Friday, December 30, 2011

Top health resolutions to consider in the New Year 2012

Posted by: Ramesh Venkatraman

With 2012 round the corner, resolutions are the flavor of the season. Below is my own list of the top health resolutions for the year:

Invest in your health:
I am not talking about health insurance here, what I am talking about is Time, Commitment, Planning, Perseverance, Determination, and Effort. These are the essential ingredients that will determine the success or failure of your health resolution for the year. Write a personal mission statement and commit it to memory and recall it every single day of the year for your health plan to succeed. Let us now look at the essential ingredients of a good "Health Mission Plan"

Exercise:
The single biggest game changer in any health plan. A sedentary lifestyle is a major risk factor for developing diabetes, hypertension and cardiovascular diseases. Plan your own exercise regimen - you are the best judge of what your body can and cannot do - do not fall for any of the gimmicky ads that tell you how you can develop wasboard abs and Arnold arms in 10 days. Do not spend money enrolling in a gym or health club. There are several exercises that can be done without spending a dime. Remember to include the following 3 things in any personalized exercise program you design for yourself:

  1. Stretching: Stretch before and after your session. Stretching helps prevent injury and also prepares your body before an exercise and helps soothe sore muscles after a session
  2. Cardio: Walking, jogging, swimming, skipping or any exercise that increases oxygen consumption of your body - again start slowly and increase as you get better
  3. Resistance: Pushups, pullups, squats, weight training, help build and strengthen muscles. Muscles burn more calories and therefore will aid faster weight loss and weight maintenance

Eat Watchfully: 
I think this is the only diet advice that needs to be given. Fad diets, calorie-restrictive diets, fashionable one week regimens, etc. need to be thrown into the trash can where they belong. None of these work in the long run and only end up creating disappointment or worse depression, rebound binge eating, and Yo-Yo patterns of weight-loss and weight-gain that cause greater harm than good. Follow 3 simple rules:

  1. Watch everything you eat and every morsel that goes into your mouth
  2. Eat slowly - when you wolf down your food and eat like you are in a race, you do not give your brain time to signal satiety, this is one of the reasons why people who eat quickly realize that they have overeaten only sometime after they have completed their meal
  3. Hold the two palms of your hand together - this is roughly the size of your stomach and approximately the quantity you must be consuming during one meal 

Reduce Stress: 
Stress is inherent in the lifestyles we lead and is by itself an independent risk factor for various lifestyle diseases. Take up any activity (it could be your hobby) which you truly enjoy and which can help calm your mind - meditation, pranayama, reading, writing, social service, are all examples of activities than can help relieve stress.

Sleep:
So many of us go through our days like zombies flying from one task to the next, sparing little time for one of the most important activities of our lives - a good night's sleep. So many of us struggle to keep up with the demands of multitaking, being always available and/or on call, answering every email that drops into our inbox... The first thing that most people need to do is to catch up on lost sleep and then commit to at least 7-8 hours of undisturbed sleep every night. The changes you will see in your life will be nothing short of a miracle - Try it this new year

Health Checkup:
If you are male, lead a sedentary lifestyle, are overweight/obese, over the age of 40, and/or smoke, then get yourself checked for hypertension (elevated BP), cholesterol levels (lipid profile) and diabetes.
If you are female, peri or post menopausal, above 45 years of age, lead a sedentary lifestyle, and/or smoke then get yourself checked as above and in addition start taking a calcium (Calcium citrate is best) with Vitamin D-3 supplement to prevent osteoporosis

Weed out harmful habits:
If you smoke, chew tobacco/gutka, consume alcohol then commit to change your habits slowly BUT steadily - give up smoking, chewing tobacco/gutka, and exercise moderation in consuming alcohol - choose Wine instead of stronger drinks like Whiskey/Scotch/Rum/Vodka (BTW' Wine is no longer a "Women's-only drink").

Season's greetings and Happy New Year to all!



Thursday, December 22, 2011

Varicose veins: causes, symptoms, and management

Posted by: Ramesh Venkatraman

Introduction: Veins are blood vessels that carry/return deoxygenated (impure blood or blood lacking in oxygen) blood from the various parts of the body to the heart and then the lungs. Veins have valves that help in propelling the blood forward towards the heart and prevent backflow.
Varicose veins appear swollen, twisted, bluish-purple in color, and slightly raised above the surface of the skin. Generally, the following are true of varicose veins: (a) more common in women than in men (b) can form anywhere in the body, but most commonly located in the legs, particularly visible on the calves (c) Usually painless and harmless but can sometimes become painful (d) tend to be inherited and become more prominent as one ages (e) statistics show that 1 in 2 people above the age of 50 develop varicose veins (f) typically it is the superficial veins present closer to the skin that usually become varicosed.

Causes: Although several theories exist, the commonest and most accepted cause is “defective valves” These defective valves do not perform their function of ensuring that the blood keeps moving forward. Veins with defective valves allow backflow of blood causing the blood to pool and stagnate - this causes the veins to enlarge and lose their characteristic shape causing “varicosities” in the vein. Some other causes of varicose veins include heredity and congenital (born with) abnormalities of the vein-wall which can cause the valves to malfunction.
Hemorrhoids (piles) is a very common type of varicosity that occurs in the anal/rectal region usually due to chronic constipation

Conditions and factors that can trigger or aggravate varicose veins:
  1. Pregnancy: Increased blood volume and increased weight are the primary reasons along with the effects of the hormones estrogen and progesterone which cause relaxation of the vein walls
  2. Prolonged standing
  3. Obesity, particularly people with a distended belly
  4. Chronic constipation, chronic cough, urinary retention due to an enlarged prostate and any other condition that causes you to strain and exert yourself over prolonged periods of time
  5. Surgery and/or trauma to the leg

When varicose veins become serious and when to seek medical care: Varicose veins in general are harmless and the only problem that you may face is the occasional itching besides the unsightly appearance. However go to a doctor when you experience the following:
  1. Unexplained pain, discoloration, swelling, and/or ulceration on or around the region of the varicosity - this could signify the beginning of a clot and warrants a thorough medical examination. Individuals who have been diagnosed with DVT (deep vein thrombosis) should exercise greater caution.
  2. Constant ache in the legs, centered on or around the varicosity that is preventing you from getting a good night’s sleep.

Your doctor may advise a Doppler scan to determine how serious your problem is and if you need treatment/medication. A Doppler scan is essentially an ultrasound scan that is painless and uses high frequency sound waves to provide an image of the affected part. The Doppler scan can provide information on the direction of blood flow inside the veins, how well your veins are functioning, and the presence of clots (if any).

Treatment and management of varicose veins:
  1. Compression stockings: Compression stockings are specially designed to steadily squeeze your legs and encourage blood flow towards your heart (i.e. normalize blood flow in your affected veins). Compression stockings are usually tightest at the ankle and get gradually looser as they go further up your leg and may help to relieve the pain, discomfort and swelling in your legs.
  2. Surgery: Surgery may be required if the varicosity is spread over a large surface area or if the affected veins are particularly large, or if the diagnosis shows a possibility of increased risk of developing complications. Some individuals may also choose to go in for surgery for cosmetic reasons.
  3. Simple interventions that can provide relief include: exercising, losing weight, avoiding prolonged periods of standing, avoiding tight-fitting clothes, elevating your legs when resting, and not crossing them when sitting.
  4. Yoga: Yogasanas such as UTTHAN-PADASANA, CHAKRA PADASANA, PADA SANCHALANASANA, and PAWANMUKTASANA can be extremely beneficial in people with varicose veins. These are simple asanas that you can learn on your own. Check out these sites to read about these asanas:
    http://yogadeep.blogspot.com/2010_06_01_archive.html
    http://shilpamoreshwar.weebly.com/yogasanas.html

Wednesday, December 14, 2011

Even very minimal physical activity is beneficial and can improve survival

Posted by Ramesh Venkatraman

It has been known for quite some time now, that even moderate physical activity such as 30 minutes of walking, 6 days a week significantly improves health outcomes and reduces mortality (i.e. increases life span). The public health recommendation in most countries is to walk for 30 minutes (or indulge in an equivalent activity) for 5 to 6 days of the week (approximately 150 to 180 minutes per week).

A recent study published in The Lancet (Chi Pang Wen and colleagues) now shows that even as little as 15 minutes of physical activity per day for 6 days a week reduces:
  1. All-cause mortality by 14%
  2. Cancer mortality by 10%, and
  3. Cardiovascular disease mortality by as much as 20%

What would be ideal is for all of us to spend about 300 minutes per week doing some form of moderate physical activity (approximately 60 minutes of walking or an equivalent activity per day). There seems to be a direct relationship between the amount of time devoted to exercise and the benefits that accrue thereof - See graph below. 

However studies on individuals and exercise patterns, have consistently shown that very few individuals can actually measure up to even this requirement of 60 minutes of walking/day - a reflection perhaps of the times we live in.

The key take away is that we must find ways to incorporate some form of physical activity into our daily lives - this could mean simple lifestyle interventions such as stepping out of our office cubicles for a brisk 15 minute walk during lunch break, walking to the grocery shop instead of driving, using public transport on certain days of the week... - it is for each one of us to decide what is best for ourselves.

Reference: "Survival benefit associated with low-level physical activity". Published online: Published Online
August 16, 2011 DOI:10.1016/S0140-6736(11)61029-5


Tuesday, December 13, 2011

Full article: The lymphatic system and lymphedema following breast cancer

Posted by Ramesh Venkatraman

I have had several mail requests and feedback that it is cumbersome reading the entire article as it is spread across three parts and readers have to click through several links or scroll down the page to read the entire article. Additionally, some readers have also suggested that the article be available as a download for them to read/refer offline.

Therefore I have combined the 3 parts into a single article and it is now available as a word doc that can be downloaded for offline reading. BTW, it can also be viewed/read online in case you don't want to save a copy to your system. Go to the link below to access the document: 
FULL ARTICLE


Monday, November 28, 2011

The benefits of barefoot walking


The human foot was designed for walking barefoot. The basic design that was born out of a series of evolutions from the ape-foot is an architectural and biomechanical marvel of science. The human foot has remained anatomically, architecturally, and biomechanically modern for a long time and certainly since much, much, before footwear was invented.

Several studies have pointed out the benefits that can accrue from walking barefoot. While it may not be practical or practicable to walk around barefoot all the time particularly with the state of our roads, (in India) there is definitely scope to include bare foot walking into our daily lifestyle.

A study that compared morphological and functional effects of habitual foot wear amongst three groups of individuals is revealing. Group-1 consisted of a population of habitually barefoot Indians (n = 70), Group-2 consisted of habitually shod Indians (n = 137) and a Western population (n = 48). An important note here is that even habitually shod Indians also wore shoes less often and used shoes that were less constrictive compared to their Western counterparts.

Barefoot walkers had wider feet and more equally distributed peak pressures, i.e. the entire load carrying surface of the feet was contributing more uniformly (towards bearing the load) than in habitually shod subjects, in whom regions of very high or very low peak pressures were more apparent. Additionally, western subjects differed strongly from both Indian populations (and most from barefoot Indians), by having relatively short and, especially, slender feet, with more focal and higher peak pressures at the heel, metatarsals (bones of the foot) and hallux (the big toe) [D'Ao K, et al. Footwear Science. 2009;1(2):81-94]

Another study that evaluated the effects of modern shoes on gait and lower extremity joint loads in osteoarthritis (OA) showed that shoes detrimentally increased the load on the lower extremity joints. Results showed that barefoot walking reduced the peak load on the joints and knees by almost 12%. The study goes on to say that since excess loading in OA is associated with increase in pain and worsening of the disease, modern shoes may actually worsen the problem in patients with osteoarthritis.  [Shakoor N, Block JA. Arthritis and Rheumatism. 2006;54(9):2923-2927.]

There is a message here for Indians, traditionally barefoot walkers at home who are increasingly using “chappals” and flip-flops at home - could this perhaps be the reason for the increasing incidence of knee replacement surgeries and complaints of pain in the lower extremities, particularly ankles and knees? While it is true (as stated at the beginning of this post) that it may not be possible to walk around barefoot all the time, it is certainly possible to at least incorporate small changes including:


  1. Walking barefoot inside your homes
  2. Removing your shoes if you know you are going to be sitting at a desk for a long time - using a slip-on as opposed to one with laces may make it easier for you to slip in and out of your shoes.
  3. Choosing shoes that are functional and those that are not constrictive, particularly around the large toe and the heel.
  4. Using slippers (when you go out socially or whenever possible) that are more open, less constrictive and allow your feet to breathe
  5. Carrying a functional slipper/chappal/footwear with you while going to work - you could wear it while traveling to and from work.

Wednesday, November 23, 2011

Deodorants, antiperspirants and breast cancer - Is there a link?

Posted by Ramesh Venkatraman

There are several articles floating around in the press and internet that warn people not to use deodorants and antiperspirants. These articles have pointed out that antiperspirants (a preparation that reduces underarm sweat) and deodorants (a preparation that masks body odor) could be potentially carcinogenic (i.e. cause cancer). This article examines the available evidence to see if these claims are genuine.

Most of these articles have focused on two key ingredients - aluminum-based compounds in antiperspirants and Parabens in deodorants. The articles have gone on to suggest that since antiperspirants and deodorants are applied under the arm, close to the breast region these compounds can be absorbed via the skin and/or through small nicks caused by shaving. Aluminum-based compounds and Parabens are thought to mimic the activity of the female hormone estrogen and because estrogen has the ability to promote growth of breast cancer cells some scientists have suggested that perhaps these compounds could cause breast cancer. However the question to be asked is if there is evidence to support this claim?

At the moment the available evidence is circumstantial and not completely conclusive. One study published in the European Journal of Cancer Prevention, 2003 indicated that frequent use of antiperspirants/deodorants combined with underarm shaving was associated with an increased incidence of breast cancer diagnosis at an earlier age. This was a retrospective study in 437 women diagnosed with breast cancer using a written questionnaire. [McGrath K G. Eur J Cancer Prev. 2003; 12:479-485.]. See also, the graph at the end of this article which shows a direct relationship between the incidence of breast cancer and the increase in the sale of antiperspirants/deodorants in the US.

The National Cancer Institute (NCI) of the National Institutes of Health (NIH) however maintains that more research is necessary to determine whether the chemicals used in deodorants/antiperspirants can alter DNA structure or cause any other changes in the structure of breast cells. (http://www.cancer.gov/cancertopics/factsheet/Risk/AP-Deo)

What does all of this mean to you? Should you or should you not use deodorants/antiperspirants? As it is always better to err on the side of caution, it may be useful for you to do the following:
  1. Use deodorants/antiperspirants sparingly and when necessary - This means that you restrict their use only when you are going out or if you have to be at a social gathering where you don’t want people scurrying away from you with their noses all screwed up. It also means that you don’t drench yourself in deodorant spray or slather on a thick past using the roll-on - a thin film should suffice.
  2. Observe deodorant/antiperspirant holidays: Don’t use deodorants/antiperspirants when you are at home or during weekends when all you are going to do is to laze around the house.
  3. Avoid using deodorants containing Parabens: This should be quite easy, look at the ingredients label and look for names like methylparaben, propylparaben, butylparaben, or benzylparaben. 
Antiperspirant/Deodorant Sales Versus Breast Cancer Incidence
Ref: Roush et al., 1987 [34] ; SEER Incidencepublic-Use Database, 2001 [37]. ;US Cosmetic and Toiletries Market, 2001;
Bull Cancer 2008 ; 95 (9) : 871-80.


Thursday, November 17, 2011

Monsosdium Glutamate (MSG/Ajinomoto): The hidden poison in food

Post written by: Ramesh Venkatraman

The next time you hear the phrase “No one can eat just one” on TV or radio, advertising a popular brand of potato chips you need not grin sheepishly and nod your head in agreement, ashamed at your own lack of dietary control. It might well be that manufacturers of several popular snacks are adding substances that are literally driving your neurons (nerve cells) into a state of high excitement making it impossible for you to pull your hands away from that pack of snacks - the secret to making you captive and begging for more is MSG (monosodium glutamate) more popularly known by its brand name - Ajinomoto.

Chemically speaking, MSG is the sodium salt of glutamic acid (thus, the name monosodium glutamate). Glutamic acid was first isolated from gluten (wheat). MSG is an “excitotoxin” and as the name suggests quite literally, MSG is a poison that excites your nerve cells. MSG is a chemical additive commonly used by the food industry as a “flavor enhancer” and has been in use for more than 100 years since the time it was first commercialized in 1909 by the AJINOMOTO Company, Japan. First introduced into India in 1963, MSG is now marketed in India by the Ajinomoto India Pvt Ltd.

Is it necessary to add MSG to food? The simple answer is NO, because other than its purported claim of enhancing the taste of food, it has no other role to play - then why use it? Precisely because of its ability to excite your nerve cells and make you addicted to the food substance.

Several scientific, animal toxicity studies have clearly pointed out that MSG has the potential to:
  1. cause dose-dependent swelling and death of neurons (nerve cells) - study conducted using mouse neuronal culture. [Xiong JS, et al. Int J Clin Exp Med. 2009 Nov 15;2(4):329-36]
  2. increase BP (systolic), increase muscle sensitivity, and cause headaches - study conducted among healthy male human volunteers [Hansen BL, et al. Cephalalgia. 2010 Jan;30(1):68-76.]
Another study conducted among neonatal rats injected with MSG, showed that MSG can cause several neurochemical alterations in the brain as a direct result of the excitotoxic potential of MSG. [Perez-Lopez SJ, et al. Cephalalgia. 2010 Jan;30(1):68-76.]Yet another study showed that MSG can actually cause cell death and damage to your nerve cells. [Brain Res. 2010;1317:246-56.]

Dr. Russel Blaylock in his book “Excitotoxins: the Taste That Kills” goes to the extent of saying that MSG could be the initiator of serious neural diseases like Alzheimer’s, epilepsy, multiple sclerosis, parkinson’s, autism, strokes, and learning disorders.

Even with all this evidence, MSG continues to be classified under the GRAS (“generally recognized as safe”) index by the Food and drug Administration (FDA), USA but the operational word here is “Generally”. Manufacturers themselves realize that MSG is a bad word and therefore they disguise its presence under the garb of harmless sounding names. 

A list of MSGs' various avatars is given below. Watch out for these names when you buy that pack of instant noodles, bag of chips, bottle of sauce/ketchup, sachet of ready-to-make soup:
  1. Hydrolyzed vegetable protein
  2. Hydrolyzed protein
  3. Hydrolyzed plant protein
  4. Plant protein extract
  5. Sodium caseinate
  6. Calcium caseinate
  7. Yeast extract
  8. Textured protein
  9. Autolyzed yeast
  10. Hydrolyzed oat flour 
[Jane Grey; MSG: The killer food additivehttp://janegrey.hubpages.com/hub/MSG-the-Killer-Food-Additive-Allergy]

Thursday, November 10, 2011

The home medicine chest - What YOU MUST HAVE IN IT

You have a splitting headache and you rummage through your bag, pockets, upturn the files on your table but still can’t find that damn pain killer tablet that can provide you with the much needed relief. Worse still you can’t even find that pain balm you bought a couple of years ago - If this sounds all too familiar, it is time you got yourself organized and set up a medicine chest at home. If you have an infant or a little kid at home you will need 2 medical chests - one for the adults at home and another for the kid.

Before we look at what MUST go into that medicine chest a few tips on maintaining the medical chest:
  1. Your medicines and medicine chest should not be exposed to direct sunlight
  2. Remember that all medicines need not be refrigerated - some people put everything into their refrigerators. Read the storage instructions and store medicines appropriately. If a medicine needs to be refrigerated, then put it there but also add a small note to your medical chest informing anyone who will need to use it that a particular medicine can be found in the refrigerator.
  3. Make it a habit to clean you medicine chest regularly - do it at least once a month: throw away damaged and expired medicines, check to see if you need to replenish certain medicines, and rearrange and put things back in order.
Now let us look what YOU MUST HAVE in your medicine chest. We will start with the general one for adults:
  1. Pain killers and fever medicines: This is an absolute must. Typically you should have Ibuprofen and paracetamol (acetaminophen) - Buy at least two strips of each. Common paracetamol brands available include Crocin, Calpol, Dolo-650 - You could buy any of these. Internationally a paracetamol brand that is more readily recognized is Tylenol. Ibuprofen brands include Ibugesic, Brufen in India and Advil, Motrin internationally. Also keep a bottle of pain balm - Tiger balm, Amrutanjan are good choices.
  2. Antiseptic/Disinfectant: Keep a bottle of Dettol or Savlon to wash cuts, abrasions, and any injury. Always dilute the disinfectant before applying it to the cut or wound.
  3. Antibiotic cream/ointment/gel: Keep a tube of antibiotic cream/ointment/gel. Soframycin ointment or Neosporin ointment should do. Apply an antibiotic only after you have washed and cleaned the wound. Additionally keep a tube of Burnol cream in case of mild burns, scalds, and boils.
  4. Aspirin: Absolutely essential. Aspirin originally a pain killer is now more often used as an anti-clotting agent. If you see someone gasping for breath or holding his/her chest, complains of chest pain then he/she could well be suffering a heart attack, immediately pop an aspirin into his/her mouth and ask him/her to chew on it.
  5. Anti-allergics: Keep a strip of anti-allergic tablets. Buy a strip of cetrizine - cetzine or zyrcet. Take it when you have an allergy (allergic cold/cough, skin allergies, allergies due to insect bites etc.). Although cetrizine is supposed to be non-sedative, exercise caution. Do not take it if you have to drive or need to be involved in some motor action.
  6. Betamethasone/Hydrocortisone cream: Keep a tube to provide relief in skin allergies, hives, itching, contact dermatitis (skin allergy due to contact with a substance), bug/insect bites. A tube of Betnovate should suffice.
  7. Anti-diarrheals: Keep a strip of loperamide (Lomotil, Lomofen, Immodium) and it can help stop that diarrhea. Always go to a doctor if your stools have a foul smell or if the diarrhea does not stop. Also keep a strip of lactobacillus (the good bacteria) which can help restore the balance of good and bad bacteria in your stomach - Sporlac is a good choice.
  8. Rehydration solution/salts: Keep a sachet of ORS - Electral or Electrobion are good choices. They will help restore the electrolyte balance in your body after a bad bout of diarrhea and/or vomiting. The patient should also be given the ORS even during the course of his/her diarrhea. Note: Once reconstituted the ORS should be consumed within 24 hours.
  9. Nausea and Vomiting: Domperidone is a readily available OTC medicine for nausea and vomiting. Keep a few tablets (you don’t need an entire strip). The brand Domstal is available across medical shops in India.
  10. Cold, Cough, and a stuffy chest: I am not a great fan of cough syrups. I prefer plain steam inhalation to relieve congestion and regular salt water gargle to clear irritation in the throat. In India you also get a medicine called Karvol Plus - This is a caplet that contains tea tree oils, menthol etc. and is a great addition to plain steam. All you have to do is to cut the tip of the caplet with a scissor and pour the liquid into the hot water, then drop the caplet shell as well into the hot water. Inhale deeply for instant relief. You can also apply Vicks Vaporub or Amritanjan on your chest, back and neck to relive the congestion.
  11. Heart Burn: Commonly known as acid indigestion is a burning pain/sensation in the chest/neck region particularly after a heavy meal. While preventive steps include making lifestyle changes like stopping smoking, eating low fat diets and maintaining regular eating habits, you can keep antacids like gelusil and also certain medicines like ranitidine that can prevent excess acid release - commonly available brands include Zinetac, Rantac, and Aciloc.
  12. Bandaid, bandages, gauze, cotton: Buy a variety of sizes. Also keep plain adhesive tapes which can be used to hold a medicated pad or surgical gauze. Also keep a roll of cotton and gauze bandage to wrap larger wounds and prevent leakage from the injury.
  13. Elastic wrap, compression bandage: Keep a roll ready in case of severe sprains, and when you have to support a limb or joint before going to the doctor.
  14. An accurate thermometer: If you know how to read a mercury thermometer that is ideal, else a digital thermometer should do. Do not buy the fever strips and ear thermometers - they are useless.
  15. Measuring cups/jars/beakers: Keep a couple of measuring cups and/or jars to accurately measure dosage of liquid medicines.
  16. Scissors: Keep a pair of scissors permanently in the medical chest. You don’t want to be running around the house looking for one when you have to cut a strip of bandage to dress a wound
  17. Tweezers: Keep one in the chest in case you want to remove wood splinters, or any foreign body that has become embedded in the skin.
Let us now look at the baby’s medical chest. Several items would be common but there may be variants:
  1. Pain killers and fever medicines: Acetaminophen (paracetamol) syrup and Ibuprofen (Ibugesic Plus)
  2. Antiseptic/Disinfectant: Dettol/Savlon liquid,
  3. Moisturizing cream/lotion: Keep a good brand of moisturizing lotion and/or cream to prevent skin dryness.
  4. Topical calamine lotion or Hydrocortisone/Betamethasone cream: For allergies, insect bites etc. Wycort is a brand of hydrocortisone that is available in India. You can also use betnovate (Betamethasone)
  5. Antibiotic Cream/Ointment: Soframycin ointment
  6. Antiallergic medicines: Cetzine zyrup
  7. Nausea/vomiting: Domstal syrup
  8. Stomach pain due to gas, bloating, colici pain: This is very common in children and can cause a lot of discomfort. Babies usually cry and writhe in pain. Gripe water, Omum water, Colicaid can all provide quick and effective relief
  9. Digital Thermometer: You can measure the temperature by placing it in the rectum or under the armpit.
  10. Bandaid, bandages, gauze, cotton: Buy a variety of sizes. Also keep plain adhesive tapes which can be used to hold a medicated pad or surgical gauze. Also keep a roll of cotton and gauze bandage to wrap larger wounds and prevent leakage from the injury.
  11. Chest congestion/Cold/Cough: Vicks Vaporub rubbed into the chest, neck, and back. In case of severe congestion in the chest, you can give steam inhalation but you must exercise extreme caution. Place the baby on your lap, cover the vessel containing hot water with wire mesh or use the sieve from your kitchen. Hold the baby’s head with both your hands and hold her over the steam for a few seconds and then pull away. Do this a few times. Do not hold the baby over the steam for more than a few seconds at a time. A very good ayurvedic medicine for children is Sithophaladi churna which should be available in most ayurvedic shops - a pinch of the powder has to be mixed with honey or ghee and given to the baby.
  12. Nose block: Pure saline drops (Available as Rhine drops in India) or Otrivin pediatric drops are good choices to unblock baby’s nostrils.
  13. Measuring cups, dropper, and oral syringe: Depending on the age of your baby store one or all of these as most medicines for children are liquid preparations and need to be measured out.
  14. Scissors: Keep a pair of scissors permanently in the medicine chest. You don’t want to be running around the house looking for one when you have to cut a strip of bandage to dress a wound
  15. Tweezers: Keep one in the chest in case you want to remove wood splinters, or any foreign body that has become embedded in the skin.
  16. Torch/Flashlight: Keep a small torch/flashlight for checking your baby’s nose, throat, mouth, and ears.
  17. Bandaid, bandages, gauze, cotton: Buy a variety of sizes. Also keep plain adhesive tapes which can be used to hold a medicated pad or surgical gauze. Also keep a roll of cotton and gauze bandage to wrap larger wounds and prevent leakage from the injury.





Sunday, November 6, 2011

One puff of Cigarette smoke is enough to cause a lot of harm

One puff and...

  1. Your heart rate increases by 10 to 25 beats/minute
  2. The carbon monoxide that you inhale, squeezes your blood vessels and then chases out the oxygen from your blood leaving your system starved of precious oxygen - "the fuel of life"
  3. The delicate mucus-lined cells and tissues of your nostrils, mouth, throat, and lungs burn and singe as the temperature at the tip of the cigarette soars to anywhere between 400 to 600 degrees centigrade
  4. Your lungs retain 90% of the smoke, soot, and tar so that very soon your lungs are no better than the factory chimney that guzzles smoke by the ton
  5. Your blood vessels cringe and squeeze themselves tight as they struggle to cope with the massive assault on their sensibilities - in the bargain your heart and brain lose out on life-giving oxygen
  6. Your blood pressure rises by 10 to 15 percent making you feel heady giving you that smokers high you crave so desperately, while taking away 5 years of your life in the bargain
These are only some of the changes that happen during the act of smoking. Chronic smoking as a habit is a sure shot way to kill yourself and your chance at living life to the fullest, you can choose from - cancer, heart attack, infertility, shortened life span, chronic bronchitis, asthma, premature aging... 

Think about this the next time you reach out for that cigarette.

Thursday, November 3, 2011

Charaka and his observations on the “Signs and Symptoms of approaching death”


Post written by: Ramesh Venkatraman

Today’s healthcare model is all about “evidence-based-medicine” where you will be asked to get a scan done, or subject yourself to a test before the physician even pronounces a verdict on what afflicts you, leave alone start a treatment regimen. Gone are the days when your doctor used to “touch” and “feel” your limbs or forehead, shine a torch into your mouth, or ask you to stick your tongue out before recommending a medicine. It is in this context that Charaka’s observations on the “Signs and Symptoms of approaching death” make for interesting reading. This article only lists the physical signs mentioned in Charaka’s Samhitha. It is the author’s belief that the other signs, symptoms border on the superstitious and may not be appreciated in today’s context.

The physical signs that can be noted through observation of the patient on deathbed or sudden changes that are premonitory in nature include:
  1. Sudden loss in physical strength and sensory functions
  2. Discoloration of face, nails, eyes, urine, feces, hands, and feet
  3. Sudden appearance of malodor in a deteriorating patient
  4. Loss of pulsation in body parts that had pulsations earlier, coldness in parts that were earlier warm, harness of what was soft, muscle wasting, instability in the joints
  5. Very deep or very shallow breathing
  6. Matted eyelids
  7. Displaced teeth with white concretions
  8. Absence of or very low pulse in the neck
  9. Matted eyelashes, glassy, glazed appearance of eyes with eyelids either permanently open or closed
  10. Bluish tinge under the nails
  11. Absence of cracking sound when the fingers are bent
  12. Discoloration of the abdominal wall
  13. Severe fatigue, anxiety, confusion, restlessness, severe thirst along with drastic loss in appetite
  14. Stiffness in the jaws and neck
  15. Back becomes rigid and arched

Reference: The legacy of Charaka by M. S. Valiathan

Sunday, October 30, 2011

20 different ways in which OBESITY can kill YOU!!

1.       Brain: Stroke also called cerebrovascular stroke. The arteries supplying blood to the brain can become clogged by fatty deposits causing blood supply to the brain to be cut-off leading to death of brain cells and stroke.
2.       Heart: Heart attack. The arteries supplying blood to the heart (called coronary arteries) can become clogged by fatty deposits causing blood supply to the heart to be cut-off leading to death of some of the heart cells leading to a Myocardial Infarction or heart attack.
3.       Lungs/Airway: Breathing difficulties, sleep apnea (condition where there is a pause in your breathing for a short period and/or shallow breaths while your asleep). Asthma is also more common in people who are obese
4.       Arteries: Elevated blood pressure
5.       Wrist: Carpal Tunnel syndrome (caused by the compression of a nerve in the wrist) leading to pain, numbness, tingling, and significantly reduced grip strength
6.       Breast: Cancer, particularly in women who have entered menopause
2 SIMPLE MEASURES OF OBESITY
7.       Liver: Cirrhosis (scarring of the liver along with reduced liver functioning) and hepatitis (inflammation of the liver cells)
8.       Gallbladder: Gall stones. Studies have linked higher cholesterol levels to development of gall stones
9.       Esophagus: Cancer
10.   Stomach: Cancer
11.   Immune System: Reduced resistance to diseases and disease-causing micro-organisms
12.   Kidneys: Increased weight increase the load on your kidneys leading to an increased incidence of kidney failure in the obese.
13.   Pancreas: The obese are at a greater risk of developing increased blood sugar levels and Type-II diabetes
14.   Colon and Rectum: Bowel cancer
15.   Reproductive System: Reduced fertility, labor complications in pregnant women, development of endometrial cancer
16.   Urinary Bladder: Incontinence (Leakage of urine when you laugh, lift weights etc.)
17.   Bones: Arthritis
18.   Vein: Deep vein Throbosis (DVT) - Blood clots in the veins that can be fatal
19.   Feet: Pain particularly in the heel
20.   Lifespan: Being obese reduces your lifespan by 3 to 10 years





Friday, October 28, 2011

The lymphatic system and lymphedema following breast cancer: Part-3 -Simple tips to manage lymphadema.

Post written by Ramesh Venkatraman
In part-1 we looked at the role and functions of the lymphatic system [CLICK TO READ Part-1] and in part-2 of this series we discussed lymphadema in women who have undergone treatment/surgery for breast cancer [CLICK TO READ Part-2]. In this final section we will discuss ways and methods to prevent and manage lymphedema. A few simple yoga exercises for the hand are also included which should help in reducing constriction around the affected area, improve blood circulation, any flush out any collected fluid. Always consult your physician before trying any exercise.

        I.            Avoid infections and injury:

a.       Keep your hands soft and moist with the help of a moisturizer
b.      Keep your nails short but remember not to cut your nails too close to the skin
c.       Always keep your hands and fingers clean
d.      Wear protective gloves while doing household chores particularly when you are cutting vegetables, washing dishes, gardening etc.
e.      Always wear a thimble while sewing
f.        Avoid burns (chemical, fire, oil, sun-burn)
g.       Avoid extremes of weather (extreme cold or extreme heat) - Dress appropriately when you cannot avoid going out during extreme weather conditions
h.      Avoid constrictive, tight clothes, jewelry
i.          Carry briefcases, bags in your hand, avoid using the shoulder strap as it can constrict your shoulder area
j.        Wear a compression sleeve during long flights as cabin pressure may trigger lymphedema
k.        If your blood has to be drawn (for testing) or if you have to take an injection do it in the unaffected arm. If both arms are affected, see if the injection can be given in the thigh
  
      II.            Caring for cuts, abrasions, and burns:

a.       Wash and clean the affected area with soap and water and also with a antiseptic solution like Dettol or Savlon
b.      Apply an over the counter topical ointment (like Soframycin). If you are not sure, talk to your doctor
c.       If the injury is extensive wrap a gauze bandage and change the dressing every day. Call your doctor if the bleeding persists
d.      Observe the injury to see if there is any sign of infection, pus formation, inflammation (swelling), increased redness and/or heat or if fever develops - Cal your doctor immediately
e.      In case of burns, hold the affected under running water or apply a cold water pack for 15 minutes and then apply a dressing as above - If the burn is sever, go to your doctor immediately
  
    III.            Exercise moderately but avoid muscle strain:

a.       Exercise regularly and moderately but do not overstrain
b.      If your arm starts to ache lie down and keep your arm raised above the level of your chest/heart till the discomfort goes away
c.       Avoid sudden, jerky, vigorous, repeated activity. Also avoid any heavy lifting, or pulling
d.      Avoid weight gain

A few simple yoga exercises you could do on a daily basis:

        I.            Mushtika Bandhana (Hand Clenching):

1)      Sit either cross-legged on the floor or if you are uncomfortable sitting on the floor sit in a chair
2)      Hold your arms out in front of you at shoulder level
3)      Open your palms wide, facing down, and stretch your fingers as far apart as possible
4)      Inhale deeply and hold for a few seconds (you should feel comfortable, you can increase the duration as you become more regular in your practice)
5)      Now slowly close your fingers into a fist, with the thumb inside the other four fingers (see figure). Clench and hold
6)      Exhale
7)      Repeat 5-10 times

      II.            Manibandha Naman (Wrist Bending):

1)      Sit either cross-legged on the floor or if you are uncomfortable sitting on the floor sit in a chair
2)      Hold your arms out in front of you at shoulder level
3)      Bend your hand at the wrist with palms open and fingers pointing upwards. Imagine you are pushing against a wall
4)      Inhale deeply and hold for a few seconds (you should feel comfortable, you can increase the duration as you become more regular in your practice)
5)      Now slowly bend your hands in the opposite direction so that in the final position your fingers are facing down. (see figure)
6)      Exhale
7)      Keep your elbows straight throughout the exercise, do not bend your fingers
8)      Repeat 5-10 times

    III.            Manibandha Chakra (Wrist Rotation):

1)      Sit either cross-legged on the floor or if you are uncomfortable sitting on the floor sit in a chair
2)      Hold your arms out in front of you at shoulder level
3)      Clench your fingers into a fist with the four fingers wrapped around the thumb (as in the hand clenching exercise)
4)      With the fist facing downwards, slowly rotate the fist around the wrist. The elbows and arms should remain perfectly straight, only your wrists should move
5)      If you find this difficult initially, you could start with one hand supporting the other and then repeating with the other arm
6)      Breathe normally
7)      Repeat 5-10 times


    IV.            Kehuni Naman (Elbow bending):

1)      Sit either cross-legged on the floor or if you are uncomfortable sitting on the floor sit in a chair
2)      Hold your arms out in front of you at shoulder level, with the palms facing up and inhale (Take a deep breath)
3)      Bend your arm at the elbow and slowly bring it up towards your shoulders so that the fingers gently rest on your shoulders
4)      Exhale
5)      Straighten your arms slowly and go back to the starting position (See figure)
6)      Inhale
7)      Repeat 5-10 times


      V.            Skandha Chakra (Shoulder rotation):

1)      Sit either cross-legged on the floor or if you are uncomfortable sitting on the floor sit in a chair
2)      Place the fingers of your left hand on your left shoulder and the fingers of your right hand on your right shoulder
3)      The arms should be at the same level as your shoulder (See image)
4)      Now slowly rotate your arms first in the clockwise direction and then the anticlockwise direction (3-5 times each)
5)      See if you can touch your elbows during the forward stroke (Do not strain yourself, it will happen on its own with practice and improved flexibility)
6)      See if you can touch the back of your palms to your ears during the upward stroke (Again, do not strain yourself, it will happen on its own with practice and improved flexibility)
7)      See image for greater clarity
8)      Inhale during the upward stroke and exhale during the downward stroke (If you find it hard to coordinate your breathing with the exercise initially, do not bother, focus on the exercise, the breathing will fall in place on its own

All images courtesy: http://rashmirastogi.blogspot.com
Links to original images:Wrist exercises  Shoulder/Elbow exercises

Friday, October 21, 2011

The lymphatic system and lymphadema following breast cancer: Part-2 -Infections of the lymph nodes & lymphadema

Post written by Ramesh Venkatraman

As we saw in part-1, the lymph nodes play an extremely important role in filtering out harmful bacteria, abnormal/cancerous cells, and other harmful substances from our bodies. CLICKTO READ PART-1
Usually this biological filter works perfectly but in certain cases, the lymph nodes can themselves become infected by the very same bacteria that they trap! A slice-of-life example is when a child has an injury/infection in the hand and the pediatrician feels the elbow or armpits - he is actually feeling the lymph nodes to see if there is any swelling and/or tenderness which are usually signs of an infection.
In women the breast is an organ that is richly innervated by the lymphatic vessels [See illustration showing lymphatic drainage of breast]. It is because of this rich network of lymphatic vessels that quite often cancer of the breast spreads quickly to the lymph nodes as well requiring (in some instances) removal of affected lymph nodes and lymph vessels as well along with the breast, a procedure called mastectomy.
Image Source: American Cancer Society; www.cancer.org
Removing lymph nodes and vessels makes it harder for the lymphatic fluid in the region of the breast, armpit and arm to flow out of this area. If the remaining lymph vessels are able to compensate and cover for the loss of these lymph vessels then the drainage of the breast and upper arms continues as before. However if the remaining lymph vessels cannot drain all of the fluid from these areas, then the excess fluid builds up and causes swelling of the arm, shoulder etc. This condition is called lymphedema.
Even if surgical removal of the breast/lymph nodes is not indicated and the breast cancer is treated with chemotherapy and radiation it can lead to destruction of certain lymph nodes/vessels. This may again lead to the same condition called lymphedema.
The swelling in lymphedema can range from mild to severe and may start soon after surgery or radiation treatment. In some women it may begin months or even years after surgery/therapy. As a general thumb rule women who have had many lymph nodes removed and women who have had radiation therapy for breast cancer are at a greater risk of developing lymphedema.  There is no cure for lymphedema, but it can be controlled (we will read more in the concluding part of this article). 

Symptoms of lymphedema include:

  1. Swelling in the affected part, usually the arm in case of women who have undergone mastectomy or radiation therapy for breast cancer
  2. Restricted range of motion in the affected limb along with a general feeling of heaviness
  3. Numbness and ache
  4. Recurring infections
  5. Sometimes there may be a hardening or thickening of the skin in the affected limb.
End of Part-2. In part-3 we will look at some simple tips and home remedies for managing lympedema

Wednesday, October 19, 2011

The lymphatic system and lymphadema following breast cancer: Part-1 - Lymph & lymph nodes, their role in human health

Post written by Ramesh Venkatraman
Breast cancer among women is on the rise across the world and also in India. In this 3-part article we will look at the lymphatic system and its role in human health (part-1), lymphadema following breast cancer therapy (part-2),and in part-3 we will look at some simple and natural methods in managing lymphadema, a common condition that occurs in women post breast cancer therapy.

The circulatory system:
Before we look at the lymphatic system, let us briefly look at the normal blood circulatory system in humans. The circulatory system consisting of the blood vessels and blood (along with its constituents) plays a vital role in carrying oxygen and nutrients to the various parts of the body and also in transporting and removing waste products of metabolism. The actual exchange of substances (food and waste) occurs at the level of the capillary beds (a dense minute network of blood vessels). The capillaries are microscopically minute blood vessels made up of only one layer of cells. The capillary walls are so thin that they are actually translucent - It is this “thinness” that makes it possible for substances such as oxygen, glucose, and waste materials to quickly (an easily) pass through their walls, while on their way to or from tissue cells.

The lymphatic circulation:
While the exchange of substances mostly takes place through the circulatory system, certain large substances that cannot enter or return through the micro pores of the capillary including excess of fluid and large-sized protein molecules forms what is called the lymph or lymphatic fluid. Due to the pumping action of the heart, blood pressure is created and blood oozes out of the capillaries into the spaces between tissue cells - In the tissues this fluid is called interstitial fluid or tissue fluid. Most of this fluid goes back into the circulatory system via the same capillary pores. The remainder of the interstitial fluid enters the lymphatic circulatory system flows through the lymphatic ducts and finally is returned back to the circulatory system.

Once the interstitial fluid enters into the lymphatic system it is called lymph. The lymphatic system is made up of a network of tubes similar to the blood vessels but with one major difference. These tubes are “blind-ended” i.e. they are unidirectional; the lymphatic fluid does not take the circular route of blood (going round and round). The lymphatic capillaries are similar to the blood capillaries in that they are also made up of a single layer of cells but differ from the capillaries in the size of their micro pores - These pores are larger and allow larger molecules to enter inside and eventually return back to the general blood circulation.
Image Source:  http://en.wikipedia.org/wiki/File:Illu_lymphatic_system.jpg

From the lymphatic capillaries, the lymph flows through progressively enlarging vessels lymphatic venules, followed by lymphatic veins. Finally the lymph is emptied into two large lymphatic ducts called the right lymphatic duct and the thoracic duct. 75% of the lymph is emptied into the thoracic duct and the remaining is emptied into the right lymphatic duct. From these ducts, the lymph is emptied into the large veins present in the neck region from where they go back into the general circulation. The lymphatic vessels appear like a string of beads traversing across the body. The bead like appearance is caused by the presence of valves that help the one way flow of lymph.

Lymph nodes and function:
Scattered along the pathway of the lymphatic system are several clusters of lymph nodes. These lymph nodes filter the lymphatic fluid as they traverse across the lymphatic system. This filtering function of the nodes plays an extremely important role of removing dead cells, abnormal, cancerous cells, and bacteria. Without this important biological filtration function dangerous bacteria, cancerous cells etc. would enter the circulatory system and play havoc causing life-threatening infections and diseases. The fact is that in spite of such robust in-built protection infections and diseases do occur.


End of Part-1. In Part-2  we will look at infections of the lymph nodes in general and lymphadema post breast cancer therapy in particular. Click here to go to Part-2

Thursday, August 18, 2011

Norms of eating food - The "one-third" rule and other matters...


"Fill the first third of your stomach with solid food, the second third with liquid, and leave the last third free.."
 - Charaka's 1/3rd rule on the "norms of eating food" from his Charaka Samhitha


Apart from the 1/3rd rule, there are certain factors according to Charaka that determine the "appropriateness" or "inappropriateness" of food - mind you, all these factors are postprandial and therefore you will arrive at the right combination of factors that suit you only, after trial and error (and perhaps some suffering - which may actually help to make your will stronger).
After a meal:
  1. There should be no feeling of:
    • heaviness in the belly
    • pain or obstruction in the chest region
    • difficulty in breathing
  2. All normal activities such as walking, talking, standing, sitting, lying down, laughing etc. are effortless.
  3. The senses are satisfied and there is no feeling of lingering hunger or thirst
In addition to the above, Charaka also gives a few general dietetic rules:
  1. Food we eat should be warm as it aids digestion
  2. Sit down to eat only after the previous meal has been completely digested and there is a genuine feeling of hunger
  3. Eat adequately - neither too much nor too less - The 1/3rd rule is a good dietetic rule to follow.
  4. Sit down at an agreeable place and focus only on the food in your plate - Do not talk or laugh while you are eating your food (perhaps we need to add - "Do not watch television")
  5. Neither should you wolf down your food in large gulps, not should you eat so slowly that the food becomes cold and loses its beneficial properties
  6. Subject every morsel of food and "food-type" to the scrutiny of past experience - does it suit me? have I had problems with a particular food or combination of foods in the past?
  7. Food you eat should be as "smooth as oil" so that it passes through the digestive system easily and can:
    • stimulate the digestive fire
    • smoothen the passage of food and prevent constipation
    • Strengthen the body
    • Rejuvenate the sense organs
  8. Finally, one should not eat foods and food-components that are "antagonistic" in nature (Charaka gives a detailed chart of antagonistic food items, that is beyond the scope of this article but suffice to say that your personal experience is your best judge).
"Tell me what you eat, I’ll tell you who you are." - Anthelme Brillat-Savarin

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