DEPRESSION MORE DAMAGING THAN ANGINA, ARTHRITIS, ASTHMA OR DIABETES !!

Depression is more damaging to everyday health than chronic diseases such as angina, arthritis, asthma and diabetes, researchers said. And if people are ill with other conditions, depression makes them worse, the researchers found.

"We report the largest population-based worldwide study to our knowledge that explores the effect of depression in comparison with four other chronic diseases on health state," the researchers wrote in the Lancet medical journal. Somnath Chatterji of the World Health Organisation, who led the study, said researchers calculated the impact of different conditions by asking people questions about their capacities to function in everyday situations -- such as moving around, seeing things at a distance and remembering information. "Our main findings show that depression impairs health state to a substantially greater degree than the other diseases," the researchers wrote.

The team used World Health Organisation data collected from 60 countries and more than 240,000 people to show on average between 9 percent and 23 percent had depression in addition to one or more of four other chronic diseases -- asthma, angina, arthritis and diabetes.
The most disabling combination was diabetes and depression, the researchers said. "If you live for one year with diabetes and depression together you are living the equivalent of 60 percent of full health," Chatterji said in a telephone interview.The findings show the need to provide better treatment for depression because it has such a big impact on people with chronic illnesses, Chatterji added. "What tends to happen is a health provider doesn't look for anything else but the chronic illness," he said. "What we are saying is, these people will also be depressed and if you don't manage the depression you can't improve a person's health because depression is actually worsening it."

DIABETICS AND HEART PATIENTS MAY DO WELL ON MEDITERRANEAN DIET:

Eating a traditional Mediterranean diet -- more vegetables, fruits, and fish, and fewer animal products -- does seem to ward off heart disease, an Australian study shows, and it may be especially beneficial for people with diabetes.

Mediterranean-born immigrants in Australia have lower death rates from heart disease than native-born Australians, note Dr. Linton R. Harriss, from Monash University in Melbourne, and colleagues. This prompted them to investigate dietary patterns in relation to heart-related mortality "in an ethnically diverse population." The study involved over 40,000 men and women, aged between 40 and 69 years, 24 percent of whom were native-born Mediterranean while the rest were native-born Australian. They were followed for ten years.

The researchers used food questionnaires to calculate participants' intake of Mediterranean foods, vegetables, fruits, and meats. The results of the study are published in The American Journal of Clinical Nutrition. "Those people in our study that were in the highest category of the Mediterranean foods pattern (i.e. most frequently consumed traditional Mediterranean foods) had a 30 percent lower risk of dying from cardiovascular disease compared to those who were in the lowest category," Harriss told Reuters Health. The investigators found that a Mediterranean-style diet "may be most beneficial for persons with diabetes."

Among the study participants with diabetes, Harriss said, "Our results suggest that the Mediterranean diet may lower mortality from ischemic heart disease." However, because those results are based on a small sub-sample, "more research needs to be performed to investigate these findings better. "The protective effect of a Mediterranean diet pattern against heart-related death was strongest in people who were free of heart disease at the outset. Nonetheless, "the Mediterranean foods pattern showed benefits whether we included or excluded people with a history of cardiovascular disease," Harriss said.

HIGH BLOOD PRESSURE - SYMPTOMS AND TREATMENT

When you have high blood pressure, or hypertension, the force of blood against your artery walls is too strong. High blood pressure can damage your arteries, heart, and kidneys, and lead to atherosclerosis and stroke. Hypertension is called a "silent killer'' because it does not cause symptoms unless it is severely high and, without your knowing it, causes major organ damage if not treated.

Your blood pressure measurement consists of two numbers: Systolic and Diastolic

The systolic measurement is the pressure of blood against your artery walls when the heart has just finished pumping (contracting). It is the first or top number of a blood pressure reading. The diastolic measurement is the pressure of blood against your artery walls between heartbeats, when the heart is relaxed and filling with blood. It is the second or bottom number in a blood pressure reading. High blood pressure is: 140 or above 90 or above Prehypertension is: 120 to 139, 80 to 89; Normal adult (age 18 or older) blood pressure is: 119 or below 79 or below.

Because new studies show the risk of heart disease and stroke begins to increase at lower blood pressures than previously believed, health experts lowered the acceptable normal range to promote more aggressive and earlier treatment of high blood pressure.

What causes high blood pressure?

In most cases, a doctor may not be able to pinpoint the exact cause of your high blood pressure. But several factors are known to increase blood pressure, including obesity, heavy alcohol use, family history of high blood pressure, high salt intake, and aging. A sedentary lifestyle, stress, low potassium intake, low calcium intake, and resistance to insulin may also cause your blood pressure to rise.

What are the symptoms?

Usually you will not feel any warning signs or symptoms of high blood pressure, and you will not know you have it until a health professional takes a blood pressure reading. Hypertension develops slowly and can cause serious organ damage, usually without any symptoms. If you develop severe high blood pressure, you may have headaches, visual disturbances, nausea, and vomiting. Malignant high blood pressure (hypertensive crisis), which is hypertension that rises rapidly, can also cause these symptoms. Untreated malignant hypertension can damage the brain, heart, eyes, or kidneys. It is a medical emergency that requires immediate hospitalization.
Over time, if you do not receive treatment for your high blood pressure, you may experience symptoms caused by damage to your heart, kidney, or eyes, including coronary artery disease, stroke, and kidney (renal) failure.

How is high blood pressure diagnosed?

Most people find out they have high blood pressure during a routine doctor visit. To confirm that you have high blood pressure, your blood pressure must reach or exceed 140/90 mm Hg on three or more separate occasions. It is usually measured 1 to 2 weeks apart. Except in very severe cases, the diagnosis is not based on a single measurement.

If there is reason to suspect that the blood pressure measurements taken in the doctor's office do not represent your accurate blood pressure (if, for example, you have white-coat hypertension), you may need to check your blood pressure away from the doctor's office. Your blood pressure can rise more than 20 mm Hg systolic and 10 mm Hg diastolic from white-coat hypertension. Even routine activities, such as attending a meeting, can raise your blood pressure by that amount. Other factors that can raise your blood pressure include commuting to work, exposure to cold, and drinking large amounts of alcohol.

Your doctor may have you check your blood pressure at home 3 times a day and keep a record of the readings. Or you may need to wear an automated blood pressure cuff that periodically inflates and takes blood pressure measurements during the day. This is called ambulatory blood pressure monitoring.

How is it treated?

If you fall into the prehypertension range (120–139/80–89 mm Hg), your doctor will likely recommend lifestyle modifications, including losing excess weight, exercising, limiting alcohol, cutting back on salt, quitting smoking, and following the Dietary Approaches to Stop Hypertension (DASH) diet. The DASH eating plan is a low-fat and low-saturated-fat diet that emphasizes eating more fruits, vegetables, whole grains, and low-fat dairy foods.

If you have high blood pressure (140–159/90–99 mm Hg) and you do not have any organ damage or other risk factors for heart disease (uncomplicated high blood pressure), your doctor will likely recommend lifestyle changes and possibly medications. Most people with high blood pressure will need two or more medications, including a thiazide-type diuretic, to lower their blood pressure to below 140/90 mm Hg, the goal for people with uncomplicated hypertension. If you have other conditions, such as diabetes, heart failure, or chronic kidney disease, your goal blood pressure is lower: 130/80 mm Hg. If your blood pressure is 160–179/100–109 mm Hg or higher, you and your doctor may need to try various combinations of medications to find what works best for you. You will also need to make aggressive lifestyle changes.

Overall, your treatment will depend upon how high your blood pressure is, whether you have other medical conditions, such as diabetes, and whether any organs have already been damaged. Your risk of developing other diseases, especially heart disease, will be another important factor your doctor will consider.

What increases my risk of developing high blood pressure?

Several factors increase your risk for high blood pressure. Some of them are lifestyle issues you can control. Lifestyle issues you can control to lower your risk of developing high blood pressure include obesity and not being active or exercising, drinking alcohol (three drinks a day or more), eating a lot of salty or processed foods, and not getting enough calcium, magnesium, and potassium in your diet.

Risk factors you can't control include a family history of high blood pressure, your race (being African-American increases your risk), and aging. Ninety percent of people who, at age 55, do not have hypertension will eventually develop it.

Symptoms:

People with primary (essential) high blood pressure usually do not have any symptoms. Most people with high blood pressure feel fine and only find out they have high blood pressure during a routine examination or a doctor visit for another problem. Very severe high blood pressure (stage 2), especially malignant high blood pressure (hypertensive crisis), may cause:Headaches, especially pulsating headaches behind the eyes that occur early in the morning. Visual disturbances. Nausea and vomiting. Over time, untreated high blood pressure can damage organs, such as the heart, kidneys, or eyes. This may lead to:Chest pain (angina), heart attack, or heart failure. Stroke. Kidney (renal) failure. Peripheral arterial disease. Eye damage (retinopathy). Abnormal heartbeat.

High blood pressure is a threat because it makes the heart work harder, increasing its oxygen demands and contributing to angina (chest pain related to heart disease). Unchecked, high blood pressure increases the risk of heart attacks, stroke and kidney disease.

Some people can lower and control their blood pressure with healthy lifestyle measures - losing weight if necessary (even a 10 percent weight loss might do the trick), quitting smoking if that's an issue, limiting intake of caffeine (in coffee, tea and sodas) and alcohol, all of which can contribute to the problem, as well as cutting back on salt (processed foods are the biggest sources of sodium in today's Western diet) and practicing relaxation methods.

The last of these may be the most important, yet doctors often fail to emphasize the importance of learning how to relax the involuntary nervous system, which controls the tone of blood vessels. Meditation, yoga, breathing exercises, and biofeedback training can all help. If you have high blood pressure and have made and are maintaining these lifestyle changes, you might then try to cut down on your blood pressure medication. Do so gradually, and be sure to monitor your pressure at home - at least 2-3 times a day, both when you are calm and when you are not -to make sure that it doesn't start to rise. If it does, you'll have to return to the usual dosage of your medication. It would be best to make these changes under the supervision of your physician so you will not be alone in your efforts. If you have a family history of hypertension, lifestyle measures may not be enough to keep your blood pressure under control - you probably will need some medication. But no one should depend on drugs alone. A healthy lifestyle, including relaxation practice, is also key to keeping blood pressure in the safe range.

ARTHRITIS AND REMEDIES:

Arthritis is actually a term covering over 100 rheumatic diseases; but basically, the affliction can be defined as an inflammation of the joints. The two most common forms of arthritis are osteoarthritis, which generally is caused by every day wear and tear on the foot or poor choices of shoe design, and rheumatoid arthritis, which occurs when the body's autoimmune system begins attacking its own cells, causing joint deterioration and deformation.

Some of the common things that can worsen the symptoms include lectins, such as those found in lima beans, lentils, and nightshade vegetables, food allergies, especially sensitivity to wheat and dairy products, and chemical sensitivities, particularly smoking or second-hand smoke.

Arthritis is different from most afflictions in that it isn't always a chronic condition. In a few cases, arthritis will only cause noticeable discomfort during "flare-ups" which are often caused by changes in barometric pressure and cold weather. Rheumatoid arthritis usually attacks the joints of individuals between 20 and 60, but it has been known to plague some younger joints as well in a condition known as juvenile arthritis. After age 70, new instances of the disease seem to decline. The condition affects women three times more than men.

Foods to avoid for arthritis sufferers:

Some arthritis sufferers should avoid nightshade vegetables, so named because they grow in the shade of night rather than during the day. Vegetables in this group include potatoes, eggplant, peppers (although direct application of peppers on joints can be helpful), and tomatoes. Meat is also said to aggravate arthritis, as it is high in uric acid, a primary factor in the aggravation of symptoms. The effects of uric acid can be mitigated by not consuming meat, while consuming dandelion greens, parsley, alfalfa, and the herb devil's claw.

Treating arthritis naturally:

The conventional medical theory is that there is no cure for arthritis, only treatments for joint pain and inflammation, such as aspirin, ibuprofen, and the nutritional supplement glucosamine. But anti-inflammatory medicines, while beneficial in the short-term, can begin to make the problem worse, as well as deteriorate the stomach and liver. There are surgical procedures to help with arthritis involving the draining of certain antibodies. Actual joint replacement is another procedure. But these seem rather barbaric. In the past, medical practitioners had even recommended the removal of teeth as a treatment for arthritis.

Vegetables and their juices contain phytonutrients which can be instrumental in aiding the body in regenerating cells –a vital part of treating arthritis. Even orange juice can help since it contains vitamin C, an antioxidant. Antioxidants assist the body in the reduction of swelling and inflammation of the joints.

Cherry juice for arthritis pain:

Patients had experienced at least partial relief of pain symptoms by drinking two glasses of black cherry juice (four ounces of juice diluted with four ounces of water) twice a day. The patients can discontinue consumption of the juice once their pain subsides. Parsley, broccoli, and spinach can assist in the treatment of arthritis, since these contain beta-carotene, along with carrots, apples, and ginger, all of which contain copper. Pineapple juice is the only source of the strong anti-inflammatory enzyme bromelain. Bromelain helps the body breakdown protein. Incomplete protein break down (i.e. poor digestion) is a condition implicated in arthritis. Bromelain also helps break down plaque and fatty tissue deposits that can clog arteries. It also assists in the natural healing of bruises and minor abrasions.

Other juices said to help include bilberry, celery juice, green barley juice, aloe vera juice, and boswellia extract. Birch cortisone can also help reduce inflammation of joints; however, cortisones can interfere with calcium absorption and should be used sparingly. Not all juices have a positive effect on arthritis symptoms. Spinach juice and spinach itself is bad for arthritis because it contains oxalic acid which can interfere with calcium absorption and exacerbate arthritic symptoms.

Fish oil has been known to have a positive effect on arthritis symptoms. In one experiment, patients who completely supplemented their arthritis treatments and medications with fish oil while giving up their chemical treatments experienced no relapse in their arthritis symptoms.
Some schools of thought rely on acupuncture to assist in dealing with arthritis pain.

Acupuncture is based on an ancient Chinese philosophy that the body has an energy called qi, pronounced "chee." Application of needles to certain points can restore the flow of qi along invisible channels called meridians. Theoretically, when meridians are disrupted, the body becomes ill in response, such as displaying symptoms of arthritis. Proponents of the practice explain it goes beyond temporary relief and actually re-patterns the body.

HERBALS FIGHT DISEASES:

By carefully matching the herbal properties with the symptoms being treated, it's possible to confront the entire scope of a disease at once, achieving a cure quickly and with the minimum possible dosage. Also, by referencing the herbal properties, it becomes easier to substitute one herb for another.

Alteratives:

Also known as blood purifiers, these agents gradually and favorably alter the condition of the body. They are used in treating toxicity of the blood, infections, arthritis, cancer and skin eruptions. Some Alteratives include: Red Clover, Echinacea, Dandelion Root, Alfalfa, Aloe Vera, Comfrey, Marshmallow, and Nettles.

Analgesics:

Herbs that are taken to relieve pain without causing loss of consciousness. Some Analgesics include: Cloves, Catnip, Chamomile, Skullcap, Lobelia, and Valerian.

Antacids:

Herbs that are able to neutralize excess acids in the stomach and intestines. In most cases, these also have demulcent properties to protect the stomach lining. Some Antacids are Dandelion Root, Fennel Seed, Slippery Elm, and Kelp.

Antiabortives:

Herbs that help to inhibit abortive tendencies. These are taken in small quantities during pregnancy, and include Lobelia, Raspberry Leaf, and Cramp Bark. The herbs will not interfere with the natural process of miscarriage when the fetus is damaged or improperly secured.

Antiasthmatics:

Herbs that relieve the symptoms of asthma. Some, like Lobelia, are strong Antispasmodics that dilate the bronchioles. Others, like Yerba Santa help break up the mucus. Some herbs may be smoked for quick relief including Coltsfoot and Mullein, which may also be taken as teas. Other Antiasthmatics include Comfrey, Wild Yam, and Wild Cherry Bark.

Antibiotics:

Substances that inhibit the growth of, or destroy, bacteria, viruses or amoebas. While many herbal antibiotics have direct germ killing effects, they have as a primary action, the stimulations of the body's own immune response. Excessive use of antibiotics will eventually destroy the beneficial bacteria of the intestines. In fighting stubborn infections it is a good idea to maintain favorable intestinal flora by eating miso, tamari, or fresh yogurt. Important antibiotic herbs include, Echinacea, Olive Leaf, Juniper Berries, Thyme, and Garlic.

Anticatarrhals:

Herbs that eliminate or counteract the formation of mucus. A treatment for catarrh should also include the use of herbs that aid elimination through sweat (diaphoretics), urine (diuretics), and feces (laxatives). Anticatarrhal herbs include: Black Pepper, Cayenne, Ginger, Sage, Cinnamon, Anise, Mullein, Comfrey, Wild Cherry Bark, and Yerba Santa.

Antipyretics:

Cooling herbs used to reduce or prevent fevers. Cooling may refer to neutralizing harmful acids in the blood (excess heat) as well as reducing body temperature. Antipyretics include: Alfalfa, Basil, Skullcap, Dulse, and Kelp.

Antiseptics:

Herbs that can be applied to the skin to prevent the growth of bacteria. This includes the Astringents. Some Antiseptics include: Calendula, Thyme, Garlic, Juniper Berries, and Sage.

Antispasmodics:

Herbs that prevent or relax muscle spasms. They may be applied either internally or externally for relief. One of the most important antispasmodics is Lobelia. Antispasmodics are included in most herb formulas to relax the body and allow it to use its full energy for healing. Some Antispasmodics include: Skullcap, Valerian, Black Cohosh, Blue Cohosh, and Raspberry Leaf.

Aphrodisiacs:

Substances used to improve sexual potency and power. Aphrodisiacs include: Astragalus, Burdock, and Maca Root.

Astringents:

Herbs that have a constricting or binding effect. They are commonly used to check hemorrhages and secretions, and to treat swollen tonsils and hemorrhoids. The main herbal Astringents contain tannins, which are found in most plants, especially in tree barks. Important Astringents include: White Oak Bark, Calendula, Shavegrass and Juniper Berries.

Carminatives:

Herbs and spices taken to relieve gas and griping (severe pains in the bowels). Examples of Carminatives include: Anise, Fennel, Cumin, Ginger, and Peppermint.

Cholagogues:

Substances used to promote the flow and discharge of bile into the small intestine. These will also be laxatives, as the bile will stimulate elimination. Some Cholagogues are: Aloe Vera, Mandrake, and Licorice.

Demulcents:

Soothing substances, usually mucilage, taken internally to protect damaged or inflamed tissues. Usually a Demulcent herb will be used along with diuretics to protect the kidney and urinary tract, especially when kidney stones and gravel are present. Important Demulcents include: Marshmallow, Comfrey, Slippery Elm, Licorice, Burdock, and Aloe Vera.

Diaphoretics:

Herbs used to induce sweating. To administer Diaphoretics effectively, the stomach and bowels should be emptied by fasting and using an enema. However, laxatives should not be used before using these herbs. Sweating teas should be hot; when given cold, they act as diuretics. Some Diaphoretics include: Lemon Balm, and Catnip. Diaphoretics that should be taken with Ginger or Cayenne include: Yarrow, Hyssop, and Peppermint.

Diuretics:

Herbs that increase the flow of urine. They are used to treat water retention, obesity, lymphatic swellings, nerve inflammations such as lumbago and sciatica, infections of the urinary tract, skin eruptions, and kidney stones. Whenever a Diuretic is given, a lesser amount of Demulcent herb is also given to buffer the effect of the diuretic on the kidneys (especially when the Diuretic contains irritating properties) and to protect the tissues from the movement of kidney stones. Some Diuretics include: Shavegrass, Parsley, Juniper Berries, Marshmallow, Nettles, Burdock, Dandelion, and Hawthorn Berries.

Emetics:

Herbs that induce vomiting and cause the stomach to empty. In small quantities, these will not cause vomiting, but will have other important effects on the body. Some Emetics are Lobelia, Black Mustard Seed, Ipecac, Elecampane, and Blessed Thistle.

Emmenagogues:

Herbs that promote menstruation, usually causing it to occur earlier, and sometimes with increased flow. These have been used in the past to induce abortions, so extreme caution is advised. All of these, when taken in sufficient quantity to cause abortion, have other strong effects on the body. None of these should be taken when a woman wants to be pregnant. These are now commonly used to help regulate the menstrual cycle. Herbs with strong Emmenagogue properties include: Pennyroyal, Juniper Berries, and Black Cohosh.

Emollients:

Substances that are softening, soothing, and protective to the skin. These include Marshmallow, Comfrey, and Slippery Elm.

Expectorants:

Herbs that assist in expelling mucus from the lungs and throat. Expectorants include: Wild Cherry Bark, Yerba Santa, Lobelia, Mullein, and Anise. Also, to loosen mucus, inhale steam from boiled water with Eucalyptus, Bay Leaves, and Sage.

Galactogogues:

Substances that increase the secretion of milk. Anise Seed, Cumin, and Fennel.

Hemostatics:

Substances that arrest hemorrhaging. These include astringents and herbs that affect the coagulation of blood. Cayenne, Mullein, Shavegrass, and White Oak Bark.

Laxatives/Purgatives:

Herbs that promote bowel movements. A strong laxative that causes increased intestinal peristalsis is called a purgative in many texts.

Lithotriptics:

Herbs that help to dissolve and eliminate urinary and biliary stones and gravel. For the kidney and bladder stones, use Parsley, Dandelion, Nettle, and Shavegrass (Horsetail). For the gallbladder, use Wild Cherry Bark and Cascara Sagrada.

Oxytocics:

Substances that stimulate uterine contractions to assist and induce labor, thus hastening childbirth. Oxytocics include: Black Cohosh, Blue Cohosh, and Juniper Berries.

Parasiticides:

Herbs that destroy parasites in the digestive tract or on the skin. Parasiticides include: Garlic and Thyme Infused Oil.

Rubefacients:

Substances that increase the flow of blood at the surface of the skin and produce redness where they are applied. Their function is to draw inflammation and congestions from deeper areas. They are useful for the treatment of arthritis, rheumatism, and other joint problems and for sprains. Rubefacients include: Cayenne, Thyme Infused Oil, Black Pepper, Cinnamon, and Eucalyptus.

Sedatives:

Herbs that strongly quiet the nervous system. These will include antispasmodics and nervines. Useful Sedatives include: Valerian, Hops, Chamomile, Passionflower, Catnip, and Scullcap.

Sialagogues:

Substances that stimulate the flow of saliva and thus aid in the digestion of starches. Some Sialagogues are Echinacea, Black Pepper, Cayenne, Ginger, Licorice, and Yerba Santa.

Stimulants:

Herbs that increase the energy of the body, drive the circulation, break up obstruction and warm the body. Stimulants include: Anise Seed, Cayenne, Black Pepper, Cinnamon, Echinacea, Ginseng, Dandelion, Ginger, Yarrow, Rosemary, Garlic, Juniper Berries, Sage, Pennyroyal, and Astragalus.

Vulneraries:

Herbs that encourage the healing of wounds by promoting cell growth and repair. Some Vulneraries are: Aloe Vera, Cayenne, Comfrey, Garlic, Calendula, Rosemary, Thyme, Marshmallow, and Slippery Elm.

MENTAL HEALTH CARE IN PAKISTAN:

It is said that if one wants to know about a certain society’s moral values, one can do it by witnessing its behaviour towards the mentally ill or other under-privileged communities. In Pakistan’s context, the observation would paint an ugly picture. However, in this piece an attempt has been made to objectively look at healthcare facilities and legislative protection available to the people suffering from mental illnesses in Pakistan.

Pakistan is a South Asian developing country with a population of 140.7 million. Its average population density is 106 persons per square km. Pakistan remains primarily a rural economy with about 30 per cent population living in urban areas and two-fifth (40 per cent) of this urban population living in cities of Karachi, Lahore, and Faisalabad.

Pakistan gained independence from British colonial rule a-half-a-century ago. Traces of the past colonial rule can still be seen in different socio-political spheres. Mental health is no exception. Services available to the mentally disturbed people are limited to three large psychiatric asylums and a handful of general hospital units (2,345 beds). The care delivered at these centres is more penal than therapeutic. There are only 150-200 adequately trained psychiatrists in the country. Most are in private practice and located in major urban areas. Academic frauds are rampant in the government-run public-sector hospitals. Officials are promoted to high ranks because of their political affiliations.

Community-based epidemiological studies estimate the prevalence rates for depression from 25 per cent to 66 per cent for females and 10 per cent to 44 per cent for males. There are no epidemiologically representative community-based studies on incidence or prevalence of schizophrenia. Its estimates are speculated to be similar to other low income countries in the region (0.8 per cent rural China, 3.8 per cent in Sri Lanka and 5.9 per cent in Kolkata, India). The prevalence of mental retardation is estimated to be two to eight times greater in low income developing countries (like Pakistan) in contrast to industrialised countries. In developing countries the prevalence of severe mental retardation is estimated at 5.2 to 16.2 per 1,000 children (for example, Sri Lanka 5.2 per cent; Pakistan- 15.1 per cent; Bangladesh 16.2 per cent) whereas in western countries it varies from three to five per 1,000 children. According to the Narcotics Control Board, Government of Pakistan, there are 4 million people who are dependent on drugs. There are two million heroin abusers in Pakistan; more than 80 per cent are between 15 to 35 years of age. With an increasing globalisation and social capital erosion people with mental illnesses are at a further risk of deterioration.

Mental Health Services:

The government’s budgetary allocation for the health sector is less than one per cent of the GNP; mental health allocations are negligible. It is estimated that the private sector accounts for some 70 per cent of national expenditure on provision of health services (mostly curative in nature). According to the World Health Report (2004), 100 per cent healthcare payment is out of pocket for Pakistanis. Healthcare has become a lucrative business where firms (hospitals) enter market in order to earn an exorbitant amount of money.

This need-supply gap results in poor quality of services, both in public and private sectors. There is an additional mushrooming of private psychiatric hospitals. Pakistan does not have a government-run welfare system (as in the US) nor does it have a national healthcare system like in the United Kingdom. The rights of the poor, mentally ill or other marginalised individuals are not protected by state. There is no mercy for people with mental illness, poor and marginalised communities. Against this backdrop one reads stories like a mentally ill woman in post-delivery state assaulting her young child.

There are reports on abuse of psychiatric patients. In some centres patients are chained and beaten brutally. In the absence of trained mental healthcare staff there gross negligence is witnessed as far as patients’ management goes. Psychotropic medications are used indiscriminately resulting in serious side-effects and subsequent non-compliance. It is not uncommon to read prescription with cocktail of five psychotropic medications.

Integrated Mental Health Services:

The World Health Organisation (WHO) has established a collaboration centre in Rawalipindi. The WHO has provided consultation services and initiatives on many projects to low and middle income countries. These have been implemented with variable success. The management of five common mental illnesses in primary healthcare is one of the options. The illnesses include depressive disorder, psychosis, substance abuse, mental retardation and epilepsy.

The availability of sustainable basic healthcare from Basic Health Units (BHUs) and rural health centres (RHCs) is a major issue. Some years ago the WHO and Pakistan Medical and Research Council (PMRC) did a survey in order to study the reason behind underutilisation of available BHU services. Low numbers and the attendance rate of doctors (63.8 per cent), non-availability of medicines (22 per cent), geographic inaccessibility and low quality of services were cited as some of the major problems. Public sector tertiary care hospitals (TCHs) are a major recipient of the government budgetary allocation, leaving little resources for improvement in the available primary healthcare infrastructure. Employees’ salary compromise 55-to-66 per cent of the budget in these THC leaving little room for technological advancements, equipment and medicines. It is common knowledge that there are many ghost employees. Recruitments are done regardless of merit and thus necessary skill and training is lacking.

The integration of mental healthcare in an ailing primary care system is a difficult issue. This option seems feasible for countries with an established primary healthcare system.

Mental Health Legislation:

Till five years ago, the judiciary was following the modified version of the Lunacy Act, 1912. Suicide and attempted suicide were considered a crime according to the Pakistan Penal Code 309. It is a known that the law enforcement agencies extort an exorbitant amount of money from the victims of deliberate self harm (DSH). The new Mental Health Ordinance was promulgated in 2000 which is inadequately implemented. In the absence of a comprehensive legal framework one reads reports on how a relative or a family member was admitted to a psychiatric hospital without proper assessment in order to settle a property dispute. This comes to light only when a non-governmental organisation (NGO) or a patients’ advocacy group highlights the issue in the local media.

In Pakistan, the Pakistan Medical and Dental Council (PMDC) is the sole body for proper licensing and credentialing of physicians. All physicians need to be registered with this central body which has to be renewed after a certain period. The problem lies in the implementation of rules and regulation. One sees a chain of psychiatric hospital claiming to deliver psychiatric care with no qualified psychiatrist on their panel. There is no legal action taken against these people who blatantly exploit patients with mental illness.

There are no specialised forensic facilities or psychiatrists in our country. There are no rehabilitation programmes in place for those proven not-guilty on account of mental illnesses. Psychiatrists and associated professional groups have attempted to de-stigmatise themselves by virtue of “risk assessment”. They merely act as instruments of state machinery. This is done at the cost of further isolating the mentally ill.

Possible Solutions:

Instead of going for quick-fix solutions, psychiatric services should be developed by training mental health professionals. Research methodology and courses on psychiatric epidemiological should be incorporated into psychiatric training programmes.

MAGIC OF FISH OIL:

Scientists worldwide are praising a nutrient so powerful that it may help combat dozens of diseases.

When Randal McCloy was rushed to West Virginia University Ruby Memorial Hospital's intensive-care unit, he was practically dead. The 27-year-old coal miner had spent 41 hours buried 2 ½ miles underground after an explosion in the Sago, West Virginia, mine where he'd been working. His 12 oxygen-starved colleagues had all perished.

"As far as we know, he survived the longest exposure to carbon monoxide poisoning," says Julian Bailes, M.D., the neurosurgeon assigned to the case. McCloy was in a coma and in deep shock, his heart barely beating, one of his lungs collapsed, his liver and both kidneys shut down. Even if he somehow managed to pull through, doctors predicted McCloy would be severely brain damaged, since the carbon monoxide had stripped the protective myelin sheath from most of his brain's neurons. "It's very difficult to come back from a brain injury," says Dr. Bailes. "There's no drug that can help that."

While McCloy was being given oxygen infusions in a hyperbaric chamber, Dr. Bailes was struck by inspiration: He ordered a daily dose of 15,000 milligrams (mg) docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) for the miner. In layman's terms? "Fish oil," says Dr. Bailes.
Several weeks passed. Then, unexpectedly, McCloy emerged from his coma. This in itself was amazing, but he wasn't done. In the weeks that followed, he stunned even the most optimistic experts by recovering his memory and gradually regaining his ability to walk, talk, and see, a turnaround that many in the medical field called miraculous.

Although Dr. Bailes believes the hyperbaric chamber may have worked some magic on the myelin, he thinks much of the credit belongs elsewhere. "The omega-3s helped rebuild the damaged gray and white matter of his brain," says Dr. Bailes, who now takes his own medicine, swallowing a fish-oil supplement each morning. On his orders, McCloy, still recuperating at home, continues to take fish oil daily. "I would say he should be on it for a lifetime," says Dr. Bailes. "But then, I think everybody should."

Maybe what fish oil needed all along was a better publicist. After all, this isn't the medical community's first infatuation with omega-3s. Back in 1970, a pair of Danish researchers, Hans Olaf Bang and Jørn Dyerberg, traveled to Greenland to uncover why the Eskimo population there had a low incidence of heart disease despite subsisting on a high-fat diet. Their finding: The Eskimos' blood contained high levels of omega-3s, establishing the first link to heart health. But even though this discovery spurred additional omega-3 research throughout the '70s and '80s, the public remained more interested in other nutrients—none of which had the unfortunate words "fish" or "fatty" in their names.

There are three types of omega-3s: DHA and EPA, found in fish and marine algae (which is where the fish get them), and alpha-linolenic acid (ALA), which is found in plants, seeds, and nuts. All three have health benefits, but those attributed to DHA and EPA have sparked renewed interest in recent years. Studies show that this tag team may not only reduce a person's risk of heart disease and stroke but also possibly help prevent ailments as diverse as arthritis, Alzheimer's disease, asthma, autoimmune disorders, and attention- deficit/ hyperactivity disorder—and those are just the A's. Researchers are now exploring if these multifunctional fats can, among other things, ward off cancer and even make prison inmates less violent. It's enough to make omega-3 geeks downright giddy.

"Omega-3s are fantastic!" says Jing X. Kang, M.D., Ph.D., a Harvard University researcher who made the news by genetically engineering pigs to produce omega-3s in their meat. "Not just for your heart but also for brain function, immunity function, women's health, children's health—I'm amazed at how important they are."

Omega-3s: As essential as vitamins A and D

MORE ABOUT HOMOEOPATHY:

Homeopathy (also spelled homœopathy or homoeopathy), from the Greek words ?µ????, hómoios (similar) and p????, páthos (suffering), aims to treat "like with like." The term "homeopathy" was coined by the German physician Christian Friedrich Samuel Hahnemann (1755–1843) and first appeared in print in 1807, although he began outlining his beliefs of medical similars in a series of articles and monographs in 1796.

Homeopathic treatment involves giving a patient with symptoms of illness extremely small doses of substances that produce the same symptoms in healthy people when given in larger doses. A homeopathic remedy is prepared by diluting the substance in a series of steps. Many homeopathic remedies are so highly diluted that no molecules of the original substance are likely to remain. Homeopathy asserts that the remedy will retain a memory of the diluted substance and the therapeutic potency of a remedy can be increased by serial dilution combined with succussion, or vigorous shaking. Homeopathy regards diseases as morbid derangements of the organism, and states that instances of disease in different people differ fundamentally. Homeopathy views a sick person as having a dynamic disturbance in a hypothetical "vital force", a disturbance which, homeopaths claim, underlies standard medical diagnoses of named diseases. Homeopathy is particularly popular in Europe and Subcontinent, although less so in the USA.

Is Homeopathy a Science?

Homeopathy is an elaborate and very detailed medical science based upon the principle of stimulating the body to heal itself. It is non-toxic, highly effective against both acute and chronic disease, and relatively inexpensive. Widespread throughout Europe, Great Britain, Central and South America, India, and Africa, homeopathy is experiencing an explosive resurgence in the United States as part of the movement toward alternative medicine. The principles underlying the specialty of homeopathy have been systematically proven throughout two centuries of practice and validated by over 200 scientific studies meeting modern criteria of acceptability.

What are the principles underlying homeopathy?

The basic concept is that symptoms are manifestations of the organism trying to heal. In acute disease, the fever, malaise, pain, and diarrhea or discharges are attempts to kill the offending organism and expel the toxins while encouraging the person to slow down and rest. In chronic disease, the arthritis or migraines or hypertension, etc., are attempts to heal which are not succeeding — thus, they are chronic.

In the homeopathic perspective, symptoms are any limitations of freedom — whether mental, emotional, or physical. Homeopaths observe that virtually all substances — plant, mineral, or animal — may produce symptoms if given carefully to sensitive individuals or in larger quantities to less sensitive people. These symptoms are painstakingly catalogued in Materia Medicas, which are then elaborately analyzed (in modern days, by computer) to match the symptom properties of substances to symptom pictures of patients. The basic principle, verified by vast clinical experience, is: Like Cures Like — A substance that produces symptoms in a healthy person will cure those very symptoms in a sick person. What is the method? The practitioner conducts a very elaborate and penetrating interview addressing all major and minor symptoms of mental, emotional, and physical planes. Each symptom is elucidated as to what makes it better or worse, when it occurs, whether there are others in conjunction, what circumstances produce it, what stresses seem to lead to it, and whatever hereditary traits contribute. In particular, what is unique about a patient's total personality is considered -- individual traits ("good" or "bad"), dreams, ambitions, favorite recreations, etc. A total symptom picture is built which is then matched to the best possible remedy picture.

In Classical Homeopathy, only one remedy is prescribed at a time -- no combinations. It may be administered in a single dose (on sugar pellets, like candy) in the office, or as liquid daily doses from a stock bottle sent by a homeopathic pharmacy. Progress is then monitored at four to six weekly intervals until it becomes clear that the correct remedy has been chosen. At that point,

basically only one remedy (out of 2,500 or so available) is truly curative at a given moment in time. If the correct remedy is given, there may be a brief healing crisis within a few days to a few weeks followed by gradual improvement over a span of months or years, depending on the severity of the case and allopathic drug interferences. If the remedy given is incorrect, essentially nothing at all happens — the patient is neither worse nor better as a whole even despite minor changes. In that case, another remedy is selected.

What are the principles underlying homeopathy?

The basic concept is that symptoms are manifestations of the organism trying to heal. In acute disease, the fever, malaise, pain, and diarrhea or discharges are attempts to kill the offending organism and expel the toxins while encouraging the person to slow down and rest. In chronic disease, the arthritis or migraines or hypertension, etc., are attempts to heal which are not succeeding — thus, they are chronic.

In the homeopathic perspective, symptoms are any limitations of freedom — whether mental, emotional, or physical. Homeopaths observe that virtually all substances — plant, mineral, or animal — may produce symptoms if given carefully to sensitive individuals or in larger quantities to less sensitive people. These symptoms are painstakingly catalogued in Materia Medicas, which are then elaborately analyzed (in modern days, by computer) to match the symptom properties of substances to symptom pictures of patients. The basic principle, verified by vast clinical experience, is: Like Cures Like — A substance that produces symptoms in a healthy person will cure those very symptoms in a sick person.

What ailments are appropriate for homeopathic referral?

Homeopathy is effective often within hours in acute influenza, bronchitis, pneumonia, gastroenteritis, injuries, shock, and even fright. Most appropriate for referral are the full range of chronic diseases: allergies, asthma, eczema and other dermatitides, anxiety/stress disorders, depression, bipolar disorder, OCD, ADD, PMS, menopause, migraines or cluster or tension headaches, fibromyalgia and CFS, hypertension, angina, arrhythmias, peptic ulcer, Crohns Disease, ulcerative colitis, IBS, hepatitis, lupus erythematosis, mixed connective tissue disorder, sarcoidosis, multiple sclerosis, peripheral neuropathies, etc….Homeopathy is effective at all ages as well. Good candidates for homeopathy are cases in which no clear allopathic diagnoses can be made. Because homeopathy relies on understanding the uniqueness of the person to stimulate healing forces, diagnosis is effectively bypassed. Homeopathy is not effective in insulin-dependent diabetes, specific chromosomal defects such as sickle-cell disease, or in cases of advanced mechanical obstruction (obstructed coronary arteries, blocked bile ducts, bulging discs pressing on nerves). Severe degenerative arthritis and Parkinson’s disease are difficult to cure after about 10 years duration.

What is the homeopathic interview like?

The first interview usually lasts one hour or an hour and a half. It is almost solely verbal. The task of the doctor and patient together is to create a full picture of all the unique and peculiar aspects of the person, the disease, its progression, and its meaning. Looking at mental, emotional, and physical aspects together, an effort is made to understand all the ways in which the vital force is already trying to heal. The remedy ideally acts to improve that effort, enabling cure of even chronic disease.

In homeopathy, prescriptions are based solely on the language of the vital force as it manifests in symptoms verbalized by the patient and physical observations made by the doctor. It is not based on laboratory data, machine technology, extrapolation from animal studies, etc.

The advantage in homeopathy is that it does not depend on the vagaries of diagnoses or diagnostic fads. In allopathic medicine, the hope is that a diagnosis will lead to an understanding of the causative process, and therefore will lead to cure. In chronic disease, this has uniformly failed. In homeopathy, on the other hand, diagnosis is unnecessary and a waste of effort. The sole task is to understand what is unique about the individual and his/her symptoms. That uniqueness leads to the remedy that stimulates the vital force to heal the illness, whether diagnosable or not.

HOMOEOPATHY IN BRIEF:

Homeopathy is a highly effective system of medicine in both acute and chronic diseases. At the same time it has no side effects if used correctly.

According to the WHO, homeopathy is the second most popular and used system of health in the world. Samuel Hahneman in the late eighteenth century gave us formalised Homoeopathy. The principle of treatment that a Medicine which creates similar Symptoms, which are also produced by the Disease are treated by that Medicine. This Principle has been recorded since Classical Greek Times. This Principle is called LIKE CURES LIKE .

Hahneman carried on his work and investigations tirelessly, but could not accumulate enough evidence of Medical Cure using this System. It was in 1812 when he could show the results of Homoeopathy by treating 180 cases of Typhus. Since then the effectiveness of Homoeopathy has been proved in a very very large number of patients. The Same Principle has been extended to all kinds of life including animal life.

Homeopathy is a system of medicine based on a law of nature - the law of similars ("likes cure likes"). In short, it means that a substance that is capable of inducing certain symptoms in a healthy human being, is able to cure these symptoms in a sick individual if it is given in a minimal dose (homeopathically potentized) a simple (and simplified) example: If you cut an onion, your eyes might start to water and your nose might start to run, too. Now, if you have a cold that resembles these symptoms, the onion in a homeopathic dose (called Allium cepa) will help you. By taking the case very thoroughly, i.e. regarding all the physical, mental and emotional symptoms of the patient, the homeopath is able to find a homeopathic remedy which is capable of producing symptoms so similar to the patient's symptoms that it will stimulate the patient's organism to heal itself.

Homeopathy was founded by German physician Dr. Samuel Hahnemann in 1796. Homeopathy has proven to be a highly effective method of healing for most acute and chronic diseases for more than 200 years; also for more than 200 years homeopathy has proven to be completely free of side effects if used according to homeopathic principles. Unfortunately, homeopathic remedies are often used without sufficient knowledge of these principles (even by practitioners, authors of homeopathy guide books etc.) which can result in adverse effects for the patient.

After the introductory course, you will know about these principles and will be able to use homeopathy more effectively and absolutely safely. Homeopathy treats the cause of disease rather than suppress symptoms. Conventional medicines cannot cure chronic diseases like allergies, excema, chronic pain syndromes and so on. It only suppresses the symptoms with unsatisfactory results and the treatment often causes new problems. Homeopathic physicians hardly ever need to prescribe antibiotics - for the benefit of their patients. Everybody can learn to prescribe for acute diseases. It does not matter for the homeopathic treatment if the infection is viral or bacterial - the law of similars will work. Learning homeopathy will give you a new and deep understanding of what health and illness means

The following points shows the peculiarities of homoeopathy that make it a very sensible choice of treatment:

1. No side effects.

2. No suppression of symptoms for later, more vicious reappearance.

3. No dependence on diagnosis but only a dependence on symptom observation.

4. No need for laboratory trials for the proving of medicines.

5. Allowance for and dependence on a patient's individuality.

6. Whole patient treatment.

7. Homoeopathy appears to work with the body's own disease-combating mechanisms to effect a cure and this constitutes a most natural, humane and effective method of cure.

8. No environmental pollution.