Fruits

Lychee Dangers & mysterious deaths #AtoZ

By Dr.Amrita Basu(MBBS,MS) on April 14, 2017 23

Lychee is a tropical fruit, with about 7 Lychee giving your daily dose of Vitamin C. It’s a sweet fleshy fruit, which if had in large amounts can cause stomach cramps and loose motion.

But today I will tell you about a mysterious disease surrounding Lychee.

Lychee contains many phytochemicals. The seeds contain methylene cyclopropyl glycine (MCPG).A chemical with a suspicious role in lowering blood glucose to dangerous levels.

MCPG Hypoglycemia

Hypoglycemia is a condition of decreasing blood glucose, which may have acute and long-term effects. For the growing brain, it’s really bad because glucose is the only brain food. The brain survives on glucose as its main energy molecule.No sugar, the brain can stop!

Acute effect of low blood sugar includes convulsions and even death. Chronic hypoglycemia can lead to a long-term poor neurodevelopmental outcomes in children.

The True story ..stranger than fiction

Children came from lychee-growing areas, with convulsions in the early hours of the morning. Then before they could be stabilized, they tragically died. Nothing seemed to work. Till the blood workup of a few older children who could fight it longer, came back.

These outbreaks of encephalopathy occurring in Indian and Vietnamese children were traced back to Lychee.

Several investigation teams found the condition related to hypoglycin A and MCPG toxicity. Malnourished children eating lychees (especially unripe ones) on an empty stomach and remaining empty stomachs even after that may have life-threatening hypoglycemia. Lychee may also contain unusual amino acids. which influence gluconeogenesis and β-oxidation of fatty acids, exacerbating the acute illness.

What happened: Details

An unusual, rapidly deteriorating outbreak of acute encephalitis syndrome (AES) with high case fatality was reported from Kaliachak- I, II, and III Blocks of Malda District of West Bengal in the month of June 2014 affecting 72 children with 34 deaths.
Children belonged to age groups from 9 months to 10 years, belonging to the low socioeconomic background of the lychee growing belt of Malda.
Male :(65% approx).

The case Fatality Rate was 47.2%.

The main presenting features:

Sudden onset of convulsions (100%) in the early hours of the morning
Rapid progression to unconsciousness (100%)
Decerebrate rigidity (47%).
Fever was present in around one-third of cases.
Hypoglycemia (low blood sugar) and leukocytosis(increase in white blood cells ) were two predominant laboratory features

Clinical samples subjected to molecular and serological testing were all found negative for known viruses causing acute encephalitis.

What treatment did they receive?

All cases were treated with 10% dextrose infusion in addition to standard treatment protocol with anticonvulsants, anti-edema measures like 20% mannitol, antipyretic (acetaminophen) along with other necessary measures. Serial blood glucose monitoring was done.
At first contact, health care workers and ward sisters were advised, to start dextrose(a type of sugar ) as soon as they saw the cases as the time from reporting to the fatal outcome was horrifyingly low.
Dextrose helped correct the hypoglycemia and helped reduce the fatality in the later reported cases.

Conclusion

Genetically susceptible, malnourished child ,who had litchi in large quantity followed by prolonged period of fasting can lead to metabolic encephalopathy .

The CDC report recommended that parents check , lychee consumption in children .Definitely have an evening meal, elevating blood glucose levels .Both these may help in avoiding this horror.

2 strange unexplained events:

The cases were more during the scorching days. Declined after rain showers.
Though no identifiable virus was not found and exact etiology couldn’t be identified, that hypoglycemia had a role to play is undisputed.

Research continues to find out the exact reasons. Till then it’s better to be safe.Increasing education and awareness about the condition in litchi growing belts have prevented recurrence of cases .

Disclaimer:

All information in this post is for information purposes and is to be taken with respect to the reference provided.

References:

1)Research paper: Epidemiological Investigation of an Outbreak of Acute Encephalitis Syndrome (AES) in Malda District of West Bengal, India. Available from: https://www.researchgate.net/publication/277249892_Epidemiological_Investigation_of_an_Outbreak_of_Acute_Encephalitis_Syndrome_AES_in_Malda_District_of_West_Bengal_India

Bhaswati Bandyopadhyay1*, Debjit Chakraborty2, Sibarjun Ghosh3, Raghunath Mishra4, Mehebubar Rahman1, Nemai Bhattacharya1,Soleman Alam5, Amitabha Mandal5, Anjan Das6, Abhijit Mishra6, Anand K Mishra7, Arvind Kumar7, Surya Haldar1, Tarun Pathak6, NepalMahapatra6, Dilip Kumar Mondal5, Dipankar Maji8 and Nandita Basu1

2) “Litchi virus kills 8 kids in Malda”. Times of India. 8 June 2014. Retrieved 12 June 2014.

3)https://www.nytimes.com/2017/01/31/world/asia/lychee-litchi-india-outbreak.html?_r=0

4)https://www.theguardian.com/global-development/2016/jan/14/lychee-fruit-deaths-malnourished-children-india

Protected: KIWI :Superfood,Sleep & a Scare#AtoZ

By Dr.Amrita Basu(MBBS,MS) on April 13, 2017 32

Jackfruit : Jack of all fruits #AtoZ fruits

By Dr.Amrita Basu(MBBS,MS) on April 12, 2017 25

In my childhood home in Kolkata, we have a small backyard. In an unpaved corner, my grandfather had planted a Jackfruit tree.I grew up eating fruit from our own tree, even in an urban setup.That was the beginning of my love for plants and trees.The shade of this tree made our home cool, even in the scorching summers.

Jackfruit :Ripe,delicious,juicy and just perfect.

In Bengali, the young tender jackfruit is called echor and the ripe variety ,kathal.The fruit is great cooked raw as a savoury dish, or eaten as a ripe fruit.Either way, it’s delicious if had at the right time.It has a tough slightly spiky outer skin and a very sticky inner gum ,which needs to be removed before the fruit can be enjoyed.
The seed of the fruit when dried and fried and gives a wonderful nutty flavour in dishes.The seeds can be boiled, fried or baked.Echor as the raw variety can be made into mouth-watering spicy dishes.It is often cooked just like mutton , with all spices possible.It makes a delicious nonvegetarian variation called echor chingri with prawns!

Jackfruit benefits

It’s a rich source of Vitamin B6 or Pyridoxine and is a rare fruit which has significant amounts of B complex vitamins.It also has some amount of Vitamin C, E .The fresh fruit is also a good source of potassium, magnesium, manganese, and iron.

Cool fact to improve GK & brain power

Jackfruit is the national fruit of Bangladesh.It is the largest of all fruits, weighing between 4.5 to 30 kg Jackfruit is a multiple aggregate fruit It is actually an inflorescence where each floret turns into a fruit
Jackfruit trees have up to 150 jackfruits during two yearly harvests.They grow in very hot climates and the tough skin of the fruits is a natural deterrent to pests.Jackfruit is grown across several countries of south and south-east Asia ,providing for some of the planet’s poorest and most populous countries.
India is the largest producer of Jackfruits an economically important tree.It is also an ornamental tree, popular for bringing good luck to the household.
Have you tasted Jackfruit?Comment below to let me know.

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Which fruit prevents Urinary tract infection?

You can find the answer if you read my A to G fruit posts.(Top clue: check out C !)

Protected: Indian Gooseberry : Cancer protective Wonderberry

By Dr.Amrita Basu(MBBS,MS) on April 11, 2017 17

Protected: Healthy hair : Golden rules +#Contest

By Dr.Amrita Basu(MBBS,MS) on April 10, 2017 27

Fruits and vegetables..nature’s multivitamins

By Dr.Amrita Basu(MBBS,MS) on April 9, 2017 48

Fruits and veggies are nature’s multivitamins

Nature’s bounty of fruits and vegetables are an easy way to add the much-needed multivitamins to our diet.Vitamin supplements never look half as good and no comparison is possible regarding taste.

Many of the vitamins have their source in fruits and vegetables. Some, however, may have animal products as their best sources.

An easy way to remember:

Water soluble vitamins like B complex and C: Main source fruits and veggies

Fat soluble vitamins: Vitamin A, D, E, K

Source:Animal products,eggs,meat,beef,poultry.

Our busy schedule and lack of motivation often derail all our good resolutions.While on a self-improvement trip, I was able to increase the daily dose of this goodness, hence this post! Hope it helps, to get you motivated and add more nature’s goodness to your diet.

Top 5 Reasons to make fruits and veggies our best friends

Vitamin A: Keeps our eyes healthy

Richest source is orange and yellow fruits and veggies. Carrots are a very good source.

As Retinol:Liver,fatty fish,eggs

As Beta-carotene: Red and yellow coloured veggies.Carrots, tomatoes, green leafy vegetables, sweet potatoes

Vitamin B: Important for best energy production and repair of muscle tissues.Helps to keep our digestive system healthy.

Vitamin B: Richest source germinating sprouts and most fruits and veggies

Sources of B-Complex vitamins:

Thiamine: Yeast, pulses, wheat, rice (paroled and milled), bread

Riboflavin: Milk and milk products, eggs, papaya, dried apricots, leafy veggies

Niacin:Liver,kidney,peanuts,beef,mutton,pork,wholemeal cereals,pulses

VitaminB6:Avocado,banana,legumes (dried beans),meat,nuts,poultry,whole grains.

Folate:Liver,peanuts,green leafy veggies ,avocado ,pulses.

Vitamin B12: Milk and milk products, meat

Vitamin C, E: Both these are antioxidants.They help prevent cellular damage hence has anti-aging property, helps prevent cancer.

Vitamin C sources: All sour fruits.Amla,oranges, lemon,guava,mango,papaya,pineapple, green leafy veggies,tomato,lettuce,radish

Vitamin E: Fish oils, nuts, wheat germ, beef and organ meat, sunflowers seeds, eggs, green leafy veggies.

Vitamin D, K: Keeps our skin, hair, bones healthy, role in proper blood clotting and overall neuromuscular health.

Vitamin D Source: fish oil(cod liver oil), liver, egg yolk.

Vitamin K Source: Green leafy vegetables, dried herbs, dried prune green tea, also produced by probiotic organisms in the intestine.

Fruits and vegetables :Nature’s mutivitamins are packed full of delicious goodness.5 servings are a must .More the merrier .But the less you have it ,bigger the health problems.Know how you can get them into your daily diet without breaking a sweat.

How to change ..slow and steady….the rule of 5

5 Servings per day

2 servings of fruit,3 or more of veggies, would be best, but it’s better to be slow, steady and consistent. Gradually increasing number of fruits and vegetable in every meal helps to increase the total daily intake.

5 Trick to do this

Breakfast

Bananas , apples , grapes, berries,various nuts, fig raisins with oats or corn flakes
Fruit smoothie
Spanish omelette with sprouts, carrots, French beans.onions, tomatoes, peas and any other veggies you want.

Lunch: Indians love their sabzi as a side dish, so this is generally not a problem

Sauté seasonal veggies in olive oil, add salt pepper, nuts, raisins and a portion of brown rice.garnish with lemon wedges.
Salad of cucumber, apples, pears, shredded carrots, oranges and pineapples any others.
Raita/ yoghurt with diced veggies, fruits of your choices.

Dinner

Grilled chicken with grilled veggies like carrots, beans tomatoes, peas.
Salad of cucumber, onions Tomatoes.

Snack

Diced carrots, tomatoes, onions with boiled chickpeas/ roasted peanuts/muri (puffed rice)/sprouts with a dash of salt, lemon, black pepper.

Dessert

Sweet fruits like mangoes, apples watermelon, ripe papaya, grapes, sweet berries, custard apple, by themselves are deserts but if you crave chocolate something, dip fruit of your choice in molten dark chocolate.

How to start and stick with the plan

Slow and steady definitely wins the race in this case.Whatever be the number of fruits and veggie servings you have nowadays, try to increase at least by one serve per week. A gradual lifestyle transition causes less havoc than a drastic change.
Enjoy fruits as a family together, we started having fruits in front of our toddler which made her have them enthusiastically without much trouble.

Have them as salads, chats, snacks, side dish, main dish, dessert, drink any way you want.

Buy fresh, eat whole or cut, with or without seasoning just have them.Not only do they provide us with essential micronutrients, their fibre and water content and minimal calorie count make them ideal for losing weight and keeping it off the healthy way, so keep on munching!

One small step in the right direction is a leap towards a healthier and happier life.Stay healthy, stay happy and remember Health is Wealth!

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