Unforgettable incidents during my profession: Pentachlorophenol

Modern clinical toxicology deals with a lot about environmental poisons and illness. I have experienced thousands of these problems from my patients. Here I like to inform you a few case studies to show that it can play a vital role in your health.

I got a blood sample from a child and the doctor told me that he could not understand the perplexing symptoms and requested me to find out some clue from the blood. We conducted all the analytical studies in blood and urine qualitatively and quantitatively in the lab of clinical Toxicology and found that the amount of one poisonous chemical was increased tenfold compared to the reference values of an adult.

I talked to the mother about the possibility of exposure to this poisonous chemical. There was no chance for exposure and the parents were very much worried. Finally I asked the mother to send her child to the Kindergarten Monday to Friday, go to the doctor, take blood sample from the child and go for holidays with the child for a week to a North Sea Island where even cars are banned and there were no chances of any exposition.

Returning back she had to go to a doctor and take blood sample from her child once again. She did exactly what we told. In Friday’s sample the child had this poisonous chemical, about ten times higher than the reference value of adults. When they returned from the island, the poison level was in the lower part of the reference value. We made a guess and we gathered the details about the Kindergarten. In the kindergarten there are wooden benches and wooden play equipments of children, such as, ship, slide, swing and seesaw. All are very clean and in very good condition. We gave the blood values to the doctor and he forwarded to the government departments, nobody wants to believe. Somebody from the Government rang my boss and asked him whether I am a reliable chemist and his answer was, “leave this as my problem and as long our toxicologist is doing good to the public we inform all the people concerned about this”. Such a trusting boss must everybody have to do good to the patients.

Finally the concerned authorities decided to send the blood to a high security toxicological lab belonging to the Central Government. After two days my values were confirmed and the two Kindergartens were closed. We checked further the city’s other Kindergartens and everywhere the problem was the same. All these wooden things were removed and the contamination was also controlled.

The important chemical was at that time used as a wood preservative, the notorious pentachlorophenol. This was also by-product from orange T production. Orange T was used in Vietnam War to destroy the forests in Vietnam. The chemical waste from the company contained high amount of pentachlorophenol. Instead of disposing it properly it was mixed with the paints which have been used for the benches and other wooden articles in the kindergarten. This sort of poison tourism was a cheap disposal of the deadly wastes in poor countries at the cost of the population there.

During the second half of the 1980s, this chemical was found in all the human beings in the world including Eskimos and persons living in the Amazon regions of South America.

Fortunately the half-life period of pentachlorophenol is 30 hours and it could be excreted from the body without much problem.

It was banned in Germany in the 1990s.

Long-time exposition could be detected in hair and nail.

Keep your environment clean and the environmental poisons cause more sickness than we all think. The problem is the right diagnosis, as there are no separate symptoms for environmental illness.

Can you inform me about endosulfan and its toxicity?

Endosulfan, 6,7,8,9,10,10-hexachloro-1,5,5a,6,9,9a-hexahydro-
6,9-methano-2,4,3-benzodioxathiepine-3-oxide, is an organochlorine compound. Almost all organochlorine compounds are poisons. Endosulfan is mostly used as an insecticide and acaricide. It can also be used as a wood preservative. It is uses mostly on food crops like grains, tea, fruits and on vegetables. It acts as a contact poison. It can accumulate in the body and can create health problems. It is banned in more than 65 countries and is unfortunately used in countries like India and Brazil. Because of its threats to human health and the environment, a global ban on the manufacture and use of endosulfan is being considered under the Stockholm Convention.

I have seen many patients with organochlorine chemical poisoning as a clinical toxicologist. If we come in contact with small amount of Endosulfan, the body has no problem to excrete them with its genes and enzymes. Since these pesticides are fat soluble they are deposited in our fat tissues. If a person has problems with his detoxification genes or enzymes he is going to suffer a lot or even it can be fatal to him. During the detoxification uncontrolled amount of free radicals are produced and so the free radical scavenging system must be well functioning. The antioxidants from the food are very important as well as the minerals, copper, zinc, manganese and selenium. These minerals are part of the free radical scavenging enzymes.

How toxic is endosulfan? Undiluted endosulfan is slowly absorbed into the body. The absorption is rapid if it is dissolved in alcohols, oils and emulsifiers.

Endosulfan poisoning affects the Central Nervous System. The symptoms include:

• Incoordination including a loss of the ability to stand
• Gagging
• Vomiting
• Agitation
• Diarrhea
• Convulsions
• Loss of conscience
• Blindness is noted in animals, cow, sheep and pigs, grazing the grass sprayed with endosulfan

Lot of research is done to find the lethal dose of endosulfan and the oral LD50 in different animals include:

• Rat 18 to 220 mg/kg
• Mice 7.36 mg/kg
• Hamster 118 mg/kg
• Cat 2 mg/kg
• Dog 76.7 mg/kg
• Young ducks 33 mg/kg

The dermal LD50 include:

• Rat 74 mg/kg
• Rabbit 200 to 359 mg/kg

The solvents used to dissolve endosulfan influence its toxicity. Many chronic effects have been noted in animals exposed to endosulfan. Kidneys, liver, parathyroid gland and blood chemistry are mostly affected. In rats skeletal deformities in the fetus are noted. Although there are no evidences, chronic exposure to humans may cause reproductive and/or developmental problems in humans.

It has mutagenic effects at least in two mammalian spices and this means it can also change human DNA.

In the environment the surface water is mostly contaminated with endosulfan. The half-life of alpha-endosulfan is 35 days and the beta-endosulfan is 150 days under neutral conditions. If the soil is acidic the half-life is long for both the isomers.

Endosulfan is also toxic for birds and fishes.

The breakdown product of endosulfan is the endosulfan sulfate. It is as poisonous as endosulfan and is present longer in the environment.

Endosulfan and its breakdown products are detected in vegetables, milk, sea foods and in tobacco. The right decision is to ban all the organochlorine pesticides for the whole world. This is healthy for all living beings and to our environment too.

India is the largest user of endosulfan and the problems in Kerala is well known. We must have the courage to ban this.

Is it male menopause or mid-life crisis or both?

Female menopause is a well defined condition and all the women experience this. Male menopause is called andropause and it is not well defined. Some doctors and scientists say that many men experience this, but not all. Others argue that there no such condition and this is the part of the mid-life crisis. Not all men experience mid-life crisis too. In this article I try to give you the important points regarding male menopause and mid-life crisis.

Andropause is characterized by the low production of testosterone, the male sex hormone. Loss of testosterone starts when a man is 35 years old. It may be around 1% to 1.5% per year. Mostly men experience andropause between the ages of 40 and 55. In post menopause there is no production of estrogen, the female sex hormone in women. On the contrary, the testosterone production is low with increasing age, but it is there even in one’s eighties and nineties. In these ages also a man has healthy sperm and this is the reason why andropause is not accepted as a medical condition.

The symptoms of andropause include:

• Irritability
• Reduced libido (reduced sexual desire)
• Impotence
• Tiredness
• Depression

Some men have other symptoms too and they include:

• Weight gain
• Night sweats
• Hair loss
• Dry skin
• Stiffness in the joints and muscles

Several of these symptoms can occur at the same time.

Interestingly, each of these symptoms is mostly treated alone and this makes the situation more serious. If the depression is only treated with antidepressant medicines the result is loss of libido. A good doctor considers all these symptoms and selects the treatments.

Approximately 10% of the middle aged men go through an age-related midlife crisis. Mid-life crisis is experienced by men from the ages mostly between 40 and 60 and it lasts about 3 to 10. Aging itself is one of the main causes of mid-life crisis. The other causes include:

• Physical changes with aging
• Workload or unemployment
• Relationship of family problems
• Children left home
• Sickness or death of parents

Mid-life crisis can change the life of a man drastically and the noticed changes include:

• Desire to achieve a feeling of youthfulness – lifestyle change, an affair with a young woman
• Spends more time alone
• Thinks that he has missed many good things in life
• Thinks deeply the missed chances in life
• Wants to achieve a lot, but don’t know what
• Buys costly car or motorbike
• Goes for a world tour
• Leaves job and family

These thoughts can change one’s whole life. This can have negative impacts in their work place and in the family. They can abuse alcohol or illegal drugs. They can take a young girl friend or a sex partner. They spend more time in front of the mirror and give more money for cosmetics and perfumes. They try to cover their baldness and suddenly interested to have designer clothes from young fashion. They used to blame themselves for their failures in many things. They apply pressure on their children for better performance in arts, academics and sports. Above all, the worst is the depression with all its negative symptoms.

The possible therapy for andropause is a combined therapy with testosterone replacement therapy, psychotherapy, diet, exercises and use of herbs. Testosterone replacement therapy does not give always the expected relief and the side effects must also be considered. It can bring the prostate in problem and so your doctor must be careful to decide for the right treatment. Normally in short intervals testosterone concentration and PSA the marker for prostate cancer must be controlled in the blood if it is decided for the hormone therapy.

The supporters of testosterone replacement therapy argue that in the case of bone density loss, erectile dysfunction where other remedies don’t work and loss of height it is the treatment of choice.

The problems of mid-life crisis and andropause can go hand in hand and many symptoms are common. Of course, your doctor can help you, but your spouse is very important to master this difficult period. The spouse can help a lot and they include:

• Make him to do new activities and hobbies; take part in them
• Make him to think positive
• Watch for his mood swings and try to react correctly
• Tell him always that you love him
• Stress the need for relaxation
• Try to understand and know him more. This is important for the time after mid-life crisis
• Pay close attention to his mood and behavior
• Bring him with persons who take life easy
• Avoid “why” in many situations. This can increase the fear
• Never start with a question. Share with him that you want to support him
• Listen to him and try to understand his feelings, values and fears

Men who have andropause and mid-life crisis problems must avoid grape fruit as it can convert testosterone into estrogen, the female sex hormone.

Sex; is it healthy? What are the benefits?

Sex is a taboo theme in many parts of our world. Many still think it is dirty and is mostly done when the light is off. Is it really so bad? Scientists prove that sex is extremely beneficial for our health. Here you get more information about this mostly thought, but less spoken theme.

The benefits of sex include:

• Beneficial for the heart and blood circulation, thus good oxygen supply to brain and other cells
• Balances the ratio of HDL-cholesterol and LDL-cholesterol
• Lowers the risk of prostate cancer
• Lower the risk of breast cancer
• Good for mental and emotional health. Abstinence increases the feelings of anger, frustration, self-doubt, depression etc. Endorphins and semen play here a vital role in enhancing mood after sex
• Eliminates stress. Good sex gives total relaxation and good sleep
• Increases the estrogen levels in women and this is vital for skin and hair health
• Increases the humans’ lifespan 3 to 8 years and 50% reduction of death risk
• Sweating cleanse the skin pores and improve the skin health
• Good to burn calories. Comparable of 15 minutes on a treadmill
• Strengthen pelvic, thighs, buttocks, abdomen, chest and arm muscles
• More sex means more production of pheromones that are chemicals to attract the opposite sex
• Increases intimacy to partner
• A good pain reliever than many painkillers. Oxytocin and endorphins are responsible for this. These calm pain from headaches, migraines to arthritis. Increased estrogen levels reduce premenstrual pains. Mostly the excuse not to want is headache!!!!
• Kissing lowers the acidity in the mouth and good for mouth hygiene; thus tooth decay and bad breath is prevented
• Decreases the risk to get colds, flu and other infections. The reason is the production of more immunoglobin A, an antibody which strengthens the immune system
• Helps for a better control of bladder with strong pelvic muscles and thus minimize the risk of incontinence

Children are our wealth and it is the main purpose of sex. This is accepted by all. You can see the other benefits as extra bonus.

What is normal to achieve these benefits? Twice in a week or more can give you these benefits.

Oxygen free radicals; can you explain me the free radical scavenging in the body?

Free radicals are atomic or molecular species with unpaired electrons in the outermost orbital and are unstable and very reactive. Free radicals need one more electron to become stable and try to take an electron from the other atom. This atom in turn now becomes a free radical and the dangerous chain reaction starts. Free radicals can damage our cells, particularly DNA and can do harm to our health. The well known oxygen free radicals or reactive oxygen species are superoxide ion, hydroxyl radical, singlet oxygen and hydrogen peroxide. Hydrogen peroxide is not a free radical but it is involved in the formation of many reactive oxygen species.

What are the sources of oxygen free radicals? The body uses oxygen to convert sugar and fat into energy. In this process oxygen is converted to water. However, about 2% of the oxygen may escape before the conversion is complete. These become the different oxygen free radicals. There are many other enzymatic and non-enzymatic reactions in the cells which also produce continuously free radicals.

The external sources of free radical production include cigarette smoke, radiation, environmental pollutants, ultraviolet light, chemicals including pesticides and drugs and ozone. Excess exercises or physical activities can also produce more free radicals.

Free radicals are responsible for aging. Cancer and cardiovascular problems are the very important diseases caused by free radicals. The damage of DNA in the cells and the oxidation of the LDL-cholesterol are the main reason for these diseases. Cataracts, maculopathy, the age-related disorder of the retina, auto immune diseases like arthritis or fibromyalgia, neurodegenerative diseases, aging and many other diseases go to the account of free radicals.

Does the body need oxygen free radicals? Phagocytes produce excess free radicals to destroy invading pathogenic micro-organisms and this is part of the body’s defense mechanism against many diseases. Complete elimination of free radicals is not possible, but it is possible to control the production of free radicals. This is also very important for anti aging.

The body needs mechanisms to control the amount of oxygen free radicals and the excess must be scavenged continuously. If the free radical production is high and there are not enough antioxidants to neutralize them the condition, oxidative stress is developed and this is bad for the health. The two possibilities to control free radicals are antioxidants to limit oxidation and the enzymes which can neutralize the free radicals. The important body’s own antioxidants include ubiquinol, glutathione, uric acid bilirubin and even cholesterol.

The enzymes include glutathione peroxidase, superoxide dismutases and catalase. These enzymes need copper, manganese, selenium and zinc and these must be taken from the food.

There are more than 4000 identified nutritive and non-nutritive antioxidants present in fruits and vegetables. The important antioxidants from the foods include vitamin C, vitamin E, vitamin A, natural beta-carotene, lycopene and many others including the polyphenols. This is an important reason to take several servings of fruits and vegetables in a day.

We all can do a lot for anti aging and start from today to think and do something for this. It is easy and worth doing.

Type 2 Diabetes; can you tell me the dos and don‘ts?

As we know knowledge and experience help us in every circumstance to master a problem or a challenge. It is applicable to diabetes too. With the right food, lifestyle and exercises you can prevent diabetes as well as control them without taking tablets or injecting insulin. Here, your knowledge and will power can decide a lot. If you follow this regularly there will be no problem to eat normal now and then. Dos and don’ts give you a clear picture what should be done to have a normal life with type 2 diabetes.

The dos include:

• Increase the intake of mono- and polyunsaturated fats – avoid butter and use plant oils and bread spreads. Mayonnaise can be substituted with avocadoes in salads.
• Nuts are good – can be eaten everyday by decreasing the amount of carbohydrates.
• Eat fatty fish regularly – omega-3 fatty acids are very important for your health including heart health. Two to three time fish in a week is good.
• Consume more protein from lean meat, poultry without skin and low fat milk and dairy products. Protein can be converted into sugar in the liver.
• Eat high fiber foods – wholegrain products, brown rice, vegetables and fruits are good.
• Look for low sugar foods – it is applicable to milk products, canned fruits and fruit juices. The food labels may contain sugar or honey or high-fructose corn syrup or only syrup or other sugars such as lactose or maltose and in this case go for products where there are very little or no sugar.
• Select cereals with more than 3 g fiber in one serving. It must be sugar-free and should not contain too much of carbohydrates.
• Fresh or frozen vegetables are good. Except carrots avoid all the root vegetables.
• Fresh fruits are good or canned fruits without added sugar. Fruits are better than fruit juices. Dry fruits in small quantities without added sugar are also good.
• Drink enough fluids and 70% of this must be pure drinking water.
• Reduce your weight.
• Regular exercise.
• Write down whatever you eat and drink daily so that it is easy to control your food intake.

The don’ts include:

• Too much saturated fats – high fat milk and dairy products, fatty meat, inner organs of animals, except fish all other seafood, turkey or chicken with skin. These foods contain high amount of cholesterol too.
• Trans fat.
• Carbohydrates – you can get the sugar from the protein and so the amount of carbohydrate taken can be reduced.
• Foods with lot of sugar – candies, cakes, biscuits and many other sweets including local sweets and chocolates.
• Canned fruits and dried fruits with preservatives or sugar.
• Soft drinks with lot of sugar or fructose or artificial sweeteners.
• Processed foods, fast foods and junk foods.
• Chips and other snacks.
• Replace coffee with green or black tea.
• Alcohol – one glass of wine or one beer or one drink normally increases blood sugar. More alcohol can reduce the sugar, but the blood pressure increases because of narrowed blood vessels. A healthy liver can metabolize only a maximum of 60 g alcohol. If it is more it is very dangerous for liver’s health.
• Smoking – increases the free radicals and free radicals are not good for our health.
• Stress is bad for diabetes.

This information is good to prevent type 2 diabetes as well as to manage it. If you suffer from type 2 diabetes an individual counseling is the best to optimize your food and lifestyle. Contact me if you need one…

I want to buy a microwave oven; what are the advantages, disadvantages and dangers?

Today microwave ovens are the part of all modern kitchens. Many can’t live without microwave ovens. Many have good knowledge to use the microwave properly and many use just like that without thinking too much. There are advantages, disadvantages as well as dangers. If we consider these points it can be a good help to us. If we use a kitchen instrument it is always important to know about them very well. Read the manufacturer’s instructions very carefully. Ask your family members and friends about their experiences with microwave ovens.

The principle of working microwave oven is very simple. Microwaves are energy that can be absorbed by the food particles inside an oven. Microwaves make the water content inside the food particles to vibrate and this causes the food particles to rub against each other. This produces heat energy that is used to cook the food. The variable factors for faster cooking of foods are the increase of the power supply and the cooking time.
The advantages of the microwaves oven include:

• Good retain of flavor and taste of some foods
• Short cooking time and so less nutrients loss
• Stays only very shortly between 5°C to 60°C and so less chances to be infected
• Cheap running costs as only electricity is needed
• Pre-heating is not necessary
• Can be used immediately, switching on is enough
• Doesn’t heat the kitchen unnecessarily
• No cooking odor in the kitchen and in the house
• Kitchen is clean as less or no food is spilled
• Needn’t be cleaned often, mostly simple wiping is enough
• Can be combine with conventional ovens
• Some foods cannot be cooked. You must note the manufacturer’s instructions

Where there are many advantages, there can be disadvantages too surely. These disadvantages include:

• Can cause over cooking of the food as it is very fast
• Uneven cooking, food on the top can be very hot and on the bottom cold, thus uncooked. During cooking stirring is necessary at regular intervals
• You must use special utensils. Metal vessels must be avoided
• Few types of foods cannot be cooked; note manufacturer’s instructions

There are many advantages and few disadvantages and it seems wonderful. But, there are some dangers and you must know about these very well. The dangers include:

• Radiation leaks - exposure to high levels of microwave radiation can cause health problems including cataracts and burns. Damaged oven door or not properly sealed door is the source of radiation leaks. Follow the manufacturer’s instructions always. Keep it clean and do not run it if it is empty
• Avoid burns – the cooked food in the plastic container can be very hot or lot of steam can escape quickly. Don’t heat baby milk bottles in the microwave. The milk inside can be dangerously hot although the bottles have safe temperature. Use the microwave-safe plastic wrap loosely so that the steam can escape. If the food has many layers the out layer is warm, but the inner layer can be dangerously hot.
• A microwave oven is not a sterilizer – it cannot sterilize bottles or jars. Boiling in water for 10 minutes or chemical sterilization is the best way to sterilize

The manufacturer’s instruction booklet mostly gives all the information needed. If you don’t find the information you needed you must be very careful.

What are gallstones? Can you tell me the foods preventing them?

Bile, made in the liver, is stored in gallbladder and it contains water, cholesterol, fat, bilirubin and bile salts. Bile is released from the gallbladder into the small intestine to digest fat. If the bile has too much of bile salts, fats, bilirubin and cholesterol, it can harden into stones.

There are two types of stones, one is cholesterol stones which accounts for about 80% and the rest is bilirubin stones. The stones can be very tiny or as big as a plum and there may be one big stone or hundreds of tiny stones and almost in each possible combination. About 80% of the stones are harmless and not at all detected. Gallstones come with age; obese women get it three times more often than men and are also hereditary.

Gallstones can prevent the flow of bile in the small intestine by blocking the ducts. Other ducts like pancreatic duct, opens in the common bile duct to bring its enzymes to the small intestine. The problem here is the trapped digestive enzymes of the pancreas cause an extremely painful inflammation. If it is blocked for a considerable time, severe damage is possible for liver, gallbladder or pancreas.

The symptoms of this serious problem include:

• Fever
• Jaundice
• Continuous heavy pain.

Diet plays a vital role here because it can influence the amount of cholesterol in the bile, thus preventing the formation of the gallstones. Certain foods can keep cholesterol in solution at the same time they can expel stones into the duct, causing a very painful gallbladder attack.

Increase the intake of water soluble fibre by eating fruits and vegetables. The recommended foods are apples, artichokes, grapefruit, lemon, watermelon, beet roots, broccoli, spinach, celery, carrots, fennel, radish, garlic, barley and olive oil. The non-vegetarian can take fish, turkey without skin and chicken without skin in very small quantities, but they should not forget to take enough fruits and vegetables. This is the best way to treat gallstones is to prevent them.

Whole grains and products and healthy plant oils must also be the part of the food.

The foods to avoid include:

• Meat or meat products,
• Red meat
• Pork
• Egg
• Milk
• Oily or fatty foods
• Spicy foods
• Fast foods
• Junk foods
• Processed foods
• Corn
• Beans
• Nuts
• Onions

If we take less fibre but a lot of sugar, then it is a risk factor. You need not avoid sugar but eat very moderately and take more fruits and vegetables to get enough fibres.

Coffee directly, with no milk or sugar and with or without caffeine, can stimulate the gallbladder to contract, probably bringing a gallbladder attack. It is better to avoid coffee if you are prone to gallstone attacks.

Avoid smoking and tobacco products.

The skipping of breakfast or not eating for a long time may lead to gallstones. We need food so that bile acids keep cholesterol in solution to prevent the formation of gallstone.

Overweight is a risk in women for gallstones and it is better to reduce the weight. But, do not forget, losing weight very quickly gives only the adverse result. It is better to reduce less than three kilos per month.

Physical activities are important. Select according to your time and health. It is better to consult with your doctor before you start.

Can you tell me about erectile dysfunction?

Erectile dysfunction is the repeated inability to get or keep an erection firm enough for sexual intercourse. Impotence is used as a general term for erectile dysfunction, lack of sexual desire, problems with ejaculation and orgasm. Erectile dysfunction is a taboo theme in our world. Several hundred million men have this problem. Erectile dysfunction can be a sign of a health condition which needs treatment and it may be heart disease or poorly controlled or not yet diagnosed diabetes. There may be psychological factors also for this problem.

The brain, nerves, muscles, blood vessels, hormones and emotions play a vital role in male’s sexual arousal and this process is very complex. Problems with any of these can cause erectile dysfunction. Physical and psychological problems can also cause erectile dysfunction or even worsen it.

The physical causes include:

• Low testosterone
• High blood pressure
• Clogged blood vessels
• Diabetes
• Heart disease
• Overweight and obesity
• Excess alcohol
• Smoking or other tobacco use
• Drugs abuse
• Many prescription medications
• Damage to nerves, arteries, smooth muscles and fibrous tissues
• Diseases like multiple sclerosis, Parkinson’s disease, prostate cancer, Peyronie’s disease etc.
• Injuries or surgeries which affect the pelvic area and the spinal cord
• Prolonged bicycling

The psychological causes of erectile dysfunction include:

• Stress
• Fatigue
• Depression, anxiety or other mental diseases
• Relationship problems
• Poor communication with partner leading to misunderstandings and problems

Side effects of prescribed medicines can cause erectile dysfunction. More than 100 mostly used drugs have this side effect. These prescribed medicines include antidepressants, antihistamines, medicines to treat high blood pressure, pain killers or medicines to treat prostate cancer.

The illegal drugs like, amphetamines, party drugs, barbiturates, cocaine, cannabis, heroin and others can cause erectile dysfunction.

Erectile dysfunction is a serious problem which can cause an unsatisfactory sex life for the couple, marital or relationship problems, stress, anxiety and low self-esteem. Another big problem is the inability to get his wife pregnant.

Erectile Dysfunction is treatable at all ages.

If you have problems it is better to contact your family doctor and he can send you to a urology specialist. Physical examination, blood test, urine analysis, ultrasound and overnight erection test are the usual procedures to begin with.

The treatments must proceed from least to most invasive. Quitting smoking, avoiding excess alcohol, losing excess weight and increasing physical activity may help some men to regain sexual function. If erectile dysfunction is a side effect from your medicine consult with your doctor to change that medicine. This is possible with high blood pressure drugs.

The treatments include:

• Psychotherapy – is used to decrease or remove the anxiety associated with love making. Here the patient’s wife can help for the gradual development of intimacy and stimulation.
• Drug therapy – the drugs can be taken orally, injected directly into the penis or inserted into the urethra at the tip of the penis. We all know well about Viagra, Levitra and Cialis. The tablet can be taken an hour before sexual activity. These drugs enhance the effects of nitric oxide, a chemical which relaxes smooth muscles in the penis during sexual stimulation and allows increased blood flow. Only one tablet should be used in a day. All these have side effects and so the doctor must be consulted before taking. Persons using medicines to decrease blood pressure must be very careful, otherwise it can cause sudden drop in blood pressure which can be fatal. Testosterone, the male sex hormone is often ineffective and may cause liver damage. Many men achieve stronger erections by injecting drugs into the penis. These drugs widen the blood vessels, thus a good blood supply to penis. There is a system available to insert a pellet of alprostadil into the urethra and the erection begins within 8 to 10 minutes and may last 30 to 60 minutes. Intensive research is going on in this sector to develop better medicines.
• Vacuum Devices – mechanical vacuum devises can cause erection by creating a partial vacuum which draws more blood into the penis and expanding it.
• Surgery – very invasive, consult with your doctor.

Have more fun in your life with good knowledge in everything…

Can you tell me the foods rich in magnesium?

Magnesium is an essential mineral for human health. More than 300 enzymes in the body contain magnesium and thus it is important for several metabolic functions. It is vital for the contraction and relaxation of muscles, involved in the synthesis of protein, supports calcium in bone formation and plays a role in regulating the blood pressure are the few from many to mention. The recommended daily requirements of magnesium for adult women and men are 310 and 400 mg respectively. Pregnant women and breastfeeding women need 360 to 400 mg daily. But, only few get their required magnesium from their food. Almost no one takes so much of magnesium from the diet. Therefore, it is important to know the foods rich in magnesium.

Try to include magnesium rich foods daily in your diet. The foods rich in magnesium include:

• Halibut
• Tuna
• Pumpkin and squash seeds
• Beans, black
• Beans, kidney
• Beans, Lima
• Beans, navy
• Beans, Pinto
• Soy beans
• Okra
• Groundnuts
• Almonds
• Brazil nuts
• Cashew nuts
• Pine nuts
• Walnut
• Coconut
• Banana
• Rockfish
• Scallop
• Oysters
• Soy milk
• Tofu
• Barley
• Brown rice
• Oat bran
• Buckwheat
• Wholegrain wheat
• Corn meal
• Broccoli
• Artichokes
• Beet, green
• Chickpeas
• Cowpeas
• Peas, frozen
• Lentils
• Figs, dried
• Prunes
• Yogurt, low fat
• Sweet potatoes
• Potatoes
• Tomato paste

Meat, egg and milk contain only less magnesium.
If you think you are not getting enough magnesium from food you can go for supplements. You must consult with your doctor before taking it because the following points must be considered:

• Excess magnesium has side effects
• Interferes with many medicines, can decrease or increase their effects

People with heart or kidney disease should not take magnesium supplements except under their doctor’s supervision. Be careful with children and do not give them magnesium supplements without doctor’s prescription.

If you have muscle cramps it is not always the magnesium deficiency. Low dehydration can also cause muscle cramps. It is better to drink a glass of water and wait for few minutes. 90% get immediate relief.

If you want to test your magnesium status in your blood ask your clinical laboratory to estimate the magnesium level in the red blood cells. The blood plasma has always the normal level as it is compensated regularly from the red blood cells if there is loss or deficiency. Thus the plasma level is useless.

Red wine; is resveratrol really healthy?

As we all know “French Paradox” is no more a riddle. Although the French eat more fatty foods than the Americans and the others they have lower incidence of coronary heart diseases. Lot of research has been done on this subject and the answer to this puzzle is resveratrol, polyphenol which limits the bad effects of fatty foods and even smoking. Resveratrol is a powerful antioxidant present in the red wine. The French consume regularly wine mixed with drinking water.

Red wine contains a complex mixture of bioactive plant-chemicals and they include:

• Resveratrol, the stilbene polyphenol
• Anthacyanins
• Phenolic acids
• Flavonols
• Monomeric and polymeric flavan-3-ols

Resveratrol is the most studied substance and it and some of the above plant-chemicals appear to have health benefits. It is a good antioxidant.

The health benefits of resveratrol and other plant-chemicals include:

• To prevent and treat cancer
• To protect the heart from cardiovascular diseases
• To prevent stroke
• To prevent diabetes
• To prevent inflammation
• To prevent neurodegenerative disorders
• Has antiviral effects
• May help to reduce weight in obese persons

If you have a glass of red wine the alcohol present can enlarge the blood vessels and this helps heart’s health by decreasing the blood pressure. But if you drink more the blood vessels are narrowed and the heart has to pump hard that results the increase of blood pressure.

Pregnant women and breast-feeding mothers must avoid alcohol including red wine. Dry alcoholics may go for the resveratrol supplements. It is better to consult your doctor before taking the supplement.

Can you tell me about the hereditary diseases?

A hereditary disease is a disease that is passed from one generation to the next through genes. Genes are part of DNA. That is why it can also be called a genetic disease. We know well the hereditary risk in diabetes, coronary heart diseases, breast cancer, ovarian cancer and colon cancer very clearly. The corresponding genes can be identified and estimated to calculate the increased risk. At the same time we should not forget that lifestyle, overweight or obesity, alcohol and tobacco use and no or little physical activity play a vital role in many diseases. Along with these the environmental and occupational exposure to toxins, poisons and chemicals increase also the total risk of many diseases.

Thousands of genetic disorders are already known and it is sure the research will find more in the future too. Few important hereditary diseases are given below and they include:

• Achromatopsia - the inability to perceive color and to achieve satisfactory visual acuity at high light levels
• Adrenal Hypoplasia Congenita - reduced function of adrenal gland; mainly males are affected
• Adrenoleukodystrophy or Siemerling-Creutzfeldt Disease or Schilder's disease - progressive brain damage
• Aicardi Syndrome - partial or complete absence of a key structure in brain, the corpus callosum
• Albinism/Hypopigmentation - little or no melanin pigment in eyes, skin and hair
• Alexander Disease - neurodegenerative disease which destroys myelin
• Alpers' Disease or progressive neuronal degeneration of childhood with liver disease (PNDC) or Alpers-Huttenlocher syndrome - progressive neurological degenerative disease that severely affects the brain and liver
• Alpha-1 Antitrypsin Deficiency - decreased A1AT activity in blood & lungs; most common among whites
• Alzheimer's disease – a degenerative brain disease that causes problems with memory, thinking and behavior
• Amblyopia or lazy eye (poor or indistinct vision or out of proportion to associated structural abnormalities in an eye that is otherwise physically normal)
• Angelman Syndrome - primarily affects the nervous system; this condition include developmental delay, intellectual disability, severe speech impairment, and problems with movement and balance. Most affected children also have recurrent epilepsy seizures and a small head size
• Anencephaly - a condition present at birth that affects the formation of the brain and the skull bones that surround the head
• Aniridia - underdevelopment or absence of the eye's iris
• Anophthalmia - congenital absence of the globe and eye tissue from the orbit in one or both eyes
• Ataxia Telangiectasia - affects the nervous system, immune system, and other body systems; characterized by progressive difficulty with coordinating movements beginning in early childhood, usually before age 5
• Autism - usually first diagnosed in early childhood; brain development disorder with symptoms that involve communication, social interactions and repetitive behaviors
• Bardet-Biedl Syndrome - affects the brain and can cause multiple physical problems including a deterioration of the intellect and neurological functions. It sometimes affects eyesight, a degeneration of light-sensitive cells in the periphery of the retina and causes night blindness, tunnel vision, decreased visual acuity, and extreme sensitivity of the eyes to light. Other symptoms of Bardet-Biedl syndrome may include extra toes and/or fingers, mental retardation, kidney disease and obesity
• Barth Syndrome - a serious X-linked genetic disorder, primarily affecting males. It is caused by a mutation in the tafazzin gene resulting in an inborn error of lipid metabolism
• Batten Disease - a fatal, inherited disorder of the nervous system that begins in childhood
• Best's Disease - a genetic disease that causes blindness by destroying the macula in the center of the retina
• Bipolar Disorder or manic depression - psychiatric mood disorders defined by the presence of one or more episodes of abnormally elevated energy levels, cognition, and mood with or without one or more depressive episodes. The elevated moods are clinically referred to as mania or, if milder, hypomania
• Bloom Syndrome - characterized by a high frequency of breaks and rearrangements chromosomes. People with Bloom syndrome are much smaller than average, and often have a high-pitched voice and characteristic facial features including a long, narrow face; small lower jaw; and prominent nose and ears. They tend to develop pigmentation changes and dilated blood vessels in the skin, particularly in response to sun exposure
• Branchio-Oto-Renal Syndrome - an autosomal dominant condition characterized by ear abnormalities, hearing loss, cysts in the neck, and kidney problems
• Canavan Syndrome - an inherited disorder that causes progressive damage to nerve cells in the brain
• Charcot-Marie-Tooth Disease or hereditary motor and sensory neuropathy - affects the nerves in your arms and legs; loss of muscle tissue and touch sensation
• Cleft Lip/Cleft Palate - birth defects in which the tissues of the mouth or lip don't form properly during fetal development
• Coffin Lowry Syndrome - head/facial and skeletal abnormalities, mental retardation and delayed development
• Coloboma - a hole in one of the structures of the eye, such as the iris, retina, choroid or optic disc
• Color Blindness - major types are red-green color vision defects, blue-yellow color vision defects and a complete absence of color vision.
• Congenital Heart Defects - a defect in the structure of the heart and great vessels which is present at birth
• Congenital Hip Dysplasia - an abnormal formation of the hip joint in which the ball at the top of the thighbone is not stable in the socket, dislocated
• Connective Tissue Disorders – a disorder that change the look and growth of skin, bones, joints, heart, blood vessels, lungs, eyes, and ears. Can change how these tissues work
• Cooley's Anemia/ Thalassemia - caused by mutations in the beta chain of the hemoglobin molecule
• Corneal Dystrophy - one or more parts of the cornea lose their normal clarity due to a buildup of cloudy material
• Cornelia de Lange Syndrome - can lead to severe developmental anomalies. It affects both the physical and mental development of a child
• Cystic Fibrosis or mucoviscidosis - a common disease which affects the entire body, causing progressive disability and often early death
• Cystinosis - a metabolic disease in which the amino acid cystine gets into the cells, but has no transporter to bring it out and the cell crystallizes causing early cell death
• Developmental Disabilities - birth defects that cause lifelong problems
• Diabetes - metabolic diseases in with high blood sugar
• Down Syndrome - a chromosomal disorder caused by the presence of all or part of an extra 21st chromosome; impairment of cognitive ability, physical growth and facial appearance
• Duane Syndrome - a rare, congenital eye movement disorder most commonly characterized by the inability of the eye to move outwards
• Ehlers-Danlos Syndrome - inherited disorders that weaken connective tissues
• Epidermolysis Bullosa - an inherited connective tissue disease causing blisters in the skin and mucosal membranes
• Familial Dysautonomia - affects the development and survival of certain nerve cells
• Familial Mediterranean Fever - recurrent attacks of fever, inflammation of the abdominal lining, the lining surrounding the lungs, painful, swollen joints and a characteristic ankle rash
• Fanconi Anemia - aninherited blood disorder that leads to bone marrow failure and can affect many of the body's organs, tissues, and systems
• Fibrodysplasia Ossificans Progressiva - disorder in which muscle tissue and connective tissue such as tendons and ligaments are gradually replaced by bone, forming bone outside the skeleton
• Fragile X Syndrome – an inherited mental impairment; can range from learning disabilities to more severe cognitive or intellectual disabilities. It is the most common known cause of autism or "autistic-like" behaviors
• G6PD (Glucose-6-Phosphate Dehydrogenase) Deficiency Anemia - the most common human enzyme defect
• Galactosemia - a metabolic disorder that affects the ability to metabolize the sugar galactose
• Gaucher Disease - a genetic disease in which a lipids (fats) accumulates in cells and certain organs; deficiency of the enzyme glucocerebrosidase
• Gilbert's Syndrome - a common, mild liver disorder in which the liver doesn't properly process bilirubin. Bilirubin is the breakdown product of red blood cells
• Glaucoma - leads to blindness by damaging the optic nerve
• Hemochromatosis - excessive absorption of dietary iron with deposits of iron in the body
• Hemoglobin C Disease - an autosomal recessive disorder that causes mild hemolytic anemia
• Hemophilia/Bleeding Disorders - inefficient control over blood clotting or coagulation
• Hirschsprung's Disease - a disease of the large intestine that causes severe constipation or intestinal obstruction
• Homocystinuria - disorder of the metabolism of the amino acid methionine
• Huntington's Disease - a disorder passed down through families in which certain nerve cells in the brain waste away, or degenerate
• Hurler Syndrome - disorder of metabolism; deficiency of alpha-L iduronidase
• Klinefelter Syndrome - a term used to describe males who have an extra X chromosome in most of their cells, XXY instead of XY
• Krabbe Disease - fatal degenerative disorder of nervous system
• Leber Congenital Amaurosis - a degenerative disease that results in a severe loss of vision
• Leukodystrophies - are rare diseases that affect the cells of the brain, specifically the myelin sheath that surrounds and protects nerve cells
• Long Q-T Syndrome - a heart rhythm disorder that can cause fast, chaotic heartbeats
• Marfan Syndrome - disorder of the connective tissue
• Marshall-Smith Syndrome - disorder characterized by advanced bone age at birth, broad forehead, prominent eyes, and small chin
• McCune-Albright Syndrome - affects the bones and color (pigmentation) of the skin
• Menkes Disease - is an inborn error of metabolism that markedly decreases the cells' ability to absorb copper
• Metabolic Disorders - metabolic disorder occurs when abnormal chemical reactions in the body disrupt metabolism
• Mitochondrial Disease - group of neuromuscular diseases caused by damage to the mitochondria-small, energy-producing structures that serve as the cells' power house
• Mucolipidoses - a group of inherited metabolic diseases that affect the body’s ability to carry out the normal turnover of various materials within cells
• Mucopolysaccharide Disorders - are a group of metabolic disorders caused by the absence or malfunctioning of lysosomal enzymes needed to break down molecules called glycosaminoglycans, the long chain carbohydrates
• Muscular Dystrophy - refers to hereditary muscle diseases that weaken the muscles that move the human body
• Neonatal Onset Multisystem Inflammatory Disease - a disorder that causes persistent inflammation and tissue damage primarily affecting the nervous system, skin, and joints
• Neurofibromatosis - growth of tumors in nerve tissues
• Niemann-Pick Disease - fatal inherited metabolic disorders
• Noonan Syndrome - a developmental disorder with unusual facial characteristics, short stature, heart defects, bleeding problems, and skeletal malformations, eye abnormalities occur and problems with language and speech
• Optic Atrophy - loss of some or most of the fibers of the optic nerve
• Osteogenesis Imperfecta - a genetic bone disorder
• Peutz-Jeghers Syndrome - development of growths called hamartomatous polyps in the gastrointestinal tract; particularly in the stomach
• Phenylketonuria (PKU) - deficiency in enzyme phenylalanine hydroxylase
• Polycystic Kidney Disease - multiple cysts in both kidneys
• Pseudoxanthoma Elasticum - deposits of calcium and other minerals in elastic fibers, which are a component of connective tissue. Connective tissue provides strength and flexibility to structures throughout the body
• Progeria - accelerated aging at an early age
• Ptosis - "drooping eyelid” is caused by weakness of the muscle responsible for raising the eyelid, damage to the nerves that control those muscles, or looseness of the skin of the upper eyelids
• Rentinitis Pigmentosa - a degenerative, inherited eye condition which affects the retina, resulting in progressive vision loss
• Scheie Syndrome - an inherited disease of metabolism in which the body cannot properly break down long chains of sugar molecules called glycosaminoglycans
• Schizophrenia - a chronic, severe, and disabling brain disorder
• Severe Combined Immunodeficiency - rare, sometimes fatal, congenital disorders characterized by little or no immune response
• Sickle Cell Anemia - abnormal, rigid, sickle shape of red blood cells
• Skeletal Dysplasias - a group of congenital abnormalities of the bone and cartilage that are characterized by short stature
• Smith-Magenis Syndrome - developmental disorder with a broad, square-shaped face with deep-set eyes, full cheeks, and a prominent lower jaw
• Spherocytosis - a genetic disorder of the red blood cell membrane clinically characterized by anemia, jaundice and enlargement of the spleen
• Spina Bifida - a developmental birth defect caused by the incomplete closure of the embryonic neural tube
• Spinocerebellar Ataxia - a degeneration of the spinal cord and the cerebellum, the small fissured mass at the base of the brain
• Stargardt Disease - inherited diseases causing light-sensitive cells in the inner back of the eye (retina) to deteriorate, particularly in the area of the macula where fine focusing occurs
• Stickler Syndrome - hereditary conditions characterized by a distinctive facial appearance, eye abnormalities, hearing loss and joint problems
• Tay-Sachs Disease - born without one of those important enzymes, Hexosaminidase A; then fatty proteins build up in the brain, they hurt the baby's sight, hearing, movement, and mental development
• Treacher Collins Syndrome - a condition that affects the development of bones and other tissues in the face
• Tuberous Sclerosis - two genetic disorders that affect the skin, brain/nervous system, kidneys, and heart, and cause tumors to grow
• Turner's Syndrome - a genetic disorder that affects a girl's development; only one X chromosome in each cell of a female
• Urea Cycle Disorder - a genetic disorder caused by a deficiency of one of the enzymes in the urea cycle which is responsible for removing ammonia from the blood stream
• Usher's Syndrome - an autosomal recessive condition that affects both hearing and vision
• Velocardiofacial Syndrome - characterized by cleft palate, heart abnormalities, learning disabilities, and over 180 other clinical findings
• von Hippel-Lindau Disease - an inherited disorder characterized by the formation of tumors and fluid-filled sacs (cysts) in many different parts of the body
• Werner Syndrome - a premature aging disease that begins in adolescence or early adulthood and results in the appearance of old age by 30-40 years of age
• Williams Syndrome - a rare neurodevelopmental disorder with "elfin" facial appearance, along with a low nasal bridge
• Xeroderma Pigmentosum - deficient ability to repair damage caused by ultraviolet (UV) light
• Triple X Syndrome - an extra X chromosome in each cell of a female with an increased risk of learning disabilities and delayed development of speech and language skills. Delayed development of motor skills (such as sitting and walking), weak muscle tone, and behavioral and emotional difficulties
• XYY Syndrome - an extra Y chromosome in each cell of a male with Learning disabilities, hyperactivity, attention deficit disorder, and minor behavioral disorders

The genes decide what we are…

Suspend manufacture, import of anti-obesity drug: DCGI. Sibutramine was found to have serious side effects…

NEW DELHI: The Drugs Controller General of India (DCGI) on Friday ordered the “suspension” of the manufacture and import of anti-obesity drug Sibutramine after the medicine showed serious side effects, including heart attack, among some users. The DCGI also recommended to the Ministry of Health and Family Welfare a total ban on the sale of the drug.

It proposes the setting up of various committees to oversee the safety of drugs and also the feasibility of introducing new drugs in India.

The suspension order was issued under Section 26 (A) of Drugs and Cosmetic Act, with immediate effect, with the DCGI also seeking a total prohibition on its manufacture and sale in the open market. The ban has to be formally notified by the Health Ministry on the recommendation of the DCGI.

The decision was taken following recommendations of an expert committee comprising pharmacologist Y.K. Gupta (All-India Institute of Medical Sciences), endocrinologist A.C. Ammini (AIIMS) and S.D. Seth (Institute of Clinical Research) and Anoop Misra (Fortis Hospital).

Orlistate is now the only drug in the market for obesity-management and weight loss, though many new drugs are expected to be in the market shortly.
The decision to ban Sibutramine, sold under different brand names, was taken after studies found it increased the risk of heart attack, stroke and death. The drug has already been banned in the United States, Canada and Australia and was withdrawn in China on Tuesday. The European Medicine Agency (EMA) too has recommended complete withdrawal of this drug.

The preliminary reports of the “scout trials” on Sibutramine showed increase in heart rate and blood pressure among users. This was further confirmed in the final finding of the trial, promoting the government to take prohibitory action.
This is the third drug relating to diabetes and obesity that has been banned in India in the last one-and-half years.

Last month, the government banned the import and manufacture Rosiglitazone, an anti-diabetic drug. Rosiglitazone is already banned in Europe after users experienced serious side effects, including cardiovascular events and adverse effects on lipid profile.

Prior to that, anti-obesity pill Rimonabant was banned in March 2009 after it was found to cause depression and suicidal tendencies.

One of the most commonly prescribed medicines for weight loss and obesity management, Sibutramine has been available in India since 1999. It is manufactured and marketed by over 20 generic companies under various brand names.

Special Correspondent, The Hindu
© Copyright 2000 - 2009
Date:13/11/2010

URL: http://www.thehindu.com/2010/11/13/stories/2010111368382400.htm

Stop taking this drug…

This is a very good and wise decision…Thanks to the authorities and to The Hindu…

Dr. K. Padmanaban, Clinical Toxicologist

Must I eat the costly fruits or fruit products to be healthy?

This is a very good question. Fruits are very important for our health. 4 to 5 servings a day can reduce the risk of many diseases which kills hundreds of millions persons in our world. The examples are coronary heart diseases and cancer. The antioxidants present in the fruits are necessary for the detoxification of the body. Fruits play a vital role in scavenging the aggressive and dangerous oxygen and other free radicals. Many of us know this and even then not enough fruits are eaten. Others buy the costly frozen berries from a foreign country or spend huge amount of money to buy fruit powders or juices. Are they worthy for these high prices?

In our modern time we all have no time. We run the whole day and have no time even to think. The money is not the problem for many. These persons think in a different way. The advertisements in the modern media and the personal approach of persons who sell these costly products make them to think that costly products are good for their health. They buy these and regularly take them. Are they really as healthy as praised always?

Fruits are healthy not only because they have vitamin C and other antioxidants. There are more than 10000 phytochemicals are already identified from the fruits and every day new substances are identified. Fruits have good fiber. Therefore, eating the ripe fruits is the best for our health. There are tens of thousands of fruits in our world if we consider the different varieties too. Only the rainforests of South America has more than 3000 fruits. The Indians who live there eat more than 2000 fruits. But, the Western world eats only 200 fruits from there. All the fruits available in our world are not analyzed completely for their nutrients and non-nutrients as few of the fruits which are marketed for high prices.

Fruits are grown throughout the world. According to the climate we get different fruits. In the same country the tropical plains have different fruits than the high mountains with their mild or cold climate. It is possible to get everywhere fruits and it is better to eat these fruits. Some of these fruits are far better than the costly fruits and fruit products. If you eat fruit you can select according to their color. They are:

• Red fruits – have nutrients such as ellagic acid, lycopene, quercetin and many others. These are good to lower blood pressure, reduce LDL-cholesterol levels, can scavenge free radicals and reduce the risk of prostate cancer. They have the power to reduce tumor growth.

• Orange / yellow fruits – contain beta-carotene, flavonoids, lycopene, vitamin C, zeaxanthin and many others. These are good to lower blood pressure, reduce LDL-cholesterol levels, can scavenge free radicals, have anti aging properties and reduce the risk of prostate cancer. They help in the formation of collagen and healthy joints. It is useful to keep the body alkaline.

• Green fruits – contain fiber, folic acid, vitamin C, lutein, beta-carotene, zeaxanthin and many others. These can reduce cancer risk, can lower blood pressure, reduce LDL-cholesterol and support digestion. They can boost immune system and good free radical scavengers.

• Blue and purple fruits – contain resveratrol, lutein, fiber, flavonoids, ellagic acid, quercetin, zeaxanthin and many others. These help to lower blood pressure, lower LDL-cholesterol, can boost immune system, support digestion, can limit the activity of cancer cells and as such act as an anticarcinogens.

• White fruits – contain betaglucans, epigallocatechin gallate, ligans that boost immune system and many others. These nutrients can also activate natural killer cells and thus reduce the risk of breast, colon and prostate cancer. These balance the hormone levels and thus reducing the risk of hormone- related cancers. Banana, brown pears, white nectarines and white peaches are few in this group.

When you go to the market you can notice the different could fruits and buy and eat them.

The healthy fruits in the Western countries include:

• Apple
• Banana
• Blackberry
• Blueberry
• Cantaloupe
• Cherry
• Cranberry
• Dried fig
• Gojiberry
• Grape
• Pink grapefruit
• Kiwi
• Mango
• Orange
• Papaya
• Peach
• Pear
• Plum
• Pineapple
• Pomegranate
• Prune
• Raspberry
• Strawberry
• Tomato
• Watermelon
It is better to eat fresh fruits. If the above fruits are not available in your place eat the local fruits and these are as good as the above.

Another important thing is the influence on our environment. If the fruits are produced in one corner of the world, processed and transported to another corner of the world the negative impact on environment is great. Use the ripe local fruits, be happy and be healthy.

Good fruits have no use if you have a bad lifestyle and take only processed, fast and junk foods. Change your lifestyle and food and the fruits can make wonder. Never forget the physical activities.

It is difficult for me to understand women; can you tell me the difference between men and women?

It is an interesting question. Let us try to find some answer for this. A woman/man has the same nature that a man/woman has, the same human rights to life, job, liberty and of course, the pursuit of happiness. At the same time both has the same human duties in all the fields starting from childhood to old age. Even then, a woman is different than man in many respects, not only in their anatomy. Are women and men really different? What are the evidences on the psychological level that women and men are the same or different?

Many think that women and men are entirely different. But if you see many psychological studies they reveal that 80% men and women are same in their thoughts. In the other qualities they are different, you could say almost entirely. These qualities include:

• Men think broadly, today you can say globally but women fix or focus on deep details or they are subtle.
• Men take risk in all their activities but women want to guard their knowledge they find and pass it on others too.
• Men want to be independent where mostly the women co-operate.
• Men get satisfaction from career and wealth, but women value the families more.
• Women usually make lower self-judgment than men.
• Men give priority to their personal goals and women show priority to their relationship.
• Men get more sickness than women, but women concern more about their health than men.
• Women handle individually and ready to suffer hardship and pain better than men.
• Men tend to prioritize their personal goals, while women tend to prioritize relationships.
• Men tend to get sick more than women, but women tend to be more concerned with their health than men.
• Women tend to handle monotony and endure hardship and pain better than men.

These are some of the recent findings with respect to the psychological nature and functioning of both sexes. I would like to warn you that infancy, culture and genetic factors play a major role which we cannot simply ignore. That is why it is more difficult to say whether they are same or different but we must accept that they are individuals irrespective of women or men.
There are differences in daily life also and it may be different in different countries, cultures and in races. Surprisingly, here also men act or do differently than women. Here I could tell you some of these points which include:

• Maturity – Women mature much faster than men. In Western countries most of the 19 year old women have already well paid jobs, own rental apartments, own car, go for holidays and her boy friend, may be 25 or 26 still studying and completely immature for life.
• When men and women see television each reacts very differently.
• If they have to write something the men scratch quickly and women decorate their writings.
• Most of the men have only few items in their bathroom and there are enough women in the world who have more than 400 items in their bathroom. This is applicable to shoes also.
• Mostly women make a list of things she needs and buys. But, men wait till his fridge is empty, goes to the shop and buys everything which he finds or looks good. Usually there are more unnecessary things also.
• Men see telephone or cell phone as a communication instrument and talk shortly or send short sms. Women come back from her girlfriend’s house and upon returning home she will call the same friend and talk to her several hours.
• The women sometimes admit making a mistake, but the men almost never admit their mistake.
• Women like film stars like Richard Gere and others, but men do not like them because they remind them only cheap persons who dates only married or older woman.
• A woman knows all about her children – their favorite friends, foods, dreams, sport-, music-, and doctor- appointments. Normally, a man is not aware of these things.
• Whatever women do or go out they will dress up good, but the men will dress up for his office, weddings or to funerals in the same way.
• Men love to talk about politics, but many do not go for voting. Women are interested in politics if they like the politician or the politician is a woman. Mostly, they go regularly for voting.
• Women wash their clothes very often and men do not do.
• Little girl children love to play with toys and mostly at the age of 11 or 12 they lose interest except their doll and Teddy Bear. But men lose this interest never, only with age the toy is different, mini cars to video games or more expensive things.
• Women are good to water plants in the rooms. If the man does this work when his wife or girlfriend is not there after a weak most of the plants are dead. Usually he over waters the plants.
• Women love cats and dogs and men say they also love cats and dogs. But when the women are not looking the men kick these animals.
• A man does not call a relationship a relationship. If a relationship breaks the man suffers a lot because his property is gone. The sufferings sometimes last lifelong. The woman will cry, pour her heart out to her girl or homosexual men friends, and think that all men are idiots. Then she makes a full stop and get on with her life.
• Women prefer more closeness and at least 30 – 45 minutes foreplay and men prefer 30 to 45 seconds.
• During menopause a woman goes through a variety of complicated biological, emotional and psychological changes. These changes are different in different women. The men have the same during menopause – buying modern things which normally young men buy, take a girl friend in her early twenties and buy Porsche or big BMW or big Mercedes Benz.

One more theme which is discussed very hot is who is better, men or women? If you see the education, social and demographic trends in our world here the women lead. But whether they get their share or not, is entirely a different thing.

A recent study in USA says the women are leading in the following points:
Women are better because they are

• Honest
• Intelligent
• Compassionate
• Outgoing
• Creative

Men are better because they are

• Decisive

Both are equal in

• Hard working
• Ambitious

Women make lot of progress in all the countries but they seldom come to the top in political or corporate leadership. The reasons are gender discrimination, not willing to change and the “male unity” in this particular question. Others say diplomatically that the women lack experience and their family responsibility is the reason for this.

If we take men and women in Public Office the results are very interesting. The women have better performance skills in

• Working out compromises
• Keeping government honest
• Representing public interests
• Standing up what they believe

In Policy matters

• Dealing with social issues

The men are better in Policy matters and they include:

• Dealing with crime and public safety
• Dealing with national security and defense

These are very important points which decide much in the future. At the same time I find the discussions who is the best cook or best driver are only there to talk and to have fun among men and women.

But we could not deny the facts that in schools and colleges or universities more women are studying than men. If you see the results the women are always on the top and this will have a strong impact in the future in social, political, economical, financial and industrial fields. Nobody could deny this.

The difference in thinking about sex is not dealt here.

Is it clear for you now? If not read it once again…

I’m a Malayali and working in Dubai; rice, chapathi and chicken always; can you recommend me more to be healthy?

I know the food habit of many Malayalis working in UAE. Rice, chapathi and chicken are good foods, but they do not give you all the nutrients necessary for our metabolism. Too much of carbohydrates and protein can increase the blood sugar and thus the blood fat, triglycerides. This is a risk factor for heart diseases. They are also the reason for weight gain and type-2 diabetes. Too much of chicken has other saturated fats and this increases the risk. Moreover, the body becomes acidic and loses the valuable calcium from your bones. That is why we need vegetables and fruits every day.

I will try to help you and many others who also eat like you to do the best in your / their situation. They include:

• Reduce the amount of rice, chapathi and chicken so that the weight and blood sugar are under control. Eat daily a handful of nuts.

• Poly saturated fats like omega-3 fats are very important for our health. Try to eat twice in a week fatty fish. If not possible, buy fish oil capsules and take one in the morning, midday and in the evening after your meals.

• Surely you will get frozen vegetables there. These are as good as or better than fresh vegetables. No cleaning or cutting is necessary and you can make your vegetable curry in 10 minutes. If it is not possible there are natural food supplements that you can take.

• If fruits are costly or not available try to get dry fruits and you can take this, 20 to 30 g twice in a day.

• Take one vitamin B complex tablet everyday if you are a pure vegetarian to get the vitamin B12.

• Take one 500 mg vitamin C tablet in a day as magnesium and vitamin C keep the blood vessels clean. Moreover, vitamin C is an important antioxidant.

• Use milk and dairy products, but not in excess. The minimum amount needed is enough.

• Women in child bearing age must take one vitamin B complex tablet every day. If they plan for a baby this must be taken before pregnancy so that the folic acid in the vitamin B complex helps to produce normal cell division in the embryo. It is of no use and late if you take after you know that you are pregnant.

• If you have iron deficiency and low hemoglobin level take one vitamin C tablet after every meal. During this period black or green tea must be avoided after the meals. Cucumber must also be avoided. If you are very particular to drink tea or eat cucumber take them in between meals. Eggs and red meat are very good sources of iron. Do not eat too much cheese or drink too much of milk during your meal. Excess calcium disturbs the absorption of iron from our small intestine. Avoid iron tablets. This will bring more problems only.

• Premenopausal and menopausal women can take calcium and vitamin D tablets in between two meals. Two hours after the intake of the tablets only you can take your meals.

• Do not smoke.

• Avoid alcohol; social drinking is two drinks for a man and one drink for a woman, that also only 3 to 4 times in a week. It is better to avoid if you cannot control the amount. Dry alcoholics should not touch alcohol. Never believe your husband when he says that his doctor told him that brandy is good for his health. No doctor will give this recommendation.

• Have enough physical activities. Walking quickly, jogging, riding bicycle and swimming are good. Select according to your convenience and do it for 30 minutes 5 to 6 days in a week.

Have you more questions? Feel free to ask me and you get always an answer from me. It is in your hands to be healthy. Be healthy and be happy….

Can you tell me what causes gallstones?

The gallbladder is a small pear shaped organ located just below the liver in the upper right part of the abdomen. The bile produced in the liver is stored in the gallbladder until the body needs it. Bile is secreted from the gallbladder into the small intestine during the process of fat digestion and absorption from the food. Bile has water, bile salts, fats, cholesterol, protein and bilirubin. We all produce small gallbladder stones which we never notice. When bile crystallizes into big stones the problem starts. Bile can harden if there is too much of bile salts, cholesterol or bilirubin in it. Gallstones are stones that form in the gallbladder or bile ducts.

There are two main types of gallstone and they are:

• Cholesterol stones – 80% are cholesterol stones. They are made mostly of hardened cholesterol and are usually yellowish – green in color.

• Bilirubin stones – 20% are bilirubin stones and are also called as pigment stones. They are made of biliruben, usually small and have a dark color.

Very rarely calcium is also present in bilirubin stones.

Gallstones can be very small or can be as big as a golf ball. Many people who have gallstones do not have any symptoms. The ducts can be blocked and this can cause excess pain and inflammation. Liver, gallbladder and pancreas can be affected.

The causes or risk factors for gallstones include:

• Diabetes – the increased triglycerides are the risk factor here.

• Crohn’s disease – the patients have less bile acids to keep the cholesterol in the solution and these results gallstones.

• Other diseases - cirrhosis of the liver, sickle cell disease and thalassemia are also risk factors of bilirubin gallstones.

• Cholesterol-lowering drugs – these can reduce the cholesterol level in the blood. But, actually it increases the amount of cholesterol in bile.

• Age – people above 60 years are more likely to develop gallstones.

• Obesity – it is a main risk factor in women. Overweight is also a risk factor.

• Rapid weight loss – crash diet to weight loss can produce more cholesterol.

• Estrogen – excess estrogen is a risk factor. Oral contraceptives, pregnancy and hormone replacement therapy can be the reason.

• Ethnicity – for example, the American Indians have higher risk because of the higher levels of cholesterol in their bile. Scandinavians and Mexico-Americans are also in this group.

• Hereditary – can run in the families

• Gender – women has double the risk than men.

There are surgical as well as non-surgical methods of treatment and you doctor can decide which is right for your problem.

Can you tell me the causes of dry and itchy skin?

Many people suffer from dry skin. Lower legs, elbows, forearms and buttocks are the normally affected parts of the body. It is a big problem to many as it can spoil the quality of one’s life. The irritants can attack very easily on dry skin as there is no protective layer of natural lipids. The result is itching. Scratching gives pleasure for few seconds, but the after effects, bloody scratches and infections, can give further problems. If your skin is very dry and itchy your sleep can be affected. Another reason for dry skin may be some diseases such as diabetes and kidney diseases. Many medicines make itching worse. Therefore, it is advisable to consult with your doctor to find out the reason for this dry and itchy skin. If untreated, dry skin may lead to dermatitis which is inflammation of the skin with swelling and infection. Fortunately most of the causes are external.

There are many causes for dry and itchy skin and they include:

• Dry air – It is the most common cause. Winter, indoor air whether with heating or with air conditioners can make dry skin. You have to use a moisturizer. Do not heat the rooms in winter too hot. It is advisable to use humidifier in the rooms. Water in an open vessel can help. If you go outside in winter close your skin very carefully with hats, scarves, gloves and long socks.

• Exposure to water – prolonged exposure to hot water can remove the natural fats that protect your skin. The morning or evening shower can be few minutes with cold or lukewarm water and it is better to skip the hot water. Gently pat and dry your body with a towel. Immediately apply the moisturizer. Avoid hot and long baths.

• Soap - it is the number 1 enemy if you have dry skin. It removes the skin protective layer very quickly. Average persons need soap for the face, hands, feet, underarms and groin. The other parts of the body do not need soap and water is enough to keep them hygiene. Of course, playing children or workers need a mild soap for the whole body. Washing the hands and faces often must be avoided. Buy fragrance free soaps always. Treat your skin gently so that the fats remain there. Sponges or brushes or napkins are not necessary to scrub your skin.

• Clothes that itch – avoid clothes that brings you itching or that makes your itching more. If the irritant comes from your clothing then it is a continuous exposure. To wash your clothes use detergents without perfumes or other additives. Never use a cloth that brings or increases itching.

• Medicines and drugs - Many medicines and drugs have itching as side effects. Read carefully about the side effects. If you get dry skin or itching after taking the medicine for the first time contact your doctor immediately. He may prescribe another medicine with equal effect.

• Diseases – Diabetes, kidney problems, thyroid problems, particularly hypothyroidism, psoriasis, eczema, neurodermitis and other skin diseases can cause dry skin and itching. Approach your doctor for treatment.

• Old age - Getting older can bring dry skin and especially more women suffer from this. The levels of estrogens and menopause play a role here. The majority of old people above 65 suffer from dry skin.

• Malnutrition – it can be a good reason. Consult with your doctor or dietician to have diet with all necessary nutrients to your body. Eating disorders can also cause dry skin.

• Hereditary – your genes may be the culprit for dry skin and this is irrespective of your age.

Consult with your doctor. It may be mostly only a problem of skin care that could be rectified easily. Other diseases must be well diagnosed and treated properly.

Can you tell me how to prevent osteoporosis?

Osteoporosis or porous bone is a known word to many now as the advertisements for the calcium supplements with vitamin D reaches all television watchers in our world. Bone is a living tissue and the disease caused by low bone mass and loss of bone tissue is osteoporosis. With osteoporosis you have increased risk for hip, spine and wrist fracture. It is because osteoporosis makes the bone fragile. The peak bone density is reached at approximately 30 years of age and so the damage begins much earlier.

It is not only a old women’s disease as many think. Men suffer also from osteoporosis. There are two million men suffer osteoporosis in the United States of America. Enough calcium intakes from food and an optimum calcium metabolism can prevent osteoporosis. It is important to build strong bones in young ages so that osteoporosis has no chance in later life. Young ages mean during childhood and adolescence are the best time to build strong bones. This is the best osteoporosis prevention method later in life.

The important steps to prevent osteoporosis include:

• Eat the right diet for you. It must be rich in calcium and vitamin D. Consult your dietician to take the optimum food. Maintain your normal weight. It is dangerous to have below your ideal weight.

• Physical activity like walking, jogging, running, climbing stairs, playing tennis and other similar sports, dancing and jumping rope is good. If you do this for the first time consult with your doctor.

• Weight lifting and weight machines in gym clubs. If you do this for the first time consult with your doctor.

• No smoking and other tobacco products – nicotine inhibits the bone protective effect of estrogen in women. The menopause sets earlier and thus the risk for osteoporosis. Disturbs the calcium absorption from the food.

• No excessive alcohol intake

• Take calcium and vitamin D supplements, if necessary

All these precautions are important and there is no compromise. Parents must inform the children and adolescents the importance of good food and exercise. Once understood properly they have no problem to follow that. This is my personal experience.

Prevention is better than cure. It is in your hands to be healthy. It is not advisable to consume too much processed foods, fast foods and junk foods.

Drinking water; how much must I drink in a day?

This is a very good question. Everybody knows water is important, but many drink less due to many reasons. We should not forget pure drinking water is the number 1 food for us. 60% of our body consists of water. Without water, there is no cell function and the body has no chance to live. The loss of water from your body is called dehydration. If 5% of the body water is lost we are totally tired and 15% water loss means sure death. Many have cramps in their leg muscles. Tons of Magnesium tablets are sold to relieve this. Do you know the easy way to come out from this difficult situation of muscle cramps? Drink immediately two glasses water and you can see how quickly the muscle cramps vanish.

The toxins and other wastes from your body must be removed continuously. The nutrients must be sent to all cells in your body and all these cannot function without water. Human body is not a closed system where there is no loss of water. There are continuous loss of water from our body due to breath, sweat, urine and bowel movements. The loss depends upon your work, the temperature and your health condition. Therefore, the water requirement of a person is individual. It is easy to understand that a person who sits in an air conditioned room loses less water than a person who is working in the building industry in the hot sun.

The skin needs moisture. Ear, nose, throat tissues and vagina need a moist environment to be healthy. Water is the most important for this moistening function.

You have to drink water regularly. Thirst means the dehydration has started already. The average persons must drink 2 to 3 liters of fluid everyday and 70% of that must be pure drinking water. It is told that 20% of the fluid intake comes from the food. It is correct when the meal contains enough vegetables and fruits. If you mostly eat processed or fast or junk food it is not the case.

More exercises, more physical activities and more sweating means, the body needs more water and this must be drunk. It is easy to find out from your dietician the required amount of water to you.

If you have kidney or other health problems consult with your doctor for the amount to drink. Pregnant women and breast feeding women need more water than others. The recommendations are:

• Healthy persons – 2.4 liters (8 cups)
• Pregnant – 2.7 liters (9 cups)
• Breast feeding women – 3.9 liters (13 cups)
• Others, according to their needs

If you drink enough the urine amount in a day may be approximately 1.5 liters and the color of the urine must be colorless to very light yellow. If you take vitamin B complex or other food supplements the vitamin B2 gives an intensive yellow color to the urine. This should not be mistaken as dehydration. I have seen persons who drank 6 or 7 liters and came to me afterwards and the villain was vitamin B2.

Too much of water is not healthy and it is important to consult your dietician at least once to find the optimum requirement.

Coffee and tea can be drunk, but not excessively. Fresh or packed fruit juices without additives and sugar are very good. Now and then you can have some soft drink. Soft drinks with artificial sweeteners must be avoided completely.

Now, I have given you all the information. Tell me how much fluid intake is optimum for you…