Articles on medicine

Generously Generic: Know Your Medicines

Dr. Tanoy Bose, Internal Medicine
One fine winter evening when I was consulting a 45 year old obese fair lady who actually forgot to bring her past health records, I enquired about the medicines she is taking on daily basis. She recollected a few brands which I noted down. On asking whether she is on Aspirin or Thyroxine, she denied of such drug but quickly recollected that she takes Eltroxin 50mcg and Ecosprin AV75mg daily. Well, she did not know that the active ingredient of Eltroxin is Levo Thyroxine and that of Ecosprin AV is Aspirin & Ator vastatin combined. The former is given to replace thyroid hormone deficiency to those who are hypothyroid and the latter is usually given to those who are suffering or are at the risk of developing coronary artery disease. If I am not that very wrong, more than 95% of patients do not remember medicines by their generic names. So what difference does it make? Well, it’s the money that matters. For those who are ill-informed, the market prices of most of the drugs of regular as well as special use are tagged with exceptionally high price just for the sake of an industry.The statistics from McKinsey & Co. states that the growth rates of Indian Pharmaceutical Industry is compounding at 12 to 14% per annum since last 5 years and have projected the value of the industry is going to be around $20 to $24 Billion by 2015. This growth would be driven primarily by rising incomes, and be supported by five other factors: enhanced medical infrastructure; rise in the prevalence and treatment of chronic diseases; greater health insurance coverage; launches of patented products; and new market creation in existing white spaces. If we zero down to the basic issue of generics versus branded drugs it is the pocket pinch that matters. I don’t think if quality is assured, people will love to shell out more for a branded drug rather than buying a generic product.What are generics?All drugs are products of research. They are born in a research laboratory and end up in a pharmacy shop. Whatever be the results of the research product in the laboratory, their usage in general public for any particular indication is highly regulated by the US FDA. Financially the companies have to bear a huge burden to research and develop a drug, undergo clinical trials for them in phasic manner and further make them available for general prescription. Further, after the drug is launched and approved by USFDA the company holds a patent for the drug for say tenure of 10 to 12 years. Hence, during this period the cost of drug is very high as the company needs to recover the cost of R&D. However, after lapse of license,the drug molecule is available for other companies to copy and rebrand and bring them into market again. The cost of the drug falls drastically now as the companies now selling the copied drug did not have to spend on the R&D. The only investment for these companies is the price of the molecule and the technology of packaging and marketing. These drugs which are sold under different brand names after the post licensing period of a particular molecule are called generic drugs. However, the qualities of these generic drugs are also under FDA regulation. According to FDA, to substitute a generic for a brand name drug must follow these criteria:It must contain the same active ingredient, the same dosage strength and the same dosage form (e.g. tablets, syrup etc) and have the same route of administration and further it must deliver the same of active ingredient to the blood stream.Hence cheaper does not mean poor quality. The difference from patented drugs is the generics may vary in shape,size, color or taste. They have different inactive ingredients. However, there are authorized generics that need to maintain similarity in these parameters too. Almost 50% of all drugs prescribed in India are generics. Thus generic drugs may cost almost 20 to 80% cheaper than the patented drug.Is the quality guaranteed in a generic formulation?Researchers have compared patented drugs with generic formulation from different companies in a random manner and 36 of 38 studies virtually found no differences in the drug quality control. But, FDA has barred the publication of drug equivalence studies. Hence it is difficult for the prescribing doctor to know whether there had been any difference between the drugs in the equivalence study or not. It’s worth mentioning thatIndia tops the world in exporting generic medicines worth of Rs.50,000 Crores and currently Indian Pharmaceutical industry is one of the world’s largest & most developed.What is the price paid for not using generics? It’s worth mentioning that India tops the world in exporting generic medicines worth of Rs.50,000 crores and currently Indian Pharmaceutical industry is one of the world’s largest & most developed.In spite of being the largest exporter of generics in the world the story behind the screen is very dull. Just have a look at few of the statistics.WHO says that 3.2% of Indians will fall below poverty line because of inflated medical bills.Approximately one third of the rural population do not seek medical treatment due to financial constraints.And about 47% of rural and 31% of urban hospitalizations are financed by loan and sale of assets.About 70% of Indians are spending their out of pocket income on medicines and healthcare services in comparison to 35% in other Asian countries and are still suffering from infectious & communicable diseases due to lack of quality and affordable treatmentWhere do I get the generics?Generic medicines are best bought from the government sponsored generic drug shopped opened under the banner of “JANAUSHADHI”in most of the Indian states. Janaushadhi stores are functioning under the banner of Bureau of Pharma PSUs of India (BPPI) under the aegis of Department of Pharmaceuticals, Government of India. States like Punjab, Delhi, Haryana,Andhra Pradesh, Odisha, Uttarakhand, Chandigarh, Jammu & Kashmir, Himachal Pradesh and Jharkhand have already implemented Janaushadhi stores providing quality generic medicines at a cheap and affordable price. Few states like West Bengal has initiated Fair Price Medicine shops in a Public Private Partnership models to provide generic medicines at a whopping discount of up to 62.7%. They are opened adjacent to or in collaboration with different government healthcare establishment the largest being at the SSKM Hospital, Kolkata.Can we have examples of price comparison?I have made an attempt to compare the prices of the generics available on the website of Janaushadhi to that of branded generics available in the market. In fact I have approached a regular chemist shop and asked for these prices. Also I have reduced the quote by 11%as that particular chemist shop was giving a discount of 11% on any drug bought from the chemist. Now let’s compare the cheapest discounted branded drugs with the Janaushadhi generics. Generics and Branded Generics : The price difference This comparison is bound to raise eye brows. I am sure it’s unthinkable for most of us that we had been buying medicines at such high price and we are at the verge of realization after sucha long period of illiteracy. Do we get all sorts of medicines at these generic drug stores?Well, wish the answer could have been yes. Unfortunately all medicines are not available at the generic drug stores.While scrolling down the list provided by Janaushadhi website I found drugs for treatment of Rheumatoid Diseases are missing. Drugs for treating neurogenic pain, Parkinsonism, schizophrenia, newer drugs for diabetes management,inhalers and insulins are missing. I am sure they will soon be incorporated or might have been incorporated by now. Even without these drugs the net price of the monthly medications fall drastically if purchased from the generic drugstore.Any words of Caution?Well, there has to be some words of caution. The country is lagging in maintenance of quality control and most of the quality control is outsourced. Further, the government not necessarily declares the data of quality check to the general public. Hence, many doctors keep on highlighting the quality of the generic medicines.My recommendation is, whenever you have the opportunity to buy the drugs from a government sponsored stores, consider the quality is guaranteed by the government. Hence, you can very well go and purchase the medicine and use it personally.Adverse Reactions: Unless the drug is too spurious, it is unlikely that somebody will suffer from any adverse reaction. Spurious drugs are usually sold in peripheral aspects of a city or major town mostly is districts and village areas. Hence, one should be very careful about purchasing generic drugs from these areas.What I practice and recommend?When I am sitting in my clinic at Kolkata, I write the composition of the drug e.g. Paracetamol.[ Drug that reduces fever ], Amlodipine [Drug that controls blood pressure] ,Pantoprazole [ An Antacid ] instead of the brand names. This helps the patients in two ways. Either they can go to the Fair Price shop and buy the cheapest ones and save a lot, or they can go to any chemist and ask the chemist to provide the brand which is cheapest for that particular composition. I do practice in districts of West Bengal where there are brands which I have never heard off. In these areas I always write the brand of the drug and tend to keep the price low. In this way the spurious drug sellers can be fended away and I can ensure that quality drug is served and chances of health hazard is minimum.

Psychiatry and Siddha Medicine

Dr. Jerome Xavier, Siddha
சித்த மருத்துவமும் மன நோய்களும் psychiatry and siddha medicine           சித்த மருத்துவமும் மன நோய்களும்சித்த மருத்துவத்தில் மன நோய்களுக்கான முழுமையான சிகிச்சை முறைகள் உள்ளன என்பதை அறிமுகப்படுத்தவே இந்தக் கட்டுரை.பொதுவாக மன நோயாளிகள் தொடர்ந்து மருந்துகள் சாப்பிட்டுக் கொண்டிருக்கும்வரை சரியாக இருப்பார்கள். மருந்தை இடையில் கொஞ்சம் நிறுத்தினாலும் மீண்டும் பிரச்சனைகள் உருவாக ஆரம்பிக்கும்.அப்படியானால் மன நோயாளிகள் அனைவரும் வாழ்நாள் முழுவதும் மருந்துகள் எடுத்துக் கொண்டேதான் இருக்க வேண்டுமா?இல்லை.அப்படியானால் ஏன் பெரும்பாலானவர்களுக்கு மன நோய் முற்றிலுமாக குணமாவதில்லை?சித்த மருத்துவத்தில் மன நோய்கள்:சித்த மருத்துவம் மன நோய்களை பல்வேறு விதமாக வகைப்படுத்துகிறது.மன நோய்கள் ஒரு தனி பிரிவாக(Psychiatry) சித்த மருத்துவத்தில் உள்ளது. கிரிகை நோய்கள் என இவை வகைப்படுத்தப்படுகின்றன.யூகி, அகத்தியர் போன்ற சித்த மருத்துவ அறிஞர்களின் நூல்கள் மன நோய்களைப் பற்றி விளக்குகின்றன.சித்த மருத்துவத்தில் மன நோய்கள்:-               கிரிகை-               பிரமை-               உன்மத்தம்-               மதஅழிவுஎன பலவிதமாக வகைப்படுத்தப்படுகின்றன.மன நோய்களுக்கான அடிப்படை காரணங்கள்:மரபணு ரீதியாக வருபவை(Genetic)உடலில் இயங்கும் இயக்கங்களை வாதம், பித்தம், கபம் போன்றவற்றில் மாறுபாடுகளால் ஏற்படும் மன கோளாறுகள்.உடல் தாதுக்களான சாரம் (fluid part of all tissues), இரத்தம், தசை, எலும்பு, கொழுப்பு, நரம்பு, விந்து அல்லது அண்டம் ஆகிய ஏழு உடல் தாதுக்களில் ஏற்படும் பாதிப்பினால் உண்டாகும் மன நோய்கள்.நச்சுக்கள் மற்றும் மருந்துகளால் ஏற்படும் பாதிப்புகள்(Toxins).புற காரணிகள் (Social factors).மன நோய்களுக்கான சிகிச்சை:நான்கு நிலைகளாக மன நோயாளிகளுக்கு சிகிச்சை அளிக்கப்படும் போதுதான் முழுமையான விடுதலை கிடைக்கும்.முதல் கட்ட சிகிச்சை:உடலில் மாறுபாடடைந்த இயக்கங்களான வாதம், பித்தம், கபம் என்பவைகளை சரியான அளவுக்கு கொண்டுவர வேண்டும்.இதற்கு முதலில் நோயாளியின் நாடிநிலையை (Pulse reading) கணித்து அதற்குரிய சிகிச்சையை செய்ய வேண்டும்.இரண்டாம் கட்ட சிகிச்சை:பலவீனமடைந்த உடல் தாதுக்களை பலப்படுத்தும் விதத்தில் மருந்துகளையும், உணவுகளையும் கொடுக்க வேண்டும்.மூன்றாம் கட்ட சிகிச்சை:என்ன நோயினால் பாதிக்கப்பட்டிருக்கிறார் என கண்டறிந்த அதற்குரிய மருந்துகளைக் கொடுக்க வேண்டும்.இதில் உள் மருந்து மற்றும் புற மருந்துகளைக் கொடுத்து சிகிச்சை அளிக்கப்படுகிறது.நான்காம் கட்ட சிகிச்சை:மேற்கண்ட மூன்றும் உடலை சரிசெய்வதற்கான சிகிச்சைகள். இதனை அடுத்து மனதை சரிசெய்வதற்காக சில பயிற்சிகளை கொடுக்க வேண்டும்.இதற்கு அட்டாங்க யோகம் எனும் எட்டுவித பயிற்சிகள் உள்ளன.இயமம்நியமம்ஆசனம் – யோகாசனம்பிரணாயாமம் – மூச்சுப்பயிற்சிபிரத்தியாகாரம்தாரணைதியானம் – Meditationசமாதிபோன்ற மனதை நிலைப்படுத்தும் பயிற்சிகள் உள்ளன. இவைகள் நோயின் தன்மைக்கும் நோயாளியின் தன்மைக்கும் ஏற்றவாறு பரிந்துரைக்கப்படுகின்றன.ஆற்றுப்படுத்துதல் (Counseling):மேற்கண்ட நிலைகளின் நோயாளியின் உடலையும் மனதையும் சரிசெய்த பிறகு அவர்களின் பிரச்சனைகளுக்குத் தக்கவாறு அவர்களை ஆற்றுப்படுத்துவது அவசியம்.இவ்வாறான படி நிலைகளில் மன நோய்களை சரிசெய்யும் போது முற்றிலுமாக அந்நோயிலிருந்து விடுபட முடியும்.மருத்துவ ஆலோசனைக்கு:Dr. ஜெரோம் சேவியர் B.S.M.S., M.Dசித்தமருத்துவ மையம்,டாக்டர்ஸ் பிளாசா,சரவணா ஸ்டோர் எதிரில்,வேளச்சேரி பேருந்து நிலையம் அருகில்,வேளச்சேரி, சென்னை.அலைபேசி எண்: 9444317293

Integrative Medicine - an Evidence Based Approach

Dr. Kshamashree Madle, Yoga and Naturopathy
WHO defines Health as not mere absence of Disease but complete, Social, Emotional, Mental and Spiritual well-being. Thus by definition, a Complete medical solution should encompass all aspects of life of a person. Integrative Medicine emphasizes the relationship between various systems of medicine and makes use of all appropriate therapies, both Conventional (Allopathic Medicine) and Traditional (e.g. Yoga, Naturopathy, Ayurveda, Nutrition etc.)National Center for Complementary and Alternative Medicine (NCCAM) defines Integrative Medicine as – that which combines main stream medical therapies and CAM therapies for which there is some high quality scientific evidence of safety and effectiveness. Conventional medicine is often expensive and invasive but a preferred choice in acute care and surgical corrections. To fill the lacunae left by Conventional Medicine there is a need for another type of medicine that is a complete system of medicine in itself and can be complementary to Conventional Medicine. Traditional Medicine systems world over have now been in focus because of active research going on that now has provided enough evidence that it can act as a partner to Conventional Medicine in creating an Integrative Medicine eco-system. These traditional systems of medicines are closer to nature, affordable, less invasive and are proven to be more effective in chronic disease management. The basic criteria for choosing which system of medicine to integrate are:Evidence Backed in treatments for chronic ailmentsPossibility of Functional Integration of therapies based on what best therapies each system can bring rather that taking all therapies from one system aloneNon-Pharmacological, Less Invasive, more natural and use body’s own healing responseFocused on Prevention and Positive Promotion of Health than only curing a diseaseSystems of medicines which can be integrated with Conventional medicineMind body medicine such as YogaEnergy medicine such as AcupunctureHerbal medicine such as Ayurveda

Is Ayurveda Alternative Medicine?

Dr. Kaustubh Kane, Ayurveda
Ayurveda is part of alternative medicine.As today, there are many people who are vary of harmful side effects of modern medicines (Allopathy), there has been a growing so-called ‘trend’ of ancient holistic medicines such as Ayurveda in western countries. We Indians have a bad habit of accepting things which arise or develop in western countries. For e.g we didn’t accepted ‘Kalripayat’ (form of ancient fighting skillset), until it was converted into ‘Karate’ by Japanese monk and made famous by Hollywood in early 80’s. Same ‘trend’ is being carried with Ayurveda, people doesn’t realize strength of our own system until any outsider tells its worth. Another such example is ‘ghee’. For many years allopathy doctors have been advising to avoid ‘ghee’ for cholesterol problems on basis of their previous study, but recent studies have shown that ‘cow ghee’ contains high density lipids which are necessary for human body and also important factor for reducing harmful cholesterol, which Ayurveda had been advising for so long. Comparatively modern science is very young and developing and is incomplete science. It only believes seen knowledge which in Ayurveda is stated as “Pratyaksha praman”. Modern medical science needs to develop because it is incomplete. Whereas Ayurveda is a complete science, I am not stating that research should not be done or can’t be done in Ayurveda, but like numbers in mathematics (0-9), it is all. All other numbers are permutation and combinations of these. Even basic maths like plus, minus, multiply, divide are researched and proved themselves over period of time, no matter how much research is done now it is not going to change. Same is the case with Ayurveda no matter what you research, it is a science which has been researched and proven (e.g. no one can add even 1 doshas in existing 3 doshsas or substract one).Even the word Ayurveda itself is very meaningful –“Aayu   + ved = Ayurveda (Life) + (Science) = Science of life. As the name suggests Ayurveda has very detailed description of every aspect of not only health but of life.Everyone today refers to Ayurveda as alternative and to some extent lower level or poor science and is frowned upon. Just because western thinking doesn’t accept or know any other science doesn’t make it less important. Many Indian doctors have termed Ayurveda as old, outdated and non-scientific. Worst part, they spread this to patient without any true knowledge about it. YES Ayurveda is old but does that make it non-scientific?"Humans are afraid of the unknown”Just like any other science i.e physics, chemistry etc. Ayurveda has its postulations, assumptions, theories, and then field applications to prove those theories. In fact Ayurveda has been gradually developing science rather than a one person contribution.How can a science of around 5000 years termed ‘Alternative'? If Ayurveda is approached as first choice many regular and bigger health problems can be avoided before it even happens. Why to Cure, when we can Prevent it from happening? So instead of being afraid of it, get to know Ayurveda. Experience the beauty of natural healing.

Acupuncture - the Ancient Medicine With Modern Outlook

Dr. Gurudatta H K, Yoga and Naturopathy
Acupuncture is one of the “drug less therapies”, based on the philosophy of Traditional Chinese Medicine (TCM) and recognized by WHO, and is a treatment of choice for several chronic ailments.It involves the inserting of very fine, pre-sterilised, one-time use disposable needles on acu-points skilfully by a qualified Doctor.The “acu-points” are energy points located on the energy meridians, which are imaginary pathways through which the energy called Qi (pronounced as 'chee'), flows all over our bodies to maintain a state of homeostasis.Qi is the vital energy or power that animates and supports the functions of the body and provides nourishment for the entire body. When Qi becomes 'blocked' or its supply starts to become inadequate or excess, the body and organ systems become 'stressed out' and our health starts to get compromised.The Qi imbalances are determined by a thorough evaluation by a Doctor, along with Pulse & Tongue diagnosis. Even modern diagnostics are also taken into consideration.By inserting the acupuncture needles on the acu-points and manipulating them, either manually or electrically, causes the energy flow to get normalised once again and there by eliminating the disease condition.This means that, acupuncture treats not only the symptoms but also gets to the root of the disease and holistically addresses our body, breath, mind & intellect.Typically everybody has some apprehensions regarding the pain while inserting the needles. However the extent of such pains depends on the skill of the doctor and the quality of needles used. Generally, the finer & sharper the needles, the lesser are the pains.The science of Acupuncture requires a thorough knowledge of the human anatomy and physiology, the underlying pathology and an understanding of Chinese traditional philosophy, to effectively manage ailments.Therefore I would like to recommend that all readers consult qualified & registered practitioners and to also check for the quality of needles used. Thereby the treatment sessions can be much more comfortable, leading to better recovery from your health problems.There are a number of diseases which can be effectively managed by acupuncture therapy. To mention a few:Cervical Spondylitis & SpondylosisLumbar Spondylitis & SpondylosisLow back & Neck painSciaticaOsteo-arthritis, Rheumatoid arthritisMigraine headachesRecurrent Stress Injuries (RSI) Post Herpetic NeuralgiaFacial Palsy (Bell's Palsy), Trigeminal NeuralgiaAnxiety & Depression disordersInsomnia & Sleep disordersMale & Female infertility problemsMenstrual disordersHypertensionStress & Pain managementSide effects of ChemotherapyOver the last 3 - 4 decades, the practice of Acupuncture has grown spectacularly in the Western world and a significant amount of research & development has been promoted & funded by the National Institute of Health (USA). All the modern studies have indicated that Acupuncture therapy results in the release of neurotransmitters such as endorphins, which heal our body & mind. Recent studies on fMRI also have indicated that upon inserting needles on acu-points, several changes in the neurons of the brain are effected, which bring about a balance of our functions & emotions.

Cupping for Overall Spine & Pain Management

Dr. Shaik.T, Alternative Medicine
Cupping Therapy  is indicated  for  blood disorders, pain  relief, inflammatory  conditions,  mental and physical relaxation,  varicose veins and  deep  tissue  massage and  quotes up  to  50% improvement in  fertility  levels.   Cupping is  an  ancient  method  of  treatment that has been  used  in the treatment  and cure  of  a  broad range of  conditions;  blood diseases  such  as haemophilia  and hypertension, rheumatic conditions ranging  from  arthritis,  sciatica, back  pain,  migraine, anxiety  and  general physical  and  mental  well-being. The  aim  of  Cupping  is to  extract blood  that  is believed  to  be  harmful  from  the body  which in turn rids  the  body  of  potential  harm  from  symptoms leading to  a reduction in  well-being  (Ullah,  2007). Wet-cupping  has been  used as an  alternative treatment  method  throughout  the  world,  especially  in Asia, the Middle  East  and  Europe. The  main  purpose of  this therapy  is to precipitate  the circulation of blood and  to  remove  blood-stasis  and  waste  from  the body(Kim, 2011). Benefits  of  Cupping: By  creating  suction and negative pressure, cupping  has been  found to affect the body  up  to  four  inches  into  the  tissues, which  is used  to treat muscle pain  and  spasms, drain  excess fluids and  toxins,  loosen  adhesions,  connective tissue and stubborn  knots in  soft  tissue,  stimulate  blood circulation  and  bring  blood  flow  to  nourish  stagnant muscles and  skin,  enhance  the  flow  of  energy, stimulate the peripheral  nervous  system, activate the lymphatic system, clear  colon blockages,  help activate and  clear  the arteries,  veins,  and capillaries, and improve  varicose veins. Cupping  draws the inflammation  out,  yet  does  not  add  to  it. Due  to its stimulating and strengthening effects cupping  has been used successfully  to  treat all of  the following: bowel  conditions (IBS, constipation  and  diarrhea), headaches, back  pain, arthritis,  period  pain,  injuries, asthma,  cellulite,  fatigue (ME), anemia, depression and emotional  problems, atrophy, sciatica, common cold and  flu, skin problems, blood  pressure, ladies problems, weight loss, and  more(Baird, 2011).

Cost of Diabetes Medicines Can Be a Major Concern for Patients

Dr. Anirban Chakraborty, Internal Medicine
As a Diabetes Specialist I see many patients who have come from all over India or even Bangladesh to whom cost of treatment for Diabetes is a major concern.Many patients stop taking medicines because of rising medicine bill. One can’t blame them, as the latest medicines ( the DPP4 inhibitors or the SGLT inhibitors ) can be prohibitively expensive -each costing around 40 – 50 Rs per day.The good news is that these medicines are not the first choice, and the older medicines with proven track records are still the most commonly used medicines worldwide. There is no reason why most of our patients should not be on an optimal dose of these medicines before moving on to newer expensive medicines, especially if cost of therapy is an issue.Metformin is the cheapest, safest and most tolerated diabetes medicine used in the world. It is the first line of medicine used worldwide for these reasons.I would urge all the doctors practising Diabetology to try and prescribe at least 2000mg of Metformin daily ( unless there is issue of contraindication,  intolerance or organ failure) before adding these newer expensive medicines. HbA1c reduction by the newer medicines is no better than Metformin so they are no more effective than Metformin usd appropriatelyEverybody has the right to the correct treatment for diabetes, and we should help the patients as much as possible. Cost of Treatment should be borne in mind while prescribing medicines in India.Stay healthy and Beat Diabetes.

Narrative Medicine- the Human Touch in Treatment

Dr. Sabita Girish, Gynecologist/Obstetrician
Narrative Medicine- the Human Touch in Treatment : In typical medical practice, Infertility in particular, it is important that doctors listen to patients and interpret what they say regarding bodily experiences and health fears. Pain, suffering, worry, anguish and the feeling that something isn’t right – are hard to put down in words. So, patients have a difficult task‘telling’ the doctor, while doctors have a difficult task to ‘listen’. ‘Narrative Medicine’ a phrase coined by Dr. Rita Charon, is all about doctors spending time listening and empathizing with their patients as they share their stories. In an increasingly tech-driven and impersonal world where modern technology, superior medical imaging, robotic surgery and the sheer volume of patients have changed the face of medicine, there are certain things that have fallen by the way side – the human touch, the bond between the doctor and patient, and the hand-holding through times of ill health. As doctors become more and more data-driven, with lab results and scan findings getting more importance, they maintain a clinical distance from their patients and do not have a detailed dialogue on the patient’s health concerns, or listen to the patient’s narrative, by giving it the importance that it deserves. Narrative Medicine – a) helps doctors in making accurate clinical decisions; b) conveys the commitment and compassion of the clinician towards the patient; and c) increases the likelihood of enhancing the trust on the doctor thereby making the patient do what the doctor recommends. Most of all,it helps to make doctors more empathetic, encouraging them to treat the patient as a person (and not a file) in the context of a de-humanizing system.Found it interesting and thought it necessary to share the concept and magical effects of ‘Narrative Medicine’ as expounded by Dr. Rita Charon, Professor of Clinical Medicine, and Director of the Program in Narrative Medicine at the Columbia University College of Physicians and Surgeons. (Information drawn from the write up by Sudha Umashanker published in The Hindu, March 9, 2014)N.RamakrishnaManaging DirectorMOMSOON Fertility & IVF Centre, Bangalore9886001999

The Fact and Facets of Complementary and Alternative Medicine

Dr. Chandrasekaran. C
What is CAM?Complementary and alternative medicine (CAM) is to describe a diverse group of healing systems that are not presently considered to be part of mainstream medicine.Health and disease involve a complex interaction of physical, spiritual, mental, emotional, genetic, environmental, and social factors.What are the basic principles of CAM?The focus is on the whole person -- physical, emotional, social and spiritual. Prevention of illness is a primary concern. Treatments are highly individualised.Treatments are aimed at the causes of illness rather than at its symptoms. Treatments are designed to support the natural healing processes of the body. What are the major types of CAM?Alternative Medical Systems: built upon complete systems of theory and practice. Examples include homeopathy, naturopathy, traditional Chinese medicine (TCM), Siddha and Ayurveda. Biological Medicine: use of substances found in nature, such as herbs, animals, foods, and vitamins to promote health.Energy Medicine: involves the use of energy fields to promote health. Examples of biofield therapies include qi gong, Reiki, and Therapeutic Touch.Other forms of energy medicine involve the use of electromagnetic fields, such as electroacupuncture. Manual Medicine: based on manipulation and/or movement of one or more parts of the body. Examples include osteopathy, physical therapy, massage, chiropractic and reflexology.Mind-Body Medicine: uses a range of techniques that help boost the mind's ability to influence bodily functions and symptoms. Examples include biofeedback, deep relaxation, guided imagery, hypnotherapy, meditation, prayer, support groups, and yoga. Beautiful stages in the healing of disease: there are Seven beautiful stages such as Peace, Hope, Joy, Faith, Certainly, Wisdom and Love.There are some time-honoured Bach flower remedies of England as stated below-MIND AND HEALTH ELIXER OF LIFE: KAYAKALPATiredness of body-OliveBrain tired, Boredom -WalnutDread-Hornbeam God’s grace –Sweet chestnutHealth depends on being in harmony with our soul- Dr Edward BachHealth Insurance: Water violet + Red chest nutDoctor’s Tonic: Red chest nut + Vine + Chestnutbud + cereto.I.C.UNIT: Water violet for patientRed chest nut + Rock water + Gorse + Sweet chestnut for relativesMIND AND WEALTH Prayer pills “Prayer made in faith”-Holy Bible.Sweet chestnut for abject despairGorse for settled despair.To buy own house:Crab apple + Aspen +Sweet chestnut +Gorse +Chicory.For Family Problems: Mustard + Vine+ Chest nutbud.For the settlement of children’s marriage: Parents: Sweet chestnut +Walnut/Surabha Bride/Bridegrooms: Elm.To earn lot of money/respect: Agrimony + Oak. To get more gold/golden jewels: Agrimony +Wild rose +Water violet.For settling down in life: Mustard +Gentian + Wild rose would help youMIND AND EDUCATION Memory Complex:Slowness in Learning& Escapist mentality - Chestnutbud Unsteadiness of mind- ScleranthusLack of self-confidence-LarchBlames others for our own mistakes-WillowRegret over missed chances-Honeysuckle.Teacher/Lecturer/Professor : Elm +Chestnutbud +Walnut.Scientist/Researcher: Estare-de-colonge. (Exploration)Written exam/ Interview: Rock rose,pine,oak (+Elm).Buisness executives: Elm + Water violet + Impatiens + Walnut + Chest nutbud /Red chestnut.MIND AND RELATIONSFamily problems: Chestnutbud + Vine + Mustard.Life/Lifetime problems- Mustard.In-Laws Problems: Elm.Maharaja yogam: Chestnutbud +Gentian +Honeysuckle for men.Mahalaximi yogam;Elm/ Mustard +Rockrose for women.De-addiction remedyClear case of addiction indeed -WalnutUnsteadiness of mind- ScleranthusTo forget worries- AgrimonyThe status monger- VineIrresistible temptation- Cherry plum Celebrative mongers- Wild roseTonic monger- HornbeamNervous fellow- MimulusMiser- Chicory.What is spirituality?Faith. A person's most deeply held beliefs strongly influence his or her health. Faith increases the body's resistance to stress.Hope. Without hope—a positive attitude that a person assumes in the face of difficulty—many people become depressed and are more prone to illness. Forgiveness. Forgiveness is a release of hostility and resentment from past hurts.Love and Social Support. A close network of family and friends that lends help and emotional support has been found to offer protection against many diseases. What is the future of spirituality in medical practice?Prayer. The act of putting oneself in the presence of or conversing with a higher power has been used as a means of healing across all cultures throughout the ages. There is also interesting research emerging that evaluates the impact of religion and spirituality

Are Ayurvedic Medicines Same and Safe for Everyone? Yes and No

Dr. Neelam Nath Bhatia, General Physician
Science of Ayurveda relies on personality of a person. Since not even 3 daughters of same mother have same personality, medicines for all the 3 of them too are different.We have 3 types of personalities- Vatta, Pitta & Kapha.Vatta is like Air- Flighty, go getter,intelligent ,thin,result oriented and prone to lots of Stress, be it of the healthy kind showing positive results.Pitta is like Water- Cool, Accepting reality,balanced human but a bit suspicious but giving anyway.Kapha is like Mother Earth- giving lots but expecting lots in return & may not be getting as much, prone to Abuse, Trusting kind & less of a Always on the move.If medicine for cool person is given to a flighty person, it is harmful for sure.Ayurveda medicine is a system of medicine with historical roots in Indian Subcontinent and it has Nothing to do with Hindu Religion. This Science is equated to way of life like Hindu religion is.In The Western World Ayurveda Therapies and practices (which are manifold) have been Integrated in General Wellness applications and as well in some cases in medical use.It is believed that medical knowledge is transmitted from Gods to sages, and thence to human Physicians. Thus the Sushurta Samhita narrates how Dhanwantri,the "greatest of mighty celestial"incarnated himself as Devodasa ( servant of Gods),a mythical king of Varanasi,who taught a group of wise physicians including Sushurta himself.The Science has evolved over centuries, more than 2 millennia.Therapies are based on complex Herbal Compounds, but no scientific studies have been done. Ayurvedic doctors regard physical existence, mental existence & personality as a Unit. Diagnosis of illness is made by feeling the pulse, vision, speech, appearance tongue, hearing (all of 5 senses.) There are no tests advised as a routine and treatment should be taken from learned FEW Only.Ayurveda is getting popular through word of mouth as of today.Flax seeds do reduce bad fats in blood.Lemon & honey with warm water taken on empty stomach does reduce weight.No harm in doing Surya Namaskar for 20 minutes- it is best way to get natural Vitamin D,the Sunshine Vitamin.Pure Ghee is now promoted by Allopaths also but to be taken in moderation only as good fats are essential to our body.But Do Not Follow Advice of Each other without Looking Within & knowing your own bodies.There is No Harm In Combining Allopathic Medicines with practices of Ayurveda which is a Way of Life.Happy Ayurveda Day to everyone reading this.