Linking traditional and modern medicine

The extent to which modern medicine is linked to traditional medicine has been broughout in the essential drugs monitor No. 20 a publication of the World Health Organisation action programme on essential drugs, where they say.

Therapeutic value

“The therapeutic value of some 200 - 250 of the worlds higher plants has been sufficiently demonstrated scientifically to warrant their inclusion in allopathic (western) medicine.”

The article by Norman R. Farnsworth, Christopher W.W. Beecher and Harry H.S. Fong goes on.

Essential Drugs Monitor

Rational use

The NAPRALERT database: linking traditional and modern medicine

Norman R. Farnsworth, Christopher W.W. Beecher, Harry H.S. Fong

WHO estimates

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 can be assumed that the placebo effect sometimes contributes to the success of such therapy.

The therapeutic value of some 200 to 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. 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.

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.

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”.

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”.

Holiday eating the healthy way

Dr. Kayathri PERIYASAMY MRCP (UK)

First it was Ramadan, and then came Diwali. All full of rich and sweet treats. Now here come the holidays followed by Christmas and the New Year. It will be time to visit with family and friends. It is the time for giving and parties abound. But this could turn out to be a nightmare for those who have diabetes.

Along with these merry days of celebration comes the fear of gaining unwanted pounds and toppling those well-maintained blood sugars. While traditional meals and dishes are hot favourites at this time, these delicacies are usually high in calories and loaded with simple sugars and fat.

Does that mean that you miss out on all those goodies and fun? Never! With these simple tips you can be a part of all the happenings and yet be in good control.

Strategies for Healthy Holiday Eating

Small, frequent meals - Make an extra effort to eat small meals frequently so that you are not eating too little or too much at a time. In addition, small, frequent meals prevent hypoglycaemic episodes. Portion control is important even while dining out. Skipping meals is only a set-up for a food binge.

Stay active - Exercise helps in lowering blood sugar and burns calories. Even if you don’t have the time for your normal routine, try short brisk walks of 15 minutes whenever possible. It will help burn off those accidental encounters with goodies that sometimes happen to the best of dieters. Exercise can be your secret weapon.

Reduce the fat - Reduce the fat and calories in the traditional recipes by using fat-free or low-fat milk and cheese. Trim the fat and skin from meats before cooking. Cook meats on a rack so that the fat can slowly drip away.

More veggies and fibre - Serve plenty of vegetables, especially in the form of salads and appetizers with low-fat or fat-free dips. The increased fibre will help keep you satisfied.

Natural sweetness - Think of serving low-fat and low-sugar desserts, such as baked fruits sweetened with cinnamon or natural juices. Or use artificial sweetner.

Count the carbs - Remember that it is the total amount of carbohydrate eaten that will impact your blood sugar levels, no matter if the carbohydrate comes from sugars, starches, or fruits. If you do indulge in the occasional dessert, be sure to account for it by eating less carbohydrate at another meal.

Pick and Choose When You Indulge - You don’t have to eat all the holiday foods that may be coming your way via work, friends, family and parties. You can consciously choose not to indulge on the days when nothing special is going on. Save your calories for the celebrations. You might want to indulge at only one event a week, and make healthy choices the rest of the time.

Dodge the Guilt - when someone has gone to a lot of trouble making a special treat, it may seem like an insult if you refuse to eat. And you may feel bad about that. Try complimenting the food and the cook, and remark about the attention to detail, the craftsmanship, the artistic vision, the dedication and love that must have gone into each item. Then, take only a little.

Be the Master of Your Mouth - When all is said and done, nothing can go into our mouths unless we put it there. We really do have control. We don’t have to eat everything that’s handed to us. Make a deal with yourself. Set rules to follow. Manage the flow of Christmas cookies by planning to have one cookie every night after dinner for dessert.

Focus on the Fun, Not the Food - The holidays aren’t just about food. They’re about friends and family, too. Use the season to spend time catching up with loved ones, enjoying things like community events, carolling, and shopping. Bring the focus away from eating and celebrate the people in your life at this time of year.

Bring Your Own Goodies - Offer to bring something for the party. Make a vegetable or fruit platter, or a low calorie treat. At least there will be one thing there that won’t lead you astray.

Check the Blood Sugar - checking your blood sugar frequently during this period will ensure that it doesn’t go out of control too much. It will also remind you when you have indulged too much.

(Dr. Kayathri is the MO Diabetics at Healthy Life Diabetic Clinic, Colombo 3).

Health educating on Lipid profile

Dr. Kelum Pelpola (Faculty of Medicine, Colombo and Healthwatch Medical Advisory Panel)

The lipid profile is a widely done medical investigation today. The aim of this article is to give an insight of this common test to the general public.

What is a lipid profile?

The lipid profile is a group of tests done to assess the status of fat metabolism in the body and is important to determine risk of coronary heart disease.

The tests that make up a lipid profile are tests that have been shown to be good indicators of whether someone is likely to have a heart attack or stroke caused by blockage of blood vessels (caused by cholesterol containing plaques in the vessel wall).

This includes measuring lipids (fats) and its derivatives known as lipoproteins. Lipoproteins are compounds containing fat and proteins and include free cholesterol, cholesterol esters, triglycerides, phospholipids and apoproteins.

What are the desirable lipid profile values?

The newest recommendations are listed below. (source - Department of Preventive Cardiology and Rehabilitation at The Cleveland Clinic Heart Center, USA).

However, this is only a rough guide and your doctor should be consulted in deciding on treatment since different treatment goals are there depending on the cardiovascular and other risk factors of the patient.

Units for all the values given below are mg/dl

Which biochemical markers are used?

Total cholesterol comprises all the cholesterol found in various lipoproteins such as high-density lipoproteins (HDL), low-density lipoproteins (LDL), and very low-density lipoproteins (VLDL). HDL helps to take cholesterol away from the cells and transport it back to the liver for removal. It is thus called “good” cholesterol as persons with high levels of HDL may have a lower incidence of heart disease.

LDL contains the greatest percentage of cholesterol and is responsible for cholesterol deposits on the wall of the artery resulting in coronary artery disease. LDL is thus known as the “bad” cholesterol.

The cholesterol/HDL ratio is derived by dividing the total cholesterol by the HDL. This ratio helps in assessing the risk of heart disease in individuals. Triglycerides are neutral fats found in the tissue and blood.

Excess calories, alcohol or sugar in the body are converted into triglycerides and stored in fat cells throughout the body. Triglycerides containing lipoproteins may also contribute to the disorders related to coronary heart disease.

Your total blood cholesterol is a measure of LDL cholesterol, HDL cholesterol and other lipid components.

What preparations are required?

The patient needs to be fasting for 12-14 hours, and only drinking water is allowed before drawing the sample. A good option in the Sri Lankan context is to fast overnight (from about 8 p.m.) and get the test done before having tea or breakfast next morning around 8 a.m.

It should be noted that inadequate and over fasting both may make the results of the test unreliable. He/she should also be on his normal diet pattern. Intake of alcohol on the previous night should be avoided.

What are the factors that affect lipid profile?

Factors that affect an individual’s lipid profile include:

Age / Sex

Body weight

Alcohol and tobacco use

Exercise

Genetic factors

Medications

Chronic disorders such as hypothyroidism, obstructive liver disease. diabetes, and kidney disease

This means that when interpreting a lipid profile, not only the number, but also the above conditions have to be born in mind so that we get an idea of the total picture.

How often do you need a lipid profile test?

Recommendations are for healthy individuals with no other risks of heart disease to be screened for cholesterol and HDL every five years. You do not need to have a full lipid profile.

However, if you have other risk factors have had high cholesterol in the past, you should be tested more regularly and you should have a full lipid profile.

The frequency depends on the lipid values and also on the number of other concurrent risk factors the patients have.

So, it is best decided by your doctor after doing a full assessment of you, by taking a complete history, doing complete examination and other relevant investigations.

Park Hospital Colombo 5 opens new Specialized Psychiatric Treatment Centre

Dr. Amal Harsha de Silva, Director - Private Health Sector Development-Ministry of Health and Nutrition was a Chief Guest of the launching of the new treatment centre with modern inventive equipments, seclusion therapy units, ECT treatment facilities and updated knowledge on par with international standards.

The opening ceremony of the new psychiatric ward with 10 fully equipped rooms was held on November 10 with the participation of all Senior Psychiatrist Consultants and officials from Health Ministry and Provincial Councils.

Wards with all the provisions needed for the patients are provided along with round the clock supervision and services of senior Consultants throughout the day and night and all supporting systems such as laboratories, pharmacy, X ray emergency treatments, made to function along with them.

The Park Hospital also has reorganized and upgraded the state of art clinics such as Eye clinic, Dental surgery unit, Vaccination unit, Channel Consultation, Operation theatre and labour room.

Clinics such as Drug, Alcohol & Smoking Addiction, Memory dysfunctions, Sexual dysfunctions, Stress management, General Psychiatric illness/disorders are conducted by senior psychiatrist consultants.