Health Hazards of Mobile Phones in Children

Current Issue | August 2009 | Volume 57 JAPI

Correspondence

Health Hazards of Mobile Phones in Children

MA Aleem

Head & Professor of Neurology KAPV Govt. Medical College & AGM Govt Hospital, Trichy 620017. Visiting Consultant Neurologist ABC Hospital, Trichy 620018. Received: 22.12.2008; Accepted: 6.2.2009

Sir,

I wish to create awareness on the cell phone induced health hazards in children. Mukta Kapdi et al (JAPI 2008; 56 : 893 - 897) has discussed all the problems of cell phone related health issues.1

As shown by increasing number of biological clinical and epidemiological studies the radiations emmited by telephony at levels that people are daily exposed are highly bioactive producing a variety of effects on human beings particularly in children.

Electromagnetic field is an important biotropic factor, affecting not just a human health in general, but also the processes of the higher nervous activity, including behavior and thinking. Radiation directly affects human brain when people use cell phones. For the first time in history, we face a situation when most children and teenagers in the world are continuously exposed to the potentially adverse influence of the electromagnetic fields (EMF) from mobile phones.

Despite the recommendations, which insist that persons under 18 years should not use mobile phones, children and teenagers became the target group for marketing the mobile communications. The current safety standards for exposure to microwaves from the mobile phones have been developed for the adults and don’t consider the characteristic features of the children’s organism. The WHO considers the protection of the children’s health from possible negative influence of the EMF of the mobile phones as a highest priority task. This problem has also been confirmed by the Scientific Committee of the European Commission, by national authorities of the European and Asian countries, by participants of the International scientific conferences on biological effects of the EMF.

Potential risk for the children’s health is very high and which include:2

The absorption of the electromagnetic energy in a child’s head is considerably higher than that in the head of an adult (children’s brain has higher conductivity, smaller size, thin skull bones, smaller distance from the antenna etc.).

Children’s organs have more sensitivity to the EMF, than the adult’s;

Children’s brains have higher sensitivity to the accumulation of the adverse effects under conditions of chronic exposure to the EMF;

EMF affects the formation of the process of the higher nervous activity;

Today’s children will spend essentially longer time using mobile phones, than today’s adults will.

The following health hazards are likely to be faced by the children mobile phone users in the nearest future: disruption of memory, decline of attention, diminishing learning and cognitive abilities, increased irritability, sleep problems, increase in sensitivity to the stress, increased epileptic readiness.

Expected (possible) remote health risks: brain tumors, tumors of acoustic and vestibular nerves (in the age of 25-30 years), Alzheimer’s disease, depressive syndrome, and the other types of degeneration of the nervous structures of the brain (in the age of 50 to 60).3

So there is urgency to defend children’s health from the influence of the EMF of the mobile communication systems. An appeal to the government authorities, to the entire society to pay closest attention to this coming threat and to take adequate measures in order to prevent negative consequences on the future generation’s health is a must in the current scenario.

The children using mobile communication are not able to realize that they subject their brain to the EMF radiation and their health - to the risk. We believe that this risk is not much lower than the risk to the children’s health from tobacco or alcohol. It is our professional obligation not to let damage the children’s health by inactivity.

References

Mukta Kapdi, Sumedh S Hoskote, Shashank R Joshi Health Hazards of Mobile Phones: An Indian Perspective. J Assoc Physicians India 2008; 56:893-897.

Krause CM. Bjornberg CH, Pesonen M, et al. Mobile phone effects on children’s event related EEG during an auditory memory task. Int J Radiat Biol 2006; 82:443-450.

Preece AW. Effect of a 915 MHz stimulated mobile phone signal of cognitive functions in men. Int J Radiat Biol l999;75:447-456.

 

Copy rights Association of Physicians of India

Stroke Epidemic

The Worldwide Stroke Epidemic

Over one quarter of deaths worldwide are the result of ischemic heart disease and stroke, and the problem is getting worse because the stroke and heart attack rates are highest in low- and middle-income countries, where most of the world population resides.

Several factors are to blame: poor access to care; an aging world population; urbanization (more than one half of the world's population now lives in cities) that leads to a sedentary lifestyle and access to processed foods; increasing obesity rates; and a high prevalence of smoking . Moreover, between 25% and 50% of adults worldwide have hypertension, and most are untreated.

Public health measures that promote healthy diets and physical activity, and access to high-quality and affordable primary care, are a cornerstone to stem the stroke epidemic.

Neurology Of Kissing

Almost no other animals kiss. Chimps and bonobos kiss but not with the kind of passion humans do.

Women value kissing more than men.


Kissing is like a taste test and a smell test. This isn't at all about breath, although I think we all can agree that stinky breath is lame. Researchers have discovered that there is a scent we pick up on when we are kissing -- and it's believed to be related to a person's DNA. Women are most attracted to the scent of a man who has a genetic code most different from themselves.


Some women give off a scent when they are ovulating that is picked up by men when they are kissing. It could be subconscious but it turns men on.


When you kiss someone for the first time, you get a spike in the neurotransmitter dopamine, making you crave more.




Dopamine can also make you lose your appetite and make it hard for you to sleep.




Two thirds of people tilt their head to the right when they kiss.




When you kiss someone your heart beats faster and more oxygen reaches your brain.
All thanks to neurotransmitters epinephrine and norepinephrine which promote the fight-or-flight response. And it makes your pupils dilate.
Which might be why we usually close our eyes.

Endorphins released during kissing bring on waves of euphoria.


You can thank your pituitary gland and hypothalamus for this natural high.

The muscle you use to pucker your lips is called the “orbicularis oris”.



Kissing triggers the release of oxytocin in your body.

Often called the “love hormone”, though that’s not all it does by a long stretch, oxytocin is involved in developing feelings of attachment. It’s thought to be what keeps the love in a relationship alive long after the initial honeymoon period (and dopamine spike) is over.





Women tend to rate kissing as more important in relationships than men do.





13. The world record for the longest kiss stands at well over two days with a kiss lasting 58 hours, 35 minutes and 58 seconds.

Your lips have a disproportionate number of nerve endings compared to other parts of your body.
As demonstrated on something known as the “cortical homunculus”.

When your lips touch someone else’s 5 out of 12 of your cranial nerves are engaged.You’re brain is basically trying to gather as much information as it can about the other person.

Over time, kissing lowers your levels of stress hormone cortisol, making you feel all safe and secure.





Lips are 100 times more sensitive than the tips of the fingers. Not even genitals have as much sensitivity as lips.

 Approximately two-thirds of people tip their head to the right when they kiss. Some scholars speculate this preference starts in the womb.



 The most important muscle in kissing is the orbicularis oris, also known as the kissing

 Indian Four Vedic Sanskrit texts (1500 B.C.) contain the first mention of a kiss in writing


 Passionate kissing burns 6.4 calories a minute. kiss contains 26 calories, which takes five minutes of walking

 Mechanically speaking, kissing is almost identical to suckling. Some scholars speculate that the way a person kisses may reflect whether he or she was breastfed or bottle fed

 Scientists believe that kissing may be a way of exchanging body salts or sebum that form relationships with parents and lovers, just as it does some birds. During mating, some birds chew food, then kiss-feed it to a prospective mate. If a bird’s sebaceous glands are removed so there is no sebum, its mate flies off.

 Kissing is good for teeth. The anticipation of a kiss increases the flow of saliva to the mouth, giving the teeth a plaque-dispersing bath.


 Indian Kama (desire) Sutra (type of verse) lists over 30 types of kisses, such as “fighting of the tongue.”


 Kissing may have originated when mothers orally passed chewed solid food to their infants during weaning. Another theory suggests kissing evolved from prospective mates sniffing each others’ pheromones for biological relation





 Diseases which can be transmitted through kissing include mononucleosis (“kissing disease”) and herpes. Contraction of HIV through kissing is extremely unlikely, though one woman was infected in 1997 when the woman and infected man both had gum disease. Transmission was likely through the man’s blood and not his saliva.



 Cunnilingus is a type of sexual kissing whereby a person stimulates the external female genital organs with the mouth or tongue. The word “cunnilingus” derives from the Latin cunnus (vulva, vagina) and lingua (tongue) or lingere (to lick up).

 The mouth is full of bacteria. When two people kiss, they exchange between 10 million and 1 billion bacteria.

 “X”s at the end of a correspondence letter represent the
contact of the lips during a kiss.
   
An act of kissing puts 29 facial muscles in motion. In other words, kissing can be used as an effective exercise to prevent the development of wrinkles.


Lovers swap saliva containing various substances e.g. fats, mineral salts, proteins while kissing. According to latest studies, the exchange of the above substances can give a boost to the production of antibodies which are made specifically to deal with the antigens associated with different diseases as they are encountered.


As a rule, 66 percent of people keep their eyes closed while kissing. The rest take pleasure in watching the emotions run the gamut on the faces of their partners.
 
A quick romantic kiss will burn about 2-3 calories, whereas French kiss (an open mouthed kiss with tongue contact) will obliterate more than 5 calories.
Sensitivity of the lips is 200 times higher than that of the fingers.

 

Sex Differences In Humen Brain

Differences between the brains of men and women.

GENETICS

Male and female brains actually differ right down at the genetic level in quite a drastic way. Studies reveal that typically EVERY CELL in the male brain contains a Y chromosome. Quite alarmingly, female brains usually contain no Y chromosomes at all! This lack of a Y chromosome has many obvious physical effects, but most women still manage to lead normal, cognitively-unimpaired lives despite this clear deficit in the very DNA of their brains. Research into how they manage this is ongoing.

LOCATION

One startling difference between male and female brains is where they are found. It may surprise many, but male brains are found almost exclusively inside male skulls, whereas female brains are found only inside female skulls! Such an extreme bias in brain-skull association can’t possibly be due to coincidence. The fact that male and female skulls are also different and perfectly sized to house their associated brains is even more unlikely. Explain that with your so-called science.

SIZE

As previously mentioned, there is an established size difference between male and female brains. Male brains tend to be bigger overall than female ones. This is also true for male legs, torsos and skeletons in general. Human men generally tend to be bigger than women, and this is reflected in brain size. Some argue that this means men are more intelligent than women. Using that same logic, human beings are intellectually inferior to elephants and sperm whales. Certain people may scoff at this very notion. “You never see elephants or sperm whales queuing for the latest version of the iPhone!” the might say, which probably doesn’t prove the point they think it does. Sperm whales and elephants also never publicly criticise statements made by figments of their imagination, so they’re doing well overall.

CONNECTIONS

Male and female brains differ in the connections they form. Most notably, the male brain is generally connected to a penis by various involved systems. The female brain lacks this connection and is instead linked to a vagina via a complex system of associations. The male brain-penis association seems to be more straightforward than the female brain-vagina one, but that may be due to the fact that the latter has a lot more bilge written about it.

PAIN SENSATION

It is generally believed that the male brain is better able to tolerate pain than the female one. However, the female brain is able to raise tolerance to pain when engaging in the process of ejecting a human from the pelvic regions. Thus far, no male brain has ever been recorded doing this.

SPECIALISATION

Observational studies have shown that the male brain is hardwired to be paid more, occupy more powerful roles and positions, and be more inclined to kill things randomly, whereas the female brain is hardwired to get more harassment and oppression, develop worrying obsessions with physical appearance and to care more about other humans and sometimes kittens.

Or, and this may seem controversial to many but it’s worth considering, it could be that the human brain develops in accordance to what it experiences, and things it experiences and is made to do more often are reflected in the sorts of connections that develop. This would suggest that there aren’t actually any marked differences between male and female brains. However, this would mean that there is no scientific basis for all of our stereotypes and prejudices about what certain sexes should/shouldn’t do and they all stem from irrational or unpleasant cultural influences that haven’t gone away yet, forcing us to admit to ourselves that our preconceived notions about certain sexes or genders are just self-fulfilling clichés with no logical basis, potentially threatening our beliefs, our positions and even our identity.

Differences between the brains of men and women.

GENETICS

Male and female brains actually differ right down at the genetic level in quite a drastic way. Studies reveal that typically EVERY CELL in the male brain contains a Y chromosome. Quite alarmingly, female brains usually contain no Y chromosomes at all! This lack of a Y chromosome has many obvious physical effects, but most women still manage to lead normal, cognitively-unimpaired lives despite this clear deficit in the very DNA of their brains. Research into how they manage this is ongoing.

LOCATION

One startling difference between male and female brains is where they are found. It may surprise many, but male brains are found almost exclusively inside male skulls, whereas female brains are found only inside female skulls! Such an extreme bias in brain-skull association can’t possibly be due to coincidence. The fact that male and female skulls are also different and perfectly sized to house their associated brains is even more unlikely. Explain that with your so-called science.

SIZE

As previously mentioned, there is an established size difference between male and female brains. Male brains tend to be bigger overall than female ones. This is also true for male legs, torsos and skeletons in general. Human men generally tend to be bigger than women, and this is reflected in brain size. Some argue that this means men are more intelligent than women. Using that same logic, human beings are intellectually inferior to elephants and sperm whales. Certain people may scoff at this very notion. “You never see elephants or sperm whales queuing for the latest version of the iPhone!” the might say, which probably doesn’t prove the point they think it does. Sperm whales and elephants also never publicly criticise statements made by figments of their imagination, so they’re doing well overall.

CONNECTIONS

Male and female brains differ in the connections they form. Most notably, the male brain is generally connected to a penis by various involved systems. The female brain lacks this connection and is instead linked to a vagina via a complex system of associations. The male brain-penis association seems to be more straightforward than the female brain-vagina one, but that may be due to the fact that the latter has a lot more bilge written about it.

PAIN SENSATION

It is generally believed that the male brain is better able to tolerate pain than the female one. However, the female brain is able to raise tolerance to pain when engaging in the process of ejecting a human from the pelvic regions. Thus far, no male brain has ever been recorded doing this.

SPECIALISATION

Observational studies have shown that the male brain is hardwired to be paid more, occupy more powerful roles and positions, and be more inclined to kill things randomly, whereas the female brain is hardwired to get more harassment and oppression, develop worrying obsessions with physical appearance and to care more about other humans and sometimes kittens.

Or, and this may seem controversial to many but it’s worth considering, it could be that the human brain develops in accordance to what it experiences, and things it experiences and is made to do more often are reflected in the sorts of connections that develop. This would suggest that there aren’t actually any marked differences between male and female brains. However, this would mean that there is no scientific basis for all of our stereotypes and prejudices about what certain sexes should/shouldn’t do and they all stem from irrational or unpleasant cultural influences that haven’t gone away yet, forcing us to admit to ourselves that our preconceived notions about certain sexes or genders are just self-fulfilling clichés with no logical basis, potentially threatening our beliefs, our positions and even our identity.

Blood Donation-Some Facts

Safe blood for saving mothers

The focus for this year’s campaign is “Safe blood for saving mothers”. The campaign will increase awareness about why timely access to safe blood and blood products is essential for all countries as part of a comprehensive approach to prevent maternal deaths.

WHO encourages all countries and national and international partners working on blood transfusion and maternal health to develop an activity plan to highlight the need for timely access to safe blood and blood products in the prevention of maternal death


Every year, on 14 June, countries around the world celebrate World Blood Donor Day. The event raises awareness of the need for safe blood and blood products and to thank voluntary unpaid blood donors for their life-saving gifts of blood.

Every day, about 800 women die from pregnancy or childbirth-related complications. Almost all of these deaths occur in developing countries. More than half of them occur in sub-Saharan Africa and almost one third in South Asia. The risk of maternal mortality is highest for adolescent girls under 15 years of age.

Severe bleeding during delivery and after childbirth is a major cause of mortality, morbidity and long-term disability. However, access to safe and sufficient blood and blood products and the rational and safe use of blood transfusion still remain major challenges in many countries around the world.


Blood donation facts

Giving blood is safe and simple, but whether you’re a donor or non-donor, you may have questions about how it all works and what donating or hosting means to your community. From quick facts to key stats, you’ll find all the answers here.



Blood

There are four main blood types: A, B, AB and O.

Type O- is the universal blood donor and type AB+ is the universal recipient.

Whole blood is composed of three main components: red cells, plasma and platelets.

13 tests (11 for infectious diseases) are performed on each unit of donated blood.

One unit of blood can support up to three lives.

Shortages of any blood type can happen at any time, especially during the summer and winter months.

The need

Every two seconds, someone needs blood.

Each year, 4.5 million Americans would die without blood transfusions.

Car accident victims can require red blood cell transfusions of 50 units or more.

Severe burn victims require approximately 20 units of plasma during treatment.

Children being treated for cancer, premature infants and children having heart surgery need blood and platelets from donors of all types, especially type O.

Some patients with complications from severe sickle cell disease receive blood transfusions every month — up to four units at a time.

A patient could be forced to pass up a lifesaving organ if compatible blood is not available to support the transplant.





Donating blood

Donating blood involves four easy steps: a medical history review, a quick physical, blood donation and snacks.

The actual blood donation part usually takes about 10 minutes. The entire process — from the time you sign in to the time you leave — takes about an hour.

After donating blood, you replace the fluid in hours and the red blood cells within four weeks. It takes eight weeks to restore the iron lost after donating.

You cannot get AIDS or any other infectious disease by donating blood.

Giving blood will not decrease your strength.

Blood drives hosted by companies, schools, places of worship and civic organizations supply most of the blood donations across the U.S.

If only one more percent of all Americans would give blood, blood shortages would disappear for the foreseeable future.

Be the giving type

It only takes about an hour to donate blood and help those in your community who need it most


Facts about blood needs

Every year our nation requires about 4 Crore units of blood, out of which only a meager 40 Lakh units of blood are available.

The gift of blood is the gift of life. There is no substitute for human blood.

Every two seconds someone needs blood.

More than 38,000 blood donations are needed every day.

A total of 30 million blood components are transfused each year.

The average red blood cell transfusion is approximately 3 pints.

The blood type most often requested by hospitals is Type O.

Sickle cell patients can require frequent blood transfusions throughout their lives.

More than 1 million new people are diagnosed with cancer each year. Many of them will need blood, sometimes daily, during their chemotherapy treatment.

A single car accident victim can require as many as 100 units of blood

Facts about the blood supply

Blood cannot be manufactured – it can only come from generous donors.

Type O-negative blood (red cells) can be transfused to patients of all blood types. It is always in great demand and often in short supply.

Type AB-positive plasma can be transfused to patients of all other blood types. AB plasma is also usually in short supply.

Facts about the blood donation process

Donating blood is a safe process. A sterile needle is used only once for each donor and then discarded.

Blood donation is a simple four-step process: registration, medical history and mini-physical, donation and refreshments.

Every blood donor is given a mini-physical, checking the donor's temperature, blood pressure, pulse and hemoglobin to ensure it is safe for the donor to give blood.

The actual blood donation typically takes less than 10-12 minutes. The entire process, from the time you arrive to the time you leave, takes about an hour and 15 min.

The average adult has about 10 units of blood in his body. Roughly 1 unit is given during a donation.

A healthy donor may donate red blood cells every 56 days, or double red cells every 112 days.

A healthy donor may donate platelets as few as 7 days apart, but a maximum of 24 times a year.

All donated blood is tested for HIV, hepatitis B and C, syphilis and other infectious diseases before it can be transfused to patients.

Facts about blood and its components

Blood makes up about 7 percent of your body's weight.

There are four types of transfusable products that can be derived from blood: red cells, platelets, plasma and cryoprecipitate. Typically, two or three of these are produced from a unit of donated whole blood – hence each donation can help save up to three lives.

Donors can give either whole blood or specific blood components only. The process of donating specific blood components – red cells, plasma or platelets – is called apheresis.

One transfusion dose of platelets can be obtained through one apheresis donation of platelets or by combining the platelets derived from five whole blood donations.

Donated platelets must be used within five days of collection.

Healthy bone marrow makes a constant supply of red cells, plasma and platelets. The body will replenish the elements given during a blood donation – some in a matter of hours and others in a matter of weeks.

Facts about donors

The number one reason donors say they give blood is because they "want to help others."

Two most common reasons cited by people who don't give blood are: "Never thought about it" and "I don't like needles."

One donation can help save the lives of up to three people.

If you began donating blood at age 18 and donated every 90 days until you reached 60, you would have donated 30 gallons of blood, potentially helping save more than 500 lives!

Only 7 percent of people in India have O-negative blood type. O-negative blood type donors are universal donors as their blood can be given to people of all blood types.

Type O-negative blood is needed in emergencies before the patient's blood type is known and with newborns who need blood.

Thirty-five percent of people have Type O (positive or negative) blood.

0.4 percent of people have AB-blood type. AB-type blood donors are universal donors of plasma, which is often used in emergencies, for newborns and for patients requiring massive transfusions.

There are four main blood types: A, B, AB and O.

In 1901, Karl Landsteiner, an Austrian physician, discovers the first three human blood groups. On his birthday i.e June 14th "World Blood Donors Day" celebrates. On October 1st ‘National Blood Donation Day’ celebrates in India.

WHAT TYPE ARE YOU?

FREQUENCY OF BLOOD TYPES

O+ 1 person in 3

O- 1 person in 15

A+ 1 person in 3

A- 1 person in 16

B+ 1 person in 12

B- 1 person in 67

AB+ 1 person in 29

AB- 1 person in 167




EXAMPLES OF BLOOD USE

1. Automobile Accident

50 units of blood

2. Heart Surgery

6 units of blood / 6 units of platelets

3. Organ Transplant

40 units of blood / 30 units of platelets

4. 20 bags of cryoprecipitate

25 units of fresh frozen plasma

5. Bone Marrow Transplant

120 units of platelets/ 20 units of blood

6. Burn Victims

20 units of platelets

World Blood Donor Day 2014:

World Blood Donor Day 2014: Safe blood needed to save mothers

On World Blood Donor Day – 14 June – world health organization(WHO) is calling to improve access to safe blood for saving the lives of mothers.

Every day, almost 800 women die from causes related to complications of pregnancy and childbirth. Severe bleeding during pregnancy, delivery or after childbirth is the single biggest cause of maternal death and can kill a healthy woman within 2 hours if she is unattended. Urgent access to safe supplies of blood for transfusion is critical to saving these women’s lives.

“If all obstetric facilities provided safe blood for transfusion, many of these mothers’ lives could be saved.”



When a new mother dies, not only does her baby face greater risk of death, malnourishment and lifelong disadvantage, but the whole family’s wellbeing is affected. If all obstetric facilities provided safe blood for transfusion, many of these mothers’ lives could be saved.

Voluntary unpaid blood donation

The safest source of blood is from regular, voluntary unpaid donors whose blood is screened for infections. A World Health Assembly resolution adopted in 2010 highlights that a secure supply of safe blood components, based on voluntary, non-remunerated blood donation, is an important national goal to prevent blood shortages.

Today, in many low- and middle-income countries, blood supply is critically inadequate. Sub-Saharan Africa, which has the highest maternal mortality rate in the world of 510 deaths per 100 000 live births, also has the lowest blood donation rates.

According to the latest WHO survey on blood safety and availability, 40 African countries collect less than 10 blood donations per 1000 population per year; of these, 25 countries collect less than half the blood that they need to meet transfusion requirements. High-income countries collect around 35 donations per 1000 population per year.

In many countries, family members are often pressured to donate blood or find a replacement donor in an emergency situation. This causes emotional and financial stress and significant delays in obtaining suitable blood, and also puts women at risk of bloodborne infections as there is often no time or facilities to properly screen the donated blood.

Safe blood transfusion to save mothers

Safe blood transfusion is one of the key life-saving interventions that should be available in all facilities that provide emergency obstetric care. Yet in 2014, equitable access to safe blood for obstetric care still remains a major challenge, contributing to high maternal mortality in many countries.

Currently, 73 countries collect more than 90% of their blood supply from voluntary unpaid blood donors (38 are high-income countries, 26 middle-income countries and 9 low-income countries).

About 108 million blood donations are collected worldwide every year. Almost half of these are collected in high-income countries, home to just 15% of the world’s population.

In low- and middle-income countries, a high proportion of blood supplies are needed for the management of complications of pregnancy and childbirth as well as for treating severe childhood anaemia. In high-income countries, blood transfusion is most commonly used in heart surgery, transplant surgery, trauma and cancer therapy.

WHO maintains that providing safe and adequate supplies of blood and blood products should be an integral part of every country’s efforts to improve maternal health.

The Organization provides policy guidance and technical assistance to support countries in developing national blood systems based on voluntary unpaid blood donations, and implementing quality systems to ensure that safe and quality blood and blood products are available and used appropriately for all people who need them.

World Blood Donor Day is celebrated annually around the world. It provides an opportunity to highlight the lifesaving role of voluntary unpaid blood donors and also thank those donors who give this precious gift, with no incentive to them, to save millions of lives every year.

Chikungunya Fever

Mosquito-Borne Chikungunya Virus Infection


"Chikungunya virus is a mosquito-borne alphavirus transmitted primarily by Aedes aegypti and Aedes albopictus mosquitoes. These vectors also transmit dengue virus . Humans are the primary amplifying host for chikungunya virus, and most infected persons develop symptomatic disease.

The usual clinical manifestations are acute onset of fever and polyarthralgia with bilateral, symmetric joint pains that may be severe and debilitating. In most patients, symptoms improve within 1 week, but in some, joint pain may persist for months. Death is rare and occurs primarily in older adults.




Clinicians should consider chikungunya virus infection in patients with acute onset of fever and polyarthralgia, particularly if they have recently returned from areas with known virus transmission.

Because no specific treatment, vaccine, or preventive drug is currently available for chikungunya virus infection, treatment is palliative, including rest, fluids, analgesics, and antipyretics.

To prevent further transmission, infected persons should be protected from mosquito exposure during the first week of illness.

The best way to prevent chikungunya virus infection is to avoid mosquito bites by indoor use of air conditioning or screens and outdoor use of insect repellents, long sleeves, and pants.

Herbal medicines put into context-BMJ 2003;327:881

Herbal medicines put into context


BMJ 2003; 327 doi: http://dx.doi.org/10.1136/bmj.327.7420.881 (Published 16 October 2003)

Cite this as: BMJ 2003;327:881

13 December 2003

HERBAL MEDICINES ARE NOT WITHOUT ADVERSE EFFECT

EDITOR - The editorial by Ernst on herbal medicines put into context1 was heartening. Herbal medicines are the most widely used one in India. According to an all India Ethno-botanical survey conducted by Indian Ministry of Environment [1985-1990], the tribal communities alone have a knowledge of the use of over 9000 species of plants of which the single major use catagories is tratitional medicine for which over 7500 species are used. The general public has a more positive view about herbal medicine because they are precieved as being natural and safe. In India some area of Tamil Nadu and Kerala have reported over 2000 plants and other resources are used for health care at the house hold level.

Recently many reports have shown that the plant medicines can also have mild to severe adverse health effects. Aristolochia and kava kava are proved to have nephro and hepatotoxicity2. St.Jhon’s wort is proved to have the potential of interaction with various other medicines and which may led to serious adverse effects such as graft rejection and failure to suppress HIV3. Ginko biloba extract have a variety of adverse effects which include headache, diarrohea, vomiting, and hemorhage due to ginkgolids a component of this extract4. Other commenly used herbal medicines that are thought to affect blood clotting include garlic, ginger, ginseng extracts5.

In India many plant medicines used by the traditional healers are not safe. In one of my study about iatrogenic seizures a 26 years old female had treatment for bronchial asthma from a traditional healer with indigenous plant extract probably containing Xanthine alkaloids developed generalized tonic clonic seizures6.

So it is important to realise that the plant medicines contain biologically active ingradiants which may cause adverse effects or they may interact with other conventional drugs.

M.A.ALEEM. Assitant Professor of Neurology, Dept of Neuromedicine KAPV Govt Medical College and AGM. Hospital, Trichy 620017. TAMIL NADU, INDIA. E-Mail: drmaaleem@hotmail.com

KALAVATHY PONNERIVAN, Professor of Biochemistry & DEAN KAPV. Govt Medical College and AGM Hospital, Trichy 620017. TAMIL NADU, INDIA.

Competing Intersts: None declared.

1. Ernst E.Herbal medicines put into context. BMJ 2003;327:381-2.

2. Barnes J, Quality efficacy and safety of Complementary medicines; fashions, facts and future. Part II: effiecncy and safety Br. J clin pharmacol 2003; 55:331-40

3. Ioannides C pharmacokinetic interactions Between herbal remedies and medicinal drugs, Xenobiotica 2002; 32:451-78

4. koltai M, Hosford D, Guinot P et al. platelet activating factors [PAF]. A review of its effects anatagonists and possible future clinical implications (part 1) Drugs 1991;42:9-29

5. Ang Lee MK.Moss J.Yuan C.S. Herbal medicines and perioperative care JAMA 2001; 286:208-16

6. Aleem.M.A Iatrogenic seizures a clinical study from southern india. J Neurol Sci 2001; 187(suppl):s411;

Competing interests: None declared

Adult Attention Deficit Hyperactivity Disorder (ADHD)

Adult ADHD (attention-deficit/hyperactivity disorder)

Definition

Adult attention-deficit/hyperactivity disorder (ADHD) is a mental health condition exhibited by difficulty maintaining attention, as well as hyperactivity and impulsive behavior. Adult ADHD symptoms can lead to a number of problems, including unstable relationships, poor work or school performance, and low self-esteem.

ADHD always starts in early childhood, but in some cases it's not diagnosed until later in life. It was once thought that ADHD was limited to childhood. But symptoms frequently persist into adulthood. For some people, adult ADHD causes significant problems that improve with treatment.

Treatment for adult ADHD is similar to treatment for childhood ADHD, and includes stimulant drugs or other medications, psychological counseling (psychotherapy), and treatment for any mental health conditions that occur along with adult ADHD.

Symptoms

Attention-deficit/hyperactivity disorder (ADHD) has been called attention-deficit disorder (ADD) and hyperactivity. But ADHD is the preferred term because it includes the two main aspects of the condition: inattention and hyperactive-impulsive behavior.

Adult ADHD symptoms may include:

Trouble focusing or concentrating

Restlessness

Impulsivity

Difficulty completing tasks

Disorganization

Low frustration tolerance

Frequent mood swings

Hot temper

Trouble coping with stress

Unstable relationships

Many adults with ADHD aren't aware they have it — they just know that everyday tasks can be a challenge. Adults with ADHD may find it difficult to focus and prioritize, leading to missed deadlines and forgotten meetings or social plans. The inability to control impulses can range from impatience waiting in line or driving in traffic to mood swings and outbursts of anger.

All adults with ADHD had ADHD as children, even if it was never diagnosed. Some people with ADHD have fewer symptoms as they age, while others continue to have significant symptoms as adults.

What's normal and what's ADHD?

Almost everyone has some symptoms similar to ADHD at some point in their lives. If your difficulties are recent or occurred only occasionally in the past, you probably don't have ADHD. ADHD is diagnosed only when symptoms are severe enough to cause ongoing problems in more than one area of your life. These persistent and disruptive symptoms can be traced back to early childhood.

Diagnosis of ADHD in adults can be difficult because certain ADHD symptoms are similar to those caused by other conditions, such as anxiety or mood disorders. And many adults with ADHD also have at least one other mental health condition, such as depression or anxiety.

When to see a doctor

If inattention, hyperactivity or impulsive behavior continually disrupts your life, talk to your doctor about whether you might have ADHD. Because signs of ADHD are similar to those of a number of other mental health conditions, you may not have ADHD — but you may have another condition that needs treatment.


Causes

While the exact cause of ADHD is not clear, research efforts continue.

Multiple factors have been implicated in the development of ADHD. It can run in families, and studies indicate that genes may play a role. Certain environmental factors also may increase risk, as can problems with the central nervous system at key moments in development.


Risk factors

You're potentially at increased risk of ADHD if:

You have blood relatives (such as a parent or sibling) with ADHD or another mental health disorder

Your mother smoked, drank alcohol or used drugs during pregnancy

Your mother was exposed to environmental poisons — such as polychlorinated biphenyls (PCBs) — during pregnancy

As a child, you were exposed to environmental toxins — such as lead, found mainly in paint and pipes in older buildings

You were born prematurely


Complications

ADHD has been linked to:

Poor school performance

Trouble with the law

Problems at work

Alcohol or drug abuse

Frequent car accidents or other accidents

Unstable relationships

Financial stress

Poor physical and mental health

Although ADHD doesn't cause other psychological or developmental conditions, a number of other disorders often occur along with ADHD. These include:

Mood disorders. Many adults with ADHD also have depression, bipolar disorder or another mood disorder. While mood problems aren't necessarily due directly to ADHD, a repeated pattern of failures and frustrations due to ADHD can worsen depression.

Anxiety disorders. Anxiety disorders occur fairly often in adults with ADHD. Anxiety disorder may cause overwhelming worry, nervousness and other symptoms. Anxiety can be made worse by the challenges and setbacks caused by ADHD.

Personality disorders. Adults with ADHD are at increased risk of personality disorders, such as borderline personality disorder or antisocial personality disorder.

Learning disabilities. Adults with ADHD may score lower on academic testing than would be expected for their age, intelligence and education.



Treatment

Treatment for adult attention-deficit/hyperactivity disorder (ADHD) typically involves medication, psychological counseling or both.

Stimulants (psychostimulants) are the most commonly prescribed medications for ADHD, but other drugs may be prescribed.

Stimulants appear to boost and balance levels of brain chemicals called neurotransmitters. Examples include methylphenidate (Concerta, Metadate, Ritalin, others), dextroamphetamine (Dexedrine), dextroamphetamine-amphetamine (Adderall) and lisdexamfetamine (Vyvanse). These ADHD medications help treat the signs and symptoms of inattention and hyperactivity.

Other medications used to treat ADHD include atomoxetine (Strattera) and antidepressants such as bupropion (Wellbutrin). Atomoxetine and antidepressants work slower than stimulants do and it may take several weeks before they take full effect. These may be good options if you can't take stimulants because of health problems or if stimulants cause severe side effects.

The right medication and the best dose vary among individuals, so it may take some time to find what works for you. Talk with your doctor about the benefits and risks of medications. And keep your doctor informed of any side effects you have.

Counseling for adult ADHD can be beneficial and generally includes psychological counseling (psychotherapy) and education about the disorder. Psychotherapy may help you:

Improve your time management and organizational skills

Learn how to reduce your impulsive behavior

Develop better problem-solving skills

Cope with past academic and social failures

Improve your self-esteem

Learn ways to improve relationships with your family, co-workers and friends

Often, medication combined with psychological counseling works best.