The New Nation - Internet Edition

Lactobacillus acidophilus : A human friendly bacteria

Easir Abedin

Lactobacillus acidophilus ( L. acidophilus ) is the most commonly used probiotic, or "friendly" bacteria. Such healthy bacteria inhabit the intestines and vagina and protect against the entrance and proliferation of "bad" organisms that can cause disease. This is accomplished through a variety of mechanisms. For example, the breakdown of food by L. acidophilus leads to production of lactic acid, hydrogen peroxide, and other byproducts that make the environment hostile for undesired organisms. L. acidophilus also produces lactase, the enzyme that breaks down milk sugar (lactose) into simple sugars. People who are lactose intolerant do not produce this enzyme. For this reason, L. acidophilus supplements may be beneficial for these individuals.

Other potential probiotics include a variety of Lactobacillus species (spp.), such as the caseiGG , rhamnosus , NCFM, DDS-1, and johnsonii strains, Bifidobacterium longum , Bifidobacterium bifidum , Streptococcus thermophilus , Enterococcus faecium , Saccharaomyces boulardii , Bacillus spp., and Escherichia coli .

Probiotics offer a variety of potential therapeutic uses. These include the following:

· Replacing the "friendly" intestinal bacteria destroyed by antibiotics.

· Aiding digestion and suppressing disease-causing bacteria.

· Preventing and treating diarrhea, including infectious diarrhea, particularly from rotavirus (a virus that commonly causes diarrhea in children).

· Treating overgrowth of "bad" organisms in the gastrointestinal tract (a condition that tends to cause diarrhea and may occur from use of antibiotics).

· Alleviating symptoms of irritable bowel syndrome and, possibly, inflammatory bowel disease (such as Crohn's disease and ulcerative colitis).

·Preventing and/or reducing the recurrence of vaginal yeast infections, urinary tract infections, and cystitis (bladder inflammation). The best scientific evidence exists for vaginal infections.

· Improving lactose absorption digestion in people who are lactose intolerant

· Enhancing the immune response. Studies have suggested that consumption of yogurt or milk that contains specific strains of Lactobacillus or supplements with Lactobacillus or Bifidobacterium may improve the natural immune response. Further research is needed to confirm these early findings and to best understand how the improved immune function may or may not help in warding off infections.

· Aiding the treatment of respiratory infections such as sinusitis, bronchitis, and pneumonia. More research is needed in this area.

· Lowering risk of allergies. Examples include asthma, hay fever, food allergies to milk, and skin reactions such as eczema.

· Helping to treat high cholesterol. More research is needed.

· Reducing the risk of recurring bladder tumors once this cancer has been treated. Much more research is needed in this area.

· Other conditions under investigation for use of probiotics include colon cancer, HIV related diarrhea, and Helicobacter pylori, an organism that can lead to development of ulcers.

The primary dietary sources of L. acidophilus include milk enriched with acidophilus, yogurt containing live L. acidophilus cultures, miso, and tempeh.

Prebiotics are found in breast milk, onions, tomatoes, bananas, honey, barley, garlic and wheat. L. acidophilus preparations consist of dried or liquid cultures of living bacteria. These cultures are usually grown in milk but can sometimes be grown in milk-free cultures. L. acidophilus is available in the following forms:

· Freeze-dried granules

· Freeze-dried powders

· Freeze-dried capsules

· Liquid L. acidophilus preparations (which must be kept refrigerated)

Prebiotics occur naturally in foods, but supplements provide a more concentrated source of this substance. Prebiotics are oligosacchrides, chains of sugar units linked together. Inulin is a long-chain oligosacchride (from 2-60 sugars) and fructooligosaccharides (FOS) are short-chain oligosaccharides (from 2-7 sugars). It is not clear at this time which type of prebiotic is most effective.

Newborns and Infants (0 to 1 year)

· Liquid preparations may be used as a lotion and applied topically to diaper area for yeast infections and diaper rashes.

· If the child is on antibiotic therapy, ¼ tsp or ¼ capsule can be taken orally 2 hours after each dose of antibiotics to replace beneficial bacteria.

· Add ¼ tsp or ¼ capsule to water for the treatment of oral infections.

Children (1 to 12 years)

· Refer to recommended dosage on product label

Recommended doses of L. acidophilus vary depending on the health condition being treated. Check the specific dosage recommendations on the product label. The following list provides guidelines for the most common uses:

· Prevention or treatment of diarrhea: 1 to 2 billion viable cells per day (some experts may recommend up to ten billion cells per day)

· Vaginal infections: 8 ounces of yogurt (with live active cultures containing one of the Lactobacillus or Bifidobacterium strains listed above) daily or an oral daily supplement containing at least 1 to 2 billion live organisms. Clinical experience also suggests that placing yogurt with live acidophilus cultures directly to the vaginal area, using a disposable spatula and wearing a sanitary pad, helps to relieve itching and inflammation. Similarly, lactobacillus capsules or tablets may be inserted directly into the vagina.

· Cystitis: 1 to 2 capsules or tablets inserted into the vagina nightly for two weeks

· Maintaining normal intestinal flora: 1 to 10 billion viable cells per day

Because of the potential for side effects and interactions with medications, dietary supplements should be taken only under the supervision of a knowledgeable healthcare provider.

Mild gastrointestinal upset may occur in some individuals (not on antibiotic therapy) who take more than 1 to 2 billion L. acidophilus cells per day.

There has been one report of anaphylaxis (a serious allergic reaction accompanied by shortness of breath and loss of consciousness) in a person taking inulin, a type of prebiotic.

If you are currently being treated with any of the following medications, you should not use Lactobacillus or other probiotics without first talking to your healthcare provider.

(The writer is an Assistant Manager, Quality Control at NOVO Healthcare and Pharma Ltd.)

Say no to Tobacco

Bobby Ramakant

It is a pity that India's robust smoke-free policies have been challenged by those with vested interests neglecting the immense and undisputed proven public health benefits of implementing such policies for people at-large.

India is to ban smoking in public places nation-wide from October 2. However the ITC Limited and the Indian Hotel Association are among those who have challenged these public health policies in the court of law. The hearing by the honourable court is due."Secondhand smoke, also know as environmental tobacco smoke (ETS), is a mixture of the smoke given off by the burning end of a cigarette, pipe or cigar and the smoke exhaled from the lungs of smokers. It is involuntarily inhaled by nonsmokers, lingers in the air hours after cigarettes have been extinguished and can cause or exacerbate a wide range of adverse health effects, including cancer, respiratory infections, and asthma" informs Professor (Dr) Rama Kant, who heads the Tobacco Cessation Clinics at CSM Medical University and Gandhi Memorial & Associated Hospitals.

"Secondhand smoke has been classified by the Environmental Protection Agency (EPA) as a known cause of cancer in humans (Group A carcinogen)" informs Dr Rishi Sethi, Department of Cardiology, CSM Medical University.

Secondhand smoke exposure causes disease and premature death in children and adults who do not smoke. Secondhand smoke contains hundreds of chemicals known to be toxic or carcinogenic, including formaldehyde, benzene, vinyl chloride, arsenic ammonia and hydrogen cyanide. Secondhand smoke causes approximately 3,400 lung cancer deaths and 22,700-69,600 heart disease deaths in adult nonsmokers in the United States each year, further adds Dr Sethi.

Nonsmokers exposed to secondhand smoke at work are at increased risk for adverse health effects.

There is enough data to de-bunk the apprehensions of ban on smoking at the workplace. Since 1999, 70 percent of the U.S. workforce worked under a smoke-free policy, ranging from 83.9 percent in Utah to 48.7 percent in Nevada. Workplace productivity was increased and absenteeism was decreased among former smokers compared with current smokers.

Secondhand smoke is especially harmful to young children. Secondhand smoke is responsible for between 150,000 and 300,000 lower respiratory tract infections in infants and children under 18 months of age, resulting in between 7,500 and 15,000 hospitalizations each year, and causes 430 sudden infant death syndrome (SIDS) deaths in the United States annually, says Dr Sethi.

Secondhand smoke exposure may cause buildup of fluid in the middle ear, resulting in 790,000 physician office visits per year.10 Secondhand smoke can also aggravate symptoms in 400,000 to 1,000,000 children with asthma.11

The Surgeon General's Report concluded that scientific evidence indicates that there is no risk-free level of exposure to secondhand smoke.

The 3rd edition of the "Global Tobacco Treaty Action Guide 2008: Protecting Against Tobacco Industry Interference" was released earlier this week in many countries including India.

The Global Tobacco Treaty Action Guide 2008 is produced by Corporate Accountability International [which is in official relations with the World Health Organization (WHO)], along with the Network for Accountability of Tobacco Transnationals (NATT).

"The repeated delay, at times weakening, and postponing the implementation of public health policies in India, particularly the provisions of the Cigarettes and Other Tobacco Products Act, 2003, mustn't occur again. With few days to go before India enforces ban on smoking in public places from 2 October 2008, and few more weeks to go before mandatory pictorial warnings on tobacco products from 30 November 2008 get enforced, it is high time to prepare ourselves to contribute effectively in the implementation of these health policies" said Dr Sandeep Pandey, national convener of National Alliance of People's Movements (NAPM) and Magsaysay Awardee (2002).

"For years the tobacco industry has operated with the express intention of subverting public health policies. If the tobacco giants were truly serious about saving lives, they would back off and let governments swiftly, fully implement the public health policies, including the national health policies and also the Framework Convention on Tobacco Control (FCTC) - the first global corporate accountability and public health treaty" added Dr Pandey.

Let us hope that good sense prevails and public health and welfare is upheld above corporate interests.

(The author is a World Health Organization (WHO)'s WNTD Awardee (2008) and a FCTC Working group member of Network for Accountability of Tobacco Transnationals (NATT).

Ensuring health budget monitoring

Richard M. Gomes & A.H.M Foysoul

Good Health does not only mean free from diseases but it also means more i.e physical, mental and economic well beings. DORP aims to establish rights to health by integrated development with the slogan "Sunte habe tader katha jader katha haini suna'' listen to the words of those who were not heard through implementation of PRSP, MDG and Peoples Health chart. Development Organization of the Rural Poor-DORP, a non-government development organization has been working for the last few years through its Searching for poor Upazila Health and Family Planning Budget project. DORP has been implementing the project as a pilot scheme in 66 Upazilas under 06 Divisions of the country.

DORP prioritizing health sector working to establish health rights to the poor facilitating for providing quality health and health care services in the country along with 06 local NGOs in 06 upazilas with the following slogans. "We want implementation of health care rights and health care services";" Have Poor no health? Where is my share in the budget"; The local Organization and areas where DORP is implementing the project are: SHABOLOMBI, Lohagara upazila of Narail, SCOPE, Bakergonj Upazila of Barisal, DISHARE, Kaliakair upazila of Gazipur, Jana Kalyan Kendra-JKK, Kamalganj upazila of Moulvibazar, Polli Mukti Sangstha-PMS, Sirajgonj Sadar upazila of Sirajgonj and Upakulio Sathijan Parishad-USAP, Ramgati upazila of Laxmipur district.

All the above stated NGOs are continuously making the local poor community aware to avail the health and health care services provided at upazila Health Complex and in Union Health & Family Welfare Center. The local NGOs are working on 3 issues. At Union level a 7-member committee through regular contact is activating the Union Health Study Committee and this committee keeps regular contact and enquire about the welfare of the recipient women of maternity allowance Amir Khasro, Program Coordinator asserted that local NGOs are working as a promoting agencies. The tools-format prepared at the National Meeting with the active participation of Experts, UHFP officer, UFPO, Reporters and representatives of NGOs are being used by the local NGOs. The information to be collected in tools--format will help to find out if the expenditures under upazila Health Budget have been expended as per approved budget. Mohammad Zobair Hasan, Researcher, DORP stated that through the application of the tools-format the situation of Neatness and cleanliness, position of stock of medicines, allocation of fund for satellite clinics and up keeping of medical appliances will be ascertained. Already the tools-formats are in use and local organization is regularly holding Advisory Committee meeting at Upazila Health Complex to improve the health and health care services to the public. In order to aware the people of different professions about the health and health care services at the upazila health complex a "Health and Family Planning Budget Club" has been formed at upazila level. This club is rendering services as a strong civil society platform at local level. The members of the budget club discuss the prevailing problems and issues of union and upazila health and family planning budget and try to solve those locally through different initiatives. The issues & problems those cannot be solved locally the members of the budget club put forward those to DORP for advocacy and lobbying at the national level. Already a significant impact has been noticed at local level on different activities and initiatives of budget club.

AHM Nouman, Secretary General DORP while briefing the activities of the project said that DORP is giving due importance in the activities of health, utilizing its 20 years' experience from 2001. DORP has declared the village as "Health Village" and working through integrated development approach. Following the trend DORP is implementing "Pro-poor Upazila Health and Family Planning Budget. Investigation" project. At same time DORP has introduced Maternity Allowance to the poor pregnant women that has been helping in reducing infant mortality rate, increased feeding colostrums to the infants, increased taking nutritious food during pregnancy period, taking ANC & PNC services, increased utilizing EPI and family planning services, prevention of illegal divorce and child marriage and the birth and marriage registration.

Presently, the government is implementing the maternity allowance project through the Ministry of Women and Child Affairs. AHM Nouman again expressed his thanks and gratitude to the Chief Advisor, Dr. Fakruddin Ahmed for inclusion of Maternity Allowance in the national budget. Nouman as to the next initiative to Maternity Allowance urged the government to prepare and implement an integrated package and Social Assistance Program for Non-Assenters-(SAPNA) in order to make Bangladesh poverty free within 2030. He emphasized that government may introduce a block grant for a family for realizing 5 rights (Health Card, Education Card, A shelter for living house and Tk. 30.000 as living seed money and micro-credit fund). He stated that implementation of 'SAPNA' will be a social investment towards development of women and children. The initiative will help in reducing birth rate and will accelerate the agricultural yield.