What to do after a snakebite? Dos, don’ts and everything you want to know

As per the WHO figures, a million people are bitten by snakes in India per year and fifty thousand out of them die. The main victims are the young farmers, the breadwinners of the cultivator family. Others who are at risk are the construction workers, trekkers and campers. In conversation with Dr Vijay Muralidhar Sonar who has been treating the victims of snakebite for the past fifteen years in the city of Ahmednagar. He is an MBBS and MD, anesthesia from BJ Medical College Pune, India. He has been practicing general and emergency medicine. He treats about 150 snakebite victims a year.

In India, how many types of snakes do we have?
We have 250 species of snakes in India, fifty from those are venomous and five are very dangerous for humans. Four of them are responsible for most of the killer bites – common cobra (called naga), saw scaled viper, common krait (manyar) and Russell’s viper. The concept of the Big Four is slowly becoming a thing of the past. Humpnosed pit viper, also called hypnale was considered as harmless to humans but is capable of causing uncontrolled bleeding and sudden kidney failure leading to death. The current anti-venom serum (AVS) does not give protection against the bite of this viper. Sea snakes are also poisonous to humans.

Which of those five dangerous ones is the most dangerous?
If you ask me it is the common krait, for its bite has hardly any local symptoms – no swelling, no bleeding and no pain. It is a very peculiar snake, in the villages it comes out in the dead of the night to explore for food (rats) and bites people who sleep on the floor. This can happen to people camping outdoors. The problem with Krait bite is that sometimes one cannot even ‘see’ the wound and in many cases people, especially the children are unaware that they are even bitten. The bite of krait is deceptive, while the local symptoms are minimum it has severe degree of venomation (injection of venom into human body). In most of the cases the victim gets severe stomach pain and vomiting and even if he/she is taken to a doctor, the victim is treated for the stomach pain. By morning the neurotoxin spreads in the body and the victim dies of respiratory failure. We always advise people to sleep on a cot, or while camping outdoors use mosquito nets to keep the reptiles away. Russell Viper is also very dangerous for it injects maximum venom in its victim and has less number of dry-bites.

snakebite1

snakebite2

So the venom of a snake attacks the nerves?
Venom of a snake …continued »

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Declining mobility caused brittle bones in humans: Study

Rather than urbanisation or diet, rise of agriculture and fall in mobility has led to lighter, brittle bones among humans today, interesting research has found.

The study of the bones of hundreds of humans who lived during the past 33,000 years in Europe sheds light on a monumental change that has left modern humans susceptible to osteoporosis, a condition marked by brittle and thinning bones.

At the root of the finding is the knowledge that putting bones under the “stress” of walking, lifting and running leads them to pack on more calcium and grow stronger.

Earlier humans had stronger bones and that weight-bearing exercise in modern humans prevents bone loss.

“By analysing many arm and leg bone samples from throughout that time span, we found that European humans’ bones grew weaker gradually as they developed and adopted agriculture and settled down to a more sedentary lifestyle,” said Christopher Ruff from the Johns Hopkins University’s school of medicine.

Modern lifestyles have famously made humans heavier, but, in one particular way, noticeably lighter weight than our hunter-gatherer ancestors: in the bones.

“The decline continued for thousands of years, suggesting that people had a very long transition from the start of agriculture to a completely settled lifestyle,” Ruff said.

Better bones are still achievable, at least for younger humans, if they recreate to some extent the lifestyle of their ancestors, notably doing a lot more walking than their peers, the authors said.

The paper appeared in the early edition of the journal Proceedings of the National Academy of Sciences.

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Many probiotics could actually be harmful: Study

If you believe that probiotics are good for your health, there is a piece of news for you. A new study finds that more than half of popular probiotics contain traces of gluten.

Gluten is a protein found in wheat, rye and barley, and patients with celiac disease need to eliminate it from their diet or face pain, bowel symptoms and an increased risk of cancer.

(Also read: Probiotic drink could help prevent diabetes)

Tests on 22 top-selling probiotics done by investigators at the Columbia University Medical Centre (CUMC) revealed that 12 of them (or 55 percent) had detectable gluten.

Probiotics are commonly taken by patients for their reported effect in promoting gut health.

“Many patients with celiac disease take dietary supplements and probiotics are particularly popular,” said Samantha Nazareth, gastroenterologist at CUMC and the first author of the study.

We have previously reported that celiac patients who use dietary supplements have more symptoms than non-users, so we decided to test the probiotics for gluten contamination, Nazareth said.

Most of the probiotics that tested positive for gluten contained less than 20 parts per million of the protein, and would be considered gluten-free by Food and Drug Administration (FDA) standards.

However, four of the brands (18 percent of the total) contained in excess of that amount.

More than half of the 22 probiotics were labelled gluten-free but this had no bearing on whether or not traces of gluten were present.

Two probiotics that did not meet FDA standards carried the label.

“It appears that labels claiming a product is gluten-free are not to be trusted, at least when it comes to probiotics,” said study co-author Peter Green.

“This is a potential hazard for our patients and we are concerned,” he added.

“We know that most patients with celiac disease only develop intestinal damage when consuming more than 10 milligrams of gluten daily. Still, these findings raise troubling questions,” said study co-author Benjamin Lebwohl from CUMC.

The study was presented at Digestive and Disease Week in Washington DC recently.

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‘Cancer treatment ain’t just for the rich’

When the World Health Organisation added 16 new anti-cancer medicines to the model list of essential medicines (WHO EML) on May 8, a group of Young Professionals’ Chronic Disease Network headed by Indian-origin US resident Sandeep Kishore was elated.

The WHO had created a new global standard for cancer treatment and it was a watershed moment for this network group with 300 members – all below 40 years – from 41 countries and 170 organisations. “We hope this will create new national standards – expectations – for treatments. Cancer treatment is not just for the rich. By deeming these medicines as essential, it now becomes the responsibility of governments and international communities to provide these medications to patients at affordable prices,” Kishore, who hails from Hyderabad, told The Indian Express.

Kishore, who has helped redefine global health policy, had in 2007 spearheaded the addition of cholesterol-lowering statin to the list, petitioned WHO to include aproton pump inhibitor and a modern beta blocker and now is the co author of the petitions to add cancer medicines to the WHO list.

In 2012, two teams of experts petitioned the WHO to include imatinib for the treatment of chronic myeloid leukemia (CML) and trastuzumab for the treatment of HER2+ breast cancer on the WHO EML. The consideration of these applications for two highly effective cancer treatments initiated a review process of the cancer section of the WHO EML.

For imatinib, brand name Gleevec, five-year survival rates for CML increased by over 35 per cent. The number of patients needed to be treated to see a complete cytogenetic response (a key marker for CML treatment) was less than two, which made this a good treatment, Kishore explained. The drug had been used in South Africa, Mexico, China and India.

India was one of the first countries to add imatinib to India’s Essential Medicines List in 2011 and we cited this to demonstrate how important and life-saving this medicine actually was for selected-cancer patients, Kishore pointed out.

For trastuzumab, we were tackling breast cancer, an urgent global health priority. India has been a crucial supporter and it is important to note that anyone in the world can petition the WHO to add or delete a medicine from the essential medicines list, Kishore said.

The organisations supporting this petition were Young Professionals Chronic Disease Network (YP-CDN), Knowledge Ecology International (KEI), University of California, San Francisco, Universities Allied for Essential Medicines (UAEM), Third World Network (TWN). In New Delhi, Kalyani Menon-Sen was the coordinator of the campaign, while Peter Dhillon, an epidemiologist, based with the Public Health Foundation of India, has been a crucial supporter.ens

(With ENS inputs)

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Diet diary: Does your body say no to what you eat?

It’s not surprising when one sees nutritional deficiencies among those who cannot manage a square meal, but it surely is when one finds severe malnutrition among those who are well fed. Malnutrition with deficiencies of iron, calcium, magnesium and vitamin B12 seems to be a grave concern among those who eat adequately—even overweight and obese people.

The issue is certainly not the intake but the body’s inability to absorb or pick up these nutrients, also called mal-absorption. This is often associated with a condition called the leaky gut.

Leaky gut is caused by intestinal inflammation, which leads to increased permeability of the intestinal lining. At times, the intestines can be so badly damaged that nutrient uptake slows down and mal-digestion of nutrients, including carbohydrates and proteins, leads to malnutrition and ill-health. Leaky gut is associated with chronic fatigue, foggy brain, neurological disorders, migraines, food intolerances, food allergies, lowered immunity and auto-immunity, skin problems like eczema, psoriasis and hyper-pigmentation, fibromyalgia (muscle pains, joint pains) and inflammatory bowel disease. Certain serious health maladies like celiac disease are also associated with increased gut permeability.

Some of the common causes are excessive alcohol, prolonged use of certain medicines especially non-steroid, anti-inflammatory drugs (NSAIDs) or antibiotics, chronic stress and chronic intestinal infections due to viruses, parasites, yeast or bacteria, mal-digestion or nutritional deficiencies. Depletion of beneficial bacteria and growth of potentially harmful bacteria, a situation termed as dysbiosis, increases the likelihood of leaky gut. Bacterial toxins (endo-toxins) and ingested toxic material can also injure the intestine, making it more porous.

Toxins may also find their way into the body and burden the immune system, compromising the immunity and increasing inflammation. Circulating immune complexes and toxic residues may trigger auto-immune reactions leading to auto-immune health conditions such as rheumatoid arthritis, thyroid disorders, multiple sclerosis, vitiligo and lupus.

Treatment involves eliminating the underlying causes, improving diet, reducing alcohol consumption, limiting intake of sugar, processed food and trans-fatty acids and consuming antioxidant rich food, good fats (omega-3 fatty acids), prebiotics and pro-biotics. Supplements with specific nutrients is important to heal the leaky gut.

So, ensure you take good care of your gut as it can spell the difference between heath and disease.

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Why getting more fibre in our daily diet is important

By Nalini Saraf

In 2014, author Anderson et al suggested that fibre intake in developed and developing countries are generally below the recommended intake by relevant authorities. According to the study, many people are consuming fibre-depleted refined-grain products and it is a good idea to add fibre rich products to make healthy food choices.

A study was thus conducted on a group of 30 volunteers to study their diet and quantify the amount of dietary fibre present.

graph Average nutrient intake in 24-hr recall by all participants.

As you can see in the chart, against 215.4gm of carbohydrate/day (on an average), only 28.4g of fibre is being consumed.

In the study, 12 most consumed dishes by the participants were compared on the basis of their fibre content.

fiber2 Top 12 dishes as per serving consumed vs. their dietary fiber.

6 dishes out of top 12 in serving sizes provided 0.0g dietary fibre, meaning no fibre. Tea, Marie Biscuit, Milk, Green Tea, Curd, Tomato sandwich don’t help you with your fibre requirements at all. It’s clear that we need more fibre-rich food in our daily diet.

Wonder why’s fibre so important? 

Why do we need fibre in our daily diet?
Recommended intake of dietary fibre is 40 g/ 2000 kcal to be consumed per day; this is rationalized in all communities based on their recommended energy intake. (ICMR, 2009).

You are at lower risk of deadly diseases

Another expert in 2009 stated that individuals with high intakes of dietary fibre are at a significantly lower risk of developing coronary heart disease, stroke, hypertension, diabetes, obesity, and certain gastrointestinal diseases.

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Fibre prevents against Diabetes

Increasing fibre intake lowers blood pressure and serum cholesterol levels. Soluble fiber improves glycemia and insulin sensitivity in non-diabetic as well as diabetic individuals. Fibre supplementation in obese individuals considerably enhances weight loss. Moreover, augmented intake of fibre benefits a variety of gastrointestinal disorders like gastroesophageal reflux disease, duodenal ulcer, diverticulitis, constipation, and hemorrhoids. Prebiotic fibres appear to enhance immune function as well. Dietary fiber intake provides similar benefits for children as for adults.

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It also fights Obesity

According to another author Freeman in 2000 dietary fibre has many functions in diet, one of which is to aid in energy intake control and reduced risk for development of obesity. Its role in energy intake regulation and obesity development is related to its unique physical and chemical properties that aid in early signals of satiation and enhanced or prolonged signals of satiety.

obesity Big-box retailers like Walmart along with full-service and fast-food restaurants are key contributors to the obesity epidemic in the US.

So you basically lose weight rapidly…

Yet another study by Liu established that women who consumed larger quantities of dietary fiber gained an average of 1.52 kg less than those with small increase in intake of dietary fibre (Liu et al; 2003).

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Here’s how you can get your recommended fibre

(The units mentioned in the bracket is the quantity of the product, units mentioned after the hyphen is the fibre content)

Whole Wheat(100g) – 12.5g

wheat-seeds
Bajra (100g) – 11.3g
Maize, dry (100g) – 11.9g
Ragi (100g) – 11.5g
Jowar (100g)- 9.7g

Bengal Gram Whole (Chola) (100g) – 28.3g

Bengal grain Bengal gram whole

Red Gram Whole (Tuver) (100g) – 22.6g
Black Gram Whole (Urad) (100g) – 20.3g
Curry Leaves (100g) – 16.3g
Drumstick (100g) – 9g
Soyabean (100g) – 23g
Fenugreek Seeds (100g) – 48.6g

Methi
Corriander Seeds (100g) – 47.4g
Cinnamon (100g) – 48.5g
Cloves (100g) – 35.1g
Dry Dates (100g) – 8.3g

Guava (100g) – 8.5g

Guava Guava

Chiku (100g) – 10.9G

Source: (Gopalan et al. NIN. ICMR. 2012)

The research was conducted by the author. Nalini has done her BSc Biotechnology from Jaihind college. She has also completed MSc in Management Science from Lancaster university. After an experience of 2 years as strategic manager, she has just completed MSc in Clinical Nutrition and dietetics. She is currently doing an internship in Nair hospital. 

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Want a super brain even as you grow old? Here’s what you need to do

People who are having healthier diets with higher quantities of vegetables, fruits, fish, nuts, soy products and moderate alcohol intake are at a reduced risk of cognitive decline as they get older, says new research.

The team from Ontario-based McMaster University tracked the health and habits of 28,000 people who were taking part in two international studies across 40 countries.

(Also read: ‘Good fat’ communicates with brain to counter obesity)

Researchers found that of the 5,700 people with the healthiest diets, 14 percent had developed cognitive decline.

On the other hand, in the 5,460 people with the least healthy diets, about 18 per cent of them experienced cognitive decline.

FOOD FOR BRAIN

broccoli-main Broccoli (Source: Thinkstock Images)
apple-main Apple (Source: Thinkstock Images)
dryfruit Dryfruits (Source: Thinkstock Images)

 

fish Fish (Source: Flickr)

The unhealthy foods were red meat, deep-fried foods and sweets. It may not sound like a big difference but it is about a 24 percent reduction in risk for the people on healthy diets.

(Also read: Beware! High-fat diet can damage your brain)

“The consumption of ‘healthy’ choices may be beneficial but the effect may be reduced with the consumption of ‘unhealthy’ choices,” Forbes reported, quoting the researchers.

FOOD TO AVOID

junk Fried and processed food 
ice-cream Foods high in sugar 
Red Meat (Source: blogs.plos.org) Red Meat (Source: blogs.plos.org)

For example, the beneficial effect of fruit may be lost if prepared with high amounts of fats or sugars.

“Our data suggest that an overall healthy diet is more important than the consumption of any one particular food,” study author Andrew Smyth emphasised.

Healthy diets are rich in antioxidants and are excellent for the brain health.

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Viagra may prevent malaria transmission

The anti-impotence drug Viagra helps eliminate malaria from the blood circulation which may reduce transmission of the deadly parasite from humans to mosquitoes, a new study has found.

It does so by increasing the stiffness of erythrocytes infected by the causal agent of malaria, researchers said.

This astonishing discovery, made by scientists at the Institut Cochin in Paris and the Institut Pasteur, working in collaboration with a team from the London School of Hygiene and Tropical Medicine, could lead to a treatment to reduce the spread of malaria within a population.

Plasmodium falciparum, the parasite that causes malaria, has a complex developmental cycle that is partially completed in humans and partially in the anopheline mosquito.

Treatments for malaria target the asexual forms of this parasite that cause symptoms, but not the sexual forms transmitted from a human to a mosquito when it bites.

The sexual forms of the parasite develop in human erythrocytes sequestered in the bone marrow before they are released into the blood. They are then accessible to mosquitoes, which can ingest them when they bite.

But circulating erythrocytes – whether they are gametocyte-infected or not – are deformable, thus preventing their clearance via the spleen, which constantly filters the blood and only retains stiff, old or abnormal erythrocytes.

However, gametocyte-infected erythrocytes can easily pass through the spleen and persist for several days in the blood circulation.

During a new study, the scientists showed that the deformability of gametocyte-infected erythrocytes is regulated by a signalling pathway that involves cAMP.

When the cAMP molecules accumulate, the erythrocyte becomes stiffer. cAMP is degraded by the enzyme phosphodiesterase, whose action thus promotes erythrocyte deformability.

Using an in vitro model reproducing filtration by the spleen, the scientists were able to identify several pharmacological agents that inhibit phosophodiesterases and can therefore increase the stiffness of infected erythrocytes.

One of these agents is sildenafil citrate, better known under its brand name of Viagra.

The authors showed that this agent, used at a standard dose, had the potential to increase the stiffness of sexual forms of the parasite and thus favour the elimination of infected erythrocytes by the spleen.

This discovery could help find new ways to stop the spread of malaria in a population, researchers said.

Modifying the active substance in Viagra to block its erectile effect, or testing similar agents devoid of this adverse effect, could result in a treatment to prevent transmission of the parasite from humans to mosquitoes.

The research was published in the journal PLOS Pathogens.

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Diet Diary: Maintaining weight — doing it right

health, express health, weight, weight loss, lose weight, good health, lifestyleThere are those who lose weight and then manage to maintain their new-found selves. Then there are others that start diets but give up on them mid-way while a third category set off on diets, lose weight, but regain more pounds than they had initially — ending up depressed and frustrated.

It is estimated that 95 per cent of all those who lose weight on a diet, gain it back. This is because most diets are deprivation diets. They fail not because one doesn’t lose weight but because one finds it difficult to maintain the new weight.

Why is it that despite knowing the basics we continue to fall off the wagon — are we eating wrong or overeating? Researches in psychology and marketing are now providing some insights into eating behaviour. Identification of individual behaviour, perception and beliefs associated with eating is key to improving the efficacy of dietary treatment and lifestyle modifications in obese and overweight individuals. From these have emerged powerful principles which can improve therapeutic strategies and outcomes in weight loss.

Before embarking on an altered lifestyle programme, it is important to know why you are going through it — what is the motivation behind the decision to start? Body image and health are the two most compelling issues. Secondly, are you open to change? That is, willingness to change. Finally, are you ready for what is called ‘mindful eating’? Awareness about diet and knowledge about foods along with principles of healthy eating is all that it takes to get where you want. But, remember – set realistic goals.

Almost all of us would have indulged in mindless eating at some point in our lives. Eating without hunger because of external or environmental cues, simply for pleasure or for comfort is something we all do, no matter how literate we are about diets and nutrition facts. Most of us do not stop eating even when we are full. Here are some tips which can help keep you from doing so.

1. Stop eating when you are “no longer hungry”, not when you are “full”. The traditional way is to stop when you still have hunger for one more chappati or eating until so that you are just 80 % full.

2. Don’t eat with your eyes, eat according to hunger.

3.Learn to say “no”. Avoid the “just one more” helping request.

4. ‘Pre-plate’ your food. According to research, people eat about 14% less than when they take smaller amounts and go back for seconds and thirds. Mostly people tend to eat less if they put everything on their plate like in a ‘traditional Thali’ or the Japanese “Bento Box” as they see how much they are going to eat.

5. Use smaller plates, bowls, spoons, cups and glasses. It helps to create an illusion about the volume of food you eat.

6. Eat slowly. Make overeating difficult. Don’t keep unhealthy food around in your room or home. …continued »

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Ride the Metro to shed some extra flab

Taking a Metro train or cycling to office will help you shed more weight in couple of years than driving, a study has found.

Switching from a car to walking, cycling or public transport was associated with a statistically significant average reduction in the Body Mass Index (BMI).

In the first analysis which included 3,269 respondents, 179 people had stopped driving to work and were either walking or cycling or taking public transport.

The “switchers” were young and less likely to have access to a car than those who continued to drive.

“Switching from driving to work to using public transport, walking, or cycling might help commuters shed weight within a couple of years,” the team wrote in the Journal of Epidemiology & Community Health.

Given that car use is high, the findings strengthen the case for incentivising walking or cycling to boost population health, the researchers said.

In the second analysis which included 787 people, 268 switched from active to passive travel.

Some 156 stopped walking or cycling and 112 switched from public transport (usually a bus or train) to the car.

Switching to a car was associated with a significant weight gain of around one kg per person after taking account of other influential factors.

“If a larger proportion of commuters were able to abandon their cars for a more physically active commute, this could help drive down the average population BMI,” the study said.

Combined with other potential health, economic, and environmental benefits associated with walking, cycling and public transport, these findings add to the case for interventions to promote the uptake of these more sustainable forms of transport, they concluded.

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