Re: Re: VOD/Charmak disease/ Camel belly disease

[Guest guest]

Dear Dr. Santosh,

Many thanks for the detailed information about Gulran Disease, it was the fact that it was caused by contaminated wheat but not itself by wheat.

Could you please elaborate the pathophysiology of the disease and its evidance in other countries

Best Regards

Mohammad Bashaar

From: drsantosh74 <drsantosh74@...>Subject: Re: VOD/Charmak disease/ Camel belly diseasenetrum Date: Monday, June 30, 2008, 4:13 PM

Dear all,

As many as 10 people have died in western Afghanistan from a rare liver disease believed to be caused by contaminated wheat,

At least 161 people were also hospitalized with Gulran disease in Herat province on the Iranian border, said Graaff, resident representative of the U.N. World Health Organization.

A toxic weed called charmak grows in the area and contains chemicals that can cause Gulran disease, WHO said. Graaff said the disease is not new but rare, and has killed as many as 10 people in recent weeks.

Abdul Hakim Tamana, the director of the Herat public health department, said Gulran disease "has spread all over" the affected district.

It was unclear exactly how the people became ill. The WHO was sending an epidemiologist from Geneva to Afghanistan within days to investigate whether wheat or other foods were contaminated, and whether people might be eating the weed accidentally or deliberately as a flavor enhancer, Graaff said.

WHO and Afghan government authorities believe local wheat was tainted with charmak and have taken measures to distribute fresh wheat supplies.

Tests have not been done to check for contamination and laboratories in the capital, Kabul, were unable to detect the cause of the illness.

"Maybe the flour they have is contaminated, " Graaff said. "Is it the wheat that is contaminated, or do people eat it deliberately to add to the taste? Or other food products might be contaminated. "

The Afghan Red Crescent Society received $14,000 to purchase new wheat to replace suspect supplies in the district as a precautionary measure, said Graziella Leite Piccolo, a spokeswoman for the International Committee of the Red Cross in Kabul.

Tamana said that Gulran disease has affected people in the area for the past 40 years, and that several people died from it in 1999 and 2001.

____

Dr.Santosh Pillai

Associate Professor

Department of Pharmacology

Pushpagiri Medical College

Tiruvalla 689101

> >> > Dear Dr. Bashaar:> > We all are fortunate and delighted enough to have a learned > scholar like you as moderator for the ongoing discussion at NETRUM. > I wholeheartedly welcome you and wish you success and a great time > for your topic of discussion. To set the ball rolling I

am > reproducing here an article on Hepato veno-occlusive disease (VOD) - > also known as camel belly disease for information of all members. It > is self-explanatory in nature.> > AFGHANISTAN: WHO confirms `charmak’ disease in Herat Province > > Photo: Khalid Nahez/IRIN > > Charmak disease â€" also known as camel belly - is caused by > exposure to pyrrolizidine alkaloids found in Charmak weed which > grows in grain fields, WHO says > > KABUL, 15 May 2008 (IRIN) - Confirmed cases of hepatic veno-> occlusive disease (VOD) - also known as “camel bellyâ€� or > `charmak’ disease - in Gulran District of Herat Province, western > Afghanistan, have surpassed 190, and 17 people have died so far, > provincial health officials said. Citing the result of tests at the > National Institute for Public Health in the Netherlands, the

UN > World Health Organization (WHO) said the disease was caused by > exposure to pyrrolizidine alkaloids found in `charmak’, a > poisonous weed believed to be growing mostly in grain fields in > Gulran District, and which often finds its way into locally produced > wheat flour. > > > > According to WHO, regular consumption of bread contaminated by > alkaloids contained in the weed can cause rapidly filling ascites > (also known as peritoneal cavity fluid, peritoneal fluid excess, > hydroperitoneum or abdominal dropsy), severe abdominal pain, > vomiting and jaundice. “VOD of the liver is a form of toxic liver > damage caused by pyrrolizidine alkaloids,� WHO said. The outbreak > of `charmak’ disease was first reported in November 2007. Of the > 17 deaths six were men, six were women and five children, according > to

Herat’s public health department. “Thirty eight other > patients are currently under medical testing which will determine > whether or not they have `charmak’ disease,� Aziz Noorzai, the > head of Gulran hospital, told IRIN on the phone on 14 May. > > > > “No magic pill� > > > > Until early May local health officials did not know what > medication should be given to `charmak’ patients to cure their > illness. Medical experts now say - based on the Netherlands test > results - that two grams of sodium in the daily diet, the use of > vitamin and mineral supplements, and the extraction of unnecessary > liquids from a patient’s swollen belly in serious cases, can save > lives and treat the disease, according to Rana Graber Kakar, a WHO > expert in Kabul. “There is no magic pill for

it,� said Kakar, > adding that technical research and studies were under way to > illuminate characteristics of the disease and help the Ministry of > Public Health (MoPH) to overcome similar challenges in future. Rest > is also recommended for long-term recovery, she said. > > > > > > Photo: Khalid Nahez/IRIN > > A father and his son are suffering "charmak" disease in the Gulran > district of Herat > > Food aid distributed > > WITH REGARDS> > > > In an effort to curb the outbreak, the MoPH has launched a public > awareness campaign in Gulran District through which people are > encouraged to stop consuming locally produced flour. But the drive > has been received coldly by most of Gulran’s poor populace. > “When we tell them not to eat Gulran flour, they ask what they > should eat

instead,� said Noorzai. The UN World Food Programme > (WFP) said it had distributed 700 tones of mixed food items to about > 55,000 people in Gulran under food-for-work and education incentive > schemes, and a further 860 tonnes would be distributed to 24,000 > people in the near future. An Italian Provincial Reconstruction Team > has also delivered food and non-food relief items to vulnerable > families, the NATO-led International Security Assistance Force said > in a statement on 28 April. > > > > Improved wheat cultivation needed > > > > `Charmak’ has appeared at least three times in the past 50 > years - always in Herat Province - and had affected hundreds of > people each time, according to local officials. Health experts said > the disease cannot be prevented through medical measures only, but > that improvements in

wheat cultivation, harvesting, threshing and > milling - and enabling farmers to eliminate poisonous weeds in their > fields - would help avert future outbreaks. “In the long-term, the > government needs to focus on agricultural policies that will reduce > contamination of grain with Heliotropium [`charmac’] weeds,� the > WHO said in a weekly epidemiological monitor on 11 May.> >  > > Dr. Geer M. Ishaq> > Sr. Lecturer> > Dept. of Pharmaceutical Sciences> > University of Kashmir> > Srinagar-190006 (J & K)> > Ph: 9419970971, 9906673100> > E-mail: ishaq@> > Website: http://ishaqgeer. googlepages. com > > > > > > Forgot the famous last words? Access your message archive > online at http://in.messenger ./ webmessengerprom o.php>

>>

[Guest guest]

hello

having read whatever was posted on this rare disease, a similar case comes to my mind which will not be out of place to put here.

In India several years ago, we received aid from USA in the form of wheat. The interesting fact was that the wheat we recd had to be picked( cleaned) before milling because it contained ergot seeds.after a decade it was observed that a peculiar grass is growing in all parts of India which is resistant to weed killers.

we call it congress grass as it is ubiquitous like our political party "congress". And it was the result of the contamination in the wheat imported from USA. Could it be that what aid you are receiving from other countries, have caused this rare disease or was it there even before your country went to war?

kunda

From: drsantosh74 <drsantosh74>Subject: Re: VOD/Charmak disease/ Camel belly diseasenetrumgroups (DOT) comDate: Monday, June 30, 2008, 4:13 PM

Dear all,

As many as 10 people have died in western Afghanistan from a rare liver disease believed to be caused by contaminated wheat,

At least 161 people were also hospitalized with Gulran disease in Herat province on the Iranian border, said Graaff, resident representative of the U.N. World Health Organization.

A toxic weed called charmak grows in the area and contains chemicals that can cause Gulran disease, WHO said. Graaff said the disease is not new but rare, and has killed as many as 10 people in recent weeks.

Abdul Hakim Tamana, the director of the Herat public health department, said Gulran disease "has spread all over" the affected district.

It was unclear exactly how the people became ill. The WHO was sending an epidemiologist from Geneva to Afghanistan within days to investigate whether wheat or other foods were contaminated, and whether people might be eating the weed accidentally or deliberately as a flavor enhancer, Graaff said.

WHO and Afghan government authorities believe local wheat was tainted with charmak and have taken measures to distribute fresh wheat supplies.

Tests have not been done to check for contamination and laboratories in the capital, Kabul, were unable to detect the cause of the illness.

"Maybe the flour they have is contaminated, " Graaff said. "Is it the wheat that is contaminated, or do people eat it deliberately to add to the taste? Or other food products might be contaminated. "

The Afghan Red Crescent Society received $14,000 to purchase new wheat to replace suspect supplies in the district as a precautionary measure, said Graziella Leite Piccolo, a spokeswoman for the International Committee of the Red Cross in Kabul.

Tamana said that Gulran disease has affected people in the area for the past 40 years, and that several people died from it in 1999 and 2001.

____

Dr.Santosh Pillai

Associate Professor

Department of Pharmacology

Pushpagiri Medical College

Tiruvalla 689101

> >> > Dear Dr. Bashaar:> > We all are fortunate and delighted enough to have a learned > scholar like you as moderator for the ongoing discussion at NETRUM.. > I wholeheartedly welcome you and wish you success and a great time > for your topic of discussion. To set the ball rolling I

am > reproducing here an article on Hepato veno-occlusive disease (VOD) - > also known as camel belly disease for information of all members. It > is self-explanatory in nature.> > AFGHANISTAN: WHO confirms `charmak’ disease in Herat Province > > Photo: Khalid Nahez/IRIN > > Charmak disease â€" also known as camel belly - is caused by > exposure to pyrrolizidine alkaloids found in Charmak weed which > grows in grain fields, WHO says > > KABUL, 15 May 2008 (IRIN) - Confirmed cases of hepatic veno-> occlusive disease (VOD) - also known as “camel bellyâ€� or > `charmak’ disease - in Gulran District of Herat Province, western > Afghanistan, have surpassed 190, and 17 people have died so far, > provincial health officials said. Citing the result of tests at the > National Institute for Public Health in the Netherlands, the

UN > World Health Organization (WHO) said the disease was caused by > exposure to pyrrolizidine alkaloids found in `charmak’, a > poisonous weed believed to be growing mostly in grain fields in > Gulran District, and which often finds its way into locally produced > wheat flour. > > > > According to WHO, regular consumption of bread contaminated by > alkaloids contained in the weed can cause rapidly filling ascites > (also known as peritoneal cavity fluid, peritoneal fluid excess, > hydroperitoneum or abdominal dropsy), severe abdominal pain, > vomiting and jaundice. “VOD of the liver is a form of toxic liver > damage caused by pyrrolizidine alkaloids,� WHO said. The outbreak > of `charmak’ disease was first reported in November 2007. Of the > 17 deaths six were men, six were women and five children, according > to

Herat’s public health department. “Thirty eight other > patients are currently under medical testing which will determine > whether or not they have `charmak’ disease,� Aziz Noorzai, the > head of Gulran hospital, told IRIN on the phone on 14 May. > > > > “No magic pill� > > > > Until early May local health officials did not know what > medication should be given to `charmak’ patients to cure their > illness. Medical experts now say - based on the Netherlands test > results - that two grams of sodium in the daily diet, the use of > vitamin and mineral supplements, and the extraction of unnecessary > liquids from a patient’s swollen belly in serious cases, can save > lives and treat the disease, according to Rana Graber Kakar, a WHO > expert in Kabul. “There is no magic pill for

it,� said Kakar, > adding that technical research and studies were under way to > illuminate characteristics of the disease and help the Ministry of > Public Health (MoPH) to overcome similar challenges in future. Rest > is also recommended for long-term recovery, she said. > > > > > > Photo: Khalid Nahez/IRIN > > A father and his son are suffering "charmak" disease in the Gulran > district of Herat > > Food aid distributed > > WITH REGARDS> > > > In an effort to curb the outbreak, the MoPH has launched a public > awareness campaign in Gulran District through which people are > encouraged to stop consuming locally produced flour. But the drive > has been received coldly by most of Gulran’s poor populace. > “When we tell them not to eat Gulran flour, they ask what they > should eat

instead,� said Noorzai. The UN World Food Programme > (WFP) said it had distributed 700 tones of mixed food items to about > 55,000 people in Gulran under food-for-work and education incentive > schemes, and a further 860 tonnes would be distributed to 24,000 > people in the near future. An Italian Provincial Reconstruction Team > has also delivered food and non-food relief items to vulnerable > families, the NATO-led International Security Assistance Force said > in a statement on 28 April. > > > > Improved wheat cultivation needed > > > > `Charmak’ has appeared at least three times in the past 50 > years - always in Herat Province - and had affected hundreds of > people each time, according to local officials. Health experts said > the disease cannot be prevented through medical measures only, but > that improvements in

wheat cultivation, harvesting, threshing and > milling - and enabling farmers to eliminate poisonous weeds in their > fields - would help avert future outbreaks. “In the long-term, the > government needs to focus on agricultural policies that will reduce > contamination of grain with Heliotropium [`charmac’] weeds,� the > WHO said in a weekly epidemiological monitor on 11 May.> >  > > Dr. Geer M. Ishaq> > Sr. Lecturer> > Dept. of Pharmaceutical Sciences> > University of Kashmir> > Srinagar-190006 (J & K)> > Ph: 9419970971, 9906673100> > E-mail: ishaq@> > Website: http://ishaqgeer. googlepages. com > > > > > > Forgot the famous last words? Access your message archive > online at http://in.messenger ./ webmessengerprom o.php>

>>

Explore your hobbies and interests. Click here to begin.

[Guest guest]

Hello Dear Madam,

Obliged for kind information and case study. I can't waive this possibility, since we are receiving aids from many countries, especially seeds/fertilizers. But it is not the first time we are experiencing such disease.

Best Regards

Mohammad Bashaar

From: drsantosh74 <drsantosh74>Subject: Re: VOD/Charmak disease/ Camel belly diseasenetrumgroups (DOT) comDate: Monday, June 30, 2008, 4:13 PM

Dear all,

As many as 10 people have died in western Afghanistan from a rare liver disease believed to be caused by contaminated wheat,

At least 161 people were also hospitalized with Gulran disease in Herat province on the Iranian border, said Graaff, resident representative of the U.N. World Health Organization.

A toxic weed called charmak grows in the area and contains chemicals that can cause Gulran disease, WHO said. Graaff said the disease is not new but rare, and has killed as many as 10 people in recent weeks.

Abdul Hakim Tamana, the director of the Herat public health department, said Gulran disease "has spread all over" the affected district.

It was unclear exactly how the people became ill. The WHO was sending an epidemiologist from Geneva to Afghanistan within days to investigate whether wheat or other foods were contaminated, and whether people might be eating the weed accidentally or deliberately as a flavor enhancer, Graaff said.

WHO and Afghan government authorities believe local wheat was tainted with charmak and have taken measures to distribute fresh wheat supplies.

Tests have not been done to check for contamination and laboratories in the capital, Kabul, were unable to detect the cause of the illness.

"Maybe the flour they have is contaminated, " Graaff said. "Is it the wheat that is contaminated, or do people eat it deliberately to add to the taste? Or other food products might be contaminated. "

The Afghan Red Crescent Society received $14,000 to purchase new wheat to replace suspect supplies in the district as a precautionary measure, said Graziella Leite Piccolo, a spokeswoman for the International Committee of the Red Cross in Kabul.

Tamana said that Gulran disease has affected people in the area for the past 40 years, and that several people died from it in 1999 and 2001.

____

Dr.Santosh Pillai

Associate Professor

Department of Pharmacology

Pushpagiri Medical College

Tiruvalla 689101

> >> > Dear Dr. Bashaar:> > We all are fortunate and delighted enough to have a learned > scholar like you as moderator for the ongoing discussion at NETRUM.. > I wholeheartedly welcome you and wish you success and a great time > for your topic of discussion. To set the ball rolling I

am > reproducing here an article on Hepato veno-occlusive disease (VOD) - > also known as camel belly disease for information of all members. It > is self-explanatory in nature.> > AFGHANISTAN: WHO confirms `charmak’ disease in Herat Province > > Photo: Khalid Nahez/IRIN > > Charmak disease â€" also known as camel belly - is caused by > exposure to pyrrolizidine alkaloids found in Charmak weed which > grows in grain fields, WHO says > > KABUL, 15 May 2008 (IRIN) - Confirmed cases of hepatic veno-> occlusive disease (VOD) - also known as “camel bellyâ€� or > `charmak’ disease - in Gulran District of Herat Province, western > Afghanistan, have surpassed 190, and 17 people have died so far, > provincial health officials said. Citing the result of tests at the > National Institute for Public Health in the Netherlands, the

UN > World Health Organization (WHO) said the disease was caused by > exposure to pyrrolizidine alkaloids found in `charmak’, a > poisonous weed believed to be growing mostly in grain fields in > Gulran District, and which often finds its way into locally produced > wheat flour. > > > > According to WHO, regular consumption of bread contaminated by > alkaloids contained in the weed can cause rapidly filling ascites > (also known as peritoneal cavity fluid, peritoneal fluid excess, > hydroperitoneum or abdominal dropsy), severe abdominal pain, > vomiting and jaundice. “VOD of the liver is a form of toxic liver > damage caused by pyrrolizidine alkaloids,� WHO said. The outbreak > of `charmak’ disease was first reported in November 2007. Of the > 17 deaths six were men, six were women and five children, according > to

Herat’s public health department. “Thirty eight other > patients are currently under medical testing which will determine > whether or not they have `charmak’ disease,� Aziz Noorzai, the > head of Gulran hospital, told IRIN on the phone on 14 May. > > > > “No magic pill� > > > > Until early May local health officials did not know what > medication should be given to `charmak’ patients to cure their > illness. Medical experts now say - based on the Netherlands test > results - that two grams of sodium in the daily diet, the use of > vitamin and mineral supplements, and the extraction of unnecessary > liquids from a patient’s swollen belly in serious cases, can save > lives and treat the disease, according to Rana Graber Kakar, a WHO > expert in Kabul. “There is no magic pill for

it,� said Kakar, > adding that technical research and studies were under way to > illuminate characteristics of the disease and help the Ministry of > Public Health (MoPH) to overcome similar challenges in future. Rest > is also recommended for long-term recovery, she said. > > > > > > Photo: Khalid Nahez/IRIN > > A father and his son are suffering "charmak" disease in the Gulran > district of Herat > > Food aid distributed > > WITH REGARDS> > > > In an effort to curb the outbreak, the MoPH has launched a public > awareness campaign in Gulran District through which people are > encouraged to stop consuming locally produced flour. But the drive > has been received coldly by most of Gulran’s poor populace. > “When we tell them not to eat Gulran flour, they ask what they > should eat

instead,� said Noorzai. The UN World Food Programme > (WFP) said it had distributed 700 tones of mixed food items to about > 55,000 people in Gulran under food-for-work and education incentive > schemes, and a further 860 tonnes would be distributed to 24,000 > people in the near future. An Italian Provincial Reconstruction Team > has also delivered food and non-food relief items to vulnerable > families, the NATO-led International Security Assistance Force said > in a statement on 28 April. > > > > Improved wheat cultivation needed > > > > `Charmak’ has appeared at least three times in the past 50 > years - always in Herat Province - and had affected hundreds of > people each time, according to local officials. Health experts said > the disease cannot be prevented through medical measures only, but > that improvements in

wheat cultivation, harvesting, threshing and > milling - and enabling farmers to eliminate poisonous weeds in their > fields - would help avert future outbreaks. “In the long-term, the > government needs to focus on agricultural policies that will reduce > contamination of grain with Heliotropium [`charmac’] weeds,� the > WHO said in a weekly epidemiological monitor on 11 May.> >  > > Dr. Geer M. Ishaq> > Sr. Lecturer> > Dept. of Pharmaceutical Sciences> > University of Kashmir> > Srinagar-190006 (J & K)> > Ph: 9419970971, 9906673100> > E-mail: ishaq@> > Website: http://ishaqgeer. googlepages. com > > > > > > Forgot the famous last words? Access your message archive > online at http://in.messenger ./ webmessengerprom o.php>

>>

Explore your hobbies and interests. Click here to begin.