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Showing posts from November, 2013

Dealing with Rape

The recent death of 2 victims of rape that the media highlighted is a gruesome reminder of how pitiably inadequate our state of preparedness is for dealing with this hazard to health and life. I am told that the reason why crime rates in Singapore are one of the lowest in the world is because people there are scared to commit them. What deters potential criminals is a high chance of being nabbed (good policing) , that no amount of phone calls can prevent or reverse. Further, the punishment for crime is strict and harsh. What happens in India is quite the opposite. Most rapists feel confident of getting away. The girl, they feel, would be so shocked, “stigmatized” or perhaps even dead that she and her family would probably not dare to complain. The culprits of the Delhi gang-rape case in which 6 criminals assaulted a 23 year old in a bus probably thought that way! What deters a victim further is the lack of grooming of the hospital and police staff to attend to a victim’s co

Wheat Intolerance

Many people find it hard to imagine that intestines could revolt against as innocuous and staple a food as wheat, and could be the cause of a disease that can even kill. Celiac Disease, a condition in which the body reacts to gluten, a protein present in wheat, is on a steep rise in India. Tables are now being turned on the long held view that it is a “Western disease” that does not occur in India. Neha (name changed), a college student from Delhi, came in to see me for problems of 2 to 3 loose stools every day for 4 years.   Several doctors she had consulted had diagnosed her condition as IBS (Irritable Bowel Syndrome) and prescribed medicines either for infection or to slow her “hyperactive” bowels. Her relief had predictably not been lasting. What struck me at the outset was her “thinness”. Although she claimed to eat well, she had a Body Mass Index of 17 (normal range 20-23.5). She also looked anaemic (Hemoglobin was 9).   Endoscopic examination of the stomach and large in

Are Schools Doing Enough to Curb Bullying?

In the recently held inter-school skit competition named HOPE-SKIT, yet another of HOPE Initiate's innovative ways of creating awareness on health issues,   more than half of the 46 participating schools focused on   bullying as their central theme, finally pulling it out from under the carpet and placing it on   centre stage as a major health menace. A chief hurdle in controlling bullying in schools, as illustrated by students of Lucknow Public School, Janakipuram,, is the victim’s diffidence and lack of courage to complain.   But are the victims really to blame? Victims of bullying are usually the most timid and innocent of the lot, and it requires sensitivity to understand why they prefer to suffer silently rather than raise their voice in protest. The harsh truth is that they feel uncertain about the sincerity and ability of their teachers and parents to protect them from the retaliation from their tormentors. At the core of the issue, therefore, is the question “ H

Mind Body Therapy

If there is a set of diseases that modern medicine seems to have passed by, it is psychosomatic disorders. Most surgeons and specialists find themselves unable to recognize or deal with them effectively, while dissatisfied patients knock door to door with little respite. A 40-year-old Russian woman came to see me for symptoms of gas and acid that had vexed her for the last 5 years. She had visited several gastroenterologists, had undergone 4 endoscopic examinations, and had been offered similar prescriptions of proton pump inhibitors (medicines that reduce the production of acid from the stomach) sometimes with tranquilizers that had made her sleepy and had interfered with work. I realized that I was in line for being counted as yet another doctor. Not to be clichéd, I threw her a few questions and discovered that she had been staying and working in India for 8 months, leaving her 2 children and mother in her hometown 8000 km away. Her father, who had been caring and supporti

Halwai’s and Gyms tie the knot on Diwali

Unlike most businesses that peak during Diwali, fitness centres patiently wait for the last diya to die out and the last cracker to fall silent for their clients to walk in. Weight watchers, who usually go off-guard for a few weeks, find themselves piling up two to six kilos around this time. Diwali, and the weeks that lead to it, is a time when calorie intake shoots up dangerously. Dry fruits, sweets and barfis start coming home, and most of us are unable to keep our hands off the loaded trays. A ritual visit to a relative or friend’s home is customarily associated gorging of sweets or snacks that are dense in calories! And no matter how health conscious you may be, refusing to pick up a piece from the thali and depositing it into your mouth is fraught with the risk of being labelled stiff, snobbish, unsporting, or lacking in the “Diwali Spirit”, that you can’t afford at this time. While talking of spirits, yes, spirit consumption also goes up significantly at these times. A

Dengue Debacle

Our media has been so obsessed with scams and corruption that it has not had space and time for the Dengue epidemic raging across the country. And in a country of 1.2 billion, numbers of those affected or dead have ceased to shock us any more. The travesty of the Dengue epidemic, in Shakespearean parlance, could go well in the way “When beggars die there are no comets seen; the heavens themselves blaze forth the death of princes”. Let us therefore not count the number of the incognito dead but focus on a few precious lives that fatal mosquito bites have claimed. When the nation of movie lovers had just celebrated the 80th birthday of one its best loved romantic movie-makers, Yash Chopra, and started marveling at his good health at this vintage, the Aedes mosquito struck stealthily with its fatal sting. And as is typical of Bollywood, our media and us Indians, while we went into hysterical reminiscence of the lovely movies that he had made in his lifetime, we chose to overlook

Re discovering the Bicycle

In our present times when we are excessively dependent on cars, piling up excess weight, and falling prey to the epidemic of diabetes and heart disease, the bicycle can roll into our lives as quite a game changer.   There are 5 good reasons why we should take to cycling:   1. For Your Body:   The bicycle has been acclaimed as a great device for working out and keeping you fit. It increases cardiovascular fitness, strength, balance, flexibility, endurance and stamina and is an excellent way to burn the extra calories. One major advantage that cycling offers over jogging or the tread mill is that being non-weight bearing, it causes less pressure on the ankles and knees in overweight people with creaking joints. During a fellowship to Germany, my host and friend Dr Winfried Hauser had arranged a bicycle for me and insisted on showing me the countryside on bike. I remember the ordeal of the 1st day when I found myself out of breath after cycling a mere 2 kilometers. Over d

Blend sense with tradition this Diwali

If you fancy yourself as a good blend of modern sense and customary tradition, upcoming Diwali is the time and opportunity to experiment and demonstrate to neighbours and friends smart new ways of doing old things. Regular sweets such as barfis, gulab-jamoons and multi-coloured khoya sweets are so predictable, calorie-dense and heavy, that most guests either shun them or reluctantly pick up the smallest piece on the plate when compelled. With diabetes, obesity and heart problems being as common as they are, most of these traditional delicacies do not go down well with those for whom they were intended, but find their way to homes of servants, drivers and junior office staff.  Should you want your guests to eat, enjoy, take an extra-helping and remember what they had at your house, you need to make them appealing, healthy and different. Manju never failed to surprise me over the years with her innovative preparations: mouth-watering and memorable, with that right mix of be

Stupid Benefits of Celebrating Festivals

The modern-day sceptic looking through his logical lens at what we do at this festive time of the year, often finds it as meaningless, wasteful old fashioned mass hysteria! Attempts by Indians to reconnect with their families and friends, pray and fast together, perform rituals, wear new clothes, hug each other and rejoice and try to keep their traditions and faiths alive make little practical sense. What is worse is that the food is usually poisonously rich, roads are choked, offices and businesses come to a grinding halt in what appears quite stupid. And yet the air that gets charged with renewed excitement is what scientists find difficult to measure and analyse. While lifestyle and food are indeed important for good health, studies suggest that human emotions may have a significant, perhaps crucial impact on an individual's well-being. Researchers from University of Kansas found that positive emotions are critical for upkeep of physical health for people worldwide, especi

Cyclone and health

One of the problems of preparing for natural onslaughts such as the cyclone that hit our east coast last evening is that we are always caught under-prepared despite met warnings and visits of chief ministers to the potential disaster sites to oversee preparations.  The problems are understandably formidable with very  large number of vulnerable people living in ramshackle homes with scanty food reserves. The scenario is compounded by poor communication, proneness to crime and disinclination to follow instructions. It is worth looking back at what happened after hurricane Katrina struck America in 2005. Despite the USA being far more resourceful than us, Hurricane Katrina brought with it flood waters, loss of power and livable space, created a breeding ground for mosquitoes and turned into crime havens. It caused molds to grow, endotoxin levels to rise, depleted clean drinking water, spoiled food, allowed diseases to spread. Close to 2000 people died and around 800 went miss

Tobacco – A status report

Despite the image enhancement that tobacco companies try to achieve by diversifying into other forms of businesses, sponsoring sports events or music, and doling out prizes and awards for gallantry, their practice of manufacturing and selling tobacco products continues to cause great harm to society.  And they continue to market and bank on tobacco sales for their profit. Two thousand people will die today in India due to tobacco. India has 250 million tobacco users with around 900,000 succumbing to tobacco-related diseases every year.  We ranks 1st in the world for incidence of oral cancer, caused almost entirely by tobacco use. One of our senior ministers had to be operated in USA for cancer of the cheek due to his Gutka habit. Although his face reveals a lack of symmetry, it is a matter of satisfaction that he is cured of cancer, and has turned a major anti-Gutka campaigner in Maharashtra. Tobacco has no nutritive value or health benefit. While smoking, one inhales 43 ca

Are you a Type A Personality ?

The family and friends of Mr KM, a successful manager of a private bank, who recently suffered a heart attack at the age of 40, could have foreseen it coming if they had recognized what his “personality type” was driving him up to. KM had a classical “Type A” personality; he was fiercely ambitious, charged and aggressive.  Friends recall how he was always setting high targets and then restlessly struggling to achieve them. And instead of relaxing for a while when done, he would promptly set another much higher target that he would start to pursue. He had to be more successful than others, finding it hard to be one of many. Not surprisingly, he had come to achieve an important position at such a young age.  And not surprisingly, he had a heart attack now despite being a non-smoker and regular gym goer. The constantly charged state of such people generates frequent surges of stress hormones called adrenaline and corticosteroids. The health price they often pay for their ach

Try Happiness Therapy for Good Health

Recent research is turning the relationship of health and happiness on its head; healthy people are of course happier, but more startling is the observation that those who are happy and satisfied with their lives are a lot healthier. Moreover, the benefit comes with a quick turn around time, with greater happiness boosting health in as little as 3 years. In a scientific study, 10,000 adults were assessed how happy and satisfied they had been by their response to 2 simple questions: “During the past 4 weeks, have you been a happy person?” and “All things considered, how satisfied are you with your life?” The answers were correlated with physical health parameters in 2001 and then 3 years later in 2004. “We found strong evidence that both happiness and satisfaction have an impact on our indicators of health”, says Dr Siahpush, from the University of Nebraska Medical Center, Omaha, USA. They were associated with excellent or very good physical health, absence of long-term limiting i

Dengue prevention for you, the family and locality

The scare of the currently raging Dengue epidemic in Lucknow is neither a false alarm nor media hype. Good many people have fallen prey, and few have already died. The tragedy is that Dengue assumes an aggressive form in young healthy adults, who were, till yesterday, up and about their usual lives, going to school or college, attending to work, partying or planning a grand Diwali bash. Attempts at mosquito control seem to have gone away. Many might ask if it had started at all, seeing the heaps of polythene bags by the roads. The striped Aedes mosquitoes are easily seen in homes and offices on their dauntless flights landing on arms, necks and feet for their blood meals and injecting the virus through skin pricks. What can you do to protect your self and your family? Involve your neighbours, make a local team, pool some money and arrange people to clear the heaps of polythene bags from the neighbourhood, burning them if necessary. Arrange a fogging machine and organi

Rationalism and Life’s Lessons

I felt a tinge of pride on learning that the recently murdered rationalist in Pune, Narendra Badholkar, was a medical man. This 67 year old doctor held a medical degree, and had practiced medicine till 16 years ago before turning a full-time activist of Indian Rationalist movement to fight superstition, black magic and faith healing. A doctor indeed finds himself so closely nestled between the overlapping spheres of the body, mind, emotions and faith that he comes face to face with irrational practices and social issues almost every day. Progress in science has been the single strongest factor to dispelin a step-wise manner what we have held as “supernatural”. As a child, I remember hearing stories of how a “possessed” woman could walk in sleep or go through phases of abnormal behaviour. These conditions are probably still treated in villages by witch-doctors through black-magic, animal sacrifices and wearing of stones. As a medical student, I realized that sleep-walking or s

Clinical Trials, Industry and Doctors

Despite general agreement on the pivotal role and necessity of “clinical trials” to usher in better treatments and to keep pushing the boundaries of what medical science can achieve, the term continues to evoke suspicion and cynicism in the minds of the public. The history of clinical trials has been both epoch making as well as shameful. During my recent discussions with an international pharmaceutical organization that has developed some promising new molecules for Hepatitis B and C and was trying to identify reliable hospitals and clinical investigators in India, I was told that clinical trials are banned in some states in the country. Some investigator-doctors here had obviously flouted safety and research norms and jeopardised the lives of innocent patients.  But why did they do it? The possible reasons:there is often unusual eagerness to recruit patients in a trial as successes in the eyes of industry sponsors as well as financial remuneration are linked with the number o

Crohn’s Disease and Biologicals

Anjali (name changed), a 38 year old bank executive, who had been troubled by recurrent bouts of loose stools over a yearand had lost 4 kg weight,and for which she had been prescribed several courses of antibiotics, without lasting relief, had begun to get a “gut feeling” that something was not quite right. She had also started experiencing severe backaches and stiffness of the joints that was interfering with her work. Exhausted, and at her wit’s end, she underwent a colonoscopy, by which we inspected her large intestine, and discovered that she had patchy ulcers and swellings. The biopsy report indicated Crohn’s Disease. Crohn’s Disease(CD) is an auto-immune disease, in which the defence forces of the body misguidedly attack its own parts, the intestines in this case. Immune cells called lymphocytes pile up in the intestinal walls and pour out cytokines that imprudently attack and destroy the intestinal cells instead of invading germs. Once considered rare, CD is being increasi