DAILY NEWS BULLETIN LEADING HEALTH, POPULATION AND FAMILY WELFARE STORIES OF THE Day Wednesday

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1 DAILY NEWS BULLETIN LEADING HEALTH, POPULATION AND FAMILY WELFARE STORIES OF THE Day Wednesday Medical ethics Doctors participation in executions violates medical ethics: IMA (The Hindu: ) The participation of doctors in State executions a hotly debated ethics issue across the world has now been taken up by the Indian Medical Association (IMA). The national body of over three lakh doctors has written to the Medical Council of India (MCI) requesting that a guideline be introduced, stating that physicians participation in execution is unethical. The IMA s letter comes in the wake of the World Medical Association s (WMA) reaffirmation, during its general assembly in Chicago, U.S., on October 14 that it is unethical for physicians to participate in capital punishment, in any way, or during any step of the execution process, including its planning and the instruction and/or training of persons to perform executions. Monitor vital signs In India, doctors are required to monitor vital signs during hanging and look for signs of life and then pronounce death. Opposing the participation of doctors in any form, the WMA came out with a Resolution on Physician Participation in Capital Punishment in 1981 and amended it in The global

2 organisation also requested its constituent member associations to advise all physicians that any participation in capital punishment as stated above is unethical. Subsequently, in its general assembly in 2012, the WMA again passed a resolution reaffirming its 2008 resolution. The recently amended WMA Declaration of Geneva The Physician s Pledge adopted by the WMA general assembly on October 14, 2017, in Chicago, U.S., has again reaffirmed this. IMA as a founder member of WMA is bound to follow the resolution, IMA national president K.K. Aggarwal told The Hindu. He said the WMA had urged all its 114 constituent member associations to lobby actively with their national governments and legislators and ensure that physicians are not forced to participate in any form of capital punishment. For us, there is no difference between a prisoner or a common patient and our participation in executions is against the core tenets of medical ethics of do no harm (non-maleficence) and do good (beneficence), Dr. Aggarwal said. Smart suit Smart suit can track the wearer s health (The Hindu: ) Comes equipped with sensors Chinese scientists claim to have developed a smart suit fitted with large-area textile sensors that can detect temperature, ph levels, pressure and other indicators that give clues to the health of a person. By wireless transmission, those signals can be sent to a cellphone, a computer, or even to a doctor thousands of kilometres away, so a person s health can be monitored any time and anywhere, according to Wang Zhonglin, an academician at the Chinese Academy of Sciences. Displayed at conference The suit was showcased at the third International Conference on Nanoenergy and Nanosystems in Beijing. The conference, organised by the Beijing Institute of Nanoenergy and Nanosystems, touched on topics such as nanogenerators, self-powered sensors and systems, piezotronics,

3 piezophototronics, energy storage and self-charging power systems, Xinhua news agency reported. Nano tattoos Scientists also unveiled nano tattoos and a self-charging cardiac pacemaker, which does not need replacement. The nano tattoos are stickers that can be worn on the arm to administer drugs into a patient s veins, providing a painless way of injection for diabetics, said Mr. Wang. Scientists have made prototypes of all the gadgets at the institute s technopark. They are expected to hit the market in two to three years, Mr. Wang said. Malaria strains Four malaria strains in blood, Bastar boy is a test case (The Indian Express: ) Science journal says 14-year-old Hunga Ram Kashyap of Bastar the first in India to carry all four types of parasites; a medical anomaly, he is currently healthy. In July this year, American scientific journal Public Library of Sciences documented the case of a 12-year-old boy from the forests of Darbha in Bastar, Chhattisgarh, as the first reported case in India of someone having all four types of malaria parasites in his bloodstream. Hunga Ram Kashyap hasn t heard of any such first. Who will come and tell me? he smiles. In Bastar, it s not uncommon for people to live the tenuous line between life and death. Now 14, Hunga has had malaria at least twice and has seen his family being attacked by Maoists and chased out of their home for defying a diktat to send him to school. He laughs as he tells these stories. In July 2015, the National Institute of Rural Tribal Health (NIRTH), under the Indian Council of Medical Research, set up a malaria clinic at the primary health centre (PHC) in his village. Darbha itself is representative of the Bastar narrative it is heavily forested and the PHC is less than 5 km from the site of the 2013 attack on a Congress convoy by Maoists, leaving 28 dead. Darbha has another problem too: Malaria.

4 A month after the small, one-room malaria clinic opened, Hunga, then 12, hobbled up to it, helped by a boy one year his senior. They both came from the Darbha government boys hostel, 2 km away, and Hunga remembers he could barely walk. The lines were long and everything was done in a hurry, and thus, Ranu Ram, a Class 7 student, became Hunga s father in the paperwork that was filled. Dr Sanjay Basak, the then district malaria officer of Bastar district and one of the authors of the PLOS paper, told The Indian Express that after a consent form was filled, a little blood was taken from under the fingernails of the patient, and studied under a microscope. The RD kit we used at the clinic could read two types of malaria bacteria plasmodium of falciparum and vivax and said mixed if there were more types. We immediately started the boy on medicines for the two strands of malaria that we detected and kept him at the Darbha clinic, which has a few beds. Fortunately, he recovered after a week and was sent back to the hostel, Basak says. While Bastar has an acute malaria problem, he adds, the cases are usually limited to two strands. There are four malaria strands in total falciparum, vivax, malaria and ovarie. The first two are the most prevalent in Bastar, and in India in general. But in Bastar, falciparum is the real danger and often leads to cerebral malaria Malariae and ovariae are similar to the first two in terms of their treatment, so the medication doesn t differ much. But we had never before seen a case with all four strands in the bloodstream, Basak says. And thus, beginning August 2015, slides with Hunga s blood on them travelled across the world, including the US. While NIRTH confirmed that all four strands were present, this was verified again by the World Health Organisation. The PLOS paper does not mention Hunga s name but calls it the first such case in India and indicates a greater need for training of health staff in malaria diagnosis. The paper says the boy checked himself out of the clinic against medical advice. However, both Basak and Hari Verma, the man who examined his blood at the clinic, say Hunga completed his treatment at Darbha. The details were taken in 2015 and the paper written in 2017, so there was some communication gap, especially because it is difficult in these areas to track down the patient and his family, says Basak. But even as his blood was examined as a medical anomaly around the world, Hunga was blissfully unaware. When The Indian Express tracked down the 14-year-old to the Darbha hostel and verified case details from government records, he was shy, speaking barely a sentence at a time, but laughing all through. Is his name Hunga Kashyap? Yes. Is he from the Madia tribe? Yes. Did he go to the clinic in Darbha with Ranu Ram on August 4, 2015? Yes. Does he know he is the first case in the country of four different strands of malaria in his bloodstream? A wide smile, masking confusion. Phirse bolo (Say that again), he says. And then laughing, he shouts out to his classmates from Class 9: Did you hear? I m the first in the country. One of his friends asks, in Gondi, Is this after you fell sick this time or the last time?

5 Earlier this year, Hungra was taken, with extreme fever and weakness, to a hospital in the Jagdalpur district headquarters, 45 km away. There is no telling if this time too there were multiple parasites in his bloodstream, for he wasn t taken to the NIRTH centre in Darbha. But like last time, I felt like I was dying, he says. Prescription reports he showed state Hunga had both malaria and jaundice. This time too, he recovered in a week. M L Kacchi, the principal of the government boys school where Hunga studies, says, Every week, one child or the other from here is admitted to the hospital with malaria. Even the teachers fall ill very often. There is not much we can do except get them treatment on time. R Prasanna, Director, National Health Mission for Chhattisgarh, acknowledges that the problem in Bastar has lasted a while, and says they are now adopting another approach. The mosquito is only the carrier (of the parasite). Until two years ago, we were only attacking the mosquito, attempting to kill it. But now we are attacking the parasite through mass screenings and treatments, even when there are no symptoms of fever. We have also distributed RD kits across villages, he says. Ask Hunga if he is afraid of contracting malaria again and he again laughs. He says he is thankful it happened when he was in school. It was the only reason he got treatment. And the only reason he is in school is because his parents defied Maoist diktats against it. They now live in secrecy, Hunga says. Dengue Dengue deaths: Mismatch in govt, media reports (The Hindu: ) Under-reporting of dengue cases has come to light in Haryana this year. The government figures on the number of confirmed cases reported so far do not match the ground situation. According to the Health Department figures, 1443 cases of dengue have been reported in the state until now. Sources say, No death due to dengue has been reported fromanywhere in the state, as per the government s figures till Monday, as the deaths are immediately reported telephonically to the headquarters. However, media reports have confirmed two deaths in Hisar (Thandu Ram from Dabra and Kaushalya Devi from Urban Estate), two in Fatehabad (Milan Bhatia and Amar Chand Garg from Tohana) and one in Panchkula in the past few days.

6 A Sirsa-based physician says, Dengue has assumed epidemic proportions in the state. I have so far treated over 60 positive cases of dengue in thelast 20 days. There are more than 20 qualified physicians in Sirsa district and all have been receiving a large number of dengue patients. The Health Department s record shows 25 cases till October 17, whereas the Civil Surgeon s office confirmed 30 dengue cases till Sunday. The physician says the health authorities discourage doctors from notifying the cases to avoid surveys. It is mandatory for medical practitioners to notify the Health Department about the cases of dengue, malaria, chikungunya, Japanese encephalitis, etc. He adds it is unfortunate that doctors are punished instead of being rewarded for treating patients if they notify such cases to the department. Once we report a case, three or four teams inspect our records and ask a plethora of questions. We have to ignore the patients in order to entertain them. When the authorities are indifferent, why will we take the trouble to inform them? says the doctor. A physician from Fatehabad echoes similar sentiments. He claims the health authorities have requested them not to report too many cases. For the past one month, I have been reporting cases with high fatality risk, he says. Former Chief Minister Bhupinder Singh Hooda has already said he would raise the issue of dengue outbreak in the state Assembly. Our own mahila Congress leader Chander Kanta lost her life to the disease and former minister Subhash Batra too is suffering from dengue, said Hooda. Dr Suraj Bhan Kamboj, Director (Vector Borne Diseases), Health Department, however, deniesthe under-reporting of dengue cases. Private doctors depend on card tests which are not confirmatory in nature. We rely on the ELISA test or the NS1 Antigen test performed in government labs only, he adds. Chander Kanta lived in Punjab and had tested negative for dengue. Dengue cases DistrictCases Rohtak 240 Fatehabad 182 Hisar 159 Ambala 140 Kaithal104

7 Panchkula 103 Jhajjar 88 Faridabad 81 Panipat72 Rewari 50 Gurugram 44 Sonepat 34 Kurukshetra 28 Jind, Karnal 25 each Yamunanagar, Bhiwani 18 each Mahendragarh 1 Nuh and Palwal 0 Pollution Pollution hotspots in Delhi-NCR under lens (The Hindu: ) The EPCA today directed the Delhi -NCR authorities to draw up a time-bound action plan to clean up the air of a few pollution hotspots in the region - Anand Vihar, Bhiwadi, Noida and Ghaziabad - within a week. While Anand Vihar, in east Delhi, has consistently recorded alarming levels of pollution, Bhiwadi, an industrial area in Rajasthan's Alwar district, has emerged as one of the most polluted zones of the country in recent times. Ghaziabad and Noida are satellite townships in Uttar Pradesh, located near the national capital. The Central Pollution Control Board (CPCB) monitors have recorded high pollution at Noida's Sector 125, near the Amity University. All these locations have been recording

8 'severe' air quality even as Delhi's air have turned a shade better to 'very poor' since October 21, the Environment Pollution (Prevention and Control) Authority said during a meeting here. EPCA Chairman Bhure Lal, who inspected Anand Vihar today, expressed grave concern over the situation there and observed that the area, which does not have a single toilet or urinal, resembled an "open air latrine". Officials of Rajasthan, who were present in the meeting, said they have roped in IIT-Kanpur to get a study done on the major sources of pollution in the area and suggest corrective measures. Bhure Lal also suggested that around 900 buses belonging to the Uttar Pradesh State Transport Corporation operating in Delhi use the bus terminal of UP, which has ample space and located close to the Anand Vihar ISBT. "The entire area resembles an open air latrine. Garbage heaps are strewn across, the roads are unpaved and need to be tiled. There is no arrangement of sprinkling water," he said, slamming the inaction of the East Delhi Municipal Corporation. He also criticised the Haryana Pollution Control Board for having failed to close a visibly polluting hot mix plant near the Delhi border at Jhajjar despite repeated reminders. PTI Passive euthanasia Passive euthanasia (The Asian Age: )

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10 Vitamin D Vitamin D might prevent type 1 diabetes (Medical News Today: ) Children who are genetically susceptible to type 1 diabetes could see their risk of the condition reduced if they get enough vitamin D. This is the conclusion of a new study published in the journal Diabetes. Researchers found that children with low blood levels of vitamin D were more likely to experience islet autoimmunity, compared with those who had higher levels of the vitamin. Islet autoimmunity is a process wherein the immune system mistakingly attacks the insulinproducing cells of the pancreas, causing type 1 diabetes. Lead study author Jill Norris, Ph.D., of the Colorado School of Public Health at CU Anschutz in Aurora, CO, and colleagues say that their study is the first to show that higher levels of vitamin D may help to prevent islet autoimmunity. Type 1 diabetes is a condition in which the body fails to produce sufficient amounts of insulin, which is the hormone that regulates blood glucose levels. In type 1 diabetes, the immune system launches an attack on pancreatic cells called the Islets of Langerhans which are often referred to as islets. These are clusters of cells that contain beta cells, whose function is to detect glucose in the blood and release it when required. As a result of the immune attack on islets, the beta cells fail to produce sufficient amounts of insulin, causing blood glucose levels to become too high. While type 1 diabetes can occur at any age, onset is most common in childhood. According to the American Diabetes Association, around 1.25 million children and adults in the United States have type 1 diabetes. Addressing the controversy Previous research has indicated that low levels of vitamin D may raise the risk of type 1 diabetes. In response to such studies, scientists have been investigating whether or not higher levels of the vitamin could have a preventive effect against type 1 diabetes, but their studies have produced conflicting results.

11 Vitamin D is often referred to as the "sunshine vitamin," as the sun is the body's main source of it. Vitamin D is also present in some foods including fatty fish, cheese, and egg yolks and it is available as a dietary supplement. Targeting vitamin D receptors could prevent type 2 diabetes Targeting vitamin D receptors could prevent type 2 diabetes Researchers suggest that targeting vitamin D receptors may help to lower the risk of type 2 diabetes. READ NOW For this latest research, Dr. Norris and colleagues set out to learn more about the link between vitamin D and type 1 diabetes. Specifically, they investigated whether or not vitamin D levels in childhood affect islet autoimmunity. "For several years," notes Dr. Norris, "there has been controversy among scientists about whether vitamin D lowers the risk of developing of islet autoimmunity and type 1 diabetes." Risk of islet autoimmunity reduced The study which forms part of The Environmental Determinants of Diabetes in the Young Study included 8,676 children who had a genetic risk for developing type 1 diabetes. As part of the study, blood samples were taken from each child every 3 6 months from infancy, for up to 4 years. These samples were used to identify vitamin D levels and islet autoimmunity. A total of 376 children developed islet autoimmunity, and the vitamin D levels of these children were compared with those of 1,041 children who did not develop the condition. The researchers found that among children who possessed a variant in the vitamin D receptor gene, higher vitamin D levels during infancy and childhood were associated with a reduced risk of developing islet autoimmunity. The team says that its study is unable to prove cause and effect between higher vitamin D levels and reduced risk of islet autoimmunity, and that further studies are needed. That said, Dr. Norris and colleagues believe that their findings indicate that vitamin D has the potential to prevent type 1 diabetes in children genetically susceptible to the condition

12 Alzheimer's Could Alzheimer's be prevented with a vaccine? (Medical News Today: ) Scientists have devised a vaccine that has shown promise in the treatment of psoriasis and cat allergies, as well as in the prevention of Alzheimer's disease. The new research was a collaborative effort among universities in the United Kingdom and Switzerland, and the findings were published in the journal Nature Vaccines. Dr. John Foerster, a dermatologist and clinical senior lecturer at the University of Dundee in Scotland, U.K., jointly supervised the research with Martin Bachmann, a professor of vaccinology at the Jenner Institute in Oxford, U.K. Dr. Foerster, Prof. Bachmann, and their research team designed a new vaccine by combining an existing anti-tetanus vaccine with a protein from a virus that affects a variety of plants. The viral protein was taken from the so-called cucumber mosaic virus (CMV) a virus that received this name because it was first found in cucumbers. The scientists incorporated a so-called tetanus-epitope into the CMV particles and tested the resulting vaccine in animal models of psoriasis, allergies, and Alzheimer's disease. An epitope is the part of a foreign substance in this case, tetanus that elicits an immune response in the body. Vaccine effective for chronic conditions As the researchers explain, the vaccine was successful against psoriasis and cat allergies, with the mice showing signs that their immune system was fighting off the infection. The vaccine proved to be efficient even in old mice and at low doses. Dr. Foerster explains the mechanism by which his discovery could prevent chronic diseases or treat them after they have already developed. "The idea is pretty simple. [For] diseases

13 such as psoriasis or eczema, the newest and most effective medicines on the market are socalled 'antibodies,' which are what you and I produce against bugs in a common cold." "For chronic diseases," he adds, "these antibodies are specially made against one of the body's own proteins. By blocking that single protein, the disease gets better." Menopause may trigger Alzheimer's disease Menopause may trigger Alzheimer's disease Could a lack of estrogen cause Alzheimer's disease in women? READ NOW "To use the example of psoriasis," he continues, "a protein called Interleukin 17 needs to be active for the disease to progress." As the authors explain in the study, existing drugs that target this protein are very expensive, although efficient and safe. "By creating a vaccine that stimulates the body to make antibodies against Interleukin 17 itself," explains Dr. Foerster, "we can replace the need for frequent and expensive injections." "[We can] make this type of treatment much more affordable and accessible to patients who could otherwise not afford specially made antibodies," he notes. "Our research shows that this technique works in mice and, importantly, our new vaccine technology shows that it is likely to be a more effective type of vaccine than existing ones in older people." Dr. John Foerster "Since many patients with chronic conditions like psoriasis are elderly," he continues, "this technology may work much better." A vaccine against Alzheimer's In a mouse model of Alzheimer's disease, the vaccine increased levels of certain antibodies that are believed to protect against the neurodegenerative disease. More specifically, the vaccine raised levels of the Immunoglobulin G antibodies that are thought to recognize and fight against aggregates of beta-amyloid plaque in the brain which is a marker of Alzheimer's disease. Based on the findings, the authors suggest that "a prophylactic vaccination approach could be a viable public health intervention" against Alzheimer's disease. Evidently, more research is needed to test these benefits in humans. The vaccine could be adapted to almost any foreign substance, or antigen, the authors write, and it would be "ideally suited [...] for aging populations." This is what makes the findings particularly encouraging, says Prof. Bachmann. He notes:

14 "Alzheimer's disease usually develops in elderly people. The fact that the vaccine described here is optimized for old individuals seems therefore particularly helpful." "An additional important aspect," Prof. Bachmann concludes, "is that we developed a platform technology and are currently broadening our preclinical studies to vaccines against Parkinson's disease as well as chronic pain." Antibiotics Strength in numbers: How biofilms outfox antibiotics (Medical News Today: ) Bacteria are vital for survival, but when they form communities, they can wreak serious havoc and pose a threat to our health. When bacteria flock together and form a community, this is called a biofilm. Found all over the planet from desert rocks to the surfaces of buildings biofilms are an integral part of nature. Biofilms are tricky beasts because they have a tendency to become resistant to all manner of efforts employed to eradicate them. This spells bad news for anyone with conditions such as cystic fibrosis, periodontitis, or chronic wounds as medical implants and catheters are hotspots for biofilm formation. But why are biofilms so persistent, and what are doctors and scientists doing to outsmart these clever microbial communities? What are biofilms? "Biofilms are one of the most widely distributed and successful modes of life on Earth," says Prof. Hans-Curt Flemming director of the Institute for Interface Biotechnology at the University of Duisburg-Essen in Germany in a 2016 article published in Nature Reviews Microbiology. Biofilms can be made up of populations of the same bacteria or of communities, which, in turn, are made up of many different species, all living together under a protective dome. This dome is composed of a so-called matrix of extracellular polymeric substances (EPS), which contains a mixture of sugars, proteins, fats, and DNA molecules. In much the same way as human communities, biofilms have highly specialized areas: some of them are responsible for nutrient recycling, while others produce new EPS components or send messages from one area of the biofilm to another.

15 Living together in such close proximity allows bacteria to share resources more successfully than when they are in their free-living state. Crucially, it allows them to avoid conventional methods of eradication. Evading eradication Prof. Flemming describes biofilms as a "fortresses" that protect their inhabitants. Shielded from dehyration and antibiotics, bacteria ride out the storm of interventions thrown at them. Interestingly, antibiotics can actually enter a biofilm in many instances, but the EPS actively shields its inhabitants from such compounds, promoting antibiotic resistance. Biofilm residence also affords the bacteria with antibiotic-resistant genes the ability to easily share these among their neighbors using a process called horizontal gene transfer. Although this also happens in free-living bacterial communities, it is significantly more efficient in biofilms. The result of this is that antibiotic resistance spreads like wildfire. So, when faced with biofilm infections, what can doctors do? The battle against biofilms Biofilms are a serious threat to health, which is why doctors utilize aggressive treatments in the fight against them. Such treatments include surgically removing the area that is infected with a biofilm or using high-velocity water sprays to physically disrupt the biofilm, often in combination with antibiotics. However, Prof. Hyun Koo director of research at the Levy Centre for Oral Health in the School of Dental Medicine at the University of Pennsylvania in Philadelphia explains in a recent review article that "killing [the bacteria] does not necessarily eradicate the biofilm." If the EPS matrix remains intact, other opportunistic microbes can lie in wait and take up residence. Researchers hope to disrupt biofilms by using many different approaches, including targeting the formation of the EPS or using enzymes to degrade this complex mesh, disrupting cell-tocell communication, and inhibiting nutrient sources. Emerging technologies Many believe that the path to treatment lies in prevention. Advances in technology have allowed researchers to develop new materials actively designed to stop bacteria from attaching and forming biofilms in the first place. The ultimate aim is that these will stop bacteria from sticking to the surface of medical implants and catheters, by coating surfaces with antibiotics or by including certain topographic surface features that are naturally hostile to bacteria.

16 One of these is called the Sharklet micropattern and is inspired by shark skin, which is naturally resistant to bacteria colonization. Made of groves arranged in a microscopic diamond pattern, researchers have shown that bacteria do not stick to this pattern as well as they do to smooth surfaces. While there are no guaranteed treatments to rid us of biofilms just yet, researchers are increasingly getting to grips with the complex biology that underpins these microbial communities. In the meantime, the hunt for effective ways to eradicate this threat to our health continues. Pollution (Dainik Gagaran: )

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18 High BP (Dainik Gagaran: )

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20 Medicine (Dainik Gagaran: ) 1 ȡ^ ɉ ȧ कम 1 à Ǘ- æ Ȣ क ȡ ȣ \ è ȡ ɉ Ʌ ȡ^ ɉ और Ê Ǘ Ȫ ȧ कम Ȳ ȡ ह ब शक è ȡèØ Ȳğ Ȣ और à Ǘ- æ Ȣ ȯ Ü ȡ_ क रप र शन ã ȣ सभ दव इय ` Þ करव न क द व कर रह ɉ, मगर इस समय \ è ȡ ɉ ȧज ǔè Ǔ ह, वह Ǔ Ȣ ȣȳह Ȣस Ȣ भ \ è ȡ Ʌ^ Ʌ Ȣक छ ड़कर \ Û ȣȳपर भ Ê Ǘ Ȫ तक ȣȳह ȣ Ȣर ख स न च रहन व ल ȣ ɉक सबस \ पर श न आ ȣह ऐस ȣȳह ȡ^ ɉव Ê Ǘ Ȫ ȧकम ह न क अनम न \ è ȡ Ĥ ȡ और ȡ Ȣ \ ȡǐ ɉक पहल ȣȳथ मगर Ȣन भ इस ग भ रत स ȣȳ ȡ@यह ȣब र ह \ è ȡ ɉ Ʌ ȣ ɉक Ê Ǘ Ȫ तक ब ज र स ȣ ल न पड़ रह ह यह [ Ǒ ह क छ [पहल ȡÏ क सभ ȡ ȣ \ è ȡ ɉ Ʌ ȡ^ ɉव \ Û स म न क Ü ȡ_ करन क सरक र न à Ǘ- æ Ȣ ȯ Ü ȡ_ क रप र शन क ǔ à ȡ ɋ ȡथ Ȳ ȡयह ह त न [ब द भ क रप र शन Ʌġ Ʌ ȡ[Ü Ü ȡ_ Ȣभ è ȡèØ ǓǕ ǔæ ȣȳबन प य यह सब उस समय ह जब è ȡèØ एव ȡ ȡ Ȳğ Ȣ इस [सभ è ȡèØ Ʌġɉ Ʌĥ ȧ Ĝ Ȩ Ȣ ल ग करन क Į ȯ ल चक ɇ@ à Ǘ æ Ȣ Ʌइस समय ȣ ब स ĤǓ ल ग ȣ Ȣ र ख स न च रहत ɇऔर Þ ȯĥǔ स \ ȡ ȣ \ è ȡ ɉ पर Ǔ [ ɇ@ऐस Ʌअगर \ è ȡ ɉ ȧ ȣǔè Ǔ ȣत आन व ल Ǒ ɉ Ʌ ȣ ɉ Ʌर ष बढ़त ज एग ȡ ȧ ȯ क ल ज ȧ^ Ʌ Ȣ Ʌ ȣहर Ǒ औसतन प च स क ȣ ȣ अपन इल ज करव त ɇ@ब हतर ह त अगर ȡÏ सरक र ^ Ʌ Ȣ Ʌ ȣ ɉ क ȣसभ ज वन दव इय ` Þ करव प त इस समय Ʌġ व ȡÏ सरक र ȧकई ऐस य जन ए ɇजह पर Ǔ : Ǖã इल ज क Ĥȡ ȡ ह, ȯ इनक ल भ ȣ ɉक तभ ȯ ȡजब समय पर ज वन ȡ^ ɉव \ Û स म न ȧ ȣ ȡ ȣह ग

21 Brain (Dainik Gagaran: )

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23 Alcoholism (Navbharat Times: )