The New Nation - Internet Edition

Jamayet Ali

Gulancha is a deciduous climbing shrub found in bushy and fallow lands of rural BangIa. Its stems are rather succulent with long filiform fleshy aerial roots from the branches. Bark grey-brown or creamy white, warty; leaves membranous, cordate with a broad sinus; flowers small, yellow or greenish yellow, appearing when the plant is leafless. The plant is sometimes cultivated for ornament and is propagated by cuttings. The leaves afford a good fodder for cattle. Moreover the leaves are rich in protein and fairly rich in calcium and phosphorus. The stem and extract of the plant can be obtained in shops and bazaars. The root is not generally available in bazaars, but can be procured without difficulty at the cost of collection. Botanical name of Gulancha is Tinospora cordifolia.

Medicinal Values: The stem is bitter stomachic; stimulates bile secretion; causes constipation; tonic; allays thirst, fever, burning sensation, vomiting; diuretic; enriches the blood; cures jaundice; useful in skin diseases; the juice is useful in diabetes, vaginal and urethral discharges, low fevers, and enlarged spleen (Ayurveda). Stem bitter; appetizer, stomachic, tonic, antipyretic, expectorant; good in cough, jaundice, giddiness, vomiting, piles, anaemia, chronic fever; renews the blood; mixed with sesame oil it is useful for massaging the body (Yunani). The root and stem are prescribed in combination with other drugs as an antidote to snake-bite and scorpion-sting.

An infusion of the powdered stem is used as an alterative and tonic and enjoyed the reputation among ancient Hindu writers of being an aphrodisiac. Among the Mundas of Chota Nagpur the whole plant, well ground, is applied on fractures. In Ceylon the stems are used in fevers, skin diseases, jaundice, and syphilis. The starch obtained from the roots and stems of the plant is similar to Arrow-root in appearance and effect. It answers not only as a remedial medicinal agent in chronic diarrhoea and some forms of obstinate chronic dysentery, but it also a valuable nutrient, when there is intestinal irritability and inability to digest any kind offood. I have myselfhad experience ofthe usefulness of this starch. I think this drug is useful where there is an acid-diarrhoea, due to an acidity of the intestinal canal or acid dyspepsia. It is useful in relieving the symptoms of rheumatism. There is another preparation of the plant, the succus Guice), freshly prepared from the fresh plant. It acts as a powerful diuretic. It is prescribed by ancient Hindu physicians in gonorrhoea with advantage ( Kirtikar).

In certain parts of India the plant is regarded as a specific for the bites of poisonous insects and venomous snakes. The juice and decoction of the root are applied to the bitten, poured frequently into the eyes and administered internally by mouth at intervals of half an hour. A tincture was tried in mild cases of malaria and was found to be useless in such cases. The aqueous extract was tried in the low chronic fever of kala-azar and also in diabetes, but it was not found to possess the virtues attributed to it. The drug was given another fair trial in the form of a liquid extract in several cases of malarial fever, both in children and adults. The action was found to be very low. The drug had to be

administered for several days before even mild cases were cured. In chronic cases it did not do any good, although it is a reputed medicine in the Hindu Pharmacopoea for all fevers (Koman). The root and stem are useless in the additional treatment of snakebite; the root is also useless as a collyrium or as an external application to the bitten part (Mhaskar and Caius). The root is equally useless in the treatment of scorpion-sting (Caius and Mhaskar). (Indian Medicinal Plants, K.R. Kirtikar and B.D. Basu, 78, 79).

Medicinal Properties: Gulancha is mentioned in Ayurvedic literature as a constituent of several compound preparations, used in general debility, dyspepsia, fevers and urinary diseases. The aqueous and alcoholic extracts caused reduction in the fasting blood-sugar which has been interpreted as indicating some indirect action of the drug on carbohydrate metabolism. Similarly, glucose tolerance was increased but a deterioration in tolerance occurred after one month treatment. It has been suggested that the action of the drug is due to its favourable effect on the endogenous insulin secretion, glucose uptake and inhibition of peripheral glucose release.

A decoction of the leaves is used for the treatment of gout, and young leaves, bruised in milk, are used as a liniment in erysipelas. The leaves are bitten with honey and applied to ulcers. Dried and powdered fruit mixed with ghee or honey, is used as a tonic and also in the treatment of jaundice and rheumatism. The root is powerful emetic and used for visceral obstructions; its watery extract is used in leprosy. After all, the entire plant including stem, leaves, root is regarded as a valuable alterative and tonic and is used in general debility, fever, jaundice, skin diseases, meumatism, urinary diseases, dyspepsia etc. It enters into the composition of many elaborate prescriptions Chakra datta and other Sanskrit writers, most of which contain many other more or less powerful medicines. The plant early attracted the notice of European physicians in India. Fleming remarked on its use as a febrifuge, and as a tonic in gout; for snake-bite and Taylor states that the watery extract was, in his time, administered for leprosy. A little later, a paper was published on the subject by Dewan Ramkamal Sen in which he described the method of preparing the extract, also a decoction of the stem, root and leaves. (The Wealth of India, Raw materials)

Medicine: O'Shaughnessy states that the extract was found to be a very useful tonic in several trials made at the Calcutta College Hospital, though decided febrifuge effects could scarcely be attributed to it. The decoction or cold infusion he described as a very great utility in the treatment of several cases of chronic rheumatism, and of secondary syphilis, its action being decidedly diuretic and tonic in a very high degree.

Gulancha was accordingly admitted to the Bengal Pharmacopoeia of 1844 and the Indian Pharmacopoiea of 1886. In the latter a tincture, infusion, and watery extract (which correspond to the palo of the natives) are officinal. Waring corroborates O'Shaughnessy's statements regarding its greater value as a tonic than as an antiperiodic.

"The fresh plant is said to be more efficient than the drug; it is taken with milk in rheumatism, acidity of the urine and dyspepsia. The juice with pakhanbed and honey is given in gonorrhoea, and is an ingredient paushtiks given in phthisis. In Guzrat a necklace called kamala-ni-mala (jaundice necklace) made of small pieces of the stem is supposed to cure that disease". Moodeen Sheriff considers the drug alterative tonic and antipyretic, and states that the root and stem, but especially the extract, are useful in slight cases of fevers, in secondary syphilis and rheumatism, jaundice, general debility after long standing sickness, and splenic affections. He suggests that one or other of the officinal preparations might be substituted for quinine, James' powder, potassic iodide and sarsaparilla.

Special Opinions: "There is a general belief amongst the Muhammadans of India that the gulancha growing on a Margosa tree is more efficacious as a medicine than that which may be found on other kinds oftrees, hedges, etc. and they, therefore, cultivate the plant in their own houses and gardens, and make it run over Melia azadirachta. The watery extract of the plant is greatly used as a remedy in fevers and is called 'Indian Quinine' by some Hakims. This is of course, a great exaggeration of its value but there is no doubt that it is a very useful drug, especially in some very obstinate, low, and longstanding remittent and typhoid fevers.

Its action is generally more satisfactory when employed in combination with other drugs of similar medicinal properties. Although it is not costly drug, yet it is generally substituted by, or adulterated with, many cheaper substances in the bazaars, so much that out of the seven specimens I have received from different places, including Calcutta, Hyderabad and Lucknow, none is found to be genuine" (Honorary Surgeon Moodeen Sherif, Khan Bahadur, Triplicane, Madras) "Have used it a little in the shape of decoction of the root, as an antiperiodic but not successfully" (Surgeon D. Picachy, Pumeach).

"Gulancha, which grows on neem trees, is considered most efficacious for remedial purposes" (Surgeon Anund Chunder Mukerji, Noakhally) "Tonic and antiperiodic" (Assistant Surgeon Nehal Singh, Saharanpore). "The bazaar extract is starchy in its nature and does not contain the bitter principle of the plant" (Surgeon Ma-Major Robb, Civil Surgeon, Ahmedabad.) "Bitter tonic and diuretic in the form of decoction" (Civil Surgeon C.M. Russel, Sarun). "Gulancha is an excellent substitute for Calumba. The starch prepared from the plant is much used, but it is not so efficacious as the infusion" (Surgeon R.L. Dutt, M.D., Pubna). "Tonic useful in chronic rheumatism and fevers" (Asstt. Surgeon S. C. Bhattacharji, Chanda). "Useful in chronic rheumatism and secondary syphilis" (Surgeon-Major H.J. Hazlitt, Ootacamlend). "Is a favourite dispensary remedy as a tonic and alterative in the Behar district" (Surgeon R.D. Murray, M.B. Burdwan). "An extract made from the stems by crushing and infusion, is much valued by the natives as an antiperiodic. It is given in doses of 5 grains, and commands a high price in the bazaar. It is superior to cinchona febrifuge" (Narain Misser, Khate Bazar Dispensary, Hoshangabad, Central Provinces). (Dictionary of the Economic Products of India)

Dr. Md. Nazrul Islam

Therapeutic life -style change means change of those things, which are highly related to negative deflection of health and corresponding diseases. Theses negative deflections are harmful for the health as well as survival of socially and economically productive life.

Modern disease:-Modern disease means these diseases which does not possible to prevent by traditional method of isolation, immunization or improvement in sanitation -such as obesity, Diabetes, Hypertension, coronary heart disease.

Civilization is a particular kind of culture, characterized by increasing complexity in social economical and political organization, a settled life, a food supply in excess of subsistence level, occupational specialization, writing and reckoning and innovation in the arts and science -all maintained by a large number of people over a significant period of time.

Mark Twain said that ''habit is habit, and not to be flung out the window by any one, but coaxed downstairs a step at a time." Changing negative life style patterns in to healthy one is often a time-consuming and difficult process. Factors which influence life style change can be divided in to three general categories-

a) Predisposing factors-Our life experiences, knowledge, culture and ethnic inheritance and current beliefs and values are all predisposing factors influencing life-style change. For example -If children parents are used to smoking -90%more likely to start smoking than someone whose parents didn't.

b) Enabling factyors:- Skills or abilities, physical, emotional, mental capabilities; and resources and accessible facilities that make health decision are more convenient or difficult are enabling factors,

c) Reinforcing factors;-The presence or absence of support, encourage and discouragement that significant in life bring to a situation is a reinforcing factors.

Physical activity is any force exerted by skeletal muscles that results in energy usages above the level used when the body system are at rest. A regular program of aerobic exercise improves the efficiency of cardio vascular and respiratory system. As a benefit of regular physical exercise, the heart is able to pump more blood with each stroke; these lowering resting heart rate Additionally the body capacity to distribute for respiration are strengthened. A major cause of low activity levels is the abundance of labor saving device in the modern threshold. Typing on computer key board rather than manual type writers, getting up to change the TV Channel rather than using remote control button, Walking up a flight of stairs rather than taking the elevator and Pushing vacuum cleaner rather than sweeping floors cause us to expend fewer calories than previous generation's did .The automobile is a great convenience, but it lowered our muscle tone and cardiovascular efficiency.

Exercise is defined as physical activity at higher than normal levels for exertion. Regular exercise strengthens the heart, enabling it pump more blood each beat. The increased efficiency means that heart requires fewer beats per minutes to circulate blood through body

Low to moderate exercise training lowers both systolic and diastolic blood pressure by about 10 mm Hg in people with mild to moderate hypertension

Regular exercise is known to reduce the level of Low density lipoprotein (LDL-bad cholesterol) while increasing number of High density lipoprotein (HDL-good cholesterol) in the blood .Higher HDL levels are associated with lower risk for artery disease because they remove some of the LDL from artery walls and hence prevent clogging. The net effect of these two physiological responses to exercise is a diminished risk of cardiovascular disease.

A recent large epidemiological studies found that for every two thousand calories of energy expended during leisure time activities, the incidence of diabetes was reduced by 24%

A landmark study conducted at the Institute of Aerobic Research in Texas found that exercise does increase longevity. Participants who changed from a sedentary life-style to one that included a brisk 30 to 60 minutes walk each day experienced significant increase in the life expectancy.

Just how exercise alters immunity is not well understood. We do know that brisk -exercise temporarily increases the number of White Blood cells (WBCs), the blood cells responsible for fighting against infections. After brief period of exercise, the number of WBCs typically returns to normal levels within one to two hours .An increase number of WBCs suggests increase immunity to disease and infection.

The term aerobic means "with oxygen" and describes any type of exercise, typically performed at moderate levels of intensity for extended periods of time, that increase individual maximum heart rate (To calculate target heart rate -subtraction of age from 220 for female or from 226 for male. The result is maximum heart rate.

A target heart rate of 70% of maximum is some times called "conversational level of exercise" because these levels are able to talk with a partner while exercising.). Aerobic activity such as walking, jogging, bicycling and swimming are among best exercise for improving overall health status as well as cardiovascular fitness. Aerobic capacity commonly written (VO2max) is defined as the volume of oxygen consumed by the muscles during exercise.

To measuring aerobic capacity by treadmill test or a graded exercise test. According to the exercise testing guidelines of the American College of Sports Medicine -maximal aerobic capacity treadmill test s should not conducted on men over 40 and women over 50 without a prior comprehensive physical examination and permission from their physician.