Stroke: Let's know about its pros and cons

Dr. Turin Chowdhury

If blood flow to our brain gets obstructed due to any reason, the brain cells are deprived of oxygen and nutrients. As a result they start dying quickly. The dying brain cells causes loss of body function control capacity of the brain. This creates a medical emergency which is known as stroke. Similar to heart attack, we can also call it a brain attack. Stroke is characterized as a group of signs and symptoms related to sudden loss of body controlling functions by brain due to problem in the blood supply to the brain. These signs and symptoms should be present for at least more than 24 hours.
   Effect of stroke: Stroke can affect a person in different ways. Generally the magnitude and variety of the effects depends on the type of stroke, the area of the brain involved and the extent of the brain injury. Brain injury from a stroke can affect the senses, motor activity, speech and the ability to understand. It can also influence ones behavioral and thought patterns, memory as well as control on emotions. Paralysis or weakness on one side of the body is common. A severe stroke attack can even lead to fatal outcome.
   Risks related to Stroke: The risks related to stroke event should be considered in a couple of perspectives. The presence of these risk factors sets up the stage for the stroke event to happen. And the triggering factors will initiate the acute onset of the stroke event.
   Risk factors: These are the factors which contribute to increased risk of having stroke. Stroke risk factors should be considered in two angles:
   1) Uncontrollable risk factor;
   2) Modifiable risk factor.
   Uncontrollable risk factor: These are the risk factors which increase possibility of stroke, but they are part of our life process, such as;
   Increasing age: The risk of stroke increases as we grow older. As a natural phenomenon the old-age stroke attack results have higher chance to become fatal.
   Gender: Men have a greater risk of stroke than women do. Men have a higher risk of stroke attacks during the earlier ages in life in comparison to women.
   Family history of stroke: Offspring of parents with stroke risk factors are more likely to develop it themselves. Most people with a strong family history of stroke have one or more other risk factors present among them. In addition, families may contribute to this disease by practicing or upholding poor health habits, such as smoking or eating high-fat diets.
   Modifiable risk factor: Certain factors increase the risk of stroke but they can be controlled to some extent. As a result the chance of developing stroke can be reduced to significant amount. One can modify or eliminate many of these risk factors to reduce the danger of having a stroke. Modifiable coronary risk factors include:
   High blood pressure: This is the most important risk factor for stroke. Sustained long-term high blood pressure can damage arteries that supply blood to the brain. Additionally, a sudden surge of the blood pressure level creates rupture in the blood vessels in the brain leading to stroke event.
   Tobacco smoking: Smoking and long-term exposure to tobacco smoke damage the interior walls of arteries, including arteries to the brain. Smoking also enhances the risk of lethal blood clots forming which may lead to causing a stroke event.
   Inactive physical activity: A physically inactive lifestyle contributes to bad cerebro and cardiovascular fitness. Inactive lifestyle worsens the risk factors like high blood pressure, high cholesterol levels and obesity. On the contrary, people who get regular moderate amount of physical exercise have better vascular fitness. This decreases overall risk of stroke not only in people with other risk factors but also for people apparently relatively free from stroke risk.
   Diabetes mellitus: Diabetes greatly increases the risk of a stroke attack by speeding up atherosclerosis and negatively affecting blood pressure and cholesterol control. Diabetes is caused by too little insulin, resistance to insulin, or both in our in response to blood glucose. Insulin, a hormone secreted by the pancreas, allows the body to use glucose, which is a form of sugar from foods. In diabetes body cells are deprived from the very essential glucose, even if plenty of glucose is available in the blood.
   Alcohol: Excessive drinking habit contributes to the worsening risk profile of stroke attack. Drinking leads to the raise in blood pressure and triglyceride levels thus increasing the risk of stroke.
   LDL-cholesterol or Triglyceride levels: Increased level of blood LDL-cholesterol has been associated with the build-up of plaques that can narrow or even block blood vessels, including those that supply in parts of the brain. A high LDL-cholesterol level is undesirable and is often a byproduct of a diet high in saturated fats and cholesterol. A high level of triglycerides, a type of blood fat related to our diet, also contributes to atherosclerosis thus increasing risk of stroke.
   Obesity and overweight problem: Obesity raises the risk of not only stroke but also many other diseases. Obesity is associated with high blood pressure, high blood cholesterol levels and diabetes. Obesity is the condition of having a high proportion of body fat. Someone who carries too much fat around the middle of the body, rather than the extremities, is more likely to have health problems.
   Drug abuse: Drugs that are abused, including cocaine, amphetamines and heroin, have been associated with an increased risk of stroke. Some more addiction to drugs is often a chronic relapsing disorder associated with a number of societal and health problems.
   Socioeconomic factors: This might be little confusing but in medical research there are some evidence that points towards the particulars that strokes are more common among low-income people than among more affluent people. But this is still a less well-documented risk factor.
   Risk evaluations:: In the effort to do the risk evaluation we should have two components in the activities.
   1) Risk factor screening and
   2) Risk estimation:
   Knowing our risk factors - uncontrollable or modifiable both - will equip us with the necessary knowledge in regards to living healthfully against the risk of stroke. This will be helpful not only in the fight against the stroke but also the fight against other chronic illness like heart attack, diabetes, hypertension, abnormal lipid condition, etc. All people, especially with presence of the risk factors, should undergo risk factor screening that includes recording blood pressure, body mass index, waist circumference, cholesterol and glucose test regularly. And doctors will estimate each person's percentage risk of developing cardiovascular disease based on the risk factor screening.

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Interviewing top executives

Rayyan Kamal

They kept me quite busy at my internship this week. There was a week-long telecommunications conference, CommunicAsia 2007,that I was assigned to cover along with two of the fulltime journalists at Dow Jones. The conference was well attended, both by the smaller players as well as telecom heavyweights like Motorola and Ericsson. There were press conferences, panel discussions, launch of new product ceremonies, and exhibitions where companies displayed products that haven't even been officially released yet.
   On Monday, the day before the conference began, arrogant Nokia had its own daylong extravaganza where it announced the launch of three new headsets, three new Bluetooth devices and the signing of a contract with a Malaysian company to provide commercial mobile broadcast TV services in that country. However, Nokia "declined to divulge" any "substantial" information - the financial terms of this contract, its forecasted revenue from the sale of the new mobile phones, its plans to maintain its majority market share in Asia. The journalists were, however, treated to lots of free food and an interesting lecture on the research that goes behind the design of a Nokia phone.
   The Finnish mobile phone company has a team of anthropologists who go all over the world, shadow Nokia-users and take copious notes on things like where they keep their handsets, where they charge their phones, and even seemingly unrelated things like which food item is the last to be eaten at the dinner table. The findings were quite interesting. About 60 per cent of male Nokia-users keep their handsets in their front right pant pockets and 60 per cent of female Nokia-users keep their handsets in purses or bags. As a result, women miss calls 20 per cent more calls than men do.
   As for coming up with the design itself, nature serves as the main inspiration. For example, the numbers on one phone were built to resemble sand dunes. The speaker also talked about how the phone has to appeal to all five senses of the user. It should feel sleek to the touch "sensual" when you press the keys. For slide-open phones, the sound of the click when you slide the phone open or closed should, like the click of the closing door in an expensive car, affirm that you are the owner of a classy, elegant product.
   The next day I attended a panel discussion where the "convergence" of TV, internet, camera, and the phone was discussed. I know that you already have camera phones with internet capabilities, but I just can't imagine surfing the web on a mobile phone, or watching TV on such a tiny screen, for that matter. But apparently that's what the future holds, according to the giants in the industry.
   I was also assigned to "be present" at one-on-one interviews with the head of AT&T Asia-Pacific and the marketing director of Cable & Wireless in Asia. I learned about how difficult it is to be the interviewer. You need to simultaneously write the story in your head as you are interviewing and digest what the interviewee is saying. This requires being on your toes, always knowing what to ask next, and having back-ups in mind if the interviewee declines to answer the question that would have provided you with your lead paragraph. Being on the other end is not a walk in the park either. As the interviewee, you don't want to reveal top-secret company information, but at the same time, you don't want to frustrate the interviewer either. After all, he is the one writing the story.
   Rayyan Kamal is a sophomore at Yale University.

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Dr. Asghar Ali Engineer in New Delhi

The recent defeat of BJP in UP elections has given the party not only a great shock but also has made its leaders review its policies. The BJP in UP was deserted even by the Indian Brahmins, its traditional 'vote bank'. Till the mid-80s the Brahmins were voting for the Congress. The Congress used to win elections by getting votes of Brahmins, Muslims and Dalits. However, when the Muslims deserted the Congress in the late 80s on the question of laying the foundation stone of Ramjanambhoomi Temple, the Congress lost power.
   Subsequently Brahmins too deserted the Congress as there was no chance of its coming to power. The Brahmins switched their loyalty to the BJP as it was raising the issue of Ramjanambhoomi and had much better chances of coming to power. The Brahmins continued to vote for BJP as long as it had the potential to capture power either by itself or through suitable alliances.
   
   Rising star
   However, during the 2007 state assembly elections in UP Ms. Mayawati was the rising star for a number of reasons; one was her alliance with both Brahmins and Muslims. Ms. Mayawati was following the well-tested Congress formula of Brahmin-Muslim-Dalit alliance to win the elections. She had solid Dalit base and had also convinced the Brahmins to vote for her. Besides, she had also wooed the Thakurs and was sure to get votes of a section of Thakurs too. The Brahmins weighed all this and deserted the BJP which had any way never fulfilled its promise to build Ram Temple. The BJP was, however, hoping against hope that Brahmins might vote for it but drew blank.
   The BJP also tried to woo Hindus by not only its Ramjanambhoomi rhetoric but also by circulating anti-Muslim propaganda. It could not of course get away with anti-Muslim C.D. as the Election Commission took notice of it and stopped it from using it. This was also a moral as well as a legal blow to the BJP. Having lost elections in its own constituency is a serious setback to its senior leaders.
   
   Virulent course
   However, there is no easy way out for them. To revive itself in UP in the absence of any wave in its favour is a Herculean task. With 20 per cent Muslims of UP hostile to it and Brahmins also having deserted, it is under pressure to change its virulent anti-Muslim course. But that is also not an easy task. The BJP senior leaders in Delhi, nevertheless are thinking on these lines. A Mushaira (poetic gathering) at the home of BJP leader Shahnawaz was organised and many BJP leaders participated in it.
   Of course this will not be easy both from Sangh Parivar's as well as Muslim viewpoint. Sangh organizations like VHP and Bajrang Dal - which are accusing BJP leaders of soft pedalling Hindutva agenda - will vehemently oppose this change of course. Their very existence will be in danger. On the other hand, after years of anti-Muslim propaganda, it would not be easy to carry conviction with Muslims, let alone aspire for the sizeable Muslim vote. They want to, however, convince Muslims that it was Vajpayee who initiated the Indo-Pak friendship process and also took initiative for solving the Kashmir problem. How far it will convince Muslims is anybody's guess. The Congress could not win Muslims back in UP despite all efforts.
   It is very interesting to note that Mayawati - encouraged by her success in UP in getting Brahmin votes - is trying to woo Brahmins in other states too. The Brahmins are also elated by the UP experiment in as much as it has opened new doors for increasing their political influence by supporting the Bahujan Samaj Party (BSP). Recently the All India Brahmin Federation (AIBF) has decided to support the BSP in all future elections in its convention in Tirupati. It also wants to embark on a special mission to improve Brahmin-Dalit harmony. The Shankaracharya of Kanchi Kamakoti Peeth Swami Jayendra Saraswati is also scheduled to attend the convention.
   Kotashankar Sharma, a Brahmin leader, even commented that most of the communal tensions between Hindus and Muslims were due to the ignorance and inability of the common man to see through the intrigues of vested interests. The AIBF conference is seen as an important event for Brahmins to become politically active again.
   
   Great worry
   Thus the coming together of Brahmins from entire country to support Dalit leadership is a matter for great worry for the BJP. If this patterns of Brahmin-Dalit-Muslim alliance emerges on all India basis BJP will loose ground in other places too. After UP the BJP lost election in Goa also.
   Surendra Kulkarni, media adviser to the then Prime Minister Shri Vajpayee, has been writing a series of articles in the Indian Express suggesting that the BJP should woo Muslims to the mutual benefit of both. Mr. Kulkarni is even trying to prove that RSS has never been anti-Muslim and has been quoting from writings of Shri M.S.Golwalkar. In his column in Indian Express on 10th June 2007 he quotes Golwalkar from his interview given to Dr. Saifuddin Jeelani, an Arabic scholar. Golwalkar said, "According to our religious belief and philosophy, a Muslim is as good as a Hindu, it is not the Hindu alone who will reach the ultimate Godhead. Everyone has right to his path according to his own persuasion." [Bunch of Thoughts, p 639]
   
   Hinduisation
   Kulkarni further informs us that specifically refuting the charge that the Sangh's concept of Indianisation meant Hinduisation of Muslims, Golwalkar observed, "Follow your own religion. The God of Islam, Christianity and Hinduism is the same and we are all His devotees. Give the people true knowledge of Islam. Give people true knowledge of Hinduism. Educate them to know that all religions teach men to be selfless, holy and pious..."
   Kulkarni also quotes from Golwalkar to prove that Golwalkar did not support Uniform Civil Code; and was in favour of allowing Muslims to follow their Shari'ah law. He (Golwalkar) also maintained that "it is better that Muslims themselves reform their outdated laws and customs. I will be pleased if they come to the conclusion that polygamy is not good for them. But I would not like to impose my views on them."
   Significantly, Mr.Kulkarni says, in the same interview, Golwalkar warns: "Uniformity is a pointer to the downfall of nations. I am in favour of preservation of diverse ways of life. At the same time, we should pay attention to ensure that these diversities nurture unity of the nation."
   
   BJP-Muslim dialogue
   Mr. Kulkarni, therefore, is attempting to explore ways in which a fruitful BJP-Muslim and RSS-Muslim dialogue might start. One wishes Mr.Kulkarni all success. But he himself has been in journalism and a political analyst. Politics is not all about piety and noble sentiments, even if what Golwalkar said is true. Otherwise the RSS and BJP would not have been doing in their political propaganda that they have been doing.
   I would like to ask Mr. Kulkarni that if M.S.Golwalkar was against Uniform Civil Code in early seventies why the BJP adopted it as its Hindutva agenda and still today it is on their agenda? Did Mr. Advani not preach Hindutva agenda at his aggressive best throughout late eighties and nineties? Were RSS leaders not aware of this? Or was Hindutva agenda formulated without RSS consent?
   How about the textbooks taught in RSS run schools? Do they not spit venom against Muslims and grossly distort medieval history? If Golwalkar wanted people to be good Muslim and good Hindu, why Babri masjid was demolished and event celebrated? Was it being a good Hindu? Did RSS approve of it or not? Does RSS insist on Hindutva agenda or not? It often chides the BJP for not doing enough for fulfilling the Hindutva agenda.
   How can one then have constructive dialogue between RSS and Muslims or BJP and Muslims. Did RSS leadership say a word in condemnation of what happened in Gujarat in 2002? A word opposing the Gujarat carnage from RSS leadership would have won over the hearts of millions of Muslims. On the contrary Narendra Modi became an apple of RSS eye. He has always been considered as an RSS man.
   This is not to suggest that there should be no dialogue between Muslims and BJP or with RSS for that matter. But if Shri Kulkarni is suggesting dialogue at the BJP leadership's instance in the changed circumstances, let him suggest where and how to begin. He must know that there is deep distrust between Muslims and Sangh Parivar and in the best of conditions it will take great deal of efforts to create even a semblance of trust. In any case even if there is possibility of any dialogue it is for the Sangh Parivar to take initiative and convince Muslims for a need for a dialogue. Writing such articles might be an exploratory process but much more substantial would have to be done.
   A good beginning could be an apology for demolition of Babri Masjid and then an appeal to Muslims to come forward for a reasonable solution of the problem without hurting religious sentiments on either side. Such an eventuality seems nothing more than a distant dream for the present.
   Centre for Study of Society and Secularism, Mumbai.

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