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| Friday, 16 April 2004 |
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Curtain raiser on western medicine
To what extent western (allopathic) medicine has gone traditional is revealed in an article published in the Essential Drug Monitor issue No. 20, a copy of which has been sent to us by one of our readers from Colombo. In this article - Linking Traditional & Modern Medicine, by Norman R. Fernsworth, Christopher Beecher and Harry H.S. Fong it is stated, The Traditional Absorption "The therapeutic value of some 200-250 of the world's higher plants has been sufficiently demonstrated scientifically to warrant their inclusion in allopathic (western) medicine. "Virtually all such plants have been "discovered" through information derived from their use in traditional medicine". As you can see from this para, the Western drug Monitor does not hesitate to acknowledge publicly and with gratitude how much the eastern system owes in its healing therapy to the age old traditional therapies, which some of us in our own countries tend to disregard and even look down upon. We reproduce the article here for your enlightenment. Linking traditional and modern medicine Who estimates that up to 80 per cent of people in developing countries rely at some time on indigenous traditional medicine to meet their health care needs, and it can be assumed that a major part of traditional therapy involves the use of plant extracts. Of the conservatively estimated 250,000 species of higher (flowering) plants that exist on earth, perhaps at least 20 per cent have been employed in traditional medicine. The effectiveness of these medicinal plants is due to the presence of one or more biologically active chemical constituents, although it abstract services. Around 600 scientific articles per month are added to the Napralert relational data-structure. The system can be used in a number of ways, ranging from simple retrieval of information to complex problem solving can be assumed that the placebo effect sometimes contributes to the success of such therapy. The therapeutic value of some 200-250 of the world's higher plants has been sufficiently demonstrated scientifically to warrant their inclusion in allopathic (Western) medicine. Virtually all such plants have been "discovered" through information derived from their use in traditional medicine. Future systematic studies of plants with validated traditional uses will undoubtedly produce additional drugs. The scientific validation of medicinal plants for inclusion into primary health care systems is a very worthwhile, but monumental task. As a starting point, it is logical to draw on the vast published literature on the pharmacological evaluations of plant extracts. A combination of information indicating that a specific plant has been used in an indigenous health care system for centuries, together with efficacy and toxicity data published by several groups of scientists, provides a promising correlation to justify further investigation. Napralert, a computerized database housed in the WHO Collaborating Centre for Traditional Medicine, College of Pharmacy, University of Illinois at Chicago, is increasingly used for such studies. Napralert, an acronym for Natural Products alert, is a unique database of world literature on the chemical constituents and pharmacology of plant, microbial and animal (primarily marine) extracts. In addition, considerable data on the chemistry and pharmacology (including human studies) of secondary metabolites of known structure, derived from natural sources, are stored in this system. Data are obtained from some 700 scientific journals and several abstract services. Applications of the NAPRALERT database to traditional medicine The most common types of information requested from NAPRALERT are ethnomedical data; results of biological tests carried out on extracts of plant, microbes or animals; and secondary chemical constituents reported to be present in plants, microbes or animals. These are collectively referred to as the "NAPRALERT 3-PART PROFILE". Other types of data available Citations containing information on almost any subject concerning natural products can be retrieved, or a list of organisms involved in the search parameter can be provided, together with a bibliography. Other types of profiles can be generated based on the interests and needs of the user. Verifying rational use An important practical application of the NAPRALERT database, is analysis of data to determine or verify the rational use of specific medicinal plants in various traditional medical systems. One example was an analysis of published experimental data on plant extracts prepared from 248 plants used in traditional Chinese medicine, as described in a book intended for use by the "barefoot doctors" in the Beijing area. To evaluate potential effectiveness, it was important to determine whether one or more components of the prescription had a valid pharmacological basis of action. Modern drug development In the discovery and development of drugs from natural sources, a major approach is to examine traditional uses. Its value was demonstrated in a study to determine the correlation between plant use in traditional medicine and derived drugs in modern (western) Medicine. The pharmacological actions of 119 chemical compounds were compared to the traditional medical uses of the plants from which they were derived. Of the 119 plant derived drugs (chemicals) analysed 88 (74 per cent) had a direct or indirect correlation to the ethnomedical uses of their source material. ############### Expectancy diet In an article to this page on - do's and don't for expectant mothers Dr. P. A. Denagama Obstetrician and Gynaecologist, General Hospital, Trincomalee advice them to be diet specific in the first 11 weeks, and with regard to medicine, only take the very essentials as certain multi-vitamins and fortified food could be harmful to the baby. Only the essential drugs should be used during this initial 11 weeks of the last period. Certain vitamins included in multivitamins and fortified food drinks may be harmful to the baby during the first 11 weeks. Vitamins of B family and vitamin C may be taken freely. Iron preparations are better avoided during this period. If the mother is still feeding the baby she should be using Calcium tablets. Diet is very important when you are expecting. In almost all circumstances the diet taken by the pregnant woman should be a balanced diet. Balanced diet consists of all the accepted constituents of diet - carbohydrates, proteins, oils and fat, vitamins and minerals. Cereals such as rice, flour based food like rotty, bread etc, yams and potatoes all are carbohydrates. Protein is supplied by eggs, milk, meat, fish, Soya, dhal, beans etc. Fruits contain vitamins and minerals. It has been shown that diets which predominantly consist only of one of the required constituents lead to ill health of the baby. Mothers who predominantly ate only proteins faced poor growth of the baby. For the mothers who have been suffering from high blood pressure, or diabetes there is no special diet other than the balanced diet, but mothers suffering from diabetes are advised not to take anything sweet to the tongue other than a small amount of fruit. On the other hand, mothers suffering from kidney failure are expected to stick to the renal failure diet. (This type of diet was first started in Sri Lanka in 1997 in G.H. Anuradhapura by the author). Since three months of missing periods, mothers are advised to be on Calcium and Iron tablets along with folic acid and vitamin C. Calcium should ideally be taken in the morning and the iron tablet with folic acid and vitamin C at night. Mothers should be careful-enough not to take capsules which contain both iron and calcium together. On the contrary, you can opt for a single capsule that contains iron, folic acid and vitamin C. Physical exertion Pregnant women should be conscious about the desirable extent of physical exertion that they can make. The newly conceived baby is moved from the Fallopian tube to the uterus only by about 7 to 10 days of conception. In the uterus the conception gets fixed on to the inner surface by this time. So there is some chance of getting a pregnancy disturbed by vigorous movements until a lady just misses her periods. On the other hand, there is only a very much remote chance for getting a pregnancy disturbed by vigorous body movements after missing her due periods. The only possibility how such movements might disturb an established pregnancy is as follows. During exercises the blood flow is directed predominantly to the muscles. This leads to a relative reduction of blood supply to the uterus depriving the baby of its due blood supply. The common understanding about travelling in pregnancy is that it should be as much as possible avoided during the first and the last three months of pregnancy. In fact, when long distance travelling is done during the last one or two months of pregnancy the force applied on the mouth (cervix) of the uterus might lead to the onset of labour pains well before the expected date of delivery. If there is an inevitable journey to be made it is best done lying fully flat turned on to the left side. Sexual relationships With regard to the sexual relationships, it is recommended only during the middle three months of pregnancy. The reasons behind this kind of a recommendation are as follows. The mouth of the uterus is usually closed by a plug of mucous to avoid the ascend of germs into the abdomen through the uterus and Fallopian tubes. In pregnancy, the hormonal environment may render the mucous plug of uterus loose leading to the possibility of ascending infection. During the first three months of pregnancy, the baby is too tender to withstand an infection. Seminal fluid contains certain chemicals which might induce uterine contractions leading to earlier onset of labour during the last month of pregnancy. Safety of the baby Whenever a woman is expecting or is exposed to unprotected sexual intercourse, until the pregnancy is confirmed it should be assumed that she is pregnant. In other words she should make sure the safety of the baby. Now we will consider how and when the pregnancy can be confirmed. The traditional urine test becomes positive at 42 days of the last menstrual period. Now there are urine tests which are more sensitive and hence the test becomes positive just as she misses her period. There are some tests done on blood which become positive by about 7 to ten days of conception. Usually the conception occurs two weeks after the first day of the last menstrual period. Hence when the lady just misses her due periods, it is only two weeks to the nascent baby. Normally a woman waits for another one week before she suspects pregnancy. This shows that during the first three weeks after the conception, there is not much protection to the baby by the mother. This vulnerable period is governed by a wonderful regulation of nature in which the baby responds peculiarly to any insult within the first three weeks of conception. During this period the conception is either totally destroyed or does not undergo any change in response to an insult. In fact, the folic acid deficiency affects the baby from 21st to about 28th days of conception and that is why any lady having unprotected relationships is advised to be regularly on folic acid. The rapid growth and development of the baby occurs until it is 8 to 9 weeks of the conception. This is the most vulnerable period for the occurrence of abnormalities in it. So up to about 10 to 11 weeks from the first day of the last menstrual period, the mother has to take folic acid, stick to a natural and balanced diet and to avoid drugs and chemicals as much as possible. Ultrasound scanning is very much helpful to determine the expected date of delivery, if it is done within the first three months of the first day of last period. One important point to be pondered here is that mostly the ultrasound scan machines are kept in radiology departments where there may be at least some radiation hazard to the baby. So in general I believe ultrasound scanning is better postponed until it is 11 weeks since the last period. This understanding should not delay any prescribed ultrasound scanning done on emergency basis. Folic acid Within the first three months of conception, the mother should be using folic acid only. Moreover she should be careful to avoid any damage to the conception by avoiding chemicals, infections and any radiation. Parboiled rice manufactured in warm areas is reported to contain a toxic chemical called Aflatoxin. There were recent reports that white rice is dyed brownish red with non-permitted non-health friendly dyes. Vegetables harvested soon after the application of insecticides may be available in the market until the farmers or the authorities make sure of toxic chemical-free vegetables. As consumers you should wash vegetables thoroughly before preparation. Some authorities advise on soaking vegetables in dilute salt water before washing well. ############### Moderate alcohol consumption associated with decreased incidence of diabetes mellitus Although diabetes mellitus and alcohol consumption are prevalent in the United States, yet physicians are poorly informed about how alcohol use affects risk for or management of diabetes. US researchers conducted a systematic review assessing the effect of alcohol use on the incidence, management and complications of diabetes mellitus in adults using English-language studies in persons 19 years of age or older that were identified by searching the Medline database from 1966 to the third week of August 2003 and the reference lists of key articles. 32 studies that met inclusion criteria were reviewed. They found: "Compared with no alcohol use, moderate consumption (one to 3 drinks/day) is associated with a 33% to 56% lower incidence of diabetes and a 34% to 55% lower incidence of diabetes-related coronary heart disease, compared with moderate consumption, heavy consumption (more than 3 drinks/day) may be associated with up to a 43% increased incidence of diabetes. Moderate alcohol consumption does not acutely impair glycemic control in persons with diabetes". The researchers concluded: "Moderate alcohol consumption is associated with a decreased incidence of diabetes mellitus and a decreased incidence of heart disease in persons with diabetes. Further studies are needed to assess the long-term effects of alcohol consumption on glycemic control and noncardiac complications in persons with diabetes. The editors' list the following points: - Best evidence suggests that moderate alcohol consumption is associated with a reduced incidence of diabetes mellitus. - Some evidence suggests that heavy alcohol use may be associated with an increased incidence of diabetes mellitus. - There is no evidence of an acute effect of moderate alcohol ingestion on glycemic control. - The effect of alcohol use on diabetes self-care behaviours has not been well studied. - Limited evidence suggests that ingestion of alcohol while using a sulfonylurea or thiazolidinedione does not result in an adverse event. - Strong evidence shows that moderate alcohol consumption is associated with a decreased incidence of coronary heart disease in persons with diabetes. - Evidence is insufficient to establish the effect of alcohol consumption on noncardiac complications in persons with diabetes". Sent to us by Dr. Desmond Fernando |
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