Dealing with Pimples

Pimples are those unwelcome pink little bumps that crop up on the cheeks, chins and foreheads of youngsters often spoiling that otherwise perfect party or sometimes shattering self-esteem and scarring their faces for years. True, they are not dangerous, in the sense, they do not kill or shorten life, but their effects can be pretty nasty and long lasting, on the skin and on their personalities.

Also known as acne, spot or comedo, they result from oily secretions getting stuck in skin pores. Inside the pore are sebacious glands that produce sebum. When the outer layers of skin shed (as they do continuously), the dead skin cells left behind may become 'glued' together by the sebum.

Their appearance around adolescence suggests that hormones play a role in their development. Around puberty, the skin tends to get thicker and the sebaceous glands go into overdrive producing more sebum that builds up behind the blockage. Sometimes this sebum gets infected with bacteria such as Propiobacterium acnes, causing infection, soreness, formation of pustules that sometimes cause scars.

Scientists are not quite clear why some people develop acne while others do not, and why they come in some as occasional pimples while in some as huge crops. It is however a by-and-large urban phenomenon.

Certain types of diet seem to bring them on in people who are prone. Studies suggest that high consumption of simple sugars, fats and carbohydrates could be harmful. Indeed, people with bad crops of acne often benefit from periods of fat and sugar free, high fibre diets of veggies and fruits.

Treatment consists of keeping the skin pores often and clean, removing the debris and oily secretions with frequest washes. Soaps are not bad and alcohol based skin cleaners can be of help in many with difficulty resistant acne.

Treatment in earlier times often consisted of long courses of antibiotics such as doxycycline or tetracycline. These kill the germs that infected the blocked glands. A better approach is to allow the glands draining well by keeping the pores or mouths open with frequent skin cleansing.

Vitamin A has been found to be helpful in people with difficult pimples. Tretinoin or one of its compounds is often a favourite with modern dermatologists. One needs to be careful though that high doses can be heavy on the liver.

Pimples don’t kill, but they sometimes maim and change the course of events in a young person’s life. Help is at hand. Do not let them dictate your future!

Environment and Human Health

With leaders of over 190 countries discussing global climate in Paris this month, unprecedented floods wrecking havoc in Chennai since last week, smog engulfing the Chinese capital Beijing right now, and air quality charts of Delhi showing that the air we are breathing is choking our lungs and hearts, I would have to be quite an ostrich to write about any other health issue this week.

The health consequences of the Chennai floods that have killed over 200 people is just the tip; what is of greater concern is the wave of infections especially diarrrhoeal diseases, typhoid, pneumonias, malaria, dengue, skin infections and stress that are to follow. Further the floods have devastated the lives of several million and sent shivers down our spines by reminding us that some freak natural disaster could usurp our lives just as it did to Uttarakhand a couple of years ago.

One of the core issues is the amount of green-house gases emitted in to the atmosphere due to the use of fossil fuels such as coal, diesel, kerosene, petrol and CNG. This topic makes headlines and forms the top item in the agenda for inter-governmental discussions. These gases comprising carbon dioxide and methane, warm up the climate, making ice caps melt, that in turn push up sea levels and unusual weathers causing untimely heavy rains and floods.

Another issue is air-pollution and the effect it has on our lungs and hearts. “People think the talks are about protecting the environment, plants, animals,” explained Dr Maria Neira, Director of Public Health and the Environment Department at the World Health Organisation, during a sessions in Paris recently. “But it’s as much about human health”

Some of the effects of climate change that can affect our health are strikingly apparent. During the recent Beijing smog for instance, the air quality index that measures small particulate matter was 611 (a value above 300 means that the entire exposed population is at risk of ‘serious’ health effects) forcing the Chinese government to shut schools and some of its factories. And the air in Delhi has been reported to be 5 times worse at 2000 and we are still going about our lives in our “bindaas” ways!

Particles in the air we breathe enter our lungs and cause chest congestion, cough, asthma and breathlessness. In the long term they can also cause lung cancers, often seen in women who use fossil fuels for their ‘chulhas” or stoves in closed kitchens.
Particles that are smaller than 2.5 microns are called “small particles” and can be even more dangerous. They can enter the bloodstream from the the respiratory tracts and reach all parts of our body. They can damage small blood vessels causing injury to heart and brain, and can also cause a variety of cancers.

The number of health issues linked to climate change are too many to enumerate.
And while global climate has indeed changed through the earth's history, what is making the present crisis unique is that it is our “behaviour” that is causing the trouble this time.

Importance of Emergency Medical Care

 Among the many issues that grabbed media headlines in the aftermath of the Paris carnage recently, the story of how the French medical emergency services responded to the unexpected challenge holds many lessons for us.

Within just TEN minutes of the blasts and shootings, information reached the Emergency Medical Services and its crisis cell called Assistance Publique-Hopitaux de Paris (APHP) got activated. This cell mobilised 100,000 health-care professionals, 22,000 hospital beds and 200 operation theatres across 40 public hospitals in preparedness, all within an hour. A crisis WHITE PLAN that had been worked out and rehearsed for several years was activated, making this the most coordinated medical rescue and support mission in Europe in its history.

The tasks of gathering information, networking and coordinating transport was managed by a cell of 15 people. Forty five well-equipped emergency ambulances with doctors, nurses and technicians were pressed into service, each knowing where to take whom, and each hospital being prepared with prior information to receive the patients being brought there.

When the blasts and shooting were going on, the state could not be sure as to how many more casualties may occur. It therefore took extra care of putting 2 other major university hospitals at the periphery of the city on alert.

A fleet of 10 helicopters was pressed into service for evacuation of casualties and monitoring medical rescue efforts. Thirty-five psychiatrists and a large number of counsellors were immediately brought in to meet with and provide support to panic stricken victims or shocked relatives.

Hospitals were kept out of bounds for the press and public. We did not get to see familiar visuals of bleeding patients, grieving relatives or corpses on television. Photo-ops of politicians visiting patients were also not seen. We did not see pretty young TV reporters thrusting microphones at grieving relatives and asking them about their feelings at such times!

Steps taken by Russia when its flight carrying over 200 holiday-goers crashed in Egypt was also educative. The flight’s destination was St Petersburg. On receiving information of the crash, one of the first steps taken by Russian authorities was to get 65 psychiatrists and counsellors to the airport hotel in that city where shocked and grieving relatives were expected to gather, anticipating human responses in such tragic occasions.

France and Russia, and for that matter most developed countries spend around 7 to 16% of their GDP on health. India, in contrast, spends a measly 1%. It is little surprise therefore that we deal so differently with our victims of floods, stampedes, blasts and earthquakes.
.
A developed country is also known by the health care it provides to its citizen. We are a nation growing in might and aspiring for a place in the security council of the United Nations, but we have miles to go before we can match our “developed” counterparts in medical emergencies.

Traditional Medicine Finally Gets Nobel Nod

Traditional medicine has got its biggest stamp of approval from the scientific community up until now, with one of its practitioners finally getting the Nobel Prize for medicine in 2015.
Dr. Tu Youyou, the 84 years old lady scientist from China who introduced the anti-malarial properties of extracts of a plant (sweet wormwood) to modern medicine, is the recipient of this year's prestigious prize. Artemisinin, the compound that she extracted and discovered, is currently the most favored and safest anti-malarial drug used worldwide, and has saved millions of lives from malaria.
The story of Dr Tu’s discovery is an interesting one. In 1967, Communist leader Mao Zedong decided there was an urgent national need to find a cure for malaria when it was spread by mosquitoes and killing Chinese soldiers fighting Americans in the jungles of northern Vietnam.
A secret research unit was formed to find a cure. Tu Youyou was appointed head of Mission 523 and dispatched to southern China where malaria was rampant. For six months, she stayed there, leaving her four-year-old daughter at a local nursery.
When she started her search for an anti-malarial drug, over 240,000 compounds around the world had already been tested, without any success.
Finally, the team found a brief reference to one substance, sweet wormwood, which had been used to treat malaria in China around 400 AD. The team isolated one active compound in wormwood, artemisinin, which appeared to kill malaria parasites.
How the original Chinese texts helped is the story that should inspire our traditional practitioners: when the team tested extracts of the compound, nothing proved effective in killing malaria initially until Tu Youyou returned to the original ancient text. After another careful reading, she tweaked the drug recipe one final time, ensuring not to boil the extract, that then destroyed the anti-malarial property, but to extract it at lower heating temperatures or through use of solvents.
What should further inspire our practitioners of CAM (Complimentary and Alternative Medicine) is that Dr Tu did not have a medical degree, no doctorate, and had never worked overseas, the three pre-requisites we often consider essential for medical discovery. She was however observant, questioning and persevering in what she pursued.
Traditional medicine is a huge market today of US $ 60 billion. Chinese traditional medicine accounts for $14 billion. Indian traditional medicine also occupies a slice of the pie.
But it is that final proof that makes a compound or extract get global scientific acceptance. And that is where our Indian traditional practitioners should do well to work hard and leave their stamp.