The American who introduced apples into India

He was not an Indian. Nor was he a European. He was an American. He had come to India to work as a volunteer in a leper home. Yet, he actively participated in the Freedom Movement of India. He was also the only foreigner who signed the Congress Manifesto. Infact, he even attended several Congress sessions, which in those days gave a lead to the people yearning for freedom.

He also fought against bonded labour and compelled the British to outlaw the practice. Today, he is just not remembered for his fight for India’s Independence, but as the man who introduced apples in Himachal Pradesh. Then, these apples were known as Red Delicious American. Now, they are famous as Himachal appeals and they have their own brand in the market.

He was a wealthy American Quaker-who set sail for India aged twenty two. Once in India, he worked with great zeal and enthusiasm and later became a Hindu and even took a Hindu name. 

This man is Satyananda Stokes, who was born as Samuel Evens Stokes.

Born on August 16, 1882, to a distinguished and wealthy Quaker family in Philadelphia, his father was a successful businessman and also the founder-owner of the Stokes and Parish Machine Company, the leading manufacturer of  elevators in the USA.

Samuel could not acquire any professional skill and he appeared totally disinterred in his father’s business.

In 1904, Samuel left for India to work at a leper colony at Subathu in Shimla Hills of Himachal Pradesh. Though his parents opposed his decision, Samuel decided to set sail for India.

In India, Samuel met his calling and he began living with the villagers. In 1912, he married Agnes, a local Rajput Christian girl, and purchased a farm. In 1916, he then decided to improve his farm and he began cultivating a new variety of apples developed by the Stark Brothers of US in 1915.

If the Stark Brothers called their variety of apples grown in their nursery in Louisiana as the Red Delicious, Samuel planted them in his farm at Barobagh in Thanedar in the winter of 1916 and this was the birth of the famous Himachal apples

The apple trees took root and the first apple crop was harvested in 1926. Samuel then encouraged other farmers to take up apple cultivation.    

In 1932, he converted to Hinduism and took the name Satyananda, while Agnes became Priyadevi.

Meanwhile, he had started taking active interest in the freedom movement. He was the only American to become a member of the AICC and alongwith Lala Lajpat Rai, he represented Punjab at the AICC session. He was also the only non-Indian to sign the Congress manifesto in 1921, calling upon Indians to quit government service.

The British put Samuel into jail on charges of sedition. Samuel thus became the only American political prisoner in the freedom struggle. He died on May 14, 1946 in Shimla. Ironically, many  leaders had gathered at Shimla to discuss India’s future constitutional framework with the visiting Cabinet Mission from England.

He was cremated in Shimla and his ashes later taken to Kotgarh.

Though apple growers of Kashmir and Himachal still remember Samuel, the Government seems to have forgotten him. There is no mention of this great man or his contribution in Shimla. Indeed, there is not even a statue. 

Fishing for blood clots

Nets are generally used by fishermen to catch fishes. But can you imagine a net to retrieve blood clots from a human body.  What is more, these are clots or thrombi that have formed due to stroke and they have stopped the supply of oxygen and blood to the brain, causing paralysis.

Such nets are now being used regularly in the United States to get to the blood clots and remove them from the brain of patients who had suffered a stroke or have had a series of strokes.

Generally, upwards of four strokes occur in a human being when blood clots block a blood vessel from carrying blood to the brain. When the clot stops the flow of blood, the brain is starved of oxygen and glucose and the cells die by millions, damaging the tissues (infarcts) leading to paralysis and in some cases even death.

Till now, the clots were removed or dissolved with the help of drugs. The drug, rt-PA, is almost fully effective if administered to victims within three hours of a stroke felling them. Unfortunately, it fails to dissolve large blood clots.

Doctors also use anticoagulants, which are popularly known as blood thinners, to treat clots. These medications- heparin, low molecular weight heparin, and warfarin-slow the time it takes for blood to clot and also prevent growth of a clot. However, all of them have side effects.

Other techniques to remove a clot include MERCI Retrieval System, which can be used at any time. This is a minimally invasive catheter-based system to retrieve and remove clots in patients experiencing acute ischemic stroke. The catheter is inserted into the brain to remove the clot. Another option is the Penumbra System, but this can be used only within eight hours of a patient suffering a stroke. Here, suction is used to remove the clots and restore blood flow.

Now, a team of doctors and researchers in the US have successfully tested a new technique to remove clots. They have used small nets to get to the place where the clot has formed. The net is sent to the brain through an artery in the leg.

When the net reaches the clot, the tip expands into a net and pulls out the clot into itself.

The device has been named as Solitaire and it has so far yielded promising results in a recent medical trial at the University of California, Los Angeles. This devise is different from the MERCI and its success too is double of MERCI.

Researchers were stunned to find that when MERCI was used, 598 per cent of the patients reported improved mental and motor functioning within a three month period. This compared well with those treated with MERCI (33 per cent).

More importantly, only 17 per cent of those treated with Solitaire died following treatment compared to 38 per cent treated with the MERCI.

Another study involving 178 patients showed those  treated with Solitaire had almost double the chance of living independently after treatment.

Why this success rate?. One reason is that it has allowed doctors to  successfully open up arteries and save the brain. What makes this device all the more valuable to a patient suffering from stroke is that it has been proved to effectively reverse a stroke even while it is happening.

This is because the brain cells can survive if blood supply can be restored quickly. This is what Solitaire can do.

Moreover, it is always advisable to use clot retrieval devices than go in for clot dissolving drugs.

By the way, the Solitaire was approved by the US Food and Drug Administration (FDA) for use as a clot retriever in March 2012. This is actually called Covidien Solitaire FR Revascularization Device.

Dissolving blood clots

By the way, a John Hopkins study in the US has come up with a new technique to dissolve blood clots in brain and also lower the risk of brain damage after stroke.

The research is supported by the National Institute of Neurological Disease and Stroke

The technique which involves minimally invasive treatment   removes potentially lethal blood clots in the brain safely without cutting through easily damaged brain tissue or removing large pieces of skull.

More importantly, this technique was particularly successful in treating victims of intracerebral hemorrhage (ICH), which is considered to be the last  untreatable form of stroke.

ICH is caused by high blood pressure and in such cases the clot builds up pressure and leaches inflammatory chemicals. This leads to irreversible brain damage, causing death or extreme disability. Very few undergo the more invasive and risky craniotomy surgery, which involves removing a portion of the skull and making incisions through healthy brain tissue to reach and remove the clot. Roughly 50 percent of people who suffer an intracerebral hemorrhage die from it.

This new technique, if found positive, allows patients with stroke and paralysis to recover independent functioning of the organs that had been affected. The USP in this technique is that the brain remains safe and only a small hole the size of a coin is made in the skull to get to the damaged tissue which is then treated with rt-PA which is allowed to drip on the damaged cells.  

A new tablet for HIV/AIDS

Today, the field of medicine is a vast one and almost all sectors therein are witnessing rapid research and development.

One of the most dreaded diseases in recent years in the medical field which has posed a challenge to nations, R and D organizations and to the field of medicine has been HIV/AIDS. There has been constant research by several organisations, multinationals and even countries who are in a race to find a cure for this disease.  

India is one of the few countries that has a separate institute to work on a cure for this epidemic. On the other hand, the private sector in the United States is leading the research in this field.

A few weeks ago, the US Federal Drug Administration (FDA) approved a new drug to fight HIV/AIDS. The new drug is currently available in the US and it should be in the Indian market any time. This is one of the drugs that are being tested on people diagnosed with HIV/AIDS.

This drug is called Tivicay and it is currently manufactured under licence by GlaxoSmithKline.

It is used to treat the most common strain of HIV, the virus that causes AIDS. It is also known as dolutegravir and it is generic drug. It acts as integrase inhibitors: it blocks the HIV virus from entering cells.
Tivicay, as of now, is owned by ViiV Healthcare, an HIV joint venture between GSK, Pfizer Inc and Shionogi & Co Ltd.
US researchers say Tivicay (50mg) can be used to treat infected adults who have been treated or are being treated with other drugs or are new to treatment.

Tivicay is an integrase strand transfer inhibitor that interferes with one of the enzymes necessary for HIV to multiply. It is a pill taken daily in combination with other antiretroviral drugs.

Researchs in US says Tivicay is approved for use in a broad population of HIV-infected patients. It can be used to treat HIV-infected adults who have never taken HIV therapy (treatment-naïve) and HIV-infected adults who have previously taken HIV therapy (treatment-experienced). This also includes those who have been treated with other integrase strand transfer inhibitors.

Tivicay is also approved for children ages 12 years and older weighing at least 40 kilograms (kg) who are treatment-naïve or treatment-experienced but have not previously taken other integrase strand transfer inhibitors.

It is available as a small, yellow, 50-mg tablet. Importantly, it can be taken with or without food and at any time of the day. Tivicay is now available in pharmacies in the US.

Coming back to the disease, HIV/AIDS occur due to a variety of reasons. It is important for a doctor who treats such patients to zero in on the cause and if you happen to know the cause, you would be doing yourself a favour by revealing it.

In Bangalore, all Government hospitals such as KC General, Bowring and Victoria Hospitals in Bangalore have HIV/AIDS cells. These hospitals have opened Voluntary Counselling and Testing Centres mainly for providing Anti-Retroviral Therapy (ART).

The ART is best understood when you visit one of the centres. By the way, eating nutritious food is an important factor when undergoing ART.

The Karnataka Government has provided certain facilities for HIV/AIDS patients for patients undergoing ART, including subsidized travel and treatment.

The Department of Health and Family Welfare and Karnataka State Aids Prevention Society (KSAPS) first inaugurated this facility in Bangalore. Besides, the Government last year opened  the ID NAT (Individual Donor Nuclic Acid Testing) facility at K C General Hospital in Malleswaram.

Under this scheme, the Government will give 80 paisa per kilometer to HIV+ patients. The patients can reimburse the amount from the government. Patients from urban areas will be paid Rs. 20 to travel one way for ART treatment. In case they spend more than Rs. 20 then the government will reimburse at the rate of 80 paisa per kilometer. A maximum of Rs. 100 will be paid for patients travelling from outside the district  and the procedure of reimbursement will be monitored by a nodal officer.

The ART consists of at least three anti-retroviral drugs to suppress the HIV virus and so far this has been found to be the most effective allopathic treatment. These drugs are being distributed free.

The government also offers treatment for tuberculosis (TB) - one of the deadly opportunistic infections suffered by people living with HIV (PLHIV) and even this is free of cost.

However, free ART and TB medicine do not alone complete HIV treatment. With immunity levels dipping constantly and with new stains being discovered, the infected people need regular and constant medical attention. Besides, recurring infections like herpes and diarrhea could call for regular hospitalisation.

As written earlier, a combination of drugs can be used to control the virus. Each of the classes of anti-HIV drugs blocks the virus in different ways. It is best to combine at least three drugs from two different classes to avoid creating strains of HIV that are immune to single drugs. The classes of anti-HIV drugs include:

Non-nucleoside reverse transcriptase inhibitors (NNRTIs). The NNRTIs disable a protein needed by HIV or virus to make copies of itself. Examples include efavirenz (Sustiva), etravirine (Intelence) and nevirapine (Viramune).

Nucleoside reverse transcriptase inhibitors (NRTIs). NRTIs are faulty versions of building blocks that HIV needs to make copies of itself. Examples include Abacavir (Ziagen), and the combination drugs emtricitabine and tenofovir (Truvada), and lamivudine and zidovudine (Combivir).

Protease inhibitors (PIs). PIs disable protease, another protein that HIV needs to make copies of itself. Examples include atazanavir (Reyataz), darunavir (Prezista), fosamprenavir (Lexiva) and ritonavir (Norvir).

Entry or fusion inhibitors. These drugs block HIV's entry into CD4 cells. Examples include enfuvirtide (Fuzeon) and maraviroc (Selzentry).

Integrase inhibitors. Raltegravir (Isentress) works by disabling integrase, a protein that HIV uses to insert its genetic material into CD4 cells.

This treatment should begin if you have or are having Your CD4 count under 500: You have HIV-related kidney disease: You're being treated for hepatitis B.

HIV treatment regimens can involve multiple pills at specific times every day. The side effects can include nausea, vomiting or diarrhea, abnormal heartbeats, shortness of breath, skin rash, weakened bones, bone death, particularly in the hip joints.

Please remember that some health issues are a natural part of aging and that they may be more difficult to manage if you have HIV. Some medications that are common for age-related cardiovascular, metabolic and bone conditions, for example, may not interact well with anti-HIV medications. Talk to your doctor, family doctor if you have one, about other conditions you're receiving medication for. There are also known interactions between anti-HIV drugs and:Contraceptives and hormones for women: Medications for the treatment of tuberculosis and Drugs to treat hepatitis C

Once the ART commences, your response is measured by your viral load and CD4 counts. Viral load should be tested at the start of treatment and then at regular intervals-say every three to four months during therapy. CD4 counts should be checked every three to six months.

HIV treatment should reduce your viral load to the point that I becomes undetectable. Mind you, this does not mean that HIV has vanished. It just means that the test is not sensitive enough to detect it or the low levels. Yet, you can still transmit HIV to others when your viral load is undetectable.

In India HIV is most commonly diagnosed by testing your blood or saliva for the presence of antibodies to the virus. Unfortunately, these types of HIV tests are not fully accurate immediately after infection because it takes time for your body to develop these antibodies — usually up to 12 weeks. In rare cases, it can take up to six months for an HIV antibody test to become positive.

A newer type of test checks for HIV antigen, a protein produced by the virus immediately after infection. This test can confirm a diagnosis within days of infection. An earlier diagnosis may prompt people to take extra precautions to prevent transmission of the virus to others. There is also increasing evidence that early treatment may be of benefit.

If you receive a diagnosis of HIV/AIDS, several types of tests can help your doctor determine what stage of the disease you have. These tests include:

CD4 count. CD4 cells are a type of white blood cell that's specifically targeted and destroyed by HIV. A healthy person's CD4 count can vary from 500 to more than 1,000. Even if a person has no symptoms, HIV infection progresses to AIDS when his or her CD4 count becomes less than 200.

Viral load: This test measures the amount of virus in your blood. Studies have shown that people with higher viral loads generally fare more poorly than do those with a lower viral load.

Drug resistance: This blood test determines whether the strain of HIV you have will be resistant to certain anti-HIV medications and the ones that may work better.

Tests for complications:
Your doctor might also order lab tests to check for other infections or complications, including tuberculosis, hepatitis, toxoplasmosis

Sexually transmitted infections, liver or kidney damage and or

urinary tract infection

In resource-poor nations like India and in the continent of Africa, TB is the most common infection associated with HIV and a leading cause of death among people living with AIDS. Millions of people are currently infected with both HIV and tuberculosis, and many experts consider the two diseases twin epidemics.

Salmonellosis: You contract this bacterial infection from contaminated food or water. Symptoms include severe diarrhea, fever, chills, abdominal pain and, occasionally, vomiting. Although anyone exposed to salmonella bacteria can become sick, salmonellosis is far more common in people who are HIV-positive.

Cytomegalovirus (CMV): This common herpes virus is transmitted in body fluids such as saliva, blood, urine, semen and breast milk. A healthy immune system inactivates the virus, and it remains dormant in your body. If your immune system weakens, the virus resurfaces — causing damage to your eyes, digestive tract, lungs or other organs.

Candidiasis: Candidiasis is a common HIV-related infection. It causes inflammation and a thick white coating on the mucous membrane of  mouth, tongue, esophagus or vagina. Children may have especially severe symptoms in the mouth or esophagus, which can make eating rather painful and difficult.

Cryptococcal meningitis: Meningitis is an inflammation of the membranes and fluid surrounding your brain and spinal cord (meninges). Cryptococcal meningitis is a common central nervous system infection associated with HIV, caused by a fungus that is present in soil. It may also be associated with bird or bat droppings.

Toxoplasmosis: This potentially deadly infection is caused by Toxoplasma gondii, a parasite spread primarily by cats. Infected cats pass the parasite in their stools, and the parasites may then spread to other animals.

Cryptosporidiosis: This infection is caused by an intestinal parasite that's commonly found in animals. You contract cryptosporidiosis when you ingest contaminated food or water. The parasite grows in your intestines and bile ducts, leading to severe, chronic diarrhea in people with AIDS.

Cancers common to HIV/AIDS

Kaposi's sarcoma: This is a tumor of the blood vessel walls. Although rare in people not infected with HIV, it's common in HIV-positive people. Kaposi's sarcoma usually appears as pink, red or purple lesions on the skin and mouth. In people with darker skin, the lesions may look dark brown or black. Kaposi's sarcoma can also affect the internal organs, including the digestive tract and lungs.

Lymphomas: As the name itself suggests, this type of cancer originates in your white blood cells. Lymphomas usually begin in your lymph nodes. The most common early sign is painless swelling of the lymph nodes in your neck, armpit or groin.

Other complications

Wasting syndrome. Aggressive treatment regimens have reduced the number of cases of wasting syndrome, but it does still affect many people with AIDS. It is defined as a loss of at least 10 percent of body weight and is often accompanied by diarrhea, chronic weakness and fever.

Neurological complications. Although AIDS doesn't appear to infect the nerve cells, it can still cause neurological symptoms such as confusion, forgetfulness, depression, anxiety and trouble walking. One of the most common neurological complications is AIDS dementia complex, which leads to behavioral changes and diminished mental functioning.

Kidney disease: HIV-associated nephropathy (HIV AN) is an inflammation of the tiny filters in your kidneys that remove excess fluid and wastes from your bloodstream and pass them to your urine. Because of a genetic predisposition, the risk of developing HIV AN is much higher in African Americans. Regardless of CD4 count, anti-retroviral therapy should be started in people diagnosed with HIV AN who are not already being treated.

The symptoms of HIV and AIDS vary, depending on the phase of infection.

Primary infection
The majority of people infected by HIV develop a flu-like illness within a month or two after the virus enters the body. This illness, known as primary or acute HIV infection, may last for a few weeks. Possible symptoms include: fever, muscle soreness, rash

Headache, sore throat, mouth or genital ulcers, swollen lymph glands, mainly on the neck, joint pain, night sweat and diarrhea.

Although the symptoms of primary HIV infection may be mild enough to go unnoticed, the amount of virus in the blood stream (viral load) is particularly high at this time. As a result, HIV infection spreads more efficiently during primary infection than during the next stage of infection.

Clinical latent infection:
In some people, persistent swelling of lymph nodes occurs during clinical latent HIV. Otherwise, there are no specific signs and symptoms. HIV remains in the body, however, as free virus and in infected white blood cells.

Clinical latent infection typically lasts eight to 10 years. A few people stay in this stage even longer, but others progress to more-severe disease much sooner.

Coming back to AIDS in India, the country has seen a 57 percent drop in number of new HIV infections during the last decade and these are the latest figures from the National AIDS Control Organisation (NACO).
India has seen reduction of new Human immunodeficiency virus (HIV) infections (among adult population) from 2.74 lakh in 2000 to 1.16 lakh in 2011.
NACO says nearly 1.5 lakh lives have been saved due to free Anti-retroviral Therapy (ART) medicines provided to HIV/AIDS patients. But these figures are nothing to crow about when you remember that the first case of HIV/AIDS was reported in India in 1986.

(These facts are compiled from several medical and pharmacy reports and also bulletins and journals. The information here is meant only to help guide people and all drugs and medication should only be taken with doctors’ prescription. The facts here are only for purposes of reference and not for any other purpose).

The torpedo that was invented in Bangalore

Bangalore is known by many names such as Pensioners’ Paradise,  Garden City and Silicon City. Known as one of the most happening cities in India, it has taken giant strides in information technology and its progress in biotechnology is mind boggling. Decades earlier, Bangalore was known as the city of public sector units. It had many public sector units and it was also known for its research in science and technology. Several world class institutions such as the Indian Institute of Science (IISc) and the Indian Institute of Astrophysics came up much before India gained Independence.

Thus, Bangalore was already on the scientific map of the world. Its researchers and scientists had published several papers at the national and international level and scientists like C.V.Raman gave Bangalore a scientific reputation that other scientists found it hard to match.

Though Bangalore’s strides in satellite and rocket technology is well known today thanks to the host of space institutions abounding here, it was also known for military research.

I am not talking about the DRDO or the many scientific and defence research institutions that are working on Light combat aircraft (LCA) or other defence-related projects. These institutions, with the exception of HAL, are of recent origin.

I am talking of a special type of explosive that was conceived, planned, made or manufactured in Bangalore. This explosive device became so famous that it came to be known by the name of Bangalore-the city which started it.

This is the Bangalore torpedo. It was invented by the British during the first world war.

The Bangalore torpedo is an explosive charge placed within one or several connected tubes. It is used to clear obstacles and paths that have been mined with barber wires. It is also called as Bangalore mine, Bangalore bangers or even Bangalore.

This device has been found very effective for clearing a path through wire and mines up to 15 metres (49 ft) long and one metre (3 ft 3 in) wide.

The credit for coming up with this device goes to Captain McClintock, a British soldier in the Madras Sappers and Miners group of British Indian Army.

The unit was in Bangalore and Capt. McClintock invented the device in 1912. They were found t be highly effective and were first used by the British during the Boer wars in South Africa.

They exploded  bobby traps and barricades in the Boer war first and then came t be extensively used during the course of the Russo-Japanese war.

The advantage of this device was that it would be exploded over a mine without a solider having to go near it. Thus, Bangalore not only saved lives of soldiers but also cleared the path for the easy and quick movement of troops.

It was  adopted by the US Army during the second world war and used as the M1A1 Bangalore Torpedo.

These devices are now manufactured by Mondial Defence Systems of  Poole in United Kingdom and they are used by the armed forces of  United States and United Kingdom.

The last use of these devices were in Afganisthan which had been heavily mined by the Taliban. The US troops have used them in clearing arms and ammunition in deep crevices and caves.

However, when they were invented, the initial use of Bangalore torpedo was to clear barbed wires before launching an offensive. The device could be used even when the enemy was firing.

These torpedoes consisted of  several  externally identical 1.5 m (5 ft) lengths of threaded pipe, one of which contained the explosive charge. The pipes would then be bundled together using connecting sleeves to make a longer pipe. A cone would be fitted at one end.

The cone would be screwed to prevent the device from snagging on the ground. It would then be pushed forward from a protected position and detonated, to clear a 1.5 m (5 ft) wide hole through barbed wire.

The best demonstration of using this device to punch holes in barbed fences is in the 1927 silent film Wings. This film went on receive the Academy Award for the Best Motion Picture.

Another film to show the Bangalore torpedo is the 1950 reel classic Breakthrough.

Tobruk (1967), Saving Private Ryan, The Longest Day, Storming Juno, The Big Red One and Call of Duty also depict these devices.     

Today, the Bangalore torpedo exists with a lot of variations. They are used with a lot of innovations by US, UK and Canadian

troops.