Emedinews:Inspiration:A Tale of Two Seas

An Inspirational Story
(Dr Prabha Sanghi)

Sitting in the Geography class in school, I remember how fascinated I was when we were being taught all about the Dead Sea. As you probably recall, the Dead Sea is really a Lake, not a sea (and as my Geography teacher pointed out, if you understood that, it would guarantee 4 marks in the term paper!)

It is so high in salt content that the human body can float easily. You can almost lie down and read a book!

The salt in the Dead Sea is as high as 35% - almost 10 times the normal ocean water. And all that saltiness has meant that there is no life at all in the Dead Sea. No fish. No vegetation. No sea animals. Nothing lives in the Dead sea. And hence the name: Dead Sea.

While the Dead Sea has remained etched in my memory, I don't seem to recall learning about the Sea of Galilee in my school Geography lesson. So when I heard about the Sea of Galilee and the Dead Sea and the tale of the two seas - I was intrigued. Turns out that the Sea of Galilee is just north of the Dead Sea. Both the Sea of Galilee and the Dead Sea receive their water from river Jordan. And yet, they are very, very different.

Unlike the Dead Sea, the Sea of Galilee is pretty, resplendent with rich, colorful marine life. There are lots of plants. And lots of fish too. In fact, the Sea of Galilee is home to over twenty different types of fishes.

Same region, same source of water, and yet while one sea is full of life, the other is dead. How come?

Here apparently is why. The River Jordan flows into the Sea of Galilee and then flows out. The water simply passes through the Sea of Galilee in and then out - and that keeps the Sea healthy and vibrant, teeming with marine life.

But the Dead Sea is so far below the mean sea level, that it has no outlet. The water flows in from the river Jordan, but does not flow out. There are no outlet streams. It is estimated that over a million tons of water evaporate from the Dead Sea every day. Leaving it salty. Too full of minerals. And unfit for any marine life.

The Dead Sea takes water from the River Jordan, and holds it. It does not give. Result? No life at all.

Think about it.

Life is not just about getting. It’s about giving. We all need to be a bit like the Sea of Galilee.

We are fortunate to get wealth, knowledge, love and respect. But if we don't learn to give, we could all end up like the Dead Sea. The love and the respect, the wealth and the knowledge could all evaporate. Like the water in the Dead Sea.

If we get the Dead Sea mentality of merely taking in more water, more money, more everything the results can be disastrous. Good idea to make sure that in the sea of your own life, you have outlets. Many outlets. For love and wealth - and everything else that you get in your life. Make sure you don't just get, you give too. Open the taps.

And you'll open the floodgates to happiness.

Emedinews:Insight on Medicolegal Issues:Grievous Hurt as per IPC (Contd. from yesterday)

Grievous Hurt as per IPC (Contd. from yesterday)

As per Section 320 Indian Penal Code (IPC), the following kinds of hurt are designated as "grievous";

• Permanent disfiguration of the head or face: The word ‘disfigure’ means to cause some external injuries which detracts from his personal appearance but does not weaken him.
• Fracture or dislocation of a bone or tooth: It is not necessary that a bone should be cut through and through, the cut should be up to the medulla. If there is a break by cutting or splintering of the bone or there is a rupture or fissure in it, it would amount to a fracture but the doctor must document the dimension of fracture and duration/age correlation with age of injury. Dislocation means displacement. Mere looseness of teeth will not amount to dislocation. It has to be proven that the tooth was originally not loose and that there was fracture or dislocation by the injury.
• Any hurt which endangers life or which causes the victim to be in severe bodily pain or unable to follow his ordinary pursuits for a period of 20 days: A wound may cause intense pain, prolonged disease or long lasting body injury but does not fall under any of the seven clauses. A body injury/beating may not mutilate the sufferer or fracture his bones but may be so harsh and painful may cause even death. The eighth clause provides for such hurts. Under this, three different clauses of hurt are included. These are:
• Any hurt which endangers life
• Any hurt which causes the victim to be in severe bodily pain for a period of 20 days
• Any hurt which prevents the victim from following his ordinary pursuits for a period of 20 days

Emedinews:Makesure: A patient on 10 units of insulin developed hypoglycemia after taking a light breakfast.

Situation: A patient on 10 units of insulin developed hypoglycemia after taking a light breakfast.
Reaction: Oh my God! Why was the insulin dose not reduced?
Lesson: Make sure that insulin dose is correct. The formula is 500/total daily dose. The value will be the amount of sugar fluctuation with ten grams of carbohydrates.

Emedinews:Inspiration:The stone soup story

Many years ago three soldiers, hungry and weary of battle, came upon a small village. The villagers, suffering a meager harvest and the many years of war, quickly hid what little they had to eat and met the three at the village square, wringing their hands and bemoaning the lack of anything to eat.

The soldiers spoke quietly among themselves and the first soldier then turned to the village elders. "Your tired fields have left you nothing to share, so we will share what little we have: the secret of how to make soup from stones."

Naturally the villagers were intrigued and soon a fire was put to the town's greatest kettle as the soldiers dropped in three smooth stones. "Now this will be a fine soup", said the second soldier; "but a pinch of salt and some parsley would make it wonderful!" Up jumped a villager, crying "What luck! I've just remembered where some been left!" And off she ran, returning with an apron full of parsley and a turnip. As the kettle boiled on, the memory of the village improved: soon barley, carrots, beef and cream had found their way into the great pot, and a cask of wine was rolled into the square as all sat down to feast.

They ate and danced and sang well into the night, refreshed by the feast and their new-found friends. In the morning the three soldiers awoke to find the entire village standing before them. At their feet lay a satchel of the village's best breads and cheese. "You have given us the greatest of gifts: the secret of how to make soup from stones", said an elder, "and we shall never forget." The third soldier turned to the crowd, and said: "There is no secret, but this is certain: it is only by sharing that we may make a feast". And off the soldiers wandered, down the road.

eMedinews:Ask Dr KK

Ask Dr KK

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinews)

Dear Dr Aggarwal, Namaskar. Please give me some information about postural hypotension. Is it more common in patients with Parkinson’s disease? How is this condition treated? Vinod Agrahari

Yes, postural hypotension is common in Parkinson disease. A proper lifestyle is the only answer. One must get up slowly and in stages from the lying down position. If this fails, then there are some drugs that may help.

The initial treatment of orthostatic hypotension should focus on non drug measures: removal of offending medications, using elastic stockings, physical maneuvers and exercise. If drugs are required one must follow step-wise treatment using fludrocortisone for patients with disabling symptoms despite non drug measures, followed by a sympathomimetic pressor agent, such as midodrine, for patients who remain symptomatic on or cannot tolerate fludrocortisone. Several other modalities (as mentioned below) may be beneficial

1. Caffeine in the morning may help.
2. A trial with recombinant erythropoietin can help in patients with anemia.
3. Nonsteroidal antiinflammatory drugs may be useful in those with refractory symptoms

Emedidnews:Insights on Medicolegal issues:Grievous Hurt as per IPC

It is very difficult to draw a line between those bodily hurts which are serious and those which are slight. To make out the offence of voluntarily causing grievous hurt, there must be some specific hurt, voluntarily inflicted and coming within the scope of following as per law. As per Section 320 Indian Penal Code (IPC), the following kinds of hurt are designated as "grievous";

• Emasculation: It means depriving a male of masculine power.
• Permanent privation of sight of either eye: The gravity lies in the permanency because it deprives a person the use of the organ of sight.
• Permanent privation of the hearing of either ear: It deprives a man of his sense of hearing. Injury to the tympanum or auditory nerve or by thrusting something into the ear which causes deafness.
• Privation of any member or joint: The term ‘member’ means an organ or a limb being part of man capable of performing a distinct function. It includes, nose, mouth, hands, feet, phalanges etc.
• Destruction or permanent impairing of the powers of any member or joint: the use of limbs and joints of body are essential to the discharge of the normal functions of the body. Their deprivation causes lifelong crippling and makes the person defenseless and miserable.

Emedinews:Makesure:A patient on 10 units of insulin developed hypoglycemia with 11 units of insulin.

Situation: A patient on 10 units of insulin developed hypoglycemia with 11 units of insulin.
Reaction: Oh my God! Why was additional insulin given?
Lesson: Make sure that insulin dose is correct. The formula is 1500/total daily dose. The value will be the amount of sugar fluctuation with one unit of insulin.