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Showing posts from December, 2015

Coping with Midlife Crisis

When a 57 year old well-established doctor suddenly decided to quit his stable government job of 25 years, 8 years ahead of his retirement age, change his career path, move to a new town, buy a swanky car, many were taken by surprise. When a lady of 52 years, decided to leave her career of 15 years as a school-teacher, to dive into her passion of Hindustani classical music, her friends and family were taken aback. When a 40 year-old successful industrialist running a health care industry suddenly deciding to leave his corporate life and take to spirituality and social service, his colleagues were stunned. Many men and women, usually between 35 and 65 years, often show a change of mood, or surprising behaviour, that smack of mid-life crisis. It was described first by Elliot Jacques in 1965, and since then been recognised the world over. The common symptoms and signs include: 1. Change of job, often giving up one that had been going smoothly for years, and taking up a more c

How To Deal With Pimples

Pimples are those unwelcome pink little bumps that crop up on the cheeks, chins and foreheads of youngsters often spoiling that otherwise perfect party or sometimes shattering self-esteem and scarring their faces for years. True, they are not dangerous, in the sense, they do not kill or shorten life, but their effects can be pretty nasty and long lasting, on the skin and on their personalities. Also known as acne, spot or comedo, they result from oily secretions getting stuck in skin pores. Inside the pore are sebacious glands that produce sebum. When the outer layers of skin shed (as they do continuously), the dead skin cells left behind may become 'glued' together by the sebum. Their appearance around adolescence suggests that hormones play a role in their development. Around puberty, the skin tends to get thicker and the sebaceous glands go into overdrive producing more sebum that builds up behind the blockage. Sometimes this sebum gets infected with bacteria such as

Environment and Human Health

With leaders of over 190 countries discussing global climate in Paris this month, unprecedented floods wrecking havoc in Chennai since last week, smog engulfing the Chinese capital Beijing right now, and air quality charts of Delhi showing that the air we are breathing is choking our lungs and hearts, I would have to be quite an ostrich to write about any other health issue this week. The health consequences of the Chennai floods that have killed over 200 people is just the tip; what is of greater concern is the wave of infections especially diarrrhoeal diseases, typhoid, pneumonias, malaria, dengue, skin infections and stress that are to follow. Further the floods have devastated the lives of several million and sent shivers down our spines by reminding us that some freak natural disaster could usurp our lives just as it did to Uttarakhand a couple of years ago. One of the core issues is the amount of green-house gases emitted in to the atmosphere due to the use of fossil fuel

Importance of Emergency Medical Care

Among the many issues that grabbed media headlines in the aftermath of the Paris carnage recently, the story of how the French medical emergency services responded to the unexpected challenge holds many lessons for us. Within just TEN minutes of the blasts and shootings, information reached the Emergency Medical Services and its crisis cell called Assistance Publique-Hopitaux de Paris (APHP) got activated. This cell mobilised 100,000 health-care professionals, 22,000 hospital beds and 200 operation theatres across 40 public hospitals in preparedness, all within an hour. A crisis WHITE PLAN that had been worked out and rehearsed for several years was activated, making this the most coordinated medical rescue and support mission in Europe in its history. The tasks of gathering information, networking and coordinating transport was managed by a cell of 15 people. Forty five well-equipped emergency ambulances with doctors, nurses and technicians were pressed into service, each knowi

Traditional Medicine Finally Gets Nobel Nod

Traditional medicine has got its biggest stamp of approval from the scientific community up until now, with one of its practitioners finally getting the Nobel Prize for medicine in 2015. Dr. Tu Youyou, the 84 years old lady scientist from China who introduced the anti-malarial properties of extracts of a plant (sweet wormwood) to modern medicine, is the recipient of this year's prestigious prize. Artemisinin, the compound that she extracted and discovered, is currently the most favored and safest anti-malarial drug used worldwide, and has saved millions of lives from malaria. The story of Dr Tu’s discovery is an interesting one. In 1967, Communist leader Mao Zedong decided there was an urgent national need to find a cure for malaria when it was spread by mosquitoes and killing Chinese soldiers fighting Americans in the jungles of northern Vietnam. A secret research unit was formed to find a cure. Tu Youyou was appointed head of Mission 523 and dispatched to southern China whe

Sensitivity: Key to a Healthy Society

When I was a child and encountered the first death in the colony of an elderly neighbourhood-uncle, my grandfather taught me an important lesson. The news of Mr Khan’s sudden death ushered in hushed discussions amongst elders, puzzled questions from kids, and a quick large gathering of friends and relatives at the neighbour's home three houses down the lane in our colony. That evening when we were ready in our sports gear and prepared to go down the same road to the play-field, my grandfather dissuaded us with “when neighbours grieve, it is unkind and insensitive to rejoice and play in front of them”. He had not used authority, nor quoted laws and rights, but had left it to us to decide how sensitive neighbours ought to behave. And we had hung up our shoes and sacrificed our pleasure of that day in an act of solidarity! When I became a doctor and earned my first stipend, I had taken a bunch of friends (Ali, Bhaskar, Mohan and Shyam Sunder Kothari) to a restaurant to dine. One

Understanding and Managing Addiction

Scientists seem to have found the underlying defect that explains why some people get addicted, be it to substances (alcohol, tobacco or drugs), sex, the internet, gadgets or shopping, with the discovery that addiction drives up levels of a chemical substance called Dopamine in a part of the brain called the “Pleasure Centre”. In an article published in the journal Nature Neuroscience in June 2014, researchers from USA looked at addiction related role of nerve-to-nerve communication in the brain, and concluded that activity in the neural circuit that provides the feeling of pleasure gets unduly strengthened in addicts, to the extent that it then starts obstructing other circuits dealing with r easoning and self-control. Addiction is therefore proving to be a brain disease of a chronic relapsing nature that cause compulsive seeking of pleasure-providing substances or acts that the addict finds helpless in controlling by will power or logical reasoning. Anyone who has observed an

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, thank s 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,

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

Murderers: Are they Born or Made?

Most people would find it hard to commit murder, but in the backdrop of several high profile homicides in recent times, people are asking loudly what makes some people go ahead and do it. Neurobiologists identify two types of murderers: those who are hot-headed, aggressive and easily provoked to anger, and another that are cold, calculating, and “psychopathic”, and the two groups seem to differ considerably in the ways their brains function. The story of taking a peep into the brains of murderers started in the early 1990s when the women of a crime-prone family in the Netherlands approached a neuro-geneticist to look into the brains of their men-folk who had had repeated bookings for violence, arson, rape and murder, to see if there was an evil gene in the family. And not surprisingly, doctor Hans Brunner who undertook the investigation found that these aggressive men had an abnormal gene located on their X chromosome that encoded for an abnormal subtype of a brain enzyme called

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’

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 promot

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 pers

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 a

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 th
Music and Well Being Several modern clinics, hospitals and operating theatres are discovering the clinical benefits of soothing music and using it not just to make patients feel better, but to improve medical outcomes too. Several surgeons who undertake nerve racking long critical operations on the brain, heart or liver, ensure that there is music playing in the OT, usually instrumental, often classical. Surgeries sometimes require up to 20 hours during which a human life dangles uncertainly from the surgeon’s hands that are expected to remain consistently and unwaveringly steady. And it is often left to music to ensure they do. Studies on the effect of music on patients and relatives waiting for surgical or endoscopic procedures have consistently shown that a period of exposure to music in the waiting chamber during this stressful wait significantly reduces heart rate, blood pressure and anxiety levels. This prepares the patient to face the procedure better. The e