like rows of bricks one on top of the other, the brain cells are very different. The actual cell body of a brain cell will be in one place but its process may be in a portion of the brain that is distant from it. One cell may have about 50,000 connections with another cell or its processes. So the brain is a group of cells that has such an intricate network – around 2 billion cells are in the brain. This cannot be duplicated by any computer – 2 billion cells with 50,000 interconnections!

This has its own advantages and disadvantages. Once the brain is damaged, it is almost impossible to reestablish all of these 50,000 connection between cells. That’s why recovery is more difficult in cases of injury to the brain as compared to other organs. But the brain is adequately protected, unlike any other organ – it’s the only one with a hard bone covering. Now, even this has its advantages and disadvantages – a tumor growing in the brain has no place to expand whereas a tumor in any other organ has space to expand. So in the brain even a slight increase in volume produces quite a lot of ill health or is life threatening. Also in the case of infection – all other places in the body have their own defense mechanisms to fight against infections; the brain has much lesser capacity for this.

H.C: Is aging a part of the brain function?

Technically speaking, the reason that a person ages and dies, is due to the gradual decrease in brain function. In the first two years of your life, your brain grows by 200%. This is sustained for many years – up to 30-35 years. After this, even in people who are in the best of health, the brain slowly starts degenerating. When your brain starts failing, then every other organ slowly starts failing. This degeneration depends on how much of your brain you use. In all of us the capacity utility of the brain is hardly 2-20%. There are areas of the brain that are literally dispensable, simply because we are not using the whole brain. When you use a part of your body, there is a corresponding blood flow to a certain part of the brain. So leading an active life, using your brain and its thinking and processing capacities, engaging your mind - these are all things that will help keep the brain active and healthy.

H.C: What’s your opinion of the quality of the medical profession in India now? Are we moving in the right direction?

We cannot make a flat statement about that. The younger generation is more intelligent – that is evolution. So that process is going on, they are much more intelligent, versatile, and resilient. But the existing social order, the circumstances that exist, the lack of ideal people to look up to… these are all things that need to be addressed if the profession is to evolve in a good manner. When children are in their teens, having a role model is essential. We do not have good role models for our children to be inspired by. All we have is a distorted perception of life that is acquired through TV or other popular media. Many of them find their own way through trial and error. If there is anything wrong with the younger generation, the social order or the system is to blame. So if we correct the system, things will be better.

H.C: Are there ways in which the medical establishment can function in a much better way, so that the people are benefited more?

The evolution of the health delivery in our state is quite ideal –and over time, things are definitely improving. When a need comes, an adequate change comes. Availability of an efficient medical service at an affordable cost – is not available in many states of even other advanced countries. Even in a place like the USA, almost 40% of people who need medical care may not be in a position to receive it. Here, we have a combination of public and private sectors and other national institutes to ensure that everyone who needs medical attention gets it. So we can say that our system is a better system by any standard. We have to remember however, that quality improvement always comes when there is a demand for it and when you are vigilant. In Kerala we have a population who is health conscious and are also very demanding that they want the best. This kind of a watchdog role is being taken by the public so there is a constant automatic improvement happening in the system.

Almost all areas of our state are receiving good health care through the private or government sector – even remote areas. Of course there is commercialization, and corruption does exist to an extent. But the positive aspect is that we are improving, we are giving better health care, at an affordable cost. So generally, the direction that it is going in is alright.

H.C: What is your opinion of the condition of the auxiliary services that we have right now?

A lot of improvements are actually happening in these areas. Earlier, the ambulance was used only to transport a dead body. It was just a vehicle with a driver. It’s not like that anymore. We have well equipped ambulances, with well qualified professionals. But this should be cost effective. The number of ambulances should be increased on the basis of utility. If you have 100 ambulances, which are not being utilized, then that is a waste of resources. The number of trained people also should be increased in accordance with the need. This can go a long way in givingtimely help to patients. For example, if a patient has a heart attack, an ambulance goes to pick him up, the accompanying healthcare professional should be able to thrombolize the patient– which is same thing to be done for a stroke. This will shorten the time taken for the patient to get adequate attention, and can improve his chances of survival and recovery. For a stroke, if you can thrombolize within four hours, it can go a long way to dissolve the clot and prevent further complications.

H.C: What is your take on many patients going in for alternative treatments following a stroke and other such neurological conditions to facilitate and aid recovery?

The scope of an alternate system is limited. If you have a genuine disease, modern medicine is the one thing that can give you maximum relief; I have no doubt about that. People with psychological and psychosomatic disorders – for example, a patient complaining of back pain and repeated scans do not show anything wrong – such patients might get solace from alternate systems. For any real diagnosed disease, modern medicine is the only science that can give good relief. Ayurveda, in particular is effective for chronic illnesses, like stomach upsets or dermatological conditions. And the massages and other things are a substitute for physiotherapy. But even this needs a word of caution – a patient who suffers from neck pain should not go for Ayurvedic treatment without proper investigation – or it could do more harm. Especially in cases of disc prolapsed or bone disease; if proper diagnosis is not done initially, in many cases, massage can make things worse.

H.C: So what would be your advice for a stroke patient – many are conflicted about what to do next.

For a stroke, you have to always go back to the reasons that caused it and continue to treat it. Diabetes, cholesterol and lifestyle habits- all these are contributing factors. And a patient who gets a stroke is likely to get many more strokes over time. So lifestyle and dietary changes, exercise - these are the things to be strictly followed. And adding physiotherapy for recovery is scientific- if these things are followed, there is nothing more to be gained from any other alternate system. I don’t mean to belittle any other systems, but the scope of what they can do is the same as what the patient can achieve with these changes. There are, however, a large number of patients that do go for alternatives like naturopathy etc. Most of these are related to psychological symptoms. The main things to remember is that rather than emphasizing on the curative aspect, we should be focusing on prevention of disease. Curative aspects are always taking great strides forward, but these are all expensive, so we should be looking to prevent disease….

and many are lifestyle related.

If you had not become a doctor, what profession would you choose to be in?

(chuckles)I would have been an engineer. You see, in neurosurgery, instrumentation and the mechanical aspect is very much there – the surgery is very dependent on tools and other equipment. This is something very interesting to me- the mechanical aspect of the brain.

H.C: What was your response to the prestigious award that you received recently?

Of course, there is a satisfaction that what you are doing is being recognized…but basically it gives you much more responsibility. Because once you get this kind of recognition you have to live up to it and keep improving your performance.

H.C: Finally, what would be your advice to someone of the younger generation who wishes to be an effective doctor?

First thing is, if you have an aptitude for it, go for this profession. This is a field that requires a high level of social commitment. You have to practice medicine with religiosity. It’s just like a prayer in a place of worship, and if you do that, then the rest of the things will follow automatically.

Cosmetic Dimples

2011-09-02T16:23:00.000+05:30

Article by Parvathy Nambidi (The Health Cafe' - September 2011)

Don’t despair if you were born without a dimple- now you can get one!

Preity Zinta, Shah Rukh Khan, Deepika Padukone…Angelina Jolie, Jennifer Garner…not to forget Marc Anthony, Ben Affleck, Jim Carrey… and these are just the ultra famous ones. What do these stars have in common you say? Why, dimples of course!

For years, dimples have been seen as a little touch of something special that enhances beauty. Could it be that a little break in the symmetry of a face adds to its beauty, or is it simply that a cute little dip in the cheek or a strong cleft in a masculine chin possesses a power all of its own, making the beholder wish they had one too…?

Whatever the reason may be, dimples are widely considered to add an extra something to an already pretty face. Anatomically speaking, a dimple is an abnormal attachment of the smile muscle (zygomaticus) to the cheek skin, which pulls that part of the cheek when smiling. Since dimples are genetic, most folks who did not descend from families blessed to have a ‘dimple’ gene popping through, have resigned themselves to adoring their favorite dimpled celebrities, with no hope of having one of their own.

But wait! Here’s good news from the world of cosmetic surgery. If a dimple is what you are dying to have, just get to a cosmetic surgeon, and walk out with one on your cheek! The dimple fabrication procedure has recently been making the rounds on beauty forums, consumer sites and on TV shows. Since this is done under local anesthesia as a day care procedure, its demand is steadily increasing. Dr. Hari Menon, Cosmetic Surgeon at Lakeshore Hospital, Cochin says, “Dimple creation surgery is a straight forward procedure performed as a day care cosmetic surgery”. What’s more, there are no visible scars afterwards since only a small incision is made on the inside of the cheek.

How is a dimple surgically created?

The surgeon simply creates a connection between the muscle and the skin in the area selected. If you would like to have a dimple on your cheek, all you need to do is check into the hospital as an outpatient, and have the procedure done in the clinic, under local anesthesia in less than 45 minutes. You will be awake and comfortable during the entire process.

During the procedure, a punch biopsy instrument is placed against the inner cheek which cuts through the mucosa, submucosal fat, and cheek muscle. A circular core composed of these tissues is removed, leaving the skin intact, which will create a shallow cylindrical-shaped defect under the skin.

This ‘defect’ is then closed by placing an absorbable suture through the cheek muscle on one side of the hollowed out area, then through the dermis layer of the skin and finally through the cheek muscle on the outer cheek. A surgical knot is tied, which in turn will result in the person having a dimple in the cheek, even without smiling. In a week or two, the suture is absorbed and the skin will flatten out. The internal scarring which takes place will connect the muscle to the skin, creating a dimple when one smiles.

Dr. Menon adds, “It is a relatively safe surgery when performed by an experienced cosmetic surgeon”. The actual procedure takes about 20 minutes and you can go home right away after the procedure. Excessive facial animation or exercise is usually advised to reduce the swelling that may follow the procedure. For a more prominent dimple, a bigger punch biopsy will be used. This procedure can be performed on any kind of cheek, although it is easier to do it on a face that is not too chubby. For several weeks, a visible, static dimple will be seen whether you smile or not. This slowly converts to a dynamic dimple over time which will appear only when one smiles.

Individuals with severe medical problems that require additional treatment and investigation or have bleeding disorders, will not qualify for this procedure. Dr. Hari Menon says that most inquiries into the procedure have come from women. For many, after a lifetime or envying others with dimples, or wanting to look a little like their favorite celebrity – this is finally a chance to make one of their dreams come true.

In India this procedure is available at:

• The Apollo Hospitals

at Bangalore, Chennai,

Hyderabad, Delhi and Goa.

• Fortis Hospital, Delhi.

• Artemis Hospital, Gurgaon.

• Max Devki Devi Heart

and Vascular hospital, Delhi.

• BGS Global Hospital,

Bangalore and Hyderabad.

• Lakeshore Hospital,

Kochi, Kerala.

THE GREAT DETTOL MAGIC by Jacob George

2011-08-15T12:42:00.000+05:30

It stings. It pricks. And it has a pungent smell which reminds us of a hospital ward. But still people love Dettol. It has been a household name in India for about 78 years now, the most trusted antiseptic liquid of Indian mothers from generation to generation. The Dettol saga began in the year 1933. Even today, it is the default antiseptic liquid that people use for cuts and grazes, bites and stings and minor burns and scalds. This iconic brand continues its successful journey even today, with no potential threat coming up against it from any quarter. The brand has become synonymous with protection from germs. It’s identity is so strong that the whiff of Dettol in a room is enough to give one the assurance that this is a space that has no bacteria or germs in it.

Though Dettol was launched as a solution for fresh cuts and wounds, in India it was first used in hospitals and nursing homes for first aid and disinfectant uses like cleaning wards, washing hospital clothes etc. Very soon ordinary people started taking it as a first aid tool for their familes. Apart from being a liquid for cuts and wounds and even small burns, it was used for bathing, mopping and even shaving. Over the years, Dettol became the trusted brand of the people - not only in India, but in several countries across the globe.

Today, Dettol is a formidable brand – one that has its iconic brand image standing tall. The unmistakable Dettol smell is very strong and clinical in nature, a kind of ‘hospital smell’. The painful fact is that it hurts when it is applied on fresh wounds. Mothers are happy when the child cries as Dettol is applied on the wound. Because she knows that the Dettol has started working. That it has started killing the germs and that the child is safe.

Dettol is a good multipurpose first aid liquid. Good to use for midwifery or to bathe with, to clean minor wounds and kill germs. When you use this for first aid, to clean grazes etc., you are reducing the risk of a cut or graze going septic. The sword on the logo of Dettol implies that the contents are intended to kill germs.

Dettol has become an essential household product today. People use it for washing hands, in bath water and even as an after shave lotion. The brand is owned by Reckitt Benckiser India Ltd. (RBIL), a fully owned subsidiary of Reckitt Benckiser, a company that operates in 60 countries and sells its products in 180 countries. RBIL manufactures and markets a wide range of products in personal care, pest control, shoe care, antiseptics, surface care, fabric care etc. Apart from Dettol, the company also has other popular brands like Mortein, Harpic, Cherry Blossom, Lizol and Colin. All of these products have been successful in gaining a prime position in peoples’ perceptions through unique advertisements and excellent marketing techniques. For example, the Dettol brand has always focused on celebrating the mother’s role in protecting her family.

The antiseptic liquid market in India, estimated to be at Rs 150 crores, is dominated by Dettol which has about 85 % market share. Savlon, from Johnson & Johnson is the other significant player in the field with a market share of about 12%. The chemical name of Dettol is Para chloro meta xylenol (PCMX) and the main ingredient that defines its unique antiseptic property is an aromatic chemical-chloroxylenol. When poured into water, it produces a white emulsion which gives a cloudy look. This is because of the fact that some of the ingredients are insoluble in water.

The steady growth of the Dettol brand over the years in India and several parts of the world is a big business lesson too. The only brand that has dared to challenge Dettol was Savlon. Despite a massive advertising campaign that was spread over a long time, Savlon could not overthrow the monopoly of Dettol.

Though Dettol had a high penetration level and almost all households kept a bottle of it handy, they rarely used it. In order to stoke sales, Reckitt decided to expand Dettol’s usage beyond cuts and bruises. This resulted in a campaign that showed that Dettol could be used as an all-purpose antiseptic while shaving, rinsing babies’ nappies, as a general disinfectant and so on. At present, the brand has spawned yet product – namely, Dettol soap, which is a major contributor to the 230-crore turnover that the brand enjoys.

Dettol Vs Savlon the brand war

Here’s the story of how Savlon and Dettol came head-to-head in a fight to establish supremacy in the antiseptic kingdom. There have been studies that show that Savlon has a lot of advantages over Dettol. Test indications were that it is a more effective germ killer than Dettol. The reason for this is that Savlon is effective against both Gram Positive and Gram Negative germs.

Moreover, Savlon does not sting when applied on wounds as opposed to the sting that Dettol delivers. Savlon also scores higher on the scent front – the tests showed that Savlon’s scent was preferred to Dettol’s, which was felt to be more ‘clinical’.

After years of Dettol being King of Antiseptic Lotions, Savlon got a boost through this feedback and leapt into the arena, armed for a good fight. During its relaunch by Johnson&Johnson, the main areas focused on were Savlon’s better scent and its no-sting property. The product was positioned as an antiseptic that does not hurt while healing.

Dettol did not take the attack lying down. Their response was to target one of the most valuable Johnson & Johnson brands – Band-Aid. Dettol launched its own plasters. This was a blow for Savlon because the new Dettol plasters had the advantage of the existing brand value that Dettol had been enjoying for years.

Johnson & Johnson scrambled to protect Band-Aid by launching a series of variants in the medicated plaster segment. In doing so, resources were spent on defending Band-Aid rather than in advancing Savlon.

Savlon suffered heavily because it lost valuable support in terms of investment in brand building. Dettol had a brand equity built over more than five decades and it was not an easy task to break into that strong base. However, Savlon was pushed to a back burner after Dettol introduced the plaster. And so it is that even today, Dettol rules the market.

jacobgeorgetvm@gmail.com

Breast Cancer

2011-08-03T15:58:00.001+05:30

Dr. JAYAPRAKASH MADHAVAN, Senior Oncologist in Kerala, and Head of KIMS Pinnacle Oncology, Thiruvananthapuram, gives an expert analysis to help empower you to combat breast cancer.

One of the biggest challenges that modern medicine faces today is understanding and dealing with the disease called cancer. The word “cancer” simply means uncontrolled growth of a few cells, which may invade into surrounding tissue and may even spread to other parts of one’s body. Breast cancer is the second leading cause of cancer deaths today, after lung cancer and is the most common cancer among women, excluding non-melanoma skin cancers.

Every woman is at a definitive risk of breast cancer, which is second only to cervical cancer among women in India. On rare occasions, men also present with breast cancer. The rise of breast cancer among women is being documented mainly in the metros, but it can be safely said that many cases in rural areas go unnoticed. It is reported that one in 22 women in India is likely to suffer from breast cancer during her lifetime. In Kerala, this is the most common cancer diagnosed among women. Statistics has it that approximately 4500-5000 women in Kerala develop breast cancer annually.

When diagnosed early, breast cancer can be treated using surgery, radiation therapy and systemic therapies (chemotherapy, hormones or both). If diagnosed in the early stages, this cancer is pretty much curable. Unfortunately, the majority of patients in India come in for treatment when the disease has already reached advanced stages. In such scenarios the onco-surgeon and oncologist have fewer options of treatment to offer to the patient and breast removal is a norm either with or without chemotherapy, followed by radiotherapy many times. Since the incidence of breast cancer is increasing in India, it has become very important to prevent and detect it early in order to reduce breast cancer related fatalities.

Risk factors

Most breast cancers are sporadic, caused by multiple factors. Only about 5-10% are due to familial cancers. The hereditary breast cancer is traced to inherited mutation in the BRCA1 and BRCA2 genes. The main identifiable risk factors for breast cancer are family history of breast cancer, increasing age, early menstruation with late menopause, and women who have had no children or have had their first child after 30 years. There are also other factors like long-term use of post menopausal replacement therapy and early exposure of chest or breast to radiation.

Symptoms and early detection

The most important feature of breast cancer is a lump that develops in the breast or surrounding area. The mass that develops is often painless. Since most breast cancers are painless, and not all lumps are cancers, it is advisable to follow the following steps to facilitate early detection. Women aged 40 and older should have a screening mammogram every year and should continue to do so for as long as they are in good health. Women in their 20’s and 30’s should have a clinical breast examination (CBE) as part of a periodic health examination by a health professional, at least every 3 years. After age 40, women should have a breast exam by a doctor or a trained nurse every year.

Breast self exam (BSE) is another option for women starting in their 20’s. Women should be informed about the benefits and limitations of BSE. Any changes in the breast tissues to the doctor right away. Current recommendations emphasize that women at high risk (greater than 20% lifetime risk) should get an MRI and a mammogram every year. Women at moderately increased risk (15% to 20% lifetime risk) should talk with their doctors about the benefits and limitations of adding MRI screening to their yearly mammogram. Yearly MRI screening is not recommended for women whose lifetime risk of breast cancer is less than 15%.

Many a time breast cancer may present or be associated with skin changes called peau d’orange appearance (the skin will have a pitted surface, like the peel of an orange), dimpling of skin, nipple retraction, or crusting of the nipple. Associated nipple discharge may also be present. These are due to the strictures and contractions formed by the growing cancer beneath.

Diagnosis

Diagnosis of breast cancer is done from history, physical examination and mammography. Diagnosis is confirmed by cytological or histopathological examination of a biopsy sample. Fine needle aspiration cytology (FNAC), core needle biopsy, incisional or excisional biopsies are done to obtain the tissue sample for examination. Pathological examination helps to grade the tumor, and assess the completeness of the surgery. Special immunohistochemistry examinations and molecular markers (like ER – Estrogen Receptor, PR– progesterone receptor or Her2Neu – Human Epidermal Growth Factor Receptor 2) help to assess the receptor status to predict the behavior of the tumor and select the appropriate treatment for a particular tumor. Medical science is moving to the era of personalized treatment.

Staging

After confirming the diagnosis of breast cancer, staging investigations are done to assess whether the tumor has spread to other areas. Cancer can spread to lung, liver, bone and brain. So imaging studies like CT scan, MRI scan, bone scan and PET scan are done to rule out this possibility. Once all the investigations are obtained, the patients are advised to decide the optimal management. Breast cancer patients require surgery, radiation, chemotherapy, hormones and biological agents for treatment.

Treatment

For treatment purposes breast cancer patients can be divided into three major groups

1- Early operable breast cancer

2- Locally advanced breast cancer

3- Metastatic breast cancer

Surgery: Earlier the better

Early breast cancer is operable and usually limited to breast alone or and to axillary lymph nodes. Treatment of early breast cancer has two components. The first step is local treatment surgery alone or surgery and radiation. The second step is systemic treatment - chemotherapy, hormones and biological agents. This systemic treatment is called adjuvant treatment.

Local treatment varies from removal of the breast and axillary lymph nodes (Modified Radical Mastectomy) to lumpectomy and radiation. (breast conservation treatment). In breast conservation treatment, the tumor with a thin rim of normal breast tissue all around the tumor is removed (lumpectomy). After lumpectomy, the breast is irradiated. Both mastectomy and breast conservation treatments have shown equal success in locally controlling and curing the tumor. In western countries 90% of patients present with early stage disease and the majority opt for breast conservation treatment. Even after a mastectomy, some high risk patients require post operative radiation to the chest wall and the armpit. Breast reconstruction surgeries can be done after the mastectomy.

Recurrence-Another threat

Adjuvant systemic treatment (supporting treatment) is given to early breast cancer patients because many such patients come back with the cancer recurring at distant sites. At present we do not have mechanisms to predict which patient is going to relapse and which patient is going to be cured by local treatment. Therefore, all are given adjuvant systemic treatment to prevent future recurrence of the disease. The choice of the drugs for adjuvant treatment is determined by factors like stage and grade of the tumor, age, menopausal status, and molecular markers

Adjuvant treatment is given for a definite period of time. Almost all early breast cancer patients receive chemotherapy. Some of them require hormones and or biological agents like Trastuzumab in addition to chemotherapy. These adjuvant treatments are very effective in significantly reducing the number of breast cancer related deaths.

Locally advanced breast cancer

More than fifty percent of women approach the doctor when the disease is at an advanced stage. This group requires anterior chemotherapy to reduce the tumor in order to facilitate complete surgery. After mastectomy they need local radiation to the chest wall and local lymphatic drainage area, along with systemic treatment.

Metastatic breast cancer

When breast cancer spreads outside the breast and regional lymph nodes to distant areas, it is called Metastatic breast cancer. The objective of treatment at this stage, is control of disease and prolongation of life. Only subsets of patients achieve long term relief and cure. At present metastatic breast cancer is treated with systemic treatments. The main groups of drugs are chemotherapy, hormones and biological targeted drugs. These drugs are used in combinations or sequentially to control the disease and improve the quality of life. Occasionally patients need radiation treatment to bone and brain metastasis.

Prevention and early detection

The incidence of breast cancer is increasing in India. It has been observed that lifestyle changes contribute much to this. Low fat intake and regular exercise can reduce the incidence of breast cancer. Drugs like raloxifene are effective in preventing breast cancer in the high risk group of women.

Early detection is very important, because early stage breast cancer has a high cure rate. The currently available methods of early detection are self examination, Physician breast examination and Mammographic Breast Examination. Mammographic examination uses soft X-rays to image the breast. With this test we can detect tiny, even non palpable breast cancer. Mammography is used for women above 40 years. In high risk women below the age of 40, MRI examination of the breast is useful to detect early cancers. The American Cancer Society recommends annual mammographic examination for all women above 40 years of age.

Early detection and adjuvant treatment of breast cancer have contributed immensely to reducing breast cancer related deaths. Early detection will help the majority of our women with breast cancer to undergo breast conservation treatment also, which in turn can help them lead a normal life.

_____________________________________________________________________________________________

Women at high risk include those who:

•Have a known BRCA1 or BRCA2 gene mutation •Have a first-degree relative (parent, brother, sister, or child) but have not had genetic testing themselves •Have a lifetime risk of breast cancer of 20% to 25% or greater, according to risk assessment tools that are based mainly on family history

•Had radiation therapy to the chest between the ages of 10 and 30 years

•Have Li-Fraumeni syndrome, Cowden syndrome, or hereditary diffuse gastric cancer, or have first-degree relatives with one of these syndromes

Women at moderately increased risk include those who:

• Have a lifetime risk of breast cancer of 15% to 20%, according to risk assessment tools that are based mainly on family history (see below)

• Have a personal history of breast cancer, ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS), atypical ductal hyperplasia (ADH), or atypical lobular hyperplasia (ALH)

• Have extremely dense breasts or unevenly dense breasts when viewed by mammograms

_____________________________________________________________________________________________

Loving the lepers

2011-08-02T15:56:00.001+05:30

“I choose the poverty of our poor people. But I am grateful to receive the Nobel in the name of the hungry, the naked, the homeless, of the crippled, of the blind, of the lepers, of all those people who feel unwanted, unloved, uncared-for throughout society, people that have become a burden to the society and are shunned by everyone.” -Mother Teresa

In a world that was driven by schisms, skeptical of master plans and utopian schemes, this small woman refused to let ideology concern her, but instead shone as a beacon of humanity and compassion. She dedicated her life to the cause of humanity. Gentle, human and full of energy, Mother Teresa was an apostle of love devoted to the slums of Calcutta, who became a respected and beloved citizen of the world. Her selfless work among the poverty-stricken people of Calcutta is an inspiration for people all over the world.

Mother Teresa’s primary work was among the lepers of Calcutta. India continues to have the largest number of leprosy patients, with 1.37 lakh new cases recorded every year. When Mother Teresa began her work, the social stigma attached to leprosy was strong. This was a major obstacle to self-reporting and early treatment. She took care of the lepers at a period when they were ostracized and often abandoned by their families.

From childhood, Agnes Bojaxhio had a call to help the destitute. At the age of twelve, while attending a Roman Catholic elementary school, she records that she knew she had a vocation to help the poor. She decided to train for missionary work, and at the age of eighteen joined the Sisters of Loreto, an Irish community of nuns with a mission in Calcutta. After a few months of training in Dublin she was sent to India, where in 1928 she took her initial vows as a nun. On May 24, 1931, she took the name ‘Teresa’ in honor of St. Teresa of Avila, a sixteenth-century Spanish nun. From 1931 to 1948 Mother Teresa taught at St. Mary’s High School in Calcutta, but the suffering and poverty she glimpsed outside the convent walls left such a deep impression on her that in 1948 she requested and received permission from her superiors to leave the convent school and devote herself to working among the poorest of the poor in the slums of Calcutta.

In India’s slums, huge numbers of people were infected with leprosy, a disease that can lead to major disfiguration. Mother Teresa eventually created a Leprosy Fund and a Leprosy Day to help educate the public about the disease and established a number of mobile leper clinics. These started working in September 1957, and worked to provide lepers with medicine and bandages near their homes. By the mid-1960s, Mother Teresa had established a leper colony called Shanti Nagar (“The Place of Peace”) where lepers could live and work.

She persuaded the city of Calcutta that leprosy was not contagious and got the lepers to build a self-supporting colony at Titagarh that she named after Mahatma Gandhi.

Mother Teresa began an open air school for homeless children. She was later joined by voluntary helpers, and financial support was also forthcoming from various church organisations, as well as from the municipal authorities. On October 7, 1950, she received permission to start her own Order “The Missionaries of Charity”, whose primary task was to love and care for those persons that nobody was prepared to look after. Today the Order comprises about one thousand sisters and brothers in India, of whom a small number are non-Indian. Many have been trained as doctors, nurses and social workers, and are in a position to provide effective help for the slum population as well as to undertake relief work in connection with such natural catastrophes like floods, epidemics, famine and dealing with refugees. The Order provides food for the needy and operates hospitals, schools, orphanages, youth centers, and shelters for lepers and the dying poor. It now has branches in 50 Indian cities and 30 other countries.

While the hospitals were overflowing with patients who hardly had a chance to survive, Mother Teresa opened a home for the dying, called Nirmal Hriday (“Place of the Immaculate Heart”), on August 22, 1952. One of her happiest memories was of the man who said, as he lay dying in her lap, “All my life I have lived like an animal on the streets and now I am dying like an angel.” Her prize children, often without limbs or with terminal diseases, were ones she would rescue from dustbins. Each day, nuns would walk through the streets and bring people who were dying to Nirmal Hriday, located in a building donated by the city of Calcutta. The nuns would bathe and feed these people and then place them in a cot. These people were given the opportunity to die with dignity, with the rituals of their faith.

From a single school which she started in a Calcutta slum in 1948, Mother Teresa’s Order grew into a multinational organisation that continued to be run from a small office in Calcutta. In the year before her death, her Order ran 755 homes in 125 countries. During that year the Missionaries of Charity fed half a million hungry mouths in five continents, treated a quarter of million sick, taught over 20,000 slum children and ran homes for the mentally destitute, the leprosy-afflicted, AIDS patients, the crippled, alcoholics and drug abusers. They ran day crèches, night shelters, soup kitchens and TB sanatoriums.

Mother Teresa wore a sari similar to those worn by Calcutta’s municipal sweeper women, so that she could identify with the poorest of the poor. Later the saris worn by everyone in the Missionaries of Charity were woven by lepers’ hands. She believed in taking one small step at a time but had the administrative capability to perform many tasks simultaneously. Because she saw her God in everyone, she was able to bring out the best in their responses, big or small, which itself wrought a chain of goodness that went around the world and made the work of the Missionaries of Charity possible.

Legacy and depictions of the Mother

Mother Teresa has been eternalized through the charity institutions she initiated. ‘Missionaries of Charity’, the international order established by Mother in 1950 consists of over 4,500 sisters and is active in 133 countries. Today, the Order consists of both Contemplative and Active Branches of Brothers and Sisters in several different countries who vow to give “Wholehearted and Free service to the poorest of the poor”.

Mother Teresa has been memorialized through Museums, been named patroness of various churches, and has had various structures and roads named after her, including Albania’s International Airport. In 2009, the Mother Teresa Memorial House was opened in her hometown Skopje, in the Republic of Macedonia.

The Mother Teresa Women`s University-a public university, was established in 1984,in Kodaikanal, Tamil Nadu.

Various tributes have been published in Indian newspapers and magazines authored by her biographer, Navin Chawla.The Indian Railways introduced a new train, “Mother Express”, named after Mother Teresa, on 26 August 2010 to mark her birth centenary.

Mother Teresa is the subject of the 1969 documentary film and 1972 book ‘Something Beautiful for God’, a 1997 Art Film Festival award winning film starring Geraldine Chaplin called ‘Mother Teresa: In the Name of God’s Poor’ and a 2003 Italian miniseries titled Mother Teresa of Calcutta, (which received a CAMIE award).

Yoga helps reduce radiation therapy side effects

2011-08-02T15:53:00.001+05:30

Yoga offers unique benefits for breast cancer patients undergoing radiation therapy,says research from the MD Anderson Cancer Center, University of Texas. Patients who participated in the research performed yoga that incorporated yogic breathing, postures, meditation, and relaxation techniques into their treatment plan.They experienced improved physical functioning, better general health, and lower stress hormone levels.

Lorenzo Cohen, PhD, professor and director of MD Anderson’s integrative medicine program led the study, which formally assessed the benefits seen in patients who performed yoga,compared to an active control group that performed only simple stretching exercises. The Swami Vivekanada Yoga Anusandhana Samsthana yoga Research Foundation in Bangalore, India, also collaborated in the study.

After completing radiation treatment, only the women in the yoga and stretching groups reported a reduction in fatigue. At one, three, and six months following the radiation therapy, women who practiced yoga during the treatment period reported greater benefits to physical functioning and general health. They were also seen to be more likely to perceive positive life changes from their cancer experience than women in the other groups. Women who practiced yoga also had the steepest decline in cortisol levels across the day, indicating that yoga had the ability to regulate this stress hormone.This is particularly important because higher stress hormone levels throughout the day, known as a blunted circadian cortisol rhythm, have been linked to worse outcomes in breast cancer,according to Cohen and colleagues.

Childhood Epilepsy: Make it stigma-free

2011-08-02T15:42:00.000+05:30

Article by Dr.Arif Khan is a Senior Specialist Registrar in Pediatric Neurology at Leicester, London. He took his M.B.B.S. from Al Ameen Medical College, Karnataka and Diploma in Child Health from J.J.M Medical College, Karnataka. He is currently pursuing an MSc in Epilepsy from Leeds Metropolitan University, UK. He is a member of the General Medical Council, UK, Indian Medical Council, India, MDU Membership, British Medical Association, Royal College of Paediatrics and Child Health and the British Academy of Childhood Disability, UK. This is the first article in a series on Epilepsy in Children by Dr Arif Khan who will write articles on other areas of Pediatric Neurology as well.

Epilepsy is a condition in which disturbances to the brain’s normal electrical activity cause recurrent seizures or brief episodes of altered consciousness. Epilepsy comes in many forms and each person’s experience is different. The incidence of epilepsy in children is estimated to be 700 in every 100,000 children under 16 years. There are about 7 million children in Kerala below this age and therefore, about 7000 children with epilepsy. There is significant discrepancy in the care that these children receive, depending mainly on socio-economic status, geographical location and literacy.

It’s not possible to prevent epilepsy from developing, but for those with the condition the chance of attacks can be reduced. Anti-epileptic medication can prevent seizures from recurring. Once epilepsy has been diagnosed and the doctor has discussed it with you, an anti-epileptic drug (AED) will be prescribed to prevent further seizures. The choice of drugs depends on your health and the type of epilepsy you have. The initial dose will be low and will be gradually increased until the seizures stop.

When a teenager or child of any age develops seizures, the impact on the family can be enormous. The effects of epilepsy on children’s behavioral, intellectual, and social development are extremely variable. Most children with epilepsy lead normal lives and have few or no restrictions on social or physical activities. Even if the seizures are well controlled, however, the diagnosis of epilepsy and the medical visits can be frightening to them. For some children, seizures and the effects of the antiepileptic drugs cause many difficulties. Other children have additional medical and neurological problems that affect their lives. Regardless of the severity of the condition, children with epilepsy need special attention to ensure that their outlook and self-esteem are positive.

Children with epilepsy see the disorder through the window of their parents’ eyes. On hearing the diagnosis of epilepsy, parents are likely to go through a series of responses: shock, bewilderment, disappointment, hopelessness, guilt, anger, and grief, but not necessarily in that order. The adjustment period is followed by the realization that life goes on, that the child and family can enjoy life and flourish. If the parents take a positive outlook, the child’s outlook will be positive.

The situation for children with epilepsy, in the developing world remains problematic. The misrepresentation of epilepsy often results in children with the condition being socially ostracized. Most children with epilepsy do not receive the treatment they require to bring their seizures under control and which would render their epilepsy less visible to others.These children express a feeling of stigma and are more likely to report other impairments like low self-esteem, anxiety and depression which would additionally contribute to poor quality of life. They grow up into adulthood with reduced opportunities for social interaction, employment and marriage.

As responsible members of society, we ought to understand this stigma and work towards developing measures to overcome it. Both personal and public adaptation is required if the impact of stigma is to be lessened. Efforts to educate people with epilepsy and their families need to focus on the relation between knowledge, stigma and adjustment, and public education initiatives need to be further developed to promote increased awareness of epilepsy as both a social and medical disorder. Better awareness of the disease can very well reduce the misconceptions and misinformation about epilepsy that pose threats to the identity, self-esteem, security and opportunities of children with epilepsy.

Mammography

2011-08-02T15:05:00.000+05:30

A mammogram is an x-ray of the breast. A diagnostic mammogram is used to diagnose breast disease in women who have symptoms or an abnormal result on a screening mammogram. Screening mammograms are used to look for breast disease in women who are asymptomatic; that is, they appear to have no breast problems. Screening mammograms usually take two views (x-ray pictures taken from different angles) of each breast. For some patients, such as women with breast implants, more pictures may be needed to include as much breast tissue as possible. Women who are breast-feeding can still get mammograms, but these are probably not quite as accurate because the breast tissue tends to be dense.Strict guidelines ensure that mammogram equipment is safe and uses the lowest dose of radiation possible. To put dose into perspective, if a woman with breast cancer is treated with radiation, she will receive around 5,000 rads, if she had yearly received 20 to 40 rads.

For a mammogram, the breast is pressed between two plates to flatten and spread the tissue. This may be uncomfortable for a moment, but is necessary to produce a good, readable mammogram. The compression only lasts a few seconds. The entire procedure for a screening mammogram takes about 20 minutes. A black and white image of the breast tissue is obtained either on a large sheet of film or as a digital computer image that is read, or interpreted, by a radiologist (a doctor trained to interpret images from x-rays, ultrasound, MRI, and related tests).

In females with very dense breasts or with cysts, ultrasound mammograms, nuclear mammograms called scintimammograms or MRI mammography may be advised. These are painless techniques and are reserved for specific cases and not used routinely.

Facing Diabetes

2011-08-02T14:43:00.001+05:30

Article by Dr. Sreejith N. Kumar, Chairman of the Indian Diabetes Association and President of the Indian Medical Association, Thiruvananthapuram. Dr. Sreejith took his MBBS from Thiruvananthapuram Medical College and Masters in Medicine from Armed Forces Medical College, Pune. He also has a Diploma in Diabetology from Vuk Vrhovac Institute, Zagreb, World Health Organisation Collaborating center. He is the Editor of the Kerala Medical Journal and the Secretary of the Thiruvananthapuram Diabetes Club.

When your body is not making any insulin or isn’t making enough, your body can’t convert blood sugar- glucose- into fuel for your body’s cells. This condition is diabetes, an illness that is growing on a global scale. Find out the causes, symptoms and diagnosis of diabetes.

what is diabetes?

Diabetes simply means an increased amount of glucose in blood. However the condition is not as simple as one might think, in terms of the disease per se and its causes.Most of the food we eat is turned into glucose, a form of sugar. We use glucose as a source of energy to provide power for our muscles and other tissues. Our bodies transport glucose in our blood. In order for our muscles and other tissues to absorb glucose from our blood, we need a hormone called insulin. Without insulin, our bodies cannot obtain the necessary energy from our food.

Insulin is made in a large gland behind the stomach called the pancreas. It is released by cells called beta cells. When a person has diabetes, either their pancreas does not produce the insulin they need, or their body cannot use its own insulin effectively. Many new mechanisms leading to high blood glucose have recently been described. We will see some of the details later.

People with diabetes cannot use enough of the glucose in the food they eat. This leads to the amount of glucose in the blood increasing. This high level of glucose or “high blood sugar” is called hyperglycaemia.All of us have glucose in our blood. Normally, it is <100 mg/dl before food and <140mg/dl after meal. In a diabetic patient this level increases to >126 mg/dl before and >200 mg/dl after food. The values in between Diabetes and normal ranges include impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). These conditions are otherwise called pre-diabetes. Thus we have three sets of values as shown in the table below.

To see the full online flipper version of this article, click this link and search archives for the August 2011 issue. On clicking the thumb image of the cover you can read the whole magazine online.

There are many ways to check the blood glucose values. Usually we check the glucose level in the blood, drawn from a vein using a syringe or from the capillaries obtained by a finger prick. A fasting sample has to be taken after eight hours of overnight fasting. After meal blood is drawn two hours after breakfast. Ideally the post meal value should be obtained from a blood sample drawn two hours after consuming 75gm glucose dissolved in a glass of water.

Diabetes is usually associated with some symptoms like Increased thirst, urination and unexplained weight loss. If someone has these symptoms even one value of blood glucose more than 200 mg/dl will define diabetes. However, if someone does not have the classical symptoms of Diabetes, then a repeat check up done on a different day also has to be abnormal before the person can be labeled as Diabetic. Another method to diagnose Diabetes is by doing a test called HbA1C. Hb (Hemoglobin) is the pigment which gives red colour to blood. Some of the Hemoglobin in the blood would combine with glucose. This is known as glycated Hemoglobin (Hb A1C). The glycated hemoglobin level can be estimated by some special techniques. The normal level is <5.4 %. If it’s more than 6.5%, the person is diabetic. Estimation of HbA1C has an advantage over blood glucose. The lifespan of the red blood cells is three months. Hence glycated hemoglobin gives an estimate of the blood glucose over the past three months. Blood glucose estimation can tell us the value only at that particular point of time. However HbA1C estimation has some limitations as well. In our country the standardization is not proper and all the A1C results we get may not be accurate. HbA1C estimation is difficult and also is eight to ten times more costly than blood sugar estimation and is therefore not yet very popular in India for diagnosis of Diabetes.
If someone has the symptoms of Diabetes he should check the blood glucose value to find out whether they are high. Even if there are no symptoms it is good to check blood glucose once in a while. We have some specific guidelines in this regard which will be detailed later. It is very important that Diabetes is detected and treated early. We have many new evidences coming up in this regard. So the message is clear – if in doubt check now, the earlier the better.

To subscribe to THE HEALTH CAFE' click on the title linked to the online website. By signing in to the newsletter you are eligible for a free full access online trial version of THE HEALTH CAFE'

Sick of Morning Sickness?

2011-08-02T00:37:00.002+05:30

Pregnancy and nausea often go hand in hand.

Here’s your guide to the phenomenon of morning sickness.

Anyone who has had a baby will tell you that the glow of health that lights up a woman’s visage during early pregnancy is almost always accompanied by a ‘not- so-welcome companion’ – morning sickness. This is a feeling of nausea, which often leads to vomiting that occurs during the first few months of pregnancy.

Some women have the odd bout of mild queasiness when they first wake up, while others may have to endure weeks or even months of feeling or being sick all day long. Morning sickness reportedly affects 80% of pregnant women. Since each woman is different and each pregnancy is unique, the severity of nausea and vomiting of pregnancy (NVP) will vary from woman to woman. Fortunately, this condition is generally mild and self-limited and can be controlled with conservative measures.

No one knows exactly what causes nausea during pregnancy. Most researchers believe it is caused by a combination of the physical changes that take place in the mother’s body such as the elevated levels of hormones. There is also some research that indicates that the mother’s diet may also be a contributing factor – since women who had a healthier, plant-based diet were found to have less or no morning sickness, whereas those with a high meat based diet were seen to suffer more.

Characteristically, nausea and vomiting begin around the sixth week of pregnancy. This is called ‘morning sickness’ because it occurs most often in the morning, but this does not in any way mean that the sickness is limited to the daytime. Many women experience NVP several times during the day and sometimes, at night. For 80% of expectant mothers, this condition wears off around the 12th week of pregnancy. The remaining 20% are usually afflicted by the condition for a longer period of time.

Triggers for the NVP are usually smells and foods, with the most commonly reported aversions or repulsions being towards meat, fish, poultry and eggs. Interestingly, some doctors who research the condition, point out that these are the very foods that are most likely to carry harmful micro-organisms or parasites. This indicates that NVP could be the body’s own highly developed radar that encourages the mother to eat foods that are most beneficial to the baby during the most crucial days of fetal development.

How does it affect you?

Most cases of nausea and vomiting in early pregnancy aren’t harmful to the mother or the unborn child. Rather, there are indications that the body could actually be expelling foods that were hard to digest, or were potentially damaging to the fetus when its developing internal organs are most vulnerable to parasites and chemicals. While short-term dietary deficiencies do not appear to have any harmful effects on the pregnancy’s outcome, severe and persistent nausea and vomiting pregnancy symptoms can affect the mother’s health. Most women experience nausea or have episodes of vomiting at certain points of the day, and can eat and manage to keep food down during the rest of the day. However, mothers who are acutely affected may be missing or skipping meals for days together, which could mean that the baby may not be getting all the necessary nutrients for optimal growth. Excessive vomiting in early pregnancy could lead to the loss of almost 5% or more of the mother’s body weight.

About 1% of pregnant women worldwide suffer from excessive vomiting in pregnancy-medically called “hyperemesis gravidarum”. Hyperemesis Gravidarum (HG) is a severe form of morning sickness, with “unrelenting, excessive pregnancy-related nausea and/or vomiting that prevents adequate intake of food and fluids.” Hyperemesis is considered a rare complication of pregnancy but, because nausea and vomiting during pregnancy exist on a continuum, there is often not a good diagnosis between common morning sickness and hyperemesis.

One of the main things to watch out for during morning sickness is dehydration. This happens when the body does not have adequate amounts of ﬂuids which may be caused by losing the fluids that were taken in, or by not consuming enough. Severe cases of dehydration may require intravenous ﬂuids and vitamin supplementation from the hospital. Systematically rehydrate or seek medical attention if the mother shows signs of dehydration – such as infrequent urination or dark yellow urine.

____________________________________________________________________________________

Tips to control nausea and vomiting

DIET – Food

• When you wake up, eat a few crackers, or similar carbohydrate –high substitute and then rest for 15 minutes before getting out of bed.

• Eat small meals or snacks often so that your stomach does not become empty (optimally every 2 hours). Try not to skip meals.

• Do not hesitate to eat whatever you feel like eating, whenever you want to.

• If cooking odors trigger the condition, try to get soemone else to cook. If you have no other option, ventilate the room as well as you can.

• Try eating cold food instead of hot (since cold food may not smell as strong as hot food).

DIET – Drinks

• Drink small amounts of ﬂuids frequently during the day.

• Avoid drinking ﬂuids during meals and immediately before or after a meal.

LIFESTYLE

• Get plenty of rest since nausea tends to worsen when you are tired. Taking naps during the day is ideal since a pregnant woman needs more sleep in the ﬁrst three months of pregnancy.

• You may need to take some time off work or make other arrangements for household chores and childcare.

• Do not hesitate to enlist the support of friends and family.

• Get plenty of fresh air and avoid warm places. Feeling hot can add to nausea.

• Try ginger, an alternative remedy that is often effective in settling the stomach. Dosages of up to 250 mg four times a day appear to be safe.

• Try taking your prenatal vitamins (one with a lower amount of iron if that mineral makes your nausea worse) with food or just before bed. If multivitamins make your nausea worse, take folic acid alone on a daily basis.

______________________________________________________________