Controlling Anaemia through Indian System of Medicine · 2014-09-01 · 6 State Planning Commission, TamilNadu Controlling Anaemia through Indian System of Medicine Incidence of anaemia

Controlling Anaemia through Indian System of Medicine

State Planning Commission17th June 2013

Workshop Series : 2 / HSW / 2013

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State Planning Commission, TamilNadu





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Tamil Nadu State Planning Commission The State Planning Commission was constituted in Tamil Nadu as an Advisory body on 25th May 1971 under the Chairmanship of the Hon’ble Chief Minister to make recommendations to the Government on various matters pertaining to the development of the State. The Chairman of the Commission is assisted by Vice Chairman, Full Time Member & Part Time Members who are experts in various fields. The Principal Secretary to Government, Planning, Development and Special Initiatives and the Principal Secretary to Government, Finance Department are the ex-officio members. The Member Secretary is responsible for administration in the Commission.

The Commission has the following technical divisions:1. Agricultural Policy and Planning2. Industries, Power and Transport3. Land Use4. Education and Employment5. Health and Social Welfare6. District Planning and Rural Development7. Plan Co-ordination.

Main activities of SPC:1. Preparation of Five Year and Annual Plans based on the policies and priorities of the Government.2. Undertake Mid Term review of the Five Year Plan, other special reviews on the Economy and

advise the Government on appropriate modification and restructuring of the schemes.3. Monitor development indicators that influence the Human Development Index, Gender

Development Index, etc., at a disaggregated level and suggest correctional measures.4. Undertake special studies as required for formulation and implementation of plan projects and

programmes.5. Tamil Nadu State Land Use Research Board (TNSLURB) is functioning under the chairmanship

of Vice Chairman, State Planning Commission as a permanent body in the State Planning Commission. This Board is intended to promote interaction and study in the vital areas of land use. The State Planning Commission organizes seminars/workshops and undertake studies.

6. Human Development Reports (HDRs) were prepared for Dindigul, Sivagangai, Tiruvannamalai, Cuddalore, Nagapattinam, the Nilgiris, Kanyakumari and Dharmapuri districts. The concept of Human Development has been disseminated to all districts through workshops organized in the concerned districts. Proposal for preparation of District Human Development Reports (DHDR) for the remaining districts is under process.

7. State Balanced Growth Fund (SBGF) is operated to bridge the regional imbalances among the districts.

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Page No.

Workshop Team 4

Executive Summary 6

Introduction 7

Prevalence of Anaemia 7

Description 7

Classification of Anaemia 8

Causative factors 9

Symptoms 9

Possible Complications 10

Remedial Measures 11

Ayurvedha 12

Naturopathy 14

Unani 20

Siddha 23

Homoeopathy 25

Government Interventions in addressing Anaemia 26

Views/ Suggestions of the Participants 28

Recommendations of the State Planning Commission 33

List of Participants 34

CONTENTS

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STaTE PlaNNiNg COMMiSSiONTmt. Santha Sheela Nair, I.A.S.,(Retd.),Vice Chairman

Dr. V. Shantha, Member (Health)

Dr. K. Sridhar, Member (Health)

Thiru. M Balaji, I.A.S.,Member - Secretary

Tmt. S.R. NavaneethamHead of Division,Health and Social Welfare Division

Thiru S. Boopathy MohanProgrammer

Tmt. K.S. Jayanthi,Technical AssistantHealth and Social Welfare Division

Thiru. A. Sabarinathan,Planning Junior Assistant,Health and Social Welfare Division

Tmt. S. Vijayalakshmi,Typist, Health and Social Welfare Division

WORKSHOP TEaM

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PRESENTaTiONS by

Dr. V.R. Seshadri, (Ayurvedha)Visesh Ayurvedics, Chennai.

Dr. N. Manavalan, (Yoga & Naturopathy)Principal, Government Yoga & Naturopathy Medical College, Chennai.

Dr. Syed M.M. Ameen, (Unani)Project Director & Chief Functionary, Centre for Unani Ilaj Bit Tadbeer, Gummidipoondi.

Dr. P. Manivannan, (Siddha)Medical Officer, ESI Hospital, Ayanavaram, Chennai.

Dr. Krishnaveni, (Siddha)Reader, Government Siddha Medical College, Chennai.

Dr. R. Gnanasambandam, (Homoeopathy)Editor, Homoeo Times (Ex-President, Homoeo Council),Royapettah, Chennai.

Dr. Jayshree Vencatesan, Managing Trustee, Care Earth Trust, Chennai.

WORKSHOP TEaM

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Incidence of anaemia is due to under-nutrition and mal-nutrition of the children and the adverse impact of anaemia on morbidity and mortality are very high. In addition to this, anaemia results in potential loss of output to the economy by affecting earning capacity, longevity of life and huge medical costs on the individuals. Viewed in the above perspective, the incidence of anaemia should be eliminated through proper identification and treatment of the problem and taking prophylactic measures.

Those who presented papers in the workshop stressed the various facets relating to incidence of anaemia. They have spelt out the reasons for occurrence of anaemia, level of magnitude of the problem and prescribed suggestions to cope with it. Unless, we arrest the incidence of anaemia at an early stage, it is bound to sap the very vitality of the economy as well as society in terms of enormous loss of potential output and quality of life and human resource capital.

Executive Summary

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Anaemia is deficiency in the number of red blood cells or in the haemoglobin content of the blood, resulting in pallor, shortness of breath and lack of energy. Anaemia is the most common disorder of the blood and is a global health problem that affects populations in both rich and poor countries. The primary cause of anaemia is iron deficiency and IDA (Iron Deficiency Anaemia) is the most important contributing factor to the global burden of disease.

Prevalence of anaemia

Anaemia is common in young children and women of reproductive age group and it continues to be a common cause of mortality and morbidity in India. Anaemia during pregnancy is also a major public health problem throughout the world, particularly in the developing countries.

According to NFHS III data, the incidence of anaemia in urban children is 71% and rural is 84% and the overall is 79%. UNICEF’s State of the Adolescent Report 2012 says nearly 50% of Indian adolescent girls are anaemic and adolescent anaemia is a challenging problem in India. The prevalence in the vulnerable groups like adolescent girls and pregnant women is as high as 60% both in Urban and Rural Tamil Nadu.

Hidden Hunger, this term was coined by WHO in 1986 and refers to the problems associated with the deficiency of three essential micronutrients.

• Iron

• Iodine

• Vitamin A

Iron deficiency is the most common micro-nutrient deficiency in the world affecting 1.3 billion people, ie 24% of the world population. As per WHO global database on anaemia, out of the 30% global prevalence, 50% of it is IDA and as per NFHS III, it is 51.8% in India (13% of men are also anaemic).

Description Anaemia is decrease in number/ volume of red blood cells (RBCs) or less than the normal quantity of haemoglobin (haem - iron component & globin – protein component) in the blood, ie the oxygen-carrying capacity of the blood.

introduction

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Main function of RBCs is oxygenation to the cells, which gets impaired due to anaemia. Red blood cells carry oxygen to the tissues and are present in almost half the blood in the body veins and arteries. It has a lifespan of only approximately 120 days before it is being destroyed and then replaced. About 1 trillion or 100 million red blood cells are created everyday in the bone marrow. Iron, proteins, vitamins, especially folic acid and vitamin B12 are required to reproduce these new cells. Among these raw materials, iron and protein are essential in building up haemoglobin (Hb).

Each person should have about 15gm of haemoglobin per 100 ml of blood and a blood count of approximately 5 million red cells per millimeter of blood.

The normal Hb values are as follows :

• Male : 13g/dl& above

• Female(non-preg) : 12g/dl & above

• Female(pregnant) : 11g/dl & above

• Children 6mto 6yr : 11g/dl &above

• Children 6-14 yrs : 12g/dl& above

Below these levels, it is termed as anaemia.

Classification of anaemia

There are different types of anaemia, some due to deficiency of either a single or several essential nutrients and others from conditions that are not related to nutrition such as infections, genetic disorders etc. “Nutritional Anaemia” is the most common anaemia in South Asia. Women, in general, have smaller stores of iron than men and loss of blood through heavy menstruation in the reproductive age group place them at higher risk for nutritional anaemia.

The three main classifications for causes of Anaemia include impaired RBC (erythrocyte) production (low erythropoiesis), increased RBC destruction (Haemolysis) and bleeding (haemorrhage).

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Anaemia caused by impaired Erythrocyte production are:

• IronDeficiencyAnaemia

• MegaloblasticAnaemia

• AnaemiaofChronicdiseases

• Thalassemia

Anaemia caused by Blood Loss are :

Acute Blood Loss

• ResultofsuddenHaemorrhage

• Trauma,surgery,vasculardisruption

Chronic Blood Loss

• GI,GU bleeding, Haemorrhoids,Menstrual blood loss

Causative factors

The history of medical problems that could cause anaemia are Sickle cell Disease, Thalassemia, Renal Disease and Hereditary Spherocytosis. The common causes of Anaemia are Iron deficiency (poor dietary intake or malabsorption), Haemolysis (Blood loss), Pregnancy and lactation, chronic diseases (rheumatoid arthritis, kidney disease), persistent bleeding (peptic ulcer, haemorrhoids etc.), infections such as malaria and hookworm infestations.

Iron deficiency anaemia is the most common type of anaemia overall and it has many causes. RBCs often appear hypochromic (paler than usual) and microcytic (smaller

than usual) when viewed with a microscope. Iron deficiency anaemia is due to insufficient dietary intake or absorption of iron to meet the body’s needs. Infants, toddlers, and pregnant women have higher than average needs. Iron is an essential part of haemoglobin, and low iron levels result in decreased incorporation of hemoglobin into red blood cells. Worldwide, the most common cause of iron deficiency anaemia is parasitic infestation. Iron Deficiency can result from:

• Pregnancy/lactation

• Bloodloss

• Intravascularhemolysis

• Gastricbypass

• Malabsorption

Although the primary cause is iron deficiency, it is seldom present in isolation and more frequently it coexists with a number of other causes, such as malaria, parasitic infection, nutritional deficiencies and haemoglobinopathies. Anaemia can also occur due to lack of hydrochloric acid in the stomach, which is needed for digestion of iron and proteins and the presence of intestinal parasites or worms, which feed on the supply of blood as well as on the vitamins.

Symptoms

Anaemia goes undetected in many people. Symptoms are vague like feeling of weakness, fatigue, general malaise etc. Most

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common symptoms are feeling weak or lacking of energy, dizziness, and fatigue. Other symptoms include looking dull and tired, worn out, tired looking eyes, shortness of breath, premature wrinkles, headache, poor memory, slow healing of wounds, palpitation and paleness of skin. In children and adolescents, it leads to poor concentration.

Anaemia leads to lack of oxygen in organs leading to shortness of breath, dyspnoea on exertion, palpitation, angina, intermittent claudication pain of the legs, headache, painful menstruation, loss of appetite and pricking sensation in fingers and toes.

Decreased oxygenation leads to:

• Exertionaldyspnoea

• Dyspnoeaatrest

• Fatigue

• Boundingpulses

• Lethargy,confusion

Decreased volume leads to :

• Fatigue

• Musclecramps

• Posturaldizziness

• Syncope

Possible Complications

Anaemia leads to hypoxia (lack of oxygen) in organs. Since all human cells depend on oxygen for survival, varying degrees of anaemia can have a range of clinical consequences.

The possible complications that could arise due to anaemia are brittle or rigid fingernails, hypoxemia behavioural disturbances

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in children. Hypoxemia resulting from anaemia can worsen the cardio-pulmonary status of patients. Cold intolerance occurs in one in five patients with iron deficiency anaemia and becomes visible through numbness and tingling. Anaemia is a serious problem especially during pregnancy.

The consequences of nutritional anaemia are:

• Impaired cognitive performance at allstages of life

• Significant reduction of physical workcapacity and productivity.

• Increased morbidity from infectiousdiseases.

• Greaterriskofdeathofpregnantwomenduring the perinatal period.

• Negative foetal outcome: intrauterinegrowth retardation, low birth weight, prematurity.

Remedial measures

Though Anaemia is serious and even life-threatening, it is largely preventable and treatable by increasing dietary intake (such as iron supplements), healthier hygiene and sanitation practices, regular deworming etc. Anaemia can be overcome through the various traditional systems such as Ayurvedha, Yoga & Naturopathy, Unani, Siddha, Homoeopathy (AYUSH) as discussed below. India is the only country where AYUSH traditional systems have been codified.

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Sarvamanyam parithyajya shareram anupalayeth Tadhabhavihi bhavanam sarvaa bhava shareri

- We are what we eat. When Health is lost everything is lost.

In Ayurvedha, Anaemia is referred to as “Pandu roga”, which literally means “Pallor of the body”. The causes of Pandu roga are dietetic habits, daily regimen and Nidanarthkar vyadhi. The types of Pandu are Vataja, Pittaja, Kaphaja, Sannipataja and Mrut bhakshanajanya.

Though Acute Anaemia has been successfully managed with contemporary sciences, Chronic Anaemia can be better tackled by various treatment modalities explained by Acharyas of Ayurvedha in both preventive and curative aspects. The principles of treatment are Shodhana (purificatory procedure) and Shamana (palliative procedure).

The numerous Churna kalpanas (powder preparations), Vatis (tablets), Lauha bhasma (calcined iron preparations), Arishta (self-fermented alcoholic preparations),

ayurvedha

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Ayaskriti (Iron processed in cow’s urine) enhance the bio-availability of iron, facilitate better gastrointestinal absorption and also prevents the usual side-effects caused by the direct oral administration of iron supplements.

The evaluation of an Ayurvedic compound in treatment of Iron deficiency Anaemia (Pandu roga) shows that all groups showed almost equal efficacy but compound mandura churna showed better results than the other groups. Also, mandura churna did not produce constipation, gastric irritation and other side effects compared to other groups. From the aetiopathological study, it was concluded that krimi (worm infestations) is the most important nidana (causative factor) for the occurence of Pandu roga.

The treatment modalities and medications not only supplement the body with iron but also normalise the Agni (digestive fire). Thereby, the metabolism is balanced and the body is given a chance to recoup and maintain itself. Synergistic action of the ingredients of Punarnava mandoora by way of increasing appetite, digestion, absorption and diuretic action help in achieving better level of TRBC and Hb (g%) during pregnancy.

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• Improvessleep

• Improves absorption and assimilationsystems in the body.

Hydrotherapy

Hydrotherapy is the usage of water at different temperatures to heal and ease variety of ailments.

Hydrotherapy is the most beneficial system of restoring normal functions in the body. It is employed to balance the metabolism. Hydrotherapy improves the oxygen carrying capacity of the blood cells and in that way it helps in Anaemia.

Anaemia Management through the traditional method of Yoga and Naturopathy include:

• Yogatherapy

• Hydrotherapy

• Diettherapy

• Chromotherapy

• Magnetotherapy

• Massage

• Aromatherapy

• Mudtherapy

• Acupuncture

• Reflexology

• PranichealingandReiki

Yoga Therapy

Yoga as a therapy works on the body as a whole.

• Increases the RBC production as well aspurifies the blood.

• Helps to manage many symptoms ofanemia.

• Helpstoimprovevitalenergyinthebody.

• Improvesmentalhealth.

• Maintainsgoodhealth.

• Improvesbloodcirculation

• Improvesappetite.

Naturopathy

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Diet Therapy

• Intake of iron from foods such as greenleafy vegetables like spinach should be increased.

• Iron from animal sources is more easily absorbed than iron from plant foods.

• VitaminC increases theuptakeof iron.Sofoods containing Vit C (eg. orange juice, tomato salad) may be added to the iron-rich meals.

• Lack of Vitamin B12 can contribute toanaemia, so in addition to adding iron to eating plan, intake of foods containing vitamin B12 may be increased.

• Intakeoffolatecanbeincreasedbyaddingthese foods to the diet such as green leafy vegetables, Brussels sprouts, broccoli, whole grains, wheatgerm, fortified breakfast cereal, avocados and melon.

• Symptoms of iron-deficiency anaemiamay be aggravated by certain foods. So consumption of foods that reduce iron-absorption or deplete iron reserves should be reduced. These foods include: tea, coffee, bran or bran cereals.

• Oneof thenatural foodsthatcancombatAnaemia are Beetroot (Its juice is rich in minerals like sulphur, iron, calcium and iodine),

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• Amla (Indian Gooseberry) which contains Ascorbic acid commonly known as vitamin C is necessary for our body as it helps in absorption of iron in our body.

• Honey and lemon have proved to be beneficial for anaemic patients when consumed early morning in empty stomach. Pomegranates are also rich in iron and various other minerals.

• Other iron rich foods include, Sesame seeds, Palm Jaggery, Prunes, Dates, Grapes,

Raisins, Drumstick leaves, Curry leaves, Lotus stem, Mint leaves, Coriander leaves, Nuts,

Beans and pulses, Whole grains, Fortified cereals, Bran.

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Wheatgrass juice (Two ounces of wheatgrass is equivalent to eating 4 pounds of green vegetables),

Pumpkin seeds, Collard greens, Tomatoes, Green beans, Brussel sprouts, Bok choy, Green peas, Broccoli, Spinach, Quinoa, Kale, Sprouts, Turkey-berry, Spinach etc are also iron rich foods.

Importance of Iron Utensils

• Cooking in iron utensilswill improve ironcontent in the food.

• Cooking in iron vessels may be economic and effective to fight deficiency of micronutrients.

• In ancient times, people were using ironand pottery vessels for cooking.

• Copper is necessary for the absorptionofiron from the gastro intestinal tract.

• Waterstoredincoppervesselovernight isgood to improve vitality.

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Nutritional dangers of Microwave cooking

• Lossofwater, vitalnutrientsandmineralslead to empty calories instead of nutritional values.

• Toxinsmayleechoutintothefoodduringcooking and can be potentially harmful and even carcinogenic.

• Intense radiation of microwave cookingmay affect nervous system results in headache, backache, disorientation and altered brain wave pattern.

• Excessiveconsumptionofmicrowavefoodleads to decreased haemoglobin in the blood, decreased HDL and WBC.

Chromo Therapy

Chromotherapy uses vibrant colours which has all healing properties to maintain harmony.

• Colourexposure• Thermoleum• Ambience

Magneto Therapy

Magnet works on human metabolism mainly through the circulation of blood which contains haemoglobin and iron.

Without iron, there will be no oxygen transport, thus iron is very essential for life and magnet influences iron radical.

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Mud Therapy

Mud therapy is being used by people to cure diseases since ancient times.

It is believed that the earth has healing powers which are refreshing and invigorating for the body. Mud also contains most minerals like cobalt, copper etc.

Acupuncture, Accupressure and Massage, Refloxogy.

Accupuncture is an effective way to help nutrient absorption and to treat the symptoms of anaemia.

Massage encourages the efficient transport of oxygen and nutrients throughout the body.

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In Unani System of Medicine, Anaemia is known as Faquruldum. The following are used both for Preventive & Curative purposes.

Vitamin B12

Meats, specifically kidneys and liver and some dairy products contain vitamin B12, which is needed for preventing and curing anaemia.

Beets

Beets have high iron content, which helps in the formation of red blood cells. Beet juice contains potassium, phosphorus, calcium, sulphur, iodine, iron, copper, carbohydrates, protein, fat, vitamins B1, B2, B6, niacin, and vitamin P (bioflavonoids). It also strengthens the body’s resistance to sickness and is an excellent remedy for anaemic children and teenagers.

Fenugreek Fenugreek leaves should be cooked and given to adolescent girls after their menstruation period. It helps in new blood formation. Its seeds are also rich in iron which can also be used to cure anaemia.

Lettuce

Lettuce contains considerable amount of iron which is easily absorbed by the body. Regular consumption of lettuces will help prevent anaemia.

Spinach

Spinach is a leafy vegetable having high source of iron. It helps in the formation of haemoglobin and building up the new blood cells when absorbed by the body.

Unani

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Soyabean

Soyabean is rich in iron and also has a high protein value. It should be given to anaemic person in a very light form, preferably in the form of milk or soymilk to aid them from weak digestion.

Almonds

An almond contains 1.15 mg of copper for every 100 gm. The copper, along with iron and vitamins, acts as a catalyst during the reproduction of haemoglobin. Take 7 almonds, remove the thin red covering, soak it in water for about two hours and ground into a paste. Eat the paste once every day for 3 months.

Sesame Seeds

Black sesame seeds are rich source of iron. Soak one teaspoon of black sesame seeds in warm water for a couple of hours, strain it and then ground it into powder. Mix it in a cup of milk sweetened with sugar.

Honey

Honey contains iron, copper and manganese, so it helps in building new red blood cells in the body.

Other Foods

Other rich sources of iron are bananas, black grapes, plums, strawberries, raisins,

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dates, dry figs, onions, squash, carrots,radish, celery, and tomatoes. Eating Drumstick leaves, curry leaves or taking juice regularly can cure anaemia. Apples should be eaten without peeling them.

Usage of Iron Pots

Cooking in iron pots has proved that it significantly increases the amount of iron in the cooked foods.

Treatment through Ilaj Bit Tadbeer – Regimental Therapy

A cold water bath is among the most valuable curative measures in anaemia. The patient should be given carefully graduated cold baths twice daily. Cold friction, Hot Epsom

salt bath for 5 to 10 minutes once a week and an occasional cabinet steam bath are also recommended.

Full sun baths are especially beneficial as sunlight stimulates the production of red cells.

There are other important factors which are helpful in curing anaemia. Deep breathing and light exercise like walking and simple yoga asanas should be undertaken to tone up the system. Massage also helps to keep the blood level high.

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According to siddha “Food is medicine and Medicine is food”. Healthy diet itself acts as a good remedy to fight against disease and it is the basic concept of Siddha. Siddha lays a great emphasis on food, daily and seasonal regimen including personal Hygiene.

Management of IDA includes treatment and dietary education.

Treatment

There are three phases of treatment. The first phase is Preparatory treatment (to eliminate worms and other accumulated toxins of the body), the second phase is Promotion of appetite and the third phase is Medicines to improve Hb %.

Deworming with Vaividanga churanam (Embelia ribes), Murukan vithai maathirai (Butea frondosa - the key ingredient) is the first approach. Madhulai manappagu- syrup with

pomegranate and Amukkara churanam is the most preferred treatment in pregnant women and children. Annabedi chenduram up to 120 mg has better bio-availability.

Diet To fight anaemia, malnutrition has to be corrected. More fruits like Fig, Pomegranate, Indian gooseberry, Dates and leafy vegetables like Moringa leaves, Manathakaali leaves,

Curry leaves, Karisalai, Ponnanganni, Arakeerai, Sirukeerai, Drumstick, Curry leaves

Siddha

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and other vegetables like Indian Butter Bean, Brinjal, Asafoetida, Sesame seeds and Turmeric have to be consumed.

Iron present in organic sources gets absorbed in the body easily. Haematinic Medicinal Plants in Siddha Medicine are:

(IRON in100gm)

• Fig(Ficusracemose) -1.0mg

• Pomegranate

(Punica granataum) - 1.7 mg

• Dates(Phonexdactilifera)-7.3mg

• Gooseberry

(Phyllanthus embilica) - 1.2mg

• Pepper(Pipernigrum)-12.4mg

• Thippili(Piperlongum) -62.1mg

• Curryleaves(Murrayakoengi)-0.93mg

• Mookirattaikeerai-18.4mg

• Sesame(Sesamumindicum)-9.3mg

• Turmeric(Curcumalonga)-67.8mg

• Asafoetida(Ferulaasafoetida)-39.4mg

Comparison of Haematinic Minor Millets and Grains:

S. No Protein (gm)

Iron (mg

Calcium(mg)

1 Rice 7.6 1 28

2 Wheat 11 3.5 30

3 Thinai 12.3 2.8 3.3

4 Cumbu 11.6 8 42

5 Varagu 8 trace 27

6 Ragi 8 4 350

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Anaemia results in varying degrees of tissue respiration, hypoxia and metabolic changes. Basically the Haempoitic system is deranged in many cases of anaemia. The key components of haematologic system are:

• Bone marrow

• Liver

• Spleen

• Lymph system

Homoeopathic management of Iron deficiency anaemia include treatment of underlying disease/ problem with drugs such as Ferrum Phos and Ferrum Mettalicum and with dietary measures like Green Leaves, Jaggery, Gingelly, Meat, Dry Grapes, Fruits and Vegetables.

Homoeopathy

Vitamin B12 (cobalamin) is an important

water-soluble vitamin. Deficiency of Vitamin

B12 is also known as pernicious anaemia.

Vitamin B12 deficiency will have the general

symptoms of anaemia, Anorexia, Parathesias

of the feet and hands. Folic Acid is required

for RBC formation and maturation. Folic Acid

Deficiency also causes Megaloblastic anaemia.

Deficiency of Vitamin B12 and Folic

Acid may lead to the erythrocytes production

in the bone marrow and liver. The Vitamin B12

deficiency mainly occurs due lack of intrinsic

factor in the stomach which can be aided with

Homoeopathic Medicines like Merc Sol, Borax

along with dietary supplements like Leafy

green vegetables, Liver, Mushrooms, Oats,

Peanuts and butter beans.

Homoeopathic Management Anaemia

of Chronic Disease include Individualistic

approach, root the cause and elimination by

totality of treatment. Homoeopathic treatment

is effective in Anaemia caused by blood loss in

chronic stages like Gastro-intestinal bleeding,

Haemorrhoids and fibroids. The anaemia of

Haemolytic types mostly auto immune origin

could also be treated with Homoeopathic

medicines effectively.

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• Government of Tamil Nadu is implementing various schemes to combat Anaemia. The schemes include issue of Tablets and Syrups through Anganwadi Centres. Siddha medicines are also given.

• Iron rich foods are being popularised through IEC activities. The Hon’ble Chief Minister of Tamil Nadu has announced iron rich curry leaves as dietary supplement for cure of anaemia.

• Yoga has been introduced in Primary Health Centres for good physical and mental health.

• It is also proposed to supply medicinal kits and create awareness. Pearl millet (cumbu), Finger millet (kelvaragu), Fox tail millet (thinai), Kodo millet (varagu) will be encouraged to be consumed in larger quantities to keep anaemia away.

government interventions in addressing anaemia

Fig: Ragi (Finger millet)

Fig: Cumbu (Pearl millet)

Fig: Thinai (Italian millet)

Fig: Varagu (Kodo millet)

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• A Pilot study has been proposed by Tampcol

for a new Siddha Poly Herbal formulation

in tablet form with a combination of

nine herbs (Kariveppilai, Vellai karisali,

Ponnnankanni, Kadukkai, Nellivatral,

Milagu, Adhimathuram, Sundaivatral,

Thanneervitan Kizhangu) for controlling

Anaemia.

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She quoted the example of LION DATES, where one entrepreneur has promoted DATES in a large scale. She also suggested that, to give correct information/ messages about the Indian medicines, we need to compete with private marketing professionals.

The Vice-Chairperson, State Planning Commission enquired the departments whether Nutritious Meal Programme has contributed to combat anaemia. She remarked that, if anaemia persists inspite of NMP, whether it is absolutely necessary to take up a study on the other factors (such as unhygienic preparation of food, poor storage of food materials etc.) causing Anaemia. She also observed that, in all anaemia related strategies like supply of Iron tablets etc., people have resistance against Iron consumption and even millet consumption has come down and there is a notion among people that, Iron consumption and certain millets cause pigmentation on skin even in unborn child. She mentioned that, it is fascinating to know that the basic principles of all traditional Medicine branches (AYUSH) are all the same.

Views / Suggestions of the Participants

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Dr. P. Senthil Kumar, i.a.S., Special Secretary, Health and Family Welfare and Commissioner of indian System of Medicine (i/c) highlighted the prevalence of Anaemia and the various causes of anaemia. He detailed about the Hematinic Medicinal Plants in Indian System of Medicine and highlighted the importance of millets to keep anaemia away. He also mentioned about the various measures taken by Government to combat anaemia. He concluded that, by changing the dietary habits (consuming more Millets and haematinic food supplements) and if necessary, using effective pure poly herbal formulation, we can fight against anaemia.

Dr. V.R. Seshadri, Chief Physician, Visesh Ayurvedics, mentioned that there is a misnomer that traditional medicines have side effects and to dispel such myths, proper awareness has to be created. He highlighted that the need of the hour for promoting

traditional medicines are need for exploration, promote easy accessibility and documentation & interpretation.

Dr. N. Manavalan, Principal, Govt. Yoga & Naturopathy Medical College, Chennai stressed the importance of drugless therapy and more water intake (minimum 3 litres of water daily). He suggested that publicity/ awareness programmes should focus on greens, sprouts etc.

He also suggested that consumption of coffee/ tea should be minimized, as it reduces iron absorption. He concluded that, people are trying to adopt the natural foods as in olden days, which is a welcome change.

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Dr. Hakim Syed M.M. Ameen, Project Director & Chief Functionary, Centre for Unani Ilaj Bit Tadbeer-Regimental Therapy suggested the following:

• Agriculture and Forest Departments may supply one Drumstick plant to one family.

• Iron vessels may be used in the Noon Meal Centres. Curry Leaves, Drumstick leaves, Coriander leaves and Arugampul juice may be included in the Noon Meal.

• Health Education to be incorporated as one of the subjects through which the importance of cleanliness, sanitation, food habits, health practices, exercises, meditation etc. can be imparted to school children.

Dr. P. Manivannan (Fellow WHO), Medical Officer, Tamil Nadu Medical Service recommended the following:

• Health education of proper food and toilet habits to prevent intestinal parasites, Cleansing therapy (Purgation/ deworming - once in four months), use of coconut milk once in 15 days and Agathikeerai once in fortnight are recommended.

• Currently, even in the tribal pockets, use of minor millets rich in Iron and other essential elements is not in practice and therefore

Views / Suggestions of the Participants

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they should be encouraged to grow them and use as food.

• Uninterrupted Siddha drug supply, which is effective, safe and also cost effective.

• Usage of Non-invasive test kit developed by IIT-Delhi.

• Involving NGOs in Health Education and Nutrition

• Prepare specific IEC material for Siddha interventions for display in GH/GPHC/CHCs.

• Visual media advertisement & Print media advertisement on healthy food including greens/ fruits /minor millets.

Dr. Krishnaveni, Reader, Government Siddha Medical College stated that anaemia which cannot be corrected by dietary sources can be treated successfully by effective siddha medicines. She also stressed that, Coffee/ Tea should not be consumed with meals. Further millets and Panjamoota kanji (prepared with ingredients Yellow split peas, Black gram, Bengal gram, Green gram and raw rice) to enhance protein may be included in daily diet.

S. No

Nutrient value of Panchamoota Kanji

Protein(gm)

Ironmg)

Calcium(mg)

1 Thuvaram paruppu 28.2 6.3 69

2 Ulunthu 24 8.6 154

3 Kadalai paruppu 22.5 9.5 56

4 Siruparuppu 24.5 3.9 75

5 Pacharisi 6.8 0.7 10

Dr. R. Gnanasambandam, Editer, Homoeo Times, stated that chronic illness prone anaemia have effective Homeopathic remedies. He said that errors in Haemopoitic system had been effectively treated based on individual study of every patient.

He cited the examples of patients affected by Thalassemia and Leukaemia, who have successfully recovered with Homoeopathic treatment. He emphasized the need for effective management of Anaemia in Health care and stated that cross referral among physicians of the ISM&H is needed.

Dr. Jayshree Vencatesan, Managing Trustee, Care Earth Trust, stated that, of the many forms of Anaemia, those caused due to malnutrition are known to be typical amongst marginalized communities. While such communities that are typical to urban or peri urban and rural communities are the visible representation of the condition, those communities that are predominantly forest

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dwelling are often invisible and unrepresented. Adding yet another dimension to this invisibility is the popular notion that tribal and forest dwelling communities, by the virtue of their inherent access to natural resources and the largely hunter-gatherer form of existence, are healthy and devoid of nutrition related disorders and conditions.

She stated that, the tribal people have stopped collecting wild fruits from Kolli hills in Namakkal and Sathyamangalam forests in Erode district which are of rich iron content. She suggested that intake of indigenous animal foods like fish and locally grown minor millets like Samai, Thinai, Varagu etc. should be encouraged.

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• A pilot study to be conducted for analysing the condition of the patients affected by anaemia. ie. before and after taking iron tablets/drugs.

• NGOs should popularise iron rich millets/ medicinal plants curing anaemia among the people.

• To create awareness on Life-style, dietary habits, utility of millets and yoga practises through awareness campaign among the people, especially school children, adolescent girls and ante-natal mothers.

• Professional approach/ Commercial approach may be adopted to disseminate the medicinal value of iron rich foods.

• Importance should be given to the palatability of the herbal products.

• The need for cleanliness during preparation of food should be stressed, which can also control anaemia.

Recommendations of the State Planning Commission

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S.No. Name and Designaton

1 Tmt. Santha Sheela Nair, i.a.S.(Retd.),Vice-Chairperson, State Planning Commission, Chennai.

2 Dr. P. Senthil Kumar, i.a.S.,Special Secretary, Health and Family Welfare Department, Secretariat. (and)Commissioner of Indian System of Medicine (i/c).Chennai.

3 Dr. R.T. Porkai Pandiyan,Director of Public Health and Preventive Medicine, Chennai.

4 Thiru. S. KumaradhasDeputy Secretary to Government,PD & SI Dept., Secretariat, Chennai.

5 Dr. b. Shanthi,Deputy Director (Health)Integrated Child Development Services,Taramani, Chennai.

6 Dr. V.R. Seshadri, Visesh Ayurvedics, Chennai.

7 Dr.N. Manavalan, Principal, Government Yoga & Naturopathy Medical College, Chennai.

8 Dr. Syed M.M. ameen,Project Director & Chief Functionary, Centre for Unani Ilaj Bit Tadbeer, Gummidipoondi.

list of Participants

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9 Dr. P. Manivannan, Selection Grade Medical Officer, ESI Hospital, Ayanavaram, Chennai.

10 Dr. Krishnaveni, Reader, Government Siddha Medical College, Chennai.

11 Dr. R. gnanasambandam,Editor, Homoeo Times, (Ex-President, Homoeo Council),Royapettah, Chennai.

12 Dr. Jayshree Vencatesan, Managing Trustee, Care Earth Trust, Chennai.

list of Participants

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Documents

Controlling Anaemia through Indian System of Medicine · 2014-09-01 · 6 State Planning Commission, TamilNadu Controlling Anaemia through Indian System of Medicine Incidence of anaemia