Transdermal patch collage

How To Apply a Transdermal Patch like Lidocaine, Nicotine, Exelon, etc

How To Apply a Transdermal Patch

How to Use Transdermal Patches from

    1Read the patient information for use before using your patch. Each product will have specific instructions for use. 1 Application instructions
 2Wash your hands.  2 Application instructions
 3Select an area of skin to apply the patch. Be sure to follow any specific instructions provided by your doctor or the product instructions as to site selection or rotation. Prepare the skin area and make sure the skin is clean and free of any powders, oils, and lotions.  3 Application instructions
 4Carefully open the packaging.  If using scissors, be careful not to cut the patch. Never use a patch that has been cut or damaged in any way.  4 Application instructions
 5Remove the protective liner according the product directions. Be sure not to touch the sticky side of the patch. Some protective liners are removed in two parts. If so, place the sticky half of the patch on the area of skin and gently peel off remaining liner.  5 Application instructions
 6Press down on the patch firmly with the palm of your hand.
 7Go around the edges with your fingers to press them onto the skin. Make sure that the patch is flat against the skin (there should be no bumps or folds in the patch).  7 Application instructions
 8Throw away the empty pouch and the protective liner in a closed trash can.
 9Wash your hands.  9 Application instructions
 10When it is time to remove the previous patch, use your fingers to peel it off slowly. Fold the patch in half with and press firmly to seal it shut.  10 Application instructions
 11Throw the used patch away in a closed trash. Used patches may still contain some medication and may be dangerous to children, pets, or adults.  11 Application instructions
 12Wash your hands.  12 Application instructions
 13Ask your doctor what to do if the patch loosens or falls off before it is time to replace it. Generally, you should try to press it back in place with your fingers. If the patch cannot be pressed back on, throw it away and apply a fresh patch to a different area. Replace the fresh patch at your regularly scheduled patch change time.

NINDS Neuromyelitis Optica Information Page

Information about Neuromyelitis Optica from the National

Institute of Neurological Disorders and Stroke (NINDS)


NMO or Devic Disease

Devic’s Syndrome

Table of Contents (click to jump to sections)

What is Neuromyelitis Optica ?



Neuromyelitis optica (NMO) is an uncommon disease syndrome of the central nervous system (CNS) that affects the optic nerves
and spinal cord. Individuals with NMO develop optic neuritis, which causes pain in the eye and vision loss, and transverse
myelitis, which causes weakness, numbness, and sometimes paralysis of the arms and legs, along with sensory disturbances and
loss of bladder and bowel control. NMO leads to loss of myelin, which is a fatty substance that surrounds nerve fibers and
helps nerve signals move from cell to cell. The syndrome can also damage nerve fibers and leave areas of broken-down tissue.
In the disease process of NMO, for reasons that aren’t yet clear, immune system cells and antibodies attack and destroy myelin
cells in the optic nerves and the spinal cord.

Historically, NMO was diagnosed in patients who experienced a rapid onset of blindness in one or both eyes, followed within
days or weeks by varying degrees of paralysis in the arms and legs. In most cases, however, the interval between optic neuritis
and transverse myelitis is significantly longer, sometimes as long as several years. After the initial attack, NMO follows
an unpredictable course. Most individuals with the syndrome experience clusters of attacks months or years apart, followed
by partial recovery during periods of remission. This relapsing form of NMO primarily affects women. The female to male ratio
is greater than 4:1. Another form of NMO, in which an individual only has a single, severe attack extending over a month or
two, is most likely a distinct disease that affects men and women with equal frequency. The onset of NMO varies from childhood
to adulthood, with two peaks, one in childhood and the other in adults in their 40s.

In the past, NMO was considered to be a severe variant of multiple sclerosis (MS) because both can cause attacks of optic
neuritis and myelitis. Recent discoveries, however, suggest it is a separate disease. NMO is different from MS in the severity
of its attacks and its tendency to solely strike the optic nerves and spinal cord at the beginning of the disease. Symptoms
outside of the optic nerves and spinal cord are rare, although certain symptoms, including uncontrollable vomiting and hiccups,
are now recognized as relatively specific symptoms of NMO that are due to brainstem involvement.

The recent discovery of an antibody in the blood of individuals with NMO gives doctors a reliable biomarker to distinguish
NMO from MS. The antibody, known as NMO-IgG, seems to be present in about 70 percent of those with NMO and is not found in people with MS or other similar conditions.


NMO Antibody test

Is there any treatment?

There is no cure for NMO and no FDA-approved therapies, but there are therapies to treat an attack while it is happening,to reduce symptoms, and to prevent relapses. Therapies used in the U.S. include a corticosteroid drug (methylprednisolone)to stop the initial attack, immunosuppressent drugs such as mycophenolate mofetil (CellCept) and azathioprine (Imuran), andthe monoclonal antibody ritixumab (Rituxan). If frequent relapses occur, some individuals may need to continue a low doseof steroids for longer periods. Plasma exchange (plasmapheresis) is a technique that separates antibodies out of the bloodstream and is used with people who are unresponsive to corticosteroid therapy. Pain, stiffness, muscle spasms, and bladderand bowel control problems can be managed with the appropriate medications and therapies. Individuals with major disabilitywill require the combined efforts of occupational therapists, physiotherapists, and social services professionals to address their complex rehabilitation needs.


What is the prognosis?


Most individuals with NMO have an unpredictable, relapsing course of disease with attacks occurring months or years apart.
Disability is cumulative, the result of each attack damaging new areas of myelin. Some individuals are severely affected by
NMO and can lose vision in both eyes and the use of their arms and legs. Most individuals experience a moderate degree of
permanent limb weakness from myelitis. Muscle weakness can cause breathing difficulties and may require the use of artificial
ventilation. The death of an individual with NMO is most often caused by respiratory complications from myelitis attacks.


What research is being done?


The National Institute of Neurological Disorders and Stroke (NINDS) conducts research related to NMO in laboratories at the
NIH and also supports additional research through grants to major medical institutions across the country. Much of this research
focuses on finding better ways to prevent, treat, and ultimately cure rare neurological syndromes such as NMO.


NIH Patient Recruitment for Neuromyelitis Optica Clinical Trials


Column1 Column2
Multiple Sclerosis Foundation
6520 North Andrews Avenue
Ft. Lauderdale,
http://www.msfocus.orgTel: 954-776-6805
888-MSFOCUS (673-6287)Fax: 954-351-0630
National Eye Institute (NEI)
National Institutes of Health, DHHS
31 Center Drive, Rm. 6A32 MSC 2510
http://www.nei.nih.govTel: 301-496-5248
National Organization for Rare Disorders (NORD)
55 Kenosia Avenue
http://www.rarediseases.orgTel: 203-744-0100
Voice Mail 800-999-NORD (6673)Fax: 203-798-2291

Publicaciones en Español

Prepared by:

Office of Communications and Public Liaison

National Institute of Neurological Disorders and Stroke

National Institutes of Health

Bethesda, MD 20892

NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by
or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice
on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined
that patient or is familiar with that patient’s medical history.

All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.

Last updated June 4, 2014


Be Physically Active

Nutritional requirements in old age

Nutritional requirements in old age

by Ms. Rachana Pilankar, NutrHealthy Tipsitionist




Aging is something no one can avoid. Old age is calm, expanded, relaxed, gives opportunity to do the things we want to do. But at the same time health issues can be obstacles in our enjoyment of life. Proper nutrition is very important as we grow.
Malnutrition is very common in old age & it gets affected by physical, psychological, social issues. As changes begin to happen I one area of a person’s life, most likely the other two will affect as well.
How we age is result of our diet, exercise, personal habits & psycho-social status. Dietary intake changes during the course of aging leading to acute to chronic complications, repeated hospital admission, functional disability, osteoporosis and late surgical recovery.Don't s for the elderly




Physiological changes occurs slowly over time in the body system. These changes influenced by life events, illness, genetic traits. Some of these changes which affect nutrition in old age are

 Sensory changes
 Loss of teeth
 Reduced gastro-intestinal functions

 Functional mobility

Nutrients of importance

Sensory changes affect the appetite in several ways. Diminished taste or smell takes away the appeal of many foods & may lead to preparing & consuming food that are no longer safe to eat like spicy food, fried items, sweets.
Loss of teeth causing chewing difficulties takes away pleasure of eating food. Modifying the consistency & texture of food helps to improve appeal, intake & acceptance of food.
Acidity, heart burn, constipation, flatulence are common problem in elderly due to reduced gastro intestinal functions. Balanced diet & small frequent meals can help in reducing these complaints.Eubie Blake quote
Sedentary life style, social isolation, loneliness and depression affect oral intake leads to malnourishment.



Be Physically Active

A Reology Retreat in Japan

Reology: The Science of Reorienting Your Life




The Philosophy of “Re-righting” Our Thoughts

My intention here is not to trace the history of how this school of thought originated and developed, though it is of great interest to sociologists, anthropologists, psychologists, and ALL lay people making efforts at personal development.

What I will do, instead, is to lay out a few of the basic principles to help the reader understand – and possibly learn enough to want to learn more, and maybe even practice the philosophy.

What we learn from Reology

Reology teaches us that we have the ability to choose how we react to certain stimuli in the environment that elicit an emotional reaction. This form of emotional regulation gives us the power to react the way we want – in a responsible manner that will not cause potentially negative consequences.

It comes from a place that says, “I make me feel and therefore I can choose what feeling to feel.”

For example, we can be responsible and make statements like, “When you say those things you make me feel ______ (fill in the blank)”.

However, Reology takes it to a whole new level and adds, “I make me feel _____(fill in the blank)”.

Reology asks us to be responsible for all the negative feelings we have because we chose them!

Reology focuses on growth rather than change.

Reology tells us that when we speak with others, we must make it very clear right at the beginning that we are talking about our perspective, and not ‘What is out there’. Most disagreements happen when we argue on this issue.

If you are saying, ‘This is how this thing makes me feel’, you are not saying, ‘This is how this thing IS.’

I would argue with you on the second point, because I have my own view on WHAT IS, whereas there is nothing to argue in the first statement, because what you feel is known to you more than it is to anybody else.

In fact, the next position is: “I acknowledge how you feel about this; I accept you have a right to feel the way you do, and I honor that fact.”



Now, this is of such fundamental importance, but our language is peppered with sentences and words that constantly deny this reality. Reology takes the help of PERCEPT LANGUAGE, which corrects our way of speaking, making sure we constantly apprise other people of the above statement. I will come to Percept Language presently.

Basic premise of Reology

The basic premise is that given the importance of relationships in our lives, we invest a lot of time and effort on them. We ALL want fantastic relationships and that means we are loved and liked by people we interact with. The first question to ask ourselves is: “How can I expect others to love me if I don’t love myself in the first place?”

Most of us will react with, “Don’t be daft! I do love myself!”

Let us take a step backward first. A majority of human beings believe that things happen to them; they are constantly in the midst of some unpleasant situation which they believe they didn’t ask for or create.


Am I a Victim or am I in Control?

Now, let us ask ourselves one thing: “What are my choices?”There are basically two: I accept the situation as unavoidable, there being nothing I can do about it; or, I take charge of things and put in efforts to change things around. Which would you rather do?This is a fundamental starting point; I am not arguing in favor of or against destiny, fate, and things like that.If you are okay to let things be as they are, put in no struggle, refuse to fight for your own improvement – then it doesn’t matter what you think is the reason for the situation you are in. Your actions prove what you really think: you are a victim.On the contrary, when you desire to take charge, want to be in control – then the question becomes important.

What is BELIEF?

So it boils down to what I want to believe (or need to believe).

The next question is: What does it matter what I believe, if what I believe is wrong? For example, people believed the Earth is flat, but that did not change the Earth’s shape!

So, let us say I am someone who wants to be in charge and control my own destiny; in that case, does it make more sense for me to BELIEVE that I CAN influence my destiny? Will I feel more empowered if I believed that to be true?

Now here is the next fundamental thing: BELIEF is not about FACTS which you can verify.

The flat Earth hypothesis did not stand the test of time, because scientific evidence to the contrary was not late in coming.

Defining BELIEF

A BELIEF (as defined strictly) is a thought – or a habitual way of thinking – about something which you cannot verify by your various senses – but you WANT it to be true. It is an expression of your desire, the way you want things to be. It’s about a future which you HOPE will be in a certain way.

You want your child to be a beautiful human being: in that case, which is the fact – that at some point in the future, your child is a bad person – is that the fact? Or that your child IS the beautiful person that you wanted him to be – is THAT the fact?

BELIEF is thinking about a future event or situation which YOU WANT – with the idea that there is NO DOUBT that it will be so. It is like knowing it just the way you know something which has happened in the present time.

When you consider Belief to be such a thing – wouldn’t you like it to be the best you ever wanted?

I BELIEVE I am a good person; I believe I am happy and joyous; I believe I am wealthy and prosperous; I believe I am healthy and full of energy.

Isn’t this, then a matter of how we think, rather than what we think is OUT THERE?


The BIGGEST FUNDAMENTAL change in thinking in modern times is the realization that our lives and our experiences are EXACTLY as we want them to be. We MIGHT say we want something, but our thoughts, attitudes, speech, and our actions may not be reflecting that – which is the reason we are not experiencing it in our lives.

This, in a nutshell, is the LAW OF ATTRACTION. And we attract people, things, events, and circumstances by constantly thinking about them.

Here, then, is the fundamental need for Re-righting our thinking – because that is the only way we can construct a future according to our thoughts and desires.


Jake & Hannah Eagle

The foremost practitioners of this method of thinking, talking, and acting are Jake and Hannah Eagle, hence a lot of what is said here is based on their words, culled from their various talks, and a review of their book: “Re-right your life: An Introduction to Reology”.


ReRight Your Life: An Introduction to Reology

Jake Eagle’s book on Reology presents its rules and guidelines in a conversation between Jake and his brother Tom. Jake’s brother Tom had an inoperable brain tumor, hence he and Jake had every reason to believe they were victims of fate.

Reology is a new way of thinking and puts the control of having a happy, fulfilling life right in your lap. The book is the first step in taking your life in a completely new direction. It asks you to revisit what you think you know and rethink it. It asks you to change how you speak and respeak it.

What is Percept Language?

Percept language is a tool for navigating with one another; by using percept language, we can avoid the pitfalls that come from interfering, judging, assuming, and comparing ourselves with others. This language sounds strange, new, perhaps awkward at first, but can became a much better way of expressing ourselves.


How is it useful?

By using this special form of the English language, the effort is to improve our awareness of ourselves, heighten our sensitivity to our sensations, as well as take ownership of our feelings, thoughts, actions, and perceptions.


This is also a method of letting other people know that you are willing to let them have their own feelings, thoughts, and perceptions.

“Feel Clearer in the Interior”

Through this, the practitioners of this language feel ‘clearer’ about their ‘interior’ and feel more connected with Spirit. They feel that they are more often non-judgmental, can more easily be direct and remain truer to their experience, and can be more open and revealing to others about themselves.


The users of this language then feel they are ‘more themselves’, true to themselves in the here and now, and to others. They feel universally rewarded in this manner by this new way of expressing.



This is a language that is used as the medium of expression in interior (‘in the mind’) dialogue, as well as when in groups, called ‘Circle’. In Circles, this language helps them to ‘stay present to ourselves’, witness to one another, avoiding interpreting others, and honoring that each has a different ‘place’ or ‘position’ in the Circle.

For example, the practitioners sit in a Circle, and may all be looking at a candle, but each has quite different perceptions of the candle and each perception is ‘equally valued’ and can neither be duplicated nor completely understood by another.


You can only experience it to know the benefits

Percept language is an experiential language (meaning that its advantages and benefits can only be understood through experience, and may not be amenable to adequate description).  It is used to learn more about oneself, and through this awareness, to be able to act with more of one’s own power under one’s conscious authority.


Comparison of everyday language, called ‘Concept Language’ and ‘Percept Language’:


Concept Language  Percept Language 
is everyday language; is the language of behavior, of change;
the language of “Outside of me”;   The language of “Inside of me”;
it is English as I learned it; it is familiar; expectable, conventional; it is my common mode of speech;  
it is often judgmental; is non-judgmental; 
circuitous, sometimes devious;  direct;  
obscuring and screening  revealing and disclosing
circumspect and oblique; the language of perception;
  is experiential;
  the mode of “self- speaking”;
  the language of owning my behavior;  


To move from Concept Language to Percept Language, words like it, that, what, this,are droppedand substitute by I, or sometimes, me.


Concept Language  Percept Language 
“This is really delightful.” “I delight me with this.”
“I don’t know what to say” “I don’t know how to say me.”
“It doesn’t seem to matter.” “I don’t seem to matter.”



Sorting out our feelings, our thoughts and beliefs and labeling them accurately is an important part of percept language; this is one way in which the speaker can ‘differentiate’ herself and make her clearer to herself.


Concept Language  Percept Language 
“I feel this is the right road.” “I think this is the right road.”
“I think I’m angry.” “I anger me.”
“I feel that I’m correct” “I think I’m correct”
“I feel it’s going to rain.” “I think it’s going to rain.”


In Concept language one can speak of oneself as the passive object of some various “things that happen to me.” In Precept Language, the perpetrator (Subject) is the self, and actions are done on oneself.

Concept Language  Percept Language 
“I caught a fever.” “I fevered me.”
“I don’t know why I get these headaches.” “I don’t know why I ache my head.”
“I’m bored” “I bore me.”
“You make me angry” “I anger me.”


In Percept, one is in control – not a victim of circumstances

In concept language we speak as though events, feelings, dreams, and thoughts all were visited upon me, while in percept language we acknowledge to the world that we visit all these states upon ourselves.


We take responsibility for our own actions and the results thereof;  One way to make sure I am being responsible is to use the form—I have me.

Projections, interpretations, and assumptions regarding others are my mirror of me.

If we were better at asking questions and answering them, then things would be much better; by ‘better’ is meant ‘more precise’ – and we would be clearer about ourselves and straighter in our relationships.



A Nation of Idol – worshipers and iconoclasts

We have always been a nation of idol – worshipers; and invasion by armies of idol – haters has not changed us – maybe made us stronger in our superstitions.

Personally, I am not so much against idol – worship and idolization; my issue is with the enslavement that this leads to.

Do you know the consequences of this attitude?

Read my blog to get a funny perspective on this issue:



Hidden Costs of a Big Mac

The Big Mac (introduced in the city of Pittsburgh in 1967 and all over the US in 1968) is a  hamburger sold by McDonald’s, an international fast food restaurant chain. It is one of the company’s signature products. It consists of two 1.6 oz (45.4 g) 100 per cent beef patties, American cheese, “special sauce” (a variant of Thousand Island dressing), iceberg lettucepickles, and onions, served in a three-part sesame seed bun.   The Big Mac was created by Jim Delligatti, the owner of several of MacDonald’s outlets in the Pittsburgh area; it was first sold for 45 cents.

The Big Mac is known worldwide and is often used as a symbol of American capitalism. The Economist has used it as a reference point for comparing the cost of living in different countries – the Big Mac Index — as it is so widely available and is comparable across markets. This index is sometimes referred to as Burgernomics. source, Wikipedia.

In the year 1999 3 judges in the UK’s, Court of Appeal ruled that a diet consisting of high-fat McDonald’s products may lead to heart disease.

Reright your life Jake and Hannah Eagle

Reology and Percept Language

Do you think the world around is a mess? Do you read the newspaper, and then shake your head in bewilderment or disbelief, as if to say, “How can people be so dumb or cruel?”

Believe me I do it all the time!

Cincopa WordPress plugin

  • Russia invades Crimea and takes it over from Ukraine.
  • US is attacked – 9/11
  • US sends troops to Iraq, Afghanistan, and everywhere else where it doesn’t even have borders.
  • Syria sinks into civil war;
  • Palestinians continue to die fighting for existence in a country which was wiped out of the map following WWII.
  • China takes over islands which are closer to Malaysia, Brunei and Philippines then to China;
  • Rampant corruption in India and Indonesia forces people to live in abject poverty, without even basic amenities.


But if we were to look closer home, into our own personal lives, do we feel some sort of unease or discontent? Do you feel that your relationships are not doing well, even going sour? At the work – place, everything that happens is like an attack on me; I am paranoid beyond belief. If a boss only tells me about some work, it means he is taking advantage of the fact that I never say no; if he doesn’t talk to me about it, he is favoring others.

This thread of thought runs through our head in an endless cycle; it is always ‘me against them’. Our thoughts are filled with worry, anxiety, suspicion, paranoia, fear, jealousy.  It significantly impairs the quality of life, since everything is experienced in a negative way.

But what is the reality? Is this constant feeling that the world is ganging-up on me genuine, the product of a deranged mind, or the result of a relentlessly negative mind? In my opinion, it is only when we take this inner dialogue seriously, and either act on it or express it to others that we get into trouble. People are likely to criticize us for negative thinking (even though they are as negative as we are), tell us to see a psychiatrist, or persecute us in different ways.

Why is staying positive so difficult? Why can’t we wake up every morning and promise ourselves that we will stay positive, and then keep that promise for the rest of the day?

Want to know more about them?


Cerebral Palsy Autologous Cord Blood Study

Do you have a child in the family with CP (Cerebral Palsy)?

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Duke University Medical Center is conducting a study to test whether an intravenous infusion of a child’s own cord blood cells, banked at the time of their birth, will lessen the symptoms of cerebral palsy. Children, ages 12 months to 6 years, diagnosed with spastic cerebral palsy may be eligible for the study if their cord blood cells were banked when they were born.

Stop the Stigma about Epilepsy

Having epilepsy is not a crime

If your daughter had epilepsy, how would you treat her?

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Aruna was a slip of a girl who had just crossed menarche, with her entire life ahead of her. Bright eyes sparkled from under shy eyelashes and strands of unruly hair that refused to listen to her.

Shy Indian Girl


She was a spunky kid, on top of the class for the activity sessions; her studies suffered, but her teachers said it had more to do with her natural buoyancy and talkativeness than intelligence.

Her father doted on her, and never used a cross word. Her mother despaired that the girl would find things difficult when she grew up. Her skin was dusky, and though her eyes and mischievous smile gave hints of her liveliness, finding a ‘suitable match’ was going to be difficult because of the lack of appropriate skin color.


When they first brought her to the clinic, she was not at her confident best; a recent seizure – witnessed with horror and amazement by all her classmates and a very masculine and unemotional PT teacher – had dampened her spirits.


Shy Indian Girl2

After all the tests, my conclusion was that she definitely had more than a slight chance of recurrent seizures. A recent change in Epilepsy definition and guidelines meant that even after a single seizure, one may have to start treatment based on results of tests. In the earlier days, sometimes we didn’t even do tests after the first event, not only because of the expense and the cumbersome nature of these tests, but also because something else comes attached with the diagnosis of Epilepsy: STIGMA.

Every child who gets this label feels stigmatized; nay, the entire family feels that way. For girls it puts a heavy pressure on the parents in regard to marriage. Facts are hidden, the truth never revealed. A few were bold enough to want to change the social mores; but when their daughters and sisters remained unmarried, they returned to the practice of hiding the fact.



What is it about epilepsy and fits that people feel stigmatized?

For one thing, in the olden days, epilepsy and fits were believed to be due to possession by spirits. Epileptics were mostly brain – damaged people, some of them of low intelligence; this led to the false belief that ALL epileptics have low intelligence, and that the fits in some way CAUSE the low intelligence.

Epilepsy can run in families, and the fear that a woman can transmit it to her offspring is another BIG reason why ‘Normal’ men don’t want to marry epileptic women.

Aruna, spirited girl that she is, questioned this: “What if a man has epilepsy? He can’t pass it on to his children?”

shatter the stigma of epilepsy

I was thrilled to hear this intelligent question from such a small girl. “Bravo, Aruna!” I said, “You are a strong person and will definitely do something great in your life! Yes, a man can pass his epilepsy to his offspring, too, just as a woman can. Most epilepsy genes are in the non – sex genes, so there is no reason to persecute women only. But the fact is, even men are persecuted for having epilepsy, which is equally bad.”

I then went ahead to explain in greater details about genetics in epilepsy. “All forms of epilepsy are NOT genetically transmitted, or have complex inheritance, so an epileptic may have offspring without epilepsy. Sometimes grandchildren may manifest the problem, so you can have skip generations as well.”

“But one mistake – and this is a BIG one – is to lump ALL epilepsies as a single entity and then treat ALL epileptics in the same way. Epilepsy is a label we use for people who have recurrent fits; but it is not due to one disease.”

“Why does a person get fits, doc?” Aruna’s concerned father wanted to know.

“Fits are due to abnormal electrical discharge in the brain,” I replied. “Usually the person with epilepsy has an abnormal area in the brain which is generating an abnormal electrical current; this current then spreads through the brain leading to attacks called seizures or fits.”

A look of understanding dawned on the entire family. “But why does the brain have such an area? And can’t we solve the problem by removing that area?” Aruna’s father struck me as someone who loves action and is very bold.

“Well, sir,” I replied, “To answer the first question: epilepsy is the common term for many diseases. The mechanism by which a disease produces epilepsy is usually unique. For example, a brain tumor can produce fits, and so can injury to the head. But the two situations cause this condition in slightly different ways; but both of them lead to the development of an ‘abnormal electrical circuit’ within the brain, which produces the seizures.”

“Now I am much clearer, doctor.” Aruna’s father said gratefully. Then his brow creased. “But doctor, Aruna neither has a brain tumor nor has she suffered injury to the head; then what is the cause of her fits?”

“Those were just examples,” I clarified, “Inside Aruna’s head is also a small area of abnormal circuit, but that happened for different reasons. We don’t know the reasons, actually; her brain scan is perfectly normal. But that is because the routine MRI doesn’t visualize ALL that is abnormal inside the brain.”

“Then why don’t they invent one that can,” Aruna piped up. “I mean, invent a more powerful MRI so that we will know where this abnormal thing is and then get rid of it?”

“Not so easy!” I winked at Aruna. “Even if we find an area which is causing fits, removing it is not that easy. There is the danger of damaging normal brain and causing harm when attempting to do so. But even before that, there is one more thing: just seeing something abnormal in the MRI doesn’t mean that area is the cause of your fits: for conclusive proof you need to show that the same area is also producing abnormal current. Otherwise you may end up surgically removing something – with all the risks attached to that – and then find out that the fits are arising elsewhere.”

This discussion of surgery was distressing to the ladies: both mother and daughter started shaking. Even the father was looking distinctly uncomfortable.

“We don’t like surgery, doc” her father declared.

“Yes, anything but surgery,” said the mother, suddenly speaking up for the first time.

“Don’t worry, ma’am,” I said, as gently as I could. “Surgery is the very last option. We have just identified the condition. There is a good chance – at least a 25% chance that Aruna’s fits will not recur. Even if it does recur, in all probability it will be easily controlled with medicines. The question of surgery for epilepsy does not arise unless and until the problem has become intractable.”

I shook off the feeling that I may have unnecessarily frightened the family. “The reason I mentioned all this was to give a complete picture, a better perspective.”

“Many people leave a doctor’s clinic with incomplete understanding; they then get inputs from friends, neighbors, relatives, and colleagues. Or, the mother of all things in the world – Google – provides them the ‘much – needed’ misinformation! After that, anxiety becomes far too much for anyone to handle. Or, the other side: the family starts expecting too much from the treatment. I have had people who stopped the medicines because they found that the fits came back when the drug was stopped: their doctors hadn’t warned them this could happen, so they had mistakenly hoped the medicines were going to cure them of the epilepsy. So understanding the basics about epilepsy will definitely help you.”

“I completely agree, doctor,” Aruna’s father declared. “Better to know everything than to make mistakes out of ignorance. We really appreciate the time you took to explain us all these things. Now we feel better equipped to deal with this problem.”

I say a silent prayer for Aruna, as I remember Arfa Karim, the youngest Microsoft – certified Professional, a genius in computer – programming, who died of epilepsy at the age of 16 years.

Arfa Karim Randhawa, a genius in computer programming

Arfa Karim Randhawa, a genius in computer programming

Have Diabetes – Related Complications Declined?

Do you believe Diabetes - related complications are on the decline?

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Diabetes is in the list of the top deadly diseases to afflict mankind because it can cause serious health outcomes, including heart attack, stroke and kidney failure.

But new research from the Centers for Disease Control and Prevention offers a ray of hope that five major complications related to diabetes have declined, at least in the US, during the last 20 years.

Statistics About Diabetes

Data from the 2011 National Diabetes Fact Sheet (released Jan. 26, 2011)

Total prevalence of diabetes

Total: 25.8 million children and adults in the United States—8.3% of the population—have diabetes.

Diagnosed: 18.8 million people

Undiagnosed: 7.0 million people

Prediabetes: 79 million people*

New Cases: 1.9 million new cases of diabetes are diagnosed in people aged 20 years and older in 2010.

– See more at:


What about the Rest of the World? And, is the future going to be better or worse?

Here are some hair – raising statistics on diabetes for the Rest of the World:

some hair - raising statistics on diabetes for the Rest of the World:

Here are some hair – raising statistics on diabetes for the Rest of the World:

The prevalence reflects the population – size.

The picture below shows the prevalence of diabetes in different regions of the world, depicted in a bar diagram:

The picture shows the prevalence of diabetes in different regions of the world, depicted in a bar diagram:

The proportion of the population who have diabetes is much higher, in fact in the MENA region than even the SEA and North American region, due mainly to lifestyle issues.

The proportion of the population who have diabetes is much higher, in fact in the MENA region than even the SEA and North American region, due mainly to lifestyle issues.








This is a vivid picture of what is likely to happen given current trends:A 55 % increase in world – wide prevalence of diabetes

This picture paints a vivid picture of what is likely to happen given current trends:

• A 55 % increase in world – wide prevalence of diabetes
• In Africa and the MENA region, the increase is close to a 100%, which means the Diabetes population size is set to double!
• South-East Asia is going to see a 70% increase in the prevalence of diabetes.

  • In Africa and the MENA region, the increase is close to a 100%, which means the Diabetes population size is set to double!
  • South-East Asia is going to see a 70% increase in the prevalence of diabetes.



















This picture gives one an idea of what proportion of deaths are due to diabetes – related complications.

This picture gives one an idea of what proportion of deaths are due to diabetes - related complications.

As you can see, in the MENA, SEA and Africa regions, the figure is above 50 %, which is a definite indication that Diabetes is really deadly in these populations – possibly due to inadequate access to health care, ignorance, improper diet, lack of physical exercise, etc.





As you can see, in the MENA, SEA and Africa regions, the figure is above 50 %, which is a definite indication that Diabetes is really deadly in these populations – possibly due to inadequate access to health care, ignorance, improper diet, lack of physical exercise, etc.


Heart disease and stroke

  • In 2004, heart disease was noted on 68% of diabetes-related death certificates among people aged 65 years or older.
  • In 2004, stroke was noted on 16% of diabetes-related death certificates among people aged 65 years or older.
  • Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes.
  • The risk for stroke is 2 to 4 times higher among people with diabetes.

– See more at:


Kidney disease

  • Diabetes is the leading cause of kidney failure, accounting for 44% of new cases in 2008.
  • In 2008, 48,374 people with diabetes began treatment for end-stage kidney disease in the United States.
  • In 2008, a total of 202,290 people with end-stage kidney disease due to diabetes were living on chronic dialysis or with a kidney transplant in the United States.

– See more at:



  • More than 60% of non-traumatic lower-limb amputations occur in people with diabetes.
  • In 2006, about 65,700 non-traumatic lower-limb amputations were performed in people with diabetes.

– See more at:


Finally, some good news!

Here is an article published in the New England Journal of Medicine, titled Changes in Diabetes-Related Complications in the United States, 1990–2010


The authors used data from different US national agencies and compared the incidences of lower-limb amputation, end-stage renal disease, acute myocardial infarction, stroke, and death from hyperglycemic (high blood glucose) crisis between 1990 and 2010.

They found that the rates of ALL 5 complications declined between 1990 and 2010.

The highest relative declines were seen in heart attack and death from high blood glucose crises.

Even Stroke and Amputations declined by up to 50%.

They concluded that the rates of these complications have declined, but the prevalence of people with diabetes is increasing steadily, so the global burden of the disease as well as it’s complications is increasing relentlessly.

Lead author for this study, Edward Gregg, says: “These findings show that we have come a long way in preventing complications and improving quality of life for people with diabetes. While the declines in complications are good news, they are still high and will stay with us unless we can make substantial progress in preventing type 2 diabetes.”


Should Patients be given access to physician notes

Nurse explaining to patient

Do patients need to have access to the notes made by doctors and nurses?

This promises to be controversial!!

Way back in 2011, a report was published, in The Annals of Internal Medicine.

If you are a patient, chances are you are infuriated by the secrecy (and ‘conspiracy’?) of doctors, nurses and hospitals. The commonest complaint you have is that you have not been told anything. You reassured the doctor that you would not take it badly and wanted to know exactly what is wrong with you, but the doctor keeps repeating, “You are all right, nothing’s wrong with you.”

And this makes you even more worried, because YOU know you are NOT all right, and when the doctor doesn’t tell you anything, you now start imagining it is SO bad that they want to protect you from the news!

The Conspiracy

It gets worse when your family starts reassuring you; now it’s confirmed that everyone is in the conspiracy of hiding things from you!

Now you want your reports; you will read it, try to understand it on your own, ask a close friend who spent so much time taking care of an invalid at home that she is a ‘half – doctor’ by now. Or, you will take those report and visit another doctor, who is far off and is more likely to tell you the truth.


Is this person you?

Then the chances are that you blow your top when the hospital refuses to give you your report; they treat you like a child, as if you would not be able to take care of your own report.

One of the commonest, bitterest complaint people have with the medical system – is the refusal to give a patient her reports. Do you agree?



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Overcoming Negativity


This is a great quote from one of the greatest motivational speakers, Zig Ziglar.


As you can see, it attracted hundreds of comments and thousands of shares on Facebook.


Even a small sampling of the comments will tell you that there are varied responses; a majority, of course, agrees. A few dissenters, however, don’t think it is a good thing to leave ‘Negative People’ alone. In fact, their point of view is that we should involve these people in dialogue, help them overcome their negativity, and so on.

But the common theme is that there are ‘Positive People’ and then there are ‘Negative People’. It is “Us vs Them.”

Very few, in fact, seem to agree with me: people in this world are not divided into Negative and Positive people. We are ALL, without exception, BOTH positive and negative to varying degrees.


At times, we are VERY positive; especially when things are going in our favor or as per plan. Negativity surfaces when things go awry.
Some people lose their composure faster, at minor things; for others, it takes a lot to shake them.
But don’t you think that we are positive or negative depending on our circumstances – for a majority of our lifetime?
When the ups and the downs in our life become too much to bear, then a little wisdom percolates down. We realize that becoming negative in response to external events is taking a toll on our health and happiness.
A majority of old people like to say: “Don’t chase after material wealth so much; be contented with what you have.”
This is not such a bad advice when taken in the right spirit. The statement says ‘Don’t chase’, it doesn’t say ‘Don’t even try’. And being contented with what one has does not mean that one must not try to improve one’s life.
But to get back to the original quote: negativity comes into each of our lives when we are faced with an adverse situation, and here is where the value of contentment should be appreciated.
In fact, the word ‘Gratitude’ comes even closer to the value that I would inculcate. When the chips are down, remembering the things we are grateful for can help us overcome our negativity.
People who always appear negative, the so – called ‘Negative People’, are, in my humble opinion, those who have not learnt the value of gratitude and contentment. They hanker after things, and when they fail to get them, negativity surfaces.
So, to sum it all up:

  1. There are no ‘Negative People’, there is Negativity within people
  2. We all have some amounts of Negativity within ourselves
  3. Negativity within us surfaces when things go adversely
  4. A general habit of being positive and upbeat all the time will help us avoid negativity from surfacing
  5. One must practice GRATITUDE for things we have and the goodness in our life, regularly and diligently to maintain a positive frame of mind.
  6. Those around us who are afflicted by a lot of negativity within their minds – we cannot help them by criticizing them for it; we can only show them our positivity and attract them to it, and they will ultimately give up their bad habit.

The doctor – patient relationship

The doctor - patient relationship should be a friendly one

The doctor – patient relationship should be a friendly one



As a doctor, I face this question on a daily basis:”Doc, we just found out my dad/mum/bro/sis/wife has this —- disease. How do we get cure for this problem?”

Over the years, I have realised that, irrespective of the underlying disease, three conditions have to be met for successful treatment.

Supposing you find out you have cancer; the first thing you must then do is to find out the address of a cancer specialist,  and visit him.

The next,  equally mandatory thing you must do is to listen to him and follow his directions.

But before all this can happen, the MOST crucial thing you MUST do – and here is where the vast majority falter – is to REALISE you have the condition, accept the diagnosis, and be motivated to get the appropriate treatment for the condition.

This is true, in fact, for every situation in our lives.
When we don’t accept that our conditions in life are not the way we want them to be, we are hardly likely to seek advice to improve it, or to listen to someone willing to help us improve it.

In my experience,  I have faced patients even with very serious illness and with very poor quality of life – yet they are not in the proper frame of mind to listen or accept advice.

For such people, I make sincere efforts to help them understand their situation; but this is not met with universal success. In that situation, I accept it as God’s decree and that person’s destiny.
I never give up on anybody; but I do take a step back to let the person evaluate his situation and come to terms with it.
I have found that is the only way you can let the person have his dignity, and preserve your’s, too. You can never convince anybody against his own sense of dignity.

Cholesterol New Guidelines

Cholesterol has been at the center of much research for a long time – ever since it was identified that stroke and heart attacks result from a process happening in blood vessels called atherosclerosis.

What is Atherosclerosis?

Atherosclerosis simply means hardening of the blood vessel walls; what it entails is a progressive deposition of cholesterol in specific regions of the vessel wall with subsequent changes, all of which lead to formation of ‘plaques’ in the vessels walls. These plaques undergo further changes and can become unstable, rupture, and form clots or thrombus (plural, thrombi) on their surfaces.


Atherosclerotic plaque

Atherosclerotic plaque

What is Embolism?

The clots on the surfaces of these plaques can block the blood vessel or lead to “embolism” in which the clot breaks up into smaller pieces of “emboli”, and these smaller pieces then migrate along the blood stream. A shower of such emboli can lodge in a smaller blood vessel, blocking it, and leading to damage to the underlying tissue ( a kind of damage called ischemic infarct).



Prevention strategy

This whole process of cholesterol deposition to plaque formation to embolism may take many years – so the time course for prevention can also work over many years. Prevention strategies are also aimed at different levels.


People who have diabetes and high blood pressure are more prone to develop the negative consequences of high cholesterol levels in the blood. Uncontrolled diabetes is especially potent in increasing the risk of heart disease and stroke through this mechanism.

One strategy to reduce the risk of stroke or heart disease is to lower the levels of cholesterol in the blood. This is not such a straight – forward goal as it may be thought.


Cholesterol does not enter or leave the body so easily. In fact, Cholesterol is entirely synthesized in the body – inside the liver, in fact. It travels around in the blood stream using different vehicles, called lipoproteins. We know these as ‘good cholesterol’ which is HDL (or High Density Lipoprotein), ‘bad cholesterol’ , which is LDL (or Low Density Lipoprotein), and so on. What we absorb from the diet are in fact the fatty acids which are used to synthesize cholesterol.



LDL = Bad Cholesterol
HDL = Good Cholesterol


Beyond this, things in the Cholesterol World start getting murkier. Why isn’t it such a simple matter to reduce the cholesterol level in the blood? Why did a new Expert Panel have to come and change the guidelines and completely upset the apple cart?


Existing guidelines for lowering cholesterol

In the ATP III report, which published the existing guidelines for cholesterol control, lipid lowering was based on targets such as treat – to cholesterol target, lower cholesterol is better, and risk – based treatment approaches, etc. Over the last few decades, these guidelines spawned the use of many different drugs to lower cholesterol in people who were barely at risk for heart attack or stroke. If somebody had chest pain, bang, he had a Lipid profile done; if his LDL was over a 100 mg/dL, Bang! he was prescribed a statin. Even women in their thirties (pre-menopausal), who were always traditionally considered to be protected from heart disease were evaluated for heart disease.


It became fashionable for men and women in their twenties and thirties to undergo TMTs and Lipid Profile evaluations and for everyone to be on lipid lowering therapies. Based on the previous guidelines, an army of clinicians had broadened the scope of  the guidelines to included more and more patients from diverse ethnic backgrounds and with minimal risk factor profiling to be treated with lipid lowering drugs.

Industry – Driven

A large part of this was industry – driven. The result of this was that a majority of results seen in trials was not replicated in real life. The Expert Panel was therefore constituted to exclude certain levels of evidence not considered robust enough, and to frame new guidelines based on only the best evidence, which basically means Randomized Controlled Trials (RCTs).


RCTs are limited in number at the moment, owing to the fact that they are difficult to design and expensive to conduct. The new set of guidelines are not comprehensive, nor do they entirely replace the older set of guidelines.

So What’s new in the Guideline?

Here is a link to the pdf to the Full Guideline on Circulation

  • The Expert Panel recommended that Statins should be used in 4 identified “Benefit Groups” (see below)
  • They do not support specific LDL – Cholesterol treatment targets
  • They also do not support specific HDL – Cholesterol treatment targets
  • For the “Benefit Groups” Statin therapy should be used in appropriate intensity/dose
  • Non – statin therapy not recommended
  • They recommend a new Pooled Cohort Equation to estimate 10 year risk for heart disease or stroke

The 4 “Benefit Groups” identified by the Expert Panel are:

  1. Those with clinical Atherosclerotic Cardiovascular disease i. e., those who had a heart attack past or present, or unstable/stable angina, those having undergone a coronary revascularization procedure such as stenting or bypass, those who had a stroke or TIA, or those with peripheral vascular disease
  2. Those whose LDL – C levels are >= 190 mg/dL
  3. Diabetes aged 40 – 75 years, with LDL – C between 70 – 189 mg/dL even without clinical evidence of Atherosclerotic Cardiovascular Disease i.e., never had heart attack or stroke
  4. Those with an estimated risk of heart attack/stroke/peripheral vascular disease using the new Pooled Cohort Equation > 7.5% (even if they don’t have Diabetes and elevated LDL – C).

The factors considered in this Risk Estimator are: Gender, Age, Race, Total Cholesterol, HDL – C, Systolic BP, Treatment for BP, Diabetes, and (Whether or not a) Smoker.

Submit your information using the form below, and I will get back to you with your Heart Attack and Stroke Risk Estimation using the Pooled Cohort Equation created by the Expert Panel.


[Form id=”10″]

I am working on getting this latest Pooled Cohort Equation online for my readers to use.

Night Owls and Early Risers Have Different Brain Structures

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Sleep and wake times are strongly influenced by genetics.

Dr Rajshekher‘s insight:

Are you a morning lark or a night owl? New research is beginning to show that night-owls are more prone to depression and white matter lesions (something euphemistically labelled as ‘decreased white matter integrity’); but they are also identified as people who are more productive, with greater analytical ability, have more stamina throughout the day, have greater reasoning abilities, and so on. I don’t know: with recent demands of business and work in my life, I have changed from a morning lark to a night lark/owl! Do you want to know what role genetics plays in this? Do you want to know how to override the infulence of genetics on our sleep pattern and on our circadian rhythms? Then this article is definitely for you!!

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The Science Behind What Naps Do For Your Brain–And Why You Should Have One Today

I love taking a nap in the afternoons/during the day!

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Studies of napping have shown improvement in cognitive function creative thinking and memory performance. Ready set . . . snooze.


Dr Rajshekher‘s insight:

Do you take cat naps during the day? I do: it helps me improve my thinking, concentration and memory for the rest of the day, not to speak of behaviour, mood, and performance. Here is some scientific information to support your pet activity!

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More than 85% of mammals are something called “Polyphasic Sleepers” – which means that they sleep in short stretches at a time throughout the day; you may have seen your dog do that, or your cat – especially your cat!

The Biological Clock

Sleeping cat collage

Humans, on the other hand, have something called a ‘circadian rhythm’ – meaning that we have day – night cycle that is more – or – less hard – wired into our brains. This so – called ‘Biological Clock‘ dictates our sleep – wake cycle, so that we sleep at night and wake in the day.
A small minority of mammals like Human Beings are ‘monophasic sleepers’ – so they have this pattern of sleeping during the night and waking during the day. But you cannot assume from this that this is the natural sleep pattern and that this is the only healthy way to live: Children spend a lot more time napping, and in the first few weeks and months of life, it’s not unusual for a baby to sleep 20 hours in a day! And elderly people also nap a lot without causing them much harm!

Sleep Deprivation in the Modern Day

Modern day life – style across the globe may now be leading us to become more and more sleep – deprived. I get a lot of people in my clinic whose main complaint is ‘not getting enough sleep’. Even my nurse has a tough time: she has three kids (a pair of twins thrown in), and after work, she has to take over from her maid who’s about ready to throw in the towel by that time. So my nurse spends her night – time nursing her three kids.

“At least one of them needs to play at night every day, doc,” she complains with a brave smile, “They get their sleep while we are working; so when do I sleep?”

Naps may not be as good as night – time sleep; we may not attain the depth of sleep, or go through the different stages of sleep – there are 4 stages of what is called Slow – Wave Sleep, followed by one stage of Non – slow wave sleep (or REM – sleep in technical parlance).

It is believed that REM – sleep is very important; according to some, it is MOST IMPORTANT, and they believe the WHOLE PURPOSE of sleep is to enable us to have several episodes of REM sleep.

It is unlikely that we attain REM – sleep during the short half – hour or one – hour power naps in the day, so the other stages of sleep are also quite important.

In an article published September 23, 2013, Research psychologist Rebecca Spencer is quoted by author Janet Lathrop:

… the first research results …. show that classroom naps support learning in preschool children by enhancing memory. Children who napped performed significantly better on a visual-spatial task in the afternoon after a nap and the next day than those who did not nap.

In this study, the research workers recruited 40 children from six preschools across western Massachusetts. The children were taught a visual-spatial task similar to the game called “Memory”. In this game, the child sees a grid of pictures and has to remember where different pictures are located. The game was taught in the morning, after which each child played the game in two conditions:

  • In the first condition, the child was encouraged to nap during their regular times; each nap lasted an average of 77 minutes
  •  In the second condition, the child was kept awake for the same amount of time.
  • Memory for the game was tested after the nap and wake conditions and again the following day to see whether nighttime sleep affected performance.

Research psychologist Rebecca Spencer of  the University of Massachusetts Amherst

Research psychologist Rebecca Spencer of the University of Massachusetts Amherst

Following a nap, children recalled items 10% more than when they were tested without being allowed to nap. The children had 65% accuracy in locating the items during the memory test whey they did not nap, and this increased to 75% when tested after a nap.

The memory did not improve after an overnight sleep, leading Rebecca Spencer to conclude that napping soon after learning had a stronger reinforcing effect, whereas sleeping many hours later does not positively influence the learning pattern.



A Story of our Times

Grand parents tell stories

Grand parents tell stories

Grandfather tells a story


During our summer holidays, I loved going to our grand – parents’ home in the hills. I especially enjoyed the evenings when our grand – father would tuck us in and regale us with a story. Some of them would be short, while others would go on for days. Many of them were later on adapted for TV serials – though I suspect it could have been the other way around. But the fun part of it was the way he told them; he would be totally absorbed, he would make animal noises, and change his voice to suit character, the mood and the moment. He had been an actor at one time, but then he got married; and you know what happens after that: somebody else takes over all the talking part.

How the story began

The story I am about to tell is one such, and was especially meaningful, because we had had an argument over arriving late for appointments. Grandpa had had a stint with the Army, which had made him a stickler for time all his life, as old – timers tend to be, and many of his stories centered around the importance of being on time. This one is a lot more than just that, but it started with that.

Getting late for the Doctor’s appointment


At the village fair - buying stuff

At the village fair – buying stuff


Games at the village fair

Games at the village fair

We had planned a visit to the village fair for a couple of hours before the scheduled appointment with the doctor. I learnt that day that village fairs cannot be planned affairs. That is, you can plan when you enter, but you cannot plan your exit time. We ended up spending rather more time and money than we intended, with the result that we were several hours late for the doctor’s appointment. Another thing: in villages, loud protestations will usually get you into the doctor’s room, but grandpa was really peeved by this behavior. This seemed to rankle in his mind even after dinner, because he was talking about it even at bed – time.

More games at the village fair

More games at the village fair

The Troubled King


Barren foothills of himalayas

Barren foothills of Himalayas


Living in hardship in the himalayas

Living in hardship in the Himalayas

It was story – telling time, so he started it in the same mood.”You know,” he began, “this reminds me of the story about this kingdom in the foothills of the Himalayas. The King was very benevolent and just, and most of the kingdom was peaceful and prosperous. But the region right at the foothills was not so very prosperous; the people living there were mostly tribes. The land was not very easy to cultivate, it was barren. The hills did not provide an easy living, and the people lived in hardship. There were many small tribes and they were in constant war and conflict. It was a big headache for the king, and he could do very little for their uplift. He worried about it night and day, and dearly wished some way could be found to improve the situation.

The Monk

“Now, in the foot-hills lived a mendicant, a detached soul. In all such stories, you will always find such characters – they provide you a contrast from the other characters who are either greedy, or jealous, or selfish, or cruel.”

The Raging River

“There, in the foot-hills, also was a river – not a very helpful river, I am afraid! It was in spate most years – during the monsoon, it flooded the region, and people lost their lives trying to swim across it. They could not save their crops due to the flooding. They dearly wanted a dam to be built, and a bridge over it; but the lack of peace in the region meant that such construction was not easily possible. It was at best a treacherous proposition.

Flooding river

Flooding river

To Build a Dam

“The King, hearing about the Monk, and learning he was well – respected, and hoping he would be the right person to find a way for the improvement of this region, summoned this mendicant, and asked him what could be done. The Monk spelled out the needs of the region – the dam and the bridge to be built, the cost and the resources that would be needed. The King instantly sanctioned everything. ‘What else?’ he asked of the Monk. ‘I will,’ said the Monk, ‘ speak to the leaders of that region and make sure they cooperate.’ In this way a plan was hatched for improvement of this region.

Crops damaged by floods

Crops damaged by floods

The Minister Arrives

“One day, a Minister arrived at the Monk’s hermitage. He was the King’s envoy, bringing with him the requisite gold and resources for constructing the dam and the bridge. He was, however, a day late; the Monk’s disciples informed him that after waiting for him till late evening, their Gurudev had left at night for the foothills, to attend another meeting – it was a secret meeting they knew nothing about, the only thing they knew was that he would be back the following day.

The Minister with his entourage

The Minister arrived with his entourage, but was late – Guruji had left

The Construction Begins

“The minister was very angry for not being received and for being made to wait. When the Monk returned, he fussed and fumed. He threatened to return without handing over the things the King had sent. Before the Monk could explain anything, he ordered his soldiers to put him in chains, and thereafter began construction of the bridge.


“Over the next few weeks, work started at a fast pace and the soldiers, who were well – trained, started building the dam. But soon they were faced with resistance. The warring tribes began sabotaging their work. They would find the work done in the morning undone by night. Their best engineers would be found dead with their throats slit. Some of their laborers were ambushed.

“The commander in charge of construction summoned the Minister, who panicked and informed the King. When the King heard the Monk had been put in chains, he rushed to the spot, freed him, begged him for his forgiveness, and asked him to explain everything.

Local Politics


“With folded hands, the Monk explained, ‘O King! On that day, when Mantriji came with his entourage, I was to meet the opposing war – lords of the major tribes in the region. They have been at war for centuries. A glimmer of hope was appearing at that time. The daughter of one is madly in love with the son of another. I was negotiating between them to join this young couple in wedlock. Should these two tribes unite through marriage, peace could reign in the Valley. To me, peace in the Valley through this marriage is far more important than the dam through your money; so which meeting was more important? When Mantriji got delayed, I had no choice but to let him be received by my disciples. But these chains didn’t allow me to complete the negotiations, and lead to the unfortunate events that followed.’

“Off With His Head”

“The King turned to the minister, trembling with rage, and for a few terrifying moments everyone thought that was the end of Mantriji. Gradually, the King controlled his breathing, and then said, ‘Mantriji, if I were to be as impatient and angry as you were, your head would roll on the ground. But as the just ruler of this kingdom, I give you one chance to undo what has happened here.’

All’s Well That Ends Well

“So the humbled Minister then set about to make peace between the warring tribes, and then with their help completed the construction of the dam and bridge over the river, which helped control it, preventing floods, bringing peace, harmony, and prosperity to the region.”

Neuroscience pushes meditation into the mainstream

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MINNEAPOLIS Propelled by technological breakthroughs in neuroscience allowing researchers to monitor brain activity, the medical community is increasingly aware that meditation has beneficial physical effects on the brain.

Dr Rajshekher‘s insight:

I know and a lot of my friends, teachers, mentors, parent figures will second this one! Please let me know what you think through the comment sections! 

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The top 25 must-see movies of 2014 – Den Of Geek

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Den Of Geek The top 25 must-see movies of 2014 Den Of Geek Rosamund Pike co-stars (hopefully in better fitting clothes than she was made to wear in Jack Reacher), alongside Tyler Perry and Neil Patrick Harris, and the plan is for Fincher’s tenth…

Dr Rajshekher‘s insight:

A sneak-peak at the 25 top Hollywood movies to look-out for in 2014 – or, more realistically, the author’s list of what he thinks should be on the list – have a look and let me know if it excites you as much as it did me! 

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Online Business Education – Online Management PhD – Distance MBA

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Europe’s best online university offers cutting-edge degree-programs & open enrolment courses incl. Motorsports-, Hospitality- and Luxury Management.

Dr Rajshekher‘s insight:

About Swiss eLearning Institute

The adage ‘time is money’ is truer than ever in our modern world. With the fast-paced lifestyle that is the hallmark of busy people these days, there is precious little time left to fit in the things we would like to do, especially with regards to education and the enhancement of personal knowledge. Traditional education courses require a commitment in time and resources that many of us don’t have – not only do you have to go to class at a fixed time and place, there is also the need to consider travelling times too. All of this represents a large frame of time just for attending class, never mind the time you need for studying!

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Nature’s Energy Drink – Health Benefits of Coconut Water

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Coconut water contains easily digestible carbohydrates, which means it will provide you with a quick boost in energy. It’s also an extremely good source of potassium; coconut water is also very effective at keeping the body hydrated; coconut water contains electrolytes, this makes it an effective, natural way to replace … lost electrolytes in the body. Coconut water is also a good source of many other vitamins, minerals and beneficial enzymes. For example, … B-complex vitamins, including niacin, riboflavin, and folates.

Dr Rajshekher‘s insight:

This is more like an infotisement, because a particular brand is being endorsed. But some of the people I know (She knows who I am referring to!) will agree with this. Do you have any other comments or ideas?

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Lateral Thinking to Generate New Idesa

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The Onlilne Nerve Health Forum

Dr Rajshekher‘s insight:

Edward de Bono is a pioneer of many new Thinking Techniques; the method called PO – Provocation – was created by him. In PO, you start with something which is obviously illogical. The idea is not to ridicule it, but to let your mind be thrown into an alternate way of thinking, which could bring you to the solution of a problem which was not being reached using logical methods. Read his books to understand exactly how this works. He is world – renowned for having changed strategies for companies and countries equally! This short article was based on one of his books – How To Have a Beautiful Mind – and basically is an exercise that he asks the reader to perform. I love it, and am sure you will, too!

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Attitude – What’s Yours?

I want you to watch the video first before reading on.



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This video taught me a lot of things, so I thought I would share it with my readers here.

The people in this video

There are three people in this video – three kinds of people, that is.

First, of course, is the protagonist, or ‘hero’, who ties-up his leg and limps around begging.

Then there are all those people on the roads who give him alms.

Then, finally the District Collector (DC), who ignores our hero.

The attitude of these people

Let’s consider those people on the roads; we are a bit like them. What is their attitude? Why would they give alms to this ‘beggar’?

I know my thoughts when I see a beggar on the roads, so I will share them; I feel a few of you might identify with it, and some may have alternatives to it; but the basic attitude is still the same.

When I see a beggar on the road, I feel pity; I see his ‘handicap’, which is visible and clear in a majority, like blindness, or an obviously missing limb. I drop a few coins in his bowl, feeling thankful to God that I got this opportunity to do a ‘good deed’.  A few coins in charity do not make me a poor man, and I am content that my sins have been ameliorated to some extent by this act.

Sometimes, I get incensed by a beggar who looks hale and hearty enough to work; but then, I rationalize, maybe it’s not just his physical handicap, but other challenges in his life because of which he is under-privileged.

I don’t really know, and couldn’t be bothered to investigate.

I am also aware that sometimes people tie-up their hands or legs to appear handicapped; and that sometimes children are kidnapped and subjected to some brutality, such as the eyes being gouged out or a limb torn-off, to make them eligible for your charity.

Here is a photo gallery of beggars around the world:

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My attitude is of indifference; my sympathy is worth the coin that I put in his bowl, something that is within my means and does not ‘waste’ my time. Whether his handicap is real or fake does not enter my calculations, and I don’t waste time investigating. If I was required to do something more than this, I would resent it.

The District Collector

What about the DC? He is a proud man, no two ways about it! And we should be, too, for having a system in place which allows even people with serious handicaps like his, to have achieved something meaningful in life. He ignores the beggar at his gate – doesn’t even spare a glance. His thought is: I don’t care whether you have a game leg or you are faking it; go get yourself a job and live in dignity.

We don’t know the story back of this character, so we can conjecture; maybe he is from a privileged background, and had access to schools and books, which enabled him to attain this station in life.

But is it enough to be just given a chance? Do we still have to work on those? Is it a fact that a majority of us get some chances, but we squander them through our bad attitudes or other ‘handicaps’? His handicap made him strong in mind; his determination and will was much stronger than many of us able-bodied people; that had far more to do with his achievements than the chances or privileges he had. That was my conclusion of this man.

As for our hero, the ‘beggar’ – he starts off as someone who plays on people’s indifference and sympathy (a peculiar combination that we see commonly in our country) to earn some money. He probably earns more money doing this than working hard at some factory or doing day labour.

In the end, he realizes that his modus operandi can earn him a few dollars, but he will never get the honour and dignity that the other guy with a real game leg has. He finally realizes that a life of dignity is far more important than the one he is leading; so he throws away his crutch – symbolizing that he now doesn’t want to lead this life of a beggar any more.

My Opinion

Here, I cannot help but summarize everything; I believe we each have these three characters within us. As people on the road, other people’s handicaps – real, imagined, fake, assumed – have no importance to us – we are satisfied throwing a few coins or a few words of sympathy. We have our own lives to lead, so if somebody else is crying because he is not able to achieve something, we pay scant heed. We know there are a lot of people, who always provide excuses for failing, and we merely provide sympathy, or even do their work for them, imagining we are helping them; in reality, we are only reinforcing the effect of that person’s handicap.

If you really want to help another person, make him more capable; help him achieve something which will give him pride and joy; don’t just throw money at him.

Like the ‘hero’, the ‘beggar’, we also tie ourselves up and walk around with crutches. It could be an illness – a migraine, or something more serious. Or it could be lack of money, or education, of talent, or of luck. Each of these is an assumed or fake handicap – and we walk around with them, begging for sympathy.

And that is exactly what we get: indifference and fake sympathy. People around us will never tell us to thrown away our crutches and struggle the way the DC had in his life. They know we are not going to listen.

It’s only when we see another person who had an even greater handicap than we have, but who still went on to achieve great honour and dignity through hard work, that we ourselves can get inspired to throw away our crutches and work for our own emancipation.


Famous People With Epilepsy

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Shisha smoking is more addictive than cocaine, expert says

See on Scoop.itNerve Health

Expert says those who smoke hookah likely to switch to cigarettes within three years

Dr Rajshekher‘s insight:

Shisha smokers say that they have bad effects of long-term shisha addiction – they lose their breath and don’t have energy to do anything; the addiction to shisha is stronger than to cocaine, experts say. Read here for an alternative to cigarettes and Shisha, called the e-cigarette:



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Why Doesn’t Highest Paid CEO, Zuckerberg, Quit?

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The news is out. The highest paid CEO is Mark Zuckerberg. You can read the link to understand how he earned more than $2 billion. OK, my guess is that most people reading this are saying, “If I made

Dr Rajshekher‘s insight:

Is money the strongest motivating factor? Most people would say no; yet money is the fuel which motivates us to hold on to jobs and bosses they hate. That means most of us, continue working our jobs for a reason which is not a passion – it’s a necessity. Which is why we resent our jobs and our bosses, even if we deny it to ourselves!

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7 Food Swaps That Will Help You Slim Down

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Trying to figure out how to get skinny? Contrary to popular belief, you don’t have to resort to a calorie-crash diet or exercise two hours a day to see results quickly.

Dr Rajshekher‘s insight:

In my experience, I have never seen anyone who went on a crash-diet and succeeded in reaching or maintaining the ideal weight. I had one patient – hardly a patient, he is an inspiration – who reduced from 130 Kilos to 80 Kilos – through sheer exercise and a very sensible diet. I intend to ask him about his diet and exercise and will publish the interview with him in a future blog post . But he is an exception rather than a rule! So here is a sampling of dietary modifications which may be informative to all!

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Tofu only sounds like healthy protein. Nutritionally, soy is great for you. But soy has other problems. In your body, it mimics estrogen. Increasing your hormone levels this way can lead to a variety of cancers.


Vitamin Water has been blatantly advertising lies. The beverage claims that it’s a healthy sports drink. In reality, it has more sugar than soda. You’re literally better off chugging Mountain Dew than drinking Vitamin Water. Either way you’re drinking your way to a host of health problems.
Dieters love low-fat yogurt because it’s low in calories. But it’s also low in nutrition. And flavored diet yogurt replaces sugar with artificial sweeteners. And some of that fake sugar has been linked to cancer, Alzheimer’s and other disorders.
They sound harmless enough. But dietitians are finding links between juice cleanses and anorexia. Patients who go on juice cleanses are highly likely to follow them with a crash diet. And these crash diets can damage your organs, lower your blood sugar. Often patients become so thin after a juice cleanse that they have to seek medical treatment for anorexia nervosa.

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Negative Thinking Destroys Our Mind

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Negative thinking destroys our mind.


Have you any doubts on this?


But how do we get into negative thoughts? Other people’s negative actions are the most common reasons.


I was not there when Thomas Alva Edison was working on his different projects; I have no personal knowledge of the kind of person he really was. All I know about him is through biographies and historical accounts.


Whether I learn from his life, get inspired by him – or I judge him and criticize him would be based on the perception I get of him through these biographical and historical accounts.

So am I being fair to him – or to myself and my family – if I choose to judge him and harbor negative thoughts about him?


I want you to read the Facebook extract I have put here for you to read the first few comments on what people had to say about him and his interactions with Nikolai Tesla, and then come back here.


If you couldn’t see the above excerpt, then have a look at the image below:

John Assaraf quote

I have taken out the specific comments from this post on FB by John Assaraf – and the comments and the debate or so off the mark and so negative!

I am not saying Edison was not all the things people are saying; I am saying, I don’t care one way or the other. And the reason I don’t care is because by becoming involved in that kind of discussion about great people of the past (or present) – especially those I don’t know personally – I am becoming a negative thinker – and harming myself.


It just isn’t worth my time and my Dreams to derail my mind in this fashion.

But do you find yourself fascinated and drawn into the discussion there? Don’t worry, that’s natural and quite a human thing.

But if your life is worth more than that, then force your mind out of that kind of thinking and talking. Learn only to get inspired by people who achieved great things. Don’t concern yourself with what they may (or may not, for all you know) have done wrong.

The way to positive thinking starts from this habit.

Mother Brings Baby Back to Life With Two Hours Of Loving Cuddles After Doctors Pronounce Him Dead

It was a final chance to say goodbye for grieving mother Kate Ogg after doctors gave up hope of saving her premature baby. She tearfully told her lifeless son – born at 27 weeks weighing 2lb – how much she loved him and cuddled him tightly, not wanting to let him go Read More: – Follow us on Facebook: whydontyoutrythis

Dr Rajshekher‘s insight:

It was a final chance to say goodbye for grieving mother Kate Ogg after doctors gave up hope of saving her premature baby. She tearfully told her lifeless son – born at 27 weeks weighing 2lb – how much she loved him and cuddled him tightly, not wanting to let him go Read More: – Follow us on Facebook: whydontyoutrythis

Mother’s embrace brings baby back to life, watch the TV interview:

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Chinese Boy with Ability to See in Pitch Black Stuns Medics

A young Chinese boy who was born with beaming blue eyes has stunned medics with his ability to see in pitch black darkness. Read More: – Follow us on Facebook: whydontyoutrythis

Dr Rajshekher‘s insight:

A young Chinese boy who was born with beaming blue eyes has stunned medics with his ability to see in pitch black darkness. Read More: – Follow us on Facebook: whydontyoutrythis

Watch the video here:

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The Heart Always Wins

The Heart Always Wins

A long time ago, there lived a pious family in one of the princely kingdoms of ancient India. The father was a court priest and much revered for his scriptural knowledge. His wife, a simple woman with few needs, tended to the house and their child, a bonny baby born after many years of prayer to God.


This child was growing up fast, sharp in intelligence, with a quick tongue. Soon he was a strapping young lad, handsome of figure & quick of wits. He earned the reputation of a scholar very fast, and there was no one in the kingdom who could match his knowledge of the scriptures. He defeated many renowned scholars in contests at the king’s court, and his home was full of such trophies given by their benevolent ruler. He was expected easily to take his father’s place soon.

Brahmin of ancient india

Th boy was well – versed in the scriptures and his knowledge and wisdom was renowned far and wide

Brahmin boys

Brahmin boys were brought up to learn the scriptures

But one day, this young man, the hero of our story, and the winner of many trophies, felt the pangs of unfulfillment.

Victory was always too easy for him.

To him, his future appeared bleak: it would be no different from his father’s, the greatest scholar in the kingdom. The thought filled him with dissatisfaction: he did not want the slow, contented life of his father. He wanted adventure, money, and a good name. He wanted to be known not only in his own kingdom, but all across the world. He was already well – known in the kingdom; he wanted his fame to spread far and wide.

Seeing him pensive, his mother sat by him and tried to understand her child; his words filled her heart with dread. He talked of leaving home, of travelling to foreign lands, of exploring the kingdoms far and near, of mixing with cultures alien to theirs. For long hours mother and child talked, and the kind mother tried to reason with him that the life in a King’s Court would be one of contentment and happiness. The son was bent upon a life of adventure; but you know how a mother’s heart is :

The thought of the child not being with her felt like a stone on the heart.

TONHF logo – Get it now!

THE ONLINE NERVE HEALTH FORUM is the one-stop shop for you to get information, guidance, and support for your HEALTH needs – whether PHYSICAL, MENTAL, ECONOMICAL, or SPIRITUAL!

Dr Rajshekher‘s insight:

This is The Online Nerve Health Forum App to access the FULL website! Install it on your Smartphone/Tablet for free and access loads of health-related information at the Click of a button! 

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Health Benefits of Blueberries

Blueberries contain the same compounds that are found in cranberries which prevent the bacteria that cause urinary tract infections from adhering to the bladder wall (Health Benefits of Blueberries,,,,,,,,,,,,,,)…

Dr Rajshekher‘s insight:

Blueberries have one of the highest antioxidant capacities among all fruits, vegetables, spices and seasonings. Antioxidants are essential to optimizing health by helping to combat the free radicals that can damage cellular structures as well as DNA.

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Dr Edward De Bono



I used Edward de Bono’s Random Word technique to generate some new ideas.
These were exercises in his book “HOW TO HAVE CREATIVE IDEAS”.

Dr Edward De Bono

Dr. Edward de Bono is the world’s leading authority on conceptual thinking as the driver of organizational innovation, strategic leadership, individual creativity, and problem solving. Since 1970 his exclusive tools and methods have brought astonishing results to organizations large and small worldwide and to individuals from a wide range of cultures, educational backgrounds, occupations, and age groups. Dr. de Bono delivers the advanced training solutions that are greatly needed for success in these challenging times.

I liked the process so much that I decided to share the results of my first effort with my friends and readers.
The Random Word technique requires you to select random numbers from Tables given at the end of the book; you use the first number for the Table number, the second for column number, the third for Group number, and the fourth to select the word in the Group as your Random Word.

Edward de Bono - how to have creative ideas

Everybody wants to be creative. Creativity makes life more fun, more interesting and more full of achievement, but too many people believe that creativity is something you are born with and cannot be learned.
In How to Have Creative Ideas Edward de Bono – the leading authority on creative thinking – outlines 62 different games and exercises,

As my first exercise, I selected the three areas in which you are asked to provide new Ideas; these are:
Can you generate some ideas of your own? Read on to check my answers, then contribute by posting some great comments!

Are Left – Handed people gifted? Or is it a sign of brain damage?

A majority of people are right – handed; many gifted people are left – handed – so this has given rise to the folk-lore that left – handed people are gifted. But what is the reality? This article may give you some startling facts on this topic!

Dr Rajshekher‘s insight:

Are left-handed people really gifted? Or is it a sign of brain damage? What is the reality behind it?

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Obese stomachs tell us diets are doomed to fail

The way the stomach detects and tells our brains how full we are becomes damaged in obese people but does not return to normal once they lose weight, according to new research.

Dr Rajshekher‘s insight:

Only about 5% of people who achieve weight loss through diet are able to maintain it for any lenght of time – this is an established observation; did you know that there is scientific evidence now that nerves and the hormone leptin has a role to play? This article summarizes the findings – and gives you some clue on what is a sensible way to lose weight!

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An Apple a Day

You may also like:

I am starting a new series: these are contributions from a dear friend, who prefers to remain unnamed. We get so many stories and jokes in our e-mail inbox and through all the Social Media sites that we lose count. But here are a few stories – very short and simple, yet giving us profound insight into our own lives and behavior.

Here is the story of a little boy who couldn’t seem to get simple math correct – and it was the teacher’s turn to learn something new!

Do read, comment, share, recommend – and maybe even implement!




Left – handedness has been considered a gift and a curse at different times in history and in different cultures – but what is the reality?

Left – handed people get a lot of attention – from scientists as well as society in general. Is this because there are so few of them – only about 8%? And this figure apparently has remained stable through the eons – or at least as long as humans have walked the planet.

This last bit is based on findings by archaeologists; their methods may be open to question, but apparently, animals have paw preferences, too, but among animals the preferences are more evenly distributed in the populations (about 50% for each paw).

Read on to know more about the latest on this subject.



Migraine and related headaches are responsible for 20% of all clinic visits, and they are the leading cause for loss of man-hours at work. It’s no exaggeration to say that not only is migraine a problem for the sufferer – it’s a headache for employers as well!


Student with migraine


Does Migraine Cause Brain Damage?

Migraine and related headaches are responsible for 20% of all clinic visits, and they are the leading cause for loss of man-hours at work. It’s no exaggeration to say that not only is migraine a problem for the sufferer – it’s a headache for employers as well!

Lady with migraine

Do frequent episodes of migraine lead to structural brain damage


A major concern for doctors and migraineurs alike is the burning question – do frequent attacks of headache lead to any lasting damage to the brain? Does a life-long battle with migraine leave scars in the brain? Do my headaches mean I am going crazy or demented?

I did my own search of the literature on this subject, and here’s what I found.

In Focus: Dyslexia

In Focus: Dyslexia.

Does your child suffer from learning difficulty? Are you frustrated because your child appears to be lazy and slow at learning? Are your child’s grades falling at school? Or are you a grown-up who always had difficulty reading, but hid it from the world to avoid the shame?

Epilepsy on Facebook

The Epilepsy Network (TEN)

The Epilepsy Support Group

Woman with Epilepsy on Anti - epileptic drugs

Drugs in pregnancy

Drugs in pregnancy

Pregnant women with epilepsy are a highly vulnerable population; they have to balance the risk posed to the pregnancy from having a fit, against the risk of taking medicines to control the fits.

There are a few anti-epileptic drugs which have been shown to increase the risk of congenital malformations in the baby; the risk is reduced considerably by the use of Folic Acid, which is now used even in pregnant women without epilepsy.

One great difficulty in this situation is of getting information on safety of any new drug in pregnancy; while safety is not established, it is considered unsafe to expose the mother and the baby to any drug. That is why, whenever a new drug is introduced into the market, there is a disclaimer that its safety in pregnancy is unknown.

The general guideline is to avoid using any new drug during pregnancy. Hence, data on safety in pregnancy is obtained only by anecdotal reports where someone has been accidentally exposed to the drug – and for this a Pregnancy Register is established in most countries.

An extremely well – designed study was recently published on this topic, and some very useful information was obtained about safety of anti – epileptic drugs in pregnancy. Read on for more information.


Exercise and diet

Change Diet and Lifestyle to Slow Aging

I want to live long and stay younger!

Aging is a process considered inevitable till a few short decades ago; only in the last century has life-expectancy (at birth) increased from a measly 31 years in the early 20th century to 67 years by 2011 figures. These figures are contentious, hence I am quoting the source here, but the fact remains that we are living longer – and hence, expecting more out of life.


I am sure I echo the sentiments of a majority of readers here. And this is the reason why Aging research is so heavily-funded.

Let me get on with the reason for this blog-post.

Child with head injury

Doc, Is my child’s brain scan okay?

Child with head injury

The Child with head injury is vulnerable as much from the injury as from parental anxiety, x-ray exposure and the anxiety arising from incidental findings on the brain scan!

The Child With Head Injury

I have had many parents bring their child after a fall, worrying about internal injuries that may not be apparent but which may prove dangerous later on. Cases of people dying after neglecting such injuries abound, and add to the anxiety, especially since the child herself is quite oblivious.

As a clinician dealing with this situation, my dilemma has always been to weigh the benefit derived from relieving the anxiety of the parents versus the risk of subjecting the child to anesthesia or sedation – which is required in many instances – as well as the small cancer risk arising from radiation exposure.

How do you think I should handle parental anxiety on this issue? Read on to know more about this…

Nothing Less Than A Miracle!

Nothing Less Than A Miracle

Imagine this place – the very place where you are at the moment while reading this – but 500 years in the past.

High likelihood it was something completely, utterly different from what it is today. Right?

The landscape was completely different.

None of the wide roads, no traffic, no honking cars, no bustling people rushing to their work-a-day lives.
Or if you are in an Indian village, chances are that even here the landscape was very different. No blaring horns, no movie theatres, no loud-speakers spewing the latest Bollywood item numbers.

Not all of these conjure up the best of 21st-century progress, I am afraid.

Ok, here’s some concession.

No mobile phones, laptops, 108 inch screens – forget it, no LCDs or plasma TVs to talk of!
Five hundred years ago is a long way off!
Earth is a good 5 billion years old! Now how many zeroes is that after 5? That’s 9 zeroes, 7 more than 500!

Mother Nature wrought many a miracle – make no mistake about it. Life is no mean miracle! But the miracles she wrought THROUGH Man in 500 years beat all the others in speed, don’t they?

Mother Nature has done more in the Miracles Department through one agent – Man – than she has without that agent in the longest time!

This thought occurred to me this morning, and felt like sharing with my dear readers!

Does your child have Dyslexia

In Focus: Dyslexia

Does your child suffer from learning difficulty? Are you frustrated because your child appears to be lazy and slow at learning? Are your child’s grades falling at school? Or are you a grown-up who always had difficulty reading, but hid it from the world to avoid the shame?

In this and the next few articles that I will publish, I will focus on this very common issue called Dyslexia; there is important new information coming in about this condition which should help teachers and parents together to help their child at an early stage to overcome the problem.

Can you name a few famous people who not only survived, but thrived despite Dyslexia? Here is a short list of these  people…..(Click Next)

TMS to study the function of brain areas

Excessive Thinking Worsens Performance

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How many times has your spouse told you to stop thinking too much? Do your parents nag you for worrying too much? Do you perform poorly in an exam because you get “psyched out”?

Well, here’s News for you: Conscious efforts to improve performance can actually make the result worse!

A new study published in the Journal of Neuroscience by a group of collaborators in University of California in Santa Barbara have found that there is evidence that parts of the brain involved in attention interfere with those parts of the brain required for forming a kind of memory called IMPLICIT MEMORY.

Read on to know more about this study….

Health News in Digestible bits

Obese lady

Obesity is an epidemic and is related to many diseases

Diabetes can be cured by Bariatric Surgery!

Diabetes is one of the deadliest diseases of mankind. One major reason why it is so deadly, is because with all the available treatment options, there was no way to cure diabetes.

But now, there are certain types of surgeries which can cure or improve the situation for the morbidly obese patients with Type 2 Diabetes Mellitus. Read on for more information…… 


Does prohibition really work?

Does Prohibition or Drug Control Really Work?

Draining liquor during prohibition

Draining liquor during prohibition

Drugs are a big concern not only in the UAE, where we live, but in the rest of the world as well.

The term Drugs, with an initial capital letter, obviously refers to Drugs of Abuse, Substances of Abuse – which include Alcohol, Hashish, opium, cannabis, LSD, Crystal Meth, etc.

A short list of drugs of abuse and their dependency rates

A short list of drugs of abuse and their dependency rates

The Drug Menace is eating away our youth. This is a world-wide phenomenon, and a major reason for drug-trafficking, for the existence of a Narcotics Squad, and so on. That’s a whole big chapter and it has it’s own vocabulary. Naturally, as young parents, we are all very concerned: our teen-aged kids are vulnerable, and we would not like them to be exposed to this menace. The authorities in the UAE are very vigilant, and there are strict rules, and as everybody knows, these are strictly implemented. The efforts by the UAE government in this are indeed laudable. Here is a link to the Abu Dhabi govt website which provides comprehensive information on the subject.

Government efforts for Prevention and treatment of Drug Abuse:

Abu Dhabi Police has a dedicated section for combating drugs.The UAE Ministry of Health provides a comprehensive directory on the measures to be taken when dealing with drugs in general. The National Rehabilitation Center: focuses on providing excellent services in the area of prevention, treatment and rehabilitation from addiction of alcohol and drugs. The Poison and Drug Information Center in the Abu Dhabi Health Authority focuses on providing the latest information about drugs, promoting the safe use of medicines, and protecting the society and professionals from poisoning.

The Center serves to provide the latest poison and drug information, promoting safe medication use and poison prevention.

The Center serves to provide the latest poison and drug information, promoting safe medication use and poison prevention.

Remember prohibition - it still does not work!

Remember prohibition – it still does not work!


Prohibition simply forces the activity to go underground

What everybody does not know is that strict implementation usually sends the activity underground; this has been the experience world-wide, including in India. This experimentation has been going on, especially with alcohol. In Gujarat, Prohibition of Liquor has been in force since 1947 without a break, but the ground reality is that liquor is available more or less freely; there is more underground trade in the item than in most other States, more money can be made out of it, and so on. Prohibition has been in force in Andhra Pradesh, a state in India,  from time to time, changing with governments; the effect has been that people have had access to it freely at times, and at other times they have resorted to smuggling it across the borders, making a lot of money in the process. When it has been freely available, the incidence of serious alcohol-related diseases have been there for us to visualize in a large scale, both at individual and at social levels.

Prohibition allows criminals to make a lot of non - taxable income

Prohibition allows criminals to make a lot of non – taxable income

So, both as a doctor, and as someone who looks at society in general, I have mixed ideas about prohibition. Let us look at the experience of North European countries (Scandinavian countries) which believe that such things like alcohol, drugs, sexual preferences etc cannot be curbed by prohibition, but would be more difficult to control if we were to implement such laws. They have tried to allow lax rules, while trying to put some sort of control on them at the same time. The result, as far as I can make it, has been that the people indulge in these activities at their leisure, and those of them who have had enough or too much of it, tire of it, and then chose more spiritual pursuits. Either way, it is a matter of choice.
Most people go through a phase in their lives when they want to experiment with things, enjoy the good life, hang-out with friends, fit-in with the crowd and do what their friends are doing. They are most vulnerable to getting addicted to substances of abuse at such times. After this, some of them are able to get over these addictions – by various means – either sheer will power or through assistance.
But a good number of such people are not able to – and crave for the drugs; and there is a huge market for these drugs. We want to keep such people away from drugs – but would it help if the drugs were made difficult to obtain? The experience so far has been that for those with strong cravings, this is hardly a deterrent: they simply have to pay more – and leads them to penury and dissolution faster.
In my opinion, the experience in countries where prohibition is applied strictly has been mixed at best; but a major disadvantage is that these activities then become more difficult to control.

Is legalizing drugs the right solution?

Is legalizing drugs the right solution?

What is the philosophy behind legalizing these activities?

Material cravings are a part and parcel of our mental make-up; a majority of us gain some modicum of control over this as we grow older. But for those caught in the grips of a strong addiction, does it help to merely make it more difficult to get these drugs?
By artificially creating a demand-supply gap are we not increasing the suffering?
So, in short, I am in favor of the methodology adopted by the Scandinavian countries as a little bit more enlightened one; maybe it needs further modification or evolution, that’s all.

Even important medicines become controlled or unavailable

Another down-side of such strong control of drugs is that any drug used as medicine, but which is known to have sedative side-effect, and therefore, on that basis considered to have abuse-potential, is kept on control list, then becomes difficult to obtain, and this is a serious concern for us for some really sick patients. I will write about this in a different blog; it would be comical, were it not for the lethal or near-lethal consequences.
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Your Cholesterol – How to make sense of it

Your Cholesterol – How to Make Sense of it.

For the time being the form above only provides interpretation for lipid panel reports giving the results in mg/dL. I am working on it to provide the interpretation for reports in mmol/dL as well – this will be out in a few days, just keep a check on this page.


Making sense of your Cholesterol report

Your Cholesterol – How to Make Sense of it

Who should monitor his/her cholesterol levels?

A high fat meal is one of the reasons for high cholesterol levels

A high fat meal is one of the reasons for high cholesterol levels

  • Have you been told you have high Cholesterol?
  • Does somebody else in your (blood) relations have high Cholesterol?
  • Does anybody in your immediate family have diabetes?
  • Has somebody in your family suffered a heart attack or stroke?

These are a few of the reasons for you to check out your cholesterol levels – and not just Total Cholesterol, but the entire lipid profile.

What is the Lipid Panel?

A blood test to check cholesterol levels — called a lipid panel or lipid profile — typically reports:

  • Total cholesterol
  • LDL cholesterol
  • HDL cholesterol
  • Triglycerides — a type of fat in the blood

For the most accurate measurements, don’t eat or drink anything (other than water) for nine to 12 hours before the blood sample is taken.

Click Here to make sense of your lipid panel report


Interpreting the numbers
Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood in the United States and some other countries. Canada and most European countries measure cholesterol in millimoles (mmol) per liter (L) of blood.

For the time being the form above only provides interpretation for lipid panel reports giving the results in mg/dL. I am working on it to provide the interpretation for reports in mmol/dL as well – this will be out in a few days, just keep a check on this page.

Over the next few days, I will provide a few more guidelines on diet and medical treatments, as well as information on why keeping a close watch on your lipid panel report is important.



Feedback can be a double-edged sword

Feedback – a can of Worms!


“Conway’s Law: In any organization there will always be one person who knows what is going on; eventually this person will be fired.”

– Anonymous

Giving feedback at the hospital

Giving feedback at the hospital

The administration at the hospital pleaded, then threatened, and then, when all else failed, pleaded again, for the staff to provide feedback.

They sounded too sincere and could take my feedback too seriously: that couldn’t be too good for my budding career! Enough reason to think twice before putting pen to paper.


But my close friend and confidante, a colleague at work, PK, felt more enthused, and decided to give some feedback for the administrative department. Combine that with my penchant for anything electronic, and what do you have? Yes, you have electronic feedback!

Read more about what happened after we gave feedback by clicking the share button!

Stroke Risk estimator

Assess Your Stroke Risk

Stroke affects millions of men and women around the world, and it can lead to disability and death. Many strokes are preventable, and there are important steps you can take to lower your risk.

This interactive tool estimates your risk of stroke. Anyone can use it, but it’s most accurate for people who have never had a stroke, a transient ischemic attack (mini-stroke), or heart disease. If you have any of these conditions, be sure to talk to your doctor about your risk.

A cat with BIG ears!

Feedback Week – How To Give It Without Losing Your Teeth


Have you ever felt things were not as they ought to be at your work-place? Have you ever felt a strong urge to contribute to improving the environment around you by giving appropriate feedback? If so, this story is for you.


The Boss giving it back!

Feedback is a 2-way street – you feed them, and they give it BACK!

This is a blog post I published a few years ago – the credit for the story goes to an esteemed colleague, who shall remain unnamed; but the lessons I learned from his real-life accounts are too profound and precious not to be shared with my readers, so here is a brief description.

Feedback Week was over; we had been asked to fill-out a 5-page questionnaire asking us how the hospital where we worked was doing as far as staff-satisfaction was concerned. After hesitating for a week over how candidly to fill the form, we finally submitted it with extensive modifications. It looked more like an 8th grader’s Answer Sheet on a day when he had lots of time to make corrections.

We survived the Feedback Week without too many losses. But we were treated to some feedback ourselves, by none other than the Director himself, as he waxed eloquent over what he thought about his superiors, and the sweat was still fresh above our brows.

He just couldn’t be stopped; he went on and on about the CEO’s extended family who were visiting, their various pets and how aggrieved he felt about having to be nice to all of them.

Fifteen minutes of patient listening from us unwound him sufficiently; he brightened considerably, thanked us profusely (I don’t know why), and left.

Sitting in PK’s room with our respective cups of coffee we were trying to get our eyesight back to normal; such onslaughts can leave your vision foggy and the body limp. I was more than a little riled. I know there is no such word in the dictionary, but when a man does a smear campaign (as opposed to a woman doing it), should we call it “dogging” or not?

“The boss is always right,” PK said, in an attempt to get the perspective back. “Never say anything against him, even if you think he is doing something wrong. Especially not on his face. You pay the price otherwise.”

“Sounds a bit extravagant,” I argued, “I mean, there has to be a limit, right? The Director is always so deferential to everybody; but behind the back, his language is something else! Imagine if we gave that kind of feedback in those forms, especially for things that really matter!”

“Yes, but that is life! He has to do that to keep his position safe. You want to needle him about it?” He waited a few breaths till I shook my head, before he resumed.

“Reminds me of a story,” he began, and then continued, ignoring my groans, “It’s very pertinent, you’ll understand. We were in this hilly location, a little ways off from head-office, but fully equipped, quite self-sufficient – you know how army cantonments are?”

As an ex-Army doctor, PK had his good points, but this was not one of them; he is apt to button-hole you for some of his juicier stories. But you realize how apt they are only at the end.

The way he continued speaking proved that his last statement was not really a question. “The camp commandant had a cat; now this one was a scrawny specimen with a bushy tail, and had a habit of finding its way to all those places where it was least welcome, and would look at you with piteous eyes and mew in the most miserable manner possible.”

A scrawny cat with imploring eyes

A scrawny cat begging for food

Egyptian cat in front of Pyramid

Egyptian Cat imploring for goodies

PK looked around to confirm he had captured his audience; I gave him my best get-to-the-point look. He continued undeterred: “One of the most offensive sights was its presence in the Officer’s Mess; it would land-up there at the most inopportune of times and make the most unreasonable of demands.”

Now the story was in full flow. “But who could dare object to its presence? Who could, literally, bell the cat? There was no soldier worth his salt in those barracks who could face that cat! Facing an enemy bullet was far easier!”

“So this cat had a grand time! The moment it entered the Officer’s Mess, the stewards would serve it milk, biscuits and whatnots; they would pamper it as if it were the Queen of Sheba herself!”
PK continued, “And the officers could not be out-done in their praise for the cat; some talked about its dreamy eyes, some compared its sharp claws and feline grace to those of a wild tiger, others praised its mewing as if it was the Nightingale’s voice! Even the second-in-command at the camp chipped in to describe the bushy tail, drawing on knowledge gleaned from some encyclopedia he had referred, about cats with bushy tails.”

“‘Egyptian cats have bushy tails,’ he said, ‘that proves that this grand cat has at least partial descent from an Egyptian lineage.’ By elevating the cat to somewhere close to Timur the Lame, this second commandant had solidly cemented his position. It goes without saying that all this kept the camp commandant in high spirits and all was hunky-dory at the camp.”

PK looked at me with the eyes of someone about to deliver the final denouement. “Then the camp commandant got transferred; he had to urgently report to another station, and left, leaving wife, daughter and cat for a month. They would follow when he had settled in the new place.”

“For one month, that master-less cat continued to roam about in the same way as it was wont; but now it had no admirers. People shunned it; those who had earlier found its eyes dreamy, now felt she looked hideous. Those who had praised her voice now thought her mewing grating. It irritated the steward no end when she reported to the mess for her daily cup of milk.”

“The second-in-command had now become the camp commandant, and was one day at the Officer’s Mess with us when this cat made its appearance,” PK continued. Her bushy tail apparently no longer appealed to him. He would rather have her shot, he exclaimed, and sling her from the nearest tree. He went on in that vein for quite some time, getting quite carried away with his emotions.Army marchers


Now PK is a hot-blooded man if ever there was one; he always had a little difficulty suppressing his feelings. So he asked the new commandant: “Sir, what happened, sir? Just one week back you were praising this cat, about its voice, its claws, its bushy tail, its Egyptian lineage and all that. Now all of a sudden it is worse than a pariah dog? What has changed, sir?”

There were a few moments of stony stares before PK was sent off to cool himself in the barracks. PK didn’t have much time after this, for he was given a 3 months’ posting to a remote outpost starting the next day, so he had to hurriedly pack his stuff and leave; he didn’t know what happened to the cat after all. He learnt later that the new commandant followed up this exchange by inquiring about ‘that impudent little medico who was talking so much’ from the other officers.

“You mean,” I could barely hide my amusement, “He sent you off to a place without any facilities for 3 months just because you gave him some direct feedback once?”

It was PK’s turn to give stony stares: “You see, you may think the worst about me, but when it comes to telling a tale, you will never find it impertinent!”

“You mean irrelevant,” I corrected him.

“I know the difference between impertinent and irrelevant,” he growled, glowering.”You are lucky I can’t post you to some remote place.”

It dawned on me that I had underestimated PK’s grasp of the English language; I had a sneaky suspicion he was giving me some feedback when he used the word ‘impertinent’. Anyway, as colleagues in a private hospital, he hardly had the power to send me to a remote outpost; but he could do other things, and I didn’t want to take that risk!

Feedback Week was over, for the rest of my life!
Posted 21st August 2011 by Rajshekher Garikapati


New Parkinson Disease Target for Therapy

Parkinson’s disease discovery pointing to new therapeutic strategy


Stooped posture and tremor in Parkinson Disease

Parkinson disease (PD), the second-most common neurodegenerative disease to afflict mankind after Alzheimer disease, is the target for intense research.

Read on for some amazing new information that should help develop new strategies to treat Parkinson Disease.

Gall stones

Gall Stones – FAQs

Gall Stones

by Dr Phanipriya Garikapati, MS, FMAS

Gall bladder filled with stones

A Gall Bladder filled with calculus or stones

Gall stones, or Stones in the Gall Bladder, are the commonest problems which afflict the organ. Gall stones can occur in any one – man/woman; child/grown-up, even the aged; thin/fat, and any race or ethnic group. Women are more prone to gall stones than men. The incidence is high in the pregnant status during which time complications too seem to be higher. It is sometimes seen to be present in different members of a family.

The earlier belief – that a Fat Fertile Female of Forty is the kind of person who gets a gall-stone – is no longer considered to be true.

Read further for more on gall-stones


Woman addicted to drugs

Addiction – a Disease or Weak Will?

MRI scan showing effects of addiction

Can we blame the addict, or should we pity her?

Is addiction a disease, or is it due to a weakness of character?


The simple answer is that addiction is now considered to be a disease state; but to make it more complex – we like it that way, don’t we? –  weak will adds to the problems.



Are we responsible for all our behaviors?

The law takes its own position on this – but medical science has progressively eroded our confidence on Independent and Free will – many now believe that we are what our hormones – or brain chemicals – make us.

Addiction is now considered to be a chronic brain disorder  that is initiated by the drug itself; imaging studies have revealed that prolonged and consistent use of drugs of abuse – be it heroin, cocaine, crystal meth, or alcohol – initiates and maintains changes in the internal circuitry of the brain which affects memory, thinking, concentration, behavior control, and decision – making. All these changes then somehow lead to the compulsive and destructive behavior characteristic of the condition.


Cocaine sniffing is popular among elites as well

Do circumstances or social factors play any role?

Addiction cannot be considered to be a purely biological or a purely environmental problem – it is a mixture of both.

That means that certain personality traits of the individual make them prone to compulsive,  repetitive, and mind-less behavior. Such people are also prone to suggestions, have a need to conform to a group or to their circle, and may have various reasons to start taking drugs along with their friends. These are environmental factors.

The Pleasure Priniciple

In the initial stages, taking the drug gives the person pleasure, called ‘a high’ in street slang, and ‘reward‘ in psychological parlance.


Intravenous Drug Use is possibly the riskiest

Reinforcers are agents which increase the possibility of a particular sequence of events happening in the brain circuits.

Natural reinforcers which produce the reward effect include sex and food; a drug has a greater effect as a reinforcer than any natural reinforcer, which is why drug-addicts give up sex and food in favor of the drug of abuse.

Changes with long-term abuse of drugs

On the other hand, repeated intake of the drug alters critical areas in the brain such that the individual suffers severe reactions – called withdrawal symptoms – if the drug is not taken; this initiates the vicious cycle of addiction.

Drug addiction before and after images

Drug addiction before and after images in Crystal Meth user

These changes have been documented in imaging studies, and much is now understood about the exact areas in which these changes occur. Based on this, several new therapeutic techniques are being evaluated.

For example, nicotine patches and e-cigarettes are helpful in reducing addiction to tobacco. Naloxone is used not only for morphine/heroin, but is also useful in alcohol addiction.

Chronic use of drugs of abuse result in changes in the protein and RNA within the cells, and that is one reason why the effects are long-lasting, even after the drug intake has stopped; this is the critical phase when the individual is at risk of relapsing to addict behavior.

Do genes have a role to play in Addiction?

Genetic factors contribute to the vulnerability to developing drug addictions and the different response to treatment for addiction.

The OPRM1 gene has been studied the most in this respect. One particular variant of the gene which makes the person prone to addiction (called the 118 G allele) is most common in Asian populations (40%–50%), has moderate frequency in European populations (15%–30%), and has very low prevalence in African populations.

The 118G allele has been associated with dependence to opium-like substances as well as to alcohol and other substances, reduced hormonal response to stress, and reduced benefit from morphine and other opiates.

Carriers of the 118G allele also show an elevated sensitivity to pain. Other genes are commoner in the other races.

Does this mean addiction is inherited?

When certain diseases are seen more frequently in some families, the temptation is to blame it on genes; this is the great Nature versus Nurture debate.

The basic point is that a family shares not only genes, but a common environment.

The currently accepted model here is that genes do play a very important role in expression of diseases, especially those affecting our minds, psychology, or behavior; but these genes express themselves more depending on the environmental factors.

This means that it’s not enough for an individual to have the genes; if the parents model certain kinds of behavior for their children, then those who have the relevant genes are more likely to express similar behaviors.

So the blame is not entirely on the genes, but also on our own behavior!

Some Fundamentals of Brain neuronal circuits


A neuron

A Neuron has a cell body and some projections – called dendrites and a single Axon

As we all know, the brain is made up of nerve cells, or neurons.

Neurons connect with each other through their axons and dendrites, and communicate with each other across this connection called the SYNAPSE.

This communication involves transmission of very weak electrical currents. This electrical current differs from the electricity we use in our daily life – because it is related to chemical changes – it is an electrochemical phenomenon.

Spatial memory circuit

Proposed map showing connections in the Medial Temporal lobe, explaining the circuit which plays a central role in spatial memory (an example of a circuit in the brain)

Information is transferred across the synapse through special molecules called neurotransmitters; examples include adrenaline (epinephrine), dopamine, serotonin, etc.

The hippocampo-entorhinal circuit

The hippocampo-entorhinal circuit – and illustrative image; the hippocampus receives inputs from layers 2 and 3 of the entorhinal cortex and sends output to layer 5 of the entorhinal cortex

Neurons combine together to form circuits; based on their connections, these circuits play specialized roles.

Learning new skills is dependent on reinforcing activity within special circuits. As we practice more and more to develop a skill, activity in a particular circuit becomes progressively more efficient. This concept of circuit is important to understand addiction.

Drug addiction involves multiple brain circuits

A network of four brain circuits are involved in drug abuse and addiction: (a) reward, located in the nucleus accumbens (NAc) and the ventral pallidum; (b) motivation/drive, located in the orbitofrontal cortex (OFC) and the subcallosal cortex; (c) memory and learning, located in the amygdala and the hippocampus; and (d) control, located in the prefrontal cortex and the anterior cingulated gyrus (CG).

Don’t worry if the anatomical names here don’t mean anything to you; the important point is that reward, motivation/drive, memory and learning, as well as (executive) control have special circuits; activity within a circuit is either suppressed or enhanced in a given situation.

Findings on Imaging Studies

Imaging studies – such as PET and fMRI have revealed neurochemical and functional changes in the brains of drug-addicted subjects that provide new insights into the mechanisms underlying addiction.

Crystal Meth user

An example of the kind of effects Crystal Meth has on the face of the user

Neurochemical studies using these high-end imaging technologies have shown that increases in a major neurotransmitter in the brain called dopamine are associated with the reinforcing effects of drugs of abuse.

Cingulate Cortex

The Anterior Cingulate Cortex becomes hypo active during chronic addiction

After chronic drug abuse and during withdrawal, brain dopamine function is markedly decreased; this decrease leads to dysfunction of parts of the fore-brain (prefrontal regions including orbitofrontal cortex and cingulate gyrus), which have much to do with our capacity to think, judge, and take decisions.

Functional imaging studies have shown that during drug intoxication, or during craving, these same (frontal) regions become activated along with other areas which are related to reward, motivation, memory, and cognitive control.

Model for Addiction

Based on these findings and our understanding of brain neuronal circuits, a model for understanding addiction has been proposed.

As per this model, addiction is a state initiated by the qualitatively different and larger reward value of the drug.   This triggers a series of adaptations in the reward, motivation/drive, memory, and control circuits of the brain.

Activation of reward pathway by drugs

Activation of reward pathway by drugs

These changes result in an enhanced and permanent value for the drug, and in the loss of inhibitory control (from the forebrain), favoring the emergence of compulsive drug administration.

Implications of this model

The model has treatment implications, for it suggests strategies to combat drug addiction — specifically:

(a) Interventions to decrease the rewarding value of drugs, such as pharmacological treatments that interfere with the drug’s reinforcing effects as well as treatments that make the effects unpleasant;

(b) Interventions to increase the value of nondrug reinforcers, such as pharmacological and behavioral treatments that increase sensitivity to natural reinforcers and establish alternative reinforcing behaviors;

(c) Interventions to weaken learned drug responses,

(d) Interventions to strengthen inhibition, such as cognitive therapy.

Fruits, vegetables, whole wheat and bran

High Fibre Diet Good for Health

Fresh fruit and vegetables are rich in fibre

Fresh fruit and vegetables are rich in fibre

High Fibre diet is good for health.

By Dr Phanipriya Garikapati, MS

High Fibre diet improves constipation

High Fibre diet improves constipation

A diet rich in fibre improves constipation – it keeps stools soft and bulky.

Diagrammatic representation of Anal fissure and piles

Diagrammatic representation of Anal fissure and piles

Cancer of the Colon

Cancer of the Colon

Highly refined or canned foods poor in fibre tend to cause constipation, and predispose to various anal conditions – anal piles, haemorrhoids, and fissures.

Haemorrhoids or piles

Haemorrhoids or piles

Some other diseases prevented by high-fibre diet

Read on to know more about this….

Trudy Bentley Reich Dreamer

How a dream told me to use Natural methods for treatment!!

Dreams are symbolic, and full of hidden meanings. Sometimes we have to try hard to understand them; at other times the meaning may be embarrassingly obvious. But the interpretation of dreams can be an involved and difficult subject.

I recently had a dream which led to its meaning within minutes of having it: my mind, or whatever it is that causes us to have dreams was sending me some message, and didn’t want me to miss it. I resolved to set it down in black and white in the morning.
It was a strange and fantastic dream; there was an animal in it, something which I thought was an elephant, but it progressively became larger during the dream.

It was ailing with something, and I was very concerned and worried about this, as were some other people in the dream, who were, unfortunately, only vague figures. I was a doctor in my dream, so I understood some of the problems; it was some sort of anomaly of the animal’s body part. It had some abnormality of it’s legs and other body structure which made it difficult to move, and we were trying to transport it to some place where it could be provided help.

But this was not easy, and as I mentioned, the animal – the elephant – was progressively becoming bigger, fell off from the vehicle we were transporting it in – and one of my friends reported, in a very unhappy and terrified way, that one side of the animal’s leg was unusually long, malformed, and completely immobile, and that it seemed completely hopeless trying to help it!

At this point, I woke up, and in a still groggy state, staggered to the washroom. As I was relieving myself, the meaning of the dream flashed in my mind; the dream imagery was still in my mind, still very fresh, but now I was aware that this was a dream. This was a lucid dreaming state, and my conscious mind now gave me the meaning.

What it told me was that there are many problems in the world which are due to the natural state; don’t try too hard to solve them. Don’t try so much that you use unnatural methods to solve problems. There is some personal message here also, I believe, because I often catch myself trying too hard for things.
But the most important message I thought I got from the dream was that one must use only natural methods for healing and curing; or maybe the emphasis is on avoiding unnatural methods. This can be the starting point for further understanding and application, I suppose, but the message itself is clear enough.
Posted  by 
Anti reservation argument

Professor Niall Ferguson’s article and the Indian Reservation policy

Professor Niall Ferguson’s article (Opinion page, Khaleej Times, 18 Oct 2011; Click here to go to article) highlights a very important aspect of public life, which is also a factor in the Great Indian Debate on Reservations.

Niall Campbell Douglas Ferguson

Ferguson at the Special World Debate, 2 July 2010 (age 49)



Centuries of dominance of some castes over the others led to great social inequities in Indian society. Money, land, and power were in the hands of the few who were privileged in the past. This created deep divisions in society which created huge sections – once grouped as “untouchables” – who were downtrodden.
Around the time India gained independence from British rule, uplift of these sections was seriously attempted. Mahatma Gandhi called them “Harijans”, a term of endearment which was an effort to make affluent sections treat them fairly. BR Ambedkar was instrumental in framing the rules of Constitution in a way that allowed Government department to look upon these sections favorably, a process called positive discrimination, reverse discrimination, or Reservation.

Dr BR Ambedkar

Bhimrao Ramji Ambedkar 14 April 1891 – 6 December 1956), popularly also known as Babasaheb, was an Indian jurist, politician, philosopher, anthropologist, historian and economist. A revivalist for Buddhism in India, he inspired the Dalit Buddhist movement. As independent India’s first law minister, he also oversaw the drafting of the Constitution of India.


At the time of framing these rules, it was envisaged that the rules for Reservation for government jobs would be applicable for the first few decades; by this time, it was hoped, these sections would be uplifted sufficiently so that the social inequities that existed then would disappear.
Unfortunately, this did not happen; the poor remained poor, the rich got richer, and the under-privileged and under-represented sections remained as they used to be. Reservations were continued due to this failure, the thinking being that many centuries of backwardness cannot be reversed in such a short time, and more time would be required. Reservations were extended to include education, starting from colleges and universities, and progressively extended downwards to schools when it was realized that the lack of opportunities at that level were ultimately responsible for the lack of benefit from reservations at the higher levels.


One aspect of reservations has never been seriously considered by pro-reservationists: do reservation of jobs and seats in colleges and schools really help to reverse the existing backwardness? This question should be addressed seriously without prejudgment.
Many people who are against reservations are those who have been born in under-privileged families and have exactly the same problems as those benefiting from reservation.
The current generation benefiting from reservations are backward not because of caste divisions which exist today, but from the effects of those divisions in the past, which are now either defunct or have no significant economic effect. There are still pockets in society where this discrimination exists (in terms of economic suppression), but these have ceased to be active in the general stream.
Backwardness in today’s India is along economic lines rather than along caste; but reservations are still practiced in the terms of the older classification. There has been an effort to exclude the “creamy layer” of privileged BC members from the ambit of reservation, but there is no effort for the backward members of those sections previously classified as “Forward Castes.
Abandon caste respect merit


Professor Niall Ferguson has clearly said in the article that it is lack of opportunity that is the root cause for many ‘geniuses going unrecognized’. In Indian society, years of practicing a skewed reservation policy has resulted in the development of a huge section of economically backward “Forward caste” members who lack opportunity for intellectual and economic development.
The solution lies not in reserving seats in schools and colleges, or reservation in jobs; rather, as pointed-out by the professor, we need to provide all sections equal opportunity in material terms to enable them to compete at an equal footing with everybody else. This involves much more government engagement in the shape of providing the wherewithal to attend school and college to these sections.
The difficulty all along has been the misuse of existing laws and the leakiness of any government scheme to benefit weaker sections of society due to inherent corruption and greed. These problems have to be tackled along with a change in policy as well.
Without this change in thinking in society, we will continue to create more social inequity, and caste-divisions will only become deeper.
Posted  by

Woman addicted to drugs

Addiction – the science behind it

Woman addicted to drugs

Alcohol, cocaine, heroin, hashish, cannabis – what causes addiction?

Is addiction simply because of a weak will? Can we blame it on bad circumstances, the stress of modern life, peer pressure, or the compulsive need to conform? Or is it a physical malaise, and the sufferer is helpless to do anything?

Right from Ancient times, till as recent as a few decades ago, Addiction was considered a flaw in character, reflecting a weak will. Addicts were largely looked down upon, objects of loathing rather than pity. Addiction was considered a sin and addicts were publicly flogged or otherwise punished.

Modern Science has a way of turning our beliefs on their heads – and then just as we start settling down into a new Belief system, it makes an about – turn on the issue; so much so that every new scientific discovery now comes with its own disclaimer!

So what is Science now saying about addiction? Is the current trend of blaming everything on either genes or one’s circumstances the story for this hot topic as well?

The Nature versus Nurture debate appears to have been given some respite, with the consensus that it is never “Either Nature or Nurture”, but actually “Nature Through Nurture”. This is an excellent middle-ground, because you can please both sides without having taken any sides!

But my reading of biological processes tells me that this is indeed the correct viewpoint; if your son is as destructive as you are, chances are that he has your genes, but you are also modifying his choice by modeling destructive behavior for him to emulate!

Life is much more complex than a simple Nature vs Nurture debate, and so is the topic of Addiction; the numbers of people in the grips of impulsive and addictive behavior tells me that it is a burning question in everybody’s mind. That is why I decided to look up the available literature to try and understand the current ideas on the topic.

For answers to these questions, visit this blog in a few days!


Cell phone use and cancer

Prolonged cell phone use

Prolonged cell phone use close to the head is the norm these days

Cell phone use and cancer

Does prolonged cell-phone use cause cancer or other health effects? This is a burning question ; about 30% of Americans believe – without any evidence to support the belief – that prolonged use of cell phones is associated with brain tumors.

Are there other health effects of the non-ionizing radiation associated with mobile phones? People avoid keeping the phone in the upper left pocket of their shirts – too close to the heart!


Smartphones have a higher tendency to emit non-ionizing radiation

But what is the scientific evidence on this topic?

I was prompted to do my own reading on this topic when a paper was recently published in the International Journal of Behavioral Nutrition and Physical Activity1.
Read on to learn what I found out!







Blood vessel wall layers

Heart Blocks in Diabetes – new targets

Diabetes graphic

Diabetes is the most common of the deadly diseases which afflict Mankind

Heart blocks in Diabetics – key mechanism unraveled

Diabetes is known as a silent killer – most notably because of its effects on the blood vessels.

Major DM complications

The major complications of Diabetes

Diabetes can affect the smaller blood vessels (microvascular complications) leading to disease of the retina or the kidney.
Or, the effect of Diabetes can be on large blood vessels (macrovascular) leading to heart disease (cardiomyopathy) or on the large blood vessels leading to hardening of these vessels (atherosclerosis).

What is Atherosclerosis

Atheroscelrosis or hardening of the larger as well as smaller blood vessels due to accumulating fatty deposits can lead to heart attack and stroke.

Diabetes leads to blockage of blood vessels by increasing fatty deposits (atherosclerosis)

Diabetes leads to blockage of blood vessels by increasing fatty deposits (atherosclerosis)

What are the risk factors for Atherosclerosis?

The risk of atherosclerosis is universal in all humans, but various factors increase the tendency in some groups; Hypertension, Diabetes, High cholesterol and lipids, smoking, excessive alcohol are some of the most important of these factors which increase this tendency.

What is the mechanism of accelerated atherosclerosis in Diabetes?

So far it was known that the high blood glucose levels in Diabetes was somehow responsible for this effect, but the exact mechanism had not been worked out in full detail.
While controlling blood glucose remains the major target for any diabetic, it also remains a challenge due to difficulties in maintaining strict control over diet, as well as emergence of some problems, such as insulin resistance.

Latest Research

Researchers have recently found that the high blood glucose in diabetics increases a specific enzyme called the Protein Kinase C (PKC) in the endothelium (the inner lining membrane of the blood vessels).

Blood vessel wall layers

The vessel wall layers showing the inner lining or endothelium

Activation of the PKC enzyme has been shown to have an increased effect in fatty deposits in blood vessels, accelerating the atherosclerotic process.

This data has come conclusively from recent studies done on laboratory rats, which were genetically modified to make them prone to diabetic macrovascular complications.

Drug trials on various agents which can inhibit the PKC enzyme have only been partially successful; this is partly because there are many variants of the PKC enzyme in a person’s body, and to be effective, a drug should be able to block all the various isoforms.

Future studies

Further clinical trials are being planned with drugs designed to block all the PKC isoforms, and these studies should help us understand whether blocking this mechanism can prevent some or all complications of diabetes.

The Bikini Babes!

How much glucose in your food?

How Much Sugar Is In Your Food?

Are we aware of exactly how much sugar or glucose we consume when we eat something?

Spoonful of sugar

Even though our cells need sugar (glucose) to survive, consuming too much of it can cause numerous different health problems

As a physician dealing with patients who have diabetes among many other things, I discuss diet on a daily basis.
I tell them that DIET is the first level of treatment of diabetes; only after a perfected diet fails to control your glucose do we escalate the treatment to include medicines (oral hypoglycemic agents, OHAs).
So, my question to you – are you aware how much calorie is going down the hatch when you are devouring that cake?

Read on to find out!!

Miserable lives of doctors

Miserable lives of doctors

Most doctors lead miserable lives but are too egoistic to admit it.
They spend a major part of their young adult years educating themselves, learning skills they will use in their later years to earn a living, when the rest of the world is out enjoying themselves.
The rest of the world pays the price of their debauchery, of course, by falling ill and needing these doctors by the time they are in their 30s and 40s, and the doctors become busy serving their clients and earning briskly – and making a killing.
This is the reason that for a pretty long time, the doctor’s profession, in addition to being called a noble profession, was also considered a very lucrative one, and everyone knew that a doctor’s family would never die of hunger.
Now let’s see the other side of the coin.
In a world where a job is the be-all-and-end-all of a career, being qualified as a doctor is indeed the best – you can never really be unemployed.
But things have moved way beyond that, and this is the era of passive income; people now work towards creating passive income, not only in Real Estate, but in the share market and other places. Even if you earn a lot of money in the job market, you would be losing money in inflation if you don’t park your money in investments and assets that earn you a passive income.
A job, or any career, which depends on continuous effort of the individual makes you a slave, and nothing more; this paradigm shift in our thinking was late in coming, but is now happening. Even getting two jobs is no insurance against an illness in the family.
This is why even the best job in the world is not enough to give you any passive income. And guess what, the best job, for which you spend the longest period in your life learning, is possibly the worst, because by the time you reach the pinnacle of success, you are in such rarefied company that nobody else can take your place. You may get a lot of respect, but try trading respect for the supermarket bills.
You are doomed to do the job yourself and have nobody else who can take your place even to give you a short breather. As medical care has improved and we lead longer lives and enjoy life more, we spend lot more, and we end up becoming broke in later life when we are least likely to be able to generate an active income.
But forget the future for a while; is a doctor’s current life any better? Even a hefty pay packet is not worth the life-style, since they don’t have the time to enjoy the good things in life. From year-end to year-end, all the doctor does is work at the hospital, and this is considered normal, because everybody else is doing the same!
If this was the price for a great future, that would probably be worth it; but that is something we already decided to forget!

Celebrities endorsing e-cigs

What is an e-cigarette?

E-Cigarettes and the future of Vaping!


Smoking e-cigs is now fashionable

Smoking e-cigs is now fashionable

An e-cigarette is designed to look and behave like a cigarette but delivers only vaporised nicotine and none of the toxins associated with tobacco to its users; people who use e-cigarettes call themselves “VAPERS” rather than smokers!


They look and feel like real cigarettes, but they’re much more than that.

The look and feel of e-cigs

The look and feel of e-cigs


Created in 2003 and introduced to the U.S. market in 2007, e-cigarettes give smokers the freedom to smoke whenever and wherever they want, tobacco-free, while simultaneously quitting their traditional smoking habits.


Doubling in market share annually, electronic cigarettes are taking off.  E-cig brands seem to be popping up everywhere. Presented as healthier, cheaper, and more environmentally-friendly than cigarettes, smokers are using them to break their habit and

celebrities are endorsing them.

The components of an e-cigarette

The components of an e-cigarette


Components Of E-Cigs

It looks like a cigarette, smokes like a cigarette, but doesn’t damage or smell like one. This product is a tobacco-free simulation of the cigarette experience. It’s actually an electronic inhaler. The flame is simulated, along with the vapor smoke, and plastic ash tip. The whole experience is “fake,” but satisfying. E-cigarette smokers inhale and exhale a liquid nicotine vapor heated by a battery; the amount of nicotine is chosen by the user.

Although e-cigs lack tobacco, they do have nicotine and other potentially harmful ingredients.

Myths about hookah

Myths about hookah

Is This The Future Of The Cigarette?

Many other substitutes have failed, but the smoking experience provided by e-cigs is a

Smoking substitutes - the nicotine patch

Smoking substitutes – the nicotine patch

sure sign of success for this product and market. Why? Because people addicted to cigarettes are addicted to holding the packing, taking out a cigarette, putting it to their lips, and inhaling. The entire step-by-step process is a package that triggers the emotional response of the smoker.

Harmful effects of smoking

Harmful effects of smoking

The niche for this smokeless product might be the key to understanding the success of the e-cig. Take smoke as an example. Both smokers and nonsmokers hate the smell of smoke; e-cigs have a pleasant aroma–an important differentiator in the market.

Cigarettes were once a cause for alienation of their users, but e-cigs have made it possible for users to “smoke” indoors with little-to-no disruption of other patrons. The indoor smoking of this product has been prohibited in some locations.

Second-hand smoking is an important reason for alienation of smokers

Second-hand smoking is an important reason for alienation of smokers

The safety of secondhand nicotine-vapors is not known.

The ECITA logo

The ECITA logo

To read further on safety concerns of e-cigarettes, go to this Medscape article.

The Raja of Awadh

The Raja of Awadh – on Belief

This is a true story, with only minor deviations in some details, since the events described here happened more than a thousand years ago, in the great kingdom of Awadh.


The majestic emperor of Awadh, Maharana Umed Singh, was well-known as a mighty


Maharaja Umed Singh of Awadh

Maharaja Umed Singh of Awadh

warrior. His legendary skills as a soldier were part of the folk-lore. It was said that no one who had dared to fight him in single, unarmed combat had ever come out unscathed; either they were killed in battle or subject to humiliating defeat. With the sword, he was a terror to even the best of swordsmen.

As commander-in-chief of his father’s army, Umed Singh proved himself to be a master tactician. He meticulously planned and executed each move in battle, and led his army to inevitable victory. And the more his body acquired the marks of battle, the more

Umed Singh was a master strategist and tactician at war

Umed Singh was a master strategist and tactician at war

his fame grew, so that by the time he ascended the throne at the death of his father, balladeers sang at cultural events of his great courage and skill. During his 30-year rule of Awadh, he won many battles merely on reputation. His enemies trembled in their shoes at the very thought of meeting him in battle.

But, being a kind man at heart who eschewed violence if he could, he ensured that all neighbouring kingdoms lived in peace and paid his respects to every ruler.

The period of his rule was truly a golden one; but Umed Singh was dejected towards the end of his tenure. The two sons his first wife had borne had lived a motherless life, since she had not survived childbirth. He gave them enough love and attention, or so he thought, and under the able tutelage of different teachers, they grew up to be great warriors themselves; but in his heart, Umed Singh knew that neither possessed the tactical prowess that he had, or the canny ability to lead their soldiers to victory after victory, in the manner he had.

Raja Umed Singh in full battle regalia

Raja Umed Singh in full battle regalia

And on this particular day in April in the 30th year as ruler of Awadh, he stood, in full battle regalia, dejected and unsure of himself, for he was faced with the responsibility of leading his men into yet another battle with the army of Magadh. Now in his 60th year and not as agile as he used to be, Umed Singh was a mere shadow of his former self. The towering personality with the powerful visage before which even friends trembled like leaves, was sagging and despondent. Care lined his furrowed brow, and the thought of the battle filled his mind with dread. In his bosom, he felt that his people faced certain defeat. Never in his life had he felt so utterly alone, for both his sons had given up active soldierly life for the pleasures offered by wine and women.

The loyal ministers of Awadh had full faith in their Rana, but observing him dejected and fearful for the future of the kingdom, they felt frightened, too. Calling an urgent meeting, they had discussed the implication of this situation, and came to the conclusion that it was not possible for the Rana to lead them to victory in this state of mind. They resolved to take the advice of a famous saint of the time, who also happened to be the Teacher, Advisor and mentor of their king. This mendicant had been summoned and was now in the palace to meet the king.

The Mendicant who taught, guided, and mentored Raja Umed Singh

The Mendicant who taught, guided, and mentored Raja Umed Singh

Observing the king pacing up and down in his chamber, the mendicant placed a kindly hand on his shoulder. The obsequies over, the mendicant sat in the offered chair and chided the Rana on his mental condition. “How can you expect your soldiers to have any belief in themselves if your own mind is racked with disbelief, O King?”

Umed Singh was at a loss for words, and the mendicant realized that the only way that Awadh could win in the coming battle was to increase the King’s belief in his own victory. He rose, and pulled lightly at Umed’s arm, saying, “Come with me, O King! Let me show you something.”

After a moment’s persuasion, the Rana rose reluctantly and followed his venerated teacher to the next room, but even as he did so, he noticed something very strange.

The Raja was amazed to see signs of celebrations

The Raja was amazed to see signs of celebrations

Though very familiar with the rooms around his chamber, he noticed that there was something unfamiliar. Then he realized that the scene was very unlike what he had seen a few minutes ago; there were a lot more people and the hubbub of excited voices filled the room. He passed a calendar on the wall, and noticed to his utter astonishment that the date was not in the month of April, but rather, it was almost a full 3 months later!

He was getting more and more perplexed; at first he tried speaking to his cousin who was standing with a battle-weary group, in tattered and bloodied clothes but wearing triumphant smiles, talking about their exploits in the last battle. But when he approached them, they not only did not answer him, they did not even turn to him when he spoke. Not used to being ignored, anger rose in his heart as he tried shaking his cousin by the shoulder, and found that he could not!

The Arati was performed with Regal pomp and show

The Arati was performed with Regal pomp and show

It slowly dawned on him that the mendicant had used his extraordinary powers to make them invisible, and had actually brought him into the future! And his surprise knew no bounds when he saw himself in the room at a distance from where he was now standing.

He decided to watch the proceedings, and realized that his own self (his body double, which was him in the future) was now the subject of attention, as his many wives busily conducted a welcoming arati on him. There was much pomp and show, and the whole ceremony took the better part of an hour, after which a grand feast was laid out for all guests. During the meal, the soldiers shared their experiences, and he realized that the battle of Magadh had been successfully completed! It took nearly 3 months, and many lives were lost, including his brothers, but in the end victory had been theirs! The best part was that somewhere in between, his two sons had given up their life of debauchery and  joined him in battle, and the transformation had come about through the very women into whose arms they had surrendered themselves!

The mendicant walked king Umed Singh back into his previous room, back to the present. Needless to say that the king found new courage from this glimpse of the future gifted him by his teacher, and went into battle with renewed vim and vigour, and led his men with much more enthusiasm than he had before witnessing the above scene, so that whatever he saw and heard there actually came to pass. But for us, the conversation he had with his teacher after that experience is much more informative.

Perplexed by what he had witnessed, the king pressed his teacher to explain: “Did I really see us all after the battle? How is that possible? Was that an illusion, or a hallucination? Did you make me see what I wanted by playing tricks with my mind?”

The mendicant explained everything thus: “O King, the future always remains a possibility, and never a certainty for our current selves. If it were to become a certainty, then it would cease to be the future, and become the past. What was it that you saw? That’s a choice that you will have to make; if you think it was a dream or an illusion, then that is what it will be. If you choose to believe that it has happened in reality, it can be that also. We create our own future, first by thinking or saying what we want it to be, and then going out and doing the things to make it happen. Belief is everything; but belief in external things is only the beginning. When you believe in yourself and in your ability to create the future of your choice, that is when the real work starts for the creation of your own cherished future.”

A bloody battle ensued

A bloody battle ensued

History has of course recorded the bloody battle that ensued; the events that happened immediately prior to that battle, and which I have recorded here for our benefit, have remained a footnote to that record. In my opinion, the lives of great men of the past teach us important lessons not only by their actions, but also by the choices they make, whether it is with regards to the advisors they choose to listen to or the lessons they choose to learn.

Life truly is a matter of choosing, and choosing wisely.

What’s It Like To Ask Warren Buffett For Money

What’s It Like To Ask Warren Buffett For Money | LinkedIn

John A. Byrne February 07, 2013

What’s it like to ask Warren Buffett, the third wealthiest man in the world, for money?
[slideshow_deploy id=’739′]
Though he has pledged to give away 99% of his fortune, it’s apparently not so easy to get the Oracle of Omaha to write a check.

Just ask Columbia Business School Dean Glenn Hubbard who is in the midst of raising $500 million for a new business school campus. Buffett enrolled at Columbia Business School after learning that securities analysts Benjamin Graham and David Dodd, authors of one of his favorite investing books, taught there. He ultimately earned an MS degree in economics from Columbia in 1951.

Buffett, whose net worth is estimated at around $50 billion after having given billions away largely to the Gates Foundation, was an obvious person for Hubbard to come to with tin cup in hand. But in an interview with, Hubbard acknowledged that he hasn’t been very successful.

“You know,” says Hubbard, “Warren is close to the school. He visits and sees our students. And he says amazing things. He says that Columbia Business School changed his life. It’s terrific. But that’s not going to happen.”

Asked if that’s because Buffett prefers to put his money into saving lives rather than training investment bankers, Hubbard insists that a business school has social value.

“I think what we are doing makes a social difference. I think people who go out and create wealth are a noble thing. I often sit with donors who say they would rather give to the hospitals or the medical school and I talk them out of it — not because I don’t think giving to medicine is not valuable but we are valuable, too. It’s not just minting investment bankers. That’s not what our life is about. I have made this argument to Warren. I have made so many arguments to Warren,” adds Hubbard.

“One of his points was, ‘I invest better than you and so I want to hold the money.’

“And I said, ‘Well I have a great deal for you, Warren. Just give me stock. I won’t sell it. I will hold it.’

“He said, ‘You’re good but you’re not that good.’”

For the rest of our interview with Hubbard which includes his views on the value of the MBA, the impact of online technology on business education, and why he felt like Wile E. Coyote when the school’s MBA applications plunged 19% last year, see

A Remarkably Candid Interview With Columbia Business School Dean Glenn Hubbard

via What’s It Like To Ask Warren Buffett For Money | LinkedIn.

What Happens after the Concussion?

MommaSaid | What Happens after the Concussion?

February 1, 2013

I am absolutely certain that I suffered at least one untreated concussion while playing soccer as a kid. This is where I’m supposed to say, “But I turned out fine.” Only, I know better. Lately, concussions have been receiving a high profile in the youth sports community, in part because of greater awareness.

In fact, last season my fellow coaches and I were required to undergo the Heads-Up concussion training in order to coach club soccer. And our U-14 boys’ team has seen our share of concussions, one on our watch, two on other soccer teams, one on a skateboard and one in a car accident with a basketball re-injury.

In January, I attended a round-table discussion on concussions at the National Football League’s headquarters in New York City, where we learned some of the ways that football is changing to better avoid and treat concussions. The best advice for all coaches, parents and athletes, “When in doubt, sit them out.”

According to the Centers for Disease Control and Prevention, ERs treat an estimated 173,285 sports- and recreation-related Traumatic Brain Injuries, including concussions, among kids ages 0-19.

Thanks to the CDC’s Concussion Program, I know how to identify the symptoms of concussion:

  • headache
  • difficulty thinking clearly
  • difficulty concentrating, remembering new information
  • irritability, more emotional
  • sleeping more or less than usual
  • balance problems
  • sensitivity to noise or light
  • nausea, vomiting
  • fatigue

But what happens after the concussion? I’ve seen kids return to school too soon, only to go back home for days, even weeks, when their symptoms act up again.

“Every time you stress the brain and make symptoms worse or bring them back, it’s telling the kid, ‘I’m not recovered yet,’” says Dr. David Dodick, Professor of Neurology and Director of the Concussion program at the Mayo Clinic in Phoenix, Arizona.

He recommends a gradual return to class for concussed students, assuming they can first read and sit at a computer without symptoms. He likens it to returning to sports after an injury. You start slowly, by trying the exercise bike a few days a week. You don’t just return to a weekend-long tournament. Of course, your child should never return to normal activities without a doctor’s permission.

Dr. Dodick, who is also the president of the American Migraine Foundation and the immediate past president of the American Headache Society, reminds parents that kids actually want to go back to school, so they may try to hide their symptoms. They don’t want to fall behind in school, and they miss their friends. What’s more, parents don’t want their kids to fall behind at school by missing class and tests, so sometimes they push them to return to school before they’re fully recovered.

“But that prolongs recovery, and then they can start under-performing,” he warns. Taxing the brain that’s still recovering can actually make the situation worse in the long run. He suggests that parents stay in contact with the school nurse, who can help oversee the concussed child’s return to school, checking in with teachers and the student during the school day.

“It takes a community of people and a coordinated approach with the parents, teachers, school nurse and healthcare provider,” says Dr. Dodick. “You’ve got to think about the kid, their health and the long term.”

Meanwhile, 39 states have adopted concussion laws designed to help young athletes and their families, coaches, teachers, and healthcare providers deal with concussions. Check out what your state is doing (or not doing) to help:

Related posts:

via MommaSaid | What Happens after the Concussion?.


Migraine among most disabling medical conditions

Migraine II

Migraine Headaches are the most common source of pain to people all over the globe.

Migraine continues to be rated among the most disabling medical conditions

– General News – News | American Migraine Foundation
Migraine continues to be rated among the most disabling medical conditions

January 18, 2013 08:37 AM

Migraine continues to be rated among the most disabling medical conditions, as reported by the recent study of the Global Burden of Disease (link: Vos et al., Lancet, 2012). Specifically, of 291 diseases or injuries, 289 of them cause disability, with migraine ranking as the 8th most disabling condition.

The top 10 leading causes for disability were low back pain, major depressive disorder, iron-deficiency anemia, neck pain, chronic obstructive pulmonary disease, other musculoskeletal disorders, anxiety disorders, migraine, diabetes, and falls.

Top 10 most disabling conditions

Migraine continues to be rated among the most disabling medical conditions, as reported by the recent study of the Global Burden of Disease

In 2010, there were 777 million “years lived with disability [YLD]”, up from 583 million in 1990. Between 1990 and 2010, migraine not only continued to be among the most disabling but also among the most prevalent (surpassed only be tension-type headache and dental carries), suggesting that ongoing research, treatments and improvement in patient care are warranted on a global level.



Reference link:

Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2013 Dec 15;380(9859):2163-96.

PDF reprint Link:



via Migraine continues to be rated among the most disabling medical conditions – General News – News | American Migraine Foundation.

Five Tricks for Remembering Names | LinkedIn

Rita J. King February 11, 2013

How can you avoid the panic that can come from forgetting someone’s name almost as soon as you’re introduced? The fact is, names just aren’t a priority for our brains, which evolved to remember critical details that affect survival, like the face of an enemy or the location of nutritious food.

For the past couple of years I’ve been working with James Jorasch and Chris Harwood, who compete each year in the US Memory Championships. As they train for the competition this time around, I thought it would be helpful to share some of their tips on how to remember names.

1) Don’t psych yourself out.

Most people tend to believe that they have a bad memory for names. If you walk into a new situation convinced that you won’t remember names, the extra stress will ensure that you probably won’t. Instead, go in believing that the room contains at least a couple of people whose names you can and will remember.

2) Slow down and take it easy.

Part of the reason names escape us is because there’s usually a lot of activity going on around us while we’re meeting new people. Loud parties, conferences and restaurants don’t make it easier to remember a blur of names during introductions. Take a moment during introductions to make sure you get a person’s name right. Repeat the names while making eye contact with each person.

3) Ask questions.

Ask a question about the person’s first or last name. Where are they from? Is there a story behind their name? If the name is difficult to pronounce, repeat it slowly and let the person correct you until you get it right. This will help you remember it, but it also serves the purpose of ensuring that someone knows you care enough to get it right. As business becomes more global, this is critically important.

4) Use a person’s name.

During conversation, use the person’s name as often as is comfortable. They will appreciate the attention and saying it out loud will help to solidify the name in your mind, which will make it easier to put a name with a face later.

5) Create an image.

Try to create an image associated with a person’s name. Sometimes it’s simple, like when you meet a Bill Baker and you imagine him in a chef hat holding a tray of chocolate cupcakes with dollar bills folded into the icing. Other times, you need to be creative to find a way to associate an image with a name. No matter how challenging a name may seem, you can break it down into phonetic syllables and create images that get close enough for your brain to remember the association.

For example, say you meet a Rahul Banerjee at a conference. The name Rahul can be translated to the image of “raw wool” freshly sheared from a sheep in your memory. Banerjee can be pictured as a banner with a picture of a “G” or a jeep on it. These images seem weird–but the stranger they are the more your brain will remember them due to the novelty. Remember, these images exist in your mind only and don’t need to be revealed to anyone. They are there only for your benefit.

Note: Chris and James put their memory skills to work to create Memory Layer, which just released a white paper (click here to request a free copy), “Memory and Advertising: Message Clarity, Principles and Tactics to Hack the Hippocampus” for ad agencies and brands. For more memory tips and information, follow @MemoryLayer on Twitter.


via Five Tricks for Remembering Names | LinkedIn.

Experimental Therapy Crosses Blood-Brain Barrier To Treat Neurological Disease

Main Category: Neurology / Neuroscience
Also Included In: Blood / Hematology
Article Date: 04 Feb 2013 – 12:00 PST

Researchers have overcome a major challenge to treating brain diseases by engineering an experimental molecular therapy that crosses the blood-brain barrier to reverse neurological lysosomal storage disease in mice.

Posted online in PNAS Early Edition on Feb. 4, the study was led by scientists at Cincinnati Children’s Hospital Medical Center.

“This study provides a non-invasive procedure that targets the blood-brain barrier and delivers large-molecule therapeutic agents to treat neurological lysosomal storage disorders,” said Dao Pan, PhD, principal investigator on the study and researcher in the Cancer and Blood Diseases Institute at Cincinnati Children’s. “Our findings will allow the development of drugs that can be tested for other brain diseases like Parkinson’s and Alzheimer’s.”

The scientists assembled the large molecular agents by merging part of a fatty protein called apolipoprotein E (apoE) with a therapeutic lysosomal enzyme called a-L-idurondase (IDUA). Naming the agents IDUAe1 and IDUAe2, researchers used them initially to treat laboratory cultured human cells of the disease mucopolysaccharidosis type I (MPS I). They also tested the agents on mouse models of MPS I.

MPS I is one of the most common lysosomal storage diseases to affect the central nervous system, which in severe form can become Hurler syndrome. In humans, patients can suffer from hydrocephalus, learning delays and other cognitive deficits. If not treated, many patients die by age 10.

Lysosomes are part of a cell’s internal machinery, serving as a waste disposal system that helps rid cells of debris to retain normal function. In lysosomal storage diseases like MPS I, enzymes needed to dissolve debris are missing, allowing debris to build up in cells until they malfunction.

In MPS I, cells lack the IDUA enzyme, allowing abnormal accumulation of a group of large molecules called glycosaminoglycans in the brain and other organs. Researchers in the current study used the new therapeutic procedure to deliver IDUA to brain cells. But first they had to successfully engineer the therapy to carry IDUA through the blood-brain barrier to diseased brain cells.

The blood-brain barrier is a physiological blockade that alters the permeability of tiny blood vessels called capillaries in the brain. Its purpose is to protect the brain by preventing certain drugs, pathogens and other foreign substances from entering brain tissues. The barrier has also been a persistent roadblock to treating brain disease with drugs.

The scientists experimented with a set of derivative components of the fatty protein apoE, which binds to fat receptors on endothelial cells that form the inside surface of capillaries in the blood-brain barrier. They discovered that tagging some of the apoE components to the IDUA enzyme allowed the modified protein to attach to endothelial cells and cross through the cells to reach brain tissues.

An opportunity to Live a Big Dream | Changing Goal posts

Changing Goal posts The description of an evolving mind
April 24th, 2012
The vast majority of human beings are programmed by their education to WORK FOR OTHERS for a living. They are DOOMED to be EMPLOYEES; at the most, they may venture out, BE BOLD, and become SELF-EMPLOYED – start their own practice, their own small franchisee, their shop or restaurant.
EVERYBODY dreams of MAKING IT BIG – very few do; statistics show that only 3% make it big in ANY BUSINESS. The vast majority either fail, or just get by.
People watch a BIG BUSINESS OWNER – and imagine that he must have had a lot of money, or the right breaks, or known the right people – or maybe he broke the laws. Or some combination of all of these. Otherwise, how could he make it and we couldn’t?
The REALITY is – everybody who MAKES IT BIG – is simply someone who had a BIG DREAM – and was REALLY, DEAD SERIOUS about it – COMMITTED to it completely, ABSOLUTELY. He gave it everything it needed for its success. That’s it.
Yes, the stakes are high; the risk is high. A lot of capital is invested. But that is in traditional business, the
bricks and mortar world, where the only way to expand the market is to go out and build the walls and roofs.
But in the day of the INTERNET, it is now possible to build a GLOBAL ENTERPRISE without huge capital outlay, without so much investment, and so much consequent RISK.
YES, the STAKES are still high – the DREAM STILL NEEDS TO BE BIG – because the HARD WORK still needs to be done.
So we are working on such a PROJECT: we are building a vast online network of business partners spread across borders – globally – without having to spend millions of dollars for it – and still earn millions of dollars – EACH!
IF interested and excited, then contact me to know more about this opportunity.
Posted 22nd November 2012 by Rajshekher Garikapati
via An opportunity to Live a Big Dream | Changing Goal posts.

Adult Stroke Survivors Who Practice Tai Chi May Be At Reduced Risk For Falls

Article Date: 08 Feb 2013 – 1:00 PST

Tai Chi may reduce falls among adult stroke survivors, according to research presented at the American Stroke Association’s International Stroke Conference 2013.

Compared to survivors receiving usual care or participating in a national fitness program for Medicare-eligible adults called SilverSneakers®, those practicing Tai Chi had the fewest falls.

Tai Chi is a martial art dating back to ancient China. It includes physical movements, mental concentration and relaxed breathing.

“Learning how to find and maintain your balance after a stroke is a challenge,” said Ruth E. Taylor-Piliae, Ph.D., R.N., the study’s principal investigator and assistant professor at the University of Arizona College of Nursing in Tucson, Ariz. “Tai Chi is effective in improving both static and dynamic balance, which is important to prevent falls. Tai Chi is readily available in most U.S. cities and is relatively inexpensive.”

Stroke survivors experience seven times as many falls each year than healthy adults, Taylor-Piliae said. These falls can cause fractures, decrease mobility and increase fear of falling that can result in social isolation or dependence. Tai Chi has significantly reduced falls in healthy older adults. Researchers recruited 89 stroke survivors – most of whom had ischemic strokes – for a randomized prospective study outside of a hospital setting. Participants were an average 70 years old, 46 percent were women and most Caucasian, college educated and living in the Tucson area, and suffered a stroke on average three years prior to beginning the study.

Among the participants, 30 practiced Tai Chi, 28 took part in usual care and 31 participated in SilverSneakers®. The Tai Chi and SilverSneakers® groups participated in a one-hour exercise class three times each week for 12 weeks. The usual care group received a weekly phone call and written material about participating in community-based physical activity.

During the 12-week trial, there were a total of 34 reported falls in participants’ homes mainly from slipping or tripping: five falls in the Tai Chi group; 15 falls in the usual care group; and 14 falls in the Silver Sneakers group. Only four people sought medical treatment.

Yang-style Tai Chi, as practiced in the study, is the most popular of five styles used in the United States because of its emphasis on health benefits, both physical and psychosocial benefits, researchers said.

“The main physical benefits of Tai Chi are better balance, improved strength, flexibility and aerobic endurance,” Taylor-Piliae said. “Psycho-social benefits include less depression, anxiety and stress, and better quality of life.”

via Adult Stroke Survivors Who Practice Tai Chi May Be At Reduced Risk For Falls.

Women who have Migraine with Aura Increased Risk of Cardiovascular events

AAN Report Shows Women who have Migraine with Aura are at Increased Risk of also having Cardiovascular events

January 25, 2013 08:37 AM

On January 18th, the American Academy of Neurology announced the results from two separate clinical studies that report women who have migraine with aura are at increased risk of also having cardiovascular events. The results from both of these studies will be presented at the American Academy of Neurology meeting in San Diego, CA (March 16-23, 2013).

In the newly reported analysis from The Women’s Health Study, authored by Dr. Tobias Kurth, MD, ScD, (of INSERM, the French National Institute of Health and Medical Research in Bordeaux and Brigham and Women’s Hospital in Boston), migraine with aura was considered to be a significant contributor to the development of major cardiovascular events, such as stroke or heart attack. This 15-year study followed 27,860 women, of whom 1,435 had migraine with aura. Aura is a neurological condition involving the outer layer of the brain, and when aura occurs it causes patients to have visual disturbances including flashing lights, wavy lines, or blind spots. Aura may also include numbness or tingling in the face, hand or arm, or difficulty with producing speech and language fluently. In this study, the presence of migraine with visual aura was the second leading contributor to the risk of heart attacks or strokes, surpassed only by the presence of high blood pressure. Surprisingly, a diagnosis of migraine with aura was a higher risk factor for heart attack or stroke compared to diabetes, current smoking, obesity, and even a family history of early heart disease.

In a second study authored by Dr. Shivang Joshi, MD, MPH, RPh, (of Brigham and Women’s Falkner Hospital in Boston), the risk of cardiovascular disease incidence was evaluated in women who had migrainewith aura and were also taking newer vs. older contraceptives. The results from this study found that women who had migraine with aura were more likely to have experienced blood clot complications such as deep vein thrombosis, regardless of the type of contraceptives when compared to women who had migraine but no aura (migraine without aura). The occurrence of blood clot complications was also higher in women with migraine who took contraceptives as compared to women taking the contraceptives who did not have migraine. Dr. Joshi explains that it will be very important for women who have migraine with aura to include their migraine diagnosis in their medical history, and talk to their doctor about their increased risk of complications when taking contraceptives.

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via AAN Report Shows Women who have Migraine with Aura are at Increased Risk of also having Cardiovascular events – General News – News | American Migraine Foundation.

8 Things Remarkably Successful People Do « armzBLOG

Posted: January 8, 2013 in Consulting, Leadership, Marketing

Tags: business, leadership, productivity, success, success habits, work habits 1

Since moving to Calgary, I’ve been fortunate to work with, and meet some remarkably successful people. Acting as a sponge, I’ve picked up on a set of specific habits that they share, and thought I would share those with you.

1. They don’t create back-up plans.

Back-up plans are nice, and they may help you sleep easier at night. And, when times do get tough, they can create an easy out…

But, you’ll work a lot harder and a lot longer if your primary plan simply has to work because there is no other option. Total commitment – without a safety net, will spur you to work harder than you ever imagined possible.

If somehow the worst does happen (and the “worst” is never as bad as you think) trust that you will find a way to rebound. As long as you keep working hard and keep learning from your mistakes, you always will.

2. They do the work…

You can be good with a little effort. You can be really good with a little more effort.

But you can’t be great – at anything – unless you put in an incredible amount of focused effort.

Scratch the surface of any person with rare skills and you’ll find a person who has put thousands of hours of effort into developing those skills.

There are no shortcuts. There are no overnight successes. Everyone has heard about the 10,000 hours principle but no one follows it… except remarkably successful people.

So start doing the work now. Time is wasting.

3. …and they work a lot more.

Forget the Sheryl Sandberg “I leave every day at 5:30″ stories. I’m sure she does. But she’s not you.

Every extremely successful entrepreneur I know (personally) works more hours than the average person – a lot more. They have long lists of things they want to get done. So they have to put in lots of time.

Better yet, they want to put in lots of time.

If you don’t embrace a workload others would consider crazy then your goal doesn’t mean that much to you, or it’s not particularly difficult to achieve. Either way you won’t be remarkably successful.

4. They avoid the crowds.

Conventional wisdom yields conventional results. Joining the crowd – no matter how trendy the crowd or “hot” the opportunity, is a recipe for mediocrity.

Remarkably successful people habitually do what other people won’t do. They go where others won’t go because there’s a lot less competition and a much greater chance for success.

5. They start at the end…

Average success is often based on setting average goals.

Decide what you really want: to be the best, the fastest, the cheapest, the biggest, whatever. Aim for the ultimate. Decide where you want to end up. That is your goal.

Then you can work backwards and lay out every step along the way.

Never start small where goals are concerned. You’ll make better decisions, and find it much easier to work a lot harder, when your ultimate goal is ultimate success.

6. … and they don’t stop there.

Achieving a goal, no matter how huge, isn’t the finish line for highly successful people. Achieving one huge goal just creates a launching pad for achieving another huge goal.

The process of becoming remarkably successful in one field will give you the skills and network to be remarkably successful in many other fields.

Remarkably successful people don’t try to win just one race. They expect and plan to win a number of subsequent races.

7. They sell.

I asked a number of the successful people I work with, or have been fortunate enough to meet, to name one skill they felt contributed the most to their success. Each said the ability to sell.

Keep in mind selling isn’t manipulating, pressuring, scheming, or cajoling. Selling is explaining the logic and benefits of a decision or position. Selling is convincing other people to work with you. Selling is overcoming objections and roadblocks.

Selling is the foundation of business and personal success: knowing how to negotiate, to deal with “no,” to maintain confidence and self-esteem in the face of rejection, to communicate effectively with a wide range of people, to build long-term relationships…

When you truly believe in your idea, or your company, or yourself then you don’t need to have a huge ego or a huge personality. You don’t need to “sell.”

You just need to communicate.

8. They are never too proud.

To admit they made a mistake. To say they are sorry. To have big dreams. To admit they owe their success to others. To poke fun at themselves. To ask for help.

To fail.

And to try again.


via 8 Things Remarkably Successful People Do « armzBLOG.

Just What The Doctor Ordered!