The New Nation - Internet Edition

Headache: The most common health problem

Easir Abedin

Headaches are one of the most common pain-related health problems in both children and adults. You may have a headache along with another minor health problem such as a sore throat, cold, or sinus problem.

Types of headaches

The most common types of headaches usually are not serious but may occur again and again.

*Tension headaches are the most common type of headache and are often caused by stress and emotional strain. Most adults have tension headaches from time to time. See an illustration of possible areas of pain from a tension headache.

*Cluster headaches

*Migraine headaches. Approximately one-third of people who have migraine headaches first began having them as teenagers.

Common causes of headaches

Common causes of headaches include:

*Alcohol, caffeine, or other drug use or withdrawal.

*Changes in the levels of chemicals in the body (neurotransmitters).

*Coughing or sneezing.

*Dehydration.

*Dental problems or procedures, such as pain from grinding the teeth or from a root canal.

*Eating or drinking cold foods and fluids.

*Emotional stress.

*Exposure to smoke or fumes from chemicals, including carbon monoxide.

*Eyestrain.

*Fever.

*High altitude. Lower oxygen levels at high altitudes can cause headaches.

*High blood pressure (hypertension).

*Infection in the sinuses, such as sinusitis or an abscess.

*Medical procedures, such as the aftereffects of a lumbar puncture (spinal tap).

*Medicines. Many medicines can cause headaches.

*Muscle strain in the neck, upper back, or shoulder muscles.

*Upper respiratory infections.

Headaches with other serious symptoms

Although rare, a headache may be a sign of a serious illness. Other symptoms, such as vomiting, dizziness, or changes in vision, may also be present. The following serious illnesses or injuries can cause headaches.

*A head injury:

*Injury to the brain

*Fracture of the skull

*Bleeding in or around the brain

*Brain tumor, which causes swelling within the brain.

*Infection in the brain (encephalitis) or of the membrane surrounding the brain and spinal cord (meningitis).

*Stroke, a problem that occurs when a blood vessel (artery) that supplies blood to the brain bursts or is blocked by a blood clot.

*A rupture of a blood vessel with bleeding in or around the brain (aneurysm)

Headaches and other health conditions

Other health conditions that can cause or contribute to headaches include:

*Fibromyalgia, a condition that causes widespread muscle and soft tissue pain and tenderness.

*Glaucoma, an eye disease that damages the nerves at the back of the eye.

*High blood pressure (hypertension).

*High blood sugar (hyperglycemia) or low blood sugar (hypoglycemia).

*Inflammatory problems , such as arthritis, lupus, or giant cell arteritis.

*Kidney disease, which causes wastes to build up in the blood.

*Low calcium levels in the blood (hypocalcemia) or overactivity of the gland that helps control the release of calcium into the blood (hyperparathyroidism).

*Lyme disease, a bacterial infection spread by certain types of ticks.

*Mental health problems, such as anxiety or depression.

*Problems with pregnancy, such as severe high blood pressure (preeclampsia).

*Sleep problems, such as insomnia or sleep apnea.

*Thyroid problems, such as hyperthyroidism or hypothyroidism.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a doctor.

Home Treatment

Most of the time headaches get better or go away with home treatment and do not require a visit to a doctor. Home treatment for headaches can often help reduce the severity of pain and the length of time the pain is present. Home treatment may also relieve other symptoms, such as fever, nausea or vomiting, anxiety, or muscle aches. Start home treatment as soon as you can. Be sure to review the home treatment information for any other symptoms you may have.

If your doctor has prescribed a specific treatment for your headaches, begin treatment as soon as a headache starts. Be sure to follow his or her instructions when taking any prescription medicine for your headache.

For mild pain without other symptoms, try the following:

Rest in a quiet, dark room.

Place a cool compress on your forehead.

Do not smoke, drink alcohol, or use illegal drugs

Medicine you can buy without a prescription

Try a nonprescription medicine to help treat your pain

*Acetaminophen (Paracetamol)

*Aspirin (also a non-steroidal anti-inflammatory drug)

Safety tips: Be sure to follow these safety tips when you use a nonprescription medicine

Carefully read and follow all directions on the medicine bottle and box.

Do not take more than the recommended dose.

Do not take a medicine if you have had an allergic reaction to it in the past.

If you have been told to avoid a medicine, call your doctor before you take it.

If you are or could be pregnant, do not take any medicine other than acetaminophen (Paracetamol) unless your doctor has told you to.

Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.

You may be able to reduce the frequency and severity of your headaches by trying:

Relaxation exercises. These exercises can help take away tension and stress that cause headaches or make them worse. For more information, see the topic Stress Management.

Heat, such as hot water bottles, heating pads, or hot baths, to relax tense muscles. Be careful not to burn yourself.

Ice, such as an ice pack applied to the back or the neck or the temples.

Massage therapy and biofeedback, which can reduce muscle tension, especially in your neck and shoulder muscles. This muscle tension can cause headaches or make them worse. For more information, see the topic Complementary Medicine.

When your child has headaches:

Talk to your child. Let him or her know you care. Extra attention and quiet time may be all that is needed to relieve the pain.

If your child's doctor has prescribed a specific treatment for his or her headaches, begin treatment as soon as your child complains of the pain.

Let your child rest quietly in a darkened room with a cool compress on his or her forehead.

If your child's headache pain is mild, encourage him or her to go on with normal activities.

Do not allow your child to avoid chores or other activities unless his or her headache pain is moderate to severe.

Utilisation of medicinal and aromatic plants in Bangladesh

Hakim Mohammed Said

In developing countries, remedies prepared by a traditional healer from plants of the local flora are available for majority of the people. Although bulk of synthetic preparations and chemical drugs are available as proprietary and prescription products with high price, there are millions of people in all walks of life in these countries, who have faith only in the Traditional System of Medicine and this trend is growing. They think that it is a safe and dependable system because it have evolved, developed and perfected in our own communities and areas, and has been tried over a period of thousand years with uniform results, under our own climatic and living condition. This trend has also taken its current ascent due to the toxic and adverse reactions of synthetic and chemical medicines being observed round the globe. There are available data as regards the therapeutic efficacy of modern drugs which the experts feel are not applicable to our conditions especially to the South Asian and Pacific Regions.

In Bangladesh, there are several thousand traditional healers of whom many are practising in rural areas. They practice the traditional system of medicine, dispensing mostly herbal remedies and well over 60% of the country's population attend their clinics.

A correct approach to investigation of such plants would therefore be for trained physicians and pharmacologists to cooperate with healers, first acting as observers by establishing proper diagnosis and evaluating whether the treatment given by the healer is likely to be effective. In this way a number of plants might be selected, extracts of which could then be subjected to more detailed clinical trials, provided that the preliminary observations and a reasonable extensive toxicological evaluation have shown an acceptable therapeutic ratio. Further investigation of these plants could then be performed in the laboratory.

Identification of Problems Regarding Development of Medicinal Plants in Bangladesh

* Despite the fact that a large proportion of the country's population (mostly in rural and remote areas) depend upon curative properties of medicinal herbs, little or no attention has been given to the development of this resource in the past.

* Medicinal plants of indigenous origin as well as imported species are now increasingly being used in hoth raw and semi-processed forms as medicines in Greco-Arab (Unani) System. Herbal wings of multinational and national pharmaceuticals are also contributing at large in utilisation of indigenous herbal wealth.

* Although there are different areas of vegetation in Bangladesh with their distinctive agricultural products such as rice, sugarcane, jute, leguminous plants, etc. and commercially valuable trees, there is no proper methodology adopted as yet regarding dissemination of existing knowledge on state of natural occurrence of medicinal plants. There is no organised body for dissemination of ethnobotanical and scientific information in the country.

* The scope of cultivation of medicinal plants has not been clearly defined to the farmers. Therefore they lack awareness of the economic benefits. Procurement, use and preparation in herbal formulations. This fact adds much towards restriction of regular apply of required crude drugs in time to the users or to the market.

* No attention has so far been paid to the propagation and harvesting of medicinal plants in the management plans prepared by forest departments of the different zones. No proper emphasis has been given to cultivation of medicinal plants of areas that are vulnerable to droughts or to heavy floods. This has led to the fear of extinction regarding several species.

Please allow me to quote hereunder from one of my presentations at Vienna meeting: "Only the industrial development concerns have ultra modern equipments regarding analysis on medicinal plants. No research based manufacturing organisation has facilities of sophisticated insolation, phytochemical screening and identification or equipments for analysing principal active ingredients."

As regards the phytochemical data in Pakistan, H.E.J. Research Institute of Chemistry at the University of Karachi enjoys the facility of computer data link but it does not deal with taxonomic and pharmacognostic attributes for identification.

The Institute of Clinical Pharmacology established under Hamdard Laboratories (Waqf) Pakistan has started pre-clinical and clinical experiments on herbal crude drugs and on compound formulations including pharmacokinetics, pharmacology, pharmacodynamics and toxicology. Obviously, this shall result in standard advancement of the largest herbal manufacturing house in the country. Being an establishment of academic nature the institute also aims at providing national assistance to herbal medicinal manufacturers and shall become a part of the Hamdard University in the future. It shall help in establishing the efficacy of herbs and herbal formulations as well as safety and toxicity.

Source and Use of Medicinal Plants Material for Industry and Industrial Projections: Pharmaceutical Preparations comprising herb or their parts including those of bacterial and fungal origin contribute to over 60% of all preparations used for man and stock. However, we observe in most traditional pharmacopoeias, a measurable decline in the number of medicinal plants and their preparations in proportion to the increase in synthetic substances. This can be explained by changes in the ways in which medicinal plants and their products are being used. The raw materials can be categorised as: (i) raw plant material, e.g. leaves, roots, fruits, seeds, resins, gums etc., (ii) pulverized and semi-processed plant materials in the form of powders, ashes etc .. (iii) infusions, decoctions, extracts, etc.

Besides the use of raw materials and purified natural substances, a growing number of refined plant extracts are now being used in naturopathic remedies. These remedies are an integral part of what today is called "Phytotherapy". It should be borne in mind that it is not necessary for the article components to be isolated structure be established for a plant extract to be article. Indeed, it is possible that structurally different compounds present in a crude extract may have 'synergistic effect' (which is reflected in case of compound formulations too). Thus there is great potential today like in the past for the industrial development of traditional herbal remedies and plant extracts for the prevention or treatment of diseases. Phytochemical complexity of these traditional remedies and the inherent biological variation makes it necessary but also very difficult to evaluate their safety, efficacy and quality. Problems associated with this phase of development in plant-based industry thus include:

(i) lack of comparative studies between synthetic and natural herbal drugs;

(ii) lack of involvement for betterment of this industry and as a whole government patent is weak for plant-derived drugs;

(iii) continuous and long term supply of herbal raw material is not assured:

(iv) the biological variation inherent in the raw material results in quantitative deviations as well as in qualitative terms;

(v) plant extracts are often difficult to dissolve in water and

consequently difficult to test in various bioassay systems:

(vi) lack of advanced knowledge of modern separation methods and highly sensitive screening methods for trace elements and other active components in complex mixtures: (vii) instability of the active (organic) compounds in biological preparations:

(viii) loss of biological activity during laborious screening and clinical experiments:

(ix) difficulty in determining the general pharmacological activity of plant materials which needs sophisticated equipments and well-organised infrastructure:

(xi) shortage of qualified pharmacologists and traditional healers having advanced knowledge of such procedures.

Search for pharmacologically active compounds from effective medicinal plants is a team work and involves the participation of taxonomists, pharmacologists, chemists, hakims and doctors. To make these categories precise, we aim to have a triumvirate of scientists, hakims and doctors - for cultivation, standardisation, phytochemical, pharmacological and clinical studies for better utilisation of existing resources available and for the improvement and industrial development of this natural wealth.

Proposals for Policy Formation Regarding Bangladesh Medical Plants and Crude Drugs

Under the consultation of UNIDO, National Commission of International Standards on Medicinal and Aromatic Plants be set up to evaluate the situation, develop plans and policies, as well as to develop and adopt strategies for controlled processing. marketing, research and development.

Necessary assistance and incentives be given to the farmers who are growing or who shall grow medicinal plants.

Facility of tax exemption for initial years can also be of great benefit to local farmers.

Establishment to Technical Expert Committee to examine the difficulties in cultivation, processing, extraction, drying, storages, quality assurance and standardisation, as well as supply and export in order to develop future plans of action.

Formation of Technical Expert Committee on ethnobotanical aspect, distribution, availability taxonomy, pharmacognosy and ethnopharmacology, as well as for government and private sector collaboration, research, manufacturing, and marketing studies.

Information regarding each and every crude drug of herbal origin be gathered in a pool like NAPRALERT.

Scope of education regarding wild and cultivated medicinal plants survey, collection and identification should be enhanced in all the R & D institutions of the country.

I have mentioned the problems we are facing as regards the proper awareness of medicinal plant wealth. I have mentioned the advancement in the use of medicinal plant material for industry and industrial projections. I have also given the proposals for policy formation regarding our indigenous herbal wealth and the relevant developmental strategies that can be adopted in this field. Since its establishment, Hamdard has contributed fairly to the national health and this effort aimed at better health thru' herbs continues. Hamdard is promoting the health of the nation thru' medicinal plants. I am confident that UNIDO and other esteemed agencies shall take interest in Hamdard's plans to create the awareness regarding economic value of medicinal plants, proper cultivation, procurement, marketing, manufacturing, and overall development of medicinal plant industry in Bangladesh for the benefit of the mankind.

It is fortunate that Bangladesh occupies a unique position among the developing countries and has great wealth of medicinal flora under varied climatic conditions.

The Role of Hamdard in Development of medicinal Plants Industry Hamdard in India, Pakistan and Bangladesh is engaged in production and marketing of over 2,500 medicinal products classified under pharmacopoeia of Eastern Medicine and as in-house trade over the counter and prescription products, as well as simples (mufradat) in all the possible forms. A centre for Horticulture for training of farmers has been established at Hamdard's project Madinat al-Hikmat which shall enable the farmers to gain expertise in large scale cultivation or medicinal plants not only on the national scale and for use at Hamdard Laboratories, but for export too. This shall also result in the elimination of the middleman and the stockist.

Hamdard intends to compile a Directory of medicinally potential species of Pakistan and to establish a Centre for Excellence on Medicinal Botanics where experiments on cultivation shall be conducted. We intend to do the same in Bangladesh.

Hamdard also plans to establish a scientific information pool at the Bai'tal Hikmat, Hamdard University Library like the NAPRALERT at the College of Pharmacy, University of Illinois, Chicago, (the computerised database derived primarily from scientific information gathered from the world literature on natural products).

Hamdard Laboratories has also planned the large scale production of intermediate and fine products such as:

a. Crude and purified extracts, essential oils, with proper preservation techniques and their marketing and export.

b. Isolation of active constituents such .as alkaloids, and glycosides, and determination of raw materials that can be used as precursors for the synthesis of compounds like vitamins, hormones, enzymes, fibers etc.

c. Increase in proprietary formulations in addition to prescription products manufacture which can be marketed over the counter.

d. Analysis all the crude herbal drugs (simple as well as compound foundations) at its newly established Institute of Clinical Pharmacology at Hamdard University, Madinat al-Hikmat under full-scale screening programme for elementary compositions study of elements (e.g. potassium, sodium, nitrogen, phosphorus and other elements of the periodic table). This aspect, discussed at the three international conferences on the 'Role of Elements in Health and Disease' is gaining significance with time.

A non-governmental agricultural support programme for self-sustained economic development in arid zones has already been started as a project under Hamdard Foundation Pakistan and Madinat al-Hikmat with German collaboration aimed at education of the local farmers. Medicinal plants cultivation shall be an integral part of this project. Such steps are possible in Bangladesh keeping in view its tropical monsoon climate and its distinctive vegetation.

Successful sanitation movement in Narsingdi

Raipura is one of the biggest Upazilas of the country. It consists of 24 Unions Parishads and one Pourasava. In spite of being close to the capital city, the villages in Raipura are remote, poverty stricken, backward in communication and public health facilities. Men, women and children of the area are deprived of other necessary amenities. Health and sanitation facilities are very poor for them.

It is learnt, health education, sanitation and water supply projects backed by the GOB and UNICEF was initiated in February 2007. Department of Public Health Engineering (DPHE) under the ministry of LGRD is implementing these projects funded by UNICEF and DFID. Association for Rural Development is working for a successful completion of the projects. It has also been working for raising awareness among the masses about sanitation. 341 well-trained officers and employees are working at the grassroots level to ensure safe water and sanitation facilities for all. The ultimate aims and objectives of GOB-UNICEF projects are to ensure sanitation, safe water supply, and changes in health habits and arsenic free safe water supply among the people. Different government agencies are involved in the proper implementation of the projects.

At the beginning of these projects, 307 community hygiene promoters, 24 union supervisors and other staff of field agencies were trained for proper implementation of the projects. ARD organised basic training on water supply and sanitation for 3378 ward, union and Upazila committee members and public representatives including local elite and government officials. Field Agency has formed 4605 Community Action (CAP) Plans involving all classes of people.

Tube-wells and latrines are being installed according to the needs of the CAP. For this reason, poor people are now getting benefits from tube-wells and latrines, which were occupied by influential and rich people previously.

CHP are moving from house to house and motivating people on sanitation. Courtyard meetings, focus group discussions, sitting with people of different professions, interaction with poor, poorest and marginalised group, tea stall and grocery shop sessions, video shows on sanitation, sanitation fairs at union levels, drama and folk songs are regularly organised to create awareness among the people.

The people of Raipura are keeping important role in implementing the project. Union Parisad chairmen and members informed, people did not set up latrine before this. But at present they come in-groups to set up toilets. People of the remote char areas are also using sanitary latrines now. They also deposit wastes in particular pits. The population of the Upazila now shows consciousness about health and sanitation. The project is playing a vital role in bringing about radical changes in the lifestyle of the people.