Monday, December 6, 2010

Leaking Wikis!

What ever the motives behind leaking viz a viz wikis, so many analysis, anticipations, assessments, back-door generating conspiracies and speculations have come true and well documented. From where were they generated? The horse's mouth.

One thing in all this "typhoon wiki" seems strange; in almost each corner of world, politicians and cronies are put to shame and some or the other kind of embarrassment but biggest and strongest US ally, Israel, has been pardoned and come clean. Why is that? Is the creator of all this a Jew or an American agent himself?

For citizens in the third world -- and that too all Islamic states -- it is a big relief and an eye opener. Perhaps it proves to be a blessing in disguise and their so called ruling class corrects their follies no sooner then later.

Wednesday, July 28, 2010

Waterborne Diseases


With ever so massive population growth, the scarcity of food, lack of shelter and non-availability of clean water to all is becoming one major global issue for humankind. The water shortage alone, has become life-threatening. People are left with no choice but to consume water from whichever source they can, be it wells, natural rain water reservoirs, offshoots of river banks, man-made wells. The picture turns more pathetic when as is a common observation made in rural areas that human population is consuming water from the same source as being used by domestic as well by wild animals. Add to this, the industrial wastage being dumped so casually into water reservoirs, which can become a source of human as well as animal consumption.

The hazards which can result from such a compromise, are so devastating that widespread epidemics of life-threatening diseases can engulf a massive area of population. It can either result from drinking untreated water or using dirty water for cooking and bathing. One can easily conclude from the situation prevailing, the heavy burden the health facilities have to bear in order to combat situations for which they have not been prepared to handle. This poses much greater concerns in third world countries as compared to developed ones, where not only the authorities make it possible for all the residents a clean supply of water, but also educate people on avoiding exposing themselves from unhygienic water.

International monitoring of situation

- Data of general concerns.

1.1 billion people globally don’t have access to clean drinking water.
2.4 billion people globally are not provided with proper sanitation facility.
2.2 billion people die each year due to water-sanitation and hygiene related diseases.
82 million disability adjusted years are lost annually (DALYS) (R Bos, 2004)

- Data related to specific diseases.

2 billion people are infected with schistosome and soil helmithes,300 millions of these have serious illness resulting from such infestations (WHO report)

1 million people die of malaria each year (largest group being children under 5 years of age) mainly in south Sahara in Africa.

365 million cases/year of acute illness is caused only by malaria alone (pregnant woman are the major group effected)

42 million DALYS by malaria are lost each year as estimated in year 2001

Diarrhea due to multiple causes accounts for 4% of all deaths and 5% of DALYS each year.
In some regions ,specific toxins creat health situations, e.g. in Bangladesh 35 million people are exposed daily to elevated levels of Arsenic, which not only is a health hazard but also shortens life expectancy.

Sources of water pollution

- Contamination by sewage and water treatment residue.

Both surface of land and water sources meant for human consumption get contaminated, when raw sewage overflows, if there is excessive storm water flow, which in urban areas run parallel to sanitary sewer system, resulting in overflow contamination. The grave consequence of such an event is bacteria and viruses like vibrio cholera, salmonella typhi, E.coli, Giardia, Hepatitis, cryptosporidium and helminthes as well as chemical toxins like nitrates, metals etc. polluting the water meant for human consumption, giving rise to epidemics of cholera, typhoid and hepatitis etc.

- Septic tanks overflow.

These are enclosed storage spaces, where sewer is treated before dumping takes place, and it is mostly adopted in rural areas where there is no proper sewer system. This system can fail, resulting in premature entering of untreated sewer into main water reservoirs, which can be future sources of human consumption.

- Sewer lines leakages.

From industrial or domestic sewer, waste water can contaminate drinking water source if the delivery pipes are damaged and leakage goes on unabated. The damage to living being in such situation can be enormous, such as chlorides, micro-organism, organic and trace metals, and other chemicals causing life threatening diseases getting mixed in otherwise safe water sources.

- Contamination from agricultural lands.

In agricultural sector, pesticides are being extensively used, to protect the valuable crops from weeds, rodents, insects harmful to cotton fields, and moulds. They are mostly alachlor, atrazine, cyanazine, metlachlor -- all being potential cancer forming substances in human beings. They easily get into drinkable water source as runoff from lands used for growing crops, especially when the crops are young and can not reduce the concentration of these toxic substances by consuming more and more water and hence the pesticide runoff too.

Specific Disease Condition From Contamination of Water

Water born diseases can be caused by:

- Viruses
- Bacteria
- Protozoa
- Intestinal parasites

a) Viral infections through contaminated water

Adenovirus flu is caused by adenovirus which spreads through improperly treated
water. Symptoms of sneezing, coughing, body aches with moderate to high degree fever are usual present but complication of croup and bronchitis to -- as severe as -- pneumonia can develop.

Treatment: Complete bed rest, increase in fluid intake, steam inhalations, antipyretics to control fever, and in case bacterial pneumonia complicates as
is usually happens, then proper antibiotics to prescribed.

b) Viral gastro-enteritis

Caused by Parvo, enteric, Adeno and Astro viruses, manifest with symptoms of vomiting, loose motions, malaise, abdominal cramps with or without fever.

Treatment: Because there is a greater risk of dehydration, the basic aim of management is quick replacement of fluids, and electrolytes, that can either be done by intravenous route or oral route after control of vomiting.

c) Hepatitis A

This is the result of infection caused by hepatitis A virus in contaminating water for human consumption. It effects human liver acutely, giving rise to symptoms of loss of appetite, nausea, weakness, pain abdomen, vomiting, itching, yellow coloration of eyes(jaundice), with or without fever.

Treatment: Complete bed rest, high caloric, protein and a low fat diet is all that is required. It is a self-limiting condition like most of the viral infections.

In addition to above mentioned common diseases, there are less common ones which can be spread via contamination of water meant for human consumption, such as polio myelitis, caused by polio virus and spreading when feces of infected person contaminate drinking water sources. SARS (Severe Acute Respiratory Syndrome) caused by corona virus when improperly treated water is supplied to population.


d) Bacterial infection through contaminated water

Typhoid fever is caused by salmonella typhi when feces of infected person contaminates water reservoir and when the infected person handles food for human consumption. The main feature of typhoid fever is the stepladder pattern of high grade fever, which is sustained, and never touches the baseline unless infection is controlled by proper antibiotics. Other features include profuse sweating and abdominal pain, with or without loose motions. Rash may be seen specially on trunk.

With the availability of laboratory facility, early diagnosis and prompt treatment, fatality due to typhoid fever is rare.

Treatment: Complete bed rest, high calorie diet, intravenous or oral fluids to compensate for any electrolytes /calorie deficiency, symptomatic treatment with specific antibiotics to control bacterial infection. As part of preventive measures, patient should be nursed in isolation, strict hygiene must be followed, whether the patient is hospitalized or cared at home environment. Washing hands after attending the infected person under treatment.

Dysentery is also caused by different strains of salmonella and shigella group of organisms, when drinking water gets contaminated by sewage water or persons handling food are infected by causative bacteria. Predominant symptoms are frequent passage of stools with or without cramps, mixed with blood or mucus, in some severe cases vomiting of blood.

Treatment: Soft, easily palatable diet, fruit juices, and soups should be given at frequent
intervals to combat the generalized weakness resulting from illness, if there are any signs of
dehydration.

Tuesday, June 15, 2010

Intentional Tragedies

The events in life that take place suddenly without any pre-amt thought are labeled as accidents, and those events taking course with knowingly outcomes are intentions. Accidents can be avoided but they can’t be prevented! Intentions can be prevented and be avoided.

In our political culture, there is hardly any leader who thrives on good intentions. Three elements in our country’s political chain are synonym; power, authority and misuse. A leader here is defined as one who has all the resources available to him, has people positioned at right places to manipulate at right times, has the uncanny ability to change stance whenever and wherever it pleases and suits his interest.

Most of the political figure of present era we face each day have intentions not compatible with interest of a common man so what they think benefits their personal gains, they intend to achieve. For the purpose of the same, the only way to reach the goals, power becomes their tool. Once getting there, they get authority to manipulate all the rules and regulation coming their way, weather it is constitutional or legal.

The reasons given every time something done at government level, weather be it taxation, price hike of any basic amenity of the common man they justify it “in the interest of the nation” pretext or that “we have taken some painful decision for better future”.

It is a common practice for the so called “ruling class” to ask for big sacrifices from the common man, and when sacrificing their own interest comes into focus ,the privileges are strongly demanded. In the most toughest and trying times the nation faces, they are “the only” cool customers, unnerved, unperturbed by the events. Because even in the worst case scenario, they have the tickets ready all the time to “fly away” to their “home land”.

Time comes and goes. Tragedies occur, mistakes made, but what is learnt from them always remains a big question mark in our politics. For me what has been observed, they never learn for the bad days they leave behind to moan. And history repeats itself for the better, and who benefits this time around is the lone common man. so he thanks almighty for the relief he was waiting for because it is him, who controls every event, every moment. He has given wisdom to mankind but he waits until they poorly and rarely use it.

The one and only reason which is clearly visible to naked eye and mind is the wrong notion of remaining at self created throne for ever and more. Refusing to believe that like every other thing in this universe, culminating to its fateful end, the people placed in power must reach their demise. Now it is upto them to choose between the gallows or the glory!

Monday, June 14, 2010

Happily Ever After

There was a time when getting married was considered a moral obligation and a part of cultural dignity. The male part was taken as a symbol of responsibility and security whereas female was taken as a beatification sign and domestic strength. Long and time-consuming efforts were done to get a pair in making, with the groom’s family visiting the bride-to-be's family, presenting themselves as a best match for the girl. Picture-sharing was the typical presentation formula for both the boy and girl. It was almost impossible for the future life partner to see each other before legally married.

Marriages solemnized during that era were taken as long-term, never-ending relations, where family values, mutual respect and loyalties held the relation together and ever stronger. Personal gains and interest always stood last. The foremost issue had been the happiness and interest of family. Eating together was considered as a sign of ever-growing prosperity. The grandchildren were always the apples of the eye for aging parents. In-laws were loved, cared for and respected as real parents.

But as they say good things always change with time. Values change. Cultural polarization brought change in the thought process. People changed. Values which were once considered against the religion and culture are being taken as a need of time. Traditional inter-family marriages are taken over by inter-cultural marriages. Language, cast, creed and religion remain no bar. The one reason which has brought such a drastic change has been education. Not only it widened thought process but also played a key role in giving new meaning to relationships.

The other reason which played significant role has been ever-blooming electronic media. Talk shows portraying women liberty, working women, movies of different cultures, fashion shows and of course the dramas. Men and women working side by side, getting basic as well as higher education at same institute removed any prohibition which once were significant part of cultural values.

Choosing life partner in such setting has become more common. Still, the parents have to be involved, as we still value our culture and respect elders to some extent. But after getting married, the picture starts to get more clearer, as many issues start creeping into social life. Most common of these is the failure of the new bride to accommodate the in-laws in her life. If she is working, then it is more than complicated. There develops a failure to balance new relations in life. In a culture that we are in, it is not very difficult to understand that parents are to be cared for, loved and respected. This goes for both man and woman. The outcome of such a scenario has a two-prongs effect; either the young lady slowly starts understanding her role and adjusts in new family setup or totally ignores it, making life a bit hard for herself and for her husband. The former situation brings about a better and positive change whereas the latter has all the negative possibilities in offing.

So when we start analysing, it is not very difficult to conclude that the culture and tradition we are brought up has its values different than what is being depicted as modern era needs. The new generation will not have much of a problem in finding a solution. The only thing needed for them to do is to just recall how their parents got along together so many years, loving and caring for each other, bringing up the kids and caring for aging parents. It requires sacrifices from both partners and compromise few times, here and there.

This approach has all the ingredients for what we call long term relations, because no other way one can have a happy life. It’s a give and take attitude which bears fruit of fulfillment, and most of it is giving rather than taking which is more satisfying…

Tuesday, June 8, 2010

Think Twice!


None of us can deny that they love shopping and getting themselves some new garments, furniture items, kitchen ware etc. but who can claim they are the best shoppers! you can get your self- assessment by going through the following. We can categorize consumers into four different classes:

Class 1: They are the ones who don’t have expenditure limitations. They have a what we call shopaholic nature. Choosing expensive outlets is their target. They look for the most expensive price tag of the items they like, even if cheaper ones are available. To bargain is not in their vocabulary. Not to bargain is what they call is a status symbol. As for the seller, they are the best bargain of the day. They sell may be the most average items for the top price… may be at a few soft drinks cost!

Class 2: They go around shopping with wallet full of cash and with mind full of sense. They know before hand what to buy and the budget for it. They have lot of time and money available to them to shop around, select the best item and buy! As for the cost they put their own price tag! But they are most difficult of customers from the seller’s view. He can’t get much out of their wallets... talking about some extra bucks! So no soft drinks to offer.

Class 3: Their sense of shopping is primarily dictated by the capacity of the wallet and it is has limits! So they go on purchasing on daily or thrice weekly basis. To safe some money is the prime rule. Bargaining they do, but if it doesn’t work, they sacrifice quality to still safe something for tomorrow! And from sellers view they get good sale from this group, because cheaper items come much cheaper, be it grocery, fruits, furniture or electronics etc.

Class 4: This is the class of people that doesn’t shop because they have to earn their living today. They can only go for getting their necessities, the next day. Happy-go-lucky, they are.They toll hard all day long, with no worries at all for the coming day. They are the surviving ones -- the majority in our cultural set up! All they need is two meals a day, a place to sleep and some work for they next day. When they go shopping they aren’t any worry to seller.

So, if you are among the top three, don’t think you are very lucky, think about the unlucky ones; someday that can make you very lucky!

Monday, June 7, 2010

Make A Choice













Life has adopted a great change in how it takes issues in their perspective. What was important has become of secondary significance. Earlier, education, health and family were the utmost part of ones life. Now career, job and making money has taken over a major chunk. A child gets sick and parents are more worried about the test the next day rather than seeing him get well soon. As early as 3 years, a toddler looks tense watching faces of both parents sitting with him at physician’s chamber, the physician himself observes the younger one with grave concern of what is to become of him/her in the coming years. Nothing can change what ideology the parents are carrying in upbringing their child. Most of the time it is fixed and locked. It doesn’t matter how much the physician tries to reason with parents to the approach with which they are handling their offspring at this early age is going to have damaging effects on his intelligence as well as confidence level.

Like a tired horse, or heated auto engine which needs rest, a human being when sick, should rest to regain strength, and time of cooling at all cost. But the hindrance in following such an advise is the level of competition prevailing. We can live and run our lives with better achievements if we draw a line. A child should be dealt like one. He/she must live free of all worries, study, play and sleep as they please. And when not well, healthwise rest in bed; no exam, no test!

In most of the cases, you don’t get a positive response from the parents to let go and ease out a bit on a child who has just started to make assessment of what is going on around him -- good, the bad and the ugly -- rather, they put him to stressful test and an exam forced upon him. As research has proved just recently that early childhood self-learning has tremendous results and that anything new that has access to the brain of a child will be everlasting. So its quite clear that teaching done under stress or coercion will not get the required results from a child. An adult can handle any stress but a young child cannot! Let them fall a few times, they will learn to stand... on much firmer grounds.
For the much older group of children, when sick there can one of several ways to give the child the physical rest he needs and maintaining his academic activities all the while. This can easily be achieved with the co-ordinated link between parents and the school management. One of two simplest ways to attain this can either be a continuous contact between classmates or the affected child and teachers. The benefits of such an action will be two-fold: it will allow the child stipulated rest advised by pediatrician, yet keep him abreast of educational activities at school hence removing all the stress.
The parents hold the key role in making the right choice.

Saturday, May 29, 2010

Eat For Living


Diabetes dilemma

Diabetes is a serious condition .It is a chronic disorder of carbohydrate, fat and protein metabolism, characterized by elevated fasting blood sugar levels, greatly increased risk of heart disease, stroke, kidney disease and loss of nerve functions.

There has been so much research going on in medical field each day. All the efforts are aimed to improve quality of life, as well as prognosis of disease itself. Most of the work done on controlling infectious diseases has been rewarded with excellent results, as for controlling the infection as well as preventing it by vaccination.

The non- infectious ailments are becoming most difficult to manage. Diabetes is among the stubborn of all. There has been introduction of newer drugs every now and then, each has an improve outlook as for efficacy and lesser side effect. Insulin patch, insulin sprays are already in market in many western countries. although their efficacy is still being under close monitoring.

There are some countries like Canada and United states, where pancreatic cell implants have been done with encouraging results in animals.but as far as human application to this method, called stem cell generation is concern ,the use of immunosupressant like steroids has discouraging long term results.Total organ transplants are being done in united states and few other western countries,but there are more in need than the available organ donors. There are hectic efforts being done by research experts and clinical personnels all over the world, to keep mortality to minimum and morbidity as low as possible. Until major advancement is achieved in diabetic treatment, the basic diabetic management pattern will be unchanged. Diet control, mono or multiple drugs, insulin injections, insulin nasal spray (in some part of the world), regular physical exercise and blood sugar monitoring will remain the corner stone of good glycemic control.

The major part of responsibility to maintain a good blood sugar level and live as good a normal life lies on the person effected by diabetes, because he or she is going to have all main meals of the day at home or at the office, so what they will consume in terms of calories will not only determine success of treatment but also how much diabetic complications are avoided. Sadly in most cases this target is not achieved. The three basic reasons for such an obstacle are:-

(a) failure of drug compliance
(b) lack of will to adhere to diet regime advised clearly by physician
(c) sedentary life style or lack of regular physical exercise

The last two are the cornerstones of keeping a diabetic in good health and avoiding all the related complications. The complications can be:

(1) hypoglycemia

(2) diabetic coma

(3) diabetic nephropathy seriously damaging kidney functions, to the extent of needing renal transplantation.

(4) cataract

(5) neuropathy

(6) retinopathy

(7) skin ulcers and gangrene leading to amputation

(8) stubborn skin infections

(9) life threatening heart diseases.

Although as mentioned, a diabetic usually lacks the motivation and will to adopt restriction on his diet which becomes the very root cause of his complication later, but the physician cannot give up guiding and advising him about the best way to control blood sugar as normal as possible and lead a healthy life.

Following are basic and simple guidelines :

(a) Meals composed of complex carbohydrates are rich in fiber, which are slower to get absorbed and therefore provide a much slower and gradual increase in blood sugar level, giving time to limited availability of insulin to be effective.

(b) Small, frequent meals through out the day, rather than full regular meals.

(c) Intake of vegetables and fruits of low sugar content.

(d) Adopt a regular physical exercise pattern 2 ½hrs of total weekly duration. Exercise not only burns the calories, it also brings down blood sugar levels, increases tissue chromium thus in turn increases number of insulin receptors thereby enhancing effects of insulin to bring down raised sugar to control levels.

(e) Obesity is strongly associated with diabetes type 2,weight control is an important element in diabetic management. If you want to loose weight to control diabetes, high blood pressure and risk of heart diseases, then walk, walk and walk some more.

Oral hypoglycemic drugs and insulin injection don’t cure diabetes. The key word is HEALTHY LIFESTYLE through diet, exercise, certain herbs and supplements.

For more info, visit the following website: http://stemcells.nih.gov/info/scireport/chapter7.asp

Thursday, May 13, 2010

Caring

This single word, though seemingly simple carries a heavy commitment and, of course, care. As you all know, one can never guess when one's time ends. We have two choices to live our lives; live as insensitive careless being or share some burden of our fellow human beings by any which way we can. To be sensitive and to care leaves an ever-lasting impact on people around us and visa versa.

The motto is to have the will and to do good for the well-being of fellow humans and to yourself. Please join hands and let us seek around if some one needs any help or a place where they can share their problems.

As a physician, I can help you on my part. Just post your problems concerning health or social issues and let me give you the best and most suitable advice.