Healthline 1st issue April 2015 by HealthLine

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Vol: 1 Issue 1 healthline Jan-April 2015

A Voice of Asia publication

DIABETES

Risk growing for Asian and South Asian Immigrant Population

Cardiac Catheterization An invasive procedure utilized in treating cardiac illnesses

SAHNA

Survey Report by IACAN and MD Anderson

Ronald A. DePinho MD

President, The University of Texas MD Anderson Cancer Center

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ealth Line is a dream come true for me. I started dreaming about publishing a health and wellness magazine well over a decade ago. In my dreams I envisioned a magazine that would benefit everyone, not just one particular gender, or group. My thirty years of publishing experience, 40 years of community service, the credibility, and the widespread acceptance of the flagship publication, Voice of Asia, signals to me that the time to launch this magazine is NOW. Our first issue focuses on a group that tends to be marginalized in our society: seniors, and those who never contemplated that they would one day be counted among the ranks of seniors. In a society obsessed with finding the fountain of youth, health and wellness issues of the â&#x20AC;&#x153;silver hairedâ&#x20AC;? set tend to be relegated to an afterthought. This first issue is chock full of ideas and articles that I believe will help all seniors to age more gracefully. My hope is that this issue will embolden seniors to envision a dynamic and energized second half of their lives. Although the focus of the first issue is seniors, we have not left out those who are not in this category. We have articles that will interest and benefit everyone, whether you are twenty or eighty, or somewhere in between. Voice of Asia Group has the infrastructure, publication skills, and the network systems necessary to tap into the best minds of our time. Issues after issues we will bring you the best advice in health care from licensed physicians, other service providers and professionals. They will share with you the wealth of their experience and knowledge. My confidence is that their sage advice and insight will enable us all to live more empowered healthy lives. This inaugural issue is the fruition of a dream more than a decade in the making. I am proud of this magazine, and I am convinced that it is a timely answer to the health and wellness concerns facing the citizens of young and old. My hope is that this magazine will be a collaborative effort between you and Voice of Asia Group. My hard working staff and I want to hear from you. We need to hear from you the issues that matter to you matter to us. I love this magazine. My belief is that once you read this first issue, you will love it as much as I do.

Koshy Thomas Publisher & CEO, Voice of Asia Group

healthline Jan-April 2015

A Voice of Asia publication

HEALTHLINE EDITORIAL

ear Reader,

Publisher Koshy Thomas Editor-in-Chief Shobana Muratee Marketing Manager Jacob David Marketing Susan Pothanikat Accounts Manager Priyan Mathew Administration Rao Vadlamani Cover Photo Eric Kayne Magazine Layout and Cover Design Ashita Murgai Graphic Design Our Contributors Alzheimer’s Association Amanda Duke Christina Holch David Jeyaraj MD Hardeep Singh MD Harpreet Singh MD Julie E. Kutac Mahendra Jain MD Prof. Meenakshi Bhattacharjee Nik Nikam MD Phil Sneiderman Pratibha Sachdev Sabina Cherian MD Savitri K. Iyer MD Scott Merville

Welcome to our inaugural issue of HealthLine magazine, a new addition to the Voice of Asia Group. Houston, Texas is the hub of primary health care system, with state of the art hospitals, research institutes and nation’s top medical professionals serving the country’s most diverse communities. Being the nation’s largest medical state, it is likely that there are ample publications on health care floating around, then why another? Neither the idea nor the need for such a publication is new but it is brought to fruition only now, ten years late. But the timing could not be better, because Houston’s population is growing and so is the diversity. With super specialties in the medical field it is increasing difficult for individuals to comprehend the gourmet of services available. This magazine is an attempt to collect latest and most relevant information in health care, be it medicine, diet and nutrition, exercise, patient care also alternate medicine and break it down to the layperson’s understanding of some conditions that commonly affect us. Our writers were very supportive of the magazine and turned in their articles on the dot which made our work easier, our thanks to all our writers for their valuable contributions and to our advertisers for supporting our drive. From its conceptual stages, the magazine has received tremendous encouragement both, from the healthcare providers and receivers. These efforts have propelled us further into starting our own portal dedicated to health and wellbeing soon. I look forward to your valuable feedback and comments.

Dr. Sheela Keswani

Shobana Muratee

Editor-in-Chief

Shobit Keswani Thuy Hanh Trinh MD Copyright Info & Disclaimer: All rights reserved. No material herein or portions thereof may be published without the consent of the publisher. HealthLine assumes no liability resulting from action taken based on the information included herein. The opinions expressed are not necessarily those of the management. HealthLine reserves the right to edit as necessary to correct errors of fact, punctuation, spelling and to comply with space constraints. HealthLine does not endorse the advertised product, service, or company, nor any of the claims made by the advertisement. Published quarterly by Free Press LLC, 8303 SW Freeway, Suite # 325, Houston, TX 77074. Tel: 713-774-5140. Fax: 713-774-5143. Email for editorial submissions: voiceasia@aol.com; Email for advertising inquiries and submissions: ads@voiceofasiagroup.com For reprint rights, please email: voiceasia@aol.com Subject Line: Reprint rights.

HealthLine Jan - April 2015

When cancer strikes, we strike back.

At MD Anderson Cancer Center, we are focused on Making Cancer History.

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Ranked one of the top two hospitals for cancer care in the nation for 25 years by U.S. News & World Report.

07 [iCrush] Flu Understanding FLU

23 Hospice Service Addressing End of Life Care

10 HEALTH CARE TECHNOLOGY

24 Sahna Survey and Report

and how it spreads

challenges faced by Seniors

Technology promises new benefits to help improve Patient care and easy access to health information

IACAN and MD Anderson’s South Asian Health Needs Assessment report

Contents

26 Mindfulness 12 Suit for Ebola Discover your Optimal Flow State! Mindfulness treats John Hopkins University has devised an advanced suit to protect healthcare teams

15 The Medical Man President, University of Texas MD Anderson Cancer Center

various health conditions

27 Health and Healing Migraines

Alternative treatments to getting rid of your migraine

Kansa Vataki 18 A future without 28 Padabhyanga Alzheimer’s disease The race to fight Alzheimer’s and Dementia is on!

19 Speak up and speak out

Promoting awareness and preparedness to the public on Alzheimer’s and Dementia

20 AYURVEDA

Natural cures and remedies – an age old healing system

22 Dementia Alzheimer’s, a degenerative

Treating the soles of your feet

30 BREAST CANCER Symptoms and Treatment 32 Cancer Prevention

08 Diabetes

Risk growing for the Asian and South Asian immigrant population

14 CARDIAC Catheterization

Invasive procedure in diagnosing and treating Cardiac illness

16 Moon Shots Program

Program using technology to reduce Cancer mortality

Reduce the risks of developing cancer

33 Diabetic Research Bitter melon as an anti-diabetic plant source

disease is the most common type of Dementia

HealthLine Jan - April 2015

A Voice of Asia publication

CONNECT WITH US VoiceofAsiaNewsGroup voice-of-asia-news-group @VoAHouston

umerous patients have asked me questions on Flu and as a big proponent of patient education I would like to elucidate the key symptoms of Flu for the patients to remember. These are some of the FAQs: Droplet Precaution

[iCrush]Flu Harpreet Singh MD, FACP

Airborne Precaution

Distance

10m+ Droplet nudel

Droplet size

100µm 50µm Zaire ebolavirus Respiratory Viruses e.g. Influenza A virus, Corona virus, Rhinovirus

<5µm

Dr. Harpreet Singh md, facp

Droplet and Airborne Virus and Bacterial Transmission1

Doc, “Do you think I have Flu?”

Simple acronym or Vital Checklist-FLU FACTS can easily recall flu symptoms.

Flu Facts™ L U

Flu is dangerous in Asthma, heart failure and COPD patients Lung Infections-Pneumonia Upper Respiratory Tract

F A C T S

Fatigue Aches- Body ache and Headache Chills; Cough Temperature Sore throat and/or Stuffy Nose

Do you think I am contagious?1

Did you know that 1-micron meter is equal to 1000 nanometer? The size of Influenza A virus particle is 80-120 nanometer in diameter. This virus is so small that when a person coughs or sneezes, this particle remains suspended in the air. Water evaporates from these suspended droplets leaving behind gelatinous droplet nuclei that are suspended in the air. Small droplet nuclei can remain suspended in the air for hours and can flow with the wind currents. Therefore, proper hand hygiene should be practiced. Shedding of the virus starts 24-48 hours before the illness but at lower concentration and this later increases sharply one-half to one day following the exposure and this peak on the 2nd day and declines after that. On an average, shedding happens for about 4.8 days. RNA viral titres decrease with initiation of oseltamivir.

Sometimes children can develop nausea, diarrhea and vomiting with the flu. Patients who are sick to their stomach may present as “stomach flu” and this can also be caused by some other different viruses or bacteria also. We have developed an easy to remember and hard to forget Vital Checklist—What if you fly? Remember ABCD, for everyday use and as a quick reminder what to do when you are travelling, visiting somebody in the hospital or shopping. In ideal world, you should not go to the hospital if you are sick as you might spread infection to other people.  To buy this Vital Checklist, please contact hi@vitalchecklist.com; 5% of all the revenue generated will be donated to [iCrush] Foundation for patient education activities, patient education videos and iCrush walks, runs and 5k’s

Source: Dr. Katherine Arden, Dr.Graham Johnson, Dr. Luke Knibbs, ProfnIan M Mackay; http://virologydownunder.blogspot. com/2014/08/ebola-virus-may-be-spread-by-droplets.html Assessed on February 19, 2015 (reproduced with permission) 1

I am traveling and what precautions should I take. What if U Fly? Remember A-B-C-D™© W

Wash hands

HAT Hand Sanitizer (approved by TSA) I F

ILL- If you are sick, don’t travel Yearly Flu shot

Use tissue or towel to

Turn off the Faucet Lift up the Lavatory seat with tissue Yikes! Doorknobs & handles can also spread the infection. Please use tissue

L Y

A B C D

Watch for sick Airline passengers BYOD- Buy your own drink, don’t share Cover your mouth while sneezing and coughing Discard Tissue after use Tissue is the issue Dr. Harpreet Singh MD, FACP © 2015 Jan - April 2015 HealthLine

Diabetes Risk Growing for Asian and South Asian Immigrant Population Negative calorie vegetables Cabbage

Beetroot

Cucumber

Celery

“A number of studies show that Asians and South Asians may already have an increased genetic susceptibility for developing Type 2 diabetes,” said Dr. Mahendra G. Jain, a Houston Methodist Primary Care Group physician who practices internal medicine in Pearland. “This is the fastest-growing disease in that population, specifically in India. When we adapt to the American lifestyle, which can be more sedentary and can include a diet with more processed foods, the risk increases.”

Garlic

Spinach

Asparagus

Aubergine

Cauliflower Broccoli

or the millions of Asians and South Asians who have immigrated to the United States, the famed “Land of Opportunity” has provided a chance at a brighter future, both for themselves and future generations. Armed with hopes of increased economic success, better educational opportunities and greater freedoms than many of the countries they left behind, life in the U.S. can be a fresh start for many. However, health experts are issuing a warning that this population is at particular risk for developing Type 2 diabetes, a dangerous health condition if not properly managed.

According to Jain, numbers commonly used by Western medicine to determine one’s overall health and propensity for disease and obesity, such as body mass index (BMI), cholesterol and lipid profiles, are different for Asians and South Asians than for Caucasians and other races. “For someone of Indian descent, a BMI between 25 and 27 is considered

Mahendra Jain MD Internal Medicine Physician Houston Methodist Primary Care

HealthLine Jan - April 2015

Mahendra Jain MD

obese, but for Caucasians that number would be closer to 30.” He stresses the importance of annual screenings for diabetes and other diseases, which can usually only be detected by a blood test. In some cultures, he noted, routine doctor visits are not always the norm, especially for older generation immigrants, which could contribute to increased risk of serious, and sometimes deadly, complications from underlying diseases. “The most serious diabetes complications are kidney failure and cardiovascular disease. Both are very closely linked, and it is not uncommon for a diabetic patient to have a ‘silent’ heart attack,” said Dr. Jain. “Generally, by the time the classic symptoms of diabetes are present—like excessive thirst and urination—the disease has progressed and can be much more dangerous and difficult to manage.” Although the numbers are alarming and they continue to rise, Jain offers optimistic advice for those of Asian or South Asian descent who are looking to avoid diabetes and other serious health conditions. Obesity and a sedentary lifestyle are two of the biggest predictors of who will develop a catastrophic disease, he says, and regular exercise accompanied by a diet rich in fresh vegetables and fruits, lean protein and whole grains is key to good health. “Focus on small goals and incremental changes for good health. Even 15 minutes a day of moderate cardiovascular activity can make a positive impact,” he said. “Keeping your weight under control in your 20’s, 30’s and even 40’s makes a difference. It’s much healthier to work at establishing good habits in your youth rather than trying to undo the damage later in life.” 

Dr. Mahendra Jain is a board-certified internal medicine physician with Houston Methodist Primary Care Group, and has had a practice in Pearland for many years. You can learn more about Dr. Jain at houstonmethodist.org/primarycare or you may contact him at 713.485.4050.

[iCrush] Walk, Run &5k Proceeds Benefit Ashleigh Marie

May 30th, 2015 in Grand Rapids, MI Ashleigh Marie was diagnosed to have Multiple Sclerosis and her condition has worsened in the last year. [iCrush] Foundation is helping her to buy a handicap accessible van. Details at

www.icrush.org

Organized By: Dr. Harpreet Singh MD, FACP CEO & Founder- Vital Checklist President- [iCrush] Foundation Ken Fortier CEO-NetPlus Connections Media Partners: Gagan Ahluwalia Scavan Systems, Delhi Duane Weed DW Video, Michigan Sponsored By: Sheelu Keswani Sudhir Modi Crossroads Banquet Hall,Mi Dr.Paul Singh MD, FACC West Mi. Cardiology

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Gift it to a loved one or a friend! You will be happy that you did it. Jan - April 2015 HealthLine

Hardeep Singh, MD MPH

f you have been to a doctor recently, you would have seen them busy typing into their computers. The expanding role of information technology promises many benefits of improving patient care, including easy access to clinical information, better communication among healthcare providers, and solutions to reduce medical errors and quality problems. For example, electronic medical records can help doctors track vital patient information, alert them to possible serious issues and enable the use of electronic prescribing to combat illegible handwritten prescriptions and dangerous allergic reactions. Information technology (referred here just as “technology”) seemingly is a remedy for many medical mistakes and healthcare inefficiencies. However, if not designed, developed, implemented or used correctly, technology can create entirely new risks. Doctors have recently become frustrated by what they view as unnecessary and time consuming steps that make their work more difficult while using electronic medical record systems. Systems that are cumbersome to use might invite potentially dangerous “workarounds” by busy doctors. Additionally, computer logic may result in error or harm if incorrectly programmed or if the information is not up-to-date. Countless security lapses have exposed the personal health information of millions of patients. And while most technology undergoes testing before use in clinics or hospitals, this testing is mostly focused on technical features. So why do new risks appear unexpectedly once the system is put to use in the real world? New technologies often clash with people, policies, governance or the “ways things are usually done” in the doctor’s office or hospital. Many risks remain hidden

until after the electronic system goes live and an error occurs because we haven’t designed the technology to account for complexities around people (e.g., providers and personnel who maintain the system), workflow (healthcare processes), and the organization’s policies, procedures, and culture. Even factors external to a doctor’s office or hospital, such as reimbursement and legal issues, quality measurement initiatives, political and cultural factors, accreditation and regulatory requirements, all influence the way technology is ultimately used. Both the technical and non-technical components of our “sociotechnical” health care system must fit together and interact to produce the desired results.

So how do we approach this problem and account for all of these moving parts? New technology itself first needs to be proven safe and functional (for example it shouldn’t ever change kilograms into pounds while prescribing medicines). It then needs to be used safely (for example users are well-trained, able to make full use of all of the features and don’t get overloaded with meaningless information). And finally, new technology needs to do what we intended it to do, i.e. make health care safer and reduce medical errors and quality problems (for example, there are safeguards to catch patients falling through the cracks of the health care system) and ultimately make patients healthier. At each stage, considering the whole sociotechnical system outlined above is essential. Through collaborative research, our group has developed guides on safe use of electronic medical records and related technologies (www.healthit.gov/safer), available for free to doctors and hospitals across the world. However, guides are going to useful only when the entire healthcare system moves towards a culture of continuous learning and improvement. By taking a holistic approach outlined here, we can identify risks before they reach patients and ensure that new technologies help keep patients safer and healthier. 

Hardeep SIngh, MD MPH Chief Health Policy, Quality & Informatics Program Michael E. DeBakey Veterans Affairs Medical Center & Associate Professor, Baylor College of Medicine, Houston

HealthLine Jan - April 2015

It Will Take More Than Just Technology to Fix Health Care

Hardeep Singh is the recipient of Presidential Early Career Award for Scientists and Engineers (From President Obama in April 2014). You can read more about his work here: http://www.houston. hsrd.research.va.gov/bios/singh.asp or follow him on twitter: @HardeepSinghMD

Committed to your health and your family.

St. Luke’s Medical Group– Sugar Land

Jasvinder S. Sidhu, MD, FACP, FACC, FHRS Cardiology & EP

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Is your Portfolio Healthy? Gary Iyer

Morgan Stanley Financial Advisor 2800 Post Oak Blvd. Suite 1800 Houston, TX 77056 Cell: 281-221-8511 Office: 713-965-5078 Gary.iyer@morganstanley.com Jan - April 2015 HealthLine

Johns Hopkins/Jhpiego design aims to reduce infection risks

Additional funding For development of the prototype suit was provided by the BioMaryland Center, the office within Maryland’s Department of Business and Economic Development that connects life sciences companies, academic and federal researchers with each other and with potential capital sources, partners, and clients.

Eb la caregivers Improved suit for

Phil Sneiderman

chosen for funding in federal competition

n advanced protective suit for health care workers who treat Ebola patients, devised by a Johns Hopkins team, is one of the first five awardees in a federal funding contest aimed at quickly devising new tools to combat the deadly disease. The Johns Hopkins prototype is designed to do a better job than current garments in keeping health care workers from coming in contact with Ebola patients’ contagious body fluids, both during treatment and while removing a soiled suit. In addition, it is expected to keep the wearer cooler—an important benefit in hot, humid regions such as

HealthLine Jan - April 2015

West Africa. The first projects selected for the federal funding were announced today by the U.S. Agency for International Development (USAID) through its new program, launched in October, called Fighting Ebola: A Grand Challenge for Development. The improved protective suit is being developed by a team of medical experts, engineers, students, and other volunteers under the supervision of Johns Hopkins University’s Center for Bioengineering Innovation and Design (CBID) and Jhpiego, a nonprofit Johns Hopkins affiliate that focuses on international health programs. The precise amount of funding and other support that the USAID will award to this project is still under review. The agency is clearly pleased with the early results

Johns Hopkins’ improved health care protective suit grew out of a weekend-long design brainstorming event hosted in October by CBID on the university’s Homewood campus in Baltimore. The 65 participants represented a wide range of Johns Hopkins students; medical, public health, and engineering experts; and even a few community volunteers with valuable skills and perspectives, including a wedding gown designer and an architect. The organizers also took advantage of CBID’s close, ongoing partnership with Jhpiego, which has extensive experience in addressing global health challenges. For example, the organization has developed deep expertise in infection prevention and control. The group also has amassed 20 years of field experience, working with health providers and in health facilities in Liberia and Guinea, two Ebolaaffected countries.

powered, dry air source to cool the user by blowing air into the hood. The cooling technology used in the garment was originally developed for cooling patients in cardiac arrest by Johns Hopkins cardiologist Harikrishna Tandri, under the auspices of a NIH SBIR grant.

of its competition, which led to the submission, in just two months, of more than 1,500 ideas from innovators around the world. “The Fighting Ebola Grand Challenge embodies our new model of development—bringing together the world’s brightest minds to solve our biggest global challenges,” USAID Administrator Rajiv Shah said.

With the basic improvements identified, a small group of core of team members, supervised by CBID and Jhpiego, will fine-tune the Doffing with Velcro Wrist Tabs prototype protective suit User sticks down or stands on wrist with a goal of getting tabs, then stands up to doff suit some elements of the design ready for mass production perhaps as early as April.

“If ever there was a public health crisis that merits the finest science, medicine, and innovation the world has to offer, it is this one,” ,” said Leslie Mancuso, Jhpiego president and CEO. “

“The funding from USAID will support moving our concepts into fully functional prototypes,” said Youseph Yazdi, executive director of CBID. “This will allow the team to do more detailed evaluations of our concepts and quickly move to evaluations in the field. By the end of the funded timeline, we will have a product design that is ready to be taken up by a major manufacturer, or several, for large-scale production and distribution. Our goal is to follow the fastest path to get these concepts into the field and having an impact.”

The personal protection suit we are developing with our partners at the Center for Bioengineering Innovation and Design is purposefully designed to address safety and climate issues now putting health workers at risk.”

CBID operates within the Johns Hopkins Department of Biomedical Engineering. The Department is shared by the university’s School of Medicine and its Whiting School of Engineering.

Some of these enhancements inclutde a large, clear visor in the hood, which is integrated into the suit; air vents in the hood; a rear zipper to reduce infection risks while removing the garment; a cocoon-style doffing process that requires far fewer steps than existing garments; and a small battery-

The GE Foundation and Clinvue provided support for the protective suit project. Clinvue, based in Maryland, is a medical device innovation consulting company specializing in identifying and understanding unmet needs and linking these to a creative problem-solving process. 

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Jan - April 2015 HealthLine

Heart

Catheter

Catheter from groin to heart

Cardiac Catheterization Nik Nikam, MD, MHA, DTM

ardiac catheterization is an invasive procedure utilized in diagnosing and treating cardiac illnesses, especially Coronary Artery Disease. It is a simple procedure which can be done at an outpatient setting, using mild Intravenous sedation and local anesthetics. The procedure can be performed from the arm or the groin. In both cases the intent is to get the catheters into the aorta and the main coronary arteries. The patient receives a mild tranquillizer before the procedure. In the Cardiac Catheterization laboratory, we administer mild intravenous sedation. The patient still will be alert to follow doctor’s instructions. The groin or the arm is scrubbed with an antiseptic solution such as Betadine and sterile drapes are placed. The skin is infiltrated with a local anesthetic. The Radial artery in the arm or the Femoral artery in the groin is punctured with a hollow needle. Once the needle is in the artery, a very flexible guide wire is passed in to the artery. Over the guide wire, tiny long and thin (2 to 3 mm) are passed into the artery and advanced into the main aorta.

The procedure is shown performed through the groin. The intent is to get the catheters into the aorta and the main coronary arteries.

There are two coronary arteries, namely the right and the left coronary arties that supply the heart muscle. Selective catheters are placed at the origin of the coronary arteries, and an iodine contrast liquid is injected into these arteries. As the contrast lights up these arteries, a movie is recorded of the arteries filled with contrast. The movie clips can be reviewed in real time to

Nik Nikam MD Cardiologist Texas Medical Center Sugarland, Texas

HealthLine Jan - April 2015

help us determine the location and the extent of the blockages. Based on the findings, we determine if we need to take special views and also determine if the blockage can be opened up with a balloon and stent. If there are no blockages, the catheters are removed and pressure applied in the area. Later, pressure dressing is placed and the patient is returned to the room. If no stent is placed, the patients can go home the same day and follow-up with their physicians. If there is a blockage and is suitable for stent placement, the stent placement can be performed at the same setting. A slightly larger size catheter is introduce and placed in the origin of the coronary artery that shows the blockage. A very think, long, and flexible guide wire is passed in to the branches of the coronary arteries which could vary from 2.5 mm to 4.0 mm. Over this guide-wire a balloon catheter is advanced and the balloon is placed at the site of blockage. The balloon is inflated which compresses the plaque, squeeze the water content and also dilate the artery. The plain balloon is removed and another balloon with a sent mounted on it is advanced to the site of blockage. When the balloon is inflated, the stent plasters to the arterial wall. The balloon is withdrawn. The patients receive a blood thinner during the procedure and are place on long term antiplatelet agents such as Plavix or Effient, to prevent clot formation at the site of the stent placement. Generally, patients spend a day or two in the hospital after a stent placement. placement. 

With more than 30 years experience, he has authored, “Stressless Mind and Pricelesss Body”, “Heart Healthy Lifestyle”, “Ramayan Screeplay”, and “Cruise Crisis Screenplay.” As a Distinguished Toastmaster he has made hundreds of presentations to the physicians and the general public. He has written more than 100 health related articles over the years, which have been published in several newspapers.

The Medical Man

ortuguese American scientist Dr. Ronald A. DePinho, MD, 56, was chosen as the sole finalist to succeed John Mendelsohn as the next president of the MD Anderson Cancer Center, at the University of Texas in Houston.

The son of Portuguese immigrants, Dr. DePinho is a Harvard University cancer geneticist, the director of the Belfer Institute or Applied Cancer Science at the Dana-Farber Cancer Institute in Boston, and a professor of medicine and genetics at Harvard Medical School. Internationally renowned, Dr. DePinho specializes in molecular and biological processes behind the development of cancer, aging and degenerative diseases. He is known for his research on how genes control cancer and for age reversing in mice. Ronald DePinho, MD, internationally recognized for basic and translational research in cancer, aging and ageassociated degenerative disorders, is the fourth full-time president of The University of Texas MD Anderson Cancer Center. His appointment began on Sept. 1, 2011. DePinho’s laboratory has produced an array of discoveries leading to better methods of early cancer detection, improved cancer patient care and developed new cancer drugs. The range of his research includes cancer drug and biomarker development, cancer gene discovery, stem cell biology and development of genetically engineered mouse models to study cancer in humans. DePinho was the first to show that the Myc family of oncogenes (cancer-causing genes) function through common cell signaling pathways to transform “normal” cells into malignant ones. In a series of key experiments, DePinho established the concept of “tumor maintenance” to address the question of whether an original cancer-causing oncogene can remain active in maintaining a tumor despite the accumulation of many alterations in DNA during the malignant transformation process. This concept has contributed to cancer drug development by guiding identification of new therapeutic points of attack, as well as novel biomarkers that measure a patient’s response to a drug during a course of treatment. His research also provided some of the first evidence that the p53 gene can suppress the development of some cancers by stimulating apoptosis, a process by which the majority of cancer cells die naturally. DePinho and Robert Eisenman discovered a co-repressor complex (known as mSin3/HDAC)

that links a transcription factor and chromatin regulation in suppressing cancers. His lab also provided the first genetic evidence that a familial melanoma gene serves as a potent tumor suppressor in melanoma and many other cancer types. With about 78% of all cancers diagnosed in people older than 55, perhaps DePinho’s most notable contributions concern the link between advancing age and increasing risk of cancer. He convincingly established that three factors — telomere dysfunction, an impaired ability of a cell to repair DNA damage and the continued renewal of the epithelial layer of tissue that covers organs — all unite to cause rearrangements in the DNA that drive the genesis of many common cancers. Telomeres are sections of DNA at the ends of chromosomes. Each time a cell divides, telomeres lose a small amount of DNA and become shorter. In cancer cells, however, the telomeres are maintained by activation of a special enzyme, telomerase. Cancer cells usually have more telomerase than most normal cells, which contributes to their immortality and ability to spread. Beyond cancer, DePinho’s work on telomeres has established the role of telomere dysfunction in acquired and inherited degenerative disorders, such as end-stage liver failure. His findings even suggest that there may be a “point of return” in which medicines might help severely aged organs recover a youthful state. DePinho has created many faithful mouse models of human cancer. Most recently, he has developed the first metastatic prostate cancer model in mice, which he has used to identify tumor biomarkers that can stratify men into either high risk or low risk for spread of their disease. Using this approach, his laboratory has discovered prostate cancer markers that predict how lethal a cancer may be, which will better direct the course of therapy for men with this common cancer. In addition to his presidential duties at MD Anderson, DePinho remains an active scientist in his laboratory and in the new Institute for Applied Cancer Science. His lab focuses mainly on basicto-translational research programs for brain, colorectal, pancreas and prostate cancers, as well as aging and neuro-degeneration. 

78 55 %

of all cancers diagnosed

in people older than

yrs

Ronald De Pinho MD His lab focuses mainly on basic-totranslational research programs for brain, colorectal, pancreas and prostate cancers, as well as aging and neuro-degeneration. DePinho is a member of the National Academy of Sciences, the Institute of Medicine, a fellow of the American Academy of Arts and Sciences, and has received numerous other honors and awards including: 1. American Italian Cancer Foundation Prize for Scientific Excellence in Medicine, 2012 2. Albert Szent-Gyorgyi Prize for Progress in Cancer Research, 2009 3. Helsinki Medal, 2007 4. Albert Einstein College of Medicine Distinguished Alumnus Award, 2004 5. American Association for Cancer Research Clowes Memorial Award, 2003 6. American Society for Clinical Investigation Award, 2002

Jan - April 2015 HealthLine

Moon Shots Program Reducing Cancer Mortality By Using Technology Scott Merville

Photographer: Tom Ruen Lunar Eclipse observed October 8 20143

In its first full year of operations, MD Anderson’s Moon Shots Program has launched new approaches to ovarian cancer surgery and melanoma prevention, as well as targeted therapies and drug combinations for leukemia, prostate and lung cancer. And there’s more to come.

n September 2011, when DePinho was named MD Anderson’s fourth president, he proposed the notion of a moon shot moment. “How can we envision what’s possible to reduce cancer mortality if we think boldly, adopt a more goal-oriented mentality, ignore the usual strictures on resources that encumber academic research and use the breakthrough technology available today?” he asked. In operating rooms, clinics, research labs and even the Texas State Capitol in Austin, innovation driven by the MD Anderson program is already impacting cancer treatment and prevention. With a name inspired by President John F. Kennedy’s goal to put a man on the moon by the end of the 1960s, the program was launched two years ago with the goal of saving as many lives as possible, as quickly as possible. In that time, teams of researchers and clinicians have focused on six moon shots targeting eight cancers: acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), chronic lymphocytic leukemia (CLL), melanoma, lung cancer, prostate cancer, and triplenegative breast and ovarian cancers — two cancers linked at the molecular level. Giulio Draetta, MD, Ph.D., a professor in Molecular and Cellular Oncology and co-director of the Moon Shots Program, divides the ideas underpinning the program’s efforts into two themes: “Execution and rocket science.” “This first wave of accomplishments reflects the moon shots’ emphasis on execution,” says Draetta. “It’s a matter of more efficiently applying what we already know about cancer to help our patients.”

Execution

Since receiving initial funding of $1 million each, the six moon shots teams’ accomplishments include: 1. Creation of an MD Anderson algorithm for deciding when ovarian cancer patients should have surgery. This

HealthLine Jan - April 2015

systematic approach has more than doubled the rate of complete surgical removal of patients’ tumors from 25% to more than 80% of the time. 2. Leadership in developing targeted therapies for CLL has cut the use of debilitating chemo combinations from 48% of new patients in 2012 to 15% today.” 3. The first “intent to cure” clinical trial for prostate cancer, based on clinical and scientific research at MD Anderson, aims to convert periodic hormone therapy for a subset of patients into a single-episode curative regimen. 4. Identification by the Lung Cancer Moon Shot’s drug discovery program of two leukemia drugs with potential to treat certain lung cancer patients. A clinical trial of one of those drugs is underway. 5. In an important prevention milestone, the Melanoma Moon Shot provided expert information to the Texas Legislature, which led to a successful effort by a coalition of groups to persuade lawmakers to pass a statewide ban on the use of tanning beds by those under age 18. 6. Two new clinical trials, based on research findings at MD Anderson, aim to overcome resistance to standardof-care therapy for myelodysplastic syndromes. One trial is the first to deploy the rising therapy of immune checkpoint blockade against leukemia.

Rocket science

The second concept of the Moon Shots Program, what Draetta calls “rocket science,” is establishing supportive platforms to provide new or additional expertise and cutting-edge technological resources. “Rocket science enables our clinicians and scientists to make discoveries and clinical advances that really turn the world around,” he says. “Achieving that will require inventions yet to come — it will take a while.” Moon shots research already is benefiting from new “rocket science” innovations in the fields of immunotherapy, genomics, proteomics, prevention and big data — the capacity to systematically compile and analyze massive amounts of information. The program also benefits from MD Anderson’s drug discovery and development platforms, including the Institute for Applied Cancer Science.

Learning from each patient

“A central theme of the Moon Shots Program is to learn as much as we can from every single patient,” says Andy Futreal, Ph.D., the program’s co-leader with Draetta.

3 http://en.wikipedia.org/wiki/Moon#mediaviewer/File:Lunar_eclipse_October_8_2014_California_Alfredo_Garcia_Jr_mideclipse.JPG releases/2012/09/120921082809.htm

To read updates on cancer research and advancements, visit healthlinemagazine.com This article originally appeared in the fall issue of MD Anderson’s Conquest magazine. Dr. Ronald De Pinho working at the Cancer Research lab. Courtesy: MD Anderson Cancer Research Center.

“We need to think longitudinally — how patients’ conditions, treatments and tumors change over time — and be smarter about how we collect and use that information.”“You need to build an engine to learn,” Futreal says. To do this, he leads APOLLO, short for Adaptive Patient-Oriented and Longitudinal Learning and Optimization. The technology-driven program creates a more cohesive system for standardizing long-term collection of patients’ medical history, high-quality tissue and blood samples, and genomic and molecular analyses of those samples. It’s coupled with research data and aggregated in a centralized big data warehouse. The resulting information is available both to clinicians and researchers using advanced analytic tools such as MD Anderson’s Oncology Expert Advisor™ (OEA) powered by IBM Watson — the world’s smartest computer. Under development in the Moon Shots Program, OEA will tap MD Anderson databases and external sources of information such as scientific publications and clinical trial results at unimaginable speeds to deliver treatment recommendations in the clinic. By seamlessly blending patient data with the latest research insights and best practices in clinical care, and analyzing

Scott has covered science and medicine for University of Texas institutions for 17 years, most recently focusing on MD Anderson’s Moon Shots Program. His extensive experience as a newspaper reporter and editor, covering a range of topics from the Roswell Daily Record in New Mexico to the St. Petersburg Times in Florida. He has a bachelor’s degree in journalism and an MBA from New Mexico State University.

it over time, APOLLO will help researchers improve patient care by understanding factors that determine treatment response, resistance, toxicity and survival. APOLLO was piloted in Leukemia this year and is expanding to the Lung and Melanoma moon shots. “The current model is that a scientist forms a hypothesis and writes a protocol to collect biospecimens, which come from tissue that may or may not represent exactly the same point in cancer progression for each patient or speak best to the question being asked. Next, the scientist generates molecular data from these samples, analyzes the data and eventually publishes the results,” Futreal notes. “What we’re talking about here is an effort to standardize the process and expand it to many more patients. This would mean that more traditional, hypothesisdriven investigation is significantly empowered and we move into an era of data-driven hypothesis generation around key clinical questions. “We’re building an engine to accelerate the translational process,” Futreal says. “Every cancer research institution on the planet is struggling with this right now. Raising the quality of our information is going to benefit everyone. “MD Anderson has an opportunity to lead.” 

Scott Merville Program Manager, Communications MD Anderson Cancer Center, University of Texas

Credits: www.mdanderson.org http://portuguese-american-journal.com/dr-depinho-named-president-anderson-cancer-center-people/ www.sciencedaily.com/releases/2012/09/120921082809.htm

Jan - April 2015 HealthLine

A future without Alzheimer’s disease

Alzheimer’s Association Houston & Southeast Texas Chapter

Amanda Duke, Walk Specialist

he race is on. Alzheimer’s and related dementias research is a dynamic field, and momentum builds each year. The Alzheimer’s Association has been involved in every major advancement in Alzheimer’s and related dementias research since the 1980’s and is a leader in the global fight for a world without Alzheimer’s.

These walks have encouraged the growth of 550 new advocates to help promote the Association’s services to Congress and State Legislators which has helped to increase the receipt of more grants toward Alzheimer and Dementia research.

These initiatives are needed in anticipation of the escalating number of individuals who will develop Alzheimer’s disease as the baby boom generation ages and in recognition of the need to make up for lost time. The Alzheimer’s Association Walk to End Alzheimer’s is the world’s largest event to raise awareness and funds for Alzheimer’s care, support and research. Held annually in more than 600 communities nationwide and 13 locations in the Houston and Southeast Texas region, this inspiring event calls on participants of all ages and abilities

HealthLine Jan - April 2015

to reclaim the future for millions. Nationally the Alzheimer’s Association has invested $78 million in 358 projects in 21 different countries. In 2014 alone the Houston and Southeast Texas walks raised over $1.4 million; 75% of every dollar raised is used to further the mission of the Alzheimer’s Association which is to eliminate Alzheimer’s disease through the advancement of research, to provide and enhance care and support for all affected and to reduce the risk of dementia through the promotion of brain health. The walks also resulted in a growth of 550 new advocates to help promote Association services to Congress and State Legislators. Through these efforts over the years we have been able to make our voice heard and have received a number of NIH and other grants as a result. While Alzheimer’s and related dementia diagnosis are growing, the Alzheimer’s Association is working diligently to fund research to find causes and cures. 

Speak up and Speak Out

Affairs Lead Alzheimer’s Association Houston & Southeast Texas Chapter

Christina Holch Healthcare Outreach Manager & Texas

“Advocating on behalf of those with Alzheimer’s disease and other dementias is very important. We need compassionate voices to promote awareness and preparedness to the public. In addition, it is vital that we help educate our legislators on the issues that persons with dementia are facing. After all, our legislators are the ones who determine the future of our research budget, public health programs, and state health services. Medical professionals, of all types, are uniquely qualified to advocate on behalf of persons with dementia due to their first-hand experience with treating individuals with the disease. Neurologists have the subject-matter expertise of recognizing, diagnosis, and treating dementia, whereas Geriatricians and Primary Care Physicians have the unique responsibility of co-managing a patient’s dementia along with their other medical needs and/ or comorbidities. Furthermore, medical professionals that provide rehabilitative therapies, see first-hand the struggle that their patients face on a daily basis. All of these perspectives are important to raising dementia awareness in the state and federal legislature. 

Knowledge is power, and I encourage medical professionals to use their expertise to improve awareness and education about Alzheimer’s Disease and other dementias.”

Best wishes from

Drs. Gauri & Atul Varadhachary

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800-630-7894 | 713-467-7423 | www.houstonhospice.org Jan - April 2015 HealthLine

Ayurveda A 5,000 year old healing system Lakshmi Devi Maliakkal

A “

yurveda”, aptly called ‘Natural Cure’ is primarily a prevention technique that was practiced in India during the ancient times and it gradually evolved into a complete health-care system over many millennia. This system utilizes the goodness of nature and is entirely based on natural herbs, plant extracts and spices.

Those who have undergone Ayurveda procedures have experienced significant relief from conditions like Diabetes, Joint and Muscle pain, Rheumatoid Arthritis, Digestive problems, Frozen Shoulder, skin diseases like Psoriasis, Eczema etc. and a number of Lifestyle problems like stress, headache, depression, sleep disorders etc.

Panchakarma is Ayurveda’s principal purification/ detoxification technique. Panchakarma (five actions) is a cleansing and rejuvenating program for body, mind and consciousness. It is well known for the beneficial effects on overall health and wellness. The name Ayurveda is derived from two Sanskrit words, Ayur meaning Life and Longevity, and Veda meaning Knowledge or Science. In other words Ayurveda means “The Science of Life” that teaches us to live life in a true and natural balance. The ever popular practices of Yoga and Meditation goes hand in hand with Ayurveda. Health is defined as body being clear of toxins, mind at peace, emotions calm and happy, wastes being efficiently eliminated and organs functioning normally.

Lakshmi Devi Maliakkal Chief Ayurvedic Consultant Santhigram Houston © Wojciech Gajda

In this busy, stressful and toxic world, our physical and mental systems accumulate toxins causing bodily functioning deterioration. This eventually weakens our systems, opening the door for chronic & degenerative diseases to develop. Panchakarma can help reverse these negative effects of daily living, thereby restoring your natural state of health and wellness by cleansing your body of toxins, bringing balance into your system and improving bodily function. It can also help you sustain this process by making positive changes in lifestyle.  Credit: Santhigram USA

HealthLine Jan - April 2015

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Jan - April 2015 HealthLine

lder people are rightly afraid of getting dementia. In the US, 40% of people over the age of 80 have Alzheimer’s disease, the most common type of dementia. There are a number of factors that makes one susceptible to this disease. They include advancing age, defective genes, a host of other chronic illnesses including diabetes, hypertension, heart disease and a history of strokes. The microscopic hallmark of this disease is the presence of “amyloid plaques” and “Neurofibrillary tangles” in the brain. Researchers have demonstrated links between cerebral ischemia, inflammation, oxidative stress and the presence of these plaques.

It is commonly portrayed that there is no effective treatment for Alzheimer’s disease. While it is true that there are no effective medications to treat this disease, there are is a lot we can do to prevent the disease, and to halt the progression of and even, to reverse some of the effects of this deadly disease.

Diet: Studies have shown that people who consume a lot of non- fiber carbohydrate have a higher incidence of Alzheimer’s, people on the Mediterranean diet have a low incidence of Alzheimer’s disease. Exercise: Exercise improves blood flow to the brain and induces the production of brain- protective chemicals in the body. Researchers at the Cleveland Clinic found that elderly people with a defective gene that made the susceptible to developing Alzheimer’s disease who exercised regularly had a far fewer incidence of Alzheimer’s disease than people with the same gene who did not exercise. Brain exercises: Cross word puzzles, word games, reading- all these can keep the brain active and prevent cognitive impairment. Supplements: Anti-oxidants including Vitamin E and Vitamin C, Curcumin and DHA (found in fish oil) are all very effective in protecting the brain. Hormones: Researchers at the University of Washington have found that a hormone that releases Growth hormone is effective in reversing Mild Cognitive impairment in the elderly. Estrogen replacement has been shown to improve cognition and memory in women with Alzheimer’s disease. In men, testosterone replacement has been found to be effective in staving off the disease and in those already with the disease, dramatically improved the quality of life. Other hormones including Pregnenolone, DHEA, melatonin and progesterone have all been found effective in reversing the ravages of Alzheimer’s disease.

David Jeyaraj MD Internal Medicine Physician Age Management, Cengenics Institute Las Vegas Age Management Medicine Group

HealthLine Jan - April 2015

David Jeyaraj MD

Dementia

Dr David Jeyaraj has been in practice for 14 years. When he faced a personal health crisis, he at first turned to conventional medicine. He exercised, ate right, took his medications regularly. He transitioned from conventional medicine to full time age management medicine. Contact: 713.271.0705 www.texasami.com

In most cases, a Hospice care center is designed to look almost like a home. This helps the patient and their families with being able to feel at home.

ÂŠ Ocskay Bence - Fotolia

One of the rooms inside a Hospice Care center.

Hospice Services Support the Loving Care of Families

he Asian population in the United States is rapidly growing, making up 3.8 percent of the total population of Texas in 20104. As our population ages, medical professionals are finding that cultural factors influence the decisions of the patients and their families as their illnesses progress. End of life care involves a time of medical, financial, and emotional changes for patients and their families. Patients can be referred to a hospice when they are diagnosed with a terminal condition with a prognosis of 6 months or less. Hospice provides a team-oriented method of addressing not just physical pain, but also spiritual and emotional pain. The cost of hospice care is covered entirely by Medicare and Medicaid for patients with these benefits. For those patients with

Dr. Trinh received her medical degree from Louisiana State University Health Science Center in New Orleans and trained in family medicine at Baylor College of Medicine. Following residency, she completed her geriatric fellowship at Baylor College of Medicine and her palliative medicine fellowship at MD Anderson Cancer Center. She joined Houston Hospice in 2007 and serves as the Education Liaison.

Thuy Hanh Trinh MD

Asians are

3.8

of total Texas

population

private insurance, verifying benefits with the insurance company is important prior to signing on. The hospice team can provide services wherever the patient lives, whether that is in a home, an assisted living facility, or a nursing home. In the case that the patient has uncontrolled symptoms of pain, nausea, shortness of breath, or restlessness, hospice has inpatient facilities which may provide a higher level of care. Having a hospice team to address their concerns and a 24-hour hospice nurse to call can provide families with the peace of mind that they are not alone, even in their most trying times. The hospice team can follow patients and families on their journey through illness; from the time their active treatments are no longer beneficial, to comforting moments enriched by hospiceâ&#x20AC;&#x2122;s supportive care when patients can be among their loved ones. For more information about hospice comfort care, visit the Texas Nonprofit Hospice Association at www.tnpha.org ď&#x201A;§ U.S. Bureau of the Census. http://www.census.gov/popest/counties/asrh/. Accessed 2/22/2015

Thuy Hanh Trinh MD, MBA, FAAFP, FAAHPM, WCC Associate Medical Director Houston Hospice, Houston

Jan - April 2015 HealthLine

SAHNA

South Asian Health Needs Assessment report released Shobana Muratee

From left to right: Panelsits: Dr. Hardeep Singh, Dr. Deborah Banerjee, Dr. Lewis Foxhall, Dr. Beverly Gor, and Dr. Mala Pande

he findings of the SAHNA (South Asian Health Needs Assessment) survey initiated by the Indian American Cancer Network (IACAN) in collaboration with MD Anderson Cancer Center were formally released on February 22, 2015 by the Honorable Consul General of India, Houston, Parvathaneni Harish marking a significant milestone, both for IACAN and MD Anderson Cancer Center.

The project’s goal was to collect self-reported health data from at least 1500 Asian Indians 18 years and older living in Harris, Fort Bend, Brazoria and Galveston counties using a survey

that had been tailored to the local Asian Indian community and provided in English and Hindi. To enhance participation by a diverse group of individuals, only one member per household was allowed to complete the survey. Texas has the third largest Asian American (AA) population in the United States, with approximately 969,500 individuals classified as Asian Americans. (Ref: Census 2010. Summary File QT-P8. Race Reporting for Asian Population by Selected Categories: Texas). Asian Indians are the second largest Asian American population in Texas, increasing by 90% from 2000 to 2010 (from 129,365 to 245,981), and the second largest in the Houston area (the three largest Asian groups in the Houston area are Vietnamese, Asian Indian, and Chinese) (Ref: Census 2010. B02006. American Community Survey, 1 year estimates. Asian Alone by Selected Categories: Texas). The rapid growth of the Asian Indian community and lack of health related statistics for Asian Indians in the general US population often resulting in ‘under-reporting or ‘poorly understood’ were among the primary reasons for the SAHNA survey. “A study of this magnitude on health-needs of Indian Americans has not been done anywhere in the US, as far as we know,” Kanchan Kabad, President, IACAN said on the day of presentation. “The results from the SAHNA study will ultimately be useful in developing culturally appropriate educational and intervention programs to reduce cancer and chronic disease risk in our community.” Dr. Beverly Gor, EdD, RD, LD, Staff Analyst, Office

HealthLine Jan - April 2015

Source: SAHNA Report

of Planning, Evaluation and Research for Effectiveness, Department of Health and Human Services, City of Houston, presented the SAHNA findings and later took questions on the Report from the audience. Based on the self- reported data, Asian Indians displayed some serious health disparities. Approximately 21% of the male respondents had diabetes, as compared to 11% of females. Forty percent of the males (as compared to 22% of females reported that they had high cholesterol and 34% of males (compared to 18% of females) said they had high blood pressure. An interesting finding was that there was no significant difference in percentages of these conditions for vegetarians and non-vegetarians. (Chart on ‘Medical Conditions by Gender and Dietary Pattern’). The results also indicated that approximately 38% of the SAHNA participants reported no physical activity that increased breathing rate (or moderate physical activity) in the last week. Fifty-two percent of men and 44% of women were in the overweight/obese category for body mass index. The survey results also showed that the average intake of fruits and vegetables per day was 2.5 servings, half of the recommended 5 servings a day as advised by the Centers for Disease Control. (Chart Physical Activity Chart). As lack of physical activity and obesity/overweight are major risk factors for diabetes, high blood pressure, and several forms of cancer, it was recommended that culturally relevant nutrition and physical activity programs should be developed to address

Hon. Consul General Mr. P. Harish officially releasing SAHNA report with with Kanchan Kabad, IACAN President and Dr. V. K. Dorai, IACAN Director on Feb. 22, 2015 at the India House.

this disparity. In addition, SAHNA participants appeared to lack knowledge of cancer and sources for cancer information. Based on the findings it was recommended that IACAN and other organizations should continue to provide educational forums for disseminating reliable and scientifically sound information about cancer and other chronic diseases. Speaker and panelist, Dr. Hardeep Singh, MD MPH, Houston VA and Baylor College of Medicine gave three ‘Take Home Messages for Our Community.” Do away with the Illusion of the weighing scale and Let’s Get Moving on Lifestyle, to get more Knowledge of cancer risk/resources, he says “Let’s Engage More in Health Conversations” and lastly “Let’s Be More Proactive in Our Health Care,” by encouraging participation in cancer screening. 

Source: SAHNA Report

Details on SAHNA are available on the IACAN website www.iacannetwork.org

Shobana Muratee holds a Masters in Journalism. She is the Editor-in-Chief of Voice of Asia and Voiceofasiaonline. com. Over 25 years, she has authored hundreds of articles both technical and non-technical. She serves on board of Indian American non-profit organizations and is a recipient of professional and community awards. She is based in Houston and can be reached at voiceasia@aol.com

Shobana Muratee Editor-in-Chief Voice of Asia

Jan - April 2015 HealthLine

Mindfulness

A few Minutes of Mindfulness and Flow States

Shobhit Keswani

any of you may be familiar with “flow states”. Athletes and musicians often refer to it as “getting in the zone”. A flow state is a mental state of immense focus on the task at hand, along with a sudden stream of intense contentment and happiness. How do we then, hack into flow? It doesn’t really matter whether you are a business executive, a professional worker, an artist, educator, musician, athlete, or even just a student. These so called “flow states” are available to anyone who is interested in improving focus, and efficiency for a particular task or activity you desire. Mindfulness can induce these flow states. Mindfulness is being used by a lot of the nation’s top medical centers and research facilities to improve the quality of mental health. Medical journals have shown promising results in using mindfulness to treat various conditions such as depression,

anxiety, and even just generalized stress. Stress is becoming as much a part of our daily lives as a cup of coffee or tea. A simple exercise that takes just a few minutes can change this. The concept here is spatial awareness. Our ability to live in the present with a heightened sense of awareness comes along as soon as we shift our focus to breathing. Take a few minutes out of your busy life, find yourself a comfortable spot, relax and imagine your body releasing all the tension in your muscles. Don’t force a slow breath; just allow it to happen naturally. As you allow gravity to settle you in the chair, notice your breath during inhalation and exhalation. Gradually you can start noticing an entire breath. You can then increase your awareness step by step. For instance, after you can notice the duration of an entire breath (inspiration and expiration of air), notice how your belly moves with this rhythmic pattern. The beauty of this exercise is that it helps you to acknowledge where your body feels discomfort, if it does exist at that moment. This exercise can last as long as you wish for it to last. The goal is to temporarily calm down the chatter going on in your mind. I encourage you to use this technique and discover your optimal flow state. The origin and history of meditation or mindfulness is hard to pin down to just a certain country or region. While most of us know it to belong to India, different forms also exist in Abrahamic religions, which is contrary to popular belief. Buddhism and East Asia along with India have heavily contributed to the modern surge and trend behind mindfulness that seems to be picking up in the west. Fortunately for us, neuroscientists have starting quantifying it and have proven its vast range of benefits to mental health and an overall state of happiness. Mindfulness is linked to certain religions, but not limited to only those. To save us from discrepancies it is safe to say we now have a modern and scientific origin as well that can be accepted by many of us irrespective of our belief systems. 

Shobhit Keswani Medical Student Ross University of Medicine, Dominica

HealthLine Jan - April 2015

Shobhit Keswani did his undergraduate training in biochemistry. He led several small meditation groups while in college and enjoys writing and reading to keep up with the latest research on mindfulness. Keswani comes from a family in Nagpur, India and is based in Houston, TX.

Dr. Sheela Keswani

n alternative treatment to prevent Most migraine patients opt for and cure migraine may be a traditional over-the-counter long term and successful option. pain-relievers and prescription Alternative treatments include having a medications, many people are controlled diet, exercise, yoga, herbs, etc. Migraine headaches are caused by excessive turning to more natural therapies dilation of the cerebral blood vessels, though such as relaxation techniques and scientists do not fully understand what herbal remedies. causes the dilation in the first place. Blood vessels don’t just dilate spontaneously—they Some of the factors that could cause a migraine are an uncontrolled or irregular diet. Also the medication are presumably responding to chemical a person intakes, the amount and quality of sleep and changes that are occurring in the body. A controlled diet can help in reducing the intensity of migraines attacks while exercise and yoga can reduce the intensity of those attacks as well. A trial was done on 72 patients with migraine in which they were randomly assigned to yoga therapy or selfcare groups for 3 months. The subjects’ complaints related to headache intensity were significantly lower in the yoga group compared to the self-care group. Even with numerous drugs, lifestyle techniques, and surgical options available to treat and prevent the onset of a migraine, it is estimated that every 10 seconds, someone in the United States goes to the emergency room with a migraine or headache due to the excruciating pain, severe nausea vomiting with blood pressure and dehydration, drug interactions, or side effects from headache where the research show that a sleep quality becomes a key contributor to the severity of migraine.

exercise one gets, may trigger a migraine. Migraine is invisible disease in which no definitive reason can be identified immediately. The alternative medicine also called as complementary and alternative medicine (CAM), is becoming a boon for migraine patients and includes a variety of interventions—from exercise and dietary supplements to stress management strategies, biofeedback, and acupuncture. These therapies which come from many different disciplines and traditions are generally considered to be outside the realm of conventional medicine. When used in combination with conventional medicine, they are referred to as “complementary.” When used instead of conventional medicine; they are referred to as “alternative.” Eastern countries have a longstanding tradition of teaching alternative medicine. But until recently, most Western hospitals didn’t provide any alternative treatments and Western medical schools didn’t teach them. In fact, herbal remedies and meditation, as well as dozens of other treatments, fall under CAM. Although there is no strict definition of alternative medicine, it generally includes any healing practices that are not part of mainstream medicine — that means any practice that is not widely taught in medical schools or frequently used by doctors or in hospitals. Despite the lack of recognition of CAM in the US, a huge number of hospitals, clinics and individuals are beginning to acknowledge the profound benefits of using these natural methods of treatment, rather than allopathic medicine. Common disorders like migraines cannot be permanently cured, but they can definitely be improved upon, depending on the approach the patient takes to heal oneself. 

Alternative Medicine

Health and Healing of Migraines

Dr. Sheela Keswani AMP Alternative Medical Practitioner | Speaker | Trainer

Jan - April 2015 HealthLine

Kansa Vataki Padabhyanga [Treating] the Soles of your feet

Pratibha Masand Sachdev

n important goal in Ayurveda, an ancient form of health system that is still prevalent, is to identify a person’s ideal state of balance, determine where they are out of balance, and offer suggestions and interventions using various techniques and therapies to reestablish that balance. The fact that these therapies have lasted for so long and survived the test of time tells us that they are an efficacious mode of bringing our mind, body and spirit into balance. One such health supporting foot therapy is Kansa Vataki Padabhyanga.

According to Ayurveda, many Marma or energy points for body’s vital organs and sense organs are located in the soles of the feet. Gently manipulating these marma points with warm oil and Kansa Vataki or a specific three metal bowl relaxes the body and promotes good health. As with any other therapy certain contraindications do apply. It is recommended that if you are pregnant, lactating or menstruating; kindly consult with your healthcare provider before trying any new therapy. Kansa Vataki begins with a Padaprakshalana ceremony in which the feet are gently and caringly bathed in warm herbal infused Himalayan salt foot bath.

A gentle warm oil massage of Talahridaya and Kshipra, ayurvedic vital energy points is followed with a cleansing Ubtan, a blend of flour, herbs, and rose petals. This simple therapy invigorates and renews the entire body, leaving one feeling balanced from head to toe, refreshed, clearer and calmer; invoking a deep sense of relaxation and peace. 

Pratibha Masand Sachdev Certified Holistic Health Coach, AADP Author, Educator and Workshop Facilitator Ayurveda, Yoga, EFT, Reiki, and Reflexology

HealthLine Jan - April 2015

This is done after thoroughly evaluating the constitution or Dosha through a written quiz, manual inspection and after discussing the contraindications with the person taking foot therapy.

A licensed Aesthetician with over eighteen years of experience, she holds prestigious CIDESCO diploma in Advanced Skincare from Zurich, Switzerland. In her book ‘Let It Glow! 108 Recipes for Radiance’, she shares various such therapies, skincare and food recipes in detail. www.letitglow108.com

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Jan - April 2015 HealthLine

Women with Breast Cancer

Sabina George MD

Management of Gynecological Issues in

Breast cancer is the most common type of invasive cancer in women, whose lifetime risk of the disease is one in eight.

All types of breast cancer treatment have potential deleterious effects on women as well as how they view themselves. Fertility, contraceptive management, menopause, sexual function and osteoporosis are some of the most common health issues affected by breast cancer. Treatments involve surgery, radiation therapy, chemotherapy and hormonal therapies. Menopausal symptoms are common in patients with breast cancer either as a result of temporary or permanent anovulation, ovarian suppression from chemotherapy or as an adverse effect from hormonal therapies such as tamoxifen.

One of the most bothersome adverse effects is hot flushes, occurring in one-half of women taking tamoxifen. In general, the gynecologic adverse effects cause by aromatase inhibitors such as letrozole are less than those caused with tamoxifen. The one adverse effect that is more commonly reported among aromatase inhibitor users compared with women taking tamoxifen is vaginal dryness. Treatment for hot flushes include pharmacologic agents. A variety of low doseantidepressant or gabapentin can be used to manage vasomotor symptoms. Due to increased genetic testing more genetically linked cancers are being detected, although they account for only approximately 10%

Sabina George MD Obstetrics and Gynecological Surgery Center for Women’s Health

HealthLine Jan - April 2015

of overall cancers. Some high risk patients undergoing breast cancer surgery may need, or choose to, have gynecological surgery including taking out both ovaries, tubes and uterus, to decrease the risk of other types of cancers. Carriers of the BRCA gene have a hereditary predisposition for not only breast cancer but ovarian cancer as well. Because of the lack of effective screening risk-reducing bilateral salpingo-oophorectomy (removing ovaries and tubes) is typically recommended by age 40 or when child-bearing is complete. The following is a list of issues that could arise during breast cancer treatment that you may want to discuss with your gynecologist: Osteoporosis -Bisphosphonates and raloxifene for osteoporosis prevention and treatment Vasomotor symptoms -Selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), gabapentin, and clonidine Vaginal atrophy non-hormonal treatements

Born in Chicago, Illinois and grew up in Houston Texas. She did her residency in Brooklyn, NY and resided on the east coast for the last 9 years. She practices obstetrics and gynecological surgery at Center for Women’s Health’s four office locations in southwest Houston. She can be reached at 281-342-6962 for private consultation or appointment.

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Old Dr. Carver still made house calls. One afternoon he was called to the Tuttle house. Mrs. Tuttle was in terrible pain. The doctor came out of the bedroom a minute after he’d gone in and asked Mr. Tuttle, “Do you have a hammer?” A puzzled Mr. Tuttle went to the garage, and returned with a hammer. The doctor thanked him and went back into the bedroom. A moment later, he came out and asked, “Do you have a chisel?” Mr. Tuttle complied with the request. In the next ten minutes, Dr. Carver asked for and received a pair of pliers a screwdriver and a hacksaw. The last request got to Mr. Tuttle. He asked, “What are you doing to my wife?”“Not a thing,” replied old doc Carver. “I can’t get my instrument bag open.”

In a car garage, where a famous heart surgeon was waiting for the service manager to take a look at his Mercedes, there was a loud mouthed mechanic who was removing the cylinder heads from the motor of a car. He saw the surgeon waiting and lured him into an argument. He asked the doc after straightening up and wiping his hands on a rag, “Look at this car i’m working on. I also open hearts, take valves out, grind them, put in new parts, and when I finish this baby will purr like a kitten. So how come you get the big bucks, when you and I are doing basically the same work?” The surgeon very calmly leaned over and whispered to the loudmouth mechanic, “Try doing it with the engine running.” Source: medindia.net

Jan - April 2015 HealthLine

Cancer Prevention Understanding Important Facts

Savitri K Iyer, MD MD Anderson Cancer Center

ÂŠ 831days - Fotolia

ancer prevention entails important actions that can be taken to lower the risk of getting cancer. Many factors including alterations in genes, our lifestyles and environment around us can increase or decrease our risk for developing cancer. Recognition of the following established facts will help gain an understanding on how to prevent or minimize the risk of developing cancer.

Factors that may affect the risk of developing cancer

Alcohol: Increased consumption of alcohol can increase the risk for developing several cancers. Drinking in moderation or avoiding alcohol consumption can significantly lower the risk.

Physical Activity and Exercise: Obesity is clearly linked to development of cancers of breast, uterus, colon, kidney and pancreas. Maintaining a healthy lifestyle built with physical activity and exercise are important to lower the risk for developing cancer.

Environmental Risk Factors: Air pollution, exposure to second hand tobacco smoke and asbestos dust has been linked to the development of lung cancers. Drinking water with increased levels of Arsenic has been associated with cancers of skin, lung and bladder.

Avoid/control factors that are known to increase the risk Cigarette Smoking and Tobacco Use: Tobacco use is strongly associated to increasing the risk for development of many cancers particularly lung cancer. Not smoking or quitting smoking lowers the risk of getting cancer. Infection: Certain viruses and bacteria can cause cancers which occur more often in developing countries than in developed countries. Vaccinations are

available to protect against Hepatitis B infection which increases the risk for developing liver cancer and for human papilloma virus (HPV) which causes cervical cancer. HIV and HPV infection which can increase the risk for developing several cancers. Getting immunized against Hepatitis B and HPV and avoiding risky behavior can lower the risk. Too Much Sunlight & Radiation

Exposure: Exposure to ultraviolet radiation from sunlight causes skin cancers. Ionizing radiation such as exposure to X-rays, CT scans, fluoroscopy, nuclear medicine scans can also increase risk for developing several cancers. Avoid direct sunlight, stay in the shade and protect yourself by using sunglasses, hats, sunscreen and covering as much of the skin to avoid too much direct exposure to sun.

Factors that help reduce the risk of developing cancer : Diet: Studies have shown that consumption of fruits and non-starchy vegetables can protect against cancer. Meals rich in fat, protein and meat can

increase the risk for developing colon cancer. Adhering to a healthy diet rich in fresh fruits and vegetables while limiting consumption of red meat and animal fat can lower the risk for developing cancer. Savitri K Iyer MD Cancer Screening: Routine screening for several cancers such as cervix, Professor Department of breast, prostate, colon, and Pathology, MD Anderson skin are available that can Vice-Chair Institutional facilitate the early detection Review Board (IRB) of pre-cancerous lesions that can be effectively

HealthLine Jan - April 2015

treated. Routine physical examination and consultation with your doctor can be helpful for early detection of lesions that can progress to cancer. Chemo-prevention: Medicines are available that can prevent the development of certain cancers. (Consultation with your doctor regarding chemo-prevention may be necessary.) ď&#x201A;§ The information in this article is not intended to replace a one-on-one relationship with a qualified health care professional. Dr. Iyer always encourages you to do your own due diligence with a qualified health care professional.

Recent trends in diabetic research

Bitter melon (Karela) as a promising anti-diabetic plant source Prof. Meenakshi Bhattacharjee Rice University, Houston, TX

Bitter gourd has been used to treat diabetes in traditional medicine and is now commercially available as tea (from fruits or leaves), juice, extracts, and pills. In recent years researchers worldwide have started to focus on the antidiabetic effects of bitter melon/gourd. Diabetes mellitus is among the most common disorder in developed and developing countries, and the disease is increasing rapidly in most parts of the world. It has been estimated that up to one-third of patients with diabetes mellitus use some form of complementary and alternative medicine. One plant that has received the most attention for its anti-diabetic properties is bitter melon, Momordica charantia (M. charantia), commonly referred to as bitter melon/gourd, Karela and balsam pear. Abundant pre-clinical studies have documented in the anti-diabetic and hypoglycaemic effects of bitter melon through various postulated mechanisms.

Nutrient profile

Bitter melon is a powerful nutrient-dense plant composed of a complex array of beneficial compounds. These include bioactive chemicals, vitamins, minerals and antioxidants which all contribute to its remarkable versatility in treating a wide range of illnesses. The fruits contain high amounts of vitamin C, vitamin A, vitamin E, vitamins B1, B2 and B3, as well as vitamin B9 (folate). The caloric values for leaf, fruit and seed were 213.26, 241.66 and 176.61 Kcal/100 g respectively. The fruit is also rich in minerals including potassium, calcium, zinc, magnesium, phosphorus and iron, and is a good source of dietary fiber. Medicinal value of bitter melon has been attributed to its high antioxidant properties due in part to phenols, flavonoids, isoflavones, terpenes, anthroquinones, and glucosinolates, all of which confer a bitter taste.

Bitter gourd is a popular vegetable in some Asian countries, and the health benefits of the plant are well-known.

ÂŠ Francisco Manuel Blanco (O.S.A.) - Flora de Filipinas

omordica charantia, known as bitter melon, bitter gourd, bitter squash or balsam-pear in English, has many other local names. Goya from Okinawan and Karela from Sanskrit are also used by Englishlanguage speakers. It is a tropical and subtropical vine of the family Cucurbitaceae, widely grown in Asia, Africa, and the Caribbean for its edible fruit, which is extremely bitter. Its many varieties differ substantially in the shape and bitterness of the fruit. Bitter melon originated on the Indian subcontinent, and was introduced into China in the 14th century.

Bioactive compounds

Based on the multitude of medical conditions that bitter melon can treat, scientists are more and more interested in studying its bioactive compounds and their actions on the body. However, as many studies report, there has been substantial emphasis on the anti-diabetic compounds and their hypoglycemic properties. A number of reported clinical studies have shown that bitter melon extract from the fruit, seeds, and leaves contain several bioactive compounds that have hypoglycemic activity in both diabetic animals and humans.The major compounds that have been isolated from bitter melon and identified as hypoglycemic agents include charantin, polypeptide-p and vicine.

Possible modes of action of bitter melon and its extract Bitter melon and its various extracts and components are believed to exert their hypoglycemic effects via different physiological, pharmacological and biochemical modes. The possible modes of the hypoglycemic actions of bitter melon and its various extracts and compounds are its hypoglycemic effect, stimulation of peripheral and skeletal muscle glucose utilization, inhibition of intestinal glucose uptake, inhibition of adipocyte differentiation, suppression of key gluconeogenic enzymes, stimulation of key enzyme of HMP pathway, and preservation of islet Î˛ cells and their functions. Today, over 140 different studies worldwide have investigated antihyperglycemic and hypoglycemic effects of the different extracts and ingredients of bitter melon in both human and animal models. Jan - April 2015 HealthLine

Animal studies on Bitter melon

Various animal studies have repeatedly shown hypoglycemic effects of the seeds, fruit pulp, leaves and whole plant of bitter melon in normal animals. In particular, bitter melon improves glucose tolerance and suppresses postprandial hyperglycemia in rats, and bitter melon extract can enhance insulin sensitivity and lipolysis. The alcoholic extract of bitter melon was quite effective in lowering blood sugar levels and islet histopathology also showed improvement. The lowered blood sugar and improvement in islet histology remained as such even after discontinuation of extract feeding for 15 days.

Bitter melon extract can also be used as a broadspectrum antibacterial agent to fight off infections caused by a number of bacteria.In addition, the plant possesses anti-helmintic properties, which are effective in the treatment of malaria. Traditionally, bitter melon has also been used as an abortifacient agent used to induce abortions. Therefore, pregnant women are advised to avoid consumption of the plant. The extract of the seed also have antispermatogenic effect.

Other medicinal properties of Bitter Melon Bitter melon is traditionally known for its medicinal properties such as antidiabetic, anticancer, anti-inflammation, antivirus, and cholesterol lowering effects. It contains many phenolic compounds that may have the potential as antioxidant and anti -mutagen. The fruit, stems, leaves and roots of bitter melon have all been used in traditional medicine to help treat ailments such as hyperlipidemia, digestive disorders, microbial infections and menstrual problems. Bitter melon has been shown to possess powerful antiviral properties that can stimulate the immune system and activate the body’s natural killer cells to help fight off viruses such as white spot syndrome virus and human immunodeficiency virus. Studies have also shown that bitter melon has anti-carcinogenic properties and can be used as a cytotoxic agent against many types of cancer. It has been shown that the extract of bitter melon modulates signal transduction pathways for inhibition of breast cancer cell growth and can be used as a dietary supplement for prevention of breast cancer.

Prof. Meenakshi Bhattacharjee Faculty Fellow and Executive Director (CAAR),Biosciences @Rice

HealthLine Jan - April 2015

Clinical studies of bitter melon

More than 1000 herbal products have been used by diverse cultures of the world to treat hyperglycemia and among them bitter melon is one of the most popular herbal resources. An earlier study on the development of diabetic cataracts demonstrated that blood sugar level-dependent cataract formation was slowed down by the consumption of bitter gourd fruit extract in association with better glucose homeostasis. Today, processed bitter gourd in the form of capsules or tablets is commonly advertised and sold. The products are marketed under the brand names Gourdin, Karela, and Glucobetic in Canada, India, the United Kingdom, the United States, and many Asian countries. Products can also be ordered online.

Sub-continental bitter melon variety

Caution

Excessive consumption of bitter gourd, bitter gourd juice, or other bitter gourd products can lead to dangerous hypoglycemia when consumed by diabetic patients under oral drug treatment, in too high dosages, by children, or on a hungry stomach. Pregnant or breastfeeding woman should not consume bitter gourd or bitter gourd products. Although bitter gourd can help prevent insulin resistance or severe diabetic complications, it is important to consider situations in which bitter gourd may be harmful to your health. Consult your Doctor before using bitter melon products as a medicine.

Consumption Tips

Choose unripe bitter melons that are firm, like how you would a cucumber. Avoid those that have turned orange or have soft spots. Ripe bitter melons can be excessively bitter. Store bitter melons in the vegetable bin in the refrigerator which has the right temperature. It should keep for three to four days. Clean your bitter melon under cold running water and brush with a soft vegetable brush. To prepare, slice the melon length-wise and scoop out the seeds. To lessen the bitter flavor, soak it in salt water for about half an hour before juicing/cooking. The smaller variety is more bitter than the bigger one. To help make bitter gourd juice more palatable, take it with honey, or add carrot or apple juice. For diabetics, drink the juice with green apple juice. 

An internationally renowned Biotechnologist and Cyanobacteriologist, Prof. Meenakshi Bhattacharjee is the recipient of several International and National awards for her cutting edge research on Algal and Environmental Biotechnology, Has more than 200 publications in her field of work and featured in the 12th position in the Book “Lilawatis Daughters” a compilation of the biographies of top100 women scientists in India by the Indian Academy of Sciences Bangalore. Before coming to the US she was Professor and Head, Department of Biosciences at a reputed University in India.

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