FROM LEATHER TO SKIN
Sitanshu Kar*
July 16, 2004, a devastating fire engulfed a private school in Kumbakonam ,Tamilnadu. Over 90 children lost their lives and scores suffered burn injury. Doctors in hospitals turned to collagen membrane, developed by the Central Leather Research Institute to treat the injured children, showing thereby the long distance traversed by this premier Institute diversifying its areas of research from leather to skin.
The skin is often known as "the largest organ in the human body". It plays several important functions including thermo-regulation and protection of internal organs from vagaries of external environment. It derives its unique and special properties from its architectural beauty and structural integrity while maintaining the barrier between internal organs and external environment.
Structural biology and applications of skin have remained an important research area in Central Leather Research Institute (CLRI) since its inception. During the 1950’s, the structure of the main protein contained in skin, namely collagen, was an area of intense research. Prof. G.N. Ramachandran and his group in the University of Madras chose to work out the structure of collagen. CLRI provided him with the requisite sample of collagen in the pure form. The structure of collagen, which later came to be known as Madras Triple Helical Structure, was mentioned on August 7, 1954, a few months after the report of double helix structure of DNA by G.N. Ramachandran.
CLRI, in the early years of collagen research during 1960s and 70’s, made important contributions in recognizing new cross-links and in understanding of nutrition induced disorders of the connective tissues. Structural changes in collagen under conditions of arthritis and myocardial infarction were reported. New experimental techniques in unraveling the matrix structure of skin and collagenous tissues were developed. With this CLRI emerged as an important centre in fundamental research in collagen.
Skin is susceptible to different types of trauma or external injury on the one hand and to many genetic and mal-nutrition induced disorders on the other. Wound in skin alters the normal architecture of the skin and its function. In some cases abnormal scars are formed. Restoration to the normal architecture and function is promoted by healing. Wound healing requires regeneration of the lost tissue. Hastening of healing of wound calls for clever manipulation of cell biology of the skin. Healing of wounds in human skin after the incidence of trauma by burns or other types of injury has attracted the attention of CLRI.
Keloid, a skin disorder resulting from over growth of the tissue, affects generally women with coloured skins. Hypertrophic scars and keloids influence the physical and mental states of the affected person. Molecular mechanism in scar formation has been probed with a view to promote a suitable therapeutic intervention. A therapeutic insight in the management of keloid has been established in collaboration with the plastic surgeons.
Wound healing involves different phases namely inflammation, proliferation, remodeling and re-epithelialization. A balanced equilibrium of these processes is essential for successful wound healing. Modulators of the various phases of wound healing have been identified and applied successfully in promoting wound healing on human subjects.
The efficacy of frog skin in wound healing in human skin has already been demonstrated. A phospholipid contained in frog skin is a potent anti-inflammatory agent while the protein fractions from frog skins exhibit anti-microbial action against pathogenic and non-pathogenic bacteria.
Traditional wisdom advises the use of several natural products in health care. The efficacy of botanicals in skincare and wound healing have been investigated with success. Healing efficacy of crude alcoholic extract from dry leaves of Datura alba on burn wounds has been shown to be comparable to silver sulfadiazine (currently used drug), in dose dependent pattern. An isolated compound from Sida acuta has been shown to aid significantly in managing angiogenesis. Curcumin reduces hydroxyproline levels associated upon bleomycin administration, without respiratory distress. Similarly, Curcumin leads to a significant decrease in total lung protein content and many other parameters. It aids in amelioration of bleomycin induced inflammatory and fibrotic changes.
Also a process for reconstituting and for preparing collagen substratum with potential applications in grafting in management of burn wounds in human beings has been standardized. The process is simple and ensures the separation of Type IV collagen. The product is stable and is devoid of biotoxicity.
Anti bacterial drugs loaded microspheres have been impregnated onto purified collagen from calfskins and the resulting products are incorporated into fibrillar systems. The developed novel collagen scaffold impregnated with antibacterial agent delivers the drug in a controlled manner.
A plant based-reconstituted collagen substratum with applications in wound healing has been developed. The product exhibits potential medical application as a biological cover for non-healing ulcers as well as burn injuries.
CLRI has now transferred its technologies for manufacturing collagen sheets not only to domestic companies, it is also poised to provide the know-how to manufacture a whole range of wound management products e.g. reconstituted chemically modified collagen sponge, reconstituted collagen plast and haemostat, fibrogel, aminograft and collagen particle to foreign companies.
MICRONUTRIENTS - ESSENTIAL FOR PHYSICAL AND MENTAL GROWTH
Children have food preferences and they are quite fussy to take green leafy vegetables and fruits thus compromising their intake of micronutrients from dietary sources. The full genetic potential of the child for physical growth and mental development may be compromised due to subclinical deficiencies of micronutrients which are commonly referred to as "hidden hunger". Micronutrients are required for the integrity and optimal functioning of immune system. Children with subclinical deficiency of micronutrients are more vulnerable to develop frequent and more severe common day-to-day infections thus triggering a vicious cycle of undernutrition and recurrent infections. A number of micronutrients are required for optimal physical growth and neuromotor development. Isolated deficiencies of micronutrients are rare in clinical practice and usually deficiencies of multiple micronutrients co-exist. The first 3 years of life are most crucial and vulnerable to the hazards of undernutrition. However, it has been shown that it is not possible to meet cent per cent requirements of recommended dietary allowances (RDA’s) of micronutrients from dietary sources alone and most preschool children need administration of nutritional supplements to optimize their genetic potential for physical growth and mental development.
There is increasing evidence for metabolic inter-relationships between different micronutrients. For example, ascorbic acid is known to enhance the absorption of non-haem iron and high intake of zinc may interfere with absorption of iron and copper. Whereas, calcium helps in the absorption of vitamin B12 from the ileum but it interferes with absorption of zinc. Therefore, such metabolic interactions should be kept in mind while giving a "cocktail" of various micronutrients in clinical practice.
Physical Growth
Over 50 per cent of under-five children are stunted in India. They have sub-optimal vigour and stamina, poor neuromotor coordination, learning skills and mental capabilities. Vitamins and trace minerals are required for production of various enzymes, hormones and biochemical mediators for regulation of biological processes. They are required for energy production, synthesis of RNA and DNA and for providing protection against reactive oxygen-free radicals. Micronutrients are required for promotion of physical growth, sexual maturation and neuromotor development.A number of vitamins (vitamins A, E, C, D, B2, B6 and folic acid) and trace minerals (iron, zinc, selenium, copper) are recognized to boost both cell-mediated and humoral immune defences of the body. Interaction between sub-optimal nutrition and occurrence of repeated infections is the leading cause of growth retardation in children in developing countries. Dietary inadequacies and recurrent infections, interact in a mutually reinforcing manner to further aggravate nutritional status. Calcium, phosphorus, vitamins A, C, D and K are required to maintain the integrity and mineralisation of bones.
Brain Development
It is not generally realized that neurons are more sensitive to nutrients and dietary chemicals compared to other body cells. Optimal nutrition during pregnancy and first 3 years of life is most crucial because 70 per cent of the human brain develops during fetal life and remaining 30 per cent during pre-school years. Micronutrients are required for production of several enzymes and co-factors for a number of metabolic pathways. It has been well known that pellagra (niacin deficiency) leads to reduced cognition and dementia. A number of other B-complex vitamins especially B1,B2,B6,B12 and folic acid are needed for synthesis of several neurotransmitters.Some others include zinc ,copper , omega-3 fatty acids and decosahexaenoic acid (DHA). Omega-3 fatty acids are credited to reduce cellular and vascular inflammation in the brain, promote vasodilatation and ensure integrity of brain cell membranes to keep them soft and pliable. DHA is the building material for fabrication of synaptic communications and constitute almost one-half of the total fat in the brain cell membrane. It increases the level of "feel good" neurotransmitter serotonin and the "memory boosting" chemical acetylcholine.
Initiatives
Health and well being of mothers and children are intimately linked. Healthy mothers produce healthy babies while sick and malnourished mothers produce high-risk and low birth weight babies. Therefore, a life cycle approach should be followed to provide optimal nutrition and health care to girl children from infancy through childhood, adolescence, pregnancy and lactation .
The last 3 months of fetal life and first 3 years of post-natal life are most crucial and vulnerable to the hazards of undernutrition. During this period most of the brain growth is completed and a sound foundation is laid down for physical growth. Breast milk is a complete nutritional food during first 6 months of life. The nutritional quality of breast milk can be enhanced by improving the diet and providing nutritional supplements to the lactating mother. There is recent evidence to suggest that exclusively breastfed babies should be given supplements of vitamin D after the age of 2 months to prevent development of rickets. Breast feeding should be continued as long as possible but atleast upto the age of one year.Home-cooked energy-dense complementary feeds should be introduced after 6 months of age. During this period supplements of micronutrients should be provided. All efforts should be made to provide optimal nutrition to children during first 3 years of life which are most crucial for optimal physical and mental growth. It is well recognized that the stature achieved by the child at 3 years of age is a good predictor of ultimate adult height. The short stature of adults in developing countries is largely due to poor physical growth during first 3 years of life.
During adolescence, there is a rapid spurt of physical growth and sexual maturation. During this period, junk food should be avoided and children be given extra calories, proteins and micronutrients like calcium, iron, iodine and zinc. Intake of soft drinks should be discouraged due to their health hazards and efforts should be made to make children more milk-friendly. A nutritional supplement can be added in the milk to change the colour, taste and flavour. When a child dislikes to take milk or milk intake is associated with bloating or abdominal discomfort, he should be encouraged to take milk products like yoghurt and cheese. The practice of missing the breakfast should be condemned and all attempts should be made to ensure that the breakfast is the most wholesome meal of the day.
All efforts should be made that children take a well balanced nutritious food by encouraging them to consume green leafy vegetables, lentils, soyabeans, seasonal fruits, milk and dairy products, fish, eggs and chicken. Healthy children do provide a solid foundation to the society in order to ensure optimal human resource development of a country.
*- Based on an article by M.Singh from ‘The Indian Journal Of Pediatrics’Home/Self monitoring of blood pressure. Which machine shall I buy?
Dr .P. Madan Mohan MD Physician Ahalia Hospital
High blood pressure or hypertension is a major public health problem.When you enter shopping malls, pharmacies and other stores it is now common to see BP measuring equipments or monitors.BP monitors like their counterpart blood sugar monitors is becoming a big business .Many people try at it and yesterday one young lady came and told me that she has high blood pressure after measuring with such an equipment at a shop.Patients are also using them frequently.By the way the lady had normal blood pressure!.This is what made me write on them before you spend dirhams to buy it.
These are electronic equipments and there are standard companies like Omron making them.How do we know whether they are accurate?In the United states there is the Association for medical instrumentation(AAMI) and in UK the British hypertension society ,which approves these instruments.In short these instruments have to be approved by these bodies.Please enter the web site of the BHS www.bhsoc.org .You can see the list of validated instruments.Go to a pharmacy or mall in UAE and try finding the same.You hardly find one!. This is the reason, doctors can hardly recommend these since one is not sure how reliable these instruments are.I feel like the MOH controlling pharmacies, there should be a regulatory body to see that only validated equipments are available in the UAE market so that the public is not fooled.
Now there are monitors which measures Blood pressure in the upper arm, at the wrist and at the fingers.The lady I mentioned above had checked with a wrist monitor.Due to scientific reasons the wrist and finger monitors are not recommended for use.I don't think a salesman at a pharmacy knows this and people fall into this trap.
For the medical community only recently guidelines have become available as to the exact techniques of measurement, normal range etc.For a patient who wishes to home monitor his blood pressure he must consult his physician. Dose of medicine should not be changed without consulting the doctor.
Although there are some advantages in home monitoring, there are disadvantages as well. What I wanted to highlight is the current market problem with these gadgets and urgent attention into this area by the UAE authorities
Dr Madan Mohan P MD (Internal medicine)
Physician
NATIONAL BRAIN RESEARCH CENTRE UNRAVELLING THE FINAL FRONTIER
Sitanshu Kar**
One of the final frontiers of the 21st century is to understand the structure, function and development of the human brain. A marvelously complex and sophisticated organ, the brain mediates how we perceive the world around us, generates our thoughts, memories and emotions and controls our immediate and long-term behavioural responses to the environment. While the decade of the 90’s was declared as the "Decade of the Brain", the current century would provide major leads into understanding the brain function. Since brain-related disorders represent one of the major disease groups that affect millions of people worldwide, the study of the brain or neuroscience is extremely important, not only from a scientific viewpoint but also to discover better therapies and cures.
To overcome the enormous challenges of understanding the brain in health and disease, the National Brain Research Centre (NRC) was established by the Department of Biotechnology in 1999. It has brought together neuroscientists from diverse backgrounds such as molecular biology, systems neuroscience, computational and theoretical neuroscience. The NBRC campus currently located in Manesar, Gurgaon district Haryana, 40 km from Delhi is a state-of-art facility for carrying out multidisciplinary studies on different aspects of the brain. The mandate of NBRC is to function as a "Centre of Excellence in Brain Research" with state-of-art facilities, evolve the centre through a networking approach and generate highly trained human resource.
In a remarkably short period since its inception, scientists at NBRC have made very successful inroads into understanding different aspects of the brain. Amongst the their major achievements are - successfully maintaining and differentiating human embryonic stem cells into neurons. These embryonic stem cells are also being transplanted into mice to see whether they help in repairing brain injury. In addition, cures for Alzheimer’s disease are being tested in animal models using plant extracts from traditional medicine. Genotyping tests are being developed to predict the response to drugs used for the treatment of mental disorders. Yet another breakthrough by NBRC scientists is the development of a computational tool using stochastic resonance that helps to enhance the resolution of MRI images thus providing better diagnosis.
A fast-emerging field in neuroscience is that of imaging the brain in real time using techniques such as "functional magnetic resonance imagine (FMRI)", brain morphometric (volume) measurements and magnetic resonance spectroscopy, which can be used to examine the neural correlates of complex human perception and behaviour. These techniques can also be used to analyze neural basis of abnormal behaviour seen in cognitive ailments such as Schizophrenia, Alzheimer’s disease, attention deficit disorders (ADHD) and effects of malnutrition. Realising the need for an FMRI facility dedicated to research, a national research facility for brain imaging is being established at the centre. This facility would be used for furthering an indepth understanding of brain function by researchers from all over the country.
Besides its scientific activities, the centre is also mandated to creating a group of highly skilled neuroscientists in the country. The institute was awarded Deemed University status by the Human Resources Development Ministry and has initiated both PhD and MSc programs. The curriculum for these programs ranges across diverse areas as neuroanatomy, neurophysiology, neurochemistry, molecular neurobiology and development and regeneration, neurogenetics. Besides, systems, cognitive, clinical and computational neuroscience would enable NBRC students to have the widest possible exposure for their future role as leaders in the field of neuroscience. The human resource development is geared towards generation of trained manpower who can bridge across diverse disciplines such as neurobiology, physics and mathematics.
NBRC, the apex coordination centere for neuroscience research in India, is the hub of a network of 42 centres around the country that are involved in different facets of neuroscience research. The networking of existing neuroscience centers with NBRC is aimed to prevent unnecessary duplication of the work and facilities already existing. At the same time it facilitates sharing of expertise and available infrastructure for mutual benefit. Another invaluable feature of the centre is the ‘Digital Library’ that has been providing invaluable service to the Indian neuroscience research community by sharing its on-line journals and e-resources free of cost.
Looking ahead, it is envisioned that NBRC would grow into a world-class institute for brain research, catalyzing the overall growth of this discipline in the country. It would not only create a vibrant, active neuroscience community throughout the country comparable to the best in the world but also contribute to the discovery of rationale therapies and cures for brain disorders through Brain Research.(PIB Features)
Remembering Bhopal 1984
Dinesh C Sharma*
It’s 20 years since the world witnessed the worst ever chemical, industrial and environmental disaster at Bhopal in central India. On a cold wintry night of December 09, some 40 tonnes of methyl isocyanate (MIC) and other toxic gases leaked from the Union Carbide factory, killing thousands instantaneously and maiming several thousand others. The health effects of exposure to the deadly cocktail of gases continue to unfold even after such a long time.The Indian Council of Medical Research (ICMR) that followed up a cohort of over 80,000 gas victims from 1985 to 1994, has published its first report recently listing some of the adverse effects of the gas exposure. The council’s report has reiterated that the disaster can not be attributed to MIC alone. The aerosol of toxic gases inhaled by the victims possibly contained a mixture of over 20 aqueous and thermal decomposition products, and a host of reactant chemicals and polymers of MIC- including Hydrogen cyanide (HCN) - generated due to a runaway reaction in the tank at very high temperature.
This has been proved by both analysis of residues in Tank 610 and MIC, HCN and other chemicals to blood and viscera of dead and living exposes have been tracked down. For the first time, chemicals have been traced in human bodies after a massive chemical disaster, say scientists involved in research in Bhopal. Double blind clinical trials also showed that administration of sodium thiosulphate helped in relieving symptoms of cyanide poisoning and excretion of urinary thiocyanate.
The report has concluded that toxic gas inhalation caused injuries to respiratory tracts and ophthalmic systems of the people. But long-term research needs to be continued to study potential hazards of cancer and long-term involvement of other organs. After ICMR concluded its research work, it passed on the database to Centre for Rehabilitation Studies, set up by Madhya Pradesh government. The Bhopal Memorial Hospital and Research Centre (BMHRC), set up from proceeds of Union Carbide shares in 2000, also plans to undertake long-term research on MIC exposure. The BMHRC has recently established a Department of Epidemiology and Biostatics to take up public health research in both MIC related and other public health issues. It also proposes to launch studies on possible genetic mutations, especially among the offspring of the gas victims.
Clinical and toxicological studies have shown that MIC is a potent toxin. Chronic inflammation of the eye and respiratory tract account for a major portion of its adverse impact. Experts say that these damaged organs could become more susceptible to other environmental inflictions such as infections, irritants, and allergens. For instance, a person with airway damage may be more prone to infections or respond adversely to smoke and dust. Pulmonary function limitation may preclude survivors from working on jobs which require moderate or strenuous activity. Progressive pulmonary fibrosis and restrictive lung disease appear to be a major cause for concern among the gas-exposed.
While hearing a petition on the medical follow up of the gas victims, the Supreme Court has appointed an advisory panel, to be headed by director general of ICMR, to develop treatment protocols for gas-related disorders after examining current practices in Bhopal hospitals as well as to suggest research to find out long-term health impact of the exposure. The research includes effect on children born to gas-affected parents. The court constituted another panel to monitor functioning of healthcare facilities in Bhopal and to look into complaints from gas-affected patients. Both the panels are supposed to report back to the court every six months.
Yet another problem Bhopal faces is the toxic legacy leftover by Union Carbide at the factory site. A series of investigations by Indian and international agencies have found evidence of contamination of subsoil and groundwater with heavy metals and persistent organic pollutants from the abandoned pesticide plant. Chemicals such as carbon tetrachloride, chloroform, trichloroethene, tetrachloroethene and dichlorobenzene, in concentrations ranging from 5 to 600 times prescribed limits, have been found in groundwater. Only a carefully drafted remediation plan can prevent further damage to the environment and make the site safe for future use.
Calling the Bhopal disaster man-made, the ICMR report has concluded that it could have been averted if the Union Carbide factory did not have any inhabitation within four kilometer of the site, and if proper monitoring and safety devices had been maintained. It also says that MIC should not have been stored for such a long time, as was done. The gas was stored for six weeks, which was against the company’s own norms.
It is a striking fact to note that much of the mortality and morbidity could have been averted by the simple measure of covering the face with a wet cloth. MIC would have been decomposed on contact with the water. Unfortunately, the community was never informed of the existence of such a potent chemical in the factory and contingency measures to be taken in the event of a leak. This is perhaps the biggest lesson one can learn from Bhopal. We need to have emergency planning and disaster preparedness at every level to prevent such mishaps. Countries also have to exercise caution to see that only safe technologies are allowed and that multinational companies don’t follow double standards of safety and environment protection. At the same time, research on hazardous compounds – both primary and intermediate chemicals – should be carried out. All these issues have gained greater importance than 1984, because of globalisation phenomenon that we are witnessing today.
*Science WriterTURMERIC – MORE OF A MEDICINE THAN SPICE
Dinesh C Sharma*
Turmeric is more than just another spice that makes up the delectable India curry famous the world over. A few years back, turmeric hit the headlines in global media when an American patent relating to one of its many medicinal properties was revoked. The patent was granted for wound healing properties of turmeric. Indian authorities challenged it on the grounds that this attribute of turmeric was part of common knowledge in India and was not something novel that can be protected by a patent. The documents that were furnished to the patent office included some of the ancient Ayurvedic texts. This illustrates the significance of turmeric and important qualities that it has been known for centuries now.
It is part of Indian folklore and has been used for hundreds of years as a beauty aid as well as grandma’s cure for common ailments like coughs and colds, in addition to acting as a healing agent. In fact, even now turmeric paste is used to beautify brides in ceremonies preceding Indian marriages. Turmeric is claimed to be an important ingredient of many fairness creams available in the market.
India is the largest producer of turmeric in the world since nearly 80 per cent of its global production happens in the country. In terms of area, it occupies 60 per cent of the total area under spice and condiment production in the country. Haldi is also grown extensively in Sri Lanka, Bangladesh, Pakistan, Thailand, China, Taiwan as well as in Haiti, Jamaica and Peru.
Besides giving flavour, colour and taste to food, spices are known to aid in digestion and possess therapeutic value for treating chronic disorders such as arthritis, bronchial asthma, wound healing, dyspepsia besides heart and neurological disorders. Spices and plants contain substances known as phytochemicals that are basically meant for plant protection but are now being considered almost akin to vitamins and are considered highly beneficial for human beings. It is because of these chemicals that spices have moved out from grandma’s home remedy kits to test tubes of modern scientists.
New medical knowledge is being generated on these ancient commodities called spices. The medicinal elements of spices are now sought to be reinforced through scientific research. Recent studies on foods, nutrition and chronic diseases suggest that changing diets and dietary habits in order to achieve optimum nutrition and phytonutrients can minimize the risk of chronic disorders. Therefore, experts believe that traditional foods can be a cost-effective and sustainable method to reduce risks of both deficiency diseases as well as diet-related chronic disorders.
Turmeric belongs to the same family as ginger and is similar in looks in its raw form. For cooking purposes, turmeric is ground and used. Curcuma longa Linn or turmeric consists of essential oils, fatty oils, micronutrients in small quantities and Curcumin, the main coloring component of the turmeric. Curcumin has a wide range of pharmacological effects. "We have evaluated its preventive effects on pre-cancer and cancer and examined its role as an antioxidant, anti-carcinogenic and anti-tumorigenic agent", said Dr Kamala Krishnaswamy, leading nutrition scientist and former director, National Institute of Nutrition, Hyderabad.
In one such important study, turmeric has been found to be a good chemo-preventive agent effective at all stages of cancer – from initiation to progression. The spice was tested in animals using several methodologies to assess its cancer preventing profile. Since the incidence of oral cancer is very high in the country, scientists decided to see if turmeric could prevent or regress mouth cancers. Dr Krishnaswamy said turmeric appears to significantly inhibit cellular changes that lead to formation of malignancies. Several studies earlier showed that curcumin can inhibit the tumors at sites such as breast, skin, forestomach, lungs, but in higher concentrations. "Garlic, onions and mustard seeds have similar anti-carcinogenic potential", she pointed out.
Dr Krishnaswamy conducted a clinical trial in a community in Andhra Pradesh where reverse smoking is prevalent. The members of this community are at a high risk of suffering from palatal cancers. A dose of one gram of turmeric per day was administered for a period of nine months. The results, she said, suggest that it had a significant impact on the regression of precancerous lesions and also impacted on genotoxic damage. Separate studies done at the All India Institute of Medical Sciences, New Delhi, have shown that priming lung cancer cells with curcumin enhances the efficacy of conventional and newer chemotherapeutic drugs in use for the treatment of lung cancer.
Other medicinal indications of turmeric that have been scientifically tested are its ability to decrease the load of carcinogens on the body, its anti-oxidant activity and capability to repair damage caused to DNA due to smoking. One recent study has even found that curcumin can also retard the process of development of cataract, by delaying cataract formation in galactose induced cataracts in rats. Turmeric and curcumin were found to increase detoxifying enzymes in the liver and intestinal mucosa and decrease mutations and tumor formation in animal studies.
American scientists too are researching on curcumin’s role as a natural anti-inflammatory compound. Dr Amin A. Nanji from the University of Pennsylvania Medical Center, Philadelphia, has shown that curcumin inhibits alcohol-induced liver injury. He is now focusing on whether such a compound would be useful in diseases such as non-alcoholic steatohepatitis, a condition that can lead to liver cirrhosis and liver cancer.
Since turmeric in the Indian culinary practices is usually either boiled or fried, Dr Krishnaswamy said it has been found that cooking at high temperatures is unlikely to destroy medicinal attributes of turmeric. Hence, there is no denying in the fact that ‘one spoon of haldi (turmeric) a day can keep cancers away’.
*Freelance Science WriterAIIMS TO SET UP STEM CELL RESEARCH CENTRE
DR. RAMADOSS PRESIDES OVER INSTITUTION DAY FUNCTION
The All India Institute of Medical Sciences, New Delhi is to set up a Stem Cell Research Centre with support from the Department of Bio-Technology. The Centre will work to advance basic and applied research in stem cell technologies, as relevant to India’s health needs. Presiding over the Institute Day of AIIMS, here today, the Union Health and Family Welfare Minister, Dr. Anbumani Ramadoss welcomed the setting up of the Centre and said that such a Centre would help in the treatment and cure of diseases in the elderly such as Alzheimer and Parkinson. The Minister lauded the exemplary research work being carried out in the Institute and said that it should pursue seriously the development of HIV vaccine. He said the President of India was deeply interested in the researches being carried out at the AIIMS.The Minister gave away awards to outstanding and meritorious students. Addressing them, he said that there was a need to strengthen health care access in rural areas. Conveying the Prime Minister’s concern in strengthening rural health access, he exhorted the students who have acquired such priceless knowledge to stay back in India and contribute to the development of health care services in our motherland. Providing healthcare to every needy individual irrespective of his means and status should be the prime objective, he said.
Speaking on the Plans of the Institute Open New Centres in Child Health, Renal Diseases and other specialized fields, Dr. Ramadoss promised to pursue the request for a grant of Rs. 600 crores with the Prime Minister so that existing facilities in the Institute can be strengthened.
Expressing concern on the increased incidence of life style related diseases, he said that this would effect the Nation’s physical as well as fiscal health. There was a need to create awareness to check the problem. The Minister inaugurated an exhibition on “Life Style Related Diseases” in the AIIMS foyer, this morning. Congratulating the Institute on the fabulous display, he said the exhibition was very informative and he had learnt a lot about stem cell research from the panels on display.
The Minister inaugurated a new facility “Sai Vishram Sadan” which will be used by needy patients and their relatives. The Minister also planted saplings at three different places at the Campus marking his commitment to environmental protection to which he is passionately attached.
CONSULTATION BEGINS ON STRENGTHENING PUBLIC HEALTH CONSCIOUSNESS IN INDIA
A National Consultation on strengthening public health consciousness in India began in New Delhi this morning. The two day National Consultation on “Institutes of Public Health in India: Moving from Concept to Reality” has been organized in collaboration with the Ministry of Health and Family Welfare. It is being held in the background of the identified need in the National Health Policy, 2002 for specialists in public health. Inaugurating the consultations, the Union Health and Family Welfare Minister, Dr. Anbumani Ramadoss stressed the need to increase the number of seats in community medicine given the existing limited institutional capacity in India for strengthening resources and policy development in the area of public health. At the same time, he said, that training in public health should not be confined to only long-term post-graduate courses but should also address the need to upscale public health knowledge and skills of diverse groups of health professionals, health system managers and NGOs all of whom play a vital role as public health functionaries. The Minister said that during his recent visit to the All India Institute of Public Health and Hygiene at Kolkata, he was surprised by the vast variety of courses offered there for students on public health of which he as a medical professional had not been exposed to.Pointing out that awareness on public health in India is minimal, the Minister said that he had directed his officials in the Ministry to create awareness on this issue in a big way given the rapidly accelerating number of people suffering from non-communicable diseases such as Cardio Vascular diseases, diabetes, cancers and new infections like HIV-AIDS. The Minister was of the view that if people were aware of public health issues, 60% of the expenditure on health could be avoided.
The Government of India is fully committed to stimulate, support and strengthen the growth and functioning of public health institutes in India. Two new institutes which would serve as role models are being planned. The Ministry of Health and Family Welfare will also provide financial, administrative and technical support to develop a network on public health institutes across the country.
The two days consultation has participants from not only the governmental sector but also NGOs, academicians and professionals in the field of public health. Renowned public health experts of the USA, UK and Finland are also to make presentations and lead working group discussions on capacity building initiatives and creation of infrastructure in the public health field.
JAUNDICE – THE YELLOW SKIN
17:36 ISTJaundice is a cause for concern. Also known as icterus, it is a condition, which is characterised by a yellowish discolouration of the skin and the whites (sclera) of the eyes. It is a symptom or clinical sign, not a disease by itself. The yellow colouration is caused by an excess amount of the bile pigment known as bilirubin in the body. Normally, about one per cent of our red blood cells retire every day, to be replaced by fresh red blood cells. Bilirubin is formed by the breakdown of haemoglobin during the destruction of worn-out red blood cells. The old ones are processed in the liver and disposed of. The pigment is then excreted by the liver into the bile via the bile ducts. Much of the resulting bilirubin leaves the body in the stool. If there are too many red blood cells retiring for the liver to handle, yellow pigment builds up in the body. When there is enough to be visible, jaundice results.
Cause and Pathogenesis
Excess amounts of bilirubin in the body can be caused by the overproduction of bilirubin, the failure of the liver cells to metabolise or excrete the bilirubin produced, or a blockage of the bile ducts. Overproduction of bilirubin may be caused by the destruction of an unusually large number of red blood cells, which occurs in a condition known as haemolytic anaemia. In this condition the liver cannot excrete the bilirubin which is formed more rapidly. This may occur in diseases such as malaria, thalassemia, and haemolytic disease (due to destruction of the red blood cells) of the new-born. Often, mild jaundice occurs as a common and normal condition in newborn babies because at birth there is both a deficiency in the enzyme that helps to eliminate bilirubin and also an increased breakdown of red blood cells (RBC) in the body. In babies, the condition generally disappears within a few days after birth as the enzyme is formed in the body. Physiologic jaundice is the name for normal jaundice commonly seen in healthy babies. Sometimes, deficiency of this enzyme can also cause jaundice in adults.
Pathologic or the clinical types of jaundice present a health risk, either because of its degree or its cause. It arises for many reasons, including blood incompatibilities, blood diseases, genetic syndromes, hepatitis, cirrhosis, bile duct blockage, other liver diseases, infections, or medications.
There are various strains of hepatitis viruses. They are hepatitis A (HAV), hepatitis B (HBV), hepatitis C (HCV), hepatitis D (HDV), and hepatitis E (HEV). Viruses F and G also exist and may cause primary hepatitis. Hepatitis A is a common cause of infective jaundice. Transmitted through water, food and by the faecal-oral route. It often affects children and young adults, but the incidence is rising among those who are HIV positive.
The other viruses such as Hepatitis B and C are transmitted through blood. They spread through the body secretions of infected persons. Close contact, blood transfusion, contaminated needles and tattooing are factors responsible for the spread of this dreaded infection. Homosexuals contract these infections more easily. These viruses are more resistant to the various methods of sterilisation than the AIDS virus. They are a major cause for concern as they spread rapidly. There are more people infected by Hepatitis B virus in the world than the AIDS virus. Hepatitis B and C infections can lead to chronic liver diseases, cirrhosis and eventually liver cancer & liver failure.
The other viruses associated with jaundice are Hepatitis D and E. Hepatitis D is seen in individuals who are susceptible to Hepatitis B or its carriers, such as haemophiliacs and IV drug users. The disease manifestation is severe in children Hepatitis E infection can be acquired from contaminated water. Hepatitis E is seen primarily among young adults in developing countries. It is most severe in pregnant women. Congenital non-haemolytic hyperbilirubinemia such as Gilbert’s Syndrome also causes jaundice. Sometimes certain drugs such as chlorpromazine (an anti-psychotic drug) may inhibit bilirubin excretion by the liver, causing jaundice.
Symptoms
The main symptom of jaundice is the characteristic yellowish colour of the skin, sclera (whites) of the eyes, nail beds and tongue. Other symptoms usually depend on the actual cause of the jaundice. In some types of jaundice, bilirubin is excreted in the urine, which becomes yellowish brown in colour. If the excretion of bile is obstructed, stools are almost white and the digestion of fat is consequently impaired. If the jaundice has been present for a long time, pruritis (intense itching) may occur. Due to obstruction, lipid deposits on the skin such as xanthelesmas on the eyelids or xanthomas can develop. Some patients with jaundice may also have vomiting and abdominal pain, malaise and severe weakness. Complications include hepatic failure with its attendant complications such as bleeding, vomiting of blood, accumulation of fluid in the abdomen (ascites), and a condition called hepatic encephalopathy where the patient has altered consciousness and later coma. Fulminant hepatic failure and hepatic coma may often be fatal even with treatment. Another complication of hepatitis is the development of cirrhosis (due to destruction of the liver cells) and also conditions such as chronic active hepatitis wherein the jaundice may persist for several months. The prognosis in these conditions may be poor although the results are better with prompt and effective treatment.
Stones or growths, blocking the pathway of bile, cause obstructive jaundice. They usually originate in the gall bladder. This often requires removal of the gall bladder along with the stones in the biliary pathway.
Treatment and Immunisation
The treatment for jaundice depends upon the type of jaundice. For viral hepatitis causing jaundice, there is no definitive treatment. Only supportive measures are given. The virus is slowly eliminated from the body with the help of the immune system. In case of jaundice caused by blockage to the pathway of bile, surgery may be needed.
Hepatitis B is one of the common causes of jaundice that can have serious consequences. Immunising a person can prevent this viral infection and its consequences. The vaccine is easily available and is usually given in three doses either at monthly intervals or two doses are given at monthly intervals and the third six months after the first dose. Immunisation with the vaccine now begins from the infant period itself. A single booster dose is required once every five years to maintain the protection.
Food rich in glucose is recommended in jaundice. It helps the liver cells to regenerate besides providing the required nourishment for the body. It is advised to take fats in reduced quantity while deep fried food and alcohol should be avoided.
What you always wanted to know about glucometers
Diabetes mellitus is reaching explosive proportions in the community that more and more doctors are recommending self-monitoring of blood glucose (SMBG) at home for patients. As a result blood glucose meter or called glucometer for short are one of the fastest selling equipments in the market. These devices are also now regularly used in clinics, at the bedside, and in doctor's offices. There are several manufacturers of these small smart machines as well as lot of models with the same company. Some types can store hundreds of readings in their memory so that the data can be reviwed. Some supply free software so that the information on the meter is saved to a computer enabling the data to be analyzed. The real value of these data management systems is not known. There are meters having large print or even voice capabilities for people with poor vision.
Out-of-laboratory blood glucose testing started in the early 1960's,with the Ames company dextrostix that approximated well to the laboratory findings.
All meters give accurate results and what is required for testing are essentially the glucose meter, control test solution supplied from the company to make sure the meter is working properly, testing strips or sensors, lancets-short needles for pricking, and lancet device; a pen-sized holder for the lancet which holds, positions, and controls how deeply the lancet goes into the skin. The testing strips are to be used with a specific model of meter.
Always check the expiry date of the test strips and never use them after the expiry date. Heat and other factors may affect meter test strip accuracy. When strips are removed from the bottle promptly secure the lid back on the bottle to prevent humidity from damaging the unused strips. Match the code number on the testing strips bottle with the number on the meter. If the numbers do not match, follow the directions with the meter for changing the code number. In a recent study when the glucose meter code and corresponding glucose strip code were examined in a group of patients, in whom detailed instructions were given by diabetes educators, 16 % of patients had incorrect (nonmatching) codes and hence higher HbA1c arising from defective monitoring and treatment! . One has to follow the instructions with the meter. All come with detailed instructions for performing the test. Follow these directions exactly. It is important to care for your meter. All meters can be damaged by dropping or jarring them and by very hot or cold temperatures. Some meters need to be cleaned regularly and have their batteries changed periodically. Of course with time they become less precise with heavy use.
The instructions for testing are slightly different for each model. Generally follow the following steps
" Wash your hands with soapy water or alcohol stripe. Dry them well. If your hands are wet, even a small amount of water can affect the blood sugar result.
" Insert a clean lancet in the lancet device
" Remove a test strip
" Use the lancet to prick the side of the fingertip. Do not prick the tip of the finger since due to more sensory nerve endings it will be more painful and one may not get enough blood.
" If there is a problem of getting a large drop of blood, hang the hand down for 10-15 seconds and then squeeze the finger beginning close to the hand and move towards the fingertip. Don't squeeze the fingertip.
" Put a large drop of blood on the correct spot of the test strip. Follow the directions with the meter. Some require only few seconds to give the results. Record the results and time.The fingers may develop callosity after repeated pricking. Use hand lotion to soften them.
The meters are less accurate than lab measurements at extremely low or high glucose values-less than 60 or greater than 300 mg /dl.
When comparing meter and laboratory results people may notice large difference between the two test results. So the question comes ' Is my meter accurate?'. Meters and lab equipment may be calibrated, or set, to measure blood glucose in different ways and will give different results. It is important to understand how accuracy is defined. The result is considered accurate if it falls within + or - 20% of an accepted reference result, usually a lab test. Comparing a meter's test result with a lab test is the only valid method of determining its accuracy. For this fast for at least 4 hours before doing comparison tests. So ideally do it on a day when the doctor orders for a fasting blood sugar result. Take your meter with you to the lab. Make sure the samples for both tests are taken and tested within 30 minutes of each other. Use fresh capillary blood only and not collected sample. If one is not fasting finger stick glucose can increase to 20 % higher than venous blood.
While all home blood glucose meters use whole blood capillary glucose, laboratory methods measure plasma glucose. Because of this difference in sample types, whole blood tests are 10-15%, approximately 12% lower than plasma tests. Some meters are calibrated to give 'plasma' test results, making this correction unnecessary. It is crucial for diabetics to know whether their monitor and strips provide whole blood or plasma results. Plasma-calibrated meters do not require a conversion and their results may be compared directly with laboratory test results.To compare a lab test result with a whole-blood calibrated meter, you must first convert the lab result into its whole blood equivalent by dividing the result by 1.12.If your lab result is 112,divide by 1.12 =100.This represents"whole blood equivalent"of the labs" plasma "value. Then compare the meter's whole blood result to 100.If the meter's result lies between 80 and 120 (+or- 20) it is accurate.
Extremes in haematocrit may affect the results. Specimens with haematocrits >55% yield lower results. Specimens with haematocrits <35 % yield higher results. Neonates have haematocrit in the range of 45-60% and special meters may be needed. Test results are low if the patient is severely dehydrated. Salicylic acid, acetaminophen (paracetamol), and ascorbic acid (vitamin c) interfere with test results and are concentration dependant. Toxic levels may result in lower readings. Other sources of error and interference are well documented, including chylomicronemia, bilirubin, uric acid, sodium fluoride, humidity and temperature. A study from Canada, using various strips and meters, found that more than 50% of diabetics used incorrect technique. This is to emphasize that patient education is very important when prescribing these equipments.
Watching Out for the Invisible Threat Don't let 'hay fever' reduce you to tears this summer
Dubai, August, 2004: A leading local ears, nose and throat specialist has warned against the rising attacks of hay fever this season and stressed the importance of taking certain precautions to minimize the risk.
"For people who are susceptible to hay fever, August is probably the worst month of the year," Explains Dr. Fahim Tadros, ENT Specialist at Al Zahra Hospital in Sharjah and Dubai. "This is the month when the concentration of airborne pollen is at its highest and going out for only a few minutes could instigate an attack that lasts for hours."
'Hay fever', medically known as Seasonal Allergic Rhinitis, is an allergic reaction most commonly caused by exposure to airborne pollen from trees, grass and flowers.
The condition peaks during the spring and summer seasons, when pollen is at its highest. More than 10% of the population around the world suffer from different allergies. Although generally not harmful, they can cause great irritation and discomfort, and are often mistaken for an onset of the common cold, since many of the symptoms are similar.
The symptoms of Seasonal Allergic Rhinitis include thin, clear mucus and a constantly runny nose that may become too sore to blow. Both often appear together with sinus pain and repeated sneezing attacks. These symptoms are usually accompanied by itchy, watery eyes and nose.
"The symptoms of hay fever are caused by the immune system's reaction to pollen and other allergens - natural and artificial - which results in the release of higher levels of histamine into the bloodstream to counter the presence of foreign irritants," explains Dr. Tadros.
Following a series of simple tests will show if a person has any allergic tendencies, according to Dr. Tadros. "It is always a good idea to have these tests done, especially if there have been any previous complaints of any allergic symptoms. If an allergen is identified a doctor can prescribe a suitable vaccine to counter its effects."
After their onset, allergic reactions can easily be alleviated by using an antihistamine and decongestant treatment like Vibrocil nasal spray, which promptly relieves the discomfort by taking care of congestion, a runny nose, and sneezing. Vibrocil works on two fronts - the first by decongesting the sinuses and nasal passages while at the same time countering the body's release of histamine to reduce the allergic reaction. However, if the condition persists, it is advisable to seek medical help as long term treatment may require a different approach.
The doctor also advises that it is always a good idea to limit exposure to airborne pollen. "Stay away from freshly cut grass and avoid going out in the early morning and late afternoon as that is when pollen concentrations are the highest," he explains. "Wearing sunglasses will help to protect the eyes and a quick shower will wash off any pollen-dust after exposure."You don't need to wait until your eyes and nose are streaming to take it; if you have an allergy and can feel an allergic reaction coming on, you can take an antihistamine to help prevent the pain and discomfort of Seasonal Allergic Rhinitis.
Beware of HIV Positive Needles in Pubic Places
There are all sorts of loons loose in the world. This happened in Paris. A few weeks ago, in a movie theatre, a person Felt something poking from her seat. When she got up to see what it was, She found a needle sticking out of the seat with a note attached saying : "You have just been infected by HIV". The Disease Control Centre (in Paris) reports many similar events in Many other cities recently. All tested needles WERE HIV Positive. The Centre also reports that needles have been found in cash dispensers at public Banking machines. We ask everyone to use extreme caution when faced with this Kind of situation. All public chairs/seats should be inspected with Vigilance and caution before use. A careful visual inspection should be enough. In addition, they ask that each of you pass this message along to all members of your family and your friends of the potential danger. The information about the Paris incident has been sent by the Ville d'Issy Les Moulineaux Municipal Police and to all departments of Ile de France who have transmitted this news to all its' cities.
Recently, one doctor has narrated a somewhat similar instance that Happened to one of his patients at the Priya Cinema in Delhi. A young girl, Engaged and about to be married in a couple of months, was pricked while the Movie was going on. The tag with the needle had the message "Welcome to the World of HIV+ family". Though the doctors told her family that it takes about 6 months before the virus grows strong enough to start damaging the system and a healthy victim could survive about 5-6 years, the girl died in 4 months, perhaps more because of the "Shock - thought". We all have to be careful at public places, rest God help! Just think about saving a life by forwarding this message. Please, take a few seconds of your time to pass along
Kuwait Doctors decry ban on private practice
KUWAIT - August 10 2004 The Kuwait Medical Society has come out strongly against a recent ministerial order banning government doctor?s form practicing in private clinics, informed sources revealed. A delegation of the society will soon meet Minister of health Dr. Mohammed Al-Jarallah to protest against the ban. They said the decision had no basic, as their after-hours jobs do not affect their work at the ministry. They also pointed out that the minister deliberately obtained the decision from the Cabinet, although he could have issued it himself. ?He did that to argue later that the order came from the council of ministers and he is helpless, they alleged, adding that the issue will flare up as some MPs are expected to intervene on behalf of the doctors. - M.P.Kottappuram.
Watching Out for the Invisible Threat Don't let 'hay fever' reduce you to tears this summer
Dubai, 10 August, 2004: A leading local ears, nose and throat specialist has warned against the rising attacks of hay fever this season and stressed the importance of taking certain precautions to minimize the risk.
"For people who are susceptible to hay fever, August is probably the worst month of the year," Explains Dr. Fahim Tadros, ENT Specialist at Al Zahra Hospital in Sharjah and Dubai. "This is the month when the concentration of airborne pollen is at its highest and going out for only a few minutes could instigate an attack that lasts for hours."
'Hay fever', medically known as Seasonal Allergic Rhinitis, is an allergic reaction most commonly caused by exposure to airborne pollen from trees, grass and flowers.
The condition peaks during the spring and summer seasons, when pollen is at its highest. More than 10% of the population around the world suffer from different allergies. Although generally not harmful, they can cause great irritation and discomfort, and are often mistaken for an onset of the common cold, since many of the symptoms are similar.
The symptoms of Seasonal Allergic Rhinitis include thin, clear mucus and a constantly runny nose that may become too sore to blow. Both often appear together with sinus pain and repeated sneezing attacks. These symptoms are usually accompanied by itchy, watery eyes and nose.
"The symptoms of hay fever are caused by the immune system's reaction to pollen and other allergens - natural and artificial - which results in the release of higher levels of histamine into the bloodstream to counter the presence of foreign irritants," explains Dr. Tadros.
Following a series of simple tests will show if a person has any allergic tendencies, according to Dr. Tadros. "It is always a good idea to have these tests done, especially if there have been any previous complaints of any allergic symptoms. If an allergen is identified a doctor can prescribe a suitable vaccine to counter its effects."
After their onset, allergic reactions can easily be alleviated by using an antihistamine and decongestant treatment like Vibrocil nasal spray, which promptly relieves the discomfort by taking care of congestion, a runny nose, and sneezing. Vibrocil works on two fronts - the first by decongesting the sinuses and nasal passages while at the same time countering the body's release of histamine to reduce the allergic reaction. However, if the condition persists, it is advisable to seek medical help as long term treatment may require a different approach.
The doctor also advises that it is always a good idea to limit exposure to airborne pollen. "Stay away from freshly cut grass and avoid going out in the early morning and late afternoon as that is when pollen concentrations are the highest," he explains. "Wearing sunglasses will help to protect the eyes and a quick shower will wash off any pollen-dust after exposure."
You don't need to wait until your eyes and nose are streaming to take it; if you have an allergy and can feel an allergic reaction coming on, you can take an antihistamine to help prevent the pain and discomfort of Seasonal Allergic Rhinitis.
Health Monitor by Dr Madan Mohan MD
Viagra "The Pill" for Sexual Boost
For the first time after several years of research investigators stumbled upon them. Many discoveries in medicine are accidents. Researchers were trying out a new tablet for chest pain for heart patients. The users soon started telling that it is useless for chest pain, but kept coming back for the tablets. Then only they understood the curious properties of this drug. That was the birth of the now famous blue pill 'Viagra'.
It is not an aphrodisiac (a drug that arouses sexual desire) but sexual performance booster in people with' erectile dysfunction' (the scientific word for the demoralizing word impotence). Erectile dysfunction (ED -for short in medical circles) is not a new problem. The earliest reference is from India in the 8th century BC and the Bible has some reference to it. Erectile dysfunction is the inability of the male to achieve or maintain an erection satisfactory for sexual intercourse. There are several causes for it and essentially it can be divided into organic (ie, due to a disease like Diabetes) and psychogenic The drug is useful for both.
Old people and Diabetic patients may be the largest consumers. The tablets will work only when erotically stimulated. It has to be taken one hour before sex and effect lasts few hours. There is a lot of negative thinking that they are harmful, when talking to people, but they are not. Even I have used it for heart patients with success .As you know they were originally tried for heart patients and they can increase the blood supply to the heart. It should not be taken with lot of fat food since the pills will not be absorbed into the body.
Next came brothers of viagra and they have some differences.'Levitra' can be taken 25 minutes before sex and works for slightly longer time. It is affected less by consumption of fat food.'Cialis ('Super-Viagra'- This is its given name as seen in most spam e-mails circulating from the USA) can be taken 30 minutes-12 hrs before and effect lasts 24-36 hrs.
Collectively these drugs are safe and effective in approximately 75% of men. The only problem is the prohibitive costs in the UAE market. In India local brands are available and there are more than 10 versions of Viagra.
One word of caution is, after reading this please don't rush to get these pills from the pharmacy. It has to be prescribed by a competent doctor. First doctor has to judge whether you have ED and what is causing it. You may have diseases where these drugs should not be used; importantly you may be taking medications, which will react with these pills causing serious side effects. Consult a physician with in-depth knowledge of these or an urologist or endocrinologist before taking these.
Dr Madan Mohan MD
Consultant physician
E-mail.madanmp@emirates.net.ae
Health Monitor News - Mind Your Heart
Dr. Benny Panakkal MD (Internal Medicine), DM (Cardiology), has more than eight years experience in cardiology and was working as Chief Cardiologist in Amala Institute of Medical Sciences, Thrissur before joining Badr Al Samaa Muscat in March 2003. Full Report
Dont Hurt You Heart Says Leading Cardiologist
MUSCAT - December 31, 2003 The Heart is one of the most amazing organs in our body. Situated in the centre of the chest and size about that of ones' clenched fist, it is actually a very specialized pump; the right side supports the pulmonary circulation which is concerned with collecting impure blood from the body, low in oxygen content and pumping to the lungs for making it oxygen rich again; the left side is concerned with collecting oxygen rich blood from the lungs and pumping it to the various parts of the body.Full Report
Mossad agent linked to Asia scam
Which oil should we use for cooking?
by Dr Madan Mohan MD Consultant physician Ahalia Hospital
DUBAI - Now since even the lay public knows about 'Cholesterol' this question is being frequently asked to doctors. Cholesterol reduction has great public health importance since a long-term reduction in serum cholesterol concentration of 10% lowers the risk of coronary heart disease (like heart attack) by 50% at age 40,falling to 20% at age 70. Edible oil is fat and it is a principal source of energy. This, which we add to cooking, is the' visible fat' and different animal and vegetable food contain' invisible fat'. Oils contain Fatty acids (FA) and are either
1.Saturated (S FA) or
2.Unsaturated (USFA). This may be (a) Monounsaturated (MUFA) or (b) Polyunsaturated (PUFA). Dietary PUFA are of two classes:(1) n-6 PUFA and (2) n-3 PUFA, which is based on the structure.If one can grasp this small idea, further understanding will be easy. Now let us see the type of fatty acids in oils commonly available in the market.Cocoanut and Palmolein - mostly S F A
Sesame and olive - MUFA & n-6 PUFA
Sunflower and Corn - n -6 PUFA & MUFA
Mustard and Canola - MUFA, n-6 and n-3 PUFA.The proportion (%) and types of USFA in the above oils as well as in fish oil are listed below.
SOURCES MUFA n-6 PUFA n-3 PUFA
Cocoanut 8 2 --
Palm 45 9 -- Sesame 40 43 -- Olive 73 11 --Sunflower 33 58 --Corn 31 53 --Mustard 64 15 10 Fish 27 7 43
The first thing, which attracts the attention of the customer, is the label 'No Cholesterol' attached to these bottles. Many people come and tell, "We buy no cholesterol oil ". The bottles have stickers giving their composition and shows that cholesterol is 0 %. The housewife straight away falls for this. The truth is that all vegetable cells (and hence vegetable oils) do not contain cholesterol. It is not that the company is doing you a favor for your health benefit. What is the effect of actual cholesterol consumption in the diet besides the oil? Dietary intake of cholesterol above 200 mg/day is not recommended. This has raised a strong taboo against eggs containing 200-250 mg of cholesterol each. It has been estimated that contribution of dietary cholesterol to blood cholesterol is small (~ 10 mg/dl) whereas that from dietary fat may go up to 100 mg/dl. The only exception to this is persons with Diabetes who are more sensitive to dietary cholesterol. So the 0 % cholesterol is not going to be very helpful; the oil is going to contribute to your blood cholesterol. When one realizes this, it is easy to understand this misleading label.
Various studies have shown that high intake of saturated fat will elevate blood cholesterol, which is highly correlated with the incidence of coronary heart disease. This has brought a bad reputation for cocoanut oil. It must be recognized that no committee has banned the use of saturated oil in the diet; but has suggested consumption as a small proportion of the dietary fat (< 7 % of total calories). Diets rich in PUFA were associated with lower serum cholesterol and nowadays more than half of my patients when directly questioned say that they use sunflower oil, which is rich in PUFA.
PUFA is not free of problems, mostly due to its content of n-6 PUFA and sole consumption is not advised. It can be used up to 10% of total calories. Olive oil, rich in MUFA is extensively used in Mediterranean countries and high cholesterol and coronary heart disease are less prevalent here than in USA, and UK. These observations have led to recommendation that it can constitute up to 20 % of total calories.
The low prevalence of Coronary heart disease among Eskimos in spite of high fat diet and the beneficial effect of fish consumption lead to the understanding between different effects of n-3 and n-6 types of dietary PUFA.It was found that a high n-6 and a low n-3 consumption was not favourable. This can also be a risk factor for Diabetes, which is alarmingly increasing. So oils with high n-3 PUFA are preferred. Looking into the table one can see that mustard oil is preferable to olive oil because of a 10% content of n-3 PUFA.
In view of a greater need of MUFA, and the deleterious effect of n-6 PUFA, the popular corn, & Sunflower oil should no longer be the number 1 oil in the kitchen. Further these as well as sesame oil is very low in n-3 PUFA.Mustard and olive should take that place. Fish oil although not used in the kitchen is the best sources of n-3 PUFA.Capsules are available.
Mustard oil had got a bad reputation after a disease (called epidemic dropsy) was first reported. Actually this was due to contamination with argemone oil, a toxic oil. This has been solved and on one brand, which I saw, they had specifically mentioned that it does not contain argemone oil. The MUFA in Mustard oil is principally Erucic acid (40%). Erucic acid is thought to cause cardiac malfunction in experimental animals and this has never been demonstrated in man; yet what is recommended is a level less than 2% and plant breeders in Australia have managed to provide low erucic acid Mustard oil.
One must bear in mind that hydrogenated vegetable oils such as vanaspati contain Trans fatty acids (TFA). Although it is unsaturated it has all the harmful effects of SFA.TFA is seen in baked and fried fast food, stick margarine, cookies, biscuits, white bread etc.
It must be noted that total fat should not exceed 25-35 % of total calories (rest carbohydrates 50-60% and proteins ~15 %). It can be observed from the fatty acid composition that consumption of any single oil cannot provide the ideal recommended fatty acid distribution .All oils can be there in the kitchen and it is important to maintain the above described proportion between SFA, PUFA and MUFA.Maybe one can use various oils for different dishes, to suite taste. Although 'cholesterol phobia' has driven away traditional fats like ghee and coconut oil from the market, one must know that n-6 content is very low and they can be used.
One important point when I write about this proportion is that it applies to the total SFA, PUFA and MUFA consumed ie, visible fat (oil) + invisible fat. The plant and animal sources of invisible fat contain all the three. Cereals, pulses, millets, nuts and seeds, contain more of MUFA and n-6 PUFA.Milk and milk fats provide SFA.Fish is mainly n-3 PUFA.Egg yolk, lean meat and chicken has both SFA and USFA.
If one is consuming lot of milk there is no point in arguing that that since I do not consume cocoanut oil, my SFA consumption is well below 7 %. In fact Diary fat is more harmful than meat fat. It is better to go for low-fat milk and recent introduction of Benecol Milk-by Al Ain Diary Farm in UAE market should be welcome. This low-fat milk contains plant stanol ester, which blocks the cholesterol absorption into the body. This is beneficial in older than in younger persons. One caution is that it is not to be used every time when fruits and vegetables are consumed.
The cereals provide the major bulk of invisible fat in traditional Indian diet. This provides the full requirement of n-6 but is deficient in n-3. By adding oil like sunflower with high n-6 content this will only aggravate this defect. Hence it is advisable to add n-3 in the form of fish or take fish oil capsules.What is provided here are general guidelines. Finally it is better to take the advice of a dietician after you confirm hypercholesterolaemia with your doctor.
Dr.Madan Mohan whocompleted MD in general medicine from Medical college,Calicut in 1993.I hail from Quilon district and was working at Karunagappally till 1997 before joining Ahalia Hospital,Abu Dhabi. Originally hailing from the Njavarakal family, Muthukulam , Alleppey District his father's brother was the late noted film director shri.P.Padmarajan .He handles a wide variety of general internal medicine problems on an out-patient and in-patient basis.
Whole Soy Story: The Dark Side of America's Favorite Health Food
By Kaayla T. Daniel
Those who dare to question the benefits of soy tend to receive one stock answer: Soy foods couldn't possibly have a downside because Asians eat large quantities of soy every day and consequently remain free of most western diseases. In fact, the people of China, Japan, and other countries in Asia eat very little soy. The soy industry's own figures show that soy consumption in China, Indonesia, Korea, Japan, and Taiwan ranges from 9.3 to 36 grams per day.1 That's grams of soy food, not grams of soy protein alone. Compare this with a cup of tofu (252 grams) or soy milk (240 grams).2 Many Americans today think nothing of consuming a cup of tofu, a couple glasses of soy milk, handfuls of soy nuts, soy "energy bars," and veggie burgers. Infants on soy formula receive the most of all, both in quantity and in proportion to body weight.
In short, there is no historical precedent for eating the large amounts of soy food now being consumed by infants fed soy formula and vegetarians who favor soy as their main source of protein, or for the large amounts of soy being recommended by Dr. Andrew Weil, Dr. Christiane Northrup, and many other popular health experts. What's more, the rural poor in China have never seen-let alone feasted on-soy sausages, chili made with Textured Vegetable Protein (TVP), tofu cheesecake, packaged soy milk, soy "energy bars," or other newfangled soy products that have infiltrated the American marketplace. Scientists who have studied the use of soy protein in animal feeds over the years have discovered a number of components in soy that cause poor growth, digestive distress, and other health problems.24-27 To list just a few of these: Protease inhibitors interfere with protein digestion and have caused malnutrition, poor growth, digestive distress, and pancreatitis.28 Phytates block mineral absorption, causing zinc, iron, and calcium deficiencies.29-34 Lectins and saponins have caused leaky gut and other gastrointestinal and immune problems.35-36 Oxalates-surprisingly high in soy-may cause problems for people prone to kidney stones and women suffering from vulvodynia, a painful condition marked by burning, stinging, and itching of the external genitalia.37, 38 Finally, oligosaccharides give soy its notorious reputation as a gas producer. Although these are present in all beans, soy is such a powerful "musical fruit" that the soy industry has identified "the flatulence factor" as a major obstacle Full Report
INDIA APPRECIATED IN HUMAN DEVELOPMENT REPORT 2004
Atul Cowshish*
India’s secularism has received an honourable appreciation in the Human Development Report(HDR), 2004, testifying to the age-old tradition of tolerance in this country. Despite the low rank of 127 out of 177 countries assigned to India, the United Nations Development Programme (UNDP) - commissioned report should be taken as a world-wide acknowledgment of the fact that the so-called semi-literate or illiterate majority of India is more prudent in showing respect to followers of other religions than is the case in many rich, prosperous and developed nations of the world.
India also makes an impressive score among nations where the great majority of people have faith in democracy, their institutions and, above all, over 90 per cent are proud to be Indians. Democracy has of course taken very deep roots in India as the power of ballots as opposed to bullets has been proved here again and again. But many in the country will be surprised to learn that a majority of the population trusts the institutions of democracy in the country. Some of the institutions that are essential to the survival of democracy are widely perceived to have eroded a great deal. The finding of the HDR on Indians’ faith in their institutions will also appear to run counter to another recent report by Transparency International, which had placed India very high among the ‘most corrupt’ nations, basing it on the belief that bribery rules some of the great institutions of the country.
An interesting observation in the Report is about our holidays. Many in India ridicule the ‘fetish’ for religious festivals. However, the HDR 2004 has taken a laudatory note of religious holidays, calling it a celebration of the country’s diversity.
An interesting thing about the HDR 2004 is that India’s ranking has remained stationary largely because the country has seen a decline in GDP per capita in purchasing power parity. Education also has not received the needed push. The indices that are taken into consideration for preparing the Report include life expectancy, GDP per capita and adult literacy rate.
But the Report pays a wholesome compliment to India when it says: ‘As is evident from India’s performance on indicators of identification, trust and support, its citizens are deeply committed to the country and to democracy despite its diversity and highly stratified society. Their performance is impressive when compared with that of other wealthier democracies.’
It can be nobody’s case that India’s record of religious tolerance is without a blemish. Indeed, some of the communal riots have brought much shame and disgust to many in the country. But even if comparisons are considered odious, a look at the situation in the contemporary world will bring out the fact that on the whole India cannot be belittled on its record of secularism. Events after 9/11 in some of the so-called developed nations have led many to believe that the fear of ‘clash of civilisations’ might yet come true.
There are countries that are now struggling to come to terms with the fact that they have in their midst people who follow faiths other than those of the majority population. ‘Hate crimes’ that arise out of ignorance about other races and religions show no signs of abating in such countries. As a consequence of these developments, an increasing number of religious and racial minorities in such countries are complaining of discrimination. The point to note here is that this feeling is growing.
There are also countries where an entire racial or religious minority has been forced to flee, though the resultant monolithic society showed itself incapable of taking the country to heights of development. Then, there are countries where officials bandy about words like liberalism and secularism and yet subjugate the minorities to secondary position, constitutionally denying them upward movement. In India there is absolutely no constitutional bar on any citizen of the country from aspiring for the highest post in the land.
The UNDP Report disagrees that cultural diversity leads to a clash of civilisations. That is, in any case, what India has shown to the world. The Report has advocated that embracing diversity and protecting the rights of the minorities are crucial to development. ‘India’s secularism-enabled cultural integration and the affirmative action taken by offering reservations in employment and education has led to the social and political inclusion of backward classes,’ the UNDP representative said while presenting the HDR.
A debate often heard in some quarters in India revolves round ‘national identity’. The HDR 2004 is quite clear on this. ‘National identity need not imply a homogenous cultural identity. Efforts to impose one can lead to social tensions and conflicts.’
India need not rest over the laurels that it might have received from the Report. The kinks in making the society more cohesive need to be removed. But the more important thing is to push up the standard of living so that India improves its rank from the present lowly 127. The task should not look too difficult because a unified nation respecting all its citizens and guaranteeing them equal opportunities can ride faster on the road to development than a fragmented nation where discrimination of all sorts is a fact of life.
*Senior Journalist
12,000 Philips Computer Monitors for Kuwaiti Schools
- Ideal for educational settings, the 17-inch multimedia CRT monitors are reliable, compact and offer great value for money -Dubai, UAE, July 18, 2004 - Philips Electronics today announced its largest-ever order of computer monitors for a single client in the Middle East.
The Kuwait Ministry of Education placed the order through Philips' local distributor ZAK Computer Systems, which won the tender for the 12,000 units of the 17-inch multimedia CRT monitors. Installation is scheduled to take place this month.
"We are delighted that the ministry has selected Philips computer monitors for use in its schools. The Philips 107E56 is ideal for placement in educational settings because it offers great value for money, as well as Philips reliability and a compact design that is convenient for the classroom," said Khalid Tuer, Philips Regional General Manager, Middle East and Africa."We also are proud to play a supporting role in the educational system that is using the latest IT equipment to teach the children of Kuwait, who represent its future. We see this as another way that our products and solutions can make things better for current and future generations," Tuer added.
