The Tribune, Chandigarh, India

Why water is called life’s main source
By Dr K. C. Kanwar
MAN does not live by food alone. Water is vital to human health and fitness. Although it is not a nutrient per se as are carbohydrates, fats, proteins, vitamins and minerals. It, in fact, is a key nutrient inasmuch as no life is possible without it. Whereas we can do for weeks without food, we cannot live without water longer than a couple of days.

Blood banking in India: the current scenario
By Dr J.G. Jolly
BLOOD transfusion services in most of the developed countries have made tremendous progress. However, the scenario in the South-East Asian countries in general and India in particular is dismal. The reports of international agencies suggest that this programme has received considerable impetus during the course of the last two decades because of the technological advances and the availability of trained manpower.

Laughter amidst roses
By Dr S.S. Bajaj
MORE than 50 senior citizens, men and women, from various sectors of Chandigarh, converge at the Rose Garden in Sector 16, Chandigarh, before dawn everyday.

Sage advice for sanity
Converse: Converse with a smile on your face and affection within. This will make you desirable and the whole atmosphere will be surcharged with joy. This will also lead to improvement in the quality of your relationships. Mutual regard gets a boost.

Why water is called life’s main source
By Dr K. C. Kanwar

MAN does not live by food alone. Water is vital to human health and fitness. Although it is not a nutrient per se as are carbohydrates, fats, proteins, vitamins and minerals. It, in fact, is a key nutrient inasmuch as no life is possible without it. Whereas we can do for weeks without food, we cannot live without water longer than a couple of days.

Water approximates 60 per cent of the body weight of human adults. The total amount of water in a man weighing 70 kilograms is approximately a little over 40 litres. In a freshly born human infant, the water content could be as high as over 75 per cent of the body weight whereafter it progressively decreases till the end; the maximum loss of body water occurs in the first 10 years of life. The percentage of water in human tissues ranges from as low as 20 per cent in bones and adipose (fatty) tissue to as high as over 80 per cent as in grey matter (brain), bone-marrow and blood.

The molecular structure of water is unique which endows it with a number of extraordinary characteristics essential to its life-sustaining functions. It is an excellent solvent — more substances are soluble in water than in any other liquid known so far. This makes it an ideal constituent of the body fluids which sustain life-supporting chemical reactions. It dissolves varied products of digestion and transports them to the rest of the body. Likewise, it dissolves diverse metabolic wastes and helps drain them out of the body. Besides, it performs a variety of functions — some well known and well understood while other not so well appreciated yet vital. The no less important role of water is to distribute/dissipate the body heat efficiently, thereby regulating body's temperature. Water accomplishes this role ideally because it has high thermal conductivity ensuring rapid heat transfer from one part to the other.

Above all, water has a high-specific heat, implying that it takes a lot of heat to raise the temperature of water and likewise much heat must be lost to lower its temperature. Water molecules are attached to one another so strongly that it takes a lot of energy (or absorbs a great deal of heat) to vapourise a water molecule, thus making it a good coolant in summer. A football player weighing 100 kg loses an enormous amount of water in perspiration/evaporation during a one-hour scrimmage. If this does not happen, the total heat produced would have raised the body temperature by over 10° C — a fatal state for human beings. Even otherwise, we produce large amount of (metabolic) heat from a variety of chemical reactions continuously going on in our body. Were it not for the high capacity of water to absorb this metabolic heat, the body temperature would have risen to the point where life could not be sustained.

Drinking a lot of water is an inexpensive way to stay healthy. Even excess of water is harmless. Water therapy — drinking a litre or so the first thing in the morning — is kidney-friendly, to say the least, notwithstanding many claims of the adherents who find it effective in containing diverse and unrelated ailments. Even the antagonists concede that water therapy is effective in many ailments caused by improper waste drainage as a results of clogged kidneys. One needs a healthy level of water to maintain healthy kidneys.

The daily intake: Even before we start feeling thirsty, our body is somewhat dehydrated. Researchers feel that most of us are not drinking enough water and are in a permanent state of partial dehydration. To sip water as and when available without waiting for being thirsty is not a bad idea. Normally, the water balance remains fairly constant, no matter how much water one takes in excess but it (the water balance) suffers if the body is dehydrated. The water regulation in the body is affected by hypothalamus in two ways i.e. (i) by creating the sensation of thirst which makes us drink water and (ii) by controlling the excretion of water as urine. If water regulation fails, medical emergency ensues.

The water loss must be replenished promptly lest it should become a serious life-threatening hazard. If the body is dehydrated, the kidneys compensate by returning more water to the blood stream while filtering blood and, as a result, there is less but concentrated urine. At the same time, the brain reacts to dehydration by producing the sensation of thirst leading to the intake of more water. If water is in excess, the kidneys return less fluid to the blood and the subject passes more but less concentrated urine. This way the total amount of water in the body is kept fairly constant with the help of selectivity exercised by the kidneys which act dually — both as filters as well as absorption units.

It is a common experience that two individuals in the same environment show significantly different water intake. Perhaps, to a certain extent, it is habitual. Ordinarily, one requires to drink a minimum of three to four pints (1.5-2 litres) every day. In a hot and dry climate an average individual daily water intake could go as high as even five pints. To this may be added about half a pint (300-400 ml) of metabolic water produced daily by the body. At a temperature of about 20° C, out of 2300 ml of water intake, approximately 1400 ml is lost in urine, 100 ml in sweat and another 100 ml in faeces. The remaining 700 ml is lost by evaporation from the respiratory tract and by diffusion through the skin. In a healthy individual, the water intake and water output are evenly balanced to maintain the total water content constant.

On an average, a human adult requires a minimum of 1.5 litres of water in addition to the amount of urine passed to compensate for losses through other routes. To counteract the overall water loss, one preferably should drink water and avoid caffeinated beverages (coffee, tea or colas) which paradoxically are diuretic and dehydrate the system further. Similarly alcohol too dehydrates the system. "Nimbu pani", lassi and soups are good substitutes for replenishing water in the body.

If we consume less water than is needed or medically recommended, we expose ourselves to toxic overload. The liver and kidneys all need plenty of water to help them process and excrete everyday metabolic wastes and other toxins. Dehydration causes the thickening of the blood which makes its pumping difficult. The digestive system too cannot function properly without enough water. The scarcity of water in the system could produce ailments like headaches, constipation, arthritis, the irritable bowel syndrome, etc.

Prof K.C. Kanwar is a former Chairman of the Department of Biophysics at Panjab University.

Blood banking in India: the current scenario
By Dr J.G. Jolly

BLOOD transfusion services in most of the developed countries have made tremendous progress. However, the scenario in the South-East Asian countries in general and India in particular is dismal. The reports of international agencies suggest that this programme has received considerable impetus during the course of the last two decades because of the technological advances and the availability of trained manpower.

While the advancement in medicine has necessitated the increasing requirements of blood and blood products, its safety has attained immense significance because of the problem of AIDS and other transmissible infections. The elimination of high-risk donors and exclusive dependence on voluntary sources for ensuring safe blood have thus become all the more important.

The non-availability of an adequate quantity of quality blood is a recurring problem. The factors responsible for this shortage require an indepth study to understand the exact nature of the problem and evolve a strategy for an appropriate solution. An analysis of the various factors responsible for this sorry state of affairs and to plan a course of action for removing the impediments by initiating steps to achieve the highest possible standards of transfusion services are essential.

In order to evaluate the current situation of the "blood programme" in the country, the nature of the organisational set-up and its operational strategies have been studied in detail. A brief review of the material analysed is being presented here and should be of much significance in planning a course of action for improving the services.

The blood transfusion services are being operated by different agencies: governmental, semi-governmental, voluntary and commercial. There is no organised or uniform pattern of service. The nature and the standard of the services differ not only from state to state or region to region but even at different places in the same town. For a population of more than a hundred and a bed strength of over 0.80 million in all the states and the Union Territories, there is a meagre availability of four million units of blood annually as against the minimum modest requirement of 7.5 million units, thereby leaving a gap of 3.5 million units. The manner in which this gap is to be covered can be anybody's guess. But one thing is certain. Such a situation results in a variety of malpractices.

In spite of all the claims by the official and non-official agencies, the professional blood-sellers continue to dominate the scene. While a few states have made some progress in developing the programme, others continue to have deplorable services. Notable among these are the north-eastern states, Assam, Orissa, Bihar and UP. Out of the four million units of blood collected from all over the country, about 50% is consumed in 15 large metropolitan cities. Most of these cities have 300 to 500 nursing homes and private hospitals, depending mostly on blood shops. Even some of the large government hospitals draw their supplies from the same source.

It is distressing to note that over 50% of the medical colleges do not have properly functioning and self-sustaining blood centres. They unvariably depend upon commercial blood centres. About 90% of these institutions continue the practice of using whole blood and have not cared to develop a blood component programme. Many of these centres continue to depend upon glass bottles as blood containers, rather than plastic bags.

There has been a lot of talk about the development of "the voluntary blood programme" in the country during recent years. But the fact of the matter is that whereas there has been a noticeable improvement in some parts of the country, in other areas there has been a corresponding increase of commercial establishments which cater to the increasing requirements of the large number of nursing homes and private institutions that have come up during the course of the last two decades.

An analysis of the existing blood centres and the nature of their activities, the area of operation, the management and statistical data relating to collection, the pattern of operation, donor screening, the availability of resources for providing blood components, facilities for blood donation camps and the type of services provided to large government hospitals, including medical college hospitals, demonstrate that the majority of these continue to operate in a highly unsatisfactory manner.

The current upheaval about transmissible diseases, especially AIDS, needs to be looked into very carefully and the scare created on this account is to be evaluated in the right perspective. While there is no denying the fact that one has to be alert about AIDS and high-risk individuals, it is equally important that all those in the category of high risk should not be entertained as blood donors.

On the basis of material evidence from the surveillance centres for AIDS-testing, it has been demonstrated that the danger of AIDS infection through blood transfusion is primarily from professional blood-sellers. Thus, it is important that all the professional blood-sellers, who are usually drug addicts, criminals and high-risk individuals, should be completely debarred from giving blood and all the blood centres should resort to voluntary donors.

(To be concluded)

Professor Emeritus J.G. Jolly has returned to Chandigarh from the USA to help re-organise the safe blood transfusion programme for the well-being of the public. He can be contacted at 1, Sector 10, Chandigarh.

Laughter amidst roses
By Dr S.S. Bajaj

MORE than 50 senior citizens, men and women, from various sectors of Chandigarh, converge at the Rose Garden in Sector 16, Chandigarh, before dawn everyday.

They have gulped a litre of water and they have had a three-kilometre brisk walk by the time they reach their daily rendezvous.

They form a big circle with the leader in the centre.

On a command and a signal from the leader, they heave a breath as deep as they can. They retain it for as long as they can. On another signal, they swing their arms from their sides over their heads and clap, clap, clap. Simultaneously, they exhale their lungs empty by a loud "ha, ha, ha".

This goes on and on.

They started with 20. Now they do it more than a hundred times. What a rhythm, what a synchronism! It sounds perfect when heard from a distance. Only a cooing koel perched on a distant tree tirelessly responds every time.

These old cronies! Have they gone mad? Could not they sleep well at night? No, they are wise and fitter than many.

The Rose Garden has, perhaps, the cleanest fragrant ozone air in the morning. They breathe it a hundred times to enrich the haemoglobin in their blood for the day to follow.

With every breath and every clap they also move their eyes, their necks, their fingers, wrists, elbows and shoulders.

For them there is no osteoarthritis, no cervical spondylitis, no osteoporosis and no frozen shoulders. They giggle and laugh away their psychological stresses and strains.

They need no calcium; vitamins and antioxidants. There are no chronic airways obstructions in their lungs. They need no inhalers or bronchodilators, which asthmatics do.

They need no appetisers; they eat well. They need no laxatives. Their bowels move regularly.

Their blood sugar and cholesterol levels are normal. They have no hypertension.

Above all, they need no sleeping pills!

And mind you, by this group pranayama, they follow only the first step of our ancient Patanjali's Yoga Shastra!

Come one and come all to join the Clap, Clap and Ha, Ha Health Club at the Rose Garden!

Dr S.S. Bajaj is a former head of the Department of Pharmaceuticals, Government Polytechnic, Chandigarh, and the organiser of the unique Rose Garden Health Club which has no entrance fee.