Do you know ADHD occurs in about 5% to 7% children? If a child behaves a little different from others, then teachers recommend them to be taken to the psychiatric counsellors. The counsellor might diagonise the disorder as ADHD (Attention Deficit Hyperactivity Disorder).
There are many concerns among parents: Whether we should take the child for a counselling section? If the counsellor says that the child has to take medicine, then do we really have to follow the advice? Is Medication for ADHD (Attention Deficit Hyperactivity Disorder) child necessary? Will there be any side-effects of the medication? Will the child be branded as mentally unfit, if he goes for the counselling sections?
I had a discussion with Dr. Varghese Punnoose, an MD in Psychiarty regarding ADHD (Attention Deficit Hyperactivity Disorder) and its medication. He discussed every aspect of the disorder from the symptoms to the medication and the misunderstandings. Dr. Punnoose is specilaised in Child Psychiatry. He is currently Professor and Head of Department at Government Medical College, Kottayam, Kerala.
Read on to know more about Medication for children with ADHD………..
When do you prescribe medicine for children with ADHD?
In moderate to severe ADHD, we give the option of medication to the parents. Medications are not prescribed on the first day that the child comes to us. The medication is suggested only after two or three sitting. After a complete assessment, if the child needs medication, the parents have to take the decision. The child is a minor by legal terms and they cannot take a decision on their own. And we do not force our decision. We give a recommendation of medication as an evidence-based scientific option. Medications available in India are mainly two types – Methylphenidate, a stimulant group of medication and Atomoxetine.
What are the concerns parents have regarding the medications?
Many a times parents are apprehensive about the medicines that the doctor prescribes for hyperactivity. They are doubtful that the medicines are sedatives which will damage the child’s brain or make him dull and sleepy. Or the child may develop some addiction or dependence on medication.
These are much-distorted facts which are being propagated partly from ignorance and partly from some vested interest.
These are much-distorted facts which are being propagated partly from ignorance and partly from some vested interest. These medicines are specifically developed by scientific authorities with evidence for their efficacy as well as safety. They are used all over the world. Methylphenidate is available in the last thirty/forty years. Atomoxetine is available for the past 10-15 years.
Is there any benefit of the medication?
They will not cure ADHD, but they will correct some of the symptoms of ADHD. 70% of the children will improve attention span. The child will be able to hold attention for a long time. They can bring down hyperactivity not by sedating but by bringing down the extra overactivity. The brain gets a better control of motor activity.
Most of the side effects are not serious, that is why these medicines are approved for paediatric treatment.
There is no sedation or tranquillizing. The brain gets more ability to control the impulses. So the attention span improves that translates to improvement in academic functions. Hyperactivity and impulsivity in reduced. That translates to improvement in behaviour. 60%-70% children get benefitted from medication.
Will the medications cause any side effects?
Of course, they produce side-effects. But no major side effects like brain damage or addiction. Most of the side effects are not serious, that is why they are approved for paediatric treatment.
Government is very strict about approving medicines for paediatric cases. These two molecules have passed all the tests, and they are time-tested.
Loss of sleep
The possible adverse effects that we come across are if we give methylphenidate as a night time dose. The medicine will interfere with sleep. Usually, they are given as daytime dose – one in the morning or one in the afternoon.
Loss of appetite
The second problem is that they may produce loss of appetite and weight loss. In some children, it may produce anorexia, loss of appetite. But again it is for a limited period. After a few weeks, they will get out of it.
There were apprehensions that use of Methylphenidate could result in growth retardation. But long-term follow-up studies have not demonstrated any significant growth retardation in children on Methylphenidate. However, height monitoring is recommended.
What is the consequence if the medication is withdrawn?
If at all the parents are worried, then there is no problem in withdrawing the medicines or discontinuing the treatment. Very rarely some children may develop liver dysfunction or some other issues for which the children are carefully monitored. But practically we do not come across such issues.
How long to continue medication?
There is no clear-cut answer because we cannot prescribe the medicines are not like a course of antibiotics for the infection. This is a system dysfunction which varies from child to child.
Initially, the children are monitored weekly, then monthly, then once in three months, once in six months. And if the attention span in improving and ADHD score is coming down and the child is able to manage without medication, then the child may not require medication.
If you discontinue, the only thing is that some advantage that you would get from the medication.
In most of the cases, children are diagnosed with ADHD when they are in fourth standard, fifth standard or sixth standard. And they may continue medication up to ninth, tenth or eleventh also. That varies from person to person. There is no worsening.
Sometimes parents are apprehensive that if they stop the medication then thinks will become worse. Nothing like that happens. Only thing is that some advantage that you would get from the medication will not be there if you discontinue.
Why there are some apprehensions regarding the medications?
There are apprehensions about methylphenidate, the stimulant group of medications. Methylphenidate can be abused by adults that is why there is a lot of restriction on prescription. Only a qualified psychiatrist can prescribe this medication. Because of the restriction, parents are worried that this is a very dangerous component. The abuse potential in the paediatric case is nil. This has been used for the past three or four decades.
Atomoxetine does not have such restriction for the prescription. Deciding which medication to give for the child is a clinical decision. There are conditions where we prefer methylphenidate and there are conditions where we prefer atomoxetine.
Is it compulsory to take Medication for ADHD (Attention Deficit Hyperactivity Disorder) child?
We always tell the parents that medication is not the only thing; it is part of the whole package. The main emphasis is on educating the parents and teachers and encouraging the child. All are involved to improve the behaviour of the child. In moderate to severe cases medications are used so as to take away the biochemical block. If the medication is taken then the behavioural therapy becomes more effective. But if the parents are unwilling then they are not forced to take medications.
What about suicidal behaviour due to Medication?
Suicidal behaviour is not related to ADHD. Impulsive behaviour may lead on to impulsive self-injurious behaviour. However, there are no such reports in India. Whenever there is such reporting it will be put to stringent examination by authorities like The Food and Drug Administration (FDA), of the United States of America. And if at all there is the slightest suspicion of such kind of a problem they will immediately order to suspend/ban the product.
If at all there is the slightest suspicion of such kind of a problem authorities like FDI will immediately order to suspend/ban the product.
The first common cause of death in adolescence is accidents, the second is suicide. For an adolescent to commit suicide there can be a large number of factors. If the child was on a medication when he committed suicide then that has to put for scientific scrutiny. None of the studies so far have shown such results, if in case there were any issues stringent measures would be taken. So far no instructions have come. In India, approval is there only for atomoxetine and Methylphenidate.
How long will the medicine remain the system after the medication is withdrawn?
It will be there in the blood for maximum two days. It is not going to be permanently deposited in the system.
Should medication continue in adulthood?
Almost 60 percent of the symptoms may continue. Whether medication is to be continued in adulthood is a very controversial topic. In our centre, we do not generally encourage medication for the adult. We leave it as an option for children and adolescents.
Why controversies regarding ADHD?
Controversies happen because of overdiagnosis of ADHD. From certain reviews, I find that overdiagnosis is done in certain provinces in the United States. From there the movement has come that children are being medicated unnecessarily. The overdiagnosis issue is not an issue in India. Here the issue in underdiagnosis.
Why there are advocacies against medications for ADHD?
There should be some advocacy to protect the right of the citizen. Children need protection. Advocacy is good because there will be checks and balances. The opposite result happens when deserving children, who should get the advantage of medication, are denied medication because of the stir.
Every year we take new year resolution to give up a bad habit or to begin a good one. This years theme for World Arthritis Day on October 12th was “It is in your hand, take action” to live life to the fullest. Most of the people with arthritis, whom I know, put in lots of efforts so that they can keep in pace with the demands of the world and live life like normal human being. The excruciating pain, fatigue and disability are some of the hindrance for a arthritis patient. Some succumb to the condition, while other turn all the obstacles into opportunity. If those suffering from arthritis take some new year resolutions to improve their lifestyle then they too can live their life to the fullest.
Arthritis is becoming quite common in Delhi, especially after the yearly outbreaks of Chikungunya virus. People experience joint pain and difficulty to walk even a few months after they had Chikkungunya. Now a days, if you stagger, people inquire if you were suffering from Chikkungunya.
There is lot of commonality between Chikkungunya and Arthritis pain, and in some cases Arthritis pain and deformation are triggered after a Chikungunya attack. People of any age can get arthritis, but if you take some precautions you can avoid worsening of the condition. If you chart out a healthy lifestyle pattern for yourself, some of the damages get repaired and you can enjoy a normal lifestyle.
Most of the arthritis patients I meet have come up with their own creative methods to mitigate the pain. Some rely on allopathic medicines, others on Ayurveda and some on herbal remedies. They now know which food causes pain and which one relieves pain.
On this New Year, those suffering from arthritis should take the New year resolutions to live life to the fullest. Here are a few, new year resolutions, ideas based on the experience of those arthritis patients who have overcome all odds by following a healthy lifestyle:
Eat the right Food
Preferably follow a vegetarian diet, which is easier to digest. Some fishes are good, but egg and meat are better not to be consumed regularly. Have lots of water especially on an empty stomach.
And sometimes it is good to fast. Most religions have fasting period in the religious calendar. If you follow the fasting with discipline that will help relieve the pain. If you have never fasted in your life, then consult a doctor before fasting. Arthritis is an auto-immune disease where the body cells are attacking one another. Experts say that during fasting period the body cells get time to relax and repair.
Walking and Exercise
Of all the medicines, walking is the best prescription for arthritis. Some say that they walk instead of driving or riding a scooter. But that is not enough. Every day you must walk atleast 20 minutes, as part of fitness regime. Consult your doctor to find out how much time is recommended for your walking and exercise. Also find out if you are permitted to Jog. Walking is the best medicine for arthritis. If you walk atleast 5 days a week, you can maintain a healthy lifestyle. When you feel pain, doing exercise will mitigate the pain.
Meditation and Spirituality
Mental and spiritual well being is a crucial aspect of arthritis. The condition aggravates when one is mentally disturbed. Hence you should spend atleast an hour every day for Meditation. You must find the inner peace and the soul connect. Many patients with RA positive,and some even chronically bed ridden, claim to have been miraculously cured because of their belief in God. Some doctors recommend meditation for an hour daily. Being at peace with oneself and avoiding stress helps in coping with arthritis.
The population of the elderly is increasing, and so is the number of Old Age Homes. Recently I met Stanley Johnson who runs John’s Daycare and Boarding for Senior Citizens, where elders stay, who suffer from various Geriatric ailments. On a holiday I decided to visit John’s Home, in Aya Nagar, Delhi, to know more about how an old age home works and to meet the elderly. I visited the home with my family, assuming that the kids will have a new experience rather than visiting some tourist destinations.
In the lush green lawns, of the quiet haven, of John’s Senior Citizens Home, the elderly Aunts and Uncles were sitting on the benches and enjoying the cool breeze and evening sunlight. Inside the home, there was pin drop silence, and a handsome Uncle was sitting in the reception, busily scribbling something in a note book.
Mr. Stanley said that the Uncle got mentally disturbed after he suffered a huge loss in business. After coming to John’s Old Age Home he was put on medication, and now he has recovered. He does not speak much but reads voraciously, and he is also the library in-charge.
Apart from the neatly and hygienically kept rooms, which are provided to the elders, there are also common recreation and dining areas. The clean and odorless surrounding of the Old Age Home is different from the rooms of elderly at our homes, which will usually smell of medicines and human waste. “The ultimate goal of our institution”, says Mr. Stanley, “is to ensure that the elders who are with us are happy and live with dignity in a safe clean environment.”
Stanley says that the care required by the elderly are of three different types: Some are fully depended so they require complete assistance in all their activities (Dependent Ageing), some are partially depended (Assisted Ageing) and other can manage their daily routines on their own (Active Ageing). “Some normal problems of the elders are loneliness due to loss of the spouse, weak eye sight, disability in walking and another movement, self-denial, loss of Memory, paralysis, Dementia, Alzheimer, Parkinson, Blood Pressure, Diabetic, Cardiac problems and Bed sores.”
We met some of the elders, and the aunties talked more and socialized. Some of them were wealthy, some abandoned and others suffered cruelty and treachery from their relatives. Because of their willingness to talk and share their feelings, I made a video which is shared below.
The elders are given round the clock individual attention by care givers, Nursing Staff, Supervisors etc. every senior is served in a different manner as per the need of the inmate, For Eg: Arthritics patient is dealt in the softest manner of lifting and placing for food /toilet habits. Many of the elders here are affected by dementia, Alzheimer’s, partially paralyzed, physically handicapped, completely bedridden or suffering from loss of memory, sight and with a negative attitude to the life.
Dementia or Alzheimer’s require full-time nursing as the patients lose their memory and they are to be treated like new born babies. The care takers require a lot of patience and training to attend to an Alzheimer patients needs. John’s Home is known for the care they give to such patients. A 78-year-old Aunty, a Keralite, who is there for the past eight years, thinks that she has come there only a few days ago. She claims she is from a Royal family in Kerala. Stanley says “There was a mentally imbalanced upset aunty who now gets an audience to hear her sad stories and sings beautifully for the school children who visit her often”.
The Nonagenarian, Aunty, stole our heart. She is 99 and will be celebrating her 100th Birthday very soon. She is a vivacious and elegant lady who was a teacher in Nainital and Dehradun in her hey days. She is never satisfied with the care she receives/received anywhere, and she demands more care. Care for here means – someone to listen to her endlessly. She is been at Johns home for the past many months and surely enjoys her stay there. At the ripe old age, she was punctually out in the lawn after tea for her evening walk, accompanied by her attendee.
Stanley says “Once there was an unhappy Grand Father who doubted and complained about everyone in his own home. He was made the Supervisor of the floor and he had no complaints as he saw himself as a captain and is very happy and felt that this home was better placed than his previous home”.
The vision of John’s home is to ensure that the solace provided by them helps every elder staying at the home forget their past sorrows and live joyfully with a smiling face. Their future goal is to have their own home along with a Geriatric division giving Age care facilities to accommodate at least hundred Senior citizens.
“At John’s, we have been constantly working as a team on spreading awareness about the need to uplift senior citizens and help them thru their disabilities as age catches by and thus working on the human cause of uplifting social awareness. Taking our endeavors forward, this year we have crossed boundaries, serving the society is great Pleasure. Our life is incomplete till we add meaning to it.”
John’s Old Age Home provides social services to the community, especially the underprivileged by organizing medical camps in coordination with different hospitals at our center on timely intervals.
When asked why and how your team decided for serving the Seniors he explained that amongst our members there was a feeling that we could have done much more for our parents who have left this universe and that prompted us to do something and dedicate our remaining time, energy and money for caring for elders. The similar kind of feeling is shared by every child with aging parents – even after taking care of them at home, or give them complete medical attention, after their death, children ask the same question ‘Did I do as much as I should have done’. Whatever may be the reason for being sent to such homes, Old age homes like John’s Home provide complete care, attention, and love, which gives happiness to the elders in their old age.
While being interviewed for the post of a dietitian , a candidate was asked if she were a poor housewife and she wanted to cook a nutritional meal for her husband what would she cook. She said she would prepare drumstick leaf curry and sardine curry. Two items very cheaply available in Kerala two decades ago.
Nowadays our concern is about obesity. How to prepare food that is nutritional and reduces obesity. The answer is there in our traditional diet, the ingredients are available in the market. We can also grow a few vegetables in our little balconies.
I feel that ‘elaborate daily meals’ is the fad of the 21st. Having tasty food three times a day and ensuring right combination of food is as a result of the consumerist culture of today. In my childhood days, on a normal day, I don’t remember having the right kind of accompaniment for a breakfast dish: Instead of chutney or sambar there will be sugar with idli, and instead of puri with chole there will be puri with mango pickle. The right combinations were available only on special occasions. Most children in my native village use to have pazhamkanji (old rice) for breakfast.
There were many reasons for the mismatch in food combination:
- Shops were few and far between
- Very few cooking gadgets
- Unavailability of ready-made ingredients
- Less income
- Taste was of least priority
- No choice: we ate what was put before us
- Very little exposure to restaurant food
Nowadays we give the highest priority to taste, whereby nutrition comes second in importance. We ensure to have apt combinations for the meals and also taste should be as good as the restaurant one. So we add a lot of masalas and sometimes cook the food for a long time so as to get a particular tasty texture. Since tickling the taste palate in of utmost importance, we prepare different types of food every day. If yesterday we had roti, today we have puri and tomorrow idli. According to experts if we have the same kind of food every day we consume less, on the other hand, if different kinds of food are cooked then we have more food since we relish a new variety of food. For instance, the cooked rice left overnight soaked in water (pazhamkanji) and consumed for breakfast, was a tradition in Kerala. There are many nutritional benefits of pazhamkanji. Why not follow traditional diets to reduce obesity.
Go back to traditional diet………..
Nowadays we revive our tradition in our dressing, family values and ceremonies. When it comes to food, we take the tastier options of different cultures and from a tradition of our own. Why not instead of just adopting the tastier, easier, convenient and happier traditions, let us also adopt some of the tougher and bitter traditions which gave our ancestors a healthy lifestyle. Here are some tough dietary tradition followed by our ancestors and may help to reduce obesity:
Same diet every day
We know very well the staple diet of our ancestors. My ancestors used to have rice; they had rice for lunch and dinner and sometimes even for breakfast, which is known as pazhamkanji (old rice), considered as one of the most nutritional breakfasts in the world. According to some medical experts, if we stick to our childhood diet in adulthood, then we remain healthy lifelong.
prominence for nutrition
Our ancestors never added flavour to make the food tastier. Every ingredient had some kind of nutritional content. My ancestors used jaggery, (containing antioxidants and mineral) in coffee, tea, sweets, etc. They had green leafy vegetables with rice for lunch. And the labours had pazhamkanji for breakfast which gave them stamina for their hard labour.
Add some bitter in platter
Post delivery diet in my village includes a jaggery sweet mixed with equal amount of fenugreek powder. This bittersweet combination is said to be the secret of the stamina of the elderly women in their 70’s even after giving birth to 7 to 8 children. Many good medicinal food items are bitter, so we must make it a habit of giving bitter food to kids. I know a mother who never gave sugar products to her daughter till she was 5 years old. She was given only naturally sweetened products like fruits and vegetables. And in the meantime, the girl became more interested only in naturally sweet products.
When I visit my mother’s village home there are no rewards for guessing what my mother will prepare for me. During the mango season, there will be mango thoran (Thoran is shallow frying of any minced vegetable, mixed with grated coconut and spices), mango curry, mango pickle etc. During Jackfruit season there will be jackfruit chips, mashed jackfruit, jackfruit seed fry, jackfruit halwa etc. And if there is a bunch of banana: first there will be banana flower thoran; then a few raw bananas will be fried or made to thoran; then the rest of the bananas will be kept aside to ripen. Now the inner portion of the banana stem will be made into thoran ( very rich source of fibre and good for the kidney stone).
Strict meal timing
In my village, if someone asks you at 1:30 PM that if you had lunch and you answer is in the negative, then the villagers will rate you as an undisciplined person. In my village, people follow an unwritten schedule for food: Breakfast at 7:00; Lunch at 1:00; Tea at 3:30 and Dinner at 7:00. In our busy office schedule, we might say maintaining a strict timing is impossible. I know a number of people in various kinds of occupation who stick to their traditional diets and habits, no matter which part of the world they are, or how much work pressure they have.
A friend once said that the Tamil Brahmin community follows their dietary tradition no matter wherever they are. To make her point more clear she said just watch a Tamil Brahmin at a Buffet in a Five Star Hotel. They will look at all the dishes and finally settle down with idli and sambar, or rice and a veg curry.
I think we all need to follow the dietary tradition of our ancestors and not be carried away by all the tasty, enticing odour and attractively presented food items that will pave way for obesity.
Two years back I spent a month in an ayurveda hospital to recuperate from the side-effects of an accident. While lying in the hospital I saw many patients of different age groups suffering from various forms of arthritis. Since I was undergoing ayurveda massage the only activity I could do was to browse the net on my little mobile phone.
I read many online articles by medical practitioners and patients about the causes, symptoms and treatments for arthritis. There were many stories by arthritis patients about how they lived with the condition. Just like when you read the symptoms of any mental disease and you feel like you too got the mental disease, after reading about the symptoms of various forms of arthritis I felt I got one or all forms of arthritis. After reading the life stories of some arthritis patients, I imagined myself with a walking stick after few years. Then the doctor advised me to stop reading.
After returning to Delhi, I met rheumatoid arthritis (RA) patients surviving on pain Killers and they felt doomed. One even described arthritis as a ‘dirty disease’. The online articles about arthritis and the experience of the patients in Delhi were similar. They all felt the same way;
- There is not cure for arthritis
- One day you are going to be bed bound
- The doctors only prescribe pain killer, which has side-effect
And so I concluded that there is no use in taking medicines for arthritis, and all you can do is learn to live with arthritis.
After two years when I went to Kerala last month, I met a few young rheumatoid arthritis patients in their early thirties who were mostly detected with the disease only after they fell paralysed. I found positivity in their and their care takers attitudes. The patients lead a normal life while still continuing with the medical treatment. Rewinding memories to my days in the hospital I remember meeting patients and hearing stories of recovery and how Ayurveda helped them stays active.
I saw some videos of interviews by ayurveda and allopathic doctors in Kerala who claim that if arthritis is detected at an early stage, the disease can be cured and that in the last two decades many medicines have been discovered to cure arthritis. What I understand is that the people in Kerala approach arthritis not as a deadly disease but as a lifestyle disease like diabetes or cholesterol, which can be kept in control. There is no fear or phobia about the disease.
Delhi and the western countries, from where most of the articles on arthritis originates, are developed place, where people lead a fast life and so they follow only the allopathy treatment. Kerala is the land of Ayurveda, where even the Keralite diaspora living in different parts of the world rely on Ayurveda for many ailments – especially medications post delivery. Nowadays some keralite patients combine ayurveda and allopathy, or allopathy and homeopathy etc.
- Maybe there is a difference in the way Keralites deal with pain and deformity.
- Maybe the lifestyle in Kerala helps them deal with the disease is a better manner.
- Maybe the authors of articles online are those with acute arthritis.
I could sense that the approach to arthritis was different in both part of the world, so an interaction between patients on two sides of the globe will provide new hope for arthritis patients.
In Cities in India, people are aware that the environment is polluted and that Lead is one of the pollutants. During the Lead in Maggi controversy, consumers argued that compared to the other pollutants in the environment, Lead in Maggi was miniscule. In India, unlike in US there is no mandatory test among consumers to figure out lead toxicity in children. Blood Lead Level (BLL) more than 5 can cause health, growth, neurological and mental problem for children. There is very little study in India to figure out the BLL of consumers in India among those who are not directly at risk from Lead pollution.
High BLL among Middle and Lower Class
With 66 out of 100 children showing high BLL — with no known direct risks to Lead exposure — proves that there is an urgent requirement of conducting BLL test among children in cities in India.
Very little awarness of sources of Lead Exposure
The study showed that the awareness of the sources of lead toxicity and the effect of lead poisoning is very poor among consumers in India. Consumers are aware of Lead hazard from paints and batteries, but they were unaware of the lead exposure from soil, dust, groundwater and vehicular traffic. Apart from the occupational exposure to Lead, water, contaminated food and consumer items are also major sources of Lead. In Delhi there were media reports about Lead in vegetables grown near contaminated water bodies.
in the environmental compartments is still an issue of high
exposure risk in India, inspite of the relatively lesser organized
production and use of Lead as compared to the developed
Parents were prepared to conduct Lead Testing of their surroundings so as to provide safe environs for the Children.
Parents prepared for Lead Tests
The study also showed that parents were prepared to conduct Lead Testing of their surroundings so as to provide safe environs for the Children.
With 66 out of 100 children showing high BLL — with no known direct risks to Lead exposure — proves that there is an urgent requirement of conducting BLL test among children in cities in India. And also awareness should be spread among consumers about how to safeguard their children from Lead exposure. The media can be put to use to spread the message. According to studies children exposed to lead have lower IQ which effect their mental development and thereby resulting in a loss to the nation and humanity. As Lead is not required in any amount by the human body, steps must be taken to reduce or eliminate the use of Lead.
In order to reduce the menace of Lead you can also participate in the #StopLeadPoisoning campaign.
There is an alarming spread of the Zika virus in various parts of the world by the Aedes aegypti mosquito that is also the carrier of dengue, yellow fever and chikungunya viruses. The outbreak which is spreading fast across the globe due to human alterations of their environments. Scientists and Ecologists state can empower disease-carrying organisms such as Aedes, and the viruses can eventually add on in various forms.
Zika virus is an emerging mosquito-borne virus that was first identified in Uganda in 1947 in rhesus monkeys through a monitoring network of sylvatic yellow fever. It was subsequently identified in humans in 1952 in Uganda and the United Republic of Tanzania. Outbreaks of Zika virus disease have been recorded in Africa, the Americas, Asia and the Pacific. Papers published by National Institute of Virology (NIV), in Pune in 1950’s, by a team of experts and the published paper in 1953, indicates that India is also prone to Zika Virus attacks. They conducted tests on the exposure of Indians to 15 insects-borne diseases, one of which was by the Zika virus. It was found that ‘significant numbers’ of people were exposed to the virus as early as in the 1950s, even before the first official registering of a case of humans in Nigeria in 1954. Only thirty-three of the 196 people tested for the disease had immunity to it. The NIV had concluded in their paper that “It, therefore, seems sure that Zika virus attacks human beings in India.”
Malaria, dengue and chikungunya affected 1.13 million people in India last year. For a decade, the number of reported confirmed cases of malaria is nearly 1.87 crore, and the number of reported deaths due to Malaria case in India is approximately 12,000. At the outset, last year dengue cases and deaths had reached an all-time high in India with 97,000+ cases and 200 deaths in 2015 itself. Our country bears an enormous burden of mosquito-borne diseases, contributing 34 per cent of global dengue and 11 per cent of global malaria cases and with mosquito-borne diseases like Malaria, Dengue and Chikungunya being widespread in the country for many decades, India should focus how to handle the scenario in case the Zika virus outbreak.
The virus is transmitted by the same mosquitoes that carry other tropical viruses such as dengue and yellow fever. Global health officials are alarmed because of its potential link to brain defects in infants as well as a rare syndrome that can lead to paralysis. The Centers for Disease Control and Prevention (CDC) notes that because the Aedes species mosquitoes that spread Zika virus are found throughout the world, it is likely that outbreaks will spread to new countries”. The Zika virus is carried by mosquitoes and people but spread by mosquitoes. A few recent studies indicate that Zika continues to be an STD (Sex Transmitted Disease) too. Zika is an RNA virus related to West Nile, yellow fever, and dengue viruses, and caused by the bite of the Aedes mosquito.
According to WHO (World Health Organisation), Symptoms of Zika virus infection is usually mild. The most common Zika virus symptoms are fever and rash; it can also cause muscle and joint pain, headache, pain behind the eyes, and conjunctivitis (itchy, red eyes). Unborn babies and pregnant women are most at risk. Healthcare workers in Brazil were stunned to learn that, throughout all of 2015 and up to the present, there have been more than 3,500 total new microcephaly* cases that were suspected to be caused by Zika — more than 20 times higher than the numbers in prior years.
The blood-sucking pest has been just increasing with of lot environmental issues, and human intervention with the environment and the dense population of the country also need to be blamed for the rise in the unhygienic way of lifestyle. Mosquito-borne diseases just spread in, no matter in a particular geographical and before the medical intervention/ control of the scenario it just outbreaks into nuke and corner.
So, the best way of handling the bloodsucker by an individual is to manage our environment. Here are few listed preventive measures to avoid the growth of mosquito and it’s borne disease:
- Source reduction: Keep the containers such as flower pots, birdbaths, pet water dishes, cans, gutters, tires and buckets free of water storage to avoid the mosquito breeding cycle.
- Screen & Avoid: Possible ways of mosquitoes entering homes through doors, windows- Keep them netted / pre-close during the morning and evening session.
- Proper Clothing & Netting: Make sure you keep away from mosquito bites by wearing full-covered clothes. Use nets/ mosquito repellent while you sleep/ during travel.
- Environmental Survey of Locality: Report the unused swimming pools, abandoned lake/pond zones in your area to authorities for proper/regular maintenance. Park zone equipment should not cater to mosquito breeding.
DISCLAIMER : Views expressed above are the author’s own.
Our body does not require lead, an element found in nature, but because of the presence of lead in many consumer products, and manufacturing process, we get exposed to lead. We have some amount of lead in our body which is not dangerous as long as it is within permissible limits. The problem with lead is it does not get out as easily from the body, as it gets inside the body. Hence when the lead accumulates in the blood over a period of time it can lead to health issues – damaging the nervous system, causing brain disorders, repeated anemia, a low IQ level, headache, affecting the immune system, impaired fertility, and hypertension. It accumulates in both soft tissues and the bones. The US considers ‘lead’ the number one environmental threat to the health of children.
For the last few month I was trying to convey the above message to the Consumers in India, but with little effect. Along with students of Delhi University, I did a research for Consumers India about Lead Hazards in India. The findings were alarming as lead was found in food, household items, paints, soil and air. Getting the message across to the consumers was difficult because they think there are bigger health hazards in the polluted environs of the city. We were searching for new methods to educate the public – Seminars in schools, huge billboards in hospitals and messages through media. If there is a suitable substitute for lead then it can be eliminated. Lead Petrol was removed in India after protests from activists and NGOs’.
Thanks to the controversy regarding Lead in Maggi, Consumers are all ears to know about the hazards of Lead. Developed countries have a measurement to find out if a person is within the permissible limit of lead or they need to take medical help. A child in the US is said to be exposed to lead if the Blood lead level is between 4 and 10 mcg/dl(Micrograms Per Decilitre) and precaution are sought from the authorities to find out the source of exposure and precautions to be taken. And if the child has blood lead level of more than 10 mcg they have to undergo medical treatment.
There are numerous sources of lead exposures – lead batteries, lead paints, pottery with lead paints, newspaper prints, the prints on plastic cover, soil, vegetables that are grown in soil with high concentration of lead, water with lead and air. We are exposed to lead in all our daily activities and if we check our blood lead level, we might be diagnosed as victims of lead exposure. In our research we found vegetables like spinach contains lead and they are not removed even by thorough washing. Lead is also there in jellies, ice creams and tinned food, as the soldering is of lead.
Food items FDA (The US) checked for high lead c
The United States FDA has stated a number of products that may contain lead more that the permissible level.
- In 2004, United States Consumer Product Safety Commission found that Candies contained unsafe amount of lead from the wrappers.
- In 2002, FDA found that Milk Chocolate contained more than permissible limit of lead, which was because of the chocolate liquor used in it. The manufacturers were asked to take precaution while taking raw materials. However the level of lead was found to be high in Dark Chocolates as they contain higher amount of liquor chocolate.
- FDA also found lead in candy but within permissible limits. Candies contain sugar (lead in sucrose) which contains ‘average levels of contaminants that are well below the applicable limit’.
- Mexican candies with chilli as ingredient had detectable level of lead because of the soil they were grown.
- Candies with tamarind as ingredient was found to have lead because the products were packed in lead glazed bowls.
Where does lead in food come from in Maggi?
In our research we never found any case with noodles having lead. So I asked Vinay Kumar C, Environmental Researcher, National Referral Centre for Lead Projects in India, about the possible routes of lead exposure in Maggi, and following are his assumptions:
1. Masala ( Taste Makers): The success of Maggi is in it’s unique taste of added masala packet which comes with it, prepared exclusively comprising various ingredients. Lead may be entered in any of the raw materials procured – research have indicated that Lead Chromate are usually found in healthy haldi ( turmeric ) and mixed species as common adulteration.
Read also: Serve global brands in India with desi tadka – An anecdote on how Maggi made inroads in India 30 years ago.
In an interview to Wall Street Journal (WSJ) Uday Annapure, an associate professor of the department of food engineering and technology at the Institute of Chemical Technology in Mumbai, said that while none of the many food additives used in making the wheat noodles support lead, some components of the soup-flavoring packet, such as onion powder and wheat flour, “come from agricultural sources, all vulnerable to lead contamination,” (Source WSJ)
During the course of the research I asked an eminent person about who could be given the credit for the elimination of lead from petrol in India. He said in this big country, India, a single person or an organisation cannot bring about a change. I beg to differ from his argument in this case of spreading awareness about lead hazards. Had lead not been detected in Maggi, no one would have bothered to read this article. Maggi did in 2-minutes what Lead activists could not do for decades – spread awareness about lead exposure among consumers in India.
Also Read:Lead poisoning: How safe are you?
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On Good Friday a 38 year old, obese, friend decided to fast by skipping breakfast and lunch. She ended up for the next 5 days in Intensive Care Unit of a hospital suspecting cardiac arrest. She vouched never to fast again. This was a unique experience for me as usually after religious fasts – fasting, prayer and denial of certain food – people say they feel better physically, mentally and spiritually. So I began the research to ascertain whether fasting is good or bad for health.
I discovered that fasting is not just a religious custom but the most ancient and cheapest form of treating diseases. Fasting Therapy is widely being accepted to drastically improve chronic and debilitating illness like rheumatoid arthritis, lupus and diabetes. “Fasting is a simple, elegant therapy that has amazing medical benefits. It effectively treated high blood pressure, overcame Type II diabetes, consistently produced dramatic improvements in autoimmune diseases such as lupus, rheumatoid arthritis and psoriasis, and provided effective relief for asthma attacks and migraine headaches.” says Michael Klaper, M.D. a gifted clinician, internationally recognized teacher, and sought-after speaker on diet and health.
The cause of most of the diseases is the accumulation of excess and poisonous substance in the body. People, especially in the cities follow a sedentary lifestyle and consume excess food resulting in overburdening the digestive system. By staying away from food for a few days the elimination system in the body removes the poisonous substances accumulated inside. Read this post to find out knee replacement can be avoided by ayurveda.
Fasting sounds like an easy home remedy, because most people skip breakfast as part of dieting. Fasting however should be taken only for a certain duration of time, under professional guidance. Fasting for a prolonged period can be dangerous, so before fasting you must know the benefits and procedure of fasting. And also you must know when to fast, how to break the fast and when not to.
Only a well-experienced doctor, who uses fasting therapy as a treatment, can provide answer to the queries. So I had an interview with Dr. Matthew Brennecke, MS, ND, a board certified naturopathic doctor, in Colorado, who prefers fasting therapy to pharmaceutical medication for his patients. Here is the interview with the doctor :