Oraginzers Chennai Marathon
I ran the Chennai half marathon on Sunday 29 August, 2010, as an elite runner and I wished to bring a few points to your notice.
• The starting ceremony with drums and music is alright to keep the 7 km runners entertained but the hard core 21 k runners are anxious to start.
• Along the route the water stops were well staffed and supplied with water. For this I am eternally grateful (Unlike in previous years we did not have to stop in road side shops to buy water).
• The police and ambulances were very prompt efficient and polite
• There was no problem till the finish
Unfortunately, I finished in 3 hours and 32 minutes. That is as per my Garmin watch. It is an acceptable time at around 16 minutes per mile for the 50-60 age group. There were no age categories. When I reached the finish, the red mat to record the time from the computer chip had been removed. I now have only an official half time.
I had a coupon for refreshments but there were none.
I had to fight to get my finishing medal.
I was told there would be an official photo there was no photographer.
I was told to come to your office for my certificate after Sept 6. How can I? I live in Vellore.
Can I at least get my certificate on line?
Monday, August 30, 2010
Friday, August 27, 2010
sportsmanship
Sportsmanship
A couple of years ago the Pakistan cricket team came to India to play. That was when the two countries still had a semblance of civilized behaviour and diplomatic relations.
As the cricketers shook hands with frenzied fans, one of them started bleeding heavily. The fan in a misguided psychotic attempt to let India win, had hidden a razor blade in his palm!
Our commonwealth games 2010 are in shambles. Kalamidi seems to have taken bribes or allowed benami deals by which others took mamool. The infrastructure looks in danger of collapsing. We will be lucky if a wall does not collapse on an athlete or two.
The burning desire to win at all costs descends to petty levels as well. At a recent interclub swimming gala a 58 year old woman was being told, there is no one in your category so you have to swim with the 40-50 age group. (If she swam in her original group, the hosting club would lose points as they did not have a contestant).
After she came 2nd they disqualified her saying “you swam in the wrong age group!”
Again for points!
This is the pervading attitude in India.
To be a participant in the Olympics or in the Common wealth games, you do not necessarily have to be good, just rich and well connected! Stories have been circulating about money that needs to be paid to become a representative in that particular sport at the district, state and country level.
It is doubtful whether they even train or practice properly. Look at our lamentable performance in all athletic spheres!
Finally we seem to have lost all sense of proportion and shame when it comes to siphoning off money. Look at the state of the commonwealth games. Buildings are cracking and everything is being constructed and organized at an overinflated rate.
60 years after independence, our selfishness has risen to the forefront. WE and our first at the cost of our country and national pride.
A couple of years ago the Pakistan cricket team came to India to play. That was when the two countries still had a semblance of civilized behaviour and diplomatic relations.
As the cricketers shook hands with frenzied fans, one of them started bleeding heavily. The fan in a misguided psychotic attempt to let India win, had hidden a razor blade in his palm!
Our commonwealth games 2010 are in shambles. Kalamidi seems to have taken bribes or allowed benami deals by which others took mamool. The infrastructure looks in danger of collapsing. We will be lucky if a wall does not collapse on an athlete or two.
The burning desire to win at all costs descends to petty levels as well. At a recent interclub swimming gala a 58 year old woman was being told, there is no one in your category so you have to swim with the 40-50 age group. (If she swam in her original group, the hosting club would lose points as they did not have a contestant).
After she came 2nd they disqualified her saying “you swam in the wrong age group!”
Again for points!
This is the pervading attitude in India.
To be a participant in the Olympics or in the Common wealth games, you do not necessarily have to be good, just rich and well connected! Stories have been circulating about money that needs to be paid to become a representative in that particular sport at the district, state and country level.
It is doubtful whether they even train or practice properly. Look at our lamentable performance in all athletic spheres!
Finally we seem to have lost all sense of proportion and shame when it comes to siphoning off money. Look at the state of the commonwealth games. Buildings are cracking and everything is being constructed and organized at an overinflated rate.
60 years after independence, our selfishness has risen to the forefront. WE and our first at the cost of our country and national pride.
Monday, August 2, 2010
Run for Charity
Round Table Charity
Charity is laudable –it serves the soul. It makes you feel like a better person and superior to uncharitable peers. So when the Chennai round table organized a run for charity I joined with great gusto. “A Citizen’s run” they said for the school children. (I did not understand what exactly they planned for the school children. The ones that had been brought there for display were barefoot).
I did not realize that is was just a showcase event, deigned for Chennai’s high society to meet and speak to each other in their designer sports wear pulled tightly over concealed corsets , enormous sun glasses and expensive make up.
The school children, who were to receive the charity were assembled in the hot Chennai sun and forced to sit in the mud. They were given free T shirts with the logo of the organization that had contributed money—Nokia, Miot Hospitals and Ford cars.
Some drummers arrived and started to beat their drums so that the procession could start along Marina Beach. Since the T shirt clearly said “run” that is what my daughter and I did. We ran the entire 6 km (my daughter says it is only 5). The barefoot children cut through the barricades and headed for the end point. I don’t blame them. They were barefoot, the sun was hot and we had to stand in queue for the drinking water.
Hot, sweaty and dehydrated, as we reached the turning point we discovered that the organizers had abandoned their posts. We did not quite know where to turn.. There were no flags or indicators.
A few foreigners were brought as show pieces. They hung around and some of them were driven the entire route in a car.
The last straw was at the finish. The organizers, yellow arm bands and other badges of office were clustered around the Quality Walls ice cream van having a good whack.
Charity is good. Runs for charity are good. But why are we making the underfed barefoot recipients earn their money? Why are we overfed physically unfit citizens not doing the “Citizen’s Run” for them?
Charity is laudable –it serves the soul. It makes you feel like a better person and superior to uncharitable peers. So when the Chennai round table organized a run for charity I joined with great gusto. “A Citizen’s run” they said for the school children. (I did not understand what exactly they planned for the school children. The ones that had been brought there for display were barefoot).
I did not realize that is was just a showcase event, deigned for Chennai’s high society to meet and speak to each other in their designer sports wear pulled tightly over concealed corsets , enormous sun glasses and expensive make up.
The school children, who were to receive the charity were assembled in the hot Chennai sun and forced to sit in the mud. They were given free T shirts with the logo of the organization that had contributed money—Nokia, Miot Hospitals and Ford cars.
Some drummers arrived and started to beat their drums so that the procession could start along Marina Beach. Since the T shirt clearly said “run” that is what my daughter and I did. We ran the entire 6 km (my daughter says it is only 5). The barefoot children cut through the barricades and headed for the end point. I don’t blame them. They were barefoot, the sun was hot and we had to stand in queue for the drinking water.
Hot, sweaty and dehydrated, as we reached the turning point we discovered that the organizers had abandoned their posts. We did not quite know where to turn.. There were no flags or indicators.
A few foreigners were brought as show pieces. They hung around and some of them were driven the entire route in a car.
The last straw was at the finish. The organizers, yellow arm bands and other badges of office were clustered around the Quality Walls ice cream van having a good whack.
Charity is good. Runs for charity are good. But why are we making the underfed barefoot recipients earn their money? Why are we overfed physically unfit citizens not doing the “Citizen’s Run” for them?
Run for Charity
Round Table Charity
Charity is laudable –it serves the soul. It makes you feel like a better person and superior to uncharitable peers. So when the Chennai round table organized a run for charity I joined with great gusto. “A Citizen’s run” they said for the school children. (I did not understand what exactly they planned for the school children. The ones that had been brought there for display were barefoot).
I did not realize that is was just a showcase event, deigned for Chennai’s high society to meet and speak to each other in their designer sports wear pulled tightly over concealed corsets , enormous sun glasses and expensive make up.
The school children, who were to receive the charity were assembled in the hot Chennai sun and forced to sit in the mud. They were given free T shirts with the logo of the organization that had contributed money—Nokia, Miot Hospitals and Ford cars.
Some drummers arrived and started to beat their drums so that the procession could start along Marina Beach. Since the T shirt clearly said “run” that is what my daughter and I did. We ran the entire 6 km (my daughter says it is only 5). The barefoot children cut through the barricades and headed for the end point. I don’t blame them. They were barefoot, the sun was hot and we had to stand in queue for the drinking water.
Hot, sweaty and dehydrated, as we reached the turning point we discovered that the organizers had abandoned their posts. We did not quite know where to turn.. There were no flags or indicators.
A few foreigners were brought as show pieces. They hung around and some of them were driven the entire route in a car.
The last straw was at the finish. The organizers, yellow arm bands and other badges of office were clustered around the Quality Walls ice cream van having a good whack.
Charity is good. Runs for charity are good. But why are we making the underfed barefoot recipients earn their money? Why are we overfed physically unfit citizens not doing the “Citizen’s Run” for them?
Charity is laudable –it serves the soul. It makes you feel like a better person and superior to uncharitable peers. So when the Chennai round table organized a run for charity I joined with great gusto. “A Citizen’s run” they said for the school children. (I did not understand what exactly they planned for the school children. The ones that had been brought there for display were barefoot).
I did not realize that is was just a showcase event, deigned for Chennai’s high society to meet and speak to each other in their designer sports wear pulled tightly over concealed corsets , enormous sun glasses and expensive make up.
The school children, who were to receive the charity were assembled in the hot Chennai sun and forced to sit in the mud. They were given free T shirts with the logo of the organization that had contributed money—Nokia, Miot Hospitals and Ford cars.
Some drummers arrived and started to beat their drums so that the procession could start along Marina Beach. Since the T shirt clearly said “run” that is what my daughter and I did. We ran the entire 6 km (my daughter says it is only 5). The barefoot children cut through the barricades and headed for the end point. I don’t blame them. They were barefoot, the sun was hot and we had to stand in queue for the drinking water.
Hot, sweaty and dehydrated, as we reached the turning point we discovered that the organizers had abandoned their posts. We did not quite know where to turn.. There were no flags or indicators.
A few foreigners were brought as show pieces. They hung around and some of them were driven the entire route in a car.
The last straw was at the finish. The organizers, yellow arm bands and other badges of office were clustered around the Quality Walls ice cream van having a good whack.
Charity is good. Runs for charity are good. But why are we making the underfed barefoot recipients earn their money? Why are we overfed physically unfit citizens not doing the “Citizen’s Run” for them?
Friday, June 25, 2010
desi yatra travel to India
Etihad is certainly a good airline. They have a gaggle of ethnically diverse attractive men and women as flight attendants, well trained and obviously poached from other airlines. They have good pilots with smooth take offs and landings.
The one who flew us on EY 268 on June 17 from Abu Dhabi just gave us all the fright of our lives by overshooting Chennai, reaching the Bay of Bengal. Never mind that he took a smooth curve and we landed on the tarmac safely.
The luggage arrived safely and early. On reaching home and opening it, lo and behold, the baggage had been tampered with. Four bottles of perfume had been removed and nothing else. Perhaps I should be grateful I was also carrying a Bose and that was left behind for me to enjoy!
Contacting the airline is difficult. They have a “contact us” website where they promise to get in touch with you shortly but this never materializes. No one gets in touch. They have a call center number where they apologized profusely and asked me to contact “baggage claim” at the airport.
The baggage claim voice was the best of the lot. He just said, If you have left the airport you have no claim and we are not liable.
I am not seeking compensation. Okay so the perfumes are lost but should the airline not realize that some of the large number of mercenary expats they have hired have no pride in their work and no sense of honesty! If things are being stolen from the baggage it must be visible on CCTV!
Airlines have a rule that you cannot carry liquids on the flight. When (like me) your flight originates in Chicago and you have to travel all the way, what alternative is there to putting perfume in the baggage?
No one has replied to my six letters to date. As for the perfumes even the fragrance is now a distant memory
The one who flew us on EY 268 on June 17 from Abu Dhabi just gave us all the fright of our lives by overshooting Chennai, reaching the Bay of Bengal. Never mind that he took a smooth curve and we landed on the tarmac safely.
The luggage arrived safely and early. On reaching home and opening it, lo and behold, the baggage had been tampered with. Four bottles of perfume had been removed and nothing else. Perhaps I should be grateful I was also carrying a Bose and that was left behind for me to enjoy!
Contacting the airline is difficult. They have a “contact us” website where they promise to get in touch with you shortly but this never materializes. No one gets in touch. They have a call center number where they apologized profusely and asked me to contact “baggage claim” at the airport.
The baggage claim voice was the best of the lot. He just said, If you have left the airport you have no claim and we are not liable.
I am not seeking compensation. Okay so the perfumes are lost but should the airline not realize that some of the large number of mercenary expats they have hired have no pride in their work and no sense of honesty! If things are being stolen from the baggage it must be visible on CCTV!
Airlines have a rule that you cannot carry liquids on the flight. When (like me) your flight originates in Chicago and you have to travel all the way, what alternative is there to putting perfume in the baggage?
No one has replied to my six letters to date. As for the perfumes even the fragrance is now a distant memory
Sunday, June 20, 2010
vomiting in pregnancy
Morning sickness, all day long
YOUR HEALTH
DR GITA MATHAI
Pregnancy sometimes causes nausea and vomiting. It is dismissed as normal morning sickness. In some cultures, vomiting is actually taken as proof of pregnancy.
Morning sickness, however, is not necessarily confined to the morning, though 80 per cent of pregnant women fall in this category. It can occur at any time of the day or night. The remaining 20 per cent of the women may show other signs of pregnancy such as eating ravenously.
Vomiting usually starts around the sixth week — around two weeks after the period is missed. It settles around the twelfth week, and then disappears around the fifth month. Any strong smell can precipitate waves of nausea — be it garbage or spices being fried in the kitchen.
Baffled scientists put forward many theories to explain this strange phenomenon. It was touted as an unconscious rejection of the pregnancy. Women were unsympathetically told to “control themselves”. Some blamed it on the hormonal changes during the period, which causes relaxation of the smooth muscles of the oesophagus and gall bladder and slows digestion.
Scientists have now discovered that the nausea is due to sensitivity to a hormone called HCG (human chorionic gonadotrophin). The vomiting coincides with peak levels of this hormone (six to 12 weeks).
The sensitivity varies and is genetically determined. Women who vomit during pregnancy often have mothers and sisters who had the same problem. It also tends to recur in each succeeding pregnancy, though, if the tolerance levels to HCG build up, the vomiting in the second pregnancy can be less than that in the first.
Excessive vomiting causes 1 per cent of the women who vomit to become morbidly ill. They lose 5 per cent or more of their pre-pregnancy weight. The violent retching can cause tears in the esophagus, resulting in blood in the vomit. The inability to retain any food in the stomach can result in dehydration severe enough to affect the kidneys. Blood may begin to clot in the veins. The brain may be affected as a result of electrolyte imbalance or dehydration. Loss of vitamins, particularly thiamine, may cause delirium.
This severe vomiting is also known as hyperemesis gravidarum (in Latin, gravid means pregnant, and hyper is excessive). It is more likely in younger women who are underweight before the pregnancy, pre-diabetic (abnormal GTT values) or have migraine headaches.
Persistent hyperemesis can be a danger signal. It can occur if the levels of HCG are higher than normal. This occurs when it is a twin pregnancy or if the baby has a chromosomal abnormality like trisomy 18 or 21. Or, it may not be a pregnancy at all but a tumour called hydatidiform mole that mimics pregnancy. An ultrasound examination at this stage will pick up all the above abnormalities.
Well meaning advice to tackle morning sickness with bed rest is counterproductive. The reclining position may further aggravate reflux from the stomach. Moreover, inactivity may lead to loss of muscle mass. This may make it difficult to withstand the rigours of labour and childbirth.
• To tackle morning sickness, consider the following.
• A good diet with adequate vitamins, particularly folic acid.
• Exposure to fresh air. Try going for a walk outdoor for half an hour in the morning and evening.
• Eat several small meals instead of three regular ones.
• Avoid anything that triggers the vomiting even if it touted as being “good for the baby”.
Ginger helps as lozenges, ginger tea or lime juice. Supplements are available but since the other additives in the capsules are not known, it is probably better and safer to use the natural product.
Peppermint can be sucked as lozenges or peppermint oil used as inhalations.
Try acupressure. The pressure point to reduce nausea is located in the middle of the inner wrist, three finger-breadths away from the crease and between the two tendons. Locate and press firmly, one wrist at a time for three minutes.
Despite this, if uncontrollable vomiting occurs, with aversion to food, loss of weight, dark coloured urine, loss of consciousness, headache, confusion or fainting, it is better to seek medical help. Hyperemesis can be fatal.
An initial evaluation will rule out a correctable cause like a urinary tract infection, acid dyspepsia, chromosomal abnormalities or a hydatidiform mole. Intravenous fluids (IV) can be given to restore hydration, electrolytes, vitamins and nutrients.
If anti-nausea medications are used, the danger to the baby has to be weighed against the risk to the mother. Strict medical supervision and documentation of the dose and duration of treatment are required.
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
Pregnancy sometimes causes nausea and vomiting. It is dismissed as normal morning sickness. In some cultures, vomiting is actually taken as proof of pregnancy.
Morning sickness, however, is not necessarily confined to the morning, though 80 per cent of pregnant women fall in this category. It can occur at any time of the day or night. The remaining 20 per cent of the women may show other signs of pregnancy such as eating ravenously.
Vomiting usually starts around the sixth week — around two weeks after the period is missed. It settles around the twelfth week, and then disappears around the fifth month. Any strong smell can precipitate waves of nausea — be it garbage or spices being fried in the kitchen.
Baffled scientists put forward many theories to explain this strange phenomenon. It was touted as an unconscious rejection of the pregnancy. Women were unsympathetically told to “control themselves”. Some blamed it on the hormonal changes during the period, which causes relaxation of the smooth muscles of the oesophagus and gall bladder and slows digestion.
Scientists have now discovered that the nausea is due to sensitivity to a hormone called HCG (human chorionic gonadotrophin). The vomiting coincides with peak levels of this hormone (six to 12 weeks).
The sensitivity varies and is genetically determined. Women who vomit during pregnancy often have mothers and sisters who had the same problem. It also tends to recur in each succeeding pregnancy, though, if the tolerance levels to HCG build up, the vomiting in the second pregnancy can be less than that in the first.
Excessive vomiting causes 1 per cent of the women who vomit to become morbidly ill. They lose 5 per cent or more of their pre-pregnancy weight. The violent retching can cause tears in the esophagus, resulting in blood in the vomit. The inability to retain any food in the stomach can result in dehydration severe enough to affect the kidneys. Blood may begin to clot in the veins. The brain may be affected as a result of electrolyte imbalance or dehydration. Loss of vitamins, particularly thiamine, may cause delirium.
This severe vomiting is also known as hyperemesis gravidarum (in Latin, gravid means pregnant, and hyper is excessive). It is more likely in younger women who are underweight before the pregnancy, pre-diabetic (abnormal GTT values) or have migraine headaches.
Persistent hyperemesis can be a danger signal. It can occur if the levels of HCG are higher than normal. This occurs when it is a twin pregnancy or if the baby has a chromosomal abnormality like trisomy 18 or 21. Or, it may not be a pregnancy at all but a tumour called hydatidiform mole that mimics pregnancy. An ultrasound examination at this stage will pick up all the above abnormalities.
Well meaning advice to tackle morning sickness with bed rest is counterproductive. The reclining position may further aggravate reflux from the stomach. Moreover, inactivity may lead to loss of muscle mass. This may make it difficult to withstand the rigours of labour and childbirth.
• To tackle morning sickness, consider the following.
• A good diet with adequate vitamins, particularly folic acid.
• Exposure to fresh air. Try going for a walk outdoor for half an hour in the morning and evening.
• Eat several small meals instead of three regular ones.
• Avoid anything that triggers the vomiting even if it touted as being “good for the baby”.
Ginger helps as lozenges, ginger tea or lime juice. Supplements are available but since the other additives in the capsules are not known, it is probably better and safer to use the natural product.
Peppermint can be sucked as lozenges or peppermint oil used as inhalations.
Try acupressure. The pressure point to reduce nausea is located in the middle of the inner wrist, three finger-breadths away from the crease and between the two tendons. Locate and press firmly, one wrist at a time for three minutes.
Despite this, if uncontrollable vomiting occurs, with aversion to food, loss of weight, dark coloured urine, loss of consciousness, headache, confusion or fainting, it is better to seek medical help. Hyperemesis can be fatal.
An initial evaluation will rule out a correctable cause like a urinary tract infection, acid dyspepsia, chromosomal abnormalities or a hydatidiform mole. Intravenous fluids (IV) can be given to restore hydration, electrolytes, vitamins and nutrients.
If anti-nausea medications are used, the danger to the baby has to be weighed against the risk to the mother. Strict medical supervision and documentation of the dose and duration of treatment are required.
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
turning yellow
Jaundice
““Kamale” say the elders friends and relatives. After making this unsubstantiated diagnosis of jaundice, based on perhaps the patient’s yellow eyes, home remedies are tried. Food without oil, salt or protein is force fed along with goats milk and ground leaves of the keengasnellai plant.
“Don’t go to the doctor” advice well wishers , “they have no treatment for jaundice in English medicine”
The word jaundice is a corrupted form of “Jaune, ” a word coined by French physicians in the 19th century. Even at that time physicians noticed that all jaundice was not the same. The progress of the disease varied in different individuals. Many recovered completely, others bloated, some wasted away and a few died.
This difference in outcome is not based on fate. It occurs because all jaundice is not the same. jaundice is not a diagnosis in itself but a symptom seen in many disease processes .Today jaundice is evaluated with laboratory tests on the blood and urine and ultrasound and other scans. This way the diagnosis is accurate.
Not all people who appear yellow are jaundiced. Sometimes the normal skin colour appears yellow under fluorescent lighting. There may be an excess of yellow carotene pigment deposited in the skin as a result of consumption of orange-yellow fruits and vegetables like papayas and carrots. Fat deposits under the sclera of the eye or excessive exposure to dust can give dark skinned individuals a “muddy sclera” and a false “jaundiced” look.
The yellow colour in real jaundice is actually due to staining of the eyes and skin by the deposition of a pigment called bilirubin. If bilirubin is also excreted in excess, there is an obvious colour change in the urine and sweat as well.
Bilirubin is a pigment produced naturally when old red blood cells are broken down in the spleen and liver .It is then metabolized in the liver and excreted. The human eye can discern the yellow colour imparted by bilirubin when the level is three times normal or
> 3mg/dl in the blood.
If the number of red blood cells destroyed is greater than normal, the liver is unable to cope with the overload of pigment and the person becomes jaundiced.. This occurs in some hereditary blood disorders like thalassaemia, sickle cell disease. It may be due to an infection like malaria, or a drug reaction.
Even eating mouldy raw peanuts can cause jaundice because they contain aflotoxin which is toxic to liver cells.
Sometimes, the liver cells themselves are defective and unable to cope with the normal amount of bilirubin produced in the body. This occurs in certain hereditary conditions. Several members of a family are affected, the jaundice is mild and fluctuating, and it is not fatal.
Immaturity of the liver cells in a newborn, or a mother- baby blood group incompatibility (Rh or ABO) can cause a self limited treatable jaundice in the new born.
Some viral infections like that caused by the hepatitis viruses A,B C D, E, herpes virus, leptospirosis or cytomegalovirus can cause a temporary dysfunction of the liver cell enzymes and jaundice.
Alcohol is poisonous to the liver cells. Drinking regularly for many years can damage the liver can resulting in jaundice.
The drainage of the bilirubin from the liver may be prevented if the liver ducts are blocked by stones, strictures and cancer deposits. Even if the bilitrubin is formed and excreted at the normal rate by the liver, it cannot drain out.
All jaundice is not the same and cannot be treated alike. Before embarking on a course of treatment, it is advisable to obtain a precise documented diagnosis after proper evaluation with blood and urine tests from a qualified medical person.
80 % of the jaundice in young adults is due to hepatitis A. It is self limited and recovers spontaneously without treatment in a few weeks. Quackery and miracle cures are therefore widely publicized. Any treatment logical or illogical, or for a pure profit motive, with IV fluids, glucose drips and herbs, is sure to succeed.
Hepatitis A and B are preventable diseases. Vaccination against hepatitis B is offered in a 3 dose schedule before the age of 1 year. Hepatitis A vaccines are a given after the age of 2 years in a 2 dose schedule. If Injections are missed in childhood, they can be taken later at any age.
Newer curative treatments with antiviral medications, interferon and liver transplants are available for Hepatitis B and C infections. Specific medicines are available for herpes infections, leptospirosis and cytomegalovirus infections.
Recovery will be complete in secondary jaundice once the causative factor is removed. Abstaining from alcohol and discontinuing offending drugs may reverse jaundice. If a correctable obstruction is seen on scanning or laparoscopy, surgical treatment provides relief.
Jaundice requires appropriate treatment depending on the diagnosis. If this is delayed through ignorance or fear, the severity of the illness may increase or even be fatal.
Unfortunately many people still self diagnose jaundice and opt for naturopathy from unqualified practitioners. A “hit or miss” approach is alright for sports and games, not for medical conditions affecting human lives.
Dr. Gita Mathai
The writer is a paediatrician with a family practice at Vellore.
If you have any questions on health issues please write to
yourhealthgm@yahoo.co.in
““Kamale” say the elders friends and relatives. After making this unsubstantiated diagnosis of jaundice, based on perhaps the patient’s yellow eyes, home remedies are tried. Food without oil, salt or protein is force fed along with goats milk and ground leaves of the keengasnellai plant.
“Don’t go to the doctor” advice well wishers , “they have no treatment for jaundice in English medicine”
The word jaundice is a corrupted form of “Jaune, ” a word coined by French physicians in the 19th century. Even at that time physicians noticed that all jaundice was not the same. The progress of the disease varied in different individuals. Many recovered completely, others bloated, some wasted away and a few died.
This difference in outcome is not based on fate. It occurs because all jaundice is not the same. jaundice is not a diagnosis in itself but a symptom seen in many disease processes .Today jaundice is evaluated with laboratory tests on the blood and urine and ultrasound and other scans. This way the diagnosis is accurate.
Not all people who appear yellow are jaundiced. Sometimes the normal skin colour appears yellow under fluorescent lighting. There may be an excess of yellow carotene pigment deposited in the skin as a result of consumption of orange-yellow fruits and vegetables like papayas and carrots. Fat deposits under the sclera of the eye or excessive exposure to dust can give dark skinned individuals a “muddy sclera” and a false “jaundiced” look.
The yellow colour in real jaundice is actually due to staining of the eyes and skin by the deposition of a pigment called bilirubin. If bilirubin is also excreted in excess, there is an obvious colour change in the urine and sweat as well.
Bilirubin is a pigment produced naturally when old red blood cells are broken down in the spleen and liver .It is then metabolized in the liver and excreted. The human eye can discern the yellow colour imparted by bilirubin when the level is three times normal or
> 3mg/dl in the blood.
If the number of red blood cells destroyed is greater than normal, the liver is unable to cope with the overload of pigment and the person becomes jaundiced.. This occurs in some hereditary blood disorders like thalassaemia, sickle cell disease. It may be due to an infection like malaria, or a drug reaction.
Even eating mouldy raw peanuts can cause jaundice because they contain aflotoxin which is toxic to liver cells.
Sometimes, the liver cells themselves are defective and unable to cope with the normal amount of bilirubin produced in the body. This occurs in certain hereditary conditions. Several members of a family are affected, the jaundice is mild and fluctuating, and it is not fatal.
Immaturity of the liver cells in a newborn, or a mother- baby blood group incompatibility (Rh or ABO) can cause a self limited treatable jaundice in the new born.
Some viral infections like that caused by the hepatitis viruses A,B C D, E, herpes virus, leptospirosis or cytomegalovirus can cause a temporary dysfunction of the liver cell enzymes and jaundice.
Alcohol is poisonous to the liver cells. Drinking regularly for many years can damage the liver can resulting in jaundice.
The drainage of the bilirubin from the liver may be prevented if the liver ducts are blocked by stones, strictures and cancer deposits. Even if the bilitrubin is formed and excreted at the normal rate by the liver, it cannot drain out.
All jaundice is not the same and cannot be treated alike. Before embarking on a course of treatment, it is advisable to obtain a precise documented diagnosis after proper evaluation with blood and urine tests from a qualified medical person.
80 % of the jaundice in young adults is due to hepatitis A. It is self limited and recovers spontaneously without treatment in a few weeks. Quackery and miracle cures are therefore widely publicized. Any treatment logical or illogical, or for a pure profit motive, with IV fluids, glucose drips and herbs, is sure to succeed.
Hepatitis A and B are preventable diseases. Vaccination against hepatitis B is offered in a 3 dose schedule before the age of 1 year. Hepatitis A vaccines are a given after the age of 2 years in a 2 dose schedule. If Injections are missed in childhood, they can be taken later at any age.
Newer curative treatments with antiviral medications, interferon and liver transplants are available for Hepatitis B and C infections. Specific medicines are available for herpes infections, leptospirosis and cytomegalovirus infections.
Recovery will be complete in secondary jaundice once the causative factor is removed. Abstaining from alcohol and discontinuing offending drugs may reverse jaundice. If a correctable obstruction is seen on scanning or laparoscopy, surgical treatment provides relief.
Jaundice requires appropriate treatment depending on the diagnosis. If this is delayed through ignorance or fear, the severity of the illness may increase or even be fatal.
Unfortunately many people still self diagnose jaundice and opt for naturopathy from unqualified practitioners. A “hit or miss” approach is alright for sports and games, not for medical conditions affecting human lives.
Dr. Gita Mathai
The writer is a paediatrician with a family practice at Vellore.
If you have any questions on health issues please write to
yourhealthgm@yahoo.co.in
Friday, June 11, 2010
travel India style
Desi Yatra
Sitting cooped up in a plane for 22 hours—it does something to the soul. You tend to bond –with the person sitting next to you. Not that these friendships last—Usually after exchanging cell numbers, visiting cards and promising “to catch up later,” everyone just goes their separate ways.
Sometimes people are useful. Like the man sitting next to me en route Chennai- Abu Dhabhi- Chicago- Cedar Rapids. He watched my luggage, he gave me his snacks, he prayed all the way that we would not fall into the desert or the ocean. He actually prayed for both of us. It went “All merciful God let the two of us be saved if this plane crashes.”
That was when it struck me—I was seated near the window. Unless I too was saved he would have a tough time!
When the food came around he complained “this is not vegetarian.” Despite assurances from the hostess he refused to eat.
This did not prevent him from slipping the cutlery (steel) into his cloth bag. There was a fork knife and spoon. How do you explain that --
There was no need to steal the cutlery. His son had been in the USA for 6 years—he probably had his own. The airlines are very strict about (deadly weapons). I did not think they were going to look kindly on forks and knives!
My earphones were not working. I considered returning them but the hostess was too far away. I started to search in my bag for my personal phones.
“Here take mine,” he said “I don’t watch movie”.
I accepted with gratitude.
When the flight was over the airhostess came around collecting the earphones. I gave his phones back to him and returned mine.
“Oh” he said to the airhostess, “I did not get one.” After she was safely gone, he stuffed the crappy two pin airline earphones into his voluminous cloth bag.
Finally as we were waiting for immigration he said , “I have brought some Alphonso mangoes for my son. They are very expensive.”
“But,” I said, “we just signed a declaration that we have no vegetables or fruits with us!”
“Arre” he said “adjust karega”.
At that point, in a very cowardly fashion I distanced myself from him. Fortunately the officer directed me to a different line.
The last I saw of him, he was being led off by two uniformed officials with his cloth bag into a separate room.
Wonder if he ever did make it to his son’s house!
Gita Mathai
Sitting cooped up in a plane for 22 hours—it does something to the soul. You tend to bond –with the person sitting next to you. Not that these friendships last—Usually after exchanging cell numbers, visiting cards and promising “to catch up later,” everyone just goes their separate ways.
Sometimes people are useful. Like the man sitting next to me en route Chennai- Abu Dhabhi- Chicago- Cedar Rapids. He watched my luggage, he gave me his snacks, he prayed all the way that we would not fall into the desert or the ocean. He actually prayed for both of us. It went “All merciful God let the two of us be saved if this plane crashes.”
That was when it struck me—I was seated near the window. Unless I too was saved he would have a tough time!
When the food came around he complained “this is not vegetarian.” Despite assurances from the hostess he refused to eat.
This did not prevent him from slipping the cutlery (steel) into his cloth bag. There was a fork knife and spoon. How do you explain that --
There was no need to steal the cutlery. His son had been in the USA for 6 years—he probably had his own. The airlines are very strict about (deadly weapons). I did not think they were going to look kindly on forks and knives!
My earphones were not working. I considered returning them but the hostess was too far away. I started to search in my bag for my personal phones.
“Here take mine,” he said “I don’t watch movie”.
I accepted with gratitude.
When the flight was over the airhostess came around collecting the earphones. I gave his phones back to him and returned mine.
“Oh” he said to the airhostess, “I did not get one.” After she was safely gone, he stuffed the crappy two pin airline earphones into his voluminous cloth bag.
Finally as we were waiting for immigration he said , “I have brought some Alphonso mangoes for my son. They are very expensive.”
“But,” I said, “we just signed a declaration that we have no vegetables or fruits with us!”
“Arre” he said “adjust karega”.
At that point, in a very cowardly fashion I distanced myself from him. Fortunately the officer directed me to a different line.
The last I saw of him, he was being led off by two uniformed officials with his cloth bag into a separate room.
Wonder if he ever did make it to his son’s house!
Gita Mathai
Monday, June 7, 2010
dog walkers and the stray dog menace
The world is full of dog lovers and our college campus is no exception. The unreasonable overwhelming love some people feel for their 4 footed friends can get a bit trying sometimes.
There has been a population explosion and the whole area is filled with packs of stray dogs. The plus point is that they run away (even when they are in a dangerous looking pack) if you clap your hands hard enough or wave a stick at them.
One of my friends found the ideal solution. He keeps a can of Morten cockroach and pesticide spray in his pocket , a real pocket sized can. “Don’t worry,” he said “it is an insecticide. Since dogs are large, and not insects, nothing happens to them. They don’t like the smell so they run away.”
Personally I have not tried it.
We have a resident “Blue Cross” brigade. They do not allow you to do anything other than clap your hands at the dogs. Many residents were furious, there was yowling and barking at ungodly hours and then the pack descending on you when you went for a walk."We will sterilize all the stray dogs" they said.
This solution was a total disaster. The vet refused to sterilize more than five a week and he wanted to be paid per dog. He had obviously not realized that each litter had at least six dogs. Budget cuts soon put a dampener on his services and the project. He was not altruistic.
Their idea of another solution was to go to the physiology department and let the experimental dogs loose. Many had their pancreas removed to make them diabetic and were on insulin. How long they would last disconnected from their insulin pump is a moot question. But the activists did not really care.
The residents and their pets add to the problem. Many are too lazy to take their dog for a walk. A Doberman owner just lets it loose at 5 am. “There is no one around at that time,” he said “my dog is a free spirit” he likes to run loose.”
Perhaps, but what of other free spirits who like to jog at that time to get to work on time?
It is really difficult to obtain justice. Our Doberman owner is also the administer in charge of campus security and dogs.
Then there is the crazy surgeon whose dog conveniently escapes every morning . “She’s just friendly” was his constant refrain, till she took a bite out of a biking professor’s leg!
Meanwhile the Doberman just ran away. He must have been tired of the loveless family in which he lived. Not willing to leave well enough alone, they got another dog a beautiful Labrador. She “needs to know her place” said the administrator. So she spends all day tied to a leash at the kitchen door. If she escapes or manages to chew through the leash, heaven help all the pedestrians.
All this is peanuts compared to adventures with the resident Rottweiler. “He is very different from others of his kind. He is very gentle. After attacking a couple of kids that thought has been put to rest.
Why can’t people obey rules? The campus rules on pets are very clear. Pets must be leashed at all times when outside the house. They are not expected to “run around” as “free spirits!”
I thought an inability to obey was a very Indian phenomenon. That was until I came to the USA and went to watch a marathon.
The sign stated very clearly “Do not use collapsible chairs to sit on as the emergency services vehicles have to move on the side of the road. No pets are allowed.
Half the spectators were on deck chairs holding leashed slobbering dogs of all shapes and sizes.
The loudspeaker announcements went over everyone’s head. A man actually came with a megaphone and yelled at everyone. People moved a bit but then returned to their original spots and positions.
As for the dogs—they were not going anywhere!
There has been a homogenization of the human race and the animal population. People are globetrotting for jobs and to live. All international borders seem to be artificial boundaries.And they are taking their dog rearing practices with them.
Or perhaps it is just the psyche of dog lovers.
Viva la dogs viva les humans!
There has been a population explosion and the whole area is filled with packs of stray dogs. The plus point is that they run away (even when they are in a dangerous looking pack) if you clap your hands hard enough or wave a stick at them.
One of my friends found the ideal solution. He keeps a can of Morten cockroach and pesticide spray in his pocket , a real pocket sized can. “Don’t worry,” he said “it is an insecticide. Since dogs are large, and not insects, nothing happens to them. They don’t like the smell so they run away.”
Personally I have not tried it.
We have a resident “Blue Cross” brigade. They do not allow you to do anything other than clap your hands at the dogs. Many residents were furious, there was yowling and barking at ungodly hours and then the pack descending on you when you went for a walk."We will sterilize all the stray dogs" they said.
This solution was a total disaster. The vet refused to sterilize more than five a week and he wanted to be paid per dog. He had obviously not realized that each litter had at least six dogs. Budget cuts soon put a dampener on his services and the project. He was not altruistic.
Their idea of another solution was to go to the physiology department and let the experimental dogs loose. Many had their pancreas removed to make them diabetic and were on insulin. How long they would last disconnected from their insulin pump is a moot question. But the activists did not really care.
The residents and their pets add to the problem. Many are too lazy to take their dog for a walk. A Doberman owner just lets it loose at 5 am. “There is no one around at that time,” he said “my dog is a free spirit” he likes to run loose.”
Perhaps, but what of other free spirits who like to jog at that time to get to work on time?
It is really difficult to obtain justice. Our Doberman owner is also the administer in charge of campus security and dogs.
Then there is the crazy surgeon whose dog conveniently escapes every morning . “She’s just friendly” was his constant refrain, till she took a bite out of a biking professor’s leg!
Meanwhile the Doberman just ran away. He must have been tired of the loveless family in which he lived. Not willing to leave well enough alone, they got another dog a beautiful Labrador. She “needs to know her place” said the administrator. So she spends all day tied to a leash at the kitchen door. If she escapes or manages to chew through the leash, heaven help all the pedestrians.
All this is peanuts compared to adventures with the resident Rottweiler. “He is very different from others of his kind. He is very gentle. After attacking a couple of kids that thought has been put to rest.
Why can’t people obey rules? The campus rules on pets are very clear. Pets must be leashed at all times when outside the house. They are not expected to “run around” as “free spirits!”
I thought an inability to obey was a very Indian phenomenon. That was until I came to the USA and went to watch a marathon.
The sign stated very clearly “Do not use collapsible chairs to sit on as the emergency services vehicles have to move on the side of the road. No pets are allowed.
Half the spectators were on deck chairs holding leashed slobbering dogs of all shapes and sizes.
The loudspeaker announcements went over everyone’s head. A man actually came with a megaphone and yelled at everyone. People moved a bit but then returned to their original spots and positions.
As for the dogs—they were not going anywhere!
There has been a homogenization of the human race and the animal population. People are globetrotting for jobs and to live. All international borders seem to be artificial boundaries.And they are taking their dog rearing practices with them.
Or perhaps it is just the psyche of dog lovers.
Viva la dogs viva les humans!
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