The Tribune, Chandigarh, India

	Control gouty arthritis with food & exercise by Dr B.S. Aggarwal The incidence of gout is rising as there is a change in the eating habits of people. One possible reason is the consumption of preserved and stored food. Instead of fresh home food, people like to indulge in careless eating at parties and go for the stored hotel food. This is, perhaps, the result of credit-card prosperity. Protein utilisation and breakdown in the body produces urea, uric acid and creatinine. It is the uric acid component which causes sudden, painful and red swelling around the joints overnight. The most commonly affected are the base joints of the big toe and thumb called MTP and MCP joints, respectively. The next to fall in line are the wrist, ankle, knee and shoulder. Gout also affects the spine in some cases causing diskitis. The affected person gets up with great pain and spasm in the neck or back after a good overnight meal. The sufferer is a well-fed, healthy and wealthy person with a sedentary life-style. The normal range of uric acid in human beings is from 2.5 to 7.0 mg/dl. Chicken lovers will be surprised to know that chicken’s normal range is up to 15mg/dl and chicken protein can load the human body with extra uric acid. In vegetarians, gout is seen in those people who are fond of taking milk and milk products (dahi, lassi, paneer and milky tea), pulses with rice dishes (dal-bhat-idli sambar), mushroom-peas and, of course, among those who fast for more than seven days and consume non-cereal and pulses diet. The fasting people empty their protein stores in the body. It is the protein breakdown all the way which causes this type of arthritis. Gout is also found in people suffering from osteoporosis and diabetes. The bones are called to contribute protein and calcium to the general circulation during the deficiency of nutrients in blood. In diabetics, the increase in blood sugar is a product of carbohydrate metabolism. In gout, the blood uric acid level is increased because of protein metabolism. So, gout and diabetes are basically dietary diseases. Indigestion for a long time, constipation and bad breath are also contributory factors for non-articular gouty manifestations or muscular rheumatism. This condition brings muscular stiffness and aches in the whole body, particularly in the spinal region. The shifting of postures in bed gives many “ooffs” “ouches” to the people who are enjoying a sedentary life-style. To break this vicious circle, one has to revise one’s daily schedule of diet and exercise. There is need to change the over-indulgent and sedentary attitude which contributes to weight gain also. People in the North have a very high protein diet with wines. Punjabis like to take lumps of “dahi” at least twice a day. A change in this habit is required for healthy living. The best treatment would be to space out the intake of protein products and reduce its quantity to normal level. One should consume chicken or paneer once a week only and “dahi” twice a week. Whiskey-lovers should not consume too much protein salads. Chicken or “kharora” soup should be avoided. To keep away from gouty arthritis, one should practice dietary yoga. Of course, there are drugs to help reduce the pain and symptoms, but the long-term remedy lies in a balanced diet and regular exercise. Nothing is better than a balanced diet and an addiction for morning walk or indoor exercise. After all, “exercise is the best food for the body.” — The writer is a senior orthopaedic surgeon based in Chandigarh.
	Change in attitude a must for leprosy treatment by Dr Uma Vasudeva All doctors and paramedical personnel working in the field of leprosy have a strong belief in themselves and God. They accept it intellectually and emotionally that, of course, anyone can contract this disease, but “I am sure I won’t get it. God forbid, if I get, it can be cured because multi-drug therapy (MDT) hai na.” The problem with leprosy is not what the disease is, but what the people believe it to be. It is the belief system of the people which comes as a barrier in the way of solving the problem by treatment alone. Some people are still ignorant about the various stages of the disease, which remains hidden like an iceberg under water. They only know about the end-product of deformity and stigma attached to it. Anybody, high or low in status, rich or poor, can get afflicted by this disease because the bacilli mycobacterium leprae do not make any distinction. It is transmitted through the air like tuberculosis. It is tied with both immunity and exposure. It is only the very poor immune response of a person which is mainly responsible for him/her contracting this disease. The main objectives of health education are that every person must learn to seek medical opinion as soon as he or she notices any suspicious-looking patch on one’s skin which is lighter in colour, flat or red and raised, has definite loss of sensation and does not itch. Secondly, every doctor must treat a leprosy patient like any other patient. He must take full responsibility of the patient till the completion of the full course of MDT. He must ensure that motivation and counselling of the patient and his family for regular treatment are not ignored. Thirdly, society must change its attitude toward leprosy. It is the social responsibility of each and every person or institution that whenever or wherever there is the slightest suspicion of leprosy, the patient must be motivated and helped to undergo a medical examination and take the full course of MDT if indicated. The problem is not with patients or their families from the lower strata of society. Their acceptance of the disease is as natural as in the case of any other disease. They have no fears about the disease once they are motivated and counselled on the treatment schedule and prevention of deformity. The upper educated class is more resistant to the idea of having the disease. They are still positively submerged in negative perceptions that “this cannot happen to us”. This unacceptability is based on fears, which emerge out of ignorance and prejudice. People of the upper strata of society are no exception in contracting the disease. We have found doctors, lawyers, engineers, bankers, police and armed forces personnel and students from colleges and schools suffering from this (better known as Hansen’s) disease. They have been successfully treated. It needed extra care and counselling to motivate them for the full course of treatment. A lot of time and energy go down the drain very often when those working as domestic help are diagnosed as leprosy patients. Their employers throw them out of their house as they are scared and frightened of them. The disease may be in a very early and non-ineffective stage, yet they do not shoulder their social responsibility to get the patient treated, when the treatment is free and the disease is 100 per cent curable. These poor people are more worried to earn their livelihood than get treatment for a skin patch, which is a potential source of infection and the patient is doomed to deformities and disability. The rich and the privileged of society contribute a lot to leprosy home inmates by offering them choicest sweets, fruits, clothes and cash for their own better future. However, those suffering from Hansen’s disease do not need charity but their help to get proper treatment. — The writer is Medical Officer, District Leprosy Society, UT, Chandigarh.
	New study for curing motor neurone disorder LONDON: A new study has found that patients with motor neurone disease (MND) produce toxic proteins which kill off vital nerve cells. The researchers behind the study found that proteins like immunoglobulins (IgG) cause calcium levels in cells that control movement to rise too high, leading to degeneration and death. It is hoped that this discovery will lead to new ways to treat the condition. The study has been carried out by the Institute of Neurology at the University College London and has been published in journal Acta Neuropathologica. It was reported by the BBC. The researchers found that IgG taken from health individuals did not produce the same effect. MND is caused by the death of cells — called motor neurones — that control movement in the brain and the spinal cord. It affects around 5,000 people in Britain at any one time and there are 1,000 new cases of disease each year. Symptoms of MND are muscle weakness in one or more limbs and also the muscles that supply the face and throat, causing problems with speech and difficulty in chewing and swallowing. But by the time the patient first notices any muscle weakness or swallowing difficulty, it is estimated up to 50 per cent of their neurones have already died. In the majority of cases the intellect is not affected. Death usually occurs in around three to 10 years due to the paralysis of the respiratory muscles. — ANI
	New hope for foetal digestive disorder LONDON: Researchers have uncovered a mechanism which ensures proper development of the foetal gut, which in turn might lead to new treatments for a common digestive disorder in newborns called Hirschsprung’s Disease. It is a condition which currently requires surgery to enable food to pass through the bowel and the colon. The Medical Research Council has identified two crucial molecules which appear to control the movement of key cells from the brain to the gut before birth. The migration of these cells is essential for the formation of a branch of the nervous system which works independently of the brain and controls the wave-like contractions of the gut. Without this movement called peristalsis, it is impossible to move food through the digestive system properly. — ANI
	A simple breath test can detect lung disease LONDON: A simple breath test can now determine if a patient has asthma or cystic fibrosis. According to University of Virginia scientists, people with lung diseases have highly acidic breath. What’s more, the acidity of their breath rises depending on how severe their condition is. Writing in the European Respiratory Journal, they said that doctors should be able to distinguish between healthy patients and those with lung diseases quite easily. This is because healthy people have a breath which is slightly alkaline, reports the BBC. The researchers said the acidic breath associated with people with lung diseases may be caused by the overproduction of acids in the lung. They believe this overproduction may even cause some of the symptoms associated with these diseases. Dr John Hunt and colleagues said breath tests were a simple and reliable way of detecting lung diseases. The procedure was “extremely simple to perform, inexpensive and robust”. — ANI
	Drugs that stop breast cancer on anvil LONDON: Scientists have uncovered more evidence of a “switch” which allows breast cancer to grow and spread. The finding by American researchers could lead to drugs being precisely targeted to stop this process in its tracks. Mice genetically altered to produce larger quantities of a chemical called COX-2 had faster-growing and spreading breast cancers. Drugs that “inhibit” COX-2 — from the aspirin family — could have a role-fighting breast cancer, say experts. — ANI