I have tried to make my own little mark in this world. My career as a Medical Educator and Clinician in Gastroenterology (see www.gastroindia.net) and my flirtations with Health Promotion, especially amongst school children (see www.hope.org.in) are shown elsewhere.This blog contains my attempts at creative writing, most being write-ups for Health Adda column of HT City of Hindustan Times (also see www.healthaddaindia.blogspot.com) as well as a few others, and some reflections and thoughts that have struck me from time to time on my life journey.Please leave your footprint on this blog with your comment.


Monday, June 15, 2015

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.

Tuesday, June 9, 2015

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.