HEALTH & FITNESS


Deaths from rabies Deaths from rabies: a disgrace and a challenge
Dr Satnam Singh
A
mritsar’s Guru Nanak Hospital reported six deaths from rabies in the first three months of 2006. Four such deaths were reported in 2005 and one in 2004. In Verka (Amritsar district) there were reports of five children bitten by dogs and four of them died in 2004. Human rabies (hydrophobia) is not a reportable disease in the country; thus no credible information on its yearly incidence is available. In almost invariably fatal viral inflammation of the brain, patients’ relatives often take a discharge from the hospital opting for home-care and handling death in a few days’ time.

Manipulation, massage relieves tailbone pain
Dr Ravinder Chadha
C
occyx is the very end of the tailbone. Pain associated with the tailbone is termed as coccydynia. Coccyx is, in fact, the remnant of the tail, from the time when man came into existence and has not been fully lost during the evolution. Most common causes of coccydynia are injury to the area occurring either due to falling on the tailbone or being hit directly.

Ayurveda & you
How turmeric helps keep us healthy
Dr R. Vatsyayan
T
urmeric has been used in India since ages not only as a common household spice but also as a curative herb. Well documented by ancient ayurvedic texts and supported by a large number of scientific studies, the last few years have seen an increased interest in its medicinal properties.

Health Notes
Coffee cuts risk of adult diabetes

Chicago
:
Coffee, especially the decaffeinated kind, seems to offer protection against adult-onset diabetes, a study said. What causes the apparent effect is unclear, the report from the University of Minnesota said, but it is possible that minerals and non-nutritive plant chemicals found in rich amounts in the coffee bean may favourably affect blood-sugar levels or protect the pancreas from stress.

  • Red meat may cause pancreatic cancer

  • Sunlight boosts cancer survival rates

  • Antipsychotic drug linked to metabolic syndrome

  • Traditional therapy combo for migraines

 

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Deaths from rabies: a disgrace and a challenge
Dr Satnam Singh

Amritsar’s Guru Nanak Hospital reported six deaths from rabies in the first three months of 2006. Four such deaths were reported in 2005 and one in 2004. In Verka (Amritsar district) there were reports of five children bitten by dogs and four of them died in 2004.

Human rabies (hydrophobia) is not a reportable disease in the country; thus no credible information on its yearly incidence is available. In almost invariably fatal viral inflammation of the brain, patients’ relatives often take a discharge from the hospital opting for home-care and handling death in a few days’ time. Thus, in hospital returns, deaths on account of rabies are grossly under-reported. Rabies is a neglected disease in India. Punjab is one of the four worst-hit states. The other three are Orissa, Bihar and UP.

Over the years, the media had been highlighting deaths and other related sufferings caused by stray dog bites.

Let us now reflect on how rabies cases are being handled. As stray dogs are the principal reservoir of infection, primary prevention is by managing their population and keeping them immunised against rabies once a year. And if this fails, one has to go for secondary prevention by ensuring that every dog-bite case is evaluated at the nearest available public or private medical facility and put on safe and effective immunisation regime. And there is need for immunoglobulin for immediate passive immunity around the area of severe bites. We as a nation have failed on both these counts.

For containing the stray dog population, periodically the media had reported “shoot them, kill them” mood of the public. In a national daily, writing under “stray dogs” in October, 2000, it was mentioned how Delhi’s nearly 2.5 lakh stray dogs manage to bite 35,000 citizens each year, some with fatal results. Among the unsuccessful methods used by the MCD were sterilisation, immunisation and painful death by giving strychnine with food. Thus, humane killing was recommended by engaging trained shooters.

The Animal Welfare Board of India (AWBI) is callously innocent of the priorities needed for the effective implementation of the Animal Birth Control Programme (ABC). This programme has been entrusted to the local animal welfare organisations, especially the Societies for the Prevention of Cruelty to Animals (SPCAs), which are known to be sustaining on paltry funds. These bodies are in no way proficient and equipped to take up this elaborate and gigantic programme.”

The incubation period of rabies is usually three-eight weeks, rarely as short as nine days or as long as seven years, depending on various factors. Thus, post-exposure (to dog bite) immunisation is a very potent tool with us. However, to get 100 per cent protection, early wound-cleansing and vaccination with modern cell-culture vaccine, administered immediately according to the WHO recommendations, is a must.

Gone are the days of crude nerve tissue vaccines produced from sheep or mouse brains and delivered by injection in the abdominal well of the patient — a total of 9-12 and very painful. Imported cell-culture vaccines are expensive. The price was brought down nearly two years back when Indian manufacturers entered the market. The recent policy change announced by the Union Ministry of Health and Family Welfare in favour of giving such modern vaccines intra-cutaneously — instead of the earlier intramuscular route — would lower the dosage required and thus also the cost considerably.

To achieve tangible results on a sustainable basis, members of civil society, including private medical and animal health care agencies, need to be involved in the planning, implementation and evaluation processes.

The writer is Director, Regional Institute of Public Health, Chandigarh.

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Manipulation, massage relieves tailbone pain
Dr Ravinder Chadha

Coccyx is the very end of the tailbone. Pain associated with the tailbone is termed as coccydynia. Coccyx is, in fact, the remnant of the tail, from the time when man came into existence and has not been fully lost during the evolution. Most common causes of coccydynia are injury to the area occurring either due to falling on the tailbone or being hit directly. This could be due to fracture of the coccyx or strain on the sacrococcygeal joint. The other cause could be congenital, the individual being born with unfused coccyx. Disc herniation can also radiate the pain to the tailbone.

Individuals with unfused coccyx suffer pain during pregnancy or post-delivery as stress of vaginal delivery inflicts extra pressure irritating the unfused coccyx leading to pain.

The main complaint is experiencing of discomfort/pain while sitting or lying down flat on the back which is probably due to the pressure being exerted on the tailbone. Lying on one side or on the stomach helps relieve pain. Standing/walking comforts the individual as this position exerts less pressure on the tailbone.

In order to arrive at proper diagnosis a careful history and detailed physical examination are critical. X-ray of the coccyx can identify a broken or unfused coccyx.

Conservative treatment comprises anti-inflammatory drugs and local heat/ultrasound.

In a few cases, steroid injection can be given in the coccyx to alleviate pain and inflammation.

A pillow or donut cushion is ideally suited to relieve pressure on the area. The donut cushion has a hole in the middle so that the patient sits on the donut so that no pressure is exerted on the tailbone.

Massage of the pelvic floor muscles, especially Levator Ani, facilitates the reduction of pain instantly. The massage is repeated daily for five to six days which is extremely effective.

Manipulation, either external or internal, to mobilise the coccyx is very effective in relieving pain in the tailbone. In this technique the coccyx is moved in the required direction in the side lying or prone position. It takes only 15 to 50 seconds for the correction and the whole procedure takes 1 to 4 minutes.

Relaxation exercise — lying with face downwards, the patient is instructed to squeeze the buttocks and relax. Repetitions are advised.

Sitting up straight helps relieve pain. Slumped posture acts as a great hurdle as it puts undue load on the angulation of the tailbone, leading to discomfort/pain.

If a patient experiences pain over an extended period of time in spite of undergoing the above mentioned treatment, surgery is recommended wherein fractured coccyx or non-united coccygeal fragment is removed.

Although the treatment of coccydynia is very easy, it is not diagnosed early and effectively causing pain and discomfort to scores of individuals for long periods. Proper manipulation and massage brings instant relief in most cases.

The writer is a former doctor/physiotherapist, Indian Cricket Team.

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Ayurveda & you
How turmeric helps keep us healthy
Dr R. Vatsyayan

Turmeric has been used in India since ages not only as a common household spice but also as a curative herb. Well documented by ancient ayurvedic texts and supported by a large number of scientific studies, the last few years have seen an increased interest in its medicinal properties. Turmeric (commonly called haridra or haldi) is the rhizome of the plant curuma longa which is used for medicinal and culinary purposes.

The major chemical constituent of turmeric is known as curcumin which is responsible for many of its pharmacological activities. Turmeric possesses antibacterial, anti-inflammatory, anti-arthritic, anti-hepatotoxic (liver protective) and anti-allergic properties. Ayurvedic texts have additionally described it to be good for skin ailments and also as a blood purifier, wound cleanser and healer, remover of body toxins, killer of abdominal worms and a wind-repellent agent.

Data obtained from several studies suggest that turmeric definitely has an anti-cancer role, may it be the countering of initiation, promotion and progression of the disease or of increasing the immunity by enhancing natural anti-oxidant functions of the body. Curcumin has shown good results while being used to treat squamous cell carcinoma of the skin and the ulcerating oral cancer. Evidence from laboratory and animal studies suggests that curcumin has potential in various other forms of malignancies like those of prostate, breast, cervix and colon.

Turmeric induces the flow of bile, which helps break the fats in our food. In its anti-allergic role, it is a drug of choice to be used for naso-bronchial afflictions, sinusitis and common coughs and colds. Added with any other herbal cough formula, turmeric enhances its efficacy. Because of its ability to reduce inflammation, turmeric is an effective adjunct to relieve the symptoms of osteoarthritis. Old ayurvedic texts additionally indicate it to be beneficial in many other health disorders like anaemia, jaundice, obesity and diseases of the urino-genital tract.

Turmeric is also known as a household beauty aid. As a constituent of “ubtans”, it enhances glow on the face and is a trusted medicine to treat blemishes, pimples and non-specific skin allergies and inflammations. Mixed and crushed with the same amount of dried amla and sugar, half a teaspoonful of this combination, if taken with water two times a day, boosts body immunity and can be given along with any other therapy to treat stubborn skin ailments. As a ready first aid, turmeric powder is applied on minor cuts, wounds and abrasions after mixing it in a little of desi ghee.

Since many of the herbs also have their contra-indications, an over-dose of turmeric, instead of protecting the digestive tract, can enhance acidity. Though turmeric gives all its routine benefits when used as a kitchen spice, its per day medicinal dose is one to three gm in two or three divided doses. Turmeric should not be taken singularly by those who are suffering from gall stones or the obstruction of the bile passage. Similarly, it should also be used carefully where the patient is taking any other medicine which acts as a blood thinner agent or delays its coagulation.

The writer is a Ludhiana-based senior ayurvedic consultant.

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Health Notes
Coffee cuts risk of adult diabetes

Chicago: Coffee, especially the decaffeinated kind, seems to offer protection against adult-onset diabetes, a study said. What causes the apparent effect is unclear, the report from the University of Minnesota said, but it is possible that minerals and non-nutritive plant chemicals found in rich amounts in the coffee bean may favourably affect blood-sugar levels or protect the pancreas from stress.

The finding, published in the Archives of Internal Medicine, was based on a study of more than 28,000 post-menopausal women in Iowa who were followed for 11 years.

When the study of the Iowa women began, more than 14,000 of them — about half — drank one to three cups of coffee per day, 2,875 drank more than six cups, 5,554 four to five cups, 3,231 less than one cup and 2,928 none.

Over the 11 years of the study 1,418 of the women reported on surveys that they had been newly diagnosed with type 2 diabetes.

Women who drank more than six cups of any type of coffee per day were 22 per cent less likely than those who drank no coffee to be diagnosed with diabetes, the study found. Those who drank more than six cups of decaffeinated coffee daily had a 33 per cent risk reduction compared with those who drank no coffee at all, it said.

While the implication is that something other than caffeine is at work, the study was not equipped to explore causes, the report said. Previous studies are mixed on whether caffeine increases or lessens diabetes risk among adults. — Reuters

Red meat may cause pancreatic cancer

NEW YORK: A diet high in red meat appears to raise the risk developing pancreatic cancer, Swedish researchers report in the International Journal of Cancer. The good news is that consumption of poultry may cut the risk.

Pancreatic cancer is one of the most deadly cancers, due, in large part, because it is seldom detected at an early, curable stage. Surgical removal offers the only chance for a cure, but only a small percentage of patients are candidates for this therapy. In many cases, removal is not possible when surgery reveals that the cancer has actually spread outside the pancreas.

“Findings from our study”, lead investigator Dr Susanna C Larsson told Reuters Health, “suggest that high consumption of red meat is associated with an increased risk of pancreatic cancer.”

Larsson of the Karolinska Institute in Stockholm and colleagues conducted a study of more than 61,000 women. The investigators were interested in the possible effects of meat, fish poultry and egg consumption. During 17 years of follow-up, 172 of these women were diagnosed with pancreatic cancer.

Long-term consumption of red meat was associated with an increased risk of pancreatic cancer, whereas consumption of poultry was linked to a decreased risk.— Reuters

Sunlight boosts cancer survival rates

London: Sunbathing could improve your chances of surviving cancer, according to researchers. Those diagnosed with the disease in summer and autumn live longer than those diagnosed at other times of the year, British research shows.

This is probably because their vitamin D levels are topped up by sun exposure.

Researchers say vitamin D can affect the rate of cell division in tumour development and can trigger the self-destruction of cells developing in the wrong way.

The study of more than one million patients suggests the season when cancer is detected and treated could make a significant difference to progress of the disease.

It says that diagnosis in the summer and autumn months is associated with improved survival, especially in lung and breast cancer patients.

“We found sunlight exposure to be a predictor of cancer survival.”

“Our results add to a growing body of evidence that vitamin D may play an important role in cancer survival.”

Women with breast cancer had a 14 per cent lower risk of death, while women with bowel cancer were 6 per cent less likely to die. — ANI

Antipsychotic drug linked to metabolic syndrome

Washington: A study by University of Rochester Medical Center researchers suggests that the intake of clozapine, the most effective antipsychotic drug, may cause patients to develop significantly higher rates of metabolic syndrome.

Metabolic syndrome is a group of conditions that increase the risk for heart disease, stroke and diabetes. The conditions include high blood pressure, excess body fat around the waist, abnormal levels of cholesterol and triglycerides and insulin resistance. Any one of the conditions increases the risk of serious disease. In combination, the risk grows greater.

J. Steven Lamberti, associate professor of psychiatry and lead author of the journal article and his fellow researchers studied 93 patients at the Medical Center’s Department of Psychiatry who had been receiving clozapine for at least six months. The patients were weighed, measured and tested for diabetes, blood lipids and blood pressure. The researchers then compared the patients to a group of about 2,700 individuals from a national database of health information for thousands of Americans. The comparison group was matched for age, body mass, and race or ethnicity.

The researchers found that more than half (53.8 per cent) the clozapine patients had metabolic syndrome. But only about 20.7 per cent of the comparison group had the same syndrome.

The Medical Center Department of Psychiatry researchers stated that patients with metabolic syndrome would be expected to have a two-to-threefold increase in cardiovascular disease mortality. — ANI

Traditional therapy combo for migraines

NEW YORK: A product that combines extracts of Tanacetum parthenium, commonly known as feverfew, with Salix alba, also called white willow, appears to effective in reducing the frequency, severity and duration of migraine attacks, according to the results of a small study reported by a research team based in France.

The herbal combination goes by the commercial name of Mig-RL and is marketed by Naturveda-VitroBio Research Institute, the French company that sponsored the study. Recent reports have suggested that these products affect some of the same cell targets as conventional medications do.

In the study, reported in the Journal Clinical Drug Investigation, Dr R. Shrivastava, from Issorire, and colleagues enrolled 12 patients with migraine who were treated with Mig-RL for 12 weeks. Two Mig-RL capsules were given twice daily. Two patients dropped out of the study — one had almost continuous headache and was referred for neurological evaluation, the other refused to comply with the study protocol.

Migraine frequency was reduced by 57.2 per cent at six weeks and by 61.7 per cent at 12 weeks in 9 of 10 patients. Seventy per cent of the patients experienced a 50 per cent or greater reduction in headache frequency. — Reuters

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