Future medicine April 2014

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Future KERENG/2012/44529

April 2014

Medicine

Summer special

Foods & Drinks

Disease special Diabetes

A ticking time bomb

Sexual Health

Keeping romance alive

Sex education

Underage alcoholism

You Booze You Looze UAE - AED 7 US - $5 India - `50

who will deliver?

Social Health

Mobile Mania Sports medicine, Health Beat: Beauty Fitness yoga


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EDITOR’S NOTE Threat of underage alcoholism

F

irst it was just out of curiosity. If the first episode was quite accidental, the second and the succeeding episodes were planned ones as the previous experience could have been nice and exhilarating. This is the way a young boy initiates himself into the world of alcohol and narcotics. There are many valid reasons that tempt the young mind for enjoying this elated state. The young brain starts resorting to temporary comfort induced by hallucination. Loneliness, absence of love and redundancy has already given him a distorted or rather an immature view of life and persons around him. Easy accessibility of the stuff, or a hostile environment at home or the school makes him more vulnerable and tempted to get intoxicated even before he could understand what good and bad mean. By the time the people concerned intervene, the boy might have travelled a long way through the dark alleys of life. In our society, the shocking reality is that the number of youngsters taking to drinking and drug abuse is alarmingly high with most of them kick start the habit much early. It is not just an individual tragedy but a social menace affecting numerous families. Besides being illegal, underage drinking is particularly causing lots of health problems posing challenges to the wellbeing of the society. Economic and social development of our society receives a setback due to health hazards and disorientation of the younger generation. So it is our endeavour to save the young generation from alcoholism and drug abuse. The cover story of this issue brings to light the growing trend of underage alcoholism and its impact on our society. It also analyses how and why youngsters become an easy prey to alcohol and drugs as well as who are responsible for the social evil-- parents, teachers, communities or government policies. Mobile phones have become the latest object of addiction and the extent of damage it has caused is beyond one’s imagination. Although these phones are just a convenient tool for communication, it seems people can no longer live without them. The attachment to the device is so strong that people feel powerless and lonely in life in its absence. We have a detailed story on the mobile phone use today as this electronic device turns 41 on April 5. Above all, our readers, we are sure, will like the newlook Future Medicine from this issue onwards and we hope that it would be pleasing to all of you.

6 FUTURE MEDICINE I April 2014



cONTENTS

38

52 Keeping romance alive

COVER STORY

It is imperative to keep romance alive in a married life for intimacy and closeness between partners, by Mitch Temple

Lost in the tipsy world Alarming increase in youngsters taking to alcohol and drugs is a matter of great concern across the world. It is not only a self destructive act; it also destroys family relations and the society itself. Future Medicine looks at the younger generation lost in the tipsy world and the problems they raise in a society

30 A ticking time bomb The incidence of diabetes is rapidly rising all over the globe at an alarming rate. Dr Mohan reveals the present scenario of diabetes

36

14

Wash your hands, please!

Summer fruit: watermelon

Knowledge about proper hand hygiene practices on campus can help prevent illnesses

watermelon, the sweet red-fleshed fruit, is found to be associated with a wide range of benefits

19

69 Kalari for overall health

The sweet danger

There was a time when kalaripayattu and kalarichikilsa were part of our daily life

Though our cells need sugar (glucose) to survive, consuming too much of it can cause numerous health problems

Doctors sPeAK Headache Pelvic endometriosis Cervical cancer Neck pain Menopause

Dr Debnarayanan Dutta Dr Muhammed Ashraf Dr Nalini Kilara Dr Arun Oommen Dr MP Vijayalakshmi


56

62

65

67

Mobile mania

46

The mobile phone turns 41 on April 5. It, no doubt, has changed our lifestyle immensely, but its impact on our behaviour and quality of life hasn’t all been positive

Needed sex education Adolescence is the most fascinating time in one’s life, when one gets attracted to the opposite sex, wanders like a cloud in a dream world

Like a phoenix… Laxmi, a victim of acid attack and now Stop Acid Attacks campaigner, has been selected by the US for the International Women of the Courage Award

Migraine malaise Migraines can be overcome by resorting to home remedies which appear to be simple but are really capable of providing instant relief from severe migraines

Summer special Summer is fast setting in and people are scurrying around seeking ways to contain the harsh effects of the hot season. A look at the guidelines in Ayurveda to combat the ill-effects

Insurance for the elderly

72

How prepared are you for the twilight zone?

50

23

Get rid of excess hair

Partner yoga

Do you have excess or unwanted hair growth? There are effective remedies other than hormonal treatments to fix this problem permanently

Partner yoga is a harmonious blend of yoga and acrobatics practised together by couples/partners

April 2014 I FUTURE MEDICINE 9


PHOTOSPEAK

10 FUTURE MEDICINE I April 2014


Against all odds Nicholas James "Nick" Vujicic

was born on 4 December 1982. He was not a normal child as he had no legs or arms - just one foot with two toes that protruded directly from his left thigh. However, his parents were determined to prepare him for a normal life. When he was 18 months old, they taught him to swim, type on the computer keyboard using his toe. A special plastic device that slid between his toes helped him to hold on to a pencil and 'write' at school. Encouraged by his parents, he has not only graduated from college, but also established a non-profit organisation called Life Without Limbs, for people with disabilities. The 26-year old who now resides in Los Angeles, spends his time travelling and giving motivational speeches to disabled people all over the world.


World Health Day

Preventing vector-borne diseases World Health Day is observed on April 7 every year to mark the anniversary of the founding of World Health Organisation in 1948. Each year, a theme is selected to highlight a priority area of public health. The Day provides an opportunity for all to get involved in activities that can lead to better health. The topic for 2014 is vector-borne diseases By FM Bureau

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Towards better health


V

ectors are organisms that transmit pathogens and parasites from one infected person (or animal) to another. Vector-borne diseases are caused by these pathogens and parasites in humans. They are most commonly found in tropical areas and the places where access to safe drinking-water and sanitation systems is problematic. The most deadly vector-borne disease, malaria, caused an estimated 660 000 deaths in 2010. Most of these were children in African countries. However, the world’s fastest growing vectorborne disease now is dengue, with a 30-fold increase in incidences over the last 50 years. Globalisation of trade and travel and environmental challenges such as climate change and urbanisation has increased the transmission of vector-borne diseases, causing their appearance even in countries where they

were earlier unknown. In recent years, renewed commitments from ministries of health, regional and global health initiatives with the support of foundations, non-governmental organisations, the private sector and the scientific community have helped to lower the incidence and death rates from some vector-borne diseases. World Health Day 2014 will spotlight some of the most commonly known vectors – such as mosquitoes, sandflies, bugs, ticks and snails – responsible for transmitting a wide range of parasites and pathogens that attack humans or animals. Mosquitoes, for example, not only transmit malaria and dengue, but also lymphatic filariasis, chikungunya, Japanese encephalitis and yellow fever.

Protection from vector-borne diseases •

The campaign aims to raise

awareness about the threat posed by vectors and vector-borne diseases and to prompt families and communities to take action to protect themselves. A core element of the campaign will be to provide communities with information. As vector-borne diseases begin to spread beyond the traditional boundaries, action needs to be expanded beyond the countries where these diseases usually thrive. Enable families living in areas where diseases are transmitted by vectors to protect themselves Making travellers aware to protect themselves from vectors and vector-borne diseases while travelling to countries where these pose a health threat.

Vector control methods

Indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) are the two most important vector control measures that protect humans from the bite of malaria-carrying mosquitoes. In specific settings and under special circumstances, vector control interventions can be complemented by other methods such as larval source management and a scale-up of personal protection measures.

Insecticide resistance

Endemic countries are urged to draw up and implement comprehensive insecticide resistance management strategies and ensure timely entomological and resistance monitoring.

WHO-approved products The WHO Pesticide Evaluation Scheme (WHOPES) coordinates the testing and evaluation of pesticides for public health and makes recommendations on vector control tools such as longlasting insecticidal nets (LLINs) and insecticide compounds and formulations for IRS and other vector control interventions where appropriate.

Advisory bodies

The Vector Control Advisory Group (VCAG) on new tools and the Technical Expert Group on malaria vector control (VTEG) are the two main advisory bodies addressing policy topics related to malaria vector control. April 2014 I FUTURE MEDICINE 13


healthy Fruit

Watermelon

ABCD of the popular summer fruit

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Some people avoid watermelon because they assume that it has high levels of sugar. However, the sweet red-fleshed fruit is found to be associated with a wide range of benefits. Its therapeutic properties include ability to improve male potency, prevent cardiovascular disease and relieve muscle soreness


There are more than 1200 varieties of watermelon with red, orange , yellow or white flesh

By FM Bureau

R

esearchers at Florida State University found that watermelon is effective in preventing prehypertension (which can lead to cardiovascular disease). The lead author of the study, Professor Arturo Figueroa, said: “Watermelon is the richest edible natural source of L-citrulline, which is closely related to L-arginine, the amino acid required for the formation of nitric oxide essential to the regulation of vascular tone and healthy blood pressure.”

Relieves muscle soreness

Eating watermelon could be an effective means of alleviating the pain associated with muscle soreness. A study, published in the Journal of Agricultural and Food Chemistry, revealed that eating watermelon can help treat post-exercise muscle soreness because of its high levels of L-citrulline.

Improves erectile function

A study conducted by researchers at Texas A&M found that phytonutrients in watermelon can relax blood vessels in the same way Viagra does. The authors of the study said: “We’ve always known that watermelon is good for you, but the list of its very important healthful benefits grows longer with each study.”

Vitamin rich

The flesh of a sweet watermelon is delicious, but the peel is equally good. The white rind part has huge amounts of citrulline, an amino acid that is rich in vitamin C, beta carotene and lycopene, and it also contains amounts of Thiamaine, Riboflavin, vitamin A, Niacin, vitamin B6, Calcium, Iron, and Zinc too! Just saute the rinds in oil, season with salt, pepper and red chilli flakes to enjoy it.

Store the fruit outside fridge

It might be better to store your watermelons outside the fridge. A group of researchers at the USDA Agricultural Research Service found that watermelons are a lot more nutritious when they are stored at room temperature as opposed to being refrigerated.

Alongside tomatoes, watermelon has moved up to the front in recent research studies on high-lycopene foods. Lycopene is especially important for cardiovascular health, and also for bone health


Prevention

Deafness

Can you hear??? An estimated 360 million people, 5% of the world population, suffer from hearing loss. Though most of the cases are avoidable through proper medication and care, many countries lack the needed medical facilities to help the victims By Tarik Jasarevic (Communication Officer, WHO)

M

any of the countries who responded to a recent World Health Organization (WHO) survey lack the capacity to prevent and care for hearing loss, according to a report published on International Ear Care Day on March 3. WHO estimates that over 5% of the world’s population – 360 million people - has disabling hearing loss. The highest prevalence is found in the Asia Pacific, South Asia and sub-Saharan Africa. About half of all cases of hearing loss worldwide are easily prevented or treated. A leading cause of hearing loss in younger ages, particularly in low- and middle-income countries, is untreated ear infections, which often present with discharge from the ear. Vaccine-preventable infectious diseases such as rubella, meningitis, measles, or mumps can also lead to hearing loss. Just 32 of the 76 countries who responded have developed plans and programmes to prevent and control ear diseases and hearing loss. According to the report, many lack trained health personnel, educational facilities, data and national plans to address the needs of those living with hearing problems. The information received also indicates that the gap between need and services is greatest in sub-Saharan Africa. “The results of this survey are a clear call to action for governments and partners to invest in ear care, especially at community and primary levels,” says Dr Etienne Krug, Director of the WHO Department of Violence and Injury Prevention and Disability. “The programmes must aim to benefit all, including disadvantaged section of the population who are least able to access hearing services,” Krug adds.

Early detection & treatment

Good ear care practices, such as reducing exposure to noise and avoiding insertion of objects into the ears, can prevent many from developing ear and hearing problems. A large percentage of people living with hearing loss can benefit from early detection and appropriate treatment. For example,


When a foreign object is in the ear A foreign object in the ear can cause pain and hearing loss. Usually, you will know if an object is stuck in your ear, but small children may not be aware of it. If an object is lodged in the ear, follow these steps:

Don’t probe the ear with a tool:

screening programmes for infant hearing can minimise the impact of hearing loss on a child’s development. “Ear and hearing problems and the use of hearing aids are often associated with myths and misconceptions,” says Dr Shelly Chadha of the WHO unit for the Prevention of Blindness and Deafness. “National programmes should therefore not only focus on prevention and service provision but also on awareness raising.” The national plans that already exist in some countries can serve as a model for countries that still lack strategies to better address disabling hearing loss. However, each country needs to develop a unique plan based on its specific situation, the prevalent causes of hearing loss as well as the available health infrastructure.

Emergency Care

Don’t attempt to remove the foreign object by probing with a cotton swab, matchstick or any other tool. It would push the object farther into the ear and cause damage to the fragile structures of the middle ear.

Remove the object if possible:

If the object is clearly visible, pliable and can be grasped easily with tweezers, gently remove it.

Try using gravity: Tilt the head to the affected

side to try to dislodge the object.

Try using oil for an insect: If the foreign

object is an insect, tilt the person’s head so that the ear with the offending insect is upward. Try to float the insect out by pouring mineral oil, olive oil or baby oil into the ear. The oil should be warm but not hot. As you pour the oil, you can ease the entry of the oil by straightening the ear canal. Pull the earlobe gently backward and upward for an adult, backward and downward for a child. The insect should suffocate and may float out in the oil bath.

Don’t use oil to remove any object other than an insect: Do not use this method

if the child has ear tubes in place or if there is any suspicion of a perforation in the eardrum— pain, bleeding or discharge from the ear. If these methods fail or the person continues to experience pain in the ear, reduced hearing or a sensation of something lodged in the ear, seek medical assistance.

Courtesy: Mayo Clinic

A foreign object may interfere with breathing. Both children and adults can accidentally inhale objects that are in their mouths. Children are especially prone to this. Objects that pass into the airway can sometimes move into the stomach. Coins are the object most commonly swallowed by children. (University of Chicago)

April 2014 I FUTURE MEDICINE 17


Health Beat

Latest news in Health, Nutrition, Beauty, Sex, Yoga and Fitness

Garlic good for babies arlic may be bad for your breath, but it’s good for your baby, according to a new study from the University of British Columbia. The study, recently published in Applied and Environmental Microbiology, is the first to identify two compounds derived from garlic--diallyl sulfide and ajoene--that significantly reduce the contamination risk of Cronobacter sakazakii in the production of dry infant formula powder. The discovery could make the product safer to consume, easing the minds of new mothers who can’t or opt not to breastfeed. Xiaonan Lu, co-author and assistant professor of food safety engineering in the Faculty of Land and Food Systems, says the garlic compounds could be used to prevent C. sakazakii contamination on food contact surfaces and in every step of food production from processing, packaging and delivery.

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Nutrition Beat Here are some common foods and drinks with sugar content

Sweets Milk chocolate bar (44g) - 5.75 teaspoons of sugar Snickers bar (57g) - 7 teaspoons Milky Way bar (58g) - 8.5 teaspoons Marshmallows (100g) - 14.5 teaspoons Caramel piece (10g) - 1.7 teaspoons Starburst packet (45 g) - 5.5 teaspoons

Soft drinks Coca-Cola (one can) - 7 teaspoons of sugar Red Bull (one can) - 7.5 teaspoons Lemonade (one glass) - 5.5 teaspoons Orange squash (one glass) - 2.5 teaspoons Fruit smoothie (one glass) - 3.5 teaspoons

Fruits (per 100 gm)

The sweet danger T

hough our cells need sugar (glucose) to survive, consuming too much of it can cause numerous health problems. Added sugar contains no beneficial nutrients and it only contributes to tooth decay, diabetes, and obesity. In our fast-paced life, it may be difficult to keep a healthy balance of nutrients in our food. Sugar is one of

these nutrients and the cells in the body will die without it. However, nutritionists strongly recommend against consuming more than 13 teaspoons a day. To help you keep track of how much sugar you’re consuming we’ve listed some common everyday foods and drinks, together with the sugar content.

Mango - 3.2 teaspoons of sugar Banana - 3 teaspoons Apple - 2.6 teaspoons Pineapple - 2.5 teaspoons Grapes - 4 teaspoons Lemons - 0.6 teaspoons Kiwi fruit - 2.3 teaspoons Apricots - 2.3 teaspoons Strawberries - 1.3 teaspoons Tomatoes - 0.7 teaspoons Ice cream (1 scoop) - 3 teaspoons (By arrangement with Medical News Today)


Fitness Beat

Running makes you happier You’ve probably heard it that ‘exercise is medicine’. Well, it’s not just a saying; it’s the truth. There’s a raft of scientific evidence that proves that regular exercise (150 minutes per week, which is about 30 minutes five times per week) and running in particular has health benefits that extend well beyond any pill a doctor could prescribe. Studies have shown that running can help prevent obesity, Type 2 diabetes, heart disease, high blood pressure, stroke, some cancers, and a host of other unpleasant conditions.


Beauty Beat

Pink

lips Mineral makeup in vogue

M

ineral makeup is becoming very popular amongst women as it claims to be the most natural product for the skin and which stays longer than any other makeup. There are thousands of varieties of mineral makeup available in the market. Some of them are matte, some have golden and silver shimmer and

the rest are sparkling. The makeup ingredients are common minerals such as zinc, mica, titanium dioxide and iron oxide. Each of these minerals has unique properties that benefit the cosmetics. For example, unlike other makeup, mineral makeup is applied only in small amounts on the face with the help of makeup brushes. They are applied to the skin in circular

motions and moderate use of them helps to maintain a natural and fresh look all day long. Mineral makeup doesn’t easily wear off or sweat off; a person wearing mineral makeup can even swim in the water for long hours without getting the makeup smudged or washed off. It is good for those young girls who have a sensitive skin that often develop allergies, irritation and rashes with the commonly available cosmetics. The titanium dioxide and zinc oxide present in the makeup help the skin to calm and soothe. They are also very potent sunscreens as they deflect harmful UV rays. They are free of oils and hence do not clog pores of the skin.

H

ealthy and pink lips are every girl’s dream. Texture and colour of your lips can reveal a lot about your health and lifestyle. With a little bit of care, you can achieve pink, luscious and attractive lips, as you ever wanted. Apply honey on lips at bedtime and massage with a soft brush next morning. This will clear the dry and scaly layer on the lips. Take a handful of rose petals, add some cream and make paste and apply on the lips, you will see your lips become soft and pink. Apply half a teaspoon of olive oil mixed with sugar and honey on the lips, which will make your lips soft and pink. Slice a lime into half and apply on the lips in a circular motion. Apply the cream that is got from boiled milk, it moisturizes the lips and keeps them soft. Two to three raspberries mixed with a spoon of aloe vera gel and a drop of honey is a great way to achieve pink lips.Regular use of Vaseline or petroleum jelly will keep the lips soft at all times.

April 2014 I FUTURE MEDICINE 21


SEX Beat

The

‘O’

factor Like sunlight and rain, the sexual-emotional energies flowing within and around us provide critical nourishment to our manifesting world. Energy, as it moves through human beings, becomes matter. Energy-inmotion serves as the raw material with which we participate in the cocreation of reality.

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T

he word Orgasm can elicit a myriad of emotions that can swing from complete embarrassment and silence to squeals, moans, excitement and eloquence. It is perhaps one of the most happening and yet least discussed facts of life. This universal phenomenon is the ‘ultimate’ consummation of sexual intimacy. In fact, sex is thought to come a ‘full circle’ with an orgasm. Well known by slangs such as ‘cum’, or ‘climax’ and ‘heat of the moment’, orgasm for the initiated would mean the peak of high intensity excitement during sex, leaving the mind and body in a state of absolute bliss for a few seconds.Orgasm is undoubtedly

a mind-body experience. But, how does medical science make sense of this ‘out of the world’ experience? Medical science defines orgasm as a culmination of a series of changes in the body during sex, accompanied by pleasure of the highest intensity. In 1950, Robert Kinsey, a scientist, who spoke about human sexuality for the first time, described orgasm as “an explosive discharge of neuromuscular tension.” There is no prescribed limit or extent for a perfect orgasm. The extent of satiation and release following an orgasm gives a clue to psychologists and psychiatrists in assessing the state of mind post orgasm.


Yoga Beat

Partner

yoga

A boost for brain activities

P

artner yoga is a harmonious blend of yoga and acrobatics practised together by couples/ partners. Its mutually beneficial postures build trust and let them relax and have fun. Partner yoga helps couples strengthen their relationship emotionally, physically and spiritually to ultimately build a deeper connection and improve sexual health, says a sexual wellness expert at Loyola University Health System in the US. Susan Walsh, PsyD, psychologist and certified yoga instructor for Loyola’s Sexual Wellness Clinic, claims: “Partner yoga can help a couple reconnect and feel comfortable with each other.” It should only be practised under a qualified instructor.

Researchers report that a single, 20-minute session of Hatha yoga significantly improved participants’ speed and accuracy on tests of working memory and inhibitory control, two measures of brain function associated with the ability to maintain focus, take in, retain and use new information.

Participants performed significantly better immediately after the yoga practice than after moderate to vigorous aerobic exercise for the same amount of time. The study subjects were young female undergraduate students. The findings were published in the Journal of Physical Activity and Health.

Image courtesy:University of Illinois at Urbana-Champaign

Stress buster for cancer-affected For women with breast cancer undergoing radiation therapy, yoga offers unique benefits beyond fighting fatigue, according to a research. Researchers found that while simple stretching

exercises counteracted fatigue, patients who participated in yoga exercises that incorporated controlled breathing, meditation and relaxation techniques into

their treatment plan experienced improved ability to engage in their daily activities, better general health and better regulation of cortisol (stress hormone).


Weight Loss Beat

Soup Start a meal with a cup of soup and you may end up eating less. It doesn’t matter if the soup is chunky or pureed, as long as it’s brothbased. You want to keep the soup to 100 to 150 calories a serving. So skip the dollops of cream and butter.

Fruits, vegetables lower risk of preterm delivery

Pregnant women who eat a ‘prudent’ diet, rich in vegetables, fruits, whole grains and drink plenty of water have a significantly reduced risk of preterm delivery, suggests a study. A “traditional” dietary pattern of boiled potatoes, fish and cooked vegetables was also linked to a significantly lower risk.These findings support dietary advice to pregnant women to eat a balanced diet, including vegetables, fruits, whole grains, and fish and to drink water. Preterm delivery (before 37 weeks of pregnancy) is associated with significant short and long term ill-health and accounts for almost 75% of all newborn deaths. Evidence shows that a mother’s dietary habits can directly affect her unborn child, so researchers based in Sweden, Norway and Iceland set out to examine whether a link exists between maternal diet and preterm delivery.

Burger boosts kids’ asthma and wheeze risk

Eating three or more burgers a week may boost a child’s risk of asthma and wheeze -- at least in developed nations reveals a large international study. Conversely, a Mediterranean diet, rich in fruit, vegetables, and fish seems to stave off the risk, the research shows. The research team base their findings on data collected between 1995 and 2005 on 50,000 children between the ages of 8 and 12 from 20 rich and poor countries around the world. Their parents were asked about their children’s normal diet and whether they had ever been diagnosed with asthma and/ or have had wheeze. Just under 30,000 of the children were tested for allergic reactions, to see if diet also influenced their chances of developing allergies. Eating three or more burgers a week was associated with a higher lifetime prevalence of asthma and wheeze, particularly among children with no allergies in rich countries. A heavy meat diet, however, had no bearing on the prevalence of asthma or wheeze.

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Neck pain

/ ADVICES

Dr Arun Oommen Consultant Neurosurgeon, Lakeshore Hospital and Research Centre

I am a 56 year-old lady. I have constant pain in the neck, headache and back pain early in the morning. I have consulted many doctors and have taken different sorts of medication but I got only temporary relief. The MRI report has not shown any major problem. Still I am having persistent pain. What can I do to get relief? -Anita Nair, Chennai Your pain seems to be relating to degenerative changes with age- cervical spondylitis and aggravated by strain in the neck like leaning over a work surface (using computers), poor posture, toosoft mattress or any factor causing simple muscle strain (lifting weight). Sometimes, neck pain can also come from conditions directly affecting the muscles of the neck, such as fibromyalgia and polymyalgia rheumatic. The best way to relieve neck pain is to try to eliminate or ease the physical or emotional stress in addition to treating the muscles.In advanced cases, the patient can present with shooting pain, pins and needle sensation, numbness in arms and fingers, progressive weakness of arms and legs, and may require surgery. Exercise your neck and keep active: Keep your neck moving as normally as possible. During flare-ups, the pain may be quite bad, and you may need to rest for a day or so. However, gently exercise the neck as soon as you are able. You should not let it ‘stiffen up’. Gradually, try to increase the range of the neck movements. Every few hours gently move the neck in each direction. Do this several times a day. Painkillers: Paracetamol Anti-inflammatory painkillers (Voveran and Brufen). They can be used alone or in combination with paracetamol.A lowdose tricyclic antidepressant such as amitriptyline (Amitryn) is used for persistent neck pain. Local injections of cortisone or anesthetics, topical anesthetic creams, topical pain-relief patches and muscle relaxant Physiotherapy: If symptoms do not improve over a week or so, you may then be referred to a physiotherapist to help with pain relief and for advice

on specific neck exercises. Various treatments include traction, manipulation, heat or cold applications, soft-collar traction, physical therapy (ultrasound and massage). Other treatments :A good posture may help. Ensure that your sitting position at work or at the computer is not poor (not with your head flexed forward with a stooped back). Sit upright. Yoga, pilates, and the Alexander Technique improve neck posture.


ADVICES /

Headache

Dr Debnarayanan Dutta Consultant Radiation Oncologist, Apollo Speciality Hospital, Chennai

I’m a college student. Whenever I read more than half an hour, I get headache and it lasts for a longer duration. What is the actual cause of the pain in my head and how can I get rid of this problem? --Shanthini Sinha, Kolkata

Headache for a long duration needs further evaluation. There may be a number of clinical conditions such as migraine headache, eye problem, sinusitis, spondylitis (cervical bone problem), any brain problem (may be from any benign condition to even potential malignant condition) and those related to psychological disorders. The nature of the headache (like throbbing, dull ache and severe headache), duration (at night or in the evening and early morning) and precipitating cause (studying, watching television, after going out and after stress) indicate the actual cause of headache. ‘On and off’ headache that precipitates after reading may be due to eye problem and most likely needs refractory error correction (spectacles).

28 FUTURE MEDICINE I April 2014

Persons with headache after going out and long work are likely to have sinusitis or migraine. Headache after stress may be due to migraine or psychological (depression) cause. Dull headache, not responding to regular analgesics needs further evaluation with imaging (CT scan or MRI) and clinical examination. There may be any benign or malignant mass in brain or any organic problems in the eye. If there is a sudden, severe headache, there may be any hemorrhage in the brain or eye, and it needs immediate attention. Arteriovenous malformation (AVM), which is a vascular malformation in the brain, causes headache. Any cyst in brain, bleeding and hydrocephalus cause headache. Epilepsy also sometimes precipitates with headache. Migraine, psychological conditions and sinusitis are usually treated with medicine. AVM is usually treated with surgery, preferably with CyberKnife. Bleeding in the brain may need surgical evacuation. In short, any headache not responding to regular medications and prolonging more than usual, needs to be evaluated clinically. Organic causes of headache can be treated with modern medicine and complete cure is possible in most causes of headache. We do need to give adequate attention to headache and should never ignore this early sign of a potential life-threatening problem.

‘On and off’ headache that precipitates after reading may be due to eye problem and most likely needs refractory error correction (spectacles).


Menopause

/ ADVICES

Dr MP Vijayalakshmi Medical Director & Chief ART Specialist Vijaya Institute of Medical Sciences, Kochi

I’m a 50-year-old housewife. Nowadays, I am feeling very tired and stressed. Are these signs of menopause and how could I deal with menopausal symptoms? --Hemalatha Ramachandran, Madurai Menopause is a term used to describe the permanent cessation of menstruation. When we talk about menopause, we have to describe pre-menopause, peri-menopause and post menopause. Ovary ceases to function a few years before menopause-Oopause. Peri-menopause is a period (3-4 years) before menopause and followed by a one-year amenorrhoea. This is the period a woman usually experiences menstrual disorders. There is also an ovarian hormone deficiency and women suffer from excessive bleeding. Short time consequences are divided into vasomotor, depression, anxiety, mood swings, irritability and lethargy. It may be associated with the trauma in the previous years and the present stress. Female sexual dysfunction is mainly due to vaginal dryness and loss of libido mainly because of low androgen level. Long-term osteoporosis, cerebrovascular disease, urogenetial atrophy etc may occur. Some develop hypertension and cardiac irregularities after menopause. The most common symptom is hot flushes and sweating. Hot flushes are due to vasodilation that affects the face and neck and last 2-5 minutes. Sometimes, it may be severe at night and disturb sleep. Mental depression due to disturbed sleep, irritability and lack of concentration are noticed. Additional factors like calcium and vitamin deficiency also should be taken care of. Management of menopause: Proper counseling is essential for hormone replacement therapy. The alternative progesterone pills can cause irregular bleeding and depression. Calcium with vitamin A, C, E and Vitamin D400mg are given. Walking and aerobic exercise can prevent or delay osteoporosis. Yoga, medicine and social work can reduce stress. For some women, mild tranquilizers are required.

Menopause normally occurs between the age of 45 and 60. Some women have delayed menopause beyond the age of 50. The hormonal changes mainly cause estrogen deficiency. Estrogen level of over 40pg/ml exerts cardiotypic effect. Below 20pg/ml may predispose to osteoporosis and heart diseases. The changes that we see are genital organ atrophy and retrogression. Deposition of fat around the breast often makes the breast more pendulous. Skin wrinkles, hair growth around the chin and lips, and osteoporosis of bones are due to oestrogen deficiency

April 2014 I FUTURE MEDICINE 27


ADVICES /

Cervical cancer

Dr Nalini Kilara Head of Dept of Medical Oncology, MS Ramaiah Memorial Hospital

A friend of mine died recently of cervical cancer, putting all of us in deep grief. She was a lovely, very active woman over 50, but never looked her age. Her sudden death had scared us all. Could you please explain why this disease happens, the symptoms and the risk factors as it would help so many women like me to know about different aspects of the disease? --Rita Jacob, Bangalore Cervical cancer kills more women in India than anywhere in the world. Experts say it is a disease that can largely be prevented and it is the first cancer in the world to have two vaccines aimed at preventing it.With nearly 73,000 women dying every year, India now tops cervical cancer deaths and India represents 26.4% of all women dying of cervical cancer globally. It is usually a slow-growing cancer that may not have symptoms. Several risk factors increase the chances of getting cervical cancer. They include: Smoking can increase the risk of cervical cancer. HPV can be spread through unprotected sex, so using a condom can help reduce the risk of developing the infection. If a woman’s mother or sister had cervical cancer, her chances of developing the disease are 2 to 3 times higher than others. Symptoms Cervical cancer may not cause any symptoms at first but one of the most common symptoms is abnormal vaginal bleeding. In some cases, there may be

no obvious symptoms until the cancer has progressed to an advanced stage. Later, there would be pelvic pain or bleeding from the vagina. Other symptoms are bleeding that occurs between regular menstrual periods, after sexual intercourse, douching, or a pelvic exam, and menstrual periods that last longer and are heavier than before. Diagnosis There are different tests to diagnose cervical cancer which include: Cervical exam: The doctor uses a colposcope to look at the cervix. Smear tests: The doctor or nurse scrapes a sample of cells from the cervix. . Tissue sample: The removal of tissue to look for cancer cells is a biopsy. If abnormal cervical cell changes are found early, cancer can be prevented by removing or killing the changed cells before they become cancer cells.Treatment usually consists of surgery (including local excision) in early stages, and radiotherapy and/or chemotherapy in more advanced stages of the disease.


Pelvic endometriosis

/ ADVICES

Dr Muhammed Ashraf Medical Director, CRAFT Hospital

I am a 30-year-old woman and have been married for five years. I have been trying to conceive for the past four years, but in vain. My husband had a semen analysis and culture performed and reports were completely normal. I have approached various clinics for a solution and the doctor I presently consult has advised IVF. Meanwhile, I notice that my periods are becoming more painful and the pain is spreading to my legs these days and also have severe pain while having sex. Please tell me what should I do and how should I go about with my treatment? --Dhanushree Aravind, Mumbai From your case history and symptoms, I can see it to be a case of pelvic endometriosis which is a serious ailment that needs immediate and rigorous medical attention. Any delay in diagnosis and treatment can aggravate the issue to an irreversible stage. Endometriosis is a serious medical condition that leads to infertility and even permanent sterility. In this case, membrane of the uterine cavity and its tissues for some reasons develop outside uterine cavity near the fallopian tubes, ovaries and other pelvic structures, which further leads to adhesions and later to the lack of conception. If it is treated aggressively at very early stages, success rates are often high. Change in the pattern of menstrual pain is an early indication of endometriosis in adolescent and young girls. Early and effective treatment can help you resolve this issue. I suggest that you immediately seek medical help and undergo a laparoscopic surgery to evaluate the internal organs wherein the surgical corrections can be carried out simultaneously. The surgery can be expected to correct your medical issue and further enhance your fertility chances by 50%. If you fail again after surgery to elicit any positive results, you may need to think of an IVF. But first and foremost, get the best treatment at the earliest from a good centre.

April 2014 I FUTURE MEDICINE 29


Disease Special Diabetes Diabetes mellitus refers to a group of diseases that affect how your body uses blood glucose, commonly called blood sugar. Glucose is vital to your health because it’s an important source of energy for the cells that make up your muscles and tissues. It’s also your brain’s main source of fuel


Diabetes Disease Special

A ticking time bomb An estimated 77 million people in India are pre-diabetes. A large percentage of them will convert to diabetes in the near future unless they take some preventive measures

T

he incidence of diabetes is rapidly rising all over the globe at an alarming rate. India, which is experiencing rapid socio-economic progress and urbanisation, carries a considerable share of the global diabetes burden. According to the Indian Council of Medical Research, India Diabetes (ICMR–INDIAB) study, India had 62.4 million people with diabetes in 2011. Socio-economic development over the last 40-50 years has resulted in a dramatic shift in diet, physical activity, health and nutrition. Diabetes rates increase with changes from traditional to modern, leading to less physical inactivity due to technological advancements. Affluence has led to consumption of diets rich in fat, sugar and

calories and an increased mental stress. Luckily, a lot can quite easily be done to prevent the morbidity and mortality associated with diabetes. The only way to have an impact on reducing the burden of diabetes is to detect the disorder early. If the disorder asymptomatic, regular screening is the only way to detect diabetes at an early stage. Prevention and targeted control of the risk factors of diabetes could potentially reduce the impact of diabetes in the developing world. Evidence suggests that lifestyle changes could prevent and/or delay the onset of Type 2 diabetes in highrisk groups by integrating modified lifestyle with incorporation of physical activity and appropriate nutrition. The following ‘Five Steps’ can be adopted

Diabetes rates increase with changes from traditional to modern, leading to less physical inactivity due to technological advancements

to prevent diabetes:

Increase intake of healthy diet (following a traditional pattern with high in fibre, low in fat, calories and sugar intake) Increase one’s physical activity (walking at least for 30 minutes 3 times/ week) Maintain ideal body weight Reduce stress (meditation, exercise, counseling, time management etc.) Screening at regular intervals to detect early stages of the disorder

Thus more proactive steps should be taken to reduce obesity in adults and children in India, which is facing twin epidemics of diabetes and obesity. In addition, restructuring of health policies with emphasis on control of diabetes is the urgent need of the hour in India.

Dr V Mohan Chairman & Chief Diabetologist Dr Mohan’s Diabetes Specialties Centre Chennai April 2014 I FUTURE MEDICINE 31


Disease Special

Diabetes While insulin injections are the current treatment, many other methods of insulin delivery are being researched. Insulin pumps are available, which deliver insulin.

Check blood sugar,

save the child

Children are the main victims of Type 1 diabetes. Most children need two or more doses of insulin per day and if blood glucose is well controlled in them, they can live a full and productive life

T

ype 1 diabetes mellitus usually occurs in children when there is almost complete absence of the hormone, insulin, in the body. This is usually due to destruction of most of the pancreas which secretes insulin. When more than 80% of the pancreas is destroyed, diabetes occurs. Lack of insulin causes the classical features of increased thirst and urination along with severe weight loss. The child may become comatose and needs care in an intensive care unit. Since these symptoms are due to insulin deficiency, treatment consists of replacing insulin. This is the reason why life-long

32 FUTURE MEDICINE I April 2014

insulin injections are given for these children. Insulin and normal blood sugar levels are essential for normal growth and puberty. If blood glucose is well controlled in these children, they can live a full and productive life. Usually, this involves checking their

blood glucose in a drop of blood taken from fingertips using an instrument called the glucometer. Ideally, glucose checking should be done at least two times a day in insulinneeding patients. If these measures are not taken and diabetes is uncontrolled, the patient can develop various complications involving the eye, kidney and nerves. Since most of these complications occur silently, it is advisable to check for them regularly. Insulin dosage and glucose levels are related to the food intake. Therefore, it is mandatory for the patients to undergo nutritional counselling and learn to match food intake and insulin requirements.

Since most of the patients with Type 1 diabetes are children, the whole family needs to understand the problem and get thoroughly educated on all aspects of the treatment. Also, inhaled insulin and insulin in the form of pills are being studied. There are tissue markers (HLA types), different types of antibodies to body’s own tissues (auto-antibodies) and some genes which are found to be strongly associated with the development of Type 1 diabetes in close relatives of patients. Dr M Viswanathan, Chief Diabetologist Diabetes & Professor at M Viswanathan Diabetes Research Centre,Chennai


Diabetes Disease Special Women are at higher risk of diabetes than men. The disease affects mothers and unborn children alike. Worse is that with poor quality of life, women with diabetes have fewer chances of survival as compared to men

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iabetes currently affects over 246 million people worldwide and over half of these people are women. Already considered an “epidemic,� researchers expect these rates to increase to 380 million by 2025. Diabetes can be especially hard on women. The burden of diabetes on women is unique, because the disease can affect both mothers and their unborn children. Diabetes can cause difficulties during pregnancy such as miscarriage or a baby born with birth defects. Women with diabetes are also more likely to have a heart attack, and at a younger age, than women without diabetes.

gestational diabetes occurs in women with risk factors for Type 2 diabetes; they are unable to secrete sufficient insulin to overcome the increased insulin resistance that normally results as pregnancy proceeds. Gestational diabetes usually ends after the baby is born, but women with gestational diabetes have a 20%-50% chance of developing Type 2 diabetes in the 5-10 years after childbirth.

Middle age (45-64)

Approximately, 3.8 million women aged 45-64 years have diabetes. Diabetes is a leading cause of death among middle-aged American women. Effects on women Coronary heart disease is an important Diabetes is a more common cause of illness among middlecause of coronary heart aged women with diabetes; disease among women than rates are three to seven men. Among people with times higher among diabetes, the prognosis women aged between Diabetes is one of heart disease is 45-64 years with of the leading worse for women than diabetes than among men; women have those without underlying poorer quality of life diabetes. Women causes of death and lower survival with diabetes among aged rates than men. The link were more likely between diabetes and than women without women obesity is striking. Diabetes diabetes to have a low affects women differently at socioeconomic status various life stages. regardless of race, ethnicity, or living arrangements Adolescence (10-17) There is an apparent increase in the number of youth of all racial and ethnic groups being diagnosed with Type 2 diabetes, and it appears to be more common among girls than boys. By age 20, 40-60% of people with Type 1 diabetes have evidence of retinopathy or diabetic eye disease. Untreated retinopathy can lead to blindness.

Reproductive age (18-44)

An estimated 1.3 million women of reproductive age have diabetes; about 500,000 of them do not know they have the disease. Type 2 diabetes accounts for most diabetes cases during this life stage. Most women with Type 1 diabetes were diagnosed during childhood or adolescence. Most

Multiple risk factors

Older age (65 and above)

About 4.0 million women aged 65 years and older have diabetes; onequarter of them do not know they have the disease. Most of the elderly women with diabetes have Type 2 diabetes. Diabetes is one of the leading underlying causes of death among women aged 65 years and older. Being older and having diabetes accelerate the development of diabetic complications such as heart disease, stroke, kidney disease, coronory heart diseases and blindness.

(Statistics compiled from the Centre for Disease Control and the American Diabetes Association)

Coronary heart disease is an important cause for worry among middle-aged women with diabetes; rates are three to seven times higher among women aged between 45 and 64 years with diabetes than those without diabetes


Disease Special

Diabetes

control

If you manage your diabetes properly, you can prevent or delay the complications. However, diabetes causes more deaths a year than breast cancer and AIDS combined. Two out of three people with diabetes die from heart disease or stroke

diabetes Home monitoring of sugar: Simple gadgets are available in the market to check the capillary blood sugar at home. Frequent monitoring can help to achieve a smoother control of diabetes. Diet: It is very important for a diabetic to avoid highly refined food like sugar (foods with high glycemic index) because this can lead to rapid absorption and rise of blood sugar. So it is essential that the diet is as natural as possible. Excess eating should be avoided so that the body weight remains under control. It is extremely important to bring the body weight near ideal figures. A balanced diet containing cereals, pulses, fruits, vegetables, milk and milk products would suffice. Exercise: Exercise in any form improves sugar control. It increases the sensitivity of insulin. One should not stop exercise in spite of the frustration of not losing weight.

More activity, more benefit: Keep in mind that 2-1/2 hours of moderate-intensity aerobic activity a week is an excellent starting point, not an upper limit. Exercising longer, harder, or both can bring even greater health benefits. Also bear in mind that your 2-1/2 hours of activity should be in addition to the light activity that is part of everyday living.

Start slow, increase as your fitness grows:

The physical activity guidelines for Americans are general recommendations aimed at the general population. The problem with guidelines is that they try to cover as many people as possible. In other words, they aren’t right for everyone. How much exercise you need depends on your genes, your diet, how much muscle and fat you carry on your frame, how fit you are, and your capacity for exercise. If you find an exercise or a physical activity hard, maybe it is affecting your heart. If you are currently not active at all, it may be daunting to start with 30 minutes a day of activity, five days a week. So start with a shorter, less-intense bout of activity, and gradually increase over time until you reach or exceed this goal.

Celebrities with

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iabetes has not dampened the spirit of this versatile actor. He easily balances a hectic schedule and his Kamal Haasan Type 1 diabetes and even finds time to encourage other diabetics to take charge of their lives. “Preventive measures can help the patients and their families avoid going through the burden of diseases like kidney failure, diabetes and heart problems,” Kamal Haasan says.

34 FUTURE MEDICINE I April 2014

d i a b e t e s

T

he king of swing of Pakistan cricket was diagnosed with diabetes when he was 30. It was shocking for the ace swing Wasim Akram bowler who always associated diabetes with a sedentary lifestyle. Nonetheless, he modified his diet and exercise regime to counter the illness and also took insulin doses. The disease didn’t stop him from making his mark in the cricketing world, and becoming one of the greatest bowlers cricket has ever seen.


Diabetes Disease Special

Super foods for

s t n e i t a p s e t diabe

s for diabetes patient s rie lo ca w lo ith w ods Here are 10 super fo

Tomatoes

Non-fat milk and Yo

gurt

Non-starchy vegetables

that Non-starchy vegetables—varieties clude r—in suga d bloo in e spik don’t cause a asparagus and s hoke artic from ng ythi ever to broccoli and beets. These vegetables are low in calories and carbohydrates, making them some of the few foods that people with diabetes can enjoy almost with abandon

Vitamin D is essen tial for good health. One of its roles is to keep bones healthy , yet many of us don’t get as much as we need. Non-fat dairy foods, including milk and yogurt, are fortified with Vitamin D and an easily accessible way to get your daily dose of this vital nutrient.

erries and other b in C to filling s ie rr e b e Blu cting Vitam

ouses. -prote ant powerh From vision are antioxid es ighest ri h er e eb th lu some of fibre, b They have y fruit levels of an antioxidant reduce ay m and or vegetable se and heart disea the risk of tie also hav an cancer. They . es ti er p y pro inflammator

Walnuts, fl ax

seeds, and Nuts and se other nuts eds contain /seeds magnesium Omega-3 fa , fibre, and tty acids. W alnuts also linolenic ac contain alp id, an essen hatial fatty acid that boo sts heart hea lth and lowers cholesterol. Walnuts also contain vitamin E, fo lic acid, zin c, and protein .

Kale and other leafy green vegetables

Leafy green vegetables contain chemicals called glucosinolates, which activate enzymes in the liver to neutralise cancer-causing substances. Kale is a nutritional powerhouse because it provides more than 100 per cent of the recommended daily intake of Vitamin A and Vitamin K.

Oranges and

uits other citrus fr efruit ap ges and gr

s of oran eat source of provides a gr e whole fruit th t fibre. Ea ink the juice rather than dr um benefit im for the max tamin C. Vi d an of fibre

The pulpines

Tomatoes are full of lycopene, a powerful substance that may reduce the risk of cancer (especially prostate cancer), heart disease, and macular degeneration, an eye disease that causes blurred vision.

mega-3 h with O

fis hich d other acids, w lmon an ith omega-3 fatty regularly. a s d il W eat it ded w se if you on is loa

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r Salm rt disea nium fo k of hea and sele D don’t u in o lower ris m y a ll of Vit bones. If fu d o n a ls , a s s It’s , nail nse fi h hair, skin arly nutrient-de healthy imil kerel. almon, s and mac s e in d prefer s r a s herring, , and include arley, Lentils

Beans

Beans are na ture’s most nutritious food s. They’re high in fibre and protein, and th ey deliver essential min erals like magnesium and potassium. Th ey’re also low on th e GI—black beans, for example, have a GI score of only 30.

B grains other whole full of

are Whole grains d soluble an s nt da xi antio re, fib e and insolubl to helping metabolise fats and also keep the digestive People track healthy. barley d lle hu t who ea wer blood lo regularly have e grain th d an cholesterol ood sugar also keeps bl levels stable. April 2014 I FUTURE MEDICINE 35


campus health

Wash your K hands please! Students and staff on college campuses should up the ante against infectious diseases and it is most necessary to create awareness of hand hygiene practices among them By FM Bureau

nowledge about proper hand hygiene practices on campus can help prevent illnesses by reducing cross-contamination. Many factors influence how susceptible people are to infectious diseases. These include current health behaviours, exposure to stress, vaccination status and the presence of existing illnesses that make it easier for individuals to become infected. Thankfully, there is one particular area that we do have control over when it comes to keeping individuals healthy on campus: hand hygiene. Students may forget about hand washing amidst the busyness of exams and extracurricular activities. Knowledge about proper hand hygiene practices can help prevent illnesses by reducing cross-contamination. With a better understanding of hand hygiene importance, staff and students can implement their own safe guards necessary to avoid infections on campus. Upper respiratory tract infections and gastrointestinal tract infections are the cause of a significant level of illness on college campuses. However, preventative measures such as handwashing and hand sanitation are often not wellsupported, understood, or practised on campus. It is important to create awareness of proper hand hygiene practices as they relate to the everyday context of a college campus. It is also important that college authorities provide soaps and a means of hand drying in all bathrooms on campuses.


Truths & myths about hygiene on campus

Campus tips

• Emphasise proper hand washing in residence halls:For example, residence hall representatives can encourage proper hand hygiene at informational meetings in dorm halls. • Post signs and educational information in restrooms to encourage hygiene awareness: Posters or flyers in restrooms or kitchen areas describing effective hand washing practices will encourage students and staff to practise good hygiene behaviours. The Centres for Disease Control and Prevention has many hand hygiene practice and awareness posters that can easily be downloaded and posted. • Host educational sessions with health representatives to discuss the importance of effective hand hygiene:These sessions can emphasise critical points throughout the day and the types of infections that require good hygiene practices.

We know the basics of how germs are spread. Touching or coming into contact with contaminated objects or people (touching our own eyes, mouth and nose) can result in the transmission of disease-causing microorganisms that lead to illnesses. Yet, there is still much confusion about how these problems occur. To help defend against germs and diseases on campus, here are some truths and myths surrounding hygiene and cross-contamination on campus: Myth: I’m the only one that uses my desk and laptop so I won’t get infected with any diseases. Truth: Cross-contamination occurs when there is a physical transfer of microorganisms from one location to the other. We all touch many things throughout the day and thus are likely to contaminate our personal items without realising it. Therefore, even if we are the only one that uses our desk and laptop, chances are there those items are carrying other people’s germs. Myth: I don’t need to use soap as I wash my hands with hot water and wipe thoroughly with paper towel. Truth: Even the hottest water that we can tolerate without burning our hands will not help kill bacteria. Instead, using warm water with soap can effectively remove dirt, bacteria and viruses from your hands. Be sure to properly wash your hands for at least as long as singing “Happy Birthday” twice. Drying hands with a single-use paper towel may help reduce the amount of bacteria even further and also lessens the chance of cross-contamination if you touch items on your way out of the bathroom. Myth: After using a public computer, I only need to use sanitiser and my hands will be completely clean. Truth: While sanitisers are very useful, they do not eliminate all types of bacteria and viruses. Furthermore, hand sanitisers are not effective when hands are visibly dirty. According to the CDC, washing hands with soap and water is the best way to reduce microorganisms on the hands in these situations. If you decide to use handsanitiser, the sanitiser should be alcohol-based and contain at least 60% alcohol. Myth: Students get sick because they do not keep themselves and their space clean and hygienic. Truth: While hygiene plays a large role in a student’s health, other factors also determine susceptibility to disease. Factors that may influence susceptibility include health behaviours, stress, vaccination statuses and the presence of another disease that can affect a person’s susceptibility to infection. April 2014 I FUTURE MEDICINE 37


Cover story Underage Alcoholism

38 FUTURE MEDICINE I April 2014


Lost in the tipsy world Alarming increase in youngsters taking to alcohol and drugs is a matter of great concern across the world. It is not only a self destroying act; it also destroys family relations and the society itself

Gokul : Age 15 , studying in the tenth standard in a government high school in Thrissur . A few years ago , he was admitted to a de-addiction centre due to excess consumption of alcohol. His father was alcoholic and died due to heavy drinking. He used to drink on the terrace of his house and used to give young Gokul a small quantity of the drinks, for ‘company sake’. Thus Gokul started drinking at the age of six. One day his father


Cover story Underage Alcoholism

drank heavily and while trying to get up and walk, lost balance and fell down from the terrace and died. This incident shocked Gokul, putting him into deep grief. As an attempt to escape from the sad loss, he took to drinking heavily, until he lost his mental and physical balance. Seeing his sad condition, he was taken to a near by de-addiction centre , Punarjani. After continued counselling and treatment for months, he regained his life and started going to school . He is also an active participant now in campaigning against alcoholism among youngsters. Anand : Age 12 , was admitted to a de-addiction centre in Chennai and taking medicine for the last three years..He started alcohol at the age of seven , his grandfather introduces him to alcohol, pouring a ‘small’ for little Anand , whenever he drank. Sometimes he used to drink two or three times daily and slowly Anand also became a habitual drinker. Once Anand under the influence of liquor, raped his own sister. She committed suicide. Anand lost his mental and physical balance and was admitted to a de-addiction centre. After years of treatment and counselling he is now slowly recovering. Now he has even started his studying.


These are not lone cases of youngsters taking to drinking and drugs, ruining their lives and of their dear ones back home. Thousands of youngsters die every year as a result of heavy drinking-vehicle accidents, suicides, and from injuries incurred on falling, burns and drowning. Crimes perpetrated by these people are also on the rise. Here Future Medicine looks at the younger generation lost in the tipsy world and the problems they raise in a society By Sumithra Sathyan

Widespread Health Problem

Underage drinking is a risk that attracts many adolescents and teens. When young people try alcohol, they often don’t realize about the damaging effects of drinking on their lives, their families, and their communities. Besides being illegal, underage drinking is a widespread public health problem that poses many risks. According to statistics, in 2009 alone, about 10.4 million young people between the age 12 and 20, drank more than “just a few sips” of alcohol.

Treatment of alcoholism

Young people drink less often than

adults, but when they do drink, they drink more than the adults. On an average, young people have about five drinks on a single occasion, which can be considered binge drinking. Treatment of alcoholism works best when the family and the alcoholic are all involved and working together. Recovery is a life long journey and an alcoholic relapse can happen at any time. There’s a wide variety of treatment options available, including Alcoholics Anonymous, Al-Anon/Alateen, and individual or family therapy. Certain things to consider include motivation of the

drinker to quit, cost, physical condition of the drinker, and their personality.

Alcoholics Anonymous

Alcoholics Anonymous is the most widespread group antialcoholic program. The only qualification to be a member is the desire to quit drinking. On an average, an open Alcoholic Anonymous group meeting lasts one hour and has two or three speakers who share their experiences about alcoholism and recovery. Currently, there are over two million people in 150 countries that attend A.A. meetings on a regular basis.

The signs of underage drinking Academic and/or behavioural problems in school Changing groups of friends Less interest in activities and/or appearance smelling alcohol on their breath Slurred speech Coordination problems Memory and/or concentration problems The names mentioned in the story are changed to protect identity

Underage drinking risks include Death: 5,000 people under age 21 die each year from alcohol-related car crashes, homicides, suicides, alcohol poisoning, and other injuries Serious injuries: More than 190,000 people under age 21 visited an emergency room for alcohol-related injuries. Increased risk for physical and sexual assault: Youth who drink are more likely to carry out or be the victim of a physical or sexual assault. Affecting brain development: Brain development continues well into a person’s twenties and alcohol can affect this development


Cover story Underage Alcoholism

Youth And Intoxicants Blame it on parents. If children look up on their parents as role models and listen to their advices and grow up according to their guidance, they will never get addicted to intoxicants

Dr Johns K Mangalam Managing Trustee, Punarjani De addiction Center

I

n our milieu, the apprehensions regarding the escalation in the consumption rate of intoxicants by the student community is mounting day by day. What might be the reason for this scenario? Is there any enduring solution to this predicament? Even when questions on such issues are rampant among media debates and public deliberation, each parent lives in a fool’s paradise of his/her own, trusting and considering their child as a perfect role model who could hardly deviate to such

detrimental acts. It is a miserable fact that, by the time these parents realise the magnitude of this entanglement, their children would have become a real addict. We can never blame that generation, that was born during an arduous age when it was hard to earn even the elementary education itself, for their aspiration to provide their child the benefits of higher education, for their desire to make their child reap the yields of dignity which they scarcely could and for their endeavors to nurture and nourish

Excess control, extra care and extreme concern are factors that can invariably influence the mental condition of a child. Our generation has none but ourselves to blame that we fostered our children like broiler chicken by providing nothing but fast food just to generate doctors and engineers 42 FUTURE MEDICINE I April 2014


If a mother has bound his children with tears, love and sacrifice they will never get addicted to intoxicants. If they consider their father as an admirable role model his precious guidance and advices will remain forever in his mind like the delightful memories of a hailstorm. It is high time that the society realised that each addicted ones are emblematic of things going topsy-turvy

them properly. But, they forget the fact that children may not grow to be an ideal role model by lavishing all the luxuries and facilitating all the comforts. Entire discussions on this specific subject matter should commence from the basic issue that today parents are unable to up bring their children in tune with the psychological and physiological growth and transformation that they undergo during his progress into adolescence.

Influences mental condition

Excess control, extra care and extreme concern are factors that can invariably influence the mental condition of a child. Our generation has none but ourselves to blame that we fostered our children like broiler chicken by providing nothing but fast food just to generate doctors and engineers out of them and in turn denied those children the care, comfort, affection and security as promised in grandma’s tales. Those parents, who have to explain to their children that “this is gooseberry� since they raised their children without making them taste the sweet and sour tang of a gooseberry, are the ones who strive hard to cover their bygone days up. If a mother has bound his children with tears, love and sacrifice they will never get addicted to intoxicants. If they consider their father as an admirable role model his precious guidance and advices will remain forever in his mind like the delightful memories of a hailstorm. It is high time that the society realised that each addicted ones are emblematic of things going topsy-turvy.

Tension free world

Children will choose their own paths towards the realization of their dreams and will trounce the pitfalls of persuasions when we begin to consider them as primarily as children and provide them adequate love, care and concern and enable him to decipher right and wrong and by permitting him choose his likes. The parents should assess whether they are a failure in creating a ground for the same or not. In the minds of each parent there must be a strong determination that they will not let their child to be a slave to such intoxicants. Unless and until the society, that is anxious of the future of the emerging generation, takes this responsibility Kerala will turn into a paradise of psychic patients. The parents, who are blind with love for their child, who cannot see why his son turned out to be an ardent follower of Bob Marley and when he started using intoxicants for the first time, should undergo an introspection about his failures in fulfilling his parental duties than be satisfied with the discovery of the fact that my son is spoilt out of bad companionship. No doubt, when we raise our children as the promising, free citizens of tomorrow, having responsibilities and liabilities to the community instead of considering them as mere children, we can stop the children from perishing with the use of intoxicants. April 2014 I FUTURE MEDICINE 43


Cover story Underage Alcoholism

Medical and physical effects Fatal attraction A look at the bad effects of alcoholism on our health and the possible diseases it can cause

Weakening of heart muscle tissue can cause pump failure (Cardiomyopathy) Brain &Nerves & Muscles: Alcohol acts on nerve cells in the brain. The cerebral cortex is most affected. This cortex is responsible for thinking, reasoning, perceiving, and producing and understanding language. Domestic violence, crime and road traffic accidents are all due to the effect of alcohol on cerebral cortex. In the long run, brain shrinks (atrophy) and nerves degenerate (Neuropathy). Muscle weakness and cramps along

By Dr Harikumar R Nair, (Consultant Gastroenterologist,AIMS)

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popular misconception is that liver is the only organ damaged by alcohol; in reality, virtually every organ system is affected by alcohol Stomach & Intestines: The small intestine is where the majority of the consumed alcohol will be absorbed in to the bloodstream.

The alcohol that does not become absorbed through the walls of the small intestine will stay in the stomach and can cause irritation. Drinking alcohol and taking medication that causes stomach irritation, such as aspirin, can cause gastritis (inflammation of the stomach lining), ulcers, and severe

bleeding. Heart: High blood pressure associated with heavy drinking makes the heart work harder than it needs to and can be a key risk factor for heart attacks and strokes. Additionally, with an increased intake of alcohol, levels of fats in the blood can become elevated which lead to heart problems.

with decreased bone mineral density. Liver: Bears major brunt of alcoholism. Diseases such as Alcoholic Hepatitis or cirrhosis can develop from heavy alcohol consumption. Normally, toxins and wastes in the blood get filtered out when blood passes through the liver. Once cirrhosis sets in liver cancer can also develop. Sexual Functioning: Modest ethanol doses increase sexual drive and decrease erectile capacity in men. Alcoholic men may show irreversible testicular atrophy, decreases in ejaculate volume, and a lower sperm count. The repeated ingestion of high doses of ethanol by women can result in irregularities in menstrual periods, decrease in ovarian size, infertility, and spontaneous abortions.PregnancySpontaneous abortion, Growth retardation of baby, death, decreased birth weight, premature delivery and congenital malformations in the baby Cancer risk: Alcohol is implicated in the genesis of many cancers-oral cavity, larynx, pharynx, lung, liver, pancreas and colon


Prevention

Be yourself, protect your rights As a young person, you have a right to protect yourself from alcohol and drugs. Here are ten tips to save yourselves

rely on, you can talk about life, its challenges, but your decisions about alcohol and drugs are very important. The opportunity to benefit from someone else’s life experiences can help put things in the right perspective and can be invaluable.

Don’ t be afraid of saying “No”: Don’t let someone else to

make decisions for you. If someone is pressuring you to do something that’s not right for you, you have the right to say no, the right not to give a reason why, and the right to just walk away.

Connect with your friends, but avoid negative peer pressure: You may be heading

towards an alcohol party, smoking session, abusing prescription drugs or using illegal drugs, but you don’t have to go along to get along.

Make connections with parents or other adults: As you grow up, you may have people around, whom you can

Enjoy life and do whatever you like, but don’ t add alcohol and drugs to your pleasures:

Learn how to enjoy life and the people in life, without adding alcohol or drugs. Alcohol and drugs can change, limit your potential and complicate your life. Avoid the opportunities by getting out and getting active in school and community activities such as music, sports, arts or a part-time job.

Follow family rules about alcohol and drugs: As you grow up and

want to assume more control over your life, having the trust and respect of your parents is very important. Don’t let alcohol and drugs come

between you and your parents.

Get educated about alcohol and drugs: Learn

about alcohol and learn about drugs. And, as you learn, share what you learn with friends and family.

Be a role model and set a positive example: Don’t

forget, what you do is more important than what you say!

Plan ahead: As you make plans for a party or going out with friends you need to plan ahead. Don’t become a victim of someone else’s alcohol or drug use. Always remain ready for an emergency call from someone you know, day or night, for whatever reasons, you need to attend. Speak out/speak up/ take control: Take

responsibility for your life, health and safety.

If someone you know is in trouble with alcohol or drugs, (What to Look For), get help. Don’t wait. You are not alone.

Get help:

April 2014 I FUTURE MEDICINE 45


Wellness

Ayurveda

Coping with

summer

Summer is fast setting in and people are scurrying around seeking ways to contain the harsh effects of the hot season. A look at the guidelines in Ayurveda to combat the ill-effects By Vaidyamadham Dr Subin Nambudiri

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es, we are going to experience the troublesome summer and a preparation is mandatory for everyone with focus on the maintenance of health. There are guidelines in Ayurveda to be strictly followed. Greeshma (as it is called in Ayurveda) is a part of aadaana-kaala (representing the northern journey of the Sun) which is characterised by hot, dry wind. As a result, the earth dries up affecting the physical strength of living beings. Human bodies dissipate heat by losing water through the skin and sweat glands, and as a last resort, by panting when blood is heated above 98.6 degrees (Fahrenheit). The heart begins to pump more blood, blood vessels dilate to accommodate the increased flow and the bundles of tiny capillaries threading through the upper layers of skin are put into operation. Sweating, by itself, does nothing to cool the body unless the water is removed by evaporation, and high relative humidity slows evaporation. The evaporation process

46 FUTURE MEDICINE I April 2014

itself works this way: the heat energy required to evaporate the sweat is extracted from the body, thereby cooling it. Extreme high air temperatures contribute directly to deaths from cardiovascular and respiratory disease, particularly among elderly people. High temperatures also raise the levels of ozone and other pollutants in the air that exacerbate cardiovascular and respiratory disease. Pollen and other aero-allergen levels are also higher in extreme heat. These can trigger asthma. In terms of Ayurveda physiology, kapha-dosha is in the decline and vatadosha gains strength day by day. By the persistent heat, pitta also gets vitiated. The increase in circulatory, perspiratory and respiratory activities is attributed to the vitiated vata-dosha.

Heat disorders

Sunburn: The symptoms of sunburn include redness and pain. In severe cases, swelling of skin, blisters, fever and headaches can happen.

weak pulse, rapid, shallow Heat cramps: Muscular breathing, very high body pains and spasms due to temperature, dilated pupils, heavy exertion involve decreased blood pressure, the abdominal muscles or increasing dizziness and the legs. If there is heavy weakness, headache, nausea sweating, cramps will or vomiting, loss of appetite, reoccur. and mental confusion. Heat exhaustion: Due to According to Ayurveda, prolonged and profuse these clinical manifestations sweating, the body loses are caused by the vitiated large quantities of salt and vata & pitta dosha. All these water. When salt and water are better prevented by a are not supplied, blood medical team. circulation diminishes affecting the heart, brain and lungs. With heat exhaustion, sweat does not evaporate, due to Physical activity: Ayurveda high humidity or layers of advises to cut short your clothing, so the body is not exposure to sun. Exercise cooled properly. Symptoms and strenuous activities are include cool, moist, pale, to be avoided. Loose, nonflushed or red skin, heavy absorbent dress has to be sweating, headache, nausea worn. If possible, proximity or vomiting, dizziness to water resources, trees etc. and exhaustion. Body may be maintained. Ample temperature will be near time has to be devoted for normal. rest in case of exposure Heat stroke: The temperature to sun/heat. Bath should control system which be done using cold water. produces sweating to cool Regular practice of simple the body stops working. The yoga-asana, prana-ayama body temperature can rise and meditation too will aid so high that brain damage in overcoming the physical and death may result if and mental strain. the body is not cooled quickly. Signals include hot, (The writer is Assistant Professor, red and dry skin, changes VPSV Ayurveda College, Kottakkal) in consciousness, rapid,

Combat ill-effects


Foods and drinks Salt, pungent and sour tastes are to be avoided or restricted to minimum during summer. Consuming more sweet is advisable along with light, sufficient fatcontaining and liquid food. Popped rice which is powdered and added with sugar is an ideal food. White rice along with meat soup is another one. Curd added with sugar, dried ginger and pepper is an ideal drink (Rasaala). Alcohol consumption has to be avoided.


Wellness

Ayurveda

Reduce intake of spicy food Avoid fatty food Consume larger quantities of fruits and vegetables Minimise consumption of non-vegetarian food. Increase intake of lime water


Cool yourself with yoga Yoga helps people to enjoy the excitement and thrill that summer brings By Dr Vedamurthachar

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n summer, changes in environment lead to many physiological changes in our body cycle. The summer heat and long days trigger metabolic activities which cause many changes in the body-mind set-up. Certain changes in the food habit and the practice of yoga as well as pranayamas can help create a harmony within us. These changes are usually influenced by the seasons themselves, including hours of day light, foods which are good for the season are available in abundance, weather and seasonally inspired activities. The summer months are a time of light and warmth. To balance the heat and energy during the season, our body cultivates the opposite environment-cool and calm- inside. According to

Ayurveda, summer inspires the pitta dosha. The doshas are the bodily humours that help to create one’s individual constitution, and there are three different doshas: vata, pitta, kapha. Pitta is driven predominately by the solar force, so when the natural cycle of the seasons brings us to the sunny summer months, it is important to pacify the natural pitta inside our bodies so that we aren’t meeting the hot, fiery external climate with a similar internal energy. In doing so, we allow ourselves to enjoy the full excitement and thrill that summer brings, without being flooded by too much of one energetic force. But how do we balance that pitta energy? During this time of year, a good counter for the sunny weather would be to create a lunar current within the

body by focusing on activities and foods that are cooling. This approach will nourish your system and help increase your energy levels. Moon salutationsa variation of sun salutations, done with low vibratory feeling. rather than jumping forward, try to walk forward. Supported back bending, Backward bending to be done with a support like yoga block beneath the low back. Leg up the wall, lie down on the back, perpendicular to the wall, tailbone flush against the wall, rise the legs straight up. Supported shoulder stand with a towel under the shoulder to support the shoulder. Floor twists can be done either lying on the floor or sitting. All these variations or alterations send a calming wave through the nervous system. After you complete your asanas, weave

in one or both of the following.

Shitali Pranayama:

This technique is done by curling the sides of your tongue towards one another and sticking your tongue out through your lips. Inhale through your rolled tongue and exhale out through the nose. Repeat 5-20 times. If you have difficultly curling your tongue, try making a donut shape with your lips instead; inhale through the lips, exhale through the nose.

Single-Nostril Breathing: This

technique isolates one nostril. For the summer months, we are targeting the left nostril, which is called the Ida Nadi (subtle channel), which is the body’s cooling channel and is located on the lunar side of the body. Plug the right side of the nostril and breathe in and out through the left nostril for 5-20 breaths. April 2014 I FUTURE MEDICINE 49


Beauty Care

Hair Excess

Hair today, gone tomorrow Do you have excess or unwanted hair growth? There are effective remedies other than hormonal treatments to fix this problem permanently By FM Bureau

50 FUTURE MEDICINE I April 2014


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epending on the cause of the excessive hair growth, your doctor may prescribe hormonal treatments. But there are a number of nonhormonal options:

Laser hair removal:

Laser hair removal minimises damage to the surrounding skin by targeting only the hair. Traditionally, this treatment works best for patients with fair skin and dark, thick hair. But there are lasers specially designed for dark skin. If you have dark skin, there is a word of caution: melanin in the surrounding skin can absorb the laser and cause dark spots or white spots on the skin. On average, six to eight treatments will be sufficient to get rid of 80% of excess hair permanently.

Electrolysis:

In this procedure, heat or chemicals are used to destroy the hair follicle for permanent hair removal. But it has a number of drawbacks. Each follicle is treated separately, making it a tedious and time-consuming procedure. The procedure must be repeated on a weekly basis, and it could take a few years for permanent hair removal. Since each hair follicle must be treated repeatedly, it can result in an exaggerated pore size or dilated pores that are permanent.

Devices: Laser hair removal devices

can be expensive and have limitations. It can be used on limited areas of the body. They require a lot of treatment time, so they work best for smaller areas such as the underarms. If not used properly, the device can burn or blister the skin or even cause blindness. If you have dark skin, it can cause your skin to become either darker or lighter.

Creams:

These are the most tedious and least effective of the temporary hair removal options. They can irritate and burn the skin, and results last about a week or two on average.

Bleaching:

This technique requires upkeep every one to two weeks to keep coarse, dark hair faint and less noticeable.

Plucking/waxing: These remove

hair for an average of one to three weeks, but can cause side-effects. Plucking can cause ingrown hair or folliculitis (acne-like bumps). Waxing can cause temporary burns or skin irritation and should be done professionally.

Shaving:

It requires daily upkeeponce or twice a day.

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here are times when a sudden hair growth occurs on the face and this excess hair growth is called hirsutism. The common cause of hirsutism is hormonal imbalance. Here are a few home remedies that can help you deal with this chronic problem without resorting to the use of chemicals.

Turmeric or haldi

In some Indian communities, it was a common practice for women to apply a little turmeric to their faces or at least cheeks. Besides being good for one’s complexion and the antibacterial effect, turmeric is also said to have the property of curbing hair growth. Turmeric is good for other skin problems too. Make a fluid paste by soaking turmeric powder in water, apply to the facial area where you have excess hair and leave it for a few minutes. After it dries, use a cloth dipped in warm water to wipe away the turmeric and the hair, too.

Gram flour or besan

Traditionally, women in many Indian homes regularly used a face pack made by mixing gram flour or besan with turmeric. This was said to have the ability to remove the excess hair on the face, particularly around the mouth and chin. Besan also helps get smooth and flawless skin.

Mix equal amounts of gram flour and turmeric and add a little water to make a thick paste. Apply on the face, leave it until it dries totally and then rub it off with a cloth dipped in warn water. You can find that along with the besan mixture, strands of hair are also removed.

Sugar mix

This home-made wax-like substance can remove facial hair quite effectively; however, this process may be painful when compared to the turmeric face pack. Take about a tablespoon of sugar in a vessel, add a teaspoon of honey and a few drops of lemon juice, and heat this lightly for about three minutes until it becomes a smooth paste. When the paste is still slightly warm, apply it on the face and pluck the hair from the area.

Egg mask

Another remedy that works to pull off the hair is the egg mask. This is quite easy to try at home because all ingredients are easily available. Egg also has various other benefits for the skin and hair. Take the white of an egg, add one tablespoon of sugar and half a tablespoon of corn flour. Beat to make a smooth paste and apply it on the face. Once the paste dries, remove it. The paste will come off along with the hair.


Sexual life

Keeping romance

alive

It is imperative to keep romance alive in a married life for intimacy and closeness between partners By Mitch Temple

52 FUTURE MEDICINE I April 2014


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ife has a way of chipping away at our marriages: jobs and job related travel, in-laws, activities, kids, conflict and misunderstandings. Most of us run at the speed of light, wake up one day and realise, “Huh. I don’t feel very close to my spouse anymore.” The truth is that it happens to the best of us. Here are a few simple methods I have learned throughout the years to revive romance in a stale marriage.

Start dating again Go out at least once a week. It doesn’t have to be an expensive date– just something simple. A dinner in the park, a walk around the lake, a cup of coffee at a restaurant or simply putting the kids to bed early and just talking will often do the trick. Or, revisit the things that you did when you were dating like going to a movie or a nice relaxing dinner for two. After being “pulled apart” by all the pressures of modern life, it is imperative to reconnect each week. If you don’t, you won’t feel close.

Make yourself attractive If you make yourself more attractive, your spouse will often become more attractive to you. Quite often, changes that you make in your appearance can precipitate changes in your spouse just as positive actions often breed positive reactions.

Go to the gym together • • • •

Walk with your spouse three to five times a week Buy new clothes and throw out those ugly sleep shirts/pajamas Change habits Shave the beard or change your hairstyle

Get new eye glasses or try contacts

Communicate your desires with spouse Do so in non-threatening, nonjudgmental ways. For example, you could say, “Honey, let’s make some changes. We are both in a rut. We’ve changed over the years and lost some of the spark in our marriage. Let’s change how we treat each other. Let’s call each other during the day at work. Let’s change how we look. Let’s walk together each evening.”

Avoid using “you” statements Use “I feel” or “I need” instead. Try writing a letter as an alternative to face to face communication, especially if you feel he/she will react negatively.

Bringing attraction Attraction doesn’t just occur in a marriage. It is something that must be worked at. Often the process of bringing attraction begins with education and basic communication. Determine what it is that makes you feel attracted to someone. What attracted you to your partner in the first place? What are the things that you find attractive that you would like to see in your spouse? What gets your attention?

Do good things daily Doing good things doesn’t necessarily require spending a lot of money. Simple things like picking up your dirty underwear, giving a free back rub, preparing dinner, writing an appreciative note, hand picking flowers or taking on a chore that your partner normally does build intimacy and closeness in your marriage like nothing else.


Sexual life

Don’t succumb to temptation

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hen Bob planted a garden, he put up hedges all around the perimeter of his yard to help keep out pests that would eat the prized vegetables he worked so hard to nurture. His efforts proved successful. Within marriage, barriers must also be erected to protect the “garden of marital bliss” that you are trying hard to build. These barriers, which help keep out unwanted intruders, especially during times of temptation to be unfaithful, will, like Bob’s hedges, protect the marriage that God gave you. When you or your spouse feels tempted to cheat, either through participating in some online forum that promotes infidelity or flirting with a co-worker, these barriers can protect your marriage. And like Bob, you’ll reap the benefits of a well-tended garden of marital love. We have some great ideas for you on what kind of hedges or boundaries you can erect to keep your marriage thriving, healthy and safe from the dangers of temptation and extra-marital affairs.

52 FUTURE MEDICINE I April 54 February 20142014


There is no secret formula to arousal. If you think you have found a secret formula, and you attempt to repeat the recipe, your partner will change the secret.

Sex is a marital discipline. It’s part of how we serve each other in marriage. It is wrong for a wife to use sex as a reward or lack of it as a punishment. Religions clearly teach that husbands and wives don’t deprive each other in this area.

Long distance relationships: Make ‘em work! If you’re considering a long distance relationship or fall into one without much of a choice, don’t worry -- there’s help on the way. We turned to the experts for some tips on how to make your long distance relationship work. Here’s what we uncovered:

Utilise modes of communication With such busy lives and so many obligations pulling at you from all different directions, it’s easy to neglect communicating in a long distance relationship. Using other modes of communication will keep you and your partner close even though you’re technically far away from each other. If you can’t reach each another on the phone, then e-mail, IM and text messaging will do, says an expert Falzon.“When you’re stuck in a meeting halfway across the world, it’s always heartwarming to receive a loving text message from your sweetheart,” he points out. “Set aside a certain time, every day, to connect with each other.”

Partake in an eventrip exchange Odds are you and your love will be visiting each other. It’s important to make this even to

avoid a disgruntled other-half. “Make sure that each person takes a turn visiting the other’s city,” says Debra Berndt, a dating and relationship expert, and author of the book, Let Love In. “This way no one feels as though they are doing all the travelling, thus making all the effort in the relationship.”

Don’t take things (too) personally Things will get in the way so be prepared. Since you and your partner live separately, odds are you’ll maintain your lives in your own cities (as you probably should). It will help your relationship if you remain understanding and flexible.

Keep the romance alive You and your beau might not see each other every day, but it’s important to keep the love going and present. Give a little something -- mail a gift, write a love song, send a balloon-o-gram, order lunch and have it delivered to your honey -- just make it happen. You’re not physically together all the time to enjoy those little extras that your sweetheart might do for you (like bringing you a latte made just the way you like it). Your sweetie will feel cherished knowing that you’re thinking of him enough to send a special surprise. Plus, he will probably return the gesture and will make you feel super-special.

(Courtesy: shenews.com)

January March 2014 2014I IFUTURE FUTUREMEDICINE MEDICINE55 53


Social Health

Mobile Mania


Mobile Phone

The necessary

evil The mobile phone turns 41 on April 5. It, no doubt, has changed our lifestyle immensely over the four decades since its invention, but the impact of this inseparable device on our behaviour and quality of life hasn’t all been positive

Dr C J John Chief Psychiatrist, Medical Trust Hospital, Kochi

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he mobile phone has made an inevitable presence in everybody’s life irrespective of age and gender. It has made life smarter. Connectivity 24X7, while on move has helped the sensible ones to achieve new heights. But there are many who have become addicted to its abuse and have fallen into gutters. The possibilities it offers are huge due to various applications in the new generation phones. Gone are the days when the functions of the mobile were restricted to texting and talking alone. The mobile phone is a multipurpose device and a mini computer. The privacy it offers is immense. Perhaps, this advantage creates more damages in the vulnerable ones and provides opportunities for the criminal minds. A secret relationship is easy now. Watching or sharing a pornographic clipping is effortless for a teenager. Even the spread of anti-social activities can be done with ease. Many create a personal and private world around their mobile phones at the cost of face to face social connectivity and human interactions. If one takes stock of the psychological and sociological disasters the culture of abuse of this device has created, there is scope for naming a new health hazard, The Mobile Phone Behavioural Syndrome.

Mobile phone addictions

It is a reality that people get addicted to this gadget. There are certain warning signals that suggest an addiction. If you feel anxious and agitated whenever you do not have your phone in your physical possession, it is a sign. Constantly checking the phone for new texts, coupled with the compulsion to respond immediately is yet another signal. Phantom cell phone vibration

April 2014 I FUTURE MEDICINE 57


Social Health

Mobile Mania

speed of the thumb of the youngster is amazing. The repetitive thumb pressing syndrome is evident in them. They are busy receiving and sending back texts at the expense of their other duties. It may be through a chat forum of the social network sites or through WhatsApp. Interesting terminologies like Textaphrenia and textiety have been coined. Textaphrenia is the thinking that a message had arrived when it hadn’t, while textiety is the anxious feeling of not receiving or sending text messages. Binge texting is when teens send multiple texts to feel good about themselves and try to attract responses.

Mobile etiquette

or ringing syndrome is a condition when you have a false feel that your phone just vibrated or rang, and you felt it. One is compelled to look and realise it’s a false alarm. One keeps on doing this. A mobile phone addict 58 FUTURE MEDICINE I April 2014

has a tendency to ignore the person in front of him as he indulges in checking social network sites, tweets or texts. They slip into an irrational tension and irritability if they lose the phone or connectivity. Life without a mobile

phone becomes empty for them. For the mobile phone addicts, there is a disregard for every one and their own duties.

Text addicts

You can see text addicts all around. The

We score very poorly in this. It is important to lower voice in public, while talking through phone. Quite often we see people walking on public pathways immersed in conversation over mobile phone without any regard to others or the traffic. This needs to be avoided. The ideal behaviour is not to enter into a phone conversation or texting when you are in a face to face interaction. There is a need to switch off or turn it into silent mode while in public places. Avoid using mobile phones while driving for everybody’s safety. With applications to have social net work connectivity, there is a craze for users to take images of events by mobile and upload instantly. The quick sharing of information is a welcome


step. But many do not show the commonsense or internal censorship to filter the undesirable while uploading. This can be dangerous and can be instrumental in spreading rumours that will be a threat to the peace of a community. At accident sites, there is always a crowd busy taking pictures on mobile phones leaving the victims unattended. There were incidents when mobile phone nuisance created obstacles to rescue operations. The lack of discipline in the usage of the mobile is a serious social issue.

The exploitative dimensions

An 11th standard girl who was an above average student started scoring low marks in studies. Every day, she woke up with sleepy and baggy eyes. Class teacher also reported that she was sleepy in the class. It was by accident that the parents noticed that she was indulging in mobile phone chatting late at night. They had never given her a phone. When confronted, the girl confessed that the phone was a gift her lover about whom the parents knew nothing. She had been using this for a few months. Sleepless nights were spent on love and sex chatting, after others at home went to sleep. She had even let him come to her

The use of cell phones dramatically becomes a new age of convenience for billions of people around the world. The developing countries like India, are benefiting from a wireless revolution that is connecting people in far-flung towns, suburbs, and villages

room and had turned the relationship physical. She was distracted from studies and academic performance started dropping. Parents enforced strict controls. Yet she tactfully and secretly possessed mobile phones again and again. The temptation was huge. It was when the fourth phone was confiscated that the girl was brought for a counseling. This is not an isolated incident. Several instances where the mobile phones are used to exploit girls or to initiate extramarital contacts have been reported. Maybe, these instincts are prevalent in the society. Mobile phones have made expression of these instincts easy. Incidents of taking nude or semi-nude images using the mobile phone camera with or without the knowledge of the victim and using it to blackmail are reported. Suicides due to stress in such situations are also reported. There is a flood of mobile phone scripted crimes in cyber cell. Most of these cases are related to nuisance calls or texts, missed call traps, sexual exploitation and extramarital adventures.

In 2011, International Agency for Research on Cancer (IARC) classified mobile phone radiation as Group 2B - possibly carcinogenic. That means there “could be some risk� of carcinogenicity, so additional research into the long-term, heavy use of mobile phones needs to be conducted. The WHO adds that “to date, no adverse health effects have been established as being caused by mobile phone use. Some national radiation advisory authorities have recommended measures to minimise exposure as a precautionary approach

Smart phones for smart life

Mobile phone today is just not a communication device alone.It is important to be vigilant that this gadget upsets the daily routines. Do not let your dear and near complain that you are always on the phone and that they do not get your care and time. Do not allow lack of trust to grow in your family due to secretive over Indulgence of the mobile phone. Energy should never be exclusively diverted to the touching and swiping of the phone screen or the pressing of its key buttons. This can be irritating while amidst a social interaction. The mobile phones are to add quality to life not to destroy it. Always be vigilant to the exploitative hooks of this gadget and resist falling a prey to it. Let your mobile phone make you move in life constructively. Never allow it to stagnate your life with the burden of Mobile Phone Behavioural Syndromes. March 2014 I FUTURE MEDICINE 59


Sports Medicine

Sports activities for maintenance of health Your have to think twice before engaging in sports activities for the sake of exercise because it will adversely affect your health unless you are physically fit for that particular game By Dr Ranjith Kumar


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n the modern world, the word ‘exercise’ has become an unavoidable part of life. Last week one day, I happened to go to a stadium in the early morning to see my friend and surprised to watch a crowd there, indulged in all sorts of exercises from walking to cricket, and also thought whether those people were aware of the demerits of exercises along with the merits. Involvement in sports activities for maintenance of health is increasing day by day. Sending children for some kind of sports activity is common now. However, most people are unaware of the problems and risks involved in a sport if it is not properly, timely and effectively done. Social media is also projecting sports activities as an adjuvant to exercise to maintain health. But actually each sport has to be properly understood and effectively executed under trained personnel to achieve better health. What we need to decide is to choose the sport we want to engage in and the time we can utilise for that. Ill-health and injuries can happen during the sport. There are treatment modalities which may be needed prior to, during and after the sports activity. Properly managed diet also is essential for the maintenance of health. Sports medicine is becoming more and more important in this new context. In olden days, people in their youth used to involve in lots of physical activities like swimming, working in farms etc. and the common games they used to play also involved a lot of physical activities. Children were regularly sent for Kalari and Yoga practices, where they were primed effectively by Ayurvedic and marma therapies. In countries like China and Japan, and in European countries, their indigenous games are also included in sports curriculums. The outcome

Most people are unaware of the problems and risks involved in a sport. Social media is also projecting sports activities as an adjuvant to exercise to maintain health. But actually each sport has to be properly understood and effectively executed under trained personnel to achieve better health is also remarkable. Nowadays, we need everything in a “capsule” form and expect instant results. But in the case of health, if not done in a systematic and proper way, things may end up in ill-health. So, our aim is to attain good health by properly administering adequate sports events combined with an integrated approach of Yoga, Ayurveda and diet management. Before engaging in sports activities, we have to make use of modern medical facilities and investigations to know whether we are physically fit. If any unforeseen health hazard occurs, adequate medical care at a properly equipped sports medical centre must be made available. In my opinion, we should think of health centres which can provide proper education on sports, diet and related health problems, which include old priming procedures of Kalari and Yoga along with modern medical facilities.

Sports Medicine is a science that focuses on physical fitness and the injuries that can occur during exercise. It looks into how these injuries can be prevented and how they can be diagnosed if they do occur. It also tackles the issues of treatment and rehabilitation, helping athletes to recover from a serious injury.It has only been recently that this particular area of science has received a lot of attention. General practitioners can choose to specialize in this field while teams can be created to address the various needs of athletes. In such a team, all members will be there to help minimise injuries and treat them as needed

April 2014 I FUTURE MEDICINE 61


Sex Education


Needed sex education, but who will deliver? Adolescence is the most fascinating time in one’s life, when one gets attracted to the opposite sex, wanders like a cloud in a dream world, unconcerned, fearless, challenging and adventurous. This is also the time one goes through various emotional as well as physical changes and anxieties

Nirmala Mahadevan. “It’s a very sensitive subject. It must be handled in such a way that the children benefit positively. It should include lessons on sexual health, reproduction and family values. There are so many things parents feel uncomfortable to discuss with their grownup children. Those things can be addressed by qualified teachers who have a special bonding with their “children.” If the teenage son experiences a wet dream, he won’t go to the parents asking why it happens. Here is where the counsellor in the school can come to his help.” Once came from schools or tuition centres, the children are alone at home most of the time. There is nobody to tell them about the emotional and physical changes they undergo. They are forced to share these changes with their friends, who also go through the same confusions and doubts, and finally, most probably, end up acquiring wrong

knowledge. Free access to adult TV programmes, x-rated films and books add to the problems, leading them towards unwarranted relationships and exploitations. Hardly a day now dawns without a sad story of violence against children, especially girls. They are hunted everywhere, at home and in the schools, most often by the least expected people. There was a time when parents and other elders were seriously involved in helping children overcome their anxieties over the adolescent changes in their lives. Then the first menstruation of a girl child was a matter of celebration at home, dispelling all her fears about the new life she is entering. The girl’s grandmother or aunt tells her about the sexual and physical maturity she has acquired. They also tell her about the precautions she has to take in a male dominated society. She was also given an advice

By FM Bureau

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ex education is one of the most discussed subjects across the world. While there are no two opinions about the need for it considering the rising violence against children, especially the girl child, the controversy is about who would teach them. While some argue that it should start at home, parents try to pass it on to schools, saying the subject is very sensitive and it is uncomfortable for the father to discuss it with the son and

daughter. Mother says, “It’s ok; I can talk to my daughter about the need of cleanliness and some general matters. But how can I talk to my son about his problems? So school is the best place for children to share their problems with a concerned teacher or a counsellor.” That’s true, no doubt, but do the schools have enough trained teachers to do the job? “Sex education is not just a study of sex,” says renowned sociologist and counsellor, April 2014 I FUTURE MEDICINE 63


Sex Education to keep a little distance from men, whoever it may be, at home or outside and firmly say “No” to an untoward advance from a male friend. They were also taught about the family values which were necessary for a healthy society. Boys had also kept a distance from girls, maybe because of shyness, or fear. “Society was not open like today, but was healthy and adhered to certain rules. Though some among us find these practices uncivilised, it is a fact that those days were more peaceful and secure,” Mahadevan added. What happens now is that the parents put lots of restrictions on the girl child after her first menstruation, without telling her about the reasons why they are doing it so. It naturally puts her into more troubles. She feels alone, loses concentration on her studies, and remains drawn to herself and inactive. She jumps up on the first chance to establish a friendship outside her home. How can anybody blame her? Nirmala asks. She strongly supports sex education in schools, but on certain conditions. Sex education is the act of informing the teens about everything they need to know about the physical and mental changes setting in them after they reach puberty. It is not just about sex only. It includes other issues linked to family and relationships and general health that parents often feel uncomfortable talking with their children. Sex education in schools must be a little more serious rather than a recreational course.

Power Points •

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Classes must be held separately for girls and boys to avoid embarrassment among students. This will enable them to speak out their mind. It must be regular, like any other subject, at least once in a week Students may be taught the correct terms of the reproductive system through slides and books. They must be taught about the sex-related diseases such as AIDS, STD, HIV etc. They must also be taught about the contraception methods. There are so many myths around this subject, like “first time physical relationship may not result in pregnancy”. These myths must be corrected. The students must also be taught about the importance of a family life for a secure life ahead.

64 FUTURE MEDICINE I April 2014

Good fences make good relationships

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oundaries are necessary for many things. The time between the end of a class and the beginning of another is a boundary. The closed teachers’ lounge door that says, “Teachers Only,” is a boundary. There are boundaries all around us that set limits. Many boundaries are useful. And although it’s great crossing over boundaries such as state lines on a road trip, personal, physical and emotional boundaries are not a fun to

cross over. People set the boundaries that are important to them. For example, if your friend crosses the limit and goes in for a touch, you have to remind that person of the boundary or limits of your friendship. And if the friendship is strong, you can talk to the friend about this without things getting awkward because you don’t feel the same way . Often, boundaries that are strong will also be flexible, adapting to different situations.


Motivation

Like a phoenix…

If you ask me, we are worse off than rape victims because with our faces burnt, we seem to have lost our identity...

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Laxmi, a victim of an acid attack in New Delhi nine years ago and now a standard-bearer for Stop Acid Attacks campaign, has been selected by the US for the prestigious International Women of the Courage Award By Sumithra Sathyan

axmi’s story is heart-rending. Please don’t ask who is Laxmi. You may know so many girls with the name Laxmi, but this laxmi is different, a living example for how cruel a human being can be against another for virtually no reasons. She was a beautiful girl nine years ago, aged 16, like your sister or friend, living happily in New Delhi with her parents and young brother. One day, in 2005, she was waiting for bus at the busy Khan Market in New Delhi. Suddenly an acquaintance sprung up from nowhere and threw acid on her face , disfiguring her permanently. The attack was pre- planned. Her attacker, a 32-year old brother of one of her friends, wanted to use the acid to destroy Laxmi’s face for refusing to respond favourably to his romantic advances. “ I kept screaming for help but no one stepped forth. Everyone ran in the opposite direction. I could feel my flesh burning and I covered my eyes with my arms. That reflex action saved me from losing my vision.” Laxmi says about the never ever forgettable incident that ruined her life forever. ‘’Acid corrodes quickly. Within a few seconds, I had lost my face, my ear had melted and both my arms were charred black. A politician’s driver took me to a hospital, where I was to stay for the next 10 weeks. The doctors had to remove the entire skin from my face and keep it bandaged. I’ve already had seven surgeries and need at least four more before I can go in for plastic surgery, provided I can afford it. I learnt to live with the physical pain but what hurt me more was the way the society reacted. My own relatives stopped seeing me, as did my friends. I stayed indoors for eight years .’’ Laxmi says .

April 2014 I FUTURE MEDICINE 65


Motivation

Laxmi with Michelle Obama at the International Women of Courage Awards at the State Department

As her parents were trying cope with the tragedy in her life, her brother came down with tuberculosis and her father died. She was shattered for the second time. ‘’ After my father’s death, being the eldest in the family, besides Smy mother, I had to take care of the family. My mother had to be with my brother all the time. I felt really upset that she could not spend any time with me. I gathered myself together and pursued my case in court. My lawyer had filed a petition in the Supreme Court, asking for a ban of the sale of acid.’’ Laxmi says. Slowly, she started getting in touch with the other victims, most of whom are blinded or have lost their hearing. Each one of them are poor and cannot afford multiple surgeries.

Online campaign

Laxmi with Alok Dixit

Is it our fault ?

Laxmi tried to pick up a job but nobody was willing to hire her. She tried in BPOs, banks and beauty parlours but all she got was rejection. Nobody wants to hire acid victims because of the way they look. ‘’ But I ask you, is it our fault? Society accepts those born blind or those who are physically challenged. Why

66 FUTURE MEDICINE I April 2014

are we shunned? If you ask me, we are worse off than rape victims because with our faces burnt, we seem to have lost our identity.’’ Laxmi says . The only support she got was from her parents, doctor , her lawyer Aparna Bhatt and from the couple at whose house her father worked. They paid for the surgeries and are still in touch with Laxmi’s family .

She started an online petition and was happy when 27,000 people signed it. She went to the Home Ministry to submit it to the minister, Sushil Kumar Shinde. ‘’ We waited for three hours but he didn’t have even five minutes for us. I had to finally “ambush” his car to hand over the petition.’’ Laxmi says. In the meantime, Nahim Khan, the man who had attacked Laxmi with acid, went to jail after the court awarded him a seven-year sentence. Many acid attack victims never return to normal life: they often go great lengths

Many acid attack victims never return to normal life: they often go to great lengths to hide their disfigurement, many forgo education or employment rather than appear in public, and suicide is not uncommon. But Laxmi did not hide. She became the standardbearer in India for the movement to end acid attacks to hide their disfigurement. But Laxmi did not hide herself. Life has been slowly picking up. Her work for the acid attack victims has been noticed and recognised internationally. Her Stop Acid Attacks campaign was selected by the US for the prestigious International Women of the Courage Award. There have been changes in her personal life too. Last year she met Alok Dixit, a 26-year-old journalist who supported her campaign. They fell in love and decided to live together. She has also found a job as a television news anchor. Laxmi’s petition made the Supreme Court to order the Indian central and state governments to regulate immediately the sale of acid, and the Parliament to make prosecutions of acid attacks easier to pursue. Much is left to be done.



kALARI CHIKILSA

Photo: VKM Kalari

Kalari K for overall health There was a time when kalaripayattu and kalarichikilsa were part of our daily life. If learning kalaripayattu was for protecting the body from enemies, kalarichikilsa was for keeping the body healthy By FM Bureau

68 FUTURE MEDICINE I April 2014

alaripayattu, one of the oldest self-protection methods and often called the mother of all martial arts, has its origin in the southern part of India, mainly the state of Kerala. It was taught for the mental and physical development of the students apart from a fighting practice to protect themselves from enemies. It provides a student the highest degree of physical flexibility, concentration of mind and a healthy body. It is believed to have a history of 2000 years. But the most important thing of Kalari is its healing method called Kalarichikilsa, based on Ayurveda and considered to be the best for treatment of orthopedic disorders, sports injuries and neuromuscular problems like back pain, spondylosis, arthritis, inborn imperfections of the human body, bone setting and massages, using specially formulated oils and herbs. Marma chikilsa is the most important segement of kalarichikilsa. It is estimated that there are 107 marmas (sensitive

spots on our body, where a strong touch, bruise or a blow can cause even death or numbness on that area of the body. The treatment is done through massaging that particular spot using specially prepared herbal oil. Kalarichikilsa concentrates on treating the affected spot. This is considered as a suitable method for the treatment of sprains, bruises, fractures and dislocations. Knowing of the marmas is very important for this type of treatment, Anybody does the treatment without having proper knowledge of the marmas (sensitive spots) may be inviting more trouble such as complete paralysis of the body. Usually the Guru directly undertakes such therapy. One important thing in kalarichikilsa is that the vaidya will never use anything hostile to the body and ensures no toxic is left behind. This makes kalarichikilsa free from side effects, and ideal for special care areas like sportsrelated illness.


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home remedy

Overcome your

Migraine Migraines can be overcome by resorting to home remedies which appear to be simple but are really capable of providing instant relief By FM Bureau


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igraines are extreme headaches which leave the sufferer completely exhausted and depressed. It is often accompanied by sweating, nausea and pain at the back of the eyes. A severe migraine can be triggered by tension, stress, loud noise, bright light, poor sleeping, bad eating habits, certain foods, fasting, smoking and exposure to smoke, alcohol, allergies and environmental stimulants. Chocolate, nuts and cheese are all irritants to migraine sufferers. Dehydration and hormone imbalance in women during menopause also can trigger migraines. However, there are some home remedies to contain the severe condition, which are practised across the world. The first thing, of course, is consulting a doctor. If that’s not possible, try the

following: • Massage the tensed muscles with tea tree oil which will give some relief. • Pregnant women can use vinegar for migraine relief. Soke a washcloth in vinegar and lay it on the part of head that hurts the most. Allow the vinegar to seep into your skin. Allow up to 30 minutes for best results. • Drink hot tea (black tea) and allow your body to relax further. Add honey to the tea for best results. Chamomile tea or Mint tea works wonders! • Hot water shower will provide relief. Stay in the shower as long as you need. The more the hot water flows down your neck, the more pressure will be relieved. • Have someone to apply pressure to the tensed areas of your head and neck.

Each remedy mentioned above works differently for different people. Keep trying remedies till you find the one that works for you. Don’t give up!

Tea tree oil

March April 2014 I FUTURE MEDICINE 71 53


health insurance

How prepared are you for the twilight zone ?

Perhaps, the most difficult period in anybody’s life is the old age, but if you have enough money and you are self dependent, there is not much to worry about the last stage


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enior citizens, no doubt, need a decent life. Many, who were working hard throughout their life, might not be able to save enough for their retirement life. Old age is the time of poor health and illnesses, and many suffer indescribably if they don’t have enough money to meet the high cost of hospitalisation and the medicines. Keeping these things in mind, Government of India, has introduced several benefits through various schemes and policies for senior citizens. Most important among them is health insurance for the elders. Through proper regulations and guidelines for the insurance companies in India to protect the interests of the policyholders with special emphasis on senior citizens, the government ensures that the elder community benefits from the schemes. No insurer or insurance company in India can refuse or deny a senior citizen the health insurance cover or load him/her with extra premium without providing valid reasons. The IRDA (Insurance Regulatory Development Authority) also ensures

A medical insurance for senior citizens provides monetary help in case of unforeseen medical emergencies. It also empowers an elderly person to go for health check-ups and long-term medical treatment that the insurance sector across India functions with more transparency and follows uniform standards. With the entry age being extended up to 65 years, the prospective customers would have greater flexibility in choosing a plan that suits their requirements. It has become mandatory for all insurance companies to see that disclosures are explained

upfront so that an insured individual or the policyholder knows what is in stock for him. Entry age limits With the new regulations in the insurance sector, it has become mandatory that the maximum entry age for a standard health insurance policy offered by General (or nonlife) Insurance Companies should be at least 65 years. Some insurance companies, including governmentowned ones, are offering a maximum entry age is up to 80. However, a common rule applies for all health insurance products- the older an individual, the scrutiny for conducting clinical and medical examinations becomes stricter. Most companies insist on some pre-screening tests before they issue a policy. They normally will not cover pre-existing conditions and even if they do, they will only pay a fraction of the actual claim that is made. The companies smartly incorporate certain exclusions. Please do read them before making your commitment and buying a policy. April 2014 I FUTURE MEDICINE 73


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fitness corner

Fitness tips Make a habit to walk 15 minutes a day, and add time, distance, and intensity from there. Use the Buddy System Find a friend or relative whom you like and trust who also wants to establish a healthier lifestyle,Encourage one another. Exercise together. Use this as an opportunity to enjoy one another’s company and to strengthen the relationship. Make Your Plan Fit Your Life You don’t need fancy exercise gear and gyms to get fit.If you’ve got floor space, try simple floor exercises to target areas such as the hips and buttocks, legs and thighs, and chest and arms (like pushups, squats, and lunges). Aim for 10-12 repetitions of each exercise, adding more reps and intensity as you build strength. Be Happy Be sure to pick an activity you actually enjoy doing. And choose something that is convenient. Rock climbing may be a great workout, but if you live in a city, it’s not something you’ll be doing every day.

Home Gym The market is flooded with modern machines meant for exercising at home. One of them is the BL1 Body lift gym BL1

Body Lift

The BL1 Body lift gym has been designed for effective exercising at home and gaining strength. It is maintenance free and durable with its Electrostatic Powder Coated Finish. This Body Lift gym equipment comprises user friendly single handed adjustment system that offers easy mode for selecting the resistance level. The 18 inch revolving curl bar and the 48 inch steel bar pulleys allow you to adjust the gym according to your body size, height and comfort level. The fixed motion bench press and the shoulder press help you to practise wide ranges of exercises.

76 FUTURE MEDICINE I April 2014

Select the best gym equipment from the varied collections to build the perfect gym that motivates your desire for optimum health and satisfies your thirst for attaining ultimate muscle strength

How can exercise help? Studies have documented a consistent 10-20mmHg reduction in systolic BP during the initial 1-3 hours following 30-45 minutes of moderateintensity exercise in people with hypertension. Longitudinal studies further show that endurance training may elicit an average reduction of 5-7mmHg in both systolic and diastolic BP in people with stage 1 or 2 hypertension. Furthermore, physically active people with hypertension and those with higher levels of cardio respiratory fitness have been shown to have lower mortality rates than sedentary or less fit persons. When exercise is combined with healthy lifestyle modifications, it may be possible to reduce or discontinue medications.


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Celebrity Fitness

Kareena’s diet chart Actress Kareena Kapoor was born on 21 September 1980, into a family of Bollywood legends. She is the daughter of actors Randhir Kapoor and Babita, and the younger sister of actress Karisma Kapoor. She has received six Filmfare Awards, and is one of Bollywood’s highest-paid actresses. ............ Diet ............

Begins her day with a fruit juice or milk. She doesn’t like to start the day with tea or coffee ............ Breakfast ............ Muesli, bread slices or paranthas with milk

............ Lunch ............ Dal , chapatis and a lot of green salad

............ Dinner............ Dal, chapatis or vegetable soup. ............ Snacks............ Nuts and soya milk Takes small chunk of meals every three hours Avoids high calorie diet like rice

Beauty Tips Include plenty of water in daily routine Justify a day’s food intake with exercise Never go out in the sun without wearing sunscreen, Follow a balanced diet and keep feeding with small nutritious foods after a certain period of time.

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