he media have been full of stories about the “super bug from India”. The bug is actually a single-celled bacteria belonging to the Eschericia coli (E. coli) family. The species carries an enzyme called New Delhi metallo-beta—lactamase (NDM-1), which allows it to neutralise all known antibiotics and survive in their presence.
The enzyme was first isolated from a patient who had come to India for elective surgery. When he left, he took the “super bug” with him. No one knows how prevalent the organism is in India, as we do not have a centralised surveillance and reporting system that tracks hospital acquired infections and bacterial antibiotic resistance patterns.
Resistance is not a new phenomenon. Sulpha drugs and penicillin — the first antibiotics — were once hailed as “miracle” drugs. Today, they are hardly used. Overuse and misuse resulted in almost all bacteria becoming resistant to them.
If appropriate antibiotics are administered during a disease process caused by bacteria, the germs die. The host develops antibodies that help the body eliminate the weakened organisms.
E. coli has been around for thousands of years. That’s because the microorganisms developed “plasmids”, stable genetic elements composed of DNA or RNA. These help the bacteria grow resistance to chemicals and antibiotics. Once they have acquired this ability, they pass on the gene to other bacteria, even belonging to different species. Staphylococcus aureus and Klebsiella too have developed multiple drug resistance.
The outbreak of plague in Gujarat in 1994 killed hundreds. The state government realised the disease could be controlled by preventing rats from infesting human habitation and with appropriate antibiotic treatment. The situation was thus brought under control.
The spread of antibiotic resistance too can be controlled with combined concentrated effort. People are often “too busy” to consult a doctor when they are ill. The neighbourhood pharmacy then seems an attractive alternative. The man at the counter (often not a qualified pharmacist) dispenses antibiotics for coughs, colds, fever and diarrhoea. But there is often no rational or appropriate use of antibiotics.
Also, people sometimes do not complete the full course of a drug. They keep a few tablets, popping them for similar symptoms later or dispensing them to friends and relatives. A single dose may temporarily suppress the symptom. In a previously healthy person, the body’s natural defences then take over and eliminate the bacteria. The elderly or those with poor immunity become sicker, requiring the services of a qualified doctor. The bacteria, meanwhile, thrives in the presence of the antibiotic, because either they were not susceptible or the dosage was too small to be effective. Antibiotic resistance develops.
Practitioners of alternative systems of medicine prescribe and dispense antibiotics (which they are not licensed to use) inappropriately, perpetuating the problem.
At times, qualified physicians and surgeons use antibiotics prophylactically, especially after surgical procedures, to “prevent infection”. These antibiotics are eventually excreted by the body. They reach the sewage systems and seep through the earth. Bacteria are naturally present in sewage. They spread and multiply in the presence of the antibiotic.
Cattle and poultry feed are laced with antibiotics to “prevent” infection. Antibiotic resistant bacteria thrive on farms.
Everyone must play his or her part well to prevent another plague with super bugs which places the entire world population at risk.
• Take treatment only from qualified physicians
• Always buy antibiotics with a prescription, not OTC
• Complete the course in the dosage prescribed
Hygiene has to be maintained not just in the hospitals but also at home. Regularly washing hands, an elementary procedure, reduces infection and its spread.
Governments, nationally and internationally, need to maintain surveillance to monitor emerging infections and drug resistance patterns. If everyone — patients, doctors and the public — does not co-operate on a war footing, we may revert to the dark ages of the pre penicillin era. No antibiotic will work against infections and developing an infectious disease will turn out to be a death sentence.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Friday, August 27, 2010
Wednesday, August 11, 2010
work out for well being
Work out your well-being
Your Health
--------------------------------------------------------------------------------
DR GITA MATHAI
Recently, there was some media hype about the so-called negative effects of exercise and suggestions that it could actually be detrimental to health. Many couch potatoes jumped on the bandwagon, proclaiming they had been right all along — that their kind of sedentary lifestyle was preferable and healthier than an active one.
But what the article in question actually said was that a totally sedentary, overweight individual over the age of 50 should not suddenly embark on any intense aerobic activity like running and at the same time start severe dieting. The heart cannot cope with this sudden stress and starvation, increasing the likelihood of a heart attack. This does not mean they cannot do intense exercise; it means they should work up to it gradually under medical supervision.
Few people understand the importance of regular physical activity. They think their daily routine of shopping, housework and workplace activity is sufficient. As a result, 6 per cent of adults in India and 25 per cent of urban adults are clinically obese. The body mass index (BMI) or weight divided by height in metre squared is 30 or more, well above the acceptable norm of 23.
Statistics explain the reason for India being the diabetic capital of the world. Many are not yet diabetic but have “Metabolic Syndrome X”, which places them at high risk for heart attacks. Metabolic Syndrome X is diagnosed if you have:
• Raised blood pressure (systolic BP > 130 or diastolic BP > 85 mm Hg)
• Raised triglycerides ( > 150 mg/dL or 1.7 mmol/L)
• Reduced HDL cholesterol ( < 40 mg/dL or 1.03 mmol/L in men; < 50 mg/dL or 1.29 mmol/L in women)
• Raised fasting plasma glucose (FPG > 100 mg/dL or 5.6 mmol/L)
All these parameters can return to normal with a dedicated approach to diet and exercise.
After an emotionally exhausting and stressful day at work, 30 minutes of brisk walking or a workout in the gym can reduce stress, elevate the mood and rejuvenate the body. This is because exercise releases chemicals from the calf muscles that increase the levels of mood elevating serotonin in the brain. Regular exercise combats depression and increases feelings of self worth.
With exercise the lipid profile becomes normal and this prevents any build-up of harmful plaques in the blood vessels. This, in turn, prevents strokes and heart attacks.
Many often complain they are “too tired to exercise”. But actually, regular physical activity boosts energy levels. A good night’s sleep is the key to a productive day. Exercise does promote good sleep, but it needs to be completed at least an hour before bedtime. Or else the racy pumped-up feeling may not let you fall asleep. Students who want to study late can benefit from a short burst of high intensity exercise like a run around the house. It is healthier and probably more effective than coffee or other caffeine laced beverages.
Some of the chemicals released during exercise like the HSP (heat shock protein) help cells develop immunity and fight cancer and other diseases.
Exercise must be started young. The epidemic of childhood obesity is on the rise the world over. A child growing up in a family where no one exercises is unlikely to be motivated to do anything with spare time other than watch TV, play on the computer or eat snacks. Such children grow into obese adults with Syndrome X.
Walking for an hour and covering a distance of 4km in that time seven days a week is ideal. If you are between 20 and 50 years and have no health problems, jogging the same distance would be more beneficial. Children less than 10 years need to run for 20 minutes to half an hour every day. At least 20 minutes should be also spent on warming up, cooling down and stretching, preferably 10 minutes before and 10 minutes after exercise. Core strength is also essential for fitness and can be improved with sit-ups, push-ups and squats. Ten to 20 repetitions of each are all that are required.
Remember, exercise moderation is the key to success. Build up to your dream fitness level gradually to avoid strain to the heart, muscles, bones and joints.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Your Health
--------------------------------------------------------------------------------
DR GITA MATHAI
Recently, there was some media hype about the so-called negative effects of exercise and suggestions that it could actually be detrimental to health. Many couch potatoes jumped on the bandwagon, proclaiming they had been right all along — that their kind of sedentary lifestyle was preferable and healthier than an active one.
But what the article in question actually said was that a totally sedentary, overweight individual over the age of 50 should not suddenly embark on any intense aerobic activity like running and at the same time start severe dieting. The heart cannot cope with this sudden stress and starvation, increasing the likelihood of a heart attack. This does not mean they cannot do intense exercise; it means they should work up to it gradually under medical supervision.
Few people understand the importance of regular physical activity. They think their daily routine of shopping, housework and workplace activity is sufficient. As a result, 6 per cent of adults in India and 25 per cent of urban adults are clinically obese. The body mass index (BMI) or weight divided by height in metre squared is 30 or more, well above the acceptable norm of 23.
Statistics explain the reason for India being the diabetic capital of the world. Many are not yet diabetic but have “Metabolic Syndrome X”, which places them at high risk for heart attacks. Metabolic Syndrome X is diagnosed if you have:
• Raised blood pressure (systolic BP > 130 or diastolic BP > 85 mm Hg)
• Raised triglycerides ( > 150 mg/dL or 1.7 mmol/L)
• Reduced HDL cholesterol ( < 40 mg/dL or 1.03 mmol/L in men; < 50 mg/dL or 1.29 mmol/L in women)
• Raised fasting plasma glucose (FPG > 100 mg/dL or 5.6 mmol/L)
All these parameters can return to normal with a dedicated approach to diet and exercise.
After an emotionally exhausting and stressful day at work, 30 minutes of brisk walking or a workout in the gym can reduce stress, elevate the mood and rejuvenate the body. This is because exercise releases chemicals from the calf muscles that increase the levels of mood elevating serotonin in the brain. Regular exercise combats depression and increases feelings of self worth.
With exercise the lipid profile becomes normal and this prevents any build-up of harmful plaques in the blood vessels. This, in turn, prevents strokes and heart attacks.
Many often complain they are “too tired to exercise”. But actually, regular physical activity boosts energy levels. A good night’s sleep is the key to a productive day. Exercise does promote good sleep, but it needs to be completed at least an hour before bedtime. Or else the racy pumped-up feeling may not let you fall asleep. Students who want to study late can benefit from a short burst of high intensity exercise like a run around the house. It is healthier and probably more effective than coffee or other caffeine laced beverages.
Some of the chemicals released during exercise like the HSP (heat shock protein) help cells develop immunity and fight cancer and other diseases.
Exercise must be started young. The epidemic of childhood obesity is on the rise the world over. A child growing up in a family where no one exercises is unlikely to be motivated to do anything with spare time other than watch TV, play on the computer or eat snacks. Such children grow into obese adults with Syndrome X.
Walking for an hour and covering a distance of 4km in that time seven days a week is ideal. If you are between 20 and 50 years and have no health problems, jogging the same distance would be more beneficial. Children less than 10 years need to run for 20 minutes to half an hour every day. At least 20 minutes should be also spent on warming up, cooling down and stretching, preferably 10 minutes before and 10 minutes after exercise. Core strength is also essential for fitness and can be improved with sit-ups, push-ups and squats. Ten to 20 repetitions of each are all that are required.
Remember, exercise moderation is the key to success. Build up to your dream fitness level gradually to avoid strain to the heart, muscles, bones and joints.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Monday, August 2, 2010
colds and flu
Season of colds and coughs
YOUR HEALTH
DR GITA MATHAI
The monsoon has set in, bringing much relief from the scorching sun and prickly heat. The cool showers and damp surroundings have also ushered in an epidemic of sniffles and sneezes. This effects the young and old alike. There is a constant fear — is this just a cold, or something more sinister? Could it be avian or swine flu?
Both cold and flu start with similar symptoms of headache, body ache, fever, runny nose and cough. Only the severity varies. In flu, the person is unable to move out of bed, whereas one suffering from a cold is not completely incapacitated.
Colds are caused by around 200 types of viruses, the commonest of which are the rhinoviruses (rhino means nose). They spread through droplets sneezed or coughed into the air by an infected person. The virus can also survive on clothing and articles like tables and books. The infection sets in around three days after exposure.
Children have not yet developed immunity against the cold viruses. Also, they are more likely to come in contact with infected children in schools and parks. Many parents, unfortunately, do not let ill children stay at home. In many schools, children with coughs and colds are advised to “take the test and then go home”. By this time they may have infected the entire class.
Children may develop eight to 10 colds a year. Each can last up to two weeks. This makes parents feel the child is always ill. They do not document the number of illness-free days in between one infection and the next. Many of these children are erroneously diagnosed as “primary complex” and started on rifampicin, isoniazide and other anti-tuberculosis medication. As children grow, their immunity builds up. The number of infections decreases to two to three a year.
A perpetually runny nose and cough without fever may not be due to a bacterial or viral infection. It may be due to an allergy to pollen, paint, incense or mosquito mats, coils and repellents. Smoking predispose one to colds. In children, toxic allergenic smoke may be inhaled passively from a smoking adult.
The classic symptoms of a cold are mild fever (it is best to buy a digital thermometer and check the temperature instead of relying on touch), less than 102° F, watery or slightly yellow nasal discharge, a scratchy irritated feeling in the throat, cough and body ache.
The condition is best tackled with rest. If the temperature goes above 100.5° F, or if the body ache is severe, paracetemol can be taken. Adults do not require more than 500mg. In children the dose is 10-15mg per kg of body weight. It can be repeated after four to six hours. Aspirin is contraindicated in children. A sore throat can be tackled with frequent salt water gargles. Saline nose drops can be administered in each nostril every three hours. It is better to avoid decongestant chemical nose drops as they can cause rebound nasal congestion, habituation and, if used for prolonged periods, atrophy of the nasal mucosa.
Anti-histamines can cause drowsiness. Both anti histamines and cough suppressants can cause side effects. They shouldn’t be taken without medical supervision. Traditional remedies like ginger tea, rasam, rice gruel and chicken soup help soothe the throat, relieve congestion and maintain hydration and nutrition.
A doctor should be consulted if —
• The fever has lasted more than three days
• There are chills
• The headache is continuous
• There is abdominal pain or vomiting
• There is ear ache
• Breathing becomes difficult
• A cough persists
• There is drowsiness.
In children, continuous crying or grunting needs to be taken seriously.
Antibiotics will not shorten the course of a cold or prevent one from appearing. But they need to be taken in case of complications like ear infection, sinusitis, bronchitis or pneumonia. The medication needs to be taken in the prescribed dose for the correct duration under medical supervision.
The likelihood of catching a cold can be reduced by washing hands regularly, cleaning toys and table surfaces, using disposable tissues to blow the nose, covering the nose and mouth while coughing and sneezing, and not attending school or work while infected.
Influenza vaccine is available and can be given to reduce the likelihood of catching seasonal flu but not the common cold. Immunisation is advisable for children under two, those over 65, asthmatics and those with compromised immunity.
Supplements of vitamin C, zinc, iron, B complex and some herbs like Echinacea are anecdotally said to reduce the number of colds. These claims have not been substantiated by double blind controlled studies.
The number of colds can be reduced by maintaining a hygienic and healthy lifestyle with at least 40 minutes of aerobic activity a day.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
YOUR HEALTH
DR GITA MATHAI
The monsoon has set in, bringing much relief from the scorching sun and prickly heat. The cool showers and damp surroundings have also ushered in an epidemic of sniffles and sneezes. This effects the young and old alike. There is a constant fear — is this just a cold, or something more sinister? Could it be avian or swine flu?
Both cold and flu start with similar symptoms of headache, body ache, fever, runny nose and cough. Only the severity varies. In flu, the person is unable to move out of bed, whereas one suffering from a cold is not completely incapacitated.
Colds are caused by around 200 types of viruses, the commonest of which are the rhinoviruses (rhino means nose). They spread through droplets sneezed or coughed into the air by an infected person. The virus can also survive on clothing and articles like tables and books. The infection sets in around three days after exposure.
Children have not yet developed immunity against the cold viruses. Also, they are more likely to come in contact with infected children in schools and parks. Many parents, unfortunately, do not let ill children stay at home. In many schools, children with coughs and colds are advised to “take the test and then go home”. By this time they may have infected the entire class.
Children may develop eight to 10 colds a year. Each can last up to two weeks. This makes parents feel the child is always ill. They do not document the number of illness-free days in between one infection and the next. Many of these children are erroneously diagnosed as “primary complex” and started on rifampicin, isoniazide and other anti-tuberculosis medication. As children grow, their immunity builds up. The number of infections decreases to two to three a year.
A perpetually runny nose and cough without fever may not be due to a bacterial or viral infection. It may be due to an allergy to pollen, paint, incense or mosquito mats, coils and repellents. Smoking predispose one to colds. In children, toxic allergenic smoke may be inhaled passively from a smoking adult.
The classic symptoms of a cold are mild fever (it is best to buy a digital thermometer and check the temperature instead of relying on touch), less than 102° F, watery or slightly yellow nasal discharge, a scratchy irritated feeling in the throat, cough and body ache.
The condition is best tackled with rest. If the temperature goes above 100.5° F, or if the body ache is severe, paracetemol can be taken. Adults do not require more than 500mg. In children the dose is 10-15mg per kg of body weight. It can be repeated after four to six hours. Aspirin is contraindicated in children. A sore throat can be tackled with frequent salt water gargles. Saline nose drops can be administered in each nostril every three hours. It is better to avoid decongestant chemical nose drops as they can cause rebound nasal congestion, habituation and, if used for prolonged periods, atrophy of the nasal mucosa.
Anti-histamines can cause drowsiness. Both anti histamines and cough suppressants can cause side effects. They shouldn’t be taken without medical supervision. Traditional remedies like ginger tea, rasam, rice gruel and chicken soup help soothe the throat, relieve congestion and maintain hydration and nutrition.
A doctor should be consulted if —
• The fever has lasted more than three days
• There are chills
• The headache is continuous
• There is abdominal pain or vomiting
• There is ear ache
• Breathing becomes difficult
• A cough persists
• There is drowsiness.
In children, continuous crying or grunting needs to be taken seriously.
Antibiotics will not shorten the course of a cold or prevent one from appearing. But they need to be taken in case of complications like ear infection, sinusitis, bronchitis or pneumonia. The medication needs to be taken in the prescribed dose for the correct duration under medical supervision.
The likelihood of catching a cold can be reduced by washing hands regularly, cleaning toys and table surfaces, using disposable tissues to blow the nose, covering the nose and mouth while coughing and sneezing, and not attending school or work while infected.
Influenza vaccine is available and can be given to reduce the likelihood of catching seasonal flu but not the common cold. Immunisation is advisable for children under two, those over 65, asthmatics and those with compromised immunity.
Supplements of vitamin C, zinc, iron, B complex and some herbs like Echinacea are anecdotally said to reduce the number of colds. These claims have not been substantiated by double blind controlled studies.
The number of colds can be reduced by maintaining a hygienic and healthy lifestyle with at least 40 minutes of aerobic activity a day.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Wednesday, July 21, 2010
hope for the hopeless
Banking on stem cells
YOUR HEALTH
--------------------------------------------------------------------------------
DR GITA MATHAI
Actress Lisa Ray underwent stem cell therapy for multiple myeloma, a cancer of the white blood cells
Advertisements in the media advise parents to “plan and protect your children’s future and their health status”. These are not commercials for insurance plans, but private stem cell banking facilities, where, for a steep price, your baby’s umbilical cord stem cells can be preserved for future use.
Stem cells are in the news. Independent national and international laboratories are making claims and counterclaims about the “miracles” they have achieved with them. Paralysed people have been able to walk, rare degenerative nervous and muscular system diseases been reversed, and some cancers of the blood cells cured. People with terminal illnesses have also been offered hope.
Stem cells may be embryonic, adult or derived from umbilical cords. Embryonic stem cells are obtained from the extra fertilised eggs at in vitro fertilisation (IVF) centres. The use of these cells is controversial, as, theoretically, they have the potential to become human beings. They are the “spare babies” belonging to a particular IVF couple. When supplied to a stem cell research facility, they are grown in a nutrient broth in a culture dish and used for research or treatment.
Adult stem cells are found in bone marrow. These are harvested from the bone marrow of living donors. It’s a surgical procedure done under anaesthesia with some post-operative discomfort. The cells are capable of eventually forming either various types of blood cells or stromal cells from which cartilage and fat tissues arise.
Haematologists treat a variety of hereditary blood disorders and some of the blood cancers with either autologous (the person’s own) stem cells or compatible donor cells from bone marrow transplants. This technology has been used for the last 30 years. Bone marrow transplants are life saving for people with certain blood cancers. They can also be used for serious blood disorders such as aplastic anaemia. They can also help boost the immune system if it is impaired because of an inherited genetic defect or destroyed by cancer.
Umbilical cords are a rich and non-controversial source of stem cells. Cord blood has a greater ability to generate new blood cells than does bone marrow. Also, smaller quantities of cord blood cells are needed for successful transplantation. These cords are normally discarded along with the placenta from labour wards all over the world.
At present, in India, patients who require stem cell treatment or a bone marrow transplant have to search for a relative who is an appropriate tissue match. Sometimes even close first-degree relatives like a parent or sibling are not compatible. India does not as yet have a centralised national bone marrow registry to match recipients and donors.
Some foresighted countries with efficient national health schemes like the United Kingdom and Brazil do have public cord blood banks. Blood is screened for infective agents, documented in a registry and stored. The chances of finding compatible stem cells are high because of the large volumes stored.
India has private cord blood banks which store blood only for the use of that particular child for a period of 21 years. It may be a cost effective option for parents who have a family history of certain genetic diseases, such as severe hereditary anaemias, immune disorders or certain cancers. Even then, the chance that the blood can be used for that particular child is only 1 in 2,000. In families with no such risk factors, there is only about a 1-in-20,000 chance of the child ever needing a stem cell transplantation. Also, even if the child does require a stem cell transplant, it is unlikely that his or her own cord blood would be the desired source of stem cells. The same chromosomal or genetic defect causing the leukaemia, any other cancer or metabolic disorder, is likely to be present in the child’s stem cell line. There is no proof that a transplant using the child’s own stem cells is effective or even safe, especially in cases of childhood cancers.
Indians have a very diverse genetic make-up. The large-scale collection and storage of cord blood in public banks will be very useful. It can be used for matched unrelated recipients who urgently need blood cell transplants.
Stem cells are probably the future of medicine and the human race. They are multifaceted and have the potential to develop into different cell types. They can theoretically keep dividing as long as the person is alive. When a stem cell divides, each new cell has the potential to either remain a stem cell or become another specialised cell like a muscle cell, red blood cell, or brain cell. This means stem cells can be infused as a sort of emergency repair mechanism to replenish damaged tissues.
Perhaps disease, aging, cancer and even death can be controlled and conquered. And living healthily forever may become a reality.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
YOUR HEALTH
--------------------------------------------------------------------------------
DR GITA MATHAI
Actress Lisa Ray underwent stem cell therapy for multiple myeloma, a cancer of the white blood cells
Advertisements in the media advise parents to “plan and protect your children’s future and their health status”. These are not commercials for insurance plans, but private stem cell banking facilities, where, for a steep price, your baby’s umbilical cord stem cells can be preserved for future use.
Stem cells are in the news. Independent national and international laboratories are making claims and counterclaims about the “miracles” they have achieved with them. Paralysed people have been able to walk, rare degenerative nervous and muscular system diseases been reversed, and some cancers of the blood cells cured. People with terminal illnesses have also been offered hope.
Stem cells may be embryonic, adult or derived from umbilical cords. Embryonic stem cells are obtained from the extra fertilised eggs at in vitro fertilisation (IVF) centres. The use of these cells is controversial, as, theoretically, they have the potential to become human beings. They are the “spare babies” belonging to a particular IVF couple. When supplied to a stem cell research facility, they are grown in a nutrient broth in a culture dish and used for research or treatment.
Adult stem cells are found in bone marrow. These are harvested from the bone marrow of living donors. It’s a surgical procedure done under anaesthesia with some post-operative discomfort. The cells are capable of eventually forming either various types of blood cells or stromal cells from which cartilage and fat tissues arise.
Haematologists treat a variety of hereditary blood disorders and some of the blood cancers with either autologous (the person’s own) stem cells or compatible donor cells from bone marrow transplants. This technology has been used for the last 30 years. Bone marrow transplants are life saving for people with certain blood cancers. They can also be used for serious blood disorders such as aplastic anaemia. They can also help boost the immune system if it is impaired because of an inherited genetic defect or destroyed by cancer.
Umbilical cords are a rich and non-controversial source of stem cells. Cord blood has a greater ability to generate new blood cells than does bone marrow. Also, smaller quantities of cord blood cells are needed for successful transplantation. These cords are normally discarded along with the placenta from labour wards all over the world.
At present, in India, patients who require stem cell treatment or a bone marrow transplant have to search for a relative who is an appropriate tissue match. Sometimes even close first-degree relatives like a parent or sibling are not compatible. India does not as yet have a centralised national bone marrow registry to match recipients and donors.
Some foresighted countries with efficient national health schemes like the United Kingdom and Brazil do have public cord blood banks. Blood is screened for infective agents, documented in a registry and stored. The chances of finding compatible stem cells are high because of the large volumes stored.
India has private cord blood banks which store blood only for the use of that particular child for a period of 21 years. It may be a cost effective option for parents who have a family history of certain genetic diseases, such as severe hereditary anaemias, immune disorders or certain cancers. Even then, the chance that the blood can be used for that particular child is only 1 in 2,000. In families with no such risk factors, there is only about a 1-in-20,000 chance of the child ever needing a stem cell transplantation. Also, even if the child does require a stem cell transplant, it is unlikely that his or her own cord blood would be the desired source of stem cells. The same chromosomal or genetic defect causing the leukaemia, any other cancer or metabolic disorder, is likely to be present in the child’s stem cell line. There is no proof that a transplant using the child’s own stem cells is effective or even safe, especially in cases of childhood cancers.
Indians have a very diverse genetic make-up. The large-scale collection and storage of cord blood in public banks will be very useful. It can be used for matched unrelated recipients who urgently need blood cell transplants.
Stem cells are probably the future of medicine and the human race. They are multifaceted and have the potential to develop into different cell types. They can theoretically keep dividing as long as the person is alive. When a stem cell divides, each new cell has the potential to either remain a stem cell or become another specialised cell like a muscle cell, red blood cell, or brain cell. This means stem cells can be infused as a sort of emergency repair mechanism to replenish damaged tissues.
Perhaps disease, aging, cancer and even death can be controlled and conquered. And living healthily forever may become a reality.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Tuesday, July 13, 2010
fat children
Catch them early
Your Health
--------------------------------------------------------------------------------
DR GITA MATHAI
When I was a medical student (so long back that it was actually in the last century), two of the cases placed before us as “spotters” (look and diagnose, don’t touch or question) in an examination were children with kwashiorkor (lethargic and disproportionately swollen with fluid) and marasmus (wizened, wasted and looking like a wise elder). Both were common conditions, the result of malnutrition.
Such diseases are rare today. In fact, now doctors have to spot diagnose children at the opposite end of the spectrum. About 20 per cent of children (some less than a year old) and teenagers in India can be defined as overweight, obese or morbidly obese. Their weights exceed that expected for their heights by 20 per cent, 50 per cent, and even 80-100 per cent. The BMI (body mass index, calculated as weight divided by height in meter squared) which should be 23 is often well above 30. Many of these children maintain their obese status into adult life.
In addition to having a paunch, big hips, knock knees and a double chin, such children have a peculiar velvety black discolouration of the skin — called acanthosis nigricans — on the nape of the neck. No amount of scrubbing will remove it, nor talcum powder conceal it. It is a marker for obesity that is likely to progress in diabetes.
This unhealthy state of over nutrition starts in infancy. Babies are breast fed for less than a year and weaned early. They are often force fed high energy, ready-to-eat carbohydrate substitutes instead of healthy, home cooked weaning foods. Older children gorge on unhealthy packaged snacks that often serve as a substitute for meals.
The children also have limited outdoor activity. Schools do not encourage physical training or games, as academics takes precedence over sports. In the evenings, tuition, homework and television usurp their time. Many parents do not have the time, inclination or space to take the children out.
Energy intake soon overtakes energy expenditure. In children, the waistline expands and fat is deposited in the abdominal regions. A paunch develops and pushes up the stomach and other abdominal contents against the diaphragm (a muscle that separates the abdomen from the chest). The chest is unable to expand fully and breathing becomes shallow, noisy and inefficient. Infections are frequent.
The excess fat is also deposited in muscles and liver tissue. The fat makes the body resistant to the actions of its own insulin. Even young children develop relative “insulin resistance”. Glucose intolerance and hypertriglyceridemia begin to develop in them. Fat gets deposited in the blood vessels. And this can cause the blood pressure to rise and result in premature coronary artery disease.
Adolescent obesity causes hormonal imbalances. In obese girls, androgens are present in excess. They develop unsightly facial hair and menstrual irregularities. This may result in PCOS (polycystic ovarian syndrome). In men, estrogen levels rise and gynacomastia develops. Eventually, these obese adolescents become subfertile adults. Pregnancy occurs only after expensive and frustrating treatment.
Obese children are also prone to numerous orthopedic problems. They may develop bowlegs. The ends of the growing bones may slip causing deformities. All this results in the early onset of arthritis.
Moreover, children are psychologically affected by their obesity. They are often the brunt of jokes. They are often excluded from sports and cultural events.
Quite often, the overweight children appear to have a familial obesity. This correlation is likely to be due to the environment with excessive food intake, limited exercise and almost compulsive television viewing. In these children, the obesity is not genetic but a result of the upbringing.
Boys (not girls) who are obese in childhood and adolescence are at risk for sudden death from coronary artery disease (CAD) as adults. They are also at increased risk for gout and colorectal cancer. This risk remains constant even if they manage to lose weight as adults. Girls who are obese become women at high risk for arthritis.
Television viewing should be restricted to a minimum. If the parents watch television for many hours every day, children too get hooked on to it. It is better to enroll them in coaching classes for activities like cricket, swimming, tennis, football or basketball. The Sports Authority of India conducts camps during summer vacations. Children who attend these camps should be encouraged to maintain the momentum even after school re-opens. Daily running or jogging for 20-40 minutes will help them keep up their stamina and maintain weight till the next round of coaching starts.
As parents and elders, we have to keep our children fit and not fat.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Your Health
--------------------------------------------------------------------------------
DR GITA MATHAI
When I was a medical student (so long back that it was actually in the last century), two of the cases placed before us as “spotters” (look and diagnose, don’t touch or question) in an examination were children with kwashiorkor (lethargic and disproportionately swollen with fluid) and marasmus (wizened, wasted and looking like a wise elder). Both were common conditions, the result of malnutrition.
Such diseases are rare today. In fact, now doctors have to spot diagnose children at the opposite end of the spectrum. About 20 per cent of children (some less than a year old) and teenagers in India can be defined as overweight, obese or morbidly obese. Their weights exceed that expected for their heights by 20 per cent, 50 per cent, and even 80-100 per cent. The BMI (body mass index, calculated as weight divided by height in meter squared) which should be 23 is often well above 30. Many of these children maintain their obese status into adult life.
In addition to having a paunch, big hips, knock knees and a double chin, such children have a peculiar velvety black discolouration of the skin — called acanthosis nigricans — on the nape of the neck. No amount of scrubbing will remove it, nor talcum powder conceal it. It is a marker for obesity that is likely to progress in diabetes.
This unhealthy state of over nutrition starts in infancy. Babies are breast fed for less than a year and weaned early. They are often force fed high energy, ready-to-eat carbohydrate substitutes instead of healthy, home cooked weaning foods. Older children gorge on unhealthy packaged snacks that often serve as a substitute for meals.
The children also have limited outdoor activity. Schools do not encourage physical training or games, as academics takes precedence over sports. In the evenings, tuition, homework and television usurp their time. Many parents do not have the time, inclination or space to take the children out.
Energy intake soon overtakes energy expenditure. In children, the waistline expands and fat is deposited in the abdominal regions. A paunch develops and pushes up the stomach and other abdominal contents against the diaphragm (a muscle that separates the abdomen from the chest). The chest is unable to expand fully and breathing becomes shallow, noisy and inefficient. Infections are frequent.
The excess fat is also deposited in muscles and liver tissue. The fat makes the body resistant to the actions of its own insulin. Even young children develop relative “insulin resistance”. Glucose intolerance and hypertriglyceridemia begin to develop in them. Fat gets deposited in the blood vessels. And this can cause the blood pressure to rise and result in premature coronary artery disease.
Adolescent obesity causes hormonal imbalances. In obese girls, androgens are present in excess. They develop unsightly facial hair and menstrual irregularities. This may result in PCOS (polycystic ovarian syndrome). In men, estrogen levels rise and gynacomastia develops. Eventually, these obese adolescents become subfertile adults. Pregnancy occurs only after expensive and frustrating treatment.
Obese children are also prone to numerous orthopedic problems. They may develop bowlegs. The ends of the growing bones may slip causing deformities. All this results in the early onset of arthritis.
Moreover, children are psychologically affected by their obesity. They are often the brunt of jokes. They are often excluded from sports and cultural events.
Quite often, the overweight children appear to have a familial obesity. This correlation is likely to be due to the environment with excessive food intake, limited exercise and almost compulsive television viewing. In these children, the obesity is not genetic but a result of the upbringing.
Boys (not girls) who are obese in childhood and adolescence are at risk for sudden death from coronary artery disease (CAD) as adults. They are also at increased risk for gout and colorectal cancer. This risk remains constant even if they manage to lose weight as adults. Girls who are obese become women at high risk for arthritis.
Television viewing should be restricted to a minimum. If the parents watch television for many hours every day, children too get hooked on to it. It is better to enroll them in coaching classes for activities like cricket, swimming, tennis, football or basketball. The Sports Authority of India conducts camps during summer vacations. Children who attend these camps should be encouraged to maintain the momentum even after school re-opens. Daily running or jogging for 20-40 minutes will help them keep up their stamina and maintain weight till the next round of coaching starts.
As parents and elders, we have to keep our children fit and not fat.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Wednesday, June 30, 2010
probiotic prebiotic antibiotic
Cup of magic
YOUR HEALTH
DR GITA MATHAI
Curd reduces infections as well as the duration of illnesses
Probiotics, prebiotics, antibiotics. The words often cause confusion because they sound similar. But, of course, they mean very different things, although all three are derived from the Greek word “bios”, meaning “life”.
Most people would love a magic pill that would put an end to all their health problems. Preferably one that contains prebiotics (meaning “before life”) and probiotics (“helping life”), along with a few trace elements, minerals, antioxidants and vitamins.
Probiotics are defined by the World Health Organization as microorganisms, which when administered alive in adequate amounts, confer a health benefit to the host. They are advertised by the pharma industry as protective, anti-infection agents that give the body’s natural reserves a boost against disease. They are sold as capsules and powders containing organisms like Lactobacillus bulgaricus and Streptococcus thermophilus. The products are much hyped, and have fancy names and expensive packaging.
However, what advertisements do not mention is that to be effective, there should be at least 75 million live organisms in each capsule. Food and chlorine in water kill these organisms. They therefore have to be swallowed with non-chlorinated water on an empty stomach. The intestines need to be populated with these organisms. So initially, the capsules have to be swallowed four to six times a day. The minuscule numbers contained in commercially available capsules are insufficient and do not confer any real health benefit.
Probiotics are not new products; they have been around for centuries. Fermented dough and curd (yogurt) contain natural, healthy probiotics. Commercially available yogurt may not contain live lactobacillus (probiotics) unless specifically mentioned on the package.
Natural probiotics like curd have many medicinal properties that are being rediscovered now. Curd starts to act in the mouth itself. It reduces the number of plaque forming bacteria, and prevents bad breath, tooth decay and mouth ulcers.
In the stomach, curd helps neutralise gastric acidity, reducing belching, burning and dyspepsia. It prevents infections, particularly the growth and multiplication of H. pylori, which is implicated in gastric ulcers and stomach cancer.
In the intestine, probiotics live with other protective intestinal flora, reducing gas formation and diarrhoea. The immunological effects reduce the incidence and symptoms of Crohn’s disease (inflammatory condition of the intestines that may affect any part from the mouth to the anus) and ulcerative colitis. Bowel habits become regular and the incidence of colon cancer reduces in those who eat curd regularly.
The action of the probiotics on digested food results in the synthesis of B-complex vitamins. This reduces vitamin deficiencies. Children who are given curd in addition to milk have less diarrhoea than those given milk alone.
Many Indians are relatively lactose intolerant and develop bloating, abdominal pain and diarrhoea when given to drink milk. They thus tend to curtail their milk intake and in the absence of calcium supplementation become susceptible to osteoporosis. In curd, however, the milk is already partially digested, and this reduces the symptoms of intolerance. As little as one cup of curd a day is beneficial in the prevention of osteoporosis.
Studies have also shown that eating curd regularly prevents the development of candidiasis, a common vaginal fungal infection. Other studies have shown conflicting results with no real benefit. But this has not prevented pharmaceutical companies from advocating lactobacillus capsules and vaginal pessaries for candidial infection. Curd also boosts the immune system. Regular eaters swear by it, saying it reduces infections as well as the duration of illnesses.
Prebiotics, on the other hand, are soluble fibres and non-digestible food ingredients that remain in the colon. They selectively stimulate the growth and activity of beneficial microorganisms already present in the large intestine. Prebiotics are found in oats, wheat, onions and garlic. When probiotics and prebiotics are combined, they form “synbiotics”. This probably confers the best health benefits with probiotics acting in the small intestine and prebiotics in the large.
Antibiotics are used to kill harmful microorganisms in the intestine, bloodstream and the various organs. They should be used appropriately in the correct dosage and duration. Unlike probiotics and prebiotics, antibiotics are specific for a particular infection. They are not health supplements.
Antioxidants are found in coloured fruits and vegetables. Oxidation is essential for cell metabolism. During this process a few cells die releasing harmful free radicals. This is prevented by antioxidants.
All said and done, health does not come packaged as an expensive magic capsule containing probiotics and antioxidants to be drunk with a glass of artificial fibre. For good health,
Eat four to five helpings of fresh fruits and vegetables daily. The green, yellow, orange and red ones contain antioxidants
Eat one tablespoon of homemade curd first thing in the morning on an empty stomach
Eat chappatis four or five times a week
Give these health ingredients an extra boost by exercising one hour everyday.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
YOUR HEALTH
DR GITA MATHAI
Curd reduces infections as well as the duration of illnesses
Probiotics, prebiotics, antibiotics. The words often cause confusion because they sound similar. But, of course, they mean very different things, although all three are derived from the Greek word “bios”, meaning “life”.
Most people would love a magic pill that would put an end to all their health problems. Preferably one that contains prebiotics (meaning “before life”) and probiotics (“helping life”), along with a few trace elements, minerals, antioxidants and vitamins.
Probiotics are defined by the World Health Organization as microorganisms, which when administered alive in adequate amounts, confer a health benefit to the host. They are advertised by the pharma industry as protective, anti-infection agents that give the body’s natural reserves a boost against disease. They are sold as capsules and powders containing organisms like Lactobacillus bulgaricus and Streptococcus thermophilus. The products are much hyped, and have fancy names and expensive packaging.
However, what advertisements do not mention is that to be effective, there should be at least 75 million live organisms in each capsule. Food and chlorine in water kill these organisms. They therefore have to be swallowed with non-chlorinated water on an empty stomach. The intestines need to be populated with these organisms. So initially, the capsules have to be swallowed four to six times a day. The minuscule numbers contained in commercially available capsules are insufficient and do not confer any real health benefit.
Probiotics are not new products; they have been around for centuries. Fermented dough and curd (yogurt) contain natural, healthy probiotics. Commercially available yogurt may not contain live lactobacillus (probiotics) unless specifically mentioned on the package.
Natural probiotics like curd have many medicinal properties that are being rediscovered now. Curd starts to act in the mouth itself. It reduces the number of plaque forming bacteria, and prevents bad breath, tooth decay and mouth ulcers.
In the stomach, curd helps neutralise gastric acidity, reducing belching, burning and dyspepsia. It prevents infections, particularly the growth and multiplication of H. pylori, which is implicated in gastric ulcers and stomach cancer.
In the intestine, probiotics live with other protective intestinal flora, reducing gas formation and diarrhoea. The immunological effects reduce the incidence and symptoms of Crohn’s disease (inflammatory condition of the intestines that may affect any part from the mouth to the anus) and ulcerative colitis. Bowel habits become regular and the incidence of colon cancer reduces in those who eat curd regularly.
The action of the probiotics on digested food results in the synthesis of B-complex vitamins. This reduces vitamin deficiencies. Children who are given curd in addition to milk have less diarrhoea than those given milk alone.
Many Indians are relatively lactose intolerant and develop bloating, abdominal pain and diarrhoea when given to drink milk. They thus tend to curtail their milk intake and in the absence of calcium supplementation become susceptible to osteoporosis. In curd, however, the milk is already partially digested, and this reduces the symptoms of intolerance. As little as one cup of curd a day is beneficial in the prevention of osteoporosis.
Studies have also shown that eating curd regularly prevents the development of candidiasis, a common vaginal fungal infection. Other studies have shown conflicting results with no real benefit. But this has not prevented pharmaceutical companies from advocating lactobacillus capsules and vaginal pessaries for candidial infection. Curd also boosts the immune system. Regular eaters swear by it, saying it reduces infections as well as the duration of illnesses.
Prebiotics, on the other hand, are soluble fibres and non-digestible food ingredients that remain in the colon. They selectively stimulate the growth and activity of beneficial microorganisms already present in the large intestine. Prebiotics are found in oats, wheat, onions and garlic. When probiotics and prebiotics are combined, they form “synbiotics”. This probably confers the best health benefits with probiotics acting in the small intestine and prebiotics in the large.
Antibiotics are used to kill harmful microorganisms in the intestine, bloodstream and the various organs. They should be used appropriately in the correct dosage and duration. Unlike probiotics and prebiotics, antibiotics are specific for a particular infection. They are not health supplements.
Antioxidants are found in coloured fruits and vegetables. Oxidation is essential for cell metabolism. During this process a few cells die releasing harmful free radicals. This is prevented by antioxidants.
All said and done, health does not come packaged as an expensive magic capsule containing probiotics and antioxidants to be drunk with a glass of artificial fibre. For good health,
Eat four to five helpings of fresh fruits and vegetables daily. The green, yellow, orange and red ones contain antioxidants
Eat one tablespoon of homemade curd first thing in the morning on an empty stomach
Eat chappatis four or five times a week
Give these health ingredients an extra boost by exercising one hour everyday.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Monday, June 7, 2010
lousy life
Lousy problem
YOUR HEALTH
DR GITA MATHAI
A young girl gets lice removed mechanically
Itchy scalp? Scratching in public? And people looking askance at you? The problem could be dandruff or seborrhic dermatitis. Or worse, it could be lice.
Lice (singular: louse) are ectoparasites — that is, they live on the outside. Each insect is about the size of a sesame seed, with six legs and no wings. Human lice cannot survive on other animals such as cats, dogs and birds. They are also specific to the area they infest. They may live on the head (head lice). A slightly different variety lives in the genital area (pubic lice). A third type (body lice) lives only on the body.
School-going children are particularly likely to pick up head lice. In India, 60 per cent of girls in the age group of five to 11 are infested. This is, however, wrongly attributed to poor hygiene and low socioeconomic status. The social stigma attached to lice infestation and accusing letters from school authorities add to the psychological trauma of the child and her parents.
Lice feed on human blood and live for 30 days. If they fall off the body, they can survive on clothes, combs, crash helmets, bed sheets or pillows for two days. Each pair of lice lays about 100 eggs. These characteristics make them a tough species. They have managed to survive unchanged for more than 2,000 years. Archaeologists have found evidence of lice on Egyptian mummies, which are identical to the ones seen today.
The spread of lice occurs only if there is close contact with infested persons or their personal belongings. A louse cannot jump or fly. It has to crawl to its next victim. Once the insect has settled, it immediately starts to bite and feed. Lice release chemicals from their saliva which can cause intense scratching. This introduces bacteria to the skin which may cause secondary infection. The lymph nodes may become enlarged and appear as painful lumps in the neck.
There are many home remedies for lice. Mixtures of oils or ghee are sometimes applied in the hope that it will smother the lice. Others may shampoo frequently, thinking it will drown or wash away the insects. These, however, do not work.
The “lice comb” is a traditional and effective method. The comb may be made of metal, plastic or wood. Combing has to be done every day for two to three months. When the adult lice fall off, they have to be killed. Removing nits with a comb is difficult, tedious, time consuming and somewhat painful. Moreover, the child may not cooperate.
There is another effective method. Often in traditional families, all the members get their heads tonsured under some religious pretext. No hair, no lice.
Many chemicals are known to eradicate lice. Kerosene, for example, is effective when applied to the whole head and left for two or three hours. The head should be tied up securely in a cloth. But the method is dangerous as kerosene is highly inflammable.
Medicated “lice treatment” shampoos and lotions contain malathion, lindane and permethrin and can be applied to the hair. These chemicals paralyse the lice. The motionless insects must then be removed by washing or combing as they can recover movement in two or three hours.
The medications, however, do not remove all the lice. Only about 20 per cent are susceptible to the commonly used chemicals. The tough survivors mutate, thrive and multiply even in the presence of these chemicals. Higher concentrations offer no greater benefit. Instead, they seep through the skin and may build up to toxic levels. Also, the chemicals cannot be used in pregnant women and children under one. Treatment has to be repeated after 10 days to kill any newly hatched lice before they start to reproduce. Body and pubic lice respond poorly to lotions and shampoos.
In all the three types of lice infestation, relapse, recurrence and re-infection are common. This makes dealing with the parasite both embarrassing and frustrating.
Commercially advertised “herbal” products appear safer than chemicals and gullible sufferers opt for them. A few harmless ingredients like neem and tulasi are mentioned on the package. The rest are not. Their sale and production are not regulated. Their safety is questionable and side effects undocumented.
Lice can be effectively eradicated using an oral dose of 200 µgm/kg body weight of the tablet Ivermectin. It cannot be given to pregnant women or children whose weight is less than 15kg. The medicine acts only on live lice. A repeat dose is required on the eighth day when the eggs hatch.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
YOUR HEALTH
DR GITA MATHAI
A young girl gets lice removed mechanically
Itchy scalp? Scratching in public? And people looking askance at you? The problem could be dandruff or seborrhic dermatitis. Or worse, it could be lice.
Lice (singular: louse) are ectoparasites — that is, they live on the outside. Each insect is about the size of a sesame seed, with six legs and no wings. Human lice cannot survive on other animals such as cats, dogs and birds. They are also specific to the area they infest. They may live on the head (head lice). A slightly different variety lives in the genital area (pubic lice). A third type (body lice) lives only on the body.
School-going children are particularly likely to pick up head lice. In India, 60 per cent of girls in the age group of five to 11 are infested. This is, however, wrongly attributed to poor hygiene and low socioeconomic status. The social stigma attached to lice infestation and accusing letters from school authorities add to the psychological trauma of the child and her parents.
Lice feed on human blood and live for 30 days. If they fall off the body, they can survive on clothes, combs, crash helmets, bed sheets or pillows for two days. Each pair of lice lays about 100 eggs. These characteristics make them a tough species. They have managed to survive unchanged for more than 2,000 years. Archaeologists have found evidence of lice on Egyptian mummies, which are identical to the ones seen today.
The spread of lice occurs only if there is close contact with infested persons or their personal belongings. A louse cannot jump or fly. It has to crawl to its next victim. Once the insect has settled, it immediately starts to bite and feed. Lice release chemicals from their saliva which can cause intense scratching. This introduces bacteria to the skin which may cause secondary infection. The lymph nodes may become enlarged and appear as painful lumps in the neck.
There are many home remedies for lice. Mixtures of oils or ghee are sometimes applied in the hope that it will smother the lice. Others may shampoo frequently, thinking it will drown or wash away the insects. These, however, do not work.
The “lice comb” is a traditional and effective method. The comb may be made of metal, plastic or wood. Combing has to be done every day for two to three months. When the adult lice fall off, they have to be killed. Removing nits with a comb is difficult, tedious, time consuming and somewhat painful. Moreover, the child may not cooperate.
There is another effective method. Often in traditional families, all the members get their heads tonsured under some religious pretext. No hair, no lice.
Many chemicals are known to eradicate lice. Kerosene, for example, is effective when applied to the whole head and left for two or three hours. The head should be tied up securely in a cloth. But the method is dangerous as kerosene is highly inflammable.
Medicated “lice treatment” shampoos and lotions contain malathion, lindane and permethrin and can be applied to the hair. These chemicals paralyse the lice. The motionless insects must then be removed by washing or combing as they can recover movement in two or three hours.
The medications, however, do not remove all the lice. Only about 20 per cent are susceptible to the commonly used chemicals. The tough survivors mutate, thrive and multiply even in the presence of these chemicals. Higher concentrations offer no greater benefit. Instead, they seep through the skin and may build up to toxic levels. Also, the chemicals cannot be used in pregnant women and children under one. Treatment has to be repeated after 10 days to kill any newly hatched lice before they start to reproduce. Body and pubic lice respond poorly to lotions and shampoos.
In all the three types of lice infestation, relapse, recurrence and re-infection are common. This makes dealing with the parasite both embarrassing and frustrating.
Commercially advertised “herbal” products appear safer than chemicals and gullible sufferers opt for them. A few harmless ingredients like neem and tulasi are mentioned on the package. The rest are not. Their sale and production are not regulated. Their safety is questionable and side effects undocumented.
Lice can be effectively eradicated using an oral dose of 200 µgm/kg body weight of the tablet Ivermectin. It cannot be given to pregnant women or children whose weight is less than 15kg. The medicine acts only on live lice. A repeat dose is required on the eighth day when the eggs hatch.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
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