Dengue Fever

It is the familiar story line of a small David felling the giant Goliath to the ground; this time it is the small Dengue virus challenging the might of the government and bringing it down to its knees.
Dengue is having a free run this autumn, thanks to the rampant water logging and unrestricted breeding of mosquitoes.
Recognising Dengue Fever (DF): It is a viral infection transmitted by mosquitoes and presents as a sudden febrile illness of 2-7 days’ duration, with 2 or more of the following:
1. Headache
2. Pain behind the eye balls
3. Severe body aches
4. Pain in the joints
5. Rash
One of the main concerns in Dengue is the fall in platelet counts from its normal range of above 150,000. Platelets play a vital role in preventing or stopping bleeding from small blood vessels. Infusion of platelets is required only if they drop to below 20,000 or when there is active bleeding. Remember transfusions have their own risk of transmitting other infections, of allergic reactions, and their effect lasts barely a few hours.
The other concern is shock. Dengue sometimes causes fall in blood pressure due to leakage of plasma from capillaries with loss of blood volume. The Haemoglobin level paradoxically rises and urination may become less. Some patients show liver involvement (Serum ALT/AST, Bilirubin) or kidney dysfunction (increase in serum creatinine). These usually settle down with good intake of fluids and calories.
Tests for Fever: It is important to remember that all fevers may not be due to other infections such as Enteric Fever (Typhoid), malaria, and common flu that appropriate blood tests will show. It is important to get them done if fever persists for more than 2 days, because Dengue being a viral illness has no specific medicines, while typhoid and malaria have.
Tests should include Haemoglobin, PCV, white blood cell and platelet estimations, and tests for malaria, typhoid, and Dengue.
When to worry: If you have contracted Dengue, lie in bed and take rest for at least a week, drink lots of liquids (water, juices, soups, nimboo paani or ORS), take paracetamol tablets (up to 3 a day), avoid aspirin and ibuprofen as they may trigger bleeding, apply balms on your head and listen to soothing music. Consult your family physician but do not panic. Remember that there is no specific medication for Dengue and yet recovery is the rule.
Critical phase: Contrary to popular belief, the danger phase in dengue is not the 1st 2-3 days of high fever, but around the 5th to 7th day, when the fever begins to settle. Many people who are in a hurry to get back to their normal lives often crash during this phase with low BP and shock. It is therefore crucial to relax at home for a couple of days more.
And do what I am sure, the government is doing; tell yourself “This phase too shall pass”.

Eating Slow Can Help Slim Down

The slim and shapely figures of the overwhelming majority of natives I saw on the streets and trains of China during my visit to that country last week made me stand out amidst them with my Desi central bulge. And as this “ I-am –the-paunchy-one among-them” feeling is not something I feel while in Delhi, Punjab, or Gujarat, I tossed the question ‘What makes the Chinese remain slim?’
I had earlier put it to their genes. True most people with Mongolian traits (Chink eyed ones) like the Tibetans, Chinese, Koreans, Japanese look slim and short with smooth skins stretched over their bones and muscles. But catch them in USA after five years of devouring burgers and pizzas with bare hands, and notice the difference.
Or is it their diet? Most are rice eaters, but if rice was the secret to their shape, I couldn’t fathom why Bongs (Bengalis, a community to which I belong by genes and taste buds) queuing up for a table in front of “Oh Calcutta” get that paunch?
And if it is not rice, and if it is not WHAT they ate, what else could the Chinks have in common?
When my Chinese hosts took me to a traditional restaurant for dinner in Beijing, had me seated at the head of the table with a lavish spread of gourmet dishes, and then handed a pair of chopsticks, I realised I could not devour all that as quickly as I wished!
Fortunately I was not a total stranger to chopsticks, having had to use them as my survival tool during a long training trip in Japan many years ago. I remember that it had taken me a week to get the grip, grasp and movements tuned, and had started eating my full meal with just them, but at a very slow pace.
Old memories wafted in while I sipped the soup and watched how my hosts dealt with the dishes of boiled corn, pumpkins, egg, fish, chicken and even rice with just two thin sticks in between their fingers, nibbling at the food like restless ants.
What eating with chopsticks do is restrict the size of morsels. One can barely take a few grains of rice each time, unlike the large morsels that we Bongs scoop with bare hands and put in our mouths before gulping it down. And nibbling small amounts with chopsticks slows eating and stretches the meal time.
During eating, the food gets absorbed from the intestines and sends signals to the brain that then tells us to stop. If we eat slowly the signal reaches on time stopping us from consuming too much. When we eat quickly and gulp, we often miss the “Enough, Now stop” signal.
Eating slow can be a very effective way to slim down. And chopsticks ensure that you do just that. I have decided to take to chopsticks to get into shape.

India’s health : Then and Now

The country celebrated its 69th Independence Day last week. It is therefore a good time to look back on how India’s health has fared over this period. In numerical figures, we have covered some ground, but like the proverbial glass, optimists see it as half full, while pessimists view it as half empty.
The average Indian who expected to live till 32 years of age in 1950, is living twice as long now. Fewer children are dying in their first year of life (Infant mortality rate) and less mothers are dying of childbirth.
The national figures are however a mixed bag – some states and sections of society have done almost as well as developed countries, while some have lagged behind close to where we were half a century ago, dragging down our national figures.
The reduction and control of diseases mentioned above owe much of their success to several government initiatives as well as non-governmental organisations.
The major challenge of India is the dual fight of a ‘developing’ country’s basic health concerns such as malnutrition, low immunisation rates, hygiene, sanitation, and infectious disease while on one hand, while tackling environmental pollution and lifestyle choices such as alcohol consumption, smoking, and high fat diet are set to increase the incidence rates of heart diseases, strokes, diabetes and cancers, on the other.
Health and education are two sectors where results show up late. Unfortunately most governments have focussed on short term solutions like industrialisation, trade and defence, allocating less than 2% of spending on health (compare with 9 to 10% in developed countries).
While elections are decided by recent perceptions, we need leaders with far-sightedness to bring back the focus on health and education.
Here is a summary chart for those who like facts and figures;
1.Life Expectancy: Increased from 32 years in 1947 to 65 years in 2011, BUT we are nearly 15 years less than western countries.
2. New-born Mortality: Reduced to 37/1000 births in 2008, BUT still approximately 10 times more than western countries.
3. Child Mortality (0-5yrs): Reduced to 63/1000 in 2010 BUT still about 10 times more than western countries.
3.Almost 67% children are still not fully immunsed.
4. Maternal Mortality: Reduced to 254/lakh births in 2008 from 677/lakh births in 1980, BUT still almost 15-50 times more than western countries. (nearly 70,000 deaths per year)
5. Malnutrition In children under 5years: Reduced to 44% in 2006 from 67% in 1979, BUT still nearly 20 times more than western countries (Approximately 50% children under three are underweight)
6. Polio Eradicated almost completely: 1 new case recorded in 2011.
7. Leprosy: Eliminated in 32 States/UTs i.e. <1 1.27="" 2011-12.="" but="" case="" cases="" in="" lakh="" new="" p="" people="" reported="">8. Small Pox: Eradicated in 1977
9. Cholera: Reduced to 1939 new cases/year in 2006 from 2768 new cases/year in 1997. Sanitation and clean water are essential for total elimination

Building a Healthier Future Through School Health Programs

Despite the state of Uttar Pradesh having one of the worst health indices in the country, its dynamic Chief Minister, Akhilesh Yadav has been quick and far-sighted to realise that the key to setting things right in the long run may not lie in just building expensive hospitals, but supplementing it with creating health-consciousness in the minds of its young citizen so that they refrain from picking up risky habits and do not fall prey to preventable diseases.

In India, school is where several million young people spend around 6 hours of time each day for up to 13 years of their lives, providing a unique setting not just to impart scholastic education, but raise awareness on health issues that could impact their health and that of the nation.

In an unusually progressive step that matches what occurs in developed nations, Uttar Pradesh has become the first state to introduce health awareness as a component in its school curriculum. Based on the WHO concept of “school health promotion”, it has introduced a book called “ Hum Aur Hamara Swasthya” in its Madhyamik Shiksha curriculum, and is launching it in its basic education as well.

This book, written by a medical specialist and health expert and produced by a non-profit organisation called HOPE Initiative (Health Oriented Programs and Education), covers ten topics that that are considered universally important:

1. Sanitation and Hygiene that describes the seven steps of hand washing and covers toilet etiquette
2. Life style diseases such as excess consumption of fast food, lack of physical exercise, calculating one’s Body Mass Index, and tackling obesity in school children.
3. Managing examination stress
4. Bullying, ragging and violence in schools
5. Road Traffic accidents and their prevention
6. Global warming
7. Knowing about but resisting peer pressure initiation to alcohol, tobacco and drugs
8. Mosquito menace: simple steps to be taken at home and locality to ward off malaria and dengue
9. Hepatitis and its prevention. Ensuring vaccination from this preventable scourge
10. Celebrating festivals such as Diwali and Holi in a safe and healthy manner

The well-illustrated attractive book with pictures and cartoons aims to extend its reach beyond students to their siblings and parents, in what is described as a “school-to-community” approach. And to make the health topics interesting, HOPE has produced 6 documentary movies and 3 educational games as supplement.

The spade work for introducing health education in schools had begun few years ago with the Education Department of UP government engaging HOPE to provide training to teachers of 6000 schools of 25 districts of the state on health issues, with support from the philanthropic BMS Foundation.

Supporting school health programs to improve the health status of our nation’s young people has never been more important. Their health is critically related to the health-related behavior they choose to adopt.

Public health experts estimate that even a modest decline in the number of adolescents getting addicted to tobacco each year for instance, could lead to significant reduction in the incidence of heart and chest diseases, and save many lives from cardiac and cancer deaths in the community.

Barbers Join the Hepatitis Prevention Drive

Do you always make sure if your barber or beautician is using a fresh new blade each time you go to the salon or parlour for your hair-cut, pedicure or waxing,?
Shaving or piercing of the body with re-used sharp instruments help Hepatitis B and C viruses to spread from one host to another and maintain their unrelenting presence in the community.
Pamela Anderson, the Hollywood actress of ‘Bay watch’ fame became the most famous international poster girl for Hepatitis C when she contracted the infection from her then-boyfriend by sharing a needle for a tattoo.
These viruses are normally present in body secretions, serum or blood of infected individuals and are highly infective. Up to a million of these viruses could be present on a needle tip.
Skin piercing allows small amounts of serum to come in contact with the needle. If the needle is not cleaned properly and re-used in another person, there is a high chance of transmitting an infection such as hepatitis B from an infected person to a new host.
A family of 3 brothers was shocked and surprised when they had tested positive for Hepatitis B during a free screening camp last year. After delving deep into their history for possible sources of infection, we discovered that the three had visited a village fair together and got tattooed at the same stall with the same needle on that occasion.
What has intrigued medical scientists is how the hepatitis B and C viruses keep spreading in the community and maintain their prevalence of 4%. Most of those who test positive, do not have history of blood transfusion or surgery, suggesting that some other route must be at play. The missing link in the puzzle could be the re-used blades and needles that barbers and beauticians use.
HOPE Initiative kicked off a unique campaign last week by inviting 90 barbers to a seminar and discussing with them how some of their practices could be inadvertently spreading these viral infections to their clients. They took surprisingly keen interest in learning about these bugs and seemed quite willing to use fresh new blades for each client.
The challenge now is to reach out to all barbers in the country and encourage them to modify their practice, and on clients such as you to insist that your barber or beautician uses new sharps each time when you visit them.

Tales of Hepatitis B

Hepatitis B, a viral infection of the liver, has its mixed bag of stories – some of them are good while others are tragic. Here are some lessons from a single family.

Happy tale 1: If diagnosed on time, you can keep your liver healthy, protecting it from damage.
Anoop, a 36 year old software engineer working with a multinational company who was diagnosed to have this infection 6 years ago during a blood screening drive, visited me last week. His recent blood reports were perfect: the liver functions were absolutely normal and his fibroscan showed that his liver was as soft and supple as any healthy person’s. He was of course on a daily oral tablet costing a mere Rs 800 per month, all these years, but there was no trace of any live virus in his blood. When he asked me how long he expected to live, I could not suppress a laugh. “As long as elderly people do in India” I answered.

Happy tale 2: You can prevent getting infected by a very effective and affordable vaccine.
His wife and child had tested negative for Hepatitis B on blood screening tests and Anoop, on the recommendation of a doctor, had get them to take 3 shots of the Hepatitis B vaccine. Their recent blood tests had shown high titres of protective antibodies. His face lit us when I told him that they were well protected for the rest of their lives from at least one potentially serious disease, ie Hepatitis B. And could he plan to have another child with the assurance that the infection will not spread to the new born? He had the green signal.
The earlier concern of high cost is now history. What used to cost Rs 500 for each shot now costs Rs 50 or less. It means you can get a life time of protection with three doses for as little as Rs 150!

Tragic tale : Although Anoop was happy with his reports and those of his wife and child, he still finds it impossible to erase the memories of his father’s illness and death. They had taken him to a hospital for swelling of feet, pain and distention of abdomen, where his blood tests and ultrasound had showed a shrunken cirrhotic liver with a large cancer in it. The cause, the doctor had explained, was Hepatitis B infection that had been going on for years, but had not been detected in time.
His end had been agonising: he had become bed-ridden, groaning with pain most of the time. He had required repeated admissions to hospital for tapping of fluid from the abdomen and infusion of expensive medicines. Towards the end, he would lapse intermittently into coma. Finally he had vomited of a large amount of blood, a spectacle that haunts the family to this date.

World Hepatitis Day, celebrated on 28th July, is round the corner. It is an occasion when hospitals and NGOs set up camps and offer free testing and vaccination for Hepatitis B. Get yourself and your loved ones tested and vaccinated this year.

Children with Three Parents

The latest salvo that reproductive biologists have fired at traditionalists since test-tube babies and surrogate motherhood has been the recent creation of babies with genetic material from three parents.
The scientific proof and benefits have been so compelling that UK has become the first country in the world to legalise it in 2015 despite several waves of protests and criticism from “conventional” moralists.
Alan Saarinen is 11 year old and looks and behaves like any other “normal” school girl of her age, playing sports and performing well in her class. She is however one of the rare 50 children in the world who has DNA from 3 parents: her father, mother and a third lady who contributed mitochondria to fortify the defective egg of her mother.
Before she was born, her parents had tried for a baby for 10 long years. Each time her mother Sharon had conceived through numerous IVF procedures, the pregnancy had ended up in a spontaneous abortion or miscarriage.
It was then that the doctors discovered that Sharon carried a rare genetic trait due to which the mitochondria, the small power batteries of her ovum, were weak and defective. As a result the embryo’s organs requiring most amounts of oxygen, such as heart, brain and muscles, did not develop and function properly.
Dr Jaques Cohen of New jersey, USA was the first to experiment with this technique that removes the cytoplasm containing the defective mitochondria of the diseased ovum and replace it with normal mitochondria obtained from an ovum from a healthy donor woman. The “corrected” ovum is then fertilised with the sperm in the laboratory as is done for test tube babies.
While 90% of DNA is present in the nucleus of human cells comprising 23000 genes, small amounts comprising 15 genes are also present in mitochondria.
The potential of this technique was quickly recognised in the United Kingdom that has legalised it, but funnily the USA has withheld permission for this procedure at present. The concerns of the American regulatory authorities and civil society is that a formal permission may make this technique go down the un-ethical slippery slope of “manufacturing” tailor-made babies in the laboratory.
New scientific developments in human reproductive biology always evoke sharp criticism and stiff resistance from ethics groups due to fear of potential misuse. Left to unscrupulous scientists, this technology can undoubtedly be used to produce “made-to-order” babies and in large amounts, almost like cloning animals.
But as of now frustrated couples undergoing treatment for infertility in British clinics are looking forward to have their own babies with this technique from 2016.

Epilepsy, SUDEP and Miracles

During review of an un-anticipated death of a 45 year old man in our hospital, I came across the term SUDEP. This is the story of a businessman who had had epilepsy for several years and been on irregular treatment with his anti-epileptic medications, resulting in frequent recent fits. His seizures had been controlled in the emergency, but had been advised precautionary admission for a day.
He was last seen smiling and chatting with his wife, somewhat resentful about having to spend a day in hospital. A few hours later, while under close monitoring, his heart suddenly stopped and despite resuscitation, he died.
SUDEP is the acronym for Sudden Unexpected Death in Epileptic Patients, and seems to occur in one of every 1000 people suffering from epilepsy claiming over 100,000 lives every year. That is indeed a rather high figure given that epilepsy affects more than 1% of the population, amounting to over 1 crore in India itself.The cause of SUDEP has intrigued neurologists and cardiologists for long. The person found dead often does not show signs of a recent seizure, such as tongue bite or urination suggesting that the cause could have been an irregular heart rhythm. Bursts of irregular electrical activity in the

brain seems to find its way to the heart via the Vagus nerve. In the above patient who died in our hospital, that is what the cardiac monitor actually showed: the heart jerked irregularly and came to a sudden stop!
Epilepsy, a condition characterised by recurrent seizures without any obvious underlying disease, presents with episodic unexpected loss of consciousness usually with abnormal body movements. There are 6 types described: tonic-clonic, tonic, clonic, myoclonic, absence or atonic. Fortunately, there are now several effective medications available to prevent seizure activities, but the patient has to be counselled well to take them regularly without missing a single dose.
Epilepsy is indeed common and has afflicted even great men such as Alexander, Julius Caesar and Napoleon who were said to have suffered from the “falling sickness”. In more recent times celebs such as Edgar Allan Poe, Lewis Carol (writers), Theodore Roosevelt ( President of USA) , Elton John (singer) and several others are on the list, indicating that it does not come much in the way of achievement and longevity in most.
Missing doses of medications can however endanger life of the 
patient or those around him. Two months ago when I was rushing to the airport to catch a night flight, the car in which I was traveling suddenly came to halt in the middle of a busy road due the driver suffering a seizure. My experience of being stranded on the highway with an unconscious convulsing driver frothing at the mouth and the prospect of missing the flight was nightmarish, but I soon found myself thanking God for a miracle that saved my life: the unconscious driver’s right foot had fallen on the brake pedal and not the accelerator when he had suffered the seizure.

Yoga : Sum, Substance and Hype

If Google hits and evidence on the net is anything to go by, it seems indisputable that Yoga brings health benefit to its regular users. And had the proof of its benefit been tenuous, leaders and people of 170 countries would not have adopted an Indian practice only on our present government’s enthusiastic foreign policy initiatives.

Yoga increases the body’s flexibility and reduces stress. It improves muscle strength, perfects your posture, prevents breakdown of cartilage, stabilises joints, restores bone mass and protects the spine.

There is also growing evidence that it improves heart functions, reduces elevated blood pressure, brings down high blood sugar levels in diabetics and mobilises excess fat from the liver in patients with fatty liver.

The breathing exercises, with which a session typically starts, improve lung functions, increasing oxygen supply to body organs. The focus on smooth breathing and its voluntary regulation is a simple useful way to improve concentration and dispel anxiety.

Recent research is also beginning to show that Yoga may boost your immunity by enabling the body to generate higher levels of antibodies after vaccination.
A Norwegian study found the Surya Namaskar, a sequence of 8 postures, to be particularly effective in boosting immunity and improving circulation.

Two modern-day ailments seem to respond particularly well to Yoga. Migraine sufferers reported less frequent attacks with the Bridge Pose (Sethu Bandha Sarvangasana). Yoga also helps reduce food craving, a common underlying cause of the present epidemic of obesity. It improves sleep and, interestingly even sexual function in stressed out overworked young people working in multi-national companies and often struggling across different time zones.

If everything is so hunky-dory, where then are the rough edges that need smoothening?

Yoga, which started not just as a physical but also a mental and spiritual practice in ancient India around the 6th or 5th century BCE has now come to be viewed as a series of postures to tone the body. This transformation occurred around the 11th century AD, when Hatha Yoga became the popular form that largely shed the mental and spiritual aspects of the practice.

The problem of today is yet another one: that yoga gurus clamouring for limelight seeming to be at variance on the correct ways, postures and mudras in which Yoga should be practiced, leaving the public somewhat confused.

Further, in their zeal and ambition they cross boundaries of common sense, advising followers to stop all medications and rely only on Yoga.

An old patient of mine of Hepatitis B whose viral counts had become undetectable with antiviral medicines 2 years ago and was instructed to continue the tablets, came to me last week with a recent report in which his viral counts had shot up to 6 lacs! He had stopped the medications at the behest of a popular Yoga guru!

Teaching Kids to say NO to peer pressure!

Teaching Kids to say NO to peer pressure.
The single important factor that pushes youngsters to take to tobacco, alcohol, drugs or adventurous sex is undoubtedly peer pressure (PP) that they find themselves ill equipped to resist. And its effect at a vulnerable age can be so overwhelming that the feeble voice of resistance gets easily drowned to submission.
The source of this lack of assertiveness could well lie with how kids are trained by parents and schoolteachers . Our conventional mores of upbringing encourage obedience, submissiveness and respect for elders, features that funnily work against us when confronted by delinquent seniors.
“Training in assertiveness and teaching children to say NO is unfortunately lacking in our parenting and teaching skill-kit”, says Raashi Khanna, a professional counsellor. It is therefore not uncommon to see docile children yielding tamely to peer pressure during adolescence and accepting that first fag or drink from seniors due to an inability to say NO.
If the presently rampant drug addiction in Punjab is another example to go by, most victims are not the aggressive assertive sort, but weak obedient ones who got coerced due to their inability to stand up and assert themselves.
Since counselling students cannot be left only to professional counsellors, teachers of primary and middle schools as well as parents need to be trained to don the counselling cap to empower their kids to resist peer pressure. It is bound to be challenging, as the very concept of encouraging kids to be assertive often goes against the conventional ethos of “obedience” that is held in our minds as a hallmark of good Indian upbringing.
A simple method that some schools have employed is getting students to “role play” characters of victim and peer through skits and plays. In an inter-school skit competition organised by HOPE Initiative, several schools used this method to make the point effectively among different sections of students.
One may argue that submissiveness may not be the only underlying factor, as addiction victims in occident or affluent societies do not seem to be overtly submissive. In them the reason is often lack of close interpersonal relationship with parents, compounded by loneliness often contributing to their vulnerability.
Once hooked to tobacco, alcohol or drugs, getting off the hook can be a formidable challenge. Despite their annual ritual new-year resolutions, most tobacco addicts for example never seem to be able to stop until a health event such as a heart attack scares them enough to quit.
Unlike tobacco sudden cessation of severe forms of alcohol and drug addiction is often associated with painful withdrawal symptoms such as body pain, hallucinations, sleeplessness and even fits, requiring medications under the guidance of a psychiatrist.
In milder forms however counsellors employ a technique called CBT (Cognitive Behaviour Therapy) that helps the victim understand how his thinking (cognition), influences his behaviour (such as drinking), thus helping him to mend his ways.
It is time that schools and parents resorted more to counselling to fortify the health of our youngsters and our society.

Maggie Controversy:The Illusion of Truth!

I confess that I was never a great fan of the iconic 2-minute instant Maggi noodle but found it strange that this darling of mothers, school-goers, hostel students, travellers and bachelors of several decades should be catapulted so suddenly to a “Gee…it is poison…I wouldn’t give it to even my dog” status and burnt in street corners like effigies of Ravana.

What I gather from the press is that a food tester from Uttar Pradesh detected higher levels of lead than the permissible 2.5 parts per million, in the tastemaker concentrate that comes with the noodle pack, raising alarm over possible chronic lead poisoning. Excess lead entering the body can cause harm. Once upon a time when water pipes were made of lead, chronic lead poisoning was not uncommon producing abdominal cramps, anaemia, nerve toxicity (foot drop was a common feature in which the foot could not be lifted off the ground and had to be dragged) and aggressive behaviour. It was also sometimes seen in children who chewed on the lead of their lead-pencils.

The manufacturer, Nestle, points out that when the tastemaker concentrate is mixed with the noodle, as it is supposed to be done before consumption, lead concentration drops and comes down to acceptable limits. Further, the lead seems to come from onions used in making the concentrate and reflects high lead content in the soil of Indian fields, suggesting that we pay attention to our backyard where we grow our foods.

Wherever be the ‘truth’, a good David-versus-Goliath fight of this kind never fails to arouse an audience napping since the last general elections. And when newspaper headlines, TV screens, loud media anchors, activists and panic-stricken poor consumers join in a cacophony proclaiming injustice, insult and harm to society, the $2.5 billion sized Goliath is bound to be felled and brought to his knees.

This debate sent me wondering as to what is the nature of ‘truth’ (ANY truth for that matter) and if repetition actually CREATES truth. Did repetition as was used in advertising for Maggi over the years as a safe wholesome instant food, or repetition that it is harmful as is being done across all Indian media, really persuade us to accept what we think is the truth?

And although it seems too simplistic, that’s exactly what psychological research suggests: Repetition is one of the easiest and most widespread methods of persuasion, that has the power to transform even a lie into a truth.
Psychologists call ‘Easy to understand = true’ the illusion of truth effect and it arises at least partly because familiarity breeds liking. As we are exposed to a message again and again, it becomes more familiar. Because of the way our minds work, what is familiar is also true. Familiar things require less effort to process and that feeling of ease unconsciously signals truth, a phenomenon called cognitive fluency.
By the time the actual findings on the raging Maggi controversy comes up, we would have unfortunately already made up our mind about the truth!

Here are some interesting tobacco facts that you should know

 No Tobacco Day,
1. Two men who appeared in the wildly popular Marlboro Man advertisements diedof lung cancer, earning Marlboro cigarettes the nickname “Cowboy Killer.”
2. Tobacco smoking, particularly cigarette smoking, is the single-most preventable cause of the death in many parts of the world.
3. Every cigarette smoked cuts at least five minutes of life on average, which is roughly the time it takes to smoke one cigarette.
4. Of the thousands of chemical agents in tobacco smoke, more than 50 have been proven to cause cancer.a
5. Within 20 minutes of quitting smoking, a person’s blood pressure returns to normal. Within one year, the chance of suffering a heart attack decreases by half
6. Tobacco consumption is associated with not just lung cancer, but cancer of the mouth, food pipe, pancreas and urinary bladder and cervix.
7. Smokers have a much higher risk of heart disease and chronic bronchitis.
8. Smoking causes more deaths due to heart attacks than by cancer.

here are some interesting tobacco facts that you should know.

Women, sex and tobacco.

9. Women in the United States increasingly began smoking publicly in the 1920s when the cigarette was adopted by advertisers as a symbol of equality, rebellion, and women’s independence. Currently, cigarette smoking kills an estimated 178,030 women in the United States annually.
10. Pregnant women who smoke are more likely to deliver not only low birth weight babies but also highly aggressive children.
11. A British survey found that nearly 99% of women did not know the link between smoking and cervical cancer.
12. The cigarette and cigar are recognised phallic symbols, and several Internet sites are devoted to smoking fetishisms.c Ironically, smoking has been directly linked to sexual impotence.

The Devil’s fart

13. Cigarettes are the most traded item in the world.
14. Currently, over 5.5 trillion cigarettes are produced globally per year. Cigarettes are an attractive source of government revenue because so many people smoke them.
15. Smoking tobacco emerged from religious ceremonies in the Americas and was probably initially restricted to only shamans, priests, and medicine men.
16. Ramon Pane, a monk who accompanied Christopher Columbus to the Americas, is usually credited with introducing tobacco to Europe.
17. Nicotine is named after Jean Nicot, the French ambassador to Portugal who brought tobacco and smoking to the French court in the mid-sixteenth century as a medicine.
18. 19. Anti-cigarette activist and automaker Henry Ford popularised the term “The Little White Slaver” in reference to the cigarette in the early twentieth century. Both Henry Ford and Thomas A. Edison objected to cigarettes and refused to hire anyone who smoked them, on or off the job.
19. India ranks highest in the world in oral cancer, caused mainly due to tobacco chewing.
20. Renaissance author Ben Jonson called smoking the "devil’s fart

Inflammatory Bowel Disease

Inflammatory Bowel Disease

The smart young 35 year old career-oriented Divya’s (name changed) problems started two years ago with what appeared as an usual intestinal infection: cramping abdominal pain, loose stools and feverishness. She took her regular antibiotics, and although the symptoms improved slightly, they lingered and persisted.
Over the next 6 months, she had four major bouts, lost 6 kilograms of weight, became anaemic and weak, and passed blood in her stools a few times. She finally consulted a gastroenterologist who performed a colonoscopy, a test in which one passes a periscopic tube into the large intestine, and diagnosed her to be suffering from Crohn’s disease.
Like most of her age, she had never heard of Crohn’s disease. It is an autoimmune condition in which the body’s immune cells normally primed to target and kill invading germs, get misdirected and start attacking intestinal cells of its own body.
Her husband, a TV channel manager, was shocked too. The questions that seemed to flow endlessly in their minds were: How did it happen? Why did it happen? What is the cure? How long will it take? Will it impact her career? What about their plans for a baby?
To be rudely woken up into the world of Inflammatory Bowel Disease, the generic name for Crohn’s disease and Ulcerative colitis, cannot obviously be pleasant.
Most answers initially appear to be in the negative. The exact cause is not known. The disease does not have a “cure” except removal of the large intestine by surgery for ulcerative colitis, that comes with its own baggage of problems.
How long to take the medicines? Lifelong !! Are you serious? And can it turn cancerous? Yes (it may after many years). OMG.
Divya, who is now well and back to her job but on medications, will tell you how bad it had got. Initial disbelief led to anger and then to frustration. It was several months later, after several consultations, opinions and reading up on the net, that she and her husband finally accepted the reality and decided to fight on.
Thanks to a new group of medicines called “biologicals”, the treatment has become much better. Steroids, once the mainstay of therapy, are no longer a must. Remissions are easy to achieve and one can lead near normal lives with monthly shots.
Divya did take these injections with which she quickly on her feet and back into her job. They are pretty costly though, almost one lac for one dose, and she needed three for the initial induction. Luckily she had a health insurance which made it possible for her.
This week is IBD week. Every organisation has some or the other staff who suffer from this group of conditions. It is time we united and created awareness about this disease so that anyone afflicted does not have to suffer in isolation or shame. And we can bring help and information to their doors.

Summer Fruits to stay Cool

Summer Fruits to stay Cool
Some believe that when nature come

s down harshly at a place and people, say the parching summer prevailing in northern India at present, it also provides antidotes for surviving it. Seasonal fruits and vegetables constitute the survival kit, and one has to understand how and why they work.
You might have noticed that most fruits that flood the market this time are rich in fluids and minerals. The best re-hydrator is the familiar water-melon. As the name implies, it is abundant in water. Several helpings throughout the day help prevent dehydration and maintain skin turgor.
The musk or honey melon also acts in a similar manner, drawing water and minerals from sandy riverbeds and bringing it to you with added flavors. They contain a lot of polyphenols; minerals and vitamins that help the body cope with summer heat. Cucumber and “kakri” are water laden as well. When had with salt, they help correct water and sodium deficiencies that hot winds and sweating cause.
Nature seems to have craftily dealt with other shortcomings that our body encounters in this season. Mango, the king of all fruits, makes it appearance with powers to counter the heat. Raw mango juice (aam paana) prepared with generous amounts of salt, is a very good remedy for heat related disorders – it fortifies the body with vitamins (C and A), minerals and water and also serves as an energy food with its large amounts of sugar and fibre.
Of the many ingredients that papaya contains, one is pectin that keeps the bowels coated and protected form seasonal infections. It also contains an enzyme called papain that helps our digestion.
Litchis are loaded with energy in the form of sugar and fat. They make excellent snacks and are cooling as well. One needs to watch the calories though. Guava is another fruit that is rich in vitamin C and fibre and makes an excellent summer snack or salad.
Summer vegetables are equally craftily designed to provide high contents of water, minerals and vitamins. Bitter gourd, or for that matter all gourds are popular in summer for their hydrating and cooling abilities. Bitter gourd is also an appetite stimulant and helps bring down sugar levels that tend to rise with excess consumption of mangoes and watermelons.
Nature often has a design that we sometimes overlook. Hence while exotic foods like broccoli and cabbage may have their time in winters, enjoying the fruits and vegetables of the season to beat the heat makes more sense.

Life Without MOM !!

If you have been lucky to have had your mother care for you and nurture you in your infancy and childhood, thank your stars! How life could have been different without her is the subject of several scientific papers that deal with the unpleasant consequences of “Maternal Deprivation Syndrome”
Infants without moms make poor starts in life. They often do not grow well physically, lagging behind in height and weight, in what is termed “growth failure”. And funnily, this seems to occur despite the adequate nutrition reaching their guts.
Scientists are, as usual, trying to investigate what “factors” could be responsible. One explanation is deprivation of mother’s milk that lowers a child’s immunity. Breast milk is rich in anti-bodies and immune boosters that help protect the baby from recurrent infections, frequent episodes of diarrhea, pneumonia and absorption defects.
What scientists find intriguing is to segregate the “measurable” factors such as antibody levels passing from breast milk to the infant, for instance, from the un-measurable ones such as love, care, emotional support and confidence boosting that acts such as breast feeding, hugging, caressing and singing of lullabies might have on a child’s development.
Children growing up without their mothers are often emotionally handicapped from an early age. Their personalities and self-confidence do not develop well and their emotional responses remain muted. They are more prone to developing personality disorders or delinquencies than their well mothered counterparts.
The pain of growing up without a mom was well described by Steeve Jobs, the CEO of Apple Inc, whose unwed biological mother had given him up for adoption when he was an infant. Although raised well by foster parents, Steeve had never felt “normal”; he had taken to drugs in his young days and had suffered volatile moods, loneliness and depression. His search for his biological mother had remained unsuccessful, causing him frustration, till he developed and died of cancer himself.
Mom is a boon that we seem to take so much for granted, that we often do not realize how our lives might have been without her. Mother’s day is a good time to acknowledge and appreciate her and express our gratitude for having had her.
One way you could give back is to make sure she remains healthy and happy. Ensure that she takes her Vitamin D, calcium and vitamin supplements regularly. It is your turn to escort her through her regular medical visits for BP, diabetes, cholesterol, heart, hemoglobin, breast and pelvic check ups just as she did with you during the parent-teacher’s meetings when you were in school.
And it is your turn to make sure that you reciprocate and give her the time and emotional support that she needs from a grown up child, so that she remains fit and happy. And proud of having brought you into the world, and nurtured you with love and care!

Beat the Heat this Summer !

Long hot spells, when the sun bakes the earth and the mercury rises to create new records, pose major challenges to health and life. Our bodies dry up (called dehydration; remember that 2/3 of our body is made up of water) or get excessively heated (called heat or sun stroke due to the body’s thermostat failing to maintain our temperatures around 370C), posing a threat to life.
The simplest way to stay well and energetic during summer is to keep your body well hydrated at all times. Start the day with two or three glasses of water in the morning as soon as you wake up.
The trick is to drink fluids before you start feeling thirsty, because by the time you feel it, the body has already started signalling to you that it is getting dehydrated. When you start for school or work in the morning, make sure you drink two more glasses of water.
In dry hot weather, water is lost from the body through breathing and invisible perspiration. It is therefore wise to anticipate it before you set out. Your energy levels will be far better this way. And keep drinking water the whole day till dinner time.
The commonest mistake that many people make is to start the day without adequate hydration, and then drink water when thirst starts reminding us that our body is drying up. We often then overcompensate later continuing to drink till late evening, then often having to get up at night to urinate.
We need to synchronise our water consumption with the diurnal need of summer days. Dehydration is common in summers and claims around 2 million lives every year, especially in developing regions.
Children are more susceptible, and once grossly dehydrated, often find it impossible to regain health. Symptoms and signs include fatigue, headache, low BP, dizziness, fainting, dry mouth and reduced amounts of urine that is usually dark yellow. It is often precipitated by an attack of vomiting or loose motions. Drinking large amounts of water (around 6-15 glasses a day) and increasing the intake of salt (through pickles, papads, salted nimbu paani or lassi) are the cornerstones of prevention and treatment. It is important for children to be always hydrated; if not, growth and development could be affected. Luckily, children usually have intense thirst sensation; the trick is to help them develop a liking for water and not juices or softdrinks. Heatstroke is common during these dry hot spells when the body’s heat regulatory mechanism fails to maintain a balance between heat production and heat loss (losing it to from 370C of the body to the 460C of the atmosphere could well be impossible at times!). As a result, the body temperature rises causing the person to be pale, hot, irritable, confused or unconscious.
Children and the elderly are at greater risk, as are athletes, construction workers, labourers or military recruits.
It is a medical emergency and requires moving the person to a cool shade, lying him down on the floor or ground, pouring water on the head and body, placing ice cubes under the armpits and moving him to a clinic or hospital. Caps, sunglasses, wearing loose cotton clothing and avoiding anti-perspirants help

Sugar Addiction

You will be surprised to know that of all the addictive agents that you can list such as tobacco, alcohol, caffeine, betel and drugs, one that has probably sneakily getting you hooked from early childhood and making the largest impact on your health could be your addiction to sugar.

Sugar, scientists point out, poses far greater danger than we seem to realize; it is a toxin that harms our organs and disrupts the body’s usual hormonal cycles. Excessive consumption of sugar, they say, is one of the primary causes of the obesity epidemic and metabolic disorders like diabetes, as well as a culprit for cardiovascular disease. More than 20% of urban Indians and 10% of urban school children and adolescents in India are obese largely due to excessive consumption of sweets and sugar.

That the landscape of health across the world and especially in India is undergoing drastic change is reflected in the WHO’s recent report attributing over 60% of urban deaths in our country to life-style disorders of the heart, brain or cancers, replacing the old causes such as infections and starvation.  And what lies at the heart of these metabolic causes seems to be our addiction to sugar!

Our “Pavlovian” dependence on sweets start from infancy when we are introduced to sugar water, kheer, sweets and ice-cream.  And think again, how do we reward or show our love for someone? By giving him or her sweets, chocolates, rasagullas or laddoos!

The excess sugar that enters our body requires excess amounts of insulin to be secreted by the Beta cells of our pancreas. Over time, these cells get exhausted leading to diabetes. And as sugar cannot be stored in our body effectively, it is converted to fat that gets deposited in our buttocks, paunch, livers and heart!

Around the world, a growing body of opinion – the 'No Sugar’ movement – is leading a global fightback and warning that our sweet habit is completely out of control. Sugar, whether added to food by you or the manufacturer, is the greatest threat to human health. And unless we wise up and quit en masse, we don’t just risk personal obesity and disease, but national bankruptcy and collapse as the toll our ill health takes on our countries’ economies threatens to destabilise the modern world.

The sugar trail seems to be coming back to haunt India. Sugarcane has been grown in India since 500 BC. We learnt to make the white crystals from the juice much before the European tongue had its first taste of sweet  around 1500. In fact, sugar was called the white spice and was considered more preciious than gold, and shipped to Europe by the colonizers.

The movement is led by Robert Lustig, professor of pediatric endocrinology at University of California, San Francisco, author of Fat Chance: The Bitter Truth About Sugar, numerous scientific and press articles, and presenter of “Sugar: the Bitter Truth”, a YouTube clip viewed more than 3,300,000 times.  

It is time we woke up and fought our most primodial addiction to save ourselves and our future generations!

Violence against Doctors

Violence against Doctors

Last week’s gory incident in which a renowned super-specialist, Dr. Rohit Gupta was mercilessly beaten up by disgruntled relatives in a private hospital in Allahabad has shocked not just doctors, but most sensible members of society.

The CCTV video showing the goons drag Dr Gupta to a room in the hospital and thrash him for over 15 minutes, has gone viral and evoked sharp outcry. Dr Gupta who sustained a fracture of his jaw bone and multiple other injuries is undergoing treatment in another hospital. He had gone to visit the 80 year old critically sick patient at 4 AM in the morning, who died, when this incident occurred.

The fall out of such an event causes great harm to society, especially patients in dire need of medical help at odd hours. I am sure Dr Gupta, having learnt the lesson of his life, will refuse to take calls at odd hours. And so will many other doctors practicing in small hospitals and nursing homes.  If society and administration doe not inspire confidence in doctors about their safety, they are expected to retract to safer zones.

It is not without reason that doctors tend to concentrate and practice in big cities and are reluctant to settle or open clinics in small towns and villages. Vandalizing clinics and beating up doctors is not uncommon in small setups making good doctors flee to safer pastures.

Grief and frustration are legitimate emotional responses of relatives especially in the event of death of a loved one. But anger often leads to violence. And unless the law enforcers provide adequate security to doctors, they are likely to play safe and not attend to suffering patients in desperate need, at odd hours.

The good old family physician who would make a home visit on a telephone call, has almost disappeared in most places. Well qualified doctors are reluctant to visit homes. The most badly affected are the frail and elderly. Apart from the inconvenience, it is the huge costs that families will have to bear to take them now to hospitals to seek medical attention.

Violence against doctors receives a perverted sanction from movies and television serials too. It is not uncommon to see bereaved relatives in TV serials catching a doctor by the collar when he breaks the bad news.

One could argue that doctors are sometimes rude, calloused and insincere in their dealings that evoke the ire of relatives.  That the medical profession is no longer held as noble and revered as it once was, is often attributed to a doctor’s monetary greed and sometimes, unethical ways. I  am sure there are black sheep in every profession, and the medical fraternity is no exception.

But the use of violence as an instrument to “teach” doctors a lesson is bound to boomerang and jeopardize the needy and the poor. 

It would be a great disservice to the community if civil society does not condemn such violence against doctors and ensure that the culprits are punished.