MEN-TSEE-KHANG
N e w s
L e t t e r
Vol. XX
March - 2011
C O N T E N T S
Golden Jubilee Celebration
Pg: 03
Seminars, courses, medical camps, health awareness
Pg: 05-07
Research: A descriptive study on Hypertension
Pg:09-15
New Publications
Pg: 16
Chronicles of Directors
Pg: 18
Email Address
Membership / Scholarship
Sponsorhip Secretary Mailing address Men-Tsee-Khang Gangchen Kyishong Registrar Dharamsala, Distt. Kangra gsec@men-tsee-khang.org H.P Pin - 176 215 Phone:0091-1892-223222/ Mail Consultation 223113 mailconsultant@men-tsee-khang.org Fax:0091-1892-224116 Email: Pharmacy Department scholarship@men-tsee-khang.org pharmacy@men-tsee-khang.org
Editor Kalsang Dechen Assistant editor Mr. Tseten Dorjee
Director director@men-tsee-khang.org
Branch Department branch@men-tsee-khang.org branch_dir@men-tsee-khang.org
Men-Tsee-Khang Exports
Account Section account@men-tsee-khang.org Herbal Product Research Department hprd@men-tsee-khang.org Project Officer projectofficer@men-tsee-khang.org For product information and rates contact Men-Tsee-Khang Exports Astro. Department astro@men-tsee-khang.org TMAI College tmaicollege@men-tsee-khang.org Quality Control qcontrol@men-tsee-khang.org
Mailing address PT 62/5 Kalkaji Near Post Office New Delhi - 110 019 India Phone:0091-11-26214897/ 26436823 Fax: 0091 11 26211738 Email: mtkexports@vsnl.net
Mailing co-ordinator Mrs. Dolma Tsering This is the official Newsletter of Men-Tsee-Khang (Tibetan Medical & Astrological Institute of H.H. the Dalai Lama). Gangchen Kyishong, Dharamsala—176215, INDIA. It is published and distributed free of cost. However, we request donations to cover expenses. To make donations, please contact Mailing Co ordinator, Men-Tsee-Khang, Gangchen Kyishong, Dharam- sala - 176215. INDIA.
Tel: 0091-1892-223113/223222 Fax: 0091-1892-224116 E-mail: tmai@men-tsee-khang.org tmai@vsnl.com www.men-tsee-khang.org wwww.mentsee.org Newsletter Editor editor@men-tsee-khang.org
News MEN-TSEE-KHANG CELEBRATES GOLDEN JUBILEE Men-Tsee-Khang celebrated its 50th anniversary on 23 March, 2011. His Holiness the Dalai Lama kindly graced the occasion with his blessing and the guest of honour was His Excellency, Dr. Rajeev Bindal, Minister of Health and Family Welfare, Himachal Pradesh.
His Holiness the Dalai Lama inaugurated the photo exhibition of MenTsee-Khang which depicts the overall development stages since 1961. The ceremony then followed with recitation of Yuthok prayers and long life offering to His Holiness the Dalai Lama. The Director, Dr. Tsewang Tamdin presented the 50 years of Development & Progress report of MenTsee-Khang. He informed how the institute developed from a modest beginning with a doctor and an astrologer in 1961 to a total strength of 856 employees who have joined the institute in the past fifty years. He mentioned the increase in the infrastructure of seven administrative and nine academic departments, briefly explaining each department and its functions. He described how the institute moved forward in bringing efficient management in the administrative set up, integrating traditionMen-Tsee-Khang
March 2011 al and modern methods, producing standard quality medicine in relevance to scientific methods and development by setting up Quality Assurance Laboratory to follow the norms of GMP, introduced solar cum electric dryer, new machines for packaging of granules, Blister packing machine for precious pills to create better quality and hygienic conditions. Research on the efficacy of Tibetan medicine in disorders like diabetes, cancer, hepatitis and hypertension has been done in collaboration with western scientific system of anal-
ysis with AIIMS (All India Institute of Medical Science) New Delhi; Natural Medicine Research Center, Hadassah, Israel; Department of Chemistry, University of Liverpool, UK and Exchange of Education Programme with University of Minnesota, USA. A token of gratitude and appreciation was presented to His Holiness the Dalai Lama and the Honourable Health Minister, Dr. Rajeev Bindal. Award was also presented to the pioneer staff members, 20 & 30 years service and 2010 topper students in medicine and astrology. Six new
publications and a documentary film were launched on the occasion. His Holiness the Dalai Lama lauded the institute in exile for its achievements so far but also stressed to work harder in advancing further in the field of research and analysis, collaboration with western scientific system, ayurveda, unani etc, sharing of expertise and understanding the knowledge of other systems of healing. Kalon Tripa Prof. Samdhong Rinpoche also addressed the occasion. He said that there have been drastic changes in the world and the exile community in the past 50 years. Men-Tsee-Khang is one of the important institutions in exile and applauded the service rendered by the institute in the welfare and benefit of suffering beings. One should use the opportunity through dis-
cussion, research and collaboration with other sciences in the further advancement of Tibetan medicine. He said that the system is recognized by the Govt. of India and there are many things to be done and can be done in future in a flexible way. The Speaker of the Tibetan Parliament also addressed on the occasion commending the journey of the institute from a humble beginning to 3
News the full-fledged institutions amongst the Tibetan exile community. The Honorable State Health Minster, Dr. Rajeev Bindal is an Ayurvedic Graduate from MD University, 1978 and said that he belonged to an Ayurvedic family of 140 years. In his address he congratulated the successful completion of 50 years in the preservation and expansion of Tibetan medicine Sowa Rigpa. Every person on this earth should be hale and hearty and it is the target of any medical knowledge. He gave example of Israel whose people was away from their motherland for 2000 years in different parts of the world and after 2000 years they succeeded to
gain their mother land and now they are in the mainstream of the world. The Honorable Minister informed that the Govt. of Himachal is doing many things in the field of research. Many herbs are extinguished and had to be preserved. “I welcome the suggestion given by Prof. Samdhong Rinpoche, we should come together in the field of research in Ayurved and Tibetan medicine, we can do joint work for the sake of humanity, development of herbal and Himalayan medicine” said the Honorable Minister. High altitude medicine is the basic base of Tibetan mediMen-Tsee-Khang
March 2011 cine. High altitude herbs are rare and endangered. “I offer that we can go hand in hand for the purpose of research, development of medicine, understanding each other, Ayurved and Tibetan medicine in a different way to develop further for the service of mankind and to preserve the knowledge of Tibetan medicine”. The dignitaries present were Supreme Justice, Kalon Tripa & the cabinet ministers, CTA; speaker and deputy speaker of parliament, ATPD; Deputy Director (MEA) Mr. Arun Sharma; Deputy Ambassador Mr. Mattias Lentz and Ms. Alexandra Berg Von Linda, second secretary, Political and Economic Affairs, Embassy of Sweden New Delhi; SDM Dharamsala; Members of the Governing Body of Men-TseeKhang; Khamtrul Rinpoche, abbots of Namgyal monastery, Gyuto and Gyumed tantric colleges, head of various NGO’s, institutions and nunneries. Men-Tsee-Khang sponsors from India, Norway and Germany attended the function.
A total of 440 people gathered during the ceremony at MTK Hall on the occasion of Golden Jubilee Celebration. GUIDANCE & COUNSEL KALON TRIPA PROF. SAMDHONG RINPOCHE ADDRESS TO MEN-TSEE-KHANG Kalon Tripa Prof. Samdhong Rinpoche visited Men-Tsee-Khang on 28 March, 2011 on the request of the administration to give guidance and counsel on Medicine, Astrology, Administartion and Future Prospects of Men-Tsee-Khang. He gave an hour long talk briefly speaking on the origin and development of Tibetan medicine and astrology in Tibet and how in exile under the guidance of His Holiness the Dalai Lama, MenTsee-Khang was established in the preservation of this ancient culture in India. Rinpoche informed that he dislike to speak or comment on the internal matters as an outsider who has freedom to raise opinion because one is not familiar with limitations of acting in a position. He said that he was not a student or practitioner of medicine and astrology but familiar with medicine and astrology as his teacher was a scholar in medicine and astrology in Tibet. His reminiscence of those days was “Tashi Nyima a student used to recite text on pulse and urine but before he could catch up, I would memorize it”. Rinpoche said that according to Buddhist philosophy there are five 4
March 2011 sciences which are also the same as in Buddhism in India. Amongst the five sciences Sowa Rigpa is one of the significant and unique cultures and the term is commonly used in Buddhist context. There are divergent accounts as to the origin of Gyu-shi and the argument has lived on. Dr. Baghwan Das is of the view that it is a translated work on Indian sources as well as scholars of Ladakh and Himalayan region. If that is the case then it would be difficult for the Indian Govt. to accept Sowa Rigpa as a separate and unique system of healing process. It is clear from the historical facts and the usage of literature and grammar that Gyushi is not a translated work from India. Since there are controversial issues on the origin of Gyushi, Rinpoche stressed the significance of validating the science of historical events about its origin, who and when it was composed, whether it is a Terma (concealed teaching) or composed by a scholar. He said that it is improtant for Men-Tsee-Khang to have a firm stand point regarding the origin of Gyushi by doing research on the facts that we have. Rinpoche also addressed on the origin and development of Astrology in Tibet. He mentioned that even though Astrology did not advance as Sowa Rigpa (Tibetan medicine) but still there is wide scope for advancement through innovations, research and discussion. Besides, he felt that Tibetan astrology has contributed to the world through its unique system of calculation like knowing the phases of the moon on the basis of waxing and waning process, month on the basis of the moon, the year on the basis of sun, the knowledge of using both the sun and moon (luni-solar) as the basis of doing predictions on celestial bodies and the Men-Tsee-Khang
Seminar planet earth. He said that the year, month, days, zodiac signs, eclipse are all the same though the practice differs like we calculate it on the basis that the earth being static, the sun and the moon revolves around or they the other way round. Whatever differences the base may be, there is no error in the calculation methods of the two systems. He said, we have to use the loss of being in exile as a blessing in disguise by acquiring knowledge from other astrological system popular in India and the west through research, debates, discussion and assimilating it in the advancement of one’s culture. He also informed that knowledge on mathematics, a traditional science in Vedas is gaining popularity and so astrologers should also keep their interest on Vedic mathematics and other new fields of development on the basis of research and studies. There is a great opportunity and wide scope in enriching ones knowledge by bringing out new ideas and exchange of views with different scholars and professionals of medicine and astrology through collaboration, discussion and debates. He advised that the process of registration of Tibetan Medial College as a recognized college or university affiliated under UGC (University Grants Commission) and AIU (Association of Indian University) is important as Sowa Rigpa has been recognized by
Govt. of India. Rinpoche also threw light on the importance of how to maintain and update paper work, accounts, tax filing according to the rules of the state government.
SEMINAR DHARAMSALA, MTK A three day seminar on Tibetan medicine and astrology was organized by Men-Tsee-Khang from 24-26 March, 2011 on the occasion of the Golden Jubilee Celebration. There were a total of 15 speakers for medicine and astrology who were from Varanasi, Paprola, Namgyal monastery, Tirupati and Men-Tsee-Khang. Ven. Khamtrul Rinpoche spoke on Ethics of Doctors and Astrologers and Ven. Thamthog Rinpoche, abbot of Namgyal monastery gave a guidance speech to the participants. The topics on Astrology seminar were on Guru Yoga according to Kala
Chakra, Development of Astro. Science, Arising Vowels (Dbyan-gchar), The Three Days (Zha-Sum), Eclipse and Zodiac Influence. The speakers invited were ex-abbot Jado Rinpoche from Namgyal monastery; Prof. Rakdho Rinpoche & Lecturer Tashi Tsering from CUTS (Central University of Tibetan Studies), Varanasi; Prof. Radha Kant Thakur from Rash5
News
March 2011
triya Sanskrit Vidhyapeeth, Tirupati, Andhra Pradesh; Astrologer Tsering Chozom, Dr. & Astrologer Sonam Rinchen from MTK. The topics on medicine were Clinical Research on Tibetan medicine, Lecture on most prevalent diseases, Development & commentaries on Tibetan medicine, Mind & Khang to give course at the International Institute of Higher Tibetan Studies in Huttenburg. The duration of the course was for three months.
Mental disorder, Diagnostic methods of Ayurveda, Tibetan medicine and Allopathic system. The speakers invited were Ven. Khamtrul Rinpoche, Ven Thamghog Rinpoche (Abbot Namgyal monastery); Dr. Tsetan Dorjee Sadutshang & Dr. Kunchok Dorjee from Delek Hospital; Prof. Y.K. Sharma, former Principal of Paprola Ayurvedic College, Dr. Pema Dorjee and Dr. Dorjee Rabten Neshar from MTK. A total of 180 doctors, astrologers & students participated in the three day seminar. On 26 March, 2011 debates on the three best articles on Medicine and Astrology were discussed.
DIPLOMA COURSE I.I.H.T.S. AUSTRIA Dr. Tsering Thakchoe Drungtso, lecturer of Tibetan Medical & Astro. College was deputed by Men-TseeMen-Tsee-Khang
The course consisted of Module V to Module IX and it was given to the blocked group participants. Module VIII started from 10- 12 December, 2010 and Dr. Tsering Thakchoe Drungtso lectured on seven different topics of “Relationship between Tibetan medicine and astrology, Introduction of Surgical Equipments I and II, Introduction to Venesection, Introduction to Moxibustion, Pest i l e n c e disorders I and II” and c o m p l e te d the module in eight sessions. He also gave health consultation to 12 patients in Austria.
Module V to Module IX was from 17 - 30 Jan, 2011. The doctor spoke on 34 different topics completing the five modules in 40 sessions. The topics in Module V consisted of “Prerequisites qualities and types of a physician, Ethics of a physician, Introduction on Tibetan Massage, Introduction on Mild Therapies, Introduction on other Therapies and Introduction on Tibetan Materia Medica I”. Module VI topics were “How Outside Elements Influences our Inner Elements, Introduction to Seven Essential Limbs of Medicinal Plants, Allegorical Tree of Root Tantra Practical- I and II, Allegorical Tree of Explanatory Tantra Practical - I and II”. Module VII lessons were on “Introduction to Pulse Diagnosis Part I and part II, How to Relate Our Sense Organs with Internal Vital & Hollow Organs , Introduction into Urine Diagnosis part I and part II, Introduction to Medicine of Pacification, Introduction to Medicine of Evacuation”. Module VIII lectures were “Relationship between Tibetan medicine and astrology, Introduction of Surgical Equipments I and II, Introduction to Venesection, Introduction to
6
March 2011
News
Moxibustion, Pestilence disorders I and II”. Module IX topics were on “Allegorical Tree of Oral Instruction Tantra, Und e r sta n d i n g rlung Disorder I, II and III, Psychological disorders, Understanding of mKhris-pa Disorders I and II”. Group discussions, individual presentation on favorite topic, question and answer session followed after each session. There were 45 participants from different places of Europe namely Germany, Switzerland, Slovakia, Czech and Austria including doctors, health workers and activist. In total Dr. Tsering Thakchoe Drungtso gave 48 sessions to the participants of the diploma course during his visit. The participants expressed their profound gratitude for the doctor’s excellent, outstanding and inspiring explanations.
MEDICAL CAMP VARANASI Dr. Tenzin Lhadon, visiting physician to His Holiness the Dalai Lama & Head of Clinical Research Department was deputed by the administration to set up medical camp during His Holiness teachings at Varanasi from 12-17 Jan, 2011. Dr. Tenzin Lhadon with the doctors and staff of Bodh Gaya medical camp together set up the site for the medical camp. During the six days of teaching, Dr. Tenzin Lhadon, Dr. Men-Tsee-Khang
UPPER TCV SCHOOL
Tenzin Choedon and Dr. Tenzin Dorla gave consultation and treatment to 770 patients. They gave advice on dietary and life style as well. MenTsee-Khang would like to thank the administration of CUTS (Central University of Tibetan Studies) for its help and support.
HEALTH CARE TRAINING SUJA SCHOOL, TCV The Department of Health, CTA organized a basic health care training for newly arrived female students of TCV, Suja School from 17-22 Jan, 2011. The speakers were from Department of Finance (1 day), Delek Hospital (4 days) and Men-TseeKhang (1 day). Dr. Rigzin Sangmo, clinical research department, MTK was deputed by the administration to give lecture on women’s health care. She was the speaker on 22 Jan, 2011 and spoke on the gynecological problems, preventive measures, general health and hygiene in managing ones health. She explained on pre-menopause, menopause, menstruation, self breast examination and covered topics on other related women’s health care issues according to Tibetan system of healing. As requested by the trainees she also spoke on gastric disorders, its causes, prevention and remedial measures.
Dr. Pema Dorjee, advisor was deputed by the administration to speak on Tibetan medicine and the use of precious pills at Upper TCV School, Dharamsala. The talk was organized by TCV School to the house wardens of TCV branch located in Himachal Pradesh. There were 62 participants during his talk on 30 Dec, 2010 and 57 participants during his talk from 1-3 Jan, 2011. The doctor gave two and half hours lecture on dietary lifestyle, Tibetan medicine, uses and potency of precious pills, how it can be used as a health tonic and remedies for disorders. The house wardens showed interest on the topics covered and also asked queries related to health, prevention and precautions of diseases, how to handle emergency cases according to traditional system of healing. GANGCHEN KYISHONG Tibetan Parliamentary Research Committee organized a workshop to class XI students from all the Schools and teachers on 28 Dec, 1010. Speakers from Men-Tsee-Khang were Advisor Dr. Pema Dorjee; Astrologer Tenzin Nyandak and Registrar Mr. Tsering Phuntsok. Dr. Pema Dorjee spoke on the history, origin and concept of Tibetan medicine and dietary life style. Mr. Tenzin Nyandak spoke on the history, origin and introduction of Tibetan Astronomy and Astrology. Mr. Tsering Phuntsok, registrar briefed on the administration and management of Men-Tsee-Khang.
20 & 30 YEARS SERVICE Dr. Pema Dorjee joined the 2nd batch of medical students in 1969 7
Donation
March 2011
and completed his Menpa Kachupa Degree (bachelor of Tibetan medicine) in 1974. He served as a doctor in 1981 in the branch clinics at Nepal, Delhi, Itanagar, Salugara, Kol-
many times. She has served the institute for 20 years. Mr. Topgyal served the institute as a medicine store staff under Pharmaceutical department in 1990. He also took the responsibilities of an in-charge of fixtures and furnitures, cleaning raw materials, as a secretary for staff welfare committee for ten years. Since 2004, he has been serv-
kata and Dharamsala. In 2002 he was appointed as the Registrar of Men-Tsee-Khang and as the Visiting Physician to H.H the Dalai Lama in 2001. In 2005 he served as the Head of Sorig Literary Research Department and the Vice chairman of Academic Council. He was appointed as the Advisor in 2009 and a member of the Governing Body of Men-TseeKhang in 2010. He has travelled to many countries abroad and India to attend seminars, give lectures and health treatment to many suffering people. He has served the institute for 30 years. Astrologer Tsering Choezom joined the 3rd batch of astrology students and completed her five years course in 1987. She then joined the institute as an astrologer in the astrology department in 1989. From 1998 - 2003 she was appointed as the lecturer of Tibetan Medical & Astro.College. In 2005, she was transferred to the astrology department. She is one of the members in the Academic Council since 2010 and was appointed as the assistant head of Astrology department the same year. She has travelled to India and abroad for exhibitions, seminars and lectures
ing as the warden of Girls Hostel and has served the institute for 20 years. Mr. Penpa Tsering served in the Pharmaceutical department since 1990. He has worked in the grinding, pilling unit etc. Besides he served as the member of the staff welfare committee for eight years. He has served the institute for 20 years. Mrs. Nyima Tsamchoe joined the institute in 1990 and worked as accountant cum dispenser in Delhi Mayur Vihar branch clinic. She was then transferred to Bangalore branch clinic as a dispenser, as an accountant to Bylakuppe and Kollegal branch clinics. At present she is serving as a dispenser in Mundgod camp # 3 Branch Clinic. She has served the institute for 20 years. Mr. Thupten Jampa served the institute for 20 years from 1990. He worked as a dispenser in Manali
Men-Tsee-Khang
branch clinic, as an accountant in Kolkata and Shimla branch clinic, then transferred to Dharamsala in the postal section, HPRD store, college secretary, accountant in Mcleod branch clinic, Mess and at present serving as an in-charge of precious pills in the Medicine Sales and Store section. He is also the assistant head of Medicine Sales and Store section and has served as a member of the staff welfare committee for five years. Mrs. Yangzom joined the institute in 1991 serving in the inpatient ward. She was then transferred to the Pharmaceutical department worked in the cleaning and pilling unit. At
present she works in the raw material cleaning process. She has served the institute for 20 years.
DONATIONS Donation received from Branch Clinics Mr. Dorjee Khando, CM Arunachal Pradesh Roma Organics Pvt.ltd. Navi Mumbai Mrs. Nayna K. Turakhia Navi Mumbai Roma Organics Pvt.ltd. Navi Mumbai
48000.00 5001.00 10,001.00 5001.00
8
March 2011
Research report
A DESCRIPTIVE STUDY OF HYPERTENSION BY CLINICAL RESEARCH DEPARTMENT, MEN-TSEE-KHANG Title: A descriptive Study of Hypertension among Tibetan with age range from 30-70 years old living in refugee settlement in India Dr. Tenzin Lhadon*, Dr. Pema Dorjee, Dr. Dawa Dolma, Dr. Tenzin Namdol, Dr. Rigzin Sangmo, Dr. Tenzin Lhundup*, Mrs. Sonam Yangdon Clinical Research Department, Men-Tsee-Khang, Gangchen Kyishong, Dharamshala-HP India Abstract The various Men-Tsee-Khang (TMAI) branch clinics have witnessed a significant rise in hypertension cases amongst the Tibetan people within India, which has been attributed to the population's high dietary intake of calories and fats, their relative sedentary lifestyle, and the underlying stress associated with the trauma of adapting with new environments and family separation. These risk factors are also coupled with a lack of public awareness about hypertension, and poor access to health care systems to address this rising prevalence of hypertension. In this study Tibetan people within the age range of 30-70 were asked to come for blood pressure screening and to participate in the Schedule Standardized Interview , which allowed for the collection of people's identification details ,physical examinations findings, dietary patterns behavioural factors, physical and mental activity and prior treatment history. Our results found that 46% of the population screened was found to be hypertensive. The associated factors noted in the survey such as male gender, being overweight, a dietary intake of alcohol, non-vegetarian diet and Tibetan butter salted tea, and physical inactivity were shown to play significant and independent roles in the development of hypertension amongst the Tibetan refugees residing in the northern and southern settlements in India. Keywords Hypertension, Scheduled –Standardized Interview, Tibetan settlement, Tibetan medicine Introduction In the year 2004, the Clinical Research Department of Tibetan Medical and Astrological Institute proposed a screening program of hypertension amongst the Tibetan living in exile in India, based on the reports by the 47 TMAI branch clinics of Hypertension being one of the five most prevalent diseases within this population. Historically the Tibetan people in exile initially found difficulty in adapting to the dietary and behavioral changes that the new environmental conditions demanded. Therefore, they continued the regular consumption of non vegetarian diets, butter salted tea, other foods rich in oil and fat, and the Tibetan beer known as chang (wine brewed from barley). These dietary habits have been attributed to causing the elevated prevalence of cholesterol, gastric, renal and heart diseases, and now hypertension as demonstrated in this study. Other factors have been postulated to contribute to the high prevalence of hypertension amongst the Tibetan people. A majority of Tibetan farmers residing in the southern settlements (those who fled soon after the invasion of Tibet in the year 1959) were illiterate yet hardworking in nature, which led to them often working in the intense summer heat. This occurred in combination with other well established risk factors for hypertension such as the stress associated with the hectic schedules of modern civilization and increased competition, their relatively sedentary lifestyles, and the improper eating habits noted above. The academic council of Men Tsee Khang sanctioned this survey project to estimate the prevalence rate of hypertension among Tibetan refugee community based in northern India. This project included the primary aim of documenting the prevalence rate of hypertension within this population. The project also included the secondary aims of creating an awareness of hypertension within the community, and also to analyze the dietary patterns and behavioral factors which are important contributing factors in hypertension. The academic council of Men-Tsee-Khang additionally approved the next phase of screening Hypertension in Tibetan Refugees living in the southern part of India in August, 2007. Review of hypertension treatment In the traditional Tibetan medicine, the pervasive rLung is situated in the heart and maintains the principal Men-Tsee-Khang
9
Research report
March 2011
functioning of overall internal and external movements of the body. When this is imbalanced, it causes "stod 'tsang", which can be translated as pressure or tension in the upper part of the body. Hypertension in Tibetan Medicine is primarily classified into two types; blood associated hypertension, and rLung associated hypertension. Hypertension typically develops in parallel with the individual's leading sedentary lifestyles and the competitive adulthood stage of life during which mKhrispa energy dominates the body, and one becomes more arrogant, energetic and more susceptible to blood and mKhrispa associated diseases. Although the sedentary lifestyles, stress and strain, excess consumption of strong tea, sour and high salt dietary intakes, and hot climatic conditions may cause hypertension, many patients with established hypertension seems to neglect these factors and the disease itself. The Modern allopathic system emphasises the importance of measure such as DASH diet which is primarily stated in the centuries - old established Tibetan Medicine as the first of the four main treatment approaches. A large number of the Tibetan people lack the awareness regarding their health due to various circumstances. Even if this awareness was increased, and individuals were undergoing treatment with Tibetan medicine, they would most likely only adhere with the dietary and lifestyle restrictions for a short period of time, which is grave concern for the healthcare professionals. Besides, those patients undergoing allopathic treatment would continue with the same prescription without follow up and adjustment of their treatment, and so may end up with chronic complications from the disease such as renal failure. This poor access to health care may be affected by other factors apart from the degree of public awareness about the disease, such as individual and group attitudes, intellectual levels and peer behaviors. These factors seem to get gradually embedded and accepted by the society as a whole. The gray scene of people who are hypertensive need to be made aware of all the important factors such as the causes of the disease, symptoms, the importance of regular follow up visits to the concerned clinics, dietary and lifestyle modifications, the ultimate aim of treatment, and the importance of preventing hypertension within the community. Untreated and uncontrolled, hypertension can lead to severe complications such as cardiac arrest, stroke, renal failure, diabetes, edema, varicose veins, and lead on to damaging the other vital organs of the body. Objective of the study 1. To find out the prevalence rate of hypertensive patients among Tibetan people within the Tibetan Government in Exile (TGiE) in India. 2. To find out the important factors affecting hypertension, including dietary and behavioral patterns. 3. To create public awareness about Hypertension; causes, conditions, types, symptoms, treatments, and prevention of the disease. Methods and Sample The Scheduled –Standardized Interview was used to form the basis of the study, in which the questionnaire included data collection of the participants' Identification details, Physical Examination, Dietary Patterns, Behavioral Measures, levels of Physical and Mental activity, and relevant Treatment history. All the settlements followed the same protocol and measurements. The sample size consisted of 6934 Tibetan refugees within various settlements throughout the northern and southern India. a. Selection and Description of Participants The administration of Men Tsee Khang (TMAI) gave an authentic reference letter regarding the survey research to the respective research team, the representative of the settlement office, the settlement's branch clinics of TMAI and the settlement's health centre. This letter was given to facilitate the project and to convey the guidelines to the village head or community health workers to go door to door to invite all the people fulfilling the age range of 30-70 years of either gender to attend their respective TMAI branch clinics or community health centre hall for the hypertension screening program and survey. At each assembly a public health talk was given regarding Hypertension, and the participants were then grilled towards the next step of undergoing the actual screening or Scheduled Standardized Interview. The participants were asked the appropriate questions, and their answers objectively documented on the Pro-forma. The north region of survey study included the agro- industrial and handicraft based Tibetan settlements. Men-Tsee-Khang
10
March 2011
Research report
The settlements of Sataun, Puruwala, Kumrao, Herbertpur, Ponta, Clement Town, Manduwala, Rajpur and Dekyiling were group under the Dehradun settlement, seeing as they were all located in the same geographical area. (Figure no. 1) The Dehradun settlement consisted of a total number of 839 participants; 365 male and 474 female. Tibetans residing in Shimla region and Dolanji were collectively group under the Shimla settlement, which had a total number of 87 males and 130 females, totaling 217 participants. The settlements of Mcloed Ganj, Tashi jong, Bir & Chauntra, and Dharamsala were grouped under the Dharamsala settlement with a total number of of 976 male and 586 female participants totaling 1562. The above mentioned settlements were all within the northern states of India, and so represent the North region of the survey study. The south region of the study included mostly agriculturally based settlements in the Karnataka state of India. Each southern settlement consisted of a large population of lay people, and people in monastic universities, schools, and the Cooperative Society. The Bylkuppee settlement had 981 male and 857 female participants, with a total of 1838 participants. The Hunsur settlement had 307 male and 279 female participants, totaling 586. The Mundgod settlement consisted of 754 male and 529 female, with a total number of 1283 participants. The Kollegal settlement had 249 male and 360 female, with a total number of 609 participants. Overall there were 2618 participants from the north region and 3215 from the south region of the study, constituting a total sample size of 6934 participants of which 3719(54%) were male and 3215(46%) were female. b. Technical Information Material used across the study included: 1. A Sphygmomanometer of Mercurial, Desk Model, 300 mm/Hg, complete inflation system, in an aluminum case and spare rubber Bulbs (Balls) of oval shape with an end valve and Spare Air Release/Control Valves (Metal). This was used to measure the blood pressure of all the participants, with hypertension cut-offs defined as either a Systolic blood pressure (SBP) ≼140 mmHg or a Diastolic blood pressure (DBP) of ≼ 90 of mm of Hg. 2. Personal Weighing Scale with the capacity of 150 Kg x 0.5 Kg, measuring 32 cm (dia) x 6.2 cm (height), net weight of 2.90 kg was used to measure the weight of the participants in kilograms. 3. A Height Measure; Madler (company product) with the maximum limit of 200 cm which was used along with the associated weights to calculate the Body Mass Index (BMI) of the participants. c. Statistics The prevalence rate was estimated by taking the numbers of participants who qualified the above criteria for hypertension, dividing this by the total number of the participants in the survey. The demographic characteristics and prevalence rates were similar between the northern and southern settlements, and so further analysis incorporated the entire sample size as a whole. Bivariate associations between potential risk factors and hypertension as an outcome (binary outcome variable) were estimated using odds ratios (ORs) and their respective accuracies assessed with 95% confidence intervals for categorical variables. Associations with continuous variables were examined using two-sample t-tests. Finally, a logistic regression model was fit to incorporate all significant variables from bivariate analysis, and to examine their relative importance in their association with hypertension as an outcome. Adjusted odds ratios are presented alongside unadjusted odds ratios. Results The overall prevalence rate of hypertension among the Tibetan communities was 46% (95% CI 0.452-0.476), and there was no meaningful difference between northern and southern settlements (47% in the north and 46% in the south). There were several factors noted involving the daily dietary and behavioral habits adopted by the Tibetan refugee residing in northern and southern parts of India which are related significantly to the development of hypertension (140/90 mm/Hg) (Table no. 1) The overall mean SBP of all the participants was within the high normal range 128¹19.8 (6931). The overall mean Men-Tsee-Khang
11
Research report
March 2011
level of obesity amongst Tibetan women with 215±411 (3212) was comparatively higher than the mean level of obesity in males, 138±344 (3709). It is interesting to also note that there was a comparatively larger consumption of meat, strong tea, and Tibetan tea among the female cohort compared to the male population, with the number of days eating meat being 3±2 (2974) in the males compared to 4±2 (2575) in the females, strong tea consumption being 3±3 (2038) in the males compared to 4±4 (1590) in the females, and Tibetan tea consumption being 3±3 (1345) in the males as compared to 4±3 (1266)in the female population. The mean frequency of smoking amongst the male was also quite high, being 504 (90) compared to female frequency of 17(52), and the mean frequency of smokeless tobacco (narcotic chewing substances) use was also higher in males, being 3665(14) compared to 3093(2) in the females. There seemed to be no significant difference between the male and female population regarding the amount of light activities 3715(66) vs 3206(66), vigorous activities 3715(18) vs 3207(17), Hypertension Treatment 3700(14) vs 3199(15), Blood Sugar Measured 3709(2) vs 3207(2), Diabetes Told 3710(3) vs 3202(2), and Diabetes Treatment 3706(2) vs 3200(2) respectively. There was also a higher mean frequency of stress shown in the female group, being 3208(31) compared to the males being 3711(19). (Table no. 2) Out of the 6216 participants, 3397 (56) responded "yes" and 922(16) responded "no" and 1897 (27) responded "don't know" when asked whether their blood pressure had ever been measured. Out of 6923 participants, 1451(20) responded yes and 3772 (54) responded no and 1700(25) responded "don't know" when asked about the presence of a family history of hypertension. Regarding a family history of heart disease, out of 6924 participants, 603(9) responded yes, 4916(70) responded no and 1405(21) responded "don't know". (Table no. 3) An overall total of 6934 Tibetan people participated in the survey research study, comprising of 3719(54%) male and 3215(46%) females. (Table no. 4) Discussion The difference in the prevalence of hypertension being 16% (age group of 30-40) and 14% (in 41-50 age group,) between the male and female participants seems to support to age-old hypothesis of males being more prone to hypertension due to their energetic and arrogant nature, and being more powerful or stronger than females. This study also clarified that the consumption of alcohol, smoking and smokeless tobacco (narcotic chewing substances) was more prevalent in male versus female cohort, and that this may play a pivotal role in the development of hypertension amongst the males. The other important and new factor that this study illustrated regards the consumption of a non-vegetarian diet, which is commonly adopted by Tibetans. The habit of eating vegetarian food is something that needs to be improved and further developed within the Tibetan society so that the next generations of Tibetan people will also adopt these healthier diets. The female population showed an excess consumption of non-vegetarian food and Tibetan Tea (butter salted tea) an overall higher prevalence of being overweight, and more sensitive to stress than their male counterparts. These factors may result in females being more vulnerable to developing hypertension. However, the significantly higher male prevalence of smoking and smokeless tobacco use could surpass the above factors and lead to the higher prevalence of hypertension seen in the male population. Likewise, the sedentary lifestyles, over eating, and lack of physical exercise in both the groups show an overall high prevalence of important risk factors for developing hypertension, irrespective of gender. We expect that at the best possible time, all the targeted people of these settlements have attended the screening survey as they are a kind of captive audience and have fully bestowed their cooperation to contribute to the success of this survey and the results we have found. Conclusion This survey study has shown that 46% of the total populations screened were found to be classified as hypertensive which is a grave concern for the healthcare professionals servicing this population and for the society as a whole. Our secondary aim of creating an awareness of Hypertension amongst people may have also benefited many of those who were not aware of the causes or the hazard that hypertension poses to their health. This study has illustrated several important aspects that may contribute to the overall dimensions of the high prevalence of hypertension amongst the Tibetan refugee settlements. Increased access to education about hypertension and other health topics may help people to be more health aware in the future, and prevent this "silent disease" from penetrating further Men-Tsee-Khang
12
March 2011
Research report
into our society. In other words, it's now more imperative than ever to make Tibetan people aware of the need to limit their energy intake as per the amount of energy expended, to consume healthy or balanced food, and to instill good walking and other physical exercise habits in order to decrease this high prevalence of hypertension. It is advised that further follow up from this study include an evaluation of the efficacy of Tibetan medicine in the treatment of hypertension. References 1. rGyud bzhi - The Fundamental Treatise on Tibetan Medicine authored and compiled by Yuthok Yonten Gonpo, Senior & Elder, (AD 708-833) & (A. D 1126-1202), Men Tsee Khang Publication, 2. Man ngag lhan thabs, authored by Desi Sangye Gyatso (1653-1705) publisher Men-Tsee- Khang ,2005 3. Fundamentals of Tibetan Medicine, fifth revised edition 2009, copyright ŠMen Tsee-Khang, 2009 4. Vaidurya sNgon-po(The Blue Lapis lazuli),authored by Desi Sangye Gyatso(1653-1705),1994 publication, Men-Tsee Khang, 5. The Dash Diet Eating Plan- www.dashdiet.org, (access in 2010,) DASH also endorsed by: The National Heart, Lung, and Blood Institute (one of the National Institutes of Health, of the US Department of Health and Human Services) The American Heart Association The Dietary Guidelines for Americans US guidelines for treatment of high blood pressure And, the DASH diet formed the basis for the USDA MyPyramid. 6. Applied Social Research, Tool for the human services, (Third edition) by Monette. Sullivan. Dejong, North Michigan University, Harcourt Brace College Publishers, CopyrightŠ 1994, 1990, 1986 by Holt, Rinehart and Winston, Inc 7. Mayo clinic: High Blood Pressure (Hypertension) basics /Indepths www.mayoclinic.com access in 2010 8. 2003 World Health Organization (WHO)/ International Society of Hypertension (ISH) statement on management of hypertension J Hypertens. 2003 Nov; 21(11):1983-92. John Curtin School of Medical Research, Australian National University, Canberra, Australia. judith. whitworth@anu.edu.au 9. http//en.wikipedia.org/wiki/hypertension 10. Report of Hypertension Survey in Southern settlements, 5th Aug-5th Sept.2007 by Dr. Dawa Dolma, Clinical Research Department, Men-Tsee- Khang 11. Report of Hypertension survey in Mundgod settlement, 10th Aug- 23 Aug, 2007 by Dr. Tenzin Namdol, Clinical Research Dept., Men-Tsee-Khang 12. Report of Hypertension Survey in Shimla settlement, by Dr. Rigzin Sangmo, Clinical Research Dept., Me-TseeKhang 13. Official Annual Report of Clinical Research Dept. , Men Tsee Khang, 1st April 2007 -30th March 2008, 14. www.tibet.com Central Tibetan Administration/Dept. of Home/Settlement, (access in Dec 2010) 15. Association of BMI and nutritional habits with hypertension in the adult population of Croatia. Ana Ivicevic Uhernik*, Marijan Erceg and Sanja Music Milanovic, Croatian National Institute of Public Health, Rocketfellerova 7, 10000 Zagreb, Croatia. Units of Measurement Blood pressure was measured in mm/Hg, weight in Kilogram (Kg) and height in centimeters (cm) Symbols and Abbreviation OPD-out patient department. TMAI- Tibetan Medical and Astrological Institute DASH- Dietary Approaches to Stop Hypertension TGiE- Tibetan Government in Exile SBP-Systolic Blood Pressure DBP-Diastolic Blood Pressure BMI- Body Mass Index CTA- Central Tibetan Administration Men-Tsee-Khang
13
Research report
March 2011
Source(s) of Funding Men Tsee Khang, Tibetan Medical and Astro. Institute of His Holiness The Dalai Lama, (TMAI) Acknowledgements The main credit of this study goes to the Hypertension survey team headed by Dr. Dawa Dolma, previous head of Clinical Research Department and associate Dr. Tenzin Namdol, Dr. Rigzin Sangmo and Mrs Sonam Yangdon for their immense contribution in successful data collection. Thanks and appreciation for the previous and present Director, Academic Council, Administration of Men Tsee Khang, Advisor of the Dept. Dr. Pema Dorjee, Head of the Dept. Dr. Tenzin Lhadon and colleagues for inspirations and guidance. Sincere thank goes to all the doctors in charge and staffs of the respective settlement’s Branch Clinics of Men Tsee Khang who were directly or indirectly involve in facilitating this study. Hearty appreciation put across to all the representatives, village leaders and community health workers of the settlements for their directions and guidance in assembling the masses for screening. Heartfelt gratitude and thankfulness forwarded to Dr. R. M. Pandey for statistical analysis and advices on report writing. Sincere gratefulness extends to Dr. Tenzin Namdol, Dr. Rigzin Sangmo, Dr. Namdol Lhamo, Dr. Shrikant I Bangdiwala, and Mr. Dale Bosenberg for their insight and review of the report. Lastly but not the least, thanks note goes also to Ms Phurbu Lhamo for edition and inserting location in outline Indian Map. *Correspondence To Dr. Tenzin Lhadon and Dr. Tenzin Lhundup, Clinical Research Department, Men-Tsee-Khang, Gangchen Kyishong Dharamshala – HP India Email : tmai@vsnl.org Table no. 1 Risk factors in developing Hypertension among Tibetans S.No. Factors 1
Age
2
Gender
3
4
5
6
7
8
Over weight
Nonvegetaria n diet
Hypertension No (0) Yes (1)
Male
41.7(11.5) 3717 1879(50.5)
51.7(13.1) 3217 1840(57.2)
Female
1838(49.4)
1377(42.8)
No if 1988(53.5) BMI<25 Yes if 1726(46.5) BMI>25 No 857(23.1)
1004(31.3) 2203(68.7)
Yes
2689(83.5)
2860(77)
528(16.4)
Tea More < 3 cups 3133(84.3) than 3 Cups > 3 cups 584(16)
2592(80.5)
Alcohol
Light Activity
Unadj OR 95% (I)
Adj OR 95%(I)
0.76 (0.7 - 0.8)
1.06 (1.06-1.07) 0.63 (0.56-0.7)
X²= 346.2 p= 0.0001
2.53 (2.3 - 2.8)
2.51 (2.25-2.81)
X²= 47.6 p= 0.0001
1.5 (1.4 - 1.7)
1.21 (1.05-1.38)
X²= 16.5 p=0.0001
1.3 (1.1 - 1.5)
X²= 121.1 p= 0.0001
2 (1.8 - 2.3)
1.35 (1.17-1.57)
X²= 35.2 p=0.0001
1.4 (1.2 - 1.5)
1.27 (1.17-1.42)
X²= 20.9 p=0.0001
0.8 (0.7 - 0.8)
p-value p= 0.0001 X²= 30.6 p= 0.0001
625(19.4)
No
3250(87.4)
2491(77.4)
Yes
467(12.5)
726(22.5)
Yes
2578(69.4)
2013(62.7)
No
1133(30.5)
1197(37.2)
592(15.9)
648(20.1)
3119(84.0)
2563(79.8)
Vigorous Yes Activity No
Х²
Figure no. 1 Hypertension Survey of Tibetan Settlement in North and South Region of India
Men-Tsee-Khang
14
March 2011
Research report Table no. 2 Dietary Pattern and Behavioral Measures Related with Hypertension Table no. 2
Parameter
Age
30-40
Gender SBP (mm/Hg) DBP (mm/Hg) Weight (Kg) Height (cm) Normal Weight (%) Over Weight (%) Obese (%) Days Eat Fruit (%) Days Eat Vegetables (%) Days Eat Meat (%) Tibetan Tea (%) Strong Tea (%) Smoke Currently (%)
M 121±13 (1894) 83±10 (1894) 72±12.1 1890 169±6.5 (1891) 47±49 (1890) 52±49 (1890) 108±311 (1890) 3±2 (1719) 6±1 (1884) 3±2 (1437) 2±2 (1167) 2±2 (656) 1895(13)
40-50
F 115±13.3 (1250) 78±9.9 (1250) 62±11.5 1248 157±6.3 (1248) 53±49 (1248) 46±49 (1248) 146±353 (1248) 3±2 (1168) 6±1 (1248) 4±2 (931) 3±2 (655) 3±2 (443) 1250(0)
T 119±13.5 (3144) 81±10.3 3144 68±12.9 3138 164±8.8 (3139) 50±50 (3138) 50±50 (3138) 123±329 (3138) 3±2 (2887) 6±1 (3132) 3±2 (2368) 2±2 (1822) 3±2 (1099) 3145(7)
M 128.3±16.8 (575) 88±11.6 (575) 72±13 572 167±6.9 (573) 41±49 (572) 58±49 (572) 164±370 (572) 3±2 (508) 6±1 (571) 4±2 (482) 3±3 (268) 4±3 (214) 575(19)
50-60
F 125±18.4 (610) 84±11.1 (610) 65±11.6 610 154±6.1 (610) 33±47 (610) 66±47 (610) 257±437 (610) 3±2 (550) 7±1 (607) 4±2 (500) 5±4 (269) 4±3 (260) 610(0)
T 127±17.7 (1185) 86±11.5 (1185) 69±12.8 1182 160±9.1 (1183) 37±48 (1182) 62±48 (1182) 212±409 (1182) 3±2 (1058) 6±1 (1178) 4±2 (982) 4±4 (537) 4±3 (474) 1185(9)
M 137±19.6 (432) 89±11.8 (432) 71±12.6 431 164±6.1 (431) 39±48 (431) 60±48 (431) 183±387 (431) 3±2 (369) 6±1 (429) 4±2 (372) 4±3 (168) 5±4 (157) 432(17)
60-70
F 135±19.8 (640) 87±11.1 (640) 64±12.1 640 152±6.1 (640) 31±46 (640) 68±46 (640) 290±454 (640) 3±2 (566) 7±1 (640) 4±2 (539) 5±4 (277) 4±3 (285) 640(0)
T 136±19.7 (1072) 88±11.4 (1072) 67±12.7 1071 157±8.5 (1071) 34±47 (1071) 65±47 (1071) 247±431 (1071) 3±2 (935) 6±1 (1069) 4±2 (911) 5±4 (445) 5±3 (442) 1072(7)
M 143±21.3 (815) 88±11.9 (815) 70±12.5 816 164±6.8 (816) 43±49 (816) 56±49 (816) 164±370 (816) 3±2 (675) 6±1 (810) 4±2 (683) 5±4 (435) 5±3 (318) 817(8)
Total
F 141±21.1 (715) 87±11 (715) 62±11.5 715 151±5.9 (714) 35±47 (714) 64±47 (714) 233±423 (714) 3±2 (608) 6±1 (707) 4±2 (605) 5±4 (389) 4±3 (278) 715(0)
T 142±21.2 (1530) 88±11.5 (1530) 66±12.7 1531 158±9.1 (1530) 40±49 (1530) 59±49 (1530) 196±397 (1530) 3±2 (1283) 6±1 (1517) 4±2 (1288) 5±4 (824) 4±3 (596) 1532(4)
M 129±18.9 (3716) 86±11.3 (3716) 72±12.4 3709 167±6.9 (3711) 44±49 (3709) 55±49 (3709) 138±344 (3709) 3±2 (3271) 6±1 (3694) 3±2 (2974) 3±3 (2038) 3±3 (1345) 3719(13)
F 127±20.7 (3215) 87±10.9 (3215) 63±11.7 3213 154±6.5 (3212) 41±49 (3212) 58±49 (3212) 215±411 (3212) 3±2 (2892) 6±1 (3202) 4±2 (2575) 4±4 (1590) 4±3 (1266) 3215(0)
T 128±19.8 (6931) 84±11.5 (6931) 68±12.8 6922 161±9.3 (6923) 43±49 (6921) 56±49 (6921) 174±379 (6921) 3±2 (6163) 6±1 (6896) 3±2 (5549) 4±3 (3628) 4±3 (2611) 6934(7) 521(89)
Smoke Daily (%)
245(88)
6(5)
251(87)
111(93)
4(5)
115(92)
76(93)
3(66)
79(92)
72(87)
4(5)
76(85)
504(90)
17(52)
Smokeless Tobacco (% )
1877(13)
1216(1)
3093(8)
564(17)
581(2)
1145(9)
423(17)
614(2)
1037(8)
801(13)
682(4)
1483(9)
3665(14)
3093(2)
6758(9)
Alcohol (%)
1895(15)
1250(2)
3145(10)
575(27)
610(5)
1185(16)
432(37)
640(12)
1072(22)
817(39)
715(16)
1532(28)
3719(25)
3215(8)
6934(17)
Alcohol 12 months (%)
294(1)
31(1)
325(1)
157(1)
33(1)
190(1)
161(1)
81(1)
242(1)
321(1)
115(1)
436(1)
933(1)
260(1)
1193(1)
Light Activities (%)
1894(65)
1246(68)
3140(66)
573(73)
608(66)
1181(70)
432(69)
639(65)
1071(67)
816(63)
713(61)
1529(62)
3715(66)
3206(66)
6921(66)
Vigorous Activities (%)
1893(10)
1247(11)
3140(11)
574(21)
608(25)
1182(23)
431(33)
639(24)
1070(27)
817(23)
713(16)
1530(20)
3715(18)
3207(17)
6922(17)
Stress (%)
1892(18)
1248(26)
3140(21)
572(24)
607(35)
1179(30)
431(23)
640(34)
1071(29)
816(18)
713(32)
1529(25)
3711(19)
3208(31)
6919(25)
Hypertension Treatment (%) Blood Sugar Measured (%) Diabetes Told (%)
1887(5)
1239(2)
3126(4)
573(10)
608(7)
1181(9)
429(23)
639(25)
1068(24)
811(34)
713(37)
1524(35)
3700(14)
3199(15)
6899(15)
1889(2) 1893(0)
1245(2) 1244(0)
3134(2) 3137(0)
574(2) 573(3)
609(2) 606(1)
1183(2) 1179(2)
429(2) 430(3)
639(2) 638(4)
1068(2) 1068(4)
817(2) 814(8)
714(2) 714(5)
1531(2) 1528(6)
3709(2) 3710(3)
3207(2) 3202(2)
6916(2) 6912(3)
Diabetes Treatment (%)
1891(0)
1241(0)
3132(0)
573(2)
608(1)
1181(2)
430(3)
637(3)
1067(3)
812(6)
714(4)
1526(50
3706(2)
3200(2)
6906(2)
Hypertensive (%)
1895(34)
1250(18)
3145(28)
575(52)
610(38)
1185(45)
432(63)
640(60)
1072(62)
817(73)
715(71)
1532(72)
3719(49)
3215(42)
6934(46)
Table no. 3 Blood pressure measured and Family history of Hypertension & Heart disease Age Group
B.P Measured
30-40 41-50 51-60 61-70 Total Age Group 30-40 41-50 51-60 61-70 Total Age Group 30-40 41-50 51-60 61-70 Total
Male Don’t Know
Yes
No
728(48)
250(18)
295(58)
79(16)
239(62)
Female Don’t Know
Total
Yes
No
597(32)
1575(100)
509(49)
169(16)
149(26)
523(100)
317(60)
63(11)
55(14)
108(23)
402(100)
383(64)
473(60)
137(17)
180(22)
790(100)
1735(55)
521(17)
1034(28)
3290(100)
Total Don’t Know
Total
Yes
No
377(34)
1055(100)
1237(50)
419(17)
974(33)
2630(100)
178(29)
558(100)
612(58)
142(13)
327(27)
1081(100)
72(12)
164(24)
619(100)
622(63)
127(13)
272(24)
1021(100)
453(67)
97(15)
144(17)
694(100)
926(64)
234(16)
324(20)
1484(100)
1662(58)
401(14)
863(27)
2926(100)
3397(56)
922(16)
1897(27)
6216(100)
Family History of Hypertension
Total
309(16)
873(47)
712(36)
1894(100)
381(30)
614(49)
254(21)
1249(100)
690(21)
1487(48)
966(30)
3143(100)
120(19)
331(58)
124(22)
575(100)
166(26)
350(55)
93(17)
609(100)
286(23)
681(57)
217(19)
1184(100)
74(32)
283(66)
74(17)
431(100)
163(25)
374(66)
100(18)
637(100)
237(21)
657(61)
174(18)
1068(100)
121(14)
506(61)
190(24)
817(100)
117(17)
441(58)
153(25)
711(100)
238(15)
947(61)
343(14)
1528(100)
624(16)
1993(54)
1100(29)
3717(100)
827(25)
1779(54)
600(20)
3206(100)
1451(20)
3772(54)
1700(25)
6923(100)
Family History of Heart Disease
200(10)
1271(67)
422(23)
1893(100)
101(8)
892(71)
255(22)
1248(100)
301(9)
2163(69)
677(22)
3141(100)
46(8)
432(74)
96(18)
574(100)
52(8)
447(71)
111(22)
610(100)
98(8)
879(73)
207(19)
1184(100)
26(6)
342(78)
62(16)
430(100)
64(9)
449(67)
127(24)
640(100)
90(8)
791(72)
189(20)
1070(100)
43(5)
593(71)
180(23)
816(100)
71(19)
490(65)
152(26)
713(100)
114(7)
1083(68)
332(25)
1529(100)
315(8)
2638(70)
760(22)
3713(100)
288(8)
2278(69)
645(22)
3211(100)
603(9)
4916(70)
1405(21)
6924(100)
Table no. 4 Demographic Profile of the participants
Age North Group M F 686 572 30(54.5) (45.5) 40 217 208 41(51.1) (48.9) 50 169 202 51(45.5) (54.5) 60 356 208 61(63.1) (36.9) 70 Total 1428 1190 (54.5)
Men-Tsee-Khang
(45.5)
Total
M
1258 (100)
1209 (64.1)
425 (100)
South F
Total M
678 (35.9)
1887 (100)
1895 (60.3)
358 (47.1)
402 (52.9)
760 (100)
371 (100)
263 (37.5)
438 (62.5)
564 (100)
461 (47.6)
2618 (100)
2291 (53.1)
Total F
Total
1250 (39.8)
3145 (100)
575 (48.5)
610 (51.5)
1185 (100)
701 (100)
432 (40.3)
640 (59.7)
1072 (100)
507 (52.3)
968 (100)
817 (53.3)
715 (46.7)
1532 (100)
2025 (46.9)
4316 (100)
3719 (53.63)
3215 (46.4)
6934 (100)
15
New Publications
March 2011
MEN-TSEE-KHANG PUBLICATIONS Syllabus of Menpa Kachupa and Tsipa Kachupa degree Tibetan Medical & Astrological College Version: Tibetan
A Commentary on Oral Instructions Men-Tsee-Khang Version: Tibetan
This book contains the entire five years syllabus of Men-pa Kachupa (Bachelor of Sowa Rigpa Tibetan medicine) and Tsi-pa Kachupa (Bachelor of tibetan astrology) degree.
The Treasure of Medicinal Instructions Karma Choegyal Men-Tsee-Khang Version: Tibetan
Chronicles of Men-Tsee-Khang College Tibetan Medical & Astrological College Version: Tibetan This book contains the chronicles of faculty members and college students (medical 16th batch and astrology 8th batch) enrolled from 1961 to 2011.
On the basis of the Quintessential Instructions "men-nhag-rgyud" Karma Choegyal wrote many different kinds of compositions in Tibetan medicine. He collected many methods, treatment and compositions through his own experience. There are 91 chapters with a volume of 308 pages.
A key to the opening of Logic of Tibetan medicine Tibetan Medical & Astrological College Version: Tibetan
The Subsequent Tantra Translation Department Version: English The Subsequent Tantra is the last Tantra of Gyushi (The Four Tantras) consisting of theoretical principles and the major practical applications of Tibetan medicine which reveals the wisdom of one of the oldest civilization of the world.
This book contains 13 chapters of the fundamentals of Tibetan medicine integrating buddhist philosophy as well.
Donations received from January - March, 2011
Staff Children Scholarship Stefanie Frychel Germany 6,780.00 Initiative Oberland Germany 26,498.50 Valerie Fesselet France 6,780.00 Anne Brunila Finland 45,262.50 Stig and Ingela Isaksson Sweden 37,500.00 Jesselyn Barron USA 14,875.00 Inter Educare E.V. Germany 244,800.00 Janet E Goldman USA 10,750.00 Yves Betant France 22,679.82 Dr.Siegefried and Brigitte Rainer Austria 10,320.00 Nicoletta Lanciano Italy 10,320.00 Berit Lecomte Sweden 16,500.00 Tibet Charity Denmark 114,075.00
Men-Tsee-Khang
50 Years MTK celebration Mr.Tenzin Paksam (Astrologer,Ex staff) New York 10,007.00 Ladakh Jangthang Medical Camp Fund Dr.Daniel Monconduit France 223,550.00
Janet Yelowchen Yvonne Mariotti Nesurini Janet Yelowchan Sherap Sangpo Society Monika Timothy S Ness Claudia
Donation USA Swiss USA India UK USA Germany
797.00 8,966.00 2,078.00 3,000.00 3,592.00 1,334.00 2,808.00
16
March 2011
Appeal
APPEAL FOR DONORS TO SUPPORT IN ACQUIRING ADVANCED INSTRUMENTS FOR SCIENTIFIC RESEARCH High Performance Thin Layer Chromatography (HPTLC) for Quality Assurance Laboratory of Men-Tsee-Khang The present Quality Assurance Laboratory was mainly established with the goal to control the quality of Tibetan medicine and healthcare products produced from this institute. It has microbiology unit to carry out the microbiological testing of crude drugs prior passing it in the production unit and after production, finished products are tested for microbial load, and step wise vigilance of process for the microbial contaminant as per the protocol of World Health Organization (WHO) limit, chemical lab to perform the phyto-chemical testing of crude drugs and other chemical testing of skin care products. Instrumentation unit with one instrument called UV Spectometer. The current facility in the laboratory is inadequate for further scientific research of Tibetan medicine. Thus, to engage in further scientific research of Tibetan medicine, some more advanced instruments are prerequisite. Besides, routine quality control testing, various research work on the Tibetan medicine and its medicinal herbs are carried out with whatever facilities available in hand, but still due to lack of infrastructure especially availability of sophisticated instruments like High Performance Thin Layer Chromatography (HPTLC), High Performance Liquid Chromatography, Atomic Absorption Spectrophotometer etc the research on the Tibetan medicine is very limited. Thus we are planning to purchase (HPTLC) for Quality Assurance Laboratory to make sure that research on Tibetan medicine more efficient and effective. Estimated Budget for the Project: High Performance Thin layer Chromatography In Swiss Franc 1,36,022 CHF winCat Palaner Chromatography system manager software 5500 CHF Camag Automatic TLC sampler IV 32500 CHF Dosing syringe starter jkit for ATS 850 CHF Chromacol sample vials N-11 1300 CHF TLC foil down holder for ATS 4 155 CHF Compensation ledge for 10x10cm 55 CHF Chromatogram development devices 747 CHF Vario system for method development 3650 CHF Immersion device 3385 CHF TlC Visualiser 37500 CHF Quantitative Measurement and Data Handling 50380 CHF Total Amount 136022 CHF Please contact the Director of Men-Tsee-Khang for further updates and information regarding projects Men-Tsee-Khang Gangchen kyishong Dharamsala-176215 Distt-Kangra, H.P-India Phone: 01892 223113 / 223222 email: tmai@vsnl.com / tmai@men-tsee-khang.org / director@men-tsee-khang.org CORRIGENDUM Performance Thin Layer Chromatography (HPTLC) MEN-TSEE-KHANG NEWS LETTER Reference to our news published in Men-Tsee-Khang Newsletter, Vol XIX, Dec 2010, page # 13 for the appeal of donations for High Performance Thin Layer Chromatography (HPTLC). The cost of Dosing syringe starter jkit for ATS (4850 CHF), Vario system for method development (747CHF) and Immersion device (747CHF) should be read as given in the above appeal put forth. Men-Tsee-Khang
17
Directors
March 2011
Chief officers of Tibetan medicine and astrology from 1961-1967
1961-1969 Astrology
1966-1967 Medicine
1961-1966 Medicine
1967-1967 Medicine
Directorâ&#x20AC;&#x2122;s of Men-Tsee-Khang since the merger of Medicine & Astrology from 7 August 1967
1967-1971
1972-1974
1974-1974
1986-1988
1989-1989
1990-1993
1997-2001 Men-Tsee-Khang
2001-2005
1975-1980
2005-2010
1993-1994
1980-1985
1994-1997
201018
March 2011
News
No. of Employees
50 YEARS OF MEN-TSEE-KHANG IN EXILE Men-Tsee-Khang (Tibetan Medical & Astro. Institute) has completed 50 years of its establishment in exile on 23 March, 2011. With the guidance of His Holiness the Dalai Lama, the astrology school (Tsi-rig lobkhang) was set up at Glenmoor Cottage in 1960 and FIFTY YEARS OF MEN-TSEE-KHANG: Decadal Changes of Insitutional Employees medical school (Menjin khang) was set up at Chopra House in 1961. These two traditional cultures of Tibet was revived in exile and the ini800 tial foundation started from a humble beginning with one teacher (As600 634 552 trologer Dukorwa Lodoe Gyatso) and two students (Dakyab Chetsang 400 246 Hothokthu Loden Sherab & Dreloling Shakor Khentrul Yeshi Palden) in 200 52 18 astrology and one teacher (Dr. Yeshi Dhonden) and 8 students (Jampa 0 1961-70 Sonam, Tashi Gyaltsen, Yeshi Sonam, Jampa Tenzin, Jampa Wangdu, 1971-80 decades 1981-90 1991-2000 Lhakchung, Ngawang Jigme, Serme Lobsang Chophel) in medicine. 2001-2010
No. of branch clinics
In 1967 both the schools were merged and shifted to Mcleod Ganj and named as Drophen Men-Tsee-Khang constituting of a main office, pharmacy, college (medicine & astrology), clinic and hostel. The second batch students graduated in the 70's and in 80's the arrival of senior doctors from Tibet led to the FIFTY YEARS OF MEN-TSEE-KHANG: Foundations of Branch advancement of the institute in various fields such as initial prepaClinics ration of sacred formulations of precious pills in exile, the first Clinics medicine week, visit of doctors abroad etc. In 1982 Drophen Men25 23 Tsee-Khang shifted its location from Mcleod Ganj to Gangchen Kyis20 15 hong at the present site and is now registered as Men-Tsee-Khang 13 10 13 5 1 5 / Tibetan Medical & Astro. Institute of H.H. the Dalai Lama. The in0 stitute has developed from its modest beginning consisting of a col1961-1970 1971-1980 lege, hostel and pharmacy together to the present infrastructure of 1981-1990 1991-2000 2001-2010 decades seven administrative and nine academic departments. Four chief officers of astrology and medicine from 1961-1967 and 14 directors from 1967-2010 has offered their able leadership in making MenTsee-Khang as one of the important institute in the preservation of Tibetan medicine and astrology in exile. In the past 50 years Men-Tsee-Khang has enlisted a working force of 856 employees and the present status of human resource is 399 staff as on 31 December, 2010 consisting of 125 doctors, 18 astrologers and 256 staff. It has also opened 55 branch clinics in India, hosted a number of medical camps, FIFTY YEARS OF MEN-TSEE-KHANG: Over workshops, seminars, courses in medicine and astrology, exchange all Status of Institutional Employee programmes, research with western scientific medical institutes in India and abroad. The Tibetan Medical & Astrological College has 6% 5% 3% enrolled 16 batches of medical and 8 batches of astrological students. 47% As on 31 December, 2010 the Tibetan Medical & Astrological College has enrolled 358 students, among whom 290 students graduated (243 39% doctors and 47 astrologers) and 68 (50 medical and 18 astrology) as dropouts. The total enrollment given includes medicine 14 batches & astrologers 7 batches. Working 399 Resigned 330 Retired 56 Expired 44 Expelled 27 The analogy in Hind Swaraj can be rightly used â&#x20AC;&#x153;The seed is never seen. It works underneath the ground, is itself destroyed, and the tree which rises above the ground is alone seenâ&#x20AC;?. Due to the visionary insight, guidance and leadership of His Holiness the XIV Dalai Lama, the collective hardships and difficulties endured by the scholars and students at the initial stages of its foundation, directors, doctors, astrologers and the staff who worked tirelessly, we could see the advancement of the organization into a full- fledged institution in the past 50 years of its establishment. Men-Tsee-Khang
No. of Enrolment
FIFTY YEARS OF MENTSE KHANG: Decadal Status of College Enrolment & Graduate
140 120 100
Dropouts Astrologers Doctors
14
10 9
17
90
88
80 60 40 20 0
13 4 11 1961-1970
27
45
5 9 1971-1980
4 12
1981-1990
1991-2000
Decades 2001-2010
19
Personal Physicians to H.H. the Dalai Lama
1963-1980
1984-1985
1977-1985
1980-2001
1985-1992
1992-1994
1984-2002
Registrars
1998-2001
2000-2003
BOOK POST To:
If undelivered return to sender MEN-TSEE-KHANG (Tibetan Medical & Astro. Institute of H.H. the Dalai Lama) Gangchen Kyishong Dharamsala - 176 215 Distt. Kangra H.P India
1961-1966, 1994-2000
2003-2005
2005-