Is planting of saplings all there is to World Environment Day?

If most schools were not closed for summer vacation on June 5^th, the World Environment Day, students would have had to stand in the sizzling heat and clap their little hands as principals, teachers or guests undertook the annual ritual planting of samplings in the school compound. While it is true that felling of tress has made the world a lot less green, and that tree leaves soak in a good bit of the excess carbondioxide that we emit in producing global warming, I feel we need to move in more directions and with greater thrust.

In fact, under this year’s theme 'Many Species. One Planet. One Future', people from different parts are celebrating diversity, with sessions to name a gorilla to preserving rare species on the verge of extinction. To highlight environmental issues celebrations are being undertaken for 3 to 7 days so as to draw in every person into the event, as each person’s conviction and participation is crucial if the palnet has to survive.

The environment is also no longer just that abstract noun, as intangible as the government. It has 2 parts: the natural environmnet (forests, seas, mountains etc) and built ones (cities, roads, water supplies, buildings, and in fact even schools), and a great degree of expertice is going into specializing and subspecializing int these areas.

The health concerns of the environment has been categorized as:

• Air quality, including both ambient outdoor air and indoor air quality, which also comprises concerns about environmental tobacco smoke.

• Climate change and its effects on health such as deaths due to heat waves and floods

• Disaster preparedness and response as in the Mangalore air crash and several train accidents

• Foodsafety, including in agriculture, transportation, food processing, wholesale and retail distribution and sale.

• Housing, including substandard housing abatement and the inspection of jails and prisons.

• Liquid waste disposal, including city wastewater treatmentplants and on-site waste water disposal systems, such asseptic tank systems and chemical toilets.

• Noise pollution control.

• Occupational health and industrial hygiene.

• Radiological health, including exposure to ionizing radiationfrom X-rays or radioactive isotopes as happened recntly in Delhi.

• Safe drinking water.

• Solid waste managementVector control, including the control of mosquitoes, rodents, flies, cockroaches and other animals that may transmit pathogens.

While the list is long here are 3 points that each citizen might like to help play a role in:

1. Plastic is one the worst scourges causing floods, choking drains and putting 655 of the world population at risk of malaria. Banning or stopping their use can take us far.

2. Using energy efficient devices such as CFL bulbs will cut down our CO2 emissions and reduce global warming.

3. Most wars in future will be waged for water. Water harvesting or saving strategies such as more efficient WCs can help conserve this scant resource.

It is time we looked beyound merely planting saplings on June 5^th.

Alzheimer’s Disease

The quick witted and dashing trade union leader George Fernandes, who went on to become the defence minister of India and is remembered for his fabled flight in a Mig fighter aircraft, is now unable to recognize his own relatives and recall his own name. The “cowboy” American president Ronanld Reagan, the tough no-nonsense British prime minister Margaret Thatcher, and the Hollywood heartthrob Charlton Heston are also among the  26 million suffers worldwide afflicted by Alzheimer’s Disease, that robs  mental functions and reduces one to a blank vegetative state till they die.

Alzheimer’s Disease (AD) is on the rise and is being increasingly recognized. The mother of a senior executive in Lucknow, who suffered from this disease and had became comatose was, in a rare show of  devotion, kept alive for 5 long years with life support at home. And some healthy relatives have cobbled together a group to learn and share from each other about how to care for their affected seniors.

The disease starts usually after 65, and manifests slowly and subtly with forgetfullness of recent events and names (What did the new plumber say his name was? Who had come home last night to meet us?). Some may experience change in moods, undue concern and anxiety, forgeting to do the daily chores or the way back home from an evening walk, and failing to get the right word during cnversation. The withdrwal then begins, as the person sinks into apathy (not quite bothered about a family function going on in the drawing room) and the stare becomes unrecognizing and hollow.

The burden of AD on the family can be heavy. When a husband fails to recognize his spouse of 40 years, it can shatter the heart. Relatives are often caught in a dilemna of whether to let life go on as usual with the affected senior confined to a room with hired attendants (often brings feelings of guilt) or cut out much of the fun of life and stay together indoors with him (not fair to young children, and often hardly matters to the patient as he is obtunded and apathetic to realize).

What causes AD is unclear and is the subject of intense global research. The brain shrinks and develops plaques of a jelly like substance called amyloid. One of the chemical transmitters of the brain, acetylcholine, dries up leading to poor functioning and networking between various parts of the brain.

While the quest for a magic potion for AD continues, scientists have been trying to identify who might be at risk (smokers, diabetics, hypertensives) and what factors might protect (high consumption of fresh fruits, chocolates, coffee and interest in board games).  The familiar dietary ingredient, “haldi (turmeric, curcumin), loaded with anti-oxidants, has emerged as a front runner for  cure.

When I see a patient of AD I am reminded of the old adage “All good things in life are lent, not given”. Our fertile brains are no exception !!

As published in HT City Hindustan Times (Lucknow)

Awareness is the Key to Conquering Hepatitis in India

Of the several special “reminder” days that are scattered across the yearly calender, 19^th May has been declared World Hepatitis Awareness Day. Some may argue if this yet another “Day” was indeed necessary, now that we already have so many that it is hard to remember.

If World AIDS day (December 1) can be celebrated with such gaiety and World Malaria day (April 25) with such feverishness, Hepatitis surely deserves much more! While only 0.3 % of the Indian population is infected with the HIV virus, atleast 10 times more (3%) harbour the Hepatitis B infection. And with 1% of the Indian population harbouring Hepatitis C (3 fold more than HIV), around 4% of us harbour one of the 2 chronic Hepatitis infections. And most of us do not know about it, as it takes almost 20 years before symptoms and signs of liver disease appear!

Strangely, Hepatitis, especially Hepatitis B, has become a glaring example of the disconnect betweent progress in scientific research and its impact on our society. If small pox could be eradicated because of a very effective vaccine and polio seems to be on its way out for the same reason, Hepatitis B ‘s case for eradication is equally strong. The recombinant Hepatitis B vaccine is considered to be the safest and most effective of all vaccines. Further the exorbitant price of Rs 500 per dose at which the vaccine was initially priced has come down to Rs 20 per dose, offering a life time protection at Rs 60 for 3 doses.

What needs to be achieved now is more through awareness and action rather than science that World Hepatitis Awareness day is aiming at. The theme  “Am I number 12?” will  remind people that every 12^th person in the world is infected with hepatitis. And if diagnosed on time, the infection is treatablem as well.

To tackle this problem, several liver specialists from SGPGI, doctors from UP and philanthropists have started a Liver Foundation (www.liverfoundationindia.blogspot.com) under Health Oriented Programmes and Educaton (HOPE Initiative, www.hope.org.in) with support from BMS Foundation.  In a massive campaign planned in the coming week, it will set up screening camps for Hepatitis B at 4 prominent hospitals: Civil, St Joseph’s, Vivekand and SGPGI where one may get oneself tested easily. Futher Radio Mirchi will air jingles and an interview, FM a Health and Fitness programme, and reminder campaigns through the press media (watch out for Dainik Jagaran and HT). And 3 wheelers will wind through narrow streets of Sitapur blaring imformation, showing documentary movies and imparting advice.

Eradicating Hepatitis B is an achievable end, as some developed countries have shown. It is possible in Lucknow and UP too. The ball is now not in the court of medical science, but with the people. Improved awareness, detection, treatment, vaccination, with supportive government policy can make UP a model state in this regard. You too have a role to play as a responsible citizen.

As published in HT City Hindustan Times (Lucknow)

Are You Losing Hair ?

Baldness, or alopecia in medical parlance, is the description of the loss of hair from the head or body, and tends to be, almost invariably involuntary and unwelcome.Studies have estimated that around half of men around 50 suffer from some form of baldness. A quarter of men have it coming from the end of their first quarter, and three quarters of them are bald at their third quarter. Women are less affected, but around a fifth of them complain of thinning or loss of hair by their 50s. 

Given the high prevalence, it is surprising that this common condition should be source of embarrassment at all.The most common form of baldness is the male pattern or androgenic alopecia in which the hairline starts receding, initially at the lateral sides of the forehead, the hair thins out and disappears from the top or back portions, and then rarely completely from the scalp. This pattern of baldness ensues as a mix of genetic predisposition and the male hormone testosterone. Hence this androgenic alopecia is often associated with proness to diseases of the heart and prostate.Alopecia can also occur due to a variety of causes such as compulsive pulling of hair as in trichotellomania, tight pony tails, fungal infections, iron deficiency anemia, after major stress, as a consequence of chemotherapy and in certain autoimmune states. Excessive constant worrying can induce hair loss. Psychological problems due to baldness, if present, are typically most severe at the onset of symptoms.

Some balding men may feel proud of their baldness, feeling a kindred relationship with famous bald men, such as Yul Brynner, Sean Connery, Ben Kingsley, "Stone Cold" Steve Austin. Baldness has, in recent years, become less of a liability due to an increasing fashionable prevalence of very short, or even completely shaven, hair among men. It is time we enjoyed our baldness and manliness rather than hide our heads under wigs!Although women are less often affected, the psychological consequences in them are much more. They often make desperate attempts to hide their alopecia by several cosmetic strategies. Treatment with medications has limited success. Some hair loss sufferers make use of clinically proven treatments such finasteride, dutasteride and topically applied minoxidil solution, in an attempt to prevent further loss and regrow hair. 

As a general rule, it is easier to maintain remaining hair than it is to regrow.Recent studies have started linking lifestyle and food with alopecia. Bald men usually tend to be overweight, undertake less physical exercise and are much more fond of high calorie food On the other hand those who maintain normal body weights by consuming low fat diets and by undertaking regular aerobic exercises seem to suffer less hair loss. Tailpiece: A child was heard saying, “ My father has so much brains that it pushed out all his hair”. 
As published in HT City ( Hindustan Times) dated 9 may , 2010.