HEALTH TRIBUNE Wednesday, December 19, 2001, Chandigarh, India
 

Telesurgery arrives
Dr J.D. Wig
T
elemedicine is defined as the use of information and communication technology to provide healthcare to individuals who are away from the service provider. 

Take care of your food allergies
Gauri V. Singh
F
ood allergies pose very serious health-related problems in a relatively small section of the population. The majority of the people are not aware of these and their ill-effects particularly when these are caused by a major food group, making meal planning and balancing nutrition a daunting task even for nutrition experts and educated persons.

Coriander cure
Dr R. Vatsyayan, Ayurvedacharya
T
he ordinary Indian kitchen, which exudes a lot of warmth and aroma, is also a place where the traditional knowledge of the relationship between food and health is passed from generation to generation.

CRITICAL CONCERN
Cerebral palsy
Dr B.N.S. Walia
C
erebral palsy is a group of disorders, presenting as non-progressive disorder of motor functions in a child, and is caused by either the damage or abnormalities of the brain structure arising in early stages of an infant's development: two or three out of a 1000 live born infants may be afflicted by it.

Doctor ko gussa?
Dr Gurinderjit Singh

P
a
tients wait in the doctor's waiting room for hours. When they finally enter the "chamber", some of them are ready to burst and want an explanation. 

Stress on the rise
S
tress is becoming an integral part of our life. Be it a housewife, a working woman, a professional, a government employee, a farmer, a business executive, or a student, all are feeling the impact of the rapidly rising levels of stress in their lives.

IN THE 4-PILLAR SYSTEM
Biochemspeak

D
r Gopal K. Khuller, Professor and Head of the Department of Biochemistry at the PGI, Chandigarh, says: 
Medicine is like a table having four legs -- biochemistry, microbiology, pathology and pharmacology.

HOMOEOPATHY: SOME TIPS
Common "gas problem"
W
ith the increase in the consumption of rich food and sedentary life style, excessive gas formation has become one of the most common gastric disorders.
Carbo Veg (vegetable charcoal) is one of the leading homoeopathic medicines for "excessive gas". 

  • Cold exposure: winter theme

AYURVEDA & TOTAL HEALTH
Others’ care is your own

  Top






 

Telesurgery arrives
Dr J.D. Wig

Telemedicine is defined as the use of information and communication technology to provide healthcare to individuals who are away from the service provider. Telemedicine, it is believed, will simplify the exchange and diffusion of information, knowledge and surgical education by permitting broader access to expertise and second opinion without travel. Fashionable terms being used are telehealth, online health and e-health. Teleradiology, teleneurosurgery, telepsychiatry, transmission of electrocardiographic (ECG) images, use of electronic referrals enabling e-mail consultations and videoconferencing have been found valuable.

One of the most difficult challenges in surgical practice is to predict the future course of surgery. The technological revolution has affected our lives and hi-tech surgery has overcome many surgical prejudices. Surgical science and technology are progressing at a fast face and it is poised to change the way surgeons interact with their patients. New technologies — virtual reality and robotics — have made the widespread use of telemanipulation possible and will have a major impact on healthcare in the coming years.

Nature (2001; 413; 379-380) reported that surgeons working in New York successfully used remotely controlled robots to remove the gallbladder from a woman in France. This is the world' first transoceanic operation on a human-being using fiberoptic connections. Computer-assisted surgery has been reported in a wide variety of applications. The most common thing is the use of the surgical camera positioner as a surgical assistant. A variety of positioning techniques, including infrared sensors and voice activation robotic-type surgical assistants, have demonstrated their utility in the operation theatre.

A number of operations have been performed using telemanipulation devices — namely, the removal of the gallbladder, prostate, gynaecological tubal reanastomosis, and a wide variety of procedure on the heart, joints and food pipe. Remote and accurate manipulation of instruments is now possible.

An effective curriculum for training teams in robotic surgery has been developed. After training, surgeons have applied these methods safely in procedures that require advanced and finely tuned motions. The benefits of extra magnification and three-dimensional imaging help in preventing complications. The fine motor control of the instruments is enhanced as well because of motion-scaling and the filling of fine tremors.

Computer-based surgical simulation (virtual reality) is described as a collection of technologies that allow people to interact efficiently with 3D computerised databases in real time using their natural senses and skills.

The key strength of virtual reality is that it supports and enhances real-time intervention on the part of the user. Virtual reality is capable of delivering reliable and valid training and assessment systems. A wide variety of virtual reality training systems have been developed and obviate all the attendant pressures on supervised procedures in the operation theatre. These virtual-reality simulators offer repeatable, logged and computerised training often without the need for supervision.

The minimally invasive surgical trainer is available and training interface is translated into quite simple, real-time 3D computer graphics that accurately represent the movements of the instruments within a virtual operating volume. Robot-surgeon interface systems have been considered a goal of minimally invasive surgery.

Telesurgery offers a new valuable avenue for providing broad access to expertise without travel and is, therefore, time saving for experts and patients. Experimental studies have confirmed the feasibility of robotically assisted operations and the results are comparable to those of conventional techniques. Further research will show their utility and limitations in clinical surgical practice. Telemedicine has matured and the public is becoming increasingly aware of its utility.

Dr J.D. Wig, the renowned surgeon based at the PGI, Chandigarh, is the author of important books on surgical theory and practice including "Clinical Surgery: A Comprehensive Update". He also edits The Surgical Journal of North India".Top

 

Take care of your food allergies
Gauri V. Singh

Food allergies pose very serious health-related problems in a relatively small section of the population. The majority of the people are not aware of these and their ill-effects particularly when these are caused by a major food group, making meal planning and balancing nutrition a daunting task even for nutrition experts and educated persons.

Terms like food allergy, hypersensitivity and intolerance are used to depict various reactions of food, their intensity and adverse symptoms like the appearance of rashes or vomiting immediately after the consumption of a particular food item by an individual. For example, gluten, an important component of wheat, shows its allergic reaction in the form of diarrhoea, vomiting etc.

Food intolerance, on the other hand, is a result of the deficiency of a particular enzyme or any other factor in the body which, if deficient in lactase (an enzyme), cannot digest lactose, an important milk constituent, resulting in abdominal distension, cramping and diarrhoea. Such allergy symptoms, caused by allergens or antigens like dust, pollen, perfumes, moulds, fungi, fur, food etc. normally manifest themselves within a few minutes or a few hours after the meal is taken. Heredity also plays an important role in the development of allergies, along with physical and emotional stress.

Allergy to milk comes out in the form of vomiting, diarrhoea and for abdominal distension. Egg, meat and fish too are major offenders with symptoms like dermatitis, oedema, and gastrointestinal disorders.

Vegetables, fruit and fruit juices, in raw or cooked form, mushroom — a type of fungi — and yeast can also cause allergies. So is the case with soyabean, peanuts, fats and oils and legumes along with certain preservatives and additives.

The intensity and symptoms vary from person to person. In some cases, the skin may show signs of oedema, dermatitis, fever, blisters, diarrhoea, nausea, colic pain in infants, bronchitis, fatigue, irritability, tension, muscle or joint pain and general restlessness.

Full attention and medical care at the earliest are needed in the case of the onset of even bleak signs of any allergic symptom. The diagnosis and treatment may require various tests, complete dietary history, particularly an account of provocation tests in respect of foods, plus skin tests. The treatment includes the exclusion of suspected food products or causal agents which may be any of such products — egg, meat, milk, wheat, fruits or vegetables.

Awareness and meticulous care are the two most important factors in the treatment of allergies. These include reading labels, not consuming products of dubious nature, being aware of food substitutes and their use, for example, rice for wheat and soya milk for milk and cooked vegetables in place of raw vegetables or vice versa in some cases. Patients should be cautious about the use of improperly washed utensils or stirring spoons. It is easy to avoid food allergy by taking proper care.

Gauri V. Singh is a Jalandhar based dietician. Phone 0181-465193.Top

 

Coriander cure
Dr R. Vatsyayan, Ayurvedacharya

The ordinary Indian kitchen, which exudes a lot of warmth and aroma, is also a place where the traditional knowledge of the relationship between food and health is passed from generation to generation. Along with turmeric, ginger, pepper and many other day-to-day kitchen items, coriander is also a herb which is frequently used in our food — not only due to its pleasant smell but also for its many corrective and restorative medicinal properties.

Popularly called dhania, coriander is known as dhanyaka in Sanskrit and Coriandrum sativam scientifically. It is used in two forms — as a fresh and tiny leafy plant and also as dry seeds. Ayurvedic texts have described it as astringent, bitter and sweet in taste and unctuous and light in effect. Green plants of coriander are considered to be cold, whereas dry seeds have been described as semi-hot.

It alleviates vata, pitta and kapha — all the three doshas of the body. It is antipyretic, anti-flatulence, diuretic, carminative, digestive, anti-diarrhoeal, and a killer of intestinal worms. Fresh and green coriander is rich in moisture beside having protein, minerals and carbohydrates. Coriander seeds are dried when they are ripe. These seeds give an aromatic odour and spicy taste.

From ancient times, coriander is used as a medicine in Ayurveda. Its use is indicated in treating a number of diseases like indigestion, diarrhoea and dysentery, piles, intestinal worms, fever resulting from a heat stroke, migraine and cyctitis (inflammation of the urinary bladder). Interestingly, it is one of those few herbs which have been described as anti-aphrodisiac.

In everyday practice, coriander can be used as a very good home remedy for many health problems. Here are a few tips:

Diarrhoea and dysentery: To treat diarrhoea and dysentery bilgiri (the dry pulp of bael), coriander, dry ginger and nut grass (nagarmotha) should be crushed and mixed in equal quantity. Take one teaspoonful of this powder with warm water two or three times a day. This helps in relieving stubborn complaints of passing mucuous-mixed stool.

Indigestion: Simply chewing a few leaves of fresh coriander helps to overcome abdominal distress caused by acidity and gas intention. Taking one or two teaspoonfuls of its juice allays excessive thirst.

Headache: Many people complain of headache occurring at a specific time of the day. In Ayurveda, this type of headache has been described as suryavabhedaka. Take one gram of coriander powder, five crushed pieces of black pepper and the powder of two grams of ustakhadoos. Soak these overnight in a cup of water. After filtering and adding one teaspoonful of sugar, take this liquid empty stomach — preferably before sunrise. Many Unani texts recommend this formulation for the treatment of migraine also.

Coriander controls non specific excessive menstrual discharge. It is also used as a medicine to control hyper sexual excitability in both males and females. Ancient ayurvedic texts describe Dhanya Panchak Qwath which is a very good adjunct in the treatment of chronic colitis (Next week: A brief introduction to Ayurveda).

Dr R. Vatsyayan is an ayurvedic consultant based at the Sanjivani Ayurvedic Centre, Ludhiana. (Phones: 423500 and 431500; E-mail- sanjivni@satyam.net.in).Top

 

CRITICAL CONCERN
Cerebral palsy
Dr B.N.S. Walia

Cerebral palsy is a group of disorders, presenting as non-progressive disorder of motor functions in a child, and is caused by either the damage or abnormalities of the brain structure arising in early stages of an infant's development: two or three out of a 1000 live born infants may be afflicted by it. In a significant number of patients, the brain damage results from lack of breathing, causing oxygen deficiency to the brain during the process of delivery. Premature and low-birth-weight infants are specially prone to developing brain damage. When the onset of the disease is in later childhood, head injury, infections the central nervous system and severe jaundice are the common causes of brain damage.

The patients may present with spasticity of muscles which makes normal movement, slow and limited in range, like driving a car with hand breaks on which never picks up speed or may not move at all. Such disability may affect both limbs or one side of the body, both arms or both lower limbs. In the ataxic variety, body balance is lost while the dyskinetic variety may have irregular and uncontrolled movements which cannot be coordinated for purposeful action.

A baby, who fails to show the expected alertness, does not smile or coo when called for while watching a human face or cannot control its head by three months of age, should be suspected to have some neurological disorder. Similarly, an infant, who shows decreased spontaneous movements of limbs and delay in milestones of development like sitting, crawling and standing should be seen by a paediatrician. The earlier the diagnosis can be made, the better the results of remedial measures. Many parents feel discouraged when informed of the diagnosis and leave things to nature. This is unfair to the child as he is denied an opportunity of improvement which is assured, given proper remedial therapy.

If the condition remains untreated, it leads to severe disability and a wasted life. But with modern treatment, the child can be helped to attain his full potential. Children with normal intelligence, even though they have cerebral palsy, have gone on to overcome their disability and become professionals like doctors, engineers, accountants and artists.

It is a pity that a country which boasts of nuclear capabilities has such limited facilities for the management of its helpless children afflicted with cerebral palsy. Mumbai, Bangalore, Kolkata and Delhi have well-organised institutions dealing with these disorders, but the states of Punjab, Haryana, UP, Rajasthan, Himachal Pradesh and Jammu and Kashmir with a child population exceeding two crore have still to develop an institution for the care of such children.

Prayas at Chandigarh has made a small beginning where services like physiotherapy, speech therapy and occupational therapy are available but a lot more needs to be done and can be done if adequate financial support from the government as well as philanthropist individual and organisations can be found to provide special education and vocational training to this neglected group of disabled children.

Dr Walia, a former Director of the PGI, Chandigarh, is Emeritus Professor of Paediatrics at the Institute.Top

 

Doctor ko gussa?
Dr Gurinderjit Singh

Patients wait in the doctor's waiting room for hours. When they finally enter the "chamber", some of them are ready to burst and want an explanation. Most patients don't accept an explanation - "I had an emergency," or "It has been a busy day" or "My appointment went haywire". One of the best ways in which doctors can help themselves respond is to put themselves in the patients shoes. The fact is that most patients simply want a humble and deep "I am sorry!"

Patients who are upset and angry are looking to hook somebody to reduce their anger. Anger is a cry for help. The doctor can divert anger by taking the approach: "Sardar Sahib, I see that you are upset. What can Ido for you?" It takes only a minute or two to uncover the patient's true reason for anger. Simple, uninterrupted listening to what the patient says is the key. Doctors unnecessarily worry that the patient will go on forever. The fact is that most patients shut down after two to three minutes.

The sufferer is not the only beneficiary of better communication. By having peace, rather than war, doctors fare better. For the patient, who wants more than what he needs or what he is ready to pay, the doctor should simply sit, look eye to eye at the patient and verbally set a boundary. If he learns to defuse anger, there will definitely be fewer law suits, which have became quite common these days after the introduction of the Consumer Protection Act.

The writer is a consultant dermatologist at the Mohan Dai Oswal Cancer Treatment and Research Foundation, Ludhiana.Top

 

Stress on the rise

Stress is becoming an integral part of our life. Be it a housewife, a working woman, a professional, a government employee, a farmer, a business executive, or a student, all are feeling the impact of the rapidly rising levels of stress in their lives. 

It is really amazing to find how in a short period only, stress and its related problems, which were common only in the West and did not touch the Indian horizon, have stricken our lives. Today, in every walk of life, we undergo a tremendous amount of stress.

Dr Rajiv Gupta, the Ludhiana-based psychiatrist ( well-known to our readers), will look into this necessary evil to an extent and tell us what is going wrong and where, on coming Wednesday.Top

IN THE 4-PILLAR SYSTEM
Biochemspeak

Dr Gopal K. Khuller, Professor and Head of the Department of Biochemistry at the PGI, Chandigarh, says:

Medicine is like a table having four legs -- biochemistry, microbiology, pathology and pharmacology. If the table has to expand, it can do so provided its legs also grow strong enough to support it.

Disease management implies an understanding of the nature and mechanism of disease, its diagnosis and treatment. In this regard, biochemistry plays an important role in disease management.

Dr Khuller will introduce the inter-disciplinary subject for our benefit next week.Top

 

HOMOEOPATHY: SOME TIPS
Common "gas problem"

With the increase in the consumption of rich food and sedentary life style, excessive gas formation has become one of the most common gastric disorders.
Carbo Veg (vegetable charcoal) is one of the leading homoeopathic medicines for "excessive gas". The most common indication for the use of Carbo Veg is that every sort of food disagrees; even things that are easily digestible cause great discomfort. The stomach and the abdomen get swollen like a drum immediately after eating and belching is difficult but gives great relief. Three doses of Carbo Veg 30 c, taken daily for a period of one week, should bring favourable results.

Cold exposure: winter theme

With the advancement of winter, exposure to cold is the most common cause of acute complaints. It is the initial one to three hours when the symptoms appear (after exposure) that are crucial for treatment. A high percentage of cases will never need the help of a physician if the homoeopathic medicine Aconite (aconitum napelus) is administered well in time.
Aconite is needed most when, immediately after an exposure to cold, the symptoms come suddenly and with great intensity - running nose, intense chill, sneezing and cough. Three doses of Aconite 30c, repeated at the intervals of 15 minutes, should serve as the proverbial "stitch in time". 

— Dr Vikas Sharma, 1290, Sector 21-B, Chandigarh (721501)Top

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AYURVEDA & TOTAL HEALTH
Others’ care is your own

A man of the world should keep this equanimity through good fortune and bad. He should speak at the right moment and be kind, measured and graceful. A person who tames his body, speech and mind and also tries to treat the cares of others as his own is acclaimed as an embodiment of courtesy and civility. 
— Ashtang Hridayam.Top