How to keep your spine healthy
Anupam Jindal

BACKACHE/NECK pain, though not life-threatening,cause considerable disability. The pain originating in the spine can be acute (rapid recent onset) or chronic (gradual onset). Both can occur due to congenital abnormalities of spine, trauma, prolapse intervertebral disc, osteoarthritis, infections of spinal cord or its coverings, indulging in unaccustomed exercises.

Initial pain management is conservative (medicinal) but if the patient continues to have pain/neurological symptoms or develops other complications, then surgery may be required. Medicinal measures consist of analgesics (painkillers), bed rest and physiotherapy to strengthen back muscles. Those patients who are not benefitted by medical management can be treated by transcutaneous electrical stimulation, surgery (microdissectomy), epidural corticosteroid injections.

The following are some simple measures to keep spine healthy:

• Use proper sitting, lying postures.

• Back exercises: Lie down on the abdomen and lift both the legs without bending, one by one. Then lift the shoulders in the same position. "Surya Namaskar" is another good exercise for the spine (consult doctor before starting these exercises).

• Control your body weight.

• Avoid lifting weights.

• Avoid jerky movements of the neck/spine. (Consult doctor if you develop the following symptoms):

• Pain in the back/neck which also goes to the legs/arms.

• Pain associated with weak-ness/ numbness/thinning of legs/hands.

• Pain not responding to therapy.

• Any stiffness in legs/arms.

• Problem in passing urine and stool especially if it is of recent onset or abnormal sensation.

• X-ray helps in showing bone density, abnormal bony projections, spinal instability and congenital abnormalities of the spine.

• Depending upon the symptoms further investigations like MRI are performed to see the exact abnormality — MRI can easily reveal a prolapse disc, tumor, infection of spine, congenital abnormalities.

If you have any of these symptoms/problems, you may require surgery, the nature of which depends upon the cause of your pain. Surgery can vary from simple dissectomy to use of stainless steel/titanium plates to stabilise the spine. The results of the surgery may vary. In a simple disc case, there are good chances of improvement with minimal risks.

Though backache/neck pain are related to disc pro-lapse, it can be much more than that. Consult your doctor in case the pain persists.

The writer is Consulting Neuro-Surgeon, INSCOL Hospital, Chandigarh.

Inhalation therapy for asthma: some myths
Rajinder Singh Bedi

ANTI-ASTHMA therapy has made significant progress in recent years. Modern drugs and devices now make it possible for an asthmatic to lead a normal active life.

Our understanding of asthma has undergone a major change over the years. Compelling evidence reveals asthma to be a chronic inflammatory condition. Thus, asthma has two components: the spasm and the swelling. And this gives rise to the twin aspects of asthma treatment: relief and prevention.

Anti-asthma drugs are classified into two groups: relievers and preventers. Relievers treat the spasm component and preventers deal with the swelling component of the asthma. These drugs can be administered through oral (tablets, syrup), parenteral (injections) or inhalation routes. Currently, the most favoured route worldwide is the inhalation route due to a number of benefits. Metered-dose inhalers (MDI), drug powder inhalers (DPI) and nebullisers are three modes of inhalation therapy available currently.

Owing to illiteracy, poverty and ignorance, a number of myths and misconceptions are prevalent in India. As a result, the majority of our asthmatics still prefer oral drugs. A lot of stigma is still attached to "asthma" and people want to hide their ailment. This is true in the case of newly married women and young girls of marrigeable age. People feel that by using inhalers, their disease will be exposed and they will be easily identified as asthmatic.

A large umber of asthmatics consider inhalation therapy as the last resort, meant only for very chronic cases or for severe attacks. This assumption is not based on scientific facts. The basic defect due to asthma, that is swelling (inflammation)of airways is present even in mild cases and in very early stages of the disease. Unless we tackle this swelling early, the swelling will increase. This can be controlled only by inhaled preventive drugs.

The majority of our patients consider inhalers as addictive devices, which they will have to use life long. Preventive inhalers are the only drugs, with which we can stop progression of the disease, reduce its severity and control it effectively without significant side-effects. If one does not take effective preventive treatment, the disease will advance and more drugs may be required to control it later.

Many patients are under the impression that inhaler drugs will damage their lungs in the long run. This is totally baseless. By administering inhaled drugs, we are directly supplying the drug to lungs. The dose of drug is markedly reduced, thereby producing no local or systemic damage or side-effects. In fact, inhalers are the safest mode of drug administration for asthma patients.

A high degree of "steroid-phobia" is prevalent in the general population and asthmatics, apparently due to poor compliance to steroid inhalers. Steroids used by inhalation are not those used by some athletes and body builders to increase their muscles. Inhaled steroids taken in prescribed dosages do not have any serious side-effects. Steroid inhalers are the most effective anti-inflammatory drugs available.

Some patients stop using inhalers (especially preventive ones) as they do not notice any perceptible subjective improvement immediately after steroid inhalation. We should understand that preventive inhalers take longer to work, maybe a week or more before one feels the benefit; but they treat the underlying inflammation so that the lungs are no longer irritable and one will have less asthma symptoms.

Some patients, who start using inhalers, discontinue the treatment because of the high cost of steroid inhalers. But regular inhalation therapy is more cost-effective and less expensive treatment than using oral medication regularly. With regular preventive therapy, chances of severe attacks are also reduced, resulting in good savings.

Many patients discontinue inhalation therapy as they seem unable to use metered-dose inhalers (MDI) properly. Technical difficulties can be overcome by using MDI with spacers or rotahalers which are compact, portable and cheaper.

It is time the myths and misconceptions about inhalation therapy were dispelled . Patient education is vital as the success of our efforts is directly linked with the change in the socio-economic and educational status of the masses. The whole exercise requires a lot of patience and sustained effort.

The writer is with Bedi Nursing Home, Patiala.

AYURVEDA & YOU
Mango, the fruit medicine
R. Vatsyayan

MANGO has fascinated Indians from time immemorial. The cluster of mango leaves can be seen in many of the paintings and sculptures of Ajanta and Elora. The unique fragrance of its blossom and the unrivaled sweet taste of its fruit have been immortalised in the ancient Sanskrit literature which include the Valmiki Ramayana and the voluminous work of Kalidasa.

Ayurvedic texts also didn’t lag behind and have abundantly eulogised the medicinal qualities of mango. Known as amra and rasala in Sanskrit, mango had been explored for its healing properties by the ancient seers who have written in detail the usefulness of whole of its tree including the leaves, flower, fruit, seed kernel and the tree bark.

The unripe mango fruit is astringent and sour in taste and light, dry and cold in effect. But the ripe one is sweet, heavy and unctuous and also pacifies vata and pitta. Its chemical profile renders it to be a fruit of very high nutritive value.According to modern analysis, mango is rich in vitamins and also contains amino acids, starch, sugar content and an alkaloid known as mangiferin.

According to ayurveda, varied medicinal properties are attributed to different parts of the mango tree. Its leaves, root and bark are astringent, acrid, haemostatic, antiemetic and constipating in nature whereas the seed kernel is refrigerant, killer of abdominal worms and is also a uterine tonic. Unripe mango fruit has been described as digestive, carminative and appetiser. Ripe fruit is sweet, laxative, emollient, anti-oxidant, aphrodisiac and cardiac and general tonic.

Ancient ayurvedic texts have mentioned the application of mango fruit and other parts of its tree in various diseases. The root, bark, leaves and the fruit kernel are given to cure vomiting, hyperacidity, diarrhoea, intrinsic haemorrhages, uterine inflammations and other female disorders like white discharge and excessive menstruation. The unripe fruit is known to have very good effect if used in case of heat stroke, burning sensation, loss of appetite and urinary incontinence. The ripe mango is mildly laxative and is indicated for emaciation, anaemia, liver and spleen diseases and also in general weakness.

Mango is used as an easy household remedy throughout India. The bark of mango tree has an astringent action on mucous membranes and in case of diarrhoea and dysentery, its two gm dried powder, if taken two three times a day with water or buttermilk, has very good effect.

Mango seed kernel is famous for its salutary effect in non-specific leucorrhoea and is given to eat in roasting form. Mango leaves tone up the gums and are used in many tooth powders. Gargles of decoction of mango leaves are beneficial in case of mouth ulcers and spongy gums.

The amra phala prapanaka (panha) made with juice of unripe mango, sugar, cardamom and pepper is a popular home dish which allays excessive thirst and is a prophylactic remedy against heat stroke. Though mango is used in many other forms like sharbat, murabba, pickles, squashes and is also eaten as fruit, pushyanug churna and chandanadi churna are the famous classic ayurvedic formulations which contain mango as an important ingredient.

The writer, an Ayurvedacharya, is based in Ludhiana.

A new high-tech drug for diabetes is dramatically improving treatment for all types of diabetes and reducing dependence on insulin shots for those newly diagnosed with the disease. Until now, no treatment has been able to stop the downhill progression of the disease. After taking the experimental drug for just two weeks, nine of 12 diabetics were able to decrease their need for insulin shots, and with very few side effects, media reports said.

"The most important implication of this research is we can intervene in type I diabetes after onset and still have an impact," according to senior researcher Jeffrey A. Bluestone, Director, University of California San Francisco (UCSF) Diabetes Centre. "This opens up the door to a whole host of other approaches, not just this drug."

In the first human study, 12 people aged 7-27 with type 1 diabetes received daily injections of the new drug for two weeks. Patients began treatment within six weeks of being diagnosed with type 1 diabetes and reported only minor side effects.

The study is featured in The New England Journal of Medicine (May 30, 2002). Bluestone has filed a patent application for this new drug and has a commercial agreement regarding its use with Centocor and Johnson & Johnson Pharmaceuticals. IANS

Here’s an entirely new dimension to the weather-beaten expression ‘marching shoulder to shoulder’.

The Hindustan Latex Limited (HLL), a condom-manufacturing company, will launch female condoms in the country in collaboration with the United Kingdom-based Female Health Company.

HLL Executive Director M. Ayyappan told mediapersons at Madurai that the condoms would be initially imported and marketed. Later, they would be locally manufactured in a phased manner.

Costing Rs 25 each, they were being used in European countries for the past eight years, he said, adding that an acceptability study was being conducted in Andhra Pradesh. The product would be commercially launched in six months, Mr Ayyappan added. UNI

Young women in Sub-Saharan Africa are more susceptible to HIV infection than men because their partners are often older than they are, researcher said. Older men are more likely to have the virus and pass it on to their younger partners, who in turn may infect others when they marry and have children.

It is perpetuating the disease. Basically it is passing it from one generation to the next, said Dr Simon Gregson of Imperial College in London. Sub-Saharan Africa, with more than 28 million people living with HIV/AIDS, is most severely affected by the disease. In some countries, in the area, 20 per cent of people aged 15-49 are infected with the virus.

Gregson and researchers from the Joint United Nations Programme on HIV/AIDS (UMAIDS) conducted a study in Manicaland, a province in eastern Zimbabwe, to assess how the disease is spread.

After interviewing 10,000 men and women, they found that while young men under 25 usually had relationships with women their own age or a few years younger, women tended to have partners five to 10 years older than themselves. Reuters

Pacemaker rescues sick stomachs

A new, implantable electronic device that operates like a heart pacemaker could bring relief to thousands of people suffering from diseased guts, a pioneer in the field has predicted. "It’s the beginning of tut pacing, where cardiac pacing was 20 years," said, Dr Richard W. McCallum, Professor of Medicine and Chief of Gastroenterology and Hepacology, University of Kansas Medical Centre inKansas City, Kan.

McCallum told United Press International medical treatment entered a new age of gastric electrical stimulation to help people he describes as "gastric cripples." McCallum made his prediction at the annual conference during the Digestive Disease Week, where some of his pioneering work, including the Enterra Therapy gastric electric stimulation system, was featured.

At least 700,000 people in the USA are afflicted with vomiting or nausea so intrusive that it has forced many of them to put both careers and personal lives on hold. The cause of their suffering might stem from nerve deterioration caused by type 1 diabetes or surgical procedures that accidentally damaged the gastric nerves or nerves not properly formed at birth. UPI