କୋଶଲୀ ପତ୍ରିକା ‘କୁରେ ପତର’ ଉନ୍ମୋଚନୀ ଉତ୍ସବ
Kosali Dashavatar: Display of avatars of Kosali music tradition
Kosali Dashavatar, a dance drama conceptualized by Pt. Dr. Ghasiram Mishra was presented at Balangir town hall on 12th September. The presentation was produced in association with Ministry of Culture, Government of India. Padmashree Dr. Srinivas Udgata, Smt. Swayamprava Padhee from Bhubaneswar and Arindam Dakuaa, Collector, Balangir joined as the guest in the occasion.

Kosali Dashvatar exhibits the rich varieties of music of western Odisha while narrating the mythological story of Dashavatara, the ten primary avatars of Vishnu, the Hindu god of preservation who is said to descend in form of an avatar to restore cosmic order.
This show of Kosali dance drama was historical in a way when Kosal region in Odisha is going through an identity manoeuvre. The dance drama was showcasing the Kosali musical falvour with dance and drama. Parbha, Bajnia, Ghudka, folk music of Kalahandi, Samparda, Kirtan were blend into evolved the Dashavatar.
GUIDE TO NUTRITION EXERCISE AND HEALTH
Chapter – 14
Healthy Aging
When the body is shriveled
And another steps falter;
When the teeth are decayed
And the face smeared with slobber,
When sight fails
And the figure is no longer trim;
The Kinsfolk find no time for conversation
Even the son despises the man
Overcome by old age, alas!
-The Panchatantra 200 BCE?
More people than ever before are enjoying relatively good health and living longer. Experts predict that life-expectancy for men and women with the healthiest lifestyle will continue to increase. Although most people over 60 have some form of chronic disease, these disorders are often less debilitating than in the past, thanks to new ways to treat and control them.
Older people are more likely to have chronic diseases and associated disability. The most frequently reported conditions in elder population are arthritis, hypertension (high blood pressure), heart disease,hearing problem, bone and joint disease and cataract (opacity of lens).
How The Body Changes With Age
As we age, our body undergoes changes. For example, muscle strength can diminish, bone can weaken, and movement may become limits. But our lifestyle choices – especially what we eat, how active we are, how much we weigh, and whether we smoke – can slow or speed these changes. Here are some of the ways our body may change as we get older.
- Bone loses calcium and may become more brittle, which can lead to fracture.
- The gel-like disks between the vertebrae of the spine lose fluid and get thinner; the vertebrae themselves can collapse, causing the spine to curve and become compressed. Height decreases and person may look stooped.
- Joints become less flexible. Cartilage starts to rub against the bone inside the joints because of reduced joint fluid and tissue breakdown. They lead to pain and stiffness (Osteoarthritis).
- The nervous system declines, making movements, sensation, balance, and memory less sharp.
- More fat gets deposited around the middle of the body, especially around the abdomen. Fat in the abdominal area raises the risk type – 2 diabetes and heart disease.
- Muscles lose tone and cannot contract as well – even with regular exercise. Loss of lean muscle lowers overall strength.
- The immune system declines, increasing susceptibility to infection.
- Hair turns gray and thinner. Many men and women may develop hair-thinning and baldness.
- Hearing and vision decline.
While some of these changes are genetically determined, people can often control the extent and the speed at which they occur by living a healthy lifestyle. Health-promoting life style factors – including eating a healthy diet, getting regular exercise, maintaining a healthy weight, not smoking, and not drinking excessively – can overcome many genetic susceptibilities.
Healthy Diet
A diet rich in colored fruits and vegetables, whole grains, low in saturated fat, low fat milk products, beans, peas, nuts, fish, poultry and lean meat is good for all age group.
Calcium and vitamin D are two nutrients that are essential for strong bones and teeth and for reducing risk for osteoporosis. As you grow older, your need for vitamin D increases. People ages 51 to 70 should consume at least 600 International Units (IU) of vitamin D daily.
Herring, sardines, salmon, tuna, liver, eggs, and fortified milk and foods are good sources of Vitamin D.
Men between the ages of 51 and 70 should consume 1,000 mg of calcium a day and women 1,200 mg / day. Dairy products, fish with bones, soybean; nuts such as almond, and dark green vegetables are good sources of calcium.
Exercise and Physical Activity
Exercise and physical activity are the corner stone of healthy aging. People who exercise not only live long, they live better. And, being physically active – doing everyday activities that keep your body moving, walking, taking the stairs instead of the lift (elevator), doing household works and gardening. Regular exercise and physical activity can reduce the risk of developing diseases like type-2 diabetes, heart disease, stroke, osteoporosis (bone thinness) depression and memory loss. The best is to mix your exercise routine – aerobic, muscle strengthening and bone strengthening and balance. (See the Chapter on Exercise).
Exercise is also an effective treatment for many chronic conditions like diabetes, heart disease, arthritis and high blood pressure.
Pay Attention To Your Weight And Shape
People who are overweight (Body Mass Index 25 to 29) or obese (BMI over 30) are at greater risk for Type 2 diabetes, high blood pressure, heart disease, stroke, some types of cancer, sleep apnea (forgetting to breath during sleep) and osteoarthritis. People with “pear” shape, with fat deposit around the hips and thighs, are generally healthier than people with the “apple” shape, with fat mostly around the waist. Belly fat increases the risk of heart disease and diabetes. The best is to maintain an ideal body weight and avoid belly fat.
Regular Health Screening
Health Screenings are tests that look for diseases before you have symptoms. Screening tests can find diseases early, when they are easier to treat. Some conditions that doctors commonly screen for include:
- Breast cancer (mammogram) and cervical cancer for women (Pap smear).
- Colorectal cancer (colonoscopy, stool test).
- Diabetes (fasting blood sugar and HbA1C)
- Osteoporosis (bone density test).
- Overweight and obesity (BMI).
Which screening you need depends on your age, your sex, your family history and whether you have other risk factors.
Immunization for adults 50+
Here is a list of immunizations adults 50 and older should consider.
- Get a flu shot every year. The flu viruses change every year.
- Get a shot for shingles if over 60. People who had chickenpox as a child can get shingles (Herpes zoster) at any age. It is a very painful disease. Get the shot.
- People 65 and older need a series of two different vaccines for pneumococcal disease (Pneumonia). They will prevent you from getting pneumonia.
- Get a tetanus booster if it has been more than 10 years since your last shot.
Staying Mentally Active
In the past, the loss of ability to remember, learn, think, and reason – skills referred to collectively as cognition – was considered a normal part of aging. Doctors now know that most people can remain both alert and mentally able as they age. Severe mental deterioration is the result of disease – not an inevitable part of aging.
Forgetfulness can be a normal part of aging. As people get older, changes occur in all parts of the body, including brain. As a result, some people don’t remember information as well as they did, or they lose things like glasses and keys. These usually are signs of mild forgetfulness, not serious memory problems. Healthy adults, as they age, improve in certain areas of mental ability such as vocabulary.
Some memory problems are related to health issues that may be treatable. For example, medication side effects, Vitamin B12 deficiency, chronic alcoholism, tumors or infections in the brain or blood clots in the brain can cause memory loss or possible dementia. Some thyroid, kidney, or liver disorders also can lead to memory loss.
Emotional problems, such as stress, anxiety, or depression, can make a person more forgetful and can be mistaken for dementia. This memory loss or confusion forgetfulness is temporary. They get better with treatment.
For some older people, memory problems are sign of a serious problem, such as mild cognitive impairment (MCI) or dementia. People who are worried about memory problems should see a doctor for further evaluation.
Mild Cognitive Impairment (MCI)
People with MCI have more memory problems than normal for people their age, but their symptoms are not as severe as those of Alzheimer disease. They are able to carry out their normal daily activities.
Signs of MCI include losing things often, forgetting to go to important events and appointments, and having trouble coming up with desired words. The person and his / her family members worry about the memory loss. Researchers have found that more people with MCI than those without it go on to develop Alzheimer’s. There currently is no standard treatment for mild cognitive impairment.
Dementia
Dementia is the loss of thinking, memory and reasoning skills to such an extent that it seriously affects a person’s ability to carry out daily activities. Dementia is not a disease itself but a group of symptoms caused by certain diseases and conditions such as Alzheimer’s. People with dementia lose their mental abilities at different rates.
Symptoms of Dementia May Include
- Being unable to remember things.
- Asking the same question or repeating the same story over and over.
- Becoming lost in familiar places.
- Being unable to follow directions.
- Getting confused about time, people, and places.
- Neglecting personal safety, hygiene, and nutrition.
Two of the most common form of dementia in older people is Alzheimer’s disease and vascular dementia. These two types of dementia cannot be cured at present.
To Keep Your Memory Sharp
- Engage in physical activity
Several studies have associated exercise with better brain function.
- Limit alcohol use
Although some studies suggest that moderate alcohol use has health benefits, heavy or binge drinking over time can cause memory loss and permanent brain damage.
- Develop interests or hobbies
Stay involved in activities that can help both the mind and body.
Can We Prevent Aging?
People are living longer. Views on aging are also changing. Disease and disability once considered an inevitable part of growing older but that is no longer true. Many potential agents to reverse the aging process are being studied including human growth hormone; sex hormone like estrogen, caloric restriction and antioxidants.
According to National Institute of Aging (USA) – “Finding a ‘fountain of youth’ is a captivating story. The truth is that, to date, no research has shown that hormone therapies add years to life or prevent age related frailty. National Institute of Aging does not recommend taking any supplement touted as “anti-aging” remedy because there is no proof of their effectiveness and the health risks of short-term and long-term use are largely unknown.”
GUIDE TO NUTRITION EXERCISE AND HEALTH
Chapter – 13
Bones and Joints Health
I don’t deserve this award, but I have arthritis and I don’t deserve that.
-Jack Benny Comedian
Bones and joints work together to keep us mobile. It is important to care of our bones and joints to maintain their flexibility and range of motion and prevent fractures. The best way to do this is to be physically active.
Osteoporosis (thinning of the bones) and osteoarthritis (degeneration of joint) are two of the most common and debilitating conditions among the older people.
Osteoporosis
Osteoporosis means “porous bone”. It is a disorder in which bone mass is decreased, causing the bones to become fragile and leading to fracture. People with osteoporosis most often break bones in the spine, hip and wrist. It affects both male and female over the age of 50. It is more common in women.
Osteoporosis is often called a “silent” disease because bone loss occurs without symptoms, although some people may notice that they are shorter than they used to be. Their posture is somewhat stooped, or their shoulders are rounded (because the bones in their spine have weakened). People often don’t know they have osteoporosis until their bones become so weak that a sudden strain, bump or fall causes a fracture (breaking of the bone).
Risk Factors
Some people who develop osteoporosis have no known risk factors but most do.
They are:
- Being female – 70% of osteoporosis people are women.
- Being older – 50 years
- Having family history.
- Being thin – low Body Mass Index
- Low lifetime intake of calcium and vitamin – D.
- Being inactive.
- Smoking
- Alcohol use
- Certain medicines can cause bone loss – like steroids.
- Ethnicity – Asian and white women.
Prevention:
To reach your best possible peak bone density and keep your bones strong as you age, adopt the following life style measures:
Eat a well-balanced diet rich in calcium and Vitamin –D. Good sources of calcium include dairy products, dark green leafy vegetables, fish with bones, tofu, and almonds and food fortified with calcium.
Vitamin D playsan important part role by helping body absorb calcium. Your skin makes Vitamin D, when exposed to sunlight. If you are not exposed to enough sunlight take Vitamin D supplement. Adults age 50 or older should take 800 – 1000 units of Vitamin D daily.
Be physically active (See Chapter on fitness)
Like muscles, bone is a living tissue that responds to exercise by becoming stronger. Weight bearing exercise that forces the bones to work against gravity are the best – walking, running, hiking, stair climbing, skipping role, dancing and sports involving running.
Avoid Smoking and Alcohol.
To prevent falls.
- Use a cane or walker for stability if needed.
- Wear rubber – soled shoes for traction.
- Make your rooms free of clutter.
- Use grab bars on bath room walls near the tub, shower and toilet.
- Keep the bed room and bath room lit at night.
- Keep a flash light handy.
- Get your eyes checked regularly.
Medications to prevent osteoporosis
A number of medications are available for both preventing and treating osteoporosis. If you are at high-risk, get a bone-density test done (for osteoporosis) and see your doctor.
Osteoarthritis (Joint Disease)
The term “arthritis” means inflammation of a joint. There are several forms of arthritis. Osteoarthritis is also known as degenerative joint disease. Osteoarthritis is the wear-and-tear form of arthritis that develops when the surface layer of cartilage (the slick tissue that covers the ends of bones where they meet to form joint) breaks down and wears away. Healthy cartilage allows bones to glide easily over one another. Cartilage also absorbs the shock of physical movement. When cartilage degenerates, the bones underneath it start to rub together, causing pain, swelling and loss of movement in the joint. Over time, the joint may become misshapen. Bits of bone or cartilage can break off and float inside the joint space, causing even more pain and damage.
The most common symptoms of osteoarthritis include joint pain and stiffness. The joints most often affected are those near the tips of the fingers, the thumb, neck, knees, lower spine and hips.
Risk Factors
Doctors believe that osteoarthritis is the results of many inter related factors including wear and tear on the joints over time, joint injury, and inherited factors. Followings are the most common risk factors for osteoarthritis:
- Obesity
Excess weight puts added stress on the joints. Every one kilogram increase in weight increases the risk of arthritis by about 10%.
- On-the job overuse
Repetitive, forceful, or prolonged exertion of joints – heavy lifting, pushing, pulling, carrying heavy objects, and jobs requiring keeling and squatting.
- Sport injuries – football, soccer, baseball.
- Hereditary
There is more than one gene linked to an increased risk for osteoarthritis.
- Age – older people, over 60.
- Weak muscles
Doctors believe that the muscle weakness comes first and contributes to the development of osteoarthritis.
- Bone deformities – from birth
Prevention:
- Keep your weight down.
A healthy weight will lower the risk as well as slow down the progression of osteoarthritis.
- Perform Strength – training exercises
Strengthening your thigh muscles can reduce your risk of developing osteoarthritis of your knees.
- Work smart
Many cases of osteoarthritis result from work activities – especially heavy lifting and kneeling. When you lift heavy objects, bend your knees and use your legs instead of your back to bring the load up.
Osteoarthritis is a leading cause of disability around the world. By making life – style changes – maintaining normal body weight, muscle training exercises and properly lifting of weight and avoiding sport injuries, the incidence of osteoarthritis can be reduced.
Saheb Sahu, M.D., F.A.A.P., MPH.
GUIDE TO NUTRITION EXERCISE AND HEALTH
Chapter-12
Chronic Obstructive Pulmonary Disease (COPD)
Smoking is hateful to the nose, harmful to the brain, and dangerous to the lungs.
-King James I
Whenever I think to quit smoking, I need a cigarette to think.
-Le Funny.net
More than 90% of COPD deaths occur in low – and middle – income countries. The main cause of COPD is tobacco smoke, including second hand smoke and air pollution. Chronic obstructive pulmonary disease (COPD) is a term that refers to two common lung disorders: chronic bronchitis and emphysema (damage to the air sacs of the lungs). COPD is an under-diagnosed, life-threatening lung disease that interferes with normal breathing. It is not reversible. It is a major cause of disability and death.
Risk Factors
- Tobacco smoke, including expose to second hand smoke.
- Indoor air pollution – cooking and heating.
- Outdoor air – pollution.
- Occupational dusts and chemicals (vapors, fumes).
- Frequent lower respiratory infections during childhood.
Symptoms
- Breathlessness (or a need for air).
- Abnormal sputum.
- Chronic cough.
- Difficulty in daily activities, such as walking up a short flight of stairs.
- Gradual worsening of breathlessness.
Diagnosis
COPD is confirmed by a diagnostic test called “spirometry” that measures how much air a person can inhale and exhale, and how fast air can move into and out. Because COPD develops slowly, it is frequently diagnosed in people aged 40 or older.
Prevention
Quit Smoking
- Keep smoke, fumes out of your house
- Keep your windows closed and stay indoors when air pollution or dust level outside are high
- Use face mask when needed
- Get yearly flu shot and pneumonia vaccination
- Walk or exercise regularly
- Eat a balanced diet
- Do not be overweight
COPD is not curable. It is essential to stop smoking to prevent the progression of the disease. Various forms of treatments can help to increase the quality of life, but it is not reversible. If you are working in job with constant exposure to dust or chemicals always use a face mask. Get frequent lung function tests done for early diagnosis and treatment. Change job if you can if your breathing test continues to get worse.
Saheb Sahu, M.D., F.A.A.P., MPH.
The last fighter of Ghess Zamindar
I have visited Ghess many a times in connection with Haldhar Nag. Some 4 years ago on August 14, 2014 also met him along with my friends Kshetrabasi Naik & Rajesh Jhankar. A piece of news in an Odia daily urged the feeling to see the Zamindar house too. We just finished some photo shoot of the poet at his residence and we went on to see the zamindar’s house. Only thing which was giving the sign of a Zamidar house was the broken gate, else ruined, dilapidated, brick wall covered with algae of rain was giving a clumsy image.
As we enter inside, a young man dressed in a magenta coloured shirt opened with top bottoms appeared before us adjusting it in his black pant. He was trying to speak in English and Odia with folded hands; welcome welcome….! Most welcome…Sir, I’m the man who work in the college as a peon and I’m the sixth generation of the freedom fighter Ghess Zamindar. All of us were startled, and speechless. Then he asked about our identity and we introduced ourselves. I was not speaking anything to him and just observing. He was broken from inside. He then opened the doors and showed the weapons which was used in the fight against the Britishers; double edged sword, single edge sword, tamancha, and tabli etc. Rajesh babu was asking him questions and he was answering and showing. And they were taking photos to memorise. Still I was just observing silently and was mum. My heart was getting heavier and trying to control the tears. Repeatedly asking myself how can the Govt keep our fighters in such misery? We were leaving. The man who was broken from inside again folded his hands and this time spoke in Kosali, as if we the nicely dressed, babu looking guys were the Britishers and he was pleading to us, Sir, many have come and gone but nothing have changed, but do a favour to us, “Amke Ar nanglA ni karun”. The last fighter is in war for his self respect.
Saket Sreebhushan Sahu comments on culture and politics
GUIDE TO NUTRITION EXERCISE AND HEALTH
Chapter – 11
Cancer
Cancer cures smoking -The Fresh Quote
What Is Cancer?
Cancer is the name given to a collection of related diseases. In all types of cancer, some of the body’s cells begin to divide without stopping and spread into surrounding tissues.
Cancer can start almost anywhere in the human body, which is made up of trillions of cells. Normally, human cells grow and divide to form new cells as the body needs them. When cells grow old or become damaged, they die and new cells take their place. When cancer develops, however, this orderly process breaks down. As cells become more and more abnormal, old and damaged cells survive when they should die. New cells are formed even if they are not needed. These extra cells can divide without stopping and may form growth called tumors.
Many cancers form solid tumors, which are masses of tissue. Cancers of the blood, such as leukemias, generally do not form solid tumors.
Cancer tumors are of two kinds – malignant and benign. Cancer tumors are called malignant, when they can spread into, or invade, nearby tissues. In addition, as these tumors grow, some cancer cells can break off from their original site and travel to distance places in the body through the blood and the lymph system. There they form new tumors from the original site. These tumors are called metastasis. Unlike the malignant tumors, benign tumors do not spread into or invade nearby tissues. However, benign tumors sometimes can be large and can put pressure on the surrounding organs. When removed, they usually don’t grow back. Some benign tumors, depending upon the location (like-brain) can be life threatening.
How Cancer Arises
Cancer is a genetic disease – that is, it is caused by changes to genes that control the way our cells function, especially how they grow and divide.
Genetic changes that can cause cancer can be inherited from our parents. They can also arise during a person’s lifetime as a result of errors that occur as cells divide or because of damage to DNA (genetic material) caused by certain environmental exposure. Cancer – causing environmental exposures include substances such as the chemicals in tobacco products and radiation, such ultraviolet rays from the sun.
Every person’s cancer has unique combination of genetic changes. As the cancer continues to grow, additional changes will occur and new cancers will be found.
Kinds of Cancer
There are many different kinds of cancer.
The most Common Cancers are:
- Skin
- Breast
- Prostate
- Lung
- Colon and Rectum
- Bladder
- Uterine cancer (cancer of the Womb)
- Vagina and Vulvar Cancer
- Non-Hodgkin’s lymphoma
- Leukemias (Blood Cancer)
Major Killers
- Lung
- Colon and rectum
- Breast
- Prostate
- Pancreas
- Non-Hodgkin’s lymphoma
- Leukemia
- Ovarian
- Stomach
- Brain and nervous system
Risk Factors
It is usually not possible to know exactly why one person develops cancer and another doesn’t. But research has shown that certain factors, called the risk factors – like growing older – cannot be avoided, others – like using tobacco – can be.
Factors that are known to Increase the Risk of Cancer:
- Cigarette smoking and tobacco use.
- Infections
- Radiation
- Immunosuppressive medicines.
Factors that may affect the risk of Cancer
- Diet
- Alcohol
- Physical activity
- Obesity
- Diabetes
- Environmental risk factors
Cigarette smoking and tobacco use:
Tobacco use is strongly linked to an increased risk for many kinds of cancer. Smoking cigarettes or bidis is the leading cause of the following types of cancer.
- Acutemyelogenous leukemia (AML).
- Bladder cancer.
- Esophageal cancer (food pipe).
- Kidney cancer.
- Lung cancer.
- Oral cavity cancer (mouth).
- Pancreatic cancer.
- Stomach cancer.
Scientists believe that 30% of all cancer deaths are due to cigarette smoking and tobacco use.
Infections
Certain viruses and bacteria are able to cause cancer. In developing countries, they are responsible for about 1 in 4 cases of cancer. Examples of cancer-causing viruses and bacteria include:
- Human papilloma virus (HPV) increases the risk of the cancer of the cervix, penis, vagina, anus and oropharynx (mouth and throat).
- Hepatitis B and hepatitis C viruses increase the risk for liver cancer.
- Epstein – Barr virus increases the risk of Burkett lymphoma.
- HelicobacterPylori(H. pylori.) increases the risk of stomach ulcer and stomach cancer.
Radiation
- Ultraviolet radiation from sunlight causes skin cancer.
- Ionizing radiation from x-ray, CT scan and nuclear exposure can cause leukemia, thyroid cancer, breast cancer and cancer of stomach, colon, esophagus, bladder and ovary.
Immunosuppressive Medicines
Immunosuppressive medicines are linked to an increased risk of cancer. These medicines lower the body’s ability to stop cancer from forming. These medicines are used to keep a patient from rejecting an organ transplant.
Factors that May Affect the Risk of Cancer
Diet: Some studies have shown that a diet high in fat, proteins, calories and red meat increases the risk of colorectal cancer, but other studies have not shown this. Some studies show that fruits and non-starchy vegetables may protect against cancers of the mouth, esophagus, and stomach.Fruits may also protect against lung cancer.
Alcohol: Studies have shown that drinking alcohol is linked to an increased risk of the following types of cancers:
- Oral cancer.
- Esophageal cancer.
- Breast cancer.
- Colorectal cancer (in men).
- Liver cancer (may)
Physical Activity
Studies show a strong link between physical activity and a lower risk of colorectal and may be breast and endometrial cancer.
Obesity: Studies show that obesity is linked to a higher risk of the following types of cancer:
- Breast cancer.
- Colorectal cancer
- Endometrial cancer
- Esophageal cancer
- Kidney cancer
- Pancreatic cancer
Diabetes: Some studies show that having diabetes may slightly increase the risk of having the following types of cancer.
- Bladder
- Breast cancer
- Colorectal cancer
- Endometrial
- Liver cancer
- Lung cancer
- Oral cancer
- Mouth cancer
- Ovarian cancer
- Pancreatic cancer
Environmental Risk Factors
Being exposed to chemicals and other substances in the environment has been linked to some cancers.
- Link between air pollution and cancer risk have been found. These include links between lung cancer and second hand tobacco smoke, outdoor air pollution and asbestos.
- Drinking water that contains a large amount of arsenic has been linked to skin, bladder and lung cancer.
- Studies have shown that pesticides and other pollutants increase the risk of cancer. These studies have been unclear.
Symptoms
Cancer can cause many different symptoms depending on the type and location. These are some of them.
- Skin changes, such asanew mole or a change in existing mole or a sore that does not heal.
- Breast changes, such as:
- Change in size or shape of the breast or nipple.
- Change in texture of breast skin.
- Hoarseness or cough that does not go away.
- Changes in bowel habits.
- Difficult or painful urination.
- Problems with eating such as:
- Discomfort after eating.
- A hard time swallowing.
- Changes in appetite.
- Weight gain or loss with no known reason.
- Abdominal pain.
- Unusual bleeding or discharge including-
- Blood in the urine.
- Vaginal bleeding.
- Blood in the stool.
- Feeling weak or very tired.
Most often, these symptoms are not always due to cancer. They may also be caused by other health problems. If you have symptoms that last for a couple of weeks, it is important to see a doctor. Earlier the diagnosis better is the treatment outcome.
Preventing Cancer
You can reduce your risk of getting cancer by making healthy choices like avoiding tobacco products, protecting your skin from sun, keeping healthy weight, and limiting the amount of alcohol you drink.
Tobacco
Lung cancer is the leading cause of cancer death. Compared to nonsmokers, men who smoke are about 23 times more likely to develop lung cancer and women who smoke are about 13 times more likely. Chewing tobacco products cause mouth cancers. Tobacco kills up to half its users (WHO).
Protecting Your Skin
Exposure to ultra violet (UV) rays from the sun is the main cause of skin cancer. Protect yourself from sun by seeking shade, using sun screen, and wearing protective clothing, hat and sunglasses.
Reducing Excessive Alcohol Use
Alcohol use increases the risk of several cancers – oral, esophageal, breast, colorectal cancer. Limit alcohol use or avoid it altogether.
Vaccination
Get – Hepatitis B and Hepatitis – C vaccination to prevent hepatitis. Chronic hepatitis is the leading cause of liver cancer.
Human papillomavirus (vaccine) HPV will prevent cervical cancer, cancer of the vagina and cancer of the penis and mouth.
Cancers Screening Services
Some cancers can be diagnosed by routine screening of high-risk individuals.
- Mammogram – Breast Cancer
- Pap smear – Cervical cancer
- Pelvic Exam. – Vaginal and Vulva cancer
- Colonoscopy – For colorectal cancer
- Stool in the blood – Cancer of the stomach, colon, rectum
- Hepatitis C. Screening – to diagnose liver disease leading to cancer
- Low Dose Computed – for lung cancer
Tomography (LDCT)
- Prostate Specific Antigen – Prostate cancer
(PSA)
- Genetic Test – like BRAC – Genes for breast cancer
If you are in doubt, get it tested. However, not all screening tests are helpful and some have risks. Most have false positive and false negative results. They lead to over diagnosis and treatment.
Diagnosis
If you have symptoms or your screening test result suggests cancer, the doctor must find out whether it is cancer or something else. After a physical examination your doctor may order more blood test, scans, or biopsy.
Lab. Test
- Blood
- Urine
- Stool
Imaging Procedures
- CT Scan
- MRI
- Ultrasound
- X-Rays
Biopsy
A biopsy is a procedure in which the doctor removes a sample of tissue and sends it to a pathologist who looks for cancer cells:
- Needle biopsy
- Open biopsy(with surgery)
Cancer outlook (Prognosis)
Even though most people think it is, a diagnosis of cancer is not always a death sentence. Many factors can affect the outcome. Some of the factors that affect prognosis (outcome) are:
- The type of cancer and location in the body.
- The stage of cancer stage 1 to IV, stage I is better than Stage IV.
- The cancer’s grade. Grade provides clues about how quickly the cancer is likely to grow and spread.
- Certain traits (genetic markers) of the cancer cells.
- Your age and how healthy you were before your cancer diagnosis.
- How you respond to treatment. Each individual respond differently to the same treatment.
Doctors estimate outlook (prognosis) by using statistics based on prior research. Because statistics are based on large group of people, they cannot predict exactly what will happen to you. Everyone is different. Treatments and how people respond to treatment can differ greatly. But early diagnosis is the key.
GUIDE TO NUTRITION EXERCISE AND HEALTH
Chapter – 10
Diabetes
Lose the inches lower your risk. Tell diabetes. Not me. -Unknown
Diabetes is a disease in which blood glucose (sugar) levels are above normal. A hormone called insulin, produced by the pancreas, helps blood glucose get into the cells to provide them with energy.
There are 3 kinds of diabetes.
Type-I or Juvenile Diabetes
Type-1 or Juvenile diabetes is mainly occurs in children. In type-1 diabetes, the pancreas loses its ability to produce insulin. Children with type-1 diabetes require insulin (by injection) replacement every day to stay alive. They cannot be treated with oral medications.
Gestational diabetes:
Gestational diabetes is a type of diabetes that develops only during pregnancy (gestation). After the baby is born, the high blood sugar gradually returns to normal. However, mother who develop gestational diabetes have much higher risk of developing type-2 diabetes many years later.
Pre-diabetes
A person with pre-diabetes has a blood sugar level higher than normal, but not high enough for a diagnosis of diabetes. He or she has a higher risk for developing type- 2 diabetes. Without lifestyle changes to improve their health, 15% to 30% of people with pre-diabetes will develop type-2 diabetes within five years. If you have pre-diabetes, research shows that doing just two things: losing 5% to 10% of your body weight and getting at least 150 minutes of physical activity per week can help you prevent or delay type- 2 diabetes.
Diagnosis of diabetes
The best way to diagnose diabetes is by measuring blood sugar level. Blood sugar level can be measured with fasting or not fasting (random). Fasting is better. Fasting or random blood sugar reflects the blood sugar level when the sample was drawn. There is another and better test called Hemoglobin A1C or simply A1C. It reflects average blood sugar levels over 3-4 months, is not much affected by the food you ate night before.
Pre-diabetes vs. Diabetes
Test Healthy Range Pre-diabetic Diabetic
A1C < 5.6% 5-7 to 6.4% > 6.5%
Fasting Blood Sugar < 100mg/dl. 100-125 mg/dl. >126 mg/dl.
Blood sugar not fasting < 140 mg/dl 140-199 mg/dl. > 200 mg/dl.
Source – American Diabetic Association, 2017.
Risk Factors for Type-2 Diabetes
- Being over 45 years of age.
- Being overweight or obese.
- Having parents, brother, or sister with diabetes.
- Being Asian, Pacific Islander, Hispanic, African- American.
- Having prior history of gestational diabetes (high blood sugar during pregnancy) or birth of a baby weighting more than 4 kg. (9 lbs.)
- Having high blood pressure measuring 140/90 or higher.
- Having abnormal blood cholesterol, higher than 240 mg/dl. or triglyceride level 200 mg or higher.
- Being physically inactive.
What are the symptoms of diabetes?
- Frequent urination.
- Excessive thirst.
- Unexpected weight loss.
- Extreme hunger.
- Sudden vision changes.
- Tingling or numbness in hands and feet.
- Feeling tired much of the time.
- Sores those are slow to heal.
- More infections than usual.
- Very dry skin.
Preventing Diabetes
Research studies have found that moderate weight loss (5% to 10%), and exercise can prevent or delay type 2 diabetes among adults at high risk of diabetes. Steps you can take are:
- Keep your weight under control-
– BMI of 25 or less. Lose your belly (abdominal) fat.
- Increase your physical activity – at least 30 minutes of moderate – intensity physical activity on most or all – days of the week.
- Consume a healthy diet – more fruits, vegetables, fiber, whole grains, beans, fish, poultry, less fat, low sugar, low salt diet.
- Do not smoke.
- If you have risk factor or are in doubt get your blood sugar or A1C level check. Early diagnosis and treatment will minimize your complications from diabetes. It may also save your life.
Complications of Diabetes
- Heart disease.
- High blood pressure.
- Kidney failure.
- Vision problem –diabetic retinopathy.
- Nerve damage (diabetic neuropathy).
- Delayed wound healing – ulcers.
- Gum disease.
- Sexual dysfunction (erectile dysfunction).
- Frequent illnesses, cold, flu.
- Mood change.
Preventing Complications of Diabetes
Diabetes is a bad disease. It can affect many parts of your body – blood vessels nerves, eyes, heart, brain, kidneys. The good news is that you can prevent most of these complications or at least minimize them by keeping your blood sugar, blood cholesterol, triglyceride and blood pressure under control, being physically active and maintaining normal or close to normal body weight. Diabetes causes peripheral nerve damage and poor blood flow to skin and various organs. People with nerve damage do not feel pain from their sores and cuts. They should wear properly fitting shoes and check daily for sores and cut in their feet.
Diabetes is a progressive disease. It damages multiple organs. It is a major cause of disease and disability and death. Please take it seriously and get it under control.
Saheb Sahu, M.D., F.A.A.P., MPH.
GUIDE TO NUTRITION EXERCISE AND HEALTH
Chapter-9
Preventing Adult Illnesses and Deaths
The Top 10 Causes of Death
Ischemic heart disease, stroke, lower respiratory infections and chronic obstructive pulmonary (lung) disease (COPD) have remained the top major killers during the past decade (2005-2015).
Heart attack, Stroke and High Blood Pressure
Coronary Artery Disease (CAD) or heart attack, stroke and high blood pressure are interrelated. Many of the risk factors and the preventive measures are common to all three of them.
Coronary Artery Disease (CAD) (Heart Attack)
Heart attack (CAD) is the most common type of heart disease. It is the most common cause of death in both developed and developing countries. CAD is caused by a plaque buildup in the wall of the arteries (blood vessels) that supply blood to the heart, is made up of cholesterol deposits. Plaque buildup causes the inside of the arteries to narrow over time. The process is called atherosclerosis and it starts in our childhood. And it progresses until we die.
Narrowed artery walls can make it harder for blood to flow through your body. When your heart muscle doesn’t get enough blood, you may have chest pain or discomfort, called angina. Angina is the most common symptom of heart attack.
Over time, CAD can weaken the heart muscle. This may lead to heart failure, a serious condition where the heart can’t pump blood the way that it should. An irregular heartbeat, or arrhythmia, also can develop.
A heart attack, also called the myocardial infection (MI), occurs when a section of the heart muscle dies or gets damaged because of reduced blood supply. CAD is the main cause of heart attack. A less common cause is a severe spasm of an artery that supplies blood to the heart (coronary artery). Sudden cardiac arrest – the sudden stopping of the heart – occurs when the heart stops working completely –unless treated, the person will die within minutes.
Inflammation appears to play an important role in altering the cholesterol and promoting the process of atherosclerosis. Complications resulting from atherosclerosis – hypertension, heart attack and stoke are the leading cause of illness, disability and death, worldwide.
Risk Factors for Heart Attack
Factors which you have no control:
- Age 45 for man
55 for women
- Family History
If your father or brother was diagnosed with heart disease before age 55 or mother or sister before 65.
Following are the risk factors you can do something about:
- Unfavorable cholesterol profile. High bad cholesterol (LDL) 100, and Low HDL (good cholesterol)
- High blood pressure (Normal 120/80)
- Smoking, including second hand smoke.
- Obesity
- Lack of physical activity
- Excess alcohol consumption – leads to high blood pressure and bad cholesterol.
Symptoms of Heart Attack
- Discomfort in the center of the chest lasting more than few minutes or that goes away but comes back. Many people confuse it with indigestion.
- Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
- Shortness of breath with or without discomfort.
- Breaking out in cold sweat.
- Sensation of vomiting (nausea).
- Light headedness
If in doubt, do not procrastinate; get it checked by a doctor or hospital. It may save our life.
Diagnosing CAD
To find out your risk for CAD, your health care team may measure your blood pressure, cholesterol and sugar levels. Being overweight, physical inactivity, unhealthy eating, and smoking tobacco are risk factors for CAD. A family history of heart disease also increases your risk for CAD. If you’re at high risk for heart disease or already have symptoms, your doctor can use several tests to diagnose CAD.
Test What it does
| ECD or EKG
(electrocardiogram) |
Measures the electrical activity, rate, and regularity of your heartbeat.
|
| Echocardiogram | Uses ultrasound (special sound wave) to create a picture of the heart
|
| Exercise stress test | Measures your heart rate while you walk on a treadmill. This helps to determine how well your heart is working when it has to pump more blood.
|
| Chest X-ray | Uses x-rays to create a picture of the heart, lungs, and other organs in the chest.
|
| Cardiac catheterization | Checks the inside of our arteries for blockage by inserting a thin, flexible tube through an artery in the groin, arm, or neck to reach the heart. Health care professionals can measure blood pressure within the heart and the strength of blood flow through the heart’s chambers as well as collect blood samples from the heart or inject dye into the arteries of the heart (coronary arteries).
|
| Coronary angiogram | Monitors blockage and flow of blood through the coronary arteries. Uses X-rays to detect dye injected via cardiac catheterization. |
Prevention
You cannot do anything about your family history or genetic, but you can take the following steps to prevent heart attack.
- Stop smoking if you smoke.
- Lose weight if you are overweight.
- Control your blood sugar (if diabetic) and cholesterol levels.
- Control your blood pressure.
- Consume a heart-healthy diet.
- Get regular exercise.
- Eat oily fish (mackerel, salmon) at least twice a week or take fish oil.
- Take an aspirin (81 mg) everyday if recommended by your doctor. Aspirin can cause stomach bleed.
- If you already have angina (chest pain) carry a fresh batch of Nitroglycerine tablets with you all the times.
Warning
If your chest pain lasts longer than few minutes and cannot be relieved by rest or by taking angina medicine, you may be having or about to have a heart attack. Call an ambulance; chew a 325 mg. aspirin tablet (adult aspirin).
STROKE
Stroke is the second leading cause of death. To understand stroke, it helps to understand something about the brain. The brain controls our movements; stores our memories; and is the source of our thoughts, emotions, and language. The brain also controls many functions of the body – movements, breathing and digestion. To work properly, our brain needs oxygen. Although our brain makes up only 2% of our body weight, it uses 20% of the oxygen we breathe. Our arteries (Cerebral arteries) deliver oxygen-rich blood to all parts of our brain.
What happens during at stroke?
If something happens to interrupt the flow of blood, brain cells start to die within minutes because they can’t get oxygen. This is called a stroke. Sudden bleeding in the brain also can cause stroke if it damages brain cells. A stroke can cause lasting brain damage, long-term disability or even death.
If brain cells die or damaged because of a stroke, symptoms of that damage start to show in parts of the body controlled by those brain cells.
Three Main Types of Stroke Are:
- Ischemic (ii) Hemorrhagic (iii) Transient ischemic or mini-stroke
Ischemic Stroke: (lack of blood supply) 85% of the strokes are ischemic strokes. In ischemic stroke, the artery that supplies oxygen-rich blood to the brain becomes blocked. Blood clots often cause the blockages that lead to ischemic strokes.
Hemorrhagic Stroke:
A hemorrhagic stroke occurs when an artery in the brain leaks blood or ruptures (breaks open). The leaked blood puts too much pressure on brain cells, which damages them. High blood pressure and aneurysm (-balloon like bulges in an artery) can lead to the rupture of the artery and the bleeding into the brain. About 15% of the major strokes are hemorrhagic.
Transient Ischemic Attack (TIA):
A transient ischemic attack (TIA) is sometimes called a “mini-stroke”. It is different from the major types of stroke because blood flow to the brain is blocked only a short time-usually no more than 5 minutes.
Risk Factors for Stroke:
- History of previous strokes, major or “mini-stroke”.
- High blood pressure. There are often no symptoms.
- Cigarette smoking.
- Heart disease.
- High cholesterol – Atherosclerosis
- Sickle cell disease.
Know The Symptoms of a Stroke
- Sudden numbness or weakness on one side of the body-especially in the face, or in an arm or leg.
- Sudden severe headache (probably the worst you ever had).
- Sudden confusion or trouble speaking or understanding speech.
- Sudden vision problem one or both eyes.
- Abrupt difficulty in walking, dizziness, or balance or coordination.
If in doubt, (1) ask the person to smile. Both sides of the face should move equally. In stroke one side of the face does not move. (2) Ask the person to close his/her eyes and hold both arms out straight for 10 seconds. If one has a stroke, one arm drifts down. (3) Ask the person to say a common phrase. A person with stroke, slurs the words, or cannot speak at all.
If in doubt call medical emergency number or your doctor or hospital. Earlier the treatment for stroke, better the outcome. Time is of essence.
Prevention:
You can help prevent stroke by making healthy lifestyle choices. A healthy life style includes the following:
- Eating a healthy diet.
- Maintaining a healthy weight.
- Getting enough exercise.
- Not smoking.
- Limiting alcohol use
- Keeping your blood pressure within recommended range.
If you have already had a stroke or transient ischemic attack (TIA), also known as “mini-stroke”, your chances of having other strokes is higher.
During a stroke, every minute counts! Fast treatment can reduce the brain damage that stroke can cause.
High Blood Pressure
Blood pressure is the force of blood pushing against the walls of your arteries, which carry blood from your heart to other parts of your body. Blood Pressure normally rises and falls throughout the day. But if it stays high for a long time, it can damage your heart and lead to many health problems. High blood pressure raises your risk for heart disease and stroke. The only way to know if you have it is to measure your blood pressure. Then you can take steps to control it if it is too high. Some medical conditions can raise your risk for high blood pressure (like diabetes, kidney disease). If you have one of these conditions, you can take steps to control it and lower your risk.
Blood Pressure Levels
Normal – Systolic: Less than 120 mm Hg
Diastolic less than 80 mm Hg
At Risk (Pre-hypertension):
Systolic: 120-139 mm Hg
Diastolic: 80 – 89 mm Hg
High Systolic: 140 mm Hg
Diastolic: 90 mm Hg or higher
In pre-hypertension your blood pressure is slightly higher than normal, but it increases your risk of developing chronic or long-lasting high blood pressure. You should take steps to control it in the pre-hypertensive stage.
Effects of High Blood Pressure
High blood pressure can damage your health in many ways. It can seriously hurt important organs like your heart, brain and kidneys.
Heart: High blood pressure can harden your arteries, which decreases blood and oxygen to your heart and lead to heart disease. It can lead to angina, heart attack and heart failure.
The Brain
High blood pressure can burst or block arteries that supply blood and oxygen to the brain causing a stroke.
The Kidneys
Adults with diabetes, high blood pressure, or both have a higher risk of developing chronic kidney disease. Approximately 1 of 3 adults with diabetes and 1 of 5 adults with high blood pressure have chronic kidney disease. Chronic kidney disease ultimately leads to kidney failure, disability and death.
Risk Factors
- Diabetes: About 60% of the people who have diabetes also have high blood pressure.
- Age: your blood pressure rises as you get older.
- Family history.
- Unhealthy diet – Eating too much salt can increase blood pressure.
- Obesity –Obese people have higher bad cholesterol and triglyceride – leading to atherosclerosis.
- Physical Inactivity – Obesity – High B.P.
- Too much alcohol: Too much alcohol can raise blood pressure.
Signs and Symptoms:
High blood pressure is called the “silent killer” because it often has no warning signs and symptoms, and many people do not know that they have it.
Rarely, high blood pressure can cause symptoms like headaches or vomiting (late stage). There is only one way to know whether you have high blood pressure – have your doctor or nurse measure it. Measuring is quick and painless. Once you are taught how to do it, you can measure it at home.
Preventing High Blood Pressure:
By living a healthy lifestyle, you can keep your blood pressure in a healthy range and lower your risk for heart disease and stroke. A healthy lifestyle includes:
- Eating a healthy diet.
- Maintaining a healthy weight.
- Getting enough physical activity.
- Not smoking.
- Limiting alcohol use.
- Keeping your blood sugar under control.
Saheb Sahu, M.D., F.A.A.P., MPH.
GUIDE TO NUTRITION EXERCISE AND HEALTH
Chapter – 8
Adolescents Health
Adolescence is a period of rapid changes. Between the ages of 12 and 17, for example, a parent ages as much as 20 years. – Author Unknown
Adolescence is a time of rapid change. Not only the body is changing physically, the mind is also changing. The teen years can often be a time of stress. Teenagers feel pressure to conform to social trends as well as higher expectations from parents and teachers.
Adolescents can experience intense feelings of anxiety, self-doubt, pressure to conform, and demands to succeed. This is the stage, when they experiment with smoking, alcohol, drugs and sex. In 2014, according to WHO an estimated 1.3 million adolescents died, mostly from preventable and treatable causes. Other causes of adolescent death include HIV/AIDS, suicide, lower respiratory infections and violence.
Main health problems include – teen pregnancy and child birth, HIV, mental health, violence, alcohol and drugs, injuries and malnutrition and obesity.
Teen Pregnancy and Child Birth
Complications linked to pregnancy and child birth are the second cause of death for 15 – 19 years – old girls globally.
Better access to contraceptive information and services, delaying marriage age and keeping them in school can reduce the number of girls becoming pregnant. Minimum age for marriage should be 18.
Girls who do become pregnant need access to quality antenatal care. Where permitted by law, adolescents who opt to terminate their pregnancies should have access to safe abortion, including the morning after pill.
HIV (Human Immune Deficiency Virus)
More than 2 million adolescents are living with HIV. Although the overall number of HIV – related death is down, HIV related deaths among adolescents are still significant. Most HIV infected adolescents do not get tested and do not know that, they are infected.
HIV, STD, pregnancy education and counseling be available in all schools. Young people need to know how to protect themselves and have the means to do so. This includes being able to obtain condoms and the knowledge to use it. Better access to HIV, STD, pregnancy testing and counseling are also needed.
Mental Health
Depression is the top cause of illness and disability among adolescents and suicide is the third cause of death. Violence, poverty, humiliation, sexual orientation, (gay or lesbian or transgender) can increase the risk of developing mental health problems.
Building life skill in children and adolescents and providing them with psychological support in schools can promote good mental health. If problems arise, they should be detected and managed by competent and caring health workers. However, it is more said than done, even in developed countries.
Suicide Warming Signs or Signs of Depression
- Feeling of sad and hopeless for no reason, and these feelings do not go away.
- Feeling very angry most of the time.
- Crying a lot or over reacting to things.
- Feeling worthless or guilty often.
- Feeling anxious or worried often.
- Performing less well in school.
- Losing interest in things he or she once enjoyed.
- Experiencing unexplained changes in sleeping or eating patterns.
- Avoiding friends or family and wanting to be alone all the time.
- Feeling life is too hard to handle.
Prevention
If your child ever talks about suicide, even in joking way, take him/her seriously and get help immediately. Signs of depression and risk of suicide can be subtle. If you have any questions, concerns, or instinct about your child that something could be wrong, seek help immediately. You could be saving our child’s life.
Listen carefully to your child. Tell him/her that you care about what happens to him/her and that help is available. Find a doctor, counselor, psychologist, social worker, youth worker to work with your child. Most cases depression can be successfully treated.
Violence and Injuries
Violence is a leading cause of death in young people. Globally some 30% of girls aged 15 to 19 experience violence by a partner.
Unintentional injuries are another leading cause of death and disability among adolescent. Road accident is the most common cause. Many times alcohol and drugs use contribute to the cause of accident. There should be zero tolerance for drunk driving by adults as well as by the adolescents.
Drowning is also a major cause of death among adolescents. All children should learn swimming. Swimming is an excellent exercise. It will also save lives.
Malnutrition and Obesity
Many boys and girls in developing countries enter adolescence undernourished, making them more vulnerable to disease and early death. The number of adolescents who are overweight or obese is increasing in both low-and high-income countries. Adequate nutrition, healthy eating habits and physical activity and exercise, at this age are foundations for good health in adulthood. Children and adolescents who are overweight and obese are at higher risk of developing type-2 diabetes, high-blood pressure and heart disease and stroke as an adult.
Tobacco Use
The vast majority of tobacco users worldwide began when they were adolescents. Today an estimated 150 million young people use tobacco. This number is increasing globally, particularly among young women. Half of those users will die prematurely (long cancer, heart disease, stroke, pancreatic and kidney and bladder cancer) as a result of tobacco use.
Banning tobacco advertising, raising the price of tobacco products, and laws prohibiting smoking in public places can reduce the number of people who start using tobacco products. They also lower the amounts of tobacco products use and increase the number of young people who quit smoking.
Alcohol and Drugs
Alcohol, like tobacco is addictive. Many adults start drinking when they are teenagers. Harmful drinking (excessive drinking) among adolescent is a major concern in most countries. Alcohol use reduces self-control and increases risky behavior. It is a primary cause of injuries (road traffic accidents), violence (especially by a partner) and premature death. It can also lead to health problem in later life and increase disability and death.
Setting a minimum age for buying and consuming alcohol and banning alcohol advertising in all forms can reduce the use of alcohol by young people as well as adults. Taxing alcohol heavily and making it pricey also will help.
Binge Drinking – having five or more drinks in a row in one session – is particularly dangerous but common feature of adolescent drinking. Binge drinking can cause alcohol poisoning, which can lead to coma and even death. Alcohol poisoning is more common among preteens and teens than any other age group.
Alcohol can be harmful even to teens that are not drinking. If your teenager is around people who are drinking, he or she has an increased risk of being seriously injured, involve in vehicle accident, or affected by violence.
Remind your child that most teens do not drink alcohol. He/she should politely decline if offered by his friends. He/she can say –“my parents will ground me for a month if I drink”. If you suspect that your child may be drinking (like vomiting in the sink or toilet, alcohol breath, incoherent talk, unbelievable excuses), confront him/her. Don’t ignore.
Marijuana (Cannabis)
After alcohol, marijuana (cannabis, ganja) is a major drug of choice of adolescents. Long-term marijuana use can damage the airways and lungs and lead to chronic bronchitis. Marijuana smoke also contains cancer causing agents that can increase the risk for lung cancer.
Some of the telltale signs of marijuana use include the distinctive odor on your child’s clothing, the use of incense or other room deodorizers to hide the odor.
Teenagers can also get addicted to prescription drugs including pain killers, tranquilizers, stimulants and sedatives. Adolescents are more likely than young adults to become dependent on prescription drugs. Opium in all form is quite addictive.
How to Prevent Drug and Alcohol Use
Some children are abusing drugs and alcohol by age 12 or 13. Building a strong and protective relationship with your children from infancy will help reduce their risk of abusing tobacco, alcohol and other drugs. Here are some steps you can take:
- Provide emotional, intellectual, and financial support to your children.
- Keep tabs on his/her friends.
- Set clear limits and enforce them.
- Voice strong disapproval of the use of alcohol and other drugs.
- Make yourself an example –
Do not drink, smoke or do drugs.
- Establish and enforce a curfew.
- Promote involvement in extracurricular activities.
- Teach them to say “no” to smoking, alcohol, drug and sex.
Saheb Sahu, M.D., F.A.A.P., MPH.






