Executive Knowledge Lines May 13

7/28/2019 Executive Knowledge Lines May 13

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Editors Desk

1 May [email protected]

N T Nair, Trivandrum

Please don't rate this as a retrograde step by EKL, a magazine engaged

in reporting state-o-the-art technologies. But we are constrained to makesuch a view, seeing that in developing countries, where Internet and its usageare just taking baby-steps, the practice o taking reuge under websites byocialdom is rampant. In other words, with only a very small raction othe population engaged in high-tech ways o doing things, the governmentmachinery ater putting various data in its websites, expect the illiterateand the not-so-well-informed to access and use them. But, it is not yettime or governments in developing countries to ully operate in 'website'

mode, doing away with the existing practice o paper-based inormationdissemination. O course, it would be an easy way out or ocials to playsae by telling that every detail is available in the website which the citizenshould have seen - including the illiterate armer alien to computers.

Fine printand lengthy conditionsare other techniques many entities otenuse as part o their escapist plans.

An e-governance era, however, is in the ong when citizens o a countrywill be able to access the websites to know the government inormationrom time to time, through their smart phones. But it is little ar in the case

o many developing countries where sucient tele-density and computerpenetration are not yet available.

Electronic governance reers to the use o inormation and commu-nication technologies (ICT) by government agencies. Such a connected

governmentconducts digital interactions between the government and otherstakeholders - citizens, businesses, employees, other governments and inter-national agencies. They do it through well designed government websitesthat are citizen-ocused and visitor-riendly.

According to the 2012 United Nations e-government survey rankings,the Republic o Korea is the world leader ollowed by Netherlands, U.K.and Denmark, with the United States, Canada, France, Norway, Singapore

and Sweden close behind.Till such time as the preparedness o governments

and citizens in most developing countries includingIndia, or a web-centric governance reaches its maturity,the present method with its attendant problems, hasto be continued. However, the demise o the existing

system is sure to happen in every country, leading to acitizen-centric, digitally-enabled governance system.

Details in WebsiteAll countries ready for such a governance?

May 2013Executive Knowledge Lines3


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Nature Line

Cinnamon

The Sweet Wood of the WorldCinnamon is a very common

spice around the world and mostpeople have enjoyed the sweet andpungent taste o cinnamon in some

way. Cinnamon, the inner bark oa tropical evergreen tree has twomain types, Ceylon cinnamon (Cin-namomum zeylanicum Blume) andChinese Cassia (Cinnamomumaromaticum Ness). When dried,cinnamon rolls into a tubular orm known as a quill. Regardless ospecic variety, the trees bark produces essential oils, used in manyarticles ranging rom perumes to medicines or high blood pressure.

HistoryCinnamon is an ancient spice mentioned early in the Old Testa-ment and continues to play an important role even today. Cinnamonhas been traded around the entire world since the 1500s. Egyptiansused cinnamon in their embalming mixtures, and Moses used its oilas anointing oil. In the ancient days, Cinnamon was regarded more

valuable than gold. They were the most valuable medicinalplants or ancient Greeks and Romans. Both Cassia and

Cinnamon were known in the ancient world. Cas-sia was the more widespread species,

though Cinnamon was consideredto be o ner quality.

Cinnamon Treesgrow in ull sunand part shadewith regular wa-

tering throughoutthe year. Propaga-tion is by seeds.

Contd. : Page 33


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Future predictions in the dynamic human bodynever could prove correct. Doctors have been predict-ing the unpredictable or decades. The story repeats inthe area o cancer and AIDS. While cancer has not beendeeated even with all our publicity, a recent WorldCongress o AIDS showed that all the expensive new

drugs did not change either the mortality or morbidityscenario. On the contrary these drugs encouraged youngsters to ventureinto dangerous liestyles! This strategy helps the drug and instrumentmanuacturers. Most apparently healthy people, even beore the ageo sixty and certainly ater that, take, on an average, 4-6 pills per day.Their doctors believe that they are being very scientic and cover theirskin against any uture legal claims and the poor patient is made tobelieve that he/she is protecting himsel against all uture complica-

tions and death.Both the assumptions are ar removed rom the truth. Every singlepill has ills ollowing its use in the long run. Even an innocuous pilllike paracetamol did kill 136 people in one year in the UK, due to liverdamage. While drugs are needed to control symptoms on a short-termbasis, long term use o any drug is raught with danger. Emergency careis the only area where modern medicine and technology have really helpedthe sick and they are indispensable there.

This scenario has produced a new category o disease, notdescribed in the past in any system o medicine, which I would like tocall as doctor-thinks-you-have-a-disease syndrome. This new non-diseaseproduces so much o social distress in that the hapless victim suersconstant anxiety o incubating a disease. His amily suers psychologi-cally and nancially.

The whole purpose o living-or lie, liberty, andpursuit o happi-ness as envisioned in the preamble to the American Constitution, writ-ten by Thomas Jeerson in 1772, is lost orever. It would be dicult to

get an American who is not taking some drug or the other all throughhis/her lie; i not anything else, at least a multivitamin.

Even the latter has side eects. At times they could even be atal!Naturally we, in India, will have to ollow that, as America is ourintellectual master these days. This is the largest catchment area or

Predicting the Unpredictable!

Cautions Dr B M Hegde

Health CareTheme in Focus



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drug companies and instrument manuacturers, who make trillions odollars prot with this trick.

It is more protable to target the whole healthy population o thisworld to make money rather than aiming at the sick as the latter num-

ber is very small compared to the healthy ones. Luckily, nearly 80%o the world population today has no touch with modern medicine!Screening healthy people could seriously damage their health. Thereare two exceptions. Heavy alcoholics and heavy smokers blunt theirbody messages o initial illnesses that they realize there is somethingamiss only when it is too late. They could prot by regular screen-ing. The latter two categories o people are not healthy individuals,anyway! Even mammography, with all its advertisements, has not been

shown to be benecial!For a ew people who could not get into this arena o regular

checkups, another new disease awaits to rob them o their happiness.Happiness is mans only birthright! They are always anxious that theyhave not been properly evaluated to be kept constantly healthy. Theylive under the shadow o doubt. The constant anxiety could give riseto most chronic dangerous diseases.

I class this group under another new disease category-patient-

thinks-he-has-a-disease syndrome. The reasons why these people do notget into the rst net thrown by the drug and industry group could beeconomical. Poverty being the mother o all illnesses they succumb toreal disease sooner than later. The poor pay or their poverty with theirlives, anyway.

In this whole game o the drug and technology mania, the key ele-ment in human health and disease is orgotten. It is the human mind.The seed o every single disease is rst sown here. The seed then grows

in the soil, i.e. the human body and its environment, getting helprom tobacco smoke and alcohol, eventually to result in disease. Finalpenetrance o the type o disease depends, o course, on the geneticpredisposition.

To cite an example, heavy alcoholics could either die o liver dam-age early on or live to get a heart attack or sudden death due to heartmuscle disease, depending on their genetic pattern. Similar is the storyo tobacco smoke resulting in either a heart attack, lung cancer, or

emphysema based on the genetic background o the person.This, in essence, is the long and short o human illness. Any anxietythat upsets the happy human mind is the beginning o a disease. Themedical proessions present preoccupation in creating more anxiety

will result in higher morbidity and mortality. The earlier we under-stand this the better or mankind.



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I could rewrite the poem by Emily Dickinson, incorporating thephysicians as well, thus:

Physicians must be very careul

When they give a pill or every ill!Deep inside their victimStirs the Culprit-Lie!

That said, I must provide some solid evidence to throw light on thedarker side o the moon described above to make the narrative moreauthentic or a discerning reader! Here are some o the important land-mark studies.

There are three important research papers giving us details as to

how the drug industry runs the medical education in America andhow they start brainwashing students rom day one. All o them are inthe most respected medical journals.

The utility o screening healthy individuals about which I havewritten above has been brought out very well in the editorial in BMJ:(Screening could seriously damage your health, British Medical Jour-nal 1997;314:533)

Long term ollow up o patients either advised bypass surgery by

doctors or those who have had bypass surgery showed that in asymp-tomatic patients the operation did not do any good. Worse still, only16% o patients who underwent this operation did get some benetand that was by way o pain relie. Angioplasty audit did not showany extra benet in those patients who underwent the procedurecompared to medical management. In addition, this procedure almostalways led to bypass surgery and the latter was more hazardous ollow-ing angioplasty.

There is now evidence to show that these results are even tampered withand doctored to show benet!(In the eye o the beholder. Arch. Int. Med1995; 155 2277-2280) There is a very signicant study rom Harvardthat showed that the biggest culprit to catch patients and rightenthem is the routine use o angiogram in every one with chest pain.Early bypass ater a heart attack has been shown to be the biggest riskactor or strokes in the immediate uture. There is a plea or goingslow on both these areas.

Incidentally, doctors mistakes and unnecessary interventions have

resulted in 1,00,000 deaths in the USA in one year o study! Comparedto Canada, where ee-or-service does not obtain, the bypass rate in theUSA was ten times more. However, at the end o one year, surprisingly,equal number o patients in the two groups were alive despite ten timesmore intervention in the USA!




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Another area where India is trying to catch up with America is inthe eld o corporate hospitals, which are called or-prot-hospitalsin the USA. In the recent issue o the Canadian Medical Association

Journal there has been a study on the role played by such hospitals andthe conclusions are better summed up in the words o the guest editorDavid Naylor. Patients treated in these hospitals had 2% increasedrisk o death. In Canada it means 2200 extra deaths per year equalto total trac deaths in that country or deaths due to colon cancer!Does anyone still want to contract out patients to those hospitals?asksDr Naylor.

Paradoxically, many newer studies have shown that most, i notall, o the major killer diseases are not caused by anyone o the risk

actors that the medical proessor is trying to sell and correct withdrugs and interventions. Major risk actors are hatred, jealousy, pride,ego, anger, and destructive hostility. We do not seem to have wokenup yet to manage these negative traits in society. We need to move inthat direction. That is real patient care, i.e. caring or the patient andpeople at large. Simple lie style changes and sensible diet with exercise

would save millions o lives than all these interventions put together.Even intercessory prayer, in well-controlled study, has reduced death

and disability in heart attack patients.A strike by all the doctors in Israel recently where they attended toall emergencies but avoided routine work and elective interventionsor three months, death rate and disability ell down remarkably, onlyto go up to the usual level ater doctors came back to work. This speaksvolumes in avor o what is written above. Let us hope that sanity willprevail.

[Reproduced with kind permission rom the author, Pro B M Hegde]


The best remedy or a short temperis a long walk.

-Jacqueline Schi


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We pretty much take our heart or granted. In act, the heart is awonderul pump that beats approximately 70-80 times a minute rombirth to death, without any interruption, downtime or maintenanceetc. whatsoever.

When does a person go in or a heart checkup or discover thathe has a heart related problem? Most oten this happens 'by chance'

when he undergoes a health check up or insurance or or employmentpurposes, a master health check up, or when he has any symptomsthat he eels might be connected with his heart. He then either visitsa doctor who asks or some tests; subsequently, he is in the clear or hisheart needs urther attention.

Some o the basics on a check list or the maintenance o yourheart are your weight, blood pressure, blood sugar levels (are you adiabetic and i so, is your blood sugar under control?) and your lipid

prole. The lipid prole includes your total cholesterol, tri-glyceridesand your HDL and LDL (the good and the bad cholesterols). Theseare the visible parameters. The hidden ones are your stress levels; yourpersonality traits. Are you a constant worrier? A brooder? And doyou lead a totally sedentary lie style or are active? Clinical statisticshave shown that stress and sedentary liestyle play a large part in theprogression o heart disease.

The simplest test that is done to observe the hearts perormanceis the ECG or the Electrocardiogram. One oten hears the remark,I get my ECG done every year at my master health check up andit was ne. Why do I need another one now? The ECG shows theheart unction at the point when you have had the ECG done or intodays techno speak, does NOT show in real time. It will also showany problems that the heart may have suered in the past (like a previ-ous heart attack). A normal ECG o even 15 days back is not guaranteethat one will not have a heart attack in the near uture, particularly ihe is overweight, smokes, has diabetes, does not exercise etc. Hence anECG is repeatedly asked whenever there is a symptom pertaining tothe heart. This is a painless test that takes a ew minutes.

Another test or the heart is the ECHO cardiogram. This showsthe pumping capacity o the heart- as the heart is primarily a pumpand needs to pump blood to all parts o the body. This test is a sort o

A Health Check for the Heart

Some Tips




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ultrasound test, is painless test and you might need an appointment asusually a doctor gives you this test.

We now need to check out how the heart holds up under condi-tions o exercise, meaning simple tasks like walking, at rst slowly,

then with increasing speed and up a small incline. In my earlier daysin the Armed Forces, our patients would be made to do the 'doublemaster test' wherein they would climb up and down two steps, BP cuon his arm, under the eagle eyed count o a drill sergeant! In todays

world, the next test is the Tread Mill test, sometimes simply called theStress test. This test measures the capacity o your heart to withstandexertion like walking at a reasonable speed and walking up a gradient.This is literally a challenge given to your heart to see i it copes! Your

pulse and Blood pressure are measured continuously and the speedand gradient are increased based on your age, weight etc. The treadmill test is a good indicator o how much exertion your heart cancomortably withstand. It is also the rst alarm bell that your heartmight need to be urther examined. This test should always be doneunder supervision, in a place that can handle emergencies (in the eventthat a person becomes uncomortable on exercise and requires urthermanagement) and is best done in a hospital. Some persons tend to take

this test at labs which is better avoided, even i emergencies are reallythere.

Whenever the tread mill test shows that something is o the mark,the individual may not be able to complete the test and begin sweatingor panting or his pulse and BP go unnaturally high. Some are not ableto complete the test or other simple reasons like a catch in the calmuscle because they are unused to exercise. The next test to go ontois the Angiogram. The angiogram is an invasive test (meaning that

something is introduced into your body). It can diagnose a problembut CANNOT cure anything. The test is sometimes done as a daycare case or may require a days admission. A slim, fexible catheteris introduced into the vein either in your thigh or orearm and thisgoes right up to your heart. You are conscious all the time and thisprocedure will not hurt you. A radioactive dye is introduced that seepsinto all the blood vessels o your heart and shows up in a series opictures. This test will show up the exact location o blocks in your

heart blood vessels and will also indicate the extent o the block. It isthe gold standard to absolutely know i there is a block (you are likelyto get an inkling in the changes when a person does a treadmill test),the location and the extent o the block. Treatment depends on allthese actors.



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There are the newer types o angiograms called the CT angiogramsthat are non invasive; but these will require authentication with a con-ventional angiogram i any problem is perceived. LTDs tip: Ask oran angiogram - the conventional one- only i you have had episodes o

chest pain (small or big) or your Treadmill test shows up some exercisebased changes.

Whenever a person has a complaint, it is also required that he/she do some blood tests which will determine the status o the heartmuscle. Primarily, when one has a heart attack, his heart muscle isstarved o blood due to a blockage in his blood vessels. Whenever anypart o the body is deprived o blood, it hurts and maniests as a severepain. When the blood supply is not resumed, the heart muscle dies and

this is called an INFARCTION. These blood tests show i the heartmuscle is injured. Rising levels in these numbers also indicate i theheart muscle has had a cramp like situation or has been severely starvedo blood. These blood tests are oten done in a hospital when a persongoes with chest pain.

This is a brie introduction to the tests that a person is advisedto when he either wants to get his heart checked out or has had a ewepisodes o chest discomort. It is NOT a conclusive guide to all tests

and procedures. Please consult your doctor or urther tests or write in towww.letstalkdoc.com

Look out or the next instalment or treatment options.

[Dr Jyotsna Codaty,Sr Consultant in Transusion Medicine and Family Practice]

www.letstalkdoc.com

Improve your concentration.Use reasoning and ll each row,column and 3 x 3 grid in bold

borders with each o the digitsrom 1 to 9.

Solution on page 26.

EKL Sudoku 78[Hard]

6 5 7 2

2 7 3 5

1

9 6 7

7 5 9 8

6 5 4

6

7 1 8 2

1 2 8 7




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It is generally believed thathardening o the arteries - ociallyknown as atherosclerosis, which canlead to heart attacks and strokes - isa disease o modern lie, caused bysmoking, atty oods and lack oexercise. Now it appears that tastyburgers, cigarettes, and sedentarylie arent entirely to be blamed orclogged arteries, a rampant medicalproblem. A recent study o mummies as old as 4000 years has revealed thatatherosclerosis, wherein calcium deposits narrow the arteries, may have beena universal disease in all human societies, and not wholly a result o the

modern living.Mummies rom thousands o years ago and around the world showevidence o clogged arteries, this new research nds.

CT scans o 137 mummies showed evidence o hardened arteries, inone third o those examined, including those rom ancient people believedto have healthy liestyles. More than hal o the mummies were rom Egypt

while the rest were rom Peru, southwest America and the Aleutian islandsin Alaska. The mummies were rom about 3800 B.C. to 1900 A.D. The

mummies with clogged arteries were older at the time o their death, around43 versus 32 or those without the condition. In most cases, scientistscouldn't say whether the heart disease killed them.

"Heart disease has been stalking mankind or over 4,000 years all overthe globe," said Dr. Randall Thompson, a cardiologist at Saint Luke'sMid America Heart Institute in Kansas City and lead author o the paperpublished in The Lancet.

"In three dierent continents and a total o ve dierent sites

prehistoric peoples had atherosclerosis," said study co-author Caleb Finch,a neurobiologist at the University o Southern Caliornia. While someresearchers believed hardening o the arteries was a 20th century disease, thatresults rom modern overconsumption o atty, sugary oods, "the generalityo our observations suggests it is really a basic part o human ageing ."

Heart Attacks and Strokes

Seen Even in Mummies



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A new study suggests that hardening o the arteries is an oldproblem which could mean that it is a natural part o ageing under allcircumstances.

[For details:http://www.thelancet.com, https://www.saintlukeshealthsystem.org]

Ancient wisdom ensured health care and produced healthy citizens.It had the oresight to ensure that prevention was better than cure. Itrested on the strong oundation o ethics which is the antithesis o loot-ing society in the name o medical treatment and services.

The physicians really cared or the patients health and wellness.Unortunately nowadays medical treatment has become unbelievably

costly. Patrons o insurance companies get substantial cover which againrefects on the high costs o medical services. People take pride in saying

that the government or the insurance companies paid to the last pie o themedical bill running to lakhs o rupees. For the economically poor medicalbill is a nightmare.

We can make use o all available knowledge rom our ancient wisdomor real health care. This lays emphasis on prevention .Unortunatelyour medical leadership and proessionals are used to one track thinkingo creating ear o illness, existing or imaginary and suggesting increasein the number o doctors and hospitals as remedies. These add to the

costs o medical services. Further mismanagement o resources createsdistorted priorities and shortage o medical acilities. The victims arethose who really deserve with no means to pay. The high cost o medicalacilities impoverishes such patients.

Health care policies need a new direction. The objective has to be toprevent illness. This needs creating awareness and using all non expensivemethods o maintaining good health, drawing rom ancient wisdom onmaintaining the balance o the body, mind and intellect system. Overa period a sound education policy with this objective will yield goodresults. Prevention should orm the core o health care policy. Health is notabsence o disease but a state o cheerulness and well being where theindividual has enthusiasm and longing or activity. The ocus has to be

Health Care or Health Scare?Greed Breeds Disease




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the individual by strengthening his health consciousness. The ear odeath has to be dispelled. Death is a natural phenomenon and can bepostponed by proper liestyle. Surgical or other type o medical interven-

tion can only hasten it especially i the ate is decided by those prescrib-ing huge quantity o medicines and with specialization bordering onquackery.

Old age is natural but disease is not. The latter is a question o lie-style. Lessons have to be learnt rom our heritage where people livedlong with simple liestyles supported by high thinking. Greed has to berecognized as a serious diseasewhich is a vicious cost escalating actorin all

walks o lie. I this is tackled at the individual level over a period o time

medical costs could be brought down considerably. The motto should beto prevent suering, minimize it and not to promote it and thrive on it.

All relevant costs can be brought down. Cost o medical educationand cost o hiring a doctor will be reduced. Congenital and critical illness

will need the most modern method o treatment and this can continue.Failure to identiy the key disease o human greed in all walks o lie

and ailure to assimilate the best o ancient wisdom will only push upcost o health care making it health scare. Disease originates in the minds

o men and then only suraces through symptoms o the body with painand suering. Mind control, can help to engage in right physical activity,regulated diet, noble thoughts, positive thinking and lie balance.

It is benecial to teach yoga and some orm o physical activity inschool at the earliest stage o education. It is worth going through casestudies o persons with longer lie span and those who have escaped visitsto hospitals except or minor corrective treatment lasting a ew hours or

days.Lie style o octogenarians need detailed study or benet o posterityor developing good health habits. Dierence betweenlth and oodhasto be understood. We have to go back to our ancient wisdom which con-tains essential healthcare management principles. We should not look atthe sun with closed eyes and shout that the sun has no light.

The sun contributes more than any governmental machinery to wardo many diseases at no cost. Let us not orget that the chronic disease is

greed, recognizing its intensity impact and contaminating infuence o illhealth o individual and society. Only then we can march towards healthcare and be reed rom health scare.

[T Ramaswamy][email protected]



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Food is a right, good ood is a privilege and good and sae ood is theresponsibility o all.

The International Organization or Standardization (ISO), locatedin Geneva, in consultation with standards ormulating bodies o mem-ber countries , develops standards or the international community, butmaintains independence once a standard in its nal orm is accepted.Every ve years standards get reviewed and updated to enable relevance

to updated technologies.The Standards ISO 9001:2008 and ISO 22000:2005, among many

others, are currently Indian standards as India is one o the membercountries. Though ISO 9001:2008 can be applied to any organizationincluding ood manuacturers, ISO 22000:2008 is a comprehensivestandard exclusively or ood.

ISO- Approved standard by the International Organization orStandardization - (ISO means equal in Greek), 9001 - the serial num-

ber and 2008- the year o release.The system dened in this ood saety standard can also be eectively

applied to products that require high level o protection rom physical,chemical and biological contamination (Hazards). Eg. Preservation ospermatozoa or articial insemination.

This international standard was used as a guideline or ormulationo the Indian Food Saety and Standards Act 2006 whereby this Act hasbecome the rst Science based promulgation o the Government o India,

enorcing the saety o all ood manuactured in India and all ood relatedActs in existence until then have been ordered null and void. The Act ismandatory or all Indian ood business operators, but ISO 22000:2005eectively ensures that the requirements o the Indian Food saety andstandards Act 2006 or ood produced and sold in India, become ullycomplied with.

Sae ood being a prime require-ment or health everyone needs to beaware o the basics o sae ood, be it in public or at home.

The international standard ISO 22000:2005 has been designed to

address the hazards or dangers that can afict ood at every stage romarm to ork (throughout the entire ood chain). The dangers can be1.Physical- extraneous matter that can harm the consumer2.Chemical- added materials (ertilizers, pesticides), developed toxins or

cleaning materials

International Food Safety Standard

To Ensure Safe Food for All




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3.Biological- rom harmul micro-organisms.Food needs to be transported through long distances involving di-

erent transport and various handlers. The basic principles o handling

are to be taken care o by the producer, intermediary handlers may notbe aware o the requirements o ood saety. It is the responsibility o theproducer to intimate through guidelines to all concerned, the nature oprotection that is needed at each stage o movement. (packing, handling,storing, cleaning, re-packing, processing, consuming etc.)

Food in tropics undergoes aster deterioration than in temperate cli-mates as bacteria multiply aster in the 4c to 60c range o temperature.The best option or ood storage is to ensure that ood is kept out o

this range o temperature. Though western countries have learned goodhandling practices the conditions available in countries like India arepathetic in terms o knowledge on hygiene. Wayside eateries are run byall and sundry but the saving grace is that usually ood is served hot abovethe 60 C mark and hence sae.

ISO 22000:2005 prescribes a ool proo system which i practicedensures 100% sae ood. It uses a time tested system, the Hazard Analysisand Critical Control Points(HACCP), a technique developed by Pillsbury

and ne tuned and practiced by NASA to ensure sae ood or Astronauts.HACCP has eectively been incorporated into ISO 22000:2005.It calls or a detailed description o the ood in question on all o

physical, chemical and biological parameters, including a description oraw materials, ingredients that go into the intermediary and nal prod-uct. A detailed description o the method o handling, transport , storageand processing is also to be done. Now the picture becomes clear as to thecare the handler needs to give the ood item.

It calls or a detailed description o the processes involved in cleaning,pre-processing (cutting preparation beore cooking etc.), storage and nalprocessing, holding, storage, temperatures involved, processing time andserving. The description needs to be in detail with fow charts, processsteps and detailed diagrams.

The layout o the processing area is to be studied to ensure that rawmaterials, uncooked ood, and unauthorized handlers do not cross path

with nished product.A detailed recorded analysis using HACCP principles needs to be ap-

plied to locate points at which hazards (Physical, chemical and biological)that can potentially enter at each stage. In large manuacturing units itis advised that a team involving representatives o all departments o theorganization be involved in the Hazard analyzing process which enables



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all concerned to arrive at a consensus as to the various measures to beadopted to ensure protection o the ood at each stage.

Once potential areas are located, the process o putting in eectiveprotective measures / controls, to be constantly practiced during process-

ing becomes airly easy and practical. This enables dening the generalcontrol measures needed, qualication / experience o the handler, theprocess environment, hygiene practices, analytical methods or detectiono danger, permissible levels o various hazards that can inevitably enter inspite o strong controls, criticality o the hazard involved, programmes thatneed to be in place to control entry o hazard (pre-requisite programmes).Critical points where controls need to be in place in the process, and thelimits at which action need to be taken.

A airly good knowledge and a scientic approach o the variousstages o the process is essential. It is hence advisable that a knowledgeableperson is involved in the entire programme o implementation o therequirements o the standard.

The standard also emphasizes importance on communication alongthe ood chain to ensure compliance to ood saety requirements, with a

withdrawal protocol when hazards are identied in supplied ood.This Standard i practiced can go a long way in ensuring sae ood. In

the coming years ood produced and consumed in India is mandatorilyexpected to comply with all saety norms. The Indian Parliament withthe enorcement o the Food Saety and Standards Act 2006 has done usa great service that uture generations can be proud o, but the onus oeective implementation rests with the ood saety authorities o everystate.

[B. Stelzer Bouy, Lead Auditor, Trainer and Consultant]

[email protected], +91 9447104522

In Forthcoming Issues

BankinginIndia-Lessons rom Global Banking Landscape

Rule of the Road - Parking sense, vertical parking, lanediscipline, sae driving, accidents...

R&DSpending-Global and Indian Scenarios Methane,PotentGreenhouseGas-New Ways to Capture It

WhattheWorldCanLearnFromIndianMarketers-Market-ing guru, Philip Kotler




18/48

A team o scientists led by Tor Wager, a neuroscientist at the Uni-versity o Colorado, Boulder has reported recently that they were ableto "see"pain on brain scans and, or the rst time, measure its intensityand tell whether a drug was giving relie to the pain. The study prom-ises to open the door to a host o therapeutic possibilities. For example,scans might be used someday to tell when pain is hurting a baby andalso lead to new, less addictive pain medicines.

Pain is one o the major reasons driving people to a doctor, andthere's no scientic way at present to quantiy the pain. Doctors go bythe words o such a patient to judge the severity o pain.

It is hoped that the research may show a way to measure objectivelythe pain, one o lie's most subjective experiences.

[For details: http://www.colorado.edu]

Measure Pain

By 'Seeing' Pain on Brain Scans


Subscribers of EKLAn Apology from EKL TeamStarting rom the rst issue o EKL published in August 2005, we have

been encasing the magazine in a secure paper cover with the necessarydetails on it, likeFromand To addresses and other details as per instructionsrom Postal Department rom time to time. Now we have been instructedto post the copies with the postal registration number printed on it, easily

visible rom outside, without having the need to slide the magazine outrom the cover. In ull compliance with this stipulation, we are doing awaywith practice o sending it in a cover. In its place, a wrapper will be usedwith just theFrom and To addresses on it.

We know that most o our subscribers are preserving back issues oEKL as Collectors' Item and may nd the new practice leading to EKLreaching them not as in the past. We apologise prousely or this newsituation, while expressing our helplessness as well.

We are also thankul to Postal Department or the concessional postingacility which helps publishers to reach EKL - like magazines to readersacross the length and breadth o India at a nominal rate.

Wishing all our valued subscribers continued meaningul reading,

EKL Team


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Allergy is an abnormal reaction by our bodys immune system to asubstance known as allergen.Allergy has become a topic o discussion orthe past 35- 40 years. There are many actors involved. Some o themare age, sex, work place, places o stay, good habits, drugs, chemicals,dust, smoke, radiation, body fuids etc. This abnormal reaction or hy-persensitive reaction can occur through contact, ingestion, inhalation, orinoculation. Some reactions occur within minutes, whereas some maytake hours.

When the antigen enters our body antibodies are produced to repelthem. IgE is a chemical in our body fuids and they get xed in most cellsby the action o macrophagesand receptor B&Thelpercells. Eosinophilsand macrophages sensitize them. IgE also gets into blood circulation.Histamine present in the tissues acts as a mediator in sensetised mast cellsand basophils. Histamine produces vasodialatation in smooth muscles in-cluding those o bronchi and bronchioles. This produces constriction osmooth muscles, which is the process in bronchial asthma. Arachidonicacid gets metabolised by sensitised cells. Following this process, prosta-glandins and leukotrines are liberated. Hypersensitivity produces infam-matory cells and mucosal cells which attract neutrophils and eosinophils.Bronchial mucosal oedema is mediated rom the actors released rommacrophages and lung tissues. This produces hypersecretion in asthma.

Allergens come rom vegetables, animals, insects, chemicals, dust, smoke,radiation etc.a) Cats, dogs, horses - aect household members, veterinary surgeons

and animal keepers.b) Rats, mice, guinea pigs - research ellows, lab attendants household

members and sanitation workers.c) Grain mites - those who work in ood godowns, ration shops, mills

which treat them, household members.d) Locust - agricultural labour.e) Wood dusts - wood cutters, those who work in timber mills.

) Pigeon and chicken - breeding hatcheries, arms, retail sales agents.g) Oyster, prawns, crabs, eggs, shes like salmon, cows milk- aect sh-

ermen, sales outlets, and those who eat without proper cleaning andcooking.

h) Coee beans - plantation and processing unit workers.


Allergy

Reasons Elusive, But Galore



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i) Certain enzymes used in detergents, soap powderj) Isocyanates in paints and varnishesk) Metal processing units - platinum, chromium, cobaltl) Leather tanning units

m) House dust and dust mitesn) Semen allergy - one out o 15 couples suer rom thiso) Tattooingp) Colouring and favouring agents used in sweets especially tartarzine,

chocolates, sot drinksq) Toilet soaps, shampoos, ace/skin creams, oils, talcum powdersr) Vitamin D deciency in pregnant mother may cause allergy prone

babies

s) Miscellaneous - strong smells, cold, sudden change in temperature,humidity, exercise, smoking, drinking alcohol, coloured beverages,drugs etc.

t) Sunlight and radiation.Some common illness caused by allergy:1) Eczema - due to radiation, sunlight (uv rays), chemicals, ungal inec-

tions2) Migraine - triggered by eating chocolates, light, sound, smell

3) Rhinitis - dust, smoke4)Asthma - dust, smoke, pollens, ice cream and cold sot drink5) Certain drugs, mosquito repellents, body sprays6) These are only some o the common items which are allergens. Allergy

to a particular item or one person may not be allergic to another person.That is the reason why some medicines are allergic to some individualsand not others. Medicines can be tested by doing an allergy test, but notother items. WHO has made certain restrictions or testing ood items

because o the contamination caused by pesticides, preservatives etc.Many o the allergic reactions can be avoided by not using those items

which are allergic. But it is better to avoid chemical items like perumes,colouring agents, insecticides, dusts, smoke, advertised remedies etc.

[Dr P P Nayar]

The secret o health or both mind and body

is not to mourn or the past, nor to worryabout the uture, but to live the presentmoment wisely and earnestly.

- Buddha


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One day, everyone will become a senior citizen with all the at-tendant problems. Hence, providing a room with certain precau-tionary amenities or elderly people to move around saely would be

worth the eort, rom several angles - to provide better care or theelderly, prevent alls and consequent hospitalization, and above all,to enable them to lead a lie with minimum dependence on others.

Elderly people are more prone to serious injuries and long termdisability i they all. Their eyesight, hearing, balance, refexes,memory etc. wane o with age. For such people a senior citizen-riendly bedroom with an attached bathroom is to be planned andbuilt or use as living space, where they will spend most o theirtime. Some thoughts in this connection are: Flooring should be non-slippery, even with water or liquid on it. Furniture should be sturdy against toppling and may even be

supportive i used or getting up rom the foor or walking aroundholding on to it.

The layout o the urniture in the room should be such that theywill not obstruct movement o the people even with low lighting.It is better not to alter the layout rom time to time.

7 Commandments for Senior CitizensFor Happy Living

1. Thou shalt try to get along well with thy kids and their spouses tosave thysel rom alienation

2. Thou shalt try to gain new riends rom thy neighborhood to savethysel rom the misery o loneliness

3. Thou shalt avoid junk oods to save thysel rom liestyle diseases4. Thou shalt cultivate a new hobby to save thysel rom boredom5. Thou shalt learn how to manage thy money and assets sensibly to

save thysel rom nancial problems6. Thou shalt ollow thy doctors advice religiously to save thyselrom medical complications

7. Thou shalt learn how to browse internet to save thysel rombecoming an ignoramus.

[Dr Venugopal Reddiar MD, MRCP)

Senior Citizen-friendly Living Space

Some Suggestions



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Dear Editor,This reers to your short insert 'Ten Countries with Fastest Internet'in EKL

April 2013 issue. Now Google Inc is providing Google Fiber' in two cities inUSA to begin with, Kansas and Austin, which will provide Gigabit speeds orInternet - a technology breakthrough which is expected to usher in a new erain internet usage.

Your editorial on 'Citizen Science' is quite interesting.[Dr H Ganesh]

Dear Editor,I have read your editorial on Citizen Science in April 2013 issue o EKL

with great interest which has mentioned that or thousands o years, humanshave been observing the nature around them and recording what they saw.

Ornithology has been specically stated as a branch beneted by public par-ticipation. It suraced to my memory the story o Gregor Mendel who whileworking as a priest, conducted extensive experiments on plants and systemati-cally recorded the ndings which laid the oundation o the modern genetics.

[A. Suhair]

Readers say

The foor should be in a single level and even a small step shouldbe avoided, to prevent alls.

A small bathroom is advisable ; the small size will help reduce theseverity o a all as the person will be stopped by a nearby walland hence no chance o alling fat on the foor with head hittingagainst the ground. In addition suitably positioned grab-bars allaround the walls, will go a long way in preventing alls.

Light switches should be so positioned to acilitate easy reachespecially during night. A low power (LED) night lamp shouldbe ON through out the night.

While using the bathrooms it is better not to lock it rom inside, toenable others to intervene in case o an emergency. I a bolt must beprovided at all, there should be some suitable access (like a hole) romthe outside to unbolt.

As ar as possible the elders room may be provided on theground foor, or obvious reasons like avoiding climbing stair-case, attracting better attention in case o emergencies etc.

There must be an easily reachable switch, preerably wireless type, toactivate an alarm bell outside. This bell should be powered by batteryor use during power cut.


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Depression is a common men-tal health problem. Generally, 50%to 75% o patients will respondto treatment or depression in aprimary care setting. But anothergroup o patients do not respondto such treatment and hence con-sidered treatment resistant. Suchpatients are requently reerredto psychiatrists in order to imple-ment various strategies regardingimproving their condition. Thus,treatment-resistant depression(TRD) has become a common public health problem encountered by

psychiatrists.In several studies researchers have ound that a technique called

deep brain stimulation (DBS) shows an amazing and unexpecteddegree o amelioration o symptoms o acute depression.

Pro. Dr. Volker Arnd Coenen, neurosurgeon and head o theFreiburg University Hospitals Department o Stereotactic and Func-tional Neurosurgery, under this DBS procedure, implanted electrodesinto the medial orebrain bundles in the brains o subjects suering

rom major depression with the electrodes being connected to a brainpacemaker. The medial orebrain bundle is a bundle o nerve bersrunning rom the deep-seated limbic system to the prerontal cortex.In a certain place, the bundle is particularly narrow because the indi-vidual nerve bers lie close together - exactly the location in whichmaximum eect can be produced using a minimum o current. In amatter o days o starting the treatment, in six out o seven patients,symptoms such as anxiety, despondence, listlessness and joylessness

had improved considerably. An eighth patient treated since has alsoshown great improvement. The patients have been monitored or upto 18 months ater treatment, and the eects appear to be more than

just temporary - so ar. This method gives those who suer rom majordepression reason to hope. However, it will take quite a bit o time or

Fight Depression

Through Deep Brain Stimulation



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A human is a combination o mind, body and intellect. Mind isbelieved to control body using intellect in thinking. Only a healthymind can eectively control the body. People who have good mental(emotional) health are aware o their thoughts, eelings and behaviors.They have healthy ways to cope with the problems o the mind likestress and depression which are a normal part o lie. They eel goodabout themselves and have healthy relationships.

Mental health describes a level o psychological well-being o aperson. It may include an individual's ability to enjoy lie, and createa balance between lie activities and eorts to achieve resilience. It canalso be dened as an expression o emotions, and as signiying a suc-cessul adaptation to a range o demands. Mental health includes ouremotional, psychological, and social well-being. It aects the way wethink, eel and act as we cope with lie. It also helps determine how wehandle stress, relate to others, and make choices.

The WHO denes mental health as "a state o well-being in whichthe individual realizes his or her own abilities, can cope with the nor-mal stresses o lie, can work productively and ruitully, and is ableto make a contribution to his or her community".Mental health is asocially dened concept; that is, dierent societies, groups, cultures,institutions and proessions have very dierent ways o conceptual-izing its nature and causes. Cultural dierences, subjective assessment,and competing proessional theories all aect how mental health isdened.

Evidence rom the WHO suggests that nearly hal the world'spopulation is aected by mental illness with an impact on their sel-

Mental HealthControls Body Health


the new procedure to become part o standard therapy."Such sensational success both in terms o the strength o the e-

ects, as well as the speed o the response has so ar not been achievedwith any other method," says Pro. Dr. Thomas E. Schlper rom

Germanys Bonn University Hospital.Even though DBS has proven helpul or some patients, there is

potential or some complications and side eects, warranting urtherresearch, as per some observers.

[For details: http://www3.uni-bonn.de,]


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esteem, relationships and ability to unction in everyday lie. Incomedisparity is pointed out to be a vital reason o mental illness includingdepression, anxiety and addiction. Maintaining good mental health iscrucial to living a long and healthy lie. Knowledge o how to provide

eective mental health care has become imperative worldwide.Your body responds to the way you think, eel and act. When you

are stressed, anxious or upset, your body tries to tell you that somethingis not right. Happenings in lie like loss o job, death o a beloved,divorce, serious illness, money problems, getting a job-promotion,owning a new house or precious property, having a baby, etc. mayaect ones emotional health. For example, high blood pressure or astomach ulcer might develop ater a particularly stressul event, such

as the death o a loved one. The ollowing can be some other eects opoor emotional health on the body: aches and pains, loss o appetite,constipation, dry mouth, palpitation, stomach upset, sti neck andsweating. Poor emotional health can weaken your body's immune sys-tem, making you more likely to get colds and other inections duringemotionally dicult times. When you are eeling stressed, anxious orupset, you may not take care o your health as you should: you maynot eel like exercising, eating nutritious oods or taking prescribedmedicines. Abuse o alcohol, tobacco or other drugs may also be a signo poor emotional health.

It is important to be honest with your doctor in sharing your eel-ings and problems o personal lie. I your symptoms are not causedby usual health problems, the doctor can address the emotional causes.

Your doctor may suggest ways to treat your physical symptoms andhelp you improve your emotional health.

Sorting out the causes o sadness, stress and anxiety in lie can helpyou manage your emotional health. A positive outlook can improvethe quality o your lie. You may also need to nd ways to let go othings in your lie that make you eel stressed and overwhelmed. Maketime or things you enjoy. Relaxation methods, such as meditation,are useul ways to bring your emotions into balance. Meditation is aorm o guided thought. One may do it by exercising, stretching orbreathing deeply. To have good emotional health, it is important totake care o your body by having a regular routine or eating healthymeals, getting enough sleep and exercising to relieve tension. Avoidovereating and taking drugs or alcohol.

Spirituality is considered a way you may gain mental health: ndmeaning, hope, comort and inner peace in your lie through religious




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chores, music, art, values and principles or a connection with nature.No one really knows how spirituality is related to health. However, itseems the body, mind and spirit are connected. The health o any oneo these elements seems to aect the health o the others. Research

shows that things such as positive belies, comort and strength gainedrom religion, meditation and prayer can contribute to healing and asense o well being. Improving the spiritual health may help one eelbetter, prevent some health problems and cope with illness and stress.I you are being treated or an illness, it's important or your doctorto know how your spirituality might aect your eelings and thoughtsabout your medical situation. I you think your spiritual belies do notallow you to ollow medical recommendations, tell your doctor.

In order to improve your emotional mental health, the root o theissue has to be resolved. It is important to enhance an individualsability to achieve a positive sense o sel-esteem, mastery, well-being,and social inclusion. It is very important to improve your emotionalhealth by surrounding yoursel with positive relationships. Another

way to improve your emotional health is participating in activities thatallow you to relax and take time or yoursel. Increased awareness omental processes can infuence emotional behavior and mental health.

A 2011 study revealed that meditation provides an enhanced abilityto recognize emotions in others and their own emotional patterns,so they could better resolve dicult problems in their relationships.

Yoga is a good example o an activity that calms your entire body andnerves. The merging o psychological and religious therapies throughpastoral counselling by religious leaders or others trained in linking thetwo is ound to help emotional health.

[CGS]


EKL Sudoku 78Solution

4 3 1 6 9 5 7 8 2

8 2 7 3 1 4 6 5 9

5 6 9 7 2 8 1 3 4

2 9 3 4 8 6 5 1 7

7 4 5 1 3 2 9 6 8

6 1 8 5 7 9 2 4 39 8 6 2 5 3 4 7 1

3 7 4 9 6 1 8 2 5

1 5 2 8 4 7 3 9 6


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Did you ever get a bee sting?I yes, you must have experiencedinfammation at the sting siteollowed by pain within seconds.Have you ever thought what theunderlying reactions are? The sting

introduces a new set o chemicalswhich are oreign to our body (an-tigens). Like patrolling ocers, im-mune cells in blood move aroundand detect the oreign bodies and send signals (proteins) or moreassistance. Immune cells (B-cells, T-cells, macrophages etc.) producemany proteins (mainly cytokines) which trigger tremendous multi-plication o immune cells. Some set o proteins produced by immunecells switches on the pain pathway and the brain signals more blood toreach the sting site. All these reactions work together towards neutral-izing the oreign bodies and healing the sting site. As a result o thisseries o reactions, the wounded site appears red and swollen, a patho-logical condition called as infammation. Infammation is one o therst lines o deense mechanism o our immune system. Any harmulstimuli (pathogens, irritants) can trigger the infammatory cascade.

These set o reactions render the site o infammation with character-istics namely pain, heat, redness, swelling and loss o unction. Howthe immune cell does know that something wrong is happening in ourbody? Like an antenna senses signals, a protein molecule called NF-kB(transcription actor) inside the cell is the sensor that detects harmulstimulus, goes inside the nucleus, binds the DNA and turns on thegenes in charge o enhanced immune reaction and infammation. NF-kB which is otherwise involved in development o lymphoid organs

(organs related to immune system), once stimulated by oreign bodiesenters into infammatory pathway. This infammatory pathway leadsto the expression o many genes namely: a range o cytokines (whichincreases immune response), regulators o programmed cell death,cell surace receptors, stress response enzymes such as COX2, PLA2

Bee Sting

Consequent Body Reactions




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etc. COX2 is the enzyme which converts arachidonic acid (a lipid) toprostaglandins (PGE2). PGE2 then binds to nerve receptors and thesignals are passed to brain. This signaling mediates pain. Pain thusalerts the whole body about the sting site. I we inhibit the action oCOX2, PLA2 will not be ormed and the pain signals can be blocked.This is what drugs like aspirin, NSAIDS etc. does. They inhibit theCOX2 enzyme, the pain signals are blocked but the immune reactioncontinues at the sting site.

Now next question arises- Is infammation good or bad? The acuteinfammatory process as we have seen is a boon to combat harmulstimuli but infammation becomes a bane when it becomes a chronic

one. Its like a buzzer which when pressed creates an alarm, but i letcontinuously pressed creates noise pollution. Current liestyle- expo-sure to a range o toxic chemicals, unhealthy ood habits and stress leadsto a prolonged infammatory state - chronic infammation, leading tointernal tissue damage. NF-KB inside the cell senses the infammatorysignals, becomes active and transcribes a large number o downstreamgenes, which thereby continues the infammatory chain o events. Sig-nicant chronic infammations especially long-lasting ones increase the

production o cortisol, the primary anti-infammatory hormone romadrenal glands. Cortisol unctions to reduce prolonged infammationin our body, but at the same time suppress our immune system. Otheradverse eects o high cortisol levels includes: gastrointestinal prob-lems, weight gain and obesity, blood sugar imbalance, cardiovasculardiseases, inertility problems etc., prognosis o which may maniestchronic infammatory associated diseases. Chronic infammation canlead to diseases, such as type 2 diabetes, atherosclerosis, rheumatoid

arthritis, alzheimers and even cancer.We can combat the prognosis o chronic infammation with e-

cient stress management and anti-infammatory diet. Practicinghealthy ways like meditation, yoga, a small walk will help in ecientstress management. Intake o anti-infammatory diet such as ruits andvegetables which are a good source o antioxidants reduces the un-necessary activation o NF-kB. Include diets rich in bre and omega-3atty acid, reduce intake o saturated ats are some ways to avoid

chronic infammation.

[Priya DasResearch Scholar, Department o Computational Biology &

Bioinormatics, University o Kerala]



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Looking Back at EKLCommon Clinical Tests - Signicance in Health Care:

Dr G. Krishnakumar FRCP,EKL Feb. 2009Ultrasound Scanning - Principle and Progress:

Dr Alex K. Ittyavirah, EKL Mar. 2009Medical Genetics - To Know Hereditary Disorders:

Dr M. S. Subhadra, DME(Retd.) Kerala, EKL Apr. 2009On the Road to Heart Attack - Risk Factors:

Dr C.R. Soman (Late), EKL Aug. 2009Chronic Prostatitis - A Liestyle Disease:

Dr K. Sasidharan, Urologist, EKL Sep. 2009The Placebo Eect - Brains Own Healing Mechanism:

Dr G. Krishnakumar FRCP, EKL Nov. 2009Surgery - Past, Present and the Future:

Dr K.P. Haridas FRCS, EKL Dec. 2009Snoring & Sleep Apnea - Treating with new Dental Appliances:

Dr Anil .V. Koruthu BDS, EKL Jan. 2010C-Reactive Protein - Blood Test to Predict Heart Attack:

Dr G. Krishnakumar FRCP, EKL Feb. 2010Vestigial Organs o Our Body - Yet to Unravel their Roles:

Dr M.S. Subhadra DME(Retd.) Kerala, EKL May 2010Health and Healing- Through Probiotics (Part I, II & III):

Dr H. Ganesh, EKL Jul. '10, Sep.'10 & Dec. '10, Jan.'11 to Apr.'11Emotions and Human Behaviour - Mysteries o Human Mind:

Dr H. Ganesh, EKL Aug. 2010

Heart Rate Variability - To Assess Cardiac and Other Disorders:Dr G. Krishnakumar MRCP, EKL Oct. 2010Lets Talk Doctor - Connecting Patients with Doctors:

Dr Jyotsna Codaty, Sr. Consultant, Transfusion Medicine, Chennai, EKL May. 2012 Drug Interactions - Facts and Thoughts:

Dr Venugopal S. Reddiar MD, MRCP (UK), EKL Jun. 2012Be a Smart Patient - Tips to Avail Best Medical Care:

Dr Venugopal S. Reddiar, EKL Aug. 2012

The Family Doctor - The Concept is Re-emerging:Dr Jyotsna Codaty, EKL Sep. 2012 Blood Donation - To Save a Lie: Dr Jyotsna Codaty, EKL Oct. 2012 Doctors Prescription - The Neglected Part: Dr Jyotsna Codaty, EKL Nov. 2012 Medical Consent - To Give, or Not to Give: Dr Jyotsna Codaty, EKL Dec. 2012




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Volume 8 Issue 10 May 2013

Editorial Ofce

Knowledge House, Mathrubhumi Road, Trivandrum 695 035, India.Contact:Manager (Knowledge Operations), Tel. 91 471 247 2928

email:[email protected]@gmail.comwww.knowledgelines.com

ChiefEditorN T Nair

TechnicalEditorDr B N Nair

EditorialBoardPro. V K Damodaran

P R ChandranPro. Harimohan Bhattathiri

AdvisoryCommitteeDr. D S Rane

Dr P M Mathew (Vellore)Dr V Nandamohan

AuthenticationEditorsDr. C G Sukumaran Nair

Simon Zachariah

CoverDesignS Premkumar

AdvertisingandSubscriptionsS N Nair

ConsultantsFinance

R Bhadrakumar FCA

ProductionRavisankar K V

RepresentativesKolkata: T R R Menon Mob: +919433011424

email: [email protected]

Mumbai: S G Nair Mob: +919323780029

Three Old Men and GodThe rst old man, an American, asked God when will his coun-

try come out o recession."100 years," God said.

The American started weeping prousely. "I will not live to seethat day"

Second man, a Russian asked God "When will my country be-come prosperous?"

"Fity years," came the reply.The Russian too started weeping prousely. "I will not live to see

that day"Finally the Indian asked God, "When will my country be ree

rom corruption?"God started weeping. "I will not live to see that day".

[Sourced by: T S Krishnakumar Sastry, Mumbai]


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Heritage tourism is a branch o tourism dealing with the culturalheritage o the location where tourism is occurring. The National Trustor Historic Preservation o U.S. denes heritage tourism thus: Travellingto experience the places and activities that authentically represent the storiesand people o the past. India is very prominent on the heritage tourismmap o the world, with its share o World Heritage Sites.

Here are some world class heritage sites o India under threat whichrequire a serious look at the issues by various govt. agencies as well as by

the local people who also need to be concerned o the downall o thecountrys rich monuments near their homes.a) The Taj Mahal, Agra, U.P.

Symbolizing eternal love, Taj Mahal is designated as a World Herit-age Site and one o the wonders o the world. Built by the 17th centuryMughal emperor, Shah Jahan in the memory o his wie, Mumtaz Ma-hal, this world renowned edice is made o white marble transportedrom Rajasthan by over 1,000 elephants and constructed by over 20,000

Indian workers toiling or more than 20 years, supported by the mosttalented cratsmen rom India, Persia (Iran), France, Italy and Turkey.O late, Taj Mahal is in the news or increased threat posed by pol-

lution. Concerns were that environmental pollution on the banks oYamuna river (including acid rain due to Mathura Oil Renery) is a-ecting its white marble, turning it into yellow. A survey in 2010 byNational Environmental Engineering Research Institute showed thatpollution levels in Agra had risen signicantly as a result o growth inindustry, trac and population.

The tombs structural integrity is a matter o concern because o theast declining (5 t a year) water level o the Yamuna river. The waterlevels are much lower than they were when it was built and there is aserious risk that the construction will be destabilized as its oundationsare made o wood and need to be necessarily kept moist. In 2010, cracks

Heritage Tourist Sites of IndiaNeed for Protection

Management Line



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appeared in parts o the tomb. The minarets surrounding the monumentwere showing signs o tilting as the wooden oundation o the tomb maybe rotting due to lack o water.

Add to these the act that the water is heavily polluted due to thecontinuing discharge o efuents rom industry and drains around themonument. Some predict that the tomb may collapse within 5 years.

The Supreme Court issued strong directives to curb the pollution.Govt. o India set up the Taj Trapezium Zone, a 10,400 square km areaaround the monument where strict emission standards are in place. Ve-hicles are now banned rom within 500 metres o the monument and anLED display gives a running count o air pollution. A 90 m government

programme was launched between 1998 and 2000. Repeated attemptshave been made to use a clay pack treatment to maintain the shimmer-ing, pristine appearance o the marble. Measures such as a natural gaspipeline laid to supply clean uel to industries in Agra, street-wideningprojects, construction o a bypass, replacement o diesel-run rickshawsby cleaner vehicles, heavy investment in renery to reduce emissions andan improved power supply that has meant less reliance on dirty dieselgenerators have had a positive impact, but with marginal results.

Also a recent 30 m eort to clean the Yamuna has largely ailed.Water rom Yamuna reaches Agra heavily contaminated by chemical andhuman waste. In Agra, untreated sewage and solid waste is dischargeddirectly into the river. To make things worse, an upstream barrage hasdramatically reduced its fow.

To save the Taj, Yamuna needs an urgent and massive cleanup. Weshould also make a rontal assault on the citadels o the collusion betweenthe land-maa and dishonest bureaucrats that has meant the misuse o

much o the money designated to protect this proud heritage.(To be continued)

[Dr Raju Narayana Swamy IAS, Ph.D]

Cinnamon is harvested during the rainy season when the bark easily lits othe tree and the red fush o the young leaves is turning to green. A smallknie is used to ease o the inner bark into strips that are about one meterlong. The bark is then dried and curls naturally into quills. These quills arecut into segments o about 1 meter and dried in the shade.

Any pieces o bark less than 106 mm (4.2 in) long are categorized asquillings. Featherings are the inner bark o twigs and twisted shoots. Chips

Contd. rom Page 4


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are trimmings o quills, outer and inner bark that cannot be separated, orthe bark o small twigs.Uses

Today, cinnamon is recognized not only as an important spice or culi-nary purposes, but in medicinal ways as well. The bark is dried and used asa spice. It is principally employed in cookery as a condiment and favouringmaterial. It is used in the preparation o chocolate, especially in Mexico,

which is the main importer o cinnamon. True cinnamon, rather than cas-sia, is more suitable or use in sweet dishes. Cinnamon can also be used inpickling. Cinnamon bark is one o the ew spices that can be consumeddirectly.

Cinnamon has been proposed or use as an insect repellent, although itremains untested. Cinnamon lea oil has been ound to be very eective inkilling mosquito larvae.

Medicinal Uses:Cinnamon, as a warm and dry substance, was be-lieved by doctors in ancient times to cure snakebites, reckles, the com-mon cold, and kidney troubles, among other ailments. It is eective inimproving blood glucose control in patients with type 2 diabetes. Thesimple touch o cinnamon inuses warmth and energy throughout the

body. Cinnamon possesses carminative, anti-ulcer, and antivomitive prop-erties. Cinnamon prevents bloating, fatulence, heartburn and nausea. Itrelieves upset stomach and gas, diarrhoea, and various other ailments. Itstimulates appetite and enhances digestion. For its wealth o antibacterial,expectorant and anti-infammatory properties, cinnamon is considered asa good ally o the digestive system in the treatment o common respiratoryailments. Used externally, cinnamon is used primarily as an antiseptic orthe treatment o diseases related to bacteria and ungi. It reduces pain o

minor cuts and abrasions. Also, cinnamon toothpaste leaves a rereshingfavor in your mouth. The antiseptic properties o cinnamon help kill bac-teria that lead to tooth decay and gum disease. Cinnamon essential oil isa reliable remedy or athletes oot but should only be applied to the skin

when diluted with a carrier oil.You cannot get a therapeutic dose o cinnamon rom everyday uses in

cooking and baking, even though you could reely devour massive qualitieso cinnamon buns in the name o better health. Remember that the cin-

namon powder sold in the grocery is much old to have any medicinal value.

[Dr. K.Prathapan & Rakhi AlexState Horticulture Mission- Kerala, India]



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The brainstem coordinates motor control signals sent rom thebrain to the body. It controls several important unctions o the bodyincluding alertness, arousal, blood pressure, heart rate, breathing, di-gestion and several other autonomic unctions. It also relays inorma-tion between the peripheral nerves and spinal cord to the upper partso the brain [1].

The complex network o neural pathways which seems to have

progressively evolved with the brain structures, interconnect the vari-ous evolutionary strata within the human brain. However, consideredas a whole, the human brain did not develop in a logically organizedand balanced way. Evolutionary biologists say that There appear tohave been relatively long periods o stability in vertebrate brain evolution,ollowed by bursts o expansion. Dr. Gary F. Marcus, Proessor in the

Information ExplosionThe Challenge - Part 19

Info Line

Brains exist because the distribution o resources necessary or survivaland the hazards that threaten survival vary in space and time

Evolving Brains,John M. Allman, Neuroscientist, California Institute of Technology

As machines become more and more efcient and perect so it willbecome clear that imperections is the greatness o man

Earnst Fisher, German Chemist and Educator

You smile when it rainsYou smile on gentle breezeYou cry when it foodsYou cry when they build homesI love you like my parentsYou save me rom the hot SunI can sleep in your shadeI can rest on your lapsI love you or your Green CareYou get me sweet ruitsYou Are My Best FriendThe Big Tree in this courtyard

[Binsu Chandran][email protected]

My BestFriend


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Department o Psychology at New York University and Director o theNYU Inant Language Center, is a research psychologist whose workocuses on language, biology, and mind. Pro. Gary Marcus argues thatour minds are not as elegantly designed as we may believe. The evo-

lutionary process has been always progressing by piling new systemson top o old ones - a kind o haphazard development o the brainstructures creating a situation where the various evolutionary parts donot always work well together. Pro. Gary Marcus observes that theend product is a kluge, a clumsy, cobbled-together contraption. Formore details on this topic reer to [2].

In short, the human brain has been evolving in a ortuitous ashionover a period o millions o years, somewhat messing up the neuralstructures and processes along the way - resulting in the creation oseveral structural and unctional aberrations and deciencies in thedeveloping organ, all o which are being preserved intact in todayshuman brain. For example, certain neural processes are unnecessarilyduplicated; co-existence o certain incompatible processes paves the

way or conficts and conusion in the unctioning o the brain; someo the processes are very well optimized only or certain situations orexternal challenges; some processes do not unction that optimally andeciently as they should, and so on. One such unctional aberration is

explained below or purposes o illustration.Let us presume that a particular environmental situation is per-ceived as a threat by the primitive part o the brain. The externalstimuli excite the sensory organs and the corresponding inormationabout the environment travels rom the sensory organs to the primitiveparts o human brain. Sensing the risk involved, the primitive part othe brain triggers certain primary base emotions like ear and anger,closely ollowed by certain complex emotional states like avoidanceor deensiveness. In eect the primitive part o the brain is reacting

to the external threat and is quickly preparing the body or a ghtor fight state - it is the least evolved part o the brains way o assess-ing and responding to the perceived risk. This being a basic animalinstinct built into the primitive brain or survival, no time is wasted inreasoning or analysing the risk involved. Reacting this way was quiteappropriate to the era when human brain had just started evolving. Atthat time humans were more akin to animals, competing to survive inthe midst o other erocious animals - For example, when the primitive

neanderthals existed.Whereas the most evolved part o the brain can analyse and com-prehend the stimuli coming rom the external environment and assessthe risk involved, albeit much slower than the primitive part. Assumethat the highly evolved modern brain analyses the situation and arrivesat the conclusion that there is no risk involved. The brain now has to



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process two conficting responses originating rom its two dierentunctional parts. Since the primitive part reacts very quickly to theperceived threat through its built-in base instincts, the evolved partcannot contradict the primitive part o the brain - reasoning gives way

to base emotions. But the act remains that a confict has been createdand the evolved part o the brain remembers the event and keeps striv-ing to resolve the problem.

The question o which one o the above two risk assessments is therealistic one is altogether a dierent issue. The threats or challenges tothe survival o humans in present day inormation technology inten-sive environments are vastly dierent rom those o olden times whenthe development o human brain was in its most primitive stages.Naturally the question arises, Will this not lead to situations where therisk assessment o the primitive part o the brain to present day events turnout to be unrealistic adding to more conusions and conficts? Thus, oteninstead o acting sensibly, we may react emotionally and make a messo the situation, because it is the animal instinct and not reason thatrules the moment. This being an unconscious automatic process, theconcerned individual is not aware o why he/she is behaving that way.

Analyse this situation a little more deeply. What i the evolved brainslearnt experiences are not realistic?

The evolution o human brain is a continuing story. Modernneuroscience research clearly shows that human brain is not only stillevolving, but is doing so even aster than ever beore. This impliesthat in its present state o development, the human brain has not yetbecome a perect or complete organ.

The human brain undergoes very rapid and intensive developmentduring the rst six years o lie since birth. Ater that its developmentcontinues at a somewhat slower pace and in ways dierent rom therst six years o lie, through the teens and into the young adulthood;

i.e., till the early 20s by which time it would have matured into aull fedged adult brain. Scientic studies involving brain scans suggestthat dierent parts o the cortex mature at dierent rates. Areas involvedin more basic unctions mature rst: those involved, or example, in theprocessing o inormation rom the senses, and in controlling movement.The parts o the brain responsible or moretop-down control, controllingimpulses, and planning aheadthe hallmarks o adult behaviorareamong the last to mature[3].

[1]http://biology.about.com/od/anatomy/p/Brainstem.htm[2]Kluge: The Haphazard Evolution o the Human Mind, Gary F. Marcus, 2008,Houghton Mifin Company, N.Y.

[3]http://www.nimh.nih.gov/health/publications/the-teen-brain .........(To be continued)

[Dr H.Ganesh]


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TechnologyThrough the Ages - Part 24

Tech Line

There are some who question the relevance o space activities in adeveloping nation. To us there is no ambiguity o purpose. We do not have

the antasy o competing with the economically advanced nations... But weare convinced that i we are to play a meaningul role nationally, and inthe community o nations, we must be second to none in the application oadvanced technologies to the real problems o man and society.

- Dr. Vikram A. Sarabhai

As we saw earlier, modern Space Age dawned on October 4, 1957with the launch o Sputnik-1. During the cold war period, severecompetition had prevailed between the two super powers in the arenao space as in every other eld, and as a result, one spectacular eventollowed another in quick succession. Not wanting to be outdone thethird time around as earlier in case o satellite launching and mannedspace fight, President Kennedy, committed his nation, in 1961, to thetask o"achieving the goal, beore the decade is out, o landing a man

World Car Scenario India imports nearly $180 billion worth o crude oil every year. Automotive industry contributes approximately 21% to the

country's excise duty collection and 22% to the manuacturingGDP.

In January 2013, the ministry o heavy industries o Indiaunveiled National Electric Mobility Mission Plan 2020, whichtargets almost 6-7 million electric vehicles on Indian roads by2020.

59,929,016 cars were produced in the world in 2011. In 2011, China was the largest producer o cars with 14,485,326

numbers (24% o world production o 60,250,038 cars). Japan(2nd): 7,158,525; Germany (3rd): 5,871,918; South Korea

(4th): 4,221,617; India (5th): 3,038,332 (5% o world production);U.S.A.(6th): 2,966,133.

It is estimated that over 1 billion(100 crores) passenger cars travelthe streets and roads o the world today.

[Source: International Organization of Motor Vehicle Manufacturers]



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on the moon and returning him saely to the earth."Though he didnot live to see the climax, President Kennedy's words galvanized thepace o space activity. The Apollo Project ullled his dream in 1969.

In the beginning, space activities were limited to the two major

powers o the world - USA and USSR who were driven in those coldwar years by reasons o national pride and military advantage. I theromantic charm o space as a new rontier beckoning exploration anddiscovery chiefy characterized the early years, it gradually gave wayto the recognition that space also held the promise o a vast rangeo potential benets to mankind. The applicability o space technol-ogy or the growth o a nation, particularly a developing one, is nowaccepted as an established act. Whats more, space has come to be

regarded as mans ourth environment! The other three are land, waterand air (geosphere, hydrosphere and atmosphere) which have alreadybeen pressed (too much, perhaps?) into service. Space, in this sense, is anatural resource available or harnessing, judiciously though!

The conviction o Dr. Vikram Sarabhai, the ounding ather o In-dian space program,was that technology is not an objective to be aimedat, but a tool to be used or the benet o mankind. While spectacularevents were taking place elsewhere, India did not choose to remain a

passive spectator. Dr. Sarabhai, with the unstinted support o PanditJawaharlal Nehru and Dr. Homi J. Bhabha, lost no time in leadingIndia to the mission o harnessing the humane aspects o space.

Space program can be broadly classied into science, services andindustrialization. The last one, dealing with manuacturing in space,still largely belongs to the uture, though extensive preliminary experi-ments have long since been done and its easibility established. Thebenets o space services are easier to appreciate or they have become

an inseparable part o our lie already, so much so that we take themor granted. To claim that lie today is impossible without satellites

would be no exaggeration!Major benets o space technology include services such as Com-

munication, Meteorology, Remote Sensing, and Global Positioning.Geostationary orbit at 36,000 km above the equator is home to most- but not all - communication satellites. Lower orbits are also usedor certain specic purposes. Thanks to hundreds o communication

satellites providing global and domestic communication services on a24 x 7 basis, the earth has now shrunk to a global village.Satellite-based weather orecasting has been in practice rom

the early 1960s making weather orecast more accurate than everbeore. Weather satellites continually gather data even rom normally


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inaccessible places like oceans, deserts and mountains enabling us toorecast weather with a great degree o accuracy and, thereore, toprepare ourselves with advance measures to minimize loss o lie andproperty due to the erce orces o nature.

Our uture is inextricably tied to that o the earth. Much dependsupon the wisdom with which we conduct ourselves when aced withrapidly increasing world population and ast depleting resources. Thisdemands better knowledge and audit o the earths resources. The mosteective tool is Remote Sensing, which makes o appropriate imagingdevices located in satellites to provide us with a variety o observationsuseul in surveying earth resources. Just as human beings are identiedby their voiceprints and ngerprints, the dierent eatures o the earth

can be discerned by their spectral signatures in the electromagneticspectrum o radiations. Remote Sensing has an unlimited range oapplications such as agriculture and orestry, hydrology and waterresources, oceanography and marine resources, geology and mineralresources, geography, cartography (map making), land use studies andpopulation migration, not to mention spying on another country!

We once had to solely depend on stars or navigation on land andsea. But today, the Global Positioning System (GPS), a cluster oarti-

cial starsorbiting about 20,000 km up in the sky, helps us determineour position with unprecedented accuracy. The most widely used po-sitioning system makes use o 24 satellites owned by the Departmento Deence, USA. Quite expensive just a ew years ago, GPS receivershave become easily aordable and are now incorporated even in somemobile phones. Space technology, particularly concerned with humanspace fight, has gited humanity with innumerable spin-os oer-ing a wide range o applications in everyday lie. Some examples, to

name only a ew, are a broad range o alloys and materials with exoticproperties and new manuacturing techniques. A principal beneciary,however, is medical science covering human physiology and surgery,diagnosis and novel drugs, medical instrumentation and miniatureimplants, robotized walking chairs or the invalid.

(To be continued)[PR]

My own prescription or healthis less paperwork and more running

bareoot through the grass.

- Leslie Grimutter



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A Quick Look

In this column we take a quick look at some books and articles inmagazines which we consider noteworthy. As another item, we also givesome expressions in English language which we come across during our

journey through various publications o repute. The selection is basedon brevity, simplicity and power o words in daily use (not requiringdictionary reerence), style etc.

Readers are also encouraged to send similar items to be included in

uture issues or the benet o other readers. ([email protected])- EditorialTeam

ClassyExpress ions

When I'm with a patient who seems anxious, especially a child, Icrouch close and open my eyes wide. Over the years I've seen howthis can establish a trust bondand put a nervous patient at ease.- Dr Barbara Natterson-Horowitz, MD.

Earth Day seems to have become just another marketing ploy.Earth Day has been co-opted by"sustainable" capitalism, which is asick joke that would be more appropriately celebrated on April 1st.- A posting in Twitter.

A r t i c l e s

HeartDayTamashaandCholesterolLevel

Dr B M Hegde in this article says that any human being who goesor a check up becomes a patient; he or she rarely ever, i ever, becomesnormal human being again!

Magazine: BhavansJournalApril 15, 2013

SolarEnergyisbecomingMainstream:Solar in 2032Solar power systems have come a long way. As o 2012, 90 GW Solar

photovoltaic (PV) systems have been installed, worldwide. Germanyhas more than 30 GW PV systems, mainly at the distribution level.The cost o photovoltaics has allen well below that o nuclear powerand is set to all urther.

Magazine: IEEEPowerandEnergyMarch/April 2013


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Books

SeniorCitizenCaregiving101:

Things I wish I'd known

Author: LoriBurdoo eBook, February15,2013Lori Burdoo, author, was caregiver or her 95

year old Mom or the last 5 years o her motherslie when she learned the rudiments o senior citizencaregiving. She documented her observations in thiseBook - the good, the bad (although sometimespretty humorous), and, upon occasion, the very ugly.

TheBookofBarelyImaginedBeings:A 21stCentury BestiaryAuthor: CasparHendersonPublished by: University o Chicago Press, 2013($29)Inspired by medieval bestiaries (A collection

o stories providing physical and allegoricaldescriptions o real or imaginary animals along with

an interpretation o the moral signicance eachanimal was thought to embody), Henderson describes amazing butreal creatures, rom the axolotl(a salamander) to the zebra sh. Eachentry marries history and philosophy with science.

A Taste of EKLPlease visit the EKL website below to

read selected contents from back issues:www.knowledgelines.com

Perfect MarriageA husband and wie were at a party chatting with some riends when the

subject o marriage counselling came up.

"Oh, we'll never need that. My husband and I have a great relationship,"the wie explained. "He was a communications major in college and I majoredin theater arts. He communicates real well and I just act like I'm listening."

[Susy Mathew]



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Books Scan

John Sculley when he was he

Executive Knowledge Lines May 13

Documents

Transcript of Executive Knowledge Lines May 13