PCOS on the rise

Aditi (name changed) was troubled. She was anxious about her appearance and body weight since she felt that she was hairy and obese. Her periods were also irregular. She blamed herself, that is, until her symptoms were diagnosed as PCOS.

PCOS or Poly Cystic Ovarian Syndrome is one of the most common endocrine disorders that affect women of the reproductive age (12 to 45 years). It is increasingly becoming very common among young women. Dr. P. Rajasree, the Chief Medical Officer, of the University of Hyderabad Health Centre says, “Almost 20 to 30 percentages of women today are affected with PCOS. I would attribute it to a change in lifestyle with today’s youngsters indulging more in junk food and an unhealthy lifestyle.”

PCOS or Stein-Leventhal Syndrome as it is otherwise called is a leading cause of infertility among women today. “But not all women with PCOS are infertile,” says Dr. Rajasree. The syndrome has many symptoms, not all of which may be apparent in a woman. The intensity of each symptom may differ from person to person.

The most obvious symptom is infrequent or no menstrual periods, and/or irregular bleeding. This may be due to anovulation or the lack of ovulation when the egg is released from the ovary (See box). The other symptoms include acne, obesity and hirsutism, that is, excess hair growth in various parts of the body like lower abdomen and chest. This is due to excess male hormones like testosterone in the body.

But PCOS may still be present in a woman who is lean and does not have excessive hair growth. Divya, a student did not have any external appearances of PCOS though her periods were very irregular. But an ultrasound scan revealed bulky ovaries with the presence of many cysts.

PCOS increases the risk of many other diseases like high blood pressure and cholesterol and problems related to liver and heart. There is also the risk of developing Type II diabetes in women with PCOS. This is because tests have revealed women with PCOS show insulin resistance. Insulin is needed to control the blood sugar level. Researchers believe that abnormal insulin levels may be leading to the development of PCOS. Another risk is the development of uterine cancer or endometrial cancer (cancer of the uterine lining). This is often due to over accumulation of uterine lining due to the lack of periods.

The causes of PCOS are still being researched but some researchers believe that it could be hereditary. A woman with PCOS is likely to have a mother or sister with the same syndrome. Though PCOS cannot be prevented, the syndrome is treatable. Says Dr. Rajasree, “In the earlier stages, fertility medicines can be used. If they do not have the desired effect, the patient may always opt for ‘Ovarian drilling’ through laparoscopy.”

Ovarian drilling is a surgical procedure through which the cysts are punctured to release the fluids and it can lead to a normal cycle at least long enough to be able to conceive. In many cases where the woman is overweight, it has been noticed that a healthy lifestyle and weight loss itself can make a difference and increase ovulation naturally. Medication and surgery is only resorted to if the patient has difficulty in getting pregnant. There have been cases where women have undergone a normal life without being diagnosed with PCOS. “I have had irregular periods all my life but I had two children, one soon after my marriage. I was never diagnosed with PCOS but now I think I might have had since my daughter suffers from it,” says Komalam, a homemaker.

PCOS is treatable and can be controlled by following a healthy lifestyle and dietary regulations for many women. Even in cases, where women undergo difficulty in conceiving, medical treatment and alternate methods like IVF (In vitro fertilisation) are available. There are creams, medicines and laser treatment available to get rid of unwanted hair and the related embarrassment too. More than this, women who are emotionally troubled due to this syndrome may find support in talking to other women who are in the same situation.

What Happens in PCOS

The ovaries are two small organs, one on each side of a woman's uterus. A woman's ovaries have follicles, which are tiny sacs filled with liquid that hold the eggs. These sacs also are called cysts. Each month about 20 eggs start to mature, but usually only one matures fully. As this one egg grows, the follicle accumulates fluid in it. When that egg matures, the follicle breaks open to release it. When the single egg leaves the follicle, ovulation takes place.

In women with PCOS, the ovary doesn't make all of the hormones it needs for any of the eggs to fully mature. Follicles may start to grow and build up fluid. But no one follicle becomes large enough. Instead, some follicles may remain as cysts. Since no egg matures or is released, ovulation does not occur and the hormone progesterone is not made. Without progesterone, a woman's menstrual cycle is irregular or absent. Plus, the cysts make male hormones, which also prevent ovulation.

Bringing back the millet magic

Millets are not just crops, they are concepts embedded in the rural people’s food cultures and agricultural practices, proclaims the opening sentence of the MINI website. The millet network of India (MINI) is an all India alliance of 65 institutions, individuals consisting of farmers, scientists, nutritionists, policy makers, civil society groups and food activists representing over 17 states of India. They are not just advocating the re-entry of millets into the popular food culture but are also trying to underline that connected to this marginalised grain are the lives of a multitude of marginalised people.
“The millet food culture has greatly diminished from the present generation especially in the urban regions and in the rural areas where green revolution driven policies have led to complete change in farming systems and cropping,” says Srinivas Vatturi, National Coordinator MINI. The Green Revolution brought forth agricultural “development” which gave importance to irrigation-dependent, fertilizer-demanding high yielding hybrid variety of rice and wheat which overshadowed the traditional ‘coarse grains’ which did not demand too much from the soil. Along with this, the millet people, mainly Dalits, adivasis and women who had practised sustainable agricultural practices, found themselves on the fringes of the agricultural society and like their crop, pushed towards the margins.
Though neglected by the government, various kinds of millets are grown still. “In spite of millets being neglected from the mainstream, different parts of India grow different kinds of millets. Rajasthan along with a large part of ‘Rainfed India’ cultivates Pearl Millet [Bajra]. Deccan plateau [Marathwada in Maharashtra, Telangana in Andhra Pradesh and North Karnataka in Karnataka] is well known for the production of sorghum (jowar). Southern Andhra Pradesh, Tamil Nadu, Southern Karnataka, Orissa and Himalayas are the home of Finger millet [Ragi]. Uttarakhand and other hill and tribal areas cultivate a range of small millets such as Foxtail, Proso, Kodo and Barnyard,” explains Mr. Vatturi. Millets have the unique capacity to grow in only rain-fed conditions hence doing away with the need for expensive irrigation systems. If one kg of rice needs 4,000 litres of water, jowar grows on no water! They also have amazing nutritional values and are tasty too.
Cultivation of millets has obvious advantages. The second national consultation on millets held in 2009 brought out the Delhi Declaration on millets which said that India’s current agrarian crisis which would be compounded by the impending climate crisis could be effectively fought by the millet magic. They can grow in high heat, demand very little water and are an antidote to the malnutrition.
Rural poverty, malnutrition, farmer suicides and debts, loss of biodiversity and climate changes are only some of the realities that we are faced with today. The ease with which millets can be cultivated can provide food security to the poor and can also provide nutritional security. It basically provides six critical securities: food, fodder, health, nutrition, water and ecological.
Not needing to heavily depend on expensive irrigation systems and fertilizers can ease some of the pressure on farmers to have high yields and profits. And in turn they need not focus solely on cash crops and grow foods that are more resonant with their traditions and nutrition requirements. Some varieties of millets are also used as fodder for cattle which results in more natural manure and less dependence on chemical fertilizers that rob the soil of its value.
Mr. Vatturi says, “The vibrancy of millet based bio-diverse mixed farming systems that even now exist and are in full practice in many parts of the country, are true evidence to the advantages of millet food and farming in India. The famous Baranaja cropping systems in the Himalayas are a testimony to this. In this millet led system are embedded 12 different crop varieties. Saat Dhan in Rajasthan also is a host to a large variety of millets. The Pannendu Pantalu in Telengana region and the Navadhanya system in Karnataka of the South India, grow millets in combination with pulses and oilseeds, thus making it a holistic farming system.”
Going back to millets can also help reverse the ecological crisis that is fast escalating out of proportions. Rice needs standing water in the fields due to which methane gases, which contribute to the greenhouse effect and global warming, are produced. Wheat is thermal sensitive and would most likely disappear with an increase in temperatures.
Though such obvious advantages of growing millets are apparent, why are they given the step-motherly treatment that they suffer? Millets are not a part of the Public Distribution System which by supplying mainly rice at cheap prices has changed food habits of the rural poor. Millets have also been associated with poverty and thus deemed low quality of food.
It is also easier to get credit and crop loans from state institutions for commodity crops such as sugarcane and cotton grown as monocultures. And the biggest reality is that demand rules the market and the millet cultivators, to their dismay, find that there are hardly any takers for their product. But some people, especially in the urban areas, still remember the goodness of millets but find it difficult to procure them. Jhansi Perumalla, a student says, “My mother used to make jowar rotis when I was young. But she doesn’t make it now because she cannot get good quality jowar. The jowar flour that we can buy is not that good. So now she makes it on occasions like Sankranti when we get the flour from my village.”
In such a scenario, the advocacy and local level works of MINI plays a big role. As part of their endeavour to bring millets back into the food map, they aim to tackle the issue at local, national and policy making levels. MINI has asked the government to include millets in PDS. At the local levels, different NGOs and farmers groups are trying to help farmers regain the lost tradition of millet cultivation. Deccan Development Society, an NGO based in Pastapur, Medak district, for instance, runs a decentralised PDS system and a food bank belonging to millet farmers and also promotes distribution of natural seeds.
Advertising millets to gain mass appeal, processing it into attractive foods, popularizing recipes which use millets and conducting food festivals are some methods envisaged by MINI. DDS has established an organic millet restaurant called Cafe Ethnic in Zaheerabad town which specialises in millet food. Millets can also be slowly incorporated in government and welfare hostels, government offices and the like.
MINI hopes to make the government and policy makers realise that millet farming is not just the cultivation of a set of crops but is a profound concept deep rooted in the indigenous cultures, beliefs and distinct lifestyles, which together affirm life and diversity embedded in their knowledge systems. And as Mr. Vatturi likes to remind people, “The problem is with non recognition and valuing of these cropping systems, rather than lack of knowledge or culture.” If properly recognised, millets can be the unquestioned future of food and farming in India.

Its all in the belief

“To the well organised mind, death is nothing but the next great adventure” – Albus Dumbledore in Harry Potter by J.K Rowling
“Death must be so beautiful. To lie in the soft brown earth, with the grasses waving above one's head, and listen to silence. To have no yesterday, and no to-morrow. To forget time, to forgive life, to be at peace.” – Oscar Wilde
“I cannot conceive of a God who rewards and punishes his creatures, or has a will of the kind that we experience in ourselves. Neither can I nor would I want to conceive of an individual that survives his physical death; let feeble souls, from fear or absurd egoism, cherish such thoughts.” – Albert Einstein
The moment we talk of death, quite a few of us think about life after death. Does it exist? If it does, then what would it be like? From scientists to your next door neighbour, everyone has an opinion on it. While scientists seem bent on finding rational evidence for it, the common people try to justify and clarify their opinions however they can.
“I believe that everybody has a good life after death where they are happy. This is the only way I can justify the pain and suffering in the world. Something good has to await them otherwise what is the purpose of living,” says Mohammed Shareef reasoning his belief in heaven and hell. Belief in what comes after death is also mostly conditioned by the religion to which a person belongs. Deborah Williams says, “I believe in heaven, hell and purgatory and that people go to them after death based on their deeds on earth.” Both Muslims and Christians believe in a final Judgement Day.
Life after death is also taken by many to be another life altogether, that is, a reincarnation or a rebirth. Itishree Samal believes that based on a person’s good or bad deeds in one life, he/she is born in better or worse conditions in the next. The theory of reincarnations also believes in an ultimate nirvana when the soul merges with God.
Nihilistic believes are that death is the ultimate end and that nothing follows it. Those who believe this feel that people have only one life and it is up to them to put it to best possible use. They believe that believing in life after death and using it as a crutch at times is just a way to dismiss the fear of death.
Fear of death or a wishful fantasy – believes about life after death takes many forms. “I don’t believe in a life after death but I believe that there is something which I can’t explain. I believe that I might be able to watch over this life and people from wherever I am,” says Jayanti Chethri trying to give a coherent expression to her feelings. Some even believe in a parallel universe of the dead which is backed up with arguments about astral telepathy and the like.
Whether it is a fear of death or religion or a belief in God’s justice that drives people’s belief in afterlife is a question in itself. Whether there is such a life after death has been asked by many people, scientists have done research on it and religions have lived by it but it still eludes a definitive answer. At the end, it is all a question of belief.

Greater losses

“...that personal despair could never be desperate enough. That something happened when personal turmoil dropped by the wayside shrine of the vast, violent, circling, driving, ridiculous, insane, unfeasible public turmoil of a nation. That Big God howled like a hot wind, and demanded obeisance......It was never important enough. Because Worse Things had happened. In the country that she came from, poised forever between the terror of war and the horror of peace, Worse Things kept happening.
So Small God laughed a hollow laugh and skipped away cheerfully. Like a rich boy in shorts. He whistled, kicked stones. The source of his brittle elation was the relative smallness of his misfortune.”
-Arundhati Roy in ‘The God of Small Things’

The words above are one of those precious ones by a thought provoking writer, which found a permanent place in my memory. And these were the sentences I remembered when my train journey from my home town to Hyderabad at the beginning of this semester culminated in a mini-tragedy.
The issue was none other then the loss of my valuables like laptop, jewelery etc from my bag in the train. The thief made a thorough search of my bag while I was sleeping and made his/her escape. I realized it only when the train reached Secunderabad and my friends and I immediately got down to register a complaint with the railway police.
The police, like they are popularly portrayed in cinemas, were not overtly rude or bullying. But from the beginning itself we could see that they were far less than keen to accept an FIR from me. They never said so in words but many obstacles in my way. I was made to write the complaint letter at least thrice before being told that my language was bad! The general tone was that it was a wastage of time for me to log in a complaint as it was nearly impossible to find something small as a laptop which might be anywhere by then.
Almost an hour later, they told me that it might be better if I made a complaint at the Ongole station as it was likely that I had lost my items before the train passed through that town. Exasperated and mentally tired after everything, I took back my complaint and agreed to post it to Ongole while mentally trashing the idea.
At the time, I was enraged by the attitude of the police officials but later I began to look at both sides of the coin. I remembered seeing the photos of missing people outside their office and wondering about them. They, after all, were people…irreplaceable.
It was a with a sense of futility that I thought all this. At one level, I felt like that small boy, relatively happy and went ahead kicking the stones on the ground in contemplation. At another level, I also thought about the danger of people, especially officials making it an excuse to not follow up on things. For every loss, there will be a bigger loss; for every crime, a greater one. And that is the truth about India. But is that an excuse for letting things be? Is that an excuse for police dismissing the ‘smaller’ cases? How small is ‘small’?
The loss of my things seems immaterial. But what remains are the unanswered and seemingly unanswerable questions. I also think of the faces of the people on the station walls. And I wonder what greater losses would their families compare their loss to? How would they find their relative happiness?

Idiots anyone??

Promising a good year for Bollywood in 2010, 3 Idiots, the first big hit of the year, has easily been wholesome entertainment for the young and the old alike. A full blown laugh riot, the movie offers you a complete package of comedy, suspense, pathos and some good old Munnabhai-style preaching. But unlike Rajkumar HIrani’s earlier Gandhigiri-an , his new version of Rancho (Ranchoddas Shymaldas Chanchad) sticks to talking about the how the education system ought to be.
The movie revolves around three friends Rancho (Aamir Khan), Farhan Quereishi (Madhavan) and Raju Rastogi (Sharman Joshi) and their college days at the Imperial College of Engineering which is run by the strict conformist Viru Sahastrabuddhe (Boman Irani) popularly known as Virus. The film starts out with Farhan and Raju along with the loveable ‘villain’ Chatur or ‘Silencer’ (Omi Vaidya) searching for Rancho who disappeared immediately after passing out of the college. The college days are shown in flashback in which we see how Rancho tries to teach his friends to chase excellence and not success, to not memorise without understanding and to follow their dream and. Around this central theme, the story takes many twists and turns through many places like Delhi, Shimla, Manali to culminate in picturesque Ladakh. Kareena Kapoor plays the role of Pia, Virus’s daughter and Rancho’s love interest.
What is interesting and inherently good about this movie is what it tells us about our education system in which students are taught to win the race for marks and jobs however they can. But at the altar of material success are sacrificed innovative ideas, a thirst for knowledge and even the lives of those students who fall behind or dare to think differently.
But every movie, no matter how seemingly perfect, has flaws too. Some of the scenes, albeit funny, are dragged too long and some border on the plain ridiculous. The scene in which the boys help deliver Pia’s sister’s baby would have been good had it not been for the utterly ridiculous ‘Aal iz well’ kicks.
Though an attempt is made to pull the Rastogi family into the comedy fold, it fails and leaves a bad taste in the mouth for the discerning. [It was quite weird to see people laughing at the scenes which caricature poverty as far away from reality as possible. All those people asking me to stop problematising everything, excuse me!] Of course, the excuse against such a feeling is that the movie is only meant as an entertainer.Sadly, the women have hardly any role to play in the movie. Forget Kareena who is left to dance and shimmy around in the rain, The ICE itself bears the look of an all-male college.
Virus’s character, or more aptly, caricature, is rip-roaring funny and Irani does complete justice to it. Another character portrayal to be applauded is that of the Hindi-deficient Chatur. The actors have done a good job and even manage to convince you that they are 18 year olds. Overall, an entertainer that you can enjoy, laugh at and move on.

Ha!

Was reading my earlier post and well...i never jumped quite in. But a new year brings new resolutions. I do not want to make managing my blog a resolution as that is enough to make me break it. But anyway, here goes another attempt. Wish me luck.

Jump right in!

Ever heard of the term laggard? That’s me. Everett Rogers, this guy we studied about in communication class, said that people adapt to innovations at different times. So you have something like, say orkut. The moment it comes out you have a lot of people taking to it like ducks to water. Some people wait around for others to test the waters before they jump right in. Others, like me, think about it a lot and when they finally jump in, they realise that it’s so overrated that nobody’s around to give you even a small applause for your feat. With regard to blogging, that’s me right there; standing around looking so smug and happy but I realise that most people don’t care. Its no big deal, it’s been around for so long that, well, it’s overrated.
The other day, I sat around thinking as to why I took so long to start this. Well, the first and the most obvious answer that came to me was that I am lazy. The second reason that pops into my head as I write this is that when I said I was lazy in my head, I said it with a lot of force. And, well, I was at a loss to know how to let you know that I said with an emphasis. Could I probably use capital letters? I always thought that on the internet, using caps stood for shouting. Lets just say that I was never much of an internet person.
The third reason, and it’s no different for me than others, is that I found most blogs to be quite narcissistic. I am writing my thoughts here like only I exist. Now, you could ask what’s wrong with a bit of narcissism. Maybe you would choose to use the word insight instead. But the problem with narcissism is that I write all of this and direct it to you, the unknown, faceless reader, but what makes me think that you exist? A lot of people might stop blogging when they realise that not many people are following them. I just don’t want such an end. But yes, you are right, this entire third reason could have been summarised by the word cowardice. Yeah yeah, I lose. I guess you can’t always lie to yourself!
So, anyway, with the clichéd proverb, ‘Better late than never’ running through my head, I decide to plunge in! The water’s quite crowded and no one is looking at me but ah, what the hell? Maybe someone, someday, somewhere will.