|HEALTH TRIBUNE||Wednesday, March 13, 2002, Chandigarh, India|
attack major cause of death
A Tribune impact
in opiate dependency: a perspective
AYURVEDA & TOTAL
reading for the plus 55
Brain attack major
cause of death
A brain attack (stroke), similar to a heart attack, is caused by impaired blood supply to the brain. This is the third leading cause of death in the world. Stroke, usually occurring in elderly people, manifests itself in various ways — as a sudden episode of weakness of half of the body, confusion, slurring of speech, visual disturbance, headache, vertigo and altered consciousness, usually occurring in combination. The aim of this article is to make the masses aware of this problem and the treatment options available.
People afflicted by brain attack usually belong to the elderly age group, commonly males and those having a family history with genetic predisposition. These risk factors are nonmodifiable.
Of late, the disease is increasing in the younger age group (around 40 years) probably related to increasing stress and competition leading to changes in the vessels supplying blood to the brain and the heart. Other risk factors, which can be modified by a change in lifestyle and drugs, are hypertension, diabetes mellitus, cigarette-smoking, high cholesterol and triglycerides, cardiac disease, excessive alcohol intake, oral contraceptives and obesity. Oral contraception, after the age of 35 yrs, particularly if associated with hypertension, diabetes mellitus, smoking, are better avoided.
Recent evidence suggests that low-serum folate is a risk factor for a brain attack. Women are somewhat protected up to menopause because of their hormonal status. Individuals developing such symptoms should seek immediate medical help since early treatment reduces morbility and mortality.
With current upcoming treatment modalities and availabilities of confirmational investigations like CT scan and MRI studies, if a patient with a brain attack reaches the hospital within three hours, the blocked artery can be opened by intravenous tissue plasminogen activator (TPA). The prerequisites for the treatment include a combination of clinical examination, blood test and a CTscan to be done within three hours. Recently, a lady presented within 30 minutes to the hospital with weakness of half of the body. She underwent a CTscan immediately following a clinical assessment. She was started on a TPA within two hours and by the evening she started walking. Two injections, according to the weight of the patient, were utilised.
In addition to seeking appropriate medical help, another important factor in TPA treatment is the cost — which is Rs 37500 per injection.
India is a developing country, with predominantly poor people and an ever-increasing population. It is practically impossible for a patient to reach appropriate medical care in the above mentioned time frame. Lack of awareness about a brain attack is also an important factor.
Seeking immediate medical help in a brain attack with the treatment of risk factors along with administering a 10-day course of low-molecular weight Heparin injection or a tablet of aspirin will go a long way in decreasing the morbidity and mortality and preventing recurrence.
What medicine follows after three hours’ golden period is preventing the recurrence in future (secondary prevention). The medicines available are antiplatelet drugs like aspirin, dipyridamole, ticlopidine and the newly available clopidogrel. Oral anticoagulates like Warfarin and Acenocoumarol have specific indication, particularly in brain attacks with heart disease.
The narrowing of the carotid artery (the vessel supplying blood to the brain) by more than 70% as indicated by a doppler test, will need surgical intervention. Carotid endarterectomy is a surgical process by which atherosclerotic plaque blocking the carotid artery is removed. Recently, carotid artery stenting, wherein a stent is put across the narrowed vessel to increase its lumen size, is being successfully used.
"Prevention is better than care" strongly holds true in brain attacks also. At-risk-individuals should take regular medication for hypertension, diabetes and dyslipidemia. Cutting down alcohol consumption, quitting smoking and regular brisk walking for 35 minutes a day, five days a week, will decrease the risk of brain attacks by more than fifty per cent.
A Tribune impact
A cluster of villages, including and around Perchh, have got a model healthcare centre. Health Tribune highlighted their chronic problems including those caused by infected water and polluted surroundings.
Donations poured in thanks to the reputation of the Saint of the Slums, Dr (Brig) M.L. Kataria. Now Perchh has a fully equipped polyclinic. It has been inaugurated by Punjab Governor Lt-Gen J.F.R. Jacob.
The Panchayat of the area has written a letter to Health Tribune giving the details of the momentous event.
The communication is being reproduced below with the hope that there will be many Perchhes in our region, symbolising the people-NGO-Administration cooperation.
Thanks to The Tribune, amidst sky-rending cries of "Bole so nihal", Lt Gen J.F.R. Jacob, PVSM, Governor of Punjab, inaugurated the Sahibzada Ajit Singh Polyclinic at Perchh village on March 10, the first of its kind in rural India, for the benefit of a backward belt of 10 villages — Chhoti Perchh, Seonk, Chhoti Seonk, Jaiwanti, Majri, Bhagindi, Sangariwala, Guruha and Nada, located at the Shivalik foothills in Ropar district of Punjab.
"The Governor applauded the efforts of the Perchh Panchayat which built the four-room structure on Panchayat land. He was full of praise for the Sahibzada Ajit Singh Educational Society’s Memorial Charitable Trust, founded by Sardar Gurdial Singh and now headed by Sardar Baljit Singh, a renowned industrialist-engineer of Mohali, who donated the entire equipment, worth several lakhs of rupees for the polyclinic.
"The Governor asked the local MLA and Minister (Sardar) Jagmohan Singh Kang and the Deputy Commissioner to contribute a dental-care unit for the polyclinic.
"Dr (Brig) M.L. Kataria, the brain behind the polyclinic, was cheered when he announced that the free services of a computerised lab, capable of performing 150 types of tests, a 300-mA x-ray machine, an ECG and a well-stocked dispensary service would be provided, and eight specialists in family medicine, paediatrics, gynaecology, ophthalmology, oral health and orthopaedics, would be available in rotation.
"The Governor honoured Dr Shakuntla Duggal, Dr (Col) Narinder Sandhu, Dr (Maj) S. Bathla, Prof (Dr) S.P. Dhira, Dr (Air Cdr) Tajinder Singh, Dr (Brig) A.S. Kwatra, Dr (Col) G.D. Kapoor, Dr (Col) B.R. Paruthi and six medical technologists.
"As a rare gesture, defying all security measures, the Governor came down the dias to shake hands with the audience, including many retired decorated Generals, Brigadiers and Colonels, a former Chief Secretary of Punjab, Mr P.H. Vaishnav, prominent citizens and municipal councillors of Chandigarh, Mohali, Ropar and Kurali.
"This was perhaps the first-ever visit of a Governor to this region.
"He was enthusiastically cheered by the villagers, thousands of men, women and children in the pandal. He was so touched by their genuine warmth that he came down the dias again to mingle with the hoi poloi.
opiate dependency: a perspective
Drug abuse is becoming common day by day among the youth of our country. Earlier, this problem was limited to foreign countries but now it has become alarming in India too. North India is particularly in its grip.
The widely known opiates (opium, heroin, morphin, norphin, brown sugar, phensidyl, the corex syrup, and the Proxyvon capsule), are becoming common. Smack is one of the most harmful drugs used by the youth.
Earlier, opiate dependency seemed to be an incurable condition to people because of the non-application of techniques developed until then. The treatment was replacement with phenothiazines and pain-killers, which were gradually reduced.
The second line of treatment was methadone replacement and this is quite popular in foreign countries even now. Methadone is an opiate; this means that one opiate is replaced by another long-acting opiate. These methods do not provide freedom to patients from dependency and the failure to overcome dependency encourages patients to go into addiction again.
Modern technology helped physicians to understand the opiate receptors and their functioning. Dr Waismann developed a new technique for treating drug dependency called "Accelerated Neuro-regulation", which focused on treating opiate dependency at the receptor level.
It is a one-day treatment that begins in a hospital setting. The patient is treated under anaesthesia in an ICU and his opiate receptors are blocked. It is a treatment of hours — not of days — which provides freedom from physical dependency without suffering and craving for drugs.
Dr Sarbjit Singh, MD, can be contacted at the ANR Centre for Opiate Dependency, 309-New Jawahar Nagar, Jalandhar City. (Tel: 225850 (O); 98140-60371.)
*Some candid thoughts for surgical residents and those who benefit from their work by Dr J.D. Wig, FRCS.
* The painful story of young addicts by Health Tribune's psychiatry consultant, Dr Rajeev Gupta, MD.
* Dr G.D. Thapar on air-travel problems.
*The usual features and much more
Beauty and diet
A healthy diet and beautiful skin go together. A nutritious and balanced diet works wonders for the skin, whereas bad eating habits have an adverse effect on your skin, hair, teeth and figure. A balanced diet contributes more to a beautiful skin than any of the costly beauty creams and lotions.
A diet for healthy and clear-glowing complexion should contain lots of fresh fruits and vegetables. It should be high in fibre but low in fats, sugar and salt. A diet should provide the body and the skin with all the vitamins and minerals needed to function at their very best.
Mentioned below are certain essentials our body needs to keep the skin healthy and glowing:
Water: The most essential element is water. One should drink at least two litres of water a day to keep the body healthy and the skin clear and supple.
Fruits and raw vegetables: Cellulose, better known as fibre food has an indirect effect. Its action in keeping the bowel regular helps to give a brighter and clearer complexion. Besides, it provides us with a variety of minerals and vitamins.
Vitamin A: It is essential for the growth and repair of certain skin tissues. The lack of it causes dryness, itching and loss of skin elasticity. It is found in foods such as carrots, green leafy vegetables and fruits like pappaya and mangoes. Liver and fish liver oil are known to be the richest sources. It is also present in butter, ghee, whole milk and eggs.
Vitamin C: Vitamin C is needed for collagen production to help keep our skin firm. It is found in citrus fruits like orange, malta, lemons, amla, guava, grapes and strawberry.
Vitamin E: It is an antioxidant that neutrialises free radicals -- highly reactive molecules that can cause aging. it is present in foods such as almonds, hazelnuts and wheat germ.
Zinc: Zinc works with vitamin A in the making of elastin and collagen -- the fibers that give the skin its strength, elasticity and firmness.
Try this skin-tonic recipe for beautiful complexion:
Fresh green amla — 2 nos; fresh lemons — 1 nos; apple — 2 nos; any fresh leafy vegetable — 100 gm; and honey — 1 tspn.
Wash, peel, cut and mix all these. Extract the juice and mix with honey. Consume daily.
Questions and answers
Q. I get a lot of acne on my face. What should I do?
A. Avoid fatty and fried foods. Pork, bacon and sausages should also be cut down. Hot water drinks, preferably with half a lemon squeezed into them taken as the first thing in the morning, will help. Otherwise, drink at least 10 to 12 glasses of water daily. Use oil-free or gel-based lotions or creams instead of oil-based creams.
Q. Does chocolate cause pimples?
A. There isn't any scientific evidence that links eating chocolates to having skin breakouts. As a healthy low-fat, high-fibre diet is good for the skin, keep snacks like chocolates to a minimum and eat them only as an occasional treat.
Q. I am 20 years old with very dull, grey and limp hair. How can I improve it?
A. Vitamin A helps in providing a good and soft texture to the hair and Vitamin B is for colour and health. Good supplies of iron found in liver, meat, green vegetables and eggs help in maintaining the brightness and intensity of hair-colour. Iodine found in sea foods and many vegetables helps check the early greying of hair.
A seminar on Indian Systems of Medicines and Homoeopathy (ISM&H) and Health Tourism entitled "Arogya", the first of its kind in North India, will be held at Hotel Shivalikview, Chandigarh, on March 31 with support from the Ministry of Health and Family Welfare (Department of ISM&H), the Chandigarh Tourism Department, CITCO and the Directorates of Ayurveda of North Indian states.
The aim of the seminar is to make the public aware of the strengths and benefits of the indigenous medicines and diagnosis.
Health Tourism, through the use of ayurvedic and other medicines, will also be discussed, besides Indian medical therapies like Panchkarma, yoga and meditation.
An exposition will take place from March 29 to 31 at the same venue. Eminent practitioners will provide free consultation. The event will be coordinated by ITFT-Chandigarh. (Institute of Tourism & Future Management Trends).
AYURVEDA & TOTAL
Called Dhananjay and Partha and also adorned by as many names as those of the legendary warrior of the Mahabharta, the famous ayurvedic herb Arjuna is an acclaimed heart tonic of ancient times. Starting from the lower Himalyan range, its tall and big tree (Terminalia arjuna) is found throughout the greater part of the Indian sub-continent. Mainly, it is the bark of the tree which is of medicinal use.
Astringent in taste, Arjuna is light, dry and cold in effect. It is also a pacifier of kapha and pitta. Vagabhatta, the eminent physician and writer, was the first to prescribe the bark of this tree for heart diseases. Chemical analyses of Arjuna show it to contain large quantities of calcium with traces of aluminium and magnesium, besides crystalline compounds called arjunine, lactone and arjunetine.
Several studies have been made to assess the afficacy of Arjuna in cardiac disorders. The alcoholic decoction of the bark was found to be beneficial for stable cases of ischaemic heart disease besides modifying various coronary risk factors like raised lipid profile, obesity, hyperglycaemia and hypertension. Arjuna’s bark is also anti-pyretic, astringent, the healer of wounds, anti-fungal and anti-bacterial.
On the basis of the available experimental evidence, Arjuna is considered as a cardio-protective element and is known to promote vitality and general health in heart patients. As a heart tonic, 2 gm of the powdered bark can be taken with milk once a day. Simply the boiling of 5 gm of its fresh bark in a cup of milk gives the same benefits and is recommended as an adjunct in coronary artery disease.
Ayurvedic texts have described Arjuna as "hriddya", which means something beneficial to the heart. For the general maintenance of a patient with IHD, 2 gm of the powder of Arjuna, Ashwagandha, Amla and seeds of Tulasi (holy basil) , all crushed in equal parts, can be added daily to any other prescription. Arjuna also helps those patients who report excessive palpitation due to anxiety.
Apart from heart problems, Arjuna is used in a number of other ailments like chronic fever, oedema, obesity, cough, asthma and many of the skin diseases. Due to its high calcium contents, Arjuna helps the bones to regain strength after fractures. Chronic wounds heal faster if washed with the decoction of Arjuna. In blood-mixed diarrhoea, Arjuna powder is given with other anti-diarrhoeal medicines.
Arjuna is also an effective remedy for women’s diseases like non-specific white discharge and excessive menstrual flow.
There are many classic ayurvedic formulae where Arjuna is used as an important ingredient. Besides Arjunarishta (Parthadyarishta), which is the most famous among these medicines, Lakshadi Guggul, Kakubhadi Churna and Pushyanug Churna are ayurvedic preparations which contain Arjuna and have been in use for several centuries.
Caution: to avoid the possibility of adulteration while purchasing the dried bark of Arjuna, it is better to identify its plant and get the bark peeled off. Though ongoing research on its anti-anginal properties and potentials of modifying various coronary risk factors may open up larger vistas for its use in the primary and secondary prevention of ischaemic heart disease, patients are advised to consult their physician before using Arjuna.
The recurrence of asthmatic attacks forms a major disability for the patients. Homoeopathic constitutional treatment comes as a proverbial "breath of a fresh air", resulting in permanent cure. Constitutional treatment is aimed at understanding and prescribing medicines, for the psycho-physiological profile of the patient. Arsenic Album, Natrum Sulph, Bacillinum and Kali Carb are few of the lot used to treat the chronicity of asthma.
Natrum Sulph is one of the most important medicines for treating chronic asthma. It is often asked for treating asthma in children. Dr Kent (a 19th century homoeopathic pioneer), in an essay on Natrum Sulph says:"If a child has asthma, give Natrum Sulph as the first remedy". It is very useful when asthma is hereditary. Often, asthma that gets aggravated in humid weather and dampness, requires Natrum Sulph.
Arsenic Album is beneficial both in the acute phase and the chronic state. It is often indicated when attacks are frequent during night (midnight and after), accompanied with great restlessness and fear of suffocation on lying down.
According to J.H. Clarke (a major homoeopath also of the 19th century) an inter-current course of Bacillinum will often make a wonderful change in patients who have a personal or family history of chest infections. Bacillinum, a deep-acting medicine, is required for those patients who are very sensitive to cold, having a personal or family history of tuberculosis.
Many asthmatics can relate the origin to an attack of pneumonia. A few doses of Kali Carb can work wonders for them. Kali Carb is also indicated in asthma attacks that occur early in the morning.
A word of caution: The above-mentioned medicines are deep-acting and should not be used without consulting an experienced homoeopath. (To be concluded).
Worthwhile reading for the plus 55
Navtika, according to its editor, means a painting brush. She, Meenakshi Chawla ( a computer engineer) has started a monthly magazine of this name to help the plus-55 age-group people live full and healthy life.
Retirement often brings gloom. Navtika finds ways to dispel it, besides giving guidance for healthcare etc. She is being assisted by Abhay Chawla, a thorough scientific professional. The magazine is like a lighthouse; those in the evening of their lives, who are looking for the shore, should read it.
The address given to us is: 311, FF, Sector 4, Gurgaon, Haryana (Navtika @ VSNL -net.) Happy reading, all the plus fiftyfives!
The six tastes
The six tastes of nature proposed by Ayurveda are madhur (sweet), amla (sour), lavana (salty), katu (pungent), tita (bitter) and kashaya (astringent). Each taste has its specific action on the body. This applies not only to the herbs but also to the food we take daily. Under normal conditions, everyone needs a certain amount of each of the six tastes. Too much of any taste can become harmful as too little can become.