sudhieesansfrontieres

Kind attn: Divesh Nath Name: Sudha Hariharan A/c No: 424 Date: May10,2010 Need to encourage more Swap Kidney Transplant operations ( Box Item)

2010-08-03T21:23:00.000-07:00

For WE
Kind attn: Mr Divesh Nath

Name: Sudha Hariharan

A/c No 424

Date: March 17,2010

Nursing: Gaining popularity as a profession of choice

With the growth of the health industry, the demand for nurses is also increasing making a career in nursing very attractive. Nursing includes a wide range of responsibilities and functions. At the initial levels, the nurses take general care of patients, are engaged in dispensing medication, setting up and operating medical equipment, keeping records of patient's progress and administration.

Nurses and nursing assistants form the largest group of workers in health sector. They are required in the hospitals and health centers right from general ward to operation theatre.

With increasing health consciousness in India, the quality of health services has improved. Skilled and specialized nurses are in high demand by the health organizations
and nurses can get excellent employment opportunities in government or private hospitals, clinics, nursing homes, orphanages, old age homes, military services, industries and schools.

Majority of the nurses in India go abroad. Most of the nurses working throughout the world are from the Indian state of Kerala. Skilled nurses can also get the employment in specialized fields like Surgical, Medical, ICU, Telemetry and ER. Nursing today is not been given the importance in healthcare as it was three decades ago. The backbone of quality healthcare is still nursing. While a surgeon may perform a good operation if this is not backed up by excellent nursing then the ultimate result is mediocre. Nursing, in our country as well as in other countries, is undergoing a transition and is being looked upon increasingly as a profession of choice.

Ms Sheeja Kanade, recently appointed as principal of HiCON (Hiranandani College of Nursing) is an eminent personality in Nursing Education since the last 7 years. Previously associated with Terna Nursing College, MG M College of Nursing, Bombay Hospital College of Nursing, Mumbai, Leelabai Thackersey College of Nursing, Mumbai, her mission is to foster health and well -being through excellence in nursing education, practice and service. Armed with MSc Nursing degree, she has had a fulfilling and successful career spanning different areas of business and involving numerous skills
Here she answers a few pertinent and frequently asked questions:
What are the basic education qualifications necessary to join nursing course?
An individual should be HSC passed with Science stream, should have scored 45per cent and above in Physics, Chemistry, Biology and English. Qualifying a CET or Associate CET exams in Maharashtra is preferred .
What qualities are essential for someone who wants to take up nursing?
“ I believe that nursing is a diverse and rewarding practice a discipline that combines compassion with sophisticated health technology. Nurses design, manage, and coordinate care for individuals, families, groups, communities, and larger populations. They help people meet basic health needs, adapt to physical changes, recover from illness, and die with dignity.”
“Compassion, empathy, emotional stability, good communication skills, confidence, honesty, dedication, a cheerful, alert and pleasant demeanour are some of the basic qualities a person aspiring to be a nurse should have.”

“Nursing field is physically and mentally demanding and involves some risk factors such as exposure to infectious diseases. This profession requires long hours of work. The nurses should be courageous enough to handle all kinds of patients. They should be ready for night shifts and to extend their duties in emergency cases”, she adds.

Why are Indian nurses so much in demand and why are most of them from Kerala?
Indian nurses are in demand the world over because they are educated, professional well- trained, emotionally stable and dedicated. Most of them are from Kerala because of the high rate of literacy among women there, their dedication and caring attitude.
Are they well paid in India and abroad?
They are definitely better paid overseas.
What are the major advantages of opting for nursing?
The main advantage is that they can be recruited immediately after completion of studies. A graduate in nursing has immense overseas opportunities in western countries and the Gulf. There is also scope for higher and specialized education and training.
What health risks do they commonly face?
The most common risk they face is infection . This also depends on the area of function.

Do hospitals here provide for health check-ups for nurses in their employ?
hospitals do, others do not. The policy regarding regular check-ups varies from hospital to hospital

Tell us about HICON and its vision…..

I am really delighted to highlight Hiranandani college of Nursing (HiCON) as a unique College of Nursing established in the year 2009 affiliated to Maharashtra University of Health Sciences and recognized by Indian Nursing Council and State Nursing Council. Our focus is on overall development of an individual geared towards addressing not only the ongoing health challenges but also emerging health issues of the 21st century.HiCON will strive to be positioned in the top five nursing colleges in India by 2014 and to be the best in professional training.

The infrastructure is matchless, the training aids are frontline and have been procured from the very best vendors and there is; also a college hostel provided.The course curriculum at HiCON is in line with the Indian Nursing Council. Additionally they propose to introduce a Diploma Course in Health Management to arm students with a management degree. This it will give them an option to pursue a career in health management, if at some time they would like to give up nursing. The college will train students in B.Sc (Nursing) with further scope for M.Sc (Nursing) or Ph.D, if they so desire.

For WE
Kind attn: Mr Divesh Nath

Name: Sudha Hariharan

A/c No 424

Date: March 17,2010

Nursing: Gaining popularity as a profession of choice

With the growth of the health industry, the demand for nurses is also increasing making a career in nursing very attractive. Nursing includes a wide range of responsibilities and functions. At the initial levels, the nurses take general care of patients, are engaged in dispensing medication, setting up and operating medical equipment, keeping records of patient's progress and administration.

Nurses and nursing assistants form the largest group of workers in health sector. They are required in the hospitals and health centers right from general ward to operation theatre.

With increasing health consciousness in India, the quality of health services has improved. Skilled and specialized nurses are in high demand by the health organizations
and nurses can get excellent employment opportunities in government or private hospitals, clinics, nursing homes, orphanages, old age homes, military services, industries and schools.

Majority of the nurses in India go abroad. Most of the nurses working throughout the world are from the Indian state of Kerala. Skilled nurses can also get the employment in specialized fields like Surgical, Medical, ICU, Telemetry and ER. Nursing today is not been given the importance in healthcare as it was three decades ago. The backbone of quality healthcare is still nursing. While a surgeon may perform a good operation if this is not backed up by excellent nursing then the ultimate result is mediocre. Nursing, in our country as well as in other countries, is undergoing a transition and is being looked upon increasingly as a profession of choice.

Ms Sheeja Kanade, recently appointed as principal of HiCON (Hiranandani College of Nursing) is an eminent personality in Nursing Education since the last 7 years. Previously associated with Terna Nursing College, MG M College of Nursing, Bombay Hospital College of Nursing, Mumbai, Leelabai Thackersey College of Nursing, Mumbai, her mission is to foster health and well -being through excellence in nursing education, practice and service. Armed with MSc Nursing degree, she has had a fulfilling and successful career spanning different areas of business and involving numerous skills
Here she answers a few pertinent and frequently asked questions:
What are the basic education qualifications necessary to join nursing course?
An individual should be HSC passed with Science stream, should have scored 45per cent and above in Physics, Chemistry, Biology and English. Qualifying a CET or Associate CET exams in Maharashtra is preferred .
What qualities are essential for someone who wants to take up nursing?
“ I believe that nursing is a diverse and rewarding practice a discipline that combines compassion with sophisticated health technology. Nurses design, manage, and coordinate care for individuals, families, groups, communities, and larger populations. They help people meet basic health needs, adapt to physical changes, recover from illness, and die with dignity.”
“Compassion, empathy, emotional stability, good communication skills, confidence, honesty, dedication, a cheerful, alert and pleasant demeanour are some of the basic qualities a person aspiring to be a nurse should have.”

“Nursing field is physically and mentally demanding and involves some risk factors such as exposure to infectious diseases. This profession requires long hours of work. The nurses should be courageous enough to handle all kinds of patients. They should be ready for night shifts and to extend their duties in emergency cases”, she adds.

Why are Indian nurses so much in demand and why are most of them from Kerala?
Indian nurses are in demand the world over because they are educated, professional well- trained, emotionally stable and dedicated. Most of them are from Kerala because of the high rate of literacy among women there, their dedication and caring attitude.
Are they well paid in India and abroad?
They are definitely better paid overseas.
What are the major advantages of opting for nursing?
The main advantage is that they can be recruited immediately after completion of studies. A graduate in nursing has immense overseas opportunities in western countries and the Gulf. There is also scope for higher and specialized education and training.
What health risks do they commonly face?
The most common risk they face is infection . This also depends on the area of function.

Do hospitals here provide for health check-ups for nurses in their employ?
hospitals do, others do not. The policy regarding regular check-ups varies from hospital to hospital

Tell us about HICON and its vision…..

I am really delighted to highlight Hiranandani college of Nursing (HiCON) as a unique College of Nursing established in the year 2009 affiliated to Maharashtra University of Health Sciences and recognized by Indian Nursing Council and State Nursing Council. Our focus is on overall development of an individual geared towards addressing not only the ongoing health challenges but also emerging health issues of the 21st century.HiCON will strive to be positioned in the top five nursing colleges in India by 2014 and to be the best in professional training.

The infrastructure is matchless, the training aids are frontline and have been procured from the very best vendors and there is; also a college hostel provided.The course curriculum at HiCON is in line with the Indian Nursing Council. Additionally they propose to introduce a Diploma Course in Health Management to arm students with a management degree. This it will give them an option to pursue a career in health management, if at some time they would like to give up nursing. The college will train students in B.Sc (Nursing) with further scope for M.Sc (Nursing) or Ph.D, if they so desire.

For WE
Kind attn: Mr Divesh Nath

Name: Sudha Hariharan

A/c No 424

Date: March 17,2010

Nursing: Gaining popularity as a profession of choice

With the growth of the health industry, the demand for nurses is also increasing making a career in nursing very attractive. Nursing includes a wide range of responsibilities and functions. At the initial levels, the nurses take general care of patients, are engaged in dispensing medication, setting up and operating medical equipment, keeping records of patient's progress and administration.

Nurses and nursing assistants form the largest group of workers in health sector. They are required in the hospitals and health centers right from general ward to operation theatre.

With increasing health consciousness in India, the quality of health services has improved. Skilled and specialized nurses are in high demand by the health organizations
and nurses can get excellent employment opportunities in government or private hospitals, clinics, nursing homes, orphanages, old age homes, military services, industries and schools.

Majority of the nurses in India go abroad. Most of the nurses working throughout the world are from the Indian state of Kerala. Skilled nurses can also get the employment in specialized fields like Surgical, Medical, ICU, Telemetry and ER. Nursing today is not been given the importance in healthcare as it was three decades ago. The backbone of quality healthcare is still nursing. While a surgeon may perform a good operation if this is not backed up by excellent nursing then the ultimate result is mediocre. Nursing, in our country as well as in other countries, is undergoing a transition and is being looked upon increasingly as a profession of choice.

Ms Sheeja Kanade, recently appointed as principal of HiCON (Hiranandani College of Nursing) is an eminent personality in Nursing Education since the last 7 years. Previously associated with Terna Nursing College, MG M College of Nursing, Bombay Hospital College of Nursing, Mumbai, Leelabai Thackersey College of Nursing, Mumbai, her mission is to foster health and well -being through excellence in nursing education, practice and service. Armed with MSc Nursing degree, she has had a fulfilling and successful career spanning different areas of business and involving numerous skills
Here she answers a few pertinent and frequently asked questions:
What are the basic education qualifications necessary to join nursing course?
An individual should be HSC passed with Science stream, should have scored 45per cent and above in Physics, Chemistry, Biology and English. Qualifying a CET or Associate CET exams in Maharashtra is preferred .
What qualities are essential for someone who wants to take up nursing?
“ I believe that nursing is a diverse and rewarding practice a discipline that combines compassion with sophisticated health technology. Nurses design, manage, and coordinate care for individuals, families, groups, communities, and larger populations. They help people meet basic health needs, adapt to physical changes, recover from illness, and die with dignity.”
“Compassion, empathy, emotional stability, good communication skills, confidence, honesty, dedication, a cheerful, alert and pleasant demeanour are some of the basic qualities a person aspiring to be a nurse should have.”

“Nursing field is physically and mentally demanding and involves some risk factors such as exposure to infectious diseases. This profession requires long hours of work. The nurses should be courageous enough to handle all kinds of patients. They should be ready for night shifts and to extend their duties in emergency cases”, she adds.

Why are Indian nurses so much in demand and why are most of them from Kerala?
Indian nurses are in demand the world over because they are educated, professional well- trained, emotionally stable and dedicated. Most of them are from Kerala because of the high rate of literacy among women there, their dedication and caring attitude.
Are they well paid in India and abroad?
They are definitely better paid overseas.
What are the major advantages of opting for nursing?
The main advantage is that they can be recruited immediately after completion of studies. A graduate in nursing has immense overseas opportunities in western countries and the Gulf. There is also scope for higher and specialized education and training.
What health risks do they commonly face?
The most common risk they face is infection . This also depends on the area of function.

Do hospitals here provide for health check-ups for nurses in their employ?
hospitals do, others do not. The policy regarding regular check-ups varies from hospital to hospital

Tell us about HICON and its vision…..

I am really delighted to highlight Hiranandani college of Nursing (HiCON) as a unique College of Nursing established in the year 2009 affiliated to Maharashtra University of Health Sciences and recognized by Indian Nursing Council and State Nursing Council. Our focus is on overall development of an individual geared towards addressing not only the ongoing health challenges but also emerging health issues of the 21st century.HiCON will strive to be positioned in the top five nursing colleges in India by 2014 and to be the best in professional training.

The infrastructure is matchless, the training aids are frontline and have been procured from the very best vendors and there is; also a college hostel provided.The course curriculum at HiCON is in line with the Indian Nursing Council. Additionally they propose to introduce a Diploma Course in Health Management to arm students with a management degree. This it will give them an option to pursue a career in health management, if at some time they would like to give up nursing. The college will train students in B.Sc (Nursing) with further scope for M.Sc (Nursing) or Ph.D, if they so desire.

Kind attn: Divesh Nath
Name: Sudha Hariharan
A/c No: 424
Date: May10,2010
Need to encourage more Swap Kidney Transplant operations ( Box Item)
There is a major need to encourage more Swap kidney transplant operations in the country, which is vital for needy patients who have lined up for transplant operations. This was the message sent out by nephrologists assembled at a kidney transplant awareness programme on the occasion of World Kidney Day.

In a swap kidney transplant, a mutual understanding is reached between two families, where the healthy member donates one of his kidney’s to the needy member of the other family and vice versa. Even in western countries, more number of people opt for swap transplants due to more relaxed regulations.

“Today strict regulations from the government are not allowing more swap transplants. Consequently many patients have to wait for a long time, as they are dependent only on cadaver transplants (transplant from a brain dead person). I am sure if the rules are simplified, we will have more number of families opting for swap transplants,” said Dr Haresh Dodeja, Nephrologist & Transplant physician at Fortis Hospital.

“In the last 2 years Fortis has taken a lead in harvesting large number of cadaver kidney donations and we are proud of our contribution to the city. We would like to continue to do good work and the next step would be to initiate swap transplant to tide over

shortage of donors in the current scenario of nuclear families with limited numbers of donors in the family,” said Dr. Dodeja.

We have come a long way from the days of cadaver transplant, where the immediate recovery of kidney function was delayed, and the patient required 4-6 weeks to normalize and get discharged, adding to the costs of the transplant. Today we have managed to successively do cadaver transplants simulating live donor conditions, and achieving immediate graft function, and quick recovery without dialysis, and a fast discharge, saving on the costs considerably.”

Dr Dodeja who is the clinical coordinator for the dialysis and transplant services believes that a good integrated system of involving the ICU team, social workers and regular awareness programs by nephrologists will go a long way in the success of a cadaver transplant program.”

The Mumbai Nephrology Group has also decided to recognise ‘World Kidney Day’ on March 11, under the theme ‘Protect your Kidneys – Control Diabetes’. The aim of this program is to create awareness among patients, doctors and people at large about Diabetes and Kidney diseases.
In India, more than 2,000,000 patients are affected with renal failure and every year around 1, 00, 000 new patients are affected with end-stage renal failure (ESRD) that requires treatment, dialysis or transplant. Only 2 per cent of these patients can avail of dialysis treatment, 5 per cent get transplants and less than 0.5 per cent of these patients undergo peritoneal dialysis.
Maharashtra alone requires 10,000 kidney transplants per year, but only 2.5 per cent of these patients receive it.” The prevalence of chronic kidney disease (CKD) continues to increase worldwide, as does end - stage renal diseases. The most common cause of CKD is diabetes. Diabetic nephropathy affects a third of people suffering from diabetes,” said Dr. Hemant Mehta, of Mumbai Nephrology Group.

Diabetes is the most common cause of kidney failure. When people suffer from diabetes the excess glucose in the blood reacts with proteins to form compound which makes the nephron filters too porous or leaky. As a result, protein molecules begin to slip through the kidneys’ filters and into the urine leading to CKD.

Dialysis is an expensive treatment, and there is severe shortage of donated kidneys available for transplantation. Many patients therefore cannot afford end -stage renal failure treatment and hence the focus is on prevention. Simple, routine tests of urine and blood can show early signs of kidney problems. Once the problems are identified, patients can slow down and even stop chronic kidney disease, with medication and change in lifestyle habits.

Kind attn: Mr. Divesh Nath

For Woman’s Era

Name: Sudha Hariharan

A/c No: 424

Date: May 10,2010

Teenagers too can be plagued by chronic kidney disease

Its not a disease that afflicts only adults. Chronic Kidney Disease (CKD) can plague teenagers too. Dr. Rajan Ravichandran ( Director-Nephrology ,MIOT Hospital Chennai)speaks at length on how CKD affects women and the youth and how the disease can be treated

The kidneys make urine from the waste products of the body. Most kidney infections start when bacteria get into the urethra, the tube used to urinate. The bacteria may spread to infect the kidneys.
For women, risk factors for kidney infections are the same as for bladder infections (cystitis). They include:
Having sex often
Using a spermicide for contraception
Having had cystitis in the last year
Having diabetes
Having blood pressure

Sometimes the symptoms do not occur at all initially but otherwise the symptoms of having kidney infections are:
high temperature with shivering
pain in the side
back ache
nausea, vomiting or diarrhea
the need to pass urine very often
urine may look cloudy or be a different color
loss of appetite

To measure kidney function, primary care doctors typically order a blood test called creatinine. The serum creatinine should also be plugged into a formula that gives an estimated kidney filtration rate (called glomerular filtration rate, or eGFR) which is a much more accurate estimate of kidney function. Women have a lower eGFR than men for the same level of serum creatinine. Thus, the same serum creatinine level that initially appears normal for both a man and a woman can translate into depressed kidney function for the woman, making her at higher risk for undetected kidney disease.

Young girls are particularly vulnerable and can experience impaired growth and abnormal menstrual cycles due to altered metabolism and hormone deficits.
can contribute to ovarian failure and premature menopause
decreased fertility and unsuccessful child births
pregnant women with CKD are also risk developing hypertension and kidney function loss

Kidney problems in Teenagers
Kidneys are responsible for removing waste and extra fluid from what you eat and drink from in the body. The nutrients you need remain in your body while the extra waste is filtered by the kidneys. Kidneys are made up of millions of tiny filters called nephrons which remove the unwanted fluids from the blood by creating urine. The urine travels down the ureters into the bladder and is stored until it is released through the urethra.The two most frequent causes for adults to develop chronic kidney disease are high blood pressure and diabetes. In teens these causes are uncommon. However, due to unhealthy eating habits leading to excessive weight gain, more young people are prone to diseases such as diabetes and high blood pressure, which can cause kidney disease later in life.
For most teens, CKD is caused by congenital disorders or diseases that develop such as:
Urinary problems, such as UTIs (urinary tract infection)
Reflux nephropathy
Nephrotic syndrome
Nephritis
The Urinary tract infection (UTI)
urinary tract consists of the urethra, the bladder, the ureters and the kidneys. Urinary tract infection (UTI) is caused when bacteria moves up into the bladder and multiplies. A bladder infection, or cystitis, is the most common UTI. Urinary tract infections are usually easy to diagnose in teens and adults.
Symptoms Symptoms include:
frequent, painful urination
inability to urinate despite the urge
urine that appears cloudy or has an unusual smell
blood in the urine
fever and flank or lower back pain if the kidneys are infected

To diagnose a UTI, a urine sample is taken to check for the growth of bacteria. If the teenager is given antibiotics, relief usually begins within 12 to 24 hours of treatment. If the UTI affects the kidneys, intravenous medications may be necessary, requiring teens to be hospitalized.
After treatment, the doctor will collect another urine sample to determine if the medicine has gotten rid of the infection. Since UTIs tend to come back again, the doctor may want your teen to be tested on a regular basis.
Advice to prevent the recurrence of UTIs include:
After voiding, girls and women should wipe from front to back to prevent contaminating the urethra with bacteria from the anal area.
Drinking plenty of water to flush the urinary tract
Not resisting the urge to urinate
Taking a shower instead of a bath

Reflux nephropathy

Reflux disorder is often diagnosed after a teenager has a UTI. It occurs when urine goes back up from the bladder to the kidney. This is due to a defect of the “valves” between the ureters and the bladder. Reflux can cause an infection to spread to the kidneys. This can be serious and may lead to kidney damage. About 30% of older children with UTIs will suffer from reflux disorder.
Sometimes surgery is done to correct reflux disorder, but most teens are treated with antibiotics. Teens diagnosed with reflux disorder usually recover after treatment. Typically, they do not have relapses. If kidney damage occurs, however, teens may get high blood pressure later in life. If one kidney is damaged, the risk of getting high blood pressure is 10%. If both kidneys have been injured, the risk rises to 20%. Most teenagers who experience reflux disorders do well and do not experience kidney damage.
Nephrotic syndrome

Nephrotic syndrome usually occurs in children aged 6 months to 5 years old, although it can happen at any age. Boys are two times more likely to suffer from nephrotic syndrome than girls. This occurs when the kidneys are diseased and unable to keep protein from leaking into the urine. It often appears for the first time after a child has had a cold or infection
.
The cause of nephrotic syndrome is unknown. Many researchers are working to determine its cause and develop treatments. Today, nephrotic syndrome is typically treated with the medicine prednisone, and most young people improve with its use. Sometimes doctors prescribe immunosuppressive medicines. Whichever medicine your doctor chooses, your child will be monitored closely and get periodic blood tests.
Although there is no cure for nephrotic syndrome, most young children do well with treatment, and many “outgrow” the disease by the time they reach their teens. Even when a child has frequent episodes, if he responds well to treatment then permanent kidney damage is not likely.
Nephritis

Nephritis is when the kidney becomes inflamed, sometimes due to infection or a disease in the immune system called systemic lupus erythematosus (SLE). When the kidneys become irritated, they pass protein and red blood cells into the urine, causing it to have a color which resembles cola.
Teenagers who get nephritis are treated and most get better over time. Medical treatment depends on the symptoms, and includes reducing the swelling, inflammation and lowering blood pressure.

Basic symptoms for CKD in teenagers
Consult your doctor if your teenager exhibits any of the following:
Unexplained low-grade fever
Swelling around the eyes, feet, and ankles
Lower back pain
High blood pressure
Persistent abdominal pain
Frequent severe headaches
Unpleasant-smelling urine
Urine that is cloudy, bloody or dark brown
Burning sensation when urinating
Poor appetite
Slow growth or weight gain
Weak urinary stream, dribbling or fanning of urine stream
Painful urination
Weakness, excessive tiredness or loss of energy
Pale skin or “washed out” appearance

Kind Attn:
Mr. Divesh Nath
For WE

Name : Sudha Hariharan

A/c No: 424

Date: May 10,2010

Tackling kidney stones during pregnancy

A family physician who started his practice in 1958 from the heart of Delhi’s Chandni Chowk,Dr. B.S. Bansal was a man with vision. He wanted to do away with unnecessary surgery and long hospital stays and thus introduced the concept of Lithotripsy in India in 1987. Once again he introduced the concept of Holmium Laser for the treatment of enlarged prostate in 1999. He is a mentor for all Urologists across the world. He is popularly known as “Father of Lithotripsy”. Under the commendable guidance and leadership of Dr. Bansal, R G Stone has treated more than 1,00,000 patients.
DR. B.S. BANSAL,(CMD), RG Stones Urology and Laproscopy Hospital, talks about the unique, efficient and non-invasive treatment.

What would you do if you develop kidney stones during pregnancy?
Studies reveal that, “getting kidney stones during pregnancy is more likely for woman. A woman’s body goes through a number of hormonal and other changes during pregnancy. 1 of every 1500 pregnant women face kidney stones problem during their pregnancy. 80-90% are diagnosed in the first trimester.”
The changes that a woman’s body goes through during pregnancy create an environment for stone formation in urine. There is hypercalciuria during pregnancy which is extensive amount of calcium in the urine which leads to stone formation. 66-85% pregnant woman pass ureteric stone spontaneously with medical treatment.

Since X-Ray cannot be used, Ultrasound is first line of imaging study during pregnancy. Though kidney stone does not have a direct risk to foetus, but can pose problems for the mother and child such as:
* Pyonephrosis
* Infection causing growth retardation
* Abortion
* Premature labour during pregnancy
The aim is to remove the stone without harming the fetus- the risk to the fetus being through anesthesia and surgery. In such circumstances it becomes difficult to remove stones efficiently without harming the fetus.Utheroscopy with Holmium laser lithotripsy is a safe and efficient treatment in such situations. If URS is not possible then stenting can be done where the stent need to be changed every 4-6 weeks
What exactly is Pyronephrosis?
A. Pyonephrosis is a collection of pus in the kidney.

2. Are there any precautionary measures women can take to avoid this condition?
1) Drinking lots of water is of primary importance
2) If the patient is diabetic, control on sugar level needs to maintain.
3) If any kidney blockage or stone is there, take a expert doctors opinion.

3. What are the lines of treatment- ---how are they done?
. The treatment is through Uteruscopy and use of stents

1) Stenting is a procedure where a DJ stent is inserted through
natural passage which is fixed or interlock at a junction where the ureter
end to avoid infection to have a proper passage of urine and to dilate the
ureter.

2) In nephrostomy, you make a puncture and enter to kidney on your
flankside through a nephrostomy tube.
4. Is the treatment affordable?
Yes, the treatment costs 5-10 thousand only
5. Are women aware of this? Do gynecologists caution them of this? If this is such a common problem (pyonephrosis) for pregnant women, why are they not advised by their gynaecs? What can be done to create awareness?
Pyonephrosis is not very common for pregnant women, actually urinary tract infection is more common during pregnancy which can be dealt with by a gynaecologist .
6. Are there any simple home remedies to control the ailment?
No.

R G Stone has 17 branches across India and is Asia’s largest urology chain. R G employs the largest pool of super specialists under one roof and features in the Guinness Book of Records for removing the largest stone without surgery.

.

Every Km matters!

2010-08-03T21:19:00.000-07:00

Kind Attn: Divesh Nath

Name: Sudha Hariharan

A/c No: 424

Date: April 2, 2010

Cancer Awareness…Every kilometer in the journey counts

Dr. [Captain] Ritu Biyani is a multi-faceted and courageous woman—a dental surgeon, mountaineer, first lady Paratrooper from the Army Dental Corps, skydiver, avid photographer, and most importantly a breast cancer survivor. She has served in the Indian Army Dental Corps for 10 years and has traveled extensively across India.
Highways Infinite is the registered public trust founded in March 2008 by Dr. .[Capt] Ritu Biyani.
The genesis of Highways Infinite was based on her experiences and response generated after her first pilot project, Project High>>>Ways, which she conceptualized in 2005, launched and spearheaded in 2006. This also became the platform for her subsequent projects Highways Beyond Cancer 2007,2008, 2009----a unique initiative to link adventure sports with cancer awareness across the country. Assisted by her daughter Tista Joseph---the duo was awarded Manthan Awards South -Asia 2008 for pioneering on cancer education at the grassroots level.
Project Highways - 2006 was a very first of its kind endeavor undertaken in India and earned the mother-daughter team recognition in the Limca book of Records- India 2007 and 2008 .
Her innovative efforts on her High>>>ways Beyond Cancer, has taken her to various forums where she has presented papers, at many national and international conferences, to name some, Tata Memorial Hospital Mumbai, Mohandai Oswal Cancer Research Hospital, Ludhiana, 5th World Breast Cancer Conference, Canada, Reach to Recovery International Breast Cancer Support Conference Australia, UICC World Cancer Congress - Geneva, Premier Lance Armstrong Global Cancer Summit Ireland and Global Leadership Cancer Forum Canada, etc.
India has one of the largest road networks of 3.32 million kilometers including expressways, national and state highways, major and minor district roads and village roads and of course another 1000s of kms of trekking routes. Dr Ritu has so far covered 66,000 plus km since 2006 .
She feels she has miles to go as the journey has just begun. Dr. ( Capt) Biyani wants people to connect with Highways to encourage, support, contribute, and to participate in more such journeys to create awareness, motivate and bring a smile to many faces.
Dr Ritu Biyani-Joseph is currently scheduling her next expedition on cancer in May 2010, “ Every kilometer in the journey counts…similarly every contribution big or small counts”, she says.
For further information contact Dr. Ritu Biyani-Joseph at +91 9881232744 or email at missionhighways@gmail.com or visit www.highwaysbeyondcancer.org [ presently under [ HIGH>>>WAYS…INFINITE : Public Trust registered in Pune Division ( State: Maharashtra, India) on 18/March/2008, under Bombay Public Trust Act 1860.) Reg. No E-5111. Donations exempted under 80G [5] of the income tax Act, 1961]

Pregnant women, teenagers prone to varicose veins

2010-08-03T21:18:00.000-07:00

KA: Divesh Nath
For WE Health,Beauty & Sex special

Name:Sudha Hariharan
A/cNo: 424
Date: February 21,2010
Pregnant women, teenagers prone to Varicose Veins
Nature has provided for the need to push used blood back to the heart by 2 unique devices---the location of the veins and a system of valves. The veins in the legs are woven among the muscles so that when each muscle contracts, it squeezes a vein. Squeezing the vein pushes the blood closer to the heart. The valves in the vein prevent the blood from flowing backwards when the muscle relaxes
If we spend too much time sitting or standing, the used blood from the lower part of the body does not get the push it needs to return to the heart. This causes fatigue and sluggishness.
Varicose veins result from a failure of the used blood in the legs to return to the heart at the proper rate. The veins may lose some of their elasticity or the valves may fail to close properly. The used blood then accumulates and causes veins to swell. Varicose veins occur often in the legs of people whose jobs require that they stand a great deal.
Dr. Shoaib Padaria pioneered ELVES (Endovenous Laser Treatment of Varicose Veins) in India in January’ 2003. Since then, he has successfully performed over 2,500 procedures. He is a Consultant Interventional Cardiologist associated with Jaslok Hospital and other leading hospitals in Mumbai.
“Varicose Veins are enlarged, tortuous, knotty and bulging veins seen in the legs. Some of these veins may be very tiny (reticular or spider veins), while others are typically larger, increasing in size when you stand for a long period of time. In fact, this condition is known to be hereditary, and in such cases symptomatic patients could even be teenager’s “, says Dr. Shoaib. Padaria. There are two types of veins that carry blood in the body---deep veins and superficial veins. The blood flows from the superficial veins to the deep veins. These veins have valves which control the blood flow and keep the blood flowing towards the heart. However, when these valves do not function properly, the blood flows in the wrong way, leading to varicose veins.

“Varicose veins are prominent during pregnancy. During pregnancy, the growing uterus puts added pressure on the veins. As a result, the valves are also squeezed and the blood flow to our heart is disrupted. This condition is very common during the third trimester because this is when the uterus will be at its heaviest.”
“ If you are having a twin pregnancy, there are greater chances of being affected by varicose veins. During the last trimester of pregnancy, the veins on your legs may become prominent and get a dark purple or blue colouration. Apart from that, you will also experience pain in your limbs. These are symptoms of varicose veins. Usually, the symptoms disappear after delivery, but in serious cases, the bluish colouration of the veins can stay for life”, adds Dr. Shoaib.
While it usually causes problems in people over the age of 50, quite a few patients are also younger. In fact, varicose veins are known to be hereditary, and in such cases symptomatic patients could even be teenagers. It is important to diagnose varicose veins early. “In the past,” says Dr. Shoaib,” the only option was surgery – legations and stripping were used to remove a damaged vein and prevent further complications of vein damage. Today, there’s a permanent treatment for varicose veins: the laser technique.”
Endovenous Laser Treatment of Varicose Veins (ELVES) in an outpatient procedure usually completed within an hour in a clinical setting. It utilizes a diode laser, which deliver’s laser energy at a wavelength of 980 nanomicrons. This wavelength is optimally suited for absorption by haemoglobin in the blood, and does not cause any thermal injury to structures around the veins. ELVES is a safe and quick procedure that offers successful results without the complications of surgery.
Meenakshi Desai in her ninth month of pregnancy felt a sudden pain in her thigh. A bulge appeared where the pain was. Over the next seven years, it became a painful varicose vein. Eventually, the vein ran from her groin to her ankle and inhibited her in everything, from walking to caring for her children.

Mr. Sarang, a 50- year- old builder from Pune, loved walking and going for hikes in the Sahyadri Hills. A regular at the Mumbai Marathon, last year he found that he could not complete the run owing to severe pain in his legs, because of varicose veins that he had developed many years ago.
Mr. Dedhia, owner of a grocery shop, had to stand in his small shop for up to 14 hours every day. Over the years, he developed swelling in both his feet, and finally painful ulcers near his ankles that refused to heal. He was diagnosed with varicose veins.
All the above were advised regular surgery but were scared to undergo the procedure as it would hamper their lifestyle and leave scars. However, all of them finally benefited from Endovenous Laser Treatment by Dr. Padaria.
ELVES have many advantages over surgery. The treatment is performed under local anesthesia and with ultrasound guidance. A small needle is inserted into the dilated varicose veins, and a thin laser wire is passed through the needle into the vein. Laser energy delivered into the vein seals and closes the vein painlessly. The main varicose vein and its branches are closed in a similar manner, and the entire procedure takes about 30 minutes. A compression bandage is applied over the treated leg, and the patient can walk home soon after, resuming normal work the next day. The patient is required to wear special full-length stockings (socks) during waking hours for about two months after the treatment.
Many people with varicose veins live without any symptoms. However, in others, it can limit their lifestyle. Aches and pains in the legs, cramps in the calves, heaviness in the legs and swelling around the ankles while standing are common symptoms. Sometimes enlarged veins can rupture, causing sudden bleeding. A clot may form within the dilated vein and can travel to the heart. It is quite easy to diagnose varicose veins. A simple ultrasound called the Venous Doppler can show the leaking valves and swollen veins.

Meenakshi Desai, who was treated by Dr. Shoaib Padaria, says, ‘I instantly felt better.” She now feels no discomfort while walking or playing with her children.
“Everyone is at risk when it comes to developing varicose veins,” says Dr. Padaria. “But the main cause is genetic, with women nearly twice as likely to suffer as men. People with past venous diseases, new mothers, overweight individuals and people with jobs or hobbies requiring extended standing are at increased risk.”
“Meenakshi Desai’s experience shows that varicose veins can have a dramatic effect on lifestyle,” Dr. Padaria says. “They can progress from being a cosmetic nuisance to a serious medical problem causing swelling and pain in the legs. But thanks to laser treatment, these veins now can be removed simply, without surgery.”
Dr. Shoaib Padaria pioneered this treatment in India in January’ 2003. Since then, he has successfully performed over 2,500 procedures. He is a Consultant Interventional Cardiologist associated with Jaslok Hospital and other leading hospitals in Mumbai.

The Power of Epidurals

2010-08-03T21:16:00.001-07:00

Kind attn : Mr. Divesh Nath
For WE Health, Beauty & Sex Special

Name: Sudha Hariharan

A/c No : 424

Date: Feb 18, 2010

GAIN WITHOUT PAIN : The Power of Epidurals
The term epidural is often short for epidural anesthesia, a form of regional anesthesia involving injection of drugs through a catheter placed into the epidural space. The injection can cause both a loss of sensation (anaesthesia) and a loss of pain (analgesia), by blocking the transmission of signals through nerves in or near the spinal cord. An epidural can be done for regular labor and childbirth, induced labors (induction), a forceps or vacuum delivery or even a Cesaerean section.
With over 15 years of rich and successful experience in the areas of sales, training, strategic marketing, business management and people management in healthcare industry, Dr. Prabhu Vinayagam ,urrently Director, Clinical Services- Asia Pacific, BD India (Becton Dickonson India),shares a wealth of information on the subject.

“Motherhood is undoubtedly one of the most wonderful experiences in any woman’s life” says Dr. Vinayagam.” During pregnancy, a woman goes through various emotions ranging from joy to anxiety. She is not only anxious to know whether she will be blessed with a son or a daughter, but her anxiety also lies in the fact that would presumably need to go a through a painful delivery. In addition, couples today live in a nuclear set up and do not have elders living with them during this period who could provide emotional support. This loneliness also adds to their anxiety levels “.
Ironically, advancements in science and technology and increasing education levels have not done much to alleviate the fallacies and myths surrounding childbirth. A woman is usually bounded by old wives’myths and tales which hinder her from the right of having a painless delivery. First time mothers are filled with apprehension, anxiety and fear about labor pains - as one says, there’s no gain without pain.
However, today this statement can surely be amended to ‘All gain no pain’. Yes, painless delivery is possible. “Avoiding pain” during delivery is gaining acceptance – given the increasing acceptance of pre-planned Cesarean deliveries by women, who plan to have only one or two children.
Most Cesarean deliveries are done under general anesthesia, which has its own risks like the anesthetic medicine may reach the blood stream of the baby, and also subjects the body to significant surgical trauma. Epidural anesthesia offers an alternative to Cesarean (when the only reason for Cesarean was to avoid the pain of normal delivery and where there is no other medical need for the procedure) .What needs to be understood by expectant mothers is that child birth by this method is an absolutely normal delivery; and the pain is much less.
“Epidural anaesthesia is advancement in pain management during labor, which ensures that the expecting mother has a smooth and comfortable journey through labor and delivery. As labor progresses and the fetus advances through the birth passage, certain impulses occur and aggravate pain. Epidural process is used to obstruct the pain by inserting a catheter into the vertebral column for the duration of the delivery, and pain relieving drug is injected through it. This drug numbs the body below the waist and keeps the sensations and muscle functions active. This facilitates easy delivery of the baby” says Dr. Vinayagam. The mother is now advised to push at the time of the contractions. The effect of the anesthesia gradually wears off within an hour or two. Epidural anesthesia is unlikely to affect the central nervous system, thus it does not reach the child. For this reason, the mother and the child are alert after the delivery. Some women feel the contractions but do not experience the pain at all.

“Epidural procedure is suitable for patients who find it hard to get through labor pains. Since epidurals are completely safe for the mother as well as the baby, more and more patients are opting for it. Until last decade, epidurals were unheard of in India whereas today, many hospitals offer these facilities for its patients. Certain hospitals have set up individual departments for epidural anaesthesia”, adds Dr. Vinayagam.
“Epidural Anesthesia is more commonly used for C- section as well as a mean of post operative pain management. However, epidural anesthesia when used during normal delivery is also known as Painless Labor Delivery. Labor pains often last for as long as 12 hours and epidural is an efficient mean to control such pain.”
When asked about after effects,Dr. Vinayagam said, “ similar to any other surgery, complications like epidural hematoma may occur. However, there are no direct serious harmful consequences of Epidural Anesthesia. “
In India while about 10-15% of urban population is aware of the epidural procedure, only the high society opts for it whereas in developed countries like US, epidural deliveries are a widespread procedure. It is advised that one should go for epidural deliveries after obtaining knowledge about the process. It is imperative for the doctors to observe and examine the patients carefully before advising the dosage on epidurals during labor.
“ An obstetrician’s role”, says Dr. Vinayagam.” is critical where she herself has to be absolutely willing and confident while handling the patient opting for epidural analgesia”.
Rising above the myths of risks of incidence of Cesarean, more backaches and an injurious affect on baby or mother, most women today choose to use an epidural for pain relief at some point during labor.

“Contrary to common belief, says Dr. Vinayagam,” This is not true though most people tend to avoid the procedure fearing the extra cost, but it is a known fact that epidural anesthesia is a cheaper procedure than general anesthesia”.

Women, who go for an epidural delivery, state high levels of satisfaction with this form of pain management. Through this painless delivery procedure, the woman tends to concentrate more on the procedure of pushing the baby and can psychologically enjoy the happiest moment of her life. The overall objective is to achieve a good mental state and to have a wonderful birthing experience.
( Companies, such as, Becton Dickinson (BD), one of the world leaders in the field of medical device technology, has been a pioneer in introducing products for providing regional anesthesia. One of its specialised products includes BD Perisafe™ catheter kit which is a complete epidural anaesthesia solution kit. The kit contains accurately designed Epidural needle, catheter, syringe, catheter connector and filler for the administration of epidurals.)

The Power of Epidurals

2010-08-03T21:16:00.000-07:00

The Silent Killers

2010-08-03T21:06:00.000-07:00

Kind attn: Mr. Divesh Nath
For Woman’s Era

Name: Sudha Hariharan
A/c No: 424
Date: April 26, 2010

Arthritis in Youngsters, Osteoporosis in Women …The Silent Killers

Osteoporosis is a condition characterized by a decrease in the density of bone, decreasing its strength and resulting in fragile bones. Osteoporosis literally leads to abnormally porous bone that is compressible, like a sponge. This disorder of the skeleton weakens the bone and results in frequent fractures (breaks) in the bones.

In the U.S., 44 million people have low bone density (10 million have osteoporosis and 34 million have osteopenia. The situation is even worse in Asian patients. One in two Caucasian women will experience a bone fracture due to osteoporosis in her lifetime. Approximately 20 per cent of those who experience a hip fracture will die in the year following the fracture. Only one-third of hip-fracture patients regain their pre-fracture level of function.

It is a rare adult who has never experienced some form of arthritis or rheumatism. These diseases are very common and among the oldest known to man. It is only of late that the magnitude of the problem been appreciated. Consequently a great deal of new knowledge, understanding and treatment is now available. Though a complete cure is not available, treatment is helpful specially if started within the first 6 months of onset. Arthritis need not be crippling.

A recent pan-India health survey reveals that osteoarthritis has emerged as the numero uno ailment in India, even trouncing traditional heavyweights like AIDS, diabetes, cancer and hypertension. The survey conducted by TNS, an ISO-accredited market research agency in Delhi, was carried out across a swathe of 15 cities - Delhi, Lucknow, Ludhiana, Jaipur, Varanasi, Chennai, Bangalore, Hyderabad, Cochin, Kolkata, Patna, Mumbai, Ahmedabad, Nagpur and Indore.

According to the study, in the age band of 25 to 35 years, osteoarthritis is the second most prevalent disease in India after diabetes. The study showed that despite this, awareness amongst Indians about the bone ailment is almost nil as compared to high profile diseases like cancer, AIDS and diabetes. The prevalence of doctor-diagnosed arthritis is projected to increase to nearly 25 percent of the adult population by the year 2030.

Almost one-third of all cases will be in working-age adults, those 45 to 64 years old. This large increase poses a major challenge to the health care and public health systems. The World Health Organization (WHO) estimates that 70 million Indians are victims of arthritis. According to the US-based Arthritis Foundation, 80 per cent of the 50-plus people in the world will experience arthritis in one of its many hundred forms.

A study published (in the Journal of Community Medicine Vol. 1, No.1, January 2007) showed significant difference in the prevalence of osteoarthritis in elderly of rural and urban areas. The low prevalence of osteoarthritis in rural elderly could be due to differences in their life style. Rheumatoid Arthritis has a prevalence of 0.75 per cent; projected to the whole population, this would give a total of about 7 million patients in India.

Dr. Kaushal Malhan, Hip and Knee Surgeon, Fortis Hospital sheds light on the causes, symptoms and the most hi-tech and effective lines of treatment .

“Statistics have shown that over the past several years, the age of onset of osteoarthritis has been steadily decreasing. Also secondary arthritis is being commonly seen in younger people. The number of young patients with endstage joint disease seeking a satisfactory remedy is going up day by day. These patients are beyond the scope of medicines and need surgical treatment. These are high- demand patients who need high -performance surgery. Conventional joint replacement surgery is therefore less appropriate. The innovative tissue and bone sparing techniques we have been doing at our centre are very appropriate for this group of patients” says Dr. Kaushal Malhan.

Ketan Mhatre (33) a young IT professional says “Since the age of 24, when I was first diagnosed with rheumatoid arthritis, I thought I had no hopes but to live with the pain and compromised gait, till I consulted Dr. Malhan who gave me hope of a new beginning with specialized tissue preserving knee and hip surgery. He understood the needs of a young person like me and with advanced surgery truly gave a new meaning to my life” Ketan has undergone a hip resurfacing and bilateral knee replacement with tissue preserving technique.

Dr. Malhan, along with his team performed the hip resurfacing and knee replacement surgery on Ketan with specialised tissue- preserving methods to treat his worn out joints. Ketan Mhatre who lives with his wife and parents in Thane was suffering from severe pain in his joints. His hip and knee joints were damaged to the extent that they made a cracking sound while walking. He was unable to stand and walk due to excruciating pain. Medicines of all sorts were not helping him as his joints were totally damaged by arthritis. With endstage secondary arthritis in almost all his weight- bearing joints, Ketan’s life and career was crippled. This disease had completely compromised his physical and social life and posed a threat to his career.

“Ketan’s problems began with the onset of inflammatory type of joint arthritis which started to damage a number of joints in his body especially those of the lower limbs. In spite of good medical treatment , the disease progressed unabatedly and caused severe damage to the right hip and both knees. He was unable to stand straight and walk. Since the joints were completely destroyed there was no option but to consider replacement surgery. In view of his young age I decided to replace his joints with techniques that would preserve as much as possible. I did a bone conserving hip resurfacing surgery and bilateral tissue preserving total knee replacement. Both knees had to be done in one sitting because of the extreme deformity. Doing one at a time would not allow proper rehabilitation and Ketan was in no condition to allow a long drawn wait and rehabilitation,” explains Dr. Malhan.

What exactly is osteoporosis?
Normal bone is composed of protein, collagen, and calcium all of which give bone its strength. Collagen is the term applied to the supporting connective tissues of the body. It would be correct to think of bone structure as being similar to a column made of metal girders (protein chains) and concrete (calcium or hydroxyapatite). Osteoporosis represents a reduction in both of these and therefore damage to the microstructure of bone and not simply deficiency of calcium as is commonly believed. Deficiency of calcium and vitamin D can aggravate osteoporosis but is not the main and only cause. Naturally, just taking calcium and vitamin D to treat osteoporosis is not enough.

Are there any obvious symptoms that manifest with the onset of the disease?

Osteoporosis can be present without any symptoms for decades because it does not cause symptoms until bone fractures. Moreover, some osteoporotic fractures may escape detection for years when they do not cause symptoms. Therefore, patients may not be aware of their osteoporosis until they suffer a painful fracture. The symptom associated with osteoporotic fractures usually is pain and disability depending on the location of the fracture. Osteoporosis is therefore often called the “the silent killer”.

Do women have lower bone density?

Bone mass (bone density) is determined by the amount of bone present in the skeletal structure. Generally, higher the bone density, stronger the bones. Estrogen, a hormone in women is important in maintaining bone density. When estrogen levels drop after menopause, loss of bone density accelerates. During the first five to 10 years after menopause, women can suffer up to 2-4 per cent loss of bone density per year! This can result in the loss of up to 25-30 per cent of their bone density during that time period. Accelerated bone loss after menopause is a major cause of osteoporosis in women. Hormone replacement therapy post menopause prevents this loss but is of no major help once the window period of 6 yrs post menopause is over. The male hormone testosterone also maintains bone density in men and senile osteoporosis i.e. due to ageing may be seen in men after 70 yrs age due to reduction in the hormone levels. Also steroids and some medicines may predispose to osteoporosis.

What are the common risk factors women face?

Female gender, caucasian or Asian race, thin and small body frame, family history of osteoporosis, cigarette smoking, excessive alcohol consumption, lack of exercise, diet low in calcium and poor nutrition, malabsorption. Low estrogen levels in women (such as occur in menopause or with early surgical removal of both ovaries), low testosterone levels (hypogonadism), chemotherapy that can cause early menopause due to its toxic effects on the ovaries, amenorrhea (loss of the menstrual period) in young women associated with low estrogen and osteoporosis.

Amenorrhea can occur in women who undergo extremely vigorous exercise training and in women with very low body fat, for example, women with anorexia nervosa, chronic inflammation, due to chronic diseases such as rheumatoid arthritis or liver diseases, immobility, such as after a stroke, or from any condition that interferes with walking, hyperthyroidism, a condition wherein too much thyroid hormone is produced by the thyroid gland or is ingested as thyroid hormone medication. Certain medications can cause osteoporosis. These include long-term use of anti-seizure medications such as phenytoin and phenobarbital, and long-term use of oral steroids.

How can one detect the onset of osteoporosis?

A routine X-ray can reveal osteoporosis of the bone because the bones appear much thinner and lighter than normal bones. Unfortunately, by the time X-rays can detect osteoporosis, at least 30 per cent of the bone has already been lost. In addition, X-rays are not accurate indicators of bone density.

What are the treatment options available?
The best treatment for osteoporosis is prevention. Increase the bone mass as much as possible in the formative years. Impact loading exercise like brisk walking and adequate calcium, vitamin D and proteins in a healthy well balanced diet helps. Reduce risk factors as mentioned above. At risk people should get themselves screened.

In patients for established disease, treatment with calcium and vitamin D alone is not enough. One has to supplement with special osteoporosis medicines like antiresorptives e.g. bisphosphonate or bone forming drugs like teriparatides depending on which is suitable. Patients with low hormone levels will benefit from hormone replacement therapy taken after consultation the doctor.

Can you tell us a little more about preventive measures and treatments available?

Treatment of osteoporosis consists of treatment of the condition itself which is medical and its complications, which is a combination of medical and surgical treatment The best treatment is to prevent the disease. This can be done by increasing the bone mass during the first three decades of life with a good healthy diet containing adequate protein, calcium and vitamin D. Milk, eggs, nuts, cheese, curds and lots of sunshine are good sources of these. Calcium and vitamin D tablets can be taken to supplement the diet. High impact loading exercise will increase the skeletal bone mass and a daily brisk walk is useful.

The same steps are useful for patients of established osteoporosis but in addition they need anti -osteoporosis medication. This can be in the form of antiresorptives which prevent further bone mass deterioration and hence indirectly increase the overall bone stock, and anabolic drugs like teriparatides that cause production of more bone and increase the strength of the skeleton.

Are there any measures for perimenopausal and early menopausal women?

Perimenopausal and early menopausal women may consider the option of hormone replacement after discussing with their doctor. Such therapy is however useful in only the first 6-7 yrs after menopause and needs to be continued lifelong to maintain the bone mass. If started after 6-7 yrs post menopause then it of little benefit. Women who have lost their normal hormonal support due to removal of ovaries or other problems early in life can consider artificial hormone replacement therapy. Surgery is needed to mend complications like fractures due to weak bones. Common fractures are those of the hip, wrist and spine. Treatment options may range from simple plaster treatment to fixation of fractures with metal implants or joint replacement options. Non- healing painful spinal fractures may be tackled with minimally invasive techniques like vertebroplasty.

2009-09-07T22:47:00.000-07:00

PATHBREAKING MEDICAL TECHNOLOGY

World’s First Robotic Arm for Angioplasty Arrives in India at Dr L H Hiranandani Hospital

By Sudha Hariharan

The world’s first robotic arm for angioplasty arrived in India at the renowned Dr LH Hiranandani Hospital, Powai, Mumbai. With this Dr LH Hiranandani Hospital has become the country’s first and one of the world’s few centres of excellence to carry on research on this exciting international breakthrough. The robotic arm allows remote manipulation of Percutaneous Coronary Interventions (PCI).

For the first time in India, Dr L H Hiranandani Hospital conducted a live demonstration of angioplasty using this robotic arm.

As part of the multicentric clinical evaluation for US FDA approval Interventional Cardiologists Dr.Ganesh Kumar of Dr LH Hiranandani Hospital has been chosen as principal investigator and Dr. Ajay Chaurasia of Dr LH Hiranandani Hospital as co-investigator to conduct this study in India.

Earlier in December 2005, Dr. Ganesh Kumar teamed up with Rafael Beyar (considered the father of stents) and other eminent members including Tal Wenderow, Doron Lindner, and Rona Shofti, in Israel, to develop and test this equipment. The result of this path-breaking study was published in Europe’s EuroIntervention journal in November 2005. The study concluded that remote navigation system for coronary interventions including balloon angioplasty and stenting is feasible. The system was tested initially in a glass coronary model with visual feedback of the device movements through the transparent glass.

Later a normal coronary sheep model (animal model experiments) was employed to test the safety of the system. The third step was a pilot FIM (First in Man) clinical study, conducted on 15 patients with single coronary artery narrowing.

Dr. Ganesh Kumar was part of the first in man pilot study in Romania through which this system was evaluated on fifteen patients with stable angina pectoris and a typical risk of coronary heart disease with 100 percent clinical success and technical results in over 92 percent of cases. This study was a turning point in establishing the potential of such a system and was published in 2006 January in the Journal of American College of Cardiology.
Many advantages over traditional system

Percutaneous coronary intervention (PCI) is a major method of revascularization for coronary artery disease, with over 2 million coronary interventions performed annually. The majority of interventions (70-80%) are coronary dilatations using stents. Recently, drug-eluting stents (DES) have shown sustained advantage compared to bare metal stents, with a marked reduction of restenosis rates.

The catheterization laboratory personnel so far have been operating in an unfriendly environment subject to a continuous X-ray radiation throughout life. This has been unchanged since the beginning of the field of interventional cardiology more than 25 years ago. “Interventionalists’ disc disease” is a well confirmed entity with cardiologists reporting more neck and back pain, more subsequent time lost from work, and a higher incidence of cervical disc herniations, as well as multiple level disc disease owing to the tiresome standing procedure of angioplasty and the heavy weight of the anti -radiation gear that takes a toll on the operator.

This robotic remote control PCI system not only helps patients avail services of their preferred doctors over large distances, but also helps physicians operate in an X-ray free and relaxed environment with lesser chances of spinal risk thereby increasing the ability of the operator to deal with long procedural hours.

In contrast to the present angioplasty process that requires two cardiologists, the robotic remote control procedure can be conducted without need of assistants making the process more efficient and reproducible and reducing chances of operator-based error.

In this system motors and motion sensors are used to manipulate angioplasty wires, stents and balloons via a joystick and a computer touch screen, leading to enhanced precision of balloon and stent-positioning (which may be an extremely important feature in DES therapy). Semi-automatic procedures can also be robotically controlled by the system by obtaining continuous image base feedback data. On-line communication with the patient is obviously of value in generating trust and confidence of the lightly sedated patient and the medical team. The robotic remote-control system allows for doctor-patient interactions with voice and image technology. If for any reason the system malfunctions it can be switched to manual mode in a few seconds.

The current RNS (Remote Navigation System) is the first clinically oriented system for remote manipulation of PCI and allows full navigation of coronary wires and devices in parallel allowing operation in a standardized catheterization laboratory using standard wires and devices that are robotically manipulated and allow for transatlantic communication. This RNS is composed of a bedside unit and a remote manipulation unit. The bedside unit has individual wire and device manipulators capable of precise maneuvering and positioning of the wires and devices.

Hiranandani Hospital, Mumbai is considered as a centre for excellence in international quality healthcare and is well known for Primary Angioplasty in Myocardial Infarction (PAMI). Says Dr. Sujit Chatterjee, CEO of Dr LH Hiranandani Multispeciality Hospital, “We are proud that our hospital waschosen to conduct this pioneering study for the first time in India, and Dr Ganesh Kumar as the principal investigator of the world’s first team to have worked on creating such a system. We are very excited about a future possibility wherein our doctors can conduct angioplasties from our hospital when the patient is in another remote location and cannot be transported in time to our hospital due to any reason, through the help of precision controlled robots….such a process will indeed bring about a revolutionary era in cardiac interventions.”

Says Dr. Ganesh Kumar, “What was science fiction yesterday is fast becoming reality. With the positive results of the revolutionary studies, I am hopeful that the day is not far away when robotic remote control angioplasty will be the preferred procedure in coronary care bringing many far reaching advantages to the public.”

A Ray of Hope for Infertile

2009-09-07T21:25:00.000-07:00

New IVF technique

Dr. Hrishikesh Pai offers a ray of hope

By Sudha Hariharan

Dr Pai has been in the field of IVF for the last 14 years. He is a consultant gynaecologist at the Lilavati Hospital Bandra, honorary gynaecologist at the Kurla Bhaba Municipal General Hospital, hon professor at the D Y Patil Medical College, University of Mumbai. He is the administrator of Pearl Family Welfare Hospital, which is one of the leading family planning hospitals in the country. He is the scientific director of three IVF units The Babies and Us Fertility IVF and ICSI Centre at Opera House and the Advanced Fertility Centre at the Lilavati Hospital, Bandra, and at Fortis Hospital, Delhi. He is one of the pioneers in the field of micromanipulation in India. He has also been instrumental in establishing the first assisted laser-hatching unit in India. The unit has delivered one of the first few laser-hatched twins in India in the year 1999. Dr Pai has established the advanced assisted reproductive technology unit at the Batra Hospital, New Delhi.
Dr Pai has been installed as the President of MOGS ( Mumbai Obstretics and Gynaecology Society ) for the year 2008-2009

Of all the topics of special interest to families, none holds a more important place than a baby. A baby in a happy, healthy family means that two people who have joined their lives together in love and respect have created out of their devotion a new human being. A baby then is a sense of our own vision of ourselves carrying on our love, work and life into the future, eventually to be passed on by him to his own children.

Conceiving and bearing a baby presents for most families no problems at all.Medical advances have been such that pregnancy, in itself a normal process , is more comfortable and safer than ever before.There are couples ( 1 out of 10) who have trouble conceiving.
Modern science has found several reasons for this which are equally divided between husband and wife.

Some times it may be a simple, easily corrected anatomical defect in one or the other which prevents the sperm from reaching the egg. Sometimes it is a defect that causes the husband’s sperm either not to develop at all, or to develop in numbers to small or in quality too poor to make fertilization possible.
Whatever the cause, medical science has made it possible for more than half of the apparently infertile couples to achieve pregnancy, provided their problems are properly diagnosed and correctly treated.

A Ray Of HopeIn what should come as a ray of hope to couples unable to conceive naturally, doctors and technicians at Invitro fertilization treatment centers are increasingly using a new technique for freezing embryos, ensuring a better survival rate resulting in successful pregnancies.

Using a technique called vitrification, first successfully conducted in humans in Japan, the embryos are mixed with a freezing media and suddenly plunged into liquid nitrogen. The super high concentration of anti-freeze and rapid drop in temperature never lets the water inside the cell turn into the ice. Due to this sudden drop in temperature the entire embryo is turned into a glassy state, avoiding the ice crystals which are known to damage embryo survival.

This is good news for the patients as the woman does not have to repeatedly undergo removal of eggs. According to doctors, they usually take out 10-15 eggs but put back only two or three. The rest of the developed eggs are stored by freezing, wherein vitrification is showing better results.

Assisted reproductive technology has undergone significant advances and embryo freezing has become a widely used routine procedure that may contribute to increasing cumulative pregnancy rates from every cycle of a successful oocyte recovery and transfer.

Doctors in Mumbai say that their experience over the years has shown that there is an ice crystal formation which damages the eggs in the process of slow freezing. However, in vitrification, there is complete recover of embryos after the freezing process.

The technique demands higher technical skills at the clinics. Several doctors who initiated the technique in Mumbai were trained in Japan. In a recent national conference on gyanaecology in Bhubhaneshwar, vitrification was discussed and the cases debated.

The process of IVF or ICSI

The process of IVF/ ICSI involves production of many eggs which are subsequently fertilized in the incubator. This results in the formation of many embryos. Generally 1- 3 embryos are put back into the womb. The remaining embryos are classified into good and bad embryos based on their appearance under the microscope. The good embryos are frozen and stored in liquid nitrogen containers. The bad embryos are discarded as they cannot withstand the freezing process if the patient does not become pregnant after transfer of the fresh first cycle embryos. These frozen good embryos can be thawed and replaced into the womb with a very good chance of pregnancy.
With transfer of three embryos many patients land up having twins and triplets. The multiple pregnancies have problems of miscarriage or premature babies. Hence many units worldwide are putting back one or two embryos instead of the standard practice of 3 embryos and freezing the rest of the extra good embryos.
Also every time one wants to try for a pregnancy with frozen embryos 3 to 4 embryos are thawed at a time and if these embryos withstand the freezing process they are put into the womb. If this fails to yield a pregnancy they try again with a few more frozen embryos, doing this till they either achieve a pregnancy or all the frozen embryos are finished. In recent times with more efficient ways of freezing, the pregnancy rates per freezing attempt has gone up to 30%. Thus with availability of an
efficient freezing program the cumulative success rate (success rate in the first fresh cycle plus success rate in the subsequent frozen cycles has gone up to 80% for 3 attempts) with availability of good freezing the gynecologist also tends to put lesser embryos back thus reducing the problems of twins and triplets.

There are two types of freezing namely slow freeing and vitrification. The slow freezing is the traditional method of freezing. It is in existence since the 1980s-- in this the temperature of the embryo is slowly lowered from room temperature to minus 40 deg centigrade per minute and then the embryos are stored in liquid nitrogen gas whose temperature is minus196. The problems with slow freezing are many. Firstly, it needs a machine which takes upto nearly two hours to freeze embryos of one patient. Secondly, it is not a very efficient system as many embryos are lost during the thawing process. This in turn hampers the pregnancy rate. It is also not very effective in freezing day 5 mature embryos called Blast cyst.

A new method, more efficient in these aspects is the technique of vitrification .Dr. Pai answers a few questions to shed light on the new technique………

How is conventional slow freezing different from in vitrification?

In conventional slow freezing, the temperature of the embryo goes down at precisely 0.3 degree C per minute. In vitrification, the temperature is dropped at 23,000 degrees C per minute making it 70,000 times faster. At that speed of cooling and at that concentration of antifreeze, ice crystals simply cannot form.

Why are embryos plunged into liquid nitrogen?

In vitrification the embryos are mixed with the freezing media and are suddenly plunged into liquid nitrogen. Due to this sudden drop in temperature the entire embryo is turned into a glassy state without the formation of water crystals (which occurs in slow freezing technique and which are known to damage embryo survival).

What are the advantages of vitrification?

Vitrification has many advantages. It does not need a freezing machine. It is also a very efficient system and the embryo survival of 8 cells day 3, embryos and 150 cells day 5, blast cyst embryo are better than slow freezing. This results in more number of embryos available for embryo transfer following thawing. This is turn increases the cumulative pregnancy rates in IVF as compared to those with slow freezing. It is also very effective in freezing oocytes and day1 embryo called pronuclear embryos or zygotes.

Are there any other benefits of overall freezing?

Other benefits of overall freezing ---either slow freezing or vitrifoication are as follows:

a) many times the lining of the uterus or womb is not ideal for pregnancy in the first fresh cycle; if this is the case one can freeze all the embryos and transfer them in a subsequent natural cycle when the lining is ideal for implantation.
b) Also sometimes a patient may produce a lot of eggs and embryos with resultant swelling of the ovaries. This is called hyper stimulation syndrome and in such situation it is best to avoid transfer and freeze all the embryos. The frozen embryos are then thawed and transferred in the next cycle

Juice Up Your Life !!!!

2008-11-14T23:50:00.000-08:00

The next time you are exhausted, thirsty, or simply feel the urge to drench your throat, reach out for a glass of fruit juice rather than cola. Pure, unsweetened fruit juice is a good source of vitamins, minerals and a great way to replenish lost body fluids.

Fizzy drinks are bad even if they don’t contain pesticides. It’s nothing but sugar, gas and flavoured water. It’s high in calorific content and doesn’t do your body any good. Fruit juices are any day better than cola.

A glass of juice a day

Start your day by including a glass of pure fruit juice with your breakfast. You could even try a nutritious fruit smoothie. They're easy to make, full of vitamins and, because they contain real fruit, they are filling too - making them the perfect breakfast drink.

Squeezed fruit is as healthy as eating a piece of raw fruit out of your hand. A whole lot of fruit flesh gets lost when you squeeze the fruit. But your glass of orange juice contains all the fibres you need.

Fresh fruit juices detoxify your body and keep your circulatory system in order. The vitamins absorbed in the blood make skin healthy, and give you a special glow, especially oranges, carrots and beetroots that are high in Vitamin C and Vitamin A.

Juices hydrate the system and build up energy. A glass of fresh juice will keep you energetic and alert all day long. Even plain lime juice does wonders. The tangy drink purifies you inside out.

Increasing fruit intake in the diet helps maintain body weight as fruits are fat-free. You can indulge in as much as you like, not worrying about gaining weight.

The ways to consume juices are myriad. You can make a smoothie, add fruits in green salads, pasta. Try making a fruit raita with curds or even assort your ice-creams with fruit pulp. Ever tried pineapple pulp with vanilla? It tastes yummy. You can also try out mango, strawberry or peach. Run your imagination, and let your taste buds go wild. Fruit milk shakes provide calcium and make bones strong.

Why juices are better than fizzy drinks

Call them fizzy drinks, carbonated drinks, colas… all they contain is gas and lots of unwanted calories and zero nutritional value. Worse still, carbonated drinks dehydrate the system. When you pick up a fizzy drink to quench your thirst on a hot summer day, you are in fact increasing your thirst instead of slaking it.

Opt for fresh fruit juice. If you don’t have the time and energy to prepare one, there are fresh fruit juices easily available in the market. Xs, Tropicana, Real, Rasna and Jumpin, Frooti, these ready-to-drink fruit juices are made from the best tropical fruits. Available in Mango, Apple and Pineapple, Kiwi, Strawberry, Lichi, variants, these drinks are a storehouse of energy.

How we can incorporate fruit juices in our daily diet
• Start your day with a glass of juice
• Drink a glass of juice between your meals
• Try a fruit salad with food
• When you want ice cream, order one with a fruit salad
• End your day with mashed fruit pulp as dessert or simply sip a glass of lime juice
• If you don’t have the time and energy to whip up something, pick up reputed branded fruit juice from the market

So, what are you waiting for? Grab some fresh juice the next time you are out or munching something or even when you get down to read something.

###

Gender Knee

2008-11-14T03:28:00.000-08:00

Gender Knee….A special replacement for women

By Sudha Hariharan

Louise was a patient suffering from knee pain for almost 10 years. She had consulted various orthopaedic surgeons and learnt that she had osteoarthritis (pain in the knee). She tried everything from pain killers to steroids - to get relief from knee pain. She suffered little by little and stopped doing the things she enjoyed the most, because of her knee pain. The agony to stand, walk and do her daily activities Viz. running her business, cooking for the family, etc. was becoming impossible. She had to take help of her family to do any activity. Her social life was also completely compromised.

Louise also used to apply Move (pain reliever) and ice packs most of the time to get relief from pain. The pain was so excruciating that she had to take sleeping pills to fall asleep. The situation worsened day after day, so much so that she decided to opt for complete knee replacement surgery on both her knees, as advised by her orthopaedic surgeon.

Louise went to an orthopaedic surgeon in her area who was using a special knee made for women. He agreed that, not only would she benefit greatly from having both knees replaced, but also that she would be an excellent candidate for the Zimmer Gender Solutions Knee, the first and only knee replacement shaped to fit women.

Louise also benefited from advancements in knee replacement that had occurred in the years since her pain began, such as less-invasive (small incision) surgery and Zimmer’s implants that were designed for high-flexion activities, including the Gender Solutions Knee.

Louise had surgery several months after her 50th birthday and although recovery from having both knees replaced at the same time was hard work, it was worth it, she said. She was relieved to be rid of the constant, gnawing knee pain and clicking in her knees. And was thrilled that she’d be able to start exercising again and focus on losing weight, not to mention cooking, gardening, shopping, decorating, spending quality time with family and friends and “living my life like a 50-year-old in a 50-year-old body.”

Her only regret?
“I wish I would have done it sooner,” said Louise. “My advice to people is ‘Don’t wait.’ Why suffer? I had 10 years of pain.”

Like Louise, there are several women in India suffering from severe knee pain or significant disability resulting from Arthritis or Injury, in turn compromising on their daily living. All such women can now look forward to a knee which matches their shape and size to provide a better fit.

Unhealthy Knee
Injury, arthritis, and other conditions can damage the cartilage that cushions the knee bones, allowing them to grind together, which can be quite painful.
Total knee replacement involves removing the portion of bone that is damaged and resurfacing the knee with metal and plastic implants.

Three bones make up the knee joint: the end of the thighbone (femur), the top of the shinbone (tibia), and the kneecap (patella). The knee bones
are cushioned by cartilage. When cartilage is healthy and intact, it prevents wear and tear on the bone surfaces when you bend and extend your knee. But cartilage can become damaged over time, due to wear and tear (osteoarthritis), from injury or aging or rheumatoid arthritis. When the cartilage cushion is damaged or gone, the bones of the knee grind against each other. As a result, normal activities, from gardening to climbing
stairs, can become extremely painful.

What causes knees to hurt?
Women account for nearly two thirds of the more than half million people who undergo knee replacement in worldwide each year, and that number continues to grow. Yet, studies show that many more women would benefit from knee implants, and some women wait longer than they should.
Now, there’s no need to wait. For the first time, there is a knee implant
designed especially for women.. Replacement knees have long been available in many sizes, but size alone is not the only difference between man and woman.

Women are different, and so are their knees
Three distinct shape differences between women and men:
The angle between the hip and the knee affects how the kneecap moves over the thighbone when the knee is in motion. Women have a distinct shape, which frequently results in a different angle between the hip and the knee when compared to men. The Zimmer Gender Solutions Knee accounts for this difference, allowing for more natural movement.

The bone in the front of a woman’s knee is typically less prominent than a man’s. Traditional implants have a thickness in front that may end up feeling “bulky,” which may result in pain and a decrease in range of motion. The Zimmer Gender Solutions Knee has a thinner profile to accommodate this anatomical difference between women and men. It has a contoured shape to more closely match the narrower anatomy of a woman’s knee. This contouring provides for a more precise fit and may prevent the implant from overhanging the bone and potentially pressing on or damaging surrounding ligaments and tendons.
Facts About the Zimmer Gender Solutions Knee
􀂃 first and only knee replacement shaped to fit a woman’s anatomy. It is based on three distinct and scientifically documented differences between women’s and men’s knees.
􀂃 It is the only anatomically designed knee implant that addresses both shape and size features of a woman’s knee, resulting in better fit, higher
flexion, and more natural movement.
􀂃 Historically, all knee implants have been designed based on an average between the size of women’s and men’s knees.
􀂃 It’s available globally.
􀂃 It is implanted using existing, clinically successful surgical
techniques, including Zimmer’s minimally invasive approaches, which typically offer smaller scars, shorter hospitalization and quicker recovery.
􀂃 safely accommodates high flexion, which is necessary
for many activities involving deep bending.

The need for Zimmer Gender SolutionsTM Knee implants is more than just marketing. Because women currently account for nearly 60% of all total knee arthroplasties (TKAs) both in India as well as worldwide, a knee implant designed specifically with their distinctive needs in mind is a logical development. Anatomically, a woman’s knee has a distinctive shape in comparison to a man’s knee in ways that impact the clinical outcome of TKAs using traditional implants

In India, recognizing that the realities related to management of arthritic pain through TKA is similar to worldwide trend, Zimmer launched the Gender SolutionsTM Knee in Apr’07. India has been the first country within Asia and within the first 5 countries in the world where Zimmer has introduced this product even as it prepares for its introduction in other countries.

HAIR…….AND NOW !

2008-11-14T03:23:00.000-08:00

HAIR…….AND NOW !

By Sudha Hariharan

Most people become especially concerned about skin and hair problems because disorders of the dermis ( which includes both skin and hair) are extremely apparent, both to the victim and those around. Such conditions are seldom fatal or even disabling but they do produce psychological problems which may, in turn, trigger other physical illnesses such as depression, over-eating, obesity and acne.

Many people have difficulties with their hair ans scalp. Unlike the skin from which it grows,hair serves no indispensable function --- many bald people live to a healthy, old age.. However, the appearance of the hair is psychologically important----- attractive, well-groomed hair makes a person feel poise and confident.

Hair growth is affected by sex hormones and because more men than women become bald, the male hormones are probably the culprit. Hair loss cannot always be explained by hormone- hereditary patterns. While some hair loss with advancing age is natural,sudden hair loss at young age and especially among women has become more of a problem in recent times.

At Mumbai’s Dr. L H Hiranandani Hospital, a computerized hair analyzer is used to determine the cause of hairfall and pinpoint the deficiencies. A US FDA- approved latest hair growth laser that delivers energy to the hair roots and improves hair growth is also used to treat the problem.In addition to a team of surgeons, patients are also counseled by members of the International Hair Restoration Society.

Dr. Rajesh Rajput, Plastic Surgeon with the L.H. Hiranandani Hospital in Mumbai, who has been conducting hair transplants for over a decade now, spills the beans on keeping baldness at bay.

There are other causes of hair loss such as stress, dandruff, fungal or bacterial infection, liver or thyroid disease, crash dieting, iron, calcium and vitamin deficiencies, systemic illness or side effects of prolonged medication like painkillers, anticoagulants, anticonvulsants, gout drugs, anti-cancer drugs, chronic constipation, lack of sleep, neglecting the cleaning and maintenance of the hair. These causes can be investigated and treated with suitable medicines.

Advances in scientific research, and medicines like Minoxidil and Finasteride have given relief to patients with early or mild hair loss. Severe degrees of baldness can now be corrected by the latest technique of Follicular hair micro -grafting.

Baldness is a progressive disorder, becoming increasingly apparent in younger age groups. Hair on the front and top of the head is lost because it has receptors that are sensitive to hormones (male pattern baldness) and many other changes in the body. Fortunately, hair on the sides and lower back of the head is not sensitive to any of the causes and is naturally long- lasting. As much as a person goes bald, even at the age of seventy, he will always maintain a band of hair on the sides and back of the head.

“Plastic surgeons use the person’s own hair roots, removed from the long lasting areas and transfer it onto the bald areas. Such a transfer was earlier done with punches, outdated for the past 25 years, due to the clumpy unacceptable look”, says Dr Rajput

“ Next came the single follicle technique, which gave very poor density and a thinned out appearance. This too is outdated over past eight years. Now, it is realized that natural hair grows in units of 1, 2 or 3 hairs.” In the latest Follicular Micro Grafting Technique, the natural units are maintained to give good density with natural looks. All these roots grow new hair that can be cut, styled and combed as you want. If you shave this hair, it will all grow back and will continue to grow, practically for the rest of your life without any further treatments or visits to the doctor”. he adds.

Dr. Rajput, who has been conducting these procedures for over a decade says, “Good Follicular micro grafting is team work…because trained and skillful surgeons are required to handle and transplant the hair roots. “

Elaborating on the technique, he says it is important to match the angle and the direction of growth of hair in the patient The implantation is done under local anaesthesia. Once the scalp skin is numb, the hair roots are implanted, using an injection needle prick. This ensures minimum injury to the scalp so that there are no scars and the grafts heal quickly.

Dr. Rajput is assisted by Dr. Sandip Sattur alongwith five trained nurses as graft- cutters . So far this team has achieved 95-98% success rate in all the cases for the last 3 years..

The hospital is equipped with a dedicated Hair Transplant Theater( on par with global stabndards) made as per International standards. It has cold lights which do not harm the grafts, special cushioned adjustable patient support ensures the patient a comfortable lie down for 4 – 6 hours. Controlled humidity, natural lighting and temperature control are also present. Leveled platform and back rests for increasing efficiency of the graft- cutters, besides the adjustable position, enable the surgeons to implant simultaneously in combined areas. The procedure, lasting 6 hours can be offered to a patient of any age group and the patient can be discharged on the same day.

Prepping for the procedure:

On the day of the surgery, the patient is asked to come with an antiseptic body bath. A small strip of hair 1.2cm x 10cm is trimmed; local anesthesia given and this strip of skin is removed, while the patient is lying with his face down..Surgeons prepare small microscopic grafts from the harvested strip of skin. One hour later, local anesthesia is administered in the bald area and the grafts are placed in naturally occurring units with simple, painless, injection needle pricks. Placing of 2000 micro grafts is completed in 6 hours. There is no bandage on the head. A temporary dressing is applied on the backside for two days and the patient is sent home the same day. Antibiotics and painkillers are advised for 5 days. Patient is asked to avoid a head bath for 3 days and take rest at home to protect the grafts from dust, pollution, sunlight for 3 days. Small 2mm scabs at the graft site fall off at 8–10 days. Stitches from the donor area on the backside are removed after 10 days. The grafts start growing after their natural cycle of 3 – 4 months.

With such a state-of-the-art set up, the team performs 2000 – 3000 micro grafts in one sitting, while many centers in the world do only 400 – 600 grafts per session. So, a patient requiring 3 – 4 sittings is planned and transplanted in one sitting, saving repeated visits, time and money. In fact the procedure is so cost-effective that patients from all over the world have successfully availed of this surgery.

Dr. Rajesh Rajput, is also a .Member International Society of Hair Restoration Surgeons, USA.

Fragile X Syndrome

2007-10-26T02:37:00.000-07:00

FRAGILE – X SYNDROME---By Sudha Hariharan

Mohit, a two-year-old boy visited the pediatrician for a routine visit. At his last visit, at 15 months of age, the history and physical examination were normal, but he was not talking. Today, Mohit still has no expressive language. He appears to hear normally and follows simple commands. His development appears normal for his age. He is described as shy. Parents note that he is not communicative with other children or adults and consistently avoids eye contact. He is frequently irritable and hyperactive at home.

A simple blood test confirmed that Mohit was having Fragile–X Syndrome.

The diagnosis of Fragile X syndrome is suspected in males and females with otherwise unexplained developmental delay or mental retardation. Certain behavioral features (hyperactivity, social anxiety, perseverative speech) increase concern for Fragile–X Syndrome.

Cause

Fragile–X is caused by an abnormality in the X chromosome, a copy of which is present in all individuals. Boys are usually more severely affected by the syndrome, as they have only one X chromosome. Girls have a second X chromosome, which can be used instead of the faulty one, and may have only mild disabilities. They may not exhibit any symptoms and may be carriers of the condition.

Symptoms

Individuals with Fragile X syndrome have normal growth, appearance, and birth. However, developmental milestones are typically delayed, particularly speech development. Between the toddler and preschool years, certain behaviors may become noticeable, such as hyperactivity, short attention span, and autistic-like behaviours (difficulty adjusting to change, poor eye contact, hand biting or flapping, hypersensitivity to sound or light); also, anxiety and mood swings.

Affected males may have characteristic facial features such as a large head circumference, long face, prominent forehead, large ears, and prominent jaw. But these features are not always presented in young children with Fragile X syndrome. Females can have similar physical and behavioural characteristics, but typically have milder involvement.

Fragile X affects females in some different ways. About 16 to 19 per cent of females who are normal carriers experience premature ovarian failure (POF); meaning their ovarian function stops before normal menopause, sometimes well before the age of 40. Some may experience POF as early as their mid-twenties. POF affects a woman's ability to get pregnant.

Occurrence

Fragile X syndrome is seen in approximately one in 1,200 males and one in 2,500 females. Fragile X appears in families of every ethnic group and income level.

Diagnosis and treatment

Pre-natal testing is indicated to test the unborn baby if the mother has been confirmed to be a carrier. Experts inform parents of the chances of having an infant with abnormalities. They DO NOT try to convince or advise the parents to terminate the baby as it is not life threatening. Also termination is not recommended as the scope and availability of therapies minimizes the need for the same.

A number of tests are used to diagnose Fragile X. Each test has its limitations, so in many cases more than one test may be used. The most common tests are Chromosome Studies. DNA studies being sensitive can also pick up carriers. The two main DNA tests include Polymerase Chain Reaction (PCR) and Southern Blot Analysis.

However, a comprehensive genetic evaluation (including routine Cytogenetic analysis) is critical since it can also pick up other chromosome abnormalities besides Fragile X mutations in individuals referred with developmental delays.

Benefits of testing

A diagnosis of Fragile X Syndrome has important implications for the patient and his family, providing them with:

1. An explanation for child’s developmental delay

2. Prognostic information. The diagnosis of Fragile X Syndrome helps the family to understand that the subject will have permanent disability rather than to hope unrealistically that he will recover from his "delay."

3. Access to educational and/or social services. Information about genetic risks for other family members, who could consider molecular genetic testing.

4. Information to the family about their future reproductive risk as well as risk to other family members.

Doctor’s guide and counsel parents to cope up and inform the options available. They also provide detailed explanation if the awareness level is low.

Inheritance of Fragile X Syndrome is complex; parents of an affected child are likely to benefit from genetic counselling before pursuing testing. Genetic counselling would provide them with the opportunity to learn about Fragile X Syndrome as well as about testing options available to them. In addition to considering recurrence risk for the parents, genetic counselling would include the implications of a Fragile X syndrome diagnosis for other family members, particularly those of reproductive age.

Finding out that a child has a condition associated with serious learning problems can be difficult for parents, especially when the cause of the problem is hereditary. The mother will learn that the child’s problems are a result of a gene inherited from her, and she may feel guilty, or her husband and/or his family may blame her. Counselling can help in overcoming this feeling of guilt.

Cure

As yet there are no specific treatments or a cure for Fragile X, but emotional and educational support for children and their families are vital to help them reach their best potential. To date research continues and knowledge about Fragile X and its characteristics grows.

Interventions

Care for Fragile X Syndrome consists of special education, occupational therapy, and speech therapy. One important factor in developing a child's long-term potential is early intervention. The sooner a child begins to get help, the more opportunity for learning. Because a young child's brain is still forming, early intervention gives children the best start possible and the best chance of developing their full potential. Even so, no matter when a person is diagnosed with Fragile X, it's never too late to benefit from treatment.

Risk Assessment

Any child (male or female) with delay of speech, language, or motor development of unknown etiology should be considered for Fragile X Syndrome testing, especially in the presence of a positive family history of mental retardation, a consistent physical and behavioral phenotype, and absence of structural abnormalities of the brain or other birth defects.

Currently, though there is no definitive, single treatment for Fragile X, there are a variety of ways to help minimize the symptoms of the condition. Children with Fragile X who receive appropriate education, behavioral or physical therapy, and medication have the best chance of using their individual capabilities and skills. Even those with significant mental retardation can learn to master many self-help skills.

No matter what their IQ or areas of intelligence, all children and adults with Fragile X are capable of learning. Most children will progress in school and develop basic academic skills. Many adults can learn to take care of themselves and work at a job. People with Fragile X may need more time to learn, special teaching methods, or a specially tailored environment, but they usually can and do make steady progress.

SUGGESTIONS FOR WORKING WITH INDIVIDUALS WITH FRAGILE X:

· Know the learning style of the individual.

· Develop a consistent daily schedule or routine.

· Use visual signs (pictures, sign language, logos, words) and concrete examples or materials to present ideas, concepts, steps, etc.

· Prepare the individual for any changes in routine by explaining them ahead of time, possibly using visual signs.

· Include functional goals with academic goals; for instance, teaching the individual the names of different pieces of clothing as well as how to dress him/herself.

· Provide opportunities for the child to be active and move around.

· Use computers and interactive educational software.

· Provide a quiet place where the child can retreat and regroup

IF I FIND OUT SOMEONE IN MY FAMILY HAS FRAGILE X SYNDROME?

· If someone in your family, a child or an adult, is diagnosed with Fragile X, you may also want to be tested to see if you have a mutated FMR1 gene. It is now possible to test for Fragile X in people of any age, as well as before birth. These tests are simple and accurate.

· At present, testing for Fragile X is not done routinely. The tests are often done to help diagnose a child who is developmentally delayed or shows signs of autism or mental retardation. Couples who have one or more relatives with mental retardation of unknown cause may also want to be evaluated before deciding to have a child.

· An evaluation for Fragile X may also be recommended in a person with one of the following traits:

o Any person who has mental retardation of unknown cause, developmental delay, or learning disability

o Any person with autism or showing autism-like behaviors

o Any person with a relative who has Fragile X or mental retardation of unknown cause

o Women with premature ovarian failure (POF) or with a family history of POF.

Metropolis Health Services (I) Ltd. was founded by Dr. Sushil Shah in 1981. India’s first corporate diagnostic centers chain with global presence like Srilanka, UAE, South Africa, USA and Thailand. Metropolis provides over 3600 specialized tests under a single roof ranging from oncology to genetics, molecular biology and immunoassays using best-of-breed and latest diagnostic equipment. Metropolis is a preferred referral center for more than 20,000 laboratories, clinicians, hospitals and research institutions across the nation. The CAP, CLIA(USA), NABL accredited and ISO 9002 certified Metropolis chain of laboratories has over 350 franchisees and is a preferred partner for providing quality testing to over 10,000 referral network across the country

2007-09-04T07:42:00.000-07:00

Add Life To Your Years……

.Underneath the Mango Tree At Madhavbaug

by sudha hariharan

Just 60 kms from the hustle and bustle of Mumbai is that salubrious haven of natural health that your heart truly seeks…

Madhavbaug is the latest ayurvedic cardiac treatment village where ancient healing methods blend with a contemporary and scientific approach to create a complete lifestyle turnaround. These are holistic therapies that are aimed at not merely adding years to your life but at adding life to your years. With the inspiring and loving support of renowned ayurvedic practitioners,these therapies work towards reducing the risk of recurring heart attack, and help you live a longer, healthier and happier life.

A unique initiative of vd. Sane Ayurvedic Education and Agricultural Research Trust, Madhavbaug is set in idyllic, rural Maharashtra, where even the most hard-boiled are taught to: stop simply surviving and start a journey to real living in the lap of lush green forests, rustic cottages and exotic flora and fauna.

We live in a fast-paced stressful environment where the pressures of daily living subjects us to improper diet, insufficient exercise and an unhealthy lifestyle making us vulnerable to a host of cardiac problems. According to WHO ( World Health Organisation),by 2015 heart attacks will be the major ‘killers’ in India.

The ancient system of Ayurveda explains how a poor diet and an unhealthy lifestyle leads to the formation of waste substance known as ‘ama’, better known as cholesterol, which the liver refuses to cope with beyond a certain level. The deadly consequence of blockages leads to the much feared, but easily preventable ‘heart attack.’

Get A Fresh Start……

“Madhavbaug is not just for heart patients”, says Dr. Sane, ….”anyone suffering from some chronic or temporary ailment can seek immediate relief . The centre offers a 4-6 day rejuvenating experience and a guide to significant everlasting lifestyle changes in an ancient, inspiring and fun-loving way. Renowned ayurvedic heart specialists, prevention and wellness experts help you not just to reduce the risk of heart attack but also restore spirit of your body, mind and soul.”

This three-acre, green pasture, houses nine eco-friendly mud cottages with thatched roofs, mango orchards as well as contemporary luxuries to help you adapt and rejuvenate. There are special disease-free heart packages to suit every pocket.

Golden guides to renewed health:

Changes in lifestyle: The art of Dinacharya (daily routine) is taught to maintain the harmony and energy balance of the body and soul. The sense of cleanliness, doing the right amount of exercise, tuning your biological cycle to the right time of arising, sleep, elimination are some of the natural prescriptions that you can take home with you for good.

Diet: Somewhere between a triple-deck burger and the alfalfa wheat germ lies a world of balanced nutrition --cuisine to delight your body and feed your soul. Visitors are introduced to a world of healthy, heart-friendly diets monitored expert nutritionists, doctors and diet consultants.

Cardiac Exercise: Patients with cardiac problems are put through Exercise Physiology, an allied health profession, which performs evaluation and assessment of cardiovascular and metabolic effects as well as mechanisms of exercise to prescribe tailor-made programs for cardiac patients.

Yoga, Sports and fitness: A perfect combination of relaxation techniques including yoga and meditation with adequate physical exercises can help stop the progression of heart disease. A well-rounded fitness program at the resort is the foundation of an entire wellness program.

Spiritual awareness: Big city dwellers, caught up in the daily rush and grind, find solace in meditation which is now being increasingly adopted to explore your inner world and discover peace, serenity and clarity . The unique concept of the “Nakshatara Van” and the “Navagraha Van” is the spiritual energy released by the sacred trees planted according to your constellation in the spiritual garden at Madhavbaug. The spiritual centre offers exposure to all five elements---Prithvi, Jal, Tej, Vayu and Akash all of them in equal proportions.

Founded by the late Dr. Madhav Sane, one of the greatest pioneers of Ayurvedic healing in India, Sane Group has grown form a single clinic in 1970 with atleast 3 more in Mumbai and one in Lonavla. The Sane Ayurvedic Lab has come out in the market with over 15 products manufactured at the Sane Ayurvedic Panchkarma Centre. Sane Ayurvedic Educational and Agricultural Research Trust was set up in 2001, the Kanchanvan Herbal Plantation Project in Kamshet in 2002 and the latest Madhavbaug Cardiac Rehabilitation Center at Khopoli in 2006.

An MBBS from Aurangabad University, Dr. Rohit Sane, Chairman & CEO Madhavbaug Trust ,completed his MD in Alternate Science from USA in 2000. With a combination of determination, zest and maturity, the young and dynamic “I decided to take my father’s prominent contribution to ayurveda to a completely new dimension. I started getting involved in research and developmental activities through which I came out with a combination of therapies called ‘Sampurna Hridaya Shuddhikaran’ ^Ódealing with heart diseases”

What is Sampurna Hridaya Shuddhikaran?

The treatment consists of:

Udvartan: Medicines are chosen according to the condition of the patient and massaged on the body, in strokes moving towards the heart.

Swedan: A steady stream of water and cardiotonic medicine are made to enter the pores of the skin and draw out excess fluids from the body.

Hridaydhara: A warm decoction is applied to the heart/chest area. As temperature in the area increases, blood circulation also increases reducing the risk of angina and palpitation.

Basti: A sort of enema where 50 ml of herbal decoction is administered through the rectum. This is absorbed and enters the bloodstream, to reach the heart . The medication starts acting within 6 hours and is administered once or twice a day, depending on the patient’s condition.

2007-09-04T07:41:00.001-07:00

By Sudha Hariharan

VOICE PLAYS A MAJOR ROLE IN POWER COMMUNICATIONS

Power communication skills enable you to turn negatives into positives. Getting ahead in today’s competitive world requires excelling at relationship skills and, this can be developed through proper voice communications.

A string of of high-sounding degrees tagging your name could be of little use if you can’t express your views correctly , concisely and above all in a pleasant, well-modulated voice. Surprisingly, today we find highly-qualified people getting tongue-tied when they have to communicate---even more surprising is their standard of language, accent and tone.

One does not have to use high-sounding words to impress others: one must speak correctly, paying attention to usage of words, grammar, tone, etc. In short, apart from having complete command over language, one must also speak in the right tone in order to impress. In the course of several encounters, with men and women, in our day-to-day life, it is simply appalling to come across people who are academically highly qualified but exhibit a total apathy to communicating effectively.

But there are still times at work when women need to project authority----whether while giving a presentation, negotiating a raise or a deal, or vying for promotion. A well-modulated, pleasant-sounding voice and right intonation can ease the path to success. Women use language to seek confirmation, create connections and reinforce intimacy. They can, however, learn to communicate with greater authority. No matter whether you are a man or a woman, a good voice is an asset that can be cultivated inorder to enhance personality.

Our voice is a trademark, as unique as a thumbprint. More than a communications channel, it is a means of creating a favourable impact. It is also wrong to believe that only singers, performers and politicians need a good voice. We spend many hours and huge sums of money on fine-tuning our physical appearance, but we forget to hone our voice, which is our ambassador to the outer world.

Popular actor and TV anchor, Simone Singh says, “When you speak to others, your voice is conveying a message about your personality…a good voice personality projects a positive message while a poor voice gives a negative message”.

Pallavi Jha, Managing Director, Dale Carnegie Training , says “Public speaking is the best marketing tool we have today. It costs close to nothing and gives you a platform to market and sell your products. However, most people do not consider this a tool because of their fear of speaking in front of groups.”

Renowned speech expert and theatre actor Sabira Merchant, who trains Miss India contestants , says “ We often react to sloppy diction and an unpleasant voice. We cannot escape the fact that we are judged by both, our written and our spoken language. As most of us speak a great deal more than we write,we need to master every phase of voice if we are to win friends, enjoy life more fully , and succeed in earning a great living”.

It is true that often we have judged some people as weak and unsuccessful merely by hearing their voice…..sometimes we get the feeling that the person has a strong personality and is worthy of our respect, confidence and friendship. Most of the time when we listen to a person on the phone or over the radio, we tend to develop a mental image of him or her. Says Merchant, “ It is important to ask ourselves if others are ‘listening’ to what we are saying or how we are saying it.”

Dr. Natash Ann D’souza, a leading speech therapist and audiologist with Breach Candy Hospital (Mumbai) stresses on the need for refined and precise articulation.”Articulation”, she says,” is about the way your lips, tongue, teeth and other mouth parts form word sounds…it must be crisp and clear. However, often due to sheer laziness and ignorance, articulation is dull and lax, conveying a sloppy image. On the other hand, clear and crisp articulation gives the impression of intelligence”.

“Articulation” says Natasha,”is the simplest aspect that can be changed, and the best way is to practice and pay attention to the words, especially syllables or words ending with ‘f’,’r’, ‘l’, etc. You can pop large grapes into your mouth and practice”.

As Abraham Lincoln said, "You are what you think". Before each speaking opportunity, think and write out positive affirmations (i.e. "I'm a great speaker") and you will eventually believe it and become it”, says Jha, who trains numerous corporate executives the mantra of developing public speaking skills.”

"Practice makes permanent" –and just like with everything else in life the more you do it the better your skill becomes. So take every opportunity you can to speak!

Here, inflection plays an important role---how you change your voice to create interest and meaning . There are five key tools of inflection----varied pace, varied pitch, pause, emphasis and ‘ smile’. For instance when we are sad, we often speak softly in a low pitch. Poor voice personality contains too few, too many or misplacement of these tools. Good inflection is the appropriate application of the tools as it helps to hold interest and effectively communicates the meaning.

Inflection can be developed with practice. “Intonation”, says Dr. D’souza,”deals with how you develop your voice. A voice can sound ,weak, flat or strained which is unpleasant and difficult to listen to. A full, rich, voice (like Amitabh Bachchan’s) moves forward and out to the listener. Many people speak through their nose and this makes their voice squeaky; instead one should speak through the mouth”.

Together, the three features—articulation, inflection and intonation –give a person a good and compelling voice personality. Says Sabira: Nearly 40 percent of the meaning of what you say is conveyed by the personality of your voice. So if you want to get your message across clearly and effectively, developing a good voice is vital.

Pallavi Jha gives us some more insight into how to hold audiences. She says,” Visualize the audience in their underwear - You immediately calm your fears by realizing that everyone is just a person like yourself. Also 90 percent of a good presentation revolves around good planning. If you want to decrease your anxiety -- know your audience, research your topic, prepare a good outline and then follow it.

Be yourself. Many fears can be attributed to a speaker trying to adapt to a style that

is not their own. “

So whether you are seeking success in your career or harmony in your relationships

it is important to develop not just a good physical personality, but a charming and impressive voice personality too!

2007-09-04T07:39:00.000-07:00

Getting Serious About………. Child’s Play

By sudha hariharan

There was a time not too long ago when children couldn’t wait to get home from school when they would rush into the gullis and mohallas to meet up with friends , play their favourite games amidst laughter and gaiety. The holidays have already begun yet playgrounds are empty and there are hardly any signs that children are enjoying themselves outdoors after the nerve-wracking exams have long been over.The afternoon dinhas died down and an uneasy and eerie silence looms. This of course, is not an healthy trend--- for our children, as well as society as a whole.

Childhood and play go hand in hand. Play should not be regarded as a dispensable part of childhood—the importance of play can be gauged by the fact that even young ones of animals indulge in play. The advent of technology has changed all that…. children today spend hours in front of computers and TV alone. A recent study has also found that children put on 6 kgs of weight, on an average, each year just by sitting and watching TV!

Dr. Rajani Konantambigi , Faculty-Unit for Child and Youth Research, Tata Institute of Social Sciences and Dr. Meera Oke attached to Soham ,a NGO based in Pune, shed light on the importance of play on the mind and body, and its influence in moulding children ‘s personality.

“ Play encourages creative thinking in young children and this develops their ability to challenge the conventional, stay alert and express themselves effectively”, says Dr. Rajani

Extensive studies have shown that even in infants, playing with toys promotes overall growth besides providing endless hours of pleasure and teaching children about the world around them. Toys also impart knowledge of socially acceptable behaviour----about sharing, giving and taking, and the sexual role society will eventually expect of them. Children first begin to play with toys when they are about 3 months old—the age at which they are able to hold objects

Dr. Meera who has done some work on examining patterns of children’s ( 6-12 years) spontaneous group play as a potential for development of management skills. “ Children”, she says” form groups on their own and choose a leader. The group makes the rules for play, including boundaries and concessions for newcomers and weaker players”.

Parents must understand that toys and play mean a mess . A child getting messy, colouring a picture is experimenting with new ways of combining colours and representing thoughts. A child fixing his bike with a parent is learning how to solve problems by thinking creatively, even if he gets covered in oil.

What is your child’s favourite toy? Ten to one, it won’t be the Ferrari with the remote control or the Barbie doll with her chic wardrobe. The most beloved toy could well be something simple and probably cheap. These toys are loved more because they are sturdy and have withstood rough and long use. Today’s hi-tech world, with its electronic toys, computer and video

games means less time is being spent on creative play. Dr Rajani says,” Children who are brought up avoiding dirt and mess are missing out on opportunities to develop their motor skills, learn about their environment, master new skills and think creative”

“ Conflicts are a part of spontaneous group play and children resolve these with specific strategies ( particularly when rules are broken)”, adds Dr. Meera.

Play & Physical Development

Young children need the stimulation of play to develop their physical abilities. As children grow, play gives them valuable opportunities to refine and develop both large and small muscle skills. The outdoors, says Dr Rajani is one of the best physical play environments---there is freedom to run, jump, skip and develop motor skills and coordination through ball games .

Besides teaching children about sounds, smells and touch it helps them master concepts such as size, shapes, texture, weight etc and hone their skills by practice.

At least 155 million school-going children, worldwide, are overweight or obese. The calculated global prevalence of overweight kids ( including obese) aged 5-17 years is estimated by the International Obesity Task Force (IOTF) to be approximately 10%, but this is ‘unequally distributed’ with the prevalence ranging from over 30% in the Americas to less than 2% in sub-Saharan Africa.

In India, the difference between the rich and the poor is evident- a recent survey of children from six schools in Chennai, two each from high, middle, and lower income groups revealed that the tendency to be overweight ( and obese) ranged from 22% in better schools to 4.5% in lower income group schools.

In a Delhi school, with tuition fees more than Rs. 2,500/month, 31% of the kids were overweight and 7.5% obese. In Pune, the figure for overweight children were 24% and 6% in well-off schools and corporation schools respectively.

Says Dr. Rajani,” Unhealthy foods and the ‘couch potato’ syndrome have contributed to this….by promoting active lifestyles, including at least one hour of vigorous play each day, limiting TV and other sedentary activities to 2 hours/day, this trend can be reversed”.

Play v/s Risk

In order to play freely, children need to be outdoors. “However”, she says” fears about crime, drugs, abduction and road accidents are causing a growing number of parents to keep their kids indoors. This leads to preoccupation with TV and computer/ video games”.

Being overly concerned about mishaps outdoors is also one of the reasons.” Small cuts and bruises encountered while playing outdoors is only normal and equips kids to predict risk and face greater challenges. Cocooning them will make them reckless. A fear of the real, dirty world is making our kids incapable of assessing risk”.

Building Immunity

Fewer children die today in the developed world from infections, but the sterile environment in which they live prevents them from developing immunity to many harmless infections at an early age. Scientists believe that this impedes the development of the immune system and causes it to over-react. This would suggest that exposure to dirt at an early age could prevent kids from developing allergies. However it certainly does not mean that we should deliberately expose babies and young infants to bacteria, viruses or parasites through bad hygiene and sanitation. Encouraging children to play outdoors an get dirty, rather than cushioning them in sterile environments could actually reduce the risk of allergies or asthma.

Social networking

“ When kids from different communities play, socialization patterns are reflected--- particularly gender differences. It also helps bring the adults in the neighbourhood together, establishes social networks of mutual support and civic participation”, says Dr. Meera. However she laments the fact that with parents working full time, the pull of TV and the drift towards the suburbs has reduced contact between members of a community.

2007-09-04T07:38:00.001-07:00

Subhash Ghai unveils his dream project ----Whistling Woods International,

Asia’s largest film institute to commence courses in July 06 –

Few people know that Subhash Ghai , a graduate from the Film & Television Institute of India,Pune (FTII) came to Mumbai with starry aspirations. He even starred in a film opposite actress Archana. When his filmi career didn’t really take off, Ghai took up direction. He has given the Hindi film industry not only some of its biggest hits, but also some of its best talent- from Jackie Shroff, Meenakshi Seshadri, Madhuri Dixit, Manisha Koirala and Mahima.

Not for nothing is he known as the Showman….Ghai has a keen eye for talent, is an exceptional filmmaker and has a ear for melodious music. Of late he has also been promoting young and talented filmmakers , like Nagesh Kukunoor who made the stunningly successful Iqbal under Ghai’s Mukta Arts Banner.

Ghai unveiled his dream project Whistling Woods International, a first of its kind – the largest film, television and media arts institute in Asia, all set to commence its first academic year in July 2006.

Based in Film City (Goregaon, Mumbai) and promoted by Mukta Arts Ltd., Whistling Woods International will provide world-class training across all technical and creative aspects of filmmaking and television, and animation in its first phase with regular two- year intensive hands- on training and develop a research and development centre in software.

The institute will be headed by Dean Kurt Inderbitzin, a producer-director himself from Los Angeles with twelve years experience in developing, writing, directing and producing movies and TV shows for major studios, cable companies and the networks, including CBS, ABC, Lifetime, NBC, TBS, TNT, HBO and Warner Brothers Network, in all formats, High-Definition, digital video and 35 mm film.

Other key faculty including Shyam Benegal (Chairman Academic Council), Aruna Raje ( VP, Academic Affairs), Naseerudin Shah( HOD, Acting), Ashish Kulkarni (HOD, Animation) were also present on the occasion and expressed in one voice, “Here is a true platform to change the face of entertainment and media industry through the next generation of content creators”.

Besides the dean, HOD’s etc, there is also an advisory board of the institute which has top names from the industry who are and will be associated with the institute in some way or the other. The advisory board members have been visiting the institute and taking interest in various aspects. The advisory board members who have visited the institute in the last few days include Karan Johar, Hema Malini, Rakesh Mehra, Shabana Azmi.Veteran actor Dilip Kumar, Shabana Azmi and Ashutosh Gowariker were present at the launch of the institute.

Ghai,who is Chairman, WWI said, “Whistling Woods International is my way of returning to the industry what it has taught me over the last 27 yrs. Whistling Woods will act as a stepping stone for anyone who wants to make inroads into the world of Television, Cinema and Animation. WWI will have the very best to offer at par with international standards, be it technology, faculty and resources and we are fortunate to have such a strong team to take this institute much more higher standards very soon.

He further added, “I also thank all those friends, professionals and especially the Chief Minister and Cultural Minister of the Government of Maharashtra & Film City who have supported WWI with equal passion and commitment”.

Whistling Woods International will combine educational and research facilities, with the lineage of one of India’s most credible production houses Mukta Arts Ltd behind it. The Institute will offer state-of-the-art training facilities and an internationally developed and structured curriculum, and through affiliations with top film schools/experts to bring the best faculty from around the world to India to train new talent.

Kurt Inderbitzin, Dean, WWI, said, “We are absolutely devoted to putting our students first and giving them the creative freedom, the technical skills, the business edge, and yes the connections and know-how to build careers in the film and television industry”.

The full-time, two-year program provides 84 weeks of comprehensive training and hands-on experience in specialised realms of filmmaking ranging from Cinematography, Direction, Editing and Business of Film & Television to Sound Recording & Design, Screenwriting and Acting.

Whistling Woods International has been designed with state-of-the-art equipment to train students on top-of-the-line digital and analogue systems. The institute’s contemporary formats stem from the fact that only the best available infrastructure and environment can aptly prepare students for the technological transformations sweeping the industry..

The institute has technology partnerships in place with Apple, SONY, Digidesign, AMD, NVIDIA, Belden, etc., enabling us to offer our students the very best in technology advancements. The student community at Whistling Woods International would also have the unique opportunity to experience technologies and systems long before other students and professionals do, as the institute will include an onsite R & D centre which would work as a potential Beta Testing Site for its technology partners.

Workshops/short term courses tailored specifically to meet the needs of practicing industry professionals who wish to upgrade their skill levels and particular creative proficiency, be it concerning aesthetics, film and music appreciation, photography or a selection of other non-technical subjects will also be on offer and plans are underway include Art Direction, Animation, Digital Media and Radio within three years.

Built at the heart of the Indian film industry over sprawling 20 acres of land at Goregaon Film City, with access to the core and crème filmmaking fraternity, students will have International facilities to meet every need. WWI will also have on-campus training facility, encouraging students from all over the world to enroll .Applications are being processed now and the courses will commence on 15^th July 06.

2007-09-04T07:36:00.000-07:00

:Smart Investing … Online Investing.

While we understand the benefits of investing but often do not give enough importance to this process due to the hassles involved and the feeling of ‘it is not my cup of tea’.

Ketan Trivedi, Head, Marketing IDBI Capital Market Services explains how investing online can be a very easy, convenient and an informed experience.

Online Investing. Say bye to hassles of investing offline …

With the pressures of time and the sheer choice of options, the entire process of investing can be a very daunting experience for most of us. One faces several issues while investing offline like maintaining of bank and de-mat accounts separately and manually, lack of proper information, tools and advice, constant struggle with the paperwork that is generated (for example: try filling an IPO (new issue) form manually), pressures of time to plan for investments systematically and finally to keeping track of your investment portfolio and net-worth. This either leads to a situation of too much dependency on someone, total inactivity or sometimes even taking wrong decisions while planning your investments.

Fortunately, help is at hand through the online investing platforms that are available to the investors. Today technology enables you to completely plan your investing needs in the comfort of your home and at the time you like, all at the click of the mouse. All you need is a computer, net connection and a subscription to a 3-in-1 online investing account with any of such service providers. Online mode of investing largely eliminates all the major hassles of investing: - it provides a wealth of information, analysis and tools that enable you to take more informed decisions, virtually no paperwork involved as all transaction records are online and statements available in digital form, invest anytime and from anywhere at your time and convenience (yes, even at night), integrated operations between your bank account, de-mat account and trading accounts and tracking of your investment portfolio and net-worth online anytime. Today, the online mode allows you to invest across different asset classes like equity shares, Mutual Funds and IPOs amongst others. You can be your own master in planning your investments through the online mode. The online mode provides you the benefit of getting up to date information and analysis, which is often sourced and compiled, in an investor friendly format, from some of the best information providers in their respective fields.

Your advantage therefore:- not only are you able to take more informed decisions for your investing needs but in the process also reduce the probability of risk and improve probability of earning better returns on your investments.

Getting started and services to look out for…

To start investing online you would need to register as a member for an integrated 3-in-1 online trading account with any of the service providers like www.idbipaisabuilder.in. The 3 accounts are: (1) trading account, which enables you to transact online, (2) an internet enabled bank account for online money transfers through internet, with any of the banks with whom the online service provider has a tie-up with and (3) your demat account, where your shares will be deposited.

Issues you can consider while choosing your online investing account :

· Credibility and credentials of the service provider. While there are several service providers, for any retail investor like you, the backing of a reputed bank or financial institution can always provide that additional safety & surety that you seek.

· Which investments can you make online – are you allowed to invest in equity shares, Mutual funds and IPOs fully through the online route or in only one of them? To derive the full power of online investing it is important you get to invest in all of them online.

· Quality of information and content. Ensure you are getting the best of information, research support and tools, which is provided to you in an easy & reader friendly manner. This would be very important in taking informed investing decisions.

· Speed of order execution – are you able to place your equity orders and receive quick order confirmations during peak hours or are you going to struggle with getting access just when you need it most.

· Are you getting a choice of products to choose from – a few service providers provide a choice of products starting from the basic (classic) account to more advanced (trading platforms with live and streaming market information on equity markets).

· Safety – check for the security features inbuilt into the system.

· Customer Care – does the service provider have a dedicated customer care cell to take care of your queries and problems ?

· Additional features – besides the above criteria there are a combination of several additional features provided, whose importance for yourself can be determined based on your own investing needs e.g. ability to sell shares next day before receiving delivery, sms alerts, intra day trading in equities, etc.

every 10 seconds

2007-09-04T07:34:00.000-07:00

Every 10 seconds an Indian dies of stress-related heart attack!

By Sudha Hariharan

In a competitive modern world, we work hard and play harder, paying scant attention to our health. We hardly enjoy any leisure, nor do we pursue creative hobbies. No wonder that we are on the super highway to ill health. New age ailments have invaded our workplace, schools and homes. Here’s what we now face---stress-related disorders, carpel tunnel syndrome, backaches, headaches. insomnia, ulcers, piles, high blood pressure and increased old age problems.

World health statistics have revealed that of the over 52 milion deaths a decade ago, 40 million were in 14developing nations, including 9 million in the least developed countries.

A well-known and successful Indian homeopath Dr. Mukesh Batra says, “ Health isn’t just about absence of disease. It is about becoming whole and maintaining balance in the face of continual change. In our fast-paced lives, we do not have the time to pause and listen to our bodies and we don’t bother to know what is wrong …due to our negligence, our system is subjected to irrevocable damage”.

With the exponential growth of interest and publicity about homeopathy, an increasing number of people are exploring new options for their personal health care. People are opting for alternative methods which are safer, more effective and with less side effects. “Homeopathy”, says Dr. Batra.” is not just popular in the US, but has gained ground in other parts of the world as well”.

The most telling evidence of Americans’ dissatisfaction with traditional health care is that more than US $ 27 billion they spend annually on alternative and complementary medicine. In ways, large and small, people are taking active steps to venture outside the mainstream, whether by taking herbal remedies for a cold or by placing their last hopes for cancer cure in alternative medicine

The ultimate source of homeopathy lies in the constitutional study of every patient which is unique, “For instance”, he says” Nux Vomica personality is generally high-trung and tense. He is a person on whom the pressures of modern –day living are taking their toll. Late hours, odd eating habits are the bane of his existence making him vulnerable to peptic ulcer, constipation, hyperacidity and piles.

Homeopathy v/s other treatments

Homeopathy is the only system in medicine which recognizes the human being as a combination of the mental and the physical, and hence provides holistic healing for a variety of chronic ailments, skin-related problems, stress, arthritis and asthma. It also has important advantages over other forms of treatments such as:

· There are no side effects

· It cures a disease rather than merely suppressing the symptoms

· It uses only natural substances in minute doses

· Improves body’s resistance

· Ensures long-term benefits

· There are no complicated procedures for taking the medicines and no strict dietary restrictions.

· It does away with unnecessary surgery

The American Medical Association (AMA) estimates that 80-85% medical illnesses are manifestations of stress. A majority of disorders are either induced or maintained by stress. Stress can cause both, short-trm and long-term illnesses, whether it is a temporary weakening of the immune system or a chronic disorder. It is also the causative factor to illnesses like obstructive compulsive disorder, diminished sexual performance, overeating, under-eating, social withdrawal, headaches, diabetes, hypertension, ulcers, fatigue, chest pain, difficult urination, respiratory problems, increased smoking, alcohol consumption, increased coffee or tea intake, aggressive behaviour, impatience allergies and phobias.

Says Dr. Batra: Homeopathy can alter your reaction to stress….stress is not really outside you, it is your evaluation of a situation, therefore you have the power to control and manage your own stress response.

The World Health Organization (WHO) has also predicted that non-communicable diseases such as diabetes will become the worl’d main disablers and killers during the next 25 years. Nearly 177 million people suffer from diabetes worldwide---in India alone 35 million suffer from the disease with a growing number of children falling prey.”It is a misconception that homeopathy pills are sweet and not suitable for treating diabetes”, says Dr. Batra.” Patients can have aqua-based pills where no sugar or alcohol is used.”.

Homeopathy is also effective in treating obesity by changing the patient’s constitution reducing fatty deposits in the body. It can also activate the thyroid gland which increases the basal metabolic rate of the body allowing the organs to overwork and expend energy without exercising.

Conventional medicines for obesity have side effects like hairfall, menstrual irregularities, constipation and sleeplessness. Homeopathy cures obesity without side –effects, they act as appetite suppressants, help reduce weight and alter emotional responses.

Teaching Kids to use the Net

2007-08-31T21:21:00.000-07:00

Teaching kids to use the Net

By Sudha Hariharan

Don't talk to strangers.Look both ways before crossing the street. For most people, they're lessons learned at an early age. But in the digital world--where kids juggle talking on a cell phone, instant chatting with friends, doing online homework and games, and blogging on sites like MySpace.com--life's little lessons take on a whole new level of complexity.

Though children always seem to have a leg up on parents when it comes to adapting to new technology, experts say few of them have been taught the do's and don'ts online. But parents and educators are more concerned than ever with dangers presented by the Internet, given reports of privacy invasions and predators targeting children through chat rooms and blogs.

Teen Turmoil

By taking responsibility for your children's online computer use, parents can greatly minimize any potential risks of being online. Make it a family rule to:

Never give out identifying information-- home address, school name, or telephone number-- in a public message such as chat or bulletin boards, and be sure you're dealing with someone that both you and your child know and trust before giving it out via E-mail. Think carefully before revealing any personal information such as age, marital status, or financial information. Consider using a pseudonym or unlisting your child's name if your service allows it.

Get to know the services your child uses. If you don't know how to log on, get your child to show you. Find out what types of information it offers and whether there are ways for parents to block out objectionable material.

Never allow a child to arrange a face-to-face meeting with another computer user without parental permission. If a meeting is arranged, make the first one in a public spot, and be sure to accompany your child.

Never respond to messages or bulletin board items that are suggestive, obscene, belligerent, threatening, or make you feel uncomfortable. Encourage your children to tell you if they encounters such messages. If you or your child receives a message that is harassing, of a sexual nature, or threatening, forward a copy of the message to your service provider and ask for their assistance.

Remember that people online may not be who they seem. Because you can't see or even hear the person it would be easy for someone to misrepresent him- or herself. Thus, someone indicating that "she" is a "12-year-old girl" could in reality be a 40-year-old man.

Remember that everything you read online may not be true. Any offer that's "too good to be true" probably is. Be very careful about any offers that involve your coming to a meeting or having someone visit your house.
Set reasonable rules and guidelines for computer use by your children Remember to monitor their compliance with these rules, especially when it comes to the amount of time your children spend on the computer. A child or teenager's excessive use of online services or bulletin boards, especially late at night, may be a clue that there is a potential problem..

Guidelines for Parents

Check out blocking, filtering, and ratings applications. Be sure to make this a family activity. Consider keeping the computer in a family room rather than the child’s bedroom. Get to know their online friends just as you get to know all of their other friends. If your child has a cellular telephone, talk with him or her about using it safely. The same rules that apply to computer use, also apply to cellular telephones.

What Are the Risks?

There are a few risks for children who use the Internet or other online services. Teenagers are particularly at risk because they often go online unsupervised and are more likely than younger children to participate in online discussions regarding companionship, relationships, or sexual activity.

Some risks are

Exposure to Inappropriate Material A child may be exposed to inappropriate material that is sexual, hateful, or violent in nature, or encourages activities that are dangerous or illegal. Children could seek out such material but may also come across it on the web via chat areas, E-mail, or even instant messaging if they’re not looking for it.

Physical Molestation----A child might provide information or arrange an encounter that could risk his or her safety or the safety of other family members. In some cases child molesters have used chat areas, E-mail, and instant messages to gain a child’s confidence and then arrange a face-to-face meeting.

Harassment and Bullying---- A child might encounter messages via chat, E-mail, or their cellular telephones that are belligerent, demeaning, or harassing..

Viruses and Hackers----- A child could download a file containing a virus that could damage the computer or increase the risk of a hacker gaining remote access to the computer; jeopardizing the family’s privacy and safety.

Legal and Financial----A child could do something that has negative legal or financial consequences such as giving out a parent’s credit-card number . Legal issues aside, children should be taught good netiquette which means to avoid being inconsiderate, mean, or rude.

How Parents Can Reduce the Risks

While children need a certain amount of privacy, they also need parental involvement and supervision in their daily lives. If you have cause for concern about your childrens’ online activities, talk to them. Having open communication with your children, using computer resources, and getting online yourself will help you obtain the full benefits of these systems and alert you to any potential problem that may occur with their use.

How you respond will determine whether they confide in you the next time they encounter a problem and how they learn to deal with problems on their own.

Beyond these basics, there are some specific things that you should know about the Internet. For instance did you know that there are chat areas, newsgroups, and web sites that have material that is hateful, is violent, or contains other types of material that parents might consider to be inappropriate for their children? Its possible for children to stumble across this type of material when doing a search using one of the web sites that is specifically designed to help people find information on the Internet. Most of these sites, called search engines, do not, by default, filter out material that might be inappropriate for children, but some offer a childsafe option and some are designed specifically for use by children.

Also the Internet contains newsgroups, web sites, and other areas designed specifically for adults who wish to post, read, or view sexually explicit material including pictures, stories, and videos. Some of this material is posted on web sites where there is an attempt to verify the user’s age and/or a requirement for users to enter a credit-card number on the presumption that children do not have access to credit-card numbers.

Other areas on the Internet make no such effort to control access. Nevertheless, consider monitoring your credit-card bills for such charges. In addition to adult pornography, there are also areas on the Internet that contain illegal child pornography

In addition there are ways to filter or control what your children can see and do online. One type of filter, called a spam filter limits unsolicited E-mail including mail promoting sexually explicit material. Some ISPs and E-mail services include filters as part of their service but, if not, there is software you can purchase that will attempt to limit the type of mail that gets through.

Another option is to use a rating system that relies on web-site operators to indicate the nature of their material. Internet browsers can be configured to only allow children to visit sites that are rated at the level that the parents specify. The advantage to this method is that only appropriately rated sites can be viewed. The disadvantage is that many appropriate web sites have not submitted themselves for a rating and will therefore be blocked.

While technological-child-protection tools are worth exploring, they are not a panacea. To begin with, no program is perfect. There is always the possibility that something inappropriate could slip through or something that is appropriate will be blocked. Finally, filtering programs do not necessarily protect children from all dangerous activities

Kids' Rules for Online Safety

1.	I will not give out personal information such as my address, telephone number, parents’ work address/telephone number, or the name and location of my school without my parents’ permission.
2.	I will tell my parents right away if I come across any information that makes me feel uncomfortable.
3.	I will never agree to get together with someone I "meet" online without first checking with my parents. If my parents agree to the meeting, I will be sure that it is in a public place and bring my mother or father along.
4.	I will never send a person my picture or anything else without first checking with my parents.
5.	I will not respond to any messages that are mean or in any way make me feel uncomfortable. It is not my fault if I get a message like that. If I do I will tell my parents right away so that they can contact the service provider.
6.	I will talk with my parents so that we can set up rules for going online. We will decide upon the time of day that I can be online, the length of time I can be online and appropriate areas for me to visit. I will not access other areas or break these rules without their permission.
7.	I will not give out my Internet password to anyone (even my best friends) other than my parents.
8.	I will check with my parents before downloading or installing software or doing anything that could possibly hurt our computer or jeopardize my family’s privacy
9.	I will be a good online citizen and not do anything that hurts other people or is against the law.
10.	I will help my parents understand how to have fun and learn things online and teach them things about the Internet, computers and other technology.

Social Networking

2007-08-31T21:14:00.000-07:00

Sudha Hariharan

Whats social networking? Well in simple term its expanding your circle of friends on the Net.A simple definition for a social network is the circles of people you know--- your close friends, your family, your colleagues or people from your community. The Internet offers an opportunity for developing a social network with people who share something in common with you, but whose paths you wouldn't have necessarily crossed because they reside in other states or countries.

Social networking on the Internet took off in popularity several years ago. Now there are over 200 sites where you can make new friends, find a date, exchange photos or make new business connections.

Popular Social Networking Sites:

Facebook

Facebook is a social utility that connects people with friends and others who work, study and live around them. People use Facebook to keep up with friends, upload an unlimited number of photos, share links and videos, and learn more about the people they meet.

Anyone can join Facebook

All that's needed to join Facebook is a valid email address. To connect with coworkers or classmates, use your school or work email address to register. Once you register, join a regional network to connect with the people in your area.

Facebook is made up of many networks, each based around a company, region, or school. Join the networks that reflect your real-life communities to learn more about the people who work, live, or study around you.

Friendster

With more than 45 million members worldwide, Friendster is a leading global online social network focussing on helping people stay in touch with friends and discover new people and things that are important to them. Online adults, 18 and up, choose Friendster to connect with friends, family, school, groups, activities and interests. Friendster prides itself in delivering a clean, user-friendly and interactive environment where users can easily connect with anyone around the world. Friendster has a growing portfolio of patents granted to the company on social networking.

Headquartered in San Francisco, California, Friendster is backed by Kleiner Perkins Caufield & Byers, Benchmark Capital, DAG Ventures and individual investors.

LinkedIn

LinkedIn is an online network of more than 11 million experienced professionals from around the world, representing 150 industries.

When you join, you create a profile that summarizes your professional accomplishments. Your profile helps you find and be found by former colleagues, clients, and partners. You can add more connections by inviting trusted contacts to join LinkedIn and connect to you.

Your network consists of your connections, your connections’ connections, and the people they know, linking you to thousands of qualified professionals.

Through your network you can:

Find potential clients, service providers, subject experts, and partners who come recommended
Be found for business opportunities
Search for great jobs
Discover inside connections that can help you land jobs and close deals
Post and distribute job listings
Find high-quality passive candidates
Get introduced to other professionals through the people you know

LinkedIn is free to join: they also offer paid accounts that offer more tools for finding and reaching the right people, whether or not they are in your network.

MySpace:

is an online community that lets you meet your friends' friends.

Create a private community on MySpace and you can share photos, journals and interests with your growing network of mutual friends!

MySpace is for everyone:

Friends who want to talk Online
Single people who want to meet other Singles
Matchmakers who want to connect their friends with other friends
Families who want to keep in touch--map your Family Tree
Business people and co-workers interested in networking
Classmates and study partners
Anyone looking for long lost friends!

Orkut

Orkut is an online community designed to make your social life more active and stimulating. Orkut's social network can help you maintain existing relationships with pictures and messages, and establish new ones by reaching out to people you've never met before.

Orkut makes it easy to find people who share your hobbies and interests, look for romantic connections or establish new business contacts. You can also create and join a wide variety of online communities to discuss current events, reconnect with old school mates or even exchange your favorite recipes.

Who you interact with is entirely up to you. Before getting to know an Orkut member, you can read their profile and even see how they're connected to you through the friends network.

To join Orkut, simply sign in with your Google Account and you can begin to create your own profile right away.

Why is Orkut so popular?

Orkut, sounds interesting doesn’t it? With other popular websites such as Yahoo! 360, Friendwise, Classmates, and MySpace, there are many who wonder how Orkut became the name of this popular online community. Orkut is named after the individual who created it. That man was an employee of Goggle and he is known as Orkut Buyukkokten.

If the name of the website doesn’t automatically draw you in, there is a good chance that the website features will. Like many other social networking websites, Orkut has a number of different member benefits. These benefits are what makes it worthwhile to become a member of this popular social networking website. As popular as Orkut is and as much as you would like to join, there are special procedures that you must follow. Unfortunately, Google does not allow just anyone to become a member, you must be invited.

Current community members are the only ones who can extend you an invite. This means that you should not waste your time trying to convince Google to let you join. Being invited to join Orkut really isn’t as difficult as it may sound. Orkut is so popular that there is a good chance that you know someone, if not personally than online, who can extend you an invite.

Although many internet users refrain from joining Orkut, just because of the invitation requirements, there is a good reason for limited membership. Orkut is a social networking website that is free to use. Unfortunately, free means that many people would wish to use the website. Many online social networking sites, that are free to use, have literally become ridiculous. A large number of internet users get joy out of creating fake accounts and causing online controversy. Google decided to make Orkut a special membership online website to prevent instances like that from happening.

Different purposes

Orkut, like many other online social networking websites, has a number of different purposes. Of course, the main purpose of Orkut is to allow you to connect with your friends, especially the ones that have extended an invitation to you, but you can do much more than that. Once a member of Orkut, you can easily famialrize yourself with other website members who share the same interests as you do. This will not only help you make new friends, but it may also result in the finding of your next romantic partner. That is what is nice about Orkut, once you are a member, just about anything is possible.
If you are interested in learning more about Orkut, before trying to obtain an invite, you will want to visit their online website. You can do this by going to www.orkut.com.

Stay cautious

The obvious information not to publicly reveal is your actual address and phone number. In many cases you may not even want to provide your email address. It's not wise to fill in any form with your exact birthday, the true city where you were born or your mother's family name. There are all the types of information used by banks and credit card companies to verify your identify. A clever thief will troll social sites gathering this sort of information in order to steal an identity. So, be mindful when you join a social networking site that not everyone who contacts you is a trustworthy individual.

If you're interested in giving social networking a try, browse a site you want to join as a "guest" for a while or ask some of your friends what sites they belong to. Fill out only the minimal profile information when you first join. You can always add more data later when you've become comfortable with the social interaction you have on that site. Also remember to remove information from your profile when you leave a site to which you don't intend to return.

Social networking on the Internet can be fun and rewarding by expanding your circle of friends, especially in hobby or interest areas on any social networking site. But just as in real life, be mindful of your confidential information and with whom you share that information.

You may already know that blogging—keeping a public "Web log" or personal journal online—is common among teens and even younger kids.

How Kids Can Use it Safely?

Now kids can also create personal Web pages on social networking Web sites hosted by services like Windows Live Spaces, MySpace, Friendster, Facebook, and others. These Web pages can often be viewed by anyone with access to the Internet.

With these services, which are extremely popular among teenagers, kids can fill out profiles that can include:

•	Photos
•	Videos
•	Personal information such as full names, locations, and cell phone numbers

Often the services that host the social networking sites provide several different ways for people to communicate with one another, including blogging and instant messaging features.

Kids use social networking sites to connect with kids who might live halfway around the world and with kids whom they pass every day in the hallways at school.

Popular social networking sites, including MySpace and Facebook, are changing the human fabric of the Internet and have the potential to pay off big for investors, but -- given their youthful user base -- they are unusually vulnerable to the next 'new new' thing. As quickly as users flock to one trendy Internet site, they can just as quickly move on to another, with no advance warning, according to Wharton faculty and Internet analysts.

MySpace, with 70 million visitors, has become the digital equivalent of hanging out at the mall for today's teens, who load the site with photos, news about music groups and detailed profiles of their likes and dislikes. Other social network sites include Facebook, geared to college students, LinkedIn, aimed at professionals, and Xanga, a blog-based community site. In all, an estimated 300 sites, including smaller ones such as StudyBreakers for high schoolers and Photobucket, a site for posting images, make up the social network universe.

Social network sites are powerful, but mercurial, particularly since most are aimed at teenagers and young adults. "It's a complete crap shoot. Look how many of these have come along and how many were touted as the next big thing. How many have disappeared completely or find themselves in some strange little unexplainable niche?"

Next Target: Cell Phones

For the moment, MySpace and Facebook are hot. News Corp. paid $580 million last year for MySpace as part of a $1.3 billion Internet acquisition spree. Facebook just received an additional $25 million in venture capital.

Both companies are planning to extend their reach beyond the computer screen to cell phones. Cingular Wireless, Sprint Nextel and Verizon Wireless are starting a service that will allow users to post messages on Facebook's home pages or search for other users' phone numbers and email addresses from a cell phone. MySpace has a pact with Helio, a wireless joint venture between SK Telecom and Earthlink, that will allow users to send photos and update their blogs or profiles by cell phone.

Social networks have power beyond ad revenue to act as a customer relationship

Unexpected consequences

The popularity of social networking sites may also have unexpected consequences for users. A gay student attending a Christian college was expelled after administration officials viewed photos of the student in drag on Facebook. Twenty middle school students in California were suspended after participating in a MySpace group where one student allegedly threatened to kill another and made anti-Semitic remarks. part of being the pioneer.

As a web-based business, social networks do have some advantages over traditional companies in tracking user behavior in order to detect problems early. These sites also need to remain subtle in their approach to marketing if they are to build on their current success. While they provide banner and text ads, even more valuable word-of-mouth promotion lurks in the buzz within user profile pages.

Despite the huge success of sites like MySpace, Friendster and Reunion.com, millions of people have not yet seen the advantages of social networking. Perhaps it is due to the awkward situations where users find themselves wary of the friendships offered by strangers ,.Here are some of these benefits you will enjoy if you utilize these sites correctly.

Refined Search: only social networking sites offer internet users with a search directory that you can use to locate particular individuals or groups. You can search by categories like location, industry, interests and other unique preferences. This way, you do not waste your time and resources establishing connection with people you and your business have nothing in common with.
Affordable visibility: since most of these social networking sites are free, you should maximize them. Make sure that the profile you created will be interesting for the readers. Also, you should make it more personalized by adding interesting articles, images, videos and even reviews of your products.
Receptive Members: the concept of social networking sites lies on the premise that members have at least one thing in common. Because of this, it is not surprising that you will receive messages from people you do not really know or likewise, you could be interested in establishing contact with some of the members who might interest you.
Built-in Group: starting a discussion is not difficult with social networking sites compared to growing one on your site. With the millions of visitors and members, you will have no problem with attracting participants. Discussion groups are also the best place to do some soft selling. You can accomplish this by lending your expertise on particular subjects.
Expand Network Easily: the key to establishing a successful online business is being visible to other people outside your network. The fact that you are connected to these people because of an existing connection with one of your contacts, make you more trustworthy. Compared to approaching someone on the street, social networking sites would provide you with considerable marketing advantage.

How to help kids use sites effectively

Social networking can provide a helpful way for kids to express their emotions or even to perform unofficial background checks on other kids they meet at parties and at school. For example, after they meet another kid in person, a kid might visit that other kid's Web site to find out if he or she might be someone they'd like to be friends with.

Unfortunately, the information that kids post on their pages can also make them vulnerable to predators.

Here are several ways you can help your kids can use social networking Web sites more safely.

•	Set your own house Internet rules. As soon as your children begin to use the Internet on their own, it is a good idea to come up with a list of rules that you all can all agree on. These rules should include whether your children can use social networking Web sites and how they can use them. For more information on setting rules, see Using family contracts to help protect your kids online.
•	Ensure your kids follow age limits on the site. The recommended age for signing up for social networking sites is usually 13 and over. If your children are under the recommended age for these sites, do not let them use the sites. It is important to remember that you cannot rely on the services themselves to keep your underage child from signing up.
•	Educate yourself about the site. Evaluate the site that your child plans to use and read the privacy policy and code of conduct carefully. Also, find out if the site monitors content that people post on their pages. Also, review your child's page periodically. For more suggestions, see Tips on blogging safely for parents and kids.
•	Insist that your children never meet anyone in person that they've communicated with only online, and encourage them to communicate only with people they've actually met in person. Kids are in real danger when they meet strangers in person whom they've communicated with only online. You can help protect your children from that danger by encouraging them to use these sites to communicate with their friends, but not with people they've never met in person. It might not be enough to simply tell your child not to talk to strangers, because your child might not consider someone they've "met" online to be a stranger. For more advice on protecting your children on the Internet, see Online predators: What you can do to minimize the risk.
•	Ensure your kids don't use full names. Have your children use only their first names or a nickname, but not a nickname that would attract the wrong kind of attention. Also, do not allow your children to post the full names of their friends.
•	Be wary of other identifiable information in your child's profile. Many social networking sites allow kids to join public groups that include everyone who goes to a certain school. Be careful when your children reveal this and other information that could be used to identify them, such as where they work or the name of the town they live in, especially if it is a small one.
•	Consider using a site that is not very public. Some social networking sites allow you to password-protect your site or use other methods to help limit viewers to only people your child knows. With MSN Spaces, for example, you can set permissions for who can view your site, ranging from anyone on the Internet to only people you choose.
•	Be smart about details in photographs. Explain to your children that photographs can reveal a lot of personal information. Encourage your children not to post photographs of themselves or their friends with clearly identifiable details such as street signs, license plates on their cars, or the name of their school on their sweatshirts.
•	Warn your child about expressing emotions to strangers. You've probably already encouraged your kids not to communicate with strangers directly online. However, kids use social networking Web sites to write journals and poems that often express strong emotions. Explain to your children that these words can be read by anyone with access to the Internet and that predators often search out emotionally vulnerable kids. For more information, see 10 things you can teach kids to improve their Web safety.
•	Communicate with your children about their experiences. Encourage your children to tell you if something they encounter on one of these sites makes them feel uncomfortable or threatened. Stay calm and remind your kids they are not in trouble for bringing something to your attention.
•	Remove your child's page. If your children refuse to abide by the rules you've set to help protect their safety, you can contact the social Web site your child uses and ask them to remove the page. You may also want to investigate Internet-filtering tools (such as MSN Premium's Parental Controls) as a complement to—not a replacement for—parental supervision.

2007-08-20T07:05:00.000-07:00

Name : Sudha Hariharan

WEDDINGS ARE BIG BUSINESS

There’s nothing like a wedding to rake in the moolah, and we Indians should know, for over 11 million of us get hitched every year. The organized wedding business in this country is estimated to be between Rs 70,000 crores and growing at ,would you believe it, 25% per annum?. And it’s a party to which everyone’s invited. Cashing in on this craze to tie the knot are online communities, wedding service providers, magazines and event managers catering to every community, caste, religion, socio-economic class and bank balance.

The major players are designer queen Ritu Kumar followed by others like Sabyasachi ,Arjun Khanna, Manish Malhotra, in the clothes segment.The top players in the beauty segment include Shahnaz Hussain, Kaya Skin Clinic, Lakme Beauty Salon while Prabeer Kumar De and Cory Walia are among the top make-up experts.

In the jewellery segment , those who hog the limelight are TBZ, Intergold, Trendsmith , Tanishq and a host of new brand names who are specially designing bridal jewellery.

“Blame it all on tradition”says Jaahnavi P Paal, editor, www.ShaadiTimes.com, a wedding and relationship portal of Shaadi.com. Weddings in India have always been an extravagant affair, where spending is the barometer of one’s status. Marriage ranks right up there, along with politics and cricket, as one of the big money-spinners in our country. Even the poorest father will willingly sink into debt to give his daughter a marriage marked with style and pizzazz.”, she adds.

In these times when the prevailing motto seems to be “If you’ve got it, flaunt it”, extravagance has scaled greater heights than ever before. Designer outfits, theme weddings, ‘paid’ film stars as entertainers, pretty young things looking as if they’ve walked straight out of a Bollywood set and plastic ‘five star’ venues are the rage. The face of the urban Indian wedding is definitely changing.

For the bride, for whom this is the most important day (though not necessarily the best) of her life, it’s a chance to shine and be the cynosure of all eyes. ‘Enter the Wedding Dress Designer’, who enables her to make a fashion statement. Gone are the days of simple wedding outfits-- now we are raring and daring to be different! Apparently, one of the latest trends is to offer wedding outfits that can be used again. Not only is this a great idea from a budget point of view, but provides more wearability as well!

The ‘theme’ bug has crept in and weddings are becoming much more sophisticated, with brides selecting a theme that they maintain throughout all aspects of their wedding. The wedding dress must, of course, fit into this, so colours and accessories are vital.

Colour plays a big role and Indians are still hung on pastels and swarovski crystals, when it comes to wedding outfits. Some recent choices of blues, greens and flames have been bold and interesting. However, it would be safe to say that aquas and lilacs will continue to rule the roost. But the use of traditional colours like red, maroon, gold, and fabrics like brocades, silks for the actual wedding outfit have always been, are, and will always be the most sought after. Also, Indian brides, wherever they are in the world, come to India to shop for their wedding.

Your wedding is of course the time to show off. You wouldn’t want to look the same as the next bride and so, naturally, some brides go to extreme lengths to make sure that they stand out from the crowd. Hence, individually-designed wedding outfits are much-sought-after by those who can afford them.

And what is a wedding with out jewellery to match? Jewellery forms an integral part of the bride’s trousseau. With the growing awareness of fashion trends, brides today are becoming more fashion conscious and prefer functional jewellery to traditional designs, so that it is wearable and can be used on a daily basis.

So, what's the right jewellery to choose this bridal season?

Though elaborate jewellery cannot be ruled out completely , the general trend these days is to buy one heavy set and one or two light sets (in diamonds or gold) so that the jewellery is impeccable for more than one occasion. However, diamonds and real precious stones would be the perfect choice. Gold is a universal favourite, whereas platinum still remains an elite choice.

Other items of jewellery that are in vogue include long earrings, big rings and bracelets. Coloured gems and stones are also hot right now and white gold, it seems, is here to stay. Very few people understand platinum though; also the metal and labour charges are very expensive and so people would rather go in for white gold, which looks similar.

What’s more,jewellery and assorted finery has to be designer stuff. Gone are the days when the brides wore the typical red and white panetar or the red Benaras or even the virgin white and gold sari. Now it’s got to have the right stamp on it, after all you are trying to make a statement. Fashion designers are flying in from Hawaii to Honolulu not just to showcase their new lines but also to design for a client. It is not surprising to find most top-of-the-line designers shuttling between London, Dubai and New York during the ‘high season’. As couturier, Tarun Tahiliani rightly puts it, “The Indian wedding market, both at home and abroad, is recession-proof.”

It’s not enough to deck yourself up in jewels and the latest designer togs. To give it the right effect the setting has to be right. The wedding is also a celebration and has to be organized. It’s no longer something which your family elders put together. Marriage organizers and event managers are entrusted with organizing everything down to the last pin so that everything works smoothly. No more glitches on your Big Day!!

The wedding market looks all set to take off in a more organized fashion. With people willing to spend money, the sky is the limit. Destination weddings will also see a boom as more people opt for exotic locations to ensure uninterrupted participation of their guests. There’s no end to the things people dream up to make their wedding celebration a success, and more importantly, the envy of others. They’re getting married everywhere: in an aircraft, on board cruise-liners, on deserted islands, under water, in the desert…. you name it and somebody’s thought of it already. The marriage business is as competitive as the next and like a website is being constantly updated. The good times are rolling in for the industry, and it doesn’t look like stopping any time soon.

Name : Sudha Hariharan

WEDDINGS ARE BIG BUSINESS

In the jewellery segment , those who hog the limelight are TBZ, Intergold, Trendsmith , Tanishq and a host of new brand names who are specially designing bridal jewellery.

Name : Sudha Hariharan

WEDDINGS ARE BIG BUSINESS

In the jewellery segment , those who hog the limelight are TBZ, Intergold, Trendsmith , Tanishq and a host of new brand names who are specially designing bridal jewellery.

Name : Sudha Hariharan

WEDDINGS ARE BIG BUSINESS

In the jewellery segment , those who hog the limelight are TBZ, Intergold, Trendsmith , Tanishq and a host of new brand names who are specially designing bridal jewellery.

Name : Sudha Hariharan

WEDDINGS ARE BIG BUSINESS

In the jewellery segment , those who hog the limelight are TBZ, Intergold, Trendsmith , Tanishq and a host of new brand names who are specially designing bridal jewellery.

2007-08-20T07:04:00.000-07:00

Name: Sudha Hariharan

A QUESTION OF RAPE

*A young call centre executive is raped and murdered in Bangalore, stunning the city and galvanizing the BPOs to take action.

* Two women in the capital are raped- one of them by known people.

*A group of young table –tennis players from West Bengal, housed in a decrepit lodge in Pondicherry, where they are scheduled to play, are visited by strangers in the wee hours of the morning. They are threatened, molested and robbed.

*An aspiring actress, a model from South Africa is drugged and gangraped over two days.

*A 24-year-old unemployed youth abducts an 18-month-old baby from the pavement and rapes her!

* A young Pune housewife is not only raped by her husband repeatedly but is assaulted and subjected to humiliation. Her husband shoves a glass bottle into her vagina; bleeding profusely when she approaches a doctor, he suspects that she may have spilled the beans and , to punish her, he rapes her again. What’s worse, in the presence of her mother and brother-in-law, he douses her private parts with kerosene and sets her ablaze!

In the last fortnight, horrendous happenings like these in Mumbai, Delhi and Bangalore, have made headlines. People have been shocked. Investigations are

ongoing,but apart from the shock value. What are the lessons that we, as women, must learn?

According to an Amnesty International poll conducted recently, a third of people believe a woman is partially or completelyresponsible for being raped if she behaves flirtatiously. Amnesty was truly shocked by these findings and said they showed the government’s policies on tackling rape were failing.

No woman should think rape couldn’t happen to her---it could. Every woman is a potential victim, regardless of her age,race, class, religion, occupation, education or physical “

*No attractiveness”. And women are NOT to blame. So often an assaulted woman begins to think, “ If only I had done….” Or, “ If only I hadn’t….maybe….”

Researchers realize that most women are haunted by their attack long after the ordeal. Some are paralyzed by fears for decades. The American Psychiatric Association recognizes such lingering fears and phobias as the core of rape trauma syndrome, a form of post-traumatic stress disorder (PTSD), a problem that was once associated only with combat victims. Fear of touch, of men, of sex,of being suddenly awakened at night, are just a few of the fears that can plague rape victims.

Rape is an act of violence and humiliation for which there is no excuse. But even today, a great many myths still surround it. Here we take a look at some of the myths, and then the realities.

Myths

· Men rape because they are sexually frustrated.

· Most rapes are “ spur of the moment” acts committed by strangers.

· Women secretly want to be raped.

· If prostitution were legally available, men would not rape.

· It isn’t possible to rape an adult

· A woman can’t be raped by her husband.

· There is no satisfactory way to protect yourself from such an unexpected attack.

Realities

* sexual urge gives a man the right to rape.

* Rape often occurs at home---frequently the offender is a relative, friend or neighbour. And most are carefully planned.

*Fantasies about aggressive sex between consenting adults do not mean a woman wants to experience the violent, brutal, humiliating act of rape.

* Prostitution is irrelevant—this is just another way of saying” men cannot help themselves” and it’s up to women to provide the solution.

* Fear of death, threats of violence and physical brutality can immobilize anyone.

* There are always to reduce the risk and increase awareness and safety; for example self-defence classes, and knowledge is a very powerful weapon, butthis does not imply that women should be responsible for preventing rape.

If you are raped

After an assault, though you will be in a turmoil, be sure that you do not wash, shower, change your clothes, use the toilet or do anything else that you may want to do to make yourself feel cleaner, until you have had a medical check and attention. Should you decide to report the rape officially, evidence will need to be collected as soon as possible for use in court.

At this time it is important to feel you have some personal support, so you may want to contact a parent or friend to help or be with you. One of the most helpful things you can do is talk about what happened and how you feel. You could also contact a counselor, specially trained to deal with such situations. Counselling takes place in private and whatever you say remains confidential.

Medical attention

It is important for you to receive medical attention immediately after a rape for two reasons---to determine if you have been injured----frequently, after an assault, you can be in a state of shock and unaware of injuries----and to ease fears about sexually transmitted diseases, pregnancy, etc.

If you report the rape to the police, medical evidence will be necessary for use in court when the suspect is caught, and your clothing may be photographed and retained. A special kit is used by the doctor to ensure the evidence is collected and this should be as soon as possible after the attack---- certainly before you resume everyday activities like eating, drinking, urinating, bathing etc.

Even if you do not want to report the assault to the police at this time,it is a good idea to let the doctor collect all possible evidence, because you may decide, later on, that you do want to report the incident.

You may find the procedures lengthy and confusing, and you may feel embarrassed. This is a natural reaction and you should not be afraid to let the doctor or nurse know of these feelings.

Reporting rape

There are advantages and disadvantages to reporting rape. If you do, you are exercising your rights. But reporting it can be emotionally difficult: you may have to repeat your story many times--- to police, and in court.

If the rapist pleads not guilty, you will be cross-examined on your statement. The rapist may not be convicted , which could add to your feelings of anger, humiliation and depression. You may find you feel as if you are the one on trial as the rapist’s lawyer tries to discredit you. But YOU are the only one who can decide whether or not to report the rape to the police.

How you may feel

Reactions vary for each person who endure rape, but some general ones include: Emotional shock( Why am I so calm? I feel numb. I can’t cry); Disbelief and denial ( Did it really happen to me? Why me? Was it really rape?); Embarrassment ( What will people think? No, I can’t tell my family); Shame ( I feel dirty. I want to wash my hands all day); Depression and powerlessness ( How am I going to go on?),; Fear ( I’m afraid. Will I get pregnant? What if I am infected with a disease? Will I ever want to be intimate again? I can’t relax. I can’t even sit still. I have nightmares. I can’t eat. I’m afraid to be alone or in crowds; Anger ( I want to kill him).

And because rape is the only crime in which the survivor can be treated as a guilty party, agreat many women experience guilt feelings very strongly, feeling they must have done something to make this happen. So it’s important to remember that:

· It’s not your fault

· Saying no, at any stage should be enough to stop a man’s sexual overtures

· Rape is not about sex or lust, but about aggression, humiliation and power.

Almost every raped woman wonders, “ Does anyone really know how I feel? Who is there who will listen and not start to blame or judge me? Can anyone help me to get back to normal?

Getting back to normal can take a long time, but it helps to talk to someone who empathises, someone who listens and helps you deal with your feelings in the way that is best for you, and will remain ready to help whenever you need them.

While you are struggling with your own mixture of feelings, your family and friends will be struggling with theirs. They too may be in need of assistance. It is normal for them to be confused; to wonder how they can help; to try to push their ideas, because they long to do something and are upset. They may believe you should report the rape even before you have had a chance to think about it. They may view rape as a sex crime rather than a crime of violence----and this must be corrected. They may mistakenly blame themselves, or you, for the assault. They may believe not talking about your feelings will make them go away. But it must be up to you to decide who you want to talk to and what you want to say and do. It is YOU not they who have suffered the violence.

MARITAL RAPE

It was a story that shocked the world. In 1993, Lorena Bobbitt,a 24-year-old manicurist from Virginia (USA) took a twelve-inch fillet knife from her kitchen and cut of the penis of her sleeping husband. John Bobbitt had just finished raping her, she later told the police. “Forced sex, that’s what he called it”, she said. “ He said it excites him”.

According to Lorena, it wasn’t the first time her husband, a 26-year-old nightclub bouncer and ex-Marine, had raped her. After she cut John’s penis, she fled”in a panic” still holding the organ. She drove across town and tossed it into a field. Meanwhile John was rushed to the Emergency room. Lorena phoned the authorities and told them where they could find

the penis which was recovered and in a nine-and-a-half-hour operation, was successfully reattached .

As the incident made headlines across the world, people joked about it to hide their shock. But Lorena Bobbitt’s extreme action also helped persuade some reluctant lawmakers to pass a bill on marital rape.

Marital rape, is for many, a complicated issue--- for most people, marital rape is an oxymoron, says an expert psychologist. Our image of rape is the stranger jumping out of a dark alley. Some feel that whenever a man coerces his wife to have sex, it’s rape. What is the difference between a stranger holding you down and forcing you to have intercourse and your husband holding you down and doing the same? The act in and of itself is the same. Even many victims are not sure whether what has happened to them can legitimately be called rape. They often don’t define it as rape because of society’s beliefs about what should go on in a marriage. Yet spousal rape is terrifyingly widespread. Rape and domestic violence are the most unreported crime in our country. When you are raped by someone you love and trust, you lose your faith in everyone---if you can’t trust that person, who can you trust?

Men who rape their wives fall into three general categories. The largest number, say, experts, are motivated by uncontrolled anger. A second group of men use rape as a way to establish power over their wives. The third group is obsessed by sex and derive pleasure from perverse and sadistic acts. But putting these men behind bars is not easy.

Under British common law, wives were considered property, and therefore what the husband did with them was not any business of the law. In the US too, even though rapes was a crime, husbands were given a marital exemption.

This began to change in 1975, when Nebraska (US), became the first state to abolish the marital exemption. Soon other states followed. Spousal rape is now a crime throughout the US, but the legislation varies from one state to another.

In our country the loopholes in law are many and often rape—whether by a stranger or a spouse often goes unpunished. Spousal rape is hardly ever reported and women continue to bear the brunt of sexual abuse within their homes in silence.

How can we change things? Some experts believe that we need to start with our children. We need to raise our children to have higher self-esteem so that girls do not fall into relationships with boys who manhandle them, and boys should know they do not have a right to beat a woman up or rape her to prove their manhood. We will have this kind of physical and sexual violence until we fundamentally change how we think about marriage and relationships between men and women. As long as wives are seen as subordinates, this problem will continue.

** Sources catering to specific needs of rape victims, battered women and women in distress are far too few. Yet there are some non-governmental and governmental organizations who offer services to women in distress in Mumbai. They include: Asha Sadan (Umerkhadi), St. Catherine’s Home (Andheri), Snehalaya (Mahim), Stree Mukti Sanghatna ( Dadar), Maharashtra State Women’s Council and the Human Rights Law Network.