Happy New Year

May God Decorate Every Golden Ray of the Sun Reaching You With Health, Wealth, Success and Prosperity for You in the Year "2010".

Wish you a "Very Happy and Memorable New Year".

Tips to fight Malabsorption Syndrome

Normally our body has the ability to digest the food we eat and absorb the nutrients form it. Over 9 meters long alimentary canal helps to accomplish the function of digestion and absorption. Malabsorption syndrome could be defined as the inability of our body to absorb essential nutrients from the food. Malabsorption syndrome can affect any person irrespective of age and gender. It may lead to a variety of deficiencies like that of vitamins, minerals, proteins, fatty acids and other nutrients. The associated cause may be digestive or dietary deficiency. The factors that contribute to cause the malabsorption syndrome may be adoption of dieting schedules for reducing weight, habitual & excessive intake of alcohol, food allergies, a diet deficient in B-vitamins and diseases of the digestive organs like pancreas and liver. Intestinal malfunction caused due to excessive use of antibiotics and/or laxatives can also lead to malabsorption syndrome.

Symptoms of Malabsorption Syndrome:

1. Fatigue and weight loss. However, some obese persons may also have malabsorption syndrome.
2. Recurrent diarrhoea and constipation.
3. Persistent abdominal discomfort with gas and bloating.
4. Unpredictable appetite.
5. Treatment of above cited conditions with a variety of medicine further complicate the problem.

Some complications of Malabsorption Syndrome:

1. Anemia and thinning & falling of hair.
2. Muscular cramps.
3. Psychological & behavioral changes.
4. Menstrual problems in female patients.

Tips to fight Malabsorption Syndrome:

1. Adopt dietary discipline in terms of quality, quantity and timings of intake.
2. Avoid fried and starchy foods.
3. Avoid excessive intake of alcohol.
4. Avoid too cold or too hot and preserved foodstuffs.
5. Avoid over medication with antibiotics.
6. Take spicy curd or buttermilk as it supports the intestinal flora and stimulates the secretion of digestive juices.
7. Seasonal and fresh fruits should be taken in between the regular meals.
8. Take medicines and food supplements as advised by your physician.

Diabetes and Pregnancy

Pregnancy brings a sea change in the metabolism in pregnant women. Your bodyhas to produce extra insulin to meet the requirements of your body during pregnancy, especially from 4^th month onwards. Hormonal changes during pregnancy may interfere with the insulin function and if your body can't cope with the situation, you may develop gestational diabetes. Women with family history of diabetes mellitus, older mothers and obese women are at the risk of developing gestation diabetes mellitus (GDM). The diabetes mellitus in pregnancy could be classified as pre-gestational or gestation diabetes mellitus. One out of fourteen cases of pregnancy may develop GDM in second or third trimester of pregnancy due to effect of placental hormones. Ideally, all pregnant women should be tested to rule out gestation diabetes. The routine examination of urine for sugar, on every visit to the gynaecologist could give an indication about onset of gestation diabetes and need for further investigations and medication. If elevated level of blood sugar is observed on random blood sugar (RBS)investigation, one should go for glucose tolerance test (GTT). Diabetic mothers need extra care to prevent spontaneous abortion and malformations in infants. Babies born to diabetic women, who were diabetic before they became pregnant, would have a greater risk of health problems, if diabetes was poorly controlled. Babies grow bigger in diabetic expectants due to extra sugar crossing the placenta and may make labour and delivery more difficult. Periodic screening, dietary control and proper medication are must to avoid GDM associated complications in expectant mothers and babies born.

Age-Related Vision Loss: Preventive Tips

Human eye is the first imaging system, the retina of which is embedded with tone sensitive and color sensitive receptors. There are around 120 million rods and 6 million cones in the retina of each eye. There are separate sets of sensitive cones for the tree primary colors and are termed as red, blue or green receptors. These receptors supply information to our brain about shape, size and color tone of the images. The central part of the retina of our eyes is called mecula that helps us to see the finer details. With ageing comes the age-related vision loss. Eyes are very delicate organ of our body and with the advancing age need extra care and dietary supplements to offset the age-related degeneration. Age-related macular degeneration(ARMD) is a disease of our eyes that causes progressive degeneration of macula. There are two common types of ARMD: 1) Atrophic or dry ARMD causes the thinning of the mecula and affects the majority of patients, 2) Exudative or wet ARMD may be hemorrhagic and is caused by the development of abnormal blood vessels beneath the epithelial layer of retina. These blood vessels may bleed and cause scarring and loss of central vision in old age. Dry ARMD causes gradual vision loss and the risk can be lowered/prevented through regular eye check-up after the age of 55 years. The early detection of ARMD is the key to save our eyes from age-related vision loss. Treatment of both types of ARMD is available in the Eye Departments/Centers of major hospitals worldwide. The risk of developing ARMD could be lowered by regular intake of Vitamin C, E, beta-carotene and zinc supplements.

Oral Cancer: Preventive Tips

Thermal, chemical or mechanical trauma on the inner-sides of our cheeks or in the oral mouth) cavity may lead to pre-cancerous lesions in our mouth. Any smoky appearance of the inner-side of cheeks needs a check-up by a dentist or general health physician. Majority of lesions of the oral cavity caused by any type of trauma cited above are reversible if the lifestyle is modified. Very hot beverages like coffee/tea and hot curries are the cause of thermal trauma. Smoke and nicotine content of cigarettes causes the thermal as well as chemical trauma. Cumulative effect of habitual cigarette smoking may cause pre-cancerous or cancerous lesions in the oral cavity. Mechanical pressure on the outer-side of any of our cheeks may lead to injury inside. Chewing of pan-masala and green chilies also causes chemical trauma. To avoid/lower the risk of oral cancer do the followings:

1. Avoid takings very hot coffee/tea or other foodstuffs.


2. Avoid tasting chemicals and industrial solvents.


3. Use mild amount of chilies in your food.


4. Avoid smoking.


5. Avoid using ill-fitting dentures.


6. Avoid chewing tobacco, pan-masala or green chilies.


7. Chew and blow the bubble gum if you can as it rejuvenates the oral epithelium.


8. Exercise your cheeks by pushing these out by holding air in your mouth at least 10 times daily.


9. Eat curd or yogurt with your meals once or twice daily


10. Consult your dentist or family physician if you have any suspicious lesion in your mouth.
    

Morphometry and Image Analysis

Visual analysis of microscopic images of cells and tissues has been in practice since long for achieving a diagnosis of pathological lesions. The pattern recognition may vary from person to person in subjective analysis. However, many definable quantitative parameters like diameter of cells & nuclei, circularity of cells, width or length of tissue components, area or diameters of certain special structures like glomeruli etc may be well analyzed through image analysis. Image is the basis of any kind of interpretation and diagnosis in anatomic pathology. Stereology and histometry had been in practice for >150 years. Stereology is based on the theorem forwarded by French Geologist Delesse in 1847. He demonstrated that the area properties of a mineral component in a rock as seen in a random cut surface, is equal to its volume proportion. Delesse principle was further propagated in histology by Weibel & Elias (1967). The term histometry refers to measurement of tissue components while morphometry has a wider meaning in the context of biology as it refers to measurement of size of cells, organisms, nuclei, subcellular components, area and volume fractions of tissue components. Stereology is the quantitative study of the three-dimensional properties of an object from the two-dimensional images using geometrical formulae and procedures. Volumetric parameters could be achieved from the images of accurately cut and well-stained microtome sections.

Older methods were based on the manual measurements on accurately enlarged micrographs and computation with respect to magnification, but the introduction of digital technology and availability of image analysis software(s) have revolutionized the morphometry at the light microscopic as well as electron microscopic (ultrastructural) level. Grey scale or multicolored microscopic images can be captured, archived and analyzed at convenience with utmost accuracy and precision. Image analysis can be divided into two broad categories; (1) morphometry related to spatial measurements and (2) cytometry/densitometry/fluorometry related to intensity measurements. The observer needs thorough knowledge of the peripheral settings, calibrations, utility tools, image analysis protocols, parameter's settings and data management. Inter and intra-observer variations could only be kept under check with perfect training in image analysis and specimen preparation. Though till date, applications of image analysis in routine diagnostic pathology are not considered seriously, but the quantitative parameters may be important for prognosis and or understanding the progression of pathological disorders by determination of nuclear irregularity and DNA content of tumor cells, quantitation of antigen expression, measurement of glomerular parameters and interstitial fibrosis in kidney biopsies and so on. Morphometry and image analysis is a valuable research tool in quantitative and analytical histology and cytology.

Image Analysis Laboratory Setup:

There is massive development in the field of image analysis in the last two decades. This is due to significant computational capability for data accumulation and storage. The other factor is rapid development of knowledge based systems for data analysis and diagnostic decision making. Presently there is widespread use of image analysis (IA) in pathology both in clinical and research areas. Reduction of cost of hardware, software and image capture devices is encouraging to setup image analysis systems and popularize this tool. An image analysis laboratory needs a work station comprised of a best quality binocular microscope equipped with high resolution digital camera and a P-IV computer with windows operating system and loaded with image analysis software.

Areas of Application of Image Analysis:

The principle areas of application of image analysis are: 1) Morphometric assessment: such as linear distance, area and perimeter and circularity measurements, object counting, size and shape etc., 2) Chromatin pattern recognition, 3) DNA quantification and ploidy estimation, 4) Quantification of immunocytochemistry, 5) Measurement of fractal dimension, 6) Cell to cell relation assessment, 7) Diagnostic decision making and 10) Chromosomal analysis.

Image Analysis Protocol:

1. The procedure adapted to process the specimens and to prepare the histological sections or smears should be same for all the specimens. Thickness of sections for morphometry and image analysis for evaluation of immunohistochemistry or DNA should always be kept constant.
2. Switch-on the system and verify the peripheral settings and calibration parameters.
3. Focus your slide and search the area of interest and acquire/grab the image.
4. Proceed for the interactive or density detection as per your requirement.
5. Record displayed results or save the data.
   

Comparison of Data from Different Centers:

Information technology has revolutionized the data management and analysis through ‘world wide web’ services and artificial intelligence. There are many knowledge-based expert systems available for data interpretation. Artificial neural network (ANN) is one of the efficient and popular expert systems for data interpretation. This is designed on the basis of the human brain. ANN has three layers 1) an input layer 2) single or multiple hidden layers and 3) an output layer. Input layer receives signal from external stimuli. The information is processed and finally results come through the output layer. ANN learns by example rather than the specific programming logic at the backend of the customized software, for a classification procedure.

How Can We Retard The Ageing Process?

Human existence is a divine phenomenon ! Every individual is genetically programmed for birth, growth, ageing, disease and death. The mystery about ageing has been persisting since the time immemorial. Spiritualists, scientists and philosophers are all intrigued to the phenomenon of ageing to find the answers to how and whys of ageing. If we think of four stages of life as: morning , noon, evening and night; the old age could be demarcated as evening of life. In the terms of modern medicine and physiology, the ageing could be termed as an evolution of organs and senses of an individual. In fact the old age and its visible characteristics are symbols of experience and maturity of an individual. Stop worrying about ageing or old age and welcome each day as a beginning of new life. One should have very strong quest for happiness to over come the undue stress and worries. Our mind is always busy and affects our thoughts, feelings and attitude. Be creative and positive in thoughts and actions to immortalize your existence. Human body is a well organized system and its metabolic and vital functions like respiration, cardiac beat, control and maintenance of temperature and various chemical constituents (including enzymes and hormones) are taken care automatically. Various stress factors influence our vital functions and metabolism as well as ageing process due to use and overuse of organs. We can't avoid ageing but can definitely retard it to some extent by busting stress, modifying our lifestyle, eating well-balanced nutritious food and regular exercise. Positive thinking, laughter and entertainment are essential for revitalizing our mind and body. Health and fitness could only be achieved through self discipline. Wish you healthy and youthful living !

Creatine Kinase MB Isoenzyme and Myocardial Infarction

The proximity of patient, clinician and analyst improves the consultational opportunity for the care of patients suffering from myocardial infarctions. Very early diagnosis of myocardial infarction could be ascertained by bedside measurement of creatine kinase. The simplicity of the test procedure and the immediate availability of results make a significant contribution to the clinical diagnosis. There are many commercial kits for the bedside determination/measurement of creatine kinase (CK) and its MB coenzyme (CK-MB). Upto 40% of the creatine kinase activity of the heart muscle is CK-MB, and no other tissue contains high proportion. Marked increase in the plasma CK activity may only result in heart or skeletal muscle disease, but the plasma CK-MB increase is generally associated with heart muscle damage. The M-subunit of isoenzyme could be a derivative of MM isoenzyme of skeletal muscles or heart muscles and B-subunit could be a derivative of MB or BB forms of isoenzyme. It is well established that following myocardial infarction it may take several hours for CK and CK-MB activity to become normal. A sample of the patient should be analyzed on admission and two further samples should be obtained and analyzed at 6 and 12 hours. Smaller increases can be seen in dermatomyositis and progressive muscular atrophy but normal results are obtained in conditions such as poliomyelitis as the muscular abnormality is secondary to nerve lesions in this disease.

The test procedure uses dry-chemistry reagent slides for analytical measurement. The reagent preparation or blood sample preparation is not required. The color change is measured on a microprocessor-controlled instrument. The CK and CK-MB can be measured separately using specially prepared slides. For measuring CK activity (derivative of B-subunit of isoenzyme) M-subunit is neutralized by antibodies against M-subunit. Adenosine tri-phosphate (ATP) is formed by the action of CK on creatine phosphate and adenosine di-phosphate (ADP). Alpha-glycerophosphate is formed in the presence of glycerol and glycerol kinase. Further by the action of a-glycerophosphate oxidase, hydrogen peroxide is produced from the a-glycerophosphate. Hydrogen peroxide reacts with the peroxidase and oxidizes the colored dye, which is measured spectrophotometrically. Patients admitted within 12 hours of onset of severe chest pain, show elevated levels of CK-MB activity with 98% accuracy as compared to normal or non-infarction control subjects. As there is none or very little activity of CK in red blood cells (RBCs), so RBCs or hemolysis of blood sample does not interfere with the determination of CK-MB. The determination of CK-MB activity has been considered more sensitive investigation than aspartate transaminase or lactate dehydrogenase in myocardial infarction.

Who is God?

Different people had/have divergent views for and against the God. Modern people understand the modern words whereas the words of religious books and scriptures are beyond the understanding of many. There are certain things which have no physical shape or size but could be experienced, felt or appreciated like - cold, hot, beautiful, ugly, entertaining, painful, joyful
etc. The God is a cosmic energy without any definite size or shape and could be experienced though various techniques of meditation or self realization.

Human mind is like the pulse of a microprocessor of a computer and is powered by bioenergy attained through breathing. Inhalation and exhalation create positive and negative waves in our body and regulate various metabolic processes essential for life, emotions and desires. Ordinary human beings are overpowered by desires and run after Godmen for blessings for the fulfillment of their desires but fail to understand that the God is omnipresent and all pervading. The God is like the fragrance of a flower. The God is a positive energy and could be generated within through positive thinking and self realization. The God does not need any special prayer or sacrifice. Just trust your existence, love thyself and do good to others for attaining a positive aura. The truthfulness and kindness are two major attributes of the God and 'His' existence can be experienced through the attainment of these qualities.

Signs and Symptoms of Thyroid Disorders

Cretinism

Thyroid gland is associated with the general metabolism of all body tissues. Suboptimal activity of thyroid gland at birth leads to hypo-secretion of thyroid hormones and causes cretinism impairing the mental and physical growth of an infant or child. The child grows up a mentally retarded dwarf, unless diagnosed and treated with thyroid extract. The cretin child has a stunted body with broad face and wide nostrils. The mouth and tongue of a cretin child are so big that the mouth may not be closed properly. The affected child could have protuberant abdomen with an umbilical hernia. The child is very sluggish and cannot be taught to walk, talk and personal hygiene tips.

Hypothyroidism

Patients affected by under function of thyroid gland or hypothyroidism, develop generalized oedema called myxoedema (swelling of body). In myxoedema metabolic processes slow down with a tendency to gain weight. There is slowness of mind and speech and one feels lethargic. The skin becomes thickened and dry. The body temperature is subnormal, pulse slow and hair may fall or get thin. Treatment of hypothyroidism needs thyroid hormone as oral drugs. Pro-thyroid drugs used for treatment of hypothyroidism, increase the metabolic rate with a subsequent increase in catabolism. Self-medication of hypothyroidism is not advisable.

Hyperthyroidism

Enlargement of thyroid gland with increased secretion is termed as hyperthyroidism. In hyperthyroidism the metabolic rate is increased and the body temperature may be higher than the normal with very fast pulse rate. The patient loses weight and is nervous and excitable. The cardiac output is generally increased and cardio-vascular complications like fibrillation may develop if hyperthyroidism is not treated effectively and timely. However, enlarged thyroid gland could be associated with non-toxic or toxic goitre. Goitrous gland may have normal function or under function (hypothyroidism) or over function (hyperthyroidism). The exophthalmic goitre is known as Graves's disease and in this disease the eyeballs protrude. The effect is due to over activity of thyroid hormone and may not completely be reversed with treatment. The hyperthyroidism is treatable with anti-thyroid drugs but self-medication is not advisable as it could be harmful if other ailments like diabetes, cardiac problem or coagulopathies exist. Sometimes surgical removal of thyroid gland is also advised for the treatment of hyperthyroidism and thyrotoxicosis or the thyroid gland is bombarded with x-ray like radiations from radioactive iodine accumulated in the gland after it had administered to the patient.

Thyroid Gland and its Functions

Thyroid Gland and its Secretions

Thyroid is an endocrine gland situated in the front of neck. It consists of two lobes, lying one on each side of the trachea just below the larynx. Both the lobes are joined by narrow band of thyroid tissue called isthmus of thyroid. The gland receives very rich supply of blood and consists of a large number of vesicles formed by secreting cells grouped around the small cavities called alveoli. The thyroid alveoli contain very thick colloid or gummy substance, composed of thyroxine hormone, which is rich in iodine content. Secreting cells of the vesicles contain an internal secretion known as thyroglobulin which is broken down to thyroxine and released in the alveoli of thyroid. The thyroid gland governs the general metabolism of all body tissues. The triiodothyronine (T3) hormone is also present in the colloid of thyroid gland and blood plasma. The triiodothyronine (T3) has been found to be more active than thyroxine. Thyroxine is an iodine derivative of thyronine. Thyroxine has four iodine atoms in its molecule and could also be called T4 hormone. The function of thyroid is regulated by thyrotrophic hormone of the anterior lobe of pituitary gland. Normally thyroid is not palpable but may get enlarged where there is deficiency of iodine in water supply. Enlarged thyroid could be associated with non-toxic or toxic goitre. Goitrous gland may have normal function or under function (hypothyroidism) or over function (hyperthyroidism). Suboptimal activity of thyroid gland at birth leads to hypo-secretion of thyroid hormones and causes cretinism. Cretinism is a disorder of thyroid in which mental and physical growth are retarded.

Functions of Thyroid Gland

The thyroid gland controls the body metabolism in terms of temperature, pulse rate, respiratory rate, cardiac output, appetite, body weight, emotions, nervous temperament and intelligence. Though it looks strange to put the emotions, nervous temperament and intelligence under the metabolic functions but it is true that the metabolic changes influence all these. Thyroid gland and its iodine containing hormones play a vital role in metabolic processes of our body essential for good health.

Garlic as Herbal Antibiotic and Home Remedy

Garlic is one of the best sources of natural medicinal compounds, daily used by many as home remedy for a number of ailments. The botanical name of garlic is Allium sativa and it is a rich source of germanium, a mineral thought to strengthen the immune system. The health benefits of raw garlic are numerous, as are its uses. Use of garlic may play a big role in your overall health. It can protect you from digestive and allergic disorders, and provide prophylaxis against a wide range of infections and infestations. Garlic probably is nature's most potent immune system booster. Its aphrodisiac properties enhance the vitality and libido. Experimental studies have demonstrated that garlic has bactericidal action on over two-dozen bacteria. Though the modern physicians have bypassed the use of herbal antibiotics due to easy availability and reliability of pharmaceutical antibiotics, but the herbal antibiotics have least side effects.

The history of civilization stands testimony to the medicinal properties and use of garlic in a variety of ailments including atherosclerosis, rheumatoid arthritis, digestive disorders like dyspepsia and gastritis, stroke, cerebral aging, asthma, cough and cataract. The garlic's power as health promoter probably comes from germanium and rich variety of sulphur containing compounds, mainly allicin-an amino acid. It is a natural cholesterol buster also. Modern physicians have also appreciated its use in the treatment of cardiovascular diseases and hyperlipidemia. Some benefits of regular use of garlic are listed below:

• Garlic boosts the immune system and bone marrow.


• It provides prophylaxis against bacterial and viral infections.


• It helps lowering the blood pressure as it relaxes the smooth muscles and reduces the viscosity of blood.


• It helps to prevent and treat the cancer of digestive system.


• It is helpful in the management of hyperlipidemia as its regular intake lowers the LDL-cholesterol.


• Its regular intake can help to prevent atherosclerotic plaques in arteries.


• Regular consumption of raw or cooked garlic improves brain function and memory.

Important Tips:

• Chewing raw garlic should be avoided as it may cause very strong burning sensation on your tongue.


• Paste of raw garlic should be taken with curd, buttermilk (lassi), lemon water or hot curries.


• Paste of raw garlic and green coriander leaves with lemon juice with salt and pepper to taste is the best recipe to be taken with major meals.


• Curries and snacks cooked with garlic paste are equally beneficial.


• Daily intake of raw garlic in any recipe should not be more than 2 gram.

Arthritis is Curable irrespective of Causes

There is nothing to panic with a diagnosis of arthritis. If diagnosed in first two years, arthritis can be treated completely and one can lead a perfectly normal life. However, dietary restrictions are must for those suffering from gouty arthritis. There are a variety of forms of arthritis and it can affect anybody at any age. There are two major forms of arthritis: (1)Inflammatory: Which causes inflammation of joints and may effect any person at any age. Rheumatoid arthritis, psoriatic arthritis, lupus arthritis and gouty arthritis fall in this category.(2) Non-inflammatory: Age related degenerative changes causing stiffening of joints are termed as non-inflammatory arthritis. Osteoarthritis falls under this category. Most of the inflammatory forms of arthritis, especially rheumatoid, psoriatic and gouty arthritis are becoming increasingly common in the age group of 20 to 45. Gouty arthritis is caused by increased level of uric acid in blood, is more common in men than women. Regular intake of alcohol, red meat and high protein diet could be the cause of high incidence of gouty arthritis in young men than women. In women, gouty arthritis could be diagnosed during
postmenopausal age.

Symptoms of Arthritis: Swelling with stiffness, pain and redness of joints could be associated with arthritis. In the beginning ankles, wrists or small joints of fingers could be involved. Lupus arthritis represents with fever, skin rash, skin lesions and hair loss, and is more common among women. Skin lesions are also associated with psoriatic arthritis.

Important Note: Accurate diagnosis is a key to the management and cure of arthritis. Disease itself may have more adverse effects on our health than the drugs. Patients should continue the treatment without caring for the side effects of drugs if the treatment is effective and one feels normal.

Waterchestnuts as Home Remedy

The lotus fruits or waterchestnuts are known as singharas in India. You may find these in plenty with vegetable vendors in the months of May and June. They are geometrically shaped and have green to purple red color. The Asians are very fond of singharas or waterchestnuts as these are a good substitute for potatoes. Seasonal availability of these makes their use limited. These could be eaten raw or boiled as salad. They are rich source of starch and iodine and have aphrodisiac properties. Ayurveda had explored their medicinal properties centuries ago. Intake of fresh or dry waterchestnuts boosts the immune system and helps to cure sore throat and tonsillitis, and is a good home remedy for these ailments. Singhara flour prepared from dry waterchestnuts could be used as blending agent in cooking and its preparations improve the vitality and chances of conception.

Salads may cause Neurocysticercosis

It is well known that infestation with tapeworm in pork-eaters may cause neurocysticercosis when the infection reaches the brain through the blood. In India majority of vegetarians or salad-eaters and non pork-eaters have also been showing the disease. Neurocysticercosis have been found to be more prevalent in salad-eater children as compared to adults. Vegetables like cabbage, carrot, beat and radish, eaten raw could lead to cysticercosis. Farm workers should be educated to wash the vegetables in clean water before marketing or consuming. Contaminated water used for irrigation and washing the vegetable before marketing is the major cause of increasing incidence of neurocysticercosis in the rural and urban population in developing countries. Vegetarians and those who do not eat pork are equally at risk due to their salad eating habit. There is a need to develop healthy eating habit and to avoid eating salads prepared at restaurants and fast food outlets as majority of them avoid properly washing the vegetables during preparation of salads. Be conscious about hygiene.

Symptoms of neurocysticercosis are: Intense headache and seizures if the tapeworm travels to the brain. After the eggs are hatched in the intestine, the worms travel through blood stream to different organs like, brain, heart, eyes and even the spinal chord. In muscles, cysts cause nodules under the skin. Cysts in eyes can impair vision and the lesions caused by tapeworm in heart may lead to cardiac arrhythmias or heart failure.

Fat Bursting Tips

Causes of Fatness:

Fat is an essential component of our body. Medical professionals and nutritionists are trying hard to explore the facts behind the accumulation of fat and possible ways of bursting it. However, fatty persons may be healthier and fit than the lean people of the same height and age. Fatness and fitness are two distinct attributes of general health profile. The cause of fatness may be genetic, metabolic, lifestyle associated or viral infection. The body weight, size, circumference of thigh sand waist could be recorded to evaluate the degree of fatness and to monitor the effect of a slimming regimen. Studies conducted on animals and humans suggest a strong genetic association to obesity. Fatso gene has been documented in some strains of mice. There could be many fat genes in human beings. Excessive craving for food leads to metabolic slowdown and promotes accumulation of fat in the body. Some people keep on eating frequently since 6 am to 10 pm. Some people may have more fat cells. Animal studies have brought to light that persistent infection of adenoviruses may cause obesity. Antibodies to adenovirus-36 have also been demonstrated in the blood of obese patients.

Fat Bursting Tips:

The vast volume of literature available suggests that one could be fat and fit. The weight and size does not matter in defining health. More than 30% of obese people mostly have normal blood pressure, blood sugar and cholesterol and other health parameters. However, one may follow the following fat bursting tips depending on the degree of fatness or to avoid fatness:

1. Healthy Eating: Drink 250-500 ml of warm water in the morning; lemon water may be more beneficial. Low fat and low carbohydrate diet would be beneficial. Whole grains are recommended as source of low-carbohydrate and high fibre diet. Saturated fats should be avoided. Pulses, fruits and vegetables should form the major part of your diet.


2. Avoid Oxidants: Preserved food stuffs contain an extra amount of oxidants and free radicals. Free radicals and oxidants also promote obesity in addition to aging. Antioxidants have anti-aging and anti-obesity properties. Seasonal fruits and vegetables are rich source of antioxidants, so intake of fruits and vegetables would be beneficial for body shaping.


3. Avoid Craving for Cookies: The normal food does not lead to addiction, however, just a thought of delicious dishes and drinks may activate the brain cells to produce dopamine, the hormone linked to pleasure and motivation. Obese people should avoid craving for such foods otherwise they may have to consume extra than the normal to get the desired level of pleasure and satisfaction.


4. Pro-anorexia Drugs: Use of drugs to reduce appetite is the new way to tame cravings for food. For instance, vigabatrin has been studied as treatment for controlling drug addiction, do help to reduce weight. Another drug, tesofensine also regulates appetite and metabolism. Warning: Pro-anorexia drugs should not be taken without medical advice as these may have serious side effects.


5. Exercise: Regular exercise and/or brisk walking for 15-20 minutes daily in addition to customized food and eating schedule is the key to fitness.

How can we prevent Diabetes?

High blood glucose level may also be detected in non-diabetics after major meals. In most of us, even when our blood glucose level skyrockets after a carbohydrate rich meal, our body tames it down in 2-3 hours. Only in diabetics, blood glucose levels persist quite high for most of the time. It is possible to prevent diabetes for ever if we plan the calorie content of our diet. Low glycemic-index (GI) meals with low carbohydrate content should be preferred as compared to fast acting high-GI carbohydrates. Green leafy vegetable, citrus fruits, soybeans, kidney beans, green peas, pistachio, peanuts and walnuts are some low-GI food stuffs you can include in your diet. The bread and chapaties made from wholegrain flour do have low-GI. Fruits and vegetable are also packed with vitamins, minerals and fibre. Fruits and vegetables are beneficial to keep the blood glucose levels within the limits of renal threshold. Protein rich meals have low-GI, help to curb hunger and prevent diabetes. Vegetarians may include legumes, nuts, peanut butter and milk to their diet whereas non-vegetarians may take lean meat, fish and poultry products. Acidic foods have been known to tame blood glucose level. Salad and pickles seasoned with vinegar should be taken with major meals for sustainable metabolism with respect to blood glucose level and prevention of diabetes.

All Diabetics are not Alike!

All diabetics are not alike, so never take medicines for diabetes on the advice of fellow patients. The term diabetes means inordinate and persistent excretion of excessive volume of urine. Diabetes is a disease of carbohydrate metabolism with a variety of causes. Pancreas is directly associated with carbohydrate metabolism and biobalance of blood sugar (glucose) level. All carbohydrates (starches, polysaccharides, disaccharides and monosaccharides) are converted into glucose in our stomach and small intestine, absorbed in blood and taken to liver for storage in liver cells as glycogen for future use. Glycogen is also stored into muscle cells and utilized for muscle function. Insulin produced by the beta-cells in the pancreas helps in the penetration of glucose into liver and muscle cells and further storage as glycogen. Glucagon produced by alpha-cells of the pancreas regulates the conversion of glycogen in glucose through glycogenolysis, when ever glucose level in the blood falls below normal.

Defective metabolism of carbohydrates may lead to alimentary diabetes. The term diabetes insipidus pertains to a condition characterized by excessive intake of water with excessive urination but without any glycosuria (excretion of glucose in urine). Diabetes insipidus due to congenital failure of renal tubules to respond to anti-diuretic hormone (ADH) is termed as diabetes insipidus nephrogenic. Diabetes mellitus (DM) is a condition characterized by an elevated level of sugar (glucose) in blood and urine. Diabetes mellitus may affect both younger (juvenile diabetes) and older people (maturity onset diabetes). Subclinical diabetes refers to a condition where glucose tolerance test is abnormal but clinical signs of diabetes like polyuria (excessive urination with increased frequency of micturition), hunger, thirst and weight loss are absent. Obesity may be associated with diabetes but all obese people could never be diabetics. Fat metabolism is also impaired in diabetes which may lead to hypercholesterolemia and hypertension (high blood pressure) in diabetics. There is a strict need of controlling hypertension and hypercholesterolemia with customized diet, regular exercise and sometimes with medicines. It is advisable never to copy your fellow patient's treatment. Diabetes need your round the clock commitment and if taken care it would reduce your risk of serious complications like renal disease.

Important Tip: Never copy your fellow patient's treatment.

Management of Asthma

The asthma means bronchospasm and for its effective management we need bronchospasm relaxants. There are a variety of preparations containing sympathomimetics in the form of aerosols, inhalations, tablets and syrups capable of producing bronchodilations by stimulating b₂-adrenergic receptors in the bronchial smooth muscle. The choice and mode of treatment depends on the age of patient and severity of asthmatic conditions. Inhalations and aerosols may not be convenient mode of treatment in infants and children. Salbutamol and terbutaline are relatively selective drugs for b₂-adrenergic receptors. These produce optimal bronchodilations at lower concentration than those required to stimulate b₁-adrenergic cardiostimulatory receptors. Respiratory stimulants like doxapram and nikethamide are of no value and may be harmful in cases of asthma. As per the experience of a close friend of mine, sympathomimetics like salbutamol and terbutaline produce immediate relief in reversible bronchospasm associated with asthma and allergic bronchitis. Excessive and long term use of these drugs may cause cardiac arrhythmias.

Xanthine derivative drugs such as aminophylline, theophylline and etophylline are known to produce smooth muscle relaxation and bronchodilation by inhibiting the enzyme phosphodiesterase which leads to an increase in the intracellular levels of cAMP. Xanthine derivatives also produce diuresis (increase in the urinary output) and cardiopulmonary stimulation. Corticosteroids as aerosol inhalation help to reduce the mucosal edema, hypersecretion of mucous and bronchial hypersensitivity. Corticosteroids act by preventing the release of phospholipids from cell membranes in the lungs and their anti-inflammatory action helps to underplay the mediators of inflammation. Oral corticosteroid therapy should be reserved for acute exacerbations and chronic cases but after the radiological evaluation of lungs and investigations of sputum for Mycobacterium tuberculosis (tubercle bacilli or TB) and other bacterial or fungal infections. Asthmatic patients should avoid total dependence on aerosols or inhalations and should ask their physicians to prescribe them oral drugs also for emergency use. A combination of salbutamol and aminophylline or theophylline as tablets or syrup is a reliable form of treatment for asthma advisable under the guidance of a medical practitioner only.

Chemistry of Asthma and Allergy

The allergy and asthma are very serious immunologic disorders. Everyone of us has been blessed with immune system to fight infections and respond to vaccines for acquiring active immunity. Allergens too are immunogenic but elicit hypersensitive response which could cause a local or systemic reaction like asthma. It has been learnt through animal experiments that the animals sensitized (immunized) with egg albumin react very dramatically on subsequent challenge with egg albumin. In my experience the animals have shown the symptoms of generalized anaphylaxis, respiratory distress and 50% of them died probably due to asphyxia as an intense constriction of bronchioles and bronchi was observed due to the contraction of smooth muscles. Similar reactions also occur in human subjects due a variety of conditions/causes. An injection of penicillin or an insect bite may trigger anaphylaxis in sensitive individuals. Only a timely intravenous injection of adrenaline may help in countering the smooth muscle contraction.

Mediators of Anaphylaxis or Allergic Reaction:

It was resolved by Sir Henry Dale that histamine mimics the systemic changes of anaphylaxis. Experimental studies in guinea-pigs had demonstrated that serum from sensitized animals could passively sensitize normal animals of the same species. Sir Henry Dale had demonstrated that the uterus of sensitized guinea-pig released histamine and contracted on exposure to antigen. The cells that release the mediators of anaphylaxis are the mast cells (in tissues) and basophils (in blood). The mast cells in sensitive subjects are coated by hemocytotropic antibodies of IgE class (reagins) and on interaction with the specific allergen or antigen stimulate the mast cell degranulation and release of mediators of anaphylaxis. In addition to histamine, 5-hydroxytryptamine (serotonin) is also released in some species. The contraction of smooth muscles is associated with the explosive degranulation of mast cells. Other mediators released are: slow reacting substance of anaphylaxis (SRS-A; capable of inducing prolonged contraction of certain smooth muscles), platelet activating factor (PAF), heparin and chemotactic factor for both the neutrophils and eosinophils (types of white blood cells).

Anti-anaphylaxis substances produced by Eosinophils:

The mediators of anaphylaxis released by mast cells are countered by certain substances produced by eosinophils like: histamine produced by mast cells is neutralized by histaminase, eosinophil chemotactic factor (ECF-A) is countered by aryl sulfatase and SRS-A is neutralized by phospholipase produced by eosinophils in an effort of the body to control the reaction. Systemic allergic reaction as well as percutaneous anaphylaxis leads to changes in cyclic nucleotide levels. A fall in cyclic AMP (c-AMP) and a rise in cyclic GMP (c-GMP) level, favors degranulation of mast cells, whereas high concentration of c-AMP stabilize the mast cell granules. All the anti-allergic drugs either neutralize histamine or activate c-AMP to stabilize mast cells or bind to b-2 receptors on smooth muscles to counter the smooth muscle contraction.

Benefits of Breastfeeding

The new generation mothers should always be encouraged to breast feed their babies since the breastfeeding benefits the babies in many ways. Just after the birth, the baby's immune system is naive and for first few months of life the baby is dependent on the prophylaxis provided by the homologous maternal antibodies acquired through placental circulation. It is worth to mention here that there are 5 types of immunoglobulins in our blood but only the immunoglobulin-G (IgG) can pass through the placenta and reach the circulation of the baby in the womb. While the lymphoid system of the baby is developing in the first few months, it could get additional protection from the colostrum and the breast milk if adequately fed on the breast milk. The colostrum is the yellowish fluid discharged form the breasts during the first 2-3 days after the delivery and is very rich in immunoglobulin-A (IgA) content. The IgA present in the colostrum and other secretions is always in the dimer form stabilized by a secretory component and is inert to proteolytic action of digestive enzymes in the stomach and intestine. The IgA rich colostrum sucked in by the baby protects its oral and gastric mucosa from infectious agents and the amount of IgA reaching the small intestine is absorbed and transferred to the blood circulation. The IgA is synthesized locally in the breasts by plasma cells and dimerized together with a cystine rich polypeptide called J-chain. The breast milk is a very rich source of proteins, carbohydrates, calcium, minerals and hormones essential for the growth and development of the baby. No other food supplement or cattle milk could replace the human breast milk. Various studies have established that breastfeeding protects babies from respiratory problems in early life and may leave babies with stronger lungs well into the later life. The sheer physical effort involved in the suction of breast milk by the baby could be rewarding in many ways for acquiring stronger lungs, bones, immunity and health.

Tips to Prevent Lifestyle Diseases

Working couples in the metropolises and cities have very tough life. Employed women have been found to be under great pressure for running the family and business or official responsibilities. Lifestyle diseases like obesity, malnutrition, depression, hypertension, chronic backache and diabetes are affecting males and females equally. There is a need to focus our attention on preventive health care. Lack of exercise, poor nutrition, exposure to sunlight and pollutants are the main causes of obesity, malnutrition, hypertension and skin diseases. Excessive intake of alcohol, drug abuse, drug addiction, and internet addiction are also associated with the lifestyle diseases. Over indulgence or interest in internet may lead to internet addiction disorder(IAD), the most modern lifestyle disease. Ignorance about health care may have multiple implications on our health, behavior and attitude. Casual medication and poor compliance of medical advice add to the gravity of lifestyle diseases. Working couples in general and employed women in particular need to be health conscious to be healthy and more productive. They must have a time table with sufficient time for exercise, entertainment and grooming their health and beauty.

Brisk walking for 15 minutes daily may show promising results in obese, diabetics and hypertensive people as it improves blood circulation, removes lactic acid and uric acid, frees-up tight joints, balances the yang and yin energies, relaxes the muscles, tones-up the body and removes blockages from the blood vessels. Brisk walking is also beneficial for maintaining good health and preventing lifestyle diseases. Following tips should be beneficial for you to overcome a majority of lifestyle diseases:

1. Make a time table for daily activities with sufficient time for exercise and entertainment.


2. Do brisk walking daily for 15 minutes or 10,000 steps or 2-3 kilometers.


3. Respect and support your spouse or partner.


4. Avoid fried food stuffs.


5. Avoid foods with preservatives and coloring agents.


6. Never skip a meal for efficiency and productivity.


7. Avoid junk food.


8. Follow medical advice if you have some health problem in addition to life style disorder.


9. Periodic medical checkup.


10. Use proper seat and sit in a right posture at home and at workplace to avoid postural disorders like cervical sprain and backache.

Psoriasis: A Non-contagious Skin Disease

Psoriasis is an inflammatory but non-contagious skin disease. It represents erythematous reddish in color) scaly plaques. The extent of the spread of the plaques may be limited (about 5% of body surface) or widespread (40 to 50% of the body surface). The course of psoriasis has been found to be chronic and associated with remission and relapses. Psoriasis is characterized by hyperproliferation of epidermal keratinocytes. There could be abnormal differentiation of keratinocytes. The worldwide prevalence is around 3%. The racial, geographical and environmental factors do influence the prevalence of psoriasis. Male and female adults of lower, middle or higher age groups are equally affected by psoriasis. Genetic and environmental factors equally contribute to the etiopathogenesis of this disease. However, exact etiology is not known. Classical lesions start as erythematous papules, which gradually enlarge and merge together to form scaly plaques. Factors like trauma, bacterial infections, intake of drugs like antimalarials, lithium and beta blockers could aggravate the lesions. Other aggravating factors include the sunlight, hypocalcaemia (low level of calcium in the blood), alcohol and smoking. Complications apart from the disease and treatment include: itching, skin infection, eczematization, arthritis and nephritis in very chronic and poorly treated cases. The treatment of psoriasis depends on the age, sex and general health of the patient. The management of patients affected by psoriasis has to be individualized depending on the lifestyle and affordability of the treatment. The disease is effectively curable with topical application of various lotions along with anti-inflammatory drugs and to some extent with peritoneal dialysis or hemo-dialysis. Patients are advised to consult a dermatologist for further advice and treatment.

Asthma during Pregnancy

Pregnancy does not have a uniform effect on the symptoms of asthma. There could be pregnancy associated asthma or an asthmatic lady may represent aggravation of asthma symptoms during pregnancy. Asthma is probably the most common chronic illness that severely affects around 8% of pregnant women. Pregnancy alters the respiratory and cardiovascular physiology and these alterations may lead to severity of asthma. Proper control of asthma in pregnant women could significantly reduce the complications of perinatal period. The underlying mechanisms responsible for the altered state of asthma due to pregnancy are unknown. Poorly controlled asthma during pregnancy may lead to perinatal mortality and complicate labour. Prevalence of low birth weight of babies and preterm births in asthmatic women as compared to non-asthmatic women have also been documented.

Worsening of asthma during pregnancy may be due to large number of contributing factor. There could be exposure to allergens, infections of the upper respiratory tract, gastroesophageal reflux, non compliance or poor compliance of medication or unwanted use of drugs. Patients with severe asthma prior to conception and patients whose asthma has worsened during previous pregnancies could be labeled as high risk patients. Acute asthma episodes during pregnancy may significantly decrease fetal oxygenation and need medical intervention. However, the management and treatment of asthma are the same in pregnant women as in non-pregnant women and men. Following guideline need special considerations during pregnancy to prevent asthma exacerbations during pregnancy:

1. Avoid intentional exposure to known allergens like pollens, dust, animal furs, feathers and certain food stuffs.


2. Strict medical consultations are needed throughout the pregnancy for optimal control of
   asthma.


3. Delay in the diagnosis and treatment of should be avoided.


4. Smoking cessation is a must.


5. Other health problems like rhinitis, gastric reflux and any infection of upper respiratory tract should be treated effectively.


6. Pulmonary function (assessment or expiratory air flow with Spirometer) should be assessed at least once in a month.


7. Periodic antenatal fetal surveillance should be got done by a specialist.
   

Sixth and Seventh Sense

Generally everyone have five senses. Sixth sense means common sense; however, the seventh sense is nonsense. The common sense is more important and is an excellent capability. It is the snap ability of a person to understand the cause and effect relationship through his/her super-cautious analytical mind. Every manager should have a good sixth sense or common sense in addition to his/her ability and skills of planning, organizing, directing, coordinating, communicating and motivating.

Treatment of Malaria

The malaria is an intracellular protozoan infection, endemic in tropical and subtropical countries. Large number of drugs are being used worldwide for the treatment of malaria. Four species of the protozoal parasite Plasmodium cause all infections in human beings and these are: Plasmodium vivax, Plasmodium malariae, Plasmodium ovale and Plasmodium falciparum. The effectiveness of the antimalarial drugs may differ with the species and stage of parasite and the parasite load in the liver and blood circulation. The parasites are inoculated into the human host by blood sucking female anopheline mosquitoes. The sporozoites from the infected mosquito reach the liver and develop into tissue schizonts. These tissue schizonts then rupture, form free merozoites and invade erythrocytes or red blood cells (RBCs) and develop as erythrocytic schizonts and lead to rupture of RBCs. There are different groups of antimalarial drugs for the stages of malarial parasites in the liver and erythrocytes.

Chloroquine (4-aminoquinoline) has been used extensively for the treatment and prevention of malaria. It has considerable efficacy for the treatment of Plasmodium vivax, Plasmodium malariae and Plasmodium ovale infections, however, widespread resistance has been seen against Plasmodium falciparum infection. Effective suppressive prophylaxis has been documented with chloroquine, mefloquine, proguanil and doxycycline as these are schizonticidal drugs. Proguanil and primaquine are best known for causal prophylaxis as these drugs effectively kill the hepatic stages of the parasite. Quinine, chloroquine, primaquine and artemisnins are established gametocidal drugs also. Sulfonamides (sulfadoxine and dapsone) and aminoalcohols (halofantrine and lumefantrine) are also used in the treatment of malaria but are more toxic drugs. The drug toxicity may lead to acute hemolytic anemia in patients with glucose-6-phosphate dehydrogenase (G6PD)deficiency. Consult your physician for the diagnosis and treatment of malaria.

What causes Malaria ?

The malaria is a protozoan infection endemic in tropical and subtropical countries. Four species of the protozoal parasite Plasmodium cause all infections in human beings and these are: Plasmodium vivax, Plasmodium malariae, Plasmodium ovale and Plasmodium falciparum. The malaria remains the most devastating infection worldwide with around 500 million clinical cases every year.

The symptoms of malaria may be non specific like: high grade fever, lack of sense of well being, headache, muscle aches, fatigue and sometimes chest pain also. The clinical presentation of malaria depends on the species of the parasite, parasite load in the blood circulation, patient's immune status and presence of other diseases. The classical malarial symptoms are fever spikes with chills and rigors at regular intervals. Enlargement of spleen is very common among otherwise healthy individuals in the endemic areas. In untreated cases of malaria, mild jaundice and slight enlargement of liver are also common. The enlargement of spleen and liver may be more pronounced in infants and children. Plasmodium falciparum causes the most severe disease and may lead to cerebral malaria, hypoglycemia (low level glucose in blood), lactic acidosis, pulmonary edema swelling of lungs) and impairment of kidney function.

Medicinal use of Gooseberry: Indian Scenario

The health promoting and curative properties of Indian gooseberry or fruit of Emblica officinalis were known to the Indians since the Vedic era. Its trees are found in all the forests of the Indian subcontinent and south-east Asia. The height of trees of Indian gooseberry or amla is about 30 to 40 feet and these are evergreen trees. There are about 15 varieties of gooseberry in India. The spherical fruit of gooseberry have a diameter of 3 - 4 cm and the color could be yellowish green or light reddish green. The trees of some varieties start bearing fruit at the age of 6 to 8 years. The yield of fruit per tree could be around 150 kg. Around 2 million hectare land is under the cultivation of Emblica officinalis in India. There are a number of nutrients and medicinal chemicals present the juice or pulp of gooseberries. It is very rich source of ascorbic acid or vitamin-C, folic acid, iron and minerals, even in the dry form. Its pulp is the main component of chaywanprash. Around 10,000 tons of Indian gooseberry or amla are processed by various pharmaceutical companies in India alone to manufacture drugs and health foods containing gooseberry pulp or dry powder. Chaywanprash has been known to improve immunity and digestion and being marketed as natural revitalizer or health food for all age groups. Half a spoon of dry powder of amla or gooseberries if taken with warm water after major meals could permanently cure constipation and piles. It has great anti-inflammatory properties and regular intake of 3 to 6 gram of dry amla powder could treat joint pains and improve eyesight.

Medicinal Properties of Indian Gooseberry

Indian gooseberry or amla has a variety of medicinal properties. Its botanical name is Emblica officinalis. In the Ayurvedic literature Indian gooseberry had been documented as panacea. It is very rich source of vitamin-C even in the dry form. In addition to vitamin-C, Indian gooseberry also contains vitamin-B, calcium, phosphorus, carotene and iron. Intake of fresh gooseberry or powder of the dry gooseberry is equally beneficial in liver disorders, hypercholesterolemia (elevated level of cholesterol in blood) and diabetes. It improves digestion, immunity and also checks premature greying of hair. Millions of tons of Indian gooseberry fruit are processed every year for medicinal uses. Its pulp is the main content of chaywanprash and amritprash. Its jam and juice are in the top line of health promoting foods and natural revitalizers. Dry powder of amla should be taken with water only. Regular intake of half a spoon of dry powder of Indian gooseberry could supply us daily dose of vitamin-C, iron and phosphorus. People with peptic ulcer should avoid using dry powder of Indian gooseberry. The Indian System of Medicine had always admired medicinal properties of Indian gooseberry and propagated its use as natural revitalizer.

Medicinal Properties of Raisins

Dry grapes are known as raisins. Like fresh grapes these are rich source of calcium, magnesium, potassium, phosphorus, iron, natural sugars and gum. Calcium is an essential mineral of our bones and teeth. The structural strength of our skeletal system is the contribution of calcium. As a coagulation factor, calcium helps our body in checking any bleeding disorder. Phosphorus is also an essential mineral of bones, nerve tonic and buffering chemical of blood plasma and various body fluids. Calcium, magnesium and potassium take part in cellular metabolism and functions. Potassium plays a vital role in the cardiac, renal and muscle physiology. Iron is an essential component of hemoglobin and hence the red blood cells (RBCs), and also essential for the formation of blood. Consumption of 20 to 25g of raisins daily could supply us all these nutritious components. Raisins also possess anti-inflammatory properties and are useful as an expectorant for cough. Beneficial effects of raisins have also been documented in the treatment of acidity and jaundice.

Statins as New Generation Anti-Inflammatory Drugs

Non steroidal anti-inflammatory drugs (NSAIDS) are considered to be more safe drugs for inflammatory diseases since these have minimum side effects. Statins are normally meant for patients with high cholesterol levels to reduce the risk of stroke and heart attack. Current studies by researchers have found that statins could be beneficial for people with normal cholesterol levels. The drug rosuvastatin has been found to reduce the risk of heart attack and stroke to around 45% in a systematic clinical study by a team of researcher in the United Kingdom. In people with inflammatory diseases like joint pains or rheumatoid arthritis, showing elevated levels of Carbohydrate Reactive Protein (CRP) in blood/serum, it has been observed that administration of 20mg of rosuvastatin daily could scale down the level of CRP and inflammatory symptoms. Consult your physician if you feel like using statins for satisfactory relief from an inflammatory disease without much side effects.

Rheumatic Fever and Complications

Rheumatic fever is an inflammatory disease. Group-A Streptococcal infection of the throat or pharyngitis may lead to acute rheumatic fever. Central nervous system, skin, joints and the heart are predominantly affected by rheumatic fever. Young children in the age group of 5 to 15 years are usually affected by acute rheumatic fever. The incidence rate is about 3% in the patients with acute Streptococcal pharyngitis and the latent period is about 2 to 3 weeks. There is a need for throat swab culture to find out the type of bacterial infection in cases of acute pharyngitis or tonsillitis. A positive throat swab culture for group-A Streptococcal infection is considered as the direct evidence of throat infection. Antibiotics are the choice of drug to eradicate group-A Streptococci. The antibiotics could be given even if the throat swab is negative for Streptococci since the organisms may be present in the areas inaccessible to the swabs. The patient may have moderate to high grade fever with skin rash or arthralgia. Inappropriately treated cases may develop endocarditis, polyarthritis, chorea or subcutaneous nodules. There may be transient or persistent rise in 'erythrocyte sedimentation rate' (ESR). The test for acute phase protein called carbohydrate reactive protein (CRP) is also found to be positive in addition to elevated levels of 'Anti-Streptolysine-O' (ASO) antibodies. The patient needs specialized consultation and adequate treatment to avoid serious complications.

Silence Is a Sound !

The statement "silence is a sound" may look strange but could be understood well in the light of the facts cited below. The sound is associated with the faculty of hearing under our sensory system and is produced due to vibrations of molecules in the atmosphere. These vibrations are known as waves and a wave always has a definite frequency, wavelength and amplitude. Our brain is embedded with the necessary neurons capable of intercepting and analyzing the sound waves received through the ears. The sensation of hearing is interpreted by our brain as a pleasant or unpleasant sound or the music or a noise. The irregular sound waves produce noise whereas the regular and rhythmic waves produce the music. The sound waves travel at a speed of 375 yards per second in still air at 60^oC. The levels of the sound or voice are expressed in decibels (db). The decibel is a unit of sound pressure levels. Our ordinary conversation has a sound level of 60 to 70 db. The level of sound generated by heavy traffic is around 90 db and that of a jet engine could be around 150 db.

The higher is the amplitude of the sound wave the higher would be the decibel level. The sub-audible sound has very low amplitude. The ultrasound could be called an inaudible sound current or silence. The silence is beyond the sensitivity of our hearing apparatus or ears, hence inaudible. One could experience the silence as a sound through deeper incite into ones brain with eyes closed. The alpha state of our mind is the state when our mind is empowered to intercept the silence. The silence is subtle, serene and blissful.

Internet Addiction Disorder: A Lifestyle Disorder

We have been living through an era of information technology. The World Wide Web is an open source of a variety of information in every field of the science and technology. Sitting in any corner of the world we may stay connected to our near and dear ones through the voice and video chat on the internet. Too much involvement, dependence and attachment transform our habit as addiction. Those who stay glued to the internet for more than 6 hours without any professional compulsion could be called internet addicts. The internet addiction disorder (IAD) could be called a lifestyle disorder of the modern age. Everything is under the control of our intellect. Let not allow your habit become an addiction. You may be affected by IAD if you feel disturbed and angry for not being getting connected to internet and you pass your time surfing internet without any professional compulsion. Five major activities which could lead us to internet addiction have been listed below:

1. On line gaming.


2. Excessive involvement in internet surfing or exploration for needful information in the initial stage and becoming a habit for unnecessary exploration later.


3. Shopping on line and extended sessions of chatting.


4. Too much general surfing on internet.


5. A taste for net pornography.
   

Just minimize the time for above said activities to save yourself from the grip of internet addiction disorder. Those who feel being affected by the IAD should seek medical advice and change their lifestyle and dependence on internet. To overcome the internet addiction disorder one should get involved into a variety of activities like reading books and periodicals, site seeing, exercising, cooking, watching creative channels on television etc.

Four Ways of Reducing Radiation Exposure

The health of radiation professionals needs to be protected from over exposure to radiations. The four most effective ways of reducing exposure to radiation have been elaborated below:

1) Radiation protection shielding

When a sheet of absorbing material is placed between a radiation source and a detector, the radiation arriving at the detector decreases to an extent depending on the energy of the radiation and the nature and the thickness of the shield. For gamma rays (g-rays) lead is generally installed because for a given weight it absorbs more radiations than any other readily available shielding material. Its effectiveness for a particular radiation is usually indicated by the half value layer (HVL). The half value layer (HVL) is the thickness of the lead sheet capable of reducing the radiation to one half (50%) of the original. A second half value layer (HVL) will reduce the remaining half to half (i.e. 25%). A third half value layer (HVL) would
reduce the radiation to half of 25% (i.e. 12.5%) or exactly the ¹/₈th of the original and a fourth half value layer (HVL) would further reduce the radiation to ¹/₁₆th of the original. The thicknesses of HVL for some important radioisotopes used in medical field have been given below:

Radioisotope	HVL in cm Lead
Cesium-137	0.5
Chromium-51	0.2
Cobalt-58	0.7
Cobalt-60	1.2
Gold-198	0.3
Iodine-130	0.2
Iodine-131	0.3
Iodine132	1.0
Irridium-192	0.3
Iron-59	1.1
Potassium-42	1.2
Sodium-22	1.0
Strontium-90	1.2

2) Time

The exposure time is directly proportional to the time spent at a place of radiation. The necessary time for any procedure ought to be estimated well in advance, allowing a good safety margin. The equipments used in radiation applications should be simple to minimize the time of operation with a view to reduce the exposure time. But any necessary handling precaution should not be omitted to save time.

3) Distance-Inverse Square Law

The ionization radiation travels like the light and as we go away from a point source, the amount of radiation reaching a given area would decrease. The decrease would be proportional to the square of distance in centimeters. For example: A point at 40 cm from the source would receive ¹/₄th (25%) of the radiation reaching at a point at 20 cm from the source. As ^20x20/_40x40 = ¹/₄.

4) The Gamma Factor for Gamma Emitters

The dose rate at 1 cm from the point source of each gamma emitter radioisotope has been determined and with reference to this the dose rates are worked out in terms of roentgens(r). The roentgen (r) is that amount of radiation which delivers a dose of one rad. A roentgen (r) is unit based on ionization in air and rad is a unit of energy absorption, but both have corresponding amount of energy. For example: the gamma factor of Iodine-131 (¹³¹I) is 2.18, of Gold-198 is 2.35 and that of Sodium-24 is 18.4 which means that 1 milliCurie (mCi) of these radioisotopes would have a dose rate of 2.18 , 2.35 and 18.4 roentgens or rad respectively at 1 centimeter from point source. Now, if 200 mCi of Iodine-131 (¹³¹I) is placed on a table in the laboratory, its dose rate at 1 centimeter distance would be 200x2.18 entgens and at 40 cm distance it would be ^200x2.18/_40x40= 0.273 roentgens/hour or 273 milliroentgen/hour (by Distance-inverse square law). A dose rate of 15 milliroentgen/hour is considered safe at 40 cm from the point source. So to attenuate the radiation we need to place a shield of lead around the Iodine-131 (¹³¹I) container. The attenuation factor for Iodine-131 (¹³¹I) could be calculates as ¹⁵/₂₇₃=¹/18 of its value; which means we need a little more than 4 half value layers of lead shield. Four half value layers for Iodine-131 (¹³¹I) would be 4x0.3=1.2 centimeter thick lead shield.

Side Effects of Radiotherapy or Overexposure to Radiation

The x-rays and radiation from the radioisotopes play a great role in diagnostic procedures and therapy, but the exposure exceeding certain limits do have side effects on our body as elaborated below:

1. Skin Reaction: The maximum permissible dose (MPD) for the skin is 100 rads. When a limited area of the skin receives a dose of a few times of MPD within a few days, that may result in the production of erythema and the reaction may stay for a week. A dose of about 1000 rads may cause tanning of skin and hair fall. A dose in the range of 2000 rads to 3000 rads may cause permanent tanning of skin and hair loss. There is possibility of atrophy of sweat glands and serious ulcers.


2. Radiation Sickness: Even a single exposure of 50 rads or more to the trunk or entire body may cause malaise, nausea, vomiting and diarrhea, collectively called radiation sickness. Some people may not be affected at this dose, however effect may be severe at a whole body exposure at 200 rads.


3. Effects on Blood: A single exposure of 25 to 30 rads to the whole body or to the major bones/bone marrow may result in mid to moderate leucopenia (low count of white blood cells in blood), but recovery is there. A dose of 200 to 500 rads to the spinal marrow may cause leukemia in some cases. Keep in mind that the radiations have accumulated effect.


4. Production of Cataract: Excessive exposure of eyes to radiations with an accumulated dose of 100 to 200 rads could impair our vision and cause cataract.


5. Production of Sterility: Even a shorter time exposure to the radiations around 500 rads to the genital organs may cause permanent sterility in either sex. A long term exposure to lesser dose of radiations may also lead to secondary infertility in either sex.


6. Exposure during Pregnancy: Although there are a number of cases receiving radiotherapy for pelvic cancer during pregnancy and delivering normal babies, but a pregnant woman receiving a very large dose of radiation in order of 1000 rads within a few weeks may have a miscarriage or still birth. The possible effect on the fetus may vary with the period of gestation. Congenital abnormalities may affect the babies so pregnancy should be avoided during radiotherapy of pelvic cancer.


7. Genetic Hazards: Irradiation of ovaries or testicles may lead to mutations in genes and affect reproduction. Greater is the exposure, the greater are the chances of genetic abnormalities.

Safe Handling of Radioisotopes

General health precautions while handling the radioisotopes or radiochemicals are must for all professionals associated with radioisotopes or radiochemicals. Regardless of the quantity of radioisotope or radiochemical, strict precautions and personal cleanliness awareness are indispensable. Some important tips in this regard are listed below:

1. Laboratory coat should be worn to protect the clothing.


2. Rubber or plastic gloves should be worn.


3. All handling of radioisotopes or radiochemicals should be done on the surfaces lined by absorbent material.


4. Dispensing of radiochemicals should be done over stainless steel, aluminium or plastic trays to contain any spillage.


5. Eating and smoking should be avoided in a hot laboratory (the laboratory where radioisotopes are used is called hot laboratory).


6. At the end of each procedure, the person responsible should cleanup his/her work space, dispose off any contaminated material in a suitable fashion.


7. If a spill occurs, that should be dealt with immediately and brought to the notice of Radiation Safety Officer.


8. The hot laboratory should be monitored periodically for unknown radiation from accidental spillage of radiochemicals.

Personal Monitoring of Radiation Professionals

All persons associated with commercial, diagnostic or therapeutic use of radioisotopes or radiochemicals, x-rays or other sources of radiation could be labeled as radiation professionals or radiation workers. Excessive exposure to radiation beyond the maximum permissible dose (MPD) for a person of a particular age may lead to serious healthy problems. The maximum permissible dose [MPD=(N-18)x5=?Rads; where N stands for the age in years] to the whole body, at any age is equal to 5 times of the number of years beyond 18 years. The MPD in consecutive three months should not exceed 3 rads. The accumulated MPD is also the MPD for the head and the trunk of a person associated with the handling and use of radiochemicals or radioisotopes or operating radiation equipments.

The dose received by any individual is ascertained by various types of monitoring procedures. The most commonly used are film badges and small ionization chambers. The film badges and small ionization chambers are supplied and monitored by many commercial firms.

Film Badges:

The film badge is a small packet of photographic film which is sensitive to radiation; or it may be containing two pieces of photographic films of different sensitivities. A part of these films is covered by one or more metal filters to resist the beta radiation and the other part is open to the beta radiation exposure. For x-rays a different type of film and filter is employed in the film badge. The film badge is worn by the person while handling the radiochemicals or operating radiation equipments. The darkening of the film of the film badge is related to the radiation dose received by a worker. Under the open window it gives the effect of beta radiation and under the filter the effect of gamma radiation or high energy x-rays.

Small Ionization Chambers:

The ionization chambers used for the personal monitoring are small instruments about the size and shape of a fountain pen. These are also called "pocket dosimeters". Before putting to use these are charged with electric pulse from a special charger. The charging transfers the electrical charge to the insulated wire inside the pocket dosimeter. The principle of the functioning of an ionization chamber or pocket dosimeter is that on exposure to the radiation the charge on the insulated wire inside it would decrease.

Brain Tumor and Treatment with Gamma Knife

Gamma rays (g-rays) are like high energy x-rays and can be focused with electromagnetic lenses like electron beam. Gamma knife is a new development in the field of Biomedical Engineering for the surgical interventions. Gamma knife in any way does not look like your kitchen knife, but it refers to a customized beam of gamma rays (g-rays). The conventional surgical procedures for the removal of a brain tumor may need a lot of expertise and experience for a neurosurgeon. The conventional neurosurgical procedures also need utmost precision while chopping of a brain tumor. The gamma knife has made it possible to retard the growth of a brain tumor through non-invasive procedure. The well focused gamma rays (g-rays) at the pre-investigated tumor site in the brain put a full stop on the metabolic activity of tumor cells. Though the technique is called gamma knife radio surgery; the brain tumor is not removed physically but dried and destroyed in situ. The patient needs not to be anaesthetized for gamma knife radio surgery and imaging. There are very few centers in the world equipped with the gamma knife radio surgery facility for the brain tumors.

Diagnostic and Therapeutic uses of Radioisotopes of Cobalt

Three radioisotopes of Cobalt used in medical practice are Cobalt-57 (⁵⁷Co), Cobalt-58 (⁵⁸Co), and Cobalt-60 (⁶⁰Co). Cobalt-60 (⁶⁰Co) has a half life of 5.27 years and it emits gamma rays (g-rays). Half life of Cobalt-57 (⁵⁷Co) is 270 days and that of Cobalt-58 (⁵⁸Co) is 71 days only. It is important to note that the radioisotopes with shorter half life are always good for diagnostic use whereas with longer half life are good for radiotherapy or radiation therapy. Cobalt-60 (⁶⁰Co) is a preferred source of radiation for radiotherapy at present; though earlier it was in dual use. Cobalt-57 (⁵⁷Co) and Cobalt-58 (⁵⁸Co) are preferred for diagnostic applications due to shorter half life.

Use of Cobalt-57 and Cobalt-58 in Diagnosis:

The most common use of Cobalt-57 (⁵⁷Co) or Cobalt-58 (⁵⁸Co) is in the diagnosis of pernicious anemia (fetal anemia caused by vitamin B-12 deficiency due to poor absorption of vitamin B-12 by small intestine due to intrinsic factor defect). Cyanocobalamin (vitamin B-12) and hydroxycobalamin labeled with ⁵⁷Co or ⁵⁸Co are commercially available for diagnostic use. The dose is 0.5 microCurie (mCi) to 2 microCurie (mCi). The administration is oral after 24 hours of fasting and the patient is not allowed to eat for 2 hours following the administration of vitamin B-12 labeled with radioisotope. The patient does not need hospitalization for this investigation. The excretion of radioactive is measured in the 24 hour urine specimen of the patient after the administration of radioactive labeled vitamin B12.

Use of Cobalt-60 in Therapy:

The gamma rays (g-rays) emitted by Cobalt-60 (⁶⁰Co) are like high energy x-rays. The radiotherapy or radiation therapy is helpful in some types of cancers. The patients are usually hospitalized for radiotherapy with Cobalt-60 (⁶⁰Co). The exposure time is worked out by the Radiation Physicist. Smaller radiation sources of Cobalt-60 (⁶⁰Co) are called seeds and needles, and are used for intra-cavity and intra-interstitial radiation therapy. The seeds or needles of Cobalt-60 (⁶⁰Co) are removed from the body cavities or interstitial tissue after the optimal time of exposure. The large sources of Cobalt-60 (⁶⁰Co) are used for 'teletherapy' or external radiation like high energy x-rays.

Therapeutic use of Phosphorus-32

Phosphorus-32 (³²P) is a radioactive isotope of phosphorus with mass number as 32. It has a half life of 14.3 days and emits beta-particles. In the chemical form of Sodium hydrogen phosphate, ³²P is used in the treatment of leukemia (a type of blood cancer) and polycythemia (abnormal high count of erythrocytes in blood due to a variety of causes). It is also used for relief from pain in the patients affected by metastatic cancer of bone and the patient needs not to be hospitalized for such treatment. The doses range from 1 mCi to 10 mCi. In the colloidal form the radioisotope is used in the body cavities in the same manner as Gold-198 (¹⁹⁸Au) and the patient may need hospitalization for such therapy.

Phosphorus-32 (³²P) could also used in the differential diagnosis of tumors of the eye. A dose of 500 microCurie (mCi) to 750 microCurie (mCi) needs to be administered intravenously and after an hour, two hours and 4 hours, the radioactive concentration is measured in the diseased eye and the normal eye. If the tumor is malignant, the involved eye would take up more ³²P. The investigation may be performed on an out patient basis taking all the aseptic precautions by an eye specialist. It is worth to remember that after 10 half lives (143 day) this radioactive would almost exhaust in its content of radioactivity.

Role of Gold-198 in Arresting the Growth of Cancer

The radioisotope of gold (Gold-198, ¹⁹⁸Au) has a Half Life of 2.7 days and its radiations are beta particles (b-particles) and gamma rays (g-rays). In the form of colloidal suspension ¹⁹⁸Au is used as the cancer therapy. The most common use of ¹⁹⁸Au is in the treatment of ascites (accumulation of fluid in the peritoneal cavity) and pleural effusion due to metastasis of cancer in the serous surface of cavities. Only the medical practitioners associated with nuclear medicine, administer such therapy. The dose for the treatment of pleural effusion is 25 - 75 mCi and for the treatment of ascites, the dose is 50 - 150 mCi. The patient needs to be hospitalized for the first few days during the course of treatment with the radioisotope.

What is the use of Iodine-131 in Medical Practice?

There are two main uses of Iodine-131 (¹³¹I) in medicine or medical practice.

1. Diagnostic application in some procedures


2. Therapy for thyroid disorders or thyroid cancer

The Iodine-131 (¹³¹I) has a radioactive half life of 8.1 days and its radiations are beta particles(b^- particles) and gamma rays (g-rays). This is most widely used radioisotope in the management of hyperthyroidism and thyroid cancer and thyroid function related diagnostic procedures. There are half a dozen investigations associates with the thyroid function which involve the oral or intravenous administration of a few microCuries (mCi) of ¹³¹I. Subsequent study of the patient, either by the direct measurement of ¹³¹I deposited in the thyroid gland through measurement of ¹³¹I excreted in the urine of the patient or by assessment of radioactivity in the blood samples drawn at different time intervals after the administration of ¹³¹I. The part of the ¹³¹I retained or excreted depends on the normal, hyperthyroid or hypothyroid conditions. The uptake or excretion of ¹³¹I exhibits a diagnostic parameter. After absorption of ¹³¹I by the thyroid gland the iodine is elaborated into the thyroid hormone which is discharged in the blood. The hyperactive gland produces too much hormone which would be detected in the blood samples taken at 24 to 96 hours after the administration of radioactive iodine (¹³¹I). The measurement of the iodine content is computed from the counts of radioactivity detected in the blood samples. The radioactivity is measured as gamma rays (g-rays) by a Geiger Muller counter or it may be measured as beta particles (b-particles) by a Scintillation counter at a 'Hot Laboratory'.

The therapeutic use of Iodine-131 (¹³¹I) could be culminated through optimal doses of this radioisotope with reference to the thyroid disorder and the age and weight of the patient. There are specialized clinics at the authorized medical centers having facilities for the Nuclear Medicine and associated research.

Units of Radiation Dose and Maximum Permissible Doses

The radiation energy from the radioisotope is absorbed by the living tissue of the patient subjected to the radiation therapy or radiotherapy. The traditional unit of radiation dose is called Rad and one Rad stand for 100 egrs of radiation energy absorbed per gram of the absorber tissue Therapeutic doses are usually measured in hundreds or thousands of Rads. In diagnostic procedures where it is desirable to keep the dose very low, the unit is millirad (mr). One millirad is the thousandths part of a Rad and only a few hundred millirads are permissible dose.

The radiation protection is an important precaution to avoid over exposure of a patient as well as the radiation worker. The radiation protection unit is called dose equivalent and its traditional unit is REM (Rad equivalent man).

• REM = Rad Equivalent Man


• REM = Rad x Relative Badge Effect


• REM = Rad x RBE

RBE depends upon the type of the radiation energy. RBE for x-rays, g-rays and b-particles is an energy up to 3 MeV (3 MeV = 1 Rad). RBE for positrons, neutrons and a-particles is 10 rem (REM). It is evident that positrons, neutrons and a-particles exert lesser side effects as compared to x-rays, g-rays and b-particles. The S.I. unit of radiation protection is Seivert(Sv).

• 1 Sv = 100 Rem


• 1 Sv = 1000 milliSeivert (mSv) = 100 Rem


• 10 mSv = 1 Rem

Maximum permissible dose (MPD) or maximum limit of per year exposure to radioactivity could be computed separately for the patients (general public) and radiation workers. As a rule anybody below the age of 18 years is never permitted to become a radiation worker. The permissible dose can be worked out by the following formula:

D = 5 (N-18); Here D=Dose in Rem, N= Age in years.

A radiation worker who joins the duty after acquiring the age of 18 years could have maximum exposure of 5 x (20-18) = 5 x 2 = 10 Rem only up till the completion of 20 years of age or 5 Rem per year exposure. General public or a patient could be exposed to radiation energy at a MPD of one tenth (¹/₁₀) of the dose for a radiation worker and that comes out to be 0.5 Rem per year (⁵/₁₀ Rem per year). Hands and feet could be exposed at a higher dose if desired but not more than 75 Rem/year or 40 Rem/3 months. Thyroid, Bone and skin could be exposed at 40 Rem/year and other organs at 15 Rem/year. The fetus should not be exposed to a radiation dose of more than 0.5 Rem.