|HEALTH TRIBUNE||Wednesday, July 18, 2001, Chandigarh, India|
Questions & Answers
Can hospitalisation add to our woes?
The bugbear of the 21 century — increasing resistance of the microbes to antibiotics — is already evident in hospitals. Reports suggest that under Indian conditions, nearly five to ten per cent patients admitted to hospitals acquire infections from hospital environments. Hospitalisation is therefore not all that good that we expect and hope it to be.
Certain pathogenic organisms are particularly associated with hospital infection, and some of these rarely cause disease in other environs. Their role as a cause of hospital infection depends on their virulence and number. Organisms relatively harmless to normal people may cause disease in certain patients who may be more vulnerable to them.
Patients who are especially at risk of infections
Who are the patients that are more vulnerable than others to catch hospital infection? They are the ones in whom natural immunity to disease is low, such as:
Infants, who have yet to develop immunity to infection.
Very old persons whose immune system is no longer functioning at a reasonable level.
Patients who have had their spleen removed (spleen is a major organ of the immune system).
Patients on immunosuppressive drugs, e.g those in whom an organ has been transplanted.
Patients with severe burns.
Patients with AIDS, which destroys the immune system of the body. Unless inescapable, these persons should not visit hospitals. As far as possible they should be treated at home. The worst part about nosocomial (hospital acquired) infections is that they may be resistant to the action of most of the antibiotics. This resistance has been acquired by virtue of their presence in the hospital.
acquired in operation theatres pose even greater problems. They infect
the surgical wounds and seriously interfere with healing.
Common infections acquired in hospitals
Urinary tract infections and pneumonias account for almost 60 per cent of the nosocomial infections. Surgical wound infections, which are almost always nosocomial, account for another 20 per cent.
What needs to be done....
There is no doubt that the best environment for a patient is his own home. It is unfortunate that in most towns the trend is towards hospitalisation of all patients who cannot be treated on outpatient basis. The traditional home-based treatment is certainly possible in many of these cases and should be insisted upon when possible. this is especially important for the vulnerable group mentioned above.
All said and done, there will be times when hospitalisation becomes essential. The wards and rooms of the hospital need to be regularly disinfected. The operation theatres need to be located away from the general traffic areas in the hospital. Proper disinfection depends on the adequacy of knowledge of the staff and their proper supervision. The most important areas are the operation theatres and intensive care units.
Every hospital admission needs to have full justification for it.
In case you or a member of your
family needs to be admitted to a hospital, it will be worthwhile to
consider the reputation of the hospital in respect of disinfection and
rate of infection among its patients, in addition to all other
The mother plays a pivotal role in our lives. She remains the embodiment of affection, care and encouragement for her children throughout their lives. We might turn to our fathers for some concerns but for love and council, we instinctively turn to our mother.
For a growing child the role of the mother becomes all the more important. He or she needs emotional support, which the mother gives with gentleness.
1 Children need reassurance at every step: A child should be able to open his/her heart to the mother. Cultivate a friendly relation with your growing child, dear mothers, maintaining a sense of discipline at the same time. A child should feel that the mother is around him or her to help in difficult times.
2 Never be overcritical. Do not overpraise a child: Excessive criticism will lead to low confidence and excessive praise will bring down the motivational spirit of your child. Put forth praise in small but frequent doses.
3 It is important to build up high emotional intelligence: People with high emotional intelligence do better in life. They have better interaction with their colleagues and build up a high emotional IQ for themselves.
4 Show the right path to your child: Never forget that the child is a child; his or her experience in life, the ability to discriminate right from wrong, is much less than yours. It is your duty to tell him what is right and what is wrong while taking important decisions. A child need not to be treated as an adult.
5 A child should be able to listen to "no": A firm "no" said at an appropriate time will save your child from going on the wrong path. Never succumb to an unreasonable demand. A child whose demands are put a limit to grows into a person who has tolerance and the capacity to cope with hardship.
6. Every mother wants to provide as much comfort to her child as she can. But a luxurious lifestyle makes a child lazy, lethargic and less competent.
7. Maintaining a balance between studies and entertainment is essential. Exercise has its own role.
8. Help him or her build self-esteem by giving him or her a goal.
9. Moral values must be inculcated. Children need a moral compass. Here the mother’s integrity and behaviour are put to test.
10. Come down to the level of the child sometimes to facilitate communication and understanding.
11. Talk, with responsibility, to him or her about drugs, alcohol, smoking and sex.
12. Children need your quality time along with your quantity time.
Called by many names as bilva, bel, sadaphal and shriphal and held sacred, the bael tree is found from the sub-mountainous regions to the dry plains throughout India. More often it is seen in the vicinity of temples where devotees offer its leaves to Lord Shiva. The medium-size, strong and thorny tree with leaves in the set of three is usually laden with hard-shelled yellow or light-green fruits. Almost all parts of the bael tree — root, leaves, bark and fruit — are medicinal.
Bael finds mention in many ancient ayurvedic texts. It has been described as kashaya (astringent) and tikta (bitter) in taste and laghu (light), rooksha (dry) and ushna (hot) in effect. It alleviates vata and kaphay. The chemical composition of its fruit pulp shows mucilage, pectin, sugar tannic acid and a volatile oil. The wood ash contains potassium and sodium compounds, phosphates of lime and iron, calcium, magnesium and silica etc.
Different medicinal properties are attributed to various parts of bael, but it is the half-ripe bael fruit which is known for its anti-pyretic, digestive and restorative action on the body. Moreover, it is a unique fruit which is famous as laxative and at the same time as an intestinal astringent also. Leaves of bael are anti-diabetic whereas the bark and the root have proven anti-inflammatory properties.
The hard rind or shell of the bael fruit cracks open to reveal pale, tawny and aromatic pulp which is, perhaps, the most effective herbal remedy for diarrhoea and dysentery. Being astringent, it is also helpful in a number of other complicated intestinal disorders such as the irritable bowel syndrome and ulcerative colitics. The use of the ripe fruit is highly efficacious in the case of chronic constipation and where patients complain of incomplete evacuation. Some of the common uses of bael are indicated below.
Due to its digestive qualities bael sharbat is an effective home remedy for diarrhoea and dysentery. Also in the Irritable Bowel Syndrome, where the patient remains psychologically preoccupied by bowel upheavals, bael acts as stool-regulariser. Patients of ulcerative colitis can use bael fruit, its sharbat or murabba for gentle and less painful bowel clearance.
The dried powder of the bael pulp crushed along with an equal amount of sonth, rock salt, roasted jeera and nagarmotha, if taken in the dose of one to two gm twice a day with buttermilk or water, is very helpful in mucous diarrhoea.
Bael leaves are an important constituent of a number of anti-diabetic medicines. The chewing of five to 10 leaves daily on an (empty stomach) controls diabetic polyurea.
In case fresh bael is out of season, dried bael pulp, which is available in pansari shops, should be procured and crushed. This powder can be used in the dose of one to two gm twice a day. However, to make muraba, half-ripe fruit, and for making sharbat full-ripe bael, should be used. There are various classic ayurvedic medicines such as bilvadi churna, bilva panchaka qwath and pilva tailam where bael is used as the chief ingredient. The bark of bael root constitutes the famous dashamoola (ten roots of medicinal plants) which is a proven ayurvedic remedy for chronic inflammatory conditions and many of the gynaecological problems.
Dr Vatsyayan is a noted ayurvedic
consultant based at Sanjivani Ayurvedic Centre, Ludhiana (Punjab).
Phones: 423500 & 431500;
Questions & Answers
Q An ultrasound examination detected gall bladder stones in my mother but she does not have any pain in her abdomen. Does she require surgery?
A Stones which do not cause any problem are known as a symptomatic. Under certain conditions, if it is a single large stone or if the patient is diabetic or there is the history of jaundice or pancreatitis, the gall bladder having stones should be removed. Consult a surgeon.
Q My wife has been operated upon for gall bladder stones. In spite, of our requests, the surgeon did not prescribe antibiotics after the operation. Was his decision correct?
A The surgeon must have taken this decision after evaluating the condition of his patient and also the condition of his operation theatre. Clean operations carried out under aseptic conditions do not require antibiotics in the postoperative period unless there are indications for it.
Q My grandfather (85) has been diagnosed as having hernia. Can he be operated upon?
A Age is no bar for an operation, at least not for a hernia operation. You must consult a surgeon who will evaluate your grandfather, by undertaking a physical examination and a few investigations, and advise.
Q I am 45 years old and have been found to have diabetes for the last five years. Whenever I get a wound on my foot, it takes very long to heal. Please advise.
A In addition to keeping the blood sugar levels under control, the patients of diabetes mellitus have to take extra care of their feet. They must keep them clean and dry, particularly the spaces between the toes; they should wear soft, padded shoes and avoid injuries and infections; if they get any problem, they should consult a doctor at the earliest. Gangrene sets in very quickly in diabetics.
Q I am 28 years old, and in good general health. I had a caesarean delivery three years back. Following that, I developed hernia in my abdomen. Can I risk another pregnancy?
A You must consult a specialist in obstetrics and gynaecology and also a surgeon because a large abdominal hernia might have to be operated upon before you decide to have another child. It should also be evaluated whether your uterine scar is strong enough or not.
Q I am 19 years old and have high blood pressure for the past three years. I have been given medicines and my blood pressure is now under control. Do I need to do anything else?
A I will suggest that you see a good physician for investigations. Young people may have a cause for high blood pressure which, if treated properly (surgery may be required), may cure your high blood pressure problem.
Q What is "frozen shoulder"?
A "Frozen shoulder" is arthritis around the shoulder joint. All the movements are restricted and painful. Most of the patients can be treated by exercise and drugs. One should consult an orthopaedic surgeon, who may also refer the patient to a physiotherapist.
Dr Bose is Professor and Head of the Surgery Department at the PGI, Chandigarh. He can be contacted through The Tribune or on his Web Page: www.doctorsmbose.com
Q What is the theory behind hair removal by lasers?
A The ruby, alexandrite and diode lasers operate on the theory of selective photothermolysis. The wavelength of the laser light will penetrate into the depth of the hair follicle and destroy the hair. There are slight differences in wavelengths that may affect the depth of penetration and the absorption by the melanin within the hair follicle and the hair itself. Lasers with effective surface-cooling devices are better able to destroy the hair without damaging the skin surface.
Q How effective are the hair removal laser ?
A At this time, the mechanics of the ruby lasers and the alexandrite lasers appear to be the most effective methods of hair removal. The diode laser is being improved and ultimately may be as effective especially in Asian skin. The only hair that may be removed is darkly pigmented hair; blond of gray hair will resist all treatment. The hair is always in various growth phases, so treatments must be repeated several times to catch all hair in the phase of active growth.
Q Are there any risks associated with laser hair removal ?
A Surface changes of hyper and hypopigmentation are the greatest risks because all of these lasers have the wavelengths of light which are absorbed by the epidermal melanin. Too much heat may lead to scarring in rare cases. The "failure of hair to be removed permanently is a common problem.
Thanks, for your patience. Your legendary well-wisher, Brig (Dr) M.L Kataria, is going to send his advice to you from next Wednesday. Meanwhile, here are a few special thoughts obtained on your request from "Dr GDT":
Most of our present-day health problems stem directly from disobeying nature. The farther we go away from her, the worse we become. An animal is the healthiest in its natural habitat. Put it into captivity under the best of conditions and give it the best of food and shelter and yet it does not remain the same. Do not make yourself captive physically, mentally or emotionally. An open environment, an open mind and free play to your physical and mental faculties are the answer to today’s stifling sedentary life.
Your slogan should be, "Defeat old
age". Infirmities of old age are not an inevitable consequence of
ageing. Push middle-age vigour into old age. The correct time to dig a
well is when you still are not thirsty. Therefore, the time to look
after your health is now when you are young. Think young, think
healthy but without morbid preoccupation with health. Form healthy
habits and let them become second nature with you. Let your children
learn from your example and their children from theirs, so that the
cycle goes on. Make health a way of life. — K.P.S