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| HEALTH TRIBUNE |
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Depression among children
Tips to avoid constipation
Gene responsible for liver cancer in animals discovered
Green tea helps kill leukemia cells
Facts about health of mothers and children
Mental illness in Pakistan
Ayurveda & you |
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Depression among children FOR the last few decades, teachers, parents, psychologists, paediatricians and psychiatrists have started focusing their attention on the mental health of children. In India, work in this field has just started gaining momentum. Depression, one of the most common psychiatric disorders, is going to be the second commonest illness till 2020 as per World Health Organisation predictions. Unfortunately, it remains untreated because of lack of awareness about the nature of the problem. The changing family structure, academic pressures, unrealistic expectations of parents and new socio-economic trends are sowing seeds of depression among children. Usually, chances of depression increase as the age advances. Both male and female children are equally prone to have this illness, but as the child advances towards adolescence it becomes more common in females.
Symptoms The following symptoms can be seen among children with depression. (i) A child develops an irritable mood, starts losing temper on minor issues and becomes quarrelsome sometimes. Excess of crying, getting angry and weeping spells can also be one of the manifestations. (ii) Depressed children may lose interest in friends and family members and prefer to spend most of their time alone, withdrawn in their room. (iii) Activities and hobbies they once enjoyed may no longer be of any interest to them. They may do well with their schoolwork, but the standard of work declines. (iv) Sleep cycle and appetite pattern can also change. There can be difficulty in initiating or maintenance of sleep. Early morning awakening is also common. Because of poor appetite such children may lose weight within a few months. Sometimes things are just reverse, like a tendency to sleep in excess and eat more. (v) Depressive illness in children, especially among younger ones, may be present in the form of physical complaints for which they undergo a number of investigations but no medical cause is found. The complaints may be in the form of recurrent pain in the abdomen, headache and vague shifting of pain at multiple sites in the body. (vi) Problems like tiredness, lethargy, forgetfulness, poor attention and concentration are also very commonly seen in depression. Such a child may appear as if he/she has no energy in the body. In later stages, activities like walking, dressing, bathing and eating become slow and sluggish. (vii) In a severe condition, thoughts of injuring the self or committing suicide can also appear.
Management If symptoms of depression seem to be present in the child, teachers and parents should get alert. They should try to look out for the cause, listen and spend time with the child. They can ask the child a few direct questions — “How are you feeling these days?”, Are you enjoying going to school, playing and meeting friends?, “How is your mood these days?” The child might answer like “I am worthless; I can’t do anything, everybody is better than me; life is not worth living”, etc. Such children may wish that they were dead. Younger children are not as good as others in expressing their emotions. So, changes in their behaviour may be the only indication of depression. Parents should talk to teachers, classmates, the school counsellor and other persons close to the child to know about any cause of stress. The child should be encouraged to talk and express his/her feelings. Professional help from psychiatrists and psychologists should be taken as early as possible because sooner this is done, the better are the chances of recovery. Psychiatric intervention includes complete assessment about the child’s mental state, family and environmental conditions, etc. Treatment is provided in the form of counselling, psychotherapy and medications if needed. One should remember the following points:
Only a child with a healthy mind can become a successful and self-confident person later in life. So, to keep the child in a perfect mental health is as important as in the case of physical health. The writer is Senior Resident, Deptt. of Psychiatry, Government Medical College and Hospital, Chandigarh.
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Tips to avoid constipation THERE
is widespread misconception that one daily bowel movement with good quantity of evacuation is essential for normal health. It is a general belief that if bowel is not cleared daily with good quantity of evacuation, toxins from the intestine are absorbed into blood and this causes all types of diseases. So, it is commonly said that chronic constipation is the root cause of all types of diseases. Due to the fear of such misconceptions and disbelief if one does not get one’s bowel cleared with good quantity of evacuation, one generally complains of headache, giddiness, head heaviness, body-ache, weakness, sleep disturbances, palpitation, reduction in efficiency, etc. On the advice of a quack, he takes a strong purgative and passes good quantity of stool and is relieved of complaints caused due to the tension from chronic constipation. As a result of purgative, the whole intestine becomes empty. It normally takes two-three days to fill the empty intestine resulting in no bowel movement for two-three days or so. Due to the fear of chronic constipation the person complains of tension again and again and is compelled to take some stronger purgative (even enema). So, he becomes a purgative-addict. In fact, the frequency of bowel movement and the quantity of evacuation of stools depend upon the diet taken. Those who take a very refined diet pass stool once in two-three days. Those on a very high fibre diet (high roughage/ residue) pass stool two-three times a day. Both are medically normal. No toxins are absorbed from the intestine in such cases at all. So, the frequency of bowel movement and the quantity of evacuation of stools depend on a refined and high fibre diet. It is only very hard or watery stools which need medical advice. In general private clinics every fourth patient complains of chronic constipation with symptoms of tension due to some disbelief. So, it is essential to understand the following points regarding normal bowel movement. Stools are made of residue of diet and water. So, a refined diet and lack of water is a major cause of chronic constipation. It is advised that one should take a high fibre diet (10-12 gm of fibres daily). Seasonal vegetables, salad, fruits, bran, unsieved flour (not maida) and plenty of water should be taken to keep stools soft. Lazy rectum is also a very important cause of chronic constipation. If one does not attend to the call of nature in time and properly, after some time even rectum is full. It stops sending a call, resulting in constipation. Regular, timely eating and an elimination (going to toilet) habit are very important. Enough time and privacy for complete evacuation are necessary. Incomplete evacuation in a hurry causes lazy rectum. To squeeze out stools, good tone of abdominal and pelvic muscles is important. In bed-ridden patients, very old people, persons with their tummies protruding out, doing no physical activity or walking, constipation is very common. It can be prevented by undertaking proper physical activity. It improves the muscular tone. When anything reaches the stomach, the colon is stimulated, resulting in a call for evacuation. Many people take a glass of water, a cup of tea or smoke a cigarette before going to toilet. This is helpful in avoiding a purgative. In the case of certain diseases when constipation is common, treatment of the disease is essential. Among these diseases are chronic amoebiasis, irritable bowel syndrome, intestinal obstruction, anal fissures, fistula, chronic depression and diabetes mellitius. Even a sudden change in the surroundings, lack of rest or sleep can cause constipation. The writer is a retired Chief Medical Officer
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Gene responsible for liver cancer in animals discovered
WASHINGTON: University of Illinois (UIC) researchers have discovered the gene that causes liver cancer in animals. When the gene, called Foxm1b, was deleted from liver cells in laboratory mice, the animals did not develop tumours. Even when the researchers attempted to induce the formation of these tumours artificially, using a standard laboratory technique, the mice remained cancer free. “To my knowledge, this is the first time a gene has been directly linked to the growth of cancer cells in live animals,” said Robert Costa, professor of biochemistry and molecular genetics in the UIC College of Medicine and the lead investigator in the study. Earlier studies had shown that Foxm1b is crucial for tissues to repair and replenish themselves, a finding that led Costa to dub it the ‘fountain-of-youth gene’. Foxm1b, which is stimulated by growth hormone, appears to malfunction in old age and in certain rare diseases that cause premature aging. It is one of a family of genes that controls the entire life cycle of a cell, including its proliferation, maturation and death. In the current study, scientists in Costa’s lab used genetically altered mice to establish the link between Foxm1b and liver cancer, showing that the gene is essential for cancerous cells to multiply. “Foxm1b is expressed in many different kinds of cancer cells, which leads us to believe it plays a key role in promoting the growth of tumours other than liver cancer,” Costa said. The scientists also created a prototype for a drug that would block Foxm1b activity and starve tumours cells of the protein that Foxm1b manufactures, preventing their multiplication.
— ANI
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Green tea helps kill leukemia cells
WASHINGTON: Mayo Clinic researchers have discovered that a component in green tea helps kill cells of the most common leukemia. The research using laboratory cell cultures shows that a component of green tea known as epigallocatechin-3-gallate (EGCG) [epi-gallo-cat-ekin-3-gal-ate] helps kill leukemia cells by interrupting the communication signals they need to survive. The findings are reported in an early electronic article in the journal Blood. The leukemia cells studied were from patients with B-cell chronic lymphocytic leukemia (CLL) - most often diagnosed in patients in their mid-to-late 60s. Currently, there is no cure for CLL, though chemotherapy is administered in the most severe cases. The Mayo Clinic study, led by Neil E. Kay, shows that green tea’s EGCG interrupted survival signals, prompting leukemia cells to die in eight of 10 patient samples tested in the laboratory. “We’re continuing to look for therapeutic agents that are nontoxic to the patient but kill cancer cells, and this finding with EGCG is an excellent start. Understanding this mechanism and getting these positive early results gives us a lot to work with in terms of offering patients with this disease more effective, easily tolerated therapies earlier”, Dr Kay said.
— ANI
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Facts about health of mothers and children
LONDON: South Asia is home to more than half of all the underweight children in the world, with alarmingly high maternal death rates. In fact, a third of the world’s child deaths also occur in South Asia. Doctors say that female illiteracy, poverty, and lack of empowerment of women are major barriers to improvement in South Asia. Yet, they show how substantial improvements have been achieved in some places by focusing resources on low cost primary care strategies and tackling socio-economic issues. According to an article in British Medical Journal, high levels of postnatal depression among South Asian women are affecting their children’s health and development. The authors of the article suggest that not only will nutritional programmes need to be strengthened to ensure that poor children and their mothers have access to an adequate diet, but interventions for preventing and treating postnatal depression may also be required. Researchers have also argued that health care for mothers and children is seriously inadequate, both in refugee camps and in the government hospitals of most poorly resourced countries. So they have called for the urgent integration of hospital and home-based health care for women and children.
— ANI
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Mental illness in Pakistan
LONDON: Researchers have reported in this week’s British Medical Journal that the levels of anxiety and depression among people in Pakistan are alarming but supportive family and friends may protect against the development of these disorders. These disorders are an emerging public health threat in low-income countries. Researchers analysed 20 studies conducted in Pakistan that focused on anxiety and depressive disorders in adults. The overall prevalence of anxiety and depressive disorders was 34 per cent but this figure may not apply to the whole population. Pakistan’s population has been exposed to socio-political instability, economic uncertainty, violence, and conflict for at least the past three decades.
— ANI
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Ayurveda & you ACCORDING to Ayurveda, like all Indian philosophies, the purpose of life is attaining salvation or unity of the soul with the Absolute. Thus, in the deeper Indian perspective, health is not an end in itself. If the body is looked upon as a vehicle to realise the materialistic pursuits of wealth and ambition, it is the good health of the mind, body and soul which is considered the base for an accomplished and fulfilled life. Though from time to time various scholars have explained health in their own way, the most popular definition is by the ancient sage and surgeon Sushruta. He describes health as a state of complete homeostasis encompassing a functional cohesiveness of three body humors, well balanced metabolism, the structural integrity of tissues, regularity of excretory functions and harmoniously interacting senses. It goes further to say that a healthy body should be joined by a pacified mind and transcending soul. In fact, the concept of three “doshas” known as “vata”, “pitta” and “kapha” or the body humors is vital to the ayurvedic philosophy. The body, which is seen as a composite structure made of seven types of tissues called “dhatus”, is governed by these humors. The constant wear and tear of the body require it to be replenished and repaired within the system only. Many times in a short description, good health is correctly portrayed as the structural and functional equilibrium of these humors and tissues. Ayurveda believes that all changes occurring in the body — from dense to more subtle — are controlled by “agni” or the fire. Of the 13 types of its forms, the main “agni” is the one located in the digestive system. Its functional equilibrium regulates other biochemical processes taking place in various tissues. If a balanced “agni” is vital for health, its vitiation leads to impaired digestion, improper metabolism and accumulation of toxins which ultimately become the reason for a chain of unhealthy reactions in the body. A well regulated waste system is also equally essential for the total upkeep of a person. Urine, faeces and sweat have been described as the three main excretable products. A proper urinary output regulates the balance of water in the body and the sweat helps maintaining its temperature besides keeping the skin supple and moist. The correct formation of stool and its regular evacuation is believed to be an equally important milestone leading to good health. The proper equipoise and coordination of the sense organs aiming to help the body to perform its other functions normally are also counted as an important constituent of the well-being of a person. We experience the world through one or more of our senses. As the sensory organs are an interface between the mind and the body and the body and the environment, all our positive or negative perceptions and experiences have good or bad effect on our health. The psycho-somatic connection, though believed to be a modern concept, was known to the Indians thousands of years ago. Ayurveda considers total health to be much more than the physical health. It describes a healthy and a balanced mind and spiritual well-being as the ultimate standard for good health. “Svastha” the Sanskrit word for health, literally means “to be established in the self”. It denotes that the journey towards perfect health and a purposeful and righteous life includes treading through the same path. The writer is a Ludhiana-based ayurvedic consultant |
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