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VOL. 15, ISSUE 9 1st June 2017 Monthly Free Circulation

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Interesting articles on:Chronic KidneyDisease of Unknown origin�Yoga - The Optimal System of Exercise�Is Constipation Common in Summer Season?Role of Chemotherapy in Cancer Treatment�Stressed out? Try munching DarkChocolates!!!

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Core group meeting on Chronic Kidney Diseaseof unknown origin (CKDu) held

Titled Chronic KidneyDisease of unknown Etiologyin South Asia: Case definitionand research priorities� a coregroup meeting was recentlyheld at Madras Medicalmission hospital, Chennai.

CKDu is an emergingchallenge in select districts inIndia and Sri Lanka. CKDumostly affects farmers in therural areas who have pooraccess to health care. Thepurpose of the meeting was tobring together the experts fromnephrology and public health toreview the existing knowledgeand discuss the researchpriorities. The meetingparticipants includednephrologists from variousinstitutions, pathologosts andpublic health researchers andother stakeholders.

The CKDu core groupmeeting was organised byTamilnad Kidney ResearchFoundation (TANKER)Foundation with technicalsupport from Indian CouncilofMedical Research. Themaindiscussion was on coming toa consensus about thedefinition of CKDu and thepriority areas for research totake forward the cause ofCKDu. CKDu has been foundto be prevalent in pockets ofAndhra Pradesh, Orissa, SriLanka especially in rural areaswhere the economically

backward people have beenaffected.

More research needs to bedone and the group felt that itwas important for governmentand corporates to be involvedto study this and create moreawareness and find the causesand how to deal with this. Thegroup explored the ways todevelop a strong community toadvocate for the research andinterventions for CKDu inaffected areas.

A press release fromDr. Georgi Abraham andLatha Kumaraswami ofTANKERFoundation throwsmore light on the subject.

Chronic kidney disease ofunknown origin (CKDu) is anemerging public health problemin the south asia region with apopulation of 1.7 billion people.How does it differ from otherforms of kidney disease.

It is prevalent in certaingeographical areas of thedeveloping countries, it affectsmainly the people belonging tolower socio economic status,the age group is young adultsand middle aged, seenpredominantly in farmingcommunities, many membersof the family are affected, it isprogressive, the cause is notknown. They have no riskfactors such as diabetesmellitus or hypertension.

In the SouthAsian region itis prevalent in the north centralprovince of Srilanka such asAnuradhapura, Polonnaruwaand Badulla districts, in theendemic area andHambantotakl district in the nonendemic area.

In India in the state ofAndhra pradesh Srikakulamdistrict (Udhanam) which is acoastal area with beautifullandscape, greenery and fertileland, Prakasam arepredominantly affected withnearly 13% of the populationhaving different stages ofCKDu.Clusters have also beenidentified in Goa and Orrisa.

The Srilankan President HisExcellencyMaithripala Siresenahas formed a presidential taskforce for urgently looking at thescreening prevalence andmanagement of the patientsafflicted with CKDu. A fundhas been created named ISNGardiner initiative for trainingand research in to CKDu inSrilanka.

The stake holders areSrilankan society ofNephrology, The NationalScience Foundation of SrilankaRegional WHO and thegovernment of Srilanka withlocal, regional and internationalparticipations. The patients havebeen grouped in to differentstages of CKDu.And thosewhoare inStageVarebeingprovided

Dialysis, Transplantation withthe help of the Government inSrilanka.

As the Investigations forrisk factors for CKDuArsenic,cadmium, lead, selenium,pesticides and other elementswere analysed in biologicalsamples from individuals withCKDu and compared with age-and sexmatched controls in theendemic and non endemic areasfood, water, soil andagrochemicals from both areaswere analysed for heavymetals.

However the issue of geneticpredisposition has not beenlookedatwhich is adaunting taskdue to the expenses involved. Inone of the studies performed byProfessor Gangadhar ThaduriNephrologist from AndhraPradesh foundhigh silica contentin thewater and soil ofUdhanamand in the urine of patients.

While speaking to ProfessorMuhibur RahmanNephrologistfrom Dhaka, Bangladeshrecently stated that they see afairly large number of patientswith Chronic Kidney disease ofunknown cause. He said thatthe use of agrochemicals asfertilizers in Bangladesh led toincrease content of Cadmiumin rice and vegetables availablein Bangladesh (publishedscientific data). Cadmium inexcessive amount produceskidney disease. However nostudies have been done toidentify whether CKDu inregions of Bangladesh exist ornot. As the infrastructure forstudyingCKDu is unavailable atthis time in Bangladesh aconsorted effort by theBangladeshi Nephrologists willbe done in future to look forCKDu. CKDu information isnot available from Pakistan,Nepal, Bhutan.

(Continued in page 3)

22222 PADHAMHEALTH NEWS June 1, 2017

Once a Kumhar (potter)asked Lord Buddha, �Mylord what is the value for thelife we have, the life weget�. Lord Buddha gave hima stone and asked him tofind out the value of thatstone, he further said: �Becareful and you don�t haveto actually sell it�.

Kumhar went to a nearbymarket with that stone. Heasked a fruit vendor andasked: �how much is this

Other SideReal Value for Life

worth?�Fruit vendorlooked at that shiny stoneand replied: �exchange itfor 12 oranges�.

He further went to avegetable vendor and againasked for the value to thevendor. The vegetablevendor looked at that shinystone and replied:�exchange this stone for abig sack of potatoes�.

He now went to aJeweler and asked for the

value to the jeweler. Jewellersaw the shining stone andsaid: �Sell it for 50 lakhs�.

But Kumhar refused to sellit as it belonged to LordBuddha. Jewelleradded, �Alright, alright,take 2 24karat goldnecklaces, but give me thestone.�

Kumhar then told him thathis guru (Lord Buddha) hasasked him not to sell thestone. How much you wantfor this stone�.

He now went to adiamond merchant andshowed him the shiny stone.Diamond merchant saw theRuby and he knew at aninstant that it was veryprecious and one of its kind.

He proceeded by keepingruby on a red cloth and tookcircles around the ruby andbent his head in front of theruby.

Diamond merchant nowasked Kumhar �where didyou get this rare andprecious ruby from? Eveneverything on this galaxysold won�t let me price thisruby. This is very precious,super rare and hencenothing on this earth valuesequal to this ruby�

Kumhar was nowconfused and irritated, wentto Lord Buddha. Heexplained all he witnessedand said: �Now tell lord,what is the value for the lifewe have and the life weget?�

Lord Buddha said: Fruitvendor saw and said it�sworth 12 oranges. Vegetablevendor saw and said it�sworth a big sack of potatoes.Jeweller saw and said it�sworth 2 crore. Diamondmerchant saw and said itssuper precious and nothingcan buy it. Now the value oflife we have is same like this.We are a RUBY indeed butthe person in front of uswould value us based on hisknowledge, strength, Status.

You are Unique and superrare just like that ruby,nothing in this galaxy equalsyour happiness or you.Respect yourself there isonly one of you on this planetand nobody would be willingto lose you

You may be a preciousstone, even priceless, but,people will value you basedon their financial status,their level of information,their belief in you, theirmotive behind entertainingyou, their ambition, and theirrisk taking ability.

But don�t fear, you willsurely find someone who willdiscern your truevalue.�Respect yourself.Don�t sell yourself cheap.You are Unique. No one canReplace you.

The Danger ofComparisonA guy met one of his

schoolmates several yearsafter school and he couldnot believe his eyes; hisfriend was driving one ofthe latest sleek MercedesBenz cars. He went homefeeling awful and verydisappointed in himself. Hethought he was a failure.What he didn�t know wasthat his friend was a driverand had been sent on anerrand with his boss�s car!

Rosemary nagged herhusband always for notbeing romantic. Sheaccused him for not gettingdown to open the car doorfor her as her friend Jane�shusband did when hedropped her off at work.What Rosemary didn�t knowwas that Jane�s husband�scar had a faulty door thatcould only be opened fromthe outside!

Sampson�s wife went tovisit one of her longtimefriends and was verytroubled for seeing the threelovely kids of her friendplaying around. Herproblem was that she hadonly one child and have beenstruggling to conceive forthe past five years. What shedidn�t know was that onlyone of those kids was thebiological child of her friendand he had sickle cell andhad just a year left to live;the other two were adopted!

Life does not have auniversal measuring tool;so create yours and useit. Looking at people andcomparing yourself withthem will not make youbetter, only bitter. If youknow the sort of load thechameleon carries, youwouldn�t ask why it takesthose gentle strides. So,enjoy what you have and begrateful for it.

Not all that glitters isgold, everyone is goingthrough one thing or theother, live and be happywith what you have and begrateful for it.

(Source: Internet)

June 1, 2017 PADHAMHEALTH NEWS 33333

Professional PerformersGroup has honoured editor,Chitra Sivakumar, with PPGGlobal International Award2017- in appreciation of theservices of PADHAMHEALTH NEWS in the fieldof Medical Journalism. Theaward consisting of a citationand a letter of appreciationrecognises the efforts of oureditor and team PADHAM inthe dedication towards thepublication where �contentsare interesting as well asinformative to the readers�.

Our recently launchedwebsite www.padhamhealthnews.org has

PADHAMHEALTH NEWSEditor Honoured

striked a very warm chordwith the readers. The websitehas a lot of interesting sectionsand is updated constantly.

As a team that has beenconsistently striving hard for16 years to provide the readerswith the right knowledge andawareness about thingshappening around them, thatconcern their health- thisaward comes as an energy-booster and makes us striveharder!

At this point, we want tothank our readers and wellwishers, once again for theirunstinted support andfeedback that keeps us going!

They are the blood vesselswhich supply and take outblood from the glomerulus(filter), the glomerulus, thetubules which drain the urine,the interstitiumwhich occupiesthe area between the tubules.CKDu is predominantly adisease of the tubules andinterstitium contrary todiabetes mellitus andhypertension which producedamage to the blood vesselsand glomerulus. The reason forthe involvement of the tubuleand the interstitium remains amystery in CKDu. The tubuleundergoes atrophy andinterstitium develops scars(fibrosis) a condition calledtubulo interstitial fibrosis(IFTA). Nobody knows whythis happens.

The Current State ofManagement in IndiaThe Government of AP has

taken initiative to collaboratewith ICMR whose DirectorGeneral Dr.SoumyaSwaminathan has deligated ascientific team includingDr.Prabdip Kaur to support theefforts. The TANKER

FOUNDATION has beenrequested to convene ameetingof the core group ofNephrologists, Pathologists,Epidemiologists,Genetis andother environmental scientistsfrom South Asia region toidentify the cause of CKDuscreening programmes,surveillance, follow up of thepatients in already existingregions and new geographicallocations in India and otherregions.

Professor Chacko Jacob(Vellore), Professor SanjayAgarwal (AIMS New Delhi),Professor Ravi Raju (ViceChancellor AP MedicalUniversity) will lead thedifferent groups for discussionunder the leadership ofProfessor GeorgiAbraham andLatha Kumaraswamy ofTANKERFOUNDATION.Thegroup is joined by experts fromSrilanka, Professor ChulaHerath (President of SrilankanSociety ofNephrology),Dr.Nalika SepaliGunavardhana (WHO) whohave advanced in their initiativesin tackling CKDu in Srilanka.

The objectives of the Coregroup meeting is to defineCKDu in India, find out regionswith CKDu which are notidentified, look at the differentcauses which can lead toCKDu,Management of patientsstratifying them in to variousstages of CKD 1 � 5 . ProvideDialysis treatment to patients atstage V CKD.

The Srilankan Governmenthas taken initiatives to preventenvironmental contaminationby pesticides and otherenvironmental toxins andprovide safe drinking andcooking water. ProfessorGeorgiAbrahamandDr.PrabdipKaur from India were invitedand involved in tackling theCKDu in Srilanka as membersof the presidential task forceandWHO. The respective stategovernments in India and healthauthorities with politicians andbeurocrates philanthropicorganizations and scientistsshould work together tosupport the society with CKDu.

There should be specialtraining for Nephrologists andphysicians in environmentalNephrology withepidemiologists and socialworkers in addressing the issueof CKDu. The Indian Societyof Nephrology under thepresidentship of ProfessorChacko Jacob and SecreataryProfessior Narayan Prasad andEditor in Chief of the IndianJournal of NephrologyProfessor Sanjay Agarwal willuse the Journal fordisseminating the knowledgeon CKDu continuously.

The CKDu core meetingsupported by TANKERFOUNDATIONandMADRASMEDICAL MISSIONHOSPITALwill hopefullyworkas a platform for the care ofCKDu in the South AsiaRegion.

(Contd. from page 1)

Just to explain about CKDu :The Kidney has four compartments as shown in the Fig

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The Importance ofExerciseExercise is the only tool for

a healthy life; yoga surpassesall other systems of exercise.Yoga is unlike any system ofexercise. The methods ofexercising aredifferent: the mindis given immenseimportance, thereare preciseexplanations andinstructions onvarious aspects liketiming andsequence ofasanas. It is adetailed scienceand in order tounderstand it, it isimportant to knowwhy we shouldexercise at all.

Many people donot exercise andyet live to a ripe oldage. But the quality of life ofsuch persons will not be asgood as onewould like it to be.Living isnot important�livingwith excellent healththroughout ismoremeaningful.

Exercise, yogic exercise, isthe only tool that canmaintainhealth in a cellular sense. It isnoninvasive and without sideeffects. However, practice ofasanas and pranayama needswhat modern thought callsmotivation and Patanjali calls�tapas�. This is preventivemedicine according to ancientlogic.

To undertake preventivesteps onemust understand theeffects of aging on the humanbody.Aging is the diminishedability of the cells of the bodyto react and adjust to theinternal and externalenvironment. Let us reviewwhat happens to the body inthe various systems as wegrow older.

CellsThe aging cell has a poorer

capacity to remove the normalamount of free radicals formedin the body. Retention of freeradicals, is toxic to the body.The dwindling capacity ismultifactorial � stress, poornutrition, unhealthy living andlack of exercise.

Yoga- the Optimal Systemof Exercise

ByDr. Krishna Raman, Consultant Physician andYoga Expert

Anti-oxidants try to counterthe existence of free radicalsand slow the aging process.The three most importantanti-oxidants are superoxidedismutase, catalase andglutathione peroxidase. Other

enzymes capable of removingradicals include vitamin E andC, and beta carotene. Agingof the cells is associated witha decline in protein synthesisand cellular proliferation, thusaffecting the turnover ofanti-oxidants.

Cardiovascular systemThe cardiac muscle starts

to atrophy with age. Thecoronary arteries becomeblocked with plaques,reducing coronary flow. Thiscan lead to a heart attackresulting in death of the tissue� an infarct.

The size of the capillariesin the skeletal musclesdiminish, and muscle bloodflow is reduced. The elasticityof the blood vesselsweakens, adding to flowreduction. Thisincreased tension in theperipheral vesselscauses an increase inblood pressure andreflex strain on theheart. The heart has topump harder tomaintain a healthycirculation.As the cellsdo not derive a healthysupply of blood,retention of cellulartoxins damages thetissues.

Calcification of major andminor blood vessels occurs,much depending on the diet,age and sex, physical activity,level of atmospheric pollutionand genetic predisposition tothe condition.

Atherosclerosis, whichmeans hardening of thearteries with resultantreduction in blood flow to theaffected area, is a major killerin the world today. The archof the aorta becomescalcified. The aorta can alsobe dilated due to senilechanges. All blood vessels inthe body undergodegeneration, particularly inthe heart and brain.Intramuscular reduction inblood flow leads todifficult andpainfulwalking, as theworkingmuscles do not get adequateflow at times of demand.

The intracellular enzymesin the substance of the heartmusclediminish inquantity andquality, affecting the quality ofcardiac contraction. The agingnervous system affects therate and rhythm of the heartwhich slows down; this is dueto reduced sympathetic driveand domination of theparasympathetic nervoussystem.

Respiratory systemThe lining of the nose

suffers reduction in bloodsup-ply. This leads to a dry andstuffy nose and crustformation. Ciliary function ispoorer. The reflexes of thenasal lining to changes inexternal temperature are lesseffective. The sinus cavitiessuffer stagnation of secretionsand poor clearance.

Ciliarymotility is affected.Drainage passages of thesinus into the nose becomeblocked. The nasal part of thepharynx suffers reduced bloodsupply and the lining of the

cavity is not as healthy asbefore. Stagnation ofsecretions leads to sinus andupper respiratory infections.The capacity of the tracheaand the rest of the respiratorytree to expand and contract isreduced. This affects theproper flow pattern of inhaledand exhaled air. The bronchiand bronchioles receive lessblood, hence function lesshealthily. The cilia lining therespiratory tree does not cleartoxins, debris, bacteria andother pathogenic materialwell. Infections can result.Reduction in the elasticity oflung tissue increases theworkof breathing.

The number of pulmonarycapillaries reduce in size andnumber, affecting ventilationand perfusion of gases. The

alveoli dilate, retaining inhaledair. The elasticity of intercostalmuscles and ribs is reduced,making breathing difficult. Thediaphragm becomes rigid andinelastic, leading to difficulty inthe proper up and downmovement of the lungs andcirculation of the energy drawnin. Clearance of toxins in therespiratory system is thusaffected.

The vital capacity of thelungs diminishes and theperson is not as energetic asbefore. The cells not beingable to secure a healthy supplyof oxygen, cellular metabolicreactions are affected. Themitochondria need anadequate supply of oxygen.Lack of this affects generationof energy in the body.

PADHAM HEALTH GUIDE 19

A Comprehensive book onFoot care for Diabetics

� ForwardMarch

� The Human Foot-Architectural Marvel

� Diabetes Mellitus

� Changes in the foot of the Diabetics

� Wound healing in Diabetes

� Foot infection in Diabetes

� Gait Analysis in Diabetics

� Role of antibiotics in Diabetic Foot Sepsis

� Ulcers and Non-Ulcers

� Clinical assessment of foot disorders in diabetes

� Foot care awareness in patients with diabetes

� Surgical Management for diabetic foot

� To walk or not to walk�.?

� Why an amputation for Diabetic foot sepsis?

� Foot ulcers and their management

� Podiatry and Diabetic foot care

� Community Foot Care programmes and FootEducation

Good Health is onlyGood Health is onlyGood Health is onlyGood Health is onlyGood Health is only `̀̀̀̀ 20 now�20 now�20 now�20 now�20 now� Postage extra


The word constipation isderived from the Latin word�constipare�, meaning tocrowd together. The termconstipation includes a widerange of symptoms and signs.

Studies have shown poorconsumption of fluids assecond independent risk factor.These results support theobservation that constipation isa �summer disease� that may

be treated by increasing theintake of fluid.

The simplest definition ofconstipation is the difficulty ofpassage of large or hard stools.Constipation is usually definedin terms of changes in thefrequency, volume, weight,consistency or ease of passageof the stool. In children, stoolfrequency depends on age. Bythe age of four, an adult patternof bowel movement isachieved.

In children with earlierconstipation, parent should payattention to the child�s stoolfrequency during holidays ortravel in summer.

Low fluid intake alone doesnot cause constipation.Summer and the high humidweather leads to loss ofelectrolytes like sodium orPotassium.When kids can�t orwon�t use the bathroom, it�scalled �withholding�.Cleanliness can also be animportant factor. Nearly 20%dislike using outside bathroomsbecause they�re dirty and anoutdoor setting is less likely tohave clean restrooms. This canfurther discourage one fromgoing.

Non availability of toiletfacilities and postponingdefecation is one importantfactor. Continuing to resist theurge to go can cause the brainto begin to ignore the urge as

Is Constipation Commonin Summer?

ByDr. G. Sivakumar, Consultant Surgeon

well. This avoidance of goingto the bathroom is one of themost common causes ofconstipation. Low food intakeand intake packed food leadsto impaction. The mostcommon type of constipationin children is simpleconstipation.

In the elderly, low liquidintake may be indicative ofhypohydration, often thought

to be a cause of constipation.Poor dentition, a decreasedproduction of saliva anddehydration, especially in thewarmer months makes theproblemmore.

It is difficult to define andquantify as to what is andwhat is not constipation.There are persons whoevacuate the bowels three tofour times daily. At the otherend, are those persons whovisit the toilet once in three orfour days and are none theworse for it. Subjectively, hardstools, difficult stools, bulkystools or small stools andsometimes painful stools haveall been regarded asconstipation by the patient.Possibly the occurrence of abacklog in the bowel withtendency for more and morestools to be retained everydaymay be the best definitionfor constipation. But thiscannot be quantified untilsymptomsmanifest.

Studies have been madeto find out the time taken forthe ingested food to make itsjourney from themouth to theanus, using radioactive racerstagged to food. The transittime has been found to varyfrom about 20 hours to 96hours or more. The Asiaticshave a more rapid transit,which is attributed to thevegetarian high fibre diet.Possibly their relative lack of

inhibitions to defecate oftenperformed on as-is-where-isbasis, may also be acontributing factor to the rapidtransit.

The western counterparthas a much lower transitperiod. It may be relevant tostate that the higher incidenceof colon disorders like cancer,colitis and diverticolitis, maybe the price paid for by thewesterners by this delay oftransit.

Drugs can causeconstipation. In adult and inelderly people, the importanceof the use of drugs such asnarcotics, antihypertensivemedications, diuretics,antacids containing aluminiumand the long-term use ofstimulants or bulk-forminglaxatives may causeimpaction.

One myth is that wasteproducts can accumulate andcontaminate the rest of thebody.

A host of medications cancause constipation, includingiron and calcium supplements,antidepressants, painkillers,and some blood-pressuredrugs. Constipation can occurin pregnancy or be caused byserious conditions, such as anunderactive thyroid, elevatedblood-calcium levels,Parkinson�s disease, multiplesclerosis, irritable bowelsyndrome, and actualblockages of the intestine bycolon cancer. All can causedifficulty in moving one�sbowels.

The great part aboutsummer is that it keeps kidsactive, which helps preventconstipation.

Dehydration is related towater itself, but under certainconditions, dehydration cancause constipation.Constipation during thesummer season is often seenbecause people aredehydrated. During thesummertime, the water that ispresent in the digestive systemis diverted to control the bodytemperature. Water isreleased in the form of sweatand water vapour.

Fluid losses induced bydiarrhoea and febrile illnessalter water balance andpromote constipation. Whenchildren increase their waterconsumption above their usualintake, no change in stoolfrequency and consistencywas observed. The

improvement of constipationby increasing water intake,therefore, may be effective inchildren only when voluntaryfluid consumption is lower-than-normal for the child�s ageand activity level.

While sulphate in drinkingwater does not appear to havea significant laxative effect,fluid intake and magnesiumsulphate-rich mineral waterswere shown to improveconstipation in healthy infants.

In conclusion, fluid loss andfluid restriction and thus de-orhypohydration increaseconstipation. It is thusimportant to maintaineuhydration as a prevention ofconstipation.

The prevalence of moodand anxiety disorders inconstipated patients is muchhigher than general population.

Constipation is a socialdisease. Environment alsopays a major role in thisailment. Even travel toanother place is known toinhibit bowel movement.Mental tension, change of dutyhours, jet lag, a dirty toilet arewell known to contributetowards inhibitions of thebowel movement. The othercontributing factors includelow intake of fluids especiallyin summer, low residue diet,growing use of fast food or aliquid diet, which may beworse confounded by anillness where such a diet isneeded, and a metabolicdisorders like diabetes. Indiabetes apart from theexcessive loss of fluids asurine the associatedneuropathy (nervedegeneration) of the bowelmay lead to slowing of thebowel.


Doctors who treat cancer,are called as oncologists.There are three modalities oftreatment for cancers �surgery, Radiotherapy andChemotherapy.

Surgery � Removal of thecancer by operation

Radiotherapy � Usage ofelectromagnetic orCorpuscular rays to destroythe cancer.

Chemotherapy �Administration of drugs byvarious routes to kill cancercells.

Broadly speaking, slowgrowing malignancies aretreated with surgery alonewhere as, rapidly growingtumors require a combinationof surgery (Plus or Minusradiotherapy) andchemotherapy. Early stagecancers can be cured withsurgery or radiotherapy alone(although it may not true in alltypes) and advanced stagecancers requirechemotherapy.

The behaviour and naturalcourse of each type of canceris different from that ofanother. Based on the site ofcancer, its histological varietyand its stage, oncologistsstrategically choose any one ofthe above modality oftreatment or a combination ofthese modalities of treatment,which would ideally suit toattack the cancer��..

Medical oncologist is thephysician who makesimportant decisions regardinginvestigation, diagnosis,treatment and follow up in acancer patient. He guides in

Chemotherapy � APromsingFuture In Cancer Treatment

By ConsultantMedical Oncologist Dr. S. Sivakumar

screening (early detection)and prevention of cancer. Hetreats cancer by administeringdrugs. The drugs may beadministered by oral route,parenteral route or into acavity or viscera that containsthe cancer. Based on thenature and mode of action ofdrugs the medicines that amedical oncologist uses maybe classified as hormonetherapy, Biological therapy,

imuno therapy and chemotherapy.

What is Chemotherapy?Chemotherapy is

administration of drugs intothe body, in an attempt to killcancer cells. It may beadministeredorally, or througha needle into the vein, arteryor into the cancer containingcavity. Someof themedicinesmay be given into a muscle(Intramuscular) or intounderneath the skin(subcutaneous) or sometimedirectly into the lesion (Intralesional). It is classified undervarious groups according toits mechanism of action.

Chemotherapy is used:

1. To cure certainmalignancies (e.g.,choriocarcinoma certain childhood tumors, Hodgkinsdisease)

2. To palliate symptomsin advanced and disseminatedcancers (e.g., chronicleukemias,multiplemycloma,ovarian cancers).

3. To decrease the rateof relapse, after curativesurgery or radiotherapy is

completed. (e.g., Breastcancer, Bone sarcoma, Largebowel cancers).

Side-effects ofChemotherapy:1. Nausea and vomiting

2. Loss of appetite andweight

3. Tiredness

4. Diarrhoea, andabdominal pain.

5. Fever, chills, body pain

6. Mouth and ano-genitalulcers

7. Skin and nailpigmentation

8. Loss of hair over scalp,face and body

9. Kidney failure

10. Liver functionimpairment

11. Heart dysfunction

12. Lung inelasticity

13. Bone marrowsuppression

Misconceptions aboutcancer treatment:

1. Surgery causesdissemination of cancerthrough out the body.Not always true. However,

if the oncologist decides it isnecessary, he may usechemotherapy beforesubjecting the patient forsurgery (e.g., Osteosarcoma).

2. Chemotherapy andradiotherapy are painful.

Not true. However if thechemotherapy drugs escapesout of the vein duringadministration or if radiationcauses skin ulceration-it maybecome painful.

3. Non-vegetarian items arenot to be eaten duringtreatment.

Not true. However thedishes have to be hygienicallyprepared and freshly eaten.

4. Do not take food orwater before chemotherapy.

Wrong. Take adequatefood and water before eachcycle of chemotherapy. Toomuch of either of thesehowever causes vomiting.

5. Cancer induced paincannot be controlled.

Not true. Management ofcancer pain is possiblewith theavailable analgesics, opioids,radiotherapy techniques andsurgical means.

6. C a n c e rtreatment isg e n e r a l l yineffective.

Not true.Although a curemay not beachieved inmany cancers,the goal ofcancer therapyin these patientsr e m a i nsymptompalliationproviding acomfortable life, andimprovement in the overallsurvival.

7. Quack methods ofcancer therapy is as good asconventional therapies.

Absolutely wrong. Theconventional allopathictreatment of cancer has astrong scientific backing andwas born out of years ofresearch and establishedresults of numerous scientifictrials. On the other handcancer quacks areopportunists, utilizing thedesperation of patient�srelatives and their fear ofcancer therapy toxicities.

Diet for Patient�s on CancerTherapy:

� Avoid hot spicy food(pepper, chillies)

� Avoid masala, coffee,and deep fried foods.

��Take small, frequentfeeds.

��Liquids and semisolidspreferred over solids.

��Take freshly preparedhygienic food.

�Avoid eating out .

�Consume plenty of fluids.

Precautions for cancerpatients while on therapy:

��Use a soft brush forbrushing the teeth andcombing the hair.

�You may use a mouthwash after each meals(chlortexidinemouth wash)

�Get your dental cavitiestreated by a dentist beforestarting chemotherapy.

�Prevent nicks and cutswhile shaving andcuttingnails.

��Wash you hands, andp e r i n e a lr e g i o nthoroughly

��Stayaway fromp e o p l ewith cold

and flu.

��Cut your hair short

� Eat a well balanced dietwith adequate fluids and fibrecontent.

��Take sufficient rest.

�Consult your doctorwhenyou notice any new symptomseither due to the disease ortreatment.

�Wash fruits beforeconsuming them. Rinse yourmouth after eating fruits andsweets.

�Finally � the mostimportant-Be optimistic,believe that you would becured. Trust your oncologistand have confidence in him.

The last three decadeshave witnessed tremendousadvancement in theunderstanding, detection, andmanagement of cancer. Theconcept of radical surgeries,newer techniques inradiotherapy, and novelchemotherapeutic andimmunotherapy agents haveglorified cancer management.

However, among thesethree modalities,chemotherapy claims creditfor the successfulimprovement in the overallsurvival, progression freesurvival and disease freesurvival for patients inflictedwith this once dreadeddisease, and cure formalignancies like Hodgkinsdisease, testicular cancer,ovarian cancer,choriocarcinoma andchildhood cancers.

High dose chemotherapywith stem cell support (Bonemarrow transplantation) hasopened the door for curabilityin patients with acuteleukemia (blood cancer) highgrade lymphomas and evensome of the solid tumors.

Hence, chemotherapy, hasrevolutionised cancer practice,and therefore, can be aptlycalled the future of cancermanagement.



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Has informative articles on:Has informative articles on:Has informative articles on:Has informative articles on:Has informative articles on:� Corneal Transplant - Sight for Sore Eyes

� Dyspepsia

� Gene theory � A fascinatingbreakthrough

� Helicobacter Pylori

� Newborn Scoring System

� Incessant Crying

� Leprosy- Enroute Elimination

� What is Neurofibroma?

� Nutrition and Women

� YogicManagement of Pulmonary diseases


PADHAMHEALTHGUIDE11

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� Cardiopulmonary Resuscitation (CPR)

� Dealing with Disasters

� Do�s and Don�ts for the elderly

� Facing problems

� Health History �History of Braille

� Multiple Sclerosis

� Periodontal Disease - Pyorrhea

� Tuberculosis in Children

� Varicella - Chicken Pox


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Has informative articles on:Has informative articles on:Has informative articles on:Has informative articles on:Has informative articles on:� Emotions and Brain

� Fact File � Echocardiogram

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� Home nursing- Need of the hour

� Health History � World Red Cross Day

� Luscious Lemon

� Plus points of physicalActivity

� Skin care during scorching heat

�Xerophthalmia (Dry Eye)


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Good Health - Naturally!!Good Health - Naturally!!Good Health - Naturally!!Good Health - Naturally!!Good Health - Naturally!!By Janani Koushik

At times, when you arestressed at work or irritated bya long commute- the wiserpeople around youmight haveoffered you a bar of darkchocolate. No, they are notjust being polite. They areright!Dark chocolate is not justheavens descended on earthfor chocolate aficionados, butalso a storehouse of goodness.And that�s what we are goingto discuss in this issue�s GoodHealth, Naturally.

Often termed as the�healthy chocolate�, darkchocolate is a variant ofchocolate that has a highercontent of cocoa butter andlesser milk content thanregular chocolates. Identifiedas a superfood and stressbuster- dark chocolate ispopular all across the world.The scientific name of cocoabean is Theobroma Cacao,that translates to �Food of thegods�. History reports thatthose who drank it felt

increased energy, focus,stamina, happiness, andvirility.

Dark chocolate andirregular heat beat:

A recent study conductedin Denmark has found thateating chocolate helps reducethe risk of one type of irregularheartbeat, known as AtrialFibrillation. Dark chocolate isrich in antioxidants thathelps inmaintaining a healthyheart.Antioxidants are a group

of compounds known to fightthe damaging effects ofoxidative stress on cells withinthe body and are increasinglythought to have many heart-healthy properties.

Also, it is known to calmand relax the mind. Since thesugar content is less in darkchocolate compared to thevariants, it is alsorecommended in moderationfor diabetics. A recent studyfound that dark

chocolate helps restoreflexibility to arteries while alsopreventing white blood cellsfrom sticking to the walls ofblood vessels - both commoncauses of artery clogging.

Another report clearlysuggests how those (whoweresurveyed) reported asignificantly lower bloodpressure when they consumeddark chocolate, against thosewho consumed whitechocolate. The flavonoidscontent in dark chocolate alsohelps in treating bodyailments.

These are useful in treatinganemic patients as well asthose having poor dietaryhabits. The flavanols also helpyou to maintain the glow inyour skin. A Finnishstudy found that chocolatereduced stress in expectantmothers, and that the babiesof such mothers smiled moreoften than the offspring ofnon-chocolate-eating parents.

Correlation to stress andother medical benefits:

By stimulating the

productionof endorphins in thebody- dark chocolate makessure you feel happier andstress-free each time you diga bite into it. Other stimulantsin dark chocolate includetheobromine and caffeine. Thepolyphenols and antioxidantscontent helps in maintaininggood blood flow and improvedvascular health.

The serotonin level in darkchocolate may act as aneffective anti-depressant.It contains serotonin, whichhas nearly identical qualities ofanti-depressants. Thinkingnutrient rich food? Think dark

chocolate, again. Rich inmagnesium, copper, selenium,iron, potassium and zinc- it isthe ideal nutrient-richsuperfood you would want inyour house (of course, inmoderation).

Recipes you�ll love:Dark chocolate is, in simple

terms, heavens descended inearth. With a slightly bittertaste and less sugary- it canbe the ultimate mid-day snackor late-night binge eating. Inaddition to the ready madebars you can dig a bite into,there are various recipes youcan try to satiate the choco-craving.

From homemade pies, tochocolate cakes, to chocolatemousse, there aremany thingsto try. You can also bake afresh batch of choco-nutcookies as an evening snackfor kids after they are backfrom school.


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PADHAM HEALTH NEWS Office is at26, II Main Road, C.I.T. Colony, Mylapore,

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Editor :ChitraSivakumarSub-editor: JananiKoushik

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