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EDITORIALS

Sajjan Kumar’s acquittal
Verdict aggravates Sikh sense of hurt
T
he release of Congress leader Sajjan Kumar in a case of murder of five members of a Sikh family in Delhi's cantonment area during the mass killings in the aftermath of the assassination of Indira Gandhi has triggered protests by sections of the Sikh community. He has been named along with another Congress leader, Jagdish Tytler, by several witnesses for his role in the 1984 massacre.

General’s shattered dream
Receiving wages of his own sins
G
eneral Pervez Musharraf, who had ruled Pakistan with an iron first for around nine years, is faced with the most challenging situation today. He lost power when he began to govern his country like the worst dictator in Pakistan’s history. It was good riddance for his country when he decided to stay outside Pakistan after the party he had indirectly floated failed to win as many National Assembly seats as could enable him to remain tied to the post of President.







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People and the police
Trust between the two crucial
M
ansa police district has been adjudged best in the implementation of community policing initiatives and Bhawanigarh police station in Sangrur has been found the best among 396 assessed in Punjab, Chandigarh, Assam and Meghalaya. The assessment has been done by Altus, a global body working for public safety and justice. It may be an award among a small number of states, but the significance lies in the fact that this is an initiative recognised in a police force that has had its share of negative publicity.

ARTICLE

Valley requires healing touch
It’s essential under the circumstances
by Lt-Gen Kamal Davar (retd)
I
T was indeed more than encouraging that during the past two years, barring an incident or two, the Kashmir Valley was slowly displaying signs of normalcy with a record number of tourist footfalls both from abroad and all over India. The state had two peaceful, incident-free Amarnath Yatras having been conducted in 2011 and 2012. That this state's beleaguered economy was showing signs of a welcome revival, attributable to its tourism picking up, once again, was heartening for its hapless people in particular.

MIDDLE

Most misunderstood Menon
by Ravindra  Vatsyayan
T
he new generation may not have heard about him, but in independent India VK Krishna Menon as Defence Minister was said to be the second most powerful person after Jawaharlal Nehru. I saw him in 1965 when he came to address a public rally at the famous Daresi Ground of Ludhiana. He was a dark- complexioned and thinly built man whose stern bony face equally matched his rigid body language. Menon gave his speech in English which was later translated in Punjabi. I remember him gazing but not responding to my “Namaste” when he walked past a group of young boys with whom I was standing near the stage.

OPED Health

Donating gift of life
Dr Archana Dhawan Bajaj
Male infertility is on the rise with changing lifestyle patterns. Sperm donation can help infertile couples overcome the problem
T
here has been a rise in number of infertile couples in India. The onus is no longer on a woman's barrenness, as even a man's fertile state can be put to question due to the changing lifestyles. A man’s infertile state can contribute to at least 30-40 per cent of the approximately 10-15 per cent overall infertile cases noted on a yearly basis.







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EDITORIALS

Sajjan Kumar’s acquittal
Verdict aggravates Sikh sense of hurt

The release of Congress leader Sajjan Kumar in a case of murder of five members of a Sikh family in Delhi's cantonment area during the mass killings in the aftermath of the assassination of Indira Gandhi has triggered protests by sections of the Sikh community. He has been named along with another Congress leader, Jagdish Tytler, by several witnesses for his role in the 1984 massacre. Though there are still three other cases pending against Sajjan Kumar, Tuesday's verdict has scratched the wounds inflicted more than 28 years ago on the Sikh psyche by mobs of hooligans which targeted Sikhs and their properties in a bid to avenge the assassination of the then Prime Minister by her Sikh bodyguards.

It is alleged that the trial court believed the testimony of the witnesses for convicting five accused persons but disbelieved it in the case of Sajjan Kumar for some technical reason. What led the court to let off the Congress leader will be known only after the punishment to the convicts is pronounced and the judgment becomes public. The case itself was registered as late as 2005 on the recommendations of the Justice G.T. Nanavati Commission. Since so much time has lapsed witnesses might have made mistakes when cross-examined by lawyers. The State has been accused of inaction and connivance during the killings. The Nanavati Commission, the Delhi High Court and the CBI have all found fault with the functioning of the police during that critical period. Oddly, six policemen testified in favour of the accused.

Though it is natural for the families that have lost their near and dear ones in the 1984 pogrom to feel outraged at the verdict, political leaders and other representatives of the Sikh community must exercise restraint in the expression of their response and should not make statements that may inflame passions. Throwing a shoe in a court cannot be justified in any way. Nothing should be done that may discredit the genuine efforts being made to pursue the 1984 cases to bring the criminals to justice.
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General’s shattered dream
Receiving wages of his own sins

General Pervez Musharraf, who had ruled Pakistan with an iron first for around nine years, is faced with the most challenging situation today. He lost power when he began to govern his country like the worst dictator in Pakistan’s history. It was good riddance for his country when he decided to stay outside Pakistan after the party he had indirectly floated failed to win as many National Assembly seats as could enable him to remain tied to the post of President. However, within four years he got sick of a life without power and decided to end his self-imposed exile and try his luck again for regaining what he had lost in the 2008 elections.

But his dream got shattered after his nomination papers were rejected from all three constituencies from where he chose to contest the May 11 elections. Now his fate has been permanently sealed by the Peshawar High Court which has barred him for life from contesting polls for any elected body, including the Pakistan National Assembly and the Senate. Of course, he can challenge the high court’s order in the Pakistan Supreme Court, but he cannot hope to get his wish fulfilled through the apex court because of the record of his relations with the higher judiciary during his rule.

The high court is justified in observing that the man who abrogated the constitution twice — first by usurping power through an army coup in 1999 and then again by promulgating an emergency in 2007 — cannot be allowed to enter public life by contesting elections. The judges also pointed out that the person who targeted the judiciary so blatantly was now seeking relief from the same institution. In their view, he must not be allowed to enter the precincts of any elected House to ensure that Pakistan’s interests remain safe. Did he not visualise such a scenario? He, perhaps, depended too much on the Pakistan Army Chief, Gen Ashfaque Kayani, his protégé at one time. Or, maybe, General Kayani, too, feels helpless under the circumstances when there is no love lost for the retired General in any section of society.
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People and the police
Trust between the two crucial

Mansa police district has been adjudged best in the implementation of community policing initiatives and Bhawanigarh police station in Sangrur has been found the best among 396 assessed in Punjab, Chandigarh, Assam and Meghalaya. The assessment has been done by Altus, a global body working for public safety and justice. It may be an award among a small number of states, but the significance lies in the fact that this is an initiative recognised in a police force that has had its share of negative publicity. It was about time the Punjab Police took the initiative, however cosmetic it may seem, towards presenting a softer and humane side to the public.

Punjabis are historically a hardy and proud community, not the easiest of people to handle. The police — which comes from amongst them — naturally had to be tough. The two decades of violence and terror did a lot to damage the very outlook of the police towards the ‘public’ and, in turn, people’s trust in it. The cynicism on both sides continues in a vicious cycle. People don’t trust the police enough to help it, and the rough treatment they get from the police does nothing to change the situation. That is where community policing comes in. The idea of Sanjh Kendras is to make police services such as security verifications or certificates more accessible to people — provided in an environment that is not intimidating to the most humble of visitors.

The key lies in instilling a level of confidence in people that they may see the police as the first point of help in virtually any situation of distress. Approaching a police station should not be seen as something to be feared. That legacy of the Raj period has to go, when it was ‘us’ and ‘them’. Any community would be the most secure when people do the policing, i.e., they cooperate with the police, serving as its eyes and ears in their towns and villages. Let community involvement not be a distinction of one district or police station, but a matter of course for the entire force.

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Thought for the Day

Life consists not in holding good cards but in playing those you hold well. — Josh Billings

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ARTICLE

Valley requires healing touch
It’s essential under the circumstances
by Lt-Gen Kamal Davar (retd)

IT was indeed more than encouraging that during the past two years, barring an incident or two, the Kashmir Valley was slowly displaying signs of normalcy with a record number of tourist footfalls both from abroad and all over India. The state had two peaceful, incident-free Amarnath Yatras having been conducted in 2011 and 2012. That this state's beleaguered economy was showing signs of a welcome revival, attributable to its tourism picking up, once again, was heartening for its hapless people in particular.

However, the hanging of the mastermind of the 2001 attack on Parliament, Afzal Guru, a Kashmiri, vitiated the entire law and order scenario in the valley. That the separatists in J&K and their mentors across the Line of Control found the much needed oxygen to re-fuel their dying struggle against the Indian state, thanks to the delayed and badly handled, though legally in order, hanging of Guru, appeared to have put the clock back in J&K. However, that phase is also getting over.

That everything and anything in India gets politicised is not surprising, but some politicians of varying hues, instead of soothing nerves, compound even security problems of grave proportions by their irresponsible utterances playing to the gallery, unmindful of its repercussions. Be that as it may, the Central government, in particular, has to speedily take an objective view, holistically factoring in all the likely challenges to stability, law and order and a worsening economic situation in J&K.

Terrorism and calls for "Azadi" usually appeal to empty stomachs, unemployed youth and often misplaced perceptions of governmental apathy. That terror in the Valley gets intensified, off and on, by well-orchestrated strategies from across the border is a fact which does not require either any elaboration or should be surprising to anyone in India or elsewhere. That the Pakistani establishment of any hue will not ever change its mindset as regards J&K, and sooner the Indian establishment factors this as an indelible cardinal truth in its policy vis-a-vis Pakistan, the better. The Pakistan Parliament's passing of a resolution against Indian citizen Afzal Guru's hanging is the latest testimony of it being congenitally anti-Indian. Without overly worrying for the omnipresent Pakistani hand to stir ferment in J&K, India has to ensure that this hand does not become omnipotent. Thus, India has to utilise its own genius, its own pluralistic values and its large resources to bring peace and also economic relief to J&K.

As the Central government in concert with the state government gets its act together to reach out to the common folk in the Valley, some tangible and visible steps have to be speedily taken to assuage their wounded feelings — some real and some based on misperceptions and ignorance perpetrated by false propaganda by anti-national elements.

Despite the need to continue to keep in operation the much-debated but unpopular Armed Forces Special Powers Act (AFSPA) in J&K, the government, after deliberations with the Indian Army, could consider repealing the Act from Srinagar and a couple of other towns in the state as the first and important visible step. The Indian Army must be, however, convinced that they will not be given the wrong end of the legal stick while operating in any anti-terrorist operations in those areas where the AFSPA has been rescinded. However, in the border areas along the Line of Control and even the areas in the interior of J&K, which are still hotbeds of terror, the AFSPA may continue as hithertofore. This policy could be tried out for a year or so to check its efficacy and then corrective steps could be taken as required. The Army may now wish to adopt a more flexible approach towards the AFSPA in the larger national interest as it has always done in its glorious service to the nation. The promulgation of such a step will obviously thrust far more responsibility on the state government, the Central police units operating in the Valley and, importantly, the local police. If they can rise to the challenge it will be good for the nation and the state in the long-term perspective for more reasons than one.

Another visible and significant measure could be the announcement of a special economic package for the state with the emphasis on setting up manufacturing units and establishing special skills institutes — both measures could usher in better employment opportunities for its restive youth. The armed forces, Central police organisations and the para-military forces should also recruit in large numbers youth from this state to bring them into the national mainstream. Nevertheless, any step initiated by the Central government must be implemented speedily and with sincerity by the state government — a common malaise which afflicts India is our rather indifferent record in implementation at the grassroots level!

Importantly, India has to seriously factor in the strategic scenario in this entire region, which will evolve as a result of the impending ill-timed US and International Security Assistance Forces (ISAF) withdrawal from violence-ridden and still unstable Afghanistan in 2014. That out-of-work, well-trained and motivated Taliban and Al-Qaida terrorists may be diverted from the land of the Hindu Kush to neighbouring J&K, as part of Pakistan's infamous ISI's strategy is well on the cards. The ISI's main henchman in Pakistan, terror chieftain Hafez Saeed of the Lashkar-e-Toiba, other terror outfits like the Lashkar-e-Jhangvi and the Hizbul Mujahideen have publicly advocated this strategy of intensifying their evil activities in J&K. Thus, the Indian state will have to gear up holistically to confront this looming challenge to its integrity before it proceeds to provide to its strategically important state of Jammu and Kashmir the much-required healing touch.

The writer was the first chief of the Defence Intelligence Agency, India.

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MIDDLE

Most misunderstood Menon
by Ravindra  Vatsyayan

The new generation may not have heard about him, but in independent India VK Krishna Menon as Defence Minister was said to be the second most powerful person after Jawaharlal Nehru. I saw him in 1965 when he came to address a public rally at the famous Daresi Ground of Ludhiana. He was a dark- complexioned and thinly built man whose stern bony face equally matched his rigid body language. Menon gave his speech in English which was later translated in Punjabi. I remember him gazing but not responding to my “Namaste” when he walked past a group of young boys with whom I was standing near the stage.

Born this day in 1896 in Kozhikode in Kerala, Krishna Menon was a man of extraordinary brilliance. He graduated from Madras Law College and later obtained his post-graduation in economics and political science from the London School of Economics and the University College of London. While in England Menon became a proponent of India’s independence and as the secretary of the India League, he came into close contact with not only the front-ranking leaders of the freedom movement, but also with world-famous thinkers and writers of that era.  Menon’s intimate friendship with Nehru also emanated during the latter’s frequent visits to England in the 1930s.

After Independence, Menon was appointed High Commissioner to the United Kingdom. Noted journalist and writer Khushwant Singh also served as press attaché in the High Commission during that period and both of them had a very abrasive relationship. After returning to India, Menon became a Member of Parliament and later the Defence Minister of India. On the world political scenario it was the era of Cold War whereas on the domestic front also the time was no less turbulent. It was during Menon’s tenure as the Defence Minister that India suffered the worst ignominy of defeat at the hands of the Chinese in 1962.

Despite his extraordinary intellectual calibre and erudite status, Menon was not lucky enough to be liked by his peers and the public.  During his lifetime he had gained disrepute of being temperamental and arrogant, and it looked that all his good qualities were put under shade, making him extremely controversial. Though Menon was a great logician and an irresistible speaker, he lacked the resilience of a politician and a statesman. I had often observed seniors saying that Krishna Menon’s biting sarcasm and non-accommodative stances gave an impression that he was expert in the art of making enemies.

Even 40 years after his death, Menon is among the few leaders of independent India who are debated and opinions about whom remain sharply divided. Many political pundits believe that Menon’s marathon speech in the UN defending Kashmir’s accession to India, his high-pitched campaign against colonialism and apartheid and strong advocacy of the non-aligned movement are some of his best contributions to the Indian cause. His fearless and scornful attitude towards the capitalist world was indicative of his ultra-socialistic leanings and the international community was surprised to find the stark divergence between the suave and well-mannered Nehru and an aggressive and maverick Menon.

Whenever I happen to be in Lutyen’s Delhi and pass through the road named after him, I start thinking about this enigmatic leader and the complexities of his character. Krishna Menon is the subject of a couple of biographies but none of these could explain him beyond a point. Khushwant Singh has devoted a full chapter to Menon in his autobiography – “Truth, Love and a Little Malice”. Making a very unkind remark, wily Khushwant Singh has ended up saying that Menon was “a bachelor, same as his father”.

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OPED Health

Donating gift of life
Dr Archana Dhawan Bajaj

Male infertility is on the rise with changing lifestyle patterns. Sperm donation can help infertile couples overcome the problem


At least 13 to 19 million Indians are likely to be infertile, according to the Indian Council of Medical Research

There has been a rise in number of infertile couples in India. The onus is no longer on a woman's barrenness, as even a man's fertile state can be put to question due to the changing lifestyles. A man’s infertile state can contribute to at least 30-40 per cent of the approximately 10-15 per cent overall infertile cases noted on a yearly basis.

Male infertility is generally the result of an inability to properly produce healthy sperms or because of a blockage that prevents sperm from joining the semen. The known causes of male infertility can be subdivided into four areas:

Sperm production problems: The disruption of the production of sperm within the testis or the production of antibodies against sperm, which block their function. This is the most common cause affecting about 60 in 100 patients.

Blockage of sperm transport: Concerns the obstruction (or blockage) of the tubes leading sperm away from the testis, namely in the epididymis and vas deferens, into the ejaculate. This is the second most common cause affecting about 30 in 100 patients.

Erection and ejaculation problems: Relates to problems of erection and ejaculation that are necessary for normal sexual intercourse. These problems affect about five in 100 patients.

Unknown problems: In 40 per cent of men with male infertility, the cause of the problem is unknown. This is referred to as 'idiopathic infertility' or 'cause unknown'.

Hormonal problems: The failure of the pituitary gland at the base of the brain to stimulate the testis. Disorders of this group, usually referred to as endocrine causes of male infertility, are relatively rare. It affects approximately 1 in 100 patients.

A boon for childless

Sperm donation is a boon for couples with male-factor infertility. With this procedure many couples experiencing male-factor infertility may choose to undergo donor insemination for IUI or IVF procedures in order to achieve pregnancy.


Thinkstock Photos/GettyImages

In India, the Indian Council of Medical Research (ICMR) has laid down guidelines which state that 13 to 19 million Indians are likely to be infertile at any given time. The prevalence of male-factor infertility is approximately 30 per cent.

The accepted age for sperm donors is 21 to 45 years. Sperm is often donated through a sperm bank or clinic on the condition of donor anonymity. Before donating the sperms, the donor is screened for infectious diseases. Once the sperms are donated, they are frozen / quarantined for at least 6 months after which it is re-tested on diseases. The sperm is usually used for in-vitro fertilisation and intrauterine insemination.

As per guidelines, “Use of sperm donated by a relative or a known friend of either the wife or the husband shall not be permitted. It will be the responsibility of the assisted reproductive technology (ART) clinic to obtain sperm from appropriate banks; neither the clinic nor the couple shall have the right to know the donor identity and address, but both the clinic and the couple, however, shall have the right to have the fullest possible information from the semen bank on the donor such as height, weight, skin colour, educational qualification, profession, family background, freedom from any known diseases or carrier status (such as hepatitis B or AIDS), ethnic origin, and the DNA fingerprint (if possible), before accepting the donor semen. It will be the responsibility of the semen bank and the clinic to ensure that the couple does not come to know the identity of the donor. The ART clinic will be authorised to appropriately charge the couple for the semen provided and the tests done on donor semen.

The samples are generally frozen and stored for at least 6 months after which the donor will be re-tested for the STIs. This is to ensure no new infections have been acquired or have developed during the period of donation. Providing the result is negative, the sperm samples can be released from quarantine and used in treatments.

Washing techniques have been developed that purify sperm from viral load of HIV and hepatitis C, but nevertheless clinics do not offer sperm from carriers of significant STIs.”

There are two types of sperm donors: anonymous and known.

Anonymous donor

Those who wish to donate their sperm to a sperm bank have to relay his intention of donating sperm. Donor needs to go through a multitude of tests, like HIV, blood sugar, Hepatitis B and C, psychological mapping, STDs, et cetera. Moreover, the candidate's first sperm specimen is not used for the procedure. It is quarantined for at least 6 months and checked for all kinds of infections. After this, donor is asked to come in again and give two to three fresh samples, which are thereafter used for all in-vitro fertilisation procedures.

If the prospective sperm donor is a good match and meets all requirements of the sperm bank facility, only then he is asked to donate his sperm.

Known donor

The process for known sperm donor is similar to that of the anonymous sperm donor. However, the donation takes place at the fertility clinic where the infertile couple is being treated. The procedure will vary from case to case but the donor will undergo an extensive physical examination similar to that of the anonymous donor to ensure that he is healthy and fertile.

Treatment procedures

Intrauterine Insemination: Intrauterine Insemination (also known as artificial insemination) is the process of preparing and delivering sperm so that a highly concentrated amount of active motile sperm is placed directly through the cervix into the uterus.

Intrauterine Insemination (IUI) is done with washed and prepared sperm. The female partner must produce eggs and have healthy/ patent fallopian tubes. The sperm is placed in the woman’s womb or uterus (uterine insemination) after ovulation induction. One or more inseminations may be carried out around the time at which the egg is released. A pregnancy rate of 15-20 per cent per treatment cycle is expected, depending on factors such as the woman’s age and treatment cycle number, cause of infertility among others.

Process

There are several techniques available for preparing the sperm for IUI. All techniques involve separating sperm from seminal fluid. It is not possible to inject semen that has not been separated directly into the uterus because of chemicals in the fluid that can cause extremely painful uterine contractions. “We primarily use a method of sperm separation called "Density Gradient Separation". In this technique, motile sperm are separated from dead sperm and other cells through the use of viscous solution. Approximately two hours are required to process the sperm. After preparation, the sperm concentrate is placed through the cervix into the uterus by using a thin, flexible catheter. The time required for insemination is 5-10 minutes. The patient may experience mild cramping during the procedure but this symptom should resolve shortly after the procedure is completed

Every male donor providing a semen specimen for IUI preparation must be tested for infectious diseases. If a woman is using donor sperm from a sperm bank, we require that she should have infectious testing performed prior to initiating donor sperm inseminations. The specific tests required are HIV, HTLV I, RPR, a test for syphilis, Hepatitis B Surface Antigen, and Hepatitis C antibody. The donor profile for physical characteristics, blood group, family background, educational qualification and social background. Apart from tests like thalassaemia screening, hemogram, among other key tests as per the guidelines are performed. It is important to note that detailed history of the donor and his family is matched to the recipient to rule out common genetic disorders. Once testing is complete, a woman can waive repeat testing for subsequent treatment cycles, if needed.

Studies suggest success rates with IUI are enhanced with the addition of moderate treatment of the female partner with medications. A decision regarding medication to stimulate the ovaries is made in consultation with the physician. Most patients start with oral medications taken for five days shortly after the menses begins for ovulation induction. Alternatively, patients may be advised to take injectable fertility drugs which are more aggressive in stimulating multiple egg release from women (the more eggs that a woman produces during a treatment, the higher the chance for success but also, the higher the chance of a multiple pregnancy).

With such advancement, it has certainly made possible for most childless couples to enjoy parenthood. Though earlier male-factor infertility was not much accepted, now-a-days with technological advancement, male infertility is finding acceptance.

In-vitro fertilisation process

In-vitro fertilisation (IVF) involves fertilisation outside the body in an artificial environment. This procedure was first successfully used for infertility in humans in 1977 at Bourne Hall in Cambridge, England. To date, tens of thousands of babies have been delivered worldwide as a result of the IVF treatment. Over the years, the procedures to achieve IVF pregnancy have become increasingly simpler, safer and more successful.

Steps involved in the IVF process

Stimulation of the ovary to produce several fertilisable oocytes (eggs).

Retrieval of the oocytes from the ovary.

Fertilisation of the oocytes and culture of the embryos in the IVF Laboratory.

Placement of the embryos into the uterus for implantation (embryo transfer or ET)

— The writer is Consultant Obstetrician, Gynaecologist, Fertility & IVF Expert, The Nurture Clinic, New Delhi

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