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EDITORIALS

Infertility in Punjab
Need to wean youth away from drugs
A
WHO study has pointed to a sharp increase of infertility among Punjab’s males and attributed it to drug abuse, alcoholism and pesticides. Drug abuse is affecting not only the health of Punjab youth but also their chances of employment. The police and the armed forces used to attract well-built, tall youngsters from Punjab’s rural areas. Now, as media reports indicate, many fail to meet the minimum physical standards.

Deoband controversy
Vastanvi’s fate hangs in the balance

T
he
Majlis-e-Shoora (General Council) of Darul Uloom, Deoband (UP), the most influential Islamic seminary of Asia, has taken the middle path while handling the controversy that arose after Maulana Ghulam Mohammad Vastanvi, a Gujarati with a pro-Narendra Modi image, became its Mohtamim (Rector) on January 10 this year.


EARLIER STORIES

Judgement on Godhra
February 23, 2011
Breakthrough on JPC
February 22, 2011
Advani’s gesture to Sonia
February 21, 2011
The phenomenon of Faiz Ahmed Faiz
February 20, 2011
Spectrum swindle
February 19, 2011
Move ahead on reforms
February 18, 2011
Pushed hard by scams
February 17, 2011
UNSC’s expansion
February 16, 2011
India can’t part with territory
February 15, 2011
Zardari in command
February 14, 2011
Unsafe inside and outside womb
February 13, 2011


Big fat weddings
Curb wasteful spending

I
ndian
weddings, especially North Indian ones, are often extravagant affairs that last days, and involve many, many guests. Conspicuous consumption is the rule rather than an exception and there is no doubt that for parents, the wedding of their daughters is a costly affair that strains the resources of most, often to a point where loans are taken.

ARTICLE

Dialogue with ULFA
Nothing should be allowed to rock the boat
by B.G. Verghese
Talks
between the government and ULFA, now formally split between the moderate Arabinda Rajkhowa wing and the militant Paresh Barua faction operating somewhere in the Myanmar-China borderlands after being expelled from Bangladesh, have formally opened with a first round in Delhi.



MIDDLE

Degree Mata Ka Mandir
by V.K. Kapoor

W
ith
a podium glibness, he used to talk of visions, omens, portents and life beyond. We lost touch after college. I was covering the Prime Minister’s visit. I spotted him sitting in the front row along with politicians of the area. After the Prime Minister’s departure, we met after nearly 20 years.



OPED HEALTH

The experience of having undergone a major procedure like bypass or angioplasty should afford an opportunity to the patient and family members to adopt healthier lifestyles, for they play a major role in ensuring long-term good health and disease-free survival
Bypass or angioplasty done. Now what?
Naresh Trehan

W
hen
a diagnosis of blockage in the arteries of the heart is first made, it usually comes as a shock to the patient. The first reaction in many of the patients after undergoing an angiography is to enquire whether they will be alright with medicines alone or not. Unfortunately, that is not always possible and several people require angioplasty or a bypass surgery to ensure event free, fruitful and active lives. These are life-changing experiences for many people and having undergone that, the next question is what do we do now so that we remain healthy and free from recurrences.

 


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Infertility in Punjab
Need to wean youth away from drugs

A WHO study has pointed to a sharp increase of infertility among Punjab’s males and attributed it to drug abuse, alcoholism and pesticides. Drug abuse is affecting not only the health of Punjab youth but also their chances of employment. The police and the armed forces used to attract well-built, tall youngsters from Punjab’s rural areas. Now, as media reports indicate, many fail to meet the minimum physical standards. During the recruitment of constables in Patiala last week there were 3,300 aspirants and more than half could not run even half the qualifying distance. Their height was not up to the required level.

Earlier, given the pathetic state of government educational institutions in the rural areas, youth lacked the basic skills needed for a job. Since educationally they could not compete with urban students, they were successful at least in jobs requiring physical strength. Now they all lag behind in health. Unemployment drives them to depression. This, in turn, forces them to take to drugs, which are easily available all over Punjab, thanks to a thriving nexus of politicians, policemen and drug peddlers. Media reports indicate that the number of drug addicts has risen sharply to 60-70 per cent of the population in the border districts of Amritsar, Gurdaspur and Ferozepur. The network is well known. Narcotics are available over the counter at chemist shops.

At least three steps are needed to tackle the drug menace. First, drug availability should be stopped by firm police action and political backing. Secondly, the government should spend more on sports and provide adequate facilities in every school and college instead of just holding big tournaments for NRIs. Punjabis are known for their excellence in games. Thirdly, awareness should be spread among rural youth about innovative agricultural practices and agri-businesses by providing cheaper credit and training. Poverty is a mother of various ills, including poor health. A healthy environment alone can produce healthy youth.

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Deoband controversy
Vastanvi’s fate hangs in the balance

The Majlis-e-Shoora (General Council) of Darul Uloom, Deoband (UP), the most influential Islamic seminary of Asia, has taken the middle path while handling the controversy that arose after Maulana Ghulam Mohammad Vastanvi, a Gujarati with a pro-Narendra Modi image, became its Mohtamim (Rector) on January 10 this year. Besides appointing Mufti Abu Qasim of Varanasi as Working Rector, the Shoora members have, as was expected, constituted a fact-finding committee, which will submit its report soon after going into the factors that led to the demand for the new Rector’s removal. Maulana Vastanvi offered his resignation as he did in the past when the Shoora met on Wednesday, but it was rejected, perhaps, because this would have sent out a wrong message. But will he really wait for the committee’s report to hang on to the otherwise prestigious post? A negative report will be too embarrassing for a person who has done so much for the cause of education among the Muslims. If he leaves the seminary, it will be a victory for the two anti-Vastanvi factions of the Jamiatul Ulema-e-Hind, one headed by Maulana Arshad Madani and the other by his nephew Mehmood Madani.

If Maulana Vastanvi survives at Deoband and completes his 12-year term as the Rector, the historic seminary may not remain what it is today. With his experience of successfully running a number of educational institutions, including those providing engineering and B. Ed. degrees, the courses taught at Darul Uloom may undergo a major transformation. The seminary will have no dearth of funds, as Maulana Vastanvi, a Bohra, is known for his influence among the Muslim NRIs, particularly those belonging to Gujarat and Maharashtra. Besides this, the Deoband seminary will be free from the clutches of the Madanis, who have been misusing it for promoting their personal interests.

However, Maulana Vastanvi’s image, which suffered a major dent after he praised Gujarat Chief Minister Narendra Modi’s administration, may affect the standing of Darul Uloom among the Muslim community. Ordinary Muslims have nothing to do with the fact that his appointment has broken the monopoly of the Madanis or that he is the first non-UP scholar to have captured the Rector’s position. His poor standing as an Islamic scholar may affect the acceptability of any opinion that the seminary will pronounce. His functioning will always be compared with that of his illustrious predecessor, Maulana Marghoobur Rehman, respected for his learning by all the factions at Deoband.

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Big fat weddings
Curb wasteful spending

Indian weddings, especially North Indian ones, are often extravagant affairs that last days, and involve many, many guests. Conspicuous consumption is the rule rather than an exception and there is no doubt that for parents, the wedding of their daughters is a costly affair that strains the resources of most, often to a point where loans are taken. From time to time, various social organisations have tried to reverse the trend, but not to much effect. As for the government, it can limit the number of guests at marriages and other events under the Guest Control Order, which was enforced during the 1960s and 1970s. Although it was successful to an extent, the social resentment it led to soon made the government rethink on the issue.

Now the Union Food and Consumer Affairs Minister KV Thomas wants to curb extravagance, especially in consumption of food, during weddings. While the idea is laudable, the devil will be in the details of enforcement. Although it is not clear how the Minister came to the figure of 15-20 per cent wastage of food, but anyway, there is no doubt that in a nation where thousand of people eat the bare minimum for survival, wasting food is a criminal act. While the government looks at the issue of wastage of cooked food, it also needs to address the problem of loss of food grains that are stored in its facilities. It is generally acknowledged that approximately 20 million tonnes of food grain are lost every year to the damage caused by fungus and rodents. This, in turn, is because of poor and insufficient storage facilities. The government must make concentrated efforts to preserve food grains.

Attitudes have to change before wasteful expenditure on weddings can be cut down. Social and religious organisations have an important role to play in such endeavours, and as for the government, it could, at best, impose punitive measures like a tax on wedding and other parties where the number of guests exceeds a certain limit. 

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Thought for the Day

Peace cannot be kept by force; it can only be achieved by understanding. — Albert Einstein 

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Dialogue with ULFA
Nothing should be allowed to rock the boat
by B.G. Verghese

Talks between the government and ULFA, now formally split between the moderate Arabinda Rajkhowa wing and the militant Paresh Barua faction operating somewhere in the Myanmar-China borderlands after being expelled from Bangladesh, have formally opened with a first round in Delhi.

The ULFA leadership has dropped its demand for sovereignty but insists it has come to the table without preconditions. This should be accepted at face value. ULFA cannot be seen to have abandoned its core position even before the commencement of the talks and must be given enough leeway to declare in due course that it has been “persuaded” to drop this demand in lieu of corresponding “concessions” by the government. Such tactical manoeuvres are par for the course and should not be allowed to rock the boat by those unable to differentiate process from outcomes.

The NSCN, ULFA or the United National Liberation Front of Manipur, like the separatists in J&K, need to understand that India represents a commonwealth of peoples. They, in turn, are engaged in transforming diverse and ancient communities into a plural, democratic society of equal citizens armed with the constitutional flexibility innovatively to accommodate all manner of ethnicities and autonomous entities within a structure of cooperative federalism.

The NSCN (IM) leadership appears to have softened its stance on Naga independence though it must be appreciated that this will not be formally dropped until a settlement is concluded. The idea of a Naga constitution within the Constitution was earlier bruited and could conceivably yield a solution acceptable to all. These already exist in embryo in the family of Articles 370, 371, 371A to 371-I pertaining to different states and sub-regions within the country and under the provisions for upward and downward “entrustment” contained in Articles 258 and 258A. Likewise, non-territorial solutions can and have been devised in the Indian context to provide satisfaction to smaller ethnic groups without formal separation.

Equally, special provisions exist in or can be devised under the Constitution to provide for the special needs of various sections of society whether religious, linguistic, minority, backward, scheduled caste, tribal, women and children. So, there is plenty of negotiating space to accommodate diversity within unity.

Meanwhile, there will be some disquiet following reports that a ranking Naga leader, Anthony Shimray, who was abroad and arrested while clandestinely entering India, has confessed to the Naga leadership talking to the Chinese about posting a “permanent representative” in China and seeking other assistance in return for providing intelligence on Indian Army movements in Arunachal and the activities of the Dalai Lama. If true, this would scarcely be in keeping with the spirit of the suspension of operations agreement under which the current peace talks with Delhi are proceeding. It would appear that sections of the Manipur and Bodo underground are also in touch with the Chinese. These reports merit clear explanations from those involved.

The 24-hour suspension of operations 10 days back by the security forces against the Maoists near Naryanpur in Chhattisgarh to permit the release of some abducted police personnel through the good offices of Swami Agnivesh and another social activist, Gautam Navlakha, in its own way offers an opening to initiate a dialogue and efforts to restore normalcy in at least some Naxal-affected areas. There has been no real or sustained let-up in their activity but with the build-up of a better coordinated and trained security grid, the Maoists have found it increasingly difficult to impose their writ at will.

The decision to locate an Army training camp in interior Chhattisgarh has also unnerved the Maoists as its very presence will induce caution in engaging in unlawful activities. Demanding that the Army camp not be located there if negotiations are sought is an unacceptable demand. The military encampment is not being placed there for operations and the Army will only react - in accordance with the specified terms of engagement if attacked or provoked.

The Centre and the Planning Commission have between them worked out a series of socio-economic measures to be implemented in the Naxal belt. These will not go far unless three obvious and essential measures are taken. First, the Fifth Schedule must be activated in full as wilful failure to implement it represents a breach of faith with tribal India and a gross violation of the Constitution. The failure to take this simple fact on board even at this juncture is astonishing. Governors have been in default of their bounden duties and must be enjoined to fulfil these conscientiously. Secondly, there must be a dedicated and suitably incentivised administrative cadre for the tribal areas with a single line administration so that innocent tribals are not driven from pillar to post even on petty matters.

Thirdly, the State must engage with civil society and corporates in the social and economic development of these very backward areas under a strict but reasonable framework of environmental safeguards and corporate social responsibility within a well-defined legal framework. Continuing ad hocism will simply not do.

Such an effort will be assured of greater success if Maoist-sympathisers are brought on board and are convinced of the bona fides of the State. Once the bowl is drained, hardcore, proletarian-revolution Naxals will, like fish, find it difficult to survive in depleting waters.

Finally, the murder of two young siblings by the Lashkar-e-Toiba (LeT) in Sopore sends out yet another message about the wholly negative attitude of the Hurriyat and separatists who live in fear and denial.

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Degree Mata Ka Mandir
by V.K. Kapoor

With a podium glibness, he used to talk of visions, omens, portents and life beyond. We lost touch after college.

I was covering the Prime Minister’s visit. I spotted him sitting in the front row along with politicians of the area. After the Prime Minister’s departure, we met after nearly 20 years. He told me that he was running a couple of educational institutions. The local Commissioner told him that his daughter had completed her M.A. He immediately offered her a job. The Commissioner thanked him profusely.

He accompanied me to the Rest House and told me the story of his life. After college, he did not get any job. He went to his native village. One day out of sheer desperation he buried his degree in a field, and erected a small structure over it. He called it Degree Mata Ka Mandir. He floated a story that goddess Saraswati had appeared before him in a dream and desired that he should educate children. He started teaching school children in the open. Gradually, he opened a school. As time rolled on, he started a college and called it Degree Mata Vidyalaya.

Villagers claimed that they had heard divine music near the college at night. To sell a product, you have to create a hype around it, and package it well. When you are talking of God, you are tapping the collective unconscious. God brings cosmic reassurance as well as fear. It is the sense of a distant cloaked observer that is really eerie. Myths mobilise people by their promise and optimism. Myths require constant re-enforcement. Gullible and unsuspecting people accept anything. Innocence is a sister of stupidly, ignorance, naivete, and other things that we would be rather without. A clever ruse is always more effective than brute force. He became a popular figure in the area. People called him “Acharya Jee”.

I found him a sweet mix of cunning and convention and his two personalities smartly co-existed. He started meeting me in Delhi. He told me that he wanted to start a Doomed (Deemed) University. He was able to get permission, and invited a senior leader for its inauguration.

He got some highly educated people to work for him. He maintained that “people knowledge” is more important than “product knowledge”. He spent a lot of money on gifts he gave to important people. He told me that when others blow your horn, the sound goes further, but the horn needs proper lubrication to produce the desired and correct sound. He said that some bureaucrats and politicians could sell their maternal milk for a proper price. There men were a shrines of sin. He gave doctorate degrees to a couple of uneducatecl politicians so that they could feel respectable. He was keen to get a Padma Shri and then become a member of the Rajya Sabha. He asked me to join as Vice-Chancellor of his university after I retired.

In India it is a time of harvest for adventurers and the unscrupulous. In the new economic order the spoils will go to the quick-witted unconventional entrepreneurs and not to people restricted to traditional professions. Things are not always what they seem. A whale is not a fish, a peanut is not a nut, a tomato is not a vegetable. There is no medicine like hope, no incentive so great, and no tonic so powerful as expectation for something better tomorrow. HOPE deceives more than cunning can.

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OPED HEALTH

The experience of having undergone a major procedure like bypass or angioplasty should afford an opportunity to the patient and family members to adopt healthier lifestyles, for they play a major role in ensuring long-term good health and disease-free survival
Bypass or angioplasty done. Now what?
Naresh Trehan

When a diagnosis of blockage in the arteries of the heart is first made, it usually comes as a shock to the patient. The first reaction in many of the patients after undergoing an angiography is to enquire whether they will be alright with medicines alone or not. Unfortunately, that is not always possible and several people require angioplasty or a bypass surgery to ensure event free, fruitful and active lives. These are life-changing experiences for many people and having undergone that, the next question is what do we do now so that we remain healthy and free from recurrences.

It is important to realise that both angioplasty and surgery are palliative procedures and not curative, that is,they take care of the major immediate problems, but the disease process is still active and if proper precautions are not taken, there are greater chances of new blockages developing and the previous ones getting reblocked. These procedures, by themselves, do not alter the basic disease process in an individual's arteries. It is a mistaken belief in several individuals, after the initial shock has worn off, that they are now cured and can do whatever they want. In reality,nothing is farther away from the truth. If at all, the experience of having undergone a major procedure like these should afford an opportunity to the patient and family members to adopt healthier lifestyles, for they play a major role in ensuring long-term good health and disease-free survival. These are generally simple facts, known to all but often ignored and taken for granted and so they need to be reinforced.It is also important to emphasise that preventive measures remain the same whether a person is only on medical treatment or has had an angioplasty or a bypass surgery.

One would think that all this is commonsense, not rocket science. Yet, you would be surprised how often this advice is not followed!

Diet, exercise and weight loss: We are what we eat!! An old saying, specially true in this situation. One does not have to sacrifice taste and appealing food, but some modification is required. Total fat intake needs to be restricted and a rough estimate is about half a kg of cooking oil is to be used per person in a month. One should also use more than one type of cooking oil as certain nutrients may be present in one oil and others in a different one. A combination of sunflower or groundnut oil with olive oil and occasional use of mustard oil is fine. An occasional indulgence is allowed, but only if it remains occasional! Too many sweets and unrefined sugars add to weight and increase certain blood fats called triglycerides. Total calorie intake has to be restricted. Eat five times a day, but eat right and take small amounts at a time. Plenty of vegetables and fruit, whole grain cereals and fish are recommended. Certain heart patients are recommended low salt diet and restricted amounts of fluid intake, specially if heart muscles have become weak. These instructions need to be adhered to.

Gradual increase in exercise, reaching to about one hour of walk at least five times a week is recommended for most of the patients, unless there are specific contraindications. More vigorous exercises and sports activities should be undertaken in consultation with your cardiologist. Exercise not only strengthens the muscles and tones up your body, but is also helpful for weight loss and cardiovascular health. Exercise should not be undertaken on a full stomach and one should avoid exposure to extreme cold. Therefore, very early morning walks on cold days are best avoided.

Overweight is an additional risk factor for patients with heart disease and imposes extra strain on the heart. Additionally, it contributes to several other health-related problems like arthritis which restrict mobility and impede exercise, further preventing weight loss. Weight loss can generally be achieved with prudent diet and regular exercise as outlined above. One should keep a target of about 2 kg per month till the target is achieved and then ensure that it is sustained by weighing oneself twice a week. Remedial action should be taken if weight increases by 1-2 kg and one should not wait till there is a substantial weight gain.

Smoking and alcohol: Tobacco in any form is to be absolutely avoided, whether chewed or in any form of smoking. It causes or aggravates several diseases like heart attack, cancers of lung and mouth, blood pressure, blockage of the arteries of limbs causing gangrene etc. Even passive smoking has been shown to adversely affect a person's health. It is, however, difficult to stop and requires constant support from the family and counselling by the physician. There are nicotine patches and gum and certain drugs which help but most of all, a strong motivation is required. Once a person stops smoking, the benefits are visible within a few days and the risk keeps decreasing progressively.

Alcohol has always been a contentious issue. Generally, a glass of wine or two small drinks of 30 ml each for men and one drink for women are acceptable 2-3 times a week. However, only some people are likely to adhere to that limit. As a saying goes: "One drink makes a new man out of you, but the problem is that this new man now wants another drink". So, if you have to drink, stay within this limit. Certainly, nobody should be advised to start drinking as a therapy!

Diabetes and high blood pressure: These two are very important risk factors for patients of heart disease and often not well controlled. Blood pressure needs to be maintained below 130/85 for all persons. A common misconception among people is that the BP should be age+100, which is not true. It is easy to learn to monitor blood pressure at home which should be done at least once or twice a week, even if it is well controlled. Diabetics are advised to keep a glucometer at home and keep a record of their blood sugar levels at least once or twice a week depending upon the stability of their sugar values. Anytime they find that it is out of range, the dose needs to be adjusted. This strategy also empowers the person to have a better control of their sugar levels, especially if there has been dietary indiscretion. A major problem in diabetics is that their heart disease may progress and they may not be aware of it. Pain is often absent and there may only be subtle changes like increased breathlessness or fatigue. Any suspicious symptoms in diabetics, therefore, need to be taken seriously.

Followup and medicines: Regular checkup with your cardiologist is important for several reasons. The frequency of checkups will depend upon the severity of the heart disease and the kind of medication required. For those people who had suffered a major heart attack resulting in significant damage to their heart muscle, the monitoring has to be closer. They may require periodic adjustments of their medicines, especially if their symptoms persist. A constant chest discomfort over the scar area is quite usual soon after a bypass surgery and should not be a cause of concern. It takes 3-6 months to settle down in a majority of individuals. In the first few weeks after a bypass, one should avoid pressure or trauma to the chest. However, at any stage, if a person experiences chest discomfort or breathlessness on walking which is relieved with rest, a checkup is required. As mentioned earlier, diabetics need to be a lot more alert to even minor symptoms. Three or four months after a bypass or angioplasty, one should consult their cardiologist for a review of their cardiac status and ensure that their lipids, kidney functions and haemoglobin levels are normal and a treadmill test or an Echo, depending upon their disease may be required. A yearly check on the same lines helps in an early detection of any recurrence of the disease.

Medicines that a person needs to take by and large remain the same for people who have had angioplasty or surgery or are only on medical followup. Usual prescribed drugs are blood thinners, medicines to keep cholesterol under control and some other medicines which reduce the chances of recurrence of the disease. In addition, people who have had their valves changed need to take stronger blood thinners called anticoagulants either for three months for tissue valves or lifelong for metallic valves. These drugs require close monitoring to ensure that their effect is within the optimal range because overdose and underdose can both have disastrous consequences.

Reblockages: Despite tremendous technological advances in this field, a small number of patients will get roblockages of their arteries. The reasons may be poor quality of arteries, especially in diabetics, poor adherence to the preventive principles outlined above, technical reasons or progression of the disease over time. If this is suspected by your cardiologist, further investigations may be advised, which could be stress test, thallium, coronary CT angio or a catheter angiography. If a significant blockage is found, a decision may be taken for an angioplasty or a bypass surgery. It is important to understand that having had a bypass or angioplasty does not exclude a person from having the other procedure in course of time, should it be required. A second or a third bypass, if required, is possible in technically advanced centres with acceptable results.

Optimal utilisation of technology and medical treatment and adherence to these simple principles generally ensures that a person with coronary artery disease can lead a fruitful and active life with relative freedom from further symptoms. Psychosocial support in the first few weeks after a heart disease and prudent lifestyle later on are the keys to achieve these goals.

The writer is chairman and managing director, Medanta - The Medicity, Sector 38, Gurgaon

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