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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
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