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Calcaneal spur (Heel spur) is a painful condition in which there will be severe pain in the heel. There is a bony outgrowth in the calcanial bone (Heel bone) due to continuous stress in the region. The pain in this disease will be more severe when waking up in the morning or walking after period of rest.

In siddha system of medicine the calvaneal spur is referred as Kuthikaal Vatham.


The main aim of the treatment is to reduce the level of injury in the concerned area and thereby maximum possible pain relief, for that internal medicines, external applications and exercise are must.


The following siddha medicines can be used with an advice of a siddha physician.
Singi Chunnam
Chitramutti madakku thylam
Ayakantha chenduram
Ayaveera chenduram
Arumugha Chenduram
Chandamarutha Chenduram
Athirshta Rasayanam.


Chitramutti Madakku Thyalam
Sivappu Kukkil Thylam
Mayana Thyalam

Special Medicines for Calcaneal spur (To be prepared by self)

1. Euphorbia tirucalli (Thirikkalli) is fried with castor oil and add crushed leaves of Clerodendrum phlomodis(Thazhuthalai), Vitex negundo(Nochi) to it and applied to the affected foot as a medicated bandage. (Agasthyar vaidyam 292,293/ External therapies of siddha medicine (P.9))

2. Calatropis giganta (Erikku) leaves are cleaned and placed over a hot Brick and step over it until get sufficient heat. Do it daily twice after applying suitable oils to the affected part.


The aim of exercise is to strengthen calf and lower leg muscles there by reduce the stress in the calcaneal bone.

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'Thus spoke the Cadaver
Handle me with little love and care,

As I had missed it in my life affair,
Was too poor for cremation or burial,
That is why am lying in dissection hall.

You dissect me, cut me, section me,
But your learning anatomy should be precise,
Worry not, you would not be taken to court,
As I am happy to be with the bright lot.

Couldn't dream of a fridge for cold water,
Now my body parts are kept in refrigerator,
You do students sit around me with friends,
A few dissect, rest talk, about food, family and movies,
How I enjoy the dissection periods,
Don't you? Unless you are interrogated by a teacher.

When my parts are buried post-dissection,
Bones are taken out of the skeleton,
Skeleton is the crown glory of the museum,
Now I am being looked up by great enthusiasm.

If not as skeletons as loose bones,
I am in their bags and in their hostel rooms,
At times, I am on their beds as well,
Oh, what a promotion to heaven from hell.

I won't leave you, even if you pass anatomy,
Would follow you in forensic medicine and pathology,
Would be with you even in clinical teaching,
Medicine line is one where dead teach the living.

One humble request I'd make,
Be sympathetic to persons with disease,
Don't panic, you'll have enough money,
And I bet, you'd be singularly happy.'

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नशा छोड़ें,घर को जोड़ें
नशा छोड़ें,घर को जोड़ें
नशा ऐसी बीमारी है जो हमें,हमारे समाज को ,हमारे देश को तेजी से निगलते जा रही है आज शहर और गावों में पढ़ने खेलने की उम्र में स्कूल और कॉलेज के बच्चे एवं युवा वर्ग मादक पदार्थों के बाहुपाश में जकड़ते जा रहे हैं l
इस बुराई के कुछ हद तक जिम्मेदार हम लोग भी हैं हम अपने काम धंधों में इतना उलझ गए हैं कि हमें फुर्सत ही नहीं है ये जानने की कि हमारा बच्चा कहाँ जा रहा है, क्या कर रहा है कोई परवाह नहीं,बस बच्चों की मांगे पूरी करना ही अपनी जिम्मेदारी समझ बैठे हैं l
क्यों करते हैं लोग नशा -
कभी शौक के नाम पर तो कभी दोस्ती की आड़ में,कभी दुनियाँ के दुखों का बहाना करके तो कभी कोई मज़बूरी बताकर ,कभी टेंशन तो कभी बोरियत दूर करनेके लिए लोग शराब ,सिगरेट,तम्बाकू आदि अनेक प्रकार के मादक द्रव्यों का सेवन करते हैं लेकिन नशा कब उनकी जिंदगी का हिस्सा बन जाता है उन्हें पता ही नहीं चलता, जब पता चलता है तब तक बहुत देर हो चुकी होती है l
नशे से नुकसान-
हिंसा,बलात्कार,चोरी,आत्महत्या आदि अनेक अपराधों के पीछे नशा एक बहुत बड़ी वजह है l शराब पीकर गाड़ी चलाते हुए एक्सीडेंट करना, शादी शुदा व्यक्तियों द्वारा नशे में अपनी पत्नी से मारपीट करना आम बात हैl मुँह ,गले व फेफड़ों का कैंसर, ब्लड प्रैशर,अल्सर,यकृत रोग,अवसाद एवं अन्य अनेक रोगों का मुख्य कारण विभिन्न प्रकार का नशा है l
उपचार -नशा छोड़ने के लिए निम्न उपाय करें -
डायरी बनायें - नशा कब और कितनी मात्रा में लेते हैं लिखें l
विचार करें -आपके लिए आपका परिवार,बच्चे ,कैरियर और स्वास्थय कितनी अहमियत रखता है ,आपके नशा करने से इन चीजों पर कितना असर हो रहा है l
नशा छोड़ने से आपको क्या फायदे और क्या नुकसान होंगे एवं यदि आप नशा जारी रखते हैं तो आपके भविस्य पर क्या असर होगा ,गम्भीरता से विचार करें l
पॉजिटिव रहें ,अपने आपको खेल कूद ,किताबें पड़ना,फ़िल्म देखना एवं गाने सुनना जैसी गतिविधियों में व्यस्त रखें ,अकेले ना रहें l
यदि इतने उपाय करने के बाद भी नशा छोड़ने में सफल न हों तो विशेषज्ञ एवं नशा मुक्ति केंद्र से राय लेना बेहतर होगा l
Dr.Manoj Gupta
Palam Vihar,Gurgao(Haryana)

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BHANG OR ,MARIJUANA May Have Potential as an HIV Treatment


As marijuana continues to gain legal status in some U.S. states, evidence is emerging that it may be able to help in the fight against HIV -- but legal restrictions are making it difficult for scientists to find out for certain.
Tetrahydrocannabinol (THC), the main active ingredient in marijuana, could help prevent HIV from spreading throughout the body, according to a recent study. A team of Louisiana State University researchers is behind the findings, which it reached by studying a group of macaque monkeys infected with SIV, the simian form of HIV. After the monkeys received a daily injection of THC for 17 months, researchers saw a dramatic decrease in the damage to the monkey's duodenum (part of the small intestine) and an increased population of healthy cells near the damaged tissue compared to macaques who didn't get THC treatment.

"It adds to the picture and it builds a little bit more information around the potential mechanisms that might be playing a role in the modulation of infection," said Patricia Molina, M.D., Ph.D., lead author of the study.

Molina's study is in line with science that is researching the gut as a key area of importance in fighting HIV. Also, research suggests that THC could be helpful in preventing infected cells from entering the brain, and that cannabis may have beneficial properties for those with advanced HIV. Several studies have also pointed to marijuana's ability to ameliorate common side effects of HIV and treatment, like loss of appetite and pain.
Finding out whether marijuana has medicinal benefits for people living with HIV may prove difficult, as the substance is still classified as a Schedule I drug -- the most restrictive of the five categories outlined by the Controlled Substances Act. As a result, scientists who want to use marijuana in their research often have trouble getting funding, and the federal government controls access to the small legal supply of "research" marijuana and THC

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Poly Drug Use (Multople Drug Use)
Combining Drugs (Polydrug user)

Polydrug use refers to combination of more than one substance (psychoactive drugs) to achieve some particular effect. One drug is used as a primary drug with additional drugs to compensate for the side effects of the primary drug and/or make the experience more enjoyable with drug simulating effects or to supplement for primary drug when supply is low.

Drug abusers have historically tended to abuse more than one drug. However, over the last few years there has been an increasing tendency to combine narcotics, alcohol, sedatives, and/or stimulants. Polydrug use encompasses wide variations in user populations and patterns of use: from occasional alcohol and cannabis use to the daily use of combinations of heroin, cocaine, alcohol and benzodiazepines

Why do people use multiple drugs?

There are a lot of different reasons for mixing one substance with other drugs at one time. Substances, which when taken together may have cumulative or complementary effects, may be mixed to increase the overall psychoactive experience. Sometimes one drug is used with other to counteract the effect of first consumed substance, say for example, benzodiazepines (sleeping pills) is taken after consuming some stimulant to induce sleep (without being aware that using these drugs together is hazardous.). Other reasons includes, use of several substances by an individual over a longer period of time might reflect the replacement of one drug by another, due to changes in availability of drugs in particular region, legal problems, price or current trends. For instance, methadone substituting heroin, cocaine replacing ecstasy. Use of 2 or 3 drugs at a time also shows that in different settings (like age groups, type of party etc), or simply reflect regular multiple drug use due to drug dependence. Cannabis (bhang) use mainly occurs during adolescence and young adulthood, ecstasy can be associated with certain lifestyles and activities, and heroin use frequently results in major health problems. Intensive alcohol use is often a major, but overlooked, component of polydrug use. For example, stimulant drugs such as cocaine may enable users to consume large quantities of alcohol over longer periods than would otherwise be possible.

This has become particularly apparent in recent years, as increasing prevalence levels of drug use (e.g. alcohol, cannabis and cocaine) have translated into additional populations of drug users, and as an increasing range of available substances has resulted in additional drug combination possibilities.

Simultaneous/combinations tend to increase the risks of adverse health effects. Such effects can occur (generally as acute toxicity) shortly after the consumption of several substances, or within a short time. They can also occur following a long period of use, affecting body systems, including the liver and the central nervous, cardiovascular or respiratory systems.

Many drugs taken together have the potential to interact with one another to produce greater effects than either substance taken alone. The combination of drugs may produce a new or unexpected effect. For example, alcohol, opioid analgesics (like morphine, fortwin) and benzodiazepines (like alprazolam, diazepam) are all depressant drugs. When taken alone, they can cause relaxation, loss of inhibition, loss of coordination and sleepiness. If these depressant drugs are taken at the same time, these effects are increased many folds. These combinations may result in altered mental status, confusion, depressed breathing, injuries from falls, coma and death.

Many other medicines taken for treatment of other diseases like for epilepsy, nausea, allergies common cold, heart problems, blood clotting disorders, fungal, bacterial infections and diabetes when taken with other depressants like alcohol, they can also be dangerous. Combining drugs may also seriously impair a person’s ability to operate a motor vehicle or other machinery.

Medical interventions: It is not possible to arrive at a single definition of polydrug use, which would be necessary to develop standardized measures. Understanding polydrug use also requires a focus on the use of a range of drugs by the individual; but most drug monitoring information remains substance-specific and reported as aggregated national data.

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Smoking, the act of inhaling and exhaling the fumes of burning plant material. A variety of plant materials are smoked, including marijuana and hashish, but the act is most commonly associated with tobacco as smoked in a cigarette, cigar, or pipe. Tobacco contains nicotine, an alkaloid that is addictive and can have both stimulating and tranquilizing psychoactive effects. The smoking of tobacco, long practiced by American Indians, was introduced to Europe by Christopher Columbus and other explorers. Smoking soon spread to other areas and today is widely practiced around the world despite medical, social, and religious arguments against it.

Banning tobacco advertising and sponsorship is one of the most cost-effective ways to reduce tobacco consumption, according to the World Health Organisation (WHO).
“A comprehensive ban on all tobacco advertising, promotion and sponsorship could decrease tobacco consumption by an average of about 7 per cent, with some countries experiencing a decline in consumption of up to 16 per cent,” said Dr Samlee Plianbangchang, WHO Regional Director for Southeast Asia.
“Our efforts should focus on preventing the youth from being exposed to all forms of tobacco advertisement, promotion and sponsorship. Enforcement of a ban on sale of tobacco to minors should also be strengthened,” he added.

Smoking and health
At the dawn of the 20th century, the most common tobacco products were cigars, pipe tobacco, and chewing tobacco. The mass production of cigarettes was in its infancy, although cigarette smoking was beginning to increase dramatically. According to the ninth edition of the Encyclopædia Britannica (1888), tobacco products were suspected of producing some adverse health effects, yet tobacco was also considered to have medicinal properties. Many scholars and health professionals of the day advocated tobacco’s use for such effects as improved concentration and performance, relief of boredom, and enhanced mood.
By the dawn of the 21st century, in stark contrast, tobacco had become recognized as being highly addictive and one of the world’s most-devastating causes of death and disease. Moreover, because of the rapid increase in smoking in developing countries in the late 20th century, the number of smoking-related deaths per year was projected to rise rapidly in the 21st century. For example, the World Health Organization (WHO) estimated that in the late 1990s there were approximately four million tobacco-caused deaths per year worldwide. This estimate was increased to approximately five million in 2003 and six million in 2011 and was expected to reach eight million per year by 2030. An estimated 80 percent of those deaths were projected to occur in developing countries. Indeed, although tobacco use was declining in many countries of western Europe and North America and in Australia, it continued to increase in countries of Asia, Africa, and South America The tobacco epidemic is one of the biggest public health threats the world has ever faced. Mass media campaigns, graphic warnings and alternative crop options for tobacco growers can help stop or reduce the estimated 800,000-900,000 tobacco-attributable deaths per year in India, experts say.
According to Global Adult Tobacco Survey (GATS) – India 2010, tobacco use is a major preventable cause of death and disease and is responsible for 1 in 10 death among adults worldwide. Approximately 5.5 million people die around the world every year – with India accounting for nearly a fifth of this..

Major health effects of tobacco product by type
product addiction1 heart disease lung cancer2 oral cancer chronic lung disease pregnancy problems
Cigarette +++ +++ +++ +++ +++ +++
Cigar ++ ++ ++ +++ ++ +
Pipe ++ ++ ++ +++ ++ +
Oral nonsmoked
(e.g., chewing tobacco) +++ + - +++ +

The primary constituents of tobacco smoke are nicotine, tar (the particulate residue from combustion), and gases such as carbon dioxide and carbon monoxide. The effects of nicotine, tar, and carbon monoxide on health are summarized in the table.The main health effect of nicotine is its addictiveness. Carbon monoxide has profound, immediate health effects. It passes easily from the lungs into the bloodstream, where it binds to hemoglobin, the molecule in red blood cells that is responsible for the transfer of oxygen in the body. Carbon monoxide displaces oxygen on the hemoglobin molecule and is removed only slowly. Therefore, smokers frequently accumulate high levels of carbon monoxide, which starves the body of oxygen and puts an enormous strain on the entire cardiovascular system.

Health effects of primary smoke constituents
substance addiction cancer heart disease lung disease pregnancy problems
Nicotine +++ - ++ +
Carbon monoxide - - +++ ++ +++
Tar (particulate residue) + +++ ++ +++ undetermined

The harmful effects of smoking are not limited to the smoker. The toxic components of tobacco smoke are found not only in the smoke that the smoker inhales but also in environmental tobacco smoke, or secondhand smoke—that is, the smoke exhaled by the smoker (mainstream smoke) and the smoke that rises directly from the smoldering tobacco (sidestream smoke). Nonsmokers who are routinely exposed to environmental tobacco smoke are at increased risk for some of the same diseases that afflict smokers, including lung cancer and cardiovascular disease.
Health consequences of smoking
A major health effect common to all forms of tobacco use is addiction, or, more technically, dependence. Addiction is not lethal in its own right, but it contributes to tobacco-caused death and disease, since it spurs smokers to continue their habit, which repeatedly exposes them to the toxins in tobacco smoke. Although there are many historical accounts of the apparent ability of tobacco use to escalate into an addiction for some smokers, it was not until the 1980s that leading health organizations such as the Office of the Surgeon General in the United States, the Royal Society of Canada, and WHO formally concluded that cigarettes are highly addictive on the basis of their ability to deliver large doses of nicotine into the lungs, from which blood quickly carries it to the brain.
Tolerance—greater amounts of nicotine are needed in order to experience the same effect. Typically, when tolerance has developed and nicotine intake has increased, the body becomes physiologically dependent on nicotine, and any abrupt abstinence from smoking will trigger withdrawal symptoms. These symptoms include impaired ability to concentrate, irritability, weight gain, depressed mood, anxiety, difficulty sleeping, and persistent cravings. The symptoms typically peak within a few days and subside within a month. However, the experience varies from person to person, and, for some, powerful cravings can persist for years.
Nicotine’s ability to help tobacco users control their mood and appetite and sustain their attention when working undoubtedly contributes to the persistence of tobacco use. Some of these effects interact with physical dependence. For example, increased exposure to nicotine can increase physical dependence and thereby make the effects of withdrawal stronger. During withdrawal, resumption of smoking provides rapid relief of withdrawal effects. This reaction may lead the smoker to believe that smoking in itself enhances mood and performance, when in reality the effect is mainly that of reversing the withdrawal symptoms.

Methods to control Tobacco consumption in our country & current status:-----------
“Glamorisation of smoking” impacts young people, but counter messages during smoking scenes in films help in discouraging people.It is believed that if celebrities are shown smoking, it influences impressionable minds. To counter that, a new law mandating a disclaimer about the evils of tobacco use has to be flashed while showing smoking scenes in films or on television. “A brief interview of those who were addicted to tobacco or cigarettes should be shown instead of the same old images.,filmmakers can attach clippings of celebrities talking about the harmful effects of tobacco with their films. The government needs to convince farmers to not grow tobacco. They should be given incentives for growing other crops. This should be done gradually otherwise there will be a rise in farmer suicides. According to a study conducted by HRIDAY, the current use of tobacco is five times higher in students who were highly receptive to tobacco advertising than those who were least receptive. In India more than 5,000 youth initiate tobacco use every day.
The tobacco industry spends crores of rupees every year to market its lethal products by using sophisticated and covert forms of advertising and promotion sponsorship. It links its products with success, fun and glamour, a health minister said on World Tobacco Day. “We cannot indefinitely tolerate a public health hazard in the name of protecting livelihoods,” the minister said after releasing GATS – India 2010.
Later the Food Safety and Standards Authority of India (FSSAI), the apex body to ensure food quality in the country, under its Food Safety and Standards (Prohibition and Restrictions on Sales) Regulations, 2011 restricted the use of products that contain any substance that may be injurious to health.
Its immediate effect was when Madhya Pradesh banned gutka and pan masala. Kerala, Mizoram, Gujarat, Bihar, Rajasthan, Maharashtra, Haryana, Chhattisgarh, Jharkhand and Delhi soon followed and most recent to join the list is Tamil Nadu.

An anti-tobacco group on Thursday expressed “shock” over West Bengal chief minister Mamata Banerjee’s joke asking people to smoke more, so more revenue could be garnered to compensate investors of the collapsed Saradha chit fund.
“This is a great discouragement for those working in the area of public health,” said Bhavna Mukhopadhyay, executive director, Voluntary Health Association of India.
Mukhopadhyay said West Bengal chief minister announced a 10 per cent tax hike on cigarettes. “Higher prices discourage youth from initiating cigarette smoking and encourage current smokers to quit, but such a move should certainly not be accompanied by suggestions that people should use more tobacco.”

The Supreme Court on Wednesday directed 23 states and five union territories to file status report on the implementation of the notification issued by them banning the sale of gutka and pan masala containing tobacco or nicotine.The apex court bench of Justice G S Singhvi and Justice Kurien Joseph also directed the remaining states and union territories to explain the reasons why they had not imposed the ban and the time needed to do so.
The court passed the order after Additional Solicitor General Indira Jaising brought to its notice a circular issued by the union health and family welfare ministry in August 2012 asking the states to ban gutka (tobacco-laced areca nut pieces) and pan masala laced with tobacco and nicotine.But Nicotine and cigarette lobby & Pan Gtka lobby is so rich and of crores of rupees is playing a great role in its spread even by ban by bribing police,politicians,Bureaucrats and even hiring media and common people for not publishing stories against it,therefore in the country like us where corruption is ruling the country practical ban is still miles away so this great killer is killing innocent people like anything and one has to be alert onself to ban it otherwise we have to die as we are dying.
— with Shreya Nakipuria and 2 others.

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1: Know Why You Want to Quit
So you want to quit smoking, but do you know why? "Because it's bad for you" isn't good enough. To get motivated, you need a powerful, personal reason to quit. Maybe you want to protect your family from secondhand smoke. Maybe the thought of lung cancer frightens you. Or maybe you'’d like to look and feel younger. Choose a reason that is strong enough to outweigh the urge to light up.
No. 2: Don't Go Cold Turkey
It may be tempting to toss your cigarettes and declare you've quit, plain and simple. But going cold turkey isn't easy to do. Ninety-Six percent of people who try to stop smoking without therapy or medication end up relapsing. The reason is that nicotine is addictive. The brain becomes used to having nicotine and craves it. In its absence, the symptoms of nicotine withdrawal occur.

No. 3: Try Nicotine-Replacement Therapy

When you stop smoking, nicotine withdrawal may make you feel frustrated, depressed, restless, or irritable. The craving for "just one drag" may be overwhelming. Nicotine-replacement therapy can help reduce these feelings. Studies suggest nicotine gum, lozenges, and patches can help double your chances of quitting successfully when used with an intensive behavioral program. But using these products while smoking is generally not recommended.
No. 4: Ask About Prescription Pills

To ease nicotine withdrawal without using products that contain nicotine, ask your doctor about prescription medications. There are pills that help reduce cravings by affecting chemicals in the brain. They may also make smoking less satisfying if you do pick up a cigarette. Other drugs can help reduce troubling withdrawal symptoms, such as depression or inability to concentrate.
No. 5: Don't Go It Alone
Tell your friends, family, and co-workers that you're trying to quit. Their encouragement could make the difference. You may also want to join a support group or talk to a counselor. Behavioral therapy is a type of counseling that helps you identify and stick to quit-smoking strategies. Combine behavioral therapy with nicotine replacement products and/or medication to boost your odds of success

No. 6: Manage Stress
One reason people smoke is that the nicotine helps them relax. Once you quit, you’ll need another way to cope with stress. Try getting regular massages, listening to relaxing music, or learning yoga or tai chi. If possible, avoid stressful situations during the first few weeks after you stop smoking.
No. 7: Avoid Alcohol, Other Triggers
Certain activities may boost your urge to smoke. Alcohol is one of the most common triggers, so try to drink less when you first quit. If coffee is a trigger, switch to tea for a few weeks. And if you usually smoke after meals, find something else to do instead, like brushing your teeth or chewing gum.
No. 8: Clean House
Once you've smoked your last cigarette, toss all of your ashtrays and lighters. Wash any clothes that smell like smoke and clean your carpets, draperies, and upholstery. Use air fresheners to help rid your home of that familiar scent. You don't want to see or smell anything that reminds you of smoking.

No. 9: Try and Try Again
It's very common to have a relapse. Many smokers try several times before giving up cigarettes for good. Examine the emotions and circumstances that lead to your relapse. Use it as an opportunity to reaffirm your commitment to quitting. Once you've made the decision to try again, set a "quit date" within the next month.

No. 10: Get Moving
Physical activity can help reduce nicotine cravings and ease some withdrawal symptoms. When you want to reach for a cigarette, put on your inline skates or jogging shoes instead. Even mild exercise is helpful, such as walking the dog or pulling weeds in the garden. The extra calories you burn will also ward off weight gain as you quit smoking.

No. 11: Eat Fruits and Veggies
Don't try to diet while giving up cigarettes -- too much deprivation is bound to backfire. Instead, focus on eating more fruits, vegetables, and low-fat dairy products. A study at Maulana azad medical college ,i have found suggests these foods make cigarettes taste terrible. This gives you a leg up in fighting your cravings while providing disease-fighting nutrients.

No. 12: Choose Your Reward
In addition to the tremendous health benefits, one of the perks of giving up cigarettes is all the money you will save. Reward yourself by spending part of it on something fun.

No. 13: Do It for Your Health
There's more than the monetary reward to consider. Smoking cessation has immediate health benefits. It lowers your blood pressure and reduces your pulse after only 20 minutes. Within a day, the carbon monoxide level in your blood returns to normal. Within two weeks to three months, your risk of a heart attack decreases and your lungs begin to function better. Long-term benefits include a reduced risk for coronary heart disease, stroke, lung cancer, and other cancers.

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How Does Magnetic Therapy Work?
Magnet therapy takes many different forms. In some cases, magnets are applied to illness-affected areas with the help of wraps, shoe inserts, self-adhesive strips, belts, or "magnetic jewelry" like bracelets, necklaces, and earrings. Other products include magnetic mattress pads and blankets, as well as magnetic-field-generating machines and even magnet-conditioned water.

Since scientific support for its use is so limited, it's difficult to determine how magnetic therapy might promote healing. However, proponents maintain that magnets can stimulate circulation, relax the blood vessels, increase endorphin levels, reduce muscle tension, and normalize metabolic functioning.

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avoidable tragedy: spurious liquor
Avoidable Tragedy: Spurious Liquor

With more than half of all alcohol drinkers in India falling into the criteria for hazardous drinking, alcohol abuse is emerging as a major public-health problem in the country. The problem becomes more compounded especially where we find the urban poor and rural peasants flocking to the liquor shops with a 10 rupee note and buying death in a sachet as seen in the recent Calcutta tragedy India's reputation as a country with a culture of abstinence especially in matters regarding alcohol is underserved, say experts. The country, which has seen a rapid proliferation of city bars and nightclubs in recent years, is fast shedding its inhibitions about alcohol as a lifestyle choice.
This situation has led to fears of an undocumented rise in alcohol abuse not only among poorer classes but also in sections of society that were previously considered dry. The entire policy regarding the pricing and trading of state sponsored liquor outlets with singular aim of generating revenue needs to be questioned by concerned citizens. The increasing production, distribution, and promotion of alcohol have already seen drink-related problems emerging as a major public-health concern in India. Sales of alcohol have seen a growth rate of 8% in the past 3 years. Officially, Indians are still among the world's lowest consumers of alcohol—government statistics show only 21% of adult men and around 2% of women drink. But up to a fifth of this group—about 14 million people—are dependent drinkers requiring “help”.

The concern, say experts, is that there has been a rapid change in patterns and trends of alcohol use in India. Chief among them is people are beginning to drink at ever-younger ages. The percentage of the drinking population aged less than 21 years has increased from 2% to more than 14% in the past 15 years, according to studies in the southern state of Kerala by Alcohol and Drugs Information Centre India, a non-governmental organization (NGO). Alarmingly, the study found that the “average age of initiation” had dropped from 19 years to 13 years in the past two decades.
The centre points out that a “powerful international and domestic alcohol lobby” is purposely targeting young Indians. The local industry has introduced flavored alcohol drinks to attract previously non-drinking women and young men. Multinational companies have identified India with its vast unexploited markets as one of the worlds most sought after places for investment.
Many alcohol adverts now feature spirited groups of young people having a good time. Although alcohol advertising is banned in the electronic and print media, surrogate advertising is rife, “Drinking water and apple juice is packaged by alcohol companies. It's all about getting young people to start early and be life-long consumers. Bollywood films now glorify alcohol where the good guys drink.”
The shifting composition of Indian drinkers has seen a rise in the number of Indian women drinking regularly and heavily. One recent study in the southern state of Karnataka found young women consumed similar amounts of alcohol to young men on any typical drinking occasion.
What is of particular concern—and an important indicator of health risks—is that the signature pattern of alcohol consumption in India is frequent and heavy drinking. More than half of all drinkers fall into the criteria for hazardous drinking, which is characterized by bingeing and solitary consumption to the point of intoxication. Moreover, spirits account for 95% of the beverages drunk in India.
There is evidence even to suggest that the poor are beginning to drink more than they earn—a deadly spiral of alcohol and debt. Although the Indian constitution includes the prohibition of alcohol among its directive principles, alcohol policy is devolved to individual states—as is the levying of taxes on it. Since most states derive around a fifth of their revenue from alcohol taxation—the second largest source after sales tax—they are generally ambivalent towards stemming its flow. Moreover, there is a long history in India of a powerful alcohol lobby with industry figures influencing the political process, both in the form of party donations and as representatives. But experts argue that Indian society is losing considerably more than it gains.
According to a recent study by researchers from NIMHANS it is shocking to know that the direct and indirect costs attributable to alcohol addiction is more than triple the profits of alcohol taxation and several times more than the annual health budget of Karnataka. These included the tangible costs of health care, occupational, financial, social, and legal factors.
Indian Alcohol Policy Alliance, an NGO aiming to prevent alcohol-related harm through evidence-based policy intervention, says that the key is to break the stranglehold of state revenue departments who see increasing consumption of alcohol as a boon to treasury coffers.
In less than a week after more than 90 women, men, and children died in a calamitous fire at the AMRI hospital in Kolkata, illicit brew has claimed the lives of about 150 people, at Sangrampur in the South 24 Parganas district of West Bengal. The hooch was sold in sachets, priced between Rs.7 and Rs.20, virtually opposite a police post in the area. Starting with a couple of deaths early in the morning, the toll kept rising through the day and touched 80 by daybreak next day. Most of the victims complained of body pain, stomach cramps, vomiting, and a burning sensation. The recurrence of heart-rending tragedies caused by the killer brew only lends credence to the thinking among political parties and State governments that it might be better to introduce legal sale of licensed liquor than let addicts go for the illicit stuff. There is a demand from sections in government to suggest monopolizing sale of government controlled liquor as the Tamil Nadu Model .Of course the protagonist will feel that this step might be catastrophic. But the evidence from across India shows that prohibition just doesn't work; in fact, it brings on all sorts of ill effects, social as well as medical. Although States that still implement prohibition, full or partial, have set up separate wings in the police department to handle cases arising out of prohibition offences and illicit brewing, it is common knowledge that connivance between the brewers and sections of the police makes the hooch flow, particularly in festival season. Most, if not all, victims tend to be poor laborers, and the families end up paying a terrible price. Alcoholism is a social menace that needs to be tackled in a sensitive, intelligent, multi-pronged way. Driving it underground, to dangerous devices, is clearly not the way.

(Prof Gourishankar Patnaik is a senior Consultant in orthopedics based in Bhubaneswar. He can be contacted at

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Review of book by prof. Manish Munjal of DMC Ludhiana
Review of book by prof. Manish Munjal
Otology is an intriguing subdiscipline of otolaryngology –head and neck surgery, which during our formative years appears glamorous but later only the hardened few, i.e. those who have mastered the anatomy of the ear on either side of the tympanic membrane survive, to practice otology. The authors have painstakingly produced a comprehensive atlas with lucid and relevant text which addresses normal and diseased state of tympanic membrane, ear canal and middle ear. The masterpiece pivoted on the concept of "the mind recollects and applies", which it has seen, has introduced, "tele-otoscopy", vis a vis with far better illumination and excellent clarity contrary to the traditional outpatient Bull's lamp or otoscopic examination and the time consuming cumbersome examination under microscope. The book shall be boon for the medschool novice and those already inducted in the fold of otolaryngology as even minute details like findings of both ears individually, which are sometimes are confusing are taken care of. It is an update for the specialist treating otological pathologies as it is a "photogallery" of clinical findings accumulated over a period of time. A sequele of the book covering middle ear pathologies in detail would be eagerly awaited. The book is a reflection of the current knowledge of otology and perplexing queries, it is hoped that it stimulates the reader to seek an answer to their queries to provide better patient care.

Prof. Manish Munjal

Dayanand Medical College


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