September 2016-Health Spectrum

www.healthspectrum.orgSeptember 2016 Volume I Number 3 Price ` 75 Holistic Medicine in Organ Failure The dream of ORGAN TRANSPLANT for all should simultaneously explore to harvest the potential of simple, affordable, and highly reproducible model ofHealth SpectrHuomlistic Medicare : Dr. R. K Tuli

2 September 2016 Health Spectrum

September 2016, Volume 1, Number 3 Dr. Raju Vaishya Dr. (Prof.) Raju Vaishya is President of Arthritis Care Foundation &Editor: Vinod Kumar a Senior Orthopaedic & Joint Replacement Surgeon at IndraprasthaManaging Editor : Sushila Kumari Apollo Hospitals, New Delhi. He is also well known for hisEditorial Head : Aarti Kapoor academic contributions. (Page : 20-22)Editorial Advisors:Dr. Manoranjan Sahay Dr. P. K. TalwarDr. Pallavi Vaishya Dr. P. K. Talwar is a Senior Plastic and Cosmetic Surgeon & DirectorContent Team : of Cosmetic Laser Surgery Centre of India, Greater Kailash - I,New Delhi : Dr. Atul Kumar, Uday Kumar New Delhi. He was also associated with the Indraprastha ApolloManna, Adheesh Vats, Deba Prasad Sahoo Hospitals, New Delhi as a Senior Cosmetic Surgeon. (Page : 30-31)Mumbai : Sama Irani, IPS YadavLucknow : Choudhary Zia Imam Dr. Rahul GuptaRanchi : Aloka Dr. Rahul Gupta is a Senior Neuro and Spine Surgeon at FortisPatna : Arun Kumar Mayank Hospital, Noida. He worked in many government hospitalsSingapore : Deepa Tomar including PGIMS, Rohtak, PGIMER Chandigarh & G B PantKuwait :Vartika Hospital, New Delhi. (Page : 18-19)Bangkok : Dr.Alka GuptaArt Director : Kripa Shankar Dr. R. K. TuliDesign & Graphics : K A Choudhary Dr. Tuli is the founder of Society for Holistic AdvancementAdmin & Business : Satnam Singh of Medicine “SOHAM”. He established the world’s first-everWeb & Mobile : Athar Haque Department of Holistic Medicine in Indraprastha Apollo Hospitals,Editorial Office : 21, UNI Apartments, New Delhi in year 1996. (Page : 38-40)Sector-11, Vasundhara, Ghaziabad – 201012Tel : +91 120 4320050 Dr. Sunil MittalM: +91 9013074414, +91 9868793203 Dr. Mittal is a Consultant Psychiatrist with over 30 years of clinical,Delhi Office : 909-910, B-Wing, Naurang research and teaching experience. After working at the PGIMER,House, Opposite : Hindustan Times Chandigarh and the Lady Hardinge Medical College, New Delhi,Building, Kasturba Gandhi Marg, he established the Cosmos Institute of Mental Health & BehavioralNew Delhi-110001 Sciences (CIMBS). (Page : 30-32)Mumbai Office : 37/911, Adarsh Nagar,Worli, Mumbai- 400030 Dr. Murtaza kamalLucknow Office : 338, Prince Complex, Dr. Kamal is a practicing pediatrician at Safdarjung Hospital, NewHazaratganj, Lucknow -226001 delhi. Dr. Kamal is associated with many medical research journalsSingapore Office : 236, Westwood Avenue, including Elixir International Journal, USA and International5-42 SG 648363, Singapore Journal of Medical Pediatric and Oncology. (Page : 24-25)Email : [email protected] : www. healthspectrum.org Dr. Sonia MalikPrinted, Published and Owned by Dr Sonia Malik is an esteemed Obstetrician, Gynecologist andVinod Kumar IVF & Infertility Specialist. She is the Programme Director atPrinted at Subhashini Offset Printers, F-10, SOUTHEND FERTILITY & IVF. New Delhi. (Page : 35)Jagdish Nagar, Patel Nagar-III, Ghaziabad(U.P.) Dr. P. K. SinghalPublished at 21, UNI Apartments, Sector-11, Dr. P. K. Singhal is a Senior Pediatrician at Walia Nursing &Vasundhara, Ghaziabad – 201012 Maternity Home, Laxmi Nagar, New Delhi. He is also associatedEditor : Vinod Kumar with Indraprastha Apollo Hospitals, New Delhi. (Page : 44)RNI : UPENG/2016/68419 Dr. Blossom Kochhar Health Spectrum Dr. Kochhar is a veteran beautician, doctor and entrepreneur. She has been a stalwart in promoting a healthy and natural lifestyle in our country. She is the Founder and chairperson of the most popular skin care range- Aroma Magic. (Page :34-35) September 2016 3

September 2016Cover Story CIMBS Suicide Study v 55% people knew someone in their personal, social or pro- fessional circle who had lost their life to suicide v 61 % people knew some- 26 one in their personal, social or professional circle who had at- tempted suicide (but managed to survive) v 53% of respondents felt that they were personally impacted by such incidents of suicideHealth issue Happenings l National Injury Control Program on the anvil: Shri J P Nadda 8 l Delhi Cartilage Club launched for 9 promoting cartilage medicine l Traditional Knowledge Digital Library 9 l Cocoona Centre for Aesthetic 10 Transformation in Delhi  l Leprosy Case Detection Campaign  10 HEALTH STUDY/RESEARCH 12 12 l Birth Control Pills may have Reduced 13 the Deaths from Ovarian Cancer l Antibiotics Before Age 2 May Be Linked to Allergies Later l Exercise may help patients with lung diseaseDr. Murtaza Kamal 14 HEALTH BASICS l Targeted Therapy : Dr. Meenu Walia 13Newborn Screening : Do COVER STORYwe Indians really need it? l Is Enough Being done ? As India Emerges as a4 September 2016 Global Suicide Capital : Dr. Sunil Mittal 24 Health Spectrum

HEALTH ARTICLE Alternative Medicinel Touch Screen Smartphones And Tablets Can Holistic Medicine in Organ FailureCause Arthritis And Repetitive Stress Injuries 16 38BEAUTY CAREl Honymoon Essentials : Dr. Blossom Kochhar34l 7 Beauty Tips For Monsoon :Dr. Shuba Dharmana 36Alternative Medicinel Yoga Can Help Prevent Suicide 41l Sports Acupuncture Scores Points : Dr. Raman.Kapur42CHILD CAREl Choose The Right Activity For Your Kid : Health ArticleDr. P. K. Singhal 44 Sports Medi-Q&A cine : Sports Injuries andl Puberty In Girls : Dr, Sonia Malik 45 Arthritisl Vitamin D Deficiency : Dr. Pallavi Vaishya 47HEALTHY MOTHERHOODl Healthy Motherhood : Sex During Pregnancy 2046NUTRITION Dr. Raju Vaishyal Simple Ways To get Rid of Sugar : Dr. SachhiSohal  48 BACK PAIN Six Pack Surgery Dr. P. K. Talwar Back pain is ranked sec- ond to headaches as the 31 most frequent location of pain. Four out of five This is one of the specialty lipo- adults will experience at least suction procedures, where we one bout of back pain at some can create a nicely sculpted ab- time in their lives. It is almost domen, for the appropriate pa- next to common colds in the tient with liposuction, alone. list of common diseases. 18 Dr. Rahul GuptaHealth Spectrum September 2016 5

Editor SpeakInhumane treatments to patients : whathappened to the Hippocratic Oath ?ndia may be a land of diversities, but no doubt, India is a land of disparities. This is true in Health Sector too. On one side there are five star hospitals with ultra modern facilities for rich patients but on other side poor patients are dying because of simple illness which can be treated by ORS solution. In some I hospitals patients are given costly and luxurious treatment and facilities but in some hospitals they are being treated like animals. Some day back two incidents stirred the national consciousness. In one ofThose who are the country's poorest districts in Odisha, a man walked 10 km with his wife'sin providing body on his shoulder, his weeping 12-year-old daughter by his side. Dana Ma-health facilities, jhi had no vehicle to take home his wife's body after she died of tuberculosis ateither doctors or a government hospital in Kalahandi, about 60 km from his village. He pleaded for a vehicle, but he was denied. So he wrapped his 42-year-old wife Amang Dei's body in a sheet, hoisted it on his shoulder and began to walk home. Hisadministrators daughter walked by his side, holding a bag with their meagre belongings,and staffs of any weeping. It is also a shame for a nation that a person has to die not because ofhospital or health cancer, heart attack or failure of any vital organ but because of TB, a scourgecentre, have added being vainly tackled by us for decades. In another incident, a man lost his son on his shoulders as hospitals denied medical help in Kanpur. This man has to carry his ill son on his shoulders from hospital to hospital in Kanpur as theyresponsibility toprovide at mini-mum primaryhealth care but to show human denied providing “medical facilities” to his son.approach to their These incidents once again highlight poor medical care facilities and patients either apathy of hospitals in India. These incidents have created an outrage across poor or rich. the country. The incidents reprersent not only the poor medical care facilities in our country, but also the declining compassion for fellow humans among citizens of the country. But unfortunately, these events are no exception. Every day and every where similar incidents happen, some got media attention but most of the incidents are ignored. Health status of any country cannot be determined on the basis of facilities and treatments being provided to a few rich citizens but it is determined on the basis of facilities being provided to the poorest of the poor. And I am sorry to say, that on this basis our country fails to be called a healthy nation. However, in India there are general apathy towards persons in distress, be it in hospitals or on roads, which should be stopped if India wants to be called humane and civilized country. Those who are in providing health facilities, either doc- tors or administrators and staffs of any hospital or health centre, have added responsibility to provide at minimum primary health care but to show human approach to their patients either poor or rich. With thanks, Vinod Kumar6 September 2016 Health Spectrum

HEALTH STUDY/RESEARCHHealth Spectrum September 2016 7

HappeningsNational Injury Control Programon the anvil: Shri J P NaddaT he Health Ministry will soon come out with a Na- vehicle fleet. tional Injury Control Program to provide trauma Shri Nadda pointed out that some of the important rea- healthcare and save lives of the lakhs of persons lostin accidents and to injury. This was announced by Shri J sons of increased mortality in developing countries like In-PNadda, Union Minister for Health and Family Welfare on dia that included: non-availability of trauma systems whichthe inauguration of the third World Trauma Congress on include care from the injury site till rehabilitation; pre-hos-18th August, in New Delhi. Dr. Mahesh Sharma, Minister of pital care is absent in many states, and in some states veryState, Tourism and Culture was also present, primitive without the state of the art ambulances, trained manpower and proper organization in a definite geographi- Addressing the Congress and highlighting the need for cal area; in-hospital trauma care infrastructure presentlysuch a national program, Shri Nadda pointed out that road cannot cater to the needs of ‘multiply injured patients’ duetraffic injuries are among the three leading causes of death to lack of trained manpower and resources; Emergencyfor people between 5 and 44 years of age. Unless immediate Medical Services (EMS) Legislation is not uniformly adapt-and effective action is taken, road traffic injuries are predict- ed; only state of Gujarat has enacted it; lack of authentic dataed to become the 5th leading cause of death in the world, and trauma related research; and non-existent or few reha-resulting in an estimated 24 lakh deaths each year, he stat- bilitation facilities. He also urged for more convergence withed. He noted that road injuries and deaths cause a colossal Ministries such as Road Transport and Highways (MoRTH)economic cost of up to 1.5% of the Gross National Product and other related stakeholders.(GNP) in the low- and middle-income countries. The figurefor India is close to 3% GDP.As per the latest statistic, in In- The congress is being organized by the ‘J P N Apex Trau-dia 52 persons died every hour in various accidents in 2014, ma Centre’, AIIMS New Delhi and co-hosted by the Indianthe major causes of accidental deaths in India are “Traffic Society for Trauma, Acute Care (ISTAC) and the Worldaccident, “Drowning”, “Poisoning” and “Accidental fire”. In- Coalition for Trauma Care (WCTC) with objectives to ex-dia has the highest Road crash mortality in the world. change ideas, experiences and lessons learned about the role of internationally accepted systems and protocols in the As per the statistics quoted in the report of the action field of trauma care, mass causality incidents, and disasters.for road safety, each year nearly 16 lakh people die glob-ally as a result of a road traffic collision— more than 3000 Also present at the Congress were Shri C K Mishra, Sec-deaths each day—and more than half of these people are not retary (HFW), Prof. M C Misra, Congress President, WTCtravelling in a car. About 2 to 5 crore more people sustain 2016, Prof. Raul Coimbra, Founder President and Chief Ex-non-fatal injuries from a collision, and these injuries are ecutive-World Coalition for Trauma Care, Dr Ronald Stew-an important cause of disability worldwide. Ninety percent art, Chairperson American College of Surgeon-Committeeof road traffic deaths occur in low- and middle-income on Trauma, Dr Etienne Krug, Director, Deptt. for manage-countries, which claim less than half the world's registered ment of NCD, Disability, Violence and injury prevention, WHO Geneva. n 8 September 2016 Health Spectrum

HappeningsDelhi Cartilage Club launchedfor promoting cartilage medicineDelhi Cartilage Club (DCC), the first of its kind in In- dia, launched in National Capital with the objective of promoting cartilage repair treatment and regen-erative medicine.With a motto to “restore the cartilage and preserve ajoint’’, DCC, was launched on 8th August in presence ofmore than 100 joints and cartilage experts including Prof. AA Shetty, a leading cartilage scientist from the United King-dom, Dr Deepak Goyal, President of Indian Cartilage Socie-ty (ICS) and Dr. Raju Vaishya, Joint Replacement Surgeon at Prof. Shetty delivering keynote address, said. “Injury toIndraprastha Apollo Hospital. The pioneering club will work the cartilage is quite troublesome. “Once an injury occursas a subsidiary of Indian Cartilage Society (ICS). to the cartilage, it is seldom repaired.” He noted, “Cartilage defects have a tendency to progress, leading to symptomatic On this occasion, Dr. Vaishya said that there are many Osteoarthritis (OA) and ultimately resulting in the require-barriers to the routine use of these useful cartilage restora- ment of a joint replacement. Hence, interventions aimed attion techniques due to lack of clear guidelines and under- repairing and restoring the cartilage is needed, especially instanding of the administrators, insurance companies and younger individuals. In the last two decades, there has beenapproving authorities from the government side. He urged a flurry of interest in cartilage research. Many techniquesthe union government to remove these barriers for benefits are now being used for cartilage repair, including cartilageof patients. transplantation, either as a two-stage or a single-stage pro- cedure.” Dr. Vaishya, Co-ordinator of Delhi Cartilage Club said,“DCC will launch various activities in Delhi to make people Dr Goyal said, “Due to increasing knowledge and prom-aware about the concept of joint preservation. Through the ising results, cartilage repair treatment is now moving outactivities of the club, we hope to create awareness amongst of the realm of super specialists to the more widespread or-the doctors about the latest scientific techniques in the field thopaedic community. Both the doctors and the patients areof cartilage restoration and regeneration. I strongly feel that now looking out for the so-called ‘biologic treatment’ option‘Regenerative Medicine’ will win over ‘Reconstructive Medi- for joint injury and disease.” ncine’ in times to come.”Traditional Knowledge Digital LibraryT he Ministry of AYUSH had established Traditional Knowledge Digital Library (TKDL) in collaboration (IPOs), International Access Agreements on TKDL have with Council for Scientific & Industrial Research been concluded with United States Patent & Trademark Of- fice, European Patent Office, Canada Patent Office, Germany(CSIR). As per the information provided by the CSIR, TKDL Patent Office, Japan Patent Office, United Kingdom Patentconsisting of more than 2.90 lakh medicinal formulations of Office, Australia Patent Office, Malaysia Patent Office, ChileAyurveda, Unani and Siddha which are available in the pub- Patent Office and Indian Patent Office.lic domain, in five international languages namely English, Apart from bio-piracy, to prevent misappropriationJapanese, French, German and Spanish. To facilitate the pro- of Yoga, Ministry of AYUSH through Sangeet Natak Aka-tection of country’s traditional knowledge, access of TKDL demi (the nodal organization of Ministry of Culture) hashas been provided to International Patent offices (IPOs) un- filed nomination of Yoga at UNESCO to include Yoga inder International Agreement. In addition, pre-grant opposi- the representative list of the Intangible Cultural Heritage oftion on patent applications along with prior art evidences Humanity. Indian Patent Office had also brought out Guide-from TKDL are submitted on a regular basis. lines for processing Patent Applications relating to Tradi-As per the information provided by the CSIR, the imple- tional Knowledge and Biological Material to help Patent ex-menting agency of the TKDL project, the total cost incurred aminer to analyze what constitute novelty and inventive stepon the project is Rs. 20 Crores approximately. in Traditional Knowledge (TK) related invention.As per the information received from CSIR, till date This information was given by the Minister of State (In-TKDL has been successful in preventing the grant of wrong dependent Charge) for AYUSH, Shri ShripadYessoNaik inpatents in 220 cases. For further facilitating the prevention written reply to a question in Lok Sabha in 12nd August. nof grant of wrong patents at International Patent OfficesHealth Spectrum September 2016 9

HappeningsCocoona Centre for Aesthetic Transformation in DelhiC ocoona Centre for Aesthetic Mazen Arafeh, Medical Director and han, Medical Director and Consult- Transformation announced its Specialist Plastic Surgeon; Dr Cres- ant Plastic Surgeon, Dr Reema Arora,plans for India, at the launch of its cenzo D'Onofrio, Specialist Plastic Cosmetologist; Dr Jangid B.L.L, Spe-Delhi centre. The Dubai-based aes- Surgeon and; Dr Anna Maria Nadols- cialist Dermatologist, and a few otherthetic and cosmetic clinic is adopting ka, Cosmetologist. The Delhi team for visiting doctors. na two-pronged approach: it will estab- the centre comprises Dr Sapna Mo-lish plastic and cosmetic surgery cen-tres in key metropolitan cities such asMumbai; parallel to this it will openexclusive hair-transplant clinics intier II and III cities, such as Nagpur,Meerut, and Chandigarh, this finan-cial year. Along with the various dignitariespresent at the event, a large medicalteam from Cocoona, Dubai was herefor the event. Actress Gauahar Khan,Dr Sanjay Parashar, Consultant Plasticand Aesthetic Surgeon and founder ofCocoona Centre for Aesthetic Trans-formation, Dr Sapna V Roshni, Medi-cal Director of the Delhi Centre, DrLeprosy Case Detection CampaignM inistry of Health and Family Welfare has launched the biggest Leprosy Case Detec- of the campaign is the early detection of leprosy in affected tion Campaign (LCDC) in the country on persons so that they can be saved from physical disability5th September 2016 across 149 districts of 19 states/ and deformity by providing them timely treatment and thusUTs. This fortnight-long campaign will cover 1656 also halting the transmission of disease at the communityblocks/urban areas of these districts and screen a to- level.tal of 32 crore people for leprosy. For this purpose,297604 teams comprising of one lady ASHA worker The first LCDC was launched during March-Apriland one male volunteer each would visit every house in 2016 in 50 districts of 7 states namely Bihar, Chhattisgarh,their allotted area and screen all the family members Jharkhand, Madhya Pradesh, Maharashtra, Odisha and Ut-for leprosy. tar Pradesh wherein a population of about 6.8 crores was covered. During this campaign 65427 suspected cases were The states and UTs covered in this campaign are identified out of which 4120 were later confirmed . nAndhra Pradesh, Assam, Bihar, Chhattisgarh, Gujarat,Haryana, Jharkhand, Karnataka, Maharashtra, Naga-land, Odisha, Tamil Nadu, Uttar Pradesh, Uttarakhand,West Bengal, Chandigarh, Dadra & Nagar Haveli, Del-hi and Lakshadweep. The districts having a prevalence rateof more than one case per 10,000 population in any of thelast three years have been included in this campaign. The Leprosy Case Detection Campaign is a unique initi-ative of its kind in the world where each and every memberof the targeted population will be examined by the searchteam constituted of one male and one female volunteer athousehold level. House to house visits will be done by thesearch team as per the micro plan prepared for the local areato detect hidden and undetected leprosy cases. The objective10 September 2016 Health Spectrum

In The NewsHealth Spectrum September 2016 11

HEALTH STUDY/RESEARCHBirth Control Pills may have Reducedthe Deaths from Ovarian CancerAnew study published in the An- nals of Oncology found that in Still, this new study notes that ovar- in the U.S. and 10 percent in the E.U. the U.S. and Europe, deaths due ian cancer rates dropped most drasti- They cite the continued use of oralto ovarian cancer have dropped signifi- cally in nations where oral contracep- contraceptives, better detection andcantly. Between 2002 and 2012, they tives were introduced earliest. The treatment for women who have ovar-declined by 16 percent in the U.S. and decline was also most drastic among ian cancer, and declines in menopau-10 percent in countries that are part of women between 20 and 40 years old, sal hormone use as evidence for thisthe European Union. Drops were also and these ladies are more likely to be prediction. Only time will tell whetherseen in various other parts of the world, taking oral contraceptives than women they're right, but the positive outlook isbut to a lesser degree. The researchers over 40. promising.stated that the main reason for the im-provement is the use of a medication The researchers also took a stab at Ovarian cancer is often referred toyou may be quite familiar with oral predicting how the death rate will con- as a \"silent killer,\" since its symptomscontraceptives. Numerous studies have tinue to decline by 2020, which they aren't initially alarming and often don'tshown that the Pill may lower the risk believe will drop further by 15 percent even become noticeable until the dis-of ovarian cancer, including one in the ease is very advanced. Unlike breastEuropean Journal of Cancer. Research- cancer and cervical cancer, which haveers aren't completely sure how the Pill standardized screening procedures,helps prevent ovarian cancer yet, but there's no reliable screening proto-it's thought to be linked to the hor- col at the moment for ovarian cancer,mone progestin. A 1998 study suggest- and even a pap smear won't check fored that progestin may trigger damaged it. The main ways you can be vigilantovarian cells to die before they become about prevention and detection arecancerous, but more research is needed committing to a healthy lifestyle andto confirm this and so far, there's been being informed about common symp-no real progress. toms like prolonged bloating, needing to pee more frequently, and discomfort in the pelvic area. nAntibiotics Before Age 2 May eczema and a 15 percent to 56 percent increased risk of hay fever later in life,Be Linked to Allergies Later the study review found.T aking antibiotics at a very young age could increase the the first two years of life was associ- Risk for both conditions was risk of certain allergies later in ated with a 15 percent to 41 percent higher among those who receivedlife, new research suggests. increased risk of the skin condition two courses of antibiotics than among those who received one course of anti- \"Early life exposure to antibiotics biotics, according to the study.is related to an increased risk of botheczema and hay fever later in life,\" said While the study doesn't prove aFariba Ahmadizar of Utrecht Univer- cause-and-effect relationship, it's pos-sity in the Netherlands and colleagues. sible that antibiotics disrupt microor- ganisms in the gut, leading to reduced The researchers analyzed dozens immune response, the researchersof studies published between 1996 and said.2015 that included hundreds of thou-sands of people. The findings were to be presented Tuesday at a meeting of the European Treatment with antibiotics within Respiratory Society in London. Re- search presented at meetings is usually12 September 2016 considered preliminary until peer-re- viewed in a medical journal. n Health Spectrum

HEALTH STUDY/RESEARCHExercise may help patients with lung diseaseI ncreased physical activity among the general population, the study said. cance since mental disorders are com- patients with a type of lung dis- But, the results suggested that in pa- mon in patients with COPD,” Puhan ease could reduce their risk of tients with COPD, higher levels of added Physical activity promotionanxiety as well as depression, a study physical activity could lessen the risk programs could be considered to low-has found. Chronic obstructive pul- of developing anxiety by 11 per cent er the burden of mental disorders inmonary disease (COPD) is a group of and that of depression by 15 per cent. COPD patients, the researchers sug-lung diseases that block airflow and gested. Conversely, low physical ac-make it difficult to breathe. “In COPD patients, those with tivity could increase the risk of other high physical activity are less likely highly prevalent health conditions The prevalence of depression and to develop depression or anxiety over such as cardiovascular, neurological,anxiety is approximately 40 per cent in time,” said Milo Puhan from Univer- hormonal, musculoskeletal, cancer,COPD patients while the correspond- sity of Zurich, Switzerland and infectious diseases in patientsing figure is less than 10 per cent in with COPD. “The study has particular signifi- For the study, the team included 409 patients from primary care prac- tice in the Netherlands and Switzer- land. The researchers assessed physical activity using the Longitudinal Ageing Study Amsterdam Physical Activ- ity Questionnaire at baseline and fol- lowed patients for up to five years. The study was presented at 2016 European Respiratory Society (ERS) InternationalCongress in London, re- cently. nhEALTH bASICS interfering with specifictargeted molecules needed for carcinogenesis and tumour growth, rather than by simplyTargeted Therapy interfering with all rapidly dividing.T argeted therapy which is different from traditional Many target therapies have been approved in cancer chemotherapy is a cancer treat- treatments. But this doesn’t work same way as normal ment that uses drugs. The drugs chemotherapy treatment. known as targeted therapy help stop cancer from growing and spreading. Also using a drug that works on spe- They work by targeting specific genes cific cancer may seem simple but at the or proteins. The genes and proteins are same time it is a very complicated one found in cancer cells or in cells related and is not always effective. The following to cancer growth, like blood vessel cells. has to be kept in mind before going for the same. The drugs that are used are like v A targeted treatment will not work if Avastin, Herceptin and Erbitux. These the tumor does not have thetarget. drugs are used in treatments that in- v Having the target does not mean the clude surgery and radio therapy apart tumor will respond to the drug. from treating cancerous cells. These therapies include hormone therapy, signal transduction For Eg. These are usually different inhibitors, gene expression modulators, apoptosis in- from traditional chemotherapy effects. ducer, angiogenesis inhibitors, and immunotherapy and For example, patients getting targeted therapy often de- toxin delivery inhibitor. velop skin, hair, nail, or eye problems. n The Writer is Dr. Meenu Walia the first DNB Medical Targeted therapy blocks the growth of cancer cells by Oncologist of India and is the Director of Max Oncology Centre at the Max Hospital ( Patpargan)j in New Delhi.Health Spectrum September 2016 13

Health Issue Newborn Screening DreoalwlyenIeneddiaint?s Dr Murtaza Kamal T he emerging preventive adrenal hyperplasia (17-OHP levels), Senior Resident public health programme- Glucose 6 phosphate dehydrogenase “Neonatal screening,” is still deficiency, galactosemia, cystic fibro-Department of Pediatrics and Child in the neonatal stage of its sis etc. Currently in our country there Health development. It is a programme in is no government funded programme which the neonates are screened for for the same. Is screening of the masses VMMC & Safdarjung Hospital the diseases which might have their helpful for a country like ours where a New Delhi-110025 presentation clinically later in the life. lot of the children are undernourished The common diseases which are gen- and below poverty line? Email: [email protected] erally screened include congenital hy- pothyroidism (TSH levels), congenital A survey conducted recently in14 September 2016 Bangalore which included doctors( Health Spectrum

Health Issueobstetricians, paediatricians and neo- ciency is common among Punjabis of prick) are generally collected fornatologists), nurses and general public north India whereas congenital adre- screening on a filter paper and ana-showed that approximately two-thirds nal hyperplasia is seen mainly in the lysed by TMS (Tandem Mass Spec-of the doctors, 95% of the nurses and southern part of our country. Consan- trophotometry). These filter papersas high as 99% of the general public guinity also is a factor in some of these should not be touched by anyone aswere unaware of the neonatal screen- diseases and hence those diseases need even the sweat can alter the results. Ifing. It was even found that though to be screened in those communities. the screening tests come out to be pos-the awareness among the public was itive then they need to be confirmedlow, they were not ever eager to know It is also important to see which without delay as the treatment needsabout it, maybe because there doctors method has been used for screening to be started.didn’t tell them about these at the time and the timing at which screeningof discharge. Hence, there is a need has been done as the results vary with Follow up of the babies who haveto create awareness both among the these parameters too. There should been diagnosed with these diseasesmedical professionals and the public. be standard protocols for the further holds very important place in our confirmation and management of the country where the majority of the Recently Indian council of medical disease if they turn out to be positive population is lost to follow up. Doc-research (ICMR) conducted a project in the screening tests. tors who are specially trained in genet-at 4 centres of the country to see if the ics need to council the parents aboutprogramme is feasible to be imple- The samples (blood from heel-mented in our country. On the other the disease, its treatment, its long termhand a lot of private centres in metro sequale and the importance of followcities are offering the screening tests at up.around 5,000-6,000 rupees. This givesthe rich and affording people an upper So, a public-private partnership ishand over those who can’t afford. the need of the hour to this issue as none is in a position presently to han- The people need to be taught about dle the situation alone. nthe implications of these metabolicdiseases, the need of retesting, con- Dr. Murtaza Kamal is a practicingfirmatory testing and the treatment pediatrician at Safdarjung Hospital,available. We don’t have the treatment New delhi. Dr. Kamal is associated withavailable presently for all these diseas- a number of medical research journalses and hence a battery of tests to di- including Elixir International Journal,agnose those with no treatment avail- USA, International Journal of Medicalable will add worry and tension to the Pediatric and Oncology, Indian Jour-minds of parents and caretakers only. nal of Case Reports & Yuva Journal of Medical Sciences. These screening programmes can-not include universal tests for the dis-eases. In a huge country like ours thediseases vary according to the regionsand cultural practices very much. Glu-cose 6 phosphate dehydrogenase defi-Health Spectrum September 2016 15

Health Article Touch Screen Smartphones And Tablets Can Cause Arthritis And Repetitive Stress Injuries Excessive use of touchscreen Smartphones and tablets can lead to wrist and finger joint pain, arthritis and stress-related inju- ries of your hands, arms and back, warn orthopaedic experts Dr. Gaurav Bhargava T hose who indulgeds in too years in the number of people com- M.S.(Ortho) Director much gamming and texting on plaining of aches and pains in their Bhargava Medical & Trauma Centre touchscreen smart phones and fingers, thumbs and hands. This pain 30 E, O Block, Kidwai Nagar, tablets can suffer from wrist and fin- and stiffness may be the result of a Re- ger joint pain and some time crippling petitive Stress Injury (RSI). RSI’s oc- Kanpur-208023 arthritis of fingers. Longer duration of cur when the same motion is repeated www.bmtckanpur.com gamming and texting can cause wrist over and over again, for a long period and finger joint pain.In the age group of time, causing inflammation in the16 September 2016 of young children, longer use of gam- ligaments and tendons of joints ing devices is associated with more pain. Now a days you can spot people using tablets and smartphones in dan- As constant use of touchscreen gerous ways, whether it's texting be- phone, smart phone and tablets has hind the wheel or strolling with their led to an increase over the past few eyes on the screen. Health Spectrum

Health Article Arthritis Repetitive Stress Injury to bend your neck forward or back- should use a keyboard on a laptopare common touchscreen related ill- ward, and especially avoid turning or desktop PC) - though the factnesses. your head or tilting it to one side or the screen is positioned at or near another for prolonged periods. Take lap level means you're likely to bend Repetitive Stress Injuries can re- frequent breaks, and if you feel any your neck, which is problematic forsult from recurrent large or small pain, numbness, or tingling, stop your posture.movements that affect joints, mus- what you're doing immediately andcles, tendons, and nerves. For ex- find a more comfortable position. \"Touch surfaces don't want toample, people who frequently use be vertical.\" The more perpendicu-their thumbs to type text messages Tablets function vertically, hori- lar the screen, the more you have toon cellphones sometimes develop de zontally, and anywhere in between. bend your wrist to type, a postureQuervain syndrome, a painful afflic- Horizontal use is typically less stress- that anatomists call \"dorsiflexion.\"tion that involves the tendons that ful, especially when the tablet is That puts more pressure on the me-move the thumb. Although the caus- in a comfortable position for your dian nerve and the other structuresal link isn't as well established as in arms and hands (similar to how you in the carpal tunnel in the wrist.patients who suffer from pain fromprolonged desktop keyboard use, Vertically oriented Vertically oriented touchscreenthere's little doubt that overzealous touchscreen monitors monitors require you to reach for-texting can cause debilitating pain. require you to reach ward and lift your arm against grav- forward and lift your ity, which tires your muscles rapidly. Most people use touch screen in arm against gravity, That also happens to some extentunnatural and wrong postures. Stress which tires your mus- when you use a mouse or trackpadreleated injuries can also occur when cles rapidly. That also while sitting too far away from yourpeople use their bodies in ways that happens to some extent desk, but the fix is easy: Move closer.induce physical stress, such as tilting when you use a mousetheir hands too far inward or out- or trackpad while sit- If both horizontal and verticalward while tapping or putting force ting too far away from positions are problematic, what angleon their wrists while typing. Carpal your desk, but the fix is is acceptable? Unlike desktop com-tunnel syndrome, perhaps the best- puter setups, where there are well-known disease in this category, re- easy: Move closer. established guidelines based on sci-sults from pressure on the median entific research, recommendationsnerve in the wrist. for people who use touchscreens are scarce and sometimes contradic- Your neck and the cervical spine tory because they depend on the taskthat supports it are highly susceptible you're doing. For reading, it's best toto poor posture, which can compress place the device so that you can seeor stretch on the nerves that exit the the entire screen clearly. Generally,spinal cord. Resist the temptation that means a steep angle close to per- pendicular to your line of sight -- in other words, like that of a standard monitor. But for typing and tapping, shallow angles (about 30 degrees) are best. Avoiding injuries from typing and tapping. The position of your wrist also affects the likelihood of injury from performing multitouch gestures on touchscreens. The more you dorsiflex your wrist, the greater the chance of injury. But, he adds, most gestures don't require too much force, so you're usually safe as long as you don't bend your wrist excessively or repeat gestures too rapidly. n Dr. Gaurav Bhargava is the Director of Bhargava Medical & Trauma Centre, Kanpur.Health Spectrum September 2016 17

Health ArticleWhat is causing my Back Pain 75 to 85 % of all people will experience some form of back pain during their lifetime SeniorDNre.uRraoh&ulSGpiunpetsaurgeon Fortis hospital Noida Email : [email protected] Back pain can affect people of any age, it is significantly more common among adults aged between 35 and 55 years. Experts say that back pain is associated with the way our bones, muscles and ligaments in our backs work together. Back pain is pain anywhere in the back that usually originates from the muscles, joints, nerves, bones or other areas in the spine. Back pain can present in the back and legs and can be associated with other factors like depression, stress/anxiety. Do you have any of the follow- ing forms of back pain?Back pain is ranked second to headaches as the most frequent v Acute sudden onsetlocation of pain. Four out of five adults will experience at least v Chronic long term, dull, achingone bout of back pain at some time in their lives. It is almost v Dullness aching, deep sensationnext to common colds in the list of common diseases. v Sharp piercing, hot or coldBack pain may be sudden and sharp or it may be dull and if per- v Constant never endingsistent for more than a week it might result in tension, soreness v Intermittent periods of relief, followed byor stiffness of back muscles. Pain may aggravate with slightest of pain onsetmovement or even with coughing and sneezing. It may also be v Isolated one general areaaccompanied with numbness and tingling in the arms or legs. v Radiating spreads out18 September 2016 Health Spectrum

Health Article Common Spinal Con- instructs patients about good postures height and relieve pain caused by os-ditions and strength and conditioning exer- teoperatic spinal fractures. A small cises. balloon is inflated in the fractured ver-v Herniated Disc tebral body to create a void and bonev Osteoporosis Epidural Steroid Injections cement is injected into the void.v Spondylolisthesisv Stenosis An epidural spinal injection in- Disc Replacement (Arthroplas-v Spinal Fractures volves delivering anti-inflammatory ty)v Spinal Trauma medication directly into the areav Spinal Tumors around the irritated spinal nerves that The surgeon will replace a diseasedv Degenerative Disc Disease (DDD) are causing the pain. or degenerated disc with an artificialv Radiculopathy one to maintain the normal mobilityv Scoliosis Surgical Options of the spine and lessen pain. Not very popular for lower back. n Decompression How is Back Pain Com- Dr. Rahul Gupta is the man be-monly Diagnosed? In this procedure, the surgeon will hind the department of Brain and remove the offending bony fragments spine surgeon at Fortis Hospital, X-Rays Powerful invisible rays or disc material causing your symp- Noida. He was trained at Nagoya toms. Japan, which has made him anthat make it possible to see inside expert in Endovascular proce-things such as the human body, par- Spinal Fusion dures.ticularly the bones. He worked in many government The surgeon will decompress your hospitals including PGIMS, CT Scan Computer-processed spine and unite two bony segments. Rohtak, PGIMER Chandigarh & He may use metal rods and screws to Govind Ballabh Pant institute ofX-rays to produce cross sectional im- stabilize the spine until the fusion can Postgraduate Medical Educationages or ‘slices’ of the body used to visu- occur. & Research, New Delhi.alize bones and soft tissue. Dr. Rahul Gupta has performed Minimal Access Spinal Tech- surgeries on hundreds of patients MRI An imaging technique that nologies (MAST) with head and spine injury. He has treated numerous complexuses magnetic fields and radio waves Compared to standard spine pro- spine ailments like metastaticto show internal structures of the body cedures, MAST surgeries are done tumors, osteoporotic fracturesincluding tissues and nerves. through very small incision thereby (vertebroplasty), degenerative reducing the amount of muscle dam- diseases and isthesis. Myelogram A radiographic dye age, blood loss and hospital stay. September 2016 19injected into the spinal canal to help Balloon Kyphoplasty /verte-show if the vertebrae are pinching the broplastyspinal cord. This is a minimally invasive spinal Bone Scan A radioactive tracer procedure used to restore vertebralis injected into the patient. The patientis then scanned to look for certain ab-normalities in bone. Treatment Options Non-Surgical Options Most people who have back paincan visit their family practitioner orinternal medicine physician, who’dadvise conservative care for the pa-tient. Conservative care is treatmentdesigned to avoid medical or operativetreatments. Examples of conservativetreatments for back pain are injec-tions, exercise and physiotherapy. Ifconservative care does not work, thepatient should be reffered to a spinespecialist.Exercise and Physiotherapy At a physiotherapy session, a phys-iotherapist educates patients aboutbasic anatomy and physiology andHealth Spectrum

Health Article Sports Medicine Sports Injuries and Arthritis People of all ages are increasingly Dr. (Prof) RAJU VAISHYA participating in sporting ac- ing surface is no longer intact, pain, swell- President, Arthritis Care tivities. This is a healthy trend, ing and stiffness may result. This is what is Foundation & as sports are well known to be referred to as arthritis. helpful for cardiopulmonary fitness and Sr. Consultant Orthopaedic weight-control. However, with the ben- Arthritis is usually seen in older peo- & Joint Replacement Surgeon efits does come some risk, namely sports ple, but is also seen in younger people Indraprastha Apollo Hospi- injuries. Most sports injuries are mild and who either have a less common form of temporary, with no long-term effects. Mi- the disease or have suffered an injury. tals, New Delhi nor sprains and bruises or overuse inju- The most common form is osteoarthritis, ries treated properly may be nuisances but also referred to as degenerative arthri-20 September 2016 do not necessarily cause any permanent tis. It usually occurs naturally, without problems. Some injuries, however, may any specific prior injury, in older people. lead to arthritis later in life. However, this form of arthritis is also the type seen after injury. In this case, it may Millions of people are affected by ar- be referred to as post-traumatic osteoar- thritis, a potentially painful and debili- thritis, or wear-and-tear arthritis. What- tating condition. Arthritis is the result of ever the name, the result is the same – a disease or damage to articular cartilage, painful, swollen, stiff, and sometimes en- the white glistening surface of our bones larged or deformed joint. It can be mild in found in the joints. Articular cartilage is some people, offering only an occasional found in all major joints of the body, in- reminder of an old sports injury, or it can cluding the hips, knees, and shoulders, as be severe, causing daily suffering and de- well as the smaller joints of the upper and grees of disability. lower extremities and even the spine and pelvis. When this normally smooth glid- It is important to understand the types of injury that can go on to cause arthritis in later life. The types of inju- Health Spectrum

Health Articleries that lead to arthritis include directinjury to the cartilage (as in fracturedjoints) or injuries that alter joint me-chanics, increasing the stress on thearticular surface. The first type is lesscommon in sports, more often seen inmotor vehicle accidents or falls from agreat height. In these instances, severebruising of the cartilage surface maylead to permanent injury and eventualarthritis. It may also occur from a frac-ture of the bone through the cartilagein the joint. In these cases the jointmay heal with irregularity causing thecartilage to wear unevenly and eventu-ally erode, resulting in arthritis. A keyfactor is that, while cartilage is a livingtissue and does respond to injury, itsreparative capacity is limited, and anysignificant damage usually results in apermanent alteration. The more common way a sportsinjury leads to arthritis is when a liga-ment or supporting structure is dam-aged, causing abnormal mechanics Arthritis is torn cartilage. in the joint. This greatly increases the an athlete injures the ACL trying to The menisci are a different stress on the articular surface, which pivot. The result of a torn ACL is gener- form of cartilage found in over time, wears out and causes ar- ally an unstable knee, one that buckles the knee. They are roughly thritis. One of the most known exam- occasionally, especially with strenuous semicircular wedges, two in ples of this type of this injury is in the activities or further participation in each knee, that function to knee. With the increased attention of sports. This instability abuses the knee, cushion the joint, absorbing media to the injuries sustained by star and over time, the articular surfaces a great deal of stress, and athletes, most people have heard of an are damaged by the abnormal stresses. also more evenly distributes ACL injury. ACL stands for anterior Once again, the result is eventual ar- cruciate ligament, one of the major sta- thritis, although the timetable ranges stress across the joint. bilizers of the knee. The ACL is in the from a short time to many years. center of the joint and keeps the tibiaHealth Spectrum (lower leg bone) from moving forward Another knee injury that results on the femur (thigh bone). Commonly in arthritis is torn cartilage. The me- nisci are a different form of cartilage found in the knee. They are roughly semicircular wedges, two in each knee, that function to cushion the joint, ab- sorbing a great deal of stress, and also more evenly distributes stress across the joint. A torn meniscus alone can be painful and cause swelling and stiff- ness, leading a patient to seek early sur- gical treatment. Historically, the entire torn meniscus was removed. We now know that, while this treatment relieves the acute pain and swelling, it eventu- ally predisposes the patient to prema- ture arthritis due to the absence of the protective effects of the menisci. Cur- rently, attempts are made to repair a September 2016 21

Health Articletorn meniscus to remove only the torn mechanics and thereby hopefully pre- placement can be performed. Unfor-part, leaving as much healthy meniscus venting arthritis. tunately, there is no cure for arthritis,as possible. Despite these efforts, an in- and that is why prevention is the bestjured meniscus may still lead to earlier If arthritis does result, there are treatment. narthritis. also many ways to treat the symptoms. The first is activity modification. Occa- Dr. (Prof.) Raju Vaishya , a surgeon The next issue is treatment of ar- sionally, orthotics or braces may help. of international repute, is best knownthritis due to sports injuries. As is true Medications such as acetaminophen for his swift surgical skills in the fieldin most cases, the best treatment is pre- (Tylenol) or anti-inflammatory medi- of Orthopedic & Joint Replacement. Hevention of the injuries. There are a few cines such as ibuprofen may offer relief. has been working at Indraprastha Apol-different methods to prevent sports in- Physical therapy, including exercises, lo Hospitals, New Delhi as a Professorjuries. The first is proper conditioning. are sometimes helpful. New over-the- and Senior consultant. He is the founderWhen someone is poorly conditioned counter nutritional supplements have president of Arthritis Care Foundation.or fatigued, the muscles do not protect also shown promise. Occasional joint Apart from his distinguished clinicalthe joints, and an injury is more likely. injections may give some relief. When work in the field of arthroscopic andIt is important for athletes at any level all other measures have failed, surgery joint replace¬ment surgery, he is wellto be properly conditioned for their ranging from arthroscopy to joint re- known for his academic contributions.sport, not only with regards to stamina He has more than 150 published articlesbut also strength and flexibility. Proper in various International and nationalnutrition and hydration also come into peer-reviewed medical journals and hasplay. The next aspect of prevention is been regularly invited to give lectures,proper form and technique in the spe- chairing sessions,etc. in Orthopaediccific sport, assured in part by following conferences around the world. He hasthe rules of the game. Finally, certain been awarded for the best paper publica-sports offer protective equipment, and tion on nu¬merous occasions by Delhithis may be of benefit in injury preven- Orthopedic Association and Apollotion. Hospitals. His work was recognized in the Limca book of records in 2012, 2013 Once an injury has been sustained, & 2015 for do¬ing bilateral Total Kneethere are still measures that may pre- Replacement in 93 years old gentleman,vent arthritis. Avoiding strenuous or bilateral Total Knee Replacement in thedemanding activities may decrease the oldest couple in a single sitting, ACL re-chances of arthritis. In many cases, as construction on oldest man.in the torn ACL, the problem can besurgically corrected, restoring proper Health Spectrum22 September 2016

Cover StoryHealth Spectrum September 2016 23

Cover Stroy Is Enough Being Done? As India Emerges as a Global Suicide Capital T he history of suicides is nearly Dr. Sunil Mittal as old as that of human soci- cial public health issue in the Indian Director ety. Surprisingly, despite in- context. numerable threats to human Cosmos Institute of Mental survival, suicides rank among the top WHO estimates that nearly onr Health & Behavioural Sciences 13 causes of death in all ages worldwide million people die every year due to and continues to present significant suicides.Statistics specific to India are (CIMBS), New Delhi challenges to our society’s collective alarming – over 2 lakh lives are lost eve- CIMBS at East Delhi wisdom. ry year to suicides – 37.8% of which areCIMBS - Delhi Psychiatry Centre by those below 30 years of age, and 71%35 Defence Enclave, Vikas Marg Suicides represent a desperate at- by those below 44 years of age. These Delhi 110 092, India tempt to escape suffering that has be- represent an overwhelming number come unbearable, blinded by feelings of preventable deaths; lives which may of self-loathing, hopelessness and isola- have been saved if help was available in tion. Often, a suicidal person is unable time. In any case, from some studies we to see the path towards relief, except already know that 9 out of 10 people in through death. But despite a desire for India are unlikely to receive the mental the pain to stop, most suicidal individu- healthcare that they may require.” als are deeply conflicted about ending their own lives – while they seek an The government’s recent decision to alternative to committing suicide, they decriminalize attempted suicide created aren’talways able to see one. a stir and revived a debate on the merits and demerits of this bold step. Statistically, suicides have a higher prevalence among males than females, For every suicide related death, it and the commonest means resorted to is estimated that 20 other individuals are poisoning, hanging or burning.In attempt it. Given that we’ve seen cases what is a matter of concern in recent where patients and their family mem- times, suicides have emerged as a crui- bers have suffered immensely, we’ve engaged with MPs and policy makers for over two decades to sensitize them24 September 2016 Health Spectrum

Cover Stroyto repeal Section 309 of the IPC and While most suicidal individualsto consider its impact on the broader may not verbalize it, they seekpublic health policy. It is cruel to pun- alternatives to suicide and areish a vulnerable person in the midst of in need of help as suicide doesemotional chaos, creating a wedge be- not present as a solution to thetween them and the help they require problems they face, but only an– while in fact what works is affection escape. Talking about suicideand understanding. or death, saying goodbyes, self- destructive behaviour, sudden Small step may go a long way in calmness in behaviour, etc mayterms of the level of care which is avail- be signs which could indicateable to suicidal individuals. Repealing suicidal tendencies and must beof this law will certainly contribute to taken seriously, and professionaltimely help being available to a person help and care must be sought.contemplating such an extreme step,and hopefully raise the bar in terms of of committing suicide may be suffer- When suicide is treated as abetter treatment, therapy and rehabili- ing from diagnosed or,possibly in a criminal offence, it fails totation options available – as opposed large proportion of the cases, undi- take into account the realitiesto being labeled criminals. agnosed psychiatric illnesses like al- of the conflicts that the indi- coholism, or drug abuse, or bipolar vidual may be undergoing. When suicide is treated as a crimi- disorders, etc. Further, as the offence wasnal offence, it fails to take into account one of ‘attempted’ suicide,the realities of the conflicts that the in- In practice, we also see a growing it has the potential of eitherdividual may be undergoing. Further, number of depression cases which motivating a vulnerable indi-as the offence was one of ‘attempted’ are aggravated due to social problems vidual to go one step further,suicide, it has the potential of either including unemployment, dowry dis- or for the incident to not bemotivating a vulnerable individual to putes, personal conflicts, financialgo one step further, or for the incident burdens, etc also seem to have a role reported at all.to not be reported at all. to play. In a country like India, which faces While most suicidal individualsan acute shortage of qualified mentalhealth professionals, the evidence ofincreasing suicides and mental healthissues poses great challenges to psy-chiatrists, psychologists, social work-ers, and public health personnel toidentify underlying factors promotingsuch tendencies and devise strategiesto improve the general mental healthof the society.Often, those at the riskHealth Spectrum may not verbalize it, they seek alter- natives to suicide and are in need of help as suicide does not present as a solution to the problems they face, but only an escape. Talking about suicide or death, saying goodbyes, self-de- structive behaviour, sudden calmness in behaviour, etc may be signs which could indicate suicidal tendencies and must be taken seriously, and profes- sional help and care must be sought. Identifying signs of suicidal behaviour by being aware, and facilitating profes- sional health care is the most impor- tant step towards prevention. n September 2016 25

Cover Story Compiled by Vinod kumarCIMBS Suicide StudyA large majority of 71% were not aware of what to do in case someone is suicidalv 55% people knew someone T he Mental Health expert team at Cosmos Insti-in their personal, social or profes- tute of Mental Health and Behavioural Scienc-sional circle who had lost their life es (CIMBS) recently carried out the ‘CIMBSto suicide suicide study’, to understand the public per- ception and level of awareness about suicide as well asv 61 % people knew someone to understand the underlying psychological and trigger-in their personal, social or profes- ing causes associated with suicidal behaviour. The studysional circle who had attempted comprised of two parts, with a public survey to gaugesuicide (but managed to survive) awareness, perception and impact of suicide in general public, and a clinical research of data to assess variousv 53% of respondents felt that psychological trends associated with suicidal behaviour.they were personally impacted bysuch incidents of suicide According to the findings of the CIMBS Suicide study, while most of the respondents (91%) were optimis- tic that suicides are preventable, a large majority (71%) were not aware of what to do in case someone is suicidal. Study show that 55% of the respondents from the gen- eral population knew someone in their personal, social or professional circle who had lost their life to suicide, while 61% knew of someone who had attempted to do26 SAeupgtuemst b2e0r126016 Health Spectrum

so. A majority (53%) felt that they had Cover Storybeen personally impacted by such in-cidents of suicide (while 25% denied Detail about the Public Surveybeing impacted, 22% could not say yesor no for sure) v A survey was conducted to gauge the level of awareness, perception and impact of suicide among the general public “The results of this study arealarming. This highlights the profound v This was a cross-sectional type of studyimpact that suicides have on society at v Survey was done with the use of online as well as printed questionnairelarge and need for awareness building v Participation in the study was invited on voluntary basisabout recognizing early signs of sui- v Sample Size: the first 500 participants were included in the study v Participants in the study were from the general public, from Delhi-NCR region, with ages ranging from 18 years to 62 years (out of which 88% of survey takers were in the age group of 18-35years). Male : Female ratio of participants was nearly equal (52% : 48%). Results cidal behavior and ensuring timely in- tervention. Suicides can be preventedv 55% people knew someone in their personal, so- if early warning signs are recognized cial or professional circle who had lost their life and timely help is provided. Untreated to suicide Mood Swings, recent life trauma, sud- den calmness after mood swings, talk-v 61 % people knew someone in their personal, ing about suicide and making prepa- social or professional circle who had attempted rations to give away possessions may suicide (but managed tosurvive) be red flag signs of potential risk for m From Completed Suicides Reported suicide. If any such signs are noted, m 12% were teenagers (13-19years age) m 27% were young adults (19-24 years) m 4% were over 50 years old m 35% were 24-35 years old NOTE: In 91% of cases where incidents of suicide were m 15% were 35-49 years old known, the victims were younger than 35 years of age m 10% were over 50 years old v 53% of respondents felt that they were personallyNOTE: In 75% of cases where incidents of suicide impacted by such incidents of suicide (while 25%were known, the victims were younger than 35 years denied being impacted, 22% could not say yes orof age no for sure)v From Attempted (but not completed) Suicides v 91% of respondents were optimistic, that suicides can be prevented (while 9% disagreed) Reported v A large majority of 71% were not aware of what m 22% were teenagers (13-19years age) to do in case someone is suicidal m 34% were young adults (19-24 years) v When asked about their opinion about most m 35% were 24-35 years old common causes for suicides, respondents attrib- m 5% were 35-49 years old uted suicides to the following causes:Health Spectrum m Academic difficulties 38% m Relationship difficulties 43% m Difficulties at work 9% m Financial difficulties 10% v Only 7% of respondents were aware of associa- tion between suicides with underlying psychiat- ric or psychological difficulties like depression, addictions, psychosis, personality disorders,etc SeptAeumgbuesrt 2016 27

Cover StoryPart 2: Clinical Research Datav An analytic type of study was carried out to analyse m Interpersonal Problems (Marital difficul- the psychological trends in people presenting with ties, break up in relationship, Family prob- suicidal behaviour, and to understand the underly- lems): 32 % ing factors associated with suicidal behaviour m Academic/ Career Difficulties or failures:v Total Number of clinical cases analysed : 1000 14%v Duration of presenting to the hospital: January m Battling chronic illness (Cancer/ terminal 2016 to August 2016 illness): 11%v Total number of people presenting with suicidal be- m Death of a loved one: 7% haviour: 372 m Financial Loss: 5% m Number of Patients Presenting with sui- m Without any immediate trigger: 31% cidal attempts: 57 v Associated Psychiatric and Psychological difficul- m Number of people presenting with idea- ties in people presenting with suicidal behaviour tions/ plans about suicide: 315 m 67% had Major Depressive Disorder m 12% had Bipolar Affective Disorderv Out of people presenting with suicidal behaviour m 7% had Schizophrenia m Suicidal Thoughts and Ideation: 62% were m 55% had Alcohol or other addictions females m 26% had Personality Disorders m Suicidal Attempts: 55% were females m 2% had Eating Disorders (Anorexia/ Bu-v Age Distribution of people presenting with suicidal limia nervosa) behaviour (Percentage figures in this category overlap, as some m Teenagers 13-19 years: 17% people had multiple diagnoses as well, for instance, De- m Young Adults 24-35 years: 42% pression along with addiction, or bipolar disorder along m 35-49 years: 33% with personality disorder, or addiction along with per- m Over 50 years of age: 8% sonality disorder, and so on) v Profession of people presenting with suicidal be- haviour Discussion: m Self Employed: 18% m Professionals: 22% The above findings highlight the need for awareness m Retired: 2% building about suicide and its association with underly- m Students: 26% ing psychological and psychiatric difficulties. Identifica- m Unemployed: 32% tion of at risk populations, timely intervention and clar- ity about what to do if someone is suicidal are importantv Immediate precipitating events prior to suicidal be- for suicide prevention. haviour:family members and next of kin must Dr. Shobhana Mittal, Consultant Psy- the general population were aware ofintervene and help the person suffer- chiatrist at (CIMBS) said, “an analysis such underlying causes. 67% of peo-ing from suicidal ideation find timely of psychological trends in people with ple presenting to us with suicidal be-help from mental health care experts. suicidal behavior, who came in con- havior had an underlying Major De-Timely intervention in the moment tact with our team of mental health pressive disorder, 55% had alcohol orof crisis can help save their life,” says care experts at CIMBS, revealed that other addictions, 26% had PersonalityDr. Sunil Mittal, Senior Consultant suicidal behaviour on the surface Disorders, 12% had Bipolar affectivePsychiatrist and Director, Consult- often had a strong association with disorder, 7% had schizophrenia whileant Psychiatrist at Cosmos Institute of deeper underlying psychological dif- 2% had Eating Disorders like Anorex-Mental Health and Behavioural Sci- ficulties, most of which are treatable ia or Bulimia. People attempt suicideences (CIMBS), New Delhi. if timely intervention is done. Surpris- when they are no longer able to bear ingly, barely 7% of respondents from the psychological pain and become Presenting an analysis of the study, Health Spectrum28 September 2016

Cover Storyoverpowered by a feeling of hopeless-ness. Stressful life events like death ofa loved one, financial loss, retirement,academic difficulties, ragging and re-lationship difficulties can be triggersfor an act as serious as suicide. Also,majority of people who presented withsuicidal behavior were below 35 yearsof age (59%), 17% being in their vul-nerable teenage years. According to Dr. Shobhana Mittal,an analysis of the clinical data revealedthat out of all people presenting withsuicidal ideation and attempts, womenoutnumbered men (62% and 55% re-spectively). Stressful life events likeinterpersonal relationship difficulty(32%), academic or career related dif-ficulties (14%), battling chronic illness(11%), death of a loved one (7%) andfinancial loss (5%) can be the breakingpoint for triggering suicidal behavior. “The reasons underlying suicidalbehaviour can be many and complex.This throws light on the pressuresfaced by today’s youth and need fordeveloping adequate coping skills todeal with pressures from outside as “Most women today bal- may be in the form of voicing suicidal toleration of stressful life events,” says ance work and home, and thoughts to family or friends, or even Ms. Mitali Srivastava, Clinical Psy- writing about it on social media. This chologist at CIMBS. the challenges faced by cry for help must be heard and timely today’s woman are many. intervention from mental health care Suicides are among the top three Suicide has various bio- experts must be done,” says Dr. Sa- leading causes of death worldwide, logical, psychological and meer Kalani, Consultant Psychiatrist and the most common cause of death social factors which come at CIMBS. in youth age group in India, with road together and contribute to traffic accidents following in second “If you know of anyone around place. Every year, approximately one its manifestation. you who may be facing such difficul- million people worldwide lose their ties, it is advisable to provide them life to suicide. The number of peoplewell as from within,” says Dr. Shob- with psychological support and watch who attempt suicide is even more thanhana Mittal. for talk or gestures of self-harm, as the figures that come to light. Suicide they may be vulnerable at this point remains a big threat that looms large “Most women today balance work in their lives. Support of significant over today’s society and youth, evenand home, and the challenges faced by others is crucial, and at the same time though suicides are preventable iftoday’s woman are many. Suicide has psychotherapy can help develop skills timely intervention is done. nvarious biological, psychological and for emotional regulation and bettersocial factors which come together - Vinod Kumarand contribute to its manifestation.Those underlying factors must be un- September 2016 29derstood and dealt with in order toprevent suicide. A person who is sui-cidal may give a cry for help, whichHealth Spectrum

Beauty CareSIX PACKSURGERY! Awashboard stomach can Dr. P. K. Talwar be extremely difficult to where the doctor sucks fat from yourSenior Plastic and Cosmetic Surgeon achieve, since even well- belly, revealing the abdominal muscles conditioned muscles can that lie underneath. Director be hidden by a thin layer of fat. ForCosmetic Laser Surgery Centre patients who diet and exercise, have Abdominal etching surgery is a good skin and muscle tone, but have safe way to give the abs more defini- of India a few extra fat in the abdomen that are tion. The plastic surgery procedure E-34, Greater Kailash - I, stubborn, a six-pack abdomen, may be accentuates the existing muscle by re- the answer. This is one of the specialty moving fat, producing the highly cov- New Delhi - 110048 liposuction procedures, where we can eted \"six-pack\" appearance.Phones: +91-11-29236550, 29236912 create a nicely sculpted abdomen, for the appropriate patient with liposuc- Abdominal etching is popular E-mail - [email protected] tion, alone. No implants are needed, among men who desire a more cut Website : www.drpktalwar.com and the patients usually think the re- and defined look. Men can find a plas- sults are spectacular. ticsurgeon who will remove those last layers of fat to sculpt the abs and make Six-pack surgery, more profession- the stomach muscles appear more ally known as abdominal etching sur- prominent. In women, it can be dif- gery, is the procedure which will turn ficult to achieve a leaner appearance your pudgy belly into a washboard. especially in the stomach. Surgeons It'sa kind of precision liposuction, can perform abdominal etching to produce a six-pack stomach with fem- inine contours.30 September 2016 Health Spectrum

Beauty CareIdeal candidates : Side Effects of Abdominal Etching Because abdominal etching removes After abdominal etching, patients may experience soreness, bruising,precise lines of fat to reveal the patient’s and limited mobility. This is normal and will disappear as the abdomennatural muscle tone, the best candidate heal. After abdominal etching, patients will be prescribed painkillers. Af-already has well-toned underlying ab- ter about a week, patients can go off of the prescriptions and switch to overdominals that can be emphasized by the counter medication.etching. Good candidates also includepatients who have undergone tummy Effectiveness of Abdominal Etchingtuck surgery or liposuction and wantabdominal etching to achieve a fitter, The fat cells that are removed during abdominal etching will not reap-more chiseled appearance. Those con- pear again. However, you can gain more fat cells through diet and poorsidering abdominal etching surgery exercise after having the procedure. Weight gain will lessen the results ofshould maintain a proper diet and abdominal etching.healthy amounts of exercise, since thelongevity of the surgical results depends Anaesthesia for Abdominal Etchingon it. Abdominal etching is usually performed under general anaesthesia,Males : which means that you won't be awake or feel anything during the proce- The ideal candidate should be phys- dure. Some doctors may choose local anaesthesia-- make sure to discuss this aspect of the surgery before hand. nically fit and have naturally athletic-looking abdominal muscles but with sexy upper abdominal indentation. It is traditional liposuction is more suitablerelatively small pockets of fat in the not suitable for patients with larger ac- for those patients. If your total body fatabdominal areaand who have between cumulations of abdominal fat seeking is more than 18 percent, you are likelyone to two centimetres of \"pinch able to significantly reduce their belly size not an appropriate candidate for ab-belly fat\". or accomplish weight reductions as the dominal etching.Females : amount of fat removed is fairly small. A For women, if they desire to haveHealth Spectrum September 2016 31

Beauty CareProcedure : The abdominal etching procedureusually takes only an hour, and can beperformed as an outpatient procedureunder either local or general anesthesia.Before surgery, the doctor will outlinethe patient’s abdominal muscles and usethese lines to serve as a guide duringsurgery. During the procedure, severalsmall incisions are made in the navalor the natural creases of the abdomen, Instructions where they are inconspicuous. A can- patients are able to return to their regu- After Surgery nula, or a flexible tube, is then inserted lar schedule within 1-2 weeks. It takes through the incisions to sculpt the abs up to 6 months to see full results. Dur- v Pain is moderate to minimal by removing excess fat along the lines ing liposuction recovery, patients will and can be controlled with pain of the patient’s abdominal muscles. The experience bruising, swelling, and some killers. four or five remaining scars are very pain, which can be eased with proper v Patients often can shower small - only about an eighth or a quar- care and medication. It is important that within 48 hours after surgery. ter inch in length. Most incisions are postoperative patients limit exercise and v All sutures are under the hidden in the natural body creases of avoid lifting weight over ten pounds and skin and are dissolvable. the body leaving very small scars. For putting any pressure on the abdominal v Medical compression gar- those patients who exercise on a regular area. The full results typically become ment to wear at all times other basis or with excellent skin tone, a bet- visible within six months, after the body than bathing for six weeks. ter defined washboard stomach can be has had ample time to heal. n v You can return to work is in obtained in just hours. Surgery usually about 3-5 days. takes one to two hours under general Dr. Talwar is one of the leading cosmetic v Patients are restricted in anaesthesia and plastic surgeon in India. Since 1996 their activities for about one to Recovery he has been running Cosmetic Laser three weeks, and may not be able Surgery Centre of India. He was also to lift items weighing 10 pounds Immediately after the surgery, pa- associated with the Indraprastha Apollo or more for much longer. tients are asked to wear a compression Hospitals, New Delhi (India) as a Senior v Most patients take a few garment for a few weeks, which should Consultant, Cosmetic Surgeon. His days off work and resume exer- only be removed when bathing. They clientele includes Top Models, Film Stars cise in 3-4 weeks. must also not shower for 48 hours. Most from neighboring countries, Sport Stars v Final shape is evident in and a lot of foreign tourists. about 4-6 weeks. Health Spectrum32 September 2016

HEALTH STUDY/RESEARCHHealth Spectrum September 2016 33

Beauty CareHoneymoon EssentialsI t is often said that romance and Sandalwood Cacao was first cultivated to make festivities are interlinked and cocoa butter in 1695 by the Europe- there is no better time than Fes- Sandalwood oil contains a sweet ans, when the Spanish \"discovered\" tivals and weddings to woo your woody aroma which has both sensual the Americas and exported it back toheartthrob . This year we recommend as well as meditative properties. It is Europe. It was an Englishman by theyou try a dash of aroma to enhance specifically recommended as a fra- name of Joseph Fry who, in 1847, in-your love life and see the difference !!!! grance for men. It can be blended with vented the first form of solid chocolate other oils such as basil, lavender ,rose as we know it today. It has long been known that aro- etc. Use of Sandalwood essential oilmas can lend to enhancing the senses. elevates the level of physical intima- Cacao has long been thought of asEach oil has a therapeutic property to cy. It's rich, sweet, warm, and woody a natural medicine; its diverse thera-balance, relax, enhance, and aid in cre- aroma is enticing, erotic and soothing, peutic qualities of the plant include aating a more satisfying love life. making it an excellent, exotic gift for decrease in depression; an increase in your spouse! general health; a lessening of stress; Most of these oils can be applied and enhancements in pleasure, in-directly on the skin, as well as taken Chocolate Essential Oil for Love cluding sex. Chocolate is said to pro-internally. The most common and duce the euphoric feelings so choco-easiest way is of course , through the The ancient Maya believed that late combined with aromatherapy issense of smell. Our sense of smell is money really did grow on trees; cacao the ultimate indulgence!more powerful than we give it credit trees, that is. The cacao tree takes itsfor; it affects our emotions and physi- name from the Mayan word kakaw Cacao absolute is made from thecal wellbeing. Particular smells and and it is native to South and Central cacao beans of the cacao tree; it has aodours can elicit old feelings and America ;the seed of the cacao tree are rich, dark chocolate aroma. With thememories…some good and some not used to make theobroma oil (theobro- incredible aroma of the finest choco-so well. Essential oils can work with ma cacao) or, as it is more commonly late, this dark exquisite Cacao seed ab-us at an energetic level, impacting us known, cocoa butter. solute makes a highly intriguing andemotionally and spiritually. Some es- delightful scent. Use Cacao absolutesential oils can be uplifting, while oth- The Maya people traded the prized with confidence as a rich middle noteers can have more of a relaxing effect. cacao bean throughout their empire in all of your love potions. Sensual,And there are essential oils that can be and used it as a form of currency. They heady, and delicious while adding astimulating or even have aphrodisiac were the first to produce hot chocolate hint of intrigue; cacao is an excellentproperties. which was used in many events of ingredient in erotic formulations. their lives from births to marriages to34 September 2016 death. The main use of cacao absolute is Health Spectrum

Beauty Carein the perfumery industry as oppose It eases depression and mental fatigue of all fragrances.” This fragrance is tra-to therapeutic aromatherapy practice and rejuvenates tired muscles and de- ditionally used in aromatherapy to– but that does not mean that you can- congests tissues. Combine rose essen- sharpen the senses and to temper de-not seduce your true love with some tial oil in a massage lotion or oil or add pression, fear, anger, and jealousy. Forchocolate aromatherapy this wedding a few drops to a romantic bath for a these reasons, and also because of itsseason! sensual delight . reputation as an aphrodisiac, the flow- ers are spread on the beds of the newlyCumin Oil Romantic Jasmine Essential Oil married in Indonesia. Cumin oil has profound advantag- Jasmine: Jasmine, whose name Ylang: Ylang oil has historicallyes for both women and men. However, means heavenly felicity, has captured been used as a tonic to help overcomeit is not very famous for its aphrodi- the imagination of poets and perfum- sexual difficulties. However, this oilsiacal properties. Cumin oil is said to ers for thousands of years and has been may cause headaches if you use tooimprove fertility in women. In men, described in the literature with more much of it.cumin oil brings out intense feelings superlatives than any other single es-of attraction and stimulates sensual sence. If Rose is the oil of love Jasmine Neroli Essential Oil for Weddingsmood. is certainly the oil of romance! Neroli, or orange blossom, alsoRomantic Rose Essential Oil Long considered an aphrodisiac, has associations with love. Victorian jasmine has historically been associat- brides wore a sprig of neroli in their One of the most expensive essen- ed with promoting intimacy, romance, head dress and carried neroli in thetial oils, Rose is considered to be the transcending physical love, closeness bridal bouquet in an attempt to calm“queen of flowers”. A favourite flower and breaking down barriers to full ex- nerves and stimulate romance on thefor brides, it is a traditional symbol pression of sexuality. wedding night! Neroli essential oil isof love. Rose was prized by the an- often adulterated so be sure to choosecient Egyptians, Greeks and Romans, Jasmine's anti-depressant proper- pure neroli oil for true aphrodisiac ef-both in love and skincare products. ties and beautiful scent is an excellent fects.Cleopatra of Egypt and Josephine tool in helping overcome a range ofBonaparte of France are just two his- sexual problems which are in the head, So , go ahead and seduce your truetorical figures who were known to use rather than direct physiological prob- love with some aromatherapy this fes-rose, in one form or another, to seduce lems of the reproductive systems. tive season , its easy and fun and thera-lovers. It is said that when the Mughal peutic as well !!! nEmperor Jehangir married the Prin- Wear a garland of jasmine flowerscess Noor Jehan, a canal encircling the in your hair to make your Day Special Dr. Blossom Kochhargardens was filled with rose water. and see your love bloom . Aromatherapy Expert Aroma Magic Rose essential oil is base note oil, Bridal Ylang Ylang Essentialand consequently it is a heavy fra- Oil to enhance your Love lifegrance. Apart from its aphrodisiacproperties it has many other uses. It Ylang: Ylang is also an exotic es-assists in relieving premenstrual ten- sential oil – both in name and naturesion and is helpful during menopause. - used for love and romance. Origi- nating in the Philippines, Ylang Ylang means “flower of flowers” or “fragranceHealth Spectrum September 2016 35

BHeEAaLuTtHy CSTaUreDY/RESEARCH Dr. Shuba Dharmana The problems you face with mon- spas will also help. At home you can MBBS, DFFP, DPD soon are winds, rain and hu- also use a leave in conditioner for the midity. This causes frizzy and mid - bottom lengths of your hair Cosmetic Dermatologist, dry skin and you are also exposed to Hair Transplant Surgeon the polluted waters the rain brings. 2. Never comb wet hair with a normal Founder Lejeune group 1. You must try and protect hair brush. Detangle always with a wide of Medspas toothed comb. Wet hair is very fragile www.lejeunemedspa.com from the environmentally polluted wet and can break easily if combed with a rains. Use a raincoat, hoodie, umbrella regular brush. Never use heat style wet36 September 2016 or a hat. hair.Blow dry it first before you use the irons. Use a heat protecting serum or Indulge in oil massages regularly. spray before you heat style. Moroccan Wash with an SLS free shampoo reg- oil, argan oil are all good choices. ularly and use a clarifying shampoo once every 2 weeks to remove buildup 3. Since the skin is more dry at this and condition. You can use moroccan oil serums and other such similar se- time of the year, use cleansers that are rums to prevent frizziness. Frequent soap free or SLS free. This takes care deep conditioning treatments or hair of the gentle facial skin and does not Health Spectrum

HEALTH STUDBYe/aRuEtSyECAaRrCeHstrip away the essential skin oils. If you have oily skin you may usecleansers with tea tree oil, benzoyl peroxide or salicylic acid4. Moisturise regularly. The monsoons are harsh on the skin.If you have oily skin, use a hydrating lotion or serum which willnot clog your pores. Cream based formulations can be used if youhave dry skin. Combination skin types must follow the same regi-men as oily skin.5. Suncreen is a must even in the most cloudy and rainy seasons.A good sunscreen with SPF 30 or more is necessary to preventsome of he signs of ageing and sun damage. Most BB creams andCC creams have a built in sunscreen but the SPF in them is usu-ally not enough. Look for something with SPF 30 or use a basesunscreen and layer the CC/BB cream on top. Don’t forget to ap- September 2016 37ply on the neck and ears too6. Exfoliate facial skin once in a week unless you have activeacne. Don’t forget to exfoliate the full body. You can use a scrubor a pumice stone every 2 weeks over the body to exfoliate7. Dry cracked heels, dry knees, dry elbows,chapped lips canall be helped by exfoliating and moisturizing. For dry crackedheels, elbows and knees use a pumice stone everyday in the bathand moisturize with oil or emollient cream. Dry cuticles can behelped by using a cuticle oil at the base of the nail and massag-ing the oil in. Use sugar on the toothbrush and brush the lips toexfoliate and follow it with shea butter or bees wax. nHealth Spectrum

Alternative MedicineHolistic Medicine in Organ FailureOur country recently launched a very important could be conducted in the whole country last year, which is ORGAN DONATION and TRANSPLANT out of the figure of 3500 heart transplants carried out in the programme on national level under the aegis whole world.of the National Organ and Tissue Transplant Organiza-tion (NOTTO) of the Ministry of Health & Family Welfare, We should take appropriate stock of limitations of theGovernment of India. It estimates insurmountable need for scope of any such programme based exclusively on mod-100,000 Cornea; 250,000 kidney; 80,000 liver and 50,000 ern sophisticated medical care and surgery, simply for lackheart transplants, respectively, in the country every year. of its accessibility, availability and affordability. We have to Whereas the ground reality is that there is an ever in- seriously think right at this stage the challenges of this verycreasing backlog of blindness in the world due to Cataract important national organ and tissue transplant campaign.which can be corrected by a 5-minute simple surgical pro- In comparison, we appear to be far more realistic in ourcedure costing merely a few hundred rupees. On the Cornea aspiration to reach the mars, even though at the expensefront, the largest eye bank in Asia at LV Prasad Eye Institute of hunger, backwardness, illiteracy and poor health in theof Hyderabad’s Ramayamma International Eye Bank leads country. Let’s be closer to ground and better prepared inthe record in whole world to have so far achieved in 25 years projecting a huge and very noble programme, lest it meetto harvest over 36,000 donor corneas, and transplanted a the fate of WHO-UNICEF global programme “Health Formere 20,000 of them to needy patients. All By 2000 A.D.” The projected need of 250,000 such transplants everyyear appears utopian when the Indian transplant registry Dr. R. K.Tuli, the global leading figure in promoting allreveals the total number of kidney transplants carried out inclusive and comprehensive approach to health states, “Ifin our country in last 25 years (1991 to 2015) till date is just we were to learn a lesson and be wise, we should concur-20,952. No figures are available on actual number of liver or rently expand our vision and be guided by the prime min-heart transplants, etc., from the registry. ister’s SKILL INDIA dream, to complement conventional Even in the USA, where 800,000 people suffer from medical care with the easily accessible simple potential ofNYHA Class IV advance heart failure, only 2000 transplants the all inclusive integrated drug-free modalities of tradi- tional systems of health, termed Holistic Medicare. It’s been38 September 2016 found to be very efficient to arrest and help in reversal of the Health Spectrum

Alternative Medicinedamage to sick organs. Therefore, we must tap its potential EUREKA-1for rejuvenation of sick organs and reduce the gap in needof essential transplants. We may have limited example of its Dr. Deepak Chandra is the 1964 batch alumnus of Armedscope at this stage, but it has the potential of a “eureka” possi- Forces Medical College, Pune. He is the most popular Fam-bility through large scale scientific studies to make a unique ily Physician in Kanpur. His Clinic was shut down for threeglobal beginning.” years during his sickness, but it bounced back to its old glory as soon as he resumed it in year 1998, after regaining his Dr. Deepak Chandra of Kanpur shares, “I’ve been given health. He enjoys his wellness to live life fully so many yearsa SECOND LIFE by Holistic Medicine therapy! In the year after recovery, certainly better than any Liver Transplant1998, I had slipped into Hepatic Coma & Total Renal Shut recipient anywhere in the world! CELEBRATING his 70thDown following Chronic Progressive Multi-Virus Hepatitis. Birthday with the Blessed FamilyThe attending specialists at AIIMS gave up on me and I wasdischarged from the ICU! At this critical stage my family What is Holistic Medicinesought the services of Dr. R.K. Tuli, the renowned HolisticPhysician. Due to his sincere and vigorous support I gradu- Holistic Medicine = Modern + Traditionalally improved in my health and finally regained normal kid- (Alternate = TMraeddiitciionneal + NewAge)ney and liver functions. What’s amazing is that the universal-ly incurable Hepatitis ‘C’ & ‘E’ antigens and the entire virus [Conservative Medicine + Life-Style & Stress Manage-load was eliminated from my body. After about one year of ment + Ashtanga Yoga + Acupuncture-Reflexology +Holistic Medicine therapy, my health bounced back to be Panchakarma-Detoxification + Counseling-Hypno-better than in previous ten years. I was able to resume my therapy- PLRT-NLP + Reiki-Pranic Healing-Chakramedical practice which was shut down due to my sickness. Ifind myself fully healthy and all my medical parameters have Balancing + Regenerative Medicine]continuously maintained within normal limits ever since.” What’s Holistic Medicine? Manoj Sohi from Haridwar writes, “I had been sufferingfrom uncontrolled blood pressure leading to kidney prob- Holistic Medicine is the wholesome approach to Healthlem (HTN + CKD – ESRD + Renal Lithiasis + Anemia) with where each individual is treated as a whole ‘Body, Mindpoor health, from last one year. The doctors told me for Di- & Spirit’ by a synergy of the evidence based ‘science’ ofalysis and advised Kidney Transplant in Sir Ganga Ram Hos- modern medicine with the complementary and highlypital. But, since I came to Dr. Tuli, it was a great experience. reproducible time honoured ‘art’ of drug-free modali-My mental, physical and emotional health started improving ties of the various officially recognised traditional sys-immediately, the blood pressure was controlled, and by 3-4 tems of health to restore the disturbed ‘internal milieu’months of treatment at this “SOHAM” Clinic, my water re- of the individual to initiate one’s own natural inherenttention is all gone, my hemoglobin has improved from 7.2 infinite healing that leads to elimination of all sicknessto 12.0 gms%, as the kidney functions have improved a lot. I and to restore positive health and total wellness : Dr. R.feel proud to share that my total health has improved from a K. Tuligrade of 2/10 to 10/10, now. Dr. Tuli is a God for me.” nual medical check-up confirm that both my kidneys have Dr. Tuli highlights that it’s a highly reproducible phe- remained fully functional, and I’ve lived my life fully evernomenon, as elucidated and endorsed by other beneficiar- since. I pray to God for Dr. Tuli’s greater success to cure oth-ies of this therapy, thus qualifying need for its scientific ers like me.” nvalidation. The management of each patient has been muchsimpler, easier, healthier, at a fraction of cost, and displays September 2016 39certainly far superior and lasting results restoring highest‘quality of life’ compared to progressive morbidity and even-tual mortality in conventional medical management. The decorated veteran Colonel B.K. Chathli of GreaterNOIDA likes to share, “In the year 2004, I was diagnosed tosuffer from Ch. Renal Failure-ESRD. In 2005, I was startedon dialysis three times in a week. Doctors told my daughterthat I need Kidney Transplant. But, her boss Ms. Prema Sa-gar recommended that I consult Dr. Tuli at the “SOHAM”clinic. With great suspicion and reservation, making surethat the holistic therapy in no way interfered with my ongo-ing medical treatment, I started it here. Today, 11 years laterand at the age of 76 years, as I visit this clinic for my wife’streatment, I feel proud in writing that with his ‘HEALINGTOUCH’ I had got fully CURED in nearly four months. An-Health Spectrum

Alternative MedicineTESTIMONIALS Eureka-2 HIGHEST FORM OF HEALING“Holistic Medicine is SURELY the highest form ofHealing. Dr. Tulis’ team is really aiding the DivineHealer and in the process motivating their patientsin the right direction.” : Dr. (Prof) Kusum SahgalFmr. Professor, Director & Principal, Lady Hard-ing Medical College, New Delhi MAY THIS TREATMENT BE AVAIL- ABLE TO ALL PEOPLE“I’m grateful to Dr. Tuli to help me get over drug-resistant and persistent numbness in my fingers andproblems with my shoulder due to Cervical Spon-dylosis-Radiculopathy and Peri-Arthritis Shoulder.The treatment sessions helped me to relax, tensionswere gone and I felt rejuvenated. This therapy, also,helped my husband suffering from Parkinson’s Dis-ease. I hope this treatment will become available tomore people in our country.” : Margaret Alva, Fmr.Union Minister Govt. Of India and Governor ofUttarakhand & Rajasthan COLONEL BALDEV KRISHAN CHATHLI AT THE PEAK OF HIS GLORY WHEN ALLOPATHIC MEDICINE FAILS Colonel B. K. Chathli joined 31st Course of Indian Military Academy in the year 1963, and was commissioned into the premium GORKHA“I had brought my wife Veena Gupta after I was fed RIFLES. He rendered exemplary service in both the 1965 & 1971 wars,up with allopathic treatments as in spite of best she and always volunteered to serve upfront in the most challenging ter-continued to suffer from multiple problems of Men- rains throughout his career to earn highest service accolades and respecttal Depression-OCD; Hypothyroidism; Fibromy- from all. Having recovered his health fully, at the age of 73 years, healgia; Obesity; Cervical Spondylosis + Vertigo with continues to serve the society with equal zeal in various capacities.Osteoarthritis of Knees & Ankles + Restless Legsand APD-GERD + Fatty Liver, etc. After drug-free “The natural healing force within each one of us is theHolistic Medicine therapy at “SOHAM” just over the greatest factor in getting well.” : Hippocrateslast two months, I am THRILLED with the improve-ment and shall continue with it till she is in absolutePositive Health. I wish more people take advantageof this treatment pioneered by Dr. Tuli. My GoodWishes and Blessings.” : Dr. A. K. Gupta, Fmr.TDean, Maulana Azad Medical College & World “Holistic Medicare facilitates this very force in getting well from any sickness.\" : Dr. R. K. TuliBank Technical Expert he all inclusive and integrative approach to health termed Holistic MediCare, available at the unique Dr. Tuli’s Clinic helps to extend the best of each sys- tem of medicine, at the same time overcome inherent deficiencies in the re- spective systems, to offer a ‘synergy’ of all of them to ensure ‘Health For All’at all ages of life, and all stages of every sickness. This latest speciality of medicineis called Holistic Medicine. It’s a board certified specialty in the U.S. for nearly twodecades, and is catching up very fast amongst all the developed nations. Therefore, it’shigh time that we adopt it into our health care and make our living years happy andDr. R. K. Tuli productive. “SOHAM” The Clinic for Holistic MediCARE & CURE D-961, New Friends Colony, New Delhi-110025 Tel. 91 11 2691 4787 / 2692 4787 /40 September 2016 Health Spectrum

Alternative MedicineYoga Can Help Prevent SuicideW hen people commit suicide, it is not only their well as an explanation on how yoga can be an excellent al- lives that end up being affected as the lives of ternative treatment for depression. their family and friends will be damaged foreverbecause of this selfish act. There are many reasons that can Depression can be due to chemical factors. Wheneverlead to suicide, however the most common cause for suicide one is happy, this is usually caused by an abundant amountis depression. Some people aren't aware that there are a lot of endorphins in their body. A person who is depressed mayof alternative treatments for depression, and an example of have a low endorphin level. Yoga can help reduce depressionthis alternative treatment is yoga. By performing yoga, one by providing the body with more endorphins. Once the en-can greatly reduce the feelings of worthlessness, and other dorphin level of the body is increased, the negative thoughtsnegative thoughts that can usually lead to the development and unhappy disposition will be lessened as well.of depression. Once depression is lessened, the chances ofperforming self-harm will decrease as well. We've included A lot of people have the false notion that yoga is just allin our article a brief discussion on how yoga can greatly help about stretching and performing strange poses. These posessomeone recover from depression and prevent suicide, as can actually place a strain on the different glands and organs of the body, helping them increase the production of chemi- Health Spectrum cals that can make a person feel better. The positions that are recommended for those who want to treat depression are the shoulder stand, sun salutations and relaxation position. Yoga experts believe that the sun salutation stretches the body and the organs, thus increasing the amount of oxygen received by the entire body. If a person receives an adequate amount of oxygen, their muscles will become stronger. With the right amount of oxygen, the individual performing yoga will feel more awake and alive. Meditation is a large part of yoga. While it may seem like the person is simply sitting down or dozing off, this is an exercise that should not be underestimated. Many yoga experts believe that meditation can be used as an efficient therapy for depression. When a person is per- forming yoga, they are able to de-stress and remove all the negative thoughts and ideas that have been plaguing their minds. Meditation can also help a person focus on the pre- sent. By performing meditation religiously, one can reach enlightenment. Most people who commit suicide do so be- cause of their fear of the past and the future. Meditation can assist a person erase these fears, and can help an individual If you're wondering on what exactly are the benefits of yoga, here are a couple of reasons that may help you make up your mind. • Yoga is very affordable. Compared to other treat- ments for depression, yoga is a lot cheaper. The only thing a person has to pay for is a membership to yoga classes. • Yoga doesn't have any side effects at all. Unlike other forms of treatment for depression that can cause harmful adverse effects, yoga is a completely safe exer- cise that one can practice. There are some antidepressants that can cause panic attacks, extra pyramidal effects, and the further worsening of the condition. One doesn't have to worry about these effects while performing yoga be- cause it is an all-natural treatment that can help alleviate depression and prevent the occurrence of suicide. n - Dr. Alka Gupta September 2016 41

Alternative Medicine Sports Acupuncture Scores Points Dr. Raman Kapoor a combination of Body acupuncture side effects & I have made a significant HOD, Department of Acupuncture points and ear acupuncture points to recovery. I feel the therapy should great effect. Today, he is full recov- be made more popular so that moreASir Ganga Ram Hospital, New Delhi ered and fighting fit. To quote Yuvi“ sportspersons & cricketers can get cupuncture has caught the at- The best part of this therapy is that it benefitted from this therapy”. tention of many sportspersons is a safe , drugless therapy without any who have greatly benefitted Another famous polo player, Mr.from this therapy. Dr. Raman Kapur, All these problems were treat- Navin Khanna, took Acupuncturea renowned Medical acupuncture spe- ed concurrently by Dr. Ra- treatment for his recurrent tennis el-cialist, practicing only Acupuncture bow and got fully cured by Dr. Ramanin New Delhi since the last 32 years man Kapur with Acupuncture kapur.shares his experiences of treating some wherein he used a combinationwell known sportsmen with acupunc- According to Matt Callison, ature. of Body acupuncture points faculty member at Pacific College of and ear acupuncture points to Oriental Medicine and licensed acu- Yuvraj Singh, well known player great effect. Today, he is full puncturist in San Diego , California. ,of Indian Cricket, came to Dr. Kapur recovered and fighting fit. To traditional Chinese medicine has beenin March, 2013, with a history of mi- quote Yuvi“ The best part of an extremely helpful and growing trendgraine headaches which he has had this therapy is that it is a safe , in athletics for quite a while. San Fran-since 2007. He used to take frequent drugless therapy without any cisco 49ers Steve Young and Jerry Ricemedications to get relief. The head- have been treated with sports acupunc-aches were accompanied by blurring side effects & I have made a ture , and Canadian speed skater Kevinof vision and pain around his eye significant recovery. Overland received sports acupunctureball. His trigger would often be empty to help him earn a bronze medal in thestomach, causing wind and then head- 1998 Olympics. As a sports acupunc-aches. He has had problems of acid- turist, Callison has been treating ath-ity, gas & wind since past 4 years. He letes for 11 years. Three of those yearsalso had a disturbed sleep pattern. He were spent with the Minnesota Vikingshas had nasal allergies since youngage accompanied with urticaria. An- Health Spectrumother problem which had taken a tollon his career was his severe left sidedneck stiffness with pain radiating fromhis neck to his left shoulder and upperarm and his left upper back and leftwrist. He also had recurrent episodesof low back pain radiating to his legs,causing him to often miss matches. All these problems were treatedconcurrently by Dr. Raman Kapurwith Acupuncture wherein he used42 September 2016

Alternative Medicineduring their playoff run, and he now points on the human body connect store the body's balance makes sportstreats many of the San Diego Charg- with 14 major pathways, called merid- acupuncture and traditional Chineseers. Callison also works in conjunction ians. Chinese medicine practitioners medicine a viable preventative therapyto treat athletes from the University believe that these meridians conduct that greatly enhances sports medicineof California San Diego (UCSD). At qi , or energy, between the surface of exercises. \"Many players come to seeUCSD's RIMAC Arena athletes receive the body and internal organs. It is qi me for injury prevention by way of bal-sports acupuncture treatments in ad- that regulates spiritual, emotional, ancing their opposing muscle groups,\"dition to care from athletic trainers mental and physical balance. When especially to work on common sportsand physical therapists. Pacific College the flow of qi is disrupted through injury points.use acupuncture to help rehabilitate poor health habits or other circum-post-operative injuries, sports injuries stances, pain and/or disease can result. Dr. kapur maintains that thereand athletic performance by increasing Sports acupuncture helps to keep the are no side effects of acupuncturerange of motion, muscle strength and normal flow of this energy unblocked treatments when provided by a fullytissue healing potential.Callison re- and \"fine-tune the bio-electric sys- trained and licensed acupuncturist. Inported that the most common injuries tem,\".This ability to fine-tune and re- 1993, the National Institutes of Healthhe treats athletes for are muscle contu- Consensus Conference on acupunc-sions and tendinitis, as well as over- \"When you insert a sports ture released a similar affirmation:use injuries involving the lower back, acupuncture needle to a mo- \"The data in support of acupunctureshoulder, knee and ankle, all examples tor point region, it changes are as strong as those for many accept-of common sports injury areas. These the awareness that the muscle ed Western medical therapies. One ofinjuries typically require two sports reports to the central nervous the advantages of acupuncture is thatacupuncture treatments a week, with system, and that is completely the incidence of adverse side effects isa varied recovery time depending on different,\" Kapur said. Sports substantially lower than that of manythe injury .Marcellus Wiley, a defen- acupuncture consists of the drugs or other medical proceduressive end for the San Diego Chargers, is gentle insertion and stimula- used for the same conditions.\" \" Ath-one patient who noticed how quickly tion of thin, disposable sterile letes especially need to be balancedhe felt the benefit of acupuncture . \"I needles at strategic points near and take care of their bodies,\". \"That isresponded quickly and favorably to the what acupuncture does. Every athletetreatment,\" Wiley said. \"It was refresh- the surface of the body. can benefit from it in that respect.\"ing to receive therapy that allowed meto sustain my health for the duration Dr’s Raman is the Chairman, Dept.of a season and physically grueling ca- of Medical Acupuncture at Sir Gangareer.\" Ram Hospital, New Delhi. Dr. Raman kapur has also been bestowed with the According to Dr. Kapur, both prestigious “PADMA SHRI” by theOriental medicine and sports medi- Hon’ble President of India in 2008. ncine techniques focus on propriocep-tion, which he defines as the muscles'awareness communicating to the cen-tral nervous system. Injury can disruptthis communication, thus hinderingbalance. \" Acupuncture is one of the quick-est ways to restore muscle balance,\" Dr.kapur said. \"When acupuncture is usedat specific sites, the muscle spindles arereset, and then that balance is reawak-ened.\" \"When you insert a sports acupunc-ture needle to a motor point region, itchanges the awareness that the musclereports to the central nervous system,and that is completely different,\" Ka-pur said. Sports acupuncture consistsof the gentle insertion and stimulationof thin, disposable sterile needles atstrategic points near the surface of thebody. Over 2,000 sports acupunctureHealth Spectrum September 2016 43

Child CareCAhcotoivsietyThFeorRYigohut r KidHere are few tips to know ing a small stroll in the park, playing throw ball and volleyball in the back- yard. how much activity is needed So, before you get your kid into any for your child’s healthy growth activity whether moderate physical and development of body: activity or a vigorous physical activity, First things first. Help your kid to make sure it matches their body capac- explore different physical activities to ity and their interest. find something that he or she might Guidelines: like. Physical activity is full of fun, 8 0-2 years- Should have some a vital part of playing and learning, physical activity, could be on the floor,Dr. P. K. Singhal and very essential for fitness. But this indoor games like pencil and paperSenior Pediatrician doesn’t mean that you can put your games, card games, building games, child into tedious and strenuous activi- treasure hunt or hide and seek.Walia Nursing & Maternity Home ties all day through. This may cause ex- 8 3-5 years- Should be physi- Laxmi Nagar, New Delhi cessive exhaustion and loss of energy. cally active for at least 3 hours, eachY ou want your little joy to be a The core benefits of physical ac- day and the activity should be spread master of different skill sets. tivities are strong bones & muscles, across the day. It could be jumping, So his schedule is blocked with healthy heart and arteries, balance and running, throwing balls, kicking foot- flexibility and a reduced risk of be- ball skipping or cycling.skating classes, followed by art classes coming overweight or obese. Physical 8 6-10 years- Should do at leastin the mornings, Karate classes in the activity should not only be seen as an one activity vigorously with breaks inafternoon, followed by instrument activity to keep your child active physi- between. He or she can pick his or herlearning sessions. In between these cally but also mentally. Children who favourite sport activity.classes, he needs to sneak in time for are in the right track of doing the ac- At the end of the day the physicalyoga and tennis lessons. tivities are more likely to be confident, activity/sports child is doing shouldWell, getting your kids involved in happy and relaxed, can sleep well and be pleasurable, also ofthe amongst thefun activities is great. It is very natu- concentrate better at school and can activity he /she does in early life, mayral for a child to play, jump climb and get along with new people and make pick and choose one or two activitiesmove around. Helping your child to friends. which continue doing in the future. Sofind the right activity for him or her Physical activity isn’t always about explore your child for multiple activi-is crucial to set up a healthy body. But vigorous exercises. It is the free out- ties and let them chose what they likehow do you decide whether your kid is door activities that shapes your mind as they grow older. ngoing overboard with it. and soul. Simple activities include tak-44 September 2016 Health Spectrum

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Dramatic results are usually seen within a year of starting treatment with an LHRH analog, which is gen-aassweealrllaysa, sin8-h9eryemaarstuorfeaygeea?r(sI,nifcsohnecegpettisohne,rpmreegnnsaens- erally safe and usually causes no side effects in kids. nacsye,agreltytiansg8a-f9fliycetaedrsboyf paegrei?p(hIenracol ndciseepatisoens ,lipkreecgannacne-r,cyw,egiegthttinggaianf,flaicntyedotbhyerpaersippehcet)ral diseases like cancer, S(NDPDD(SPNOReDOrRGewOU.rGwOSU.OGTSDOoGTD,HRoen,MHRleAnEMhilAEDNahiMiDNaMi,DMM,FDMMFIFEaCIFEEaClDOEiRlDOkiRITGkRITGI,RELI,FELICFATICATTMYTMOYOS&RS)&R)IVIVFFAns.weight gainIf, cahniyldotshheorwassapneycts)igns of early sexual matu-Ans.rascrttaluritouidonainnt(igob(bnebIfe,rfofeaocrachersneitaleddag, geeesevnh7eol7laoowrorpgsrme8ad8neinnytinetsgs,itgirgiraicnlrpsllsesiosdoorofhrareeagaipggerelehyn9t9isgisen,irxnooubwrboatpolyhyums,)sbm,)ai,ticenuinno--r--Health Spectrum September 2016 45

Healthy Motherhood Sex During Pregnancy Making Love blood supply to the pelvic area. During the second During Pregnancy three months of pregnan- cy, after the first trimester Some hints for satisfying and symptoms have passed and comfortable sexuality during pregnancy include: before the growing uterus makes positioning more Positioning of a challenge, many v Side lying, with partner behind women enjoy sexual in- tercourse. woman v Woman on hands and knees, A woman's breasts increase in size during partner kneeling behind pregnancy, enlarging even v Woman sitting on partner's lapP regnancy is a time of physical more with sexual arousal. pelvic pressure. She may not like the and emotional change. Person- For some women this is the idea of intercourse and her partner also al history, symptoms and atti- first time that they truly enjoy may worry about hurting the baby. tudes about becoming a parent having their breasts fondled, whileinfluence the feelings that a woman has others experience these changes as In addition, orgasm may be some-about her body and about making love uncomfortable breast tenderness. what frightening during pregnancy.during pregnancy. The pregnancy may As the pregnancy progresses Upon reaching orgasm, the uterus con-alter how a woman and her partner feel and a woman begins to lose her tracts in a rhythmical fashion. In a preg-about making love, and differences in waistline, positioning and com- nant woman, these contractions lastsexual need may arise. fort become important in lovemaking. longer and in the third trimester they A woman may become depressed as the can occasionally turn into long, hard The best way to deal with these dif- shape of her body changes. As the baby contractions that may feel uncomfort-ferences is to talk, to listen and to be begins to move down into the pelvis, a able. Sensitivity to each other's wishes isopen to each other's feelings and con- woman may be bothered by increased vital. Cuddling and massage may be ancerns. In addition, questions about sex- alternate way to share time together. nual practices and their effect on the babyand the pregnancy should be discussed When is sex not safe during pregnancywith a health care provider during pre-natal visits. If you have any of these complications, talk to your provider to see if it’s OK for you to have sex:Pregnancy Changes and Sexu- v You’re pregnant with multiples (twins, triplets or more)ality v You had a miscarriage in the past or you’re at risk of having a miscarriage For many women, the first three in this pregnancy. Miscarriage is when a baby dies in the womb before 20months of pregnancy can bring fatigue weeks of pregnancy.and nausea. If these symptoms are pre- v You had a premature baby in the past or you have signs of preterm laborsent, a woman may not feel like making in this pregnancy. A premature baby is a baby born too early, before 37love. weeks of pregnancy. Preterm labor is when your labor starts early, before 37 completed weeks of pregnancy. Pregnancy brings an increased v You have an incompetent cervix. This is when the cervix opens too early during pregnancy. The cervix is the opening to the uterus (womb) that sits at the top of the vagina. An incompetent cervix can cause you to have preterm labor. v You have placenta previa. This is when the placenta lies very low in the uterus and covers all or part of the cervix. Placenta previa can cause seri- ous bleeding and other complications later in pregnancy. n46 September 2016 Health Spectrum

Q&A VitaminDeficiencyQ. Are Indian women deficient in Vitamin D? Can I min D that you get from food and supplements appears to be more available to the body, so those are more reli-get some statistics to show the amount of deficiency? able sources.)Ans. Vitamin D, also known as the sunshine vitamin, Darker skin. People with darker skin have a lot of melanin, which acts as a natural sunscreen and reducesis created in the body with sunlight exposure. Its major production of vitamin D in the skin.function is to maintain normal blood levels of calciumand phosphorus, which keeps the bones strong Certain medications. Medications such as steroids, antiseizure medications, cholesterol-lowering drugs, and Vitamin deficiencies usually develop slowly over sev- some diuretics reduce absorption of vitamin D from theeral months to years. Symptoms of Vitamin D deficiency intestines.are usually vague muscle/joint pain, weakness, bonepain, tiredness, fatigue or even depression. Nowadays it Q. What can be done to cure this deficiency?is observed that people who are deficient in Vitamin D Ans. Vitamin D is found primarily in animal prod-are more likely to have diabetes, regardless of how muchthey weigh. Early diagnosis and treatment can help con- ucts such as dairy foods, liver, eggs, fish and fish oils, diettrol the symptoms and prevent health related problems alone cannot provide an adequate amount of vitamin D. Sunlight exposure is the only reliable way to generate it.”Q. How does the deficiency affect a woman’s health Q. How badly are young children (below teenage) af-and longevity? Does she face any particular problemsespecially during and after childbirth due to the same? fected by Vitamin D deficiency?Ans. Vitamin D deficiency is common during preg- Ans. Inadequate supply Vitamin D from sunlight,nancy. Inadequate vitamin D can lead to abnormal bone diet or both is the most common cause of rickets, nutri-growth, fractures, or rickets in newborns.Vitamin D de- tional deficiencies of calcium and/or phosphate, geneticficiency to a higher risk of pregnancy complications such or acquired disorders of the gut, liver, kidney and me-as gestational diabetes, preeclampsia, preterm birth, and tabolism can also lead to rickets.Rickets is a disorder oflow birth weight.The symptoms of a vitamin D deficien- mineralisation of the bone matrix (osteoid) in growingcy can be subtle. They may include achy muscles, weak- bone, involving both the growth plate (epiphysis) andness, bone pain, and softened bones, which may lead to newly formed cortical and trabecular bone.fractures. Dr. Pallavi VaishyaQ. What can be done to prevent this deficiency from Senior Nutrition Consulant,affecting women? Kailash Hospital NoidaAns. Factors that might put you at risk for a vitaminD deficiency include: Obesity. Because body fat stores much of the vitaminD made in the skin, it's less available to the body. (Vita-Health Spectrum September 2016 47

Nutrition Simple Ways To get Rid of SugarDr. Shachi Sohal There are so many lists of hot foods to eat, the latest superpower foods oozing excitement and immunity, that the mind starts reeling. But unfortunately, many of theSr. Dietician (H.O.D.) foods starring in the widely circulated lists tend to be unfamiliar, since the recommen-Dr. B L Kapur Memorial dations are based largely on Western research. Which means they are either hard to getHospital locally, or are exorbitantly priced compared with local produce.New Delhi So what if blueberries are potent cancer fighters—do you really want to pay around Rs 500 for an imported punnet (125-150g)? Especially when that sum can buy your family a week’s worth of surprisingly healthy, yet neglected, home-grown produce at the local mandi (market)? You won’t see these native gems in glitzy international mag- azines, but then you don’t fly to New York to buy a Sabyasachi original either. 2. YAM BEAN OR JICAMA1. PUMPKIN Why we don’t eat more of this tuber beats us. In West Bengal, it is known as shankalu and in Bihar as mishrikand, The humble kaddu is a filling, yet low-calorie though it probably came here from Mexico. It has a won-vegetable that is high in fibre and immunity- derful flavour—very crisp, and easy to eat as a fruit or a rawboosting carotene (pro-vitamin A, which gets con- vegetable, though Mexicans also cook it. Besides taste andverted into vitamin A in the body). Plus, it is a very texture, the main thing in its favour is that it can be a cheap,good source of vitamin C and potassium (lowers hardy substitute for citrus fruit, apple or pear.blood pressure). The health equation: 1 cup (130g) contains 6g of fibre, The health equation: 1 cup (200g) pumpkin supplying just a little less than 30% of your daily require-has less than 70 calories, gives you 1.7g of fibre(you need 15g fibre per 1,000 calories a day, so ment of vitamin C. Besides, the complex carbohydratesthat’s 30g for the 2,000 calories an average man and fibre that are the bulk of this vegetable release en-might eat)—and it contains a whopping 145% of ergy gradually, slowing the rate at which its sugars are ab-your daily requirement of vitamin A. sorbed into the bloodstream. Perfect for those looking to tip the scales in a favourable direction too, at just 50 calories How to have it: Vitamin A is fat-soluble, a cup. so a little oil while making subzi is mandatory. How to have it: Peel and munch as a fruit; add it to aOr make a creamy soup of roasted pumpkin. You fruit chaat or shred it into a salad. Shredded yam bean iscan also make a warm salad of steamed pumpkin nice in a stir-fry for crunch. Or serve thin slices, raw orcubes dressed with olive oil, ginger and pumpkin roasted, with salsa or other spicy dip instead of greasy tor-seeds (replete with omega-3 fats). Vegetarians, try tilla chips or bread.pumpkin pie for a custard-like dessert.48 September 2016 Health Spectrum

Nutrition3. BLACK-EYED PEAS These beans, locally called lobia, are rich in the best sort of fibre—the solublekind—which helps to eliminate cholesterol from the body. Plus, lobia is a high-po-tassium, low-sodium food that helps reduce blood pressure. It’s pretty much a perfectfood, since it’s low in fat, high in fibre and, when combined with grains (chapatti orrice), supplies high-quality vegetarian protein. The health equation: 100g of cooked lobia is just 323 calories, very filling (3.8 gfibre and 24.1g protein), tasty and has no fats. How to have it: If you don’t like the regular curry, make a nice tangy salad withboiled lobia, some pineapple, apple and cucumber. The flavours go well together. 4. GREEN BANANAS 5. LYCHEE AND PLANTAINS This fragrant fruit is often not favoured These are excellent at promoting digestion and prevent- by dieters who equate anything sweet with ing constipation as they contain pectin, a kind of soluble fibre. weight gain, but in reality a single lychee has They also have the natural mood enhancer tryptophan, to calm only 6.1 calories, so you can eat 10 for just and soothe you on a hot, stressful day. Most importantly, they 66 calories—not bad compared with the sa- are a powerhouse of vitamins and minerals. Bananas also have tiety value of many 100-calorie snacks. Also, a calming effect; this is because they contain an amino acid lychees give you a large dose of vitamin C called tryptophan. This is converted to serotonin and causes a and contain flavanoids, a type of antioxidant calming effect because it is a brain inhibiting neurotransmitter. thought to prevent breast cancer. The health equation: 1 cup of mashed (cooked) plan- The health equation: 10 fruits (100g) tain has around 30% of your daily requirement of vitamins provide 72mg of vitamin C to help fight A and C, a good deal of potassium (regulates blood pressure seasonal colds and flues; in comparison, the and electrolyte balance) and vitamin B6 (essential for cardiac much-touted orange has only 30mg vitamin health). And contrary to the banana’s fatty reputation, it is ac- C per 100g. tually truly a “0% cholesterol” food How to have it: An excellent dessert, How to have it: Just don’t fry them. Instead, brush wedges resolving a sweet tooth much better than or slices with some oil and bake. Then munch with a spicy, many pastries and biscuits. Carry them un- home-made tomato-based sauce or add to a curry. You can peeled, as the peeling slows you down and also boil and mash it as a substitute for potatoes or use slices in prevents you from overeating. The peeled a subzi instead of potato—the texture is similar. You can also and deseeded fruit can also be frozen. use it as a rice substitute when boiled and mashed, to eat your curries with. September 2016 49Health Spectrum

Nutrition6. BEET 7. FINGER MILLET The health benefits of Extremely high in calcium, iron and protein, ragithis red, roughage-rich makes a great gluten-free flour. It is a whole grain, sovegetable are enormous. high in satiety too (from the fibre). Gluten-free ragi isFor starters, it is nutri- also a great bread substitute for people with gluten intol-tious, somewhat sweet erance. Being naturally sodium-free also makes it betteryet low in calories. 1 cup of chopped beet than bread or packaged cereals for hypertensives.(around 170g) has 10% of your daily requirement of vi-tamin C, a key antioxidant, as well as a large dose of fibre The health equation: 100g ragi has 328 calories—(1.5g), 34% of your folate needs for the day (it is essen- and 344mg calcium; the same quantity of rice has com-tial for a healthy cardiovascular system and to produce parable calo-red blood cells), and potassium—and has only 75mg. ries and only 9mg calcium. The health equation: 1 cup of shredded beet has The high iron35% of your daily folate requirement. Another group of and folic acidnutrients present in beetroot are flavanoids, which give are good forthem that deep red colour (buy the ruddiest bulbs you people whocan) and are powerful cancer fighters. are anaemic. How to have it: Grate raw into salads, hot or cold. How toBake or boil and purée into soup. Add chunks to make have it: It issome colourful dal and subzi. Purée and add to chapatti most convenient to eat as a porridge or in thin crepes.or paratha for festive colour. Marinate steamed or roast- You can enrich regular wheat flour (atta) with ragi floured baby beet in lemon juice, olive oil and fresh herbs to for more nutritious chapattis and bread.eat as a side dish to grilled meat or fish.8. JAMUN (JAMBULAN OR JAVA PLUM) This seasonal fruit is commonplace at roadside stalls, blood sugar by controlling pancreas functions (it containsbut many overlook this astringent mouthful for sweeter, a substance called jamboline, that blocks the conversionplumper imported plums. Yet, not only is the jamun a of starch to sugar).tasty treat, it is packed with nutrients, including bone-building calcium. A cup (130g) will also give you 24mg How to have it: They are easy to munch, but you canvitamin C (almost 30% of your day’s quota). also add them to salad or desserts. Purée or make into The health equation: 1 cup has juice, which can be frozen or added to a light sugarjust 80 calories and is a great di- syrup to make a preserve, if you want togestive (since it stimulates the liver enjoy them when they’re not in season.to secrete bile) and also excellent The purée can be used in frozen des-for diabetics, because it helps lower serts or as a tart sauce for a sweet salad, swirled into pancakes and the like. Berries – enjoy most of the berries in summer. Straw- store of vitamin A which lasts for months.berries with stem intact can be stored up to one year with Cherries – bright red cherries not only taste great butor without added sugar. The phytochemicals in blue ber-ries, blackberries, strawberries helps boost immunity, have also contain ellagic acid which inhibits the growth of carci-a protective effect against cancer, protects against heart dis- nogenic cells in the body.eases and circulatory problems. Cranberries have a healingeffect in urinary tract infection. Pineapples – besides being packed with most of the vi- tamins and minerals, pineapple is a very good source of an Peaches and plums – contain good amount of vitamin enzyme bromelain which aids digestion.C, beta carotene, antioxidant phytochemicals and antho-cyanins all of which help to eliminate the free radicals from For variety you can even try fresh fruit salad with somethe body. flavored low-fat yoghurt or just a plain fruit salad for des- sert. Papayas and mangoes – both are excellent source ofvitamin C, beta carotene, vitamin A and fiber. Eating suf- A fresh fruit juice will also help to satisfy thirst andficient amount of mangoes alone can make the body a rich avoid dehydration in summer months. But avoid consum- ing preserved fruit juices which contains preservatives,50 September 2016 added sugar and negligible fiber in it. n Health Spectrum