Ayurveda in the State

Dr. Gurmeet Singh

If one traces back the history of Ayurvedic/ Unani system of medicines in the State, it was only practiced by the traditional Hakeems & Vaids. For the first time, it was recognized and patronized by the then Great Dogra ruler Maharaja Pratap Singh, who inaugurated two dispensaries, one at Mubarak Mandi (Ayuravedic) second at Jullaka Mohalla (Unani) in 1920 respectively, whose staff strength was merely of a Non-Gazetted Vaid/ Hakeem and one Dawasaz. Till date the staff strength of ISM dispensaries has not changed. His highness also inaugurated a ten bedded allopathic hospital known as old Hospital situated near the city chowk, which was later on upgraded and shifted to Shalamar Road popularly known as SMGS Hospital with adequate beds and staff somewhere in 1944 whose stone was laid earlier in 1940 by his highness Maharaja Hari Singh.
If one compares both the systems and their subsequent expansion, there is a sea change in allopathic system of Medicine today from its inception. 1st Government Medical College & Hospital was established at Srinagar in1960, 2nd in 1972 at Jammu. 1st Govt. Ayurvedic/ Unani Colleges were established at Jammu/ Srinagar in 1961 respectively in the regime of the then Prime Minister Bakshi Gulam Mohammed.
The people of this state are well aware of how both of these colleges belonging to ISM have been closed and became the worst victims of the Govt's apathetic attitude and negligence. The Govt. also established two hospitals at Jammu (Govt. Ayurvedic Hospital) and Srinagar (Govt. Unani Hospital) with strength of 25 beds respectively in the year 1964. But till date not a single bed has been added in spite of many promises made for making it a 200 bedded hospital with adequate staff. Nothing has been done in this direction so far in spite of putting this clause in Ayurvedic Curriculum prospectus.
As per the condition of rural based dispensaries, numbering more than 465, situated at far flung areas of the state, is concerned; it is horrifying, ill-equipped with inadequate staff, improper building and lacking residential accommodation.
In spite of the fact, that these institutions form the “Backbone of rural health delivery system", there are 45 such dispensaries which are managed and run by a single Sr. Medical Officer (Gazetted) in the grade of Rs. 12,000/- to 16,500/- (equivalent to the grade of SE) in very odd and humiliated conditions at far flung areas, thus highlighting the negligence on Govt’s part.
Now the people of this state are the best judge to understand the intension and motive of the so called democratic Government who always has a tall claim, to provide best health facilities and treatment to all sections of the society day in & day out.
As far as the demand for creating separate “Provincial Directorate" is concerned; I don’t understand the motive behind this futile exercise of the association (IMO). But it certainly speaks volumes of a typical mentality. Since this demand is lying pending from 1991 in spite of repeated requests made from time to time to fulfill the aspiration of Jammuites.
The process of bifurcation of H.O.D in every deptt. started in year the1983 with the intention to reduce the work load of the departments and to create more administrative efficiency, accountability and transparency for the smooth functioning and proper control.
Keeping in view the enormous load of work on HOD's and considering the geographical dimension of the area stretching from Lakhanpur to Leh Ladakh including the difficult terrain covering the vast area of mountains, makes it difficult for a single person to handle this department. How it is possible for a single handed person to visit, check and control the more than 465 institution of ISM spread through out in the state in length and breadth situated in the far flung areas of the difficult terrain where there is no mode of transport facilities. In some station, one has to travel 10 to 20 km on foot.
In the year 1983, one man commission was constituted under the chairmanship of the then Health Secretary, Mr. K.B. Pillai, to look into our (All J&K Ayurvedic Congress) demands of separate directorate and pay anomalies and also to look after the possibilities to redress the long pending discrepancies prevailing in the Deptt. since ages. During our discussions, Mr. Pillai put up just one question that is to give him any concrete justification for creating a separate directorate for ISM. We quoted just one example of "West Bengal Govt.” where only 48 dispensaries existed at that time, but were functioning under the control of separate directorate. After this, without any further discussion, he conceded all the genuine demands and recommended to the Govt. for implementation. Later, on 22nd of oct in 1987, separate directorate was established. The pay anomalies were removed after the verdict of Hon'ble J& K High Court in 1995 and were practically implemented in the year 2000 w.e.f. 1998. It means the Govt. all the time did not remained serious as it ought to have been.
The Govt. should come out with comprehensive policy to streamline the system & department on sound footing so that people at large who are inclined towards this system can get the best treatment in Urban and as well as in rural areas. Not only this, it would benefit both the doctors and staff working there in.The policy of discriminatory attitude may kindly be dissolved hence with because of this,1/5th of total population of the state is deprived from the quality based health care facilities.
“BADE GOUR SE SUN RAHA THA ZAMANA, HAMMI SO GAYE DASTAN KAHTE KAHTE”

Epistaxis Bleeding from the Nose........

Dr Satish Mehta

Bleeding from the nose,commonly known as NAKSEER in Jammu region, is very common in summer especially in children and old people.The site of blood itself is a scary experience for any patient and his attendants.One must know the common causes of bleeding from the nose and its remedies both at home and in the hospital.
The commonest cause of bleeding from the nose is infection in the nose commonly called as RHINITIS.Bleeding from nose is more common in summer months because heat wave combined with dry air of the fan causes dryness of nasal lining (mucosa)resulting in ulceration and bleeding.Lack of Hygiene is a major contributor for infection in the nose. Even in winter months, because of dry cold wave, frequency of nasal infections increases.Use of heaters also causes dryness of nose and throat resulting in ulceration and bleeding.Since winters are shorter in this part of the country while summers are long,hence majority of patients present with this symptom in summer.
Apart from infective rhinitis many other causes of bleeding nose have to be kept in mind which vary from bleeding disorders, toxic effects of drugs and tumors both benign or malignant. Trauma to nose is another cause of bleeding from nose which is on the increase due to increased incidence of vehicular accidents.
The remedial measures that the patients and their attendants should take when there is an acute episode of bleeding from the nose takes place are;First and foremost is,do not create panic but reassure the patient that bleeding can be controlled easily.Because of fear patients can go into psychogenic shock.Ask the patient to sit with head forwards or if he is uncomfortable then with the head end of the bed elevated, ask him to lie down with the head turned to one side.Elevation of the head will reduce venous congestion and hence reduce bleeding while keeping the head to one side will prevent blood from going into the stomach and airway.The usual practice of making the patient to lie on his back should be discouraged as this can cause choking of airway by excessive bleeding and death of patient.
Thirdly, apply ice over the nose, this will cause blood vessels to constrict and bleeding will reduce dramatically. Ice cubes can be given to the patient to suck so that vasoconstriction occurs.
Fourthly, nose pinching should be done with a little pressure for at least 8-10 minutes. By putting pressure over anterior part of nasal septum blood supply gets occluded and bleeding stops. This manouvre is helpful in those patients where the site of bleeding is in the anterior part of nose.
Fifthly, dry cotton swab in the form of a wick should be introduced inside the nose on the side from where blood is coming or on both sides if bleeding is from both the sides.
Dry cotton will stick to raw area of nasal mucosa and helps in coagulation causing cessation of bleeding.
Sixthly, patient should be put on complete bed rest and no movements be allowed.Straining in the form of coughing,vigorous throat clearing,nose blowing etc has to be avoided.
Seventhly,patient should be given soft and liquid diet so that chewing movements are minimised. Hot fluids or hot diet should be avoided and cold fluids encouraged.
Eighthly,the patient should always be evaluated completely for the cause of his nose bleed by an ENT specialist after the above mentioned first aid is given.Even if the bleeding has stopped, a check up is mandatory as many a times an innocuous looking NAKSEER turns out to be a bleeding disorder,infective rhinosinusitis,angiofibroma(a tumour seen in young boys) and so on.Once an ENT specialist sees a patient of nose bleed,a detailed history and a complete ENT examination are carried out and the following investigations are done (1) Complete haemogram (2)X-Ray of the nose and paranasal sinuses (3) Examination of the nose and nasopharynx with a nasal endoscope (4) CT scan of nose and sinuses may be relevant in few cases where routine investigations don't reveal any pathology.
In cases where bleeding from nose does not stop after above mentioned seven simple remedial measures at home then it is best to take the patient to the nearest hospital setup and not any private clinic. The advantage in a hospital is that it provides 24hr. service to the patient and secondly, there might be patients who would have lost blood very fast in a short time and these patients may require emergency blood transfusion . Thirdly, many patients of bleeding nose may have underlying cardiac, renal or any other systemic illness which needs to be tackled along with. These patients require multidisciplinary approach which is possible in a hospital setup rather than a clinic.
Regarding nasal hygiene- one must clean the nose with water and apply any lubricant in the form of a simple coating by vaseline or a medicated cream.

Guide to Osteoarthritis

Dr Manuj Wadhwa

The word “arthritis” means joint inflammation.
The joint pain of arthritis can appear as hip pain, knee pain, hand pain or wrist pain as well as joint pain in other areas of the body.
A joint is a point where two or more bones are connected. In a healthy joint, the ends of bones are encased in smooth cartilage. In arthritis this cushioning layer called cartilage is worn out and the movement of this rough surface causes pain and inflammation.
The two most common forms of arthritis - osteoarthritis and rheumatoid arthritis are real mysteries of modern medicine or allopathy. Osteoarthritis is the most common type of arthritis, and the percentage of people who have it grows higher with age. It is more likely to occur in people who are overweight and in those jobs that stress particular joints. But men and women have the disease; before age 45 more men than women have osteoarthritis but after 45 it is more common in women. 40-60 percent of people above 70 suffer from hip or knee osteoarthritis. 80 percent of patients with osteoarthritis have some degree of limitation of movement and 25 percent cannot perform their major daily activities of life in India. About 8-9 percent (70-80 million approx.) of the adult population in India suffers from some or other form of arthritis and among this osteoarthritis is the commonest.
Usually, osteoarthritis comes on slowly and early signs can be joint aches after physical work or exercise. In later stages joint pain may become more persistent along with morning stiffness and difficulty to pursue daily chores of life like climbing stairs and getting out of bed or car or sitting for long time. One may also have a crunching feeling or the sound of bone rubbing on bone. In advanced stages of arthritis person may be confined to bed or limited walking with the help of ambulatory support.
Most successful treatment programs involve a combination of treatments tailored to the needs, lifestyle, and health to manage pain and improve function.
* Exercise - Exercise can improve mood and outlook, decrease pain and increase flexibility.
* Rest and unloading of joints - Proper sleep is important for managing arthritis pain. Regular rest is required to pain caused by overexertion. Braces and special knee caps help in unloading of joint stress in early arthritis.
* Weight Control - Obese patients have 4-5 times higher incidence of developing joint arthritis so weight reduction with diet control and regular exercises is utmost important. Control obesity by limiting calories and cutting down on fatty foods.
* Heat and Cold - Heat or cold (or a combination of the two) can be useful to limit joint pain.
* Never squat or kneel as these positions strain the hips and knee.
* Maintain good posture and wear well cushioned athletic shoes to avoid putting stress on joints.
* Disease Modigying Agents - Certain drugs like glucosamine and Chondroitin, Diacerin have properties to improve the structure and function of joint cartilage and slows down the narrowing of joint space.
* Surgery - For many people with advanced arthritis, surgery helps to relieve the pain and disability of osteorthritis. Depending on the severity of disease there are different options like arthroscopy, osteotomy and joint replacement. For patients with advanced disease the quality of life can dramatically improve if damaged surfaces of joint are resurfaced by metal and plastic parts. These days technology has improved and there are options like minimally invasive joint replacements and High - Flexion joint replacements. For patients who not only want to get back to an active lifestyle, but also resume their leisure activities like sports, squatting or sitting cross legged, the high flexion joint replacement offers excellent results.
(Dr. Manuj Wadhwa MS, MCh Orth (UK), Ranawat Joint Replacement Fellow (USA), Senior Consultant Orthopaedics, Fortis Hospital, Mohali, Escorts Hospital, Amritsar

Nutrition during pregnancy

Dr Nidhi Mahajan

Pregnancy is a time in a woman’s life when she is at her most feminine. Only woman can give birth, bringing new life into the world.
Sign of Pregnancy
* Missed Period :
This is not definite in itself. Overtiredness, excitement, chill etc. may be a simple cause.
* Moming Sickness :
This may come on about the second or third weak and cease in about ten weeks time. It is usually slight and may sometimes be prevented by taking a little food before getting out of bed. Rice cooked with the juice of pungent pomegranate (dadima) should be taken as a regular food. Dried seeds of Elattaria cardamomum (Choti Elachi) are useful in nausea of pregnancy. Take 500 Mg-I g of powdered dried seeds of Elattaria caradamomum ‘C’ sugar in belching and hiccup. In case of vomiting, juice of pomegranate with lemon juice is useful. Should the sickness be persistent and frequent, a doctor must however be consulted.
* Breast Changes :
The breasts may become tender and pricking sensation is often felt when the first period is missed. Later, about after twelve weeks, marked pigmentation may be noticed and outer ring becomes darkish brown with small, raised pink spots scattered on the surface.
* Pigmentation :
Especially in dark women. Pigmentation is found on many parts of the body. Dark rings may appear under the eyes and the line down the middle of the abdomen turns deep brown.
* Frequent desire to pass urine :
This is due to pressure from the enlarging uterus on the bladder, and usually ceases about the twelfth weeks, when the uterus rises up out of the pelvis.
*Expecting Mother’s Food Habits :
*. Being pregnant is a wonderful experience, but it requires changes in your life even before the baby is born. The most notable change in the beginning is the need for nutrition geared towards both mother and baby’s health. You are not thinking for one any more. It’s now two ! You need to first understand the changes in your pregnant body’s nutritional requirements.
* Don’t run away with the idea that because you are pregnant you must overeat, rather diminish than increase as extra work is thrown on the kidneys during pregnancy.
* A pregnant lady should neither be overweight not be underweight. If the mother does not take nutritious diet, the bay will be underweight. Before becoming pregnant itself, the woman must see a gynecologist and find out the correct body weight needed to get pregnant.
Pregnancy Diet Menu :
Do Take Lots of :
* Nutritious food to maintain the weight & exercise regularly.
* Cereals and Urudh dal.
* Cold , sweet liquid diet in first trimester as it will prevent dehydration and supply nourishment.
* Meat soup in second triemster to help provide sufficient proteins.
* Protein rich vegetables such as lentils.
* Rice gruel prepared with milk and mixed with ghee in last trimester to remain free from constipation & weakness.
* Green leafy vegetables to maintain iron levels. Dark green vegetables include broccoli and spinach. They are loaded with iron (3-5 sevings).
* Whole gains like brown rice, oatmeals as they contain fibre & essential vitamins (5-10 servings).
* Drink as much water as you can with comfort. A minimum of 5 glasses per day must be taken as it is good for you and your baby & also makes you feel full.
* The fruits can be in any form including canned or fresh.If you buy fresh fruit, make sure it is thoroughly washed to rid it of possible contaminants such as pesticides.
* Eat brightly colored vegetables several times a week. These include carrots, tomatoes and corn.
* Low fat dietary products such as skim milk. You will get the necessary vitamins without extra calories and fat contents. Take 4-5 servings a day of milk & milk products.
* Avoid sour fruits, carrot juice, trans fats.
* Limit salt and sweets.
* Mustard seeds, mustard oil and sunflower oil usage should be reduced.
* Don’t use curd/yogurt and fish together.
Followin a pregnancy diet menu will give you the assurance you need. The diet should be supplemented with folic acid, calcium and a prenatal vitamin. Good nutrition is a basic human health requirement. So when pregnant, watch what you eat, visit the doctor regularly and enjoy this special time of your life.

New Hope For Knee Arthritis Patients

Dr. Manuj Wadhwa

While much has been said about high incidence of Diabetes, Hypertension, Cancer and HIV in India, a recent study suggests that Osteoarthritis beats them all to claim the no. 1 slot among ailments in the country. About 7 crore Indians suffer from joint related problems and incidence is expected to rise.
Arthritis is not a symptom of 'just getting old'. It is an inflammatory or degenerative disease of the joints that is not necessarily a part of normal aging process. It curbs down daily activities like stair-climbing, walking, or even getting in and out of the bed. That is why arthritis can make people "feel old", even though they are still in the prime of their life. It is so incapacitating that a few people enter into depression due to the ailment. So far there have been no satisfactory options for such people other than physiotherapy, painkillers and activity restriction. Some even have to undergo total knee replacement operation for relief of pain. But now there is hope- one has an option : a high precision, minimally invasive surgery, which provides immediate pain relief, fast recovery and hastens return to an active lifestyle.
Unicompartmental Knee Arthroplasty (or UNI as it is mostly called) is a highly advanced technique of bone preservation introduced in North India by Dr. Manuj Wadhwa, Joint Replacement Surgeon. As the operation is technically demanding, it is done by a limited number of surgeons worldwide. In Western countries it has gained overnight popularity among surgeons and patients because it allows quick recovery and excellent function.
Most commonly osteoarthritis starts with wear and tear of the inner compartment. If the pain of arthritis cannot be relieved by conventional treatment i.e. pain killers, exercises, life-style modification, then one needs only to replace the worn cushion in the inner compartment. This is now possible by a high precision, minimally invasive procedure called unicompartmental knee arthroplasty. Thin layers of special polyethylene and metal are used to resurface the bone-ends of only one half of the joint. These prevent the bone ends from rubbing against each other and provide instantaneous pain relief. The rest of the joint, including all ligaments, is preserved unlike in total knee replacement. UNI is beneficial for younger age group unlike total knee replacement which is best suited for those over the age of 65 years.
The surgery is done by a very small cut (only 5-6 cm long) in front of the knee, all the ligaments are preserved, and the rest of the joint retains its normalcy. Patients can start walking the same day and can go home within 24 hours! Most importantly it is completely suitable for our lifestyle which requires sitting cross-legged and squatting on the floor. Many patients can participate in low impact sports. Above all, this alternative is far more economical and affordable than a total knee replacement.
The operation is performed under epidural anaesthesia (only the legs are made numb), the risk and complications of general anaesthesia are eliminated. With this advanced surgical technique and modern physiotherapy, patients regain full movement and are home by the next day. Should the rest of the joint deteriorate in future (as it may in 8-10 years), it can easily be converted to a total knee replacement.
With these dramatic advances in knee surgery, patients can look forward to successfully overcoming arthritis at an early stage of the disease and returning to an active lifestyle once more. The author is Senior Consultant Fortis Escorts Hospitals

Treating Pigmentation

Shahnaz Husain

The skin has wonderful protective responses. In the deeper layers of the epidermis are cells that produce melanin, the pigment that gives the skin its colour. Melanin actually protects the skin from the sun's radiation. It increases on exposure to the sun and moves up, or is transferred to the upper layers of the skin to the skin-surface. That is why the skin gets tanned on sun-exposure.
During winter, we love to bask in the sun. This not only causes the skin to become tanned, but exposure to the ultra-violet rays can also lead to dark patches or pigmentation of the skin, because the melanin is transferred in an uneven manner. The cause may be an internal one, but sun-exposure makes it visible on the face in the form of dark patches. Repeated exposure to the sun causes the patches to become more apparent and persistent. In winter, the skin also loses moisture and becomes dry. This makes the patches even more visible on the skin surface.
The first aspect of the treatment is protection from the sun. Actually, as part of the treatment, one should try to avoid sun-exposure as far as possible. Physical protection is the only answer, with an umbrella or hat, and also by applying a sunscreen before going out in the sun. Select a sunscreen with a SPF of at least 20. SPF stands for Sun Protection Factor and is usually mentioned on the label. The number is related to the duration of sun exposure. Sunscreens of higher SPF are also available.
The sunscreen should be applied about 20 minutes before sun-exposure, to allow it time to be absorbed by the skin. It should be reapplied if you are in the sun for longer than an hour. The effects of the sun increase near water bodies and snow, as they reflect the sun's radiation. Therefore, it becomes all the more important to protect the skin and re-apply the sun screen after 20 to 30 minutes.
During winter, the skin should be kept moisturized at all times, specially if it is a normal to dry skin. At night, after cleansing, apply a nourishing cream and massage it on the skin with a few drops of water. This helps to improve the skin's ability to retain moisture.
The use of scrubs and masks also help to remove dead skin cells and their contained pigment. This helps the dark patches to gradually become lighter. It also improves the skin's cell renewal function. Special products are also available to lighten the dark patches. We also do clinical procedures like vegetable peel and thermoherb, as these help to minimize blemishes.
External care, itself, can remove pigmentation permanently, provided protective care is followed afterwards. Even when the pigmented patches disappear, one should continue to use a sunscreen. In fact, the use of a sunscreen has become an important part of modern cosmetic-care, to protect the skin from problems and premature ageing.
Here are some home remedies:
To remove tan after sun exposure, you can use a facial scrub after washing or cleansing the skin. However, if there is a rash, or redness, scrubs should not be used. For dry skins, use a scrub only once a week. Then apply milk to soothe the skin.
Scrub: Mix 3 tablespoons almond meal (ground almonds) with half cup yogurt (curd). Apply on the face and neck. Rub gently, specially on the dark patches and wash off. It also helps to remove tan.
For dry skin, add half teaspoon til oil to a little milk and apply on the face. Wipe off with moist cotton wool after 15 minutes. Til oil is actually a treatment for sun-damage. It helps dark patches to gradually become lighter.
For sunburn: Actually, cold milk applied daily, using cotton wool, not only helps to soothe the skin, but also keeps it soft. It also makes the skin colour lighter over a period of time, if used daily.
To soothe sunburn: Another remedy to soothe sunburn and protect the skin is by using sesame seed, or "til". Taking a handful of the sesame seed, crush it and add half a cup of water. Let it stand for two hours. Strain the liquid and use it to wash your face.
For dark patches: Mix together a big pinch of coarse salt with a cream. Apply only on the areas with the dark patches or spots and rub gently. Wash off. Then apply cold milk and wash off after 15 minutes. Do this twice a week.
For dark patches: Mix cucumber juice and lemon juice in equal quantities and apply only on the dark patches daily. Wash off after 15 minutes. This suits oily skin more.
For dark spots: Add a pinch of turmeric (haldi) to curd and apply daily on the entire face. Wash it off after 20 to 30 minutes. This helps to lighten dark spots. For dry skin, mix one teaspoon honey with milk and apply daily on the face, washing it off with plain water after 20 minutes.
Mask: Mix 3 teaspoons oatmeal with ripe papaya pulp and one teaspoon curd into a thick paste. Apply and wash off after 20 minutes. This mask suits both dry and oily skins.

Kidney stones

Dr B L Fotedar

Our urine may look like a simple fluid, but actually it is a complex liquid that contains hundreds of chemicals, including many minerals. Normally these minerals remain dissolved, but sometimes these minerals precipitate into crystals that grow into gravel then stones thus producing a medical crisis. Super saturation and stone formation occur when excessive amounts of a mineral are excreted into the urine or when volume of fluid is decreased by dehydration. Vitamin A deficiency is one of the most important causes of kidney stones. Deficiency of this Vitamin causes damage to the lining of urinary epithelium, decreased urinary citrate, the free passage of urine, prolonged immobilization as in paralysis of lower portion (paraplegia), inadequate water in take over functioning of the hormone of the parathyroid gland (hyper Para thyroidism) are the causes of the urinary stone formation.
In about 80 percent, the principal mineral in a kidney stone is calcium, usually combined with oxylate. Sometimes paired with phosphate or other substances like uric acid.
According to Ayurvedic system of medicine, urinary tract stones can be caused by any of the doshas (biological humors). The main factors are Kapha (phlegm or water humour) known as Kafaj ashmari in Ayurveda, which accumulates in the urinary tract. Vata (wind) dries it our creating kidney stones. They are primarily related to wrong diet but other factors come into play as well. Kapha stones are mainly composed of calcium. They are soft, smooth, oval in shape, white in colour and pass out with severe pain. This type of stone can also cause arthritis, hardening of arteries and spurs. Vata stones known as Vataj ashmari in Ayurveda are phosphate stones, hard in texture, brown or black in colour, irregular in shape and spiked with rough surface. These cause severe pain thought the lower abdomen and thights. Urination becomes difficult, scanty and irregular. Repeated colic’s by these stones can cause bleeding into urine (haematuria) and urinary infection etc. gradually damaging the kidney and ultimately uremia kidney failure.
About 40 plants have been mentioned to be useful in dissoling stones in the urinary system. A review published by Mukherjee et. a. 1984. Cystone (Himalya), Calcury (Chark, Neeri (Amil), Calcurosin (Ban) are already in the market. Gataeva Nervula bark and Tribulus Terrestris (Gokhru beej) have been put under clinical trials by Indian Council of Medical Research and Cunumis Trigonus have been investigated for its diuretic activity (Naik etah, 1981).
Avoid taking soft drinks and chocolates, especially those who have the tendency of forming phosphate stone. This increases the risk of kidney stone formation. The phosphoric acid found in these beverages is thought to affect calcium metabolism in ways that might increase kidney stone recurrence risk. They should avoid food that is too light or dry including dry grains like corn. Tonic and demulcent diuretics like chopchini (smilax spp); chandan (santalum abba), Gulkairo (Althea officinalis) and Ashwangadha (withania somnifera) are good for them.
Reduce your salt consumption below the recommended maximum of 2400 mg per day. Reducing dietry salt is useful to decrease the chances of additional stones.
Take citic acid. (citrate) found in some citrus fruits, particularly lemons. This also protect you against kidney stone formation.
In Unani system of medicine juice of Anjer (figs) and a resin like substane Silajeet are known to dissolve or break the kidney and bladder stones.
Figs are boiled in water to get a decoction and are taken in a dose of an ounce twice or thrice da day. Silajit contains hipputric and benozic acid which helps in dissolving the stones.

Holi care

Shahnaz Husain

The dry "Gulal" and the wet colours used during Holi are not derived from natural sources. They contain chemicals, shiny particles of mica and even lead, which not only irritate the skin, but collect on the scalp. Since Holi is played out of doors, sun-exposure can also have a detrimental effect on the skin. Apart from harmful UV radiation, sun-exposure makes the skin dry by causing depletion of moisture. People with dry skins can really suffer, even causing skin sensitivity, with itching, flaking and rough patches. Both the skin and hair can become dry and dull after playing holi.
Remember to apply a sunscreen and moisturizer 20 minutes before going out to play holi. Use a sunscreen of SPF 15 and above. SPF is Sun Protection Factor and this should be mentioned on the label of the sunscreen product. If your skin is prone to pigmented patches, select one with a higher SPF. Most sunscreens have built-in moisturizers.
The real problem is removal of colours after playing holi. Before for your bath, use a cleansing gel or cream, applying it on the face and massaging it gently on the skin. A cleansing gel helps to dissolve the colours and facilitates their removal. Then wipe the face with moist cotton wool.
Sesame seed (til) oil can also be used to remove colours, massaging it on the skin on face and body. This not only helps to remove the colours, but gives added protection to the skin. Sesame seed (til) oil actually helps to counteract sun-damage. While bathing, scrub the body with a loofah and remember to apply a moisturiser after your bath, while the skin is still damp. This helps to seal in moisture. While washing the hair, first rinse with plenty of plain water to wash away the dry colours and tiny particles of mica. Then apply a mild herbal shampoo, working it into the hair with the fingers. Massage the scalp gently and rinse thoroughly with water again.
Add the juice of a lemon to a mug of water and use it as a last rinse. This helps to restore the acid-alkaline balance of the scalp. Beer can also be used as a last rinse. In fact, it will soften and condition the hair.
The day after holi, you may have to deal with the effects of sun-exposure, like dryness or tanned skin. Mix two tablespoons honey with half a cup of curd. Apply this on the face, neck and arms. Leave it on for 20 minutes and wash off with water. Honey is a powerful natural moisturizer and helps to soften the skin, while curd will nourish and restore the normal acid-alkaline balance. Within the next few days give your hair a nourishing treatment.
Mix egg yolk with almond oil or olive oil and massage it lightly into the hair and scalp. Wash your hair after an hour. Conditioning with henna would help to restore damage to the hair, adding shine and body. To the henna powder, add four teaspoons each of lemon juice and coffee, two eggs and enough curd to mix into a paste. Apply on the hair and wash your hair after an hour

Acne - Home Remedies

Shahnaz Husain

Acne is one of the most common skin conditions. It appears at a time when the body goes through physical changes and glandular secretions increase. Due to this reason, adolescents are the main victims of an acne condition. In many cases, the condition reduces after puberty and may disappear. Had this been all, there would be no cause for anxiety. But, acne is a skin condition that can cause deep, permanent scars. It is a misconception that acne is something teenagers must live with and "grow out of it". Acne causes destruction of skin tissue, which results in scars. Therefore, it is imperative that the condition be checked from spreading. Acne can be controlled and even prevented if appropriate measures are taken in good time.
\A great deal of hormonal activity takes place during puberty, affecting the glands. The oil glands are also stimulated, leading to excessive secretion of oil. That is why teenagers are confronted with an oily skin and conditions associated with it and acne is one of them. As we know, it is an oily skin, which is prone to blackheads, spots, pimples and acne. Reducing oiliness and removal and prevention of blackheads are important aspects of preventive and corrective care for acne. So, it is necessary to understand the skin and give it the kind of care it needs. One should also recognize the value of professional guidance and seek help in good time, so that the acne condition does not spread or become a chronic one.
People with oily skin tend to wash their face with soap and water too frequently. This actually destroys the normal acid-alkaline balance of the skin. The face should be washed with a medicated soap only twice a day, morning and night. After washing, mix lemon juice and rose water in equal quantities and apply on the face. Wash it off with plain water after 15 minutes. Avoid the use of oily creams and moisturizers. If there is dryness of the skin, it is usually a superficial dryness of the outermost layer. For this, mix one teaspoon each of honey and curd and apply daily, washing off with plain water after 20 minutes. Honey is a natural moisturizer and suits all skin types, including skin with acne. Curd softens the skin and restores the normal balance. It is also said to have a healing effect on acne.
Reducing oiliness of the skin is an essential part in the prevention and treatment of acne. Astringents help to tighten the pores and reduce oiliness.
An astringent may be used after cleansing. Lemon juice and rose water have an astringent effect. Grated cucumber or cucumber juice can also be applied on the skin for an astringent effect. Keep it on for 15 to 20 minutes and wash off. Tomato juice can also be applied on an oily skin.
If there are blackheads, a facial scrub should be used on the blackhead-prone areas. Preventing blackheads helps in the prevention of acne. However, scrubs should not be applied on acne, pimples or rash. Mix rice powder with curd or rose water. Apply it on the areas with blackheads daily. Rub gently on the skin with circular movements. Leave on for 5 minutes and wash off with water. This can be done after cleansing in the morning. The scrub can also be applied on open pores and the marks left by acne.
Sandalwood paste can be applied on the acne eruptions. Or, mix sandalwood with a little rose water and apply on the entire face. Wash off with plain water after 20 to 30 minutes.
Other ingredients may also help. Mix together one teaspoon cinnamon powder, half teaspoon methi seed powder and a few drops of honey. The mixture should be applied only on the acne eruptions and left on for a couple of hours, or even overnight. Honey helps the powdered ingredients to stick together and also to adhere on the skin. Honey itself has many healing properties.
A paste of fresh methi leaves can also be applied on the skin. Keep it on for 15 to 20 minutes and wash off with water.
Neem leaves can also be used to treat acne. A handful of neem leaves can be simmered on very low fire in 3 cups of water for one hour. Leave it overnight. Next morning, strain and use the water to wash the face. The leaves can also be made into a paste and applied on pimples, rash and acne.
Mix 4 parts water with one part vinegar. Dab the skin with this mixture using cotton wool. This can be done after washing the face. It helps to restore the normal acid-alkaline balance of the skin.
Very often an acne condition is accompanied by oily scalp and dandruff. The acne can even spread to the shoulders, upper arms, back and chest. In such conditions, the dandruff and acne must be treated together.
If you have acne, here are some tips:
Do not pick or squeeze blackheads, pimples and acne.
Keep your hair away from the face.
Wash your pillow covers and face towel daily in warm soapy water, after adding 2 teaspoons Savlon antiseptic solution
In warm humid weather, wash the face often with plain water, to wash away the sweat.
Exercising regularly helps. It also helps in reducing stress, which can trigger off or aggravate acne.
Acne can be due to a congested system, so drink 6 to 8 glasses of water daily.
Add the juice of a lemon to a glass of tepid water and have it first thing in the morning. Include fresh fruits, raw salads, sprouts, wholegrains and curd in your daily diet.
Medicated cleansers and topical preparations are available for treating acne. So before the condition gets out of hand, seek professional care to avoid extensive scarring

Stress Diabetes on the rise

Dr. Jitendra Singh

Quite in keeping with this columnist’s earlier postulations regarding stress Diabetes among Kashmiri Pandit migrants, there is now universally acknowledged scientific evidence to show that “chronic persistent stress” can cause Type 2 Diabetes Mellitus. Ironically, Diabetes itself can in turn also lead to considerable mental stress.

Towards the middle and end of 1990s, quite a lot of scientific interest and amusement was generated when this columnist for the first time published findings regarding stress induced Diabetes among the Internally displaced Kashmiri Pandit (KP) migrants. Today, vindication comes in the form of a worldwide unanimous acceptance of stress as a crucial factor in Diabetes.
Quite in keeping with this columnist’s earlier postulations regarding stress Diabetes among Kashmiri Pandit migrants, there is now universally acknowledged scientific evidence to show that “chronic persistent stress” can cause Type 2 Diabetes Mellitus. Ironically, Diabetes itself can in turn also lead to considerable mental stress.
Good Stress and Bad Stress
Stress by itself is not bad and to an extent it is necessary for maintaining life. Infact, stress can also be described as human body’s defence against external threats, assaults or pressures. In the human body, stress sets into motion both central and peripheral responses. Neural pathways get activated to induce arousal alertness, vigilance and focussed attention. These changes are certainly useful when stress-inducing events occur in bursts with long periods of stress-free intervals. However, if this stress continues at a constant even though low level, it leads to what is described as “distress” or bad stress. The person then loses his capacity to adapt thus falling a prey to Diabetes. This is precisely what was witnessed in case of displaced Kashmiri Pandit community which was hounded out of its homes and hearths in the Valley.
The tendency to good stress, which is sometimes also referred as “Eustress” or to the bad stress, also referred as “Distress”, varies from individual to individual depending among other things on genes as well as harmone or metabolic responses.
The frequency and intensity of stress determine the load on individual’s capacity for adaptation. The adaptation is easy when the stressful event passes off briefly but when the stress is chronic and persistent, the human body’s’s defence mechanisms are unable to get respite through intermittent shut-downs and the individual falls victim to disease.
Cause and Effect Relationship
Between Stress and Diabetes, there is a mutual “cause and effect” relationship. While stress can lead to Diabetes, in return diabetes can further aggravate the underlying stress thus creating difficulties in diabetic management.
Diabetes is known to be associated with neuro-behavioural and neuro-psychological changes. Incidentally, one of the important expressions of Stress is sexual dysfunction. Sleep disturbances and emotional disorders are also known.
In a nutshell, any serious endeavour to prevent or cure Diabetes must necessarily be accompanied by inputs from psycho-analysts and social scientists.

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HOW CELEBRITIES COPED WITH MIGRAINE

A C Tulli

Migraine headaches stem from various reasons. They afflict millions of people all over the world. In the USA alone, there are more than 30 million people who take regular treatment for migraine. Migraine headache is often described as a throbbing or pulsating one-sided (unilateral) pain that is intensified by routine physical activity, such as coughing, straining, or lowering of the head. The attack of migraine is often debilitating, and the sufferers are left feeling tired and weak once the headache has passed.
Interestingly, some great men and women of world-wide fame suffered from migraine for years and yet, undeterred by this affliction, they bravely carried on in their respective professions. For instance, as many as three American Presidents-Thomas Jefferson, Ulysses S. Grant and Woodrow Wilson - were chronic patients of migraine.
Thomas Jefferson (1743-1826), 3rd President of America, used to have severe migraine attacks, which he said sometimes lasted for more than six weeks. Jefferson described his attacks like this: "They came on every day at sunrise and never left till sunset." Jefferson's migraine was diagnosed to have resulted from his inner conflict and repressed anger. These attacks occurred through most of his life. But these ceased after he left the presidency. Unlike most migraine victims, Jefferson forced himself to work despite the pain. Alfred Nobel (1833-1896), renowned inventor and founder of the Nobel Prizes, suffered from acute pain in the head periodically. When an attack of migraine had him down, he would still be carrying on his writing work with his head wrapped in a wet towel. Sometime when his migraine became unbearable, he would suspend his work and disappear for weeks on end. His worried friends and assistants would eventually find that he had returned to his laboratory wearing dark glasses and a wet towel tied round his head.
Alexander Graham Bell (1847-1922), celebrated inventor, suffered from headaches all his life. In childhood, he had attacks of what his mother described as 'musical fever'. Listening to music affected Bell so deeply that he could not sleep, leaving him with a headache in the morning. In later life, Graham Bell suffered from insomnia because of overwork and stress. Acting on his mother's advice, he kept off pickles and daily splashed cold water on his eyes. Even when Graham Bell slept soundly, he would have a severe headache if someone woke him up before nine in the morning.
George Bernard Shaw (1856-1950), great paywright and critic, became a vegetarian chiefly for two reasons. Firstly, he wanted to emulate the poet Shelley, Secondly, to cure himself of the monthly headaches that left him surprised to be alive after each bout. Shaw tried many cures, but all in vain. He led quite an active life but still felt he needed more exercise to work off the protein he consumed. Then, at the age of 70, he switched to a completely vegetarian diet - beans, lentils, macaroni, fresh fruits and vegetables. He was successful in making his last 24 years more comfortable with this diet.
Sigmund Freud (1856-1939), Austrian psychiatrist and pioneer of psychoanalysis, suffered from migraine attacks all through his life. His sinusitis further aggravated the agony brought by these attacks. He took mild painkillers, such as aspirin, for the headaches. For the nasal problems he often applied cocaine. One cause of Freud's headaches was the Fohn - a warm, dry wind which blows down the slopes of the Alps and quickly changes the atmospheric pressure and temperature.
Freud also held that his migraines resulted from sexual deprivation. This was at a time when he and his wife were voluntarily exercising abstinence in order not to add to their already considerable brood of six children. Eventually, Freud's headaches decreased in number as he freed himself of many of his neuroses through careful self-analysis.
Indigestion and migraine were the two main ailments that dogged America's 28th President Woodrow Wilson (1856-1924) throughout his life. He started having his 'ominous headaches' as a child. So delicate was his health that his parents could not send him to school. So, he did not learn to read till the age of 11. Wilson never found a cure for his malady. Sigmund Freud who coauthored Wilson's biography, wrote that there were fourteen periods of physical breakdown during the course of Wilson's life, during which he was prey to severe headaches, nervousness, and indigestion.
US writer and reformer Upton Sinclair (1878-1968) spent more than 40 years of his life seeking the cause of his migraine torment. However, he did not ever allow migraine to slow down the pace of his work. He tried to cure himself by dieting and fasting, but it proved of little avail. It was not until he was in his late 70s that he found a diet that worked. It consisted basically of brown bread, fresh fruit, and celery. He kept away from wheat and meat.
Princess Margaret (1930 - 2002) suffered from migrane for most of her life. She was a patron of the British Migraine Trust. James Brough, who has written a book on Princess Margaret, says she was a victim of a hereditary porphyria which is an incurable illness with many painful symptoms, migraine being one of them. Her doctors prescribed her, by way treatment, a special diet which combats low blood sugar. It mitigated her suffering to some extent, but failed to cure her completely. (PTI)

Non-surgical treatment for varicose Veins

Dr. Pradeep Muley

Comfortable and sedentary life-style, modern fashion, special postures adopted while performing professional duties have contributed to increased incidence of a set of diseases unheard of in the past. According to one estimate, 15 to 20 per cent of the population in India is suffering from varicose vein disease these days. Women suffer from this disease four times more than men. There is an increased risk of the development of varicose vein among young females who wear tight jeans and high-heeled sandals.
Varicose veins are swollen veins that are seen through the skin in leg. They often look blue, bulging, and twisted. Large varicose veins can cause aching pain, oedema, fatigue, skin discolouration, itching, varicosities and if not treated it may develops non-healing ulcers in leg. The leg vein normally contain about 4-5 valves which helps the blood flow in direction of the heart. When these valves are diseased, blood starts pooling in the legs causing swelling of the legs and veins becomes thick and engorged.
Diagnosis of varicose veins- This is done by general examination and ultrasound Doppler study which can show the exact site of disease in the form of damaged valves & dilatation of veins.
Till now Various treatment options available for varicose veins were elevating the legs while lying down or sitting, bending legs occasionally When standing for a long period of time, Compression Stockings, Sclerotherapy for short segment and spider vein treatment. Vein Stripping Surgery is a major surgery where the recurrence rate is too high, cause ugly scar in legs and 2-3 weeks need for recovery.
Radiofrequency ablation (RFA) is the latest and most effective, patient friendly and non-surgical treatment for varicose vein using Multipolar RFA machine. Under colour-doppler ultrasound vision, a radiofrequency catheter is inserted into the abnormal vein and the vessel treated with radio-energy, resulting is closure of the involved vein.
The interventional radiologist accesses the abnormal saphenous vein just above or below the knee percutaneously through a small cannula in abnormal vein. Ablation uses a thin, flexible tube called a catheter with tiny electrodes at the tip of the catheter, which heat the walls of the varicose vein, and collapses the thick veins. This treatment is more effective than laser treatment available for certain cases.
Advantages of Treatment with RFA
Unlike traditional surgical treatment, this procedure needs no general anaesthesia, no surgical scar on skin, done as an outpatient (OPD) procedure, or just one day hospital stay, no blood loss or risk of blood transfusion and makes for faster recovery. Also cheaper than traditional surgery and the recurrence rate is very low as compare to surgery.
(Author is head and Sr. Consultant International Radiologist Batra Hospital, New Delhi. e-mail muleypradeep@hotmail.com

Diabetes is Preventable

Dr. Jitendra Singh

This columnist is often confronted in his clinic by Diabetics who desperately ask “Doctor, is there no permanent cure for Diabetes?” To each such query, the scientific answer sought to be offered is that even if Diabetes is not curable in the conventional sense, it is amenable to be kept under fairly good control through lifestyle modifications and the requisite medication. But, more important than that is to educate the unaffected people with a history of Diabetes in the family about the importance of prevention of Diabetes so that it does not occur in the first place.
More than ever before, today there is a greater need to spread the message that Type 2 Diabetes Mellitus, the world’s fastest growing chronic disorder, for which there is no radical cure ...... is preventable! Worldwide over 300 million people including children and adolescents have “Pre-Diabetes” which can be prevented from developing into Diabetes.
Key to prevention
The key to prevention of Diabetes is early detection of a recently termed condition called “Pre-diabetes” ..... a stage when blood sugar levels are higher than normal but not high enough for a diagnosis of Type 2 Diabetes. As mentioned above, there are already over 300 million people with Pre-diabetes today and this number is expected to rise to 472 million by 2025. During the pre-diabetes stage, resistance to Insulin develops with the result that Blood Sugar levels begin to fluctuate.
Pre-diabetes is known to affect one in six adults and is also prevalent in children or adolescents. It is a part of the Insulin Resistance Syndrome comprising obesity, abnormal blood sugar levels, high blood pressure, disturbed lipid/cholesterol levels and thrombogenesis. Thus pre-diabetes is considered a marker of increased risk of Type 2 Diabetes and future heart attacks.
There are no warning signs or obvious symptoms of ensuing Diabetes. However, if one is overweight or obese, has a family history of Diabetes or leads a sedentary lifestyle, then one is a likely candidate for Type 2 Diabetes Mellitus.
Tips to Remember
Any rise or fluctuation in Blood Sugar levels must be taken seriously because it may indicate Pre-diabetes and also indicate progression from Pre-diabetes to Type 2 Diabetes Mellitus which can be prevented. At this stage, lifestyle changes will work. Healthy eating and physical activity as also Yoga and meditation are twice as effective as medication and not nearly as costly. On the other hand, pre-diabetes, if left untreated, may develop into diabetes within 5 to 10 years with subsequent risk of heart attack, brain stroke, kidney failure, leg amputation and blindness.
Further, with 80% to 90% of people diagnosed as Type 2 Diabetics being overweight or obese, it is time to act before pre-diabetes progresses to full-fledged diabetes. Remember, Diabetes is preventable!