Sep 20, 2009

How to Excercise your Back

You use your back muscles in almost every activity you do, so it is worth taking the time to exercise and strengthen them.
Exercising your back will improve your overall fitness and help you to add muscle to your upper body.
Exercising your back also helps to prevent lower back injury and pain, whether work-related or not. It's critical for having a healthy and pain-free back.


  1. Stretch before you start with the exercises. Stretching is an important way to improve your health and fitness. Follow proper stretching techniques:
    • Perform balanced stretching. This means you should always stretch the muscles on both sides of your body evenly. Don’t stretch one side more than the other side.
    • Avoid over-stretching. Never stretch to the point of pain or discomfort. You will feel slight tension or a pull on the muscle at the peak of the stretch.
    • Go slowly! Always stretch slowly and evenly. Hold the stretch for about fifteen seconds and release slowly as well.
    • Never bounce or jerk while stretching. This can cause injury as a muscle is pushed beyond its ability. All stretches should be smooth, and slow.
    • Don't forget to breathe. Flexibility exercises should be relaxing. Deep, easy, even breathing is key to relaxation. Never hold your breath while you stretch.[1]

  2. Start with proper posture before you do your exercises. A good posture means:
    • A straight line from your ears, shoulders, hips, knees and ankles.
    • Head is centered.
    • Shoulders, hips and knees are of equal height.[2]

  3. Start with your back exercises. Here are some easy exercises that you can do without the use of expensive fitness devices.
    • Knee to chest exercise:
      1. Lie on your back on an exercise mat or firm surface.
      2. Hold your hands behind the thighs and pull your thighs towards your chest.
      3. Keep the opposite leg flat on the surface of the mat and maintain the position for 30 seconds. Switch legs and repeat.

    • Pelvic Tilt:
      1. Lie on your back on a firm surface or an exercise mat. Keep your feet flat on the surface and your knees bent.
      2. Push the small of your back into the floor by pulling the lower abdominal muscles up and in.
      3. Hold your back flat while breathing easily in and out. Hold for five seconds. Do not hold your breath.

    • Hip rolling:
      1. Lie on your back on a firm surface or an exercise mat. Keep both of your knees bent, and keep your feet flat on the surface.
      2. Cross your arms over your chest. Turn your head to the right as you turn both of your knees to the left.
      3. Allow your knees to relax and go down without forcing. Bring your knees back up, head to center.
      4. Repeat in the opposite direction.

    • Lower abdominal exercise:
      1. Lie on your back on a firm surface or an exercise mat.
      2. Keep your knees bent and keep your feet flat on the surface.
      3. Flatten your back to the floor by pulling your abdominal muscles up and in.
      4. Bring one knee toward your chest. Hold this position for a couple of seconds.
      5. Lower your leg to the starting position. Then repeat on your opposite knee.
      6. Bring one knee toward your chest. Straighten your knee and hold for a couple of seconds. Slowly lower your leg to the starting position. Repeat it on your opposite leg.
      7. Raise your leg, keeping your knee straight. Hold for a couple of seconds. Slowly lower your leg to the floor. Repeat on your opposite leg.
      8. Maintain your pelvic tilt and keep your resting leg relaxed at all times. Do not hold your breath.

    • Curl Up:
      1. Lie on your back on a firm surface or on an exercise mat.
      2. Keep your feet flat on the surface and keep your knees bent. Maintain your pelvic tilt for the curl up exercises.
      3. Slowly reach your arms in front of you as much as possible, curling your trunk. Slowly keep the neck muscles relaxed. Breathe normally. Slowly return to the starting position.
      4. Fold your arms on your chest. Tuck your chin to your chest and slowly reach your elbows to your knees, curling your trunk. Keep your neck muscles relaxed and breathe normally and return to the starting position.
      5. Keep your hands behind your head, and slowly curl your head to your chest and then your trunk. Relax, breathe and then slowly return to the starting position.

    • Cat and camel:
      1. Kneel down on the floor and assume the "all-fours" position. Keep your head straight so that the gaze of your eyes is toward the floor.
      2. Slowly allow your trunk to sag as far as you can so that your back is arched. Do not pull it down, but let it relax as you lift up your face towards the ceiling.
      3. Round your back up at the waist as far as you can by contracting your lower abdominal muscles as you lower the top of your head toward the floor. All motion should be initiated from your lower back.

    • Tail Wagging:
      1. Kneel on a mat and assume the "all-fours" position. Keep your head in a neutral position, looking down at the floor.
      2. Keeping your shoulders still, move your right hip toward your right shoulder as far as you can.
      3. Slowly return to the starting position, then move your left hip toward your left shoulder as far as you can.

    • Hip extension:
      1. Assume the "all-fours" position. Bring one knee toward your head as you lower the head.
      2. Extend the head up and the leg out to a flat position, parallel to the floor. Return to the starting position.
      3. Repeat, with your other leg.

    • Hand-knee rocking:
      1. Kneel on a mat in a child pose with your knees and ankles against the mat. Allow your buttocks to rest on your heels.
      2. Take your upper body over so you are in a crouched position with your arms stretched out in front of you.
      3. Relax in this position and then slowly move forward with your elbows, straight into a press-up position.

    • Lying prone in extension:
      1. Lie on your stomach on a mat with your weight on your forearms.
      2. Lean on your elbows and stay in this position for a couple of seconds, making sure that you relax your lower back completely.

    • Press up:
      1. Lie on your stomach on a mat. Place your hands, palms down, under your shoulders.
      2. Straighten your arms, and raise your upper torso off the floor.
      3. Keep your pelvis against the mat, allowing your lower back to arch. Hold for a couple of seconds. Return to your starting position and repeat.

    • Back extension:
      1. Lie on your stomach on a mat. Place your arms at your sides so that your hands are by your hips.
      2. Raise your head and shoulders off the mat as high as comfortably possible. Hold for a couple of seconds.
      3. Lower your head and your shoulders. Do not tense your shoulder muscles.

    • Arm lifts:
      1. Lie on your stomach on a mat. Stretch your arms over your head and go slightly out to the side (in a V position).
      2. Lift one arm, with your hand positioned so that the thumb points upward. Keep your thighs and your opposite arm relaxed.
      3. Slowly lower your arm, then raise your other arm in the same manner.

    • Hip extension:
      1. Lie on your stomach on a mat. Bend your knee to a 90 degree angle so that the sole of your foot faces the ceiling.
      2. Lift one thigh off the mat approximately 6 inches by raising your foot toward the ceiling. Make sure that your hip bones do not leave the mat as you lift your leg.
      3. Slowly lower your thigh back to the starting position.

    • Knee push up:
      1. Lie on your stomach on a mat. Place your hands with the palms down on the mat at the level of your shoulders.
      2. Push with your arms. Lift your trunk and thighs off the surface of the mat until your elbows are straight. Your knees should be bent, and your lower legs and feet should be on the mat.
      3. Keep your back straight and do not let your stomach sag.
      4. Slowly bend your elbows, lowering your trunk and thighs toward the surface of the mat. Push away from the mat again, and straighten your arms.

    • Push up:
      1. Lay on your stomach, and place your hands, with the palms down, on the floor at the level of your shoulders.
      2. Flex your toes so that the weight of your body is shared by your hands and the soles of your feet. Push with your arms and raise your trunk and legs off the floor.
      3. Keep your back straight and do not let your stomach sag.
      4. Bend your elbows to lower your body halfway toward the floor, then push your body back by straightening your arms.

    • Trunk rotation:
      1. Assume the "all-fours" position. Reach one arm under your body toward the opposite knee. Hold for a couple of seconds. Slowly return to the starting position. Repeat, with alternating arms.
      2. With weight on both hands, bring one knee towards the opposite shoulder. Hold for a couple of seconds. Return to the starting position, repeat with alternating knees.

    • Full back release:
      1. Sit in a chair with your feet flat. Relax your shoulders and keep your head level. Your weight should be evenly distributed between your buttocks and your feet.
      2. Relax your neck. Curl your neck, upper back and low back slowly forward.
      3. Allow your hands to reach the floor so your palms are touching the floor. Hold for a couple of seconds. Go straight up slowly, so that you bring your head up last. Return to the starting position.

    • Upper back stretch:
      1. Sit on a stool with your back flat against a wall.
      2. Lift your arms overhead. Keep your head and back flat against the wall, and hold for a couple of seconds.
      3. Make sure that your shoulders can touch the wall while keeping your back flat. Hold for a couple of seconds, and lower your hands to the starting position.

    • Side bending:
      1. Stand up straight with your arms at your sides and your feet shoulder width apart.
      2. Bend your trunk to one side, by lowering your shoulder, run your hand down the outside of your thigh and hold for a couple of seconds.
      3. Slowly straighten up. Repeat to the opposite side.

    • Backward bending:
      1. Stand up straight with your feet shoulder width apart.
      2. Keep your knees as straight as possible. Place your hands on your back firmly at your waist level.
      3. Bend backwards at your waist keeping the knees as straight as possible. Hold for a couple of seconds. Return slowly to the upright position.

    • Pectoralis stretch:
      1. Stand with your legs together facing a corner. Extend your arms and place your palms against the opposite walls of the corner.
      2. Lean toward the corner. Keep your body and legs straight and your heels firmly on the floor and hold for a couple of seconds.
      3. Return to the starting position. Repeat, gradually increasing your distance from the corner.

Sources and Citations



Article provided by wikiHow, a wiki how-to manual. Please edit this article and find author credits at the original wikiHow article on How to Exercise Your Back. All content on wikiHow can be shared under a Creative Commons license.

How to Ignore Pain and Feeling

Pain and emotions are just thoughts triggered in your head that seem too strong to overcome. When confronted with these senses or thoughts, one usually has little control over his or her action in the following sequences. Many can suppress emotions and try to hide pain, but with a controlled thought and strong will, both can be ignored completely up to a certain level. It doesn't make you invulnerable, but it makes you more durable or less fearful. The feeling is a cold one and shouldn't be taken on by those with a weak mind, body, or soul.


  1. Know the pros. Everybody has natural (and necessary) mechanisms for ignoring pain and negative feelings. The harder thing to do is to let yourself feel the feelings fully, when you are ready, and deal with them. However, at times it can be important to ignore them for some time. For example, when they are too powerful for you to deal with, and you are not ready, when they interfere with a strong need, such as the need for survival, to work for money, to negotiate a tough situation with people who cannot support you with your feelings, or to protect yourself from temporary hazards.
  2. Know the cons. Read the warnings below. Hiding your feelings can delay your progress, can inhibit healthy communication and trust.
  3. Control your anger. Before anything else, the key is anger. As anger builds in you, it can be used to help block off thinking. Try to concentrate to be angry and to push it down.
  4. Stop feeling whatever it is If you wish to live with no sorrow, after you can control your anger well enough, begin to talk yourself out of sadness; to just not care. This is the next step in learning - to not lose yourself in emotions and feelings. Try to stop caring and say, i control my life. Be bold be strong. Try push it out of your head. Things wont bother you if you wont let them.
  5. Block out mental stresses and pain for physical pain. This system is a bit different because now you must endure before you can truly leave behind physical pain. This doesn't mean you have to cut yourself. You just have to accept the feeling of pain when you're hurt. Find a sparring partner, a close friend perhaps, preferably someone bigger.
  6. Focus. Now you must realize a truth in life. It's a truth that you will need to focus on. All your feelings come from thoughts and impulses in your head that tell you something is wrong or right, like a burn or a tickle. What you must do is realize that with enough pushing and controlled thought, you can change wrong to right, sorrow into happiness, etc. With pain, all you do is tell yourself it doesn't hurt. It seems simple, but is harder than one can truly imagine.
  7. Inspiring Quotes."" Will help you too. Try to look up inspiring quotes on google, they make you feel better. Try listening to songs that have strong lyrics. Know that this wont be forever.


  • Don't be overconfident. Don't try to breeze through such a drastic change in one's self. Be safe about how you do this - no cutting, stabbing, or poking yourself intentionally. Life is full of pain and all you need to do is wait for it.
  • Also, for the first and second steps, it might seem as though there isn't a lot of description to it. That is because only your own mind and way of thinking can judge how long it takes and how you must go about following those steps.


  • This will drastically alter a person. The life it gives you can be a cold one. Don't ruin something good and don't do anything stupid when trying this. If one goes through with this change, be prepared. In fact, in my opinion, no one should ever try this if there are doubts in their minds.
  • Do not think only about yourself- think about the other people you WILL hurt, such as your loved ones.
  • Remember, though you will not feel pain or sadness, you will not feel happiness or joy either. Life is pain. If you subtract pain, you subtract joy.
  • Do not be fooled into thinking that this way of life is peaceful!

Article provided by wikiHow, a wiki how-to manual. Please edit this article and find author credits at the original wikiHow article on How to Ignore Pain and Feelings. All content on wikiHow can be shared under a Creative Commons license.

How to Empty your Mind

Emptying your mind is very powerful when you have a problem. Now, learn how to!


  1. Sit somewhere quiet. Total silence is not necessary – but music, television noise, or people talking will be distracting.
  2. Sit comfortably. Sitting in a chair is fine. Sit reasonably upright, but do not strain to achieve any particular posture.
  3. Wear loose, comfortable clothes. Loosen your belt if it is tight.
  4. Close your eyes almost all the way, so that a little light enters but you cannot see anything clearly.
  5. When thoughts come – let them come. When thoughts go – let them go. If you find yourself involved in a stream of thoughts, let go of your involvement with them. Keep letting go of involvement. Remain uninvolved. Just let go. Whatever happens – let it be as it is.
  6. If you feel good – do not hold on to those positive thoughts. If you feel bad – do not reject those negative thoughts. Especially important: if you feel nothing in particular – do not drift into numbness and lack of presence.
  7. Remain alert. You probably will feel refreshed and empty minded.


  • Do this in a dark, quiet room.
  • You should keep your eyes closed.
  • You can do this in your bed or a couch, but if you think you will fall asleep, don't lay down.


  • You may feel strange when you first start. But don't be alarmed- this is all part of the process.

  • Closing the eyes for a long time may make you feel sleepy.Focus on brain and make sure you empty your mind without thinking any life's petty ordeals.

Things You'll Need

  • A couch or bed
  • A thought you'd like to get rid of (Optional)
  • A dark place (optional)
  • No distractions

Article provided by wikiHow, a wiki how-to manual. Please edit this article and find author credits at the original wikiHow article on How to Empty Your Mind. All content on wikiHow can be shared under a Creative Commons license.

How to Control Food Addiction

Are you gulping down food every 5 minutes? Do you want to know how to stop this addiction and lose weight? If so, read on.


  1. To start off, you will have to admit to yourself that this is unhealthy and must stop. If you want, you can ask a family member to guard the fridge, so if you get a temptation to eat, they will stop you (unless they have an addiction themselves).
  2. Next, drink water whenever you have the urge to eat. Believe it or not, one glass of water really helps your appetite go down.
  3. Talk to anyone with a cured addiction for food, and ask them how they stopped eating. They will probably mention that it is very hard to stop yourself.
  4. Meditate and see how many days you can keep up without eating extra junk(main meals like breakfast, lunch and dinner don't count).
  5. Finally, after a few weeks, or a couple of months, hopefully your addiction will be gone!

suck on sugar free hard candy
stay busy
plan your meals ahead of time.
Don't keep foods you like to eat in the house


  • In the first few days, it will be EXTREMELY hard, so drink plenty of water and keep away from the fridge!
  • Your family members might want to set up an alarm on the fridge to keep you from eating.
  • Do try to have a bigger breakfast, that will keep you full in the afternoon until your lunch!

suck on sugar free hard candy
stay busy plan your meals ahead of time.
Don't keep foods you like to eat in the house


  • Do not try this when you are fasting. It can be overly dangerous, and might make you pass out (everyone needs to eat sometimes).
  • The alarm on the fridge may contain lasers so try this at your own risk.

Article provided by wikiHow, a wiki how-to manual. Please edit this article and find author credits at the original wikiHow article on How to Control a Food Addiction. All content on wikiHow can be shared under a Creative Commons license.

Relieve your Anxiety

Almost everyone experiences anxiety which may be described as any feeling of worry or dread, usually about events that might potentially happen. Anxiety about stressful events is normal, however, if you feel anxious without reason and your worries persist and affect your day-to-day life you may have generalized anxiety disorder.

Symptoms of generalized anxiety disorder may include restlessness, felling tense or on edge, irritability, impatience, or poor concentration. You may also notice changes in your physical health such a s bloating, chest tightness, dry mouth, excessive sweating, fatigue, headaches, indigestion, insomnia, jaw pain and muscle tension.

Although it is important to be evaluated by your doctor for a proper diagnosis and to rule out other medical problems that may resemble anxiety, there are ways in which you can take control of your anxiety.

Here’s how:

Address the cause(s) of your stress.

Physical exercise, yoga, tai-chi, self-hypnosis and meditation are just some stress reduction techniques for anxiety. Try different techniques and determine which routine you can stick to keeping in mind your schedule.

Avoid stimulants such as caffeine.

Take a multivitamin cone a day. This may help reduce anxiety and feelings of stress.

Physical stimulants such a caffeine

Take a multivitamin once a day. This may help reduce anxiety and feelings of stress. Increasing your intake of calcium, magnesium and the rage B-vitamins will also help.

Calm the nervous system by taking an herbal combination of valerian (valeriana officinalis) (100 to 200 mg) and passionflower (Passiflora incarnate) (45 to 90 mg) three times a day. While passionflower has been used as folk remedy for anxiety and insomnia, valerian will help reduce your insomnia. Be careful, as passionflower should not be taken with other sedatives without medical supervision, and the use of valerian should be limited to three months at a time.

Kava, which is native to Polynesia and has been found to have anti-anxiety effects in humans.

Plant essential oils can be added to baths, massage oil, or infusers. Essential oils that are used for anxiety and nervous tension are: bergamot, cypress, geranium, jasmine, lavender, Melissa, neroli, rose, sandalwood, ylang-ylang. Lavender is the most common and forms the base of many relaxing blends.

Massage therapy, shiatsu, and other forms of bodywork are widely used to diminish muscle tension, relieve stress and improve sleep.

By Dr Aftab Saeed
The writer is Research Professor, HIASR, Faculty of Eastern Medicine, Hamdard University, Karachi.

Sep 13, 2009

The Antidepressant Debate

In 1990, depression was determined to be the fourth leading cause of the global burden of disease (death and disability caused by an illness) amongst all diseases. By 2020, it is projected to jump to second place.

Antidepressants and psychotherapy are the two firs line treatments for most patients with depression. The Royal College of Psychiatrists ( recommends that psychotherapy is effective in mild and moderate to server depression. However on a practical level, because of a global shortage of trained psychotherapists, and the cost and time involved in psychotherapy, perhaps more than 95% of depressed patients are treated with antidepressants the world over.

In this scenario, when a respected psychologist from the university of Hill, Irving Kirsch (Kirsch et al. 2008) initial severity and antidepressant benefits: a meta analysis of data submitted to the FDA. PLoS Med 5(2) suggests that there seems little evidence to support the prescription of antidepressant medication to any but the most severely depressed patients. How does one reconcile the above piece of research with the daily observation of psychiatrists and patients that many people, who have been low and depressed of months, and sometimes years recover within four to six weeks of taking antidepressant medication?

The answer probably lies in the way psychiatric research is conduced, reported and interpreted. Without going into too much jargon, Kirsch et al calculated an effect size (a statistical measure of how well a drug works) of .32 while another study done by Erick Tumer, an Assistant Professor of Psychiatry at the university of Oregon, USA reported an effect size of .31. Interestingly, Kirsch’s conclusion was that antidepressants don’t work while Turner’s conclusion was that they do!

And this is where the confusion arises in that different studies have reached different conclusions because they have interpreted almost identical results differently. To summaries, as the current knowledge stands, psychotherapy works well in mild to moderate depression, while antidepressants should be used for moderate to severe depression. However, if you have any personal choices for or against drugs or psychotherapy make sure you discuss it with your psychiatrist.

By Dr Syed Ahmer

The writer is Assistant Professor, Department of Psychiatry, Aga Khan University Karachi.

An Experience in Psychoanalytical Psychotherapy

It was a dull Wednesday afternoon when I heard a scream from my patient’s room. Kylie, a sweet teenager had tied to take her life one again by cutting both her wrists in different areas.  Her mother was crying profusely and blamed herself for trusting Kylie to go to the bathroom alone.  To Kylie, her life didn’t matter as much as converting the inner pain into physical pain did. To her mother no place was safe. 

Kylie had undergone series of traumatic incidences in her life, due to which she suffered from one of the most serious personality disorders, known as the borderline personality disorder.  She had server mood swings; avoided close relationships most rusted men and suffered from a poor self image and a chronic feeling of emptiness. 

Kylie considered my role in her life as that of a demon. Every time t tried to interne she would plan a self sabotaging behavior. 
All my efforts to treat her with supportive psychotherapy had failed and I was unable to build a therapeutic alliance until I introduced a form of modified analytical procedure known as psychoanalytical psychotherapy. 

Gradually introducing the new technique, I tried to deflect her negative behaviors and restructured our sessions into meaningful, analytical conversations.  I tried to find meaning behind each aggressive step she would take and introduced measures to block those actions.  I helped her transfer he feeling, thoughts and behavior originally experienced on to a person involved in her current interpersonal relationship.  Slowly she transformed into a more cooperative person.  It took time and perseverance but finally I changed in her eyes from a demon to an angel.  She no longer cut herself.  At the time of discharge, Kylie smiled and said, I will never be back.

By Dr Faisal Mamsa
The writer is a physician trained in Psychiatry from the USA.  He is currently Practising at South City Hospital Karachi.

Alternative Therapies for Headaches

The medical term for a headache is cephalgia, and is defined as a pain that occurs above the eyes or ears, behind the head, or in the upper neck. Headaches are either classified as primary or secondary. Primary headaches include migraines, tension headaches and cluster headaches; secondary headaches are caused by other diseases.

Tension headaches are the most common type of primary headaches with up to 90% adults suffering from them at one time or another; these headaches are more common among women than men. Similarly, migraines mainly affect women, and cause a throbbing headache that is usually accompanied with nausea and disturbed vision.

Cluster headaches, which cause extreme pain in one side of the head, are rare and mainly affect men.

Secondary headaches may result from innumerable conditions, ranging from life threatening ones such as brain tumors, strokes, meningitis and sub-arachnoid haemorrhages to less serious conditions such as withdrawal form caffeine and discontinuation of pain killers. Many people suffer from mixed headache disorders in which tension headaches or secondary headaches may trigger migraines.

The treatment of the headache depends on its type and severity and other factors such as the age of the patient.

There are a number of different complementary and alternative Medicine (CAM) treatments for headaches, which fall into two major groups: those intended a prophylaxis or pain relief, and those that reduce the patient’s stress level.

Those CAM therapies that help to reduce stress include the likes of Yoga and Tai Chi, medication, aromatherapy. Swedish massage, aromatherapy and music therapy amongst others.

CAM therapies intended to prevent or relieve discomfort include:

  1. Feverfew (Tanacetum parthenium). Feverfew is an herb related to the daisy that is traditionally used in England to prevent migraines. Published studies indicate that feverfew can reduce the frequency and intensity or migraines, it does not, however, relieve pain once the headache has begun.

  1. Butterbur root (petasites hybridus). Petadolex is a natural preparation made from butterbur root that has been sold in Germany since the 1970s as a migraine preventive.

  1. Brahmi (Bacopa monnieri). Brahmi is an herb used in Eastern / Unani medicine and Ayurvedic medicine to treat headaches related to anxiety

  1. Acupuncture. Studies funded by the National Centre for Complementary and Alternative Medicine (NCCAM), USA, have found that acupuncture is an effective treatment for headaches.

  1. Naturopathy. Naturopaths include dietary advice and nutritional therapy in their approach to treatment, which is often effective for patients with episodic or chronic tension headaches.

  1. Chiropractic. Some patients with tension or migraine headaches find spinal manipulation effective in relieving their pain.

By Dr Aftab Saeed

The writer is Research Professor, HIASR, Faulty of Eastern Medicine, Hamdard University Karachi

Sleep well..

Almost everyone experiences insomnia or sleeplessness. Factors such as continuous worries, depressions, irregular hours, noise, pain, too much coffee or unfamiliar surroundings can lead to restless nights.

In addition, if you suffer from insomnia you might find it difficult to relax sufficiently to fall asleep. And if you are in the habit of staying up late surfing the Net or watching television, this can easily turn into a vicious cycle of overtiredness and insomnia which can lead to exhaustion.

Because time drags when you are trying to sleep, you might overestimate the length of your sleeplessness. Remember there are no rules about how much sleep is necessary, everyone’s needs are different. Babies and some teenagers may sleep for up to 18 hours, while older people may require only five or six hours.

Also remember that your body can make up for sleep loss without catching up on every lost hour. For example if you have had several night’s broken sleep you can recover after a single sleep lasting about 12 hours.

Here are a few ways that might help in ensuring that you get a good night’s sleep.

Note your sleep patterns to help you find out the cause of your insomnia.

Drink a glass of warm milk with a teaspoon of honey before going to bed.

Establish regular sleeping hours and have a warm bath before going to bed.

Exercise regularly either in the morning or evening but not before going to bed.

Keep your bed room well ventilate and quiet and ensure that your bed is comfortable i.e. gives your body proper support.

Place the table clock out of sight and while trying to sleep, think about something you find enjoyable.

Go to bed at least two hours after dinner.

If your insomnia is not caused by indigestion or a medical condition, a soothing massage can work wonders before bedtime.

Herbs with a natural sedative action such as Passion Flower (Passiflora Incarnata), hops (Humulus lupulus), Sunbul at teeb (Valeriana officinalis), skull cap (Scutellarea latriflora) and Chamomile (Matricaria Chamomilla) are natural sedatives and are also known to have analgesic and antihypertensive qualities. They can be taken in liquid form mixed in a bit of cold water.

The infusion of chamomile (Matricaria Chamomilla Babuna), valerian (Valerian officinalis) as well as a cooled down light decoction of dill (Soya) and rauwolfia root (Rauwolfia serpentine) with dried coriander (Coriandrum sativum) are relaxing.

Eastern medicine treats insomnia (Sahar/Bedari) with the administration of Musakkinaat (Sedatives). Munawwemaat (hypnotic/somnifacient), Murattibaat (moistening) and Maghziyaat (tonics for brain). There is a long list of drugs under these headings of Mufredaat (herbs) with Sunbul at teeb and Babuna being frequently used in different forms. The most popular compound drugs include somina and Besha’shaa.

The writer is Research Professor, HIASR, Faculty of Eastern Medicine Hamdard University.

Dealing with Allergies

For many of us spring heralds an onslaught of allergies, for others living with an allergy is part of their lives. A number of theories have been tabled to explain why more and more people find themselves suffering from allergies. These include the increased stresses on the immune system ( a weak defense due to greater chemical pollution in the air, water and food); early weaning and introduction of solid food to infants; genetic manipulation of plants resulting in food components which cross-react with normal tissues and increased ingestion of foods lacking basic components such as fiber, proteins, vitamins etc.

Then there is the fact that most common allergies are the expression of an inherited genetic predisposition. For example, studies have found that when both parents are allergic, 67% of the children are also allergic. On the other hand, when only one parent is allergic, 33% of the children end up being allergic. This makes knowing your family’s medical history all the more important.

The question, however, still remains, “How do I deal with allergies?”

This question is even more pertinent for sufferers who find that taking anti-histamines causes them to slow down to a certain extent, which considering today’s hectic lifestyles can be extremely inconvenient if not outright impossible.

Not all is lost though, as there are other ways of dealing with allergies.

Here is a look at a few:

Avoidance and Elimination. The simplest and most effective method of treating your allergies is by avoiding the allergic item, environment or food. In cases of food allergies, the symptoms will start to alleviate in three to five days, once your intestinal tact has eliminated the allergy causing food. Remember, avoidance means not only avoiding the food in its most identifiable sate (e.g. eggs in an omelets), but also in its hidden state (e.g. eggs in bread).

Rotary Diversified Diet (RDD). This method requires eating tolerated foods at regularity spaced intervals of four to seven days. This approach is based on the principle that infrequent consumption of tolerated foods is not likely to induce new senilities. Additionally, it has been found that tolerance for eliminate foods (those which caused the allergy) returns usually within four to seven days at which time they may be added back into the rotation schedule. Not only does this system help vary your diet; it also helps in minimizing inhalant allergies such as dust, pollen, mould, etc. By reducing the load on your immune system and proving improved nutrition.

Immune system support. Bolster your immune system by taking vitamins and minerals such as B-complex, Vitamin A, selenium, Zinc etc.

Underlying and Associated Conditions. If you find that although your allergies have subsided, you still continue to suffer from conditions such as dermatitis (inflammation of the skin) or an upset digestive system it is always better to have lab tests done and get proper medial treatment.

Eastern (Unani) medicine. General treatment follows the principle of evacuation (tanqiyah) or the morbid matter developed as a result of any specific type of allergic condition. The process consists of concoction, purgation and detoxification / evacuation. Then natural anti-allergic drugs such as combination of lavender ( Ustkhudus / Lavandula stoechas), Artemisia (Afsantin / Artemisia absinthium) and soapnut (Retha / sapindus trifoliatus ) are administered. A common medicine in the form of tablets (Qurs Shilarji) is prescribed frequently to allay allergic conditions.

The writer is Professor of Pharmacognosy and Phytotherarpy, Faculty of Eastern Medicine, Hamdard University Karachi.

A surgeon’s Day

Contrary to popular belief, a surgeon’s job is not the moment she or he steps out of the operation theatre after surgery.  It continues with the post-operative care and the follow ups, with the surgeon finally taking a huge sigh of relief when she or he gives the patient a clean bill of health. 
On most days, a surgeon sticks to a routine which may well be blown into smithereens if an emergency case comes up.  Generally, speaking a regular day starts around 9 a.m. 
The first task for people in my profession involves checking the in-tray which invariably holds medical queries from most importantly case sheets of operable case.  The days of my week are divided between clinical evaluations, surgery and follow-ups, with each day bringing its won surprises. Perhaps it’s 40 plus overweight lady who needs to have her gall bladder removed because of stones or may be an  80 year old gentleman with inguinal hernia. 
The choice of surgical procedures as well as the unaesthetic agents to be used and the medical fitness of the patient prior to surgery cannot and are not taken care of by the surgeon alone.  A team of highly dedicated individuals lends their feedback to the choice which is eventually made with very little room for mistakes. 
Once the surgery is finished, my nursing staff takes over when the patient reaches the recovery room.  A well trained and highly competent nursing staff can make a surgeon’s job easy. 
The beauty of general surgery is that you never know what will be coming through your door next.  Practicing this particular branch of surgery is about dealing with uncertainty.  My emergency cases may include road traffic accidents, acute appendicitis or a ruptured appendix.  So while my patients rely on me, I rely on my training, skill and experience.  It does not always go as planned.  My schedule can be exhausting and time consuming and I often run late.  By the end of a typical day, I am tried and hungry but on a kind of high, I have helped people and that is an instant reward in itself. 
By Dr. Shoaib Ghangat
The writer is a practicing consultant general surgeon.   

Unique Mango Cures

An Indian legend tells the story of a mango tree that grew from the ashes of the sun princess, who had been incinerated by an evil sorceress. The Emperor fell in love with the mango ripened and fell to the ground, the beautiful sun princess emerged. Thus, the mango became a symbol of love in India, and a basket of mangoes is considered a gesture of friendship.

Native to Southeast Asia and India, the mango is purportedly the most widely consumed fresh fruit in the world, with worldwide production exceeding 17 million metric tons a year; Mexico is the largest exporter of mangoes in the world. The mango is a member of the Anachardiaceae family which includes poison ivy, cashews and pistachios. Cultivated for over 6000 years, the mango comes in over 50 varieties, ranging in colour from green, yellow, to reddish, often tinged with purple, pink, orange-yellow, or red. It is also known as manga, mangga, mangot, mangou, and mague in different parts of the world.

Besides being eaten in their sweet raw form, mangoes are used extensively in the Subcontinent for a variety purposes. For example, mangoes are dried, ground into a powder called amchur, which is used in the preparation of a number o foods as well as chutneys. And there are the ever popular achars made from mangoes.

But beyond the mango’s culinary uses and symbolism of friendship, the fruit has a number of medicinal uses.

  1. In the subcontinent mangoes are used as blood builders when taken with milk. Because of their high iron content they are recommended in the treatment of anemia and are beneficial to women during pregnancy and menstruation.

  1. People who suffer from muscle cramps, stress and heart problems can benefit from the high potassium and magnesium content of mangoes.

  1. Unani physicians have found mangoes very effective in treating ailments affecting the kidneys as well as tuberculosis.

  1. Raw mangoes have been known to help in breaking down kidney and bladder stones.

  1. Safoof-Khasta Anba is used to provide extra heat and relieve allergies.

  1. Anba (Maghz Biryan), which comprises a power (safoof), is an aphrodisiac tonic.

By Dr Aftab Saeed

The writer is part of the Faculty of Eastern Medicine, Hamdard University.

Travel at Ease

The summer break is just around the corner and this means an opportunity to travel to new and exciting destinations. Unfortunately, if you suffer from motion sickness what should be an enjoyable experience can turn into an ordeal.

For those who suffer from this condition know from experience that it can strike suddenly and progress from a feeling of discomfort to cold sweats, dizziness and then vomiting. Rather than allow this unpleasant condition to affect your travel plans, a few simple measures can help you have an incident free trip.

Perhaps the best way to counter motion sickness is to sit in those seats where motion is felt the least. For example, when traveling by car, either drive or sit in the front set. If you plan to travel by train a forward facing window seat near the front will help reduce the effects of motion sickness. When flying, ask for a seat overlooking the edge of a wing and once seated direct the air vent flow to your face. If you are planning a cruise this summer, reserve a cabin located in front or middle of the ship or on the upper deck.

Here are steps to help you cope with motion sickness.

  1. Focus on the horizon or a distant, stationary object. Don’t read; don’t overeat.

  1. Place your head against a head rest and keep it sill.

  1. Don’t smoke or sit near smokers.

  1. Avoid spicy and greasy food before and during your journey.

  1. If you feel queasy eat dry crackers or drink a carbonated beverage to settle your stomach. Alternatively, chew on raw ginger or drink some ginger tea to help ease the symptoms.

  1. Eating pickles or chutneys made of alu Bokhara, imli or gulab before you travel can help prevent motion sickness.

  1. If you are going on a short journey barely water (aab-jao) and fruit juices are also helpful.

Having tried these remedial measures, if you still find that you are still unable to counter the effects of motion sickness, take an over the counter antihistamine or one containing dimenhydrinate at least 30 to 60 minutes before you travel. Patches are also available which you can apply behind your ear for 72 hour protection. Talk to your doctor before suing the medication if you have health problems, such as asthma, glaucoma or urine retention.

Motion sickness usually subsides as soon as he motion stops and the more you travel, the more easily you will adapt to being in motion. A word of caution for parents, children between the ages of four and 12 are particularly prone to motion sickness.

By Atab Saeed

The writer is Research Professor, HIASR, Faculty of Eastern Medicine, Hamdard University Karachi

Sep 12, 2009

Practising Paediatrics

Practising Paediatrics

Children are perhaps the most versatile of all patients. From those who can only cry to express how bad they might be feeling at any particular moments to the older ones who can fully explain what is bothering them and where, a paediatrician’s day is full of surprises.

Children tend to suffer from different illness as the seasons change. For example, in the summer, child specialists see a lot of cases of diarrhea and vomiting. Typhoid fever also peaks during these months and responds to treatment slowly. The most common reason for this is the frequent changing of doctors by parents which generally means a change in prescriptions. This leads to the emergence of a multiple drug resistant organism.

Drinking unsafe water also contributes to a host of hepatic and diarrhoeal diseases. Of utmost importance is washing hands frequently as this not only protects against a lot of diseases but also helps in containing many communicable illnesses.

Heat and humidity conned with persistent power failures may lead to various types of skin rashes and infected skin lesions such as impetigo, carbuncle and furuncle, the more so with children because of their extra sensitive skins.

Flu-like symptoms are also common among children coming to the clinic. Those prone to allergies may come with complaints of asthma, runny nose and skin infections. Nappy rash also peaks during the summer months and may be of the fungal or the contact dermatitis varieties, and is especially worse in children under six months of age.

As a paediatrician, I hear a lot of grandma myths, hand-me-down taboos and false beliefs about different type of foods from my patients’ parents. Even educated parents, medial doctors included, tend to believe in many such bizarre ideas, what to say of the uneducated lot.

Here as some examples.

  1. Parents refrain from giving chapattis to children suffering from typhoid fever and hepatitis. Children suffering from cough are strictly not allowed to eat bananas and rice on the pretext that this results in the increased production of sputum. All such beliefs are followed without any scientific basis.

  1. Perhaps the worst feeling you get as a paediatrician is when the parents of a child under you are express dissatisfaction because their child has not recovered well within three to four days.

  1. This usually results in changing the doctor which may actually cause the child to suffer more as every new doctor starts treatment from the base line.

By Dr Syed Ahmer Hamid

The writer is a consultant paediatrician at Mamji Hospital.

Sep 5, 2009

Lend me your ears

As an Ear Nose Throat (ENT) specialist my clinical work comprises both medical treatment and surgery. Let me state the outset that the disease pattern in our society is somewhat different than the rest of the world due to a lifestyle unique to our part of the world.

Perhaps the most unfortunate aspect about ENT diseases in our society is the fact that many people continue to suffer from diseases which are preventable. Take for example, oral sub mucous fibrosis, a disease caused by chewing beetle nut, an integral ingredient found in paan, mithi chalia, gutka etc.

Betel nut gradually restricts the mouth’s ability to open to such an extent that eventually the patient is restricted a liquid only diet. Complications of the disease can lead to cancers of the mouth. Tragically, this disease is more common in young patient as the habit of chewing chalia is becoming increasingly prevalent in this age group.

Another group of patients that I come across are children studding to become hufaz in madaris and who are required to recite the Holy Quran in a loud voice. This excessive use or the incorrect projection of the voice strains the vocal cords and results in hoarseness or voice fatigue caused by the formation of nodules.

What is even more tragic is the fact that the disease can be prevented through the correct use of he voice and temporary abstinence.

The use of cotton buds or Q-tips to clean the ear after bating is also common. As cotton buds are inexpensive and easily available heir use is taken as harmless which could not be further from the truth.

Injuries scratches to the ear canal, bleeding due to trauma, pain in the ear due to an infection and in extreme cases rupture of the ear drum are some of the harmful effects of suing cotton buds. To make maters worse if by chance a cotton bud is not available at the time when there is an urge to scratch the ear, keys, hairpins or matchsticks are used as alternatives. The simple advice not to use cotton bud at all is generally not acceptable to patients.

Among the vulnerable are those who live, work, or do business in noisy streets and music livers using headphones. The hearing loss permanent and the only way to rehabilitate are by the use of hearing aids.

All these factors underline the importance of creating awareness in our society about issues such as noise pollution and the fact that in many cases our suffering is of our won making.

The writer is Associate Professor, Department of Ear Nose Throat Diseases, Ziauddin University Karachi.