Healthline May - August 2015 by HealthLine

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Vol: 1 Issue 2 healthline MAY-AUG 2015

A Voice of Asia publication

Women’s

Special Menopause

Hot Flashes Dealing with Menopause

Gynecology

Alternatives to Hysterectomy

Breast Cancer Early start in breast cancer awareness goes a long way in its prevention

Sumita Chowdhury

MD mph facc mbA

Cardiologist

One Woman Dies Every Minute From Heart Disease Next Issue Senior’s Health

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healthline May-Aug 2015

A Voice of Asia publication

Publisher Koshy Thomas Editor-in-Chief Shobana Muratee Marketing Manager Jacob David Marketing Susan Pothanikat Accounts Manager Priyan Mathew Administration AR Vadlamani Digital Coordinator Harsha Mary Pradeep Cover Design and Magazine Layout Ashita Murgai Graphic Design Cover Photo Daniel Angulo Cover Image credits in order of appearance Fotolia: nenetus • Inna Vlasova • © 2015 Joana Lopes, All rights reserved Printed at Richmond Printing LLC Our Contributors Accamma Kallel, RN, MSM, CCRN, ANP-C

HEALTHLINE EDITORIAL

ear Reader,

Women’s health issues were among the top priorities when we planned for HealthLine and we are glad to bring you the many aspects - some known, some obscured - that border women’s wellness. It was hard to filter topics as they all seemed relevant, so we will continue covering more topics on women’s health in our future issues as well. Our January issue was well received and we got great reviews for its style and content. We also received very valuable feedback from our readers, so thank you. Initially, we had planned for three issues a year but for 2016, we will be making it a quarterly due to a wealth of material which we have collected from professionals and can’t wait to share with our readers. It seems like we have just scratched the surface and hit a jackpot in health information.

Akbar H. Jafferally DMD Alexandria S. Williams Anna Maria Storniolo, MD Bharat Pothuri, MD Beverly J Gor, EdD, RD, LD Hussain Ali, CEO, DSCE, DSDE, ISF-C, CCNA, OCP Julie Nangia, MD P. Kartik, BNYS Meenakshi Bhattacharjee, PhD Neda Nosrati, MD Lakshmi Devi Maliakkal Sabina K. Cherian, MD Subodh Chauhan, MD

HealthLine has been a wonderful learning experience for us in the matters of health care, especially preventive care, which is being emphasized at every event. Health fairs are on the rise, spreading through communities providing free or subsidized services. It is incredible to witness how they are able to bring the most intricate tests, screening and even experts to attendees through these fairs. Have you taken advantage of these fairs? There are limitless options to acquire knowledge on health; we like to believe we are one of them. Thank you again for supporting our mission.

Sumita Chowdhury, MD, MPH, FACC, MBA

Shobana Muratee

Tina Pariani, MD

Editor-in-Chief

Thuy Hanh Trinh MD, MBA, FAAFP, FAAHPM, WCC Vishalakshmi Batchu, 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.

Contents 16 One woman Dies

04 Cardiovascular 20 Assessing Disease Prevention and Decreasing Heart attacks in women don’t always feel the same as in men

Your Risk for Developing Breast Cancer

Pregnancy

Over five million Americans living with Alzheimer’s

06 Dental Treatment during Safe and Effective

Every Minute From Heart Disease

18 Breast Cancer Awareness Early start in awareness goes a long way in its prevention

08 Women’s Health and Skin Issues 10 Nature Cure Introduction to basics, role in prevention and management of disease

12 Colon Cancer In Women

21 Alternatives to Hysterectomy

Lesser Known Facts

23 Hot Flashes

A Common Concern In Aging Women

Multiple factors need to be taken into account

14 Digital Signage Use Increasing in Healthcare 15 Osteoporotic Fractures

24 Ayurvedic Approach to Menopause

Balancing Tridoshas

26 Houston Women Donate to the Unique Breast Tissue Bank

27 Polycystic Ovarian Disease (PCOS) 28 Acupuncture and Women’s Health 29 Healthy Eating for Diabetics 30 Anemia Cure in Women Home Remedies

Dealing with Menopause

22 Our Brains Matter!

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HealthLine May - Aug 2015

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Cardiovascular Disease Prevention Heart attacks in women donâ&#x20AC;&#x2122;t always feel the same as in men

Accamma Kallel RN, MSM, CCRN, ANP-C

omen in the U.S. have made big advances in every field. Women are strong, smart, they solve problems. Studies have shown that women are better than men at multitasking. However cardiovascular disease (CVD) is a major healthcare issue for women in the United States.

Most women today, including mothers, are in the work force. Stress levels in women have skyrocketed both at home and the workplace, increasing the risk of heart disease. The prevalence of heart disease varies among ethnic groups. Immigrants from India (South Asia) have four times greater risk of developing heart disease than other Americans. Indians are more likely to develop premature heart disease, have heart attacks at an earlier age and develop diffuse disease due to a genetic predisposition and a multitude of lifestyle risk factors. This includes both vegetarians and non-vegetarians. Reports also reveal that the heart disease rates among South Asian women are as high as or higher than South Asian men. More than one in three women in U.S. have some form of CVD, including hypertension, heart disease, stroke, peripheral artery disease and diseases of the veins. CVD is the number one cause of death in all U.S. women. The majority of these deaths are attributed to coronary heart disease (CHD), and more than 60% of women who died suddenly of CHD had no previous symptoms. Each year, 1 in 3 women die of heart disease and stroke. But we can change that because 80 percent of cardiac events can be prevented.

Older women are at higher risk for CVD than younger women are; however, intervention at an early age can make a positive impact on disease prevention. High blood pressure, migraine with aura, atrial fibrillation, diabetes, depression and emotional stress are stroke risk factors that tend to be stronger or more common in women than in men. 4

HealthLine May - Aug 2015

Cardiovascular disease is the number one killer of women in the United States, but a woman’s risk can be decreased with preventative measures. Indian women are more prone to have abdominal obesity, diabetes, sedentary lifestyles and diets high in fat and starches which can increase the risk of developing heart disease. Even though Indians have a strong genetic risk for heart disease they can lower their risk by making healthy lifestyle changes. A heart attack strikes someone about every 34 seconds. A heart attack occurs when the blood flow that brings oxygen to the heart muscle is severely reduced or cut off completely. This happens because the arteries that supply the heart with blood can slowly narrow from a buildup of fat, cholesterol and other substances (plaque).

8. Limit salt intake, avoid salty snacks like chips, pickles, canned foods and processed meat. 9. Lose Weight (lose abdominal fat, waist circumference goal women <32 inches). 10. Lifestyle modifications such as a low-fat, low salt, low carbohydrate diet, regular exercise, yoga, meditation, avoiding stress, laughing, being positive could prevent heart attacks. Women who are knowledgeable about their risk factors are more likely to follow recommended lifestyle behaviors and therapeutic regimen for prevention. Nurses and Nurse Practitioners are blessed with opportunities to educate women about CVD risks at work place, at local communities and in larger societies. Educate yourself and your family on CVD prevention and make life style changes to prevent heart attack and stroke.

When a heart attack strikes, it doesn’t always feel the same in women as it does in men. But a woman doesn’t always experience the familiar symptoms of heart attack. She needs to look out for non-typical symptoms. She may experience shortness of breath, pressure or pain in the lower chest or upper abdomen, dizziness, lightheadedness or fainting, sweating, nausea, vomiting, upper back pressure or extreme fatigue. If you feel heart attack symptoms Please call 911. Chewing an aspirin is also helpful. Get medical attention immediately.

tips to reduce the risk

1. Schedule an appointment with your healthcare provider to learn your personal risk for heart disease. 2. Quit smoking. Did you know that just one year after you quit, you’ll cut your risk of coronary heart disease by 50 percent? 3. Start an exercise program. Just walking 30 minutes a day can lower your risk for heart attack and stroke. 4. Modify your diet if needed. For example, with poultry, use the leaner, light meat (breasts) instead of the fattier dark meat (legs and thighs), and be sure to remove the skin. 5. Avoid deep frying; try to broil, bake or steam instead. Use olive oil or canola oil, do not re-use cooking oil, Avoid ghee (clarified butter). 6. Use low fat milk and dairy products, Increase fruit and vegetable and fiber intake. 7. Increase intake of fish, nuts, Decrease intake of starches like white rice, roti, white potatoes and naan.

Do not hesitate to ask more about cardiovascular disease prevention from your health care provider, a nurse practitioner or a nurse.

Accamma Kallel, RN, MSM, CCRN, ANP-C Cardiology Nurse Practitioner, Michael E DeBakey VA Medical Center With more than 30 years of diverse nursing experience, Accamma has worked in the US for last 25 years prior to which she worked in India, Ethiopia, and Saudi Arabia. She also serves as an adjunct faculty at the Texas Woman’s University. She is very active in The Indian American Nurses Association of Houston and currently serves as the Chair for the Education Committee and Outreach Committee.

National Wear Red Day is celebrated in U.S. on the first Friday in February every year to raise awareness about heart disease of women. For more information on National Wear Red Day please visit: https://www.goredforwomen.org/ home/get-involved/national-wear-red-day/

Going for periodic checkups, taking medications as prescribed by your doctor or nurse practitioner is also very important to prevent heart attack and stroke.  May - Aug 2015 HealthLine

ost people are aware of the fact that good oral health is very important for the overall health of a mother and a child. Often the misconception of the safety of dental care during pregnancy may cause women to not see the dentist. But in reality, when a dentist creates a treatment plan for a pregnant patient, it is considered safe, effective and critical in fighting the adverse effects of oral diseases.

When a woman is pregnant, her dental health may suffer significant changes. According to an article published in the November/December 2010 issue of General Dentistry of the Academy of General Dentistry (AGD), pregnant women can experience gingivitis, pregnancy tumors, and mild to severe gingival enlargement.

A graduate of Tufts School of Dental Medicine in Boston, Massachusetts, Dr. Jafferally came to Texas in 2001. He serves on the Board of Directors for Ibn Sina Medical Foundation, a non-profit clinic which serves low income patients. He has also been recognized as one of the “Top Dentists” for 2011 and 2012.

Akbar H. Jafferally, DMD Smiles on Greatwood Dentistry, Sugar Land, Texas 6

During an oral examination, pregnancy gingivitis and non-pregnancy gingivitis are very similar. Symptoms include redness and inflammation of the gum tissue, bleeding during probing, and some tooth mobility.

Dental Treatment during Pregnancy Safe and Effective

“Although bleeding and inflammation of the gums has been noted in all trimesters of pregnancy, it typically disappears three to six months after delivery, provided that proper oral hygiene measures are implemented,” says Crystal L. McIntosh, DDS, MS, lead author of the article.

Good oral hygiene and visits to a dentist can help to alleviate gum inflammation. The article also mentions that pregnancy tumors are reported by 10 percent of pregnant women. These noncancerous tumors that appear as growths in the mouth and will usually disappear after delivery of the child. The tumors can be painless and purple or red in color, and in some cases have spots of spontaneous bleeding. “If a pregnancy tumor is

HealthLine May - Aug 2015

Akbar H. Jafferally DMD painful, bleeds severely, or interferes with eating, surgical removal is the treatment of choice,” says AGD spokesperson Robert Roesch, DDS, MAGD. Enlargement of the gingival tissue or gum tissue, happens less frequently than gingivitis and pregnancy tumors. In very severe cases, the gums can expand to cover the teeth completely. “Pregnancy gingivitis and gingival enlargement are thought to be the result of a heightened response to bacteria in the mouth,” says Dr. Roesch. “That’s why it is extremely important to educate and motivatepatients to maintain good oral hygiene during pregnancy.” If proper oral hygiene is not initiated prior to or during pregnancy, conditions such as gingivitis, pregnancy tumors, and gingival enlargement can worsen as the pregnancy progresses. Pregnant women should maintain their regular, semiannual checkups and consult a dentist if they notice any changes in their oral health.  Source: Academy of General Dentistry.

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May - Aug 2015 HealthLine

ermatology encompasses a wide variety of conditions affecting the skin. As a dermatologist, I see people of every age group, gender and skin type. I have noticed that many of my female patients are surprised to learn that conditions which they thought were only a problem for teenagers and men can affect them as well, specifically referring to hormonal acne and thinning hair.

Health and Skin Issues

Neda Nosrati, M.D. is Board Certified by the American Board of Dermatology. After practicing in the Dallas area, she returned to Houston in 2013 and joined the team at Bellaire Dermatology Associates. Her dermatology specialty training was completed at the University of Texas Medical Branch in Galveston. Dr. Nosrati is experienced in medical, surgical, and Cosmetic dermatology and sees both adult and pediatric patients for a variety of skin conditions.

Neda Nosrati, MD Dermotologist,

Bellaire Dermatology Associates

Neda Nosrati MD

The acne we see in adult women is usually very different from the acne we see in teenagers and that also translates into very different treatment options. Teenage acne tends to be multifactorial, and we typically use a combination of topical medications and oral antibiotics for treatment; whereas in adult females, acne can actually be hormonal. There are several clues which we use to help determine which type of acne a patient has. First of all, hormonal acne often shows up around the mouth, along the jawline, and on the neck. The pimples associated with hormonal acne are usually deep and painful, what we often refer to as acne cysts. Sometimes with hormonal type acne, women notice that it will flare right before or around their menstrual cycle. Many of my patients who are experiencing this type of acne are concerned that their hormones are abnormal. Fortunately, that is not usually the case, but if the hormonal acne is associated with other symptoms such as excessive hair growth and thinning hair, we may consider doing bloodwork or have them further evaluated by a gynecologist. The goal of examining the blood would be to investigate if there is any evidence of androgen excess and to rule out conditions such as polycystic ovarian syndrome (PCOS). Treatment of hormonal acne is mainly centered on trying to block excess androgens in the body. The medication which we use most often to achieve this result is actually a blood pressure medication that has been available for many years called spironolactone. Overall this medication is tolerated very well with few side effects, having the added benefit of being safe for long term use. Oral contraceptives also have a very successful role in the management of hormonal acne either alone or in addition to spironolactone. Besides oral medication we like to utilize topical medications which work by different mechanisms, one of which can have antiaging benefits as well. Sunscreen is an important but often neglected

HealthLine May - Aug 2015

Women’s

part of any skin care regimen as it can help prevent the dark spots which are often left behind after acne has resolved. Another condition which can be related to hormonal acne is hair loss and it affects millions of women. Patients often come into the office complaining of thinning hair, very concerned about the large amount of hair they are picking out of the shower drain and finding on their brush. There are multiple causes of thinning hair including pregnancy, medications, chronic illnesses such as thyroid disease, certain deficiencies such as iron deficiency, major stressors both physical and emotional, and aging/genetics. A detail review of medical history, a medical exam and possibly bloodwork can help elucidate the cause. Androgenetic alopecia, also known as female pattern aging is similar to the type of hair loss often seen in men; although the pattern of hair loss is different with women tending to lose hair preferentially from the crown and then diffusely, while men tend to lose at the temples initially and then progress to the vertex of the scalp. Many of the first line treatments we use are actually over the counter including the B vitamin Biotin and Rogaine 5% foam. If these therapies are not helping then we can use prescription medications including the hormonal medication mentioned above, spironolactone. Beyond prescription medications there are some laser and surgical options as well.

Both of these conditions, hormonal acne and thinning hair, are issues that plague many of our adult female patients. Even though these conditions are not dangerous, they can cause significant amounts of stress and negatively impact a woman’s quality of life. Therefore, it is important to seek out medical help as there are multiple treatments which can be employed to improve these bothersome entities. 

SUBODH CHAUHAN, M.D.,

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May - Aug 2015 HealthLine

ature cure is a drugless therapy that involves the use of the five great elements (Panchamahabhutas)of nature to restore, to build-up, and to maintain health. Naturopathy explores the cause of disease. When the cause is uncovered it’s easy to define the elements that have to be restored, and this could be done in an effective way through the proportional utility of panchamahabhutas.

Nature Cure INTRODUCTION TO BASICS, ROLE IN PREVENTION AND MANAGEMENT OF DISEASE P Kartik MD BNYS

Dr. P. Kartik, is certified in Naturopathy and Yoga working for Autoimmune disorders with special focus on Lupus at his “Nature Cure” facility. He is the Director of Sri Lakshmi Narsimha Swamy (SLNS) Nature Cure Hospital in India. Learn more about Dr. Kartik at www.slecure.com or you may contact him at drkarthikbnys@gmail.com

P Kartik, BNYS Director, Sri Lakshmi Narsimha Swamy Nature Cure Hospital 10

Recovery of health

During the nature cure process there is more dependency on drugs or medicines. It is all natural ways of condensing proper proportions of air and water. Patients are advised to eat organically grown, seasonal fruits, vegetables and sprouts (earth). They are exposed to natural sun light (fire) and asked to meditate in peace (ether). That’s how different cases can be handled with unique procedural approach in NATUROPATHY.

Nature aids in women’s problem

A woman plays very important role in the health of the family (if she is the one cooking). Gynaecological disorders like ovarian cyst, fibroids in uterus, pelvic inflammatory disorder and dysfunctional uterine bleeding are some of the common ailments among women. As they have additional multiple responsibilities to fulfill, nature can help them live a healthy and active life by following it religiously.

Types of waste matter • Catabolic waste matter. • Waste matter of undigested and unassimilated food. • Hosting foreign bodies like germs and parasites. • Due to foreign substances which are dead. • Medicinal waste matter if any

HealthLine May - Aug 2015

The fact that we are not at ease is the best sign to let us know that it is time for a detox.

Detoxification

Detoxification is the process of removing accumulated toxins and waste products that build up within our systems. Detoxification would be a best initial step to change one’s lifestyle, whether it’s for a specific health concern like high cholesterol, rheumatoid arthritis, insomnia, or for something more general like weight loss. The benefits are almost immediately felt as energy is improved and wellness returns. This would be more efficient than complicated surgeries with sophisticated equipments.

When to detox?

Ideally one should undergo detox during every seasonal change. However the best way to understand that it is time for detox is if you encounter any of the below signs and symptoms: • Heaviness and lethargy. • Lack of mental clarity and energy. • Feel weary and unenthusiastic. • Tongue coating. • Aches and pains. • Gastrointestinal complaints of bloating, gas, constipation, acidity, etc. • Skin blemishes. • Metabolic diseases like diabetes, obesity, etc.

Benefits

Hemiplegia, Paraplegia, Paralysis, Colitis, Convalescence, Cervical Spondylosis, Irritable bowel syndrome, Constipation, Backache, Sciatica, obesity, Piles, Sexual debility & Infertility, Acne, Kidney stone, Sinusitis, Gynaecological disorders like ovarian cyst, fibroids in uterus, Irregular menstruation , High blood pressure, Heart problems, Flatulance - Gastric disturbances etc. could be cured with simple practices and diet control.

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How nature cure helps

Preventive stage Here we come across patients with no complaints, because of the patient’s vitality in his young age. But as he grow old we may not find the same activity of his body cells this leads to the destruction of scavenger cells and malfunctioning of his internal organs. At this stage patient is guided with proper lifestyle for a span of 10-15 days to demolish the problem causing toxics in his body. Control stage This is the next stage where the person has complaints like simple headache, fever, and cold. He has to be treated with a motive of curing the disease and cleaning the intoxicated materials and ultimate control should be gained over his body. This can be achieved in a span of one month where patient is under supervision of a therapist, where patient is under supervision of a therapist, where he follows conventional methods to provide proportionate amounts of the five elements through natural means (pranayama, coconut water, seasonal fruits, fasting, sunlight etc). Surgical stage When the person has diabetes, hypertension, heart problems, surgeries are mandatory. Based on intensity of the disease, duration of treatment can be estimated. Here long term treatment is required for the complete purification and rejuvenation. Purification involves in detoxification of oxygen free radicals, nitrogenous compounds, phosphates, sulphates and other impurities.

Rejuvenation by activating the scavenger cells In conventional allopathy treatment numerous drugs antacids, painkillers and nonsterodial anti-inflammatory drugs are used to treat simple body ailments. These drugs cause direct toxicity to stomach, liver and suppression of primary cells in bone marrow, which are necessary to repair the body cell. Here by the repair process is hampered.

In naturopathy this is handled in a much better way with an alter to the above mentioned side effects and indulge in complete elevation of cause of disease from the roots so that disease will not progress to further menacing stages. 

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May - Aug 2015 HealthLine

Colon Cancer In Women C

Bharat Pothuri MD

Lesser Known Facts

olon cancer is the second most cancer in women worldwide and third most cancer in men. In the United States it is the second most common cause of cancer deaths and accounts for 8.4% of all deaths related to cancer. Greater than 90% of cases are detected in patients over the age of 50.

Bharat Pothuri, MD Gastroenterologist, Northwest Houston Gastroenterology 12

In spite of increasing education and awareness in 2012 only 65% of adults between the age of 50-75 have had a colonoscopy. Screening rates have increased, however, as in 2002 only 52% of eligible patients were screened. The majority of colorectal cancers start as benign growths called polyps. A precancerous polyp is called an adenoma. Approximately 2/3 of polyps are adenomas. It takes on average seven to ten years for an adenoma to turn into colorectal cancer.

There are many screening techniques, but colonoscopy is the only test that can not only detect precancerous polyps but also remove them [during the same procedure] taking away the risk of that polyp turning into cancer into the future.

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Bharat, graduated medical school from Bangalore University, India. He did his internal medicine residency at University of Massachusetts Memorial Healthcare. He then pursued a gastroenterology fellowship at Albert Einstein College of Medicine in New York. Pothuri started his practice at Northwest Houston Gastroenterology, PLLC in 2005. His office is located in Cypress, Texas.

In the United States the incidence and mortality from colon cancer is now actually decreasing due to proper screening techniques. One study showed that up to 500,000 cases of colorectal cancer may have been prevented in proper screening techniques were implemented in the past.

The National Polyp Study Work Group followed 1418 patients who had colonoscopies and removal of 1 more polyps and followed these patients for 6 years. The incidence of colon cancer was 88-90% lower than in patients who did not have polyps removed and 76% lower than the

HealthLine May - Aug 2015

general population. There are several risk factors for colon cancer. These include family history, race [blacks are at greater risk than whites], a prior history of colorectal cancer, history of inflammatory bowel disease [Crohnâ&#x20AC;&#x2122;s disease and ulcerative colitis], history of abdominal radiation, tobacco use, excessive alcohol use, obesity, lack of physical activity, diabetes, and red meat consumption. Protective factors which may reduce the risk of colon cancer include a high fiber diet, regular physical activity, aspirin, calcium, and selenium.

When should screening start? Age 50 for average risk patients. For patients who have a family history of colon cancer screening should start 10 years prior to the age of diagnosis in the index patient who had colon cancer, or age 40, whichever is earlier.

There are certain hereditary conditions which arise from genetic mutations. Examples of this are familial adenomatous polyposis and hereditary non-polypsosis colon cancer. In these conditions colon cancer can arise even in teenagers and screening begins at a very early age.

What are the screening methods available? The accepted methods include fecal occult blood testing, fecal DNA analysis, sigmoidoscopy, [which is equivalent to doing a mammogram on 1/2 of one breast] and the gold standard colonoscopy. As stated earlier colonoscopy is the only test that can visualize the entire colon and rectum, and not only detect polyps, but remove them at the same time as well.

Are women at risk?

There is a misconception that women are immune or not at risk for colon cancer. Although the risk is slightly less than men the same screening methodology applies to women.

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Women should approach colorectal cancer screening such as they approach mammograms to prevent breast cancer and pap smears to prevent cervical cancer. Another common misconception is that the colonoscopy is uncomfortable and painful. The patient is sedated for the procedure, and many times state that they have had the best nap in their life.

From a patient perceptive the bowel preparation is of utmost importance, and newer bowel preparations are available which are of low volume. The risks of colonoscopy are minimal and the benefits far outweigh the potential risks of the procedure. A 20 to 30 minute procedure can truly be lifesaving.  May - Aug 2015 HealthLine

Digital Signage Use Increasing in Healthcare

Hussain Ali, CEO, DSCE, DSDE, ISF-C, CCNA, OCP Houston Dynamic Displays, Houston, Texas

Keeping patients, visitors and staff educated and engaged is the purpose and benefit of digital signage.

igital signage is the most innovative communication technology that’s a growing trend in today’s state-of-the – art healthcare industry.

An increasing number of medical facilities are having digital signage and kiosks incorporated into their architectural plans, essentially making them a staple in patient care and communication. In addition to the built-in audiences in patient rooms, hospital offices and waiting rooms, the constant flow of foot traffic streaming in and out of common areas like cafeterias and lobbies guarantees steady viewership. Every moment people spend in the hospital is an opportunity to inform and market. Besides providing valuable information as health news, announcements and alerts, emergency broadcasts to patients, visitors and staff, it can also be a source of entertainment for those sitting for long hours in waiting rooms. These messages can be remotely changed in real-time or programmed to adhere to a scheduled rotation.

Way-finding challenges are being met with digital signage solutions tailored to tackle existing issues. Patients and visitors who feel weak, stressed or rushed will no longer have to deal with the confusion and wasted time associated with the difficulty of reaching their destination. In addition to way-finding and communication, digital displays and touch-screen kiosks can be used to facilitate and expedite patient and staff interaction by serving as check-in stations. These kiosks allow patients to inform staff of their arrival and establish a place in line among other patients without interrupting staff workflow. Besides checking in, patients can also schedule appointments and fill out paperwork or surveys from digital touchscreen kiosks, improving the patient experience and saving time for the staff.

The software solutions that come with displays are web-based, making digital signage the most user-friendly and flexible platform for information dissemination available. 

Tel: 281-207-8200 Fax: 281-207-8388 For referrals, please call 281-207-8225

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ATRIUM MEDICAL CENTER is a long term, Acute care Hospital specializing in state-ofthe-art care of medically complex patients for an extended period of time. Physicians are board-certified specialists including, but not limited to Cardiology, Pulmonary, Surgery, Nephrology, Infectious Disease and Physiatry. 14

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Hussain Ali, CEO, DSCE, DSDE, ISF-C, CCNA, OCP

PROGRAMS

• 24/7 Nursing and Respiratory • Intensive Care • In-House Dialysis • Inpatient Hospice Services • GI / Invasive Procedures • Labs • OUTPATIENT SERVICES • Pulmonary / Ventilator Management • Radiology • Wound Management with HBOT services

Tina Pariani MD

Osteoporotic Fractures

A Common Concern In Aging Women

id you know that an osteoporotic fracture occurs every three seconds, making osteoporosis more common than heart attacks, strokes and breast cancers combined? Did you know that 1 in 3 women over age 50 will experience osteoporotic fractures, as will 1 in 5 men aged over 50? Did you know that over 80% of all fractures in people over 50 years old are caused by osteoporosis? So what exactly is osteoporosis?

Osteoporosis is a medical condition in which the bones become brittle and fragile from loss of tissue, typically as a result of hormonal changes, or deficiency of calcium or vitamin D. Let’s look at each of these factors individually staring with hormonal changes. There is a direct relationship between the lack of estrogen after menopause and the development of osteoporosis. After menopause, bone breakdown outpaces the building of new bone and the best way to build that bone back is by performing exercises. When you exercise, you don’t just build muscle and endurance. You also build and maintain the amount and thickness of your bones also known as “bone mass and density.” The 3 types of exercises for osteoporosis are weightbearing exercises, resistance and flexibility. Weight-bearing means your feet and legs support your body’s weight. A few examples of weightbearing exercise for osteoporosis are walking, hiking, dancing and stair climbing. Walking as little as three to five miles a week can help build your bone health.

Resistance means you’re working against the weight of another object. Resistance helps with osteoporosis because it strengthens muscle and builds bone. Studies have shown that resistance exercise increases bone density and reduces the risk of fractures. Resistance exercise for osteoporosis includes free weights or weight machines, using resistance bands or performing water exercises. Finally, having flexibility helps prevent injury and examples of flexibility exercises for osteoporosis include regular stretches or exercises like tai chi or yoga. For general health, most experts recommend that everyone get at least half an hour of moderate to vigorous exercise five times a week regardless of the type of activity.

As far as calcium and vitamin D supplementation is concerned, it is best to get calcium from your diet. Dairy products are a rich source of calcium. In general, it is suggested that one get 1200 mg of elemental calcium daily, total diet plus supplement, and 800 international units of vitamin D daily. Some patients require additional vitamin D supplementation based on their vitamin D levels. So make sure to keep your hallways clear and get your DEXA bone scan every 2 years based on your doctor’s recommendation. 

Dr. Parini practices Internal Medicine/ Geriatrics with the St. Luke’s Medical Group– Sugar Land. She is a member of the American Association of Physicians of Indian Origin, the American College of Physicians, the Texas Medical Association, and the Harris County Medical Society. She is board-certified in internal medicine and geriatrics by the American Board of Internal Medicine.

Tina Pariani, MD Internal Medicine/ Geriatrics St. Luke’s Medical Group Sugar Land.

May - Aug 2015 HealthLine

One Woman Dies M Every Minute From Heart Disease

Sumita Chowdhury MD, MPH, FACC, MBA

ost women think a routine health checkup consists of screening for breast and genital cancers. Rarely do women think they need to undergo a comprehensive cardiac evaluation. Surprisingly, the average American woman does not believe that heart disease is her greatest health threat. In fact, 80% of the women in the United States have a similar perception of cardiac risk that is not based on reality1.

Number 1 killer today

The reality is that heart disease is the Number 1 killer of women today, according to the American Heart Association1. The number of women dying from heart disease far exceeds all forms of cancer combined1. Almost every minute, a woman is dying from heart disease.

The chilling facts are that heart disease results in 1 in 3 deaths each year, while breast cancer results in 1 in 31 deaths each year for American women1. One of the biggest myths in our society is that men are more likely to die from a heart attack than women. This belief has infiltrated the fabric of our culture and media. The vivid image of a famous male movie star gasping for breath, clutching his chest and falling to the ground is all too familiar. While all of us have that movie scene imprinted into our long-term memories, the irony is that the heart attack victim is much more likely to be a woman, dying slowly without a hint of melodrama; yet that image has never been allowed to permeate our collective consciousness. Indeed, the facts reveal that since 1984, more women than men have died each year from heart disease1. An estimated 43 million women in the U.S. suffer from heart disease. The heart muscle needs oxygen to survive. Coronary arteries supply blood containing oxygen to the heart. These arteries can stiffen and develop blockages with buildup of cholesterol and other elements, resulting in plaque formation in a process known as atherosclerosis. These plaques can rupture and incite clot formation. The resulting blockages of the coronary artery can compromise blood flow to the heart. When the blood flow to the heart muscle is compromised, the resulting lack of 16

HealthLine May - Aug 2015

oxygen can cause a heart attack. This blockage of the coronary arteries is known as coronary artery disease and is the leading cause of death of both women and men in the United States. Although older women post-menopause are more likely to suffer a heart attack, women at every age should be motivated to adapt a healthy lifestyle. Ninety percent of women have one or more risk factors for developing heart disease. These risk factors that woman should screen for and improve include: Abnormal lipid profile: Bad cholesterol (LDL) can build up in our arteries and form plaque. Such plaques can narrow the passages, obstruct blood flow, and result in heart attacks or strokes. High levels of good cholesterol (HDL) may help to clean our arteries and protect against a heart attack. Low levels, however, can actually increase our risk. All women should follow up with their healthcare providers to learn more about their risks. Smoking: Complete cessation from smoking is the need of the hour. Smoking can increase the risk of heart disease and stroke by up to 4 times. When compared to men who smoke, women who smoke have worse outcomes with a 25 percent greater risk of developing heart disease. High blood pressure: This is known as a silent killer because blood pressure can creep up to very dangerously high levels without any symptoms. Uncontrolled high blood pressure can result in strokes, heart attacks, and kidney failure resulting in the need for dialysis and loss of vision. This can be improved by adopting a healthy lifestyle that includes regular physical activity of at least 30 minutes daily, weight loss if needed, abstinence from alcohol, and a diet low in fats, cholesterol, and sodium. Diabetes: All diabetics should work closely with their healthcare providers to control diabetes since they have up to a 4 fold higher risk of heart disease and stroke. Diabetes can damage the heart, kidneys, eyes, and circulation resulting in peripheral vascular disease, strokes, and heart attacks. Overweight: Abdominal fat increases our risk for heart attacks. That’s why it’s important to measure our waist circumference. A waist circumference of greater than 80 cm puts women at risk. For South Asian women, studies have found that a lower cut-off of 72 cm may be more useful in predicting an increase in the risk for heart disease.

Left to right: Jatin Pandit, music director, Brand Ambassador for the World Congress on Preventive Healthcare 2015, his wife Kainaz Jatin Pandit at the Press conference along with Dr. Sumita Chowdhury and Dr Palash Chowdhury held in Houston on April 9, 2015.

1 AHA Statistical Update Heart Disease and Stroke Statistics —2012 Update A Report From the American Heart Association. Circulation. 2012; 125: e2-e220

Lack of adequate daily physical exercise: This increases risks for blood clots, strokes, heart attacks, and high blood pressure. At least 30 minutes of exercise on a daily basis can reduce this risk. Moderate to vigorous physical exercise can improve blood pressure and cholesterol; it can also reduce the risk of death from heart disease by 30-40 percent and stroke by 25 percent in women.

Most women are so focused on taking care of the rest of the world around them that they often forget to put their own oxygen masks on first... Women who experience a heart attack can present symptoms that are different from those experienced by men. Women, especially diabetic or aging women, may not experience the typical “elephant on my chest” type of pressure or chest pain. Instead, they may experience extreme fatigue, shortness of breath, neck pain, jaw pain, shoulder pain, upper abdominal pain, symptoms of heartburn, dizziness, lightheadedness, nausea, or vomiting. Since most women perceive themselves to be at low risk for a heart attack, they often ignore such symptoms and do not seek medical attention right away. Women may attribute the fatigue and shortness of breath to being out of shape and exhaustion from daily chores rather than warning signs of a heart attack. Every woman who believes that she may have a risk factor should take action to prevent heart disease today by scheduling an appointment with her healthcare provider to assess her cardiac risk. 

Dr. Sumita Chowdhury is a cardiologist trained at the prestigious Massachusetts General Hospital, Harvard Medical School, at Boston. She is an acknowledged leader in the fields of cardiovascular thrombosis, atherosclerotic heart disease, preventive medicine, and women’s health. Her passion for epidemiology and disease prevention motivated her to obtain an MPH from the Harvard School of Public Health. Social entrepreneurship led her to the Wharton Business School where she obtained an MBA. Chairperson World Congress on Preventive Healthcare 2015 (Prevention2015.org) at the 35th North American Bengali Conference (NABC2015.org) George R. Brown Convention Center, Houston, July 10-12, 2015

Free cardiac screening with VAP + Lipid tests for South Asian Cardiovascular Registry Participants

Bollywood celebrity and music director Live performance along with his Bollywood Band to motivate people to come for cardiac screening at 8 am on July 11th and 12th at the Atherotech Screening Pavilion Hall A3 at the George R. Brown Convention Center

May - Aug 2015 HealthLine

reast cancer is the most common cancer in women, including Asian women. In the United States (US) one in eight women will be diagnosed with breast cancer.

In 2015, it is estimated that 231,840 women in the US will be diagnosed with breast cancer.There has been progress in curing breast cancer because of advances in prevention, early detection, and better treatment options.

Screening & Prevention

Breast cancer has very good screening available so that it can be detected at early stages when it is more often cured. Women should become aware of their breasts starting at age 20. It is very important that women learn early in life what their breasts feel like so that if a new lump appears they can see medical attention.

Dr. Julie Rani Nangia, Assistant Professor of Medicine in the section of hematologyoncology, is board certified in internal medicine and medical oncology. She specializes in the care of patients with breast cancer.

Julie Nangia, MD Director of the Breast Cancer Prevention & High Risk Clinic at Baylor College of Medicine 18

Breast Cancer Awareness

Early start in awareness goes a long way in its prevention Julie Nangia MD The most common reasons for women not doing breast exams are they forget or they don’t know how—so be proactive and ask your doctor how to do the self test! It is recommended to start clinical breast exams at age 20 (performed by physicians) and annual mammography at age 40. Mammograms can detect breast cancer when it is stage 0 and too small to be felt. If there is a family history of breast cancer or ovarian cancer in more than 2 relatives on the same side of the family or a personal history of a breast biopsy showing a pre-cancerous lesion (i.e. atypical hyperplasia or lobular carcinoma in situ) a risk assessment is recommended.

HealthLine May - Aug 2015

This is done by a medical oncologist, preferably in a breast center such as Baylor College of Medicine (713-798-1999). For high risk woman, medications can be used to decrease risk of breast cancer. If a woman does not have health insurance she can still get mammograms. The Rose (281-484-4708) will do mammograms for $100 or free if family income is low.

Prevention with Lifestyle changes Lifestyle changes can significantly decrease a woman’s risk of breast cancer. Many cancers could be prevented with simple lifestyle changes! It is recommended to exercise 3-5 hours per week. Walking is very good exercise and this can be accomplished by walking 30 minutes every day or 1 hour every other day

and is best done if it becomes part of a daily routine. Exercise decreases breast cancer risk by decreasing estrogen levels in the body. A woman should also stay thin and maintain a normal body weight. When a woman is overweight the extra fat is converted into excess estrogen in the body, which increases the risk of developing breast cancer. The best way to remember this is that obese men develop breasts! There are no specific types of foods that have been associated with breast cancer risk and a low calorie, healthy diet is recommended. Alcohol has been associated with increased risk of breast cancer because alcohol causes excess estrogen in the body. It is recommended to consume less than 3 alcoholic beverages per week. If you drink alcohol start taking folic acidâ&#x20AC;&#x201D;one study showed that in women who drink alcohol, some of the negative effects can be reversed by taking a simple vitamin, folic acid 800ug daily.

Diagnosis and Treatment

Most women are diagnosed with breast cancer because of an abnormal mammogram or a mass felt on breast exam. The initial diagnosis is made by mammogram and ultrasound followed by a biopsy. At that time a woman would see a breast surgeon or a medical oncologist.

Stage 1-3 breast cancer is curable and is when the cancer is limited to the breast and the lymph nodes in the armpit. Treatment would include some type of surgery and perhaps chemotherapy, radiation,

and anti-hormonal therapy. There are many different types of breast cancer and each of these types is treated in different ways. Stage 4 breast cancer is not curable, but is treatable and a woman can live for many years. More information on the treatment of breast cancer can be found at: http://www.cancer.gov/cancertopics/types/breast http://www.bcm.edu/centers/breast-center.

To calculate your ideal body mass index the formula for men is 50kg + 2.3kg for each inch over 5 feet and for women it is 45.5kg + 2.3kg for each inch over 5 feet. ď&#x201A;§

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Assessing and Decreasing T

Thuy Hanh Trinh MD

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

Your Risk for Developing Breast Cancer

he diagnosis of breast cancer can be devastating to patients and their families. Breast cancer is the second leading cause of cancer deaths among women, surpassed only by lung cancer. Men are also at risk, but in lower numbers. One in eight women will be diagnosed with breast cancer in their lifetime.

Screening

To screen for breast cancer, a mammogram is the best tool that can be used. However, 8â&#x20AC;&#x201C;17 percent of breast cancer cases have been missed by mammography. The American College of Obstetrics and Gynecology (ACOG) recommends that patients see a physician to perform a clinical breast examination annually in women who are 40 years and older. In women between the ages of 20 and 39, the ACOG continues to recommend a clinical breast examination every 1 to 3 years. Some risk factors that cannot be changed by lifestyle include gender, age, genetics, family history of breast cancer, and personal history of breast cancer.

Women are 100 times more likely to get breast cancer than men. Two-thirds of invasive breast cancers are diagnosed in women whose age is 55 or greater. The lifetime risk of developing breast cancer in a patient with the Breast Cancer Gene (BRCA) 1 mutation is about 60 percent, while the risk of developing breast cancer with the BRCA2 mutation is 45 percent. About 15 percent of women with breast cancer have at least one first degree relative (mother, 20

HealthLine May - Aug 2015

daughter, or sister) with the disease. Having one first degree relative with breast cancer can make a patient twice as likely to have this disease. With two first degree relatives with breast cancer, the risk of a patient developing breast cancer increases three-fold. Patients who have had breast cancer are three to four times more likely to develop a new breast cancer in either breast.

Methods to decrease breast cancer risk include avoiding obesity and weight gain, decreasing alcohol consumption, and exercising regularly. Mothers who choose to breastfeed for a year or more may reduce their risk of breast cancer. Women who are at high risk can decrease their risk with the medicines tamoxifen or raloxifene. Many organizations are dedicated to providing support for them, depending on their goals of care. From oncologists to rehabilitation specialists to hospice professionals, patients can get the support that they and their families need, whether in the inpatient setting, or in the comfort of their home. ď&#x201A;§ American Cancer Society Breast Cancer Facts & Figures 2013-2014. www.cancer.org/Research/CancerFactsStatistics/ACSPC-042725. Accessed May 4, 2015. Americal College of Obstetrics and Gynecology. Well Women Visit. www.acog.org/Resources-And-Publications/Committee-Opinions/ Committee-on-Gynecologic-Practice/Well-Woman-Visit. Accessed May 10, 20

Alternatives to Hysterectomy F

Sabina K Cherian MD

ibroids are the most common indication for hysterectomy in the United States and are very common in 70% of white women and more than 80% in black women upto age 50. Although many individuals with fibroids are asymptomatic and maybe monitored without treatment, some will require intervention.

What are uterine fibroids?

Symptoms

The most common symptoms are abnormal uterine bleeding and pelvic pressure. The uterine bleeding may cause anemia. Pelvic pressure may cause symptoms in adjacent organs with difficult urination, defecation or pain with sexual intercourse.

Treatment

Though hysterectomy is the definitive treatment some women desire future childbearing or just do not want surgery. The following are medical and surgical treatment options depending on clinical relevance. If fibroids are present treatment options are based on size, location and number, of fibroids.

Alternatives

In choosing alternatives to hysterectomy multiple factors have to be taken into account, such as safety, efficacy, risk of recurrence, benefits of uterine-sparing procedures and continued fertility etc.

Medication

Contraceptive steroids and Nonsteroidal Antiinflammatory Drugs are first-line therapy • If contraceptive steroids are initiated monitoring of uterine size and fibroids must be continued. • Nonsteroidals may help with painful periods with and without fibroids. • The levonorgestrel intrauterine system is beneficial for heavy bleeding however there is a higher expulsion rate of the device with fibroids. Uterine fibroids are benign tumors that originate in the uterus (womb). Although they are composed of the same smooth muscle fibers as the uterine wall (myometrium), they are much denser than normal myometrium. Uterine

fibroids are usually round. • Gonoadotropin-releasing hormone agonists lead to cessation of bleeding in most women and a 35-65% decrease of fibroid size within 3 months of treatment. This medication is FDA approved for preoperative therapy in women with anemia in conjunction with supplemental iron. It is most useful for large fibroids. The effects are temporary, induce menopausal symptoms and treatment is suggested to limited to no more than 6 month use without hormonal therapy for bone protection. They are also expensive. Aromatase inhibitors-further research is needed to elicit the affectivity of these medications to treat fibroids. Progesterone modulators such as Mifepristone also need further study.

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.

Surgical

Myomectomy: The goal of this procedure is to remove the visible and accessible fibroids and then reconstruct the uterus. This procedure is for women who desire uterine preservation. This may be performed as an open procedure, laparoscopic, robotic or hysteroscopic. Uterine artery embolization: performed by interventional radiologist is basically cutting down the blood supply of the uterus. In turn giving the uterus a “heart attack.” Minor complications are vaginal discharge, fibroid expulsion and hematoma. Magnetic Resonance Imaging: Guided Focused Ultrasound Surgery-needs long-term studies to discern if procedure will lead to durable results beyond 24 months. 

Sabina K Cherian, MD Obstetrics and Gynecological Surgery Center for Women’s Health

May - Aug 2015 HealthLine

Our Brains Matter! T

Over five million Americans living with Alzheimer’s

Alexandria S. Williams Communications Coordinator Alzheimer’s Association Houston and Southeast Texas Chapter

he diagnosis of any disease given to a family member is devastating. Knowing that someone whom you love so much was perfectly healthy one minute to not knowing how much longer they will be with you the next is a blow to anyone’s peace of mind.

Furthermore, Women are far more likely to develop the fatal disease than men: one in six women over 65 will get it during their lifetime, compared with one in 11 men.

Alzheimer’s disease is the sixth leading cause of death in the United States (kills more than breast cancer and prostate cancer combined). Over five million Americans are living with the disease, with someone developing it every 67 seconds.

Alzheimer’s is a type of dementia that causes problems with memory, thinking and behavior. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks. Alzheimer’s is not a normal part of aging, although the greatest known risk factor is increasing age, and the majority of people with Alzheimer’s are 65 and older. But Alzheimer’s is not just a disease of old age. Up to 5 percent of people with the disease have early onset Alzheimer’s (also known as younger-onset), which often appears when someone is in their 40s or 50s.

One out of every six women will develop the devastating memory loss of Alzheimer’s in her lifetime and, a new study from the Alzheimer’s Association finds.

Alzheimer’s in Women

Alzheimer’s takes a toll on women, according to a report released from the Alzheimer’s Association.

Alexandria S. Williams

HealthLine May - Aug 2015

And, not surprisingly, women are more likely to be caregivers for someone with Alzheimer’s, and to pay a bigger personal and professional price for that care than men do.

So what is Alzheimer’s?

Call to Action! The My

Brain Movement calls on 1 million women to use their amazing brains to help wipe out Alzheimer’s disease — one of the greatest threats to women’s health. 

Dealing with Menopause

Hot Flashes M

enopause is a natural phenomenon that occurs in every woman’s life. It is defined as cessation of menses for 12 consecutive months happening naturally and not due to any other pathological condition. Estrogen levels drop markedly causing several physiologic (natural) changes in the body during transition and after obtaining menopause

Hot Flashes

Hot flashes are the most common symptom of menopause in up to 80% of women, only 20 to 30% seek medical attention. It is defined as sudden warm sensation on the face, neck/chest that becomes generalized and may be associated with profuse sweating, palpitations, chills, shivering and a feeling of anxiety.

It can last from 2 to 4 minutes. They are bothersome, unpredictable and may even be disruptive. When they occur at night they are called night sweats. Night sweats are more disabling.

Physiology

Hot flashes occur due to thermoregulatory dysfunction at the level of hypothalamus (inside the brain). Estrogen withdrawal in menopause

Vishalakshmi Batchu MD

causes this phenomenon. Blood vessels near skin surface dilate to cool and show symptoms of warmth, perspiration, shivering and night sweats.

Risk Factors

Poor lifestyle choices, obesity, smoking, reduced physical activity, ethnicity (more common among African decent), are some of the known risk factors.

Impact

Negative quality of life, increased cardiovascular risk, Osteoporosis (greater bone loss), sleep disturbances, dementia.

Treatment

Diet and physical activity plays a significant role during menopause. Yoga, specifically pranayama (deep breathing), and meditation are popular, health practices. 

Avoiding triggers like spicy foods, stress, anxiety, alcohol, consuming high quantities of processed foods/sugars, and smoking. Obese individuals have more estrogen which is not being utilized. Weight loss helps. Hormonal, high dose progesterone preparations and non-hormonal therapies are available. It is required to consult your Primary Care Physician /Gynecologist for these prescriptions as they are given based on individual medical history. Alternative Therapies include consuming Phytoestrogens (Plant Estrogen), Soybeans, chickpeas, lentils, flax seed, grains, fruits, vegetables, black cohosh.

Vishalakshmi Batchu, MD Internal Medicine Associates of Houston, PA, Pearland, Texas

May - Aug 2015 HealthLine

omen during the age of 40-55 years’ experience Menopause recognized as an estrogen deficit state following a permanent cessation of menstrual periods i.e. there has been no menstrual period for 12 consecutive months. This occurs either naturally or induced by surgery. In the postmenopausal stage, most of these symptoms diminish but these may convert into serious health issues if not given adequate care.

Ayurvedic Approach to Menopause

Ayurveda concentrates on using the therapeutic methods to alleviate the root cause of all these disturbances rather than suppressing the symptoms. Lakshmi Devi Maliakkal

Universe is made up of five essential elements - Ether, Air, Fire, Water and Earth (PanchaMahaBhootha) which in turn form the basis of life.

Lakshmi Devi Maliakkal is the Chief Ayurvedic Consultant practicing at Santhigram Houston. She graduated in the Ayurveda discipline from Vaidyaratnam Ayurveda College, Ollur, Thrissur, Kerala.

So Ayurveda considers human body as a reflection of this universe. In human body, these elements combine to form three energetic forces (TriDoshas) - Vata, Pitha and Kapha.

Balance of these results in perfect health and any imbalance may result in various disease conditions. Ayurvedic stages of life Childhood, Middle and Old Age is dominated by Kapha, Pitha and Vata respectively. Menopause is considered as a Vata dominated stage with some Pitha imbalances as this is a transition stage from middle to old age. Menopause becomes a difficult stage for many because of the following reasons:

Lakshmi Devi Maliakkal Chief Ayurvedic Consultant, Santhigram, Houston, Registered Advanced Ayurveda Practitioner 24

• Imbalance of Tri Doshas • Dhathu Kshaya: Degeneration/weakness and impaired functioning of bodily tissues • Ama (Toxins): Disturbed metabolic and digestive power (Mandagni)results in undigested end products which settle as toxins (Ama) in human body and blocks the minute channels (Srotas) that transport nutrition to all tissues. All these are the root causes behind the symptoms of Menopause. These symptoms vary from woman to woman as each body is considered unique (Prakriti). Predominance of each Dosha exhibits different physiological and psychological symptoms. • Vata dominant: Constipation, joint-pains, vaginal dryness, anxiety, Insomnia, mood swings, memory loss etc. • Pitha dominant: Frequent UTI, hot flashes, anger/irritability, night sweats, excessive bleeding, acne/skin rash etc. • Kapha dominant: Weight gain, lethargy, depression, Edema, fungal infection etc. Ayurveda recommends a 3-fold holistic approach which focuses on strengthening and rejuvenating the body. They are: • Balance Doshas: Follow a diet rich in Calcium,

Apana Vayu is a specific state of dosha which has to be taken care at this stage as it governs the genito-urinary functions, menstruation and elimination processes of human body.

HealthLine May - Aug 2015

Iron, Ghee (clarified butter) and phytoestrogen like Soy products, whole grains, cereals, nuts, herbs like Satavari, Ashwagandha, Licorice, Fennel, etc. • Lifestyle changes: Regular Abhyangas (oil massages) performed with Dosha specific oils is very much recommended. Pranayama, Yoga and routine pelvic exercise is vital too. • Panchakarma: This Ayurveda detox program is suggested for severe symptoms of menopause like Osteoporosis, Osteo Arthritis, Weight gain, high cholesterol etc.

Talk to your Ayurvedic Consultant to get more insight into Dosha specific herbs and diet regulations, incompatible foods, benefits of using Ayurvedic compound preparations like Ashokarishta, Kumaryasava, Satavari Rasayana, Sukumara Ghrita/Kashaya etc. 

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Call us for consultation: 713-493-2565 www.houstondd.com May - Aug 2015 HealthLine

ouston’s diverse population with its diverse ages and ethnic groups is an ideal setting for any research which is why the Susan G. Komen Tissue Bank at the Indiana University Melvin and Bren Simon Cancer Center came here, America’s fourth-largest city.

The Komen Tissue Bank, based in Indianapolis, is the only normal breast tissue bio-repository of its kind in the world. To date, 10,000 women have donated DNA and blood and more than 4,000 of those women have donated breast tissue as well. And 160 Houstonian women are among those donors. More than half of those women represented Asian and Hispanic racial and ethnic groups – groups that are

currently underrepresented among the donors to the tissue bank. The Houstonian women selflessly donated a precious piece of themselves to help in the research. By using samples from women without breast cancer, researchers will be able to determine the differences between healthy and cancerous tissues, which will lead to a better understanding of the disease. The Komen Tissue Bank is uniquely positioned to characterize the molecular and genetic basis of normal breast development and compare it to the different types of breast cancer. The bank was established expressly for the acquisition of normal tissues — breast tissue, (frozen and formalin-fixed), serum, plasma and DNA — from volunteer donors with no clinical evidence of breast disease and/or malignancy, providing a resource to investigators around the globe.

Houston Women

Anna Maria Storniolo MD

Donate to the Unique Breast Tissue Bank

How does it work?

During the donation process, a tissue sample is taken from one breast with local anesthesia and a needle. The amount of tissue taken is about one gram (or the size of two peas). A trained surgeon or radiologist performs a core needle biopsy with an ATEC vacuum-assisted device. The samples are processed immediately on-site to ensure consistent and high quality samples.

Anna Maria Storniolo, MD Executive Director, Komen Tissue Bank at IU Simon Cancer Center Professor of Clinical Medicine Indiana University School of Medicine 26

HealthLine May - Aug 2015

If you’re a breast cancer researcher, please know that the tissue bank is available to you. Visit www.komentissuebank.iu.edu and click on the “researchers” tab. You’ll find information on sample availability, standard operating procedures, pricing, and how to apply for samples. Or contact our COO, Jill Henry @jihenry@iupui.edu or (317) 278-2829.

“We couldn’t successfully have done this in Houston without the support of the Lester and Sue Smith Breast Center at Baylor College of Medicine, Susan G. Komen Houston Affiliate, and the Pink Ribbons Project. Our profound gratitude goes to all of the tireless volunteers,” says Anna Maria Storniolo, M.D., Executive director, Komen Tissue Bank at IU Simon Cancer Center. 

Polycystic Ovarian Disease (PCOS)

olycystic Ovarian Disease (PCOS) is the most common endocrine disorder found especially in South Asians. Six to 10% of women in the USA have polycystic ovarian disease. Polycystic disease incidence is increasing in the USA due to the increase in ethnic numbers. The diagnostic features are a diagnosis of exclusion. They include: • Irregular bleeding (oligomenorrhea or secondary amenorrhea). • Excess androgens in the form of chemical evaluations like oily skin, acne, hirsutism, or high levels of testosterone in blood testing. • Ultrasound examination of ovaries showing more than 12 antral follicles and one ovary. Two out of 3 of the above would be diagnostic for polycystic ovarian disease. Other conditions have to be ruled out in the form of thyroid, prolactin, and enzyme disorders such as 17-hydroxyprogesterone and adrenal gland tumors. Polycystic ovarian disease is associated with metabolic dysfunction, which leads to increased risk for atherosclerosis due to cholesterol and triglyceride increase and higher risk of diabetes. All this leads to cardiac disorders in the long-term. Treatment depends upon the age of the person and the need of individual. Teenagers may have increased risk of acne, oily skin, and irregular cycles. They would benefit from trying birth control pills, which will regulate their cycles and avoid the risk of uterine cancer in addition to decreasing the risk of heavy bleeding. This is not uncommon with polycystic ovarian disease and by increasing the protein, which binds the testosterone, it cuts down the free testosterone and helps with acne and hirsutism. Woman who would like to have a family find difficulty in achieving pregnancy, as they do not ovulate most of the months. Occasionally they will ovulate and find themselves pregnant, but women with irregular cycles are unlikely to be pregnant consistently. They would benefit from treatment in the form of Clomid (clomiphene

Subodh Chauhan MD

citrate), which is a medication that helps with modulating the brain’s communication with the ovary and helps promote ovulation. There is an increased risk of multiple pregnancies with Clomid treatment. There is also the medication metformin, which is to help with insulin sensitivity. Insulin dysfunction is likely to be the underlying problem with polycystic ovarian disease and metformin helps with increased insulin sensitivity and helps them ovulate. Though the role of metformin is still controversial, there is extensive benefit achieved by this therapy. Women who have polycystic ovarian disease have higher a risk of diabetes during pregnancy, and they have an increased risk of miscarriage and adverse outcome during pregnancy. Once a woman has completed the family, she will Ovarian Cysts

The many cysts in a polycystic ovary are follicles that have matured but, due to abnormal hormone levels, were never released. In a normal ovary, a single egg develops and is released each month.

benefit from using birth control pills with routine evaluation for cholesterol, triglycerides, and diabetes every year. Increased weight compounds the condition, and one of the most practical things is to exercise regularly, eat healthy, and to maintain a normal weight and body mass index (BMI). One other option, if women do not want to take birth control pills after they no longer want to bear children, is to use an intrauterine device called Mirena, which administers local progesterone, that leads to amenorrhea. Failure to have menstrual cycles after 6 months of insertion also decreases the risk of uterine cancer due to local progesterone secretions from the IUD. 

The many cysts in a polycystic ovary are follicles that have matured but, due to abnormal hormone levels, were never released. In a normal ovary, a single egg develops and is released each month.

Dr. Chauhan’s medical training began in India and continued in England. He then moved to the United States, where he completed his fellowship training in Reproductive Endocrinology and Infertility. His extensive multinational training gives him an understanding of the issue medically and culturally from all over the world.

Subodh Chauhan, MD Medical Director, Houston Fertility Specialist, Sugar Land

May - Aug 2015 HealthLine

Beverly J Gor EdD, RD, LD Dietitian and Staff Analyst, Houston Department of Health & Human Services 28

Acupuncture and Women’s Health

cupuncture is a component of Traditional Chinese Medicine (TCM), a system of health care dating back about 2500 years developed in China. In a survey conducted in 2004, it was found that 23% of Chinese and 8% of Vietnamese individuals in the greater Houston area used acupuncture.

Acupuncture is based on the theory that there are patterns of energy flow, referred to as qi, (more precisely qì, also chi, ch’i or ki) through the body that are essential for health. Disruptions of this flow are believed to be responsible for disease. A trained acupuncturist corrects imbalances of energy flow by inserting thin, metal needles at identifiable points close to the skin. He or she may also utilize manual or electrical stimulation to enhance the treatment. Although more research is needed to prove the effectiveness of acupuncture treatments, there are several women’s health concerns for which it may have some usefulness.

HealthLine May - Aug 2015

Beverly J Gor EdD, RD, LD

Dr. Gor is a registered and licensed dietitian and a staff analyst with the Houston Department of Health and Human Services. A native Houstonian, Dr. Gor has conducted several health surveys among Houston’s minority populations focused on reducing obesity and chronic disease risk. She is a cofounder of the Asian American Health Coalition of Greater Houston, Inc., and the HOPE Clinic, a community health center providing primary health care to Asians and other residents of Southwest Houston.

Among these are premenstrual syndrome (PMS), infertility, and menopausal symptoms. For young women beginning to menstruate, acupuncture has been found to help relieve cramps and regulate menstrual periods. Some women have also found that acupuncture combined with herbal medicine reduces pain and heavy bleeding associated with fibroids and endometriosis. Acupuncture has also been shown to help women who are trying to become pregnant. After giving birth, acupuncture and herbal medicine may be helpful in restoring and replenishing a new mother’s energy level. For women experiencing “hot flashes” and night sweats associated with menopause, acupuncture may reduce these symptoms making this natural life transition more comfortable. The acupuncturist will focus on treatments to stop excessive sweating and restore restful sleep. For women seeking acupuncture treatment, it is important to visit a licensed and experienced acupuncturist. In Texas, acupuncturists are licensed by the Texas State Board of Acupuncture Examiners (TSBAE). Many providers may also have a certificate from the National Certification Commission for Acupuncture and Oriental Medicine, a nonprofit group that promotes standards in acupuncture and Oriental medicine. 

Dr Gor is NOT a licensed acupuncturist. This article is only a commentary on this topic.

Healthy Eating for Diabetics

ating healthy is the first step in controlling diabetes. at three meals a day at your meals at the same time each day and do not skip meals. Eat about the same amount of food each day. Meals should be eaten 4-5 hours apart.

Limit sugar and sweets

Eat less candy, desserts, pastries and jelly. Limit intake of fruit juice and drink sugar free beverages such as diet soda, water and unsweetened tea instead. Use sugar substitutes in place of sugar.

Control your intake of carbohydrates Carbohydrate is the main nutrient that affects blood glucose (sugar) levels. Carbohydrates turn into sugar by your body. Therefore, it is important to control the amount of carbohydrate that you eat. You should eat 45-75 grams of carbs per meal based on your weight goals.

Add low starch vegetables to your meals Low starch vegetables are low in carbohydrate and high in fiber. Add vegetables to your meals for variety, and to help fill you up. Examples include: Asparagus, Beets, Broccoli, Brussel Sprouts, Cabbage, Carrots, Cauliflower, Celery, Cucumbers, Green beans, Lettuce, Onions, Spinach, Tomatoes, Yellow Squash and Zucchini.

Eat more fiber

Fiber can help slow down the rise in blood sugar following a meal. To get more fiber in your diet, eat at least five servings of fruits and vegetables a day, choose whole grain bread/cereal and eat more beans or legumes.

Healthy sources of carbohydrates Whole fruit, whole grain bread, cereal, crackers, starchy vegetables (corn, peas, potatoes, lentils, sweet potatoes, winter squash), whole grain pasta, rice, beans, milk, yogurt, pudding

“Not So Healthy” sources of carbohydrates Desserts, candy, ice-cream, doughnuts, cookies, pies, some ‘Sugar-free or “No-sugar added” foods are made with sugar alcohol and may still raise your blood sugar.

Be careful with liquid carbohydrate! Liquids that contain carbohydrates can cause seriously high glucose levels if you drink too much. Even drinks that some people think are healthy can cause major problems. Liquids with carbs include: sodas, fruit juice, milk, sweet tea, energy drinks, coffee drinks, sports drink, and some flavored waters.

Limit your intake of alcohol Drink alcohol only with permission of your doctor. Never drink alcohol on an empty stomach as it causes a low glucose level. The limit for men is upto two drinks a day and for women is one drink a day. Do not use sweet mixers as they contain more carb.

Reduce your intake of high fat foods Cutting back on your intake of high fat food can help reduce your weight and cholesterol levels. Reduce intake of fried food, bacon, sausage, luncheon meat, gravy, sour cream, cheese, egg yolks, stick margarine/butter and whole milk. © rockvillephoto - Fotolia

Know your Blood Sugar Levels You should check your blood sugar levels on a regular basis. Blood glucose goals for most people: Before meals: 70-130 Two hours after a meal: less than 180 Bedtime: 110-150

Be more active and lose weight if you are overweight

Regular exercise can be an important part of your diabetes care. Physical activity can help lower your blood glucose levels. The type and amount of activity that is right for you should be discussed with your doctor. Losing weight may also help improve your glucose control. To learn more, ask your healthcare provider to schedule an appointment for you to meet with a Registered Dietitian.  SOURCE: VA Health Care

www.myhealth.va.gov May - Aug 2015 HealthLine

Anemia Cure in Women A

Home Remedies

Meenakshi Bhattacharjee PhD

nemia is a condition that develops when the blood lacks enough healthy red blood cells or hemoglobin. Hemoglobin is a main part of red blood cells and binds oxygen. There are many types of anemia but the most common one is caused due to deficiency of iron.

Anemia is the most common blood condition in the U.S. It affects about 3.5 million Americans mostly women, young children, and people with chronic diseases are at increased risk of anemia. While iron supplements do work to treat the condition, there are some natural ways to beat anemia too. Beetroot-Apple Juice Apple is rich in iron along with many other health friendly components. On the other hand, beet is high in folic acid as well as fiber and potassium. Its most nutrient rich part is just under its peel. So, if one plans to have beets, it has to be cooked in a microwave oven or just roasted on gas stove with its peel still on it. After it gets cooked, the beet is peeled and eaten. While one can always have an apple or two in a day, a mixture of beet with apple, increases thechances of fighting off anemia.

ÂŠ slawek_zelasko Fotolia

Sesame Seeds Sesame seeds are yet another ingredient that may excellently work to treat anemia. Especially the black sesame seeds are a rich source of iron. There is more than one way to have sesame seeds for anemia. 1st way to have sesame seeds for anemia is to soak the seeds, make a paste and mix honey with it and have the honey sesame paste twice a day. 2nd way to have sesame seeds for anemia is to make a paste of the soaked seeds, mix with milk and honey and drink sesame flavored milk daily. Blackstrap Molasses This is the folk remedy to fight with anemia. Blackstrap molasses not only contain high levels of iron but also folate which is a natural source of folic acid. There are

HealthLine May - Aug 2015

many B vitamins too in molasses. With all these components, molasses can increase red blood cell production efficiently. What is important is that even people suffering from diabetes can have this due to its low glycemic index. While you can always cover your waffles, pancakes or any other food with molasses, here is a fine home remedy that works very well. Mix 2 tsp molasses with 2 tsp apple cider vinegar and half cup water and drink this daily. Spinach Green leafy vegetables such as spinach (palak), fenugreek (methi), coriander (dhania) and Malabar spinach (Basella alba) are a great source of iron as well as folic acid that is important for the body, especially during pregnancy Just half cup of spinach daily is what one needs to cure anemia. This dark green leafy vegetable is high on Vitamins A, B9, E and C, iron, fiber, calcium, and beta carotene. Just half a cup of boiled spinach has 3.2 mg of iron which is about 20% of daily iron requirement for a woman. However, spinach should always be boiled, ÂŠ denira - Fotolia even if it is for a minute because spinach also has oxalic acid in it which interferes with the absorption of iron by the body. Boiling the leaves can reduce its oxalic acid levels. Spinach can be taken as juice, soup, salad or green vegetable curry. Tomatoes Just having more iron is not sufficient. One should be able to absorb that iron too. For this, among other foods, tomatoes can be taken for best results. Tomatoes are rich sources ofVitamin C and lycopene. Vitamin C is needed by the body to absorb iron. Tomatoes can be eaten raw in salads, sandwiches or as juice, soup, or in vegetable dishes. Pomegranate Pomegranate can be called a super fruit because it has too many beneficial components within it. It has protein, carbohydrate, fat, fiber and sugars too. More importantly, it has iron and calcium. It is enriched

as well as minerals like potassium and copper other than a host of vitamins. It excellently increases hemoglobin in the blood ÂŠ Viktorija - Fotolia and supports healthy blood flow. One will feel lesser exhaustion, dizziness, weakness that are typical symptoms of anemia. Pomegranate can be eaten as a fruit or as juice every day. Parsley Parsley, also known as rock celery, is perhaps the most popular culinary herb used worldwide. Apart from various other beneficial components, parsley is very high on iron and folic acid. A 100 g of parsley contains 5.5 mg of iron which means half a cup of fresh parsley or 1 tablespoon of this dried herb can meet 10% of the bodyâ&#x20AC;&#x2122;s daily requirement of iron! Not only this, its vitamin C helps the body to absorb iron well. Parsley can be eaten in salads, sandwiches, soups, gravies, stews and sauces. Its juice can be added to other fruit juices and also used to make tea with honey added to it. Dates Delicious palm tree fruits, dates, are a rich source of iron. 100 g of dates contain 0.90 mg of iron. Therefore it makes a good remedy for anemia as it helps increase hemoglobin in the blood. Dates are also rich in such minerals as calcium, manganese, copper, and magnesium. Copper is particularly required for the production of red blood cells. Dates can be eaten after soaking them in milk overnight and taken on an empty stomach, or eaten as such on an empty stomach in the morning. For people with lactose intolerance dates can be soaked overnight in water and eaten. Eating Liver The iron that we get from animals is called heme iron. The body absorbs this dietary iron better than the non heme iron which is obtained from plant based foods. Human body can absorb anywhere between 15-35% of the heme iron and that is a good number. Organ meat like liver is a powerhouse of iron which is the most important nutrient that the body needs when suffering from anemia. Organ meats are much higher in nutrients than the muscle meats. Liver can provide anywhere between 16 to 85 percent of the daily iron requirement depending upon what liver is eaten- calf, pork,chicken or goat/lamb. Chicken liver is one of the best sources of iron. Raw chicken liver has 9 mg iron while beef liver contains about 5 mg of iron. Liver is also a very good source of B vitamins, especially B12 as well as copper, phosphorus and zinc. However, it

is also important to eat organ meats of those animals which are raised on fresh pastures and are not treated with hormones, antibiotics and commercial feed. However, if one survives on vegetarian foods only, there are many more options like legumes. Wholegrains, Legumes, Nuts The human body can get two types of dietary iron- heme and non heme- from two sources namely animals and plant based foods. Heme iron is found in animals, particularly red meat, fish and poultry. Vegetarian sources of non heme iron are vegetables, grains, lentils and beans. Whole grains, legumes as well as nuts are good vegetarian sources of iron and folicacid. However, one needs to have balanced vegetarian diet if the iron is from plant based foods. Here are some tips for vegetarians. Have legumes like kidney beans, lima beans, green peas, chick peas and pinto beans all of which are good sources of iron. Have nuts like peanuts, almonds and walnuts. Half a cup of walnuts can give you 3.75 mg of iron. Have pulses and wholegrain cereals. Have lots of fruits and vegetables as there vitamin C and organic acids keep iron in a reduced form so that non heme iron is absorbed better by the body. Do not have tea, coffee, and cocoa with meals as polyphenols in them inhibit the absorption of non heme iron by the body. Raisins Raisins are an excellent source of various nutrients including calcium, potassium, sodium, protein, fiber and iron. A 100 g of these dried grapes can provide you with 1.88 mgiron. Many traditional medicines use raisins to treat anemia. Having raisins with honey have added benefits.

Meenakshi Bhattacharjee, PhD Faculty Fellow and Executive Director (CAAR), Biosciences @Rice 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. She has more than 200 publications in her field of work. Before coming to the US she was Professor and Head, Department of Biosciences at a reputed University in India.

Ash Gourd Also called winter melon, white gourd, winter gourd and wax gourd, (BengaliChal Kumro, Hindi- Petha kaddu) has been used since ages by Chinese and Ayurvedic medicine to treat various ailments and medical conditions. Rich in minerals and vitamins like calcium, iron, phosphorus, thiamine, riboflavin, niacin and vitamin C, ash gourd is used as a sweet for curing weakness due to anemia. There are many ways to use ash gourd to treat your anemia. While Ayurveda recommends drying of ash gourd fruit and leaves to get their powder. 1 tsp of this powder should be taken daily with a glass of buttermilk to treat anemia. However, because it is a tough task to dry out the gourd completely, so there is another way to use ash gourd for treating anemia. Ash gourd can be eaten as a sweet called Petha made in sugar syrup. ... continued on page 32 May - Aug 2015 HealthLine

Diet Plan for Anemia Above home remedies for anemia are great for acquiring nutrients that your body lacks. However, having well balanced diet is essential to prevent recurrence of anemia.

1. Iron rich foods- like liver, figs, seafood, molasses, beets, brown rice, whole grains, poultry, eggs, grapes, raisins, yams, almonds, and beans. 2. Potassium rich foods- like broccoli, bananas, sunflower seeds, vegetables, whole grains, kiwi, dried fruits. 3. Manganese rich foods- like whole grains, legumes, nuts, pineapple, eggs. 4. Vitamin C rich foods- like citrus fruits, tomato, green pepper, and chives. 5. Folic acid rich foods- like fresh green leafy vegetables, mushrooms, lima beans, blackeyed peas, kidney beans. 6. Avoid having coffee, tea, beer, or carbonated drinks like colas with meals otherwise you’ll block the absorption of iron by your body. When a balanced diet is followed as above, one may not require to follow home remedies for anemia anymore! CAUTION These are suggestions for simple anemia caused by iron deficiency. Although home remedies are known can control anemia always consult your doctor for medical advice. 32

HealthLine May - Aug 2015

Bottle Gourd Soup Anemia is caused due to nutritional deficiencies. Certain fruits and vegetables are excellent to increase the amount of iron and folic acid in our blood like beetroot, apples, dates, raisins, ash gourds and other such veggies and fruits. Bottle gourd (Hinhi- Lauki) soup can also cure anemia. To make the soup one can add, in addition to bottle gourd, beetroot and spinach in it. This vegetable is also eaten cooked as curry, made into a sweet dish with milk (Kheer). Yellow Dock Herbal Decoction Yellow dock (Rumex Cripus) is recommended by many herbalists for treating anemia due to iron deficiency. Although iron content in yellow dock root herb is not too much, what is important is its ability to increase mineral absorption by your body. This means, by itself yellow dock root cannot cure anemia but when used with other herbs rich in iron and other required nutrients, this herb can do wonders by absorbing the minerals in an excellent way. A decoction is made by boiling Yellow dock root- 1 tsp, Stinging nettle herb- 1 tsp, Peony root- 1tsp, Chinese Angelica root- 1 tsp, Red clover- 1 tsp, Molasses- 2-3 tsp, in water- 5-6 cups and drunk every day. This herbalremedy also prevents recurrence of anemia. Homemade Wheat germ Iron Tonic Wheat germ is a powerhouse of nutrients, main being iron and zinc. So wheat germ is used to fight anemia. Wheat germ can be made into an iron tonic by blending 1tsp of wheat germ,1 tsp of molasses, 1 tsp of canola oil and half cup of orange juice together and drinking it daily. This is particularly beneficial for vegetarians who cannot get some first ratednutrients sourced from animals. 

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