|
|
|
|
|
Anti-graft
bills on anvil Afzal Guru
hanging |
|
|
China’s
base in Seychelles
A failed
attempt at Bonn
Power
widows
Obesity
and cancer A
modifiable risk factor
|
|
Afzal Guru hanging
Remembering
the martyrs of the attack on Parliament has become an annual ritual. A decade has passed since the gruesome incident in which 10 persons were killed. Families of the victims have once again raised the issue of execution of Afzal Guru, the surviving conspirator whose mercy petition is pending with the President of India. During such emotional moments it is natural for people in general and the families which have lost their dear ones in particular to seek an early implementation of the death sentence. According to media reports, the Home Ministry has said it is for the President to decide, while experts feel the President acts only on the advice of the Council of Ministers. The fact is that since the 1983 Supreme Court order calling for the death sentence in the “rarest of rare” cases, the government has often dragged its feet on carrying out the death penalty, inviting criticism from various quarters. Ajmal Kasab, the sole survivor of the 2008 Mumbai attack, is among 300 persons on death row. Three Sri Lankan nationals who were awarded the death sentence for Rajiv Gandhi’s murder have sympthisers in Tamil Nadu. The Tamil Nadu assembly passed a resolution seeking clemency for the convicted Tamils because of their low-level involvement and alleged shoddy investigation and trial. Devinder Pal Singh Bhullar, who is also on death row, has his supporters in Punjab. Afzal Guru enjoys strong backing among a section of Kashmiris, and politicians, including Chief Minister Omar Abdullah, have openly come out in his defence. Their argument is if Afzal’s hanging is carried out, he would become a martyr, there could be a spurt in terrorist activity and the process of restoring normalcy in the state would suffer a setback. Many people are against the death penalty and many countries have abolished it. It is time for the government and the Opposition to revisit the issue.
|
|
|
China’s base in Seychelles
China
continues to plan and execute its strategic projects in different parts of Asia and elsewhere to expand its area of influence as a major world power. The latest is its military base in Seychelles, ostensibly established following a request from the government of this tiny island nation. It is China’s first overseas base of its kind, which is linked to its first aircraft carrier to be launched soon. The Chinese military presence in Seychelles should also be seen against the backdrop of Beijing’s anti-sea piracy operations going to begin shortly along with Thailand and Myanmar. The Chinese explanation is that it has gone ahead with its Seychelles project because it needed “safe navigation” facilities in the Indian Ocean region. China has such refuelling facilities in Oman and Yemen, too. But New Delhi has reasons to feel disturbed as Seychelles, not far away from India, also has a US drone base. Besides Seychelles, the US has a major military base in Diego Garcia. Earlier, it was the US which was accused of contributing to the militarisation of the Indian Ocean region. Now China has started playing the same role. China’s activities in the region will be more visible now as, besides its Seychelles base, it has signed a contract with the UN-backed International Seabed Authority for the exploration of polymetallic sulphide ore deposits in the Indian Ocean for 15 years. It is not only India but Japan and Vietnam will also be closely watching China’s moves to gain considerable naval strength in the region. Vietnam cannot take the development kindly as China unfairly protested against the recent pact that India signed with Vietnam for the exploration of gas and oil in the South China Sea. For India, the establishment of China’s military base in Seychelles appears to be linked to its strategy of having a string of pearls around India. But for countries like Vietnam, Singapore and the others in the ASEAN grouping, it is part of Chinese over-assertiveness to make them realise that they must learn to live with Chinese dominance in the region. These countries are looking towards India to play its rightful balancing role. India must not let them down.
|
|
|
Courage is what it takes to stand up and speak; courage is also what it takes to sit down and listen. — Winston Churchill
|
A failed attempt at Bonn
Another
conference on Afghanistan has come and gone. But the problem remains as intractable as ever. No one has any idea how the underlying issues facing Afghanistan and the region will be resolved but the international community soldiers on in the hope that ultimately there will be light at the end of the tunnel. The latest gathering at Bonn in Germany marked the 10th anniversary of the conference in the same city that established an interim government in Afghanistan after the Taliban regime was ousted in 2001. The final communiqué issued at Bonn tried to be uplifting amidst the doom and gloom surrounding the issue as it underlined that the international community was ready to stand by Afghanistan in the next 10 years after NATO’s withdrawal — in exchange for good governance and that “substantial progress” had been made since the last conference a decade back. “The protection of civilians, strengthening the rule of law and the fight against corruption in all its forms remain key priorities,” according to the document. It says the international community’s vision for Afghanistan is of a “stable and functioning democracy... conducive to prosperity and peace”. Afghan President Hamid Karzai hailed the progress his country had made but warned that such gains were by no means secure. “The people of Afghanistan are looking to this conference for clear affirmation of commitment to make security transition and economic progress irreversible,” he said. In response, the international community underscored its commitment to stand by Afghanistan as it makes this transition. US Secretary of State Hillary Clinton pledged that “the United States intends to stay the course” in Afghanistan after US and coalition troops depart in three years, though she also made it amply clear that “Afghans have more work to do” to ensure that the billions of dollars they seek are not wasted. But the reality is that Afghanistan will soon become a minor story for the US as the real story of this century — the rise of China — tests American resolve and resources. It is already clear that in the coming years, the US will shift its diplomatic and military energies to the Indo-Pacific area to manage the power transition in the region and to retain its pre-eminent position as an offshore balancer. As the economic crisis takes its toll on the West, there is little appetite now either in Washington or in Western capitals for the Afghan adventure. The US Secretary of State has already underlined that “the future of politics will be decided in Asia, not Afghanistan or Iraq, and the United States will be right at the centre of the action.” Given this flux, it is not surprising that conflicting messages are emerging from Washington and the West. It is not entirely clear what the deadline of 2014 really means. What kind of force posture the US will have on the ground in Afghanistan is an issue that all major regional powers are grappling with. The Afghan government certainly would be interested in a longer-term US military presence but Washington would like to keep a limited presence given its economic constraints and changing priorities. This uncertainty has led to all major players in the region hedging their bets. Pakistan is, of course, the most important player and its absence at the Bonn conference made sure that nothing of substance would come out of the conference. Pakistan boycotted the conference to express anger over a cross-border US airstrike that killed two dozen of its soldiers late last month though Pakistani Prime Minister Yousuf Raza Gilani has said that his nation wants to rebuild ties with the US and that he thinks “it won’t take long.” As US and Pakistan recalibrate their ties, other regional players like Iran are trying to make themselves relevant to the larger process. Expressing its displeasure over US plans to have military presence in Afghanistan over the longer term, Iranian Foreign Minister Ali Akbar Salehi suggested that any continued foreign troop deployment would not help Afghan stability. China too underscored the need to respect sovereignty of regional states, alluding to the US raids inside Pakistani territory. In contrast, both Afghanistan and India drew attention to the fact that the problem in Afghanistan could not be resolved without tackling the issue of sanctuaries in Pakistan. Asking the international community not to repeat its past mistakes and “let Afghanistan slip back,” Indian External Affairs Minister S.M. Krishna suggested that “there is need for something like a ‘Marshall Plan’ for Afghanistan, involving all the major stakeholders.” He exhorted the international community to stay engaged for a long time to eliminate the sanctuaries of terror and outlined New Delhi’s commitment to the reconstruction of the violence-torn country. It is not at all clear if the Bonn conference achieved anything substantive. Politically, it can be termed as a failure as neither Pakistan nor the Taliban attended it. The future roadmap for Afghanistan remains as contested as ever with major regional stakeholders having divergent views on how to help Kabul so that instability and radicalism in that country do not pose a threat to regional and global security. It is in this rapidly changing context that India will have to frame its policy response. Given the policy paralysis in New Delhi, it is not readily evident if India has the capacity to rise up to the challenges in its own
backyard. The writer teaches at King’s College, London.
|
||||||
Power widows Out-of-power politicians, out-of-work actors, retired bureaucrats and policemen are avoided as if they have a serious communicable disorder. Their body language also changes. Once the weaponry of office is taken away, they shrink. It is a roller-coaster drive between power and oblivion. Once a Marasi (village wit) was bowing before the thanedar’s chair. The thana munshi told him that the chair was empty, as the thanedar was not sitting there. The Marasi told him that it is the chair that lends authority to a thanedar. He told the munshi that you put an ass on the chair and he will start roaring like a lion. Power has a seductive quality. The taste in heady. There is a secret thrill that a man feels in the sheer exercise of power. The number of hangers-on increases and they react with characteristic hypocrisy and sanctimoniousness typical of the breed of sycophants that surround those in power. Politicians in power become arrogant. They forget the humility befitting those whose authority is merely on loan from the people. The government is not based on the Constitution but fluid dynamism where power shifts with personalities and personal alliances. An out-of-power person becomes like a non-functional machine for which there are no spare parts. Delhi is full of these power widows. I remember a former minister complaining bitterly about his old colleagues and chamchas who now ignored him. I told him that a colleague enjoyed your agony and resented your ecstasy, and chamchas liked a full plate. An empty plate loses its appeal. As bureaucrats reach their retirement, they start looking for new avenues and jobs. Those bureaucrats who do not get a job acquire an orphaned look. I remember a very powerful bureaucrat, who was very fond of attending parties. He always complained that he had a headache whenever he had to take scotch like Teachers Scotch or Chivas Regal. He only liked Black Label or Blue Label Scotch. After retirement, one day at the Delhi Golf Club he asked me to arrange for some same bottles of rum. I asked him the reason. He told me that he had discovered that there was a lot of adulteration in scotch, and purity was only in the name of God and Rum. Most police officers after retirement take to golf and pull their own trollies. The old arrogance is gone, but you talk to them, and they will mention about their brave deeds which never happened. Most of them, barring a few, look like small-time hoods from low-budget Punjabi films. Henry Kissinger had remarked, “Power is a great aphrodisiac”. Power is the elixir of life. Administrative widowhood is
painful.
|
||||||
Obesity and cancer
The
traditional image of a cancer patient is of a thin, wasted person; as no one tends to think that a plump person would ever get cancer. But the truth is otherwise. Among men, those with body mass index (BMI — calculated as weight in kg/height in mt x height in mt) above normal (less than 23), run an increased risk of colon cancer by more than 55 per cent. Women with a similar increase in BMI have a more than 50 per cent increased risk of developing uterus or breast cancer. In both sexes, being obese increases the risk of cancer of the esophagus, kidney, gall bladder and pancreas. It also increases the risk of various types of blood cancer and lymphomas. This article discusses the scientific basis of increased risk of different types of cancers related to obesity. Breast cancer risk The effect of obesity on breast cancer risk depends on a woman's menopausal status. Before menopause, obese women have a lower risk of developing breast cancer than do women of a healthy weight. However, after menopause, obese women have 1.5 times the risk as compared to women with healthy weight. Obese women also have a higher mortality risk if afflicted with breast cancer after menopause as compared to lean women. About 11,000 to 18,000 deaths per year from breast cancer in U.S. in women above 50 might be avoided if they could maintain a BMI of under 25 throughout their adult lives. However, obesity seems to increase the risk of breast cancer among those post-menopausal women, who do not use menopausal hormones. Among women who use menopausal hormones, there is no significant difference in breast cancer risk between obese women and women of a healthy weight. The risk is believed to be due to increased levels of estrogens in obese women. Before menopause, the ovaries are the primary source of estrogens. However, estrogen is also produced in fat tissue, and after menopause when the ovaries stop producing hormones, fat tissue becomes the most important estrogen source. Estrogen levels in post-menopausal women are 50 to 100 per cent higher among heavy than among lean women. Estrogen-sensitive tissues are therefore exposed to more estrogen stimulation in heavy women, leading to a more rapid growth of estrogen-responsive breast tumours. Another factor related to the higher breast cancer death rates in obese women is that this cancer is more likely to be detected at a later stage in obese women than in lean women. This is because the detection of a breast tumour is more difficult in obese versus lean women. The distribution of body fat may also affect breast cancer risk. Women with a large amount of abdominal fat have a greater risk factor than those whose fat is distributed over the hips, buttocks and lower extremities. Cancer of the uterus Obesity has been consistently associated with uterine (endometrial) cancer. Obese women have two to four times greater risk of developing the disease than do women of a healthy weight, regardless of menopausal status. Increased risk has also been demonstrated among overweight women. Obesity has been estimated to account for about 40 per cent of endometrial cancer cases in affluent societies. It is unclear why obesity is a risk factor for endometrial cancer; however, it has been suggested that lifetime exposure to hormones and high levels of estrogen, and insulin in obese women may be the contributing factors. Colon cancer Colon cancer occurs more frequently in people who are obese. An increased risk of colon cancer has been consistently reported for men with high BMIs. The relationship between BMI and risk in women, however, has been found to be weaker or absent. Unlike for breast and endometrial cancer, estrogen appears to be protective for colon cancer for women overall. However, obesity and estrogen status also interact in influencing colon cancer risk. Women with a high BMI, who are either pre-menopausal or post-menopausal and taking estrogens, have an increased risk of colon cancer similar to that found for men with a high BMI. In contrast, women with a high BMI, who are postmenopausal and not taking estrogens, do not have an increased risk of colon cancer. There is some evidence that abdominal obesity may be more important in colon cancer risk. In men, a high BMI tends to be associated with abdominal fat. In women, fat is more likely to be distributed in the hips, thighs, and buttocks. Thus, two measures of abdominal fat, waist-to-hip ratio or waist circumference, may be better predictors of colon cancer risk. A number of mechanisms have been proposed for the adverse effect of obesity on colon cancer risk. One of the major hypothesis is that high levels of insulin or insulin-related growth factors in obese people may promote tumour development. Kidney cancer Studies have consistently found a link between a type of kidney cancer (renal cell carcinoma) and obesity in women, with some studies finding risk among obese women to be two to four times the risk of women of a healthy weight. Results of studies including men have been more variable, ranging from an association similar to that seen in women, to a weak association, to no association at all. The mechanisms by which obesity may increase renal cell cancer risk are not well understood. An increased exposure to sex steroids, estrogen and androgen, is a possible mechanism. Cancer of the esophagus or stomach Overweight and obese individuals are two times more likely to develop a type of oesophageal cancer called oesophageal adenocarcinoma than people with healthy weight. A smaller increase in risk has been found for gastric cardia cancer, a type of stomach cancer that begins in the area of the stomach next to the esophagus. Most studies have not observed increases in risk with obesity in another type of oesophageal cancer, squamous cell cancer. An increased risk of oesophageal adenocarcinoma has also been associated with weight gain, smoking, and being younger than 59. The mechanisms by which obesity increases risk of adenocarcinoma of the esophagus and gastric cardia are not well understood. One of the leading mechanisms proposed has been that increases in gastric reflux due to obesity may increase risk. However, in the few studies that have examined this issue, risk associated with BMI was similar for those with and without gastric reflux. Gallbladder and ovaries cancer An increased risk of gallbladder cancer has been found to be associated with obesity, particularly among women. This may be due to the higher frequency of gallstones in obese individuals, as gallstones are considered a strong risk factor for gallbladder cancer. However, there is not enough evidence to draw firm conclusions. It is unclear whether obesity affects ovarian cancer risk. Some studies report an increased risk among obese women, whereas others have found no association. A recent report found an increased risk in women who were overweight or obese in adolescence or young adulthood; no increased risk was found in older obese women. Studies evaluating the relationship between obesity and pancreatic cancer have been inconsistent. One recent study found that obesity increases the risk of pancreatic cancer only among those who are not physically active. The story is not all that gloomy though. Research shows that as the BMI goes down so does the risk of the cancer associated with obesity. So it is high time that we take up the threats posed by this fatty issue seriously and put on our jogging shoes. The writer is the Director of Advanced Laparoscopic and Bariatric Surgery,
Primus Hospital, New Delhi
|
|
A modifiable risk factor Cancer is one of the hottest topics of discussion and research in the medical fraternity. It is a multi-factorial illness, where more than one factors are responsible for its causation. Some of these factors are modifiable (under our control) and some of them are non-modifiable (we do not have any control over them). Obesity is one of the modifiable factors responsible for a good number of illnesses and cancer is one of them. Evidence shows that obesity is responsible for cancer progression, recurrence of disease and increased mortality. Plenty of research has been done on this topic. In the US, statistics have shown that more than one-third of cancer patients are either overweight or obese. According to the American Society of Clinical Oncology (ASCO), following cancers have been associated with obesity: n Breast cancer (after menopause) The exact mechanism, of cancer development in obese patients is still not well understood and plenty of debates are ongoing over this issue. To sight an example: 1. In breast and the uterine cancers, disturbances in the oestrogen metabolism in obese patients increases their risk for these cancers. 2. Increased gastro-oesophageal reflux due to obesity increases the risk of oesophageal and stomach cancers. 3. Obesity leads to insulin resistance and hence is responsible for poor outcome in cancer patients. We have evidence now that obese diabetics fair poorly than lean and thin ones. There are many more causes and hypothesis explaining the relationship between obesity and cancer, but it is one of the modifiable risk factors for cancer. Weight reduction and a healthy diet not only reduces the risk of cancer, but also increases the outcome of non-obesity related cancers. Because high body mass index and insulin resistance are predictive of poor cancer prognosis, the multi-disciplinary healthcare team, including oncologists, primary care physicians and the dieticians or Certified Specialists in Oncology Nutrition (CSOs), should identify obese patients and screen them for insulin resistance to stratify individuals by risk of cancer progression. In addition to the traditional body weight assessment and laboratory tests, assessment of some obesity-related phenotypic manifestations may also be done. Cancer control through lifestyle modification and diet control Diet control plays an important role in cancer control and cancer survival. We identify three types of cancer survivors: 1. Acute survivors, depending upon the cancer diagnosis and treatment responses. 2. Extended survivors, post-treatment survivorship 3. Long-term survivors, predicting cure in cancer patients Also two major studies show that modification in lifestyle behaviours like a low-calorie diet and exercise to reduce weight prevent cancer progression and mortality. Cancer patients may also have weight management challenges due to disease-or treatment-related weight gain. During treatment, patients may experience fatigue and depression due to neutropenia, insomnia, decreased oral intake, side-effects of medicine, and changes in body composition, which may lead to decreased physical activity levels, resulting in an involuntary weight gain. Hence, once the treatment is completed, these issues must be addressed and handled by experts for achieving long-term cure and reduce mortality pertaining to cancer. The writer is a Senior Consultant, Haemato-Medical Oncology, Moolchand Hospital, New Delhi
|
|
| HOME PAGE | |
Punjab | Haryana | Jammu & Kashmir |
Himachal Pradesh | Regional Briefs |
Nation | Opinions | | Business | Sports | World | Letters | Chandigarh | Ludhiana | Delhi | | Calendar | Weather | Archive | Subscribe | Suggestion | E-mail | |
