Re: Thanks Dr Geer; welcome Dr Bashaar

[Guest guest]

Dear Colleagues,

I would like to thank Dr. Vijay Thawani for his leadership and for inviting me to moderate the new discussion (1-7 July 08). I have had the pleasure to work quite closely with my Netrum friends, and colleagues I truly appreciate the growing sense of professionalism and cooperative spirit which develops and characterizes our mutual efforts towards healthy world.

Regarding the introduction, although everything is covered by Dr. Vijay Thawani to some extent, for which I am appreciative, but in order to give a positive response to Dr. Vijay¢s request; I want to put a few words about my self.

Mohammad Bashaar (1978), member of Afghan family, graduated from Kabul Medical University, major in Curative Medicine and obtained Masters in Health Management from Preston University.

At present, I am working for United Nations Development Programme (Afghanistan), and also working as a lecturer in Karwan Institute Kabul, Afghanistan. Participated in many national and international events, my last visit was to India (Jawaharlal Nehru University, 21-25 April 08) where I presented the paper (Health Status of Afghanistan Post 9/11).

I am most deeply indebted to Dr. Vijay Thawani, Madam Kunda, for their unstinting cooperation and support and many special thanks go to Anupama, Dr. Geer, Zenat Ashraf and Dr. Santosh for their full fledged cooperation in terms of their inputs (the menace of spurious medicines).

At the last, I seek your full cooperation and total attention for the new discussion (Gulran/ Camel Belly/ Charmak Disease) in Afghanistan.

Thanks and Regards

Mohammad Bashaar

From: Vijay <drvijaythawani@...>Subject: Thanks Dr Geer; welcome Dr Bashaarnetrum Date: Monday, June 30, 2008, 6:54 AM

Hi,

On behalf of NetRUM heartfelt thanks to Dr Geer Ishaq for moderating the discussion from 23 to 29 Jun 2008 on "The menace of spurious medicines" which had > 100 posts (4550-4443=107) . Appreciations for the job well done. NetRUM would like to have you back as moderator for another topic of your choice.

Coming up next from 01 to 07 Jul 2008 is the discussion on "The Gulran / camel belly/ charmak disease in Afghanistan" which will be moderated by Dr Mohammad Bashaar. Welcome Dr Bashaar. Please take over NetRUM today at your convinience.

Dr Bashaar is a real medical activist with dynamism and determination, zeal and zest, vision and voice which can be heard. He is from Afghanistan who is trying to assist in repair of the health system of his war ravaged motherland. He constantly looks for the people who can help him in his efforts. Me and Kunda madam were fortunate to meet this young man at WHO HQ at Geneva last year during the TBS. Dr Bashaar please introduce yourself in your first post before you pick up the discussion.

I know that you will do well in your discussion.

Dr Vijay Thawani

Groupie

[Guest guest]

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 – 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 belly†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 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.

WITH REGARDS

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

From Chandigarh to Chennai - find friends all over India. Click here.

[Guest guest]

Dear Dr. Geer M. Ishaq,

Thanks for the opening and introducing the new topic. I firmly believe that all our esteemed members will take active part in this discussion.

Best Regards

Mohammad Bashaar

From: Geer M. Ishaq <ishaqgeer@...>Subject: Re: Thanks Dr Geer; welcome Dr Bashaarnetrum Date: Monday, June 30, 2008, 1:54 PM

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 – 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 belly” 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 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.

WITH REGARDS

Dr. Geer M. Ishaq

Sr. Lecturer

Dept. of Pharmaceutical Sciences

University of Kashmir

Srinagar-190006 (J & K)

Ph: 9419970971, 9906673100

E-mail: ishaq@kashmiruniver sity.ac.in

Website: http://ishaqgeer. googlepages. com

From Chandigarh to Chennai - find friends all over India. Click here.