October 9 is World Palliative Care Day. Every hour over 60 patients die in India from cancer and in pain. If the deaths from other lifethreatening illnesses are added, the number would be staggering. Such patients could have benefited from palliative care measures.

In Kerala every panchayat has around 100 patients who are bedridden or in need of palliative care. With 1000 panchayats in Kerala the number of such patients in need is around one lakh. On World Palliative Care Day, we express our solidarity with such patients and their families.

The WHO defines palliative care as the 'active total care of patients and their families by a multiprofessional team when their disease is no longer curable and life expectancy is predicted short'. The nature of illness could be any, even the aged need to be cared for. Today palliative care principles are juxtaposed into the treatment trajectory from the day of diagnosis. The word 'palliative' is derived from the Greek word 'Pallium' which means cloak or cover. Therefore in palliative care, symptoms are cloaked by a treatment plan whose primary aim of patient comfort is seeking to add 'life to years'. Palliative care is defined as a 'low technology but high touch 'specialty' (low tech and high touch). Touch is therapeutic, reassuring, and comforting.

Palliative care affirms life and regards dying as a normal process. It neither hastens nor postpones death. It integrates the psychological and spiritual aspects of care. It offers a support system to help patients to live as actively as possible until death. Palliative care is patientfocused and not disease centred. The concept of palliative care is opposed to euthanasia.

The first pain clinic in the country was started in 1985 at RCC, Trivandrum. Kerala Government became the first government in the world to have a 'Palliative care policy' passed in 2008 and to have it included in the primary health care system.

The Regional Cancer Centre is the only cancer centre in the world to have its own oral morphine manufacturing plant. Morphine is given free to poor patients in severe pain. The Regional Cancer Centre again is the only tertiary care cancer centre having a weekly 'teleclinic' on Tuesday afternoons dedicated to palliative care which benefits patients in an area 60 km around Adimali.

Hope: The hope structure in palliative care is to make the patient wanted and not to feel abandoned. It is to say 'No matter what happens to you we will not desert you' and 'You may be dying but you are still important to us'. In fact, good palliative care goes into the family in preparing for anticipatory grieving and bereavement support.

Rehabilitation of spouse and taking care of the children's future should be considered as ideal and essential in special circumstances. Such attitudes improve the 'hope quotient' of patients.

'Good Death,' the British medical journal, came up with a special edition in 2003 describing as to what constitutes a 'good death'. A good death is to have known when death was approaching and to have accorded the person dignity and privacy. The patient dies without distress or pain in the place of his/her choice which is usually the home environment. It behoves us to give the same care to those who 'leave life,' the care we gave them when they 'entered life.'

Fresh 79 cases of dengue have been reported in the national capital on Friday.

According to health officials, the new cases have taken the total number of people affected by the deadly disease to 3,938.

The officials added that Civil Lines region in the city reported the highest number of dengue cases.

An official of the Municipal Corporation of Delhi (MCD) said that 508 dengue cases have been reported from Civil Lines thus far.

As per reports, seven people have lost their lives owing to the disease during the season.

The other regions, which reported the dengue cases, include South Delhi (502), Rohini (464) and Central Zone (407).

In the meantime, twenty (20) cases of chikungunya have been reported in 2010.

The national capital has also reported 112 cases of malaria this season.

A new book by an eminent American dietician presents a unique programme to tackle breast cancer - for healthy women as well as for those who are recovering from the disease.

'Everything I included or omitted from my diet was based on a good deal of substantiated scientific study,' The Daily Mail quoted Dr Mary Flynn, Assistant Professor of Medicine at the prestigious Brown University in the U.S., as saying.

Flynn debunks, in her book titled 'The Pink Ribbon Diet', theories such as avoiding high fat foods and alcohol in one's diet. The diet proposed by her is essentially a modified form of the Mediterranean Diet.

Cut out red meat: Meat, poultry and seafood don't have the same cancer-fighting properties of other foods, said Flynn. An ideal cancer-fighting diet would be totally vegetarian.

Every day you should have:

Starch: 6-7 servings per day - a slice of bread, one pitta, half a bagel, 3 cups air-popped popcorn.

Vegetables: Unlimited, but at least four servings per day (ideally cooked in olive oil).

Fat: 4-5 servings per day, at least three from olive oil - 2 tablespoons nuts, one-tablespoon peanut butter, 1/4 avocado, 100g stoned olives.

Fruit: 3 servings per day - 1 apple, 4 apricots, half a banana, 13 cherries, 17 grapes, 11/2 kiwis, 1 nectarine, 1 orange, 1 peach, 2 plums, 3 prunes, 2 tablespoons raisins.

Dairy: 2 servings per day - 1 cup/250ml skimmed milk, 1 large egg, 1 oz/25g hard cheese, 4oz/100g cottage cheese, 125ml yoghurt.

Meat: Optional, but don`t have more than 12oz of poultry and seafood (roughly two chicken or fish fillets) per week.

A typical day's food would be:

Breakfast (about 400 calories):
2 servings of wholegrain starch.
1-2 servings of fat (eg nuts and nut butters).
1 serving of deep-coloured fruit.

Optional: One or two servings of dairy and any amount of vegetables.

Lunch (500-600 calories):
2 servings wholegrain starch or beans.
2 servings of vegetables.
1-2 tbsps extra virgin olive oil.
1-2 servings of fruit (preferably deep-coloured).

Optional: Cheese, egg, nuts (substitute for olive oil), some of your meat, poultry, or seafood allowance.

Dinner (500-600 calories):
3-4 servings of wholegrain starch or beans.
2 or more servings of vegetables.
1-2 tbsp extra virgin olive oil.
1 serving of fruit (preferably deep-coloured).

Optional: Cheese, some of your meat, poultry, or seafood allowance.

Vegetables with deeper colour contain more carotenoids, linked to lower breast cancer risk. Broccoli, carrots, peppers, spinach, beetroot, tomatoes and pumpkin are particularly rich in carotenoids.

Cucumber, okra, spinach, sweet potato, processed tomatoes, green peppers, radishes, courgettes and broccoli all contain salicylic acid, an anti-inflammatory thought to lower breast cancer risk.

Most fruits are high in the anti-inflammatory agent, salicylic acid. The deeper the colour of the fruit, the more abundant the carotenoids - and the better it is for you.

Apricots, berries, and citrus fruits are also rich in antioxidants.

Milk is unlikely to increase cancer risk, but you might want to substitute with soya milk, which has been linked with anti cancer properties. Avoid soy if you are taking the anti-cancer drug Tamoxifen, though, because it interferes with its absorption.

What to avoid:

Meat: Meat contains amino acids that stimulate insulin - and high insulin levels have been linked to breast cancer. Amino acids can also be converted in our bodies to homocysteine, a compound linked to disease-causing inflammation.

You should particularly avoid cured meats, such as ham or salami, which contain carcinogenic sodium nitrates.

Oily Fish: 'Studies show that just adding omega-3s (found in fish oil) to your diet will not make you healthier; nor do they protect against cancer,' she said.

So avoid margarine and vegetable oils such as sunflower or corn oil.

LONDON: A 15-year-old boy has become the world's first child to be implanted with an artificial heart. The unnamed Italian boy had the 10-hour operation last week and was said to be well in intensive care.

As he has the muscle-wasting illness Duchenne's synd rome, he was ineligible for a heart transplant. He was close to death when surgeons decided to save him with the artificial heart.

Antonio Amodeo carried out the operation at Bambino Gesu children's hospital in Rome, the Daily Mail reported.

Officials said the artificial heart is expected to give the boy another 20-25 years of 'normal life'.

Amodeo said the heart is 2.5 inches long and was placed inside the left ventricle and its connection with the ascending aorta.

"The device is an electrically activated hydraulic pump and is entirely located inside the thorax, in order to reduce the risk of infection," he said.

"It is powered through a plug positioned behind the left ear and connected to a battery that the patient holds on a belt and is charged during the night like a mobile phone," Amodeo added.

"This is the first time such a device has been placed in a young child and should give him an improved quality of life even though he is suffering from Duchenne's syndrome," he said.

Eight-month-old Akshu weighed only 5 kg. She was suffering from liver failure caused by congenital absence of bile ducts and needed a liver transplant to survive. The only hurdle was her young age and small size.

On September 23, Army Hospital (R&R) at the Delhi Cantt successfully operated on Akshu, transplanting a portion of her father's liver in her to give the little girl a lease of life. Akshu has now become the youngest and smallest child to have undergone such a surgery.

The operation was conducted by Brigadier Anupam Shah and his team of doctors.

Akshu, daughter of Anil Kumar who is a jawan in the Army, was admitted to the hospital for jaundice and intestinal bleeding.

According to the Army Hospital officials, the complicated operation lasted for about 9 hours. They added that the child is recovering and could be discharged from the hospital in a week.