High blood pressure — 63
By Dr Akshyakumar
Malignant Hypertension (contd): It runs a severe downhill course, and normally ends fatally within a matter of months, unless it is treated and the blood pressure controlled.
The main difference between benign and malignant high pressure is the virulence of the disease process in the latter. These cases run a galloping downhill course. The height of the diastolic blood-pressure is usually about 140 mm.Hg., or even more.
Fortunately, malignant hypertension is not very common. Less than 1% of all high blood-pressure cases are malignant.
Secondary Hypertension: Secondary hypertension is, as the name implies, secondary to some causes. That is the hopeful feature about it.
A diseased kidney is often a cause. In some kidney diseases, the blood supply to the kidney may be diminished. Deprived of blood, the kidney secretes a chemical substance in the blood, which raises the blood-pressure.
Occasionally, a rumour of one of the endocrine glands may lead to a high pressure. The tumour acts by producing excessive amounts of a blood-pressure raising substance.
In secondary hypertension, then, where the cause can be removed in time, the high blood-pressure can be cured.
Very often, people do not know they have high blood-pressure. It is, in fact, often detected accidentally. Only regular visits to the doctor will ensure that a rising pressure is discovered in good time.
A high blood-pressure may or may not give rise to symptoms. Headache, dizziness, palpitations, lack of concentration, tiredness are some of the symptoms. Over and above these, however, and far more important are the effects of the high pressure on the heart, the brain, the kidneys and the eyes. Heart failure, strokes, kidney failure and blindness are all of grave omen.
A stroke is always a serious affair. The constant pounding of a high pressure on the walls of the arteries in the brain may rupture a blood-vessel in the brain. The patient may lose consciousness, and may have paralysis of half the body on the side opposite to the rupture, (The left side of the brain moves the right side of the body, and vice versa.) A high pressure, however mildly high it may be, puts a strain on the heart, the blood vessels and the kidneys.
Management: One of the most essential factors in treating hypertension—in fact the most difficult part of the treatment—is the change often necessary in the temperament, personality and way of living. Sedatives, regular hours and relaxation all help to obtain the mental and physical respite which these patients often so badly need from the rat race of today. It is for this reason that some are put to bed at the beginning of the treatment. The blood-pressure soon falls, especially if it is a mild and benign hypertension.
A vast array of drugs is also now available for reducing blood-pressure. Many of these are very potent. Probably more potent ones will be available in future. Combination of two or more drugs have been found more useful than single ones. They enable lower doses of drugs to be used, and thus avoid or minimise any possible toxic effects of any one drug. But drug therapy, in order to be successful, must be continuous. Treatment is often a lifelong affair.
Sometimes operations are advised for high blood-pressure, especially when the pressure is secondary to some cause. If the cause can be removed, it may be possible to lower the blood-pressure. When an operation becomes necessary, it is best not to delay it, or there may be irreparable damage from the high pressure.
High blood-pressure is dangerous. Life insurance records covering millions of people have shown that a pressure of 130/90 mm.Hg. in a man aged 35, who is otherwise healthy, decreases his life expectancy by 4 years. A pressure of 140/100 mm.Hg. by about 16 years.
It is therefore important to treat all cases with a high pressure, no matter how small this rise may be.
Early detection and adequate control by checks at regular intervals are the keynotes of successful treatment.
Change your way of living, which means regular hours of work and play at might and during the week ends.
Mental relaxation is just as important as physical recreation. Physical and Yogic exercises to relax your mind and body are very useful.
Cut down your weight if you are overweight. You may be one of those who can be helped by avoiding salt.
Horse Gram (Kulthi). Chemical Composition: Analysis of seeds gave the following values: moisture - 11.8, crude protein - 22.0, fat - 0.5, mineral matter - 3.1, fibre 5.3, carbohydrates - 57.3, calcium - 0.28, and phosphorus - 0.39%, iron - 7.6 mg, nicotinic acid - 1.5 mg, carotene (international vitamin A Units) 119 per 100g.
When kept on a diet which included liberal supplements of kulthi gram extract, the condition of the patient improved considerably and his hypertension was reduced to about 50 units per day.
An infusion of kulthi seeds is prepared by infusing 30 grams of the seeds in half a litre of boiling water for 10 hours. The latter should taken 1 glass three or four times daily.
Hypertension patients who are on a prescribed diet which does not severely restrict the intake of carbohydrates, but includes liberal amounts of kulthi gram extract, have shown considerable improvement in their high blood pressure. The pressure can be lowered and blood clotting diminished by increasing the consumption of fruits, reducing protein intake, and sticking to a vegetarian diet.
Sugarcane. Chemical Composition: (a) Carbohydrate, (b) Mucilage, (c) Resin, (d) Fat, (e) Albumin and (f) Calcium Oxalate.
Sugarcane juice has many medicinal properties. It strengthens the stomach, kidneys, heart, eyes, brain and sex organs. It is, however, very essential that the juice, must be clean, preferably prepared at home.
It keeps the urinary flow clear and helps the kidneys to perform their functions properly. It is also valuable in chest pain due to hypertension. For better results, it should be mixed with lime juice, ginger juice and coconut water. Persons suffering from hypertension must get at least eight hours of good sleep, because proper rest is a vital aspect of the treatment. Most important of all, the patient must avoid over strain, worries, tension, anger, and haste. He or she must develop a calm and cheerful attitude and develop a contended frame of mind.
--------------------------
The origin of the Meiteis of Manipur
by Dr Irengbam Mohendra Singh
An abstract by Sapam Geeta
Bogus stories of migration of the Meiteis from the East: Northeast India has settlements of a variety of tribal groups including the Meiteis of Manipur. There are many oral traditions about the Meitei migration in prehistoric times from somewhere in Southeast Asia but none is verifiable. Oral traditions expose the contradictory legends on false traditions. They carry us to the gates of the land of our origin but cannot let us in. It is like Coleridge’s poem, The Rime of the Ancient Mariner: “Water, water everywhere, nor a drop to drink.” It is quite impossible to ascertain whether some of the tribes, especially the Meiteis, are the original inhabitants or migrants from the East as there are no historical routes or archaeological evidence.
The problem is worldwide, especially in Asia where the study of archaeology is comparatively new. The Chinese are still disputing their origin and migratory routes of their ancestors while there is an increasing doubt in India whether the so-called horse riding Aryans ever invaded India with their sacred fire and bullock carts, as there are no archaeological traces.
In this long battle, a battle by no means finished, the DNA of the Meitei genome will in the near future. Reveal backwards, the Meitei origin, language and behaviour in a specific texture of time, place and circumstance. It will still be a hypothesis but nearer to the truth. Breakthroughs in Science are all about trumping probabilities.
I have a hypothesis: While awaiting a scientific development I have a hypothesis. In Science you form hypotheses, test them against the evidence and if they fit the evidence, you can assume that you are closer to truth. This is however not a real thesis but what the journalists call a “cuts job” — a thesis culled from secondary sources. It is a staple of scientific literature and Meitei social history. At the least, it will reveal another, more scientific aspect to the Meitei genealogy, in this age of doubt, aesthetics and Darwinism.
At an international conference staged by the institute for Asian and African Studies, Humboldt University of Berlin, 23 - 25 May 2008, Prof Robin Burling of Anthropology/Linguistics, University of Michigan, who researched in the Garo Hills in India in 1950s, asked the question whether the curiosity about the migratory origins of the tribes in northeast India might have been a foreign import. In the absence of records that would provide reliable history, colonial and missionary observers have searched for stories of migration as a substitute.
I find myself in agreement with the professor’s view. My hypothesis is that the Meiteis were the primogenitors of Manipur as the Burmese or the Tibetans were in their respective lands. Confronted by these ongoing debates, my attempts here are to indulge in an elaborate scientific discussion about the autochthonous state of the Meiteis of Manipur. It is hypothesised that the early settlers of Manipur branched off from the migrating human African ancestors in India, citing indirect evidence of modern human genetic studies.
The prehistoric origin of the Meiteis is completely unknown and it remains a rock-steady illusion to many. We have the Meitei Royal chronicles, Cheitharol kumbaba. But these date back only 2,000 years, 33 CE. But they are only oral traditions and thus cannot be validated. However, it is quite possible that they were the earlier inhabitants of Manipur.
To the shifting goalposts of our illusory origin I would like to add another shift with a new persuasion pitch aimed at the like-minded scientific folks to observe natural events and conditions in order to discover facts about our ancestral origin. To quote Darwin, “Doing what little one can to increase the general stock of knowledge is as respectable an object of life, as one can in any pursue.”
The methodology of this study, pro-tempore (until the genetic studies of the Y chromosome and mitochondrial DNA of the Meitei genome clarify our origin), follows the mathematical procedure known as permutation and commutation— an exercise in the gradual elimination of variables. As for instance, you are one of the 10 invitees to a dinner party. There are place cards with everyone’s name on the table. Supposing you forgot your spectacles, the best option for you is to wait until everyone has sat down. The chair that is left is for you.
As facts are hazy about the origin of the Meiteis, many people go for an arresting general claim, and because they are abstractions with counter-abstractions, nobody wins. The real origin of the Meiteis remains an illusion, interpreted differently by various people, as migrants from different regions of Southeast Asia.
Illusions distort reality. They are generally shared by most people. There are a variety of illusions but the optical illusions are most well known and understood such as the optical illusion of the rainbow or the racial inequality between the blacks and whites and the grouping of all the Mongoloid-looking tribes in the Northeast India as Tibeto-Burman.
Human beings did not evolve to see things accurately, but to see things that would be useful. They look at things they want, which do not always work out as planned.
The only time when we notice an illusion is when something goes wrong. By way of explaining what I mean by the illusory nature of the origin of the Meiteis, I would like to take the reader to watch and optical illusion. I sounds pejorative but it is a phenomenon that when all the loose ends are tied up, will reveal the truth. It is about the rainbow. —to be contd
--------------------
End stage renal disease: Causes, prevention and treatment
Renal Failure or End-stage renal disease (ESRD), which is often related to diabetes or hypertension, is a serious medical and economic public health problem throughout the world. An understanding of the scope of this condition, as well as the trends in outcomes, is essential for optimizing treatment of ESRD and establishing meaningful strategies for prevention.
The incidence of terminal renal failure is rising at an alarming rate, in spite of impressive advances in the management of ESRD. An estimated one-lakh people develop ESRD every year. This is in addition to a pre-existing pool of about 20 lakh sufferers. More than three-fourths of the people suffering from ESRD do not get treated at all. Further, the burden of renal disease is growing rapidly in India. Particularly distressing is the number of older patients who need renal replacement therapy. In fact, more than 50% of patients undergoing renal dialysis or transplantation for ESRD are age 65 or older.
What are the symptoms of renal failure?
The main external symptoms are general feeling of sickness, tiredness, swelling around the feet/ankles/eyes, loss of appetite, and nausea. Blood tests will show up a very high concentration of a toxic substance called urea, creatinine, which the body is not able to excrete. Urine tests will normally show abnormally high protein content, as the kidneys are not able to reabsorb the protein before urine is passed out. Also gradually many patients tend to lose their daily urine output.
It is vital for kidneys to function to sustain human life. Kidneys act like blood purifiers as they filter out toxic products and excess fluid from our system. They also maintain the chemical balance of important electrolytes such as sodium and potassium within our bodies. End-stage kidney disease occurs when the kidneys are no longer able to function at a level that is necessary for day-to-day life. It usually occurs as chronic renal failure worsens to the point where kidney function is less than 10% of normal. At this point, the kidney function is so low that without dialysis or kidney transplantation, complications are multiple and severe, and death will occur from accumulation of fluids and waste products in the body.
Chronic renal failure usually occurs over a number of years as the internal structures of the kidney are slowly damaged. In the early stages, there may be no symptoms. In fact, progression may be so gradual that symptoms do not occur until kidney function is less than one-tenth of normal. This is usually in response to a chronic (ongoing, long-term) disease such as diabetes or high blood pressure. In some cases this kidney disease is hereditary. (For any feedback please visit norenning@gmail.com) —to be contd