Soursop – an adjunct to chemotherapy from tropics

Soursops or prickly custard apple have dark green skin, are pear-shaped and have a white juicy flesh with tangy flavour. Also called Graviola at local markets, the tree bearing the fruit is prized in the tropics for its medicinal properties.

All parts of the Soursop tree are used in natural medicine in the tropics. The fruit and its juice are taken to expel parasites and to increase mother’s milk after child birth while the leaves are known to have powerful anti-inflammatory effects. Soursop tea is used in traditional medicine to heal wounds, for soothing knee pain and for reducing mucous in colds and in sinuses.

The roots are known for their sedative effects. In the United States and Europe, sour sop is increasingly sold as a popular adjunct to chemotherapy for cancer patients. This use has stemmed from scientific studies and published research on its naturally occurring compounds and anticancer action, rather than folk medicine.

Scientists who have been studying its properties since 1940’s have found a compound called acetogenins in the leaf stem, bark and seeds. They demonstrate selective toxicity to tumour cells at very low dosages, without harming healthy cells.

So encouraging were the results that in 1997, Purdue University published news that several acitogenins are not only effective in killing tumours that have proven resistant to anticancer agents, but also have special affinity for cells which are resistant to conventional therapy. Studies on Soursop shows benefits in 12 types of cancers including pancreatic cancer.

According to the Cancer Association of South Africa (CANSA), Soursop is 10,000 times stronger in slowing growth of cancer cells compared to chemotherapy without the side effects of the latter. The association, however, makes it clear that the fruit is not a substitute for medical advice.

Cancer patients and health care practioners are adding the natural leaf and stem of Soursop as a complimentary therapy to the cancer treatments. After all Soursop has been a long history of safe use as a herbal remedy for many other conditions.

There is, however, a word of caution. A study published in 2006 in the journal of neural transmission showed that it contains compound that may also damage the neurons ( brain cells) that control movements. The study linked their discovery to the high occurrence of Parkinson’s-like disease in the Carribean Islands where the fruit is commonly consumed. Other contra indications and precautions include its interaction with other drugs in pregnancy, in low blood pressure and its effect on gut flora.

So Soursop certainly exhibits anti-cancer activity but consult a medical professional before you add it to your daily diet.

Author is a clinical nutritionist and founder of and Whole Foods India

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My Curious Case: GALT in an infant

Dr Aarti Kinikar
Professor at Department of Paediatrics, B J Medical College and Sassoon General Hospital, Pune

Galactosemia type 1 is a rarely diagnosed, potentially life-threatening disease that results from the body’s inability to metabolise galactose, a sugar found in all foods that contain milk. One in 10,000 children suffer from this problem and unsurprisingly, parents are unaware of it.

Early this year, a two-month-old boy was brought to the Pediatric Intensive Care Unit at the government-run Sassoon General Hospital with jaundice and abdominal bloating. He had been suffering from the problem for a month and had developed cough with rapid breathing three days prior to landing at the hospital.

An examination showed that he had respiratory distress, peculiar odour to his breath (fetor hepaticus), deep yellow icterus and swelling of the legs. Tests also revealed increase in the size of liver and spleen.

Liver function tests revealed increased bilirubin (causing jaundice) with elevated liver enzymes suggesting injury to liver cells. Urine for reducing substances was positive, which raised a strong suspicion of Galactosemia.

A special test, the GALT(Gal1 Phosphate Uridyl Transferase) assay (done to confirm diagnosis of Galctosemia) was performed which read 0.05 microg/L (very low).

The child’s treatment included putting him on a ventilator and symptomatic management of liver disease. The patient was removed from the ventilator on the fourth day of admission and discharged.

Classic galactosemia (GALT) is an inherited condition in which the body is unable to properly digest galactose. If a child with GALT eats galactose, undigested sugars build up in the blood, rather than being used for energy, and if left untreated, can cause seizures, serious blood infections, liver damage and even death. When the condition is identified early in life and proper treatment is begun immediately, children with GALT often can lead healthy lives.

All newborn babies should be screened for this condition as early diagnosis prevents disease and death due to liver disease. The government should also consider performing this test on every newborn and also include tests for hypothyroidism.

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New system to monitor cerebral palsy levels

Children with Cerebral Palsy (CP) need to be assessed carefully to establish the intensity of impairment before any therapy is initiated. For the first time, a new and innovative testing tool has been developed by doctors that gauges the improvement in patients with CP — a disorder caused due to brain damage.

So far tools like Gross Motor Function Classification System (GMFCS), the Manual Ability Classification System (MACS) and Bimanual Fine Function (BFMF) were used to evaluate a patient with Cerebal Palsy. There were, however, limitations as it did not assess certain parameters that are essential to be evaluated in the patients with CP which include epilepsy, hearing, drooling, writing, mathematical skills, communicating and playing. Also, distinction between first two levels of GMFCS is unclear, mainly for children below the age of 2 years.

Developed by Dr Geeta Shroff, a New Delhi based gynaecologist, the new study tool, Nutech Functional Score (NFS), tracks over 32 parameters to provide accurate assessment of the progress of the disease as compared to the existing method of screening. The result of this new study tool has been published in the International Archives of Medicine (June, 2015), an open access international medical science and clinical practice journal.

Shroff told The Indian Express that NFS is a 32 point positional and directional scoring system that can assess the CP symptoms that remain far from assessment in GMFCS: Feeding, indication, epilepsy, toilet training, drooling, mathematical skills, hearing, vision, commands, smiling, constipation, recognition /awareness, eye contact, aggression, speech, breathing difficulty, defense mechanism and swallowing. As opposed to GMFCS, NFS scoring system can be used to assess patients aged above 18 years. We have also converted the scores into numeric grades, Shroff explained.

The new tool also has the advantage of revealing even the slightest improvement in CP patients. “The other advantage of using NFS is that scoring is numeric which means grades can be added or subtracted, thus revealing even the slightest improvement in the patient. While NFS tells the condition of a case from bad to good, GMFCS (a single score assigned on the basis of age and motor function) classifies CP into five levels from good to bad,” added Shroff.

Cerebal Palsy is a non-progressive disorder that occurs as a result of the damage to the brain of a foetus and newborns. Its signs and symptoms, such as spastic muscles, poor balance and gross motor delays remain lifelong and patient is subject to life with limitations. It is estimated to affect 3 per 1000 live births in India.

Shroff is the founder and medical director of Nutech Mediworld, a facility that provides human embryonic stem cell therapy.

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Be calm, take control: Seven easy tips to beat the stress

Calm mind brings inner strength and self-confidence, and that’s very important for good health.
– Dalai Lama

What a calm mind can achieve, a stressed mind cannot even attempt. Yet, a lot of people today are in stress and suffering from stress-related disorders like heart disease, obesity, diabetes, depression etc. According to health surveys, stress is increasingly becoming a lifestyle risk factor and India is one of the most stressed countries in the world. So what do we do? Is it possible to get rid of stress? Psychologist Nisha Khanna gives tips to keep our stress levels in check.

1. Physical Workout: Physical activity helps in increasing the production of your brain’s feel-good neurotransmitters, called endorphins. Simple physical activities like jumping, cycling, skipping, swimming, badminton, jogging, yoga, etc can go a long way in stress management. “Walking on treadmill at the speed of 8.5 for 10-15 minutes can prove beneficial,” advises Dr. Nisha Khanna.

2. Travelling: Take out time and plan an outstation trip or go out for a holiday with your friends or family. This will re-engergize your body and help relieve stress. ”Traveling changes your state of mind, and help in releasing stress” says Dr. Khanna.

phone Take out time and plan an outstation trip or go out for a holiday with your friends or family.

3. Recreation: In order to release stress, it’s essential to relax your mind. This can be done by watching entertaining serials, happy movies or comedy shows. People interested in art or music should paint or play instruments to de-stress themselves. “We should watch comedy shows and light serials after coming back home post a tiring day,” says the psychologist.

4. Eating Habits: Keep munching healthy snacks like almonds, pistachios, walnuts, pretzels etc. It helps in boosting the immune system and also lowers blood pressure levels to make the body relaxed and stress free. “One should have a heavy and healthy breakfast between 9-10 am and lunch after 2 pm,” says Dr Khanna.

dryfruit Keep munching healthy snacks

5. Sharing and listening: Getting into the habit of sharing your thoughts with someone and listening to others can help in de-stressing. “Some people are in the habit of listening but they don’t share their opinions whereas some people only speak and don’t listen to others. There should be a balance between sharing and listening.” says the expert.

6. Sound sleep and smile: 6 hours of sleep is a necessity. It is essential to plan your day and work accordingly. A good sleep taps your energy for the rest of the day. Take out a few minutes for laughter therapy. Smiling curbs the stress hormones and controls the blood pressure level in the body. ”It’s essential for us to plan our day in a way that we can take time for minimum 6 hours of sleep,” feels Dr Khanna.

smile-main Take out a few minutes for a laughter therapy.

7. Have a relaxation mantra: Positive statements like “I am strong enough to handle this”, “I feel relaxed, I can maintain my cool” can work as a tool of de-stressing yourself in a complex situation. “Having a mantra helps in self motivation and having a positive attitude.”

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Women face sexual abuse even during childbirth: WHO

Women face both physical and sexual abuse in health facilities during childbirth, a study by the World Health Organisation (WHO) shows.

The authors assessed 65 published studies undertaken in 34 countries and identified seven areas of mistreatment and abuse.

The mistreatment included physical (such as slapping), sexual, verbal, stigma and discrimination, a failure to meet professional standards of care and poor rapport between women and providers and health system constraints (such as a lack of resources to provide women with privacy), the study said.

“The rates of skilled birth attendance and of facility-based childbirth have risen in resource-limited countries over the past two decades, but almost a third of women in these countries still deliver without a skilled birth attendant,” the study said.

Among the obstacles likely to prevent further increase in the proportion of women delivering in a health facility is women’s fear of mistreatment during delivery.

“Women need to be sure that they will receive dignified and respectful care during childbirth,” said the study by Meghan Bohren and colleagues of the WHO Department of Reproductive Health and Research.

One of the United Nations Millennium Development Goals is to bring about a 75 percent reduction in the maternal mortality ratio.

In 2010, some 289,000 maternal deaths occurred worldwide, many in low and middle income countries.

While these numbers explain why attention is focused on a reduction in maternal deaths, attention is also needed to defining and measuring the extent of problems around childbirth, such as mistreatment, to better inform constructive changes in policies and practices, the study emphasised.

The results indicate that, although the mistreatment of women during delivery in health facilities often occurs at the level of the interaction between women and healthcare providers, systemic failures at the levels of the health facility and the health system also contribute to its occurrence.

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From the lab: Effect of yoga on body’s ability to fight back

At the Yoga and Biomechanic Lab, we try to carry out scientific analysis of different body postures , body mechanics and balance, including those postures that are required while performing yoga asanas.The benefits of yoga are very well known. But we were trying to analyse the impact of yoga exercises on particular body functions and its role in tackling specific medical conditions.

The Yoga and Biomechanic Lab at IISc and M S Ramaiah Medical College in Bangalore have been collaborating on this project for a long time. Together, we decided to examine the effect of yoga exercises on the body’s ability to tackle inflammatory diseases, a condition the body slips into while fighting an external injury. For the purpose of our study, we had two groups of people, 109 in each group. One group included people who were regular practitioners of yoga, performing the asanas for at least one hour every day for five years. The subjects were all taken from Dr. Omkar’s Yoga Mandir in Bangalore. The other group comprised of non-yoga performing people.

We made candidates from both groups undertake mild and strenuous exercise. The ’10 metre shuttle walk test’ was our preferred choice of exercise. The candidates had to walk back and forth on a 10 metre long path, slowly increasing their pace. On one day, the participants were asked to walk for about 7 to 8 minutes, and on another day they were made to walk for 11 or 12 minutes, which becomes quite arduous as a subject increases his speed. Blood samples of the candidates were collected just before the exercise, immediately after the mild exercise, and then after the strenuous exercise.

We observed that the yoga-performing group, in general, had lower levels of inflammatory cytokines. These are cell proteins that trigger inflammations in the body. In particular, we were studying the levels of two specific pro-inflammatory cytokines: Tumour Necrosis Factor Alpha and Interleukin-6, that play a role in coronary heart diseases, depression, diabetes, arthritis, osteoporosis, Alzheimer’s disease and periodontal (gum) disease.The rate of increase in the levels of these two cytokines (Tumour Necrosis Factor Alpha and Interleukin-6) with the increase in level of physical activity, was much higher in the non-yoga practising group. This is an indication that regular practice of yoga protects against the rise of the harmful cytokines, when people are exposed to physical stress or unaccustomed physical activity.We also observed that cholesterol, triglyceride and VLDL (very low density lipoprotein) levels were significantly low in the yoga practising group. On the other hand the level of HDL (high density lipoprotein), a good cholesterol, was significantly higher in the group. Thus, …continued »

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Smoking linked to breast cancer in young women

Smoking may increase the risk of dying early in pre-menopausal women with breast cancer, a research said.

“Overall, this work is monumental in advising patients about how smoking might affect breast cancer outcome,” said co-author Yuko Minami from Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.

This study included 848 patients admitted to a single hospital in Japan from 1997 to 2007. Active or passive smoking status was assessed using a self-administered questionnaire.

The patients were followed until December 31, 2010.

The researchers found that pre-menopausal women who smoked for more than 21.5 years had a 3.1-times higher risk of dying from any cause and a 3.4-times higher risk of dying from breast cancer.

These links were not apparent among post-menopausal women.

The increased risks seen in pre-menopausal women were especially relevant to women whose cancers expressed both the estrogen receptor and the progesterone receptor, the study said.

“Hopefully this paper will serve to reduce the number of breast cancer patients who continue to smoke,” Minami said.

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Diet diary: Dairy may not be as bad as you thought

Among the first casualties of a calorie or cholesterol free diet are dairy products. But should those starting these diets sacrifice milk-based products? The jury on the issue seems to be still divided.

While the anti-dairy lobby has several explanations for abandoning it, most scientific evidence and dietary guidelines do recommend low-fat dairy products as part of healthy diets. Besides, apart from its commonly known benefits of bone building and valuable nutrition profile, there is more to this food group than we previously knew.

The milk-based products have become a subject of controversy for various reasons: fears of heart disease, obesity and even cancer. Often those diagnosed with a malignancy are made to believe that giving up dairy would be helpful. Dairy products, however, have been found to be a good source of conjugated- linoleic acid (CLA), a variant of the essential linoleic fatty acid; CLA is believed to inhibit tumor growth.

The essential acid occurs in the rumen of cows and other ruminants and is present in their milk and other dairy products including cheese, yoghurt, butter. It can also be found in the meat of cattle and lamb.

CLA research can be traced back to 1977, when Peter Parodi identified it in cow’s milk. The turning point for CLA came after investigations by Micheal Pariza revealed its tumor inhibiting properties. CLA has also been shown to inhibit cancer by several mechanisms. It is a unique anti-carcinogen which inhibits the growth of a number of human cancer cell lines and suppresses chemically-induced tumor development in laboratory animals. CLA has been found to be beneficial particularly in cancers of colon, ovaries, prostate, breast, blood, bone marrow (leukemia) and skin (melanoma). Intake of 1 per cent CLA in diet has been reported to reduce the breast cancer incidence by nearly 60 per cent. A study reported that CLA enriched butter inhibited rat mammary tumor yield by 53 per cent.

Researchers have also discovered, in animal experiments, that CLA helps in lowering cholesterol, very low density lipoprotein (VLDL), low-density lipoproteins (LDL- bad cholesterol), LDL-HDL ratio, total cholesterol-HDL ratio and triglycerides and reduced arterial plaque build up. CLA also prevents heart diseases by exhibiting its antioxidant activity and inhibiting formation of free radicals. Researchers also suggest that CLA has a tocopherol (Vitamin E) sparing effect. Vitamin E is a powerful antioxidant vitamin.

Some studies on animal research reported reduction of body fat following CLA dietary supplements. Postulated mechanisms suggest that CLA reduces body fat by reducing energy intake, increasing metabolic rate, regulating glucose and fatty acid uptake and improving insulin sensitivity. The benefits of using CLA dietary supplements for reducing body fat, however, have not been consistent and conclusive.

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Five ways to maintain healthy skin during summers

Indulge in health diet, don’t forget to apply sunscreen and try face repair masks to keep skin in the pink of health.

Sangeeta Velaskar, vice president and Head, Medical Services and R&D, Kaya Skin Clinic, recommends a few tips to reverse the damage:

* Sunscreen: The end of summer does not mean the end of your sunscreen routine. Up to 80 percent of UV radiation can penetrate light cloud cover which is why applying sunscreen is essential even during monsoon season. This will help prevent further damage to the skin.

* Diet: A diet rich in anti-oxidants help reverse sun damage by fighting against the free radicals that cause damage to the skin cells. Ingredients such as berries, citrus fruits and vegetables protect the skin against sun induced allergies and damages. Also, the consumption of green tea helps neutralise free radicals and can even help in preventing wrinkles.

* Face repair masks: Indulge in face repair masks containing ingredients such as Arbutin which relieves the skin off the damage, vitamin C extracts that help in even skin tone. Argan oil is also a beneficial ingredient that reduces the appearance of wrinkles.

* Skin care regime: Besides the regular cleansing-toning-moisturizing (CTM) ritual, exfoliation helps in smoothening the skin. Exfoliants remove old, dry, dead skin cells, toxins and other deposits and allow new skin cells to surface.

For regular use, rely on exfoliators with botanical extracts. Additionally, incorporating a night cream will enhance the damage reversal process by healing damaged skin. Look out for products containing multi-vitamins, azelaic acid and imperata cylindrica.

* Choice of skin care products: Depending on the damage induced by the sun, choose skin care products that effectively tackle the issues. Use a water-based moisturiser to ensure a soothing effect on your skin. If you have sensitive skin, then rely on hypoallergenic products that are alcohol and paraben free.

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How to take care of oral health in 8 simple ways

Rinse properly after every meal, reduce your intake of tea or coffee and favor natural vegetables and fruits to take care of your oral health, says an expert.

Gunita Singh (cosmetic and laser dental surgeon) shares how you can maintain oral hygiene in office:

* Rinse thoroughly after every meal either with water or a mouthwash.

* Use floss or an interdental brush after a heavy meal to clean the gaps between the two teeth.

* Use a mouth freshener in case you have heavily garnished meals.

* Avoid sugary snacks (or include them along with your meals).

* Try and munch on natural vegetables and fruits to satisfy your cravings as the fibers in them act as natural cleansers for your teeth.

* You can also eat cheese to end your meal as it increases the salivary flow and reduces the risk of cavities as it cleans the sugar out of your mouth.

* Chewing gums: Sugarless gums are a great aid when you just can’t brush or floss your teeth amidst an important meeting. Moreover, chewing xylitol gums also increase the salivary flow, like cheese, and reduce cavities.

* Reduce your intake of tea or coffee to avoid getting unnecessary stains on teeth.

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