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| HEALTH TRIBUNE | Wednesday,
November 20, 2002,
Chandigarh, India |
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All about
food allergies How to
keep coughs & sneezes at bay AYURVEDA & YOU INFO CAPSULE
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Kidney
transplantation-III The role of medical professionals in the sale and purchase of kidneys has come under scrutiny. In general, medical professionals are ethically conscious and concerned about patient welfare. However, idiosyncratic ethical orientations do exist among all professionals, including those in medicine. Illicit procurement and sale of organs could not have taken place if individual physicians and the medical community had abided by international standards and refused to perform the transplantation of organs of suspicious origin. Payments to the hospital concerned and doctors in most private hospitals depends upon the number of procedures performed. In a competitive environment, if the programme falters through donor shortage, the system of competitive covert payment (also called commission) to the middleman immediately comes into play. Such a situation often forces the "ethical niceties" of paid donation to the background. It must be pointed out, however, that some physicians support paid organ donation not because of any bias or self-interest, but because of their commitment to the best interests of the patient with kidney failure, irrespective of the consequences of this act for society. Medical professionals have traditionally enjoyed a high degree of respect in Indian society. A feeling of disillusionment and distrust has arisen in the public because of a perception that the medical profession is engaged in buying and selling human organs. Some ethicists and medical professionals have recently argued in favour of payment for donor organs. Others have suggested controls, including the elimination of middlemen or brokers, ban on advertising, an independent psychological review of donors and recipients, an independent surgical team for the donor, long-term insurance for the donor, including the coverage for catastrophic illness, subsidisation of the transplant of poor recipients by the rich, an obligation for the rich recipient to give to the community to which the donor belongs and no transplant in patients from other countries. At first glance, such schemes appear reasonable. However, numerous difficulties can be envisaged in their administration, both at the individual level and societal levels. A major argument in favour of paid kidney transplants is that they improve the lot of impoverished donors. Although thousands of such transplants have been performed in India, there is no data on the status of the individuals after they have donated organs for financial rewards. A team of US-based physicians, including Dr Ravi Mehta, an alumnus of the PGI, recently interviewed over 300 such individuals as had sold a kidney in Chennai. They were asked about the reasons for selling their kidney, the amount received from the sale, how the money was spent and about the change in their health status. The results of the study have been published in the Journal of American Medical Association. It showed that 96 per cent of the participants had sold their kidneys to pay off debts. The amount that the donors received was far less than what had been promised to them during the process of initial bargaining. Crucially, instead of improving, the family income actually declined by about one-thirds after donating the kidneys, and the number of participants living below the poverty line increased, from 54 per cent before donation to 71 per cent afterwards. About 75 per cent of the participants whose motive for selling the kidney was payment of debts, were still in debt at the time of survey. The US physicians also came across cases where wives had been forced to donate a kidney against their wishes because the husbands needed money. Over 95 per cent of the sellers admitted that the desire to help a gravely ill patient with kidney disease was not a factor in their decision. Close to 90 per cent of participants reported significant deterioration in their health status after the operation. When asked what advice they would give to others contemplating selling a kidney, over 80 per cent said that they would not recommend such a step. The physicians concluded that the Authorisation Committee failed in its job to ensure that the donations were motivated by altruism alone, the donors were poorly informed about the consequences of donation, and also that the cheating of donors by middlemen and clinics continued unabated. Dr Chugh is the Emeritus Professor of Nephrology and Dr Jha is an Associate Professor at the PGI, Chandigarh. (To be concluded)
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All about
food allergies Food allergy (FA) or food hypersensitivity is increasing worldwide. The prevalence is highest in preschool children, but it can occur at any age. It is more common in the children who have atopic dermatitis and asthma. FA occurs when an individual, instead of developing tolerance to a food, becomes sensitised to it. The symptom range and severity vary from patient to patient. Symptoms pertaining to skin and the gastrointestinal tract are common, like urticaria or chhapaki, itching, redness of skin, swelling of lips, eyelids, tongue, nausea, vomiting, diarrhoea and abdominal cramps. Respiratory symptoms like cough wheezing, sneezing, runny nose and blocked nose may be present. Life threatening reactions like anaphylaxis can also occur in some. Anaemia and the failure to thrive is seen in some types of allergic reactions. Some people with pollen or latex (rubber) allergy also develop allergy to certain foods. This is known as the oral allergy syndrome. Occasionally, a baby may develop allergy to some food (s) eaten by the mother via the passage through breast milk, but this is uncommon. Food allergy is the manifestation of different kinds of allergic reactions. Therefore, the timing of reaction can vary — from almost immediately after eating the culprit food to a few hours or few days later. In a child with atopic dermatrtis, itching may occur soon after eating egg (immediate type of allergy — IgE, mediated) and eczema may worsen after a day or so (delayed allergic reaction). Allergy can develop to almost any food, but some foods are more allergenic. These vary from region to region depending upon the availability of the food item processing and eating habits. Allergy to sea food (shrimp, lobster, prawn, crab, mollusks) is seen in coastal areas and in land-locked areas where seafoods are freely available. Similarly, allergy to fish is seen in areas where it is eaten frequently. Animal milk (cow, buffalo), egg and wheat are common food allergens. Dals (Mash, arhar, channa and rajmah, have been reported to cause allergy in some patients in India. Peanuts and tree nuts (almond, walnut, etc) are also allergenic to some. Fruits and some food additives may produce symptoms. Allergy can develop to foods which were tolerated earlier. Reactions to nuts and seafood tend to be more severe. Fortunately, milk and egg allergies disappear with age in most children but other allergies persist. If FA persists if it occurs late in life. Management consists of avoiding the allergenic food. It is easy to avoid a food which is eaten sporadically, but excluding a staple food like milk for a young child or wheat is a major challenge. Moreover, milk, eggs wheat and soya are used in preparing a number of food items. Those allergic to such foods must know about all food preparations likely to contain one or more of these. If a severe reaction to food occurs, the person concerned must be rushed to the nearest medical centre. People with severe FA should consult allergy immunologists to learn how they can reduce the risk to their life in the case of accidental ingestion of allergenic foods. There is evidence to prove that the incidence of FA and other allergies like atopic dermatitis (infantile eczema) and asthma can be reduced if babies are exclusively breast-fed for at least six months. A nursing mother should avoid allergenic foods in her diet. Common allergenic foods should be introduced in the child’s diet after two years of age. The writer, a senior
consultant at Chandigarh’s Chaitanya Hospital, was earlier associated
with the PGI.
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How to
keep coughs & sneezes at bay LONDON: Despite our best efforts, the cold virus appears to have remained immune to medical advances made in the last century. However, contrary to popular opinion, science does show that the common cold is susceptible to treatment in the form of specific vitamins, minerals and herbs. There is, indeed, good evidence to suggest that natural remedies for winter infections are not to be sniffed at. Our susceptibility to infection is essentially dictated by the efficiency of our immune system — the part of the body responsible for repelling unwanted organisms, including the virus responsible for the cold. One natural agent renowned for its immune-strengthening and anti-viral actions is vitamin C. Loading up on vitamin C-rich foods such as citrus and kiwi fruits in winter may help to keep infections at bay.
However, a more aggressive approach is
likely to work better if an infection is threatening. Studies suggest
that 1.5 to 4g of vitamin C, taken in divided doses during the day at
the onset of a cold, reduces the duration of the infection by about a
third. My experience is that a heavier-handed approach is often even
more effective. Taking 1 to 2g of vitamin C every two waking hours
until a day or two after symptoms disappear seems to stop most colds
in their tracks. Guardian
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AYURVEDA
& YOU Before the massive urbanisation and arrival of aerated cold drinks in India, buttermilk used to be a favourite item to be served both as a speciality and as an adjunct to the daily meals. Many Vedic hymns give its reference. Its antiquity leads us to the roots of the Indian civilisation. One famous saying goes thus: what "amrita" is to the gods, buttermilk is to human beings. Known as "takram" in Sanskrit and "lassi" or "chhaachh" in common parlance, buttermilk has been discussed in almost every ancient ayurvedic text. Acknowledging its immense therapeutic and nutritional value, it has been mentioned as the best among all milk products. Defining buttermilk, Acharya Sushruta has written that it is a compound made of curd and water , subsequently churned so as to have the contained cream and butter completely skimmed off. It should be neither too thick nor too thin. Two other varieties of buttermilk also find mention in ayurveda . One is called "ghola" made by simple churning of curd without water and the other one is known as "mathita" or "maththa". It is the crushed curd with a little water added to it. Buttermilk is an assortment of three tastes — sweet, sour and astringent. With the sweet post-digestive effect, it is slightly hot in potency and is light and soothing in effect. Buttermilk controls the vitiation of all the three "doshas" and is nutritive, freshening and appetising in action. It is a highly acclaimed medicine for diarrhoea, dysentery, chronic specific and non-specific colitis, piles, jaundice, and also in conditions where liver and spleen dysfunctions are involved. Buttermilk is also used in some of the "panchkarma" procedures. Some of its common household uses are as under" Diarrhoea and dysentery — Buttermilk has been used in gastrointestinal upsets since time immemorial as it helps in both acute and chronic conditions where the patient passes watery or semi-solid stool. Mixing of half teaspoonful of dry ginger powder in a glass of buttermilk adds to its digestive and carminative properties. Emaciated patients suffering from chronic sprue can also take buttermilk preferably before noon. The famous classic ayurvedic medicine "takrarishta" in which buttermilk is the chief ingredient is also helpful in such conditions. Piles and intestinal worms — Those suffering from first degree piles of a bleeding or non-bleeding nature get symptomatic relief by the use of buttermilk. For this purpose one to two gm simple powder of "hararh" can be taken twice daily with a glass of buttermilk for some time. Similarly, to cure stubborn intestinal worm problem, one gm powder of seeds of "vayvding", which are commonly available at the pansari shop, can be safely used for a few days. Liver diseases — In jaundice and alcoholic liver diseases regular use of "takram" immensely helps the patient to regain normal appetite and digestion. For faster relief, one gm powder of any of the proven liver protective herbs like bhringraj, chiraita or kalmegh can be taken along with buttermilk. Buttermilk recipe — To make an all season nutritive drink of buttermilk, take half a cup of home-made curd. Blend it slowly for a few minutes. Slowly add one glass of cold water and blend it again. After discarding the fatty foam appearing on the top, add half teaspoonful of cumin powder, a few leaves of mint, and a pinch of rock salt (table salt can be a substitute). Blend just enough to mix the spices evenly and serve at room temperature. Caution — Buttermilk should not be used during the flare-up phase of rheumatoid arthritis, in severe constipation, asthmatic conditions and following immediate exposure to heat. After taking into consideration the seasonal specifications and individual suitability, one can, for better results, use appropriate additives to it. The writer is a
Ludhiana-based senior ayurvedic consultant.
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INFO
CAPSULE LONDON: In one of the first studies of its kind, researchers have discovered that heart wall contraction improved significantly after patients had their own bone marrow injected into the scar tissue caused by heart attacks. Heart wall motion improved within weeks of treatment and persisted for at least 10 months after treatment in 14 patients. "The benefit of transplanting bone marrow into scar tissue of the heart could be seen only six weeks after injection", said Dr Manuel Galinanes, a heart surgeon at the University of Leicester in the UK. The technique is a new way to strengthen heart muscle after a heart attack. Bone marrow has been used for years to treat certain types of cancer and disorders affecting the body’s disease-fighting immune system. ANI Artificial pacemakers LONDON: Scientists in the USA believe it may one day be possible to use a person’s own body tissue to repair damage around the heart, thus making artificial pacemakers redundant. Tests on rats suggest that implanting manipulated tissue back into the body could help people’s hearts to beat regularly. About 22,000 people in Britain are fitted with pacemakers every year. The electronic devices are mostly used to speed up heart rates. The pulse slows down if the electrical connections between the different chambers of the heart are damaged. This can occur as a result of disease or a heart attack. Pacemakers can restore a regular rhythm. ANI Engineered blood vessels WASHINGTON: Researchers have built mechanically sound blood vessels out of tissue from human skin cells that did not burst or develop blood clots in laboratory tests and short-term animal experiments. The technique involves tissue engineering, an emerging science that takes cells from the body, manipulates them in the laboratory to create functional tissue, and puts the new tissue back into the patient. ANI Latest on immune system LONDON: Protecting babies from infections for the first six months of life could reduce the chance of asthma. Moreover, a new study suggests that there is some evidence that exposure to certain infections may actually be good for children. A study at Imperial College, London, on mice suggests that picking up a particular type of virus during this period makes re-infection far more serious. Putting aside the extreme
difficulty in keeping a baby from picking up infections, it has been
suggested that extensive contact with other children, and by implication
an increase in exposure to common infections, may protect from a variety
of illnesses — some serious. ANI |
