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MEMO: Mass Extinction Memorial Observatory Global Monument in Memory of Extinct Species

Editorial: Please do not 35 trivialise science communication MEMO: Mass Extinction Memorial 34 Observatory – Global Monument in Memory of Extinct Species Keeping Sports Clean : A cat- 32 and-mouse game Extremely Drug Resistant 30 Tuberculosis Coconut: A Wonder food 29 History of Medicine in India 27 Safeguarding against Rabies— 24 the 1-2-3 of post-exposure treatment Recent developments 21 in science and technology

36 Editorial Please do not trivialise science communication Dr. R. Gopichandran

Let me argue for the cause of science communication. Science opportunities to enhance them to help deliver appropriate information communicators are embedded in the cause. Any good for the cause in a timely manner: and (III) Create interest to perceive and interpret will mean good for people engaged in it; almost Samaritans in this credibility of messages delivered. This bottom-up stakeholder case. How often do we come across proofs/empirically evidenced engagement can be expected to create critical groundswell to tackle cause-effect relationships pertaining to science communication? challenges due to multiple anachronisms that tend to plague the When will we get to see a steep rise in the spread and depth of case message – intent – impact link. examples that demonstrate the holistic value of communication? Scale of operations is equally important. Reality checks should Is it not important to position communication at the centre of firewall this approach against illogical speculations/scepticism. In this missions, without trivialising the process or communicators? Do we process, however, communicators (including leaders, mediators and really acknowledge the importance of a bottom-up feedback on the grass root actors) for credibility’s sake, should not mistake their own sustainability of interest on all that is communicated or larger impacts (imagined) eloquence or eminence for the impact they may want expected of communication? to create. Communicators should be seen as credible and genuinely Robustness of tools that may help reach out to large numbers is a so. The logical framework about enhanced awareness should clearly stand-alone element of communication. Messages and truly messaging differentiate impacts/outcomes of such awareness; especially as a survive only account of the credibility of the former. Messages may function of the robustness of enabling circumstances. not be accepted on face value. Impacts and their sustainability are I am confident about the large quantum of communication too far away along this continuum. On the other hand, it is likely; activities that have taken place through leading communication expectations may sky rocket because of continuous messaging and institutions at the national and grassroots level. No arguments also therefore demand swift follows ups; consistent with claims/hype about the zeal and purpose they stood for. Only an overly myopic and as the case may be. What is the importance we confer on enabling self-perpetuating mind will pick illogical holes on such initiatives. The circumstances that can help transform learnings to action? Are the way ahead however has to seamlessly integrate the stated elements. contents and communicators seen as credible or condescending? This will also help the former get their due visibility. Rightly so, they Importantly, is the focus on the agenda of science for development or set the context for enhanced value we wish to collectively infuse. for self-aggrandisement? Those of us interested in the dynamics of internet tools will do Do communicators recognise or highlight the limits and well to read up the Facca & Alvarez’s1 roadmap on ‘future internet’. limitations of their own knowledge/stand/tools? I am sure you agree, Useful leads on scenarios and pathways. An equally important read is these are directly relevant for success of science communication; Top Ten Trends Driving Science published by the ACS2. especially when we see science and technology as public policy tools to improve quality of life. Add equity and justice to the equation; only References accessed on 13 March 2017 to make absolutely sure that we mean the business of inclusiveness. 1. Map of technology and business challenges for the Future Missions on environmental quality and eco-system services, alternative Internet Facca & Alvarez (Eds). https://www.fiware. energy; sustainable production and consumption aligned with market org/wp-content/uploads/tabs-img/tab-mundus5/ advantages, water, health and sanitation and innovations provide FutureInternetChallenges_web.pdf some of the best windows of opportunity for this purpose. 2. Top Ten Trends Driving Science http://images.acspubs.org/ Some of the most important tasks that have to be carried out Web/AmericanChemicalSociety/%7B1bd6e100-cd60-4d2d- in India on a priority basis are the following to address the questions a021-a1ca3c43876a%7D_TopTenTrendsDrivingScience.pdf raised: (i) Document experiences/insights on communication with special reference to local relevance for action; (ii) Assess skills and Email: [email protected] n

Editor : R Gopichandran Vigyan Prasar is not responsible for the statements/opinions expressed and photographs used by the authors in their articles/write-ups published in Associate editor : Rintu Nath “Dream 2047” Production : Manish Mohan Gore and Pradeep Kumar Articles, excerpts from articles published in “Dream 2047” may be freely Expert member : Biman Basu reproduced with due acknowledgement/credit, provided periodicals in Address for Vigyan Prasar, C-24, which they are reproduced are distributed free. correspondence : Qutab Institutional Area, New Delhi-110 016 Published and Printed by Manish Mohan Gore on behalf of Vigyan Prasar, Tel : 011-26967532; Fax : 0120-2404437 C-24, Qutab Institutional Area, New Delhi - 110 016 and Printed at Aravali e-mail : [email protected] Printers & Publishers Pvt. Ltd., W-30, Okhla Industrial Area, Phase-II, website : http://www.vigyanprasar.gov.in New Delhi-110 020 Phone: 011-26388830-32. 35 Dream 2047, April 2017, Vol. 19 No. 7 MEMO: Mass Extinction Memorial Observatory Mohd. Sajid Idrisi Global Monument in E-mail: [email protected] fossils of extinct gastropod “Portland Memory of Extinct Species Screw” (Aptyxiella portlandica) that were once abundant on the island. The MEMO as its name suggests is building materials a global monument being built will include popular in memory of extinct the species Portland limestone of our planet. MEMO is to be from the same site a beautiful iconic monument which has actually combining natural history, been the source of architecture and arts aiming fine limestone for at creating awareness about great architectural our degrading biodiversity and works ever since species loss. Stone carvings of 860 Roman times. species that have become extinct Internal cast of a Most of the buildings will find place on the walls of the Portland screwstone in Central London (Aptyxiella portlandica) building. Artist impression of MEMO (© Adjaye Associates) as well as United On geological scale – we from the Jurassic Nations’ building in are living amidst the sixth mass extinction Species extinction is a natural process Portland Stone which New York are built of of plants and animals – the sixth wave of which occurs at the rate of one to five inspired the design Portland stone. extinctions in the past 500 million years. species per year, but the rate at which we are of MEMO Building losing species currently is alarming. According (©The Trustees of Experts estimate the current to David, MEMO the Natural History extinction rate to be between 1,000 would be a journey Museum, London) and 10,000 higher than the natural in which the floor extinction rate. With this alarming is reached by a ‘cut’ into the ground with fact in mind, the Mass Extinction a continuous spiral walkway lined with the Memorial Observatory has been sculptures wrapped around a great central conceptualised and designed to be a chamber – the venue for performances and global species-extinction awareness events – ascending to, and ultimately right centre. through an ‘oculus’ of sky above. At the top MEMO is being constructed is the colossal sea view looking out over Lyme on the Isle of Portland on the south Bay and Chesil Beach stretching away into coast of Britain. The site is a part of the distance. A second spiral winds around Jurassic Coast – a Geological World the exterior of the education centre, which Heritage Site popular for its fossil- is built into the ground looking out to sea. Map: Location of Isle of Portland in UK rich cliffs, which are apparently Accessed from both spirals are interpretation (©Sajid Idrisi, Source: Google Map) 180 million years old. Stones from the same cliffs will be used to carve Mass extinctions in the past were caused due out images of extinct species. The very idea to natural events such as volcanic eruptions, that species could go extinct was discovered asteroid strikes, and various other natural here by Robert Hooke, the surveyor of the calamities, but the current one is purely city of London, who found giant ammonite anthropogenic in nature being caused by fossils in the Portland stone quarried for the human-led habitat loss/fragmentation, rebuilding of London’s public buildings after invasive species introductions, rapid climate the Great Fire of 1666. events, etc. As per IUCN (International Union for Conservation of Nature), out of Architectural Icon our planet’s 76,199 assessed species, 22,413 Designed by British architect David Adjaye, Cross section view of MEMO are in danger of extinction. the design is inspired from the ancient building (©Adjaye Associates) Dream 2047, April 2017, Vol. 19 No. 7 34 MEMO spaces within the very walls. Surrounding scientific discoveries of the early youngest of the Portland strata MEMO will be a new 4-hectare park of Royal Society and the story which is riddled with the fossil species-rich limestone grassland permanently of the rebuilding of London. hollows of Jurassic shellfish. The restored from the quarry. The total cost of The architecture itself will bell will be cast by Taylor’s Bell the project is estimated at £ 30 million (Rs. provide many creative teaching Foundry in Loughborough, UK. 300 Crore approx.) Rising almost 30 metres opportunities – from the lichens The biggest bell in the UK of St. into the air, the building will include an that will grow on it to the role Paul’s Cathedral was also cast by exhibition space, an information centre, and of limestone deposition in the the same foundry. It will also an observatory. global carbon cycle. Like all bear the name of Robert Hooke, “Its creation will provide a global icon limestones, Portland, both stone who first alerted the world to to our need to respect and protect the natural and island, is largely comprised the possibility of extinction. world and will ask in its testament whether of the bodily remains of ancient The project, which is we are worthy of the name we gave ourselves: creatures. slated to be completed by 2019- Homo sapiens — the wise hominid,” says Tim The on-site education 2020, is being supported by Smit, Principal advisor to MEMO project. programmes will mobilise several organisations and people stone carving and all the arts to in different capacities. HRH Global Education Hub interpret the science for all ages. The Duke of Edinburgh is the The basic objective of the project is to create School groups will be invited to Royal Patron. Other Patrons awareness about extinct species and those involve in innovative activities include many leading scientists which are under threat. The structure will such as carving patterns and communicators of science apparently become a focus for educational based on the forms of micro- Hawaiian Haha tree including Professor E.O. Wilson programmes, conservation initiatives, organisms and the geometry of by Harry Brockway and Sir David Attenborough. organic growth, while Portland, 2008 (Source: The principal international all visitors will be MEMO Project) authorities – the IUCN Species invited to mark their Survival Commission, which visit – by carving their initials. “I was deeply moved on learning of this brilliant, profound and ultimately humanitarian enterprise. I believe it can be the seed and soul of a renaissance in public engagement with Some extinct species (Source: Encyclopaedia biodiversity,” says E.O. Wilson, Britannica, Inc., 2008) Professor Emeritus at Harvard exhibitions and conferences and is expected University and MEMO Patron. to attract 300,000 visitors a year. The space enclosed will become a living arena for The Extinction Bell projection and performance, exhibition and One remarkable feature of MEMO building installation, conference and festival with will be a ‘geological’ or ‘extinction’ bell in the mission to inform, educate, and inspire. order to make all future extinctions audible. Schools and various conservation initiatives It will be tolled whenever another species goes will be involved from all over the world. extinct. The bell will be more than 3 metres The ‘epic of evolution’ will be told and the in diameter and weigh 9 tonnes and will be solutions to halting biodiversity loss will be cast the Bronze Age way – from ‘roach’, the Harry Brockway carving the endangered show-cased. Pink Seafan at The Lyme Regis Fossil festival, Extinct species and the reason behind UK 2010 (Source: MEMO Project) their loss will be communicated. For example, the Dodo (Raphus cucullatus), an produces the ‘Red List’; and the Secretariat of extinct flightless bird that was endemic to the UN Convention on Biological Diversity the island of Mauritius in the Indian Ocean – are committed supporters of MEMO became extinct due to over-exploitation as a Project. source of meat by sailors. Other species such as the Passenger pigeon (Ectpistes migrotorius) Mohd. Sajid Idrisi works as Biodiversity lost to overhunting, the golden frog (Atelopus and Natural Heritage Consultant with zeteki) to climate change, and many others. Indian National Trust for Art and Cultural The site will constitute the vast Scale Model for the Memo Bell Heritage [INTACH], Lodhi Estate, New geological picture, with the narrative of (© Norman Lomax) Delhi-110003.

33 Dream 2047, April 2017, Vol. 19 No. 7 Keeping Sports Clean A cat-and-mouse game Subha Sankar Ghosh “I’ve just proven to the World that you can do it clean, with hard work and determination. E-mail: [email protected] I’ve made the sport exciting, made people want to watch the sport”. 199 consecutive weeks, was tested positive —Usain Bolt (Jamaica), winner of 2008 gold medals in Olympics for the banned steroid dexamethasone and was subsequently banned for eight months. “I feel sorry for Ben Johnson. All sportsmen - not all, but maybe 90%, including our Seven-time champion own - use drugs.” Lance Armstrong, who was suspected of — Anonymous Soviet coach, The New York Times, October 1988 using performance-enhancing drugs finally admitted that he took blood booster to win all the championships. Similarly Alberto worldwide recognition, financial security, The above two statements highlights Contador, winner of the , etc., which put immense pressure on the the magnitude of doping in the world of tested positive for the banned anabolic agent participants. As a result many of them sports. . Five-time Grand Slam tennis often cannot resist the lure of using these champion Maria Sharapova was tested miraculous potions while knowing very well Introduction positive for Meldonium, a performance- of the consequences, if caught. The abuse of doping has enhancing drug. World double-sprint The offenders are willing to test been one of the most champion Tyson Gay was suspended for their fate as the dope test is done serious threats to sports. a year after testing positive in 2013 for a randomly by the International have been banned . Narsingh Yadav, Olympic Committee and as used by sportsmen from the Indian wrestler who was selected for such there is always a ancient times. Galen was Rio Olympics, has been banned probability of going a famous Greek physician from competing for the next four scot-free. who was instrumental in years. The Olympics passing on the knowledge Rumours of State have been tainted about magic potions from sponsored doping came to the time and again by the ancient games to the fore with the discovery that athletes who were Romans, praising the effects Hans-Gunnar Liljenwall East Germany has undertaken a caught on charges of of eating herbs, mushrooms dedicated drug regimen to train doping. Hans-Gunnar Liljenwall, and testicles. In the beginning the source of their athletes. In Rio Olympics, a Swedish was the first Olympic stimulants ranged from herbs, mushrooms, there was a call by World Anti- athlete who tested positive for wine potions, hallucinogens, animal parts doping Agency to ban the entire taking performance enhancing like testicles, etc. But the scenario started contingent of Russia on charges drugs at the 1968 Summer changing from last half of 19th century of prolonged doping programme Olympics. As a result he lost his when modern medicines, steroids, hormones for their athletes. and drugs came to the used rampantly by bronze medal. athletes. Initially these synthetic molecules Till the 2012 Summer Olympics, more than 50 athletes have been stripped of their What is doping? were believed to cause no adverse effects on Doping refers to the use of banned medals on doping charges. The top three athletes when taken under expert supervision, performance-enhancing drugs by athletics. offending nations were Russia, USA and but slowly the ugly effects of the same came The use of drugs has been banned by almost Bulgaria whereas the top three controversial to the fore. In spite of knowing the same, the all International sporting organisations sporting events have been weightlifting, popularity for these substances continue to as these drugs have adverse women’s cross country skiing rise because of the effects it could produce. health effects on the athletes. and men’s cycling. In addition it violates the In the recent past, the Doping and Olympics inherent spirit of sports, world was stunned to hear The Olympics is the stage where sports ought namely providing equality about high-profile sportsmen to be played with a spirit of fairness. It is the of opportunity to all the like Ben Johnson, Marion biggest sporting event for any athlete where competitors. In order to Jones and Tim Montgomery winning a medal is a dream come true. A lot keep the sports clean, the who were banned for of factors play in the mind of the participants World Anti-doping Authority doping. Lee Chong Wei, that ranges from corporate sponsorships, (WADA) was set up in 1999. Badminton World No.1 for expectations of sports governing bodies, With the progress of Dream 2047, April 2017, Vol. 19 No. 7 32 Keeping Sports Clean sports science, a myriad of drugs are being example can be given of the UK sprinter How is doping detected? used by athletes. These drugs are so chosen Dwain Chambers who was suspended in The primary objective of the dope test is to that they may help in their respective 2003 for doping. According to him he used test for the presence of banned substances in discipline and may be administered in such to take six different types of banned drugs the biological fluids of the body ie; blood and a manner that they pass undetected during for improving his performance. urine. The athlete who has been selected for doping test. On the other hand, continuous The actions and effects of different dope test is required to submit his/her urine research is going on by scientists of anti- types of drugs vary widely. and/or blood samples only to the authorised doping agencies to catch the defaulters. As As is clear from the above table, personnel under their supervision. such a continuous cat-and-mouse game is these dopes or supplements can do long- In order to avoid any form of being played every day. term damage to athletes. As such a series of contamination, the urine is collected in Broadly the substances have been tests have been formulated by scientists to presence of Doping Control Officer (DCO). categorised into different categories as listed ascertain the cases of doping. The dope tests Similarly the blood sample is collected in below- comprise of collecting urine and/or blood presence of Blood Collection Officer (BCO). The samples so collected are immediately sealed in presence of the sportsman and sent Drug Effect Drug Related Sports to accredited lab for testing. The samples For alertness Amphetamine, Caffeine, Baseball, Basketball, are primarily tested for the presence of Cocaine and other stimulants Boxing, Cycling, stimulants, narcotics, beta-blockers and Judo, Gymnastics . For relaxing blood vessels Alcohol, Beta-blocker, Archery, Diving, The samples are subjected to gas/ Cannabinoids Pentathlon, Shooting Liquid chromatography followed by mass Increased oxygen delivery Protein hormones, Cycling, Marathon, spectrometry. In chromatography, the to tissues Pentathlon, Skiing, resultant chromatogram is matched with the Swimming standardised values to detect the presence Strength and mass Anabolic steroids, Human Sprint events, Throwing, of banned substances in the sample. Gas builders chorionic gonadotrophin, Weightlifting, Football chromatography/Mass Spectrometry is one Luetinising hormone, Human of the most accurate tools for analysing , Insulin samples. Body Weight management Diuretics While on one hand sophisticated For masking doped drugs Epitestosterone, Endurance sports technologies are being employed to identify Plasma expanders, like cycling offenders, continuous research is being taken Secretion inhibitors up by pharmaceutical companies to produce drugs that can evade these tests. It has been Confessions from athletes show that sample of the athlete under supervision. found that the sportsmen involved in doping they take a cocktail of drugs instead of Usually the athletes are selected randomly are employing a host of methods to evade one. As a result, the health impacts of such for the test. detection which include the following. actions can be terrible in the long run. An a) Urine replacement – Specialised kits such as the kit were Drug Effect on the Body developed and sold commercially with the Anabolic agents Acne, Male pattern baldness, Liver damage, stunted growth help of which an athlete can replace his urine including testosterone and puberty in children, increased aggressiveness or “Roid sample with clean urine. Rage”, gynaecological problems, depression, etc. b) Epitestosterone administration – The International Olympic Committee Peptide hormones Hypertension, Heart attack, Pulmonary embolism or checks the level of testosterone by checking its and different types blockage, thyroid disorder, leukaemia, blood cancer, relative presence compared to epitestosterone. of growth factors diabetes, arthritis The standard that has been fixed for T/E is Beta-blocker Muscle cramps, nervousness, nagging headaches, nausea, 4:1. Knowing this fact, the athletes pump muscle cramps their body with epitestosterone and keep the Diuretics Dehydration, muscle cramp, dizziness, drop in blood ratio within acceptable limits. pressure, loss of body coordination c) Diuretics – Different types of Narcotics False sense of invincibility, nausea, vomiting, failure to natural and synthetic diuretics like dandelion recognise injury, decreased heart rate, addiction root, caffeine with fasting, Permacleanse, Glucocorticosteroids Loss of muscle mass, weakening of injured area, decrease in etc., are used to detoxify the body of any body growth of young people traces of substance abuse. Blood doping including Blood clotting, stroke, increased risk of hepatitis and AIDS the use of recombinant human Continued on page 22

31 Dream 2047, April 2017, Vol. 19 No. 7 Extremely Drug Resistant Tuberculosis Ashwini Kumar Dubey E-mail: [email protected] Tuberculosis (TB) is treatable and curable XDR-TB is spread through the air with a course of first-line anti-TB drugs. But as the drug-susceptible TB or MDR-TB. drug. The primary DST was not suitable for if these drugs are mismanaged or misused, TB bacteria are released into the air when testing bacteria strains that were extensively drug-resistant-TB (DR-TB) can develop. the person with TB coughs, sneezes, spits, drug resistant. The secondary test is known However, persons with TB can die if they speaks, or sings. The TB bacteria float for as ‘Bactec MGIT 960 System’ was accurate do not get proper treatment. The vaccine for several hours in the air and a person inhaling but still slow at determining the level of TB commonly known as Bacille Calmette- a small number of these TB bacteria while resistance. A recent study found that a Guérin or BCG is used in some countries to breathing can become infected. XDR-TB is research technique known as direct nitrate prevent severe forms of TB in children. not spread by kissing, touching bed linens reductase assay (D-NRA) showed efficient Extremely drug-resistant tuberculosis or toilet seats, shaking someone’s hand, or accuracy for the rapid and simultaneous (XDR-TB) is a very rare form of TB caused sharing food or drink. detection of resistance to Isoniazid (INH), by TB bacteria that are resistant to some of Rifampicin (RIF), Kanamycin (KAN) and most effective anti-TB drugs. It is defined as Diagnosis Ofloxacin (OFL). D-NRA results were TB that has developed resistance to Isoniazid The diagnosis of XDR-TB bacteria may take obtained in about 17 days, comparably and Rifampicin (resistance to these first line from 6-16 weeks. There is an urgent need less than other drug susceptibility testing. anti-TB drugs defines multi-drug-resistant of new tools for rapid TB diagnosis. The In recent years DR-TB testing has shown tuberculosis, or MDR-TB), and also a lot of progress. The Reverse Line to any member of the quinolone Blot Hybridization Assay (RLBH) is family and at least one of three accurate and takes only three days to second-line anti-TB injectable drugs determine how resistant the particular such as Kanamycin, Amikacin or strain of bacteria is. Capreomycin. The symptoms of XDR-TB are Prevention same as ordinary or drug-susceptible A person can prevent the XDR-TB TB, namely coughing with thick by taking all the medication exactly and cloudy mucous (or sputum) for as prescribed by the doctor or nurse. more than two weeks, sometimes The treatment should be completed coughing up blood, chest pain, fever, at exact time and not to be stopped chills, and night sweats, weight loss, early and doses should not be missed. fatigue and muscle weakness, and Health care providers can help prevent in some cases shortness of breath. A XDR-TB by quickly diagnosing cases, person with such symptoms does not following recommended treatments, necessarily have XDR-TB, but they monitoring patients’ responses, and must see a physician for diagnosis ensuring completion of therapy. On and a treatment plan. the other hand, to prevent getting XDR-TB is to avoid exposure to Causes and transmission XDR-TB drug susceptibility test (DST) is the original known XDR-TB patients in closed or Resistance to anti-TB drugs can occur method used to determine how well the four crowded places. Additionally, personal when the anti-TB drugs are misused and primary anti-TB drugs, namely Isoniazid, respiratory protective devices such as mismanaged. Examples include when Rifampin, Ethambutol and Pyrazinamide covering the mouth and nose are a necessity. patients do not take their TB medicine inhibit the growth of TB bacteria. In the drug An effective disease-control infrastructure is regularly; do not complete their full course susceptibility test the TB bacteria are spread necessary as well for the prevention of XDR- of treatment; do not take all of their doses as plated on an agar medium and the discs TB. Increased funding for research, and prescribed by doctor, or develop the disease containing one of the four primary drugs are strengthened laboratory facilities are much again, after having taken TB medicine in added to the culture plate. After a few weeks required. Immediate detection through drug the past It can also arise if supply of anti- of incubation the plate is examined for any susceptibility testing is vital, when trying to TB drugs is not available; or the drugs are inhibition zone of clearance around the stop the spread of XDR tuberculosis. of poor quality, or health-care providers disks. If there is a clear zone of inhibition, prescribe the wrong treatment, the wrong the drug has inhibited the bacteria and most Continued on page 28 dose, or length of time for taking the drugs. likely the bacteria is not resistant to that Dream 2047, April 2017, Vol. 19 No. 7 30 Coconut: A Wonder food

The coconut (Cocos nucifera) is known as a possibly Panama before 1492, Thereafter, it “wonder-food”. Its Indian name is narial. It gradually spread to all tropical areas of the is a near-perfect diet, as it contains almost all world. It is now widely cultivated in India, Dr. V.H. Mulimani Sri Lanka, Indonesia, E-mail: [email protected] Philippines, East Indies, the west Indies and contains about 400 to 465 ml of water. It islands of the Indian has special properties. and pacific oceans. Total 1. It is pure and hundred percent natural 61 million tonnes of and safe. coconut is grown in nine 2. Tender coconut water is a sterile countries of the world. natural drink with high nutritional The Philippines has value. the maximum coconut 3. It contains less fat compared to milk. production. Coconut It is free from cholesterol. It helps to tree grows abundantly increase good cholesterol (HDL) in along the entire coast of the body. the sea and also thrives 4. It is an excellent tonic for health. The well in loose sandy soil. It water of a single coconut contains can live up to 200 years. sufficient vitamin C to meet daily requirement of the body. High food value 5. It also contains several vitamins of the The coconut is a highly B group. These are niacin, pantothenic nourishing, strengthening acid, biotin, riboflavin, folic acid and and fattening food item. thiamine, as well as pyridoxine in the essential nutrients needed by the human It has high oil content (lauric acid) which traces. body. is easily digestible. It is more easily utilised 6. Coconut water also contains sodium, Experts describe the coconut as not by the body than all other fats. The protein potassium, calcium, magnesium, iron, just a fruit, but a nut and a seed as well – a content of coconut is of high quality, copper, phosphorus, and sulphur. drupe. It has three layers. The outermost containing all the essential amino acids. It is 7. It contains less sodium compared to part of the fruit is green and shining when also rich in potassium, sodium, magnesium, beverages available in the market. tender. It becomes rough after its maturity. and sulphur. The energy value of dried 8. Since tender coconut has high contents It is almost entirely water-proof and very coconut is very high, being 662 calories per of potassium, it aids in dehydration by hard. Beneath this is a thick layer of stout 100 grams. restoring electrolyte balance. fibres, the layer being at times over 25-mm 9. Tender coconut water is good first- thick. Then follows a hard stone-like layer, Coconut water aid home remedy in place of saline about 6-mm thick. The inside of this stony The water of tender green coconut is used transfusion. layer is lined with fairly thick coating of soft, as a beverage and refreshing drink. A one- 10. It contains natural sugar and is tasty. milky-white flesh. The cavity inside the flesh month-old fully grown tender coconut 11. Coconut milk is a rich source of is filled with a watery fluid. It grows on a proteins and is easily digestible. In the tall stately, unbranched tree, with a terminal dilute form, it is good liquid food for crown of leaves growing to a height of 20 to the aged and weak. 30 metres. 12. Massaging the face with coconut milk regularly reliever pimples and prevents Origin and distribution premature wrinkles. Coconut is believed to have originated in the 13. The tender coconut kernel, which is a Indo-Malaya region and to the south west of rich source of enzymes, is beneficial to New Guinea. It was taken to the mainland of diabetics, as it does not have starch. Asia in prehistoric times. There is evidence Tender coconut water is very useful that the coconut was grown in India about in cholera, to prevent dehydration and 3000 years ago. The Vedas describe coconut electrolyte imbalance. When taken with tree as Kalpa-Vriksha or the ‘tree of heaven’, fresh lime juice it restores the electrolyte Coconut reached East Africa, and balance and neutralises the acidosis of the 29 Dream 2047, April 2017, Vol. 19 No. 7 Coconut Coconut: Nutritional facts* and piles. The tender coconut water is also an excellent remedy for flatulence, vomiting Moisture 36.3% Potassium 24.7% and dyspepsia. Protein 4.2% Calcium 40% Ascites is a disease which causes Fat 41.6% Magnesium 15% swelling in the stomach due to fluid Minerals 1.10% Phosphorus 6.3% accumulation. Coconut water is valuable Fibre 3.6% Iron 79% in ascites. The patient should be given two Vitamin B 2.2% or three glassful of coconut water to drink. Carbohydrates 13% Vitamin C 3.7% This quantity may be increased or decreased according to condition and the needs of the Fresh coconut’s calorific value− 444 patient. Dried coconut’s calorific value – 662 The oil extracted from the flesh of ripe *Values per 100 grams edible portion. Source, USDA Nutrient Database. coconut is an effective dressing for burns and scalds. It is of great value in the preparation of ointments as it penetrates the skin readily. secretion of the stomach The tar- like fluid obtained from the red, hot and gives much relief to shell of a ripe coconut is a rubefacient which the patient. Coconut causes reddening and warming of the skin. It oil is a tried and tested is household remedy for ringworm, itch and remedy not only for other skin diseases. hair fall, but is also The coconut is widely used in the helpful in maintaining preparation of many products. The oil is good texture of the hair. the most important of these products. It is There are other benefits used in cooking and also as a hair-restorer too. Application of a and is used as hair oil. Dried coconut is used paste of coconut oil in cooking and in various preparations of and turmeric powder sweets and curries. relieves pain in cracked heels and wounds. Dr. V.H. Mulimani is retired Professor of blood. Coconut water is a known source Digestive system disorders Biochemistry, Gulbarga University Gulbarga, of potassium-rich fluid and beneficial for Tender kernel of coconut is highly beneficial Karnataka state. His area of research includes cholera patients. in the treatment of digestive system disorders. enzymology and nutrition. Mature dried coconut is valuable in the It is valuable in conditions like indigestion, treatment of acidity. Its oil reduces the acid colitis, gastric ulcers, diarrhoea, dysentery

Extremely Drug Resistant Tuberculosis (continued from page 30)

Treatment higher mortality rate compared to MDR-TB. shown that men are more prone to getting The treatment of XDR-TB requires extensive Recent studies have shown that XDR-TB XDR-TB than women. One study showed chemotherapy for up to two years. For XDR- can be treated through the use of aggressive that the male to female ratio was more than TB there is a reduced number treatment regimens. Successful outcome depends on threefold. options and therefore it is associated with a number of factors such as the extent of drug resistance, the severity of the disease XDR-TB and HIV/AIDS and whether the patient’s immune system TB is one of the most common infections is compromised. It also depends on access in HIV/AIDS patients. Where XDR-TB is to laboratories that can provide early and most common, HIV patients are at greater accurate diagnosis so that effective treatment risk of becoming infected with XDR-TB, is provided as soon as possible. compared with HIV negatives, because of their weakened immune system. Risk factors Studies on the effect of age and XDR-TB Ashwini Kumar Dubey, ICMR-SRF have found that individuals who are 65 and working on antimicrobial peptides from up are less prone to getting XDR-TB. A study lactics at Department of Biochemistry and in Japan has found that the younger are at Molecular Biology, Pondicherry University, higher risk of getting XDR-TB. Studies have Puducherry. Dream 2047, April 2017, Vol. 19 No. 7 28 History of Medicine in India Dipayan Pal During the Stone Age, tools that were used prayers were to be offered to placate these E-mail: [email protected] as weapons began to be used for performing superhuman beings who brought diseases surgical operations. In this regard, there are upon mankind. Plants were acknowledged semen). Ayurvedic medicines are mainly extensive archaeological to have healing capacity. It was herbal and are used in a broad range of evidences like the discovery believed that diseases like jwar therapies. The origin of Ayurveda can traced by V.S. Wakankar of (fever) and yaksma (consumption) to the Atharvaveda where several diseases Mesolithic rock paintings had some magical causes whereas are mentioned along with their treatments. in Bhimbekta Rock Caves wounds and other external Atharvaveda even classifies drugs into in Madhya Pradesh that maladies were believed to be two kinds: bhai saj yäni (those which cure portray surgery being due to physical causes. There is diseases) and üyu syäni (drugs which prolong performed on a subject’s evidence that proves that poison life). However, systematic development of head. Psychotherapy was widely used. Elementary ideas Ayurveda began during the 6th century BC occupied a significant of the physiological process, a and continued till 7th Century AD. This place in primitive medical superficial knowledge of anatomy period is known as ‘Samhita period’ when care system. People and simple forms of surgery are several classical works on Ayurveda were believed that diseases were revealed in the Vedic Literature. produced. caused by external agents Indian method of the There are numerous texts on Ayurveda like demons and evil restoration of the nose by Auyrveda which were mainly spirits, and intrinsically plastic surgery, from article In the post-Vedic period, written in Sanskrit the physicians were priests by B.L. to Mr Urban, Indian medicine reached language. The earliest of and magicians. During concerning Cowasjee, a its zenith. During these texts are Sushruta the 3rd Millennium BC, man who had his nose this period, medicine Samhita (compendium developments took place reconstructed with the aid developed on a rational of Sushruta) and Caraka around the course of the of plastic surgery.(Courtesy: platform eliminating Samhita (compendium Indus River that ultimately Wellcome Library, London) mystical and magical of Caraka). These led to the establishment of faith. In Sanskrit, the two texts form magnificent Indus Valley Civilisation. No classical system of Indian medicine is the cornerstone of doubt that some kind of medical system called Ayurveda (science of long life). Ayurveda that have existed, but the scripts of this matured Ayurveda is a medical system which Hortus Indicus Malabaricus survived from ancient civilisations remain undeciphered. So, we has both preventive and prescriptive India. The Caraka know little about the medical practices of aspects. The basic concepts of Ayurvedic Samhita is believed to have been composed the Indus Valley Civilisation. However, the medicine are essentially true for all times. in northwestern India whereas Sushruta Indus Valley Civilisation declined during the In theory, Ayurveda stipulates three Samhita was composed in Benares (now 2nd millennium BC, and the entire populace bodily Dosha or humours (bile, airy element Varanasi). There are several other important migrated to far away villages. and phlegm) and seven bodily components texts that were written later which include During the late 2nd millennium BC, (blood, flesh, chyle, fat, marrow, bone and Bhela Samhita, Astangahrdaya Samhita of Indo-Europeans (Aryans) began to migrate Vagbhata, Bhava-prakasa of Bhavamisra, and to South Asia. Their sacred scripture Sarngadhara Samhita of Madhavakara. written in Sanskrit is called ‘Veda’ (meaning These texts ignited new concepts like knowledge). From the paeans that were rearrangement of medical agenda recited by the hereditary priests (Brahmanas), according to pathological categories, use we can infer that some medical system was of metallic compounds and an idea of prevalent in those days. In unified sense, respiration. there’s nothing called ‘Vedic medicine’. The Both the Caraka Samhita and scene emerges that there were two kinds Sushruta Samhita discuss general ancient of approach to the causes of disease and theories on epidemics, sensorial prognosis, medicine: religious approach and magical pathology, diagnosis, the use of enemas, approach. Several deities were imputed anatomy, therapeutics, pharmaceutics, specific healing powers. People believed proper use of alcohol, etc. They differ that diseases were caused by evil spirits in one major aspect: Sushruta Samhita or by external accidents and rituals and Sushruta, ‘The Father of Surgery’ contains extensive details on surgical 27 Dream 2047, April 2017, Vol. 19 No. 7 History of Medicine in India

war (1789-92), was captured by the forces of Tipu Sultan. As a punishment, his nose and one hand was cut off. One year later, he turned to a man of Brickmakers’ caste to have his face repaired. Two British surgeons in the Bombay Presidency named Thomas Cruso and James Trindlay witnessed the operation and prepared a description of what they had witnessed, together with a portrait of the patient and illustrations of the plastic surgery that was performed by an anonymous brickmaker. The skin graft and nose reconstruction procedure used by the anonymous brickmaker was superior An oculist treating a patient, with to the operations ever performed by an A earpicker, specialist in removing wax, specialist instruments laid out before him. English surgeon. This surgery changed the with his instruments laid out before him. (Courtesy: The British Library, London) very course of plastic surgery in Europe. The (Courtesy: The British Library, London) paradox is that rhinoplasty (plastic surgery of techniques, cataract surgery, plastic surgery nose) operation is not delineated in Sushruta a major practice in Europe till Edward Jenner and removal of foreign bodies whereas Samhita. Whatever contentious evidences discovered vaccination in 1796. There are Caraka Samhita is primarily a foundation may surround this case, this incident clearly also historical evidences that prove the fact of general medicine and has long reflective manifests that surgery was a major medical that the practice of inoculation was brought and philosophical passages. The medicine in practice in the late 18th century in India. to from . In the year 1767, both the texts contains a broad assortment Before the early 20th century, an English surgeon described in a treatise of vegetable, animal and mineral substances. inoculation was widely practised in India that inoculation was widely practised in Caraka stipulates an ‘Oath of Initiation’ that as it was an effective protection against Bengal. There is also some evidence to push can be analogised with the ‘Hippocratic smallpox (masurika). Europeans started the practice of inoculation back further to Oath’. ‘Oath of Initiation’ is taken by a practising inoculation after Lady Mary the year 1718. Again a historical paradox, practitioner of Ayurveda at the beginning Wortley Montague (writer and wife of a as inoculation is nowhere mentioned in of his tutelage. The Ayurvedic physicians are British Ambassador to the Ottoman Empire) the Sanskrit texts but smallpox is certainly called Vaidya. A good vaidya is supposed to returned to England to preach the new acknowledged. have a thorough knowledge of the Sanskrit technique after seeing a woman practising Instances like inoculation and texts and memorise large medical verses on inoculation in Constantinople. This became rhinoplasty clearly depict the fact that three humours, kinds of diseases and their we need to delve deeper into the issues to healing procedures. understand the history of Indian medicine. Sushruta Samhita is well-known for Historians argue that developments have its extensive chapter on surgical techniques. hardly taken place in the field of Ayurveda It demystifies the ways a surgeon should as the two foundation texts (Caraka Samhita be trained and the process of performing and Sushruta Samhita) appear as a timeless an operation. There are also descriptions source of knowledge having no scope for of removal of arrows, suturing, ophthalmic further development. Developments have couching, and analysis of dead human taken place in the domain of diagnostics bodies for the study of anatomy. Sushruta and new prognostic methods have also come even professes that Salyatantra (surgery) is into practice. Ayurveda, which once received the most ancient and coherent of the eight royal patronage, has become a highly branches of medical science. But, there is no popular modern medical system. Apart from strong historical evidence that surgery was Ayurveda, however, there are other medical performed by the vaidyas. systems like Unani system of the Muslims, With the proliferation of the caste Siddha system of Tamils, and Shamanism system, vaidyas resisted surgeries and treated and other folk medicines. by other techniques like massage therapies. There is one kind of ancient medicine However, there is a famous historical event known as astrological medicine. Astrologers that is mostly cited to prove the fact that are supposed to pacify planets and cure Sushruta’s surgery was widely known. In diseases which are influenced by the so- the year 1793, a Maratha named Cowasjee, Anatomical painting with Sanskrit called celestial demons (grahas). They are who had been a bullock-driver with the medical annotation supposed to be able to interpret and solve English Army in the Third Anglo-Mysore (Courtesy: Wellcome Library, London) a person’s problems and also predict an Dream 2047, April 2017, Vol. 19 No. 7 26 History of Medicine in India individual’s future. Grahas are clearly defined (first medical book printed in India) after as celestial bodies in Sushruta Samhita and gathering valuable materials from the local the literature of Indian astrology is known physicians. For the rest of the 17th Century, as Jyotish sashtra. There was a popular belief there was free exchange of ideas between that grahas mainly attack children and the Indians and the Portuguese on medical afflict them with diseases. In the year 1383, treatment. The Dutch East India Company Virasimha composed Virasimhavaloka which was also very much interested in the describes the close connection between traditional medicines of India and showed a astrology and medicine as a remedial system. great deal of regard for the local flora and Till today, Indian astrologers continue to fauna of the Malabar Coast. Heinrich Van charm and pray to supposedly ward off Rheed, administrator of the Dutch East evil influences from one’s life (although India Company, went a step ahead and there is no scientific basis for such a belief). wrote a comprehensive treatise titled Hortus There is another ancient spiritual practice Malabaricus, which deals with the properties known Shamanism where the practitioner is of Indian medicinal plants in Kerala. The supposed to communicate with the spirits to treatise is spread over 12 volumes and was gain information on healing. A person who first published in Amsterdam. believes in evil spirits and devils visit such Then, the British arrived in India practitioners. Shamans even recommend the Medical and Surgical Instruments of to pursue trade which was followed by patients to modern medical clinics if they 19th Century Indian origin. According the establishment of the British East find that curing the disease is out of their to Sushruta there were 101 instruments India Company, informally known a reach. Sudhir Kakar (a psychoanalyst) has classified as either ‘blunt’ or ‘sharp’, but he John Company. Subsequently, East India given us engaging details on the shamanism recognised the main implement as the hand. Company was dissolved in the year 1858 and other folk healers of India. (Courtesy: Science Museum, London) and the administration was taken over by the British crown. Like the Dutch and the Siddha and Unani The Canon of Medicine. Unani medicine Portuguese, the British rulers also faced the In South India, a traditional medical played a very significant role during the same difficulty, i.e., affected by new set of system emanated from Dravidian culture Afghan invasion of Gujarat in the early 11th diseases in India. Naturally, they resorted to where the entire literature is in Tamil Century and developed in leaps and bounds learning the art of oriental medical treatment language. Known as Siddha medicine, it is during the Mughal era. Unani medicine is from the native practitioners. In turn, similar to the Ayurvedic system but has a still very much existent in India and it is native practitioners were highly interested preponderance of use of metals (especially quite intriguing to think that a rudimentary in learning the surgical methods from the mercury) and minerals. Pulse reading and Galenic medicine is still an extant practice. British as they were not accustomed to such urine testing were substantially developed Unani and Ayurveda have greatly methods even though there is a plethora of by the practitioners of the Siddha system. influenced each other as a result of royal information on surgery in Sushruta Samhita. Alchemy is said to have its origin in the patronage. It is surmised that Sultan Alaudin Later, we find that the attitude of the British Siddha system, which aims to transform Khilji had several notable hakims (Muslim towards the traditional medicine changed. man both physically and spiritually. Among physicians) in his court. So, it is quite evident With the introduction of Lord Bentinck’s the practitioners of Siddha, Ramadevar in that the development of Unani medicine in educational reforms in 1935, support for his work on Alchemy titled Cunnakandam India as well as Unani literature was possible Ayurvedic training and teaching of oriental mentions that he travelled to Mecca, assumed with the help of Ayurvedic physicians. There medicine in state-funded colleges ceased the name of Yakub and taught the Arabians are Sanskrit texts on Unani even though the though the oriental practitioners continued the art of alchemy. With the introduction of prime languages of Unani are Arabic and to practise. As early as the 1860s, people of modern medicines, Siddha medicine has lost Persian. For example, during 18th Century, Bengal had forced the Medical Department its popularity, but there are a large number the devout Hindu scholar Mahadevadeva of the Bengal Presidency to introduce a of people who still prefer Siddha medicine wrote Hikmatprakasa, dealing with Unani new policy, to prescribe traditional Indian for curing a few diseases like jaundice and medicine in Sanskrit. Ayurveda stipulates medicine where it is possible. chikunguniya. three humours whereas Unani stipulates four. During the Indian independence With the inception of Delhi Sultanate, The main difference is that Unani physicians movement (especially during the Swadeshi a medical practice named ‘Unani tibb’ (where medicate Muslim patients whereas Ayurvedic and Boycott Movement), traditional tibb means medicine) was brought to India. physicians medicate Hindus. medicines received inviolable support from Unani is a traditional medical system which is the Indian masses, especially from the based on the teachings of the Greek physician First medical book printed in India nationalists. Since India got independence Galen and is considerably interpreted by Ibn With the establishment of the Portuguese in 1947, the government has shown interest Sina (a Persian polymath who is regarded as East India Company in Goa (1628–1633), in the development of both cosmopolitan one of the most prominent thinkers of the Garcia d’Orta penned Colóquios dos simples Islamic Golden Age) in his Magnus opus e drogas he cousas medicinais da Índia Continued on page 19

25 Dream 2047, April 2017, Vol. 19 No. 7 Knowing about Piles— Symptoms, Causes and Diagnosis Dr. Yatish Agarwal Known in common parlance as piles, haemorrhoids are enlarged Many times, the symptoms E-mail: [email protected] and swollen veins in or around the anus and rectum. Located in of haemorrhoids clear up on their the lowest part of the back passage, the haemorrhoidal veins swell own. Often they respond to simple treatments that can be bought so that the vein walls become stretched, thin, and irritated by from a pharmacy without a prescription. However, if your symptoms passing bowel movements. They may make going to the toilet don’t get better or you experience pain or bleeding, never neglect to uncomfortable and also cause rectal pain and bleeding. speak to a doctor. Some people with haemorrhoids feel hesitant to consult a doctor because of the peculiar part of the anatomy they occur in. However, that should not be the case. The embarrassment is completely misplaced. Most importantly, you must tell the doctor about all of your symptoms – for example, tell the doctor if you’ve recently lost a lot of weight, if your bowel movements have changed, or if your stools have become dark or sticky.

Haemorrhoids are very common. Approximately 50 per cent How the doctors diagnose piles of people experience them at some time in their life. Anyone at any A doctor can often diagnose haemorrhoids by just doing a simple age can be affected by them; but they are more commonly found internal examination of the rectum. in elderly people and in women during pregnancy. Rectal examination Recognising the symptoms The doctor may examine the outside of the anus to see if a person In many cases, haemorrhoids don’t cause symptoms and some has visible haemorrhoids. Next, he is likely to carry out an internal people don’t even realise they have them. However, when symptoms examination. The simplest being a digital rectal examination. do occur, they may include: Some people are sensitive about having a rectal examination • bleeding after passing a for religious or cultural reasons. Equally, some may prefer a rectal stool – the blood is usually examination be carried out by a doctor of the same sex, or a patient may bright red want to have a friend or relative present during the examination. Let • a lump hanging down the doctor know in advance if you have any particular preferences. outside of the anus, which may need to be pushed The procedure back in after passing a stool Before having a rectal • a mucus discharge after passing a stool examination, the doctor • itchy bottom will explain the procedure • soreness, redness and swelling around the anus to you. You’ll be asked to • discharge of mucus subsequent to passing a stool remove your lower clothing • feeling as though your bowels are still full and need emptying and lie on a couch, on your Haemorrhoids aren’t usually painful, unless they get trapped left side, and to bring your in the anal sphincter and their blood supply slows down or is knees up towards your chest. interrupted. The doctor will begin by making a careful visual examination of Haemorrhoids are the main cause of anal bleeding. Faced the anus. They’ll look for any abnormalities, such as swollen blood with anal bleeding and/or rectal pain, it is best never to neglect vessels around the anus or rectum. these symptoms. Even though haemorrhoids are rarely dangerous, a Once he’s through with the inspection, he will put a glove on definite diagnosis from a doctor is essential. Very rarely, haemorrhoids one hand and use a gel to lubricate one of his fingers. eH will gently can hide a life-threatening condition, such as colorectal cancer. push the finger into oury bottom and then up into your rectum. You may feel a little discomfort or pain at this stage of the examination. Seeking medical advice During the rectal examination, you may be asked to squeeze If you are faced with persistent or severe symptoms suggestive of your rectum around the doctor’s finger so that he can assess how well haemorrhoids or suffer from rectal bleeding, always consult a the muscles in your rectum and bowels are working. doctor without any delay. You could see your family physician, a A rectal examination will usually take one to five minutes general surgeon or colorectal surgeon. This is essential because to complete, depending on whether your doctor finds anything these symptoms may sometimes hide a potentially more serious unusual. Once the rectal examination is done, the doctor will gently condition. remove his finger from your anus. There may be a small amount Dream 2047, April 2017, Vol. 19 No. 7 24 Mediscape of bleeding from your rectum, particularly if you have haemorrhoids. Second degree haemorrhoids Do not fret over it. Second degree haemorrhoids are larger swellings that may come out of the anus when a person goes to the toilet, before disappearing Proctoscopy inside again. In some cases, further internal examination using a proctoscope Third degree haemorrhoids may be needed. A proctoscope is Third degree haemorrhoids are one or more small soft lumps that a thin, hollow tube with a light hang down from the anus and can be pushed back inside; the so- on the end that’s inserted into called prolapsing and reducible piles. the anus. This allows the doctor to see the entire anal canal and Fourth degree haemorrhoids identify the haemorrhoids and Fourth degree haemorrhoids are larger lumps that hang down from their severity. the anus and can’t be pushed back inside; they are thus irreducible. It’s useful for doctors to know what type and size of haemorrhoid Types of haemorrhoids you have, as they can then decide on the best treatment. Once your doctor has carried out a rectal examination or proctoscopy, he will be able to determine the type of haemorrhoids you suffer What causes haemorrhoids? with. The exact cause of haemorrhoids is unclear, but they’re associated Haemorrhoids can develop internally or externally. Internal with increased pressure in the blood vessels in and around the anus. haemorrhoids develop in the upper two-thirds of the anal canal, This pressure can cause the blood vessels in the back passage to while external haemorrhoids develop in the lower third, closest to become swollen and inflamed. the anus. The nerves in the lower part can transmit pain messages, The following factors have been found to increase a person’s while the nerves in the upper part can’t. risk of developing haemorrhoids:

Internal haemorrhoids Family history of haemorrhoids Internal haemorrhoids lie far enough inside the rectum that you can’t Though it is still not known how exactly this happens, but having a see or feel them. They don’t usually hurt because there are few pain- family history of haemorrhoids, increases your risk of being affected sensing nerves in the rectum. Bleeding may be the only sign that with the disease. they exist. Sometimes internal haemorrhoids prolapse, or enlarge and Constipation Many cases of haemorrhoids are thought to be caused by too much protrude outside the anal sphincter. If so, you may be able to see or straining on the toilet as a result of prolonged constipation. This is feel them as moist, pink pads of skin. Prolapsed haemorrhoids may often caused by a lack of fibre in a person’s diet. hurt because they become irritated by rubbing from clothing and sitting. They usually recede into the rectum on their own; if they don’t, they can be gently pushed back into place. Obesity Being overweight or obese increases the pressure on your pelvic blood vessels, causing them to enlarge and become haemorrhoidal. External haemorrhoids External haemorrhoids lie within the anus and are often Pregnancy uncomfortable. If an external haemorrhoid prolapses to the outside, When you’re pregnant, the growing baby can place increased pressure you can see and feel it as a lump hanging down outside of the anus. on your pelvic blood vessels, causing them to enlarge. The pregnancy This usually happens in the course of passing a stool. hormones also make your veins relax causing them to enlarge and Blood clots sometimes form within prolapsed external swell. These piles due to pregnancy usually go away within weeks haemorrhoids, causing an extremely painful condition called a after you have given birth. thrombosis. If an external haemorrhoid becomes thrombosed, it can look rather frightening, turning purple or blue, and could possibly Age bleed. Despite their appearance, thrombosed haemorrhoids are As you get older, your body’s supporting tissues get weaker, and this usually not serious and will resolve themselves in about a week. If the may increase your risk of haemorrhoids. pain is unbearable, the thrombosed haemorrhoid can be removed with surgery, which stops the pain. Conditions that increase abdominal pressure Those individuals, who sit down for long periods of time, suffer A measure of severity with a persistent cough or repeated vomiting, or regularly lift heavy Depending on their size and severity, surgeons further classify objects, and experience an increase in abdominal pressure are at an haemorrhoids into the following categories: increased risk of developing haemorrhoids.

First degree haemorrhoids Chronic diarrhoea First degree haemorrhoids are small swellings that develop on the Chronic long-term diarrhoea can also make a person more vulnerable inside lining of the anus and aren’t visible from outside the anus. to getting haemorrhoids. 23 Dream 2047, April 2017, Vol. 19 No. 7 Mediscape Self-care measures This can help prevent constipation, and reduce your chances of Some basic lifestyle changes can help reduce the strain on the rectal developing haemorrhoids. and anal blood vessels and help ease the symptoms. Toilet training Dietary changes When going to the toilet, you should avoid straining to pass stools, If constipation is thought to be the cause of your haemorrhoids, as it may make your haemorrhoids worse. You must also not delay you need to keep your stools soft and regular so you don’t strain going to the toilet – ignoring the urge to empty your bowels can when going to the toilet. You can do this by gradually increasing make your stools harder and drier, which can lead to straining when the amount of fibre in your diet. Good sources of fibre include you do go to the toilet. These measures can also reduce the risk of wholegrain rice, wholegrain bread, pulses and beans, seeds, nuts haemorrhoid recurrence. and oats, and fruit and vegetables. You must also drink plenty of fluid – particularly water. You must avoid the use of medications that cause constipation – such as painkillers that contain (Next month: Cures for haemorrhoids: codeine. Home treatments and surgeries)

Losing weight if you’re overweight Prof Yatish Agarwal is a physician and teacher at New Delhi’s Eat frugally and exercising regularly can help you lose weight. Safdarjung Hospital. He has authored 47 popular health-books. n

Keeping Sports Clean – A cat-and-mouse game (continued from page 31)

d) Blood transfusion – Athletes blood the body, it is virtually impossible to bring by Government of India on 24 November dope by either using blood transfusions or the biomarkers to their normal levels. As 2005. These bodies are responsible for specific drugs to increase their red blood cell such, ABP is considered to be the latest tool devising anti-doping rules, revising the same count (haemoglobin). When they transfuse against doping. from time to time. In addition, extensive blood into their bodies, they can re-infuse The ABP program involves monitoring awareness programme is being conducted by their own blood (autologous) or use blood of selected biological parameters of an athlete them to make athletes aware of the different from another person who serves as a donor over time that may indirectly reveal doping aspects of doping and the need to keep the (homologous). over time. The longitudinal profile of the sports clean. athlete is generated and monitored. Any Emergence of ABP Program sudden abnormality in the same indicates Conclusion With the advent of designer drugs, a possible case of doping. At present three True sports aims to recognise true talents. For recombinant proteins, peptides, biosimilars different modules can be tested, namely doing the same a series of effective steps are (drugs designed to have active properties Haematological module for testing blood required to be taken. While on the one hand similar to one that have previously been doping; Steroidal module to detect anabolic extensive awareness program may be carried licensed), etc., that are strikingly similar agents; and Endocrinological module for out for sportsmen and related officials, strict to natural substances that are produced in detecting growth hormone and insulin vigilance is also required out to catch the the body, it becomes exceedingly to detect growth factor-1 (IGF-1). Of the three, the defaulters and exemplary punishments need the same using the conventional analytical Haematological Profiling method has been to be awarded to the defaulters. In short, a methods. As a result, a new form of dope test accepted on a broader scale. sense of fear must be instilled among the has come to the fore - it is famously known Even though sceptics raise some athletes. Even though there has been a steady as Athlete Biological Passport program questions regarding the universal acceptance effort to evade the dope test by employing which has been developed by World Anti- of this technology, the ABP program is a real unscrupulous ways, it is the challenge for doping Agency, WADA. big step to combat the menace of intelligent the sports researchers to tackle the same. So Human body maintains a relatively doping. It is a good complement of the the need of the hour is to go for continuous stable level for different parameters like traditional methods where the aim is to upgradation in the testing methods which haematological values (haemoglobin, detect the drug. As such a combination of may guarantee cleaner sports for everyone haematocrit, red blood cell count, mean both these methodologies may go a long way to enjoy. corpuscular haemoglobin concentration, to establish the spirit of Sports. etc.). ABP is based on the principle that if Subha Sankar Ghosh is M.Phil in any booster substance is taken by an athlete, Anti-doping agencies Life Sciences and working as a project it will result in some kind of a physiological The World Anti-doping Agency (WADA) was coordinator, Digha Science Centre under change. The same will be reflected if vital established after the first World Conference National Council of Science Museums. parameters called biomarkers are identified on Doping in Sports. The conference was He is a science communicator and popular and tested. Even though it may be possible held at Lausanne, . The National science writer. for the athlete to flush out the drug from Anti-doping agency (NADA) was established Dream 2047, April 2017, Vol. 19 No. 7 22 Recent Developments in Science and Technology Biman Basu Stable helium compound formed under sufficient pressure, form metastable E-mail: [email protected] Helium has been known to be the noblest compounds, but helium has always pressure, most recently hydrogen wherein among the noble gases – a six-member remained stubborn. Helium can form van scientists claim to have made its metallic group of elements in the periodic table that der Waals molecules – very weakly bound form. The new sodium-helium compound do not react easily with other elements. clusters of atoms or molecules, at extremely has been shown to be a highly insulating solid low temperatures – but they cannot – an electride. Electrides are something of a be sustained for long and are not chemical curiosity. They are ionic materials considered true stable compounds. within which electrons act as anions and they The recent breakthrough was find roles in catalysis and as reducing agents predicted by a team led by Artem in organic synthesis. They have been shown Oganov of Stony Brook University, both theoretically and experimentally to exist New York, USA. They used a ‘crystal in several materials at high pressures. structure-predicting’ computer model The new helium compound has been that suggested at least two helium hailed as a breakthrough that may change

compounds are possible – Na2He and many of our old chemistry assumptions. The

Na2HeO. Subsequently, researchers team now plans to synthesise a compound from China, Russia, and the United of sodium, helium and oxygen, which has States came together to see if they been predicted to be possible. According to could make the first of these, using a Oganov, the next step is to make Na2HeO. diamond anvil to apply high pressure. This compound, he says, is stable at a very A team led by Xiao Dong, working moderate pressure of 15GPa, and if the in the laboratory of Artem Oganov, researchers find a way to lower the pressure Microphotograph of the diamond anvil cell succeeded in synthesising a sodium- to 3-5GPa or so, this compound could be high-pressure cavity used to create Na He 2 helium compound using a diamond used for storing helium. light at 140 GPa after laser heating to more anvil cell to apply the requisite high than 1,500 kelvins. The sample consists of pressures – about 113GPa (gigapascals), Lost continent discovered mixture of Na and Na He. (Credit: Xiao 2 which is more than a million times the under Indian Ocean Dong et al., doi: 10.1038/nchem.2716) normal atmospheric pressure (Nature Many of us have heard about the legendary Chemistry 6 February 2017 | DOI: lost continent of Atlantis although no real Helium is the least reactive element on the 10.1038/nchem.2716). Atlantis has ever been found. But now periodic table thanks to its full outer shell. Diamond anvil cells have been used scientists have discovered remains of a real Conventional wisdom states that noble gases to study many chemicals under extreme ‘lost continent’ which they say lay submerged cannot interact with other atoms to create under the Indian Ocean. It has been officially stable compounds. However, till recently, named Mauritia, which the scientists except helium all the other noble gases believe was a microcontinent that was once – neon, argon, krypton, xenon and radon – sandwiched between India and Madagascar were known to combine with other elements as the supercontinent of Gondwanaland to form compounds. Now helium appears to broke up, some 184 million years ago. It have joined the same category. Scientists have is believed that around 85 million years reported creating what appears to be a stable ago Mauritia (roughly a quarter the size of helium-sodium compound, challenging modern Madagascar) existed after the break- some of the most basic assumptions of up of Gondwanaland. As other landmasses, modern chemistry. namely India, Madagascar and Africa Helium is the second most abundant continued to drift apart, Mauritia was pulled Crystal structure of Na He: Purple spheres element in the universe, after hydrogen, and 2 into pieces – breaking up and sinking beneath represent sodium atoms, which are inside makes up a large proportion of stars and the waves, which have now been discovered. the green cubes that represent helium atoms; gas giants. The element has an extremely According to the new results, the break-up the reddish-brown regions inside voids of stable closed-shell electronic configuration, of Gondwanaland did not involve a simple zero electron affinity and an extremely high the structure show areas where localised splitting of the ancient supercontinent, but ionisation potential. It has been known since electron pairs reside. (Credit: Xiao Dong rather, a complex splintering took place with the 1960s that the heavier noble gases will, et al., doi: 10.1038/nchem.2716) “fragments of continental crust of variable 21 Dream 2047, April 2017, Vol. 19 No. 7 New Horizons

India and Australia. The break- of food poisoning. Usually, most people get up was caused by the geological better without treatment. But, Salmonella process known as plate tectonics can cause more serious illness in older – a process that keeps the ocean adults, infants, and persons with chronic basins in continuous motion and diseases. Recently an international team moving between 2 cm and 11 cm of researchers led by Jin Hai Zheng, from per year. Continents ride on the Chonnam National University Hwasun plates that make up the ocean Hospital in Jeonnam, South Korea have floor, which causes the movement managed to turn this dangerous bacterium of the continents. into a life-saver by making it infiltrate According to Ashwal, tumours and marking the cancer cells up to “Discovering new pieces of the body’s immune defences, making them Mauritia is the name given to the proposed ‘lost continent,’ continent will help geoscientists a target for attack. Of course, the scientists whose remains may exist today beneath the Indian Ocean. to understand the details of used genetically modified Salmonella, which Scientists picture it as a microcontinent that broke away how continents break apart, and is a million times less potent than the version as what is now India and Madagascar separated some 60 how the pieces can be better of the bacterium that causes food poisoning. million years ago. (Credit: Nature Communications) reconstructed to their pre- In other words, it a very safe strain and does breakup configurations. This not seem to cause any systemic inflammation sizes left adrift within the evolving Indian could, for example, be used as an important or toxicity in internal organs. In trials with Ocean basin”. exploration tool for mineral deposits”. mice transplanted with human colon cancer The first clue to the possibility of cells, more than half the animals were the existence of a lost continent came from Dangerous bacteria turned completely cured without any side effects samples of zircon almost 3 billion old years into cancer fighter (Science Translational Medicine 8 Feb 2017 | found in lava-coated pieces of the ancient Cancer is any malignant growth or tumour DOI: 10.1126/scitranslmed.aak9537). landmass recovered off the coast of Mauritius caused by abnormal and uncontrolled The team discovered the possibility of by a research team led by Lewis Ashwal cell division. The immune system of our using Salmonella for cancer immunotherapy of the University of the Witwatersrand, body can fight infections because it identifies accidentally while working on unrelated Johannesburg, South Africa. Zircons are pathogens as ‘foreign’ and destroys them. But research in which they noticed that the minerals found in rocks spewed up by lava our immune system cannot destroy cancer bacteria that attacked shellfish produced during volcanic eruptions and occur mainly cells. This is because, with some major a protein called ‘FlaB’ that caused a strong in granites from the continents. They exceptions, cancer cells generally have all immune response. This led them to contain trace amounts of uranium, thorium of the same antigens as the rest of our cells, genetically modify the common Salmonella and lead, and since they survive geological so any immune cells that would have been bacteria so that it, too, would produce the process very well, they contain a rich record activated by their antigens are not around same protein – and stimulate the immune of geological processes and can be dated to react. Several research groups have been system into action. extremely accurately. According to Ashwal, looking into the possibility of training our It has been known for some time that the sample of zircon found were far too old immune system into attacking cancer cells, certain types of bacteria, including strains to have originated on the relatively young or cancer immunotherapy. of Salmonella, are able to grow in cancerous island of Mauritius, which is believed to be Salmonella is a rod-shaped anaerobic tumours but not in normal tissues. But until no more than 9 million years old. According microbe notorious for causing most cases now, attempts to use bacteria as anti-cancer to the researchers, the discovery of therapies have had only limited zircons of this age proves that there success, both in the laboratory and in are much older crustal materials the clinic. The current work by Zheng under Mauritius that could only have and colleagues therefore represents a originated from a continent (Nature fascinating new approach to using Communications, 31January 2017 | bacteria to fight cancer. DOI: 10.1038/ncomms14086). It must, however, be mentioned The story goes back to here that the modified bacteria do not more than 184 million years ago kill cancer cells directly; they only when the supercontinent called trigger the immune system to mount Gondwanaland started breaking an attack on the tumour. There up. The supercontinent existed have been previous studies that have more than 200 million years ago looked at using bacteria to carry anti- and contained rocks as old as 3.6 Genetically modified Salmonella is a million times cancer drugs into tumours. But this billion years old, before it split up less potent than the version of the bacterium that is the first time scientists have used into what are now the continents of causes food poisoning, but can make cancer cells bacteria to trigger the body’s own Africa, South America, Antarctica, prone to attack by the body’s immune system. immune response to combat cancer. Dream 2047, April 2017, Vol. 19 No. 7 20 New Horizons

Encouraged by the success of animal trials large thickness. According the team is now seeking funding for clinical to the researchers, walls of trials on humans. such thickness are not found even in historic times when Harappans built the earliest the conflicts have been more tsunami-protection wall common and the weapons The Harappans who lived around 5,000 have become increasingly years before present may have been aware of more destructive. The wall the devastation caused by tsunami. This has thickness at Dholavira exceeds been revealed in a recent study by a group the functional (protection of marine archaeologists of CSIR-National from Harappan weapons, Institute of Oceanography (NIO), Goa at the namely sling shots/bow ancient port town of Dholavira in Kuchchh, arrow) and investment (in The remains of the magnificent Northern wall of Gujarat. Dholavira was the largest port-town terms of material and labour Dholavira that is believed to have been built as a of the Harappans, and is the second largest involved at the times of protection against storm surges and tsunamis. Harappan site located within the present limited resources) limits of borders of India. According to archaeologists, military protection. Moreover, discovery of to the scientists, Dholavira site has the first it was perhaps the best planned Harappan city gunpowder and its introduction in India was evidence of tsunami-protection wall in the with several divisions and many new features much later than the timing of the Dholavira world (Current Science, 25 December 2016 | settlement. There must have been doi: 10.18520/cs/v111/i12/2040-2043). other reasons. According to Rajiv Nigam of NIO The real purpose of the who led the team, study of oceanography Dholavira wall has been a topic showed that Makkran coast that was close of considerable debate. After to Bhuj was a highly tsunami-prone area examining the wall closely and and their research study indicated that the surveying a hitherto unexcavated earliest recorded tsunami in the region was area using Ground Penetrating about 8,000 years old. The structure of the Radar (GPS) and systematically Dholavira wall is similar to that of 400- collecting soil samples, the CSIR- kilometre ‘sea-wall’ that Japan is said to have NIO team has come to the started last year, although given the use of conclusion that the thick wall was concrete material these days the width of the built to protect the town from sea-wall would be 12 metres, but the idea is Location of Dholavira in Great extreme oceanic events such as storm the same. It means our Harappan ancestors Rann of Kuchchh, Gujarat. surges and tsunamis. Dholavira, were aware of tsunami and succeeded in being close to the sea could have creating a defence to it. hitherto unknown. This well-planned urban been vulnerable to oceanic calamities. There settlement flourished for about 1,500 years is a traditional history of tsunami waves and Biman Basu is a former editor of the from about 5000 to 3450 BCE. strong storms hitting the Gujarat coast. The popular science monthly Science Reporter, Archaeological excavations show a coastal geomorphology of Kuchchh region published by CSIR, He is a winner of the unique feature of Dholavira – the presence indicates that inland portions of the coastline 1994 ‘NCSTC National Award for Science of a 14-18-metre thick wall, apparently have features which amplify the effect of Popularisation’. He is the author of more built as a protective measure. The most tsunami waves when they get coupled with than 45 popular science books. intriguing feature of the wall is its unusually high tide, thus becoming fatal. According

History of Medicine in India (continued from page 25) and traditional medicines. The Chopra traditional medicines in the rural areas due Century and is still advancing at an report of 1948 declared that “Science is to the social problem of poverty. Today, there exponential rate. Today, there is a plethora Universal” and stressed the need of bringing are several government-funded institutions of medical facilities available and a patient all the healing traditions together. In the providing professional courses in Ayurveda. can take any of the many available paths to post-independence period, our leaders After graduating from such institutions, cure his/her illness. emphasised on science and unity which students can run clinics or be employed at were of paramount importance. As a result, Primary Health Care Centres. Dipayan Pal is an independent researcher. the government recognises Ayurveda in its In conclusion, it can be said that His main research interest includes History health policy. Cosmopolitan medicines medical science in India has developed of Science and Technology. He often writes have not been very successful to overhaul the in leaps and bounds during the late 20th for newspapers and magazines. 19 Dream 2047, April 2017, Vol. 19 No. 7