Cysticercocis
Maneka Gandhi
 Many
years ago, my husband and I had gone for
dinner to a close friend. There was
another guest, a young girl of 18. While
we sat around the table talking, suddenly
she shrieked and fainted. We panicked and
rang up her mother. The girl woke after
several minutes and asked us what we were
doing in her house. She had complete
amnesia. After getting up to drive us all
away, she fainted again. By then her
mother came and she was taken home and
the doctor called. When I rang up her
mother in the morning she told me that
the girl’s right arm was paralysed
for an hour and she had been taken for an
MRI. A few days later it was established
that she had a cyst in her brain caused
by the pork tapeworm. For three years
after that she was on medication.
Three days ago, I read about Mohammed
Hasseb in the newspapers, a barber from
Faizabad. He was admitted to the Sion
Hospital, Mumbai with severe headaches
and blurred vision. The doctors found 400
cysts in his skull. Each cyst contained
thousands of tapeworms and had to be cut
out carefully for if the liquid had
leaked out, more cysts would be formed,
killing the person.
There are two kinds of tapeworm
infections: those created by the
Echinococcus granulosus worms- as in
Hasseb's case and those caused by Taenia
solium as in the tennis player Leander
Paes' case. Both are caused by eating
meat.
Cysticercosis and Taeniasis are two kinds
of infections caused by Taenia solium, a
tapeworm normally found in meat of pigs .
Though pork is the main carrier, you can
get infected from the meat of sheep and
goats as well. A recent WHO study showed
that 10% of sheep slaughtered in Delhi
are infected with tapeworms and the
percentage is much higher in Mumbai.
Cysticercosis occurs when Taenia solium
eggs enter the stomach through infected
meat or water contaminated with infected
human fecal material. Once inside the
stomach, the tapeworm egg hatches. The
larvae of the tapeworm, called cysticerci
or bladder worms, then penetrate the
intestine, and migrate into the skeletal
muscles, heart, eyes ,brain and spinal
cord. Once there, they form small cysts
containing the worm.
In muscles, cysts create nodules under
the skin and cause swelling. If cysts
form in the eye, they can impair vision
and can cause blindness by floating in
the eye and detachment of the retina.
Lesions in the heart can lead to abnormal
heat beat rates or heart failure
Formation of cysts in the brain or spinal
cord is called Neurocysticercosis.
According to Centers for Disease Control
and Prevention Division of Parasitic
Diseases, "neurocysticercosis is
symptomised by, epileptic fits, seizures,
and headaches. However, confusion, memory
loss, lack of attention to people and
surroundings, difficulty with balance,
hydrocephalus or swelling of the brain
may also occur. Death can occur suddenly
with heavy infections."
The symptoms can occur months to years
after infection. Often, there are few
symptoms. Neurocysticercosis is difficult
to diagnose in its early stage and may be
apparent only when the first neurological
symptoms start, or when a CT scan, or a
MRI of the brain is performed for other
reasons. The first thing a doctor who
suspects it will ask is whether you eat
meat and specifically pork?
While there is anti-parasite treatment
for early cases, sometimes it is just too
late – or surgery, as in the young
girl's case, cannot be performed because
the cyst is in a very delicate area of
the brain.
Cysticercosis is not spread from person
to person. But a person who is infected
with taeniasis will shed tapeworm eggs in
their faeces and if these are eaten by
scavengers or contaminate water, then the
cycle starts again.
Even cattle meat is infected with Taenia
saginata or Beef Tapeworm. Both the pork
and the beef tapeworm infections are
widespread in Asia and Africa and on the
increase in Europe.
Cysticercosis affects an estimated 50
million people worldwide. Endemic areas
include Mexico and Latin America,
sub-Saharan Africa , India, and East
Asia. It is a leading cause of epileptic
seizures worldwide. 50,000 people die of
this disease annually.
The best way to avoid cysticercosis is to
avoid eating pork and other meats. All
pork in India is from pigs that roam
around wild in the slums of the cities.
They are usually hot and cool off by
sitting in filthy pools of feces
contaminated stagnant water. They are
never fed; they eat at the garbage dumps
and from the open drains that carry human
feces, blood, vomit, sweat and saliva.
Since it takes 11 kilos of input to
produce one kilo of meat, by the time
they are caught by the local residents
and killed by trussing them up and
repeatedly stabbing them to death, their
bodies are full of tapeworms which is
passed onto you in the pork. No meat
shops have refrigeration. No meat shops
have heard of cleanliness or even proper
disposal of meat or blood. It goes into
the same sewers that more pigs will eat
from. Look at your local slaughterhouse,
live and dead animals standing knee deep
in blood, butchers spitting and urinating
on them, the blood flowing into the open
drains, flies all over the place. Now go
to a laboratory and have an inspection
for tapeworm infestation. You might save
your own life.
Anyone wanting to join the animal welfare
movement contact Smt Gandhi at 14 ashoka
Road, New Delhi 110001 or gandhim@nic.in
*****************************************************************************************
Off the beaten track
 Watertight
itineraries, buffet lunches, guides ever
in a hurry- these ubiquitous parts of
packaged tours are being shunned by a new
breed of Indian traveller who opt for
adventures of their own, finds Ritusmita
Biswas
At first I could see nothing. And then my
eyes adjusted as I realised with a gasp
that I was finally under the sea. The
feeling was uncanny and I could see
colourful organisms and fishes all about
me. A sudden gasp from the woman next to
me and I turned my gaze in the direction
she was looking. It was then I saw it eye
to eye. Eyes as mean and almost daring me
to come out and face the challenge. Of
course, I was safe within my cage and
thankful for that. Even seeing a shark
from such close quarters would take a
toll on my nerves, I thought, but at the
same time I was elated that it was such a
welcome break from the mundane
holidays." : Shweta Pandey, 28,
finance manager with a multinational
company after her trip to Hawaiian Island
where she went shark watching.
Calm holidays comprising romance and
stargazing seem to be passé for the
regular traveller these days. They look
for thrill and unusual activities like
underwater shark watching during
holidays.
In fact, a new kind of Indian traveller
is coming up. He hates packaged tours and
buffet lunches. He is out on a foreign
land with just his backpack and is keen
to enjoy the adventure and exoticness of
a foreign country. Comfort for him is not
the key word but adventure is.
"Yes, that's correct," says
Shreoshi Moitra, a leading travel agent.
"These new travellers like to check
out everything by themselves. Although
for most Indians I would say holidaying
is sort of a comforting concept, a time
to take rest, it's not for these people.
They come to us demanding for exotic
destinations which will have
opportunities for sports related
activities." For example, a couple
months back there was this traveller who
wanted to go to a virgin place, somewhere
no one goes. "The problem with such
demands is that these places usually lack
basic tourist amenities," she adds.
But some travel agents long associated
with the industry point out that it is
not a problem for these tourists as they
are mentally prepared for it. They want
adventure and fun, thanks to the
programmes of National Geographic channel
and other adventure series that are
regularly watched in homes with cable
television.
One such traveller is Anarghya Basu. A
media professional working with a
well-known ad agency in Mumbai, he is a
mountaineer, camper and hiker to boot.
"For my travel related to work I
have enough five-star comfort and air
travel. But for my holidays, I want it
different. I keep everything necessary,
including the provisions, with me. At
times I hitch hike alone in a countryside
while at other times I go with my group
to trek at exotic locales like Pindari
Glacier." Agrees biker and
adventurer Gaurav Jani who has travelled
across India on his bike. "The
thrill of discovering something new,
going to places people usually never go
makes my holiday. It's not about comfort
but the mental happiness and relaxation
which make it worthwhile. After all, if
you want comfort it's best to stay at
home," he declares.
Keeping pace with this new kind of
traveller, travel agencies have come out
with new schemes and locales destined to
thrill the tourists. Some of the popular
activities include snorkelling and scuba
diving in the Andaman and Nicober
Islands. Here one can explore the
underwater world and enjoying sea life to
its fullest. The best time to go is
December to April.
Or one could try paragliding at
destinations like Kallahaiti (near Ooty)
Virar (near Mumbai) Billing (Kangra
valley) and other places. The paraglider
is an inflated nonporous cloth wing which
flies via openings in the leading edge in
the wing. The pilot is suspended beneath
the wing on a harness and has the control
in his hands. The best time to try out
paragliding is September to March and one
spends about Rs 1,500 per day. Then there
is parasailing which one can do even on
Goa's famed beaches. The passenger is
harnessed to a flat parachute which takes
him to air from where he can enjoy vistas
of the coastline or cliffs. One needs to
spend Rs 400-Rs 700 for 3-5 minutes in
air.
Skiing, the popular winter sport of
Europe associated with highlife, is
getting increasingly popular in India
too. Now a Ford company is even going to
start a private ski resort at the
foothills of the Himalayas. Auli in
Uttranchal has steep slopes as high as
9000 km and the best infrastructure.
Manali and Rohtang Pass could be other
destinations and the best time is
December to March. One needs to spend
around Rs 10,000 for a weeks sport and
training.
Today, unlike in the past, the Indian
traveller does not seem reluctant to
spend money in order to enjoy these
thrills. Explains psychologist Rina Basu
Roy: "People today are mostly bored
with the common things. They are forever
craving for thrills and an escape from
mundane work-loaded lifestyle. They have
all the comforts they need at home. So
the holiday becomes an ideal option for
looking at the other side of life,
experiencing nature."
Agrees trekker Soma Nath: "All of us
are scared while trying out these sports
however brave we might be. And only when
you are scared and face near death almost
that you appreciate what life is! After
all, life is so short and you need to
have all experiences in one life."
(TWF)
**************************************************************************************
Customer
satisfaction in hospitals
Arun Sharma
 The
hospital market has today changed from a
sellers' market to a buyers' market,
where the patient is all-important.
Therefore to achieve patient
satisfaction, the hospital has to develop
itself technologically, as well as become
more service-oriented.
It is essential for a hospital to reach
out to its customers/Clients (patients),
if it wants to survive the competition.
This can be achieved only by building a
bridge of trust between the hospital and
the community, so that the community can
crossover to the hospital. One needs to
understand the fact that patients do not
flock to a hospital just because its
services are cheap, but because of its
good name and good image.
Unlike customers of other service sectors
who use the services provided to them of
their own free will, and part with their
money happily, the hospital customer is
forced to be a customer because of his
illness and parts with his money
unhappily. The hospital therefore needs
to take this difference into account
while dealing with their patients.
The second differentiating factor is that
the customer of the hospital, unlike
other industries, gets a close look at
all the rungs of the hospital. He gets a
chance to interact with practically
everybody from the receptionists,
admission staff, doctors, nurses, ward
boys, ayahs, ambulance, personnel,
billing staff, among others.
A hospital's primary objectives are
usually humanitarian, philosophical or
regulatory and based on some perceived
need. However, a problem may arise when
what the patient 'needs' is different
from what the patient 'wants'. For
instance, what a patient needs from a
hospital is reasonable good quality
medical care. Yet market research over
the past few years has shown that
hospitalised patients want a variety of
amenities not associated with their need
for reasonable good quality medical care.
They want smiling, empathetic nurses and
staff, a wide selection of foods for
their meals and a quick response to their
calls.
Customer satisfaction
Customer satisfaction is a person's
feeling of pleasure or disappointment
resulting for comparing a
product/service's perceived performance
or outcome in relation to his or her
expectations. As this definition makes
clear, satisfaction is a function of
perceived performance and expectations.
If the performance falls short of
expectations, the customer is
dissatisfied. If the performance matches
the expectations, the customer is
satisfied. If the performance exceeds
expectations, the customer is highly
satisfied or delighted.
The need to achieve patient satisfaction
has made hospitals realise the importance
of healthcare marketing. Hospitals are
therefore today making efforts to
determine what healthcare customers need,
tailoring their services to meet those
needs and then attracting patients to use
these services.
In all service industries, customer
retention is a vital issue. The cost of
customer retention can vary from a smile
to an investment in a Customer
Relationship Management (CRM) system.
Most administrators do not factor the
intangible assets of the hospital. In the
intangible assets, we must surely include
a loyal patient in addition to the highly
skilled nurses, technicians and
consultants. Actually the lifetime value
of a loyal patient: Customer Lifetime
Value (CLV ) can be modelled on a
mathematical basis. Since this subject is
so important there has to be a customer
relationship management officer who is
recruited preferably from the hospitality
industry. He should be on equal footing
with the finance controller.
The story does not end here. Customers
also bring in their relatives and friends
because they act as our brand
ambassadors. They also make donations and
bequests. When did you last make an
inventory of your intangible assets and
do you have a profile of each patient
which can be entered into a CRM
programme?
*****************************************************************************************
AIR POLLUTION
Ripu Daman Sharma
 The
impact of man upon the environment has
existed ever since man himself walked on
the planet earth.
Now a days the impact of man on this
planet has proved to be detrimental on
the environment. His mad rush towards
industrialization, urbanization and
modernization has contributed certain
hazardous effects on our ecosystem. The
human population explosion has resulted
in the pollution of air, water and land
along with povert and misery. Some global
issues of great concern have also been
originated from the same root, such as
acid rains, ozone laer depletion and
global warming.
Population explosion is the biggest
challenge, which our country is facing as
it has already crossed the limit as
compare. The bulk percentage of the
population is directly dependent on the
natural resources for the basic needs of
food fuel, shelter and fodder’s, as
our number is growing our needs are also
increasing, resulting in the over
exploitation of the natural resources,
the expense of which has produced certain
serious imbalance to the environment.
IMPLICATIONS OF
AIR POLLUTION:
Air is the life-supporting component,
which has been highly threatened due to
human activities leading to its
degradation. The air born problem, with
increasing population density and
industrial growth. It may arise due to
presence of solid particles, liquid
droplets or gases in the air in such
concentrations, which can be injurious to
biolife in the environment. Man made
sources are the main causative agents
behind environmental degradation.
Industrialization, urbanization and
technological advancements, while heading
the nation on the path of progress, have
also induced many physio-chemical changes
in the quality of environment resulting
in its degradation, which is proving
detrimental to the health of man and its
livestock.
EFFECTS OF HARMFUL
GASES
Carbon monoxide (CO) is one of the
hazardous atmospheric pollutants People
moving on the busy traffic roads and
congested highways are usually affected
by this notorious pollutant, specially
drivers and traffic police men it
adversely affects our respiratory system
by reducing the oxygen carrying capacity
of hemoglobin of blood by forming carbon
hemoglobin.
Its effect on human health is more severe
and fatal. Further it may cause breathing
problems headache and irritation of
mucous membrane. Its high and prolonged
exposure may cause unconsciousness or
even death. Compounds of sulfur and
nitrogen have also caused certain
injurious effects on the atmosphere. High
concentration of sulfur dioxide in the
air is not only dangerous to the health
of man and animals but also detrimental
to paper leather, bricks, metals, marbles
etc. Constant exposure to SO2 may cause
severe ling diseases like asthma,
irritation of eyes and respiratory tract.
PHOTOCHEMICAL SMOG:
Nitric oxide is responsible for several
photochemical reactions in the atmosphere
and involves in the formation of severe
secondary pollutants like PAN (Proxy
acetyl nitrate) ozone gas etc. It has
adverse effects on plants animals and
human health causing eye irritation and
reduction visibility it causes irritation
of alveoli emphysema, anthrocosis,
fibrosis and even lung cancer.
ACID RAIN
The oxides of sulfur and nitrogen
released in form of wxhausts, react with
precipitation in the atmosphere thus,
resulting in the acid rain. The acid rain
is an invisible threat and a burning
issue for the environmentalists because
of its implications. It acidifies the
lakes and the fresh water reservoirs
kills fishes and other aquatic life and
thus affect the economy, soil by inducing
acidity and changing the vegetation,
threatening the food and freshwater
supplies, damaging forests, endangering
the wildlife and other sensitive
crreatures, corroding structures and
monuments and delustering metals.
ALKALINE RAIN
In a survey conducted in Calcutta, an
alkalinity in the rainwater has been
observed. This alkalinity in the water
ranges from pH 7.01 to pH 8.33 from the
months of April to September (Mukherjee
and Ray, 1992). Suspended particles
present in the ambient air such as
carbonates and bio carbonates of calcium
and magnesium had been surmised to be the
reason behind this alkaline rain. Its
effect on the biosphere is still not
calculated and studies are needed to
ascertain its effects on life forms,
buildings and the biotic environment.
OZONE LAYER DEPLETION:
Chlorofluor carbons (CFCs) are the
chlorinated gases, which are released
from the refrigerators, air conditioners,
cleaning solvents, aerosol propellants
etc, in huge quantities are imposing an
ultimate threat on the ozone layer. This
ozone layer is present in the
stratosphere (12-50 km above the earth
surface) and acts as a protective shield
(also termed the ozone umbrella) against
harmful radiation, such as ultraviolet
rays along with cosmic rays and gamma
rays. The exposure of this radiation to
human beings may cause a significant rise
in the occurrence of skin cancer along
with other skin diseases and eye damage.
It is also harmful to several biological
species. It is estimated that each 1 per
cent decline of ozone may cause 4-6 per
cent increase in certain kinds of skin
cancer.
The use of eco-friendly alternatives and
substitutes against these notorious CFCs
has already been started.
Hydro-fluoro-carbons are the best
alternatives for the harmful CFCs.
The eco-friendly refrigerator and air
conditioner had been experimentally
developed, based on LPG (Luiquified
Pertroleum Gas), in place of CFCs by a
research team of Thermal Science
Division, Department of Mechanical
Engineering, Anna University, Chennai.
GLOBAL WARMING:
Due to its increased concentration of
carbon dioxide along with other green
house gases (such as CH4, CFCs, SO2 and
Nox) a thick layer of gases is formed
which prevents the re-radiation of heat
from the earth surface culminating in a
rise in mean global temperature. This is
referred to as global warming or green
house effect (Mjumdar 1999) It can lead
to significant and unpredictable changes
in global climate which affects life
forms including the mankind in various
ways. The global warming can uplift the
sea. The global warming can lift the sea
level due to the melting of ice caps and
glaciers which may cause high risk of
flooding associated with fiercer storms
and hurricanes thus resulting in the loss
of lives land biodiversity, epidemics and
the poverty. The agricultural zones are
expected to be severely affected by the
calamity which are in low lying lands
along the sea cost. This rise in
temperature also triggers widespread
alteration in rainfall pattern. Due to
which some regions would see dramatic
increase in rainfall other may even lose
their present vegetation because of
drought. This change and imbalance in
climate and vegetation may adversely
affect the biodiversity on land.
***************************************************************************************
Free will and fate
are not two but one
Lt Col R K Langar
 Free
will and fate are called two legs one
walks on. They are also referred as two
wheels of a cart where both play their
part in its movement. Man is caught
between free will and fate and it would
be fatal not to recognise one or the
other. Free will relates to our exercise
of will while performing actions in the
present life whereas fate is the sum
total of the effect of past actions of
our previous lives which influence our
present life. Exercise of free will in
relation to our past actions becomes our
fate in the present life as per the law
of karma which states that each one of us
is an effect of which our past has been
the cause. Results of our past actions
can be good which made us happy in the
present life whereas result of bad action
of the past can cause us suffering. In a
broader sense we can say that free will
and fate are not two but one as both are
grounded on exercise of free will.
Even though fate or destiny plays some
part in our present life human life is
not mathematically predestined. Human
beings are endowed with free will and it
should be employed righteously and
purposefully for our self evolution. That
we have a free will is endorsed by a
single verse of Bhagavad Gita. At the end
of His discourse Lord Krishna tells
Arjuna to reflect on what he has said and
act as he likes. If everything in life
was predestined then God would not have
told Arjuna to act as he thinks what is
right. Fate or destiny is usually
described by an average mind as whatever
has to happen will happen and man can do
nothing to change the course of events
which are destined for him as Fate. This
thinking is not rational. In life people
do take up challenges and fight them way
out to obtain favourable results. Once we
accept that every thing in life is
dictated by fate we close all door of our
progress. Not only that we adopt the path
of least resistance and wait for things
to happen rather than we ourselves make
things happen. The best is to utilize the
obstacles presented to us as fate as an
opportunity to put in sustained effort to
get over them. Obstacles presented as
fate should be recognised, dealt with and
defeated by the power of our self effort.
Self effort is another name of God’s
grace which goes well with the adage that
God helps those who help themselves.
People who are inclined to believe in
free will are always gainers as they are
prepared to act and not give up. The ill
effects of the sins of the past does not
dishearten those who believe in free will
as they act positively to neutralize
these ill effects. They know that self
effort and good deeds of their present
life shall erase the ill effects of past
deeds as milk poured in black tea
neutalizes its blackness. They accept the
law of karma or the rule of cause and
effect in totality. Sri Aurobindo says in
one of his writings that we are our fate
through our action. Our other saints and
sages have always relied on the self
effort of present life for creating our
fate through our actions. Lord Krishna
says in the Gita that man should stand up
and fight thereby meaning exertion and
not submitting to fate. Sage Vashishta
while instructing Lord Rama says that
fate or the effects of our past deeds is
like a child and our self effort of the
present life is like a youth. And in the
fight between youth and child youth shall
always be the winner. This conveys that
the fate will lose its sting when
confronted with the self effort. In
Mahabharta Bhisma conveys the same idea
when he says that exertion is greater
than destiny.
At an average state of consciousness man
should not set his mind on fate otherwise
one would lose interest in life. As our
level of consciousness improves then we
realize the part played by fate or
unknown had in our life. Inter
connectedness between free will and fate
is explained in the Gita which states
that there are five causes for the
accomplishment of all work. Out of these
four causes - the seat of action, the
agent, various senses and manifold
efforts - are under human control. But
the fifth cause which is called unseen
force of past Karma, fate or Daivam
(presiding divinity) is outside
man’s control. The non human
factor’s part in our action is
evident when despite our best effort we
do not obtain desired results for our
actions.
Can the effect of bad karmas be reduced
or oblitrated. When man surrenders to
God, renounces the fruit of his actions
and offers them to God then no fate
operates for him. When man rises towards
perfection, then his free will merges
with the divine will. Then God works
through him as he has surrendered before
God. As Maharishi Ramana says what would
fate do if you have surrendered to God.
Even if everything happens as per God
will yet man must work because God
expresses. His will through man’s
actions. Then man’s will is God will
and man’s will vibrates in harmony
will infinite when man is at a higher
level of evolution. Then man does not
propose but God purposes and God
disposes.
***************************************************************************************
**********************************************************************************
|