june, 2016 issue of health spectrum : monthly health magazine

Health Spectrum

June 2016 Volume I Number I Price 50

www.healthspectrum.org

l Dr. Sushma P Sinha

l Dr. Raju Vaishya

l Dr. Rahul Gupta

l Dr. Dharminder Nagar

l Dr. H S Chhabra

l Dr. Vivek Nangia

l Dr. Rohan Khandelwal

l Dr. Ira Chopra

l Dr. Pallavi Vaishya

l Dr. Mukesh Batra

l Dr. R K Tuli

l Dr. Yuvraj Kumar

l Dr. Shobhana Mittal

Healing The Sufferings of People

Healthcare InRural India

AdultVaccinationAdultVaccination

2 Health SpectrumJune 2016

HEALTH STUDY/RESEARCH

3Health Spectrum June 2016

June 2016ContentIn The News

lPresident bestows Florence Nightingale Awards on 35 Nurses

lInternational Convention on World Homoeopathy Day

lFoundation Stone laid for three new Medical Colleges at Rajouri, Anantnag and Baramulla

Regular ColumnsFace to Face 24

Case Study 26

Q & A 48

Fitness Funda 38New Study/ResearchlEvery fourth woman in urban India either overweight or obese

lElectronic Waste: Health Hazards For 5 Lakh Child Labourers

lDietary Habits & Processed Foods Spurring Cancer Incidence in India

ArticleslIs Left-handedness a Handicap for Training in Surgery? - Dr. Rohan Khandelwal 27lBlue Light Hazard: Eyes Face Threat from Blue Violet Light -Dr. Ira Chopra 28lCholesterol Woes 52

Parenting lUnderstanding Psychology of Your Children - Dr. Shobhana Mittal

46 8

9

28

3020

14Current Issues

lHuge manpower gaps bedevil healthcare in rural India: How Private Sector Can Help - Dr Dharminder Nagar

lRedefining Wheel-chair: Empower People with Disabilities with Technology -Dr. H. S. Chhabra

lIndia Needs Universal Neonatal Hearing Screening

lAdult Vaccination - Dr. Vivek Nangia

Beauty Care 32When Beauty is more than Skin Deep – Dr. P. K. Talwar

Healthy Motherhood 33Know what to expect from high-risk pregnancies

Food & Nutrition 34Important to take Bal-anced, Nutritious Diets during Pregnancy – Dr. Pallavi Vaishya

Fitness 36Benefits of Swimming

Alternative Medicine 40

lHomeopathy: Treatment of the ‘Cause’ and ‘Effect’ -Dr. Mukesh Batra 40 lEra of Holistic Medicare -Dr. R. K. Tuli 44

4 June 2016

Doctors should provide simple, easy and accurate health information to patientsI think one of the main problems in Indian medicine is the tremendous gap in knowledge that exists between patients and doctors. This leads to doctors developing a paternalistic attitude and they investigate, prescribe and advise courses of treatment which are accepted by patients unconditionally but may not always be in their best interests. There is a great need for vehicles to provide health information to patients which is simple, easily understood, authoritative and, most important, accurate. I have had experience of trying to narrow this gap in knowledge through television programmes such as the World this Week many years ago, via the internet - Doctor NDTV and now www.Raxadoctor.com and am delighted that a monthly health magazine ‘Health Spectrum’ is being launched. I am sure it will become very popular. It deserves to be.

Dr. Samiran NundyDean, The Ganga Ram Institute for

Postgraduate Medical Education and Research, Sir Ganga Ram

Hospital, New Delhi

Health Spectrum : a platform to discuss health Problems and solutions This is a good initiative by Medi Media to lauch monthly health

magazine ‘Health Spectrum’. With increasing number of people seeking the Dr Google for medical problems, it is important that we have a credible group of professionals who can give unbiased and scientific information to the public. Also a lot of information on the internet is for the western population and does not suit the Indian public. For example, Avocado fruit for breakfast to loose weight. Non communicable and life style diseases are rapidly competing with infections and cancer and will eventually become the number one cause of medical problems in India. A forum like “Health Spectrum’ would give opportunity to discuss the prevention and management of these health problems and its solutions

Dr Arun PrasadSenior Consultant Surgeon -

Minimal Access Surgery (Gastro intestinal, Robotic, Bariatric &

Thoracoscopy), Apollo Hospital, New Delhi.

bartkj jgsxkLokLF; thou dk ewy gS vkSj blds ckjs tkx:drk dk;e djus dh fn’kk esa gsYFk LisDVªe dk izdk’ku cgqr gh t:jh dke gSA mEehn gS fd bldk fgUnh laLdj.k Hkh ‘kh?kz gekjs ikl gksxkA bartkj jgsxkA ‘kqHkdkeuk lfgrA

Mk- izseiky ‘kekZizfl) ys[kd ,oa iwoZ vf/kdkjh ¼jsy ea=ky;½]

dyk fogkj] e;wj fogkj&Qst&1 ,DlVsa’ku] ubZ fnYyh

Share your opinion at [email protected].

Letters

It gives me immense pleasure to know that Mr Vinod Kumar (Editor) is launching a monthly health magazine “Health Spectrum” with the objective to create health awareness in our society and will cover all aspects of Health and Medicine. I would like to congratulate Mr. Vinod & his entire team for the inaugural issue of the magazine.

Dr. Sunita GodaraAsian Marathon Champion 1992

Director-Health Fitness TrustPresident-Health Fitness Society

June 2016, Volume 1, Number 1

Editor : Vinod KumarManaging Editor : Sushila KumariEditorial Advisors : Dr. Jitendra KumarDr. Manoranjan SahayDr. Pallavi Vaishya Content Team : Himanshu Patra, Jyoti Choudhary, Prem Babu Sharma, Ajit Kumar, Deba Sahoo (Delhi), Sama Irani (Mumbai), Aloka (Ranchi), Arun Kr. Mayank (Patna) & Deepa Tomar (Singapore)Art Director : Kripa Shankar Design & Graphics : K A ChoudharyAdmin & Business : Satnam SinghM : +91 8826335577Web & Mobile : Athar HaqueHead Office : 909-910, B-Wing, Naurang House, Opposite : Hindustan Times Building, Kasturba Gandhi Marg, New Delhi :110001Registered Office : 21, UNI Apartments, Sector-11, Vasundhara, Ghaziabad – 201012Tel : +91 120 4320050M: +91 9013074414, 9868793203 Mumbai Office : 37/911, Adarsh Nagar, Worli, Mumbai- 400030

Published & Printed by Vinod Kumarat Angkor Publishers (P) Ltd, B-66, Sector 6, Noida-20130Published from 21, UNI Apartments, Sector-11, Vasundhara, Ghaziabad – 201012Editor : Vinod KumarEmail : [email protected] : www. healthspectrum.orgNote : Views expressed in articles are the views of the individual author. They do not represent the views or interests of Health Spectrum.

facebook/spectrumhealthindia

Title Code : UPENG04171


Editor Speak

The need for constant health awareness

Our health, which is an invaluable asset of our life, is determined and affected by an array of diverse factors — from the genes that we inherit from our parents to the climate we live in and the work we do. But there is a growing body of scientific

evidence that shows our lifestyles play a huge part in how healthy we are. From what we eat and drink, to how much exercise we do, and whether we smoke or take drugs, every single factor is impacting our health, not only in terms of life expectancy but also in terms of our ability to live without experiencing chronic diseases

In India, the situation is absolutely different because Indians are discarding their centu-ries-old lifestyle and traditional food and recklessly adopting a western life and junk food.

Due to this fast-changing scenario, India is witnessing an alarming spurt in several life-style diseases. The disturbing fact that starkly stares in our face is that the country accounts for the highest number of diabetes cases and some other health problems like cancer and cardiovascular diseases. It is hardly surprising that India has become the world capital of several life-threatening ailments.

There are a number of factors contributing to the dismal health scenario in our coun-try. Indians are genetically predisposed to a numbers of diseases, particularly cardiovas-cular problems, but vast disparities in the healthcare delivery and lack of awareness about medical facilities among the general public have largely contributed to it. It is imperative to generate mass awareness about the symptoms, repercussions, complications and treatment of a disease. Most of the time, ignorance about a disease proves fatal.

India may be witnessing an Information Revolution boom with the emergence of hun-dreds of TV Channels, newspapers and websites, but it is ironical that majority of people still have no access to quality and authentic health information. Even in the 21st century, people depend on hearsay or primitive health techniques.

It is precisely because of this reason that we, a small but dedicated team of health communicators, have decided to bring out “Health Spectrum”, with the avowed objective of disseminating scientifically proven health information among the general public. It is one baby step in that direction but our ultimate objective is to position the magazine as a bridge between Health Experts/Doctors/Researchers/ Health providers and the general public. We hope that it will become a medium of communication between them.

In this inaugural issue, we are honoured to share with our readers the profound and thought-provoking articles from some committed people. The first issue of ‘Health Spec-trum’ is now in your hands. We appreciate your support and are delighted to have you as a reader of the magazine. We earnestly hope that you will constantly provide guidance and support to this initiative through a sustained readership.

We will look forward to your suggestions and feedbacks for improving the magazine. After all, it is your magazine. We will surely publish the worthwhile comments from our readers.

With warmest thanks,

Vinod Kumar EditorHealth SpectrumEmail : [email protected]

Greetings and a warm welcome to our very first issue of Health Spectrum!

India may be witness-ing an Information Revolution boom with the emergence of hun-dreds of TV Channels, newspapers and web-sites, but it is ironical that majority of people still have no access to quality and authentic health information. Even in the 21st cen-tury, people depend on hearsay or primitive health techniques.


In The News

The President Shri Mukherjee with Florence Nightingale Awardees. Shri J.P. Nadda and the Health and Family Welfare Secretary, Shri B.P. Sharma are also seen.

President bestows Florence Nightingale Awards on 35 Nurses

The President of India, Shri Pranab Mukherjee presented the National Florence Nightingale Awards to nursing personnel on May 12, 2016) on

the occasion of International Nurses Day at Rashtrapati Bhavan.

Speaking on the occasion, the President said nursing professionals are the backbone of the healthcare system. Nurses play a vital role in all aspects of healthcare, be it national health campaigns like polio eradication, mid-wife services and community education. Their level of commitment and care are much valued in both urban and rural areas, including remote areas of the country. Their contribution is critical in the achievement of the nation’s healthcare goals. Their inputs into health sector policies are equally important for they help in creating the neces-sary supportive work environment for their practice.

The President said emerging global threats such as microbial resistance, new pandemics, infections, and natural disasters have added to the pressure and demands on healthcare services. The services of nurses are crucial for a response system that a government creates to meet these challenges. Nursing personnel in our country are increasingly better educated and well-trained. They are now more adept at communicating with patients, and connect-ing with citizens, communities and policy makers. In the next fifteen years or so, the nature of their services will undergo significant change. Training and capacity building in this field will require new levels of innovation and leadership. Yet, one thing will endure. And that is, the premium all communities in the world place on the sensitivity, empathy and humanity of Indian nurses.

Minister for Health and Family Welfare, Shri J P Nadda congratulated the award winners and appreciated their exem-plary services. Shri Nadda also informed that the Ministry has

undertaken number of initiatives for strengthening of nurs-ing cadre. The Florence Nightingale awards are given to the outstanding nursing personnel employed in Central, State/UTs. Nurses working in Government, Voluntary Organiza-tions, Mission institutions and the private institutions can apply with the due recommendation of concerned State Government. The Florence Nightingale Awards carries Rs.50, 000/- cash, a certificate, a citation certificate and a Medal.

Also present at the award ceremony were Sh B P Sharma, Secretary (Health and Family Welfare) and senior officers from the Ministry of Health and Family Welfare along with invitees. n

The President presenting Award to Nursing Sister, Medical Speciality Hospital, Chandigarh, Ms. Jaswinder Bakshi.


In The News

The Minister, Shri Shripad Yesso Naik also released a commorative stamp and a souvenir on this occasion.

Shri Naik, in his inaugural address, ex-pressed regret over the fact that the po-tential of Homoeopathy remains largely unexplored and, therefore, underuti-lized in public health. This, despite the fact that Homoeopathy is practised in more than 80 countries of the world and is known to be effective in various communicable and non-communicable diseases, chronic diseases and diseases of children and mothers, he added. He said that, during pregnancy, when expecting mothers are usually advised not to take much medication, Homoe-opathy is a safe alternative. The scope of prevention of various epidemic diseases through Homoeopathy is also huge, but not yet tapped, he added.

The Secretary, Ministry of AYUSH Shri Ajit M. Sharan informed the gath-ering that the Government of India is putting in all efforts to develop centers

of excellence in Homoeopathy. North Eastern Institute of Ayurveda and Ho-moeopathy is being given impetus and work on All India Institute of Homoe-opathy has been initiated, he added. He also said that the centers of excel-lence so formed would be models for education, research and patient care in specific fields. Shri Sharan highlighted the importance of research for scientific advancement of Homoeopathy.

The International Convention on World Homoeopathy Day was organ-ised by CCRH, an autonomous research organization of Ministry of AYUSH, Government of India and an interna-tional organisation Liga Medicorum Homeopathica Internationalis (LMHI). Scientists and homoeopathy doctors from 23 countries including Brazil, Russia, South Africa, Italy, Netherlands, U.K., Austria, Armenia, Canada, Israel, Australia, Bangladesh, Japan, France, UAE, Cuba, Nepal, Turkey, Argentina, Slovenia, Pakistan, Ghana and Kenya participated in this convention.

The event was organized to com-memorate the 261st birth anniversary of the founder of Homoeopathy Dr. Christian Friedrich Samuel Hahne-mann, a German physician, who was a great scholar, linguist and acclaimed scientist. The theme of the conven-tion is ‘Integrating Homoeopathy in Healthcare’.

During the convention, speakers de-liberated upon various significant issues in Homoeopathy. It includes special sessions on ‘Homoeopathy on Cancer’, ‘Homoeopathy on Mental Health’, ‘Ho-moeopathy on Epidemics’, ‘Homoeopa-thy on Public Health, Clinical Research studies, Drug Validation and Drug Development’ among others.

Among the invited guests were Mohd. Nasim, Minister of Health & Family Welfare, Govt. of Bangladesh, Mr. Mushtaq Alam, Minister of State for Health, Govt. of Nepal, Mrs. Fozia Manzoor, Counsellor of High Commis-sion, Pakistan and Mr. Anura Jayawick-rama, Health Secretary, Sri Lanka. n

International Convention on World Homoeopathy Day

Prevention of various epidemic diseases through homoeopathy is huge, says Shri Shripad Yesso Naik

Shri Shripad Yesso Naik lighting the lamp to inaugurate the “International Convention on World Homoeopathy Day”, in New Delhi on April 09, 2016.


Union Health and Family Welfare Minister Shri J P Nadda laid the foun-dation stone for three

new medical Colleges at Rajouri, Anantnag and Baramulla districts in Jammu and Kashmir, today. “The new Medical Colleges will strengthen the medical infrastructure and give a big boost to tertiary healthcare and medical education in the region”, Shri Nadda stated. He said that with total outlay of ₹ 189 crore each, the three new Medical Colleges will add 300 MBBS seats per year in the States with 100 seats per College. In addition, the medical infrastructure in the districts will be strengthened with addition of a 300 bed facility attached to each college.

Ms. Mehbooba Mufti, Chief Min-ister of Jammu and Kashmir; Dr. Ji-tendra Singh, Union Minister of State (I/C); Shri Bali Bhagat, State Minister for Health & Medical Education; and Ms. Asiea Naqash, Minister of State for Health & Medical Education, Government of Jammu & Kashmir were also present at the ceremonies.

The Union Health Minister stated that in addition to these new initia-tives, the Government Medical Col-lege, Jammu and Government Medi-cal College, Srinagar in the State of J&K have been taken up for upgrada-tion under PMSSY with an outlay of ₹ 120 Crore (i.e. Central contribution of ₹115 Crore and State share of ₹ 5 Crore) for each medical college. He added that ₹ 2194.8 crore since inception and ₹ 688.8 crore during last two financial years has also been released to Jammu & Kashmir state for implemen-tation of programmes approved under National Health Mis-sion (NHM). Shri Nadda said that the State is receiving higher allocation per capita like the North East (NE) States. State also has a provision of Hard Area Allowance, where maximum of ₹ 20,000 is provided to Medical Officer.

Shri Nadda stated that the Hon’ble Prime Minister had an-

nounced development package for Jammu & Kashmir on 7th November, 2015 which includes creation of two AIIMS-like in-stitutions. Moreover, one time grant of up to ₹120 crore each for 2 State Cancer Institute at Jammu and Srinagar and up to ₹45 crore each for 3 Tertiary Care Cancer Centre (TCCC) at District Hospital in Kupwara, Kishtwar & Udahmpur districts has also been approved. Shri Nadda said that these new initiatives shall significantly improve the healthcare facilities in the State. n

Foundation Stone Laid For Three New Medical Colleges At

Rajouri, Anantnag And Baramulla

Shri J.P. Nadda and Ms. Mehbooba Mufti laying the foundation stone for the new Medical College, at Baramulla, in Jammu and Kashmir

Shri J.P. Nadda and Ms. Mehbooba Mufti laid the foundation stone for the new Medical Col-lege, at Rajouri, in Jammu and Kashmir

A big boost to tertiary healthcare and medical education in the region: J P Nadda

In The News


New Study/Research

Every Fourth Woman In Urban India Either Overweight Or Obese

Recent surveys by various agencies have claimed that India has world’s third highest number of obese

persons behind the USA and China and even as experts claimed that the problem is more acute among women than men.

On the basis of data of the third round of the National Family Health Survey (NFHS) and Indian version of Demographic Health Survey (DHS) which is conducted in more than 80 countries all-over the world, experts claimed in urban India, about 25 percent of w omen are either overweight or obese, which is higher than the prevalence among men (20%) .

A sensational 44% of diabetes burden and an estimated 10% to 40% of certain cancer bur-dens are attributable to overweight or obesity. Obesity reduces the life span of an individual by an increased risk of diabetes, cancer, heart attacks, stroke, kidney and liver failure.

This problem has added to the already existing woes of our country that has been struggling to come to grips with undernutrition and infectious diseases. With a substantial 40% of the country being under nourished and an estimated 20% ‘over nourished’, overall India has 60% malnourished people and “this is mat-ter of concern.

As India is struggling to eradicate the problem of undernutrition and anaemia mean-while, our country already witnessed the over-weight and obesity problem which has more than 30 million obese people, and the number is increasing alarmingly. These findings only throw up the challenge of two different nutri-tion-related health problems in the country. India has to therefore grapple with the problem of undernutrition and anaemia in one hand and overweight or obesity on the other hand. (by Shama Irani) n

Obesity has added to the already existing woes of our country that has been strug-

gling to come to grips with undernu-

trition and infectious diseases. With a sub-

stantial 40% of the country being under

nourished and an estimated 20% ‘over

nourished’, overall India has 60% mal-

nourished people and “this is matter

of concern.


India’s 5 lakh child labourers face health risk due to dismantling and recycling the electronic waste produced in the country, according to a report by the Associated

Chambers of Commerce and Industry (AS-SOCHAM) – Frost and Sullivan, India’s 5 lakh child labourers face a serious health risks due to the electronic waste (e-waste) generated in the country, according to a study by the Associ-ated Chambers of Commerce and Industry of India (ASSOCHAM)-Frost and Sullivan.

According to the report, child labourers in the age group of 10-14 years who are found en-gaged in various e-waste dismantling activities, without adequate protection and training in handling and recycling the waste, are at greater health risk.

India is expected to produce 30 lakh metric tonnes (MT) of electronic waste (e-waste) per year by 2018 from the present 18.5 lakh MT.

More than 95 percent of e-waste generated in the country is managed by the unorganised sector and scrap dealers, the study revealed.

E-waste includes discarded computer monitors, motherboards, cathode ray tubes, printed circuit board, mobile phones and chargers, compact discs, headphones, white goods such as liquid crystal display/plasma televisions, air conditioners and refrigerators. These products contain toxic substances, in-cluding lead, cadmium, mercury, hexavalent chromium, plastic, polyvinyl chloride and other heavy metals.

“This deadly mix can cause severe health problems in those handling the waste. Printed circuit boards, for instance, contain heavy metals like antimony, gold, silver, chromium, zinc, lead, tin and copper. The method of ex-tracting these materials from circuit boards is highly hazardous and involves heating the metals in the open,” B K Rao, chairman of ASSOCHAM Health committee that re-leased the ASSOCHAM paper, said.

The study showed the people who are engaged in recycling e-waste without any proper training, including children, use primitive and hazardous methods like acid stripping and open air incineration for processing e-waste. These methods are highly unsafe and cause pollution by releasing toxins from the

e-waste into the environment.“Exposure can cause headache, irrita-

bility, nausea, vomiting and eyes pain. Re-cyclers may suffer liver, kidney and neuro-logical disorders”, Rao added.

The ASSOCHAM report has advocat-ed bringing about a new legislation in the country which prevents the entry of chil-dren into the labour market, particularly the e-waste dismantling activities. It said children should not be allowed to collect, segregate or distribute e-waste.

The study further said that Mumbai tops the list of cities generating high e-waste, with 120,000 MT produced there every year. Delhi-NCR (98,000MT) and Bangalore (92,000MT) follow Delhi in

terms of e-waste generation. Chennai, Kolkata, Ahmadabad, Hyderabad and Pune are the other cities in India that generate high quantities of e-waste, the study revealed.

It added that only 2.5 percent of India’s total e-waste gets recycled because of poor infrastructure and inadequate legis-lative framework which has led to wastage of natural resourc-es, and irreparable damage to environment and health of the people working in industry. n

Electronic Waste: Health Hazards For 5 Lakh Child Labourers

India is expected to produce 30 lakh metric tonnes (MT) of electronic waste (e-waste) per year by 2018 from the present 18.5 lakh MT. More than 95 percent of e-waste generated in

the country is managed by the unorganised sector and scrap dealers, the study revealed.

The study further said that Mumbai

tops the list of cities generating high

e-waste, with 120,000 MT produced there

every year. Delhi-NCR (98,000MT) and Ban-galore (92,000MT) fol-low Delhi in terms of e-waste generation.

New Study/Research


New Study/Research

Not just the numbers have increased, the age of incidence of cancer is also markedly low today, ringing a sense of alarm among doctors and experts

Rapid changes in dietary habits, increased consump-tion of packaged foods, high levels of industrial and environmental pollution and the inadvertent entry of chemicals in the human food chain are factors

that are spurring an alarming rise in cancer incidence in India.Dr Tanmoy Mukhopadhyay, Senior Consultant Clinical

Oncologist, Apollo Gleneagles Cancer Hospital, Kolkata says not only has the numbers of several cancers increased in recent years, but in an alarming trend the average age of incidence has also reduced drastically in recent years. On an average, nearly 12 lakh new cancer cases get added annually to the 25 lakh existing patients across the country.

“The downward shift in the average age of cancer incidence is also a very dis-turbing trend. Earlier, the risk of cancer was believed to increase with age. What was earlier considered a disease primar-ily of the old in now increasing afflicting young men and women, even in their 30s and 40s. The common factors that are responsible for the rise in increase

of cancer incidences are lifestyle, food habits, chemical usage such of pesticides, insecticides, fertilizers, preservatives and likewise,” says Dr Mukhopadhyay.

“Change in dietary habits from traditional to western, increasing intake of processed/ preserved/packaged foods and decreasing consumption of raw vegetables and fruits are fac-

tors that are being recognized as probable risk factors. Another hazardous factor is dangerous industrial and environmental toxicants that are rampant in our air and water bodies and find their way into our fruits and vegetables. Excessive use of pesticides also pollutes fruits and vegeta-bles, as does the use of chemicals that is used for artificial ripening of the fruits and vegetables,” adds Dr Mukhopadhyay, explaining the probable causes for rising incidence of cancers.

Consumption of packaged foods has been a regular practice of lifestyles in the west where incidence of colorectal cancers has traditionally been high. In-creasing urbanization and convenience is prompting more and more Indians today

Dietary Habits & Processed Foods Spurring Cancer Incidence in India

At the same time, a turn towards sedentary life-

styles, increased obesity, smoking and drinking

are all factors that con-tribute to increasing risk of breast cancer among

women,” says Dr Mukho-padhyay. It is estimated that by 2030 the number

of new cases of breast can-cer in India will reach just under 2,00,000 per year.


to adopt western lifestyles. Eating lots of red or processed meat increases the risk of bowel cancer, stomach and pancreatic cancers. Another reason for the rise in cancer incidence is the high consumption of alcohol, smoking and tobacco.

“Lack of awareness is one of the leading challenges faced by India in fighting cancer. A majority of diagnoses in India hap-pen in advanced stages (stages 3 or 4) unlike the West where regular screenings have ensured that most cases are diagnosed in early stages and treated. Delay in diagnosis often means that a treatable disease becomes untreatable. Many people, especially in rural areas, tend to see local medical practitioners who might lack sufficient knowledge of the disease,” says Dr. Mukhopadhyay.

According to the World Cancer Report 2014, commis-sioned by the International Agency for Research on Cancer (IARC), WHO’s research body, cancers figure among the leading causes of mortality worldwide, with approximately 14 million new cases and 8.2 million cancer related deaths in 2012. While the 5 most common cancers among men in 2012 were lung, prostate, colorectum, stomach, and liver cancer; among women the 5 most common sites diagnosed were breast, colorectum, lung, cervix, and stomach cancer. A study has revealed that in 2007 Kolkata had topped the metros in new lung cancer cases.

“Indian cities and urban centres have witnessed major lifestyle and behavioral shifts including greater independence of women and their increased participation in professional fields. This has helped delay marriages, pregnancies, reduced the number of pregnancies as well as duration of breast feed-ing while increasing consumption of oral contraceptives. At the same time, a turn towards sedentary lifestyles, increased obesity, smoking and drinking are all factors that contribute to

increasing risk of breast cancer among women,” says Dr Muk-hopadhyay. It is estimated that by 2030 the number of new cases of breast cancer in India will reach just under 2,00,000 per year.

What is scary is the estimate that cases are expected to rise by about 70% over the next 2 decades, something that calls for urgent attention on prevention and lifestyle modification. It is predicted that by the end of 2020, over 10 million people would die globally each year because of cancers with 70% deaths from the developing countries only. WHO believes that around one third of cancer deaths are due to the 5 leading behavioral and dietary risks which are High body mass index; Low fruit and vegetable intake; Lack of physical activity; To-bacco consumption; Alcohol intake.

A sedentary lifestyle that includes lack of exercise, eating junk foods, inadvertent use of chemicals in foods can increase the risk of cancer. Keeping a healthy body weight can help reduce the risk of bowel, breast (postmenopausal), kidney, womb, esophageal, pancreatic and gall bladder cancers. There-fore, adopting such as regular exercise, eating food on time, intake of nutritious food, quitting habits like smoking and alcohol can help in preventing cancer. (by Sagarika Dutta)n

New Study/Research


Current Issues

For all the animated talk about India’s rapidly-growing, medical-tourism attracting healthcare sector and projections of it becoming a USD 280 bil-lion industry by 2020, the fact remains that our health sector is bedevilled by major disparities when it comes to accessibility between urban and

rural areas.According to estimates almost 70% of the doctors in India are concentrated

in urban centres, serving around 30% of the total Indian population. Urban India enjoys access to almost 65% of the country’s hospital beds despite having less than 30% of the total population.

At a time when technology and infrastructure make distances shorter, we still have a long way to go in building the bridges to cover the gaps in rural healthcare. Home to more than 60% of the national population, India can no longer simply dismiss its rural sector as the ‘sick child’, and needs to take essential steps in order to steer its healthy recovery.

Huge Manpower Gaps Bedevil Healthcare In Rural India

How Private Sector Can Help

Dr Dharminder NagarMD & CEO, Paras Healthcare, says

that quality tertiary healthcare is not available even to a bulk of urban

population living outside a few glittering metropolitan cities.


Current Issues

One of the raging issues in the uplift-ment of health and sanitation in remote areas has been the sheer lack of trained medical professionals to cater to the eve-ryday needs of the habitants, who are thereby deprived of the basic medical fa-cilities necessary for survival.

Forget the rural hinterland, remote villages and tribal areas, quality tertiary healthcare is not available even to a bulk of urban population living outside a few glittering metropolitan cities. For exam-ple, in north India while Delhi NCR re-mains a hub of the best multi-specialty hospitals, even a 100 km move outside the region will leave you without a decent tertiary care hospital. This is evident from the fact that the Delhi NCR hospitals are crowded with people coming from Uttar Pradesh, Bihar, Haryana and even West Bengal.

A lot of people have to travel long dis-tances to avail of life-saving treatments like dialysis. In the absence of quality car-diac care in smaller towns and villages, many people fail to survive a heart attack as they are required to travel long distanc-es to nearby cities with decent healthcare facilities.

While primary healthcare facilities continue to suffer from shortage of staff and absenteeism, private sector finds little incentive in investing heavily in rural ar-eas. However, through some low cost but effective initiatives, the private sector can play a positive role in helping address the deficit of manpower in rural healthcare to some extent:

TELEMEDICINE CENTRESTelemedicine, as we know, refers to the

use of information technology to provide medical consultation in far flung areas. It is intended to overcome geographical barriers, connecting users who are not in the same physical location with an aim to improve health outcomes. Remote popu-lations, which often lack minimal physi-cian presence can benefit to a large degree by telemedicine centres through which physicians can offer basic minimum con-sultation and medical advice. Notably, communicable diseases are among the leading afflictions affecting rural popula-tions and basic consultation and hygiene advice can also go a long way in treatment and reducing their incidence.

PRIVATE-PUBLIC PARTNERSHIPS

We need more public private partner-ships to involve the private sector in rural areas. These partnerships can offer incen-tives to doctors to offer services in rural areas for a small number of days of a year. With severe shortage of specialized cardi-ologists, nephrologists, neurologists and gynaecologists, rural populations often have to make with less skilled doctors or worse quacks. PPPs that can take skilled doctors of reputed hospitals to offer ser-vices in rural health centres and recom-mend patient transfer if needed, can play a role in bridging this gap.

TURNING TO SMALLER CENTRES

It is understandable that for a pri-vate entity it doesn’t make much business sense to open tertiary care hospitals in villages. However, the needs for profit and social benefit can be balanced by open-ing hospitals in smaller towns and cities which cater to large surrounding popula-tions.

TRAINING LOCAL MANPOWER

Notably, the deficit in manpower in rural areas is not just about doctors, it is about healthcare providers in toto. Even nurses, radiologists, pathologists and paramedics are hard to find. Launching training programs for nurses and para-medics in smaller centres is another im-portant initiative that can help address manpower shortage to an extent. n

We need more public private partnerships to involve the private sector in rural areas. These partnerships can offer incentives to doctors to offer ser-vices in rural areas for a small number of days of a year. With severe shortage of specialized cardiologists, neph-rologists, neurologists and gynaecologists, rural populations often have to make with less skilled doctors or worse quacks.



When our eyes first come across a person sitting in a wheelchair, we often feel a pang of overwhelming sym-

pathy and try our best to accommodate the occupant with the best of intentions. The lack of wheelchair friendly facilities and infra-structure in our nation, required to make the lives of these specially-abled people easier, can leave one quite red-faced and helpless at such a point.

In today’s time, there are millions of wheel-chair occupants in India who suffer from the twofold consequences of unavailable spaces dedicated to wheelchairs in pavements, pub-lic places and buildings, and the absence of a low cost motorized wheelchair in the market. This is especially true for the rural and semi urban population which faces the financial constraints that prevents ownership of such

a technological advancement, and also deals with uneven terrain making such an entity es-sential for survival.

However, a wheelchair doesn’t and shouldn’t symbolize dependence, agony and disability. With some technical and social support, a wheelchair occupant in our society can become much more independent and lead a dignified life. Afterall, they are free think-ing intelligent individuals who like everyone else want to lead a life with purpose. The ge-nius physicist, cosmologist Stephen Hawk-ings whose body has been severely affected by motor neuron disorder continues to enamour the world by his mental prowess, and theories about black holes and the expanding universe. A highly advanced technologically equipped wheelchair has been crucial in helping him lead a highly productive life despite the physi-cal disability.

Redefining Wheelchair

Technology-backed wheelchair modification is the new route towards making wheelchairs self-sustaining and dignified. writes Dr H S Chhabra.

Empower People With Disabilities With Technology


Dr H S ChhabraMedical

Director & Chief of Spine Service at Indian Spinal

Injuries Centre, New Delhi

Current Issues



A number of small to major inter-ventions can go a long way in helping individuals with disability lead inde-pendent and productive lives using technologically equipped wheelchairs that can not only be used as a transport mechanism but also be flexible enough to maneuver all areas of a house or a workplace, offer a greater adaptive driv-ing experience and even personal mobil-ity seating and positioning systems that make the experience more comfortable. For example, manual and electric wheel-chairs and foam, gel and air cushions for proper seating.

Specialized computer software and equipment like adaptive keyboards, monitors and voice recognition pro-grams are only few of the exciting tech-nologies which can be explored. Ergo-nomic workstations and modifications for home and workplace with different environment control units for home, work and school can completely change the lifestyle of the individuals with dis-abilities. India can move towards finally becoming a disabled friendly nation through such initiatives.

This is not only an achievement that will reaffirm the scientific and techno-logical prowess and advancement of the nation, but will also boost the human resource development by enhancing the standard of living and capabilities of these individuals.

Researchers internally are working on incorporating path-breaking tech-nologies into the wheelchair. Designers have even conceptualized and put into development models of wheelchairs that can climb stairs, move at faster speeds to allow the users faster transport, be ad-justable into public transport systems and enable the users travel easily to and fro from work.

Approximately 65 million wheel-chairs are needed worldwide, and those in less-resourced environments, such as India, are faced with the difficult chal-lenge of accessing devices that can pro-vide functional mobility for an afford-able price. Unfortunately, efforts have not addressed the needs of people who would benefit from appropriate wheel-chairs, and low-cost western style de-vices are beginning to crowd the market despite the fact they perform poorly, fail prematurely, and in some cases have been discontinued in the western mar-kets.

Though some such services are avail-

able in India as well, cost remains an ob-stacle that prevents many from availing them. In this context, the Department of Assistive Technology of Indian Spi-nal Injuries Centre is working with the University of Pittsburgh, USA closely for transferring the latest technology in the field to the Indian settings.

A recent example of this collabora-tion is the low cost motorised wheel-chair, ISIC-LOCOMO . ISIC has part-nered with the Ministry for the People with Disabilities in order to bring the ve-hicle to India, and remodel it according to Indian needs & terrain. At a relatively low and affordable cost of Rs. 45000 as compared to the imported motorised wheelchairs (which cost a whooping 1.5 lakh), ISIC-LOCOMO boasts of a unique suspension system to accom-modate Indian environment conditions.

It also features a 360 degree joystick controller and rechargeable battery to ensure ease of operation and has a light weight and easy-to-fold and assembling consistency to enable portability.

This will result in the fulfillment of the dream of both the organizations in helping people with disabilities to lead self-reliant lives, with the help of tech-nology and modifications.

It is high time that we stop feeling sorry for these victims of unfortunate circumstances, and instead empower the people with disabilities by enabling them to live a life of independence and self-sustenance. After all, this effort is a very small price to pay to restore the dig-nity of the disabled, and can only bear the sweetest of fruits for the nation in the future. n

Current Issues


Current Issues

Hearing impairment is one of the most prevalent congenital disabilities in India, with an estimated 8 per 1000 infants born with moderate to pro-

found hearing impairment. However, more than half of the children born with hearing defects fail to get timely medical intervention resulting in substantial language and speech development de-lay and a consequent loss of growth and cognitive development.

As we celebrate World Hearing Day (March 3), experts in the field are pointing out the need to

establish better hearing screening mechanisms for newborn babies to ensure that all children born with hearing impairment are detected early on in life. The theme for this year’s World Hearing Day is ‘Childhood hearing loss: act now, here is how!’ It aims to draw attention to preventable causes of hearing loss, right health measures needed to pre-vent the same and importance of early identifica-tion and suitable, timely interventions in children afflicted with hearing impairment.

Unlike developed countries which have imple-mented near universal newborn hearing screen-

Majority of Hearing Impaired Infants Fail to Receive Crucial Early Medical Attention that becomes a major obstacle in their normal growth & cognitive development

Neonatal Hearing ScreeningIndia Needs Universal


Current Issuesing programs under which newborns are tested at birth, India lacks such a sys-tem. Consequently, hearing disability is discovered much later in a large number of children. Hearing impairment in chil-dren leads to substantial language and speech delay that causes cognitive and developmental challenges. This further leads to academic challenges and delays in learning. In the absence of a screening at birth mechanism, suspicion of hear-ing disorder by family members is still the main mode of detection of child-hood hearing impairment, and this di-agnosis often doesn’t occur as late as two years of age.

“Children learn 90% of their lan-guage in early childhood (0-3 yrs) inci-dentally. This is possible only when they are hearing well. A child absorbs a lot of information and cognitive ability in the first 2-3 years of life, this includes ability to speak, pick up languages and identify objects. Without ability to hear, much of this crucial time is lost on children and they may suffer significant cogni-tive losses. In most cases, children are brought to us much later, at 2, 3 or 4 years of age, sometimes even later. Most parents in India determine that their child may be suffering from hearing dis-ability much after birth when they ex-perience lack of response to sounds in a child or inability to speak. To improve this, we need a system where all children

are tested at birth in hospitals. A cohe-sive universal system will prevent delay in intervention,” says Neevita Naraya-na, leading Audiologist and founder of Sphear Speech & Hearing Clinic.

Early detection of hearing impair-ment can prevent related disability of speech, language, cognition and overall development of the child. But, absence of neonatal hearing screening in the country delays identification, correc-tive measures and rehabilitation of such children. It is recognized that children identified with hearing loss prior to 6 months of age have better chance of de-veloping skills equivalent to their peers by the time they enter kindergarten. The American Academy of Pediatrics rec-ommends that hearing loss in infants should be identified and when possible treated before 6 months of age. Children identified much later may suffer from ir-reversible and permanent impairments in speech, language, and cognitive abili-ties.

“Permanent hearing loss is one of the commonest congenital disorders with the incidence being much more than the conditions newborns are rou-tinely screened for. Despite existence of mechanisms to test auditory function of newborn babies, this screening is rarely done in the absence of an established universal screening program. Besides, due to major lack of awareness about

new age solutions, many people believe a congenital hearing disability cannot be treated. However, today there are not only advanced diagnostic tools but also highly advanced solutions such as hear-ing aids, cochlear implants and auditory brain stem implants that can allow sig-nificant improvement in hearing abil-ity of even completely deaf persons. We need to create greater awareness about the availability of such mechanisms. Today auditory brain stem implants can enable even completely deaf children to hear,” says Dr Ameet Kishore, Senior Consultant Surgeon, ENT & Cochlear Implants at Indraprastha Apollo Hospi-tal, New Delhi & Sphear Speeh & Hear-ing Clinic.

Lacks of a universal program to screen babies remains a major obstacle in early identification of disability and quick corrective intervention in the form of hearing implants. Reducing the age of diagnosis is a major challenge for Indian healthcare. Universal screening at birth has found to have lowered the age at which infants receive hearing aids, from 13-16 months to 5-7 months in de-veloped countries. This prevents a huge burden of secondary disability.

Children with a hearing disability are at risk of delayed speech and lan-guage development and poor academic performance as a result. In India, such children also sometimes face ridicule and may experience loss of confidence. When implanted on time, the new age devices can allow complete assimilation of a child into the mainstream – includ-ing schools and social activity.

How is the screening done?The screening is done in two sim-

ple tests namely Otoacoustic Emis-sions (OAE) and Auditory Brain Stem Response (ABR). While the former in-volves placing a sponge earphone in the ear canal to measure whether the ear can respond properly to sound, in later, earphones are placed on ear, while elec-trodes are placed on the head and ears to measure the respond of the brain to emitted sound.

Notably, the hearing loss could be indentified in the first test itself, as dur-ing the test a measurable echo should be produced when sound is emitted through the earphone in case of a nor-mal hearing. However, no echo could signify the feared impaired hearing. n


“Prevention is better than Cure” is something that we have always known of. But did we know that the most effective way to prevent an infec-tious disease or its severe outcome, is vaccina-tion?

Vaccination annually prevents ~6000000 vaccine preventable diseases worldwide. Vac-cines contain the same germs or sometimes only a part of the germ that cause disease, but they have either been killed or inactivated to the point that they do not cause a disease but stimulate the immune system to produce an-tibodies, thus providing immunity from the disease.

Diseases that used to be common around

the world, including polio, measles, diphtheria, pertussis (whooping cough), rubella (German measles), mumps, tetanus, rotavirus and Hae-mophilus influenzae type b (Hib) can now be prevented by vaccination.

However, when we think of vaccines, we envision teary-eyed children at the doctor’s clinic.Vaccines and immunization in India, so far, have been primarily directed towards in-fants and children, although, vaccination is as important for adults as it is for children.

The adolescents and adults suffer a much a greater burden of illness and death due to vac-cine preventable infectious diseases than do children. The success of our national childhood

Adult VAccinAtion

Dr. Vivek NangiaDirector of Pulmonol-ogy, Medical ICU and

Sleep Medicine at Fortis Hospital, Vasant Kunj,

New Delhi

Current Issues


immunization program has resulted in the dramatic reduction in the incidence of vaccine-preventable infectious diseas-es in the younger population but for it to benefit the population at large it needs to be complemented by vaccination in adults. The vaccine recommendations for the adults depend on factors like age, lifestyle, high-risk medical conditions, travel plans, and what vaccines one has received in the past.

Not everyone was, or is, fully vac-cinated as a child. If one missed get-ting vaccines for diseases like Measles, Mumps, And Rubella or Chickenpox (or varicella) as a child — or any of those diseases themselves – then one must get the vaccination as an adult.

For diseases like Diphtheria, Teta-nus, Pertussis(whooping cough) im-munity is not lifelong. One may have received the DPT vaccine in childhood but a booster shot of Tdap and then Td vaccine is recommended every 10 years.

An estimated 43 million episodes of ARI (acute respiratory infections) are documented, of which 4–12% of res-piratory illnesses, are due to influenza Influenza(common Flu) spreads very easily and can be a serious illness. Be-sides being very debilitating, it can also be life threatening, especially, in those with a weak immune system. Influenza virus undergoes mutations and changes in its genetic constitution very often, thus creating new strains and rendering

the previous immunity useless. Hence, each year a new vaccine is developedto protect against the three or four strains of influenza anticipated to be most com-monly circulating in the upcoming flu season. All children, adolescents and adults must receive a Flu vaccine every year at the onset of autumn, if they do not have a medical reason not to receive the vaccine.

Herpes Zoster or Shingles is a dis-ease primarily of the adults. It is caused by the same virus that causes chicken pox and can occur more than once. It manifests as a rash anywhere in the body including face and eyes with excruciat-ing pain. This pain could interfere with day to day activities like eating, speak-ing, sleeping and could last for months.All adults more than 50 years must re-ceive the shingles vaccine, even if they

You may think that vaccines are only for children and may not realize that even adults get sick from vaccines preventable diseases. You need vaccines throughout your adult life, more so in the later decades when your immune system starts getting weak and you are prone for more diseases. Vaccines are important to your health and here are some reasons why.

v You may be at risk for serious vaccine preventable diseases that are still common

v Chronic diseases like Diabetes, Heart disease, Kidney disease or Lung disease increases the risk of some vaccine preventable diseases:

v Diabetics, in particular, are highly vulnerable to many infections.

v You can’t afford to risk getting sick:

v You can protect your health and the health of those around you by getting the recommended vaccines:

v Immunization provides the safe and best protection against vaccine preventable diseases:

Importance of adult vaccination

For diseases like Diphtheria, Tetanus, Pertussis(whooping cough) immunity is not lifelong. One may have received the DPT vac-cine in childhood but a booster shot of Tdap and then Td vaccine is recom-mended every 10 years.

Current Issues


Current Issueshave suffered from the disease.

Hepatitis B is a severe liver disease. It is 50-100 times easier to be infected by hepatitis B than by HIV. It can be ac-quired by coming in contact with an in-fected person’s blood or other body flu-ids. This could happen during a sexual intercourse or just by sharing personal items like toothbrush and razors. Most infected people are symptom free in the initial stages, thus they appear normal and yet are capable of transmitting the disease to others. One’s partner may not appear ill, but could be carrying the disease. A 3 doses course of Hepatitis B vaccination is all it takes to acquire pro-tection from this deadly disease. It also reduces the risk of liver cancer to some extent.

Human Papilloma Virus (HPV) is another common sexually transmit-ted viruses which is the most common cause of cervical cancer in women and oral and genital cancers in men and women as also of genital warts in both the genders. At least half of sexually ac-tive individuals get infected with HPV

sometime or the other in their lives. The vaccine to prevent HPV is most effec-tive when administered at the onset of puberty (12-13 years of age) but can be given to girls until the age of 26 years and boys up to the age of 21 years.

Pneumococcal disease is caused by a bacteria, and can lead to serious life threatening infection in the lungs, brain and bloodstream. It can also cause de-bilitating disease in the joints, heart, ears and sinuses. It is transmitted through droplets released by an infected person while talking, laughing, coughing or sneezing. Anyone can get pneumococcal disease. The risks are higher in elders (> 65 years of age), cigarette smokers and in those suffering from asthma, HIV, chronic diseases of heart, lungs, liver or kidneys and diabetes. Those suffering from cancers, leukemias, lymphomas, those on chemotherapy or immunosup-pressive therapy are also vulnerable to acquiring this disease.India alone con-stitutes to around 43 million childhood pneumonia cases(23% of the world’s total) and the estimated incidence of

0.37 episodes per child-year for clinical pneumonia is predicted.

There are two types of pneumococcal vaccines (PCV 13 and PPSV 23) that are now available and both must be given to all the elders. In the younger age group PPSV 23 or both may be given depend-ing upon the medical condition.

Typhoid and Hepatitis A are diseases which are transmitted through contami-nated food and water and can be easily and effectively prevented by appropri-ate vaccination. For those traveling to Sub Saharan Africa and Tropical South America,it is mandatory to take the Yel-low Fever vaccination.A single dose is sufficient to protect against the disease for as long as 10 years.

Research has shown that cost in-volved in vaccination is significantly outweighed, by the long term benefits that it provides. In today’s busy and high pressure lives, missing work because of a preventable illness can result in major financial losses. With ever increasing costs of healthcare, the cost of the vac-cine is only a fraction of what one would have to incur towards its treatment, leave alone the irreparable organ dam-age that the infection may leave behind, if one survives it.Vaccines work with the body’s natural defenses to reduce the chances of acquiring certain infections and suffering from their complications. Unlike most medicines, which treat or cure diseases, vaccines prevent them. Vaccines are regarded as one of the top ten effective public health interventions. Gift yourself a vaccination program this festive season and lead a more confident, protected life. Remember, you are never too old to get vaccinated. n

Human Papilloma Virus (HPV) is another com-mon sexually transmit-ted viruses which is the most common cause of cervical cancer in women and oral and genital can-cers in men and women as also of genital warts in both the genders.


- Himanshu Patra

Dr. (Prof.) Raju Vaishya , a surgeon of interna-tional repute, is best known for his swift surgical skills in the field of Orthopedic & Joint Replace-ment. He has been working at Indraprastha Apollo Hospitals, New Delhi as a Professor and Senior consultant for the last 20 years having total working experience of over 35 years. He is the founder president of Arthritis Care Foundation.

Dr. Raju has an outstanding academic career throught. He did his basic medical education MBBS and MS in Gwalior ,India, and subsequent higher super specialty training and education (M Ch and FRCS) in the United Kingdom.

Apart from his distinguished clinical work in the field of arthroscopic and joint replace-ment surgery, he is well known for his academic contributions. He has more than 150 published articles in various International and national peer-reviewed medical journals and has been regularly invited to give lectures, chairing sessions,etc. in Orthopaedic conferences around the world. He has been awarded for the best paper publication on numerous occasions by Delhi Or-thopedic Association and Apollo Hospitals. His work was recognized in the Limca book of records in 2012, 2013 & 2015 for doing bilateral Total Knee Replacement in 93 years old gentle-man, bilateral Total Knee Replacement in the oldest couple in a single sitting, ACL reconstruction on oldest man. Dr. Raju talks to Health Spectrum about his success story of professional practices.

***

‘Healing the sufferings of people’

"Corporatization should be

taken as a blessing and boon

for the Indians. A lot of new

technologies have been transferred

here, as a result highly professionals

retained and returned back in our coun-

try. Instead of brain drain it has become

a brain gain (a reverse trend)," Dr.

Raju Vaishya

Face to Face


Q. As a successful doctor, what is the secret of your success?Ans. Passion, dedication and honesty towards the profession.

Q. How do you take your career as a doctor?Ans. It is a very noble profession and gives us the opportunity to heal the sufferings of people.Q. What are the challenges as a healthcare provider?Ans.Need to understand the patient’s problem, expectations and provide an amicable solution, holistically.

Q. According to you, What is the most important aspect of the healthcare to be focused?Ans.Lot of emphasis needs to given for preventive medicine than the curative therapy, as ‘prevention is always better than cure’.

Q. What are the steps Government should initiate to provide quality healthcare to the masses?Ans.National programs to improve the sanitation, to provide clean and safer water, basic education to children about the health, safer roads and working environment for workers and laborers. Government should also provide the healthcare facilities within easy reach to all the population across India.

Q. What are the reasons that the patients are not willing to visit private healthcare centres?Ans. The patients have problems of searching doctors of their choice. They are equally not interested to visit the government hospitals. In government hospitals patients mostly do not get adequate and prompt care as per their expectations. Therefore, they look for private hospitals. In India, private sector has con-tributed almost 50% to healthcare. Public, private partnership

is the need of the hour in the healthcare sector.

Q. What are the changes you see in the field of Health Care?Ans. There is a sea change as far as patients’ awareness is con-cerned. They have various options like google search machine etc. of searching doctors and gaining some knowledge before coming to doctors. Things are changing very fast.

Q. Usually, doctors have more or less hectic schedule of clini-cal activities, how do you balance between your work and family?Ans. It is often very difficult to keep a strict balance between the professional work and the family commitments, as a doc-tor. But an efficient time management can help in coming over this challenge.

Q. What are your hobbies? How do you find times for those?Ans. I like sports like playing Lawn tennis, Table tennis, Swimming and watching Cricket. Medical research and publication are other passions and hobbies for me.

Q. Had you not been doctor, what would you have been?Ans. Scientist.

Q. What makes you happy or satisfied?Ans. Relieving peoples’ sufferings to the best of my abilities and a happy & supportive family.

Q. How do you see yourself after 10 years from now?Ans. Would love to retire from an active clinical practice, but would provide guidance, teaching and social work for the younger doctors and general public.

Q. Any event in your life, professional or per-sonal which has influenced you most?Ans. Meeting, Dr Prathap C Reddy, Chairman, Apollo group of hospitals in London (in 1989), when I was working in UK. He showed a glimpse of hope and light of better healthcare opportunity in India. This helped me in returning back home to serve the needy people of India. And there has

been no looking back since then.

Q. What is your opinion so far corporatization is concerned?Ans. Corporatization should be taken as a blessing and boon for the Indians. A lot of new technologies have been trans-ferred here, as a result highly professionals retained and returned back in our country. Instead of brain drain it has become a brain gain (a reverse trend).

Q. What’s about medical tourism?Ans. It is a good concept and a successful one. Patients from other countries visit India and also take treatment which has been cheaper in comparison to other developing countries. It has a lot of potential to boost the healthcare business. India is on move, many things will be happening in years to come in the health care sector. n

Face to Face


Case Study

PATIENT CONDITION A 55 year old housewife found uncon-scious at home by neighbors. She was taken to nearest Hospital in Buland-shahar and CT scan was done at after 2 hours which showed brain hemorrhage. She was referred to Fortis Hospital, Noi-da for brain angiography, Patient was admitted in Fortis Hospital in uncon-scious condition. She had difficulty in breathing.

INVESTIGATIONShe required ICU care and ventilator for breathing. Her heart was not working properly. She was resuscitated in ICU and brain angiography was done after 2 day. There was an aneurysm which has caused brain haemorrhage and she needed surgery to prevent rebleeding. But she was not fit for any anaesthesia. After one day, her condition was further deteriorated and blood pressure falled to minimum level. Her pupils dilated and doctors thought she will not able to sur-vive for more than two or three hours.

SURGERY With efforts by critical care and neuro-surgery team her condition improved. She was then operated upon after 36 hours. surgery was successfully per-formed at Fortis Hospital, Noida. Sug-eons has to perfomed craniotomy and clipping on the patient. surgeons had to open the skull because there was a large blood clot also which was to be evacu-ated.AFTER SURGERY After surgery she had severe pneumonia and she stayed in ICU and she kept on ventilator for 10 days. Then she became conscious and shifted to ward.Now af-ter oen month she has regained all her brain function. There is some left side weakness, but her condition is improv-ing fastly.

ABOUT COILING/CLIPPING Coiling or Clipping of aneurysm are methods to prevent re-rupture of an an-eurysm. Coiling is done in Neurocath-lab, where without opening the skull,

the aneurysm is packed with coils. It is a relatively new method with excellent results. In clipping, the skull is opened, aneurysm is exposed and a clip is placed across its neck. This is a time tested method and provides permanent cure.

Spontaneous brain haemorrhage is very common and almost 50% patients ex-pire before they can be shifted to a ter-tiary care hospital. Patients who are un-conscious before surgical treatment take months to recover. Unfortunately, there are few centres for rehabilitation in India and patient has to be shifted home after definitive treatment. Hence, role of pre-vention and timely intervention cannot be overemphasised.Brain haemorrhage is bleeding into the brain tissue or its surface due to rup-ture of blood vessel. It can be spontane-ous or due to head injury. Spontaneous Brain haemorrhage is usually associated with high blood pressure (BP). Different types of brain haemorrhage may have different reasons.

SURGEONS ADVICEFor preventing brain haemorrhage fre-quent monitoring and control of blood pressure with medication and lifestyle modification are most important. Brain haemorrhages are more frequent in ear-ly morning especially in winters. Drink-ing lot of water and timely consump-tion of medicines is essential. Minor headaches should not be neglected and a Neurosurgeon/Neurologist should be consulted. (by Vinod Kumar) n

Medical Emergency Sudden Brain Hemorrhage patient recovered after brain surgery.

Chief Surgeon

Dr. Rahul Gupta,

Senior Consultant Neurosurgeon,

Fortis hospital, Noida.

Team Members :

Dr Anil Dhar

Dr A P Singh

Dr Manish Marda


Articles

Despite the progress made by our society, left handedness is still not widely ac-

cepted. Parents like to see their children write with their right hand initially and start correcting them if they use their left hand. Despite coming from a family, where my mother is left handed, I have faced the music many times in my life for using my left hand. My teachers at school used to scold me for my awkward way of writing despite having a reasonable hand writing (which is uncommon for doctors?? ). In spite of the scoldings, I persisted with my own way of writing and one advantage of my style was that nobody could copy my work during the exams.

Uncommon way of writing in India but common in the west.

I always wanted to become a surgeon from the second year of medical school and while observing my seniors (who were mostly right handers) operate, the thought of a left handedness being a handicap crossed my mind many times. My teachers, most of whom were right handed, did not have much to say when I approached them with this query as a medical student but none of them discouraged from taking surgery as a career.

The thought of working as a left handed surgeon started haunting me again when I started my residency. Initially, I did find things a bit diffi-cult because all the instruments were designed for right handed surgeons and left handed instruments (like left handed golf clubs) were not widely available. Most of my seniors, initially found it difficult to teach me the basics and used to get a bit annoyed when I used to start operating by standing on

the left side of the table (for those who are not aware, most of the procedures are done by standing on the right side of the table). My mother, who is a suc-cessful left handed gynaecologist, was a constant source of inspiration during this tough period.

After the initial hiccough’s, my seniors became accustomed to my left handedness and taught me the skills more patiently. In no time, I mastered the techniques with my left hand and then started to hone my skills with the right hand as well. In fact, I tie right

handed knots better than left handed knots (probably because I was taught by a right handed surgeon).

Now when I look back, being right handed or left handed really does not matter in the long run (in terms of a surgical career) and I would urge an aspiring surgeon not to give up the dream of pur-suing a career in surgery because of being left handed. There have been many studies conducted on this topic and they have found no difference in surgical outcomes between right and left handed surgeons.

Some helpful points for a left handed surgical trainee:vDon’t switch away from your dominant hand. Get good at do-ing the basics with your left hand (cutting straight with a scalpel, basic dissection, basic suturing), then learn how to do everything right-handed. If you start too early trying to do everything with both hands, you’ll probably flounder around and not improve as quickly as you should.vLearn to tie knots right handed first, since you’re going to learn to tie with both anyway.vUse scissors with your right hand initially. Learning to cut left handed with right-handed scissors is tricky, especially with

heavy Prolene or other sutures.vOnce you’re good with your dominant hand, by all means work on ambidexterity. Being able to operate with both hands has been advanta-geous to me as I’ve progressed through residency.vDon’t let being a lefty deter you in any way from pursuing a surgical career.In the end I can just say one thing : I may be left handed, but I am always right! n

Is Left-Handedness a Handicap for Training in Surgery?

Dr. Rohan KhandelwalConsultant - Oncosurgeon (Breast Services)

W Pratiksha Hospital, GurgaonHead - Medical Affairs at Curofy

Email Contact : [email protected]+91-9810072878


The effects of harmful Ultra Vi-olet Radiation on the health of skin and eyes have been well documented and much

talked about in recent years. However, researchers today have identified that ultra violet light is not the only harm-ful component of light when it comes to visual health. The Blue Violet spectrum of visible light is another component that has the potential to cause damage to retinal cells of the eyes. In fact, research-ers have coined a new term to describe the danger this light spectrum presents to critical structures within the eye. They call it “blue light hazard”.

Interestingly, blue violet light (wave-lengths between 380 and 500 nm) is not just emitted by the sun but also by artifi-cial sources of light such as LEDs, CFLs, and digital devices such as computers and smartphones. Given the increased usage of new age lighting devices and

an increasingly ubiquitous existence of smartphones and computers, what we are witnessing today is a much higher exposure to blue violet light than say five years back.

This development has prompted a new wave of research and studies in the field of ophthalmology as well as oph-thalmologic optics. But before moving on to that let’s understand with greater precision the effects of blue violet light on the structures within the eyes.

What is Blue Light?The small spectrum of the electro-

magnetic radiation which our human eyes are capable of perceiving is termed ‘visible light’. A human eye typically re-sponds to wavelengths between 390 to 700 nm (nano metre). This entire visible spectrum can further be divided into different bands which includes blue, green and red lights. Blue light has a

Dr. Ira Chopra

Consultant Eye Surgeon, Paras Hospitals,

Sushant Lok, Gurgaon

Not Just UV Radiation, Eyes Face Threat from Blue Violet Light as Well

Blue Light Hazard

Articles


Articleswavelength of between 380 nm and 500 nm, making it one of the shortest, highest-energy wavelengths. While this range of visible light spectrum plays a generally beneficial role on health, in particular by regulating the internal biological clock, a small but specific section of this band has been found to cause dam-age to retinal cells.

Because they have shorter wavelengths and higher frequen-cy and higher energy, blue light waves create flickering and glar-ing effect on the eyes. This is perhaps why prolonged exposure to computers, television and smartphones causes strain to the eyes, headaches or fatigue. Researchers believe that prolonged exposure to blue light may cause retinal damage and contribute to age-related macular degeneration, which can further lead to loss of vision. In most cases, this photochemical damage accu-mulates over a lifetime.

Where is Blue Light?Well, it is everywhere! While sun is the main source of blue

light emission, it is certainly not the only source. Today, we are literally surrounded by sources of blue light and therefore con-tinuously exposed to it.

While solar radiation is considered to have 25% to 30% blue light, the modern, energy efficient light sources such as CFLs and LEDs emit significantly higher amount of harmful blue light (roughly 26% of the light from CFLs is blue while an es-timated 35% of light emitted by LEDs lies in the blue portion). On the contrary, the conventional, incandescent lamps which were widely used till a few years back, were noticed to emit very little blue light.

Besides, our eyes hardly stops working in front of digital screens today. The digital screen technology has evolved radi-cally over the years, and many of today's electronic devices use LED back-light technology. Computers, cell phones, flat-screen televisions and tabs are just among a few of the devices that use this technology. With their wide-spread use, not only has our cumulative exposure to blue light increased, but the duration of exposure is also radically higher today.

What are the Solutions & Preventive Mechanisms?The natural filters of the human eye do not provide suffi-

cient protection against blue light. Therefore, any preventive mechanism has to start with greater awareness and attempts to reduce exposure of harmful blue light. Researchers have also been off late working on mechanisms to help selectively filter the harmful wavelengths of blue light while transmitting the beneficial ones.

In this context, researchers at Essilor and the Paris Vision Institute have succeeded in identifying the very narrow band of blue light that is associated with photo toxic damage of the retinal cells. The culmination of this research has led to the de-velopment of lenses that has the ability to selectively filter the narrow but harmful wavelengths of blue light that are damaging to the eyes while allowing the healthy band of blue light to play its normal roles. The technology has been incorporated in the latest spectacle lenses manufactured by Essilor such as Crizal Prevencia and Eyezen.

Protecting Your VisionLimiting the amount of screen time is very important for

the generation that lives by digital devices. While one cannot do away with the requirements of work, we can certainly reduce

the leisure time spent on digital devices. Reducing time spent on chatting and surfing the Internet can be helpful in reducing eye strain, headaches and digital mental fatigue.

Using screens and digital devices in a correct posture is also important. Make sure the screen causes minimal glare, reduce brightness and surrounding lights and make sure the screen is always right ahead of your face to ensure least strain on the eyes.

Take regular breaks from screen time. Stand up from your desk every two hours and just walk around the workplace for five minutes. Blink more often.

Wearing protective eye wears in front of digital screens has emerged as the most viable preventive option in the face of in-creasing prevalence and exposure to blue light radiation. Stud-ies have also showed that wearing protective lenses with blue light filters helps reduce symptoms of eye strain and fatigue. n


As an adult, we may be of whatever chronological age. But as a parent, we are only as old as our child is. Parent-

ing is an on-going process, which is both challenging as well as rewarding. As a parent, understanding and responding to your child begins from the moment the baby is born. Be it teething aches, nappy change, growing pains, bruised knees or teenage troubles, being a parent is a never-ending role where one evolves and learns on-the-job. Each child is unique, with their own set of strengths, weak-nesses and personality traits. Under-standing your child can go a long way in strengthening your bond with your child and nurturing their growth and develop-ment in a wholesome way.

KNOW YOUR CHILD: Spend time & Communicate : The

key to having a trusting relationship with your child is to know your child as an individual. Not all children are similar

in traits and each child differs in their personality, interests, temperament and adaptability to change. As children grow, their likes and dislikes also transform.Whether you have your hands full with a tight work schedule or deadlines at the work place, set aside time for your child to stay in tune with them and let them know that you are there for them.

It is important for parents to grow along as their child grows. If a parent wishes that their teenager opens up to them honestly and shares their problems with them, the foundation of healthy communication lies in early childhood itself. It is important to spend quality time with your child right from a young age. Parents must pay attention to the ap-parently small thingstheir young one has to say- how their day was, what sports they played, what they learnt in class, who their friends are. It is important to understand your child’s fears, apprehen-sions as well as strengths and abilities. Sharing these seemingly small things

Understanding Psychology Of Your Children

Dr. Shobhana Mittal

Attending psychiatrist, Cosmos Institute of Mental

Health and Behavioural Sciences, New Delhi.

Parenting


goes a long way in forming a channel of communication between a parent and a child, and facilitates an environment of trust and belongingness. It also helps the parent know and understand their child better.

BUILD YOUR CHILD’S SELF ESTEEM

The growing years can be tough on a child, with challenges likechanges in their body that occur with adolescence, increasingly critical evaluation at the ac-ademic front and adopting mature social roles. These can take a toll on a child’s self-esteem.

As a parent, you are the main source of confidence and encouragement for your child. Children often look to their parents for validation and support. Con-stant criticism from a parent with little encouragement can hamper a child’s self-esteem.It is important to instil con-fidence in your child by acknowledging their strengths, lending them gentle en-couragement and allowing them to de-velop their individual talents in activi-ties like sports, music or dance.

STIMULATE ALL ROUND DEVELOPMENT OF YOUR

CHILD Just like it is important to take care of

your child’s academics, it is also essential to stimulate an over-all development of your child.““The growing years are cru-cial not just for the psychical growth, but also for the intellectual, social and emo-tional development of your child.Right from a young age, children learn to form social bonds, share with others, learn to deal with their emotions and satisfy

their curiosity. It

is important that parents provide their child with opportunities to develop in a balanced manner, keeping over-all growth and development in mind.

TEACH YOUR CHILD TO BE RESPONSIBLE

As a parent, it comes naturally to tell your child about “dos and donts”. But the key to efficient parenting lies in teaching

your child to be responsible and enable them to make well thought of decisions.It is important to make your child real-ize their responsibility at an early age.

Often, parents focus on punishing their child when the child commits a mistake. But for learning positive be-haviour, encouragement of good behav-iour is also important. When your child finishes their homework on time orputs their toys back in the box after playing, a word of praise can go a long way in en-couraging their responsible behaviour. Let your child learn from their mis-takes, rather than preventing your child to make small mistakes.Also, ask your child’s opinion in some family decisions, be it which colour to paint the house or which destination to choose for the next family outing. Try and understand the logic behind your child’s outlook rather than the shortcomings of their opinion. Involving children in decision making helps them develop confidence and improves their judgement, which helps them make responsible decisions as growing up,

NEVER LOSE TOUCH OF YOUR INNER CHILD!

It is important to stay flexible and look at things from a child’s perspec-tive. You need to be your child’s friend at times, in order to allow them to open up to you. At the same time, limits have to be set to provide boundaries for chil-dren. Juggling your role as a parent and as a friend can be a tough balancing act.As parents, it is easy to forget what

it was like to be a child. Sometimes,

it is important to step into your child’s shoes and look at things from their point of

view. For this to happen, it is im-

portant to stay in touch with your in-ner child! n

As a parent, it comes naturally to tell your child about “dos and donts”. But the key to efficient parenting lies in teaching your child to be responsi-ble and enable them to make well thought of decisions.It is im-portant to make your child realize their responsibility at an early age.

Parenting


When Beauty Is More Than Skin Deep

Having a greater control over their looks has empowered a lot of women, and leading the charge to ‘empower through beauty’ are dynamic women aesthetic physicians in India

Ayesha, 28 was always troubled by the deep acne scars on her face that had been there since teenage.

No matter how well she used concelaers and other make up tools, there was no hiding them. With people often enquir-ing about the cause of these scars, not just this affected her appearance but also her self esteem tremendously.

Established in her profession and earning well, Ayesha decided to take greater control over her body and met an aesthetic physician. A few session with skin lasers, and her scars are now only marginally visible. Ayesha hasn’t been happier and has never felt more confident.

For the new age bold and confident girls like Ayesha, life is to be lived on their own terms and cosmetic proce-dures are just one resource that offer this sense of empowerment.

Whether we like to believe it or not, beauty is a desirable thing. Who doesn’t want to look beautiful? Yet, there has always been this lingering belief that there is something wrong in taking a cosmetologist’s help in improving our appearance.

“For a lot of women, a greater control over their bodies and appear-ance is a boon. For a woman

who hosts guest travelers all the time as an air hostess, it is of utmost impor-tance to have a good appearance. Not only to enter the profession, but also to remain in it. Same is true for women in showbiz or women who have roles in front of the camera such as actors and news anchors. For all such women, cosmetic procedures are really helpful. Even women outside such professions today are actively seeking options to improve their appearance, and there should be absolutely nothing wrong with it,” says Dr P. K. Talwar, leading cosmetic & plastic surgeon and director of Cosmetic Laser Surgery Centre of India, New Delhi.

For women in such careers and fields, cosmetic procedures are a way to keep themselves fighting fit, much like fitness training is for athletes. Today, an increasing number of women are taking recourse to cosmetic treatments, both surgical ad non invasive, to achieve some of their dreams. In this sense, having a greater control over their ap-pearance makes them empowered.

“More popular though are non-invasive treatments like Botox, fillers, lasers, medi-facials, oxygen and vitamin infusion therapies etc that are quick and do not

carry the need of going under the knife. Facial contouring to redefine features is another popular aspect of facial aesthet-ics today and a number of women like to get their lips augmented, their cheeks highlighted and their chins redefined. Procedures to do away with scars, pigmentation an acne marks are among the most popular,” adds Dr Talwar.

If we talk about the field of der-mato cosmetology, the leading names that prop up in our minds in India are invariably all women. Studying medi-cine, but decisively choosing aesthetic medicine as their careers, women have literally overrun this field.

Of course, there has to be a differ-ence between undergoing cosmetic pro-cedures and becoming obsessed with them. The latter is not recommended and doctors always advice clients to be realistic in their expectations and not become dependent on cosmetic procedures.

With increase in purchasing power and greater exposure to the entertain-ment industry, the awareness and demand has grown in the cosmetic industry. (by Sushila Kumari) n

Beauty Care


Remember Kia from ‘Ki and Ka’ and her reac-tion on realizing that she was pregnant. For her the world shattered as she presumed her career to come to an end. Kia rightly

represented the ambitious careerist working women of today, for whom pregnancy and child birth is no more a priority, till at least they achieve certain level of success in their career. And by then they are most-ly in their 30s, may be late 30s or early 40s also.

Pregnancy for these women may not be smooth. With age, other comorbid complications like thyroid, gestational diabetes, high blood pressure, pile in dur-ing pregnancy making the journey tougher. However, thanks to medical development, today such high-risk pregnancies can be managed at ease with care.

According to Dr. Leena C D, Consultant Obstetrics and Gynecology, Columbia Asia Hospital, Hebbal there has been an increase in the number of high-risk preg-nancy cases.

“Mothers with a history of recurrent miscarriages, hy-pertension, diabetes, ART pregnancy, too many surgeries, abnormality of the uterus, etc. comes under the high risk pregnancy. Also, lately a lot of women have started opting for pregnancy at a later stage in life. Women older than 35 years of age often fall under the high risk category,” said Dr. Leena

The first 12 weeks of the pregnancy are most crucial especially for women with a past history of recurrent loss. One can identify complications by hypertension after 20 weeks and by diabetes after 24 weeks. It’s extremely crucial that these issues are identified as early as possible in the pregnancy to avoid complications and miscarriages.

“One has to be extremely careful during a high-risk pregnancy. In case there is a history of more than three losses, the chances of miscarriage can increase from 5% - 25%,” added the doctor.

Here are a few suggestions by Dr. Leena for to-be-mothers with high-risk pregnancies:vIt is important to go for frequent check-ups with your doctor.vAsk your doctor for anti-platelet drugs requirements.vGet the heartbeat checked ever 2 weeks for any com-plications.vGet all the necessary tests done for early detection of complications like hypertension, diabetes and thyroid. vRestricted activity is one of the most important factors during this period. (by Jytoti Chaudhary) n

Know what to expect from

high-risk pregnancies

Healthy Motherhood



Pregnancy is a wonderful milestone in the life of a woman. It is an experience that a woman would like

to nurture in her heart for a lifetime. It is a time when a woman will be overwhelmed with a variety of emo-tions ranging from the happiness of being pregnant to the anxiety about the proper health, growth and development of young baby to be.

Child bearing imposes both physical and mental strain on the body and mind. To be able to counter this, it is important that the mother has a healthy diet during pregnancy. A nutritious and rightly balanced diet during pregnancy ,is important not only to maintain the

Pre pregnancy nutrition is as im-

portant as nutri-tion during preg-

nancy, as both help to determine fetal growth and there-

fore size and health of an infant at birth.

Food & Nutrition


maternal nutritional needs and the develop-ment of a healthy fetus but also to provide continuous adjustments in maternal body composition and metabolism.

While it is important to have proper nutrition and right diet during pregnancy, pre-pregnancy nutrition is equally impor-tant, as it helps determine fetal growth and therefore size and health of an infant at birth. Well balanced, nutritious diet also plays a great role post pregnancy as well by ensuring a good health to the mother and child during lactation.

Conceiving is not an easy pro-cess and requires both health and mind to be prepared to take the leap. A major part of the nutrition given to the body during pregnan-cy is partaken by the fetus.

Therefore, it becomes im-portant for a woman to store her nutrition much in advance be-fore she decides to get pregnant. Hence, it is important to ensure intake of nutritious and well bal-anced diet pre pregnancy. And, since nutritious diet provides strength during lactation, post pregnancy nutrition becomes equally important.

The drain of pregnancy and child feeding is such that it often leads women excessively deprived of nutrients. In women who do not take conscious care of their nutritional status, this can be dangerous for both short-term and long-term health. Calcium is one of the most crucial mineral needed for the growth of a fetus and this deprives pregnant women of a lot of their own body reserves.

During pregnancy, the nutrient to the fetus is provided by the food taken by the mother. While nutrients such as mineral, vitamins and others are required for the mother to stay healthy to be able to deliver the child, nutri-tious diet is also important to ensure proper supply of nutrients to the developing fetus. In many cases women recover their bone calcium after they have delivered the baby and have

breastfed her, many are left with depleted bones for life. This can be prevented if you take care of your calcium intake and bone health from early years and ensuring a healthy from the time you decide to get pregnant.Following are the nutritional requirements during pregnancy:

Energy & carbohydrates: Additional en-ergy is required during pregnancy to support the metabolic demands of pregnancy and fetal growth.

Protein: During pregnancy there is a need for additional protein. It is to support the synthesis of maternal and fetal tissues. The efficiency of conversion of dietary protein to

milk protein is 70%. So the need for protein is greatest when lactation has reached its

maximum.Minerals: In pregnancy the

needs for calcium, iodine, iron and zinc and in lactation calcium and iron increases.

Vitamins: During pregnancy Vitamin D, Vitamin E, Vitamin K,

Vitamin C, Thiamine, Riboflavin, Folic Acid and Vitamin B6and dur-

ing lactation Vitamin C and Vitamin B are highly essential.

Fluid intake: You need to drink plenty of water. At least 4-6 glasses in addition to what is contained in the form of milk and other beverages. This should be taken throughout pregnancy and in lactation, an increased fluid is neces-sary for adequate milk production.

Supplements: These should be taken as per doctor’s prescription. Self-medication is not recommended.

Besides a healthy and varied diet, it is also important to bring changes in the lifestyle such as practic-ing light exercises regularly and avoiding stress and tension. You should try not to overload your sys-tem and keep it fresh with

Dr. Pallavi VaishyaSenior Nutrition Consulant,

Kailash Hospital, Noida

Food & Nutrition


Health Benefits of

I t may seem ironic, given that human beings are land dwellers, that one of the most comprehen-sive and effective forms of exercise we know in-volves dunking ourselves into an alien environ-

ment. Humans are not naturally designed to swim very efficiently, unlike penguins, sharks, seals and Michael Phelps. This, however, is exactly what makes it such a powerful fitness tool. Exercise—effective exercise, at any rate—must necessarily take your body out of its comfort zone, and swimming achieves this quite liter-ally.

It is also inherently safer, despite what Jaws and Baywatch would have you believe, than almost any form of land exercise, says Gokul Kamath, coach of the national swimming team in 2006-07. Kamath, current-ly head coach at the Navi Mumbai Sports Association, says: “Unlike running and other types of impact exer-cise, swimming is impact-free and can be practised by people of all ages. It also works out your entire body.”

Also, according to Santosh Jacob, a doctor of sports medicine and founder of the Indian Academy of Sports Research, Chennai, swimming is one of the few exer-cises “that incorporates respiratory and cardiovascular effort (breathing and blood circulation) without stress-ing the joints”. So with a scorching summer around the corner, you have good reason to ditch the sweaty gym for a cool pool.

Resistance training Swimming’s standout quality is that it is at once

both kinder to, and more demanding of, your body than any land exercise. Water’s higher density rela-tive to air means that your muscles are forced to work harder in a pool than they would on land. The effect is similar to resistance training, used to increase muscle strength, says Ashok Seth, chairman and chief cardi-ologist, Escorts Heart Institute and Research Centre, New Delhi, and himself a scuba diver certified by the

Fitness


Professional Association of Diving In-structors. “Also, unlike other forms of aerobic activity (such as running, tennis or aerobics classes), swimming requires you to use almost all your muscles at the same time, both upper and lower body,” he adds. All swimming techniques, ex-cept the backstroke, harness the deltoids (upper back/shoulder), abdomen, glutes (buttocks), hamstrings (back of thighs), quadriceps (front of thighs) and plantar (foot) muscles to varying degrees.

The higher density of water also counteracts gravity, reducing stress on joints and muscles. “All forms of activ-ity or exercise put stress on our joints,” says Dr Jacob. “A joint with pre-existing arthritis will definitely be aggravated by running, as it is an impact exercise. But when swimming, you exercise at 30% of your body weight and, hence, cut out the risk of musculoskeletal stress, which may lead to the degeneration of joints and ag-gravation of muscle tears.”

Indeed, Dr Seth says, not only does water ensure there is no direct impact on joints, it also prevents the jerks that are part of even gentler aerobic exer-cises such as walking. “All movements in swimming are controlled, slowed down by the resistance of water, which means there is hardly any risk of injuring your-self,” he says.

This is significant for everyone, from pregnant women to someone recovering from injury—indeed, pretty much any-one with a reduced capacity for tolerating jarring, repetitive workouts.

Good for the heart Swimming is particularly beneficial

for pregnant women as it strengthens the abdominal muscles, of particular impor-tance to carrying a baby. It also strength-ens the back muscles, making it easier for mothers-to-be to support the extra weight during pregnancy. Other com-mon issues associated with pregnancy—high blood pressure and joint stiffness—can be eased by swimming.

Swimming reduces blood pressure and lowers the resting heart rate, re-ducing risk of cardiovascular diseases. “Though there are no evidence-based studies on the effect of swimming on is-chaemic heart disease (characterized by reduced blood supply to the heart mus-cle), a controlled workout involving 30 minutes of freestyle or breaststroke can definitely reduce the risk of a heart at-

tack,” says Dr Jacob. But what about people with existing

heart conditions? For them, Dr Seth ad-vises caution, “Patients with heart disease can drown if there is a problem while in the pool, so before swimming they need clearance from the doctor.”

For the rest of us, though, Dr Seth says, “It is perhaps the only form of ex-ercise that provides aerobic benefits from raising your heart rate and increas-ing your lung capacity (because it needs breath control), as well as exercising muscles throughout your body.” Ruchira Tendolkar, technical director, BFY Sports and Fitness, Mumbai, notes that the ben-efits of a daily swim include stronger heart and lungs, better blood circulation, increased strength and endurance, and enhanced neuromuscular coordination. “These translate into a reduction in risk factors for lifestyle diseases (coronary artery disease, diabetes and so on), such as improvements in lipid profile, better control of blood glucose, reduction in blood pressure and a reduction in weight as well,” she adds.

Swimming also offers special benefits for seniors. “It increases a person’s capac-ity to use oxygen, which deteriorates with age,” says Dr Jacob. Dr Tendolkar adds that it helps maintain flexibility, which also tends to decline with advancing age.Different strokes

While running—and to a lesser extent weight training—restrict your joints and muscles to a limited range of movements, swimming is more flexible. Depending on your level of fitness, you can adopt the demanding butterfly stroke, the milder

freestyle or the fluid breaststroke. Dr Jacob says: “The butterfly stroke

is the most demanding of all and burns the most calories, while the backstroke and the breaststroke are less demanding. A combination of freestyle and butterfly is ideal for the experienced swimmer; a mix of freestyle and breaststroke is best for beginners.”

Post Comments The breaststroke, Dr Jacob adds, is

perfect for warm-ups, and has the lowest potential to pull or strain your muscles. Freestyle is somewhat more vigorous and requires more effort, while the butterfly stroke makes the highest demands on your muscles—especially your back and shoulders—and lungs. The backstroke is slightly different from the rest as it relies less on muscle power, activating mainly the muscles of the abdomen, groin and neck.

Weighty matters Experts are not unanimous in en-

dorsing swimming as simply a good weight-loss tool. An hour at moderate in-tensity (raising your heart rate to 60-70% of its maximum capacity) in a 60kg man burns 540-650 calories.

“For significant weight loss, it would have to be sustained for a much longer time,” says Dr Seth. Or you would need to work harder, making it an intense work-out (90% of maximum heart rate), which depends on your effort and fitness level rather than speed, Dr Jacob points out. That’s the difference between, say, a brisk walk in the park versus one that leaves you sweaty and breathless.

Recreational swimmers don’t usu-ally make that effort, Kamath notes. To shed serious inches, therefore, they may be better off adding other cardiovascular (such as running, cycling or aerobics) and anaerobic exercises targeting specific muscle groups.

Dr Seth also notes two drawbacks to swimming. The first is that access to a pool, and a hygienic one at that, is not universal. Not only must it be well chlo-rinated, it must enforce rules of shower-ing well to clean up before a dip. “Un-fortunately, we Indians tend to regard swimming itself as a bath,” says Dr Seth.

The other caveat is weather. Unless it is a heated, enclosed pool, you have to wait for summer. Which, fortuitously, is right now. (by Priyanka Sharma) n

Fitness



FITNESS FUNDA OF A DOCTOR

FITNESS FUNDA OF A DOCTOR

Dr. Yuvraj Kumar running in Mumbai Marathon on January 17, 2016

Dr Yuvraj Kumar is Head of Department of Orthopedics and Joint Replace-ment at Asian Institute of Medical Sciences (AIMS), Faridabad. Dr. Yuvraj Kumar is an orthopedic surgeon who has done fabulous work in Spine Sur-

gery & Joint Replacement . Dr. Yuvraj is a fitness freak. He took part in a number of marathons.


According to the United States Department of Health and Human Services, physical fitness is defined as “a set of

attributes that people have or achieve that relates to the ability to perform physical activity.” Being an orthopedic surgeon means absolute precision, a nick at a wrong place could be potentially life threatening. I strive to achieve perfection in my work and it starts at 5 am in morn-ing with a run in the ground twice a week and work out at the gym thrice a week. Immediately after work outs I have whey protein shake with magnesium tablets followed by a quick cold-water shower.

Breakfast is a healthy bowl of multi-colored fruits (ensures balanced mix of vitamins and minerals), grounded al-monds and raisins (soaked in water over-night as it increases digestibility) with honey, four boiled eggs, and one chapa-tti with green vegetables. Hit the work, which is basically 70 to 80 patients in OPD or multiple surgeries lined up.

Lunch is normal north Indian meal- two chapattis with green vegetables, leg-umes, curd, and salad. Sometimes, if you miss the lunch, due to unavoidable situ-ations or otherwise also ensure that you keep trail mix, energy bars or dry fruits in your office not just for yourself but your team too. During summer it is ab-solutely essential to remain hydrated and maintain electrolytic balance, drink lots of water, have coconut water, wood apple juice, or any electrolyte powder.

Ideally, we should have an early din-ner around 3 to 4 hours before going to bed but our cultural and work setting makes it difficult. I generally have dinner 2 to 3 hours before going to bed. Dinner is fish curry on Wednesday and Friday, Chicken or Mutton on Sunday and Mon-day, Green Vegetables and Legumes on Tuesday, Thursday and Saturday along with 2 chapattis and salad.

Although, I have been working out actively for last 10 years, the seeds were sown long time back. When I was a kid my mother would wake me up at 4 am and then she would wake up couple of other families in the colony we would all go together for a walk.

Life is a journey and so is fitness. Fit-ness is not only about exercising but also a fundamental shift in the mindset. You must have heard countless success sto-ries, the only thing they have in common is relentless commitment to not giving up. So, it is with fitness you must not give

up and keep travelling the path not for the low hanging fruits on the sides but for the joy of travelling. Yes, you may enjoy the low hanging fruits too, but the point I am trying drive through is that those low hanging fruits shouldn't be your reason.

People exercise for various reasons such as losing weight, looking beauti-ful, doctor made it mandatory, health conditions, lifestyle diseases etc. While these are all valid reasons, the problem with extrinsic motivational factors is you lose incentive once the goal is achieved. I want you to look within, dig deep and find intrinsic motivation. It is extremely

difficult to find intrinsic motivation but once you do it is similar to the Sun burn-ing from within.

I have been fasting on Saturdays for last twenty years, running and work-ing out consistently for last ten years. Patients, colleagues, friends and family regularly ask me for advice and I do share my two cents of wisdom but I often hear back excuses about demanding job, work related travel, body soreness, no access to gym etc. While I am certainly privy to these issues but I always figure out a work around. I am not going to share hacks or steps to lose weight or tricks to achieve fitness. I want every reader to understand in plain English “There is no short-cut.

There are no tricks. There are no meds.”Now, the big question, “How I do

achieve intrinsic motivation to achieve fitness?” There are no formulae, for every individual it can be triggered by different by different reason. I am going to share what worked for me and hope that it helps you too. v Start with going out in the morning or evening. Just walk, jog, run or stretch but the important thing is, “Go out every-day.” vFind a partner or group, not a nec-essary step but it helps to have a like- minded support system withwhom you can share, learn and improve. v Set long-term (year wise) and short-term(month wise) goals such as I would run Half Marathon in 2017 or I would achieve 8% body fat by December, 2017 and I would incrementally improve dis-tance by 1 km per month or improve speed by 30 seconds per month per kilo-meter or decrease body fat by 0.5% per month.v Use Jugaad, find a work around im-pediments, if you are travelling just keep your running shoes with you and if you can’t even do that then stretch or do body weight exercises.v Once, you exercise consistently for one or two months, you will start form-ing a new fitness craving habit and you will start enjoying your new fitness regi-men along with the endorphins.v Eat a balanced diet. Say no to pro-cessed foods. Ensure that your meals have 50% vegetables or fruits, 25% carbs and 25% protein.

Fitness is a state of mind, when you ex-ercise regularly you would start to see its benefit:v High energy and confidence, which will infect and impress, your col-leagues and bosses at work. v You will be more optimistic which help in your interpersonal rela-tionship with family, clients and external stakeholders.v You will possess greater mental strength, which will help you get through the times of adversity.v Cognitive functions will im-prove thus, helping you make better and more efficient decisions.

Once you get addicted to a state of mind that is fit and supported by a healthy body, trust me you would find your intrinsic motivation. n

Dig Deep. Look within. Choose Fitness.

Fitness Mantra


Homeopathy is not just a system of medical treat-ment; it is an advance in the area of mind-body,

holistic medicine. It involves treating the individual having the illness, or disease, with highly diluted substances, prescribed primarily in pill form, with the aim of triggering the body’s natural capacity for healing.

Homeopathy was founded on the law of similars, or ‘like cures like’ prin-ciple. Put in précis, “A substance that causes a set of symptoms, when taken in large doses, can in ‘small, minute doses’ treat similar symptoms.” A ho-meopath, a professional graduate or post-graduate with a university degree in the subject, will match and prescribe the most appropriate remedy, based on such ‘like’ symptoms each individual or patient presents with.

To cull an example — drinking too much coffee can cause sleeplessness and disquiet. Taking the homeopathic

remedy, Coffea Cruda, made from cof-fee beans, can homeopathically treat ‘like’ symptoms — a result of overex-citement, or joy, a pay hike, or a huge reward on the job. Interestingly, con-ventional medicine employs the same principle, in certain instances — it pre-scribes stimulants to ‘treat’ kids with attention-deficit hyperactivity disorder (ADHD). Likewise, it employs minute doses of allergens, such as pollen, to de-sensitise allergic individuals. The only ‘dissimilarity’ with homeopathic rem-edies is that the medicinal substances used are in the form of ultra-high, non-toxic dilutions. They are called homeo-pathic potencies.

Picture this. You were, the other day, affected by a sudden or rapid onset of fe-ver, which escalated into high tempera-ture in no time. Your face appeared ‘red hot’ and dry, along with flushed eyes. Your lips and mouth were pale; your tongue ‘angry’ crimson. What followed next was sweating and confusion. There

The ‘Cause’

And Also ‘Effect’

Homeopathy Treats

Dr Mukesh Batra LCEH, FSRH (MED) P (LOND), MDH (USA), FBIH (UK), a homeopath of inter-national repute, is Founder-Chairman, Dr Batra’s Group. In a career spanning four decades, Dr Batra has treated thousands of patients, including presidents and prime ministers, and revo-lutionised the way homeopathy is practiced today. A writer, photographer, singer and phi-lanthropist, Dr Batra has been honoured with several fellow-ships and over 50 national and international awards, including the Padma Shri, by the Presi-dent of India. He has authored several books too, including the critically-acclaimed cyclopedic work, Healing with Homeopa-thy.

Alternative Medicine


Alternative Medicinewas little thirst; but, there was a strong craving for sour foods or drinks. Your other symptoms included a raw, aching feeling in the eyes, with sensitivity to light and tearing, throbbing pain deep inside your ear.

According to the concept of ‘like cures like,’ as referred to earlier, a sub-stance that is capable of provoking such symptoms in an otherwise healthy in-dividual can also therapeutically act on similar symptoms in a person who is ill. The homeopathic remedy, Belladonna is employed, when accompanied by such symptoms — as described above. Such a set of symptoms actually resem-bles Belladonna poisoning. The inter-esting fact is Belladonna, in spite of its toxic nature, has for long been used as an antispasmodic, relaxant, or sedative, in herbal medicine. Homeopaths use Belladonna, in its potentised form, to treat high fevers with inflammation and pain, among other symptoms — and, with complete safety.

Most of us are ‘coached’ to acknowl-edge that the only way to stamp out in-fection is with conventional antibiotics. This is based on the precept that antibi-otics destroy micro-organisms, such as bacteria, and allow the body to recover

from illness. Interestingly, antibiotics have no effect on virus — yet, they are misused by many for viral infections, most often without a doctor’s prescrip-tion.

From the homeopathic standpoint, a homeopathic remedy is given, where the symptom pattern of the remedy ‘matches’ with the symptoms of the ill-ness and strengthens the body’s own

CASE-1 Vivian (name changed), a thirty-year-old restaurant manager, reported, “I’m

allergic to everything, including food.” His nasal anguish showed in the form of a cloudy discharge that flowed day-in and day-out. When he sat through case-taking, he wiped his nose, with tissue paper, more than a dozen times. His eyes appeared swollen, tickly and watery. Vivian told us that when he slept he had an annoying sore feeling in his throat. He also complained of cough, and headache. He felt better at home, not outdoors. He also said that he had ‘exhausted’ every conventional over-the-counter (OTC) cold and allergy medication available.

We prescribed him Allium Cepa, a homeopathic remedy, made from red onion. After six months of homeopathic treatment, and regular follow-ups, Vivian called in to say his nose was relatively dry. There was no itching; and, his sneezing bouts had reduced considerably.

Though Vivian experienced continual sneezing, for a month or two, he said that this too eased slowly. By the time he came for one of his follow-ups, a year later, his allergic symptoms had receded to a significant extent.

CASE-2Three-year-old Vilas (name changed), presented with itching eruptions (at-

opic dermatitis), all over his body, exuding blood and pus; his t-shirt and shorts were stained with blood stains. His parents informed us that Vilas suffered from this misery since birth. They had tried the best of conventional treatment, but in vain. On detailed case-analysis, we found that Vilas, as his parents complained, was highly irritable, crying and screaming, all the time. Interestingly, he was comparatively calm when he was carried around by someone. However, when he was put down on bed, he would start yelling and also get belligerent. We asked his mother about her emotional status during pregnancy; she revealed that she

went through a lot of suppressed emo-tions and anger during the time.

Based on her symptoms of ‘sup-pressed’ anger during pregnancy and ex-cessive ‘resentment’ in her child, we gave Vilas the homeopathic remedy, Chamo-milla Recutita. In about 2-3 months’ time, it not only reduced the itchiness, erup-tions and discharges, but also calmed him down and made him sleep soundly. His eruptions too reduced after 5-6 months — this was something that had not hap-pened before. This is the unique feature or clinical exquisiteness of homeopathy. It treats the person, not just the illness or disease in isolation — in other words, the individual’s symptom-picture, their distinct personality, temperament and also response to illness.

CASE EXAMPLES

ability to fight the infection from the inside out and also restores balance.

According to homeopathic prin-ciples the real cause of infection is not just the micro-organism, but the per-son’s body, or compromised immunity, and susceptibility, which provides the fertile ‘soil’ for bacteria or viruses to

survive, thrive, and proliferate. When the natural balance of the body is re-stored with homeopathic treatment, the micro-organism will not find the aug-mented inner workings of the body fa-vourable for growth. Remember, when you are in good health and well-being, you will not develop symptoms at the


drop of the word, infection, as oth-ers may do. You will also not show ‘open’ vulnerability.

Homeopathy actually views ill-ness as disagreement, or under-mined balance — occurring first at the most fundamental levels. This ‘causal’ dis crepancy is the source of all illness — it shows itself eventual-ly as symptoms, created by the body in the process of trying to correct the imbalance. It is this imbalance, again, that homeopathy addresses, using symptoms as a channel to se-lect the natural substance that can be of assistance in the process to-wards restoration of health.

Homeopathy suggests that there exists within all living beings a

smart ‘resident’ power responsible for maintaining balance in body, mind and emotions and also heal-ing. Samuel Hahnemann, MD, the founder of homeopathy, called this energy the ‘vital force’ — whose cor-ollary in Eastern thought is prana, mana and chi — or, life force. The vital force is not tangible; its effects are, however, obvious in both health and illness. In modern parlance, the vital force is the body’s immune system or defence, responsible for preventing illness and maintain-ing and bringing all bodily systems back into equilibrium. This defence mechanism is not merely physical; it also has emotional aspects linked to it.

Homeopathy treats the individ-ual as detailed earlier, so it does not limit its treatment to the diagnosis of an illness in isolation, or on the surface. When you are ill, your ill-ness has its own unique pattern of symptoms. You may tend to ‘catch’ certain illnesses that result from a particular pattern of imbalance with your immune system — one that is unique to your body, temperament, emotions and environmental fac-tors.

No two individuals, as home-opathy suggests, having the same ill-ness, by name, will present with the same symptoms. Two patients, for example, having a high fever state may show different reactions — one may want to be covered with a thick blanket (feels cold); the other may shove away even a thin covering (feels hot). This is individualistic. It calls for the use of two different ho-meopathic remedies.

To put the idea in perspective — there are over a dozen homeopathic medicines, for instance, for mi-graine, a disorder triggered primari-ly be emotional stress. The migraine you present with — ‘feels better’ with a hankie tied around the head — will require a homeopathic rem-edy that matches your particular, or unique, symptom. Your friend’s migraine (‘feels worse’ by pressure), on the other hand, will respond to an entirely different homeopathic remedy. n

Homeopathy treats the individual as detailed earlier, so it does not limit its treatment to the diagnosis of an ill-ness in isolation, or on the surface. When you are ill, your illness has its own unique pattern of symptoms.



Holistic Medicine is the wholesome ap-proach to Health by a synergy of evidence based ‘science’ of modern medicine with the time honoured ‘art’ of drug-free modalities of all the officially recognised traditional systems for promotion of Positive Health and Total Wellness ‘Body-Mind- Soul. Well known Holistic Medicine Expert Dr. R. K. Tuli says that all wise people think, talk and wish to practice Holistic Medicine these days.

Why Holistic Medicine?It’s been universally recognised that it

would never be possible to meet all the health expectations of the humanity with the conven-tional model of healthcare based exclusively on the modern allopathy system of medicine.

Therefore, the World Health Organisation (W.H.O.) recommended and our National Health Policy has promulgated integration of all the recognised systems of medicine.

It calls for us to grow beyond inherent re-strictions of the so called evidence based 'sci-ence' of modern technology. An ever increas-ing number of people wish to explore benefits of the 'art' of time honoured officially recog-nised traditional or alternate systems of health which have a proven record having helped the humanity over thousands of years.

The good news is that we, now, have very rich expertise available to complement the best of drug-based specialities of medicine with various drug-free modalities of recog-nised systems of health to ‘Eliminate all Sick-ness’ from its root cause and restore ‘Positive

Dr. R. K. TuliMBBS DHA DAc(Srilanka)

CHt(USA) MAcF(China) MD PhD FRSTM&H(UK) FICA

(USA) Chief Consultant Holistic Medi-

cine Fmr. Indraprastha Apollo Hospitals & Indian Air Force *

“SOHAM” The Clinic for Holistic MediCARE & CURE

D-961, New Friends Colony, New Delhi-110025

It's the Era of Holistic Medicare : Dr. R. K. Tuli



Health & Total Wellness 'Body, Mind & Spirit' in each individual.This all inclusive complementary approach to health helps to

extend the best of each system of medicine, at the same time over-come inherent deficiencies in the respective systems, to offer a ‘syn-ergy’ of all of them to ensure ‘Health For All’ at all ages of life and all stages of sickness. This latest speciality of medicine is called Holistic Medicine. It’s a board certified specialty in the U.S. for nearly two decades, and is catching up very fast amongst the developed na-tions. Continuous Research & Development by the profession shall help to improve scientific protocols. We must give top priority to adopt it into our main health care delivery system and make living years happy and productive for all.

What is Holistic Medicine?Holistic Medicine is the wholesome approach to Health by a

synergy of evidence based ‘science’ of modern medicine with the time honoured ‘art’ of drug-free modalities of all the officially rec-ognised traditional systems for promotion of Positive Health and Total Wellness ‘Body-Mind- Soul’, i.e.,

Holistic Medicine = Modern + Traditional + NewAge Medicine[Conservative Medicine + Life-Style & Stress Management +

Ashtanga Yoga + Nutrition +Acupuncture-Reflexology + Pancha-karma-Detoxification + Physiotherapy + Counseling-Hypnother-apy + Reiki-Pranic Healing + Chakra Balancing + Regenerative Medicine]

This approach to health matches up to our Vedic concept that health is the greatest wealth, and we need health whether to achieve personal, financial, spiritual growth, or even moksha. It’s guided by the ancient Charaka Samhita which states that life is the combina-tion of the body, the senses, the mind and the ‘atma’; they cannot separated from each other, and from this integration ensues ‘ayush’.

What are the objectives of Holistic Medicine?1. To improve the health and add life to years of each individual. 2. To complement All the Systems & Specialities of Medicine.3. To improve the Final Outcome of Every Sickness.4. To enable Permanent Cure in Maximum Patients.5. To overcome Iatrogenesis by Minimum Medical Interventions

What are the benefits of Holistic Medicine?1. It treats the human being as a whole 'body, mind & soul'.2. It offers ‘synergy’ of all the drug-free modalities of recognised

systems of Health.

1. It’s not easily acceptable, neither acces-sible to majority of people in the country, resulting in delays in commencement of appropriate treatment, leading to serious complications.

2. It treats the human being as a mere physical being, with a specialist taking care of just a limited part of the body with ‘allo’, i.e., external medicinal or surgical interventions. Best of the support based on this limited concept comes with inevitable limitations, side-effects, cumulative toxicity and compli-cations.

3. By the time a disease is detectable by mod-ern diagnostics, it’s invariably too late to reverse its basic cause and effect true cure.

4. This system treats just ‘tip-of- the-iceberg’ symptoms of the disease, with rarely being able to take care of its underlying cause, leading to progressive deterioration in health, onset of various side-effects, cu-mulative toxicity, complications, inevitable morbidity and mortality.

5. It lacks care of mental, emotional and spir-itual needs of the people.

6. It does not address to the increasing incidence of diseases due to life-style and psychosomatic disorders; or to needs of the increasing population of the elderly from diseases related to process of aging.

7. Also, it does not offer solution to changing pattern of communicable diseases, espe-cially due to emerging viruses or immune disturbances.

8. It’s based on high capital investment and ex-pensive technology, making its cost beyond reach of most people. It’s estimated that nearly 4% of population in our country falls below poverty line annually due to exorbi-tant costs of medical treatment.

9. According to official statistics, in spite of all the technological advances and availability of world class medical care in our country over the past three decades, the incidence of all common diseases has increased more than FOUR FOLD during the same period.

Inherent Deficiencies Of Allopathic Medicine:



3. It’s equally beneficial at all the levels of health.

4. It helps to take care of all the ailments of an individual concurrently as it follows the Hippocrates' observation that "The natural healing force within each of us is greatest force in getting well."

5. It's drug-free therapy: No drugs, No interventions, No Dope, No Iatro-genesis; thereby ensuring the Hip-pocrates' dictum, "Primum Non-Nocere", i.e., First Do No Harm.

6. It’s highly Efficient, as well as Cost & Time beneficial.

7. It’s very simple and easily accessible; can be rendered anywhere & every-where by skilled hands.

8. It optimizes healthcare by comple-menting existing infrastructure at no extra cost.

9. It tremendously enhances profession-al satisfaction and glory of the profes-sion..

What are the diseases curable by Holis-tic Medicine?

The holistic approach to medicare works to restore 'milieu interior' of the individual to initiate one's own inherent natural healing ever ready to initiate the process of recovery. It leads to eliminate the root cause of all diseases and help to restore positive health. It'll, without any conflict, complement medical procedures to improve outcome in all emergency and acute conditions, and enhance efforts to cure all diseases of the person, that too

concurrently. The brief indications may be as given below.

PAIN: Headache-Migraine, Arthral-gia, Neuralgia, Neuropathy, Fibro-Myal-gia, Trauma, Phantom, etc. om, etc

PALLIATIVE CARE: Incurable or Terminal Sickness, Cancer, etc.

PARALYSIS: Trauma, Polio, Stroke, etc.

STRESS / PSYCHOSOMATIC DIS-ORDERS: Anxiety, Depression, Chronic Fatigue, Neurosis, Psychosis, etc.

AUTOIMMUNE DISTURBANCES: Arthritis, Nephritis, Thyroiditis, Diabe-tes-Type-1, ILD, SLE, Multiple Sclerosis, etc.

ALLERGY – ASTHMA - ECZEMA – FOOD SENSITIVITY

DEGENERATIVE DISEASES: Ar-thritis, Spondylosis, Disc Disease, De-mentia, Parkinson’s or Alzheimer’s dis-ease, etc.

ATHEROSCLEROSIS: Hypertension, CAD, Post-PT-CA or CABG, PVD, Gangrene, etc.

METABOLIC & HORMONAL DIS-ORDERS: Obesity, Dyslipidemia, Gout, Diabetes & All Complications, Menstru-al Disturbances-PCOD, Infertility, Men-opause & Andropause, SEXUAL Health: PME, ED, Frigidity, etc.

SUBSTANCE ABUSE – ADDIC-TIONS RESISTANT INFECTIONS: PUO, MDR-TB , Viral Infections: HIV / AIDS, Hepatitis, etc.

NATURAL CHILD BIRTH / FAILED FERTILITY

SPORTS MEDICINE & INJURIES: To improve & sustain performance, fast-er recovery and early rehabilitation.

Dr. Ravinder K. Tuli is a global pioneer in spearheading the clinical concept of Holis-tic Medicine. He is the founder of Society for Holistic Advancement of Medicine “SOHAM”. He was invited to establish the world’s first-ever Department of Holistic Medicine at the state-of- the-art multispeciality tertiary care Indraprastha Apollo Hospitals, New Delhi in year 1996.

Dr. Ravi Tuli is a 1964 batch alumnus of the prestigious Armed Forces Medical College, Pune. He has been medical adviser to Air Force Sports Control Board, as well as Indian Hockey Federation representing India in several events abroad. He’s been official doctor of Pakistan & West Indies cricket teams touring India.

Dr Tuli has been rewarded with various national and international accolades.

E-mail: [email protected]; Website: www.holisticmedicare.com

An ever increasing number of people wish to explore benefits of the "'art' of time honoured officially recognised tra-ditional or alternate sys-tems of health which have a proven record having helped the humanity over thousands of years.



How ethical is to give IVF treatment to old age couples?This is absolutely not at all ethical.How can a mother of 72 years bear a child when her own body is going downhill & she is prone to multiple geriatric problems? Even a women of more than 35 years of age is called elderly for bearing a child in medical profession as complication rates go up as the age advances. The probable complications are always explainedby an obste-trician to her when she comes for antenatal check-up. The chance of Natural /IVF conception is almost zero after the age of 45 years.Why? Because god has put a limit to the reproductive age in view of the problems which can occur in advance age. You are pushing her to carry a baby when she has /or prone to have osteoporosis (thinning of the bones), high blood pressure/diabetes/ weakness /debility,heart attack and is at risk of increased morbidly & mortality. And

Recently 72-year-old Daljinder Kaur delivered a baby boy in Hisar after two years of IVF treatment. Ironically, the Amritsar-based couple had the baby to inherit property worth nearly Rs 5 crore that was being denied to them by relatives. This news inadvertently triggered a debate on the need to regulate assisted technologies such as in-vitro fertilisation (IVF). Renowned IVF expert Dr Sushma P. Sinha answers general querries about use and misuse of IVF technology

Is the IVF technology used

in the right direction?

Dr Sushma P. SinhaInstitute of Obstetrics &

Gynaecology,Indraprastha Apollo Hospitals

New Delhi

Q & A


what after the child birth? Taking care of a child, feeding her sitting straight many a times in a day is not easy. Patients even at 48yrs find it difficult & sometimes go into postpartum depression.I personally never do donor IVF in a women above 50;

How old is too old to be a mother?In my opinion motherhood should not be allowed after the age of 50. Research has shown that 33years onwards the ovarian reserve starts going down. Af-ter the age of 35chance of pregnancy is lower than before that.Indian women have faster ovarian ageing & the chance of pregnancy lowers with each added year making it less than 10% after the age of 40. Nothing is without a reason in the nature. If at all donor eggs are used in people with poor/ lower ovarian re-serve or in case of recurrent IVF failure, motherhood should not be allowed after the age of 50.

What should be the ideal age for using IVF treatment?The ideal age of conception is between 21 to 30yrs and in today’s perspective one can say 21 to 35. Younger the wom-en, higher the chance of conception but lowest age should not be less than 21.

What are the risks involved for both the mother and the baby?The risks for mother can be develop-ment of diabetes, hypertension (high blood pressure), anaemia, constant body pain, exhaustion, depression, worsen-ing of other pre-existing elements. Risk of bleeding during pregnancy, risk of infection due to poor body immunity etc. The child can be lower than average in weight. Risk of abortion &prematu-rity increases leading to complications in the new born baby &can cause long term complications like developmental problem. The nurturing of baby will be affected due to the mother’s own poor health leading to the future physical and psychological problems in the child.

Is there any law or body governing As-sisted Reproductive Technologies (ART) in India?Indian council of medical research (ICMR)has laid down certain guidelines which are there for more than 10yrs now,according to which IVF is allowed only between the age of 21 & 50. Why people are not following the guidelines?

Law has still not been past although it is in process. Once law comes stringent ac-tion taken against the defaulters should hopefully bring the change.

How important it is for India to deal with fertility issues?It is an important issue in India. Approx. 15% of couples are suffering from infer-tility. Their desperation is unimagina-ble. Lot of them suffer for depression & other psychological problems. It is a so-cial stigma & leads to lot of mental and physical torture of the lady in the house though a man is equally responsible for infertility.

In a country, where population is al-ready exploding, how such events can

affect the country?Approx 15% of couples makes it a big chunk of the whole of the population. Population explosion is one issue but agony of a childless couple is not to be ignored. As an IVF expert I feel it every day so do the couples & the family mem-bers. The physical & the psychological problems caused by infertility adds load on the government health sector and also it increases the suicidal rates. The disturbed family environment affects the performance of the employee. The latest data shows that urban population growth in India is lower than some of the western countries.

How are other countries dealing with fertility issues?

In western countries the government provides the services free of cost or in-surance companies do cover this prob-lem unlike India where there is no government support. Poors can’t afford Infertility treatment,IVF or IUI in India. Some of the government hospitals have recently started it but look at the load on them. There also they have to pay some amount which is still a lot for the pov-erty ridden population. n

Dr Sushma P. Sinha is a Senior Consultant Obstetrician Gynaecologist, IVF & Infertil-ity Expert & Co-ordinator Laparoscopic & Robotic Surgeon at Institute of Obstetrics & Gynaecology in Indraprastha Apollo Hospi-tals, New Delhi

It is an important issue in India. Approx. 15% of couples are suffering from infertility. Their desperation is unimaginable. Lot of them suffer for depression & other psychological problems. It is a social stigma & leads to lot of mental and physi-cal torture of the lady in the house though a man is equal-ly responsible for infertility.

Q & A


Health Feature

The term ‘cholesterol’ has a bad reputation and most of us fear falling prey to it. Yes, high levels are considered to

be the cause for a host of illnesses, in-cluding heart disease, blood pressure and diabetes, but did you know that cho-lesterol is not the culprit. This lipid pro-duced by the liver, is vital for many body processes, such as insulating nerve cells in the brain and providing structure for cells. The problem starts because of lower levels of high-density lipoproteins (HDL). On the other hand, low-density lipoproteins (LDL) form deposits on the walls of the arteries, thus limiting blood flow and causing cardiovascular diseases.It must be noted that it is the higher LDL and lower HDL levels, and not the cholesterol they carry, that raise the chances of developing heart disease.

Dr Narender Pal Jain, Professor in Medicine, Dayanand Medical College and Hospital, Ludhianasays, “It is im-portant to incorporate healthy changes in lifestyle and identify & reduce con-sumption of foods which mayincrease your risk of heart disease. And this is applicable to everyone with any body type. High cholesterol levels can result in heart ailments for any body type. Therefore,have your cholesterol checked regularly regardless of your weight, physical activity and diet.”

To reduce your bad cholesterol lev-els, start by limiting food with highlev-els of saturated fat and trans fat. Many packaged foods, such as potato wafers and bakery products, which use re-fined grains such as maida (all-purpose flour), are low in fibre and contain trans fats. Additionally, reusing of cooking oil also increases trans fat levels. Again, frequent consumption red meat, whole milk products, ghee and coconut oil, can increase LDL as they are rich in saturat-ed fats. Limit the intake and substitute them with fresh unprocessed foods.

There are two types of fiber, solu-

ble and insoluble. Increase your intake of soluble fiber. Both have heart-health benefits, but soluble fiber also helps lower your LDL levels. So include oats and oat bran, fruits, beans, lentils, and vegetables in your daily platter.

“Another very effective change you can make is to replace products high in saturated fats like butter with lower fat alternates likelow fat table spreads.Low fat table spreads are good for health,but, make sure that when selecting a table spread, choose the one that has 0% Cho-lesterol and 0 g trans fat on the Nutrition Facts label”, added Dr Jain.

To further enhance your efforts in improvingyour cholesterol to healthy levels include nuts in your diet, espe-cially pistachio. A recent study by the Diabetes Foundation of India (DFI) and the National Diabetes, Obesity and Cholesterol Foundation found that pis-

tachios have a low glycemic index, are naturally cholesterol free, and are source of protein, fibre and antioxidants. These properties make consumption of pista-chios potentially useful for those at risk for obesity and heart disease.Other than these, opt for wholegrains, unprocessed food, fruits and vegetables daily in your daily diet. Include flaxseed, sunflower seeds and fatty fish in the diet to increase good cholesterol. Replace high-fat dairy products with low-fat milk products.

Daily exercise for atleast 30 minutes is also essential. A simple brisk walk dai-ly, riding a bike, swimming or just play-ing your favourite sportis helpful. Even taking the stairs instead of the elevator or doing a few sit-ups while watching television can make a difference.

Remember your health is your re-sponsibility. Only you can take its best care. (by Sugandha Mishra) n

Simple Ways Toget Rid Of


HEALTH STUDY/RESEARCHTitle Code : UPENG04171

june, 2016 issue of health spectrum : monthly health magazine

Health & Medicine