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Dr. Atul Anand
Many studies and articles on dog`s behavior haverevealed that dogs have a complex range of simple unpleas-ant emotions such as jealousy and pride. The dog reactswhen another dog gets the food or when the new pet arrivesor when they are ignored. They feel the emotions comingfrom their owners. Mostly dogs developtheir behavior at the age of one year rightfrom the birth. When a new puppy isbrought to your house, you should intro-duce it with surroundings slowly and slow-ly as it is new to the sight. Show it everyobject and make it sure there is nothing tobe afraid of anything. When a new puppyis brought to your home, they should besocialized with the basic training.
You and your pet should enjoy thetraining. Don't start training, if you areimpatient. Training sessions shouldremain short to that of hardly 5-10 min-utes which keeps your dog motivated fortraining. While training, if there is noresponse to your command then don'tappreciate it, by rewarding it. Repeat thecommand again after few seconds. Youmust follow simple to complex approachof training. You should use a command forending your training session by using wordlike "free" and should omit the use of common words suchas "okay". Begin with some basic commands such as come,sit, down and stay. Also go for teaching common com-mands like leave it, give it, stop it, and enough. You must
notice while training session, the dog`s response intensi-ty will decrease with the complexity of the task. If your petdoesn't respond your orders or disobey, never punish it,just don't reward when it fails, and be little bit harder. Ifyou are rewarding it with food then start training sessionbefore meal otherwise if you are rewarding it by praising,then you must begin at the time you think your pet wants
to seek your attention, for example, whilereturning from office or when it is playing inthe park etc. The food item you choose forreward must be favorite food of your dog forkeeping your dog motivated for training ses-sion. Food item must be small, not so large;it's just for attaining attention of your pet. Itmay remain busy with chewing of food inremaining task. You should praise your petby patting it on back or rubbing the hairsalong the direction it grows. Do not irritateby annoying it like touching of your hand ontheir head is disliked by some dogs. Youshould reward the dog only when you getdesired response from it. Avoid repeatingyour commands because it is believed thatthey remember your command for at leasttwo minutes. Using short commands arebetter than longer ones for your pet torespond. With your cheerful voice, call yourdog's name, give command and then praise,
so that it can understand that it is not in trou-ble. "Affection and love is a vaccine of socialization". It islove and affection which makes your dog immune to itswild instinct. Be loving, kind, familiar, attentive, andfriendly towards your pet.
Dr Amit Misri
Congenital heart disease is a type of defect inwhich one or more structures of the heart or bloodvessels that occur before birth. The heart structures,or vessels, do not form as they should during preg-nancy. The incidence is about 8-10 case per 1000 livebirths. Many of these lesions are life threatening andif not treated at the right time cause death within thefirst year of life. On the other hand there are otherheart defects which are not so serious and remainundetected till adulthood.
To make the general population aware about the occur-rence of Congenital Heart Disease (CHD), its symptoms, andtreatment, a full week Feb 7 to Feb 14 is celebrated as CHDawareness week.
This article predominantly is dedicated to adolescent andadult patients who are having some form of congenital heartdisease.
What is the incidence of Adult CHD?Adult congenital heart disease is not uncommon. 1 in 150
adults are expected to have some form of congenital heart dis-ease in US. 800,000 adults in the United States have growninto adulthood with congenital heart disease. This numberincreases by about 20,000 each year. In India the prevalenceof CHD in adults has been estimated to be 2.4 per 1000 pop-ulation. This difference from the western world may be attrib-uted to lack of awareness about the disease and availability oflimited screening tests.
Which group reaches Adulthood? The mortality rates of CHD if untreated is about 30-40%
during first year of life. But there are many forms of CHDwhich either remain asymptomatic or cause limited symptomstill adulthood. These include small holes in heart or mildervarieties of valvular or vascular obstructions. With increase inactivity the demands of body increase and thereby symptomstend to manifest. On the other hand there are people who arediagnosed cases of CHD but cannot afford treatment. Theytend to modify their lifestyle according to the symptoms. Thenthere is other group which has received timely treatment inform of surgery or cardiac intervention and thus has been ableto reach adulthood.
What are the symptoms?Unlike infants whose symptoms remain mainly cyanosis,
inability to feed and fast breathing adults present with myri-ad of symptoms. These can be exertional breathlessness, exer-tional fatigue, chest pain, syncope, haemoptysis, palpitationsand cyanosis. Obstruction to aorta (artery supplying the wholelower body) can present as hypertension or just exertionalpain in calf muscles.
What are the risks patients with Adult CHD face? The most life threatening risk is that of sudden death. This
is predominantly because of arrhythmias (irregular heartbeats) secondary to effect of CHD on heart muscle. Apart fromthat, infection of heart is not uncommon and could be diffi-cult to treat. Patients with hypertension secondary toobstructed vessels can lead to brain hemorrhage. Patients whohave mixing of oxygenated and deoxygenated blood havechance of developing intracranial abscess because impureblood can reach brain which otherwise would have been fil-tered in lungs.
What are the management possibilities?The foremost important step is to consult a doctor who
deals with congenital heart disease and is fully aware of thehemodynamics in such situations .A correct diagnosis and thenatural history of the specific CHD is important in formulat-ing a management plan. While some CHDs like small holes ormilder form of valvular obstruction may just need a regularfollow up and certain precautions, other more significantlesions will require surgery or intervention in cath lab to cor-rect the defect.
Issues related to adult CHD?Adults having congenital heart disease face many issues.
These are related to job hunting, pregnancy and contracep-tion, insurance, requirement of non cardiac surgical proce-dures. There is a lot of apprehension in general populationand physicians regarding management of such persons. As faras pregnancy is concerned most of the treated cases andfemales with non significant cardiac lesions can safely givebirth. However it is imperative to have a multi disciplinaryapproach involving the obstetrician and cardiologist havingknowledge of adult CHD. In certain types of adult CHD oralcontraceptives may be contra indicated as they can lead tocoagulation disorders. Getting medical insurance may be anuphill task and most do not cover cardiac interventions forCHD. Jobs involving aviation or deep sea diving are more orless prohibited. Anesthesia for non cardiac surgeries in suchpatients is also challenging.
Future road ahead?With advancement in technology, diagnosis and treatment
has become much easier. More and more patients are beingdiagnosed early and receive timely appropriate treatment. Innear future we are going to see more treated cases of adultCHDs than untreated cases as is already happening in west-ern countries. Multi interdisciplinary approach involving car-diologist having knowledge of CHD, general physician, obste-trician, endocrinologist is going to be the way ahead. Withsmall life style adjustments and regular follow up this groupof population is going to live a near normal life and enjoy it tothe fullest
(The author is Dr Amit Misri Sr. Consultant Division of Pediatric Cardiology
(Medanta Heart Institute)Gurgaon Haryana. [email protected].)
SUNDAY, FEBRUARY 14, 2016 (PAGE-4)
NAUTRE
HEALTHLINES
Puppy Training
Many films in Bollywood have been made based on classicnovels. This week's release FITOOR too falls in the same cat-egory. The film's makers went on record to say that FITOORis based on Charles Dickens' 'Great Expectations', the very nov-el that showcased forbidden love, betrayal and class struggles.With a starcast that boasts of the stunning Katrina Kaif andthe hunky Aditya Roy Kapur, whether FITOOR lives upto the'great expectations' or will it turn out to be a let-down, let's ana-lyze.
FITOOR starts off with with the flashback that reflects thechildhood of a young Kashmiri boy Noor Nizami and his 'blink-and-you-miss' tryst with a random stranger (Ajay Devgn), whoturns out to be a certain Mirza Baig eventually. One of the days,when Noor accompanies his brother-in-law to Begam (Tabu)'spalace for some carpentry work, his young and innocent eyes
fall on the eternally beautiful Firdaus Jaan Naqvi. Because, shetakes a 'liking' for Noor's (torn) shoes, he gets hired as theirstable's caretaker. Gradually, the duo start liking each otherand each other's company. One day Noor comes looking outfor Firdaus at her palace when Begum informs him that shehas been sent away to London for education. The film then fastforwards a few years and now a grown up Noor (Aditya RoyKapur) leaves his hometown to move to Delhi to build hiscareer as an artist. As luck would have it, Noor meets Firdaus(Katrina Kaif) at a party and this time round, they try to 'com-plete' their 'incomplete' love. That's when Firdaus confesses toNoor that she will be soon getting married to an upcoming Pak-istani politician Bilal (Rahul Bhatt). The level of obsession thatNoor has for Firdaus reaches crazy heights. Will Noor let go ofhis childhood love Firdaus, will Firdaus have a change of heartand leave Bilal and get married to Noor or does the extremelyprotective Begam have a way different plan for Firdaus is whatforms the rest of the film.
FITOOR's director Abhishek Kapoor (who is best knownfor his films like KAI PO CHE and ROCK ON), seems extreme-ly confused in his narrative of FITOOR. While the film doeshave its moments under the sun, FITOOR turns out to be sucha BIG disappointment for all those who really had 'great expec-tations' (no pun intended) from the film. The film is nothingbut an amalgamation of senseless, confusing and disjointedscreenplay (Supratik Sen, Abhishek Kapoor) and poor direc-tion (Abhishek Kapoor). The screenplay is sorely disappoint-ing, thus making the film look like an arthouse cinema featur-ing popular stars. What adds to the downfall of the film is alsothe odd pairing of Aditya Roy Kapur and Katrina Kaif, who lackthe much needed chemistry to 'light up' a movie of this genre.After a point, the film's proceedings become way too difficultto comprehend. The makers of the film have focused on everyminute detail of the visuals in the movie, however one won-ders why they didn't do the same level of detailing in the screen-play. There are many scenes in the film that do no good to thefilm, but only land up confusing the viewers. Testimonials tothis are in the form of Ajay Devgn's role in the film, and alsothe scene wherein Aditya reads a news article about a Begamspending a fortune on her heiress' wedding, whereas, the so-called 'wedding' never seems to take place in the movie. Despiteall the flaws and shortcomings, one has to admit that the filmlooks extremely appealing visually.
As for the performances, even though it's the film's lead pairAditya Roy Kapur and Katrina Kaif who carry the film on their'able' shoulders, the confusing and lacklustre script acts as aspeed breaker in their respective performances. Both, Adityaand Katrina seem to struggle in the film with their respectivecharacters. Even though Tabu does a decent job, the explana-tion for her weird behaviour throughout the film comes in toolate. Ajay Devgn and Lara Dutta are totally wasted in the film.Rahul Bhatt, Aditi Rao Hydari, Akshay Oberoi, Delbar Aryaand others try their level best to help the film move forward.
The film's music (Amit Trivedi) is nothing to write about asonly Fitoor title track and 'Pashmina' stands out. The film'sbackground score is average. While the film's cinematography(Anay Goswamy) is outstanding, the film's editing (Deepa Bha-tia) is decent. A special mention to the people behind the film'scostumes. Though the film is only 2 hours and 11 minutes long,it feels like a never ending saga, due to its snail pace.
On the whole, FITOOR is a huge letdown despite its greatvisuals, as it fails to connect emotionally. At the Box-Office, themovie will appeal only to a minuscule set of multiplex audi-ence.
Courtesy http://www.bollywoodhungama.com.
MOVIE-REVIEW
Dr Swarkar Singh
Have ever wondered why humans give birth to humans, ele-phants to elephants, fish to fish and it remains the same for allthe living beings. Nature works here in a peculiar way andanswer to this lies in a molecule called Deoxyribonucleic Acid(DNA). DNA contains biological instructions to make eachspecies unique and along with the instructions it contains isinherited to next generation. This biological information isencoded in fragments of DNA called Genes. There are approx-imately 20,000-25,000 Genes in humans. These individuallyor in combinations, including interactions with environment,take care of composition and all the functions of Human body.Each Gene has two copies and Mother and Father contributeequally, one copy each. In this way, transmission of charactersfrom parents to offsprings is controlled (known as heredity).Genetics is a field of biology that helps us understand theseprinciples and mechanisms.
During course of inheri-tance, from one generation toanother, many a times somechanges arise in DNA, whichare called mutation or varia-tions and are inherited to thenext generation. These varia-tions can be neutral or mayhave negative or positiveimpact as they may affect func-tion of a Gene. When a positiveeffect, it can be beneficial byhelping in adaptation to envi-ronment and better survival.However, if negative impact,may result in a disease condi-tion: the scenario in Genetic Diseases.As there are two copies of each Genepresent in an individual, mutationseffect differentially in causation of dis-eases. In an individual, if one copy ofthe gene inherited has mutation, thedisease may show up but with a mildereffect or no effect. However, if both theinherited copies of Gene are withmutation the situation turns severeand many a times lethal and are calledrecessive genetic disorders. Becauserecessive disorders have severe implications and are lethalthese diseases are very rare in incidences and most of the timesare restricted to closely related individuals and families. Yet,all the rare disorders together affect more individuals thancommon diseases like Cancer and Diabetes. So, it is importantto be aware and understand these disorders. At present, aboutthousands of different types of rare disorders are known, someof which are Cystic Fibrosis, Sickle Cell Disease, Fragile X Syn-drome, Muscular Dystrophy, or Huntington disease. Raregenetic disorders can have detrimental effects on any part ofthe body. These may appear in an individual randomly butrarely, inheriting two different mutations in same Gene bychance. However, scientific evidences exist suggesting suchdisorders are found more frequently among those families thatfollow a trend of performing repetitive consanguineous mar-riages, that is, marriages between and restricted to close blood-relatives. Closer the relationship, higher is the possibility ofinheritance of both mutated Gene copies and appearance of adisorder. Especially it is alarming and critical for the familieswhere incidences of such disorders already exist.
In Jammu and Kashmir (J&K), the rate of consanguinity isrelatively high due to restricted geographical localization,endogamous population groups and utmost, majority popula-tion performs relatively high consanguinity. During the pastdecade, few rare genetic disorders, such as Cystic Fibrosis (CF),Rogers Syndrome, Rabson-Mendenhall Syndrome, abnormal-ities in normal sexual differentiation, Wolfram Syndrome havebeen reported in scientific literature in some consanguineousfamilies from J&K. Since, consanguinity is widely prevalent inmajority population, a very high prevalence of several rarehuman genetic disorders, yet to be identified and character-ized, is suspected. These disorders might have remainedunidentified due to geographical isolation, less awareness andlimited clinical resources. We hear about many mysterious andunidentified disorders prevailing in the region in local media.In light of the population structure of the state very high pos-
sibility is such disordershave a Genetic association.With this rationale, key areaof our research is identifica-tion and genetic characteri-zation of these rare geneticdisorders in the populationsof Jammu and Kashmir. Ourresearch group has recentlyidentified and genetically
characterized a very raresevere skeletal disorder, with incidence of one in million in UK,seen affecting many individuals. The disorder remainedunidentified for decades in a village of Poonch district of Jam-mu and Kashmir. With cause unknown and no management,this otherwise rare disorder, known as ProgressivePseudorheumatoid Dysplasia, started to appear profusely inthe village in recent years.
In many of such disorders, that are not lethal in early age,individuals remain normal at birth and have disease symptomslater in age that keep on intensifying with advancement of age,sometimes resulting in loss of life. These disorders as suchappear rare however, if unattended in due course may turn outto be huge problem. Worldwide, Genetics has started to attainkey position in healthcare services and rare disorders screen-ing and Orphan drug development is attaining importance asaltogether these pose huge health burdens. However, such prac-tices are still lacking in India, especially Jammu and Kashmir.
( The author is Coordinator of Human genetics Research Group, Department of Biotech-
nology, Shri Mata Vaishno Devi University, Katra.)
(Contact author swarkar. [email protected] [email protected].
Understanding Genetic Diseases in J&K
Adult Congenital Heart Disease
You must follow simple to
complex approach of training. Youshould use a command for
ending your trainingsession by using
word like "free" andshould omit the useof common words
such as "okay".
In Jammu and Kashmir (J&K),the rate of consanguinity is relativelyhigh due to restricted geographical
localization, endogamous population groups and utmost,majority population performsrelatively high consanguinity.
Not upto expectations
