T N E M H C R A P E TH Hola Readers! After running the magazine for 2 successful years and delivering 10 outstanding editions, LEXICON which remains India’s first and only leading online magazine, marks the beginning of a new milestone with its 11th Edition- LOVE, DRUGS & ADOLESCENCE! Adolescence is the most beautiful and exciting period in a human’s life. Everything is full of vigor and vitality. We have no commitments, no worries, no responsibilities. Life is full of fun and laughter. Adolescence is a time of discovery; a time to try new things, experience new insights, gain wisdom and acquire knowledge, simply a time when our bodies and mind mature. Adolescence is a transitional stage of physical and psychological human development that generally occurs during the period from puberty to legal adulthood. Despite all the delights, adolescence has its own downside as well -the anxiety, the anguish, the fear, the stress, indulgence in smoking and substance abuse, peer pressure, reproductive and sexual health problems, chronic disorders, etc. ( Zenia Poladia ) Adolescence and young adulthood are characterized by major transitions in many domains including physical and emotional development, family and peer relationships, health risk exposures, health care transitions and role in society. Lexicon- The Medical Magazine and Blog, in this edition, will explore the important role that transition plays in health and well- being from adolescence to young adulthood and how adolescent health professionals can capitalize on the strengths of adolescents and young adults to support them through these changes. Read on to find out about the delights and the malaise, you all might have experienced and dealt with, at some point in your lives, as adolescents. Cheers! Zenia Poladia Final Year M.B.B.S. Terna Medical College DIRECTOR OF THE EDITION APRIL 2015 • lexiconin.com P PANDORA'S BOX APRIL 2015 ON THE COVER The Parchment GLOBAL VISTAS Blinded by the Haze- Basalathullah Mohammad The Paradigm Shi - Dr. Caren Otadoh Health Caravan- Haleema Munir Arbor Vitae The Pen is scarier than the Sword - Khushboo Gala Suicide, Smoking and all that Mockery! – Anirban Cha erjee Dealing with the Cysts – Shinjini Chakraborty Cerebro Contracep on and STIs: How Aware Are You? – Dr. Nikita Agarwal Depression among Adolescents – Deeksha Seth EduO Apurva Lunia WORST CASE SCENARIO Love, Sex Aur Dhoka – Dr. Nikhil Tambe Teaching Basic Life Support in School – Pool Aguilar Leon LEXIAMMA’S LEXIGYAAN Is Drug addic on a new epidemic? – Ruchira Dhoke THE NEW TRUTH Fully Func oning Lab Grown Vaginas – Spandita Ghosh Redefining Adolescence: Nature vs Nurture – Subrat Das Adolescent and Sleep: Hormones at work – Dr. Geeta Sundar I Listen To Color- Shrayash Khare LOVE, DRUGS & ADOLESCENCE! The Inexplicable Reasoning – Dr. Abhijeet Sharma Love – Dr. Raviteja Innamuri Adolescence and Substance Abuse – Archit Rastogi Why Don’t We Talk About Porn? - Dr. Rohin Manipur Know That Period! – Swa Shriyan DIVERGING ROADS Dr. Richard Finkel- Saving Lives since 1992! – Trusha Taneja THE RENDEZVOUS with Dr. Sanjay Desai ACTS OF KINDNESS Breaking Barriers- with Apne Aap Women’s Collec ve (AAWP) – Priyanka Manghani BEEN THERE DONE THAT Adolescence- A Pocket Guide- Rika Rjl and Rohin Manipur Here’s What You Should Know About Adolescents! - Hiral Mehta KNOWN CASE OF Twin Fetus In Fetu – dr. Naren Nallapeta Dengue fever in a case of Hemophilia – Sneha Nandy TECH X Just a tap away – Utkarsh Mishra THE OPEN LETTER Ashwini Ronghe AAVISHKAR 2015 THE BOARDS HISTORY REVISITED Bulimia over the years – Chaitalee Ghosalkar How Problems Change & Change Causes Problems Bianca Honnikeri APRIL 2015 • lexiconin.com BLINDED BY THE HAZE Basalathullah Mohammad GLOBAL VISTAS Gandhi Medical College, Hyderabad T obacco smoking has long been recognised as the major public health problem in the world 1. It is the leading determinant of preventable deaths worldwide with one person dying every 6 seconds, either directly or by second-hand smoke! The developing countries are most affected because 80% of the 1 billion smokers live there. On an average smokers die a decade earlier than non-smokers. Of particular importance is smoking in adolescents. Nearly 9 out of 10 smokers start before the age of 18. Apart from the obvious effects of the resultant long period of exposure, smoking hampers the development of the adolescent brain. Young smokers are also more likely to abuse alcohol, other drugs and engage in risky sexual behaviour. seen which establishes the association. Dr. Carter told the New York Times3 that he had faith in the findings because it is biologically plausible that those diseases were linked to smoking. With intensified anti-tobacco measures gaining stance in recent years, the study gives even more reasons and facts to inform the public about the unknown dangers of smoking. Anti-smoking and intervention programmes targeting the youth in the form of youth clubs and school-health initiatives will go a long away in controlling the deleterious effects of smoking. Further study could uncover even more conditions caused by tobacco help uncover the full scale of its effects. Don’t smoke, don’t let smoke! A recent study by Carter et al 2 published in the prestigious New England Journal of Medicine links hitherto unknown diseases to smoking. The study is based on data from nearly a million American peoplefollowed for 10 years from 2000 to 2011 as a part of several cohort studies. While it was known that smoking hampers the general health and shortens life by a decade, this study uncovers new associations. It will probably expand the list of the 21 diseases already known to be caused by smoking. Coming close on the heels of the 50th anniversary of the US Surgeon General’s landmark report on ‘Smoking and Health’, it establishes the cause of 17% extra deaths in smokers not mentioned on the Surgeon General’s list. The study was funded by the American Cancer Society. The various associations of smoking, according to the study were deaths from renal failure, intestinal ischaemia, hypertensive heart disease, susceptibility to infections, breast cancer, prostate cancer and various respiratory diseases not previously linked to tobacco such as pulmonary hypertension. It was also noted that the relative risk for these diseases decreased in those who had quit smoking. Being an observational study, cause-and-effect relationship cannot be proved but a dose-response is DON’T SMOKE DON’T LET SMOKE When the dust settles, more unsettling facts emerge on SMOKING APRIL 2015 • lexiconin.com THE PARADIGM SHIFT Dr. Caren Otadoh, Nairobi GLOBAL VISTAS I t is considered a vice, a mutilation and a disgrace to the woman. Yet to some, it is a tradition, a rite of passage, a timeless heritage; to several, it is a definition of who they are, a display of courage, a pledge to chastity, and an honorary ushering into womanhood. It’s no wonder that its opposition has in some instances hardened hearts and fostered resilience- as curious passion and sentimentalism germinates. The world map highlights a number of African countries; and a few from the Middle Eastern and Asian cultures. Sexual integrity of the woman is a standard that cuts across each of these cultures. You see, Virginity has always been a cultural asset for women, and even in the 21st Century little has changed (Elizabeth Boskey). The heights and depths explored to uphold this attribute, flows past Female Genital Mutilation, towards infinity. Against this backdrop, opinions have grown to campaigns; campaigns to policies; and Policies have become laws, yet a few proud custodians are stuck in their culture. Female Circumcision, also known as Female Genital Mutilation; as described by the WHO, involves all procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons. It involves partial or total removal of the external female genitalia, or other injury to the female organs. In a bid to prevent illicit sexual acts, one of the following ‘surgical procedures’ is performed: 1. Removal of the prepuce plus partial or total removal of the clitoris- clitoridectomy. 2. Removal of the prepuce, clitoris (partial or total), labia minora (partial or total), and with or without excision of the labia majoraexcision 3. Narrowing of the vaginal opening, with or without removal of the clitoris- infibulations. 4. Other harmful non-medical practices (pricking, piercing, incising, stretching and scraping) As I count, beyond one palm- the total number of human rights violated by this act; I set camp at the breach of health rights. Over 125 million girls and women alive today who have been cut, and countless others who may have died, experience these and many more adverse effects: 1. Excruciating physical pain from an operation with no anesthesia; on passing urine “post-operation”; during coitus or childbirth (infibulation) 2. Heavy hemorrhage that trails the cut - later shock 3. Risk of infections: during the procedure, due to septic techniques; and recurrent urinary tract infections post-operation. 4. Increased infant mortality and infertility. 5. Post traumatic stress disorder and other psychiatric conditions Upon my virtual weighing scale, I place the apparent rationale on one side, and the above complications on the other. As the scale tips over, I’m persuaded that advocacy and enlightenment is our greatest ammunition- a two edged sword that can be used to: • expose this vice to its upholders • educate the adolescent girl on her sexuality, in milieu of her culture Everybody wins! APRIL 2015 • lexiconin.com HEALTH CARAVAN -HaleemaMunir, Final Year M.B.B.S., AllamaIqbal Medical College, Lahore, Pakistan A popular saying goes, “The only time you look into your neighbor’s bowl is to make sure that they have enough.” T he medical students of Safx, Tunisia did the same and found their neighbors’ bowls to be very much lacking. Not much far away from the city of Safx, one of the biggest urban centers of Tunisia, social inequality manifested itself as numerous households lacking access to even the very basic of healthcare facilities. The active young minds studying medicine in Safx got to work and came up with a heart-warming initiative that they were able to put into action under the umbrella of IFMSA (International Federation of Medical Students’ Associations), Standing Committee of Public Health (SCOPH) and Standing Committee of Reproductive Health including HIV/AIDS (SCORA). And so, these public health and reproductive health activists, popularly known as “SCOPHeroes” and “SCORAngels” in IFMSA, sowed the seeds of the “Health Caravan” project, under the leadership of Marissa Ben Mabrouk and Ahmed Ikken, the Project Directors, and BalkissAbdelmoula, the President of their local council of IFMSA. GLOBAL VISTAS By the end of these three fateful days, the locals were not only immensely grateful to the youngsters, who had brought a wave of health into their lives, they were also more aware of their right to basic healthcare. Health Caravan sowed the seeds of awareness that will eventually force other concerned parties to also play their role in fighting off this form of social inequality and providing the residents of ManzelChakar and other villages with primary healthcare facilities. Kudos to the concerned parties for their effective action! Very soon, the word had spread out and the team that initially comprised of medical students had now expanded to include several pediatricians, endocrinologists, nephrologists, cardiologists and gynecologists. After a very successful fundraising campaign and with a huge turnout of volunteers, the team made its way to ManzelChaker, a village merely 45 kilometers away from Safx. The team stayed in the village for three whole days and offered both curative as well as preventive medicine. The volunteers, guided by the specialists accompanying them, worked tirelessly to give free consultations for any and all health problems that the residents presented with at the medical camps. The medicine needed for the treatment of the patients was bought from the funds that were raised before setting out for the village and these medicines were handed out free of cost to all the patients. A huge proportion of children were diagnosed with refractive errors of the eye and in order to help them cope with weak eyesight, free spectacles were also arranged for all of them. Counseling of the general public was done at both individual as well as public levels. Small sessions and talks were held with the residents to make them aware of the challenges and threats that their current living style posed to their health. Special attention was paid to raising awareness of breast cancer, prostate cancer and sexually transmitted diseases. The locals were told how to avoid these conditions by avoiding the potential risk factor, and how to catch these diseases at an early stage to ensure a better prognosis. APRIL 2015 • lexiconin.com THE PEN IS SCARIER THAN THE SWORD -Khushboo Gala, Grant Medical College, Mumbai I never realized just how strong the pen is, till I met her. I met her for the first time in medical college. We used to share a table for anatomical dissection, and in the bargain, share stories and life histories. In just a few months, we became close friends. We discussed everything under the sun while wielding our scalpels, from ice- cream preferences to boyfriends. I thought I knew her inside out, till I saw her write. She scrawled untidily, in handwriting similar to an 8 year old child’s. Spelling errors glared at me, all over the page of notes she’d written. Had she not taken those notes sitting beside me in class, I would not have believed that my friend, with her sparkling intelligence and perfect diction, had written them. For the fear of confrontation, I said nothing. I saw her journals, her books… When it became too much, I hesitantly made a joke about her handwriting. She gave me a strange look and walked away. I went armed with a cone of her favourite ice- cream the next day, and begged forgiveness. She smiled, and told me, “I thought you had guessed already. I’m dyslexic.” I was stunned. Although I was a medical student, at the age of 18 I had never really grasped the extent of writing disability dyslexic children had. It was then that she told me of her school life. School, she said, was living hell. She was very obviously a bright child, yet her test papers would come back covered with red marks. Her teachers were always displeased with her performance – her parents were always called to meet some or the other irate teacher about their child’s poor grades. “She answers well in class and seems to grasp everything; she is just too impatient and clumsy to write well!” It just didn’t make any sense. She would get bullied, and she woefully told me the name all her classmates had kept for her – ‘Zero’. It was only when her parents, fed up of her repeated bad marks, took her to a counsellor, that they suspected that there was some learning disability. Then came months of counselling, of practicing spellings, of doing pages of copy-writing in an attempt to improve her handwriting… trying times, but at least she felt encouraged, knowing that finally someone understood her. She says it was a horror writing her final 10th and 12th grade papers – only she knows how she managed to pass. It was due to the MCQ based examination system that she got admission into medical college. “I’m not stupid, I’m just disabled” – is her retort. ARBOR VITAE She dreams of becoming a paediatric psychologist specializing in learning disabilities. “I want to help other kids, who weren’t given a fair chance just because their brain is wired differently. It seems like a trivial thing to you, not being able to spell – but for us, the proverbial pen is much scarier than a sword.” SUICIDE, SMOKING AND ALL THAT MOCKERY! Dr. Anirban Chatterjee, Resident, KLE Belgaum S uicide ideation appears widespread and is popularly portrayed in social media and community news very often in our country. The act seems to be trivialized especially among adolescents much to be defined as a contagious epidemic more so a chronic disorder. A handful of suicide notes tell tales of self pity, shattered pride and an objection against mistreatment. According to research and studies done worldwide, the baffling idea of self destruction engaged by the young uproots because of the spirit of experimentation, mockery and defiance .This mindless act has gained strength as an important form of self expression. Unfortunately on similar context a subject which is more diverse and deeply pathological to our youth is the stickiness to cigarettes .Only the difference in idea is to kill yourself slowly over a period of time. Think rationally, for I strongly believe that both evil actions of suicide and smoking are contagious and overrated. My question to young minds ; Are you a victim of a senseless imitation?? A common finding of contagion influencing suicide wherein the act of one person taking his or her own life under some circumstances inspired David Phillips ,a sociologist to conduct several studies .He began observing suicide attempts advertized on front pages of prominent newspapers from early 1940s to end of 1960s.Matching made it obvious that immediately after stories of suicide appeared ,suicides in the area served by the newspaper jumped .Apparently Marilyn Monroe ‘s death was followed by an increase of 12% in national suicide rate .Such studies were conducted on traffic accidents as well and results followed similar patterns reflecting on a central observation that is ; Suicides lead to suicides and is fiercely contagious . According to Phillip ; the decision by someone like celebrity to take his or her own life has the same effect ;it gives other people an uplift ,particularly those vulnerable to decision making and engaging to deviant act as well .He continues quoting “Suicide stories are a kind of natural advertisement for a particular response to your problems” Heard of epidemic suicide among Micronesian adolescents? Micronesia is a sub region of Oceania consisting of a cluster of thousand islands and more in the Western Pacific Ocean. Suicide rates since 1960 in Micronesia have undergone an epidemiclike increase. Adolescent XY aged 15-24 predominantly express a depressing form of communication rich with meaning and nuance .Between 1955 and 1965 ; there wasn’t a single case of suicide in the entire island .Then came November 1966 that witnessed the death of an eloquent and charismatic brat of islands wealthiest families .Three days later there was another suicide ,a youngster 22 years old suffering from marital difficulties .Twenty five suicides followed in the next twelve years reflecting the power of personalities having hypnotizing impact combined to make the force of his example endure beyond his death. ARBOR VITAE “Mockery is the means used by the complexed ignorant to feel wise” consistent .The first person who I remember smoking was my roommate back pre medical test preparation days in Kota (Rajasthan).Me and Karthik sang songs together every fortnight post we made our throat wet .Karthik seemed so much mature and older when he dragged in smoke and in midst of a note ,throwed out the window .He taught me how to inhale ,create the best geometrical puff holes.He had a wind proof riders leather cap and back then he was the quintessential hard core extrovert smoker who everyone wanted to be . Smoking is no different .Whether the adolescent picks up the habit depends whether he or she has contact with one of those salesmen (in my case Karthik ) who gives the “permission” to engage in deviant acts. But whether an adolescent likes it enough to keep puffing up cigarettes depends on a very different set of criteria .Smokers derived an overall pleasure from the first time they dragged though explaining the experience to be aversive .The question of how sticky smoking ends up to be for any given person depends a great deal on his/her own particular initial reaction to nicotine . Smoking matches up strongly with emotional problems .What makes someone susceptible to the contagious effects of smoking- low self esteem ,unhealthy home life and all possible utilities that bring depression in the centre stage .Depression hallmarks decreased production of certain neuro transmitters like serotonin ,nor-epinephrine and dopamine (regulation of mood ,confidence and pleasure ) which is compensated by nicotine .Here is stickiness with a vengeance ; not only because people are addicted to nicotine that they find it hard to quit but also because without nicotine they might run the risk of psychiatric illness . If you happened to remember a decent past movie titled “karthik calling karthik” you would relate to me that karthik was all convinced about the anonymous calls that came to him for his own good .It helped him recover battles in his personal and professional front .It made him ooze with confidence until he spills out the secret to someone who made it obvious to him that it wasn’t normal that he was practicing something insane .What happens next is that he gains all the attention and care to recover. Certain ailments like suicide intent or stickiness to cigarettes are subconscious imitation we are dwelling into which just needs a lot of talking moderate nurturing and little attention to eradicate best ways possible. Speak up for there‘s lot of love in the air. Does adolescent smoking also follow the same mainstream idea of mockery?? The script of smoking ,like the language of suicide seems incredibly APRIL 2015 • lexiconin.com DEALING WITH THE CYSTS: HOW THEY GOT AROUND WITH POLYCYSTIC OVARY -ShinjiniChakraborty, United Kingdom W riting about real life experiences invokes partial honesty. As I would be speaking about three people I knew who had Polycystic Ovary, and how they dealt with it, I won’t reveal their names. Firstly, because they don’t know I am writing about them. Secondly, writing about anyone involves permission too! I am not in touch with them presently. You may not jest at my loose talk, and I am missing the point here. Polycystic Ovarian Syndrome is a ‘very common’ disorder. So is cancer, and diabetes, and maybe malnutrition! Why am I choosing to speak about it? Most certainly, as I undertook a research, I found that it is often mistaken for other diseases. Isn’t that common too? Diagnosis involves so many ifs and buts. Maybe that’s why even Dr. House needed three doctors all the time to get him around the diagnosis loop! Rest apart, the delay in identifying the root cause of the manifested set of symptoms (mostly termed as a syndrome) cause reproductive complications later in the future accompanied by failure in conception and related effects. Apart from having cysts in your ovaries, the second most observable incidence in this disease and/or syndrome, is the prevalence of high amounts of the male hormones. Accompanying this, one may find the diseased having abnormal hair growth, almost always in the facial region (known as hirsutism). Skin folds of the back of the neck, underarms etc turn darker (termed as AcanthosisNigricans). Metabolic dysregulation is another concomitant effect, and truncal accumulation of weight, along with peri-abdominal accumulation of fat is distinctively observed. Let me deconstruct this a bit more; in layman terms, PCOS also robs a woman off a lot of ‘social standards’ defining feminine beauty. She gets hairy like a man; her voice gets hoarse and weight loss is a perennial cause of banter and worry. ARBOR VITAE As with all disenother. I remember one of my oldest friends, Deepa. As a kid, she was one competitive pain in the bone, and I remember arguing most of my time with her. Deepa did have a very hard life and I knew it much later; when puberty set in, when we got ‘hormonal’ and I am not talking about her predisposition to PCOS only. She had thick hair growth under her chin and face. A hoarse manly voice which I always mistook for her brother’s when I called at her home. I remember I would imitate her sometimes and she would laugh at it too. “Shinjini, stop it! I will die laughing now!” Good kid she was. Even as a girl, she struggled with weight but after years of struggle, she seemed to shed off those extra kilos. “Shinjini, don’t tell this to anyone. I have PCOS you know?” That’s when I knew. It has been four years since school got over. Deepa is pursuing a medical degree in Calcutta, and I am here, sitting at a cold lab facility writing about her. I see her pictures on Facebook sometimes. She has learnt to see her beauty too! Looks resplendent in georgette saris and wavy shoulder length hair. That was Deepa. My childhood friend. Now, about Ira.A petite little friend from my years at college. Apparently, she was too hot to handle by many and indeed she was one gem of a beauty. She would try to make up for the ‘height’ with high APRIL 2015 • lexiconin.com DEALING WITH THE CYSTS: HOW THEY GOT AROUND WITH POLYCYSTIC OVARY -ShinjiniChakraborty, United Kingdom heels and had long flowing hair. What one never missed about her was her piercing laughter, on encountering an abysmal and average joke! “Ma’am, if our restaurant’s false ceiling falls off, you are paying for it,” the manager of a roadside dhaba had quipped. “And what about the raw chicken you served us as ‘tandoori’ eh?” One thing I always appreciated about her was her ‘foot in mouth syndrome’. No, she didn’t have weighty issues and was very much a ‘woman’ in all worldly senses. I hardly observed her thick bushy eyebrows, or that hair on her upper lips and chin. Aren’t they the most obvious markers of PCOS? It never occurred to me she had anything like that. I wouldn't have known either, until someone told me to keep this revelation in confidence. “She has asked me not to divulge this to anyone. She has PCO. Polycystic ovary. Don’t you see how hairy she is around the face?” She never looked any different to me. Before or after what I had known. True, we aren’t in touch anymore. I wish we were. I wish, I could tell her, I want to write about you, and tell you that you are beautiful. PCOS is not the point here. Certainly not. Wait; doesn't PCOS pervade mankind so commonly that 2 out of 10 women have it? ARBOR VITAE “See, life is not about hankering about what makes you sick. Just pop a pill and move on!” By God’s Grace, PCOS didn't take away the most beautiful blessing of my life. I suppose, that is how it went undetected in her; less symptoms, and her ability to “move on, no matter what”. A struggler she was. And a winner too.ases, phenotypic manifestation differs from one individual to a A woman is often defined by her femininity. Our social standards expect us to wax ourselves into getting smooth skin, thread those facial hairs and pluck a bushy eyebrow. Get into a ‘bodycon’. Us women, we are ‘supposed’ to be beautiful. That is who we are. Or are we? “BEAUTY ALWAYS RESTS IN THE EYE OF THE BEHOLDER” The last story?My Ma. You see, every person with PCOS doesn't have complications with conceiving. She had me when she was 24, and it was during her C-section that the doctor had observed these abnormally numerous underdeveloped follicles in one of her ovaries. Let’s say, she was one magnanimous beauty. It was only after I was born, that she had weighty issues, but rest assured, we are ‘weighty’ people due to our ‘genes’! There were hardly any symptoms of truncal weight accumulation or abdominal fat repository. Years later, when she was diagnosed with leiomyomata in her uterus (generally put as uterine non-malignant tumours), there was a co-incidence of polycystic ovary as well. I remember her having painful periods at that time, but well, I think I have gone way overboard! She wasn’t an adolescent. But as I remember from childhood memories, she often said she too had painful periods when she was a teenager. APRIL 2015 • lexiconin.com Contraception and STIs: How Aware Are You? -Dr. Nikita Agarwal, Intern at PtJNMMC, Raipur W hether it is a medico or any other adolescent, knowledge and discussions about reproductive health usually create an uncomfortable atmosphere around us. Nothing is to blame but the society where such a discussion is seen as ‘sinful’ rather than necessary. However, kids these days have a good outlook towards such an important topic and see no shame in keeping knowledge and CEREBRO 6. Your younger sibling asks you about reproductive health. a. You’re happy to share the knowledge with them and tell them to be uninhibited about any questions they have in regards to the same. b. You’re proud that he/she has more courage in being open about such topics however; you just give them a bunch of sources from where they can find out about all their queries. c. You hush them and tell them not to talk about the topic in open. 7. Your friend tells you a lot about varied contraceptives and blogs and forums on the same. a. Proud moment for you. Now you can talk to someone who is knowledgeable. b. ‘I wish, I could also just do the same!’ c. ‘Is she crazy? Why would you go to the forums for such discussions?’ practicing the same. So what category of kids these days do you fall under? Let’s find out! 1. A friend has a girlfriend/boyfriend. He/she asks you about contraception and risk of STIs. You: a. Tell him/her about varied types of contraception available, emphasising on condoms, since they prevent STIs as well. b. Tell them to read up on it online, giving them links to various articles, which you haven’t read yet because you feel shy. c. Tell them off and silently judge them. 2. Your 19 year old maid got accidently pregnant after her recent childbirth. She doesn’t want the child since she feels not very well from last time’s pregnancy. a. You give her advice about both, improving her health and counsel her regarding the possibility of abortion, maybe also have a word with her husband. b. You do your best to help her improve her health for the pregnancy. c. You tell her to tell no one that you know about it. 3. You meet a person who is HIV positive. She tells you the story about her struggle with the disease. You: a. Appreciate her ability to have a positive outlook on life and ability to cope with the same. b. Feel that you need to be more like her and accept that it can be dealt with. c. Are horrified that she’s not hushed! 4. A girl in your social circle got raped. a. You take her to a doctor, after the initial police work is done, get her treated for trauma (physical and mental), checked out for pregnancy and treated for STIs if any. b. You sympathize with her and give her directions on how to get treated. But at the same time, you don’t want your parents to know that you’re helping her out. c. You tell her that whatever happened was a nightmare. Then you avoid her. You’re scared. 8. Your acquaintance openly shames people who practice sexual relationship before marriage. You: a. Politely tell them that it is their personal choice and we shouldn’t say anything about their choices (irrespective of your own choice.) b. Agree with her, though you know she’s wrong. c. Agree with her. 9. Someone you know got out of an abusive marriage and is coming to terms with their new life. a. You help her/him out if you’re asked. b. Although you wish the best, you fear ‘promoting’ divorce. c. ‘I just don’t think divorce is right!’ 10. A young widow who has one 6-month old child wants to remarry. a. You think she has all the rights to do it. She shouldn’t be shunned because her husband died at a young age. b. Although you know she is right, but you’re worried about the kid. c. Lost. So, let’s see where you stand. If most of your answers were ‘a’: well done kid! You’re one of those aware and open-minded chaps those are in dire need for the society of gen-next. Although your mind-set gets you into trouble at times, don’t let that little trouble abolish your great mind. I believe it was a great man who said, “ The little words cannot hurt a great idea”. If most of your answers were ‘b’: Implement. That’s the only word for you. Though you have great potential, you are submissive and give in to being liked by the society. Remember, that you have the right thinking but the wrong execution which makes it look like you have a bad blueprint. And why should you make it seem so? They may not like you at first but when you stand correct in the end, it will be them who’ll feel lessened and lessoned. If most of your answers were ‘c’: Please start evolving with the society that is to come in the future. Knowing that you’re taking this quiz and are still with me, I know you are doing so. Join the generation that reeks of knowledge and smells of potential to do good. And trust me, once you’re with this kind of thinking (of the new, uninhibited generation) you’ll feel blessed yourself. Well folks, that was all from me today. I hope you enjoyed the quiz. And yes, it was intended for fun purpose only. Until later, Yours truly, Yet another judge-y female. :P 5. You read about ‘Child of Rage’ (or any such documentary). You: a. Read more about it and share the idea of knowing about it with your friends. b. Get horrified, but tell no one that you read about the same in detail. c. Couldn’t gather the courage to read more about it. APRIL 2015 • lexiconin.com DEPRESSION AMONG ADOLESCENTS -Deeksha Seth, Kasturba Medical College, Mangalore CEREBRO 7. Which morbidities are correlated with Adolescent Depression? a. Obesity b. Neurological disorders c. Cardiac disorders d. Hormonal disorders 8. In addition to other symptoms of depression, catatonic a d o l e s c e n t s ’ p a t i e n t s m a y ex p e r i e n c e t h e f o l l ow i n g symptom/s…? a. Hypokinesis b. Selective mutism c. Both d. None 1. How many Adolescents in the world are suffering from Depression? a. 5-10% b. 10-15% c. 15-20% d. 20-25% 2. How many Adolescents in India are suffering from Depression? a. 5-10% b. 10-15% c. 15-20% d. 20-25% 3. The most common disorder associated with Depression is? a. Double Depression b. Dysthymia c. Cyclothymia d. Bipolar disorder 4. Center in the brain which is associated with fear is ______ and with sad emotions is _______? a. Amygdala and Insula b. Amygdala and Cingulate gyrus c. Iinsula and Amygdala d. Insula and Cingulate gyrus 5. Most effective first line treatment of depression? a. Monoamine oxidase inhibitors (MAO) b. Tricyclic anti-depressants (TCAs) c. SSRIs d. Combination of SSRIs and TCAs 6. In cases of chronic depression, resistance to the drugs occurs and in such cases treatment augmentation is required. Which of the following forms part of treatment augmentation? a. Lithium therapy b. Thyroid hormone therapy c. Buspirone, d. All of the above Answers: 1. 5-10% 2. 15-20% 3. Dysthymia (Chronic Depression leads to Dysthymia – which further leads to Cyclothymia. A combination of Depression with dysthymia is termed as Double Depression). 4. Amygdala and Insula 5. SSRI (followed by combination of SSRI & TCA) 6. All of the above (Also, if the person also suffers from seasonal affective disorder, light therapy is a useful way in helping augment therapeutic effects). 7. Obesity and cardiac disorders both. 8. Both (other symptoms include: posturing, mania, intense emotional pain, refusal to eat or drink) APRIL 2015 • lexiconin.com EDU- O Apurva Lunia, 2nd Year M.B.B.S, Mahatma Gandhi Medical College, Jaipur 1 NAME OF THE EVENT : 9th National Conference of the Indian Association of Adolescent Health” EDU- O 5 NAME OF THE EVENT : Indian Society of Aerospace Medicine Institute of Aerospace Medicine (IAM) Date :21-23 Aug 2015 Date :14 - 15 March, 2015 VENUE : Bengaluru, India VENUE : Regional Institute of Medical Sciences Imphal, Manipur WEBSITE LINK : http://www.medindia.net/medicalconference/schedule_new.asp#ixzz3TK5fBdZw WEBSITE LINK :http://iaahcon2015.org/spm/ 2 NAME OF THE EVENT : Society of Adolescent Health Medicine Annual Meeting Date :18-21 March, 2015 VENUE : Los Angeles, USA WEBSITE LINK : http://www.adolescenthealth.org/Meetings/ 3 NAME OF THE EVENT : International Meeting On Indigenous Child Health Date :20-22 March, 2015 VENUE : Ottawa, Canada WEBSITE LINK : http://www.cps.ca/en/imich 6 NAME OF THE EVENT : The 17th Asia Pacific League of Associations for Rheumatology Congress Date : 6- 9 Sep 2015 VENUE : Chennai, India WEBSITE LINK : http://aplar2015.com/ 7 NAME OF THE EVENT : 26th National Conference of IndSPN (Indian Society for Pediatric Neurosurgery) Date : 19 -22 Nov 2015 VENUE : Cochin, India WEBSITE LINK : http://indspncon2015.com 4 NAME OF THE EVENT : 19th European Meeting of International Association for Adolescent Health Date : 24-26 June, 2015 VENUE : Lisbon, Portugal WEBSITE LINK : http://www.mundiconvenius.pt/eventos/2015/iaah2015 APRIL 2015 • lexiconin.com LOVE, SEX AUR DHOKA - Dr. Nikhil Tambe, M.B.B.S., Instructor (American Heart Association) Life Supporters Institute of Health Sciences, Mumbai LOVE The ambulance croaked at its top voice and all the interns looked out of the window. Was it a mass casualty? A teenage looking girl was brought to the emergency room in a drowsy state by a young man in mid twenties. He described that the girl had consumed some unknown tablets and was found drowsy. On exploring further, it was revealed that the girl ran away from her village to live with her boy friend in the city, without her parents’ consent. Apparently her parents came to know this and were infuriated. As a recourse to that, the teenage looking girl who claimed to be 20 years old consumed tablets. What to do in such scenario? 1)As the Mantra goes- ABC: Maintain airway, breathing and circulation. Check the vitals repeatedly. 2)Take a thorough history laying stress on time of consumption, quantity and other medical co morbidities. 3)Using activated charcoal: Helps in reducing the toxic substance from entering the blood. 4)Blood tests, ECG, chest x-ray, urine toxin screen, arterial blood gases to treat electrolyte imbalance. 5)Insert a naso-gastric tube to perform gastric lavage (time dependant). 6)Consult psychiatrist for suicidal tendencies and counselling. SEX The other day while talking to a physician friend, he described to me a shocking case he encountered. A girl in mid-twenties was admitted in an incapacitated state. The girl had gone partying with her friends. She got drunk. After couple of drinks, she struck a conversation with a stranger who bought her ‘one more’ drink. She had hardly imagined that it would have been spiked. She started to feel dizzy; the time was perfect for the stranger to make his move. It was sheer luck that her friends spotted her in an inebriated state and whisked her away. On her way back home she became extremely sick and was rushed to the hospital. Date rape drugs are powerful and dangerous. They have no smell, no colour or any distinguishing characteristics. The most common ones are ketamine, gammahydroxybutyric acid (GHB) and flunitrazepam. What to do in such case? 1)Get medical help immediately. Don't urinate, bathe, brush your teeth, wash your hands, change clothes, or eat or drink before you go. These things may give evidence of the rape. The hospital will use a "rape kit" to collect evidence. 2)Call the police in the hospital. Tell the police exactly the sequence of events. 3)Test urine for date rape drugs. The drugs leave your system quickly. Rohypnol or flunitrazepam stays in the body for several hours, and can be detected in the urine up to 72 hours after taking it. GHB leaves the body in 12 hours. Don't urinate before going to the hospital. 4)Don't pick up or clean up where you think the assault might have occurred. There could be evidence left behind — such as on a drinking glass or bed sheets. WORST CASE SCENARIO 5)Get counselling and treatment. Calling a crisis center or a hotline is a good place to start. Prevention is always better than cure! 1)Don't accept drinks from other people. 2)Open containers yourself. 3)Keep your drink with you at all times, even when you go to the bathroom. 4)Don't share drinks. 5)If someone offers to get you a drink from a bar or at a party, go with the person to order your drink. Watch the drink being poured and carry it yourself. 6)Don't drink anything that tastes or smells strange. Sometimes, GHB tastes salty. 7)Have a nondrinking friend with you to make sure nothing happens. 8)If you realize you left your drink unattended, pour it out. 9)If you feel drunk and haven't drunk any alcohol — or, if you feel like the effects of drinking alcohol are stronger than usual — get help right away. DHOKA (cheating) This is from a time when my Dad worked at the Narcotics Control Bureau; his team came to know from a source that an African man is arriving at Mumbai Airport carrying heroine. A trap was set. He easily got lured. After taking him into custody, he revealed that he consumed the capsules filled with the drug. He was immediately taken to the government hospital. Doctors gave him ipecac and procured 800 mg of heroine loaded capsules. Teenagers are easy prey to drugs. Heroin overdose might not be that common, but when combined with other drugs may be deadly. It is a morphine metabolite. The most common symptoms include laboured breathing, decreased blood pressure, pinpoint pupils, tongue discoloration, abdominal spasms, disorientation, delirium, muscle spasticity and coma. The immediate response in suspected overdose or poisoning should be prompt medical help. If an antidote can be given, recovery from an acute overdose occurs within 24 - 48 hours. Heroin is often mixed with other substances (adulterants), which can cause additional symptoms and organ damage. Hospitalization may be necessary. Because heroin is commonly injected into a vein, there are health concerns related to sharing contaminated needles. Sharing contaminated needles can lead to hepatitis, HIV infection, and AIDS. APRIL 2015 • lexiconin.com Teaching Basic Life Support in school: Can Medical students be part of the solution? - Pool Aguilar León Medical Student, AntenorOrrego Private University WORST CASE SCENARIO A ccording to AHA, Cardiac arrest occurs when the heart’s electrical system abruptly malfunctions and the heart suddenly stops beating normally. It is often confused with a heart attack, which typically happens when blocked arteries prevent blood from reaching the heart’s muscles. There are almost 424,000 EMS-assessed out-of-hospital cardiac arrests (OHCA) each year in the United States – and most of them are fatal. The term OHCA is used to distinguish between those that happen outside of a hospital setting and those that occur in a hospital setting around medical professionals. To survive cardiac arrest, they must receive immediate cardiopulmonary resuscitation (CPR) to increase the blood flow to the heart and brain, along with an electrical shock from a defibrillator to stop the abnormal heart rhythm. For every minute without life-saving CPR and defibrillation, chances of survival decrease 7%-10%. Individuals with CPR training are more likely to deliver the lifesaving intervention to cardiac arrest victims. Furthermore, those with training perform higher quality CPR to victims of cardiac arrest and increase survival rates. Unfortunately, not enough people are able to deliver effective CPR. CPR training in high schools can teach a substantial portion of the population how to deliver this lifesaving technique and help increase the likelihood that individuals suffering a cardiac arrest will receive high quality CPR. Training students in CPR will fill schools, as well as entire communities, with lifesavers. In Addition, According to the recommendations published in the 2010 guidance of the International Liaison Committee on Resuscitation (ILCOR), training in CPR should be added in the curriculum of high school education. It is a fact the limited training in CPR for medical students in the beginning of their career, as well as lack of knowledge and skills of many graduates at the start their specialized medical training. However, Research focus on future solutions. According to a study delivered in Germany by Breckwoldt et al, medical students teaching basic life support to school children as a mandatory element of their own emergency medical course performed significantly better in practical resuscitation compared to control students. This suggests that the model described is a valuable new method in medical education. In Northern Ireland, the “ABC for life” programme was established to introduce CPR training into primary schools. Cardiac resuscitation officers from a major teaching hospital trained medical students how to act as instructors in Basic Life Support. Then, each medical student instructs small groups of teachers in BLS (ratio 1:5, respectively) who then teach the pupils in their schools using small group trainings sessions. The aim is to train up to 25.000 pupils per year to perform adequate CPR. There is a lot of information supporting the fact that children can learn and provide basic first aid measures as checking responsiveness and breathing, call for help and give correct information to the emergency medical service and Establish recovery position to an unconscious patient. Promoting a CPR teaching program in schools by medical students is a commitment to the future, education and public health of our country. It is necessary to promote education and research on this topic and in the future implement it as part of a national health plan. Students and community in general would be the most beneficiated. APRIL 2015 • lexiconin.com IS DRUG ADDICTION A NEW EPIDEMIC? Mrs. Ruchira Dhoke,Microbiologist, Mumbai Lexiamma says “The abuse of drugs among young adults has alarmingly increased and has become an extremely serious problem world over with high risk of transmitting infectious diseases like hepatitis and HIV/AIDS.” A sane person will never imagine some creepy crawly things walking down his /her arm. But a drug addict under the influence will. Drug addiction can be defined as “a complex illness characterized by intense uncontrollable drug craving, with compulsive drug seeking and use that persists even with its devastating consequences.” Lexiamma wants to persuade the young generation to stay off drugs because: Drugs Play Mind Games!! Our mind is molded in such a way that it gives an insight in our life and allows us to solve the day to day problems we face. Hence an important tool. But drugs harm one’s ability to think rationally or to stay attuned with the surroundings. These effects continue even after the effect of drug appears to have worn off. Drug Addiction And Its Vicious Cycle!! The vicious cycle of drug addiction usually begins with a problem, discomfort or some form of emotional or physical pain a person is experiencing which they find very difficult to be in sync with. In today’s competitive life which is full of expectations , either from the parents or the ones which we have for ourselves adds to a lot of problems like difficulty to fit in a social “clique” as a child or teenager, anxiety due to peer pressure or work expectations, insecurities due to lack of selfconfidence etc. This leads many people to drugs for comfort. Drugs seem to be a simpler solution to make these problems disappear for a while, giving them a very happy feeling. Drugs become valuable. They start to use them the second time and third time and in a jiffy become dependent and lose the ability to control their drug use. The result is simple: Addiction to drugs. LEXIAMMA’S LEXIGYAAN Drugs affects the brain in three ways 1.Immediately: alters perceptions or emotions 2.After repeated use: dependence by producing symptoms of tolerance and withdrawal, and 3.After chronic use: neurological damage. Mood-altering drugs change dopamine levels in the synapses causing every cell of the brain and eventually the whole body to get affected. Over time, drugs change the brain; the process is referred to as Neuroadaptation. Most drugs of abuse target the brain’s reward system by flooding the circuit with dopamine. Now, the brain becomes “accustomed” to the i n fl u e n c e o f a d r u g . I n re s p o n s e t o a c h ro n i c fl o o d o f neurotransmitters, the brain decreases the number of receptors in the nerve cells. With repeated exposure to a drug, tolerance develops, showing the expected behavioral effects. When the drug is withdrawn, the brain cells react, producing withdrawal symptoms. Consequently, even more drugs are needed to compensate for the brain’s attempt to normalize itself. NEUROTOXIC EFFECTS OF DRUGS With chronic use and/or heavy use, alcohol and drugs can damage the brain. Dementia Severe cognitive dysfunction Problems in vision and hearing Altered heart rate Emotional distress and drowsiness RISK OF CONTRACTING HIV/AIDS AND HEPATITIS B AND C There is a very high risk of contracting or transmitting HIV and hepatitis B and C not only for the ones who inject the drug but also for noninjecting drug abusers. HIV and other infectious diseases are spread primarily through the re-use or sharing of contaminated syringes, needles, or related paraphernalia among the drug users. However, regardless of how the drugs are taken, the intoxicating effect alters the judgment and inhibition, which lead them to engage in unsafe behavior like unprotected sex. APRIL 2015 • lexiconin.com FULLY FUNCTIONING LAB GROWN VAGINAS -Spandita Ghosh, Final Year M.B.B.S,KPC Medical College and Hospital, Kolkata B etween 1 in 1,500 and 1 in 4,000 females are born with MayerRokitansky-Kuster-Hauser syndrome (MRKHS), which causes the vagina and uterus to be underdeveloped or absent, though the most severe cases are rare for this condition. Most of those affected do not discover they have a problem until they reach puberty and either fail to menstruate or cannot have sexual intercourse. Women with MRKH syndrome have a female chromosome pattern (46,XX) and normally functioning ovaries. They also have normal female external genitalia and normal breast and pubic hair development. Exams typically show that the girls and young women have vaginas that are underdeveloped or completely missing. Until now, the treatments have involved surgical reconstruction. A research team led by Anthony Atala, M.D., director of Wake Forest Baptist Medical Center’s Institute for Regenerative Medicine, selected four teenage girls who received vaginal organs that were engineered with their own cells. Engineering an organ cavity created from a patient’s cells, and lining it with skin, allows the organ to create all of the layers required for long-term stability and function, including muscle support. “It’s very much like baking a layer cake, if you will,” Atala said. “You are actually doing it layer by layer. Muscle cells on one side and other cells on the other side. And then you’re reshaping the organ.” The organ structures were engineered using muscle and epithelial cells (the cells that line the body’s cavities) from a small biopsy of each patient’s external genitals. In a Good Manufacturing Practices facility, the cells were extracted from the tissues, expanded and then placed on a biodegradable material that was hand-sewn into a vagina-like shape. These scaffolds were tailor-made to fit each patient. About five to six weeks after the biopsy, surgeons created a canal in the patient’s pelvis and sutured the scaffold to reproductive structures. Previous laboratory and clinical research in Atala’s lab has shown that once cell-seeded scaffolds are implanted in the body, nerves and blood vessels form and the cells expand and form tissue. As the scaffolding material is being absorbed by the body, the cells lay down materials to form a permanent support structure – gradually replacing the engineered scaffold with a new organ. THE NEW TRUTH Follow up testing on the lab-engineered vaginas showed the margin between native tissue and the engineered segments was indistinguishable and that the scaffold had developed into tri-layer vaginal tissue. And, it has also received positive feedback from the patients. A patient who had the surgery when she was 18, says “I feel very fortunate to have a normal life, completely normal”. “This may represent a new option for patients who require vaginal reconstructive surgeries. In addition, this study is one more example of how regenerative medicine strategies can be applied to a variety of tissues and organs. Image 1 – Reference - Dr. Yuanyuan Zhang, Wake Forest Institute for Regenerative Medicine Title - Researchers grew the cells on a scaffold that was configured into a vaginal shape Title - Dr. Anthony Atala, director of the Institute for Regenerative Medicine at Wake Forest Baptist Medical Center, led a team that successfully implanted laboratory-grown vaginas created from the cells of teen girls who suffered from a rare medical disorder. REDEFINING ADOLESCENCE: NATURE VS NURTURE -Subrat Das A dolescence has been defined as a time of ‘Sturm &Drang’ or ‘storm & stress’ by Hall, ‘the father of the psychology of adolescence’. Although this theory had little scientific backing at the time of its inception, Hall and the psychologists at that time (late 19th century) who were riding on the wave of Darwinian evolution believed that individual development parallels the historical record of species development, i.e. ontogeny repeats phylogeny. This theory, on which the idea of Social Darwinism was based, made Hall believe that ‘the child and the race are key to each other’. Psychoanalysts of the mid 20th century, meanwhile, emphasized normal adolescence to be a time of psychological turmoil linked to the changes in hormonal and bodily features associated with puberty. Thus ‘adolescent rebellion’ was therefore considered as normal developmental behavior. Landmark advancements made in the field of pubertal growth & development, adolescent health & psychopharmacology and in hormonal contraceptives led to the identification and consolidation of ‘Adolescent Medicine’ as a sub/super specialty of Paediatrics. Ground breaking research in the field of adolescent growth and psychological development, especially the major hormonal events around puberty and the neuro-endocrine control of the onset of puberty, led to the clear demarcation of childhood from adolescence. Simultaneously psychoanalysts started to demarcate adolescent behavior with increased objectivity. The idea of ‘imaginary audience’- adolescents believe that everyone is watching them, and the concept of risk taking and impulsive behavior was seen as an inseparable part of the identity and natural growth of an adolescent. Whereas the biological markers helped to delineate childhood from early adolescence, the psychobehavioral data helped to demarcate adolescence from early adulthood. This view of adolescence as a period of troubled transitions one goes through before attaining adulthood, proposed by Hall and further backed by psychoanalysts reflected the primacy of ‘nature’ over ‘nurture’. However, this nature over nurture view of adolescence has been thoroughly challenged by contemporary researchers in cross-cultural psychology and fMRI studies related to development of brain. There has been ample research in cultural neuroscience and anthropology which ascertains cultural invention of adolescence as a period of life s p a n t h a t e m e rg e d a s a p ro d u c t o f m o d e r n i z a t i o n a n d industrialization. Even if we accept that there exists a transitional period of life, organised around puberty, the next logical question is if its features of ‘storm and stress’ are a universal finding too. Ethnographic research in Samoa conducted by anthropologist Margaret Mead suggested cultural differences in the experience of adolescence. In her book, ‘Coming of Age in Samoa,’ she challenged the claims of Hall about the ubiquitous nature of ‘storm and stress’ of adolescence. According to her findings the Samoan culture influenced psychological development in a way that made the transition of a girl from adolescence to adulthood smooth and lacked the ‘natural adolescence rebellion’ proposed by the evolutionary schools of thought. Samoan culture, unlike the Western culture, did not place judgments and pressure on adolescents and were more liberal, for example, in its view on sexuality, thus producing a more tranquil transition. She essentially proposed primacy of ‘nurture’ over ‘nature’ with her findings. Though some critiques have questioned the methodology of her research, ever since her work on Samoan culture an increasing body of evidence has been documented in the branch of anthropology which has studied cross-cultural differences in adolescence. In a more recent cross-cultural study of adolescence in tribal and traditional societies using data collected from over 175 societies around the world, the researchers have found adolescence as a ubiquitous, distinctive socially marked stage of life. However, the same study found that the features of ‘storm and stress’ naturally associated with adolescence is not necessarily a ubiquitous phenomenon across cultures. Based on studies comparing different THE NEW TRUTH cultures, Trommsdorff suggested that ‘turbulent’ features such as intergenerational conflict is result of the focus of the adolescent on attaining independence from parents during this period which is linked to the cultural values of individualism in Western culture. These studies suggest that adolescence, earlier described as a period of psychological turmoil as an essential part of identity development, is not the norm across cultures. Therefore, our understanding of adolescence as a period of psychological turmoil previously thought to be essential to identity development, stands challenged. This has led to the proposal of a bio-social theory of adolescence. According to this theory, puberty which is firmly rooted in the biological changes occurring in the body, interact with cultural and social factors to result in varied manifestations of adolescent behavior. This emphasizes the brain-body-world interaction, in which none is causally determinant but contribute equally in unfolding human experiences. Ian Hacking describes this as the ‘looping effect of human kinds’. For example, in adolescents, it is possible that culturally and historically shaped concepts of normal adolescence as described in science, as a transitional period between childhood and early adulthood, marked with risk taking and rebellious behavior, can create an image of how to be, to which adolescents may subscribe to, which in turn would be encoded in the brain giving rise to a bio-loop which would solidify the concept of normal adolescence as that of ‘storm and stress’. To summarize we can safely assume that though adolescence is a universal phenomenon across cultures, the very characteristics of adolescence as prescribed by psychologists is not a universal finding. This requires an inter-disciplinary approach to define and understand normal adolescence, with contributions from the field of cross-cultural psychology, anthropology and cultural neuroscience. This enriched understanding of brain-body-world interaction and bio-looping of human brain will help us to define adolescence clearly and expand our view about what constitutes ‘normal’ adolescent behavior. And as they say, you can treat pathology better when you know its normal physiology, so is it true with ‘adolescence’ and the adolescent specialty of ‘adolescent medicine’. APRIL 2015 • lexiconin.com ADOLESCENTS AND SLEEP: HORMONES AT WORK. -Dr. GeetaSundar, Kasturba Medical College, Manipal SLEEP Yes, that important part of the 24 hours’ time we wait for. To lie down, close our eyes and pass into a constant of oblivion and relaxation. We all crave it. We all want nothing more than to enter that state after a tiring day. More so the young adults than us. A growing teenage brain requires an adequate amount of sleep, around ten hours or so at night, to cater to all the needs of its body. Else, it hampers functions and causes significant deprivations in memory, attention-span, concentration; depression, aggression, clumsiness, reduced academic performance, increased absenteeism, poor decision making, and lack of enthusiasm. A regular sleep cycle has two phases that alternate over the course of the sleep period – REM and NREM patterns. Insomnia is often defined as a sleep disorder characterized by difficulty in falling and/or staying asleep. When sleep is disturbed or not complete, it causes a disruption in the patterns leading to many manifestations – heart attack, stroke, diabetes, increases risk of accidents and substance abuse; impairs judgement and if not that’s not good enough, it can cause obesity. But why insomnia in an adolescent? Peer pressure, too many activities? Or maybe excessive stress of studies? Yes and yes. But there is more. Studies conducted have researched why puberty alters the sleep cycle and how advanced electronic gadgets are now the prime suspects in condemning sleep. The onset of puberty is has been found to delay sleep 2-3 hours as compared to a pre-puberty status. This hormonal shift has been studied by researchers at Brown University where they considered 94 students – aged between 9-10 and 15-16 years in two cohorts. After determining the adolescents’ pubertal status at baseline, they followed the assessment roughly six months for the next two-and-ahalf-years with school in session. A regular recording of the sleep timings was noted by the participants prior to each assessment. Also to enhance the study, researchers also collected saliva samples every half hour, five hours prior to their normal bedtime and a last sample half hour after that time. THE NEW TRUTH The samples were used to estimate the timing of secretion of melatonin, which is an indicator of the circadian rhythm. It was noticed that as the participants got older, the melatonin onset time moved later. They were seen to go to sleep late on weekends and weekdays and ended up getting up late on weekends. Due to school timings that often averaged somewhere at 8-9 am, the participants often woke up before 7 am. By the study, it was noticed that those who were ≥11 years averaged through less than eight hours a day and teenagers only managed less than seven hours a day of sleep. Today, with the increasing availability of electronic devices, and with almost every toddler to teenager having a mobile phone, an iPod/iPad, and laptop, especially night time use of these devices has been linked to increasing sedentary behaviour prior to sleep, poor sleep quality, greater caffeine consumption, and increased daytime sleepiness. The reason is attributed often to the light emitted from these devices that causes suppression in the levels of melatonin, the neurotransmitter responsible for sleep production. The mere presence of such a device is also implicated in decreased sleep; however it’s the actual usage of one such device that is more pronounced. What makes things even worse is that an over-arousedsleep-deprived-brain finds falling asleep more tedious than a normal sleep-fulfilled one – a terrible vicious cycle ensues. Prevention is always better than cure. That statement stands tall in this effect. Parental help and good time-management skills will work a long measure to ensure good sleeping habits. Also keeping use of the devices to a minimum in the night time, decreasing intake of stimulant drinks and relaxing techniques have been found to be great at improving sleep. APRIL 2015 • lexiconin.com I LISTEN TO COLOUR -Shrayash Khare, S.N. Medical College, Agra THE NEW TRUTH The term Cyborg literally means cybernetic organisms i.e. constructed of both mechanical and organic material. It’s a term that has been confined to science fiction movies and to some extent in the real world to the modern prosthetic. But today humans are more open to the idea of implanting technology into their body so as to make them more capable and give wings to their dreams of being ‘super humans’. Neil Harbisson, was born completely colorblind. To him the life was always in ’50 shades of grey’. But even though he could not see color, he could sense it. Neil convinced a doctor to implant into his skull an antenna that could detect and transpose color into their corresponding tone, allowing him to hear color through bone conduction. Today Neil dresses in a way that sounds good rather than looks good. For him the super market is like a discotheque and he loves to eat food, which is musical. "I've been a cyborg for 10 years now. I don't feel like I'm using technology, or wearing technology. I feel like I am technology. I don't think of my antenna as a device –it's a body part." He wears it to bed and in the shower. What next for cyborgism? "We'll start with really simple things, like having a third ear on the back of our heads. Or we could have a small vibrator with an infrared detector built into our heads to detect if there's a presence behind us." Like a car's reversing sensor? "Yes. Isn't it strange we have given this sense to a car, but not to ourselves?" But the big change will come when someone else decides to have an eyeborg implanted. Then Harbisson will no longer be alone on the superhighway to trans humanism. "We will then be able to explore new languages and ways of communicating that go beyond our traditional senses," he says. "We will have skull-to-skull communication." The computer now offers the human race the opportunity to transcend limitations of intellect, strength, and longevity previously "programmed" into its DNA by eons of evolution. The question is, is it ethical for human beings to be doing this, should there be limitations on the integration of technology into human life, and what will the social consequences from all this be? This whole area is now throwing up vitally important ethical questions. Should every human have the right to be upgraded into a Cyborg? If an individual does not want to should they be allowed to defer, thereby taking on a role in relation to a cyborg rather akin to a chimpanzee’s relationship with a human today? Even those humans that do upgrade and become a Cyborg will have their own problems. Just how will Cyborg ethics relate to human ethics? The whole topic needs to be brought to the fore, now. APRIL 2015 • lexiconin.com BULIMIA OVER THE YEARS -Chaitalee Ghosalkar, 2nd Year Student of Pharmaceutical Management, SIES College of Management Studies, Mumbai HISTORY REVISITED Eating disorders form a significant portion of the battles that adolescents fight. Basically, they evolve from the need to look good, blend in with the likes of their contemporaries as also emulate the people they hold as their role model. I’m sure a significant percentage of you must have stressed over the way you look during your teenage years, and tried to alter your diet by various means that you deemed to be effective, or those tried and tested by your friends. Of the habits of food intake alteration that adolescents first undertake as an experiment, gradually manifesting into a serious problem, Anorexia nervosa i.e. starvation in an attempt to maintain the weighing scales is well known. Another equally grave condition is Bulimia nervosa. Many of us must be aware of the fundamental definition of Bulimia. A person alternates between phases of eating and non-eating. While the former is achieved by bouts of binge eating, the latter is accomplished either by purging the imbibed food, long hours of over exercising or even excessive laxative usage; all of which are harmful to the body. The history of Bulimia is quite old. Ironically, while it is now termed as a disorder arising from the need to keep one’s body weight in check, earlier it served to fulfill a person’s food fetish. This dates back to as early as the 2nd and 4th century A.D. when the Romans used to vomit the food they’ve eaten so that they could empty their stomach and continue eating. It arose mainly owing to the excessive number of food items served during meals. To suit the Romans’ gastronomical indulgences, they even built ‘vomitoriums’ where the people used to empty their gastric contents and come back and enjoy the wider selection of palatable foods. While the Romans purged to keep up with the gratification of ample choices, the Egyptians did so to preserve health. It was a common belief in their culture that human diseases came through food. Hence they used emetics and clysters to purge for three days in a row, every month. The same could be said for Europeans as well, who during the Middle Ages had purgation as a form of remedy for several diseases, as advocated by physicians of that time. Thus in those times, vomiting was considered worthy of medical attention only if the related overeating was a symptom of some disease. Several cases in the nineteenth century brought focus on the Bulimia we know of today. Documentations of physicians of that time slowly brought about an understanding of the psychological disorder that Bulimia is. There was a time when excessive eating with the optional flushing out was also linked to situational tendencies. The same was seen in refugee children brought into the United States from Europe, who tended to eat more out of insecurity; the intake decreasing drastically once they found new homes. At present, we acknowledge the eating disorder to not just binging and purging but also certain personality traits that include addictive tendencies, problem with impulse control, and obsession with weight and general looks. It is even used as a coping mechanism for the extra stress that adolescents go through nowadays. But the disorder itself has had a long course by way of evolving from the advent of A.D. to the ongoing twentyfirst century. APRIL 2015 • lexiconin.com ON HOW PROBLEMS CHANGE, AND CHANGES CAUSE PROBLEMS- THE ADOLESCENT YEARS HISTORY REVISITED Bianca Honnekeri, Grant Medical College, Mumbai (A series of poorly constructed poems examining adolescent mental health issues, as Alice strolls through her Wonderland.) “Begin at the beginning," the King said, very gravely, "and go on till you come to the end: then stop.” Vodka, whiskey, tequila and rum, The effect it has on me is like a thaumaturge… If you have enough, even in sorrow you can find a happy tune to hum! Lemon or coffee the next morning- binge, then purge. Alas, with me, my grades and career did also succumb…. I’ll go get high; these depressing thoughts simply rekindle the urge. “Who in the world am I? Ah, that's the great puzzle.” “I'm afraid I can't explain myself, sir. Because I am not myself, you see?” I see the mirror: pout-click-Selfie! That window reflects? Ooh, I’m so pretty! 3 hours at the salon- Hey, I’m also checking my texts! Why so judgemental? This is normal for me…. - You don’t suppose I have a narcissistic personality? They called me a pessimist, a total crapehanger. I don’t see a silver lining; it’s just a grey cloud. “You are suicidal- your life is in danger!” What is wrong if I fancy the final comfort of the shroud? All my life I’ve traipsed along, a lone ranger. Major depression- at least the gunshot will be heard out loud. “Yes, that's it! Said the Hatter with a sigh, it's always tea time.” “Alice: Would you tell me, please, which way I ought to go from here? The Cheshire Cat: That depends a good deal on where you want to get to. Alice: I don't much care where. The Cheshire Cat: Then it doesn't much matter which way you go. Alice: ...So long as I get somewhere. The Cheshire Cat: Oh, you're sure to do that, if only you walk long enough.” Party tonight- so all day I shall not eat, Hide away all the food, Being Size Zero is the real treat. Hunger pangs and a perpetual foul mood? Food was the incunabula of my life, but it long ago was beat. “My dear, here we must run as fast as we can, just to stay in place. And if you wish to go anywhere you must run twice as fast as that.” (The quotes have been taken from ‘Alice in Wonderland’ by Lewis Carroll.) Next week, board exams begin amain. A tournament tomorrow, yes, that too! All-nighters are the only ad hockery then, that’s plain. Oh wait- I also have that project to do! Perpetually multitasking- the clock is my life’s bane! So much stress and anxiety- I’m just 15 and I get chest pain. “Why, sometimes I've believed as many as six impossible things before breakfast.” Sales pitch tomorrow, Intern-of-the-month I must be, Who cares if someone’s in sorrow? The recommendation letter is for me! I shall be a mythomane on the morrow, My butyraceous tongue no longer moralizes against treachery. “And what is the use of a book," thought Alice, "without pictures or conversation?” My 6am alarm woke me up- my phone looked effulgent from my bed. “Today I will not waste time on it,” I augur, “I will not cone.” The hours pass by…. And with them the inutile promise I’d said, I’m late for class; I spent four hours peering at the phone. I just cannot function without it- is there something wrong in my head? Even on silent mode and tucked away in the drawer, I keep hearing my ringtone. “The Mad Hatter: "Would you like some wine?” Alice: "Yes...” The Mad Hatter: "We haven't any and you're too young.” APRIL 2015 • lexiconin.com THE INEXPLICABLE REASONING ( A TALE OF A SORDID NATION) -Dr. Abhijeet Sharma Kasturba Medical College ,Manipal LOVE, DRUGS AND ADOLESCENCE! It’s no secret that some populations deal with this concept far more prudently than others. Unfortunately, it is also the test that our “great nation” fails at badly, very badly. O ur story begins exactly like a billion other stories do. A hot, humid, dusty and noisy morning, coupled with a nauseating aroma of a nearby sewer, usually enjoyed with a cup of hot tea and newspaper. The first headline of the news bulletin will almost always pertain to something unfortunate or in some exceptional scenarios, to cricket. Trains will collide, people will be shot dead, a neighbouring nation will be questioned, a scam will be publicised or women will be raped. It’s like someone puts the “movie of India” on rewind and plays it every morning. For a nation obsessed with “fairness” of skin, it comes as no great bolt from the blue that we as individuals brand sexual conversations in public as a pathetic and downtrodden thought while engaging in heinous sexual crimes against women simultaneously. That’s what I like to call, “mother of all multitasking”. And let me be clear. My remarks are not limited to the men who rape or assault, but to each and every one of those souls who gets frustrated one fine day hearing a mishap on the news and then stare at a lady’s cleavage while travelling in the public transport. A friend of mine, resident of the national capital, who recently finished her medical course, travelled back to her home city. It had been a year since she visited the place and was apprehensive about the journey, Somewhere in this movie, playing an infinitesimally small role is reasoning and pragmatism. And the deficiency of such basic human traits is the central figure of this story. India, home to not only a sixth of the world population, but also a shelter to the most preposterous and disgusting of beliefs. We are the proud inheritors of the most rudimentary and backward pattern of thinking that has given rise to exceptional cesspools of ironical existence. For a civilization which claims to be the oldest of all, we the one not between the cities but the journey within. She called me up and asked me to stay on the line while she travelled back from the airport. That’s just one example of how terrifying it has become to possess ovaries in this country. There are countless others. I am sure the weird and ugly looking, obstreperous moron travelling alongside in the bus or the illiterate auto driver who thinks the world is a urinal or the self obsessed, shabbily dressed, brainless youngster who thinks it’s “cool” to wink and whistle or the lawyer who tried to defend his clientsmen who mercilessly inserted an iron rod up a women’s vagina eventually damaging her uterus, intestine and other vital organs, with an argument that makes him qualified for “public castration”, come to mind. exhibit very little intelligence and social maturity. With contradictions piling up in every corner of the country, it’s not surprising that flowers and sweets are offered to Goddess Durga in the morning and by evening women are raped and mercilessly killed. It’s no accident that we claim to be the oldest religious civilization. After all religion is the death of reasoning. And Indians are unmatched in showcasing this paucity. The social civility of a nation is very poignantly represented, sincerely if not completely, in how it deals with matters relating to the genitals. The manner in which people deal with reproduction and the urge to do it may be a representative sample of their basic understanding of themselves. Male peacocks attract their female partners by showcasing their scintillating feathers and dance during the rains. Lions like to display their might and supremacy by fighting other lions of the clan in order to catch the fancy of the lioness. A male stag uses his antlers as a tool to show his worth as a potential mating partner. Even the male rats wait for the female to perform the “mating dance” during her “heat”, before attempting a sexual act. The logical estimation would be that humans have a more sophisticated and cultured manner to exert a pull on their fellow females. Any logical brain would conclude that given the human’s extraordinary evolution of grey matter, they’ll develop some unique and intriguing mechanism to prove their potency as a worthy sexual partner. APRIL 2015 • lexiconin.com THE INEXPLICABLE REASONING ( A TALE OF A SORDID NATION) -Dr. Abhijeet Sharma Kasturba Medical College ,Manipal LOVE, DRUGS AND ADOLESCENCE! And indeed we have. We have successfully developed the “date-rape drug”. We have successfully managed to make our society filthy enough to blame the females for any and every mishap. We have even attained amazing achievements in the field of forceful copulation of girls even before they achieve sexual maturity. Extrapolating these soul numbing accomplishments we have not failed even a single disgusting expectation when it comes to ill- treating the female human. Sometimes it’s met with killing one still inside the mother’s womb; at other instances by stripping her of every basic human right; and still further by burning her alive or killing her after violating every single aspect that makes her a woman. Sickened enough?! I ask because there is no end to these exceptionally filthy tales. In India, politics is essentially based on the short memory of the populace. The fact that we, as Indians, are exceptionally talented in forgetting even the most unforgettable of events, lead to the production of an interview documentary by the British Broadcasting Corporation (BBC) named “India’s Daughter”. Since the broadcast of the film was banned in India, it really isn’t possible to make a fully informed comment over it. But what we can comment over is the political turmoil it caused. Whether or not that documentary should have ever been made or if it was justified to ban it, are questions whose answers differ from one individual’s perspective to another’s. But here’s the catch. It took a foreign media corporation to remind us that the convicts of the “Nirbhaya case” are still alive and have not stopped infecting the world with their thoughts. It took a political upheaval in the power corridors of the capital to remind our leaders that such low living forms must be eliminated at the earliest. It took a series of news flashes to remind the people of this rotting society that India’s daughters are indeed fighting the world every time they travel to work or step outside their homes or travel around with friends. If you ask me, I think the “British” just did us another favour. But alas, it will take more than a rape and murder, to shake the conscience of the Indian people. It took less than a week for the outrage and the anger to die down. And we will happily forget it again. We have perfected the art of forgetting over the past 6 decades. So yes, while parents all over the world are buying dresses for the “soon to arrive” daughter/son, Indians are illegally trying to find the sex of the unborn child and terminate the pregnancy in the absence of a penis. While governments across the world are trying to eliminate the gender pay gap, Indians are still trying to convince their bright young daughter that the only purpose of her existence is cooking and parturition. While people across the globe are living happily under a female leader/president, Indian males are salivating at the sight of elegantly dressed lady. While women from “beyond our boundaries” are finding cures and treatments for deadly ailments, Indians are still blaming the wives for the birth of a female baby. While the world is witnessing the magnificence and brilliance of Angela Merkel, Janet Yellen, Dilma Rousseff, Christine Lagarde, Mary Barra, Sheryl Sandberg and Virginia Rometty, Indians are still telling women to produce at the least 4 offspring and tagging rape as an innocent boyish mistake which is no big deal. Natural selection demands inferior traits to be eliminated for the propagation of superior virtues. It is indeed exquisite how we have tricked the law of “survival of the fittest”. APRIL 2015 • lexiconin.com LOVE By, Dr. Raviteja Innamuri, Psychiatry PG Resident, CMC Vellore Dear Kamadeva, Venus and Cupid What is left to write of Love? Isn’t its tale, too long, too stale, fantastic and a fantasy? But what is it that I know of love? Did I ever feel love? If love is that intense surge of hormones, pumping my heart, swelling my mind and cracking my voice, so be it, but is it so? Was it the time when I was pushed into the world and my mother pulled me into her warm bosom that I first felt love? Was it the time when my friend in school took the cane for me that I thought of love? Was it the time when I narrowly missed the accident and the doctor spoke of God’s love? Will it be when she will call me three times a day and run her hand through my hair every night that I shall feel love? Or will it be when I will have to let her go? As we grow older, we develop a sense of who we are. We develop our likes, dislikes and our personality traits, and as social creatures, we find the need for affiliation with other carbon based life forms! Which of these close relations and liking finally evolve to love? Psychology explains to us that love is a qualitatively different psychological state than mere liking. If I may, broadly there are two types of it- passionate or romantic love and compassionate love. Passionate love is the Romeo and Juliet kind of love. This is what makes ordinary men, poets and poets, insane. This is the kind of love that makes colours look brighter, hearts beat faster and gives intense desire for each other. It happens when an intense physiological arousal occurs together with situational cues that label this feeling as LOVE! This intense physiological arousal could even be anger or jealousy explaining the bad choice of our heroines who fall for eve teasing heroes who somehow manage to label these feelings as love! Compassionate love is the more frequent and steadfast type. This is one that is less electrifying, relatively stable and binds best friends, siblings, parents and children. There is deep caring, happiness for the partner, reliability and emotional trust. Sometimes, best friends can become lovers and vice versa. It’s easy for ex- lovers to remain friends if they had compassionate love before cooking it into passionate love! Sternberg’s love triangle beautifully brings out the faces of love by arguing that Love is composed of three components: intimacy (liking), passion (infatuation or physical closeness or “love at first sight”) and empty love (decision/ commitment to maintain love). The types from these combinations being: 1.Romantic love: Intimacy + Passion e.g. Layla and Majnun 2.Compassionate love: Intimacy + Commitment e.g.Veeru and Jai of Sholay 3.Fatuous love: Passion + Commitment e.g. Friends with benefits 4.Consummate love: Intimacy + Passion + Commitment e.g. Happiness by Guy de Maupassant, marriages into old age till death parts them apart! Love,Drugs And Adolescence In 1958, Nobel laureate John Steinbeck in a letter to his eldest son Thom writes on the subject of Love“There are several kinds of love. One is a selfish, mean, grasping, egotistical thing, which uses love for self-importance. This is the ugly and crippling kind. The other is an outpouring of everything good in you — of kindness and consideration and respect — not only the social respect of manners but the greater respect which is recognition of another person as unique and valuable. The first kind can make you sick and small and weak but the second can release in you, strength, and courage and goodness and even wisdom you didn’t know you had.” Surprisingly, in several cultures, love in not particularly an important concept or a necessity for lasting bonds. Not surprisingly, the concept of love is relatively a recent phenomenon. The ancient Greeks saw love as a ‘form of madness’ and until the middle ages the current concept of love didn’t even exist! Labelling feelings as love also depends upon whether the culture we live understands, appreciates and communicates these concepts explaining the controversy of the ‘Kiss Of Love’ campaign or extremists on Valentine’s Day across India. Apparently, The New York Times article To Fall in Love With Anyone, Do This, helps you find love with the help of Dr. Aron’s36 questions! Perhaps, it’s the license test for Cupid’s golden arrow. In such endless forms it exists that I wonder if it exists at all. In so many signs and no form, I am lost with labels to tag. May be I will never know love or show me if you will? So long, Embodiment of Love, RavitejaInnamuri. APRIL 2015 • lexiconin.com Adolescence & Substance Abuse -ArchitRastogi Final Year, B. Tech Biotechnology, VIT University, Vellore A h adolescence! The age of growing, the age of self – actualization, the age of burgeoning sexuality, the age that culminates when one becomes an adult. But, more than anything else, adolescence is simply the age of utter confusion. Children are under intense pressure. In addition to dealing with major confusing changes to their bodies, they are constantly told how they’re older now and are expected to behave like adults. They’re often given little instruction about important topics like sexuality, simply because of a chaste society. They’re simply told what is expected of them, with little focus on why. They’re left rudderless while traversing one of life’s most challenging seas. This only creates great confusion and stress for a teenager. They try to fit themselves to roles that have been predefined by society, irrespective of their personal thought process. One of the biggest struggles they face every day is to try to fit in with everyone else, and avoid ostracism. This conformation with the norm is often at great personal cost. A typical example is the gender divide. Since the day we are born, we are specifically told what is appropriate and what is inappropriate behavior based on our gender. But now, psychologists claim that gender is not so fixed, it is not a binary, but rather, a spectrum. All activities fit on this gender spectrum, some may be classified as more masculine or feminine, but this is only a flawed perception. Psychologist MihalyCsikszentmihalyi explores a very interesting topic in his book Creativity: The Psychology of Discovery and Invention. He states that in every single culture, men are brought up to be masculine and women to be feminine. But, creative people manage to escape this schism. They very interestingly possess the strengths of both genders. He goes on to demonstrate through example how creative women were dominant and assertive – typical masculine characteristics and creative men were more attentive to their family and environment – typical feminine characteristics. This actually makes a lot of sense. During adolescence, as people start coming into their own and discovering themselves, they often pick up many new interests and hobbies, for example playing a specific instrument. Unfortunately, they have to give up on many such hobbies simply to avoid persecution by their peers for being different. One can only wonder how many Pablo Picassos and John Lockes the world has lost simply because they were unpopular as children. It is almost tragic to imagine how many great people are nipped in the bud. The ever increasing number of teen suicides only serves to reinforce this point. To add to the turmoil, many adolescents have to deal with broken families that exert undue pressures on them. Despite being young adults, adolescents are not equipped to handle terrible family stresses. They often have to witness domestic violence and alcoholism. This not only stresses them, but robs them of vital family support. At a juncture in life where they are constantly questioning themselves and those around them, they are unable to ask their parents for guidance. This creates a very big vacuum in their lives. Traditionally, this vacuum is filled by friends. And while friends are essential, they can prove to be a bad influence – especially in the absence of authority figures like parents. Friends exert peer pressure on adolescents. This can be both positive or negative. If the adolescent is motivated by peer pressure to excel at school or a job, it is positive. But, on the other hand, if the adolescent is convinced to do something harmful, it is negative. Unfortunately, the negative outcomes are far more severe and easily outweigh any benefits the positive outcomes may confer. LOVE, DRUGS AND ADOLESCENCE! new. And, then curiosity gets the better of them. Sadly, drugs and addictive substances are one of the scenarios where curiosity ALWAYS kills the cat. Just trying it once is enough to get them hooked. The main motivation to give in to peer pressure remains the same – acceptance. Adolescents always fear ostracismmore than anything else. They are always trying to fit in. Conforming allows them to be a part of the group. It helps them feel normal. Fitting in is vital to their self – esteem. Being young adults, they highly value their self – esteem. It is linked directly to their self image. It is of the utmost importance that a healthy self image for adolescents be promoted. This equips them with better decision making abilities – a vital skill in the adult world. Many adolescents also fall into the trap of substance abuse due to a newly gained sense of independence. This is typically true of overprotected and sheltered children. Children raised with minimal freedom often fall prey to this trend. To make matters worse, drugs are readily available nowadays. Drugs are rampant in developing countries like India due to lax regulations. A number of addictive drugs don’t need any prescription and those that do, can be procured by simply paying a ‘little extra’. In developed countries like the US, hard drugs like cocaine and heroin remain easily available due to their being smuggled in from South American countries in extremely large quantities. Add to the mix the easy release that drugs provide from reality and you have yourself the perfect recipe for disaster. The adolescents who fall into the trap of substance abuse find it very convenient to escape the many stresses that adolescence puts on them, only serving to increase their dependency. The irony though, is that the very drugs that adolescents take to conform cause them to be ostracized later in life! The most common negative outcomes culminate in substance abuse. This typically arises from the group of peers egging the adolescent on to try out alcohol or a drug. And yes, tobacco is also a drug! Friends have an uncanny ability to convince an adolescent to try something APRIL 2015 • lexiconin.com Why don't we talk about Porn? -Dr. Rohin Manipur, Mumbai It starts with a room lit dimly by yellow light. On a rocking chair of auburn, polished wood, a young brunette, about my age, looks at me tantalizingly. The music is soft, not enough to overwhelm. The lighting illuminates her well, making sure she’s central as she begins to strip slowly. Shirt off. Gloves off. Saucy lingerie off. All this while she whispers endearments, excited cuss words, and becomes increasingly more breathless, swaying back and forth as her fingers travel into her trousers. She looks right into my eyes and begs me to grab her somewhere unnameable, apparently aroused merely by me looking at her. Unsurprisingly a hand reaches out and grabs her and she yells in an apparent explosion of ecstasy. Now the cuss words and endearments are yelled out in paroxysmal bursts, interspersed with numerous ‘Oh yeahs’, ‘Right theres’, and ‘OHMYGOD!s’ About 30 seconds later, after a prolonged burst of yelling, she exhales one final time, 15 seconds of contented breathing follow and then she asks me to go again. We’re 4 minutes into an hour and a half long shindig. Evidently there’s a lot more of this to come. If you’re mentally high fiving me for my vigour in bed and the near miraculous powers of my hand, you couldn’t be more mistaken. If you think I’ve copy pasted something from Fifty Shades Of Grey, nope, wrong again. If you’re disgusted by what you’ve just read, I should tell you that we’ve only begun to skim the surface. The first paragraph you just read is a description of one of the ‘mildest’ porn videos currently available for free on the Internet to anyone with a phone or a laptop and a decent Internet connection. I Googled porn and this is the first thing that showed up. How was I in the picture then? Easy. It’s one of televised porn’s oldest tricks, also known as breaking the fourth wall. She asks me for my hand, and a hand pops out from behind the camera, apparently connected to me and does what she asks me to do. It obviously isn’t MY hand, but I’m supposed to believe it is, and that I’m really instructing it to do what it is doing. It’s all part of an elaborate, overblown charade, the fluttering eyelashes, the loud gasps of pleasure convincing you that you’re really in charge of someone else’s orgasm, evidently supposed to make you feel like more of a man, or a woman. Pornography. Also called porn. Aka porno. And if you were born in the last 40 years, I’d say you’ve seen at least a glimpse of some, however unintentionally, at some point in your life unless you’ve been living in a cave with no Internet. One of the first rules of Internet porn by the way. “Show me a man who hasn’t seen it, and I’ll show you a man who hasn’t seen the Internet,” as Julie Ruvolo of Forbes so eloquently puts it. It has been around a while really, even before the Internet was invented. Nude pictures and sculptures made to sexually arouse and thrill have been around for centuries. LOVE, DRUGS AND ADOLESCENCE! Porn today is easily accessible. From the privacy of your bedroom, you could theoretically see every type of perversion you have ever fleetingly thought about. As a matter of fact, there’s another rule, the popular Rule 34, which says, “If it exists, there is porn of it. No exceptions.” Female self stimulation? Child’s play. Man with woman? Pshaw. Two men with women?Still child’s play. Three? Get a little more imaginative! Ten men with one woman? Exists, and very popular too according to studies. Girl on girl?Black with Asian? Interracial? Teenager with older women? Taxi driver porn? Nurse fantasy? Cop fantasy? BDSM (Bondage, Dominance, Sadism, Masochism for the uninitiated)? All there! Get a little darker, dig a little more and the severely illegal stuff like bestiality, coprophagia for apparent sexual stimulation (coprophagia is eating faeces – UGH!), necrophilia (sex with dead bodies), and rape fantasies come to the fore. You name it, it’s there. Wait a minute you say, does that mean there’s theoretically even Bugs Bunny and – Yup. Need I say more? It’s all there. Which brings us to a very interesting observation. How strange is it that a person you’ve never met before has thought of the weirdest sex related thing you can think of and ensured there’s a video of it on the Internet? So much for being unique! My reason for writing this article however was not merely to get into an imagination discussion with you that sends us both scampering to Google, laughing our butts off as we find even more idiotic things that have had pornographic videos made about them. I slipped in a ghost punch, something you didn’t catch. Essentially, I just acted like porn, piqued your interest, made you accept something mentally that you’d never think of on your own, and killed you with humour/satisfaction at the end so that you’re more accepting of what I said/did. Don’t believe me? Here we go. Did you know that people eat their own shit on video and pretend to be turned on by it, all for the benefit of a watching audience who get sexually stimulated by watching people eat their own shit? Disgusting? Hell yes! If I met you and told you this when you were eating, you’d probably spit the food out and throw a salt shaker at me. But now you’re just going, ‘Hang on, I think you mentioned that already just a couple lines ago. It’s not so disgusting the second time.’ Porn sort of functions the same way. Go back to the first time you ever saw nudity or porn on video, a book, and how shocked you were. And then with a bit of repeated exposure, you steadily thought ‘Oh what the hell. I’ve seen it before.’ You probably let it go there, but there are truckloads of people who don’t stop with just that, steadily going deeper, experiencing forbidden fantasy after forbidden fantasy, and with each they say ‘Oh what the hell. I’ve seen it before. It’s just a step further.’ Therefore we come to, Lesson 1: Don’t pet the dog, it bites. Er. Down Scooby? ZOINK-! According to studies, repeated exposure to porn steadily warps one’s image of sex. It also warps one’s image of what sex organs look like, what the female body looks like, what the male body looks like, and just exactly how sex happens. Steadily, perverted behaviours spill over from your phone into your bedroom. You find that regular sex just doesn’t arouse you any more; you need more to stimulate you. You need what you’re watching to happen to you in real life. That’s the ghost punch porn slips in when you’re (not) looking. The porn stars acting in the movie don’t necessarily enjoy it either. A damning video surfaced on YouTube recently, of a porn actress who quit the business, Jessie Rogers, real name Jessica Mendes, giving a lecture on the harsh realities of porn and what it does for the women acting in it. APRIL 2015 • lexiconin.com Why don't we talk about Porn? -Dr. Rohin Manipur, Mumbai She says, “A veteran male performer who was in the industry for over eight years caught syphilis and faked his test, worked knowing that he had syphilis and transmitted it to other performers. I was once hanging out with another veteran male performer off camera who I knew was sadistic but what he did to me, the night that I ‘woke up’ was something I was definitely not expecting. Long story short, he kept beating me, banging my head on his wooden floor to the point where my face and my head were bleeding. He choked me up to the point of me passing out twice, and when he would stick my head into the toilet he would not let me come up for air when I tried. I thought I was going to die that night. Through the course of my porn career, I had to go to the emergency room several times. I had several incidences where I would cry on set coz things had been so painful but none of them like this one.” Mendes exposes in shocking detail one of the most obvious truths of the porn industry, that women are mistreated, often brutally and often commit suicide rather than face more indignity. Names like Tori Black, Sasha Grey (ex porn actress), Sunny Leone (ex porn actress), and Jessica White are perhaps names the frequent porn user thinks of with a flutter in his heart, but few really contemplate the behind the scenes torment they go through. Why, now you’re getting mushy, you’ll think. Or maybe you’ll say men everywhere are the same, mistreating women! The scoundrels! The perverts! News flash. Lesson 2: The male pornstars don’t always enjoy what they do either. Picture for representational purposes only WHAT! I mean, what?! From the outside it seems like the perfect life, have sex with decked up, beautiful women to be paid money. The reality is way coarser. I want you to try an exercise in imagination for me, if you’re a guy. Any time tomorrow you hear the word ‘happy’, I want you to try and place yourself in the shoes of a porn actor, and have an erection ready exactly ten seconds after you hear it. Don’t be sheepish. Just the word happy. That means if you happen to pass by your colleague’s cubicle, and the dude’s blasting Pharrell Williams’ song Happy, wham, need it ready in ten seconds. Because I’m happy, clap along if you feel like a room without a roof! Sounds crazy? Sounds impossible? Welcome to the world of the male porn actor. In the instant the director yells ‘Action!’ these guys don’t have to throw some sappy dialogue at the camera. They have to be ready, (Get the damn song out of your head already!) not once but over and over and over again, to perform intercourse in varied positions, sometimes upside down, sometimes same sex, and all as many times as it takes till the shot is perfected. This, in front of quite a large crew. Not pleasant. LOVE, DRUGS AND ADOLESCENCE! In June last year, popular humour site Cracked.com did an interview with porn actor Lance Hart, who spoke about the difficulties of male porn actors. Essentially it boiled down to having to repeat numerous takes, sometimes having erectile injections inserted into the penis, because shooting even a ten minute video took about four hours. I won’t ruin the article for you and it is easily available if you know how to work Google, but it really shows the trials and tribulations people working in the porn industry have to face. A couple of weeks ago I saw a meme which went something like, “We are a country that doesn’t mind having an ex porn star in our films, but hushes up a girl who gets raped for fear of her family’s honour.” I might be paraphrasing here, but all those death threats Mia Khalifa got sure doesn’t make her life something to envy. It tells us much about our preconceived notions of porn stars as sex addicts who want to ‘flaunt and debase our minds and culture.’ Whether pornography has any serious issues on consumers is a debatable issue. Numerous studies have shown that porn might be a safe release for people and thus prevent them from acting out their fantasies, but an equivalent number of studies have popped up claiming that porn actually increases sexual aggression and leads to more rapes. Your take away? Lesson 3: Porn really is at least somewhat bad for you. Superb use of grammar there. I don’t want to suddenly go moral police on you after everything I’ve told you. You can make your own deductions and choices, and so I invite you to, based on what you’ve read. Sure, porn provides a release to a lot of pent up sexual fantasies in private so you don’t act them out. It also soothes raging hormones, which is probably a good thing and there are numerous studies which make associations between a boom in the porn industry and decrease in rapes worldwide. But, here’s the thing. Addiction to porn and self stimulation develops very quickly. It’s a slippery slope to be on, and soon you find you cannot live without one or the other. While it has no harmful effects on one’s body, there are the obvious harmful effects on the mind that any addiction might produce. Continued dependence affects professional life as well as interpersonal relationships. Studies report that sufferers have no interest in maintaining longer relationships, choosing instead those relationships which bring instant gratification and are ended easily, just like what they see on video. Decreased concentration is another side effect, affecting studies and work. The aforementioned tolerance and ‘Oh it’s nothing’ phenomenon is one more against the idea of porn, as is the feeling of being used to sexual violence. Although pornography has been deemed illegal in most countries, including India, it remains easily accessible by anyone. In the time you have gotten through this article, thousands of people have accessed free or paid porn and satisfied their urges. The long term effects of porn viewing on the world at large remain unfathomable. The hope, however, is not that people stop using their Google Chrome’s incognito mode, which would be impossible, but that they understand what goes into the making of the ten minutes of screen time that the girl on the rocking chair got. APRIL 2015 • lexiconin.com KNOW THAT PERIOD! - Swati Shriyan, Mumbai LOVE, DRUGS AND ADOLESCENCE! I still remember the list of not-to-do things my grandmother said, which were to be followed during “those” days of the month. As I began interacting with my other girl friends in school about the same topic, I only realized that the list kept on extending further. However, none of them really knew the reasons behind the senseless theories they proposed! Most of us live in a society that has a derogatory attitude towards menstruation.Lack of proper scientific knowledge is the sole reason behind such an attitude. Women, on an average, menstruate 3,000 days in their lifetime but still the subject is constrained by taboos, which prevent the young girls from learning to develop a safe and hygienic approach towards the management of their periods. The menstruation taboos are ubiquitous in most societies of the world, even today. Silence in the culture of such societies is due to lack of basic information among women. This silence results into lack of services and education for women.In a study, 82% of respondents in Cameroon had heard of menstruation but had no clue what caused it. A survey carried out in the Kedougou region of Senegal revealed that 40% of girls and women were frightened by their first period. In fact, women have no forum to voice their menstrual hygiene needs. The world needs to break the silence and talk of menstruation on an open platform, so that the information about this natural physical cycle reaches the masses and the associated taboos are removed from the entire system. Menstruation is the periodic discharge of blood and mucosal tissue from the uterus and vagina. It begins at menarche and ceases at menopause. It is simply the renewal of the walls of uterus. It can also be said to be a process by which a woman’s body prepares itself for pregnancy every month. Different menstrual myths are prevalent in different societies of the world. Following are few of the myths and corresponding facts to debunk them: MYTH FACT A menstruating woman is impure and hence she cannot participate in any religious ceremony or offer prayers. A menstruating woman is not impure. Menstruation is a natural and healthy body process. Menstrual fluid consists of blood and tissue that was not used to nourish a baby in the Intercourse during menstruation spreads sexually transmitted disease and if a woman conceives while she is menstruating, the baby will be born abnormal. Entering the kitchen or cooking food is completely harmless if general hygiene measures are followed. A menstruating woman should not cook food or enter the kitchen. If she does so, it would spoil the food items and anyone who consumes it will fall sick. Sexually transmitted disease would only spread if either of the partners carry the disease. Menstruation has no role to play in it. Menstruation does not have any adverse effect on Touch or even the presence of a menstruating woman will spoil wine/bread/pickle or any other food in the making. With general hygiene, menstruating women can prepare and handle food just like any other day. Menstruating woman should not take bath or go swimming. One must take daily bath. For swimming, one can use tampons. It is impossible to get pregnant during menstruation. It is possible to get pregnant during menstruation. Menstruation leads to heavy blood loss leading to anemia. Healthy menstruation does not lead to anemia. 80ml of blood is lost in a single cycle. APRIL 2015 • lexiconin.com Dr. Richard Finkel - Saving Lives since 1992 Interviewed by, Trusha Taneja, PharmD. Nova Southeastern University, Florida O bserving creepy crawlies under his microscope, a young Richard Finkel was fascinated. In middle school, biology and chemistry may aptly be described as his first love. So it was only natural for him to have t a ke n u p p h a r m a c y a s h i s vocation. “It was an actual fit”, as he puts it. Building his foundation with an Associate’s certificate in pharmaceutical courses, followed by a Bachelor ’s in S c i e n c e i n P h a r m a c y, a n ambitious Richard did not stop at that. “When the Pharm. D. degree opened up in Miami in the 1980s, I took the courses at night as a post-graduate untraditional Pharm.D. student. Then, in 1991, I did my 8 months of training on rotations and that was my background to get my Doctor of Pharmacy degree and I graduated in ’92 as a Doctor of Pharmacy post-grad!” After a year, the newly conferred Dr. Finkel got drafted into the U.S. Army where he served for close to two years. “When I went in there, I did basic training in infantry for 9 weeks. Then, I had a month of medical training as an army medic.” As a registered pharmacist, he filled prescriptions for about a thousand soldiers and their families in Washington DC, Germany and south Munich. “One weekend when I was in charge of [the] quarters, the Captain, who was the doctor, said to me ‘[if you see]Any young children who have diarrhoea or fever, call me immediately, specially with diarrhoea’. He said [that] because babies die very quickly. When they have diarrhoea, their electrolytes go out and sometimes we lose them. So he said, ‘Don’t just tell people to give their child some medicine and go home and wait [until] the next day because it may be too late’. It shocked me to hear that babies are so fragile and the lesson stayed with me for a long time. That was one of the most important lessons I learnt. It was more about patient care rather than products.” Indeed, it was and continues to be. At the Prescription Drug Foundation- the Finkel family owned and operated community pharmacy in Miami, FL- patient care is given prime importance. A male septuagenarian might as well owe his life to them. While he presumed his severe backache to be due to a minor injury, Dr. Finkel thought otherwise. On enquiring about the precise location of the pain, he pointed to his right side, inferior to his shoulder blade. He also complained of vomiting. Dr. Finkel was adept at realizing that this was no ordinary pain. He questioned the patient regarding his last meal. Sure enough, the patient’s last meal comprised of a cheesy and greasy pizza which is known to precipitate gall bladder attacks! Once in the hospital, Dr. Finkel’s suspicions were proved accurate as the patient’s gall bladder was found to be severely inflamed, a condition that could have been life-threatening at his age. Dr. Finkel has countless such experiences to share, a souvenir of his twenty-plus years as a qualified pharmacist. Lecturing Nova Southeastern University’s pharmacy students on various subjects like Pharmaceutical Calculations, Non-Prescription Therapies, and Drug Compounding, his classes are full of anecdotal stories of his interesting experiences. DIVERGING ROADS “On a day to day basis every single order that comes to me is looked at in light of the patient’s history, disease state and their previous medication history. It becomes more like solving problems... ‘Why is this patient taking this?’ ‘Maybe it should’ve been stopped a year ago.’ [etc.]. This is part of our job and our responsibility as pharmacists in the United States to know every medication that that patient is taking [and] why they’re taking it. Because one medication may be used for many different purposes. So we’re more or less the overseer and the doctors have to justify what they’re prescribing to us when we ask them a question. The OBRA ’90 and the Medication Therapy Management guidelines - which right now is optional but eventually that will be law – [state] that the pharmacists need to know everything about that patient before the new medicine goes out. We need to know why.” Dr. Finkel sure knows why pharmacy. “You could work in a community pharmacy which is not only the assembling of the medication physically but also talking to the patient in real time while they are there, asking them and advising them. We have to be in touch with the physician and recommend alternates which most of the doctors really don’t know [about]. But we have to know them all. I worked at a hospital once a day [in] a month doing consulting work. That’s for a hospice organization. A hospice is a program for people who are dying and many of their medications need to be examined very carefully. It’s very very intimate, working with nurses, doctors and patients, because you are the only one in there who has this broad knowledge of all the possibilities of how to treat certain ailments.” Other opportunities include compounding with a specialization in animal pharmacy, or as a clinical pharmacist specializing in cancer therapy or nuclear pharmacy (“where you work behind lead shields and make very small amounts of radioactive material that go into injections”) and the list goes on. “It is almost limitless, what we can do.” Certainly, it does seem to be an enticing option. But pharmacy is not an easy choice. “I did discover that it is [a] very large responsibility when you are the owner of a pharmacy because I’m in total control. It is a good feeling but then you have to always put yourself back to what you really are – you are really a pharmacist. And you can’t make rules and you can’t break rules. So you can’t break any ethical principles, [You] can’t break any laws obviously, you can’t break any professionalism because if you do break professionalism you’re liable to get in trouble with the Board of Pharmacy and the Board of Health. So no matter how big you are, there’s always somebody bigger than you.” Right you are, Dr. F. As he has consistently taught in his classes, pharmacists are the first line of medical care and to succeed, they need “It was more about patient care rather than products.” APRIL 2015 • lexiconin.com RENDEZVOUS WITH DR. SANJAY DESAI RENDEZVOUS A specialist in Pulmonary and critical care medicine, he is the ViceChair for education at the Johns Hopkins University and the Director of the Osler Medical Training Program. He is a Fellow of the American College of Physicians and is considered as one of the most notable personalities in the field of education. He is a renowned researcher and has taken keen interest in topics allied to clinical outcomes in survivors of critical illness and on graduate medical education. He currently chairs the executive Committee of a large, multi- centre randomized trial of the 2011 duty hour regulations in graduate medical education. Dr. Desai has also served as the Associate Director for Internal Medicine and the Pulmonary & Critical Care training program, at the Washington hospital Centre. Q.1) For the benefit of our readers, could you please tell us a little bit about yourself, including your foray into the field of Medicine? Ans) I was born and raised here in the U.S, in Baltimore & went to college to study engineering and economics, & actually was not interested in pursuing medicine at that time. I did bioengineering at Holy Lady College and in my senior years i.e. in the 4th year, I thought of pursuing medicine. I enjoyed engineering and economics, but then thought medicine would be better. So I took back some time and applied to medical school a year after college. I graduated from the University Of Pennsylvania as a Bachelor of Science in Bioengineering and Bachelor of Economics in health care management, and went to Harvard for medical school. I really enjoyed everything. I enjoyed surgery, medicine, and most of the experiences I had were interesting. I also started to develop interest in administration, which is when I joined the Massachusetts Medical society and was the President there. I ultimately decided to pursue and train in internal medicine at Johns Hopkins, which is where I am now. During my training, I actually took another break and worked as a management consultant for McKinsey & Company for a couple of years, and then came back to medicine and became the Chief Resident in Medicine and did fellowship training in Pulmonary and critical care medicine. After that I went to a hospital at Washington D.C. (Washington Hospital Centre), part of Georgetown University and was the Medical director for the I.C.U as well as the Associate Training Director for Medicine and Pulmonary & Critical Care. It is the biggest I.C.U. in all of Washington. Then I came back to Johns Hopkins in 2011 to be a Program Director in Internal Medicine, that is the Osler Medical Training Program, and then in 2014 became the Vice- Chair for the department of Medicine, incharge of all education programs for the department. I still practice Critical care Medicine. I have done my research, firstly, in critical care medicine- looking at outcomes of critical care and patients who survive critical illness, and secondly, in physician training- on how to find the best models in which physicians can be trained. Dr. Desai (Front row, in the middle) - Director of Osler Medical Training Program with Osler Residents 2013- 2014. The tie/scarf is given to new interns at the beginning of their Osler residency and is traditionally worn every Friday. Q.2) You have been an eminent personality in the field of medicine. How do you think medicine has changed since your graduation days? What benefits do you think medical students have these days, which you didn’t have during your graduation days? Ans) I think the emergence of technology has been wonderful for medicine. We didn’t have things like a simulation laboratory .We didn’t have ipads and mobile technology that everyone uses today and the applications of that technology have been fascinating for education. For example if you are studying any particular organ system, you can now see the 3D simulated models of that organ system. Or say any surgery, you can imagine and see exactly what it’ll look like to be sure of things For diseases of the heart, you can see very clearly what the heart looks like in three dimensions, what happens when it pumps, what occurs when there is conduction in the heart, the valves moving and therefore, when there is any pathology, to see what goes wrong. I think it is amazing for understanding. You know you don’t need microscopes anymore because you can look at these images on the computer better, so much more clear & instructive. I think its fascinating. It is tremendous for education. Even in Anatomy labs, there has been so much supplementation with computers and imaging. The imaging you do now i.e. MRI and 3D imaging is tremendous in helping people understand medicine in a way you were not able to understand before. Standardized practices and simulated scenarios, all of these things, I think, are amazing for all of us to learn and then also for us to be able to practice, without actually doing it on the real patients. So you can imagine doing surgeries, procedures, and insertion of catheters, a in ways you were unable to train before, because of technology. So I think that’s the biggest advance in medical education in the last 10 years. Q.3) Over the years, do you feel the outlook of the examiners has changed towards foreign medical graduates especially Indian medical graduates? If yes, has the outlook changed to the advantage of the IMGs? Ans) I think, clearly, it has been well recognized that Indian Medical Graduates are incredibly smart and successful. Every year, there are more and more people applying to medicine. There is always this unfair but inherent preference for U.S. medical graduates. And so when you have this preference for US graduates, and more and more of them are applying to go to medical school, it makes that even that much more competitive for Indian Medical Graduates training in the U.S. This is specifically for Indian graduates in the U.S. Q.4) Medicine all over the world is placing increasing demands on doctors and students, whether it be the corporate world's interference or difficult working conditions. What does it mean to be a doctor in this day and age, where the art has changed from simple treatment to contractual obligations, political manoeuvring, and conditions that often drive disillusioned doctors to despair and depression? APRIL 2015 • lexiconin.com RENDEZVOUS WITH DR. SANJAY DESAI RENDEZVOUS There are many people that are incredibly talented, but the world is such that not everybody will have opportunities. You have to be prepared to take advantage of the opportunities when they come before you and make sure you pick them up. So as an applicant from India for example, just do the best you can to create opportunities for yourself through networking, through research, observerships and internships etc. & when those opportunities present themselves, you have to take full advantage of them. There may be incredibly talented people that never get these opportunities, not for any fault of theirs & that’s unfortunate. However, I would like to advise you to always try your best, be the best applicant you can be and, please prepare to take advantage of any opportunity the moment it comes up. Q.6) Other than Adolescent Medicine, which sub-specialities are competitive to get into? Ans) Sub- specialities like Neurosurgery, Orthopedic Surgery, Radiology, Radiation Oncology are on the top. Q.8) You have been an inspiration for graduates both in the U.S and India. Could you give us an insight into: a)What is your inspiration? That is a tricky question! I think everybody has mentors. For me, there are a few people in my life like anyone else who could inspire you. Professors I’ve had and family members. You see these people who work day in and day out for noble causes, and sacrifice to get them or to achieve them, then you are inspired to do the same. For me it would be my father and several professors, to name a few, Prof. Charles Weiner and Prof. Fred Brancaci. Q.5) As a top medical professional at one of the world's foremost medical universities, could you give us an insight, for the benefit of aspirants who would one day like to work at the same level, into the amount of work it took to get here, and what working at Johns Hopkins is like? Ans) I think, work the hardest you can. Try to be as successful as you can. Then the part that is left is to take advantage of the opportunities you create. There are a lot of sayings on this, but as they say opportunities are best for the prepared person. b)Any advice you would like to give our readers I’m excited that they’re interested in pursuing medicine. Keep your head up and keep trying to the best of your ability. Always do what you are excited about. You should pursue what you are excited about, what you are passionate about, and success will follow. Success comes in many different forms, but if you don’t follow what you are excited about and what you are passionate about, it will be very difficult for you to succeed. That is the advice I would give everyone. Find a mentor that cares about you. That is the second very important piece of advice. Q.9) How do you balance the stress of working along with family life? Do you actively pursue any hobbies? Ans) we do a lot of sports. I am interested in triathlons. My two 8 year old boys, my wife and I spend time together as a family. One should try their best to balance everything. It is not easy, but you have to keep your priorities straight. Dr. Desai (Front row, in the middle) Ans) There has been a lot of discussion about those issues. I guess there are always going to be these kinds of challenges in medicine. Clearly, these are there today, there were 10 years ago and maybe, there will be more 10 years down the line after today. I think this is where you need to rely on the people that go into medicine for the reason that medicine is like this. If we continue to work and train adequately in the care of patients- the compassionate patient centered care of the person in front of you, then these things will all sort themselves likely. At the end of the day, there are pressures. But I’m confident that the needle will move back, as long as we are able to recruit, develop and train physicians that have their heart and mind in what we would consider the goals of medicine, which is to provide compassionate care to the person in front of you. There are always going to be challenges and the only way to overcome these challenges is continue having people who are actually passionate about making sure that the person in front of them gets the best, most effective and compassionate care. “We should recruit, develop and train physicians………to provide compassionate care to patient in front them” Dr. Sanjay. V. Desai- navigating the rules for new doctors APRIL 2015 • lexiconin.com BREAKING BARRIERS: WITH APNE AAP WOMENS COLLECTIVE -Priyanka Manghani, Terna Medical College, Mumbai ACT OF KINDNESS Apne Aap Women’s Collective was founded in 1998 on Falkland Road in Mumbai to address the plight of women trafficked into brothel-based prostitution. Initially a single-room drop-in centre, AAWC eventually developed into a resource centre to better address the women’s needs, providing them with professional counselling, medical care, microsavings facilities, and other services – the Umeed (“hope”) program. VISION: To provide brothel based prostitutes, their daughters, children and other marginalized girls in the red light district with the tools and resources to make choices for a better quality of life. MISSION: To provide a caring and supportive platform of wholesome services for a better quality of life for women and children in the red light area. ACHIEVEMENTS: As of March 2014, AAWC has served more than 2,800 women and children. Since 1998, 100% of graduates from Udaan have chosen professions outside of prostitution M e m b e r s a t t a i n a s p i ra t i o n a l p ro f e s s i o n s a n d g e n u i n e socioeconomic mobility, not simply low-wage vocational jobs Numerous Bachelor’s degrees, Master’s degrees, and professional degrees: e.g., Arts, Commerce, Dentistry, Nursing, Psychology, etc. Alumni have entered respected mainstream professions: accounting, financial analyzing, beauty, dance, education, hospitality management, luxury cuisine, medical compounding, nursing, photography, retail, social work, etc. PROJECTS AND THEIR OBJECTIVES: Excerpts from an interview: 1) How did you come up with the idea of Apne Aap Women’s Collective? Ans- It was when Mr. Sudarshan Loyalka- The founder was eagerly pursuing the field of Politics and painting and felt a lack of meaning in life. He thought that these efforts were not proving to be fruitful and he felt the urge to bring a positive change in some lives. He believes that even making a difference in the life of few is a huge achievement which has taught him the best lessons in life. From then on began his journey of setting up Apne Aap Women’s Collective with the mission of empowering women who have been trafficked into brothel based prostitution. APRIL 2015 • lexiconin.com BREAKING BARRIERS: WITH APNE AAP WOMENS COLLECTIVE -Priyanka Manghani, Terna Medical College, Mumbai ACT OF KINDNESS 2)What are the major challenges – public and private you face while working for women in brothel based prostitution? Ans- Challenges that we face while working with the commercially exploited sex workers and their community are several, such as: Community: We often don’t get entry into a brothel because they feel threatened from us. The gharwalli, partner/husband or clients don’t allow getting in touch with the women. The gharwallis often refuse to provide any identity proof of the women to make government documents. Other times women are afraid to disclose information as they fear police action or their real identity being revealed. The community has other illegal activities such as drug peddling and gambling run on a daily basis. Organization: Availability of space to run our organization has been very difficult. People are hesitant to provide us with office space on rent as they do not like the stigmatized women entering their premises. Also, it has always been a challenge to find staff and workers that are strong willed, determined and motivated to fight for a cause that most of the society ignores or stigmatizes. 3)How important is privacy legislation, considering the privacy of sex workers is often invaded when making a film/ doing a research on them? Ans- The way a brothel or the life of a commercially and sexually exploited sex worker is portrayed in a film is more than often a very unrealistic one. Several organizations and individuals often come to Living conditions: The women live in small cubicles called ‘pinjara’ which is just big enough for a bed to fit. They share it with around 4 to 15 other women to service their customers. The rooms have no sunlight, ventilation and are pitch dark even during afternoon. They cook under the bed. Garbage is strewn inside the room, corridors and around the locality. Insects such as rodents and cockroaches can be seen everywhere. Moreover, the women and their children live in degraded living space which includes withering conditions of the building, irregular supply of water and electricity and open drainage system that leads to spread of contagious diseases. Beneficiaries: Umeed (women above 18 years): Due to absence of quality health care there is a high prevalence of HIV/AIDS, tuberculosis and STI infections among the women. They become addicted to substances such as drugs and alcohol. They also suffer from unlicensed medical practitioners in the area who treat the symptoms but not the disease. They aren’t given employment easily as people are wary of their background. Moreover, due to behavioral issues it takes a very long time for us to develop their confidence and feeling of self acceptance among the women to be able to look at themselves in a positive light. Udaan (daughter/girls between 5 years to 18 years): Another foremost challenge is the task of preventing second generation cycle of prostitution. The daughters of the women are most vulnerable to entering the profession because of the normalization of being a prostitute, economic condition, religious tradition and trafficking. The society stigmatizes the girls which hinders their process of leading a dignified and respectable life away from the red light area. Umang (Toddlers between 2.5 years to 5 years): They children of the sex workers are often neglected as they play or sleep in the same room while their mothers are attending clients. They are at a major risk of being sexually abused. The children are also used for drug peddling business. Society: They are ostracized and stigmatized by the society. They are mostly denied services in hospital and getting their children admitted to good school proves to be a difficult task. the women in the area to collect information about their personal and professional life. This is a violation of their right to keep their personal information private. Hence AAWC doesn’t encourage volunteers or researchers to collect information or film the women of this community. Although I would say privacy laws are extremely important I doubt till what extent they would be helpful for the women in this community as we see a gross violation of several other existing rights and laws on a daily basis. 4)What programs/initiatives have you launched or are currently working on for vulnerable children in Kamathipura? How do you think it will help to prevent intergenerational prostitution? APRIL 2015 • lexiconin.com BREAKING BARRIERS: WITH APNE AAP WOMENS COLLECTIVE -Priyanka Manghani, Terna Medical College, Mumbai Ans- Prevention of intergenerational prostitution is the main motto of AAWC. We have the Umang and Udaan programs which are directly targeted towards the toddlers and the adolescent girls in and around the community. We have a full time day care program including balwadi for the toddlers aged between 2.5 to 5 years and look after their need for nutrition, shelter, sanitation, education and overall development, physical and mental health care. For the adolescent girls, who are in the most vulnerable age of being sucked into this cycle, we have a night shelter and a day care program which includes their admission into schools, daily tuitions, non formal education, regular counseling, personality development sessions, job skill training and placements, medical care and nutrition. We try to basically build a conducive and healthy atmosphere for the child to develop holistically and excel in life.We believe that the women who have entered the profession are the victims of trafficking due to lack of livelihood skills and opportunities and by providing education and job opportunities to their children we can help break this cycle of intergenerational prostitution. ACT OF KINDNESS Then it is every one’s equal responsibility to be a change agent and break the negative trend of stigma and discrimination associated with prostitution. Massive awareness and effective legislation enforcement is the key to it. 7)Tell us about your initiatives for HIV awareness and for women living with HIV. Also, what women empowerment programs do you conduct? Ans- Our outreach workers extensively counsel women for prevention as well as on coherent ART treatment, attend the MDACS /MSF meetings and learn new developments in the field of HIV, conduct street plays, monthly meetings on various related topics to create awareness among the target people, help women in accessing the government schemes for PLHIV, find out about the new governmental mechanisms to tackle the problem etc. We also escort women to the hospitals during their treatment and have a strong follow up of each case. We also distribute bananas, boiled eggs and nutritious bhel with nuts to our women living with HIV the area to take care of their special nutrition and health needs. For the empowerment of women we have a beauty parlour training course going on at present. In the past we have conducted paper beads jewellery making, phenyl/liquid soap making, incense sticks making and tailoring classes. We work a lot on confidence and self-esteem building of the women through various sessions to have a changed mindset. 5) How do you think we can curb sex trafficking of children in particular? What initiatives are you taking or you think should be taken to reduce child mortality in the area and promote good health and education? Ans- The root cause of the problem lies in abject poverty. I believe several children and adolescent girls are trafficked from the rural areas of India with the promise of earning money and a better lifestyle. The source area of India needs to develop effective income generation programs, and the help and services need to reach the right people. To promote good health AAWC has a diet chart which is prepared with the consultation of dieticians & doctors for the best development of the child, our children also consume Soya milk and protein cookies twice a week and attend medical check-up camps on a monthly basis. To cater to the educational needs we have regular e-learning systems, special tutors, child future planning sessions with mothers, creative activities and computer and English speaking classes for the children. 6)AAWC Alumnus Shweta Katti received a full scholarship to Bard College, New York. However not all kids and women are so fortunate to the essential right for a better life. How far do you think we still have to work to bridge the gap considering the stigma and discrimination associated with prostitution in India? Ans: We have to go a very long way till society comes to a point of being open to interact with women in this profession, be open to provide them the space to lead a dignified life and stop stigmatizing them with our direct or indirect actions. Media can emphasize more regularly the sensitive issues and state of the women in the community to have a well informed society for a social change. APRIL 2015 • lexiconin.com ADOLESCENCE – A POCKET GUIDE -Rika Rijal, Kathmandu, Nepal& Dr. Rohin Manipur, Mumbai, India BEEN THERE DONE THAT “Why are you late, beta? I’ve been trying to reach you for so long and your phone is switched off. What did you eat? Junk food again?” asked Sid’s mother, who was awaiting his return after college. It was 9 pm and normally college got over at 4. ”You don’t understand!” Sid said, running upstairs to his room, and slamming the door shut. His mom was left clueless. Adolescence, derived from Latin word 'adolescere', which means- to grow up, is a period of transition between adulthood and childhood. A person is physically developing but emotionally somewhat immature. Every one of us passes through this phase at some point in our lives. Adolescence brings with it its share of aches, heartbreaks, addictions and joys. Knowing how to differentiate between what is right and wrong, understanding that imperfections are part of every human being and being patient with oneself as physical and emotional changes are apparent is what counts. The changes that are most evident in this phase of life are as follows, Emotional Instability Sid was home late because he had been out drinking with his friends. His flagging relationship with his girlfriend had finally ground to a stuttering halt, and he was heartbroken because he felt he had no one to talk to about his low scores in college. Adolescence is often a cocktail of turmoil, angst and generally low self esteem. If you think you’re unhappy most of the time, you might be clinically depressed. In the unpredictable phases that life in adolescence brings, here are a few key points to remember. •Always have an outlet, a friend, an older cousin, a parent, whom you can talk to about things. Confiding in a trusted person often makes things easier to cope with, and you’ll have another perspective on your current situation. •Don’t isolate yourself. Barricading your feelings and not expressing your thoughts could be unhealthy in the long run. Keep a journal if you’re too shy to talk to another person or if you believe your situation cannot be understood. •Stay away from the people who consistently make you feel sad or low. The world is quite a large place. Be with people you can trust, who appreciate you and make you feel better about where you are. Likeminded people usually make good friends. Look for people who share your interests. •Do not always take yourself too seriously. Understand that there’s always much more to life than someone’s opinion of you, someone’s idea of what you should be, and that often those talking trash about you are immature and naïve. •Recognize that you might need professional help if your instability affects your day to day activities or doesn’t let you focus. If you often feel like just about nothing in life can bring you happiness, or if you begin to develop urges about hurting yourself, it would be best to visit a professional counselor for help and guidance. Physical development Sid could not come to terms with the changes occurring in his body. Physically he was growing taller, and developing many of the secondary features associated with puberty. His voice often cracked while speaking, something his friends and family made fun of. He often felt embarrassed about having hair grow in the areas of his body it had never grown before, and also of nightfall episodes. He just could not muster the courage required to talk to someone else about it. If you find yourself in a situation like Sid where the physical development of your body confuses you, here are a few key points to remember. APRIL 2015 • lexiconin.com ADOLESCENCE – A POCKET GUIDE -Rika Rijal, Kathmandu, Nepal& Dr. Rohin Manipur, Mumbai, India •Be patient with yourself. Understand that even though a lot of phenomena occurring in your body are new to you, they are part of natural growth and life and nothing to be embarrassed about. Everyone goes through them. •Don’t go by what your friends tell you about these physical changes, they’re often misinformed themselves. I once overheard one boy very seriously telling another that rubbing lemon juice over one’s face would permanently remove any facial hair growth. Claims like these have no biological or scientific basis. •Understandably, most adolescents feel very shy about confiding in their parents about these physical changes. If you feel you don’t share the sort of equation with your parents that lets you talk to them about these changes in your body, talk to an aunt or uncle who is young enough to connect with you but old enough to know what you’re talking about. •While previously the internet itself was littered with bogus guides and fake information, it has now become quite competent at really giving you the knowledge you need. If you feel like you’re too shy to talk to absolutely anyone about what you’re facing, try Google. Only rely on trusted sources like Wikipedia or health forums where other teenagers have posted with similar problems such as yours and have been answered by experts. In any circumstances, however, do not give out personal information or post a picture of yourself on a forum like this, or give out similar information to a “concerned person” who privately messages you. Academic and other performance pressure Sid’s poor performances academically made him depressed and want to turn to alcohol. He truly was trying to do his best at his studies but could not cope with the increased loads. Adolescence often coincides with the phases of your life where you’re expected to perform at a high level, whether academically or otherwise. If you find yourself unable to cope with the increased college demands, here are a few key points to remember. •Relax. This is a period of transition and the demands placed on you are far more than at any other time before. Do your best, work as hard as you can, but don’t be unrealistic in your expectations. Understand that getting a 98 percent isn’t the “be all and end all” of it, and nor does it guarantee success later in life. You’ll probably be surprised to know that most people who are immensely successful today were average performers in school and college. •Try making at least a skeleton timetable that you can stick to. If you’re aware of what needs to be done by a certain time, you will at least make an effort to do it or feel guilty if you don’t do it. •Get some light exercise as often as you can. Apart from keeping you fit, exercise boosts the levels of endorphins in your body which in turn makes you feel good. It also boosts blood flow to the brain, making you sharper and better focused. •Meditate. It’s a great way to clear the clutter in your head and soothe any anxieties you might have before an important exam. •Revise. Never underestimate the power of revision; it is essential to anyone trying to do extremely well. •Always keep yourself motivated. There’s a range of videos available on YouTube that are powerful and inspiring. Speakers like Les Brown and Eric Thomas will make sure you always bring your A-game and will keep you feeling powerful and committed. •Keep that cellphone/Ipad/laptop away. You might think it doesn’t distract you but continuously referring to your phone and replying to messages while studying drops your IQ by as much as 10 points according to sources. BEEN THERE DONE THAT •Take informed decisions about which colleges and streams to pick by consulting professional counselors rather than going by the advice of Bunty Uncle’s son Chunty. Insist on knowing as much as you can about a college before picking it. The same goes for streams or tuition classes. Peer pressure and addictions •Understand primarily that addictions to cigarettes and drugs can and will do lasting damage to your body. If you need further persuasion of this fact, Google images of nicotine and drug addicts. What you see will keep you off both for life. It isn’t worth ruining what you have for a fix. •Develop a strong sense of morality in the very beginning. This will ensure you sustain it for life. •While usually advice in this area would extend to staying away from people who do drugs and smoke themselves, realistically it is not possible to expect all your friends to be teetotalers who wouldn’t know what a cigarette is. Times have changed, and incidences of young men and women doing drugs have risen dramatically. In this scenario then, what is important is to maintain your perspective irrespective of what the people around you are doing and to be firm and strong in your denials. •Have a close relationship with your family. Often times they will be the only ones who genuinely have your best interests at heart. Listen to them and share with them. Your social and family background will gently guide you away from what’s wrong for you. •Even if you’re in love with someone, do not engage in something that harms your self respect and dignity. Set up boundaries from the very beginning and be firm about them, even in the face of insistence. Although adolescence has its share of pitfalls, regrets and wrong choices, it also has the sort of moments that will stick with you for a lifetime and make you smile. Don’t dwell too much over the things that hurt you, stay committed to your work, and learn to unwind. Life gets better to an unthinkable degree from this point on. Contribute as much as you can to that happening and enjoy this phase to the fullest. We’ll leave you with one last image that you can keep with you for good. APRIL 2015 • lexiconin.com HERE’S WHAT YOU SHOULD KNOW ABOUT ADOLESCENTS! By, Dr. Hiral Mehta, Currently pursuing Masters in Public Health at the University of Sheffield, U.K. ADOLESECENTS Lying Trying to have control over their lives Mobile phone addiction PARENTS BEEN THERE DONE THAT PHYSICIANS Do not get into the intricate details. Always remind yourself what the bigger picture you are looking for is. In most cases, it will be safety. Alternatively, forgive him but at the same time be more cautious for future instances. DO talk the issue out with your teen. Convey it to him that all you are concerned about is his safety. This can help them discuss the issues with you. DO ask him to give you the details or a contact number of a friend who is going along with him to a party so that you can call if something goes wrong, but DO NOT track him down every single hour. DO NOT always set the path of ‘to do’s and not to do’s’ for teenagers. They are at a very crucial age of stepping out of childhood and entering maturity. DO let them take control of their actions even it means falling down or doing something wrong. Let them realise their mistakes themselves and learn and evolve from them. If you suspect something serious like alcohol or drug abuse, take them to a physician rather than taking charge yourself. Well it’s not practical and “possible” from keeping your kid having a cell phone. However, what you can do about this is1.Set up a monthly limit to their mobile phone bills/recharges. And if they exceed it, there is no alternative but not to use it until next month. 2.Set up “cell-free” times and zones. Like for example, all the members will be asked to put their cell phones in the centre of the dining table (including parents). Whoever touches the cell phone first, will have to do the dishes or cook food the next day!! As stupid as it might sound, it is necessary to come up with innovative ideas to keep your child from becoming a cell-phone addict. 3.As difficult as it might be for you to understand the ‘tech-world’, try to get to know the workings of Whatsapp, Facebook, and Twitter etc. Children find it cooler if their parents know these things but REMEMBERDO NOT STALK THEM! It’s just a way of letting them know you are trying to know their world. But always have ground rules about the “tech-off” timings APRIL 2015 • lexiconin.com HERE’S WHAT YOU SHOULD KNOW ABOUT ADOLESCENTS! Currently pursuing Masters in Public Health at the University of Sheffield, U.K. Internet addiction Adolescents: Dr Kimberley Young has come up with a small questionnaire to decide whether you are addicted to the internet or not1.Do you feel preoccupied with the Internet (think about previous online activity or anticipate next online session)? 2.Do you feel the need to use the Internet with increasing amounts of time in order to achieve satisfaction? 3.Have you repeatedly made unsuccessful efforts to control, cut back, or stop Internet use? 4.Do you feel restless, moody, depressed, or irritable when attempting to cut down or stop Internet use? 5.Do you stay online longer than originally intended? 6.Have you jeopardized or risked the loss of significant relationship, job, educational or career opportunity because of the Internet? 7.Have you lied to family members, therapist, or others to conceal the extent of involvement with the Internet? 8.Do you use the Internet as a way of escaping from problems or of relieving a dysphoric mood (e.g., feelings of helplessness, guilt, anxiety, and depression)? Other Symptoms Include: 1.Failed attempts to control behaviour 2.Neglecting friends and family 3.Neglecting sleep to stay online 4.Being dishonest with others 5.Feeling guilty, ashamed, anxious, or depressed as a result of online behaviour 6.Weight gain or loss, backaches, headaches, carpal tunnel syndrome 7. Withdrawing from other pleasurable activities. BEEN THERE DONE THAT 1.Like any other addiction (alcohol or drug), it offers adolescents a way to escape painful feelings or troubling situations. As difficult as it might be, try to talk to your kid. Know what he is doing- you need not have the exact details and reports but just try and make sure he is OK. 2.Before starting a conversation, show them you care. Try to explain them that it’s not that you want to keep a check on them but because you are worried about their recent behaviours. And be specific about the behaviour- fatigue, declining grades, less sleep. DO NOT EVER JUST IMPOSE THINGS ON THEM. They are bound to retaliate then. 3.I cannot emphasize the fact enough- get TECH SAVVY. 4.Never compare them to their friends or anyone else. “Catherine uses internet only for an hour each day”. Most parents commit this mistake and they complain their kids don’t listen to them or tell them everything. Well because you drove them crazy! Understand that every child is different and adolescents will be the last ones to have themselves compared. 5.Set REASONABLE RULES. Being overly cautious might just make the things worse. Be realistic of what your child should have. Cognitive behavioural therapy- It simply m e a n s t a c k l i n g t h e p ro b l e m f ro m a psychological aspect. Get familiar with the patient first and understand the level of his i n t e r n e t a d d i c t i o n . A c c o rd i n g l y, r u n counselling sessions and start addressing the problem in small steps. Encourage the child to engage in sports and other outdoor activities. One of the most effective ways of treatment is to group them. Group your patients according to their ages or interests and ask them to spend time doing what they enjoy. It should be something completely off the internet. This will not make them feel solitary and they will be encouraged to undertake those activities. Last but not the least- appreciate your patient for having the courage to face the problem. Not all kids can handle this. This is very common in adolescents. How many times has your kid refused to attend a family wedding and you had a huge argument? Well, he might be suffering from a social anxiety disorder. They are constantly under pressure of being watched and judged by others. The fear gets worsened when you accuse them of not doing things. So always try and understand why your child is behaving in such a manner. Compliment him often on his looks or skills or even the most trivial new thing he must have done. If he disagrees to go to a social function, be easy on him!! It’s ok once in a while if he does not attend them. Give him some leeway. 1. Cognitive behavioural therapy. 2. Counselling. 3. In worst case scenarios, you can suppress the anxiety by various drugs such as antidepressants and sedatives. However, drugs should be the last resort. If your answer to most of this is a YES, it would be worth seeing your physician. DO NOT SHY AWAY and do not think it’s normal. Accepting you have an addiction, does not put you down. Perhaps this could be the best think you can do for yourself. Social anxiety APRIL 2015 • lexiconin.com HERE’S WHAT YOU SHOULD KNOW ABOUT ADOLESCENTS! Currently pursuing Masters in Public Health at the University of Sheffield, U.K. BEEN THERE DONE THAT This is a double-edged sword. Adolescents may be constantly under emotional and social pressure and develop serious problems of health anxiety. They constantly need assurance from either from the GP or try seeking information from the internet. Another important reason behind this, might be seeking your attention. It is very important for them that people notice them. They constantly crave attention and if you do not pay enough heed to this, they can resort to this. 1. Reassurance hardly ever works. Try to explain them in a practical way. For eg, if a child feels he has asthma, just casually go for a run or jog with him. At the end, prove it to him that he did not get breathless and he does not have asthma. 2. Try and accompany him when he is surfing information on the internet. 3. Try and engage him in various activities, so that he is very less time to worry about things. Blood Injection Injury Phobia Most parents make the most common mistake of saying ‘You are so big and scared of blood. C’mon grow up!’ Well, it is not on their control and they have not ‘chosen’ this phobia. You telling such things only worsens things for them. They now have a feeling of shame and embarrassment. Instead, accompany them to their various tests and just comfort them. Sometimes, you don’t even need to say anything. After finishing the test, you can celebrate their little victory by going for a dinner or movie or whatever he wants to do. This will encourage him to undertake this the next time and also give him a sense of accomplishment. Be patient with such patients, no matter you have a huge queue waiting outside. Always comfort him and reassure him that it will be fine and he has his parent and you to take care of things. Psychological therapy. Counselling. 1. Be restrictive and careful about the sites available on your child’s PC. Consult your internet operator and put restrictions on those sites. 2. Always ask your child to keep the door of his room open whenever he is surfing. You need not go and check every now and then but this will keep him from looking onto those sites. 3.Beware that your child does not go to the cyber café Be patient with such patients, no matter you have a huge queue waiting outside. Always comfort him and reassure him that it will be fine and he has his parent and you to take care of things. Psychological therapy. Counselling. This is the fear of the sight of blood or an injection which causes a person to strongly avoid medical problems. Symptoms include: 1.Fainting 2.Rapid heart rate or increased blood pressure 3.Extreme discomfort, usually in the chest 4.Tingling extremities 5.Shaking or trembling 6.Feeling of choking Porn Addiction Adolescents have been given sex education in their schools or know stuff from their friends. It obviously creates a sense of anxiety to know more about it and the internet is an open source to this. There are innumerable free porn sites and this addicts them to watching them even more. TWIN FETUS IN FETU KNOWN CASE OF -Dr. NarenNallapeta, J J M Medical College, Davangere Introduction: Fetus in fetu (FIF) is a rare condition associated with abnormal embryogenesis in a diamniotic, monochorionic pregnancy, wherein a vertebrate fetus is enclosed within the body of another normally developing fetus [1]. The FIF complex is characteristically composed of a fibrous membrane (equivalent to the chorioamniotic complex) that contains some fluids (equivalent to the amniotic fluid) and a fetus suspended by a cord or pedicle. In the uterus, the growth of an FIF initially parallels that of its twin, but stops abruptly because of either the vascular dominance of the host twin or an inherent defect in the parasitic twin [2]. FIF is mostly anencephalic, but in almost all cases its An ultrasound of the baby’s abdomen showed a large, encysted, hyperechoic and calcified heterogenous complex mass. A 64- slice CT scan of his abdomen revealed a soft tissue mass that had a bony outline resembling a fetus (Figures 2 and 3). Interestingly, we found nothing significant in the baby’s family history. We performed an elective laparotomy after correcting the baby’s fluid and electrolyte levels. We then found a well-encapsulated cystic retroperitoneal mass that was displacing his spleen, transverse colon and pancreas. This displacement presented laterally and caudally toward his cephaloid and left kidney (Figure 4). The mass had a separate blood supply connected to the baby’s abdominal aorta just below his left renal artery. We mobilized, without complication, his left colon, pancreas, duodenum and small bowel, after which we were able to excise the mass completely. The sac contained two miniature fetuses connected to each other by a cord-like structure at the umbilicus. The miniature fetuses had a welldefined foot, skin with hairs, a convex and pliable skull bone, and other undifferentiated tissues (Figure 5). A radiograph of the specimen showed cranial bones and long bones with vertebral columns (Figure 6). We then performed a macroscopic pathological examination, from which we were able to note that the mass measured 20 × 8 × 5 cm. It was also composed of a head with hair, a trunk, and rudimentary limbs connected by cord-like structures. The mass corresponded to an incompletely developed twin fetus. A microscopic examination showed that the underdeveloped twin had mature embryonic tissues containing elements of the three germinative layers. Skin, a vertebral column, germinative buds of limbs, central nervous tissue (encephalus and choroidal plexus), a stomach, small and large bowels, pancreas, adrenal glands, kidneys, upper and lower airways, cardiac striated muscles, and lymphoid tissue-like spleen were found. The histopathological study of the specimen supported the conclusion that the previously imaged calcifications could be assumed to be the skull and bony constituents of the vertebral axis, some parts of the skull, and bony constituents of the rudimentary limbs. Our patient recovered well after the surgery and was discharged. To rule out any recurrence he was followed up through clinical examination, plain abdominal X-ray examination, abdominal ultrasound, and serum alpha fetoprotein (AFP). We were unable to detect any recurrence of his previous symptoms one year after the vertebral column and limbs are present (91% and 82.5%, respectively). At the same time its lower limbs are more developed than the upper limbs. An FIF is rarely found in the central nervous system, gastrointestinal tract, retroperitoneum, vessels or genitourinary tract of its host twin. It is found even more rarely in the lungs, adrenal glands, pancreas, spleen or lymph nodes [3]. Even without performing an operation to remove the parasitic twin, the existence of the condition can be diagnosed through ultrasonography, plain X-ray and a computed tomography (CT) scan of the host’s abdomen. The surgical removal of the twin fetus is the treatment of choice. In most cases of FIF, only one fetus exists inside the baby. Only in extremely rare cases are multiple fetuses found. Case presentation A two-and-a-half-month-old, first-born, Asian Indian baby boy was admitted to the department of Pediatric surgery, S.S hospital, BHU, due to recurrent episodes of vomiting and abdominal distension since he was one month old. Upon examination of the baby’s abdomen we discovered that a smooth, firm and non-tender mass was present in the left half of his abdomen. Conventional X-ray of the abdomen showed a soft tissue mass with a vertebrae-like column. operation. APRIL 2015 • lexiconin.com TWIN FETUS IN FETU -Dr. NarenNallapeta, J J M Medical College, Davangere •Be patient with yourself. Understand that even though a lot of phenomena occurring in your body are new to you, they are part of natural growth and life and nothing to be embarrassed about. Everyone goes through them. •Don’t go by what your friends tell you about these physical changes, they’re often misinformed themselves. I once overheard one boy very seriously telling another that rubbing lemon juice over one’s face would permanently remove any facial hair growth. Claims like these have no biological or scientific basis. •Understandably, most adolescents feel very shy about confiding in their parents about these physical changes. If you feel you don’t share the sort of equation with your parents that lets you talk to them about these changes in your body, talk to an aunt or uncle who is young enough to connect with you but old enough to know what you’re talking about. •While previously the internet itself was littered with bogus guides and fake information, it has now become quite competent at really giving you the knowledge you need. If you feel like you’re too shy to talk to absolutely anyone about what you’re facing, try Google. Only rely on trusted sources like Wikipedia or health forums where other teenagers have posted with similar problems such as yours and have been answered by experts. In any circumstances, however, do not give out personal information or post a picture of yourself on a forum like this, or give out similar information to a “concerned person” who privately messages you. KNOWN CASE OF Understand that getting a 98 percent isn’t the “be all and end all” of it, and nor does it guarantee success later in life. You’ll probably be surprised to know that most people who are immensely successful today were average performers in school and college. •Try making at least a skeleton timetable that you can stick to. If you’re aware of what needs to be done by a certain time, you will at least make an effort to do it or feel guilty if you don’t do it. •Get some light exercise as often as you can. Apart from keeping you fit, exercise boosts the levels of endorphins in your body which in turn makes you feel good. It also boosts blood flow to the brain, making you sharper and better focused. •Meditate. It’s a great way to clear the clutter in your head and soothe any anxieties you might have before an important exam. •Revise. Never underestimate the power of revision; it is essential to anyone trying to do extremely well. •Always keep yourself motivated. There’s a range of videos available on YouTube that are powerful and inspiring. Speakers like Les Brown and Eric Thomas will make sure you always bring your A-game and will keep you feeling powerful and committed. •Keep that cellphone/Ipad/laptop away. You might think it doesn’t distract you but continuously referring to your phone and replying to messages while studying drops your IQ by as much as 10 points according to sources. Academic and other performance pressure Sid’s poor performances academically made him depressed and want to turn to alcohol. He truly was trying to do his best at his studies but could not cope with the increased loads. Adolescence often coincides with the phases of your life where you’re expected to perform at a high level, whether academically or otherwise. If you find yourself unable to cope with the increased college demands, here are a few key points to remember. •Relax. This is a period of transition and the demands placed on you are far more than at any other time before. Do your best, work as hard as you can, but don’t be unrealistic in your expectations. APRIL 2015 • lexiconin.com Dengue fever in case of Hemophilia -Sneha Nandy, Seth G.S. Medical College, Mumbai D engue fever is caused by an arbovirus (arthropod-borne viruses) that belongs to the genus Flavivirus of the family Flaviviridae [1]. Dengue virus has four distinct serotypes viz. DENV-1, DENV-2, DENV-3, and DENV-4 [1, 2]. Dengue has been described as having three phases: febrile, critical and recovery phase Despite enormous burden of dengue fever in tropical and subtropical region there is negligible literature of dengue in hemophiliac patients [3]) especially in Hemophilia A. Hemophilia A is a rare hereditary Xlinked recessive disorder affecting mostly males with a reported incidence of approximately 1 in 5000 live male births [4]. A recent global survey by the World Federation of Hemophilia (WFH) has cited that India harbours16,456 people with Haemophilia.As quoted in a survey, 43% of the World Haemophilia population lives in India, Bangladesh, Indonesia and China, out of which only 12% is diagnosed in these countries. [5]This bring to our notice that hemophilia is an underestimated disorder especially in India. Herein, we present a case of dengue fever in a haemophiliac patient. Past Medical History The patient is a known case of Hemophilia A. He was diagnosed at the age of eight years while being evaluated for protracted bleed after a dental extraction. Since then, he is a registered patient with Hemophilia Foundation India on regular therapy and follow-up. Also there was history of repeated instances of mucosal bleed after mild trauma, but no history of bleed requiring blood transfusion or pain in joints. Patient presentation A 14 year male, presented with altered sensorium following high grade fever, malaise, myalgia, loss of appetite, retro-orbital headache and body ache for the past 3 days. History given was suggestive of seizure. Physical exam Patient was febrile with temperature of 39 degree Celsius Hemodynamically stable Glasgow Coma Scale score of 6 (E2V1M3) Minor oral mucosal bleed was present. There was no evidence of petechiae or pupurae on skin examination and tourniquet test was negative. Evaluation Hematological investigations revealed thrombocytopenia with platelet counts of 40000/ cubic millimeter, Prothrombin Time- 30.4 seconds, Activated Partial Thromboplastin Time- 73.7 seconds, Hemoglobin of 10.3 g/dl and WBC count of 8700/cu.mm. Patient was positive for Dengue nonstructural protein 1. Other common causes of acute febrile illness in tropical countries, like malaria, leptospira and chikungunya were ruled out. Cerebrospinal fluid examination couldn’t be done due to involved bleeding risk. Factor VIII assay revealed 15% of normal levels. KNOWN CASE OF Computed tomographic scan of head revealed only cerebral edema and no other abnormality. During the course of his illness, platelet counts started dropping on day 4 of fever, he got extubated on day 5 of fever, and minor oral mucosal bleed appeared by day 7 of fever with a platelet counts of 20000 per cu.mm. The diagnosis and his course of illness was consistent with severe dengue fever in a case of mild Hemophilia A. Management Patient was managed with intubation, mechanical ventilation, anticonvulsant, fluid, blood, blood product and Factor VIII (1000 U Bi daily) transfusion. Patient resumed oral feeds and later discharged from ICU with instruction for continuing follow up of hemophilia. During his stay in ICU, his factor VIII levels had improved to 58% and there was no evidence of bleeding. Discussion Our patient fulfils the criteria of being a case of severe dengue as per his clinical, epidemiological and laboratory data. Clinically, high grade fever, malaise, myalgia, loss of appetite, retro-orbital headache and body ache are the common presentation. Epidemiologically, we have data favoring our diagnosis like resident of a tropical country. Finally, our diagnosis was supported by the trend of platelet count, leucopenia, liver affection, altered mentation which was confirmed by nonstructural protein 1 (NS 1) positive in blood and ruling out other possible causes of tropical fever (WHO guidelines 2009). There have been only six documented cases of Dengue in Hemophiliacs across South Asia. This case is being presented to share our experience of managing case of two coagulopathic conditions Hemophilia and dengue together. Its importance lies mainly in tropical and subtropical countries where both are common and no guidelines are available. Hence, early recognition and institution of management is of critical importance. References Berrington, W.R., Hitti, J., and Casper, C. A case report of dengue virus infection and acalculouscholecystitis in a pregnant returning traveler. Travel Med Infect Dis. 2007; 5: 251-253. 1.Henchal EA, Putnak JR. The dengue viruses. ClinMicrobiol Rev 1990; 3: 376-96. 2.Murray NE, Quam MB, Wilder-Smith A. Epidemiology of dengue: past, present and future prospects. ClinEpidemiol. 2013;5:299–309. 3. Anita Kar, SupriyaPhadnis, SumedhaDharmarajan&Juhi Nakade. Epidemiology & social costs of haemophilia in India. Indian J Med Res 2014; 140: 19-31. 4.World Federation of Hemophilia. Report on the annual global survey 2013, updated 2014. http://www.wfh.org last accessed on write date. APRIL 2015 • lexiconin.com JUST A TAP AWAY -Utkarsh Mishra, MGM Medical College, Navi Mumbai But these aren't the limits of the developers. Need to check up on your diabetes? Emergency measures? There are a slew of apps being developed by reputed medical fraternities that cater to the self monitoring and remote coaching needs for the society. Cooler aids, cooler functions The capitalist approach to accessories has also paved the way for these software modules to get a better 'touch' at the lives of customers. The cooler among these proposed modules have been the wrist or arm bands. Easy to use and sync with your devices, the capability of your apps is increased by quite a margin. Accelerometers for counting steps, GPS for tracking positions and light sensors have formed the basic package in many of these modules. TECH X Swearing by books, many might have trouble adapting to a faster means to obtaining knowledge via mobile applications. Having seen a variety of apps on offer, it is hard to rely on just one source. They all have their downfalls, either on having a restricted database or have one too many requirements like constant internet connections. Medical colleges are slowly adapting to such standards to keep up with the advanced pace of studies. The younger age groups are at an advantage on this front, audio visual aids have been enhanced, and lectures on a phone are quick and easy to view at intervals. The advent of heart rate monitors, galvanic skin response sensors, thermometers, UV or even a single bioimpendance sensor make such accessories popular amongst the tech savvy groups. Meticulously recorded data through these wearable devices gives assurance. Added benefit of it all? A society that is very aware of its movement throughout the day and is becoming glaringly self conscious about adopting healthier alternatives. Weighing the Options APRIL 2015 • lexiconin.com By, Ashwini Ronghe, Grant Medical College, Mumbai OPEN LETTER Dear sixteen-year-old me, Hi it’s me! I mean you! Teenage years are difficult. Period. When I look back, I see you as one person but I know there were two of you: one that the world saw and the private one that only you knew. I remember being both of you. I remember the smile I would show to my family and friends and then I remember the tearstained pillows behind that closed bedroom door. Nothing is the way I thought it would be. It’s so much better! Steve Carrell said it best in Little Miss Sunshine after Paul Dano told him that he just wanted to go to sleep and wake up when he’s 18. Steve Carrell answered, “What? High school—those are your prime suffering years. They don’t get better suffering than that.” “Do you know Marcel Proust? He had a miserable life. He gets to the end of his life and he looks back and decides that all those years he suffered; those were the best years of his life because they made him who he was. All those years when he was happy, you know… a total waste. He didn’t learn a thing. Sleep until you’re 18? Think of the suffering you’ll miss.” It’s hard to believe, but it’s true. Those painful breakups, lonely nights, and broken hearted moments are the times that make you stronger and sculpt you to become the rock-solid adult that you are now. Peer pressure helps you define yourself. If it weren’t for your friends testing your limits, how would you know what you believe in? How would you know what you like and who you want to be? It gives you a chance to know what doesn’t feel right to you. That’s how you know what you stand for and what you believe in. It helped mould you into this beautiful human being. Another thing is don't try so hard to be liked. The sooner you learn that some people won't like you, the better. You must accept that and move on.And remember that your opinion is just as valuable as anybody's. Don't be embarrassed if you get things wrong. You are human and are bound to make mistakes. The problem is you used to set an unreasonably high bar and when you weren’t able to live up to these goals you would get stressed out! This helped me understand my limits and now I never bite off more than what I can chew. There is no love like a parent’s love. As much as you feel like your parents are out to make your life miserable, when you look back, you will see the love in your parent’s hearts. I remember you saying that they just didn’t “understand” you. Perhaps you didn’t understand them. As my mother said, “You will only understand how I feel when you become a parent.” She was right. I know now that they were afraid I would make bad choices and they just wanted to protect me. Break-ups are not the end of the world. You couldn’t eat and you couldn’t sleep; love was all you thought about. Nothing mattered but you and him. You thought you would never love like that again. But life happened and you were dumped. Life is full of disappointments, break-ups, losses, and broken dreams. Those teenage losses taught you to deal with the ups and downs of life. True friends are there for you no matter what or when you need them. Teenage years are all about friendships. Some of those friendships will remain throughout the years. Sometimes you won’t speak to each other for years but whenever you need them, they will show up. These friendships taught me the value of a true friend and how to be one. I learnt so many things - how to pick up and brush myself off, and continue to move forward through the difficult times. I learned the meaning of friendship and love. I learned that happily ever after does exist, but its hard work. It’s often stressful being a teenager. But you’ll forget the details. Amnesia is wonderfully therapeutic. I have forgotten every single one of the friendship/relationship problems you must be having at the moment. There are going to be so many changes in your life. Some of it you can control and some you can’t. Remember that life is pretty simple—it’s we who insist on making it complicated. Stay focused on the positive things and the rest will fall into place. With love, really, The 52-year-old you. But not you PS: I just forgot to mention these: 1)There are no flying cars in the future. I know! I am bummed too. 2)I’ll be honest with you – that isn’t puppy fat!! It’s going to stay with you for the next 20 years,hanging over the top of your jeans and wobbling as you walk. Don’t try going on any diets. It won’t work. 3)None of the cool kids as are successful as you are! *Evil Laughter - Muahahahaha* "Letter to My Teenage Self" is a project that encourages adults to write the words of wisdom or advice that they wish they would have heard as a teenager- http://coachforteens.com/letters-to-my-teenage-self/ Comment below and let Lexicon know about the advice you would give to your teenage self!!! -Ashwini Ronghe, Grant Medical College, Mumbai APRIL 2015 • lexiconin.com AAVISHKAAR 2015 HIGHLIGHTS A avishkaar is the annual cultural, literary and sports festival of Seth G.S. Medical College & King Edward Memorial Hospital, one of leading medical institutes in the country. The fest was held from 18th - 22nd February, 2015. One of Maharashtra’s premier festivals, Aavishkaar was conceived in 1982 as a literary event. However, over a period of three decades, it has evolved into a swarm of engaging events, roping in nearly 7,500 students from over 55 colleges into campus of Seth G.S. Medical College, to be charmed by the magic of the amalgamation of thoughts and ideas. Lexicon- India’s first and only leading online medical magazine is proud to have associated with Aavishkaar this year, as the online media partner. The theme for Aavishkaar this year was ‘Arabian Nights’ and the festival managed to capture the mystery and splendour of these enigmatic tales, beautifully. The four day long extravaganza was the biggest intercollege festival of the medical fraternity of Maharashtra, with an amazing participation of more than 15,000, including medical students, leading doctors and health personnels from all over the state. The fest was celebrated with much fanfare and élan, and it was a good mix of cultural events, literary events, sports competitions and informal sessions. and entertaining. Fahrenheit was the intercollegiate fashion show, which gave an opportunity to medicos to scorch the ramp and flaunt their style. Decibel witnessed some outstanding performances by the bands from various colleges. As the KEM crowd throbbed along to the bass line, the performers set the stage on fire with their energy as they performed original songs and covers. At some places, even the police havaldars ringing the periphery of the event were seen shaking their heads to the music! Alfaaz was a mesmerizing hindi musical drama with some brilliant performances by medical students. On the other hand, Dreamz was THE dance show of Aavishkaar, with participation from students, right from the first year upto the interns, who were flaunting their dancing prowess with some terrific stunts and exuberant dance performances in the various dancing styles like hip hop, contemporary, classical and bollywood. N2O- For the first time ever, stand up comedians Sahil Shah and Sapan Verma, from The East India Company, one of the leading standup comedy troupes in the country, performed on the campus, leaving the audience in splits with their funny gags. The events at Aavishkaar this year can be broadly categorized into: PRONITES: These are the most awaited events at Aavishkar. The pronites comprise a plethora of events ranging from dance and music, to drama, etc. Step Up was the inter- college dance competition, where numerous dance groups from various colleges put their best foot, and we witnessed some phenomenal performances, which were enthralling APRIL 2015 • lexiconin.com AAVISHKAAR 2015 HIGHLIGHTS The workshop was conducted by Prof. Pritesh Rao and students were given hands on experience on using SLRs and DSLRs. APRIL 2015 • lexiconin.com AAVISHKAAR 2015 HIGHLIGHTS organisation works to remodel education space by integrating learning with arts through partnership with good infrastructure schools. Currently they are working with around 110 kids aged between 5 to 15 years at Children Welfare Centre, Yari Road. SPORTSStudents from colleges across Mumbai participated in the various indoor and outdoor sports like badminton, tennis, football, cricket, table tennis, chess and carom. INFORMALSIt was arguably the most fun event at Aavishkaar as students participated in various events like treasure hunt, drink- a- thon, hog- athon, scavenger hunt, etc. PERFORMING ARTSAavishkaar attracted the best performers throughout the stage as they sounded off against each other; be it in singing, mimicry or anything else. On Saturday, 24th January, 2015, Aavishkaar had also organized a drawing competition in association with’ The Candle Project’. The session started with the National Anthem. Then, ACP Mr. Pradeep Sonawane, addressed the children. The theme of the event was 'Republic Day Celebration'. The kids were explained about how they should follow simple values to make India a better place to live, how simple things like keeping roads clean can help the country grow; how one should not fall for petty crimes like theft or fights; etc and also how to be aware and not fall prey to cases like Child trafficking. Also present was the Head of Department of Surgical Gastroenterology from KEM Hospital Dr. Chetan Kantharia. He gave an inspiring speech and gave away the prizes too. Three prizes were given in different age groups. FINE ARTS: T-Shirt Painting, Rangoli, Mehendi, Graffiti, Pottery- there was something for everyone. LITERATI: This was a literature buff's absolute fantasy, whether one is a Harry Potter nerd, a Sherlock fan or an or inspired poet. ADVENTURA: To augment the thrill aspect of the festival, activities like Laser tag, Paintball, Zip lining, and Bowling were organised with great vigour. DIOPTRE: For the first time, a photography contest was organized for medical students. Prior to the contest, a photography workshop was organized by Aavishkaar in association with Canon India Pvt. Ltd. on 5th February, 2015. The Candle Project is a movement to empower children from underprivileged communities through holistic learning and quality education for self sustainable and independent living. The Aavishkaar was an entertainment packed and adventure tagged journey of four days which gave medical students the platform to showcase their talents in various other fields other than academics, like drama, music, literature, sports and arts. It was the much needed, fun- filled break from the daily rigors of medical studies. APRIL 2015 • lexiconin.com THE BOARDS BOARD OF DIRECTORS CORRESPONDENTS Spandita Ghosh Editorial Director: Dr. Suranjana Basak Executive Director: Dr. Abhijeet Sharma Dr. Caren Otadoh Governor: Dr. Sakhi Shah Dr. Naren Nallapeta Director of Finance: Dr. Raviteja Innamuri Director of Administration: Dr. Aakash Doshi Chaitalee Ghosalkar Director of Edition: Zenia Poladia Priyanka Manghani Asst. Directors/ Team Heads: Haymanti Saha Khushboo Gala Dr. Yashada Nabar Utkarsh Mishra Deeksha Seth Priyanka Manghani Dr. Hiral Mehta Sneha Nandy Basalathullah Mohammad Archit Rastogi Apurva Lunia Nikita Agarwal Haleema Munir Dr. Nikhil Tambe Sankhya Saroj Geeta Sundar Trusha Taneja Dr. Anirban Chatterjee Bianca Honnekeri Swati Shriyan Dr. Supriya Kumar Ashwini Ronghe SUB-EDITORS EXECUTIVE EDITORS Dr. Rohin Manipur Shinjini Chakraborty Shrayash Khare Rika Rijal Chiranjeevi Naik Dr. Debashish Sarkar Ruchira Dhoke Subrat Das Ms. HaymantiSaha Ms. ShruthiVishwanathan MARKETING EXECUTIVES Shruthi Vishwanathan Dr. Esha Gupta WEB ADMINISTRATOR Kaustubh Barde CREATIVE DIRECTORS Esha Pandit Urvish Bhatt Shivani Malik Arbaz Memon Mitali Gupta APRIL 2015 • lexiconin.com
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