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Medicine and Alternative Medicine: Treatments for COVID-19

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Anika (8th Grade student, Texas) rewarded for doing computation to design a drug molecule aiming at destabilization of the Coronavirus

by Prof. Kirthi Tennakone
National Institute of Fundamental Studies (Email: ktenna@yahoo.co.uk)

Medicine is the science of understanding functions of the human body, finding causes of illnesses, indicating remedies and preventive measures. Being a science, it basically has no divisions – Western and Eastern or indigenous and foreign. Therefore, strictly speaking, there cannot be alternatives to medicine. Nonetheless, apart from mainstream scientific medicine, which is sometimes wrongly referred to as Western medicine, there are so-called alternative practices claimed to be effective or even superior.

Alternative medicine means, curative or preventive methods whose efficacies are not proven scientifically and may include formulations or procedures which might turn out to be shown effective by rigorous scientific scrutiny. Ones that pass this test would no longer be purported alternatives but scientifically supported treatments.

In 1775, the Scottish physician and chemist William Withering was astonished to observe his patient, dying of congestive heart failure, recovered after receiving alternative treatment from a local gypsy women. Withering noted the gypsy had prescribed an herbal decoction of many plant components including foxglove (a plant-related Neeramulliya used in Sri Lankan traditional medicine). He extracted the active ingredient digoxin from foxglove leaves – Today, World Health Organization lists digoxin as an essential drug.

Many opt alternative medicines for varying reasons – irresponsiveness of a treatment as in the case Withering’s patient, personal conviction, ignorance, placebo effect, affordability, empathy and approachability of practitioners.

Generally, alternative treatments are continuations of ancient arts in scripture, belonging to different schools or therapies passing from generation to generation, advocated by clans of physicians. Again new health products often emerge as commercially motivated fashions. The pandemic is an opportune moment for such commodities and quackeries.

Ayurveda and Traditional Chinese Medicine are the major complementary alternative practices based on ancient medicine. Similar systems that originated in Europe gradually disappeared with the advent of science. Although hypothetical arguments in ancient arts of healing raises many questions in the light of modern science, subjecting them to the classification under pseudoscience is unwarranted. Ancient and traditional arts of healing served the humanity for centuries – before medicine was refined to the status of a science. As evident from the Sanskrit text “Chakra Samhita” (600-900 BCE) Ayurveda was probably the first school of thought to realize the fundamental concept that diseases are curable and preventable by intervention. Reminding of this millennia old idea is exceedingly relevant today ever than before – the confidence, a cure for COVID-19 would be found and more importantly the immediate possibility of prevention by strict adherence to control measures. Ayurveda and Chinese traditional medicine have classified many illnesses and lists symptoms correctly, largely on basis of physical observations – likely to be the optimum expected in absence of science.

Ancient and traditional medicine would continue to benefit people, especially in situations where their arts are understood in terms of science as valid. To illustrate the point, I give an example: Children frequently get bleeding scratches on skin while playing. Today, parents apply an antiseptic lotion or antibiotic cream, some rush to see a doctor. Years ago villagers did not have these facilities. A popular home remedy has been to slice a tender coconut-nut (kurumbatti) transversely and grind it over the outside of a pot recently used for cooking and apply the paste over the scratch. Why is this recipe so effective? Surface of pot is sterile and shoot acts as an excipient to form a cream with the pulp of the nut rich in substances termed tannins. Tannins bind to proteins and kills germs and also concurrently stick to exposed surface of the skin stopping bleeding and forming hard bacteriostatic barrier.

Before commissioning clinical trials with traditional remedies for COVID -19 it may be prudent to identify ingredients therein and use chemistry knowledge insightfully to assess the possible potentialities.

Drugs used in ancient and traditional medicines are predominantly plants products. Sometimes minerals containing toxic heavy metals (arsenic, mercury) are also introduced because of the historical association of alchemy and ancient medicines. Around 20-25% of potent drugs prescribed in mainstream scientific medicine are derived from plants or their synthetic modifications. Just as the discovery of Digoxin, in many other instances, ancient and traditional medicines have provided clues for their identification, leading to development of antitumor agents, antimalarials, analgesics, etc.

Plants as immobile organisms defend themselves against invading microbes, insects and herbivores via molecular chemical weapons, which they manufacture. Naturally these molecules could also possess favourable medicinal properties – as evident from effectiveness of plant products in ancient and traditional medicine and highly potent purified plant derivatives in mainstream medicine. Certainly there exists many other medicinally valuable substances yet to be discovered in the diverse variety of plants on Earth.

Scientific literature is rich in reports suggestive of antiviral properties of compounds extracted from plants. Although to date there exists no plant based antiviral drug evaluated sufficiently for clinical use, the progress in current research seems to be promising. Modern antiviral drug research involves advanced techniques and computations to elucidate how the potential molecules interact with viruses and host cells, later followed by a series of preliminary experimentation and clinical trials.

Besides the modern scientific approaches, there are also claims to the effect that COVID-19 could be successfully treated with prescriptions of ancient or traditional medicine. Such claims made with integrity and honesty could not be causally dismissed, as even an empherical hint could lead to a major discovery. However, they needs to be rigorously evaluated before clinical use – remembering no country can afford to run clinical trials to test every quackery. While endorsing efforts of searching herbal medicines Dr. Prosper Tumusiime of the African Region World Health Organization Expert Committee on Traditional Medicine for COVID-19 said “Just like other areas of medicine sound science is the sole basis for safe and effective traditional therapies”.

Attempts to find cures for COVID-19 are commendable. Recently, Anika Chevrolet, an 8th grade school girl in Texas, United States, received an award of dollars 25,000 for doing a computation to design a drug molecule aiming at destabilization of the Coronavirus by binding it to a specific protein on the spikes of the pathogen. The chemical ingredients in herbal medicines may also be assessed for antiviral activity by methods similar to her calculation technique known as “In Silico Computational Drug Design”. We need to encourage and support this, the type of work, demanding real scientific inquisitiveness – no cost except a laptop and a brilliant mind.



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Strong on vocals

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The group Mirage is very much alive, and kicking, as one would say!

Their lineup did undergo a few changes and now they have decided to present themselves as an all male group – operating without a female vocalist.

At the helm is Donald Pieries (drums and vocals), Trevin Joseph (percussion and vocals), Dilipa Deshan (bass and vocals), Toosha Rajarathna (keyboards and vocals), and Sudam Nanayakkara (lead guitar and vocals).

The plus factor, where the new lineup is concerned, is that all five members sing.

However, leader Donald did mention that if it’s a function, where a female vocalist is required, they would then feature a guest performer.

Mirage is a very experience outfit and they now do the Friday night scene at the Irish Pub, in Colombo, as well as private gigs.

 

 

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Dichotomy of an urban-suburban New Year

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Ushered in by the ‘coo-ee’ of the Koel and the swaying of Erabadu bunches, the Sinhala and Tamil New Year will dawn in the wee hours of April 14. With houses to clean, preparation of sweetmeats and last-minute shopping, times are hectic…. and the streets congested.

It is believed that New Year traditions predated the advent of Buddhism in the 3rd century BC. But Buddhism resulted in a re-interpretation of the existing New Year activities in a Buddhist light. Hinduism has co-existed with Buddhism over millennia and no serious contradiction in New Year rituals are observed among Buddhists and Hindus.

The local New Year is a complex mix of Indigenous, Astrological, Hindu, and Buddhist traditions. Hindu literature provides the New Year with its mythological backdrop. The Prince of Peace called Indradeva is said to descend upon the earth to ensure peace and happiness, in a white carriage wearing on his head a white floral crown seven cubits high. He first plunges, into a sea of milk, breaking earth’s gravity.

The timing of the Sinhala New Year coincides with the New Year celebrations of many traditional calendars of South and Southeast Asia. Astrologically, the New Year begins when the sun moves from the House of Pisces (Meena Rashiya) to the House of Aries (Mesha Rashiya) in the celestial sphere.

The New Year marks the end of the harvest season and spring. Consequently, for farming communities, the traditional New Year doubles as a harvest as well. It also coincides with one of two instances when the sun is directly above Sri Lanka. The month of Bak, which coincides with April, according to the Gregorian calendar, represents prosperity. Astrologers decide the modern day rituals based on auspicious times, which coincides with the transit of the Sun between ‘House of Pisces’ and ‘House of Aries’.

Consequently, the ending of the old year, and the beginning of the new year occur several hours apart, during the time of transit. This period is considered Nonegathe, which roughly translates to ‘neutral period’ or a period in which there are no auspicious times. During the Nonegathe, traditionally, people are encouraged to engage themselves in meritorious and religious activities, refraining from material pursuits. This year the Nonegathe begin at 8.09 pm on Tuesday, April 13, and continues till 8.57 am on 14. New Year dawns at the halfway point of the transit, ushered in bythe sound of fire crackers, to the woe of many a dog and cat of the neighbourhood. Cracker related accidents are a common occurrence during new year celebrations. Environmental and safety concerns aside, lighting crackers remain an integral part of the celebrations throughout Sri Lanka.

This year the Sinhala and Tamil New Year dawns on Wednesday, April 14, at 2.33 am. But ‘spring cleaning’ starts days before the dawn of the new year. Before the new year the floor of houses are washed clean, polished, walls are lime-washed or painted, drapes are washed, dried and rehang. The well of the house is drained either manually or using an electric water pump and would not be used until such time the water is drawn for first transaction. Sweetmeats are prepared, often at homes, although commercialization of the new year has encouraged most urbanites to buy such food items. Shopping is a big part of the new year. Crowds throng to clothing retailers by the thousands. Relatives, specially the kids, are bought clothes as presents.

Bathing for the old year takes place before the dawn of the new year. This year this particular auspicious time falls on April 12, to bathe in the essence of wood apple leaves. Abiding by the relevant auspicious times the hearth and an oil lamp are lit and pot of milk is set to boil upon the hearth. Milk rice, the first meal of the year, is prepared separate. Entering into the first business transaction and partaking of the first meal are also observed according to the given auspicious times. This year, the auspicious time for preparing of meals, milk rice and sweets using mung beans, falls on Wednesday, April 14 at 6.17 am, and is to be carried out dressed in light green, while facing east. Commencement of work, transactions and consumption of the first meal falls on Wednesday, April 14 at 7.41 am, to be observed while wearing light green and facing east.

The first transaction was traditionally done with the well. The woman of the house would draw water from the well and in exchange drop a few pieces of charcoal, flowers, coins, salt and dried chillies into the well, in certain regions a handful of paddy or rice is also thrown in for good measure. But this ritual is also dying out as few urban homes have wells within their premises. This is not a mere ritual and was traditionally carried out with the purification properties of charcoal in mind. The first water is preferably collected into an airtight container, and kept till the dawn of the next new year. It is believed that if the water in the container does not go down it would be a prosperous year. The rituals vary slightly based on the region. However, the essence of the celebrations remains the same.

Anointing of oil is another major ritual of the New Year celebrations. It falls on Saturday, April 17 at 7.16 am, and is done wearing blue, facing south, with nuga leaves placed on the head and Karada leaves at the feet. Oil is to be applied mixed with extracts of Nuga leaves. The auspicious time for setting out for professional occupations falls on Monday, April 19 at 6.39 am, while dressed in white, by consuming a meal of milk rice mixed with ghee, while facing South.

Traditionally, women played Raban during this time, but such practices are slowly being weaned out by urbanization and commercialisation of the New Year. Neighbours are visited with platters of sweetmeats, bananas, Kevum (oil cake) and Kokis (a crispy sweetmeat) usually delivered by children. The dichotomy of the urban and village life is obvious here too, where in the suburbs and the village outdoor celebrations are preferred and the city opts for more private parties.

 

 

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New Year games: Integral part of New Year Celebrations

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Food, games and rituals make a better part of New Year celebrations. One major perk of Avurudu is the festivals that are organised in each neighbourhood in its celebration. Observing all the rituals, like boiling milk, partaking of the first meal, anointing of oil, setting off to work, are, no doubt exciting, but much looked-forward-to is the local Avurudu Uthsawaya.

Avurudu Krida or New Year games are categorised as indoor and outdoor games. All indoor games are played on the floor and outdoor games played during the Avurudu Uthsava or New Year festival, with the whole neighbourhood taking part. Some of the indoor games are Pancha Dameema, Olinda Keliya and Cadju Dameema. Outdoor games include Kotta pora, Onchili pedeema, Raban geseema, Kana mutti bindeema, Placing the eye on the elephant, Coconut grating competition, Bun-eating competition, Lime-on-spoon race, Kamba adeema (Tug-o-War) and Lissana gaha nageema (climbing the greased pole). And what’s an Avurudhu Uthsava sans an Avurudu Kumari pageant, minus the usual drama that high profile beauty pageants of the day entail, of course.

A salient point of New Year games is that there are no age categories. Although there are games reserved for children such as blowing of balloons, races and soft drinks drinking contests, most other games are not age based.

Kotta pora aka pillow fights are not the kind the average teenagers fight out with their siblings, on plush beds. This is a serious game, wherein players have to balance themselves on a horizontal log in a seated position. With one hand tied behind their back and wielding the pillow with the other, players have to knock the opponent off balance. Whoever knocks the opponent off the log first, wins. The game is usually played over a muddy pit, so the loser goes home with a mud bath.

Climbing the greased pole is fun to watch, but cannot be fun to take part in. A flag is tied to the end of a timber pole-fixed to the ground and greased along the whole length. The objective of the players is to climb the pole, referred to as the ‘tree’, and bring down the flag. Retrieving the flag is never achieved on the first climb. It takes multiple climbers removing some of the grease at a time, so someone could finally retrieve the flag.

Who knew that scraping coconut could be made into an interesting game? During the Avurudu coconut scraping competition, women sit on coconut scraper stools and try to scrape a coconut as fast as possible. The one who finishes first wins. These maybe Avurudu games, but they are taken quite seriously. The grated coconut is inspected for clumps and those with ungrated clumps are disqualified.

Coconut palm weaving is another interesting contest that is exclusive to women. However men are by no means discouraged from entering such contests and, in fact, few men do. Participants are given equally measured coconut fronds and the one who finishes first wins.

Kana Mutti Bindima involves breaking one of many water filled clay pots hung overhead, using a long wooden beam. Placing the eye on the elephant is another game played while blindfolded. An elephant is drawn on a black or white board and the blindfolded person has to spot the eye of the elephant. Another competition involves feeding the partner yoghurt or curd while blindfolded.

The Banis-eating contest involves eating tea buns tied to a string. Contestants run to the buns with their hands tied behind their backs and have to eat buns hanging from a string, on their knees. The one who finishes his or her bun first, wins. Kamba adeema or Tug-o-War pits two teams against each other in a test of strength. Teams pull on opposite ends of a rope, with the goal being to bring the rope a certain distance in one direction against the force of the opposing team’s pull.

Participants of the lime-on-spoon race have to run a certain distance while balancing a lime on a spoon, with the handle in their mouths. The first person to cross the finish line without dropping the lime wins. The sack race and the three-legged race are equally fun to watch and to take part in. In the sack race, participants get into jute sacks and hop for the finish line. The first one over, wins. In the three-legged race one leg of each pair of participants are tied together and the duo must reach the finish line by synchronising their running, else they would trip over their own feet.

Pancha Dameema is an indoor game played in two groups, using five small shells, a coconut shell and a game board. Olinda is another indoor board game, normally played by two players. The board has nine holes, four beads each. The player who collects the most number of seeds win.

This is the verse sung while playing the game:

“Olinda thibenne koi koi dese,

Olinda thibenne bangali dese…

Genath hadanne koi koi dese,

Genath hadanne Sinhala dese…”

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