The Tribune, Chandigarh, India

Govern, not rule
Feudal control gone too far

Following the killing of an ASI in Amritsar by a local Akali leader, there have been more reports of workers of the party or their relatives beating up a Home Guards jawan or firing in the air to scare people in a land dispute. It may well be argued that these are routine cases, only being highlighted in the media in the wake of the shocking Amritsar incident. However, the moot question remains why are such instances ‘routine’? One plausible explanation is people associated with the alliance in power in Punjab have come to believe they ‘rule’ the state rather than govern. The subjugation of the police force during the last tenure of the alliance in power, and the subsequent success in elections, may have strengthened the faith of the leadership in the concept.

What the parties in power must realise is such cynical gains come at a cost, which is what they are paying right now. The political minions whose loyalty was won over by handing them control over police functioning in their areas are unable to handle the power. Elected representatives being given a say in developmental activities and planning is logical, but what business do they have interfering in policing, a highly specialised field dealing with crime under the law of the land. Moreover, it would be hard to recall cases of exploitation of a poor person being taken up with the police by members of the ruling alliance.

The conduct of Opposition leaders streaming to the house of the slain ASI’s grieving family has also been disgraceful. Rather than sending a few senior representatives to offer condolences and help, various parties have turned it into a photo opportunity. This, when they, too, have failed to highlight issues of people in distress, a job largely left to the media. A party such as the Congress need not wait to come into power to serve people. It is time Punjab politics moved on from its feudal roots to the constitutional scheme of things.

Crime of eve-teasing
Humiliate offenders socially

Eve-teasing” tends to cover the appalling crudity and violence inflicted upon women under the garb of what is known in common parlance as chheda chhadi — mild flirtation. It stems from an attitude that is insulting and humiliating for female sex. For some strange reason this term is used only in South Asian countries, where men have the licence to get away with murder in the name of eve-teasing. Though the Indian Penal Code does not define this word, there are three sections which deal with crimes of eve-teasing, or, to be precise, sexual harassment. These are Sections 509, 294 and 354, but none of these sections can get an offender more than two years of imprisonment, that too in rare cases. It is for these reasons that though about 60 per cent women become victims of eve-teasing, the cases are rarely reported and the conviction rate is just 5 per cent in such cases.

The law does not treat it as a serious crime, though it causes immense mental torture and humiliation to females. Therefore, it is good news that the state government of Maharashtra is planning to take some cue from Tamil Nadu, the only state in India, where eve-teasers are treated under a special law. While the Minister for Women and Child Welfare, Maharashtra, is proposing to make eve teasing a non-bailable offence, after a youth was killed in the suburbs of Mumbai by five eve-teasers, in Tamil Nadu eve-teasing led to the death of a woman in 1998, after which the government brought an ordinance, which later became an Act — the Tamil Nadu Prohibition of Eve-Teasing Act, 1998 — that gave some protection to women against this evil that enjoys social acceptance.

Though a Bill on sexual harassment at workplace was passed in the Lok Sabha this year, its reach is restrictive. Eve- teasers should be barred from educational institutions and should be denied any kind of employment. It is a social crime and its punishment should bear social ramifications.

Thought for the Day

You can't build a reputation on what you are going to do.

— Henry Ford

ARTICLE

Kasab hanging and after
A victory for India’s justice system
by T.V. Rajeswar

THE Lashkar-e-Toiba’s (LeT) founder Hafiz Saeed has said that Kasab, the only terrorist caught during the 26/11 Mumbai mayhem and now hanged, will not fade away. The LeT described Kasab as a hero whose memory, it said, will now be turned into an asset. Saeed is reportedly planning to raise more funds and recruit more youngsters for his destructive project.

Pakistan has taken some steps ostensibly to show that they are keen to bring to justice all those who were involved in the Mumbai attack. Zakir-ur-Rehman Lakhvi, a LeT commander, is one of those who are said to be under trial in Pakistan for their role in the Mumbai killings. The LeT and its subsidiary, JuD, are still active in Punjab province in Pakistan under the patronage of the ISI. They are said to be now concentrating more on Balochistan, recruiting jihadist volunteers. Saeed and his team continue to be active in the training centre in Muridke and there is nothing to show that their activities are being restrained.

That Pakistan is not really serious about prosecuting the main architect of the LeT, Hafiz Saeed, has been demonstrated by the latest statement by Pakistan Foreign Minister Hina Rabbani Khar, who said that evidence against Saeed could not hold in a court of law and that Pakistan would be happy to look at any evidence against him that would stand legal scrutiny. If the evidence thrown up by the interrogation of Lakhvi, a LeT commander, and others is not enough to hold Saeed guilty of the role he played in the Mumbai attack, it is more or less a confirmation that Pakistan is only enacting a charade and it is not really serious about prosecuting those involved in 26/11.

David Headley, a Pakistani American, was able to visit Mumbai several times for carrying out reconnaissance for various places in Mumbai as the prime target for LeT attacks. Among the places visited by Headley were Taj Hotel, the late Shiv Sena president’s residence ‘Matoshree’ and Siddhivinayak temple.

The manner in which Headley was able to do reconnaissance of important sensitive places in Mumbai during his many visits is a sad commentary on the security system as well as the visa procedures in India.

He also visited New Delhi in 2005 on the pretext of watching India-Pakistan cricket matches. In the contest of forthcoming India-Pakistan matches, it is necessary for all those dealing with issues of visas to Pakistani visitors to ensure that strict vigilance is exercised before issuing visas to them.

The America-born LeT terrorist, Headley, and his accomplice Tahawwur Rana, who had carried out reconnaissance of Mumbai repeatedly, have been charged with conspiracy for the attacks in Mumbai. They were also charged with abetment of murder of US citizens in 2008. Both Rana and Headley are due to be sentenced by the US court on January 17, 2013. With the sentencing of Headley and Rana, all the accused in the Mumbai attack case would have been sentenced. Kasab’s hanging was a final act of dispensation of justice in this case. With India continuously pressing for their extradition, they have to face the Indian judiciary and get punishment for their role in 26/11.

Commenting on the hanging of Ajmal Kasab, Salman Khurshid, Minister for External Affairs, expressed the hope that the “rule of law” would prevail in Pakistan.

The Taliban group vowed to attack Indian targets “anywhere” to avenge the execution of Kasab. Two leading English dailies in Pakistan, including Dawn, demanded that the 26/11 brains should be brought to justice to root out terror in the region. The Express Tribune wrote, “We must show the world that as a country, we are committed to fight terrorism,” and called for speedy trial of the 26/11 accused in Pakistan. Dawn said that Kasab’s execution “revived the memory of a senseless and well-planned act of mass murder” and questioned how its planning went unnoticed in Pakistan.

Kasab’s hanging was published in the correct perspective by the Urdu press in the country as well. As a commentator put it, “Ajmal Kasab’s hanging has been received with a sense of relief, almost elation by Urdu dailies across the country. The Hyderabad daily, “Munsif”, came out with an editorial, stating that the matter handled by the authorities from Kasab’s capture till his hanging was fully transparent and all aspects of law were observed to ensure justice. Another Urdu paper came out with an editorial describing Kasab’s execution as good riddance as he was a great evil.

However, there were voices of dissent from human rights activists who said that the hanging of Kasab marked a disturbing end to the country’s moratorium on capital punishment. Justice Krishna Iyer, a retired Supreme Court judge, expectedly came out with a statement deploring the hanging of Kasab.

If this is the attitude of the rulers of Pakistan as well as the common people of Pakistan, one wonders why people like Zardari and others who are in power are not able to prevent Saeed and his supporters from recruiting people and then training them for jihadi activities against India. If it is all concentrated in the hands of the Pakistan army chief and the army-operated ISI, is it impossible for them to stop their activities and bring about an atmosphere of lasting peace between the two countries?

The sad fact is the Pakistani rulers are unable to prevent Taliban activists from targeting their own people, the Shias, whose processions have been periodically attacked in Rawalpindi and Karachi. It is high time Pakistani rulers realised the fact that terrorism would consume their own people even before it targeted others in India.

In Maharashtra, the execution of Kasab evoked widespread support for Mumbai police officers, who were responsible for arresting Ajmal Kasab on the fateful night of November 26, 2008. People asked why it took four years to hang Kasab. The special prosecutor, Ujjwal Nikam, who tried Kasab in a special court in Mumbai, termed Kasab’s hanging as a victory for India’s impartial judicial system. Nikam went on to say that the Kasab case was the most crucial case in his career and he had never seen a criminal as shrewd as him. Nikam added that Kasab was given a fair trial. But the truth prevailed at the end and he was hanged only after the proper judicial process was followed. It was a victory for India’s impartial judicial system.

The writer is a former Governor of UP and West Bengal.

MIDDLE

A modern fable
by Rajan Kashyap

A well-known fable in ancient Sanskrit text Panchtantra, also to be found in Aesop’s Tales, features a cunning fox inviting his friend, a stork, to a meal that is served in a large flat ‘thali’. The guest, who is endowed with a beak for a mouth, is unable to touch a morsel of the dainty spread over the plate before him. The stork in due course gets his own back, and repays the fox in the same coin. In the Panchtantra story, when the stork gets an opportunity to play host, he serves a meal to the same Fox in a long-necked vessel. The fox, being incapable of reaching the interior of the vessel, returns home without a taste of the repast.

If animals in ancient India and ancient Greece could be astute and knew how to deal with inhospitable hosts, a similar conflict between hostile hosts and guests is being played out in international sport today.

During its summer tour of England in 2011, the Indian cricket team received a severe drubbing, losing every single international match to the hosts. The reason adduced by the distraught visitors for their humiliating defeat was that the matches were played on fastpaced, green-topped pitches, which suited the English players. The tourists, who had excelled on dry rough and slow tracks in India, could not adjust to the unfamiliar playing conditions of English cricket grounds.

Came the winter of next year when the same teams were to face each other in a return series of Test matches, this time in India. The managers of Indian cricket saw here a great opportunity to redeem the team of its poor performance abroad. Just as the fabled fox and crane had reckoned that the adversary would be uncomfortable in partaking of the delicacies presented in alien containers, the Indian cricket think tank decided to exercise their choice of playing surface to design slow cricket tracks that would assist the Indian slow spin bowlers, in the same way as the bouncy wickets of English grounds had suited the fast bowlers the previous year. Tracks were tailored to accommodate the perceived strength of the Indian team, and, hopefully, to undermine the likely frailty of the visitors.

To begin with, the strategy seemed to be successful, and the fables of yore appeared to repeat themselves in real life. In the very first confrontation, the tourists fumbled, and tumbled, in the face of a web woven by the hostile Indian spin bowlers.

Alas! The dinner diplomacy, so adroitly employed by the fictional characters, began to flop. The visiting batsmen decided to undergo a crash course to understand the vagaries of the playing dishes served to them. And the bowlers too tried to learn, and to employ, the very tactics that they themselves had been subjected to. The result? The second face-off between the opposing teams enabled the visitors to prevail over their vaunted rivals.

Will the teams go back to the drawing board, and redesign strategies for the remaining matches in the series? They surely must. Perhaps Aesop and Panchtantra will provide them some answers.

OPED — HEALTH

Beneficial beams
New advanced lasers and rays play an important role in the treatment of various dermatological disorders that have become resistant to conventional therapies
Dr Vikas Sharma

SHUTTERSTOCK Laser technology has revolutionised dermatological treatments and this is not just limited cosmetic surgical techniques. Laser is an acronym for light amplification by stimulated emission of radiation.

Laser treatments are generally associated with cosmetological treatments like facial rejuvenation, hair reduction and wrinkle reductions etc. But lasers also play a major therapeutic role in the treatment of many chronic dermatological disorders.

New advanced lasers play an important role in the treatment of the various dermatological disorders that have become resistant to conventional therapies. As laser technology evolved over the years, dermatologists have also helped re-define the specificity of laser-tissue interaction and employed newly developed technologies in innovative ways. The net result of these technological advances has been the creation of new, effective treatment techniques. These techniques are profoundly superior to conventional technology because of that these have been rapidly incorporated into practice by most dermatologists.

Lasers in dermatological science are currently the most precise and selective surgical tools with qualities of "magic targeted bullet". The light traverses through various epidermal and dermal layers of skin without affecting the normal cellular structure and behaviour and targets selective abnormal cells. Lasers are used in chronic skin diseases like vitiligo, alopecia areata, psoriasis, rosacea, vascular anomalies, chronic eczemas, nodulocystic acne, atrophoderma, hereditary palmoplantar keratodermas, other genodermatoses etc. When these diseases do not respond to conventional therapies, laser treatment is used to target abnormal cells like the abnormally dividing and proliferating cells in psoriasis, stimulating the melanocytes to produce melanin in vitiligo, targeting the abnormal vessels in rosacea and vascular anomalies, stimulating collagen synthesis in atrophoderma.

Psoriasis

Psoriasis is an autoimmune skin disease that affects millions of Indians. It often appears as red, raised patches, which can be itchy and painful. It can be treated by a wide range of methods, including creams, oral medication and cytotoxic therapy. Oral medications are prescribed only when topical remedies fail. However, these can have serious side-effects, if not monitored. Standard light therapy, which involves standing unclothed in an ultraviolet light chamber, is effective and fairly safe. But it has a rigorous schedule - three times a week for two to three months.

During psoriasis treatment, excimer lasers are used that use a light wavelength to treat the disease. It generally takes three to five minutes. There is no pain - just a sensation of warmth when used at high intensity.

The laser is very effective for localised plaques and is particularly useful for palms and soles where topical treatments aren't practical.

Laser treatment has even benefited stubborn plaque lesions, especially on elbows and knees, not responding to conventional therapies. It usually takes about 10 to 15 laser treatment sessions to achieve substantial improvement in a plaque of psoriasis. One major advantage of laser treatment is that remission times are generally much longer than treatments based on topical creams.

Alopecia areata

Alopecia areata is one of the most common forms of hair loss. The loss usually starts as coin-shaped bald patches over the scalp and can affect facial hair in men and other hairy areas. Severe forms of the disease can lead to marked psycho-social problems.

This is useful for those taking oral steroid medications as a long-time usage of steroids can cause side-effects. The use of the laser treatment in alopecia areata is effective and safe and has good tolerability.

The bald patches over scalp, face or other body parts tend to show hair re-growth after 12-15 sessions. The treatment does not have any side effects.

Rosacea

Rosacea is a chronic, progressive skin disorder which affects more than five million people in India. The laser acts by targeting the abnormally dilated tiny blood vessels. It eliminates malfunctioning blood vessels under the skin which make the face appear red. Rosacea can have devastating effects on self-esteem of affected patients because it strikes adults who are in their prime. Sufferers often feel it affects their work and social life. The laser treatment can dramatically improve the quality of life of rosacea sufferers, most of whom are in their 30s and 40s.

Usually, rosacea first appears as a flush or red patch. Common symptoms include facial redness and inflammation around the nose, cheeks, chin and forehead, as well as visibly dilated blood vessels and a burning sensation.

If left untreated, rosacea worsens over time. The redness becomes more persistent, and bumps and pimples called papules and pustules appear.

In some cases, the eyes may be affected too, becoming irritated and bloodshot. In advanced cases, the nose can become red and swollen from excess tissue. Although rosacea can be lightened in some cases with creams and antibiotics that calm down the skin, the dilated vessels beneath remain which leads to chronicity. All these problems can now be treated with laser treatment.

The laser works by heating up the blood vessel and sealing it. Although it is not quite painless - there can be a bit of a sting with each zap of the laser - it does clear up the redness.

Heat from the laser's energy builds in the vessels, making them collapse and disappear.

Patients have no bruising but there may be some swelling for 24 to 48 hours. Treatment sessions take from 15 to 30 minutes and can be carried out at six to 12-week intervals.

Vitiligo

Vitiligo is a chronic skin condition that causes parts of the skin to become depigmented (or lose pigment). Considered an auto-immune disease, vitiligo occurs when the body's immune system attacks and destroys melanocytes (the cells that produce pigment) — leaving the affected area of skin void of colour. Vitiligo most often affects the face, elbows, knees, hands and feet. The condition is more noticeable in people with skin type 4 and 5 which Indians have.

It is a condition of hypo-pigmentation, meaning that the cells responsible for skin pigmentation (natural colour), called melanocytes, are destroyed. The destruction of these cells spreads, increasing the size and quantity of the white patches.

In laser treatment, the high-intensity laser beams penetrate the skin surface in the affected areas, destroying the diseased and useless cells, and stimulate the growth of new pigment cells. The new cells increasingly populate the white patches, restoring the patient's original, natural skin color.

Before the use of laser treatment, topical creams, oral medicines and ultraviolet (UV) light treatment were used to correct vitiligo skin patches, aiming to cease its spread and restore natural pigmentation. However, the discovery of laser treatment offers hope for vitiligo patients. In severe cases of vitiligo, laser is used to whiten all of the patient's skin, so that the patient could at least achieve an even-toned skin colour. Laser treatment actually aims to rid the white spots and restore the patient's original skin pigmentation.

Re-pigmentation has been found in stubborn patches of vitiligo after 20-30 sessions without causing any ocular or dermatological adverse reactions.

Laser treatment is useful in patients with: 10-20 per cent involvement of the body not responding to conventional topical therapies; palmo - plantar involvement, stable vitiligo, scalp lesions, lesions over face.

Vascular lesions

Vascular lesions tend to manifest at birth or in early childhood. These lesions appear as red or blue-coloured areas over the face and other exposed areas. So far no treatment other than laser has been found to be effective in these disfiguring conditions. Flash-pumped pulsed dye lasers with a wavelength of 577 nm are used for treatment of cutaneous vascular lesions like hemangiomas, portwine stains, etc. The same laser technique has also been found to be useful in reducing venous lakes, spider angiomas and telengiectasias.

Eczemas

Laser treatments also benefit patients of chronic eczemas not responding to conventional topical therapies. It is particularly beneficial for patients having thick patches of eczema over palms, soles, scalp and legs. They respond better to laser therapy.

The writer is a dermatologist and dermato-laser surgeon, Panchkula

Checklist

There are various types of lasers available in the market for different cosmetic and core dermatological problems but a patient going to get laser therapy should be aware of the types of lasers, which one is the best for his/her problem, the expected cost of the entire therapy, duration of therapy, outcome (degree of beneficial effect), the adverse effects of lasers, the qualification of the person operating the laser on his/her skin. Each laser system has its own adverse effect and complication profile specific to the cutaneous lesion being treated. So it's important to have certain precautions before, during and after laser sessions. Patient education on pre- and post-laser care will optimise results and increase the chances of favourable outcome.

Precautions

Effects on eyes: These may occur via direct or indirect ocular exposure to laser irradiation. Thus, wavelength-specific eyewear must be worn by both operators and patients.

Postoperative hyper-pigmentation: It can be observed after laser procedure. This problem is more common in Indian skin types. Hyper-pigmentation, however, is almost always temporary and responds to topical therapy and resolves completely over time.

Post-operative blistering/crusting or purpura: This can occur in few patients but is a transient phenomenon that usually lasts for 7-14 days.

Post-operative erythema: Some degree of erythema lasting less than 24 hours is present in virtually all laser procedures.

In many cases, adverse reactions and complications result from wrong technique used by non-medical / unqualified personal which occurs due to collateral damage created when energy intended for the target chromophore is diffused non-selectively and absorbed by surrounding tissues and structures.

People who intend to go for the laser treatments should undergo a comprehensive counselling session prior to laser treatment session to be fully aware about the pros and cons of these new dermato-surgical tools and have realistic expectations so that they can avail the favourable outcome with this scientific discovery.