Khaas Baat : A Publication for Indian Americans in Florida
Health & Wellness

Integrating CAM therapies into Mainstream Practice: Part III


The previous two columns gave you some idea about the alternate therapies, mainly herbal products that are popular with the public. There are many more such remedies on the market that tout health benefits for multiple conditions. When I visited an Indian grocery store recently, these products were prominently displayed in a special shelf. Included were neatly packaged bottles of pills with appealing labels along with their therapeutic benefits such as Arjuna - well known for blood circulation; Ashwagandhi - Indian Ginseng; Shatavari - most beneficial for women’s health; Digestofit - for improving digestion; Karela - has metabolism-regulating properties, including improvement of diabetes; Valerian - for restful sleep, etc. Whether they actually deliver the promises as labeled is debatable. Some of them like Karela, Valerian and Ashwagandhi may have some beneficial effect. However, use them with caution.

I will discuss a few more commonly used herbal products. As you know, it is impossible to cover the entire spectrum of herbal products available on the market.

Aloe vera: widely used in cosmetic industry, it is an emollient and promotes skin healing in burns because of its antibacterial and antifungal properties. It can be used for constipation too.

Ephedra (Ma huang) is sometimes used for treating asthma, bronchitis and nasal congestion. The principal alkaloid is ephedrine and acts by releasing norepinephrine from body stores. Dietary supplements that contain ephedra alkaloids are widely promoted and used in the United States for weight loss and increased energy. Ephedrine and related alkaloids have been associated with adverse cardiovascular events, including heart attacks, severe hypertension and lethal cardiac arrhythmias. One of my obese patients who started taking ephedra developed frequent palpitations and had to quit taking it. So, beware.

Oleander: Oral oleander was once used for treating mild heart failure, but is now considered too dangerous for medicinal use.

Hawthorn has some positive effects on the heart; it improves the heart muscle function in mild heart failure. It may also have a favorable effect on hypertension, atherosclerosis, etc., and is frequently used in Germany. Several clinical studies of patients diagnosed with heart failure have shown objective improvement in cardiac performance using bicycle exercise tests and other objective parameters. However, there are better and standardized drugs available for heart failure.

Red yeast rice, classified as a dietary supplement is a popular product available in health food stores and used to reduce cholesterol because it contains naturally-occurring substances called monacolins, especially the one called Lovastatin. The refined form, lovastatin itself, is a prescription drug for hypercholesterolemia. If you can get your cholesterol levels to the target as recommended by American Heart Association with red yeast rice and if it is cheaper than lovastatin available in pharmacies, I have no objection in taking this remedy.

Recently, however, FDA has banned red yeast rice products containing lovastatin and I understand the manufacturers of these products have since recalled them. So, please check the label and make sure they contain lovastain before it is used as a lipid-lowering drug.

There are many more products on the market. Kava Kava, the most revered herb in polynesia has mild relaxing effect. President Lyndon B. Johnson and Pope John Paul II were treated to a cup of Kava Kava drink when they visited U.S. Samoa and Fiji respectively. Senna is a mild laxative, Liquorice may reduce inflammation.

There is a lot of politics governing herbal medicine therapy and marketing in the United States. Although herbal therapy is a large part of traditional medicine around the world, FDA is strict and has manufacturers submit proof that these medicines work. Generally, I am cautious in prescribing any medication because of potential side effects. Herbal products, being advertised as natural, may seem more appealing but many of them are not refined and dosages and titration not often clear as with allopathic drugs. So, my recommendation is to use them with caution and always let your treating physician know what you are taking because of the potential and sometimes dangerous interactions with the concomitant allopathic medicines. Consumers are often exposed to media propaganda, some overemphasizing the risk and underplaying the benefits but others exaggerating the virtues of these products. Try not to fall for any of this hype. Since National Center for Complementary and Alternative Medicine (NCCAM) is conducting ongoing scientific research on these therapies, the consumer is advised to follow its recommendations.

To be continued . . .

Dr. M. P. Ravindra Nathan is a Brooksville cardiologist.


LASER ‘ERASER’: Clearing Corneal Scars


The cornea is the front clear window of the eye and comprises of five layers. The shape of this cornea determines the visual error (glasses prescription) for each individual person. Therefore, eyes with curved (steep) corneas are myopic (nearsighted), those with flat corneas are hyperopic (farsighted), and football-shaped corneas are astigmatic (Refer to my previous article in September 2012 Khaasbaat: “Football and Vision: The Astigmatism Connection”).

A healthy cornea is clear and transparent. This is essential for good vision and therefore any loss of transparency from minimal haze to scarring can decrease the vision in that eye.

Corneal scars can occur from various causes, including contact lens-related infections, trauma, LASIK complication, previous Radial keratotomy, PRK surgery and even dry eyes.

The way to correct a corneal scar has traditionally been replacing the cornea with a donor cornea (cadaver eye cornea) by a surgery called corneal transplant. It is one of the most successful transplant surgeries in the field of medicine but is inherently interventional. In most cases, it results in high astigmatism (since it is stitched by hand) despite a clear cornea and hence leaves the patient with less than perfect vision, chance of rejection of this tissue and a potential weakness in the ocular anatomy in case of future accidents or trauma.

In these moderate times with heightened expectations for excellent vision and a desire for minimalistic, elegant interventions, the same laser used for LASIK surgery can be used to address most of the anterior corneal scars to help people see once again.

That the shape of the cornea decides vision and adding this to the concept of optics (according to which the front curvature of a lens is more important than the back impurities), LASIK laser can be used to shape the cornea despite its anterior scar to result in vision, in most cases, even without glasses.

Think of this concept as a carpenter’s plane shaping a piece of wood where while shaping that piece of wood, the shavings that come off are the scar. So, the focus of the surgery is not so much the scar but actually the shape and the scar coming off is actually a welcome side effect.

This modern, elegant and minimalistic approach of Corneoplastique™ to address anterior corneal scars in a three-minute surgery using numbing drops only and resulting directly in vision in most cases even without glasses is the future direction.

Corneal transplants can always be a backup surgery and finally find its place in what it was originally meant to be – a last resort.

Arun C. Gulani, M.D., M.S., is director and chief surgeon of Gulani Vision Institute in Jacksonville. He can be reached at or visit

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