Pharmacological Effects of ‘Si Wu Tang’

Chinese herbal medicine is usually composed of a combination of 3 to 5 different herbs. Since herbal medicine is widely use throughout the Southeast Asian countries, traditional Chinese herbal medicine has become one of the main interests in pharmacological studies. 

‘Si Wu Tang’ a.k.a the ‘Four-Agents-Decoction’ is a good example of Chinese herbal medicine that can nourish the human blood.  Available in the market for more than 800 years, Si Wu Tang is composed of four Chinese herbs which can treat dysmenorrhoea or menstrual discomfort.

Dysmenorrhoea is one of the most common gynaecological complaints of adolescent girls and women of reproductive age. Dysmenorrhoea can be classified as either primary or secondary. Primary dysmenorrhoea occurs when there is no identifiable pathological condition which usually starts after the period of menarche or during the early part of the ovulation cycle. Secondary dysmenorrhoea occurs when menstrual pain is associated with organic pathology such as endometriosis.

Oestrogens stimulates the release of vasopressin whereas progesterone functions by controlling the presence of vasopressin. In most cases, the over production of the uterine prostaglandins and vasopressin are the main causes of menstrual cramps. Women can also experience dysmenorrhoea in case ovarian hormones is not balance.

Purpose of Si Wu Tang

Si Wu Tang is effective in terms of enriching the blood and regulating women’s menstruation cycle. The combination of four major Chinese herbs is commonly use in treating irregular menstruation, lower abdominal pain associated with menstruation cycle, and the formation of blood mass at the time of menstruation period.

Aside from treating menstruation-related symptoms, Si Wu Tang can also cure symptoms of blood stasis wilting such as atrophy, limpness, difficulty in moving, and pain in the limbs or vessel wilting (i.e. inability to lift the lower limbs or weakness of the legs).

Four Major Composition of Si Wu Tang

Originally listed in the Prescriptions of People’s Welfare Pharmacy in China, the four major components of Si Wu Tang include the dry roots of: (1) Radix Rehmanniae praeparata (Soe Dee Huang); (2) Radix Paeoniae Alba (Bai Sau); (3) Radix Angelicae Sinensis (Dang Guay); and (4) Rhizoma Ligustici Chuanxiong (Tsuan Chyong). These herbs are readily available in Mainland China or some Chinese medicine shops. Based on the original pharmacopoeia, these major herbal components should be prepared in equal proportion and extracted in water using the ratio of 1:13.

Other Clinical Applications and Pharmacological Effects of Si Wu Tang

Protects the Bone Marrow from Damages Caused by Radiation

The intake of 20 mg of Si Wu Tang per 20g of body weight over a period of seven (7) days before irradiation can protect the bone marrow from damages caused by 1 to 9 Gy dose of radiation (Hsue-Yin et al., 1996). In fact, the four major components of Si Wu Tang (specifically the extract of Danggui and Baishaoyao) may have a major radioprotective effect on human beings (Lee et al., 1999). 

Treats Common Colds and Flu

Often characterized by the symptoms of sore throat, fever and malaise, Si Wu Tang can treat the initial stage of common colds and flu among the perimenstrual and pregnant women. The liver and spleen should have sufficient blood flow to enable the body protect itself from external factors that causes symptoms of illnesses (Han & Huang, 2007). What happens during the menstruation cycle is that a large volume of blood accumulates in the uterus. This causes the upper portion of the human body to experience insufficient blood flow.

Prevents Pre-menstrual Acne and Skin Aging

Pre-menstrual acne is associated with hormonal imbalance among women. Si Wu Tang can treat hormonal imbalance. Therefore, this herb can help us prevent the development of pre-menstrual acne. Furthermore, a regular consumption of Si Wu Tang herbal soup is effective in counteracting the health consequences of poor nutrition, environmental pollution and stress (Brown, 2005). Therefore, a premature skin aging can easily be prevented.

Improves Hematopoiesis on Patients with Blood Deficiency

Inducing Si Wu Tang decoction on mice with blood deficiency could significantly improve hematopoiesis (Tan et al., 2005). When induced by compound method of bleeding, the researcher noted a significant increase in the red blood cells from a normal volume of 4.6 x 10(12) up to 6.5 x 10(12) (ibid).   

When mice with blood deficiency were induced with cyclophosphamide (CIX) and Si Wu Tang decoction, the subjects could effectively restore up to 12 up-regulated and 3 down-regulated proteins in the bone marrow (Liu et al., 2006).

Anti-inflammation and Anti-pruritic Effects on Skin

The components of Si Wu Tang were clinically proven to be effective in treating cutaneous (skin) pruritis, chronic inflammation of the skin and other skin diseases. Antipruritic and anti-inflammatory effects can be observed when 250, 500 and 1000 mg/kg of Si Wu Tang decoction compound was administered to several mice with skin diseases (Dai et al., 2002). As little as 50 to 500 microg/ml of Si Wu Tang concentration could effectively inhibit the release of histamine from the rat’s peritoneal mast cells.

Adverse Effects of Si Wu Tang

Increase Women’s Risk of Breast Cancer

Women at risk of breast cancer should be aware that some components of Si Wu Tang could stimulate cell proliferation of MCF7 cells which causes the activation of the human epidermal growth factor receptor 2 (HER-2) positive breast cancer and downstream signaling molecules of AKt pathways and estrogen receptor (ER) K1/2 (Chang et al., 2006). Furthermore, the external domain of HER-2 should be blocked in order to effectively reduce the downstream ER K1/2 MAPK which signals the inhibiting cell growth (Knowlden et al., 2003). 

Conclusion

Si Wu Tang is one of the most commonly used Chinese herbal medicine in treating menstrual cramps and other illnesses related to blood deficiency. Si Wu Tang decoction can protect our bone marrow from damages caused by radiation. This particular chinese herbal medicine also works well in treating common colds and flu, preventing pre-menstrual acne, improving hematopoiesis on patients with blood deficiency, and protecting the skin from inflammation and pruritic.  However, Si Wu Tang should be subjected to further study because of its adverse effects related to increased risk of breast cancer.

References

Brown, R. (2005, November / December). Nexus Colorado's Holistic Journal. Retrieved April 18, 2008, from Journeys in Health, Healing and Our Search for Meaning: http://www.nexuspub.com/journeys/natural_beauty.htm

Chang, C.-J., Chiu, j.-H., Tseng, L.-M., Chang, C.-H., Chien, T.-M., Chen, C.-C., et al. (2006). Si-Wu-Tang and Its Constituents Promote Mammary Duct Cell Proliferation by Up-Regulation of HER-2 Signaling. Menopause, 13(6):967 - 976.

Dai, Y., But, P. P.-H., Chan, Y.-P., Matsuda, H., & Kubo, M. (2002). Antipruritic and Anti-inflammatory Effects of Aqueous Extract from Si-Wu-Tang. Biological Pharmaceutical Bulletin, 25(9):1175 - 1178.

Han, X.-g., & Huang, Q.-c. (2007). The Relationship between the Liver and the Disease Causes, Disease Mechanisms, and Treatment of Rheumatoid Arthritis. Journal of Chinese Medicine, 1:9 - 11.

Hsue-Yin, H., Yau-Hui, H., & Chun-Ching, L. (1996). Protection of Mouse Bone Marrow by Si-Wu-Tang Against Whole Body Irradiation. Journal of Ethnopharmacology , 52(2):113 - 117.

Knowlden, J., Hutcheson, I., Jones, H., Madden, T., Gee, J., Harper, M., et al. (2003). Elevated Levels of Epidermal Growth Factor Receptor/c-erbB2 Heterodimers Mediate an Autorcrine Growth Regulatory Pathway in Tamoxifenresistant MCF-7 Cells. Endocrinology, 144(3):1032 - 1044.

Lee, S., Oh, H., Yang, J., Jo, S., Byun, M., Tee, S., et al. (1999). Radioprotective Effects of Two Traditional Chinese Medicine Prescriptions: Si-Wu-Tang and Si-Jun-Zi-Tang. The American Journal of Chinese Medicine, 27(3 - 4):387 - 396.

Liu, L., Ma, Z., Wang, Y., Qin, H., Tan, H., Xiao, C., et al. (2006). Effects of Siwu Decoction on Bone Marrow Protein Expression of Blood Deficiency Mice Induced by Cyclophosphamide. China Journal of Chinese Materia Medica, 31(14):1172 - 1175.

Tan, W., Song, C., Tan, H., Liu, L., Ma, Z., Wang, Y., et al. (2005). Hematopoietic Effect of Siwu Decoction in the Mice with Blood Deficiency Induced by Compound Method of Bleeding, Starved Feeding and Exhausting. China Journal of Chinese Materia Medica, 30(12):926 - 929.

Drug Use in Sports

Available in the form of dietary supplement or prescription medication, performance-enhancing drugs are widely sold over-the-counter. In the form of either oral or injection, these drugs include: anabolic-androgenic steroids (AAS) a.k.a. “Di-anabol” – commonly use to improve the physical structure of athletes’ body, steroid precursors such as andro-stenedione and dehydroepiandrosterone, creatine, ephedra or ephedrine alkaloids a.k.a “ma huang”, erythropoietin, and growth hormones. Within the shortest possible time, most of the young athletes are keen to improve their physical appearance and athletic abilities. For this reason, a lot of them are tempted to use ergogenic drugs.

Anabolic-androgenic steroids (AAS) a.k.a. “Di-anabol” is one of the most commonly abused drugs in sports. In most cases, the number of male athletes who are taking steriods outweighs the number of female athletes. The use of streoids can trigger multiple organ failure that causes an increased risk of infertility and testicular atrophy in the long-run. Abusing steroids can also lead to pre-mature balding, acne, increase in blood pressure, left ventricular hypertrophy, muscle sprains / ligament sprains, and few cases of peliosis hepatitis, liver cysts, and hepatocellular carcinoma. In worst cases, needle sharing in injectable steroids and other ergogenic drugs increases the athletes’ risk of having HIV, hepatitis B and C.

The use of ergogenic drugs can trigger mild to severe depression, eating disorder, aggression, and suicidal tendencies. In fact, steroids precursors could cause male gynecomastia and virilization among the female athletes. Growth hormones can lead to risk of high blood pressure, jaw enlargement, and pre-mature physeal closure whereas creatine can cause unexplainable weight gain, minor gastrointestinal discomfort, and muscle cramps.

Ephedra are stimulants use in treating asthma and Stokes-Adams. Excessive amount of ephedra causes toxicity in the human body. Similar to steroids, ephedra can lead to a life-threatening cardiovascular toxicity including myocardial injury, thrombosis, atherogenic diseases, and vasospasm. It can also trigger high blood pressure, arrhythmias, anxiety, tremors, insomnia, seizures, paranoid psychoses, cerebral vascular accident, myocardial infarction, ischemic or hemorrhagic stroke and untimely death.

The presence of ergogenic drugs can be traced through the athletes’ blood samples. In case athletes have taken steroids during off-season, it will be difficult on the part of medical examiners to detect the presence of streoids substances days before the Olympic game. Even though there are medical techniques which can be use to trace ergogenic drugs in the blood samples of young athletes, it is unfortunate that some of them are aware on how they make the drug testing result turn negative despite the use of these drugs.

Young athletes are practicing doping because of peer-pressure. It is unfortunate that some of them are not aware of the long-term socio-economic and health consequences of abusing these drugs. To educate young athletes about the adverse health consequences of using ergogenic drugs, health care professionals should work together with parents, community members, and sports trainers.

Is Hookah Smoking Safer than Cigarette Smoking?

Hookahs – also known as narghile, hubble-bubble, goza, or shisha are commonly used in the Middle East including the Persian Gulf, Kuwait, Iraq, Bahrain, Qatar, Oman, Saudi Arabia, and UAE (Sajid, Chaouachi, & Mahmood, 2008). Over the past few years, the use of hookahs has quickly spread throughout the Southeast Asia, Europe, and other developed and developing countries around the world.

Since there are a lot of clinical evidences that shows the adverse health consequences of smoking hookahs, several studies reported that some of the public health officials consider the smoking of hookah as a ‘global tobacco epidemic’ (Chaouachi, 2009; Anjum, Ahmed, & Ashfaq, 2007; Chaouachi, 2007). This is the main reason why there is a need to educate the public about the health effects of smoking hookas.

Differences and Similarities of Tobacco Used in Hookah and Cigarette
The tobacco paste used in hookas is known as either moassel and/or jurak. This type of tobacco paste is different with the type of tobacco used in cigarettes since moassel and jurak contains around 30 to 50% more tobacco combined with molasses – sugarcane juice, different spices and dried fruits, glycerol, and flavoring essences (Khater et al., 2008).

Tobacco leaves used in manufacturing cigarettes is similar with the tobacco substance used in hookah smoking in the sense that both contains a high level of nicotine, carbonaceous materials, and tar (Maziak, Ward, & Eissenberg, 2007; Chaouachi, 2007; Al-kubati et al., 2006). Even though addiction to hookah smoking is much lesser as compared to cigarette smoking (Al-Mutairi et al., 2006), individuals who smoke hookahs once in awhile could still develop a long-term habit of smoking hookahs.

Evidences behind the Harmful Effects of Smoking Tobacco through Hookah
Aside from a total of 69 carcinogens that are present in tobacco smoking, there are also other 4,800 chemicals which could effectively promote tumor or co-carcinogens causing cancer related to lungs, nasal cavities, kidney, liver, nasal sinuses, oesophagus, stomach, and uterine cervix among others (WHO, 2002; Hoffmann, Hoffmann, & El-Bayoumy, 2001). In line with this, the harmful chemicals present in cigarette smoking include elements like 210Pb, 210Po, and Uranium (Khater et al., 2008). Although there is a significant difference in the type of tobacco used in cigarettes and hookahs, Khater et al. (2008) revealed that smoking moassel in hookahs can produce a wide-range of radioactive toxic elements which includes high concentration of 238U, 234Th, 226Ra, 210Pb, 210Po, 232Th, and 40K.

Exclusive hookah smokers receive high concentration of carbon monoxide up to 1.79 mg per 1000 ml of hookah puff as compared to 1.06 mg for each 45 ml cigarette puff (Monn et al., 2007). It means that cigarette smokers receive much higher concentration of carbon monoxide as compared to those individuals who smoke hookahs. Since hookah smoking uses water, some of the harmful chemicals react with the components of water through the process of chemical combustion and distillation under low temperature (Baker, 2006). As a result, substances like HCN or NO3 becomes less irritant on the part of the human body. This makes hookah smoking three times less concentrated as compared to smoking cigarettes (Monn et al., 2007).

Is Smoking Hookah Safer than Smoking Cigarettes?
Cigarette and hookah smoking contains carbon monoxide (Chaouachi, 2007). Since high concentration of carcinoembryonic antigen (CEA) is the major cause of transforming the cancer cells into malignant (Juang et al., 2000), it is possible to conclude that smoking cigarettes or hookahs can cause a person to develop cancer even though the CEA levels receive out of smoking hookah is lower as compared to cigarette smoking (Sajid et al., 2008).

In comparison between non-smokers and ex-smokers, the mRNA and protein expression of CEA is high in the normal lung tissue of tobacco smokers (Ohwada et al., 1995). Although the levels of CEA presence in hookah smoking is lower than smoking cigarettes, the fact that hookah smoking contributes to the increase in the CEA level in exclusive hookah smokers’ body does not exclude them from increasing the possibility that they would develop lung cancer in the long-run (Funk-Brentano et al., 2005).

References
Al-kubati, M., Al-kubati, A., Al-Absi, M., & Fiser, B. (2006). The short-term effect of water- pipe smoking on the baroreflex control of heart rate in normotensives. Auton Neurosci , 126:146 - 149

Al-Mutairi, S., Shihab-Eldeen, A., Mojiminiyi, O., & Anwar, A. (2006). Comparative analysis of the effects of hubble-bubble (Sheesha) and cigarette smoking on respiratory and metabolic parameters in hubble-bubble and cigarette smokers. Respirology , 11:449 - 455.

Anjum, Q., Ahmed, F., & Ashfaq, T. (2007). Shisha smoking: an imminent health hazard. J Pak Med Assoc , 57(9):430 - 431.

Baker, R. (2006). Smoke generation inside a burning cigarette: Modifying combustion to develop cigarettes that may be less hazardous to health. Progress in Energy and Combustion Science , 32:373 - 385.

Chaouachi, K. (2009). Hookah (Shisha, Narghile) Smoking and Environmental Tobacco Smoke (ETS). A Critical Review of the Relevant Literature and the Public Health Consequences. International Journal of Environmental Research and Public Health , 6(2):798 - 843.

Chaouachi, K. (2007). The Medical Consequences of Narghile (Hookah, Shisha) Use in the World. Rev Epidemiol Sante Publique , 55(3):165 - 170.

Funk-Brentano, C., Raphael, M., Lafontaine, M., Arnould, J., Verstuyft, C., Lebota, M., et al. (2005). Effects of type of smoking (pipe, cigars or cigarettes) on biological indices of tobacco exposure and toxicity. Lung Cancer , 54:11 - 18.

Hoffmann, D., Hoffmann, I., & El-Bayoumy, K. (2001). The less harmful cigarette: a controversial issue. a tribute to Ernst L. Wynder. Chem Res Toxicol , 14(7):767 - 790.

Juang, C., Wang, P., Yen, M., Lai, C., Ng, H., & Yuan, C. (2000). Application of tumor markers CEA, TPA, and SCC-Ag in patients with low-risk FIGO stage IB and IIA squamous cell carcinoma of the uterine cervix. Gynecol Oncol , 76:103 - 106.

Khater, A., Abd El-Aziz, N., Al-Sewaidan, H., & Chaouachi, K. (2008). Radiological hazards of Narghile (hookah, shisha, goza) smoking: activity concentrations and dose assessment. Journal of Environment Radioactivity , 99(12):1808 - 1814.

Maziak, W., Ward, K., & Eissenberg, T. (2007). Interventions for waterpipe smoking cessation. Cochrane Database Syst Rev , 17(4):CD005549.

Monn, C., Kindler, P., Meile, A., & Brandli, O. (2007). Ultrafine particle emissions from waterpipes. Tobacco Control , 16:390 - 393.

Ohwada, A., Takahashi, H., Nagaoka, I., Iwabuchi, K., Mikami, O., & Kira, S. (1995). Effect of cigarette smoke on the mRNA and protein expression of carcinoembryonic antigen (CEA), a possible chemoattractant for neutrophils in human bronchioloalveolar tissues. Thorax , 50(6):651 - 657.

Sajid, K., Chaouachi, K., & Mahmood, R. (2008). Hookah smoking and cancer.
Carcinoembryonic Antigen (CEA) levels in exclusive/ever hookah smokers. Harm Reduction Journal , 5(19). doi:10.1186/1477-7517-5-19.

WHO. (2002, July 24). Retrieved April 10, 2009, from IARC (International Agency For Research On Cancer): IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Tobacco Smoke and Involuntary Smoking. Summary of Data Reported and Evaluation : http://monographs.iarc.fr/ENG/Monographs/vol83/volume83.pdf

Thinking of Losing Weight? Beware of Gastric Banding...

Obesity is referring to excessive amount of body fat in a human body. The World Health Organization (2003) has reported that billions of people all over the world are overweight and roughly 300 million of these individuals are classified as obese. Based on the National Health and Nutrition Examination Survey, approximately 17.1% of the 3,958 children who participated in the research study were overweight and that 35% of children between the age brackets of 6 to 19 years old are seriously overweight (Ogden et al., 2006).

Obesity is a common health problem in developed and developing countries. A traditional way to lose weight is by controlling diet and promoting physical activities. In line with this, the American Heart Association and the American Dietetic Association has been strongly promoting the importance of following the low-fat dietary guidelines set for individuals who would want to lose their excess weight. On the other hand, the Atkins diet and Zone diet are suggesting the need to cut down on the intake of carbohydrates in a person’s diet.

Importance of Diet and Exercise
As compared to the practice of low-fat diet, the practice of low-carbohydrate diet was seen more effective in terms of improving weight lose and reduce the patients’ risk for cardiovascular diseases but not the patients’ blood sugar level (Hession et al., 2008). Regardless of the type of diet obese individuals would accept, several studies revealed that effective weight loss will improve cholesterol (Hession et al., 2008; Tay et al., 2008). Not applicable with high fat and low-carbohydrate diet, the research findings of Tay et al. (2008) showed that the adaptation of low-fat diet is more effective in terms of improving the LDL and total cholesterol levels but not the levels of HDL and triglyceride.

In the absence of a significant decrease in a person's weight, the practice of following either low-fat or low-carbohydrate diet will not improve the patient’s cholesterol level. The only benefit that obese patients would receive out of practicing low-carbohydrate diet and/or low-fat, high-carbohydrate diet is that obese individuals are unlikely to gain back the weight they have lost easily because of metabolic backfire (Howard et al., 2006).

Another kind of diet is the Mediterranean diet which strongly promotes the intake of high fiber and monounsaturated fats such as the use of olive oil in cooking foods. In line with the practice of this particular diet, Shai et al. (2008) revealed that Mediterranean diet is effective in terms of reducing weight more than the practice of low-fat diet especially in the case of diabetic patients.

Equally important in losing weight is physical exercise. Exercise enables a person to burn extra calories that can form as excess body fats when left unused. When combined with proper diet, studies revealed that physical activities could increase the success that obese individuals would lose weight safely (Tay et al., 2008; Howard et al., 2006; Ogden et al., 2006).

Advantages and Disadvantages of Gastric Banding
Gastric banding is a surgical procedure that is commonly used for decrease the weight of obese individuals. Basically, the main purpose of placing adjustable silicone band around the upper part of the stomach is reduces the size of the stomach. This is necessary to make obese person feel full and eat less.

The different types of gastric banding include the gastric bypass, laparoscopic adjustable gastric banding surgery and vertical banded gastroplasty (VBG). VBG procedure has a higher complication rate that the laparoscopic adjustable gastric banding surgery. Therefore, less commonly used today.

As a standard operating procedure, it is ethical for surgeons and other health care professionals to discuss with patients regarding the advantages and disadvantages of a particular medical or surgical procedure before allowing the patients to decide whether to accept or reject the treatment. However, there will always be some health care professionals who are after money more than promoting the welfare of the patients.

To give you a better idea regarding the health consequences of gastric banding, I have intentionally included some concrete evidences that could make more people think twice about deciding to go for gastric banding.

Any form of skin opening such as wound or surgical incision is a potential entry port for microorganisms to invade and destroy the natural flora of the human body. Except for the possibility that the silicone band might erode, this medical concept gives us the rationale behind further health complications of going through the surgical procedure.

Some excessively overweight individuals are willing to spend big amount of money for surgical procedures that will make them easily lose weight. Since there is a market for risky surgical procedures like gastric banding, there are medical professionals in different countries that aggressively promote gastric banding despite the potential health consequences the patients may experience in the future.

Dapri, Cadiere, & Himpens (2009) revealed that the practice of laparoscopic conversion of adjustable gastric banding is effective and feasible except for the incidence of one (1) death. Although gastric banding is effective in terms of enabling obese individuals to easily lose weight, it is undeniable that many of these individuals who undergo gastric banding are facing the risks of short- and long-term health-related complications.

With regards to the safety issue on gastric banding, Keller et al. (2009) revealed that 30 out of 50 obese individuals had to undergo open surgery and that 1 out of 50 and 3 out of 50 experienced early and late complications after undergoing the gastric banding procedure.

As of 2009, it has been reported that the possible health complications of gastric banding includes: esophagitis (28.8%), pouch dilation (15.3%), esophageal dilation (12.5%), port problems (11%), band migration (6.5%), and band leakage (6.4%) (Mittermair et al., 2009). For this reason, 251 or 32% of the total research participants (785) had no choice but to undergo a re-operation procedure (ibid).

A proper diet combined with a regular exercise is still the safest way to lose weight. Before you even think about going through a gastric banding procedure, think about the health consequences first. The last video shows how bad a gastric band erosion looks like.

References:

1. Dapri, G., Cadiere, G., & Himpens, J. (2009). Laparoscopic conversion of adjustable gastric banding and vertical banded gastroplasty to duodenal switch. Surgery of Obesity and Related Diseases , July 10. [Epub ahead of print].
2. Hession, M., Rolland, C., Kulkarni, U., Wise, A., & Broom, J. (2008). Systematic review of randomized controlled trials of low-carbohydrate vs. low-fat/low-calorie diets in the management of obesity and its comorbidities. Obesity Reviews , 10(1):36 - 50.
3. Howard, B., Manson, J., Stefanick, M., Beresford, S., Frank, G., Jones, B., et al. (2006). Low-fat dietary pattern and weight change over 7 years: the Women's Health Initiative Dietary Modification Trial. Journal of American Medical Association , 295(1):39-49.
4. Keller, P., Romain, B., Nicolae, M., Perrin, P., & Meyer, C. (2009). Is laparoscopic gastric bypass a dangerous procedure during the early phase of the learning curve? A prospective study of the first 50 cases. Journal de Chirurgie , September 17. [Epub ahead of print].
5. Mittermair, R., Obermuller, S., Perathoner, A., Sieb, M., Aigner, F., & Margreiter, R. (2009). Results and Complications after Swedish Adjustable Gastric Banding-10 Years Experience. Obesity Surgery , September 18. [Epub ahead of print].
6. Ogden, C., Carroll, M., Curtin, L., McDowell, M., Tabak, C., & Flegal, K. (2006). Prevalence of overweight and obesity in the United States, 1999-2004. The Journal of the American Medical Association , 295(13):1549 - 1551.
7. Shai, I., Schwarzfuchs, D., Henkin, Y., Shahar, D., Witkow, S., Greenberg, I., et al. (2008). Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. New England Journal of Medicine , 359(3):229-241.
8. Tay, J., Brinkworth, G., Noakes, M., Keogh, J., & Clifton, P. (2008). Metabolic effects of weight loss on a very-low-carbohydrate diet compared with an isocaloric high-carbohydrate diet in abdominally obese subjects. Journal of the American College of Cardiology , 51:59 - 67. doi:10.1016/j.jacc.2007.08.050.
9. World Health Organization. (2003). Retrieved September 21, 2009, from WHO definition of Health : http://www.who.int/about/definition/en/print.html

Does your child show symptoms of ADHD? Learn more about the evidence-based assessment of ADHD in children.

From CNN News:

Attention deficit hyperactivity disorder (ADHD) is “a childhood mental disorder characterized by inattentiveness, impulsiveness and over activity” (Hazelwood, Bovingdon, & Tiemens, 2002). As one of the most common mental health disorder among children and adolescents, a higher number of ADHD cases in male children and adolescents who belong to low-income families.

ADHD is a serious mental health condition since the child’s inattentiveness, impulsiveness and over activity could negatively affect the child’s academic performance, self-esteem, and the child’s relationship with family members and friends. ADHD can also lead to behavioural problems which often make the child unable to socialize with other people.

In the absence of proper treatment like medicine and behavioural therapy, children with ADHD could cause behavioural problems not only at home but also in school and work environment. This type of mental health condition can also cause relationship problems with the opposite sex which may lead to depression, frustration, and the use of illegal drugs.

Early medical intervention is necessary to prevent worsening of the child's mental health condition. As part of assessing whether a child has ADHD, medical professionals would often use analogue methods like conducting an interview with the child, go through the patient’s medical history in relation to the child's social, emotional, educational, and behavioural patterns, physical exam, and the use of behaviour rating and/or checklist in detecting ADHD. Likewise, laboratory measures such as the Conners’ Continuous Performance Test (CPT) and Gordon Diagnostic System – a self-contained computer device can also be utilized in detecting symptoms of ADHD.

There are so many assessment techniques that are commonly used in detecting ADHD in children. In line with this, it is safe and accurate to make use of self-report rating scales when assessing the ADHD symptoms in adult patients because adults are capable of verbalizing their behavioural experiences with the psychiatrists but not the children. Since children are unable to accurately verbalize their personal behaviour, the use of self-reporting rating scale is not advisable in assessing children for ADHD. Instead, psychologists should have a direct observation on children within a natural setting when using assessment method like CPT, BRIEF, DSM-IV factors, Conners’ Scales, and/or the behaviour assessment scale for children.

There is no single method that could provide the medical practitioners with a justifiable result given that the use of each assessment technique will generate a totally different result. Because of the limitations of each type of assessment method available in examining a child with ADHD, developing a comprehensive assessment technique is necessary before treating a child with ADHD. In line with this, the use of BADDS and ADHD rating scale is best when used in predicting clinical diagnosis.

Can Parents be Held Liable for having Obese Children?

From Yahoo News:

It is the obligation of parents to care and provide the needs of their children. However, it is difficult to draw the line with regards to the extent parents should care for them. This includes the food intake of each child. There are some parents who would allow their children to eat more than one serving even though their child is already overweight.

Studies show that obesity is related to abnormal food intake, genetic factors like metabolic defect, leptin deficiency and the use of steroids (Styne, 2005; Link et al., 2004; Roth et al., 2004). In line with abnormal eating, television advertisements play a significant role in attracting children to eat high-calorie and fatty foods. In fact, most of unhealthy food advertisements are using toys, colourful images, convincing music, and popular personalities to effectively capture the attention of children to patronize unhealthy food products (Morley et al., 2008).

Regardless of the main cause of child obesity, being extremely overweight could result to a long list of serious health concerns such as heart diseases, Type II diabetes and the different types of cancer. There are cases wherein obesity could cause the child to encounter social adjustment disorders or social discrimination especially among children of the same age.

“Times.com recently reported that there is a Scottish couple who lost custody over two of their six children because they were not able to reduce the weight of their children. Recently, the mother of the 14-year-old son weighing 555 lbs. is currently facing child-neglect charges.”

Although there are millions of children around the world who are obese, it does not necessarily mean that is solely the fault of the parents. Not all factors that causes obesity is controllable. Since obesity can be caused by genetic factors like metabolic defects, it is irrational to sue mothers for negligence only because they failed to keep their children’s weight down.

What will you do if the someone tells you that you have just lost your custody over your own children because one of your child is extremely overweight?

The Health Benefits of Pancit-Pancitan

The Philippines is a country with a diversified flora, home of many different plant species which have scientific medicinal value recently found in the current research made by the Philippine Department of Health (DoH). One of these plants is the "Pansit-pansitan".

These plants are shallow rooted and have shiny stems which are also succulent. The leaves are transparent, alternating in as turgid and heart-shaped. These plants grow easily in clumps within lightly shaded damp areas, loose soil and are conspicious in the rocky parts of canals or streams.

Pansit-pansitan is a native Philippine herb (scientific name: Peperomia pellucida) - also known as "Ulasiman bato" or English name "Peperomia" or "Shiny Bush". Pansit-pansitan is one of the crude plants known and approved by the Philippine DoH to provide relief and treatment of rheumatic pains and gout.

Pansit-pansitan plants are quite edible, from the flowers, stems and leaves. These plants grow to a length of one-and-a-half feet. Once harvested and washed, pansit-pansitan can be readily eated as salad. Likewise, these plants can also be made into a decoction by boiling one cup of washed and cleaned stems and leaves in two cups of water. Decoction should be taken twice a day - one in the morning and one in the evening. Decoction of pansit-pansitan leaves and stems are good for kidney problems as well as abdominal pains.

Pansit-pansitan can also be used to treat skin disorders such as pimples, boils, and abcesses. To create a poultice, the stems and leaves are heated and pounded to form a paste which can be applied directly to the affected area. Decoction can also be used as a wash to treat and rinse the skin disorders as well as facial problems.