EFFECTS OF FAMILY CAREGIVING ON HEALTH AND WELLNESS

GRACE PAUL, M.PHIL, MSN, RN, CNE.

Residential Faculty - Medical Surgical Nursing.,GLENDALE COMMUNITY COLLEGE

Greetings and well wishes from Glendale community College: Maricopa Nursing, Glendale,
Arizona. As part of collaboration between Little Flower College, Guruvayur, Kerala, India and
Glendale Community College, Arizona, I am happy to represent my college to present on the
topic, “Effects of Family Caregiving on Health and Wellness”.
When you go in an airplane, before the aircraft takes off, the flight attendant talks and kind of
demonstrates about the air safety rules and what to do when misfortune strikes. Most people
don’t pay attention to it, and there are some who clings on to every word trying to make sense
of what is being said. If disaster strikes, almost everyone goes into panic mode and do not now
what to do. Regardless of those facts, the flight attendants try to reiterate one simple rule –
when the masks come down, put the mask on yourself first before you help your child, spouse
or anyone ese. Unless you are fit and able to help yourself, you cannot help others.
This fact is the focus of my topic today – the importance of taking care of SELF while providing
care to our loved ones. Studies have shown thatupto 60% of caregivers are clinically
depressed. While focusing on the sick family member, often the caregiver tends to neglect
his/her own health -whether it be physical, psychological or emotional. Taking care of
someone with a chronic illness like cancer, paralytic bed-ridden family member, or other
conditions like Alzheimer’s or Parkinson’s disease involves hours of care. Juggling between
job, children and other routine chores along with taking care of the sick family member, the
caregiver hardly has time to think about his/her own needs and this results in caregiver
stress. This if unchecked can eventually result in caregiver strain, and caregiver burnout.
What is caregiver strain? Stucki and Mulvey defined caregiver strain as the strain or load
borne by a person who cares for a chronically ill, disabled, or elderly family member. It is a
multidimensional response to physical, psychological, emotional, social and financial stressors
associated with the caregiving experience. The North American Nursing Diagnosis (NANDA)
Committee defined caregiver role strain as a state in which an individual is experiencing
physical, emotional, social and/or financial burden(s) in the process of giving care to another.
Care giver burnout is a state of physical, mental and emotional exhaustion caused by the
prolonged and overwhelming stress of caregiving. While providing care and treatment, the
entire focus is on the patient as rightly so, and the need and demand of the family caregivers
are often overlooked and neglected. The vital role played by such family caregivers is well
recognized but the burden on them is poorly understood. Many studies have quantified
caregiver burden using questionnaire such as the Zarit Burden Interview (ZBI).
Caregiver stress and burnout are more severe while taking care of family members with a
debilitating condition, with a bleak outcome. It is important that the caregiver understands
and acknowledges the signs and symptoms of caregiver stress and takes preventive actions,
or if the caregiver is undergoing burnout syndrome, it is vital that actions are taken to prevent
hospitalization of the caregiver. A responsible caregiver must take care of self – be it physical,
mental or emotional. Increasing levels of anxiety, depression, and other physical aches and
pains, are a sure call to take care of self. Both the care giver and the care recipient will not
benefit from caregiver burnout.
The steps to managing stress include the following:
1. Recognize warning signs early. Don’t wait too long.
2. Identify sources of stress.
3. Identify what you can and cannot change.

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 4. Take action to reduce stress to give us back a sense of control.
Melinda (2018) outlines the common signs and symptoms of caregiver stress and caregiver
burnout as follows:
Common signs and symptoms of caregiver stress
 Anxiety, depression, irritability
 Feeling tired and run down
 Difficulty sleeping
 Overreacting to minor nuisances
 New or worsening health problems
 Trouble concentrating
 Feeling increasingly resentful
 Drinking, smoking, or eating more
 Neglecting responsibilities
 Cutting back on leisure activities
Common signs and symptoms of caregiver burnout
 You have much less energy than you once had
 It seems like you catch every cold or bout of flu that’s going around
 You’re constantly exhausted, even after sleeping or taking a break
 You neglect your own needs, either because you’re too busy or you don’t care anymore
 Your life revolves around caregiving, but it gives you little satisfaction
 You have trouble relaxing, even when help is available
 You’re increasingly impatient and irritable with the person you’re caring for
 You feel helpless and hopeless
Feeling powerless is the number one trap to caregiver burnout. When the caregiver role is
expected to be there for a long time, and when there is no guarantee for a positive outcome, or
even worse if the condition only progressively gets worse, it is hard not to feel powerless.
Nevertheless, with the knowledge that the situation is beyond our control, it is essential that
certain precautions and actions be taken to prevent caregiver burnout syndrome.
But first before taking actions, the caregiver must first remove personal barriers to self-care.
For eg, “Do you think you are being selfish if you put your needs first?”
“Is it frightening to think of your own needs? What is the fear about?”
“Do you have trouble asking for what you need? Do you feel inadequate if you ask for help?”
Once you identify your personal barriers, you can begin to change behavior.
Practice acceptance: There is never going to be an answer to the question, “why this
happened?”, or “Why this innocent child”, “why him/her – He/She didn’t do anything wrong”
or “why me? I didn’t do anything wrong”. Instead of expending all the energy on the
negativity of the situation, it is far healthier to accept the situation. There are no answers to
these “why” questions and no one can verify the answer either. Self-pityis a dangerous trap.
Feeling guilty is another unhealthy path to caregiver burden. It is better to be away from
people who try to focus on the “why” and come with solutions of their own – which may
include superstitious practices and sorcery.
Acknowledge and celebrate small victories: Try to find happiness in the small victories.
Acknowledge the different ways by which the family has become closer, even if the outcome
may not be what we want. The need to make the care recipient feel loved must never be
underestimated. Focus on the things that you can control rather than things that you cannot.
Get the appreciation you need: Studies have consistently showed that appreciation goes a
long way in making the caregiver mentally and physically healthier and stronger. This is true
whether it is from the care recipient or from other close relatives and friends. If the caregiver
is not getting the appreciation, make a mental list of all the positive things that you are
providing, and applaud your own efforts. If the care recipient is someone who cannot

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respond, it is important for the caregiver to think about how the care recipient would have
responded to your care if he/she could. Talk to family and friends who will be supportive.
Ask for caregiving help: Friends and family may not know what is needed by the caregiver.
Being truthful to what is going on and what help is needed is useful. There are well-wishers
who honestly do not know how to help. Enlist friends and relatives who live close by to run
errands when ever possible. By participating in one’s care and allowing one to participate in
the care, responsibilities can be shared, and willing friends and relatives can have the
satisfaction of having helped take care. In elderly people with dementia or Alzheimer’s, a
sitter is all that is needed to enable the primary caregiver to take some well-deserved break
even if it is for a short while. A ready list of tasks can be written down and help sought when
anyone is willingly asking for help. Don’t be shy in accepting help.
Take care of self: It is a well-known fact that laughter is the best medicine. A little laughter
goes a long way. Find ways to find a little happiness – whether it is going for a walk, or going
to the beach, reading a funny book, or what all women like to do – watch “serials”, go for
shopping, or go for a movie. It is important to maintain personal relationships and share
feelings. Sharing feelings is cathartic. Step away from home and allow yourself to have some
fun.
Take care of your own health: Find a few minutes to exercise and relax even if it is in the
middle of the day. There are several studies that have demonstrated the benefits of
meditation, yoga and mindful breathing. It only requires a few minutes. Keep your
appointments with the doctor. There is the tendency to postpone one’s doctor’s
appointments. Those must be kept. Stress can result in the release of stress hormones that can
result in fat deposits resulting in obesity, increased blood pressure, and increased cholesterol.
Therefore, skipping doctor’s appointments can end up in undetected metabolic and
cardiovascular problems. Get at least 6 to 7 hours of restful sleep. Eat well. Small frequent
meals of fresh fruits and vegetables, fish, lean proteins, and nuts help to get us rejuvenated
unlike coffee and other beverages which only give a boost for a short time.
Belong to a support group either locally or online. It is possible to find like minded people, and
tips that will help with dealing with a long-term problem like cancer or other chronic illness.
By listening to people and talking about caregiver and care recipient issues, one can feel
supported and most of all we can know that we are not alone.
REFERENCES
Melinda, S. (2018). Retrieved from https://www.helpguide.org/articles/stress/caregiver-
stress-and-burnout.htm
www.cancerindia.org.in/statistics
https://www.caregiver.org/takng-care-you-self-care-family-caregivers.

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 MERCURY POLLUTION IN INDIA: A REVIEW

DR. T. GEETHA

Assistant Professor, Dept. of Chemistry, St. Mary’s College, Thrissur

Introduction
Mercury is an element that was known to man from ancient times. Its use has been
documented in Indian, Chinese and Egyptian civilizations. Although ascribed miraculous
properties by ancient civilization it has no essential biological function. It is a highly toxic
element and is cumulative in nature. It is a known neurotoxin and chronic exposure can
lead to tremors Extreme mood changes, hearing loss and blindness. Thus exposure to even
small amount of mercury is hazardous to health.
Natural emissions of Hg to the atmosphere occur from areas with ongoing geologic
activity that includes both volcanic activity and geothermal activity. It can also be released
into the atmosphere from substrates with elevated Hg concentrations (>100 ppb) due to
mineralization as a result of geologic processes that occurred in the past (Gustin et. al.,
2008). Mercury is also mobilized into the biosphere by anthropogenic activities like
artisanal and small scale gold mining, fossil fuel combustion etc. The global emissions
inventory for 2010 estimates that 1960 tonnes of mercury was emitted to the atmosphere
as a direct result of human activity. Artisanal and small scale gold mining accounts for 37%
of mercury emitted to the atmosphere followed by burning of fossil fuel, predominantly
coal, which accounts for 25%. Other major sources are mining, smelting, & production
of metals, cement production, consumer product waste etc ( UNEP 2013).

Environmental and Health aspects

Mercury may exist in various forms like elemental (Hg), inorganic (Hg2+) and organic
forms. Humans are exposure to elemental or inorganic Hg from various sources. Inhalation
is a major exposure route of elemental mercury in the form of mercury vapor. Inhaled
mercury vapor is readily absorbed in the lungs, and quickly diffused into the blood and
distributed into all of the organs of the body, primarily in brain and kidney. Inorganic
mercury has recently been reported from eye makeup, cleaning products, cosmetic soaps,
creams and ointments like skin lightening products. These products usually contained
mercury and mercury salts such as ammoniated mercury, mercury iodide, mercurous
chloride, mercurous oxide, and mercuric chloride. Mercury salts inhibit melanin formation
by competing with copper in tyrosinase resulting in skin lightening. Mercury poisoning
after the use of skin-lightening products has been reported from several countries
including Africa, Europe, US, Mexico, Australia, and China (Park & Zheng, 2012).
The common organic forms of mercury are monomethylmercury (MMHg, CH3Hg+)
and dimethylmercury (DMHg, CH3HgCH3). In the biogeochemical cycle of Hg, these species
may all interchange in atmospheric, aquatic and terrestrial environments Although all
forms of mercury are poisonous, the ecological and human health effects of mercury are
generally related to the environmental transformations of inorganic mercury to the toxic
and biomagnification-prone MMHg. It is toxic, more stable and readily accumulates in fish
tissue The main exposure pathway of Hg to humans is through the consumption of marine
fishery products (Leermakers, et. al,. 2005). MMHg is not only toxic to humans, it is also
toxic to wildlife. Ethylmercury (EthHg) although toxic is not significantly absorbed and
accumulated in fish tissue.
Instance of methylmecury contamination to wildlife has been reported from north
America, artic Canada, China, India etc. (Eagles-Smith, et. al., 2016, Scheuhammer, et. al.,
2015, Ng, et. al.,2018, Ramasamy et. al., 2017).

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Studies in India
The studies in India on prevalence of mercury in wildlife and human are few in
number. Analysis of water, sediment and fish samples from Kodai Lake from the tourist
resort of Kodaikkanal, India, showed elevated levels of mercury even 4 years after the
stoppage of mercury emissions from the thermometer factory (Karunasagar, et. al., 2006).
Another study on mercury content in river water of palakad District Kerala, found that the
amount of elemental mercury in two of the sediment samples taken from Korayar river and
Kalpathypuzha river was found to be 0.02mg/l which is greater than the maximum
permissible limit of 0.01mg/l. (Sreelakshmi, & Ramachandran, 2015).
To evaluate the health risk to people in Machilipatnam Coast, Krishna, et. al., (2014)
estimated the “Target Hazard Quotient” (THQ) of heavy metal in fish muscle and daily fish
consumption. They concluded that concentration of the metals in fish muscle from
Machilipatnam coast pose to health hazards to the consumers. A study by Ramasamy on
total and methyl mercury in the water, sediment, and fishes of Vembanad, a tropical
backwater system in India, found that that the mercury levels in the edible fishes of
Vembanad Lake can pose serious health impacts to the human population (Ramasamy et.
al., 2017). Similarly mercury content in shellfish at Pulicat lake did not exceed the safe limit
but continuous consumption of large quantities of shellfish from the lake can lead to
mercury toxicity ( K. Dhinamala et al., 2017).
Studies that measure the bioaccumulation of mercury in humans are fewer. A study
on Sunderban wetland area found that Hair Hg conc. in residents of Sundarban and Calcutta
was considerably higher than concentration reported in the U.S. & German population
(Chatterjee, et. al., 2014). The use of hair specimens to evaluate Hg exposure is a well-
established method in population studies. Hair sequesters MeHg during its formation thus
measurement of Total Hg in hair indicates the cumulative mid- to long-term average
exposure during previous months (Boerleider, et. al., 2017). An investigation has been
performed in order to ascertain the hair Hg levels among the people living at the terai belt
of North India. Total hair Hg was found to be significantly associated with age, gender and
fish consumption frequency. 98 % of the total sample had hair Hg concentrations less than
1.0 µg/g, i.e, within safe dose, whereas only 2 % had Hg concentrations greater than 1.0
µg/g, thereby exceeding the safe dose. ( Masih, A., et. al., 2016).

Conclusion
Considering the toxicity of mercury and its ubiquitous nature more work is needed to
adequately assess the extent of the mercury pollution in India and its effect on wildlife and
humans.

Reference
Assessment, U.G.M. (2013). Sources, emissions, releases and environmental
transport. UNEP Chemicals Branch, Geneva, Switzerland, 42.
Boerleider, R., Roeleveld, N., & Scheepers, P. (2017). Human biological monitoring of
mercury for exposure assessment. AIMS Environmental Science, 4(2), 251-276.
Chatterjee, M., Basu, N., & Sarkar, S. K. (2014). Mercury exposure Aasessment in fish and
humans from Sundarban Mangrove Wetland of India.
Eagles-Smith, C. A., Wiener, J. G., Eckley, C. S., Willacker, J. J., Evers, D. C., Marvin-DiPasquale,
M., ... & Jackson, A. K. (2016). Mercury in western North America: A synthesis of
environmental contamination, fluxes, bioaccumulation, and risk to fish and wildlife. Science
of the Total Environment, 568, 1213-1226.

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Dhinamala, K., Shalini, R., Pushpalatha, M., Arivoli, S., Samuel, T., & Raveen, R. (2017).
Mercury accumulation in the gills and muscles of six species of shellfish from Pulicat lake,
Tamil Nadu, India.
Gustin, M. S., Lindberg, S. E., & Weisberg, P. J. (2008). An update on the natural sources and
sinks of atmospheric mercury. Applied Geochemistry, 23(3), 482-493.
Karunasagar, D., Krishna, M. B., Anjaneyulu, Y. A., & Arunachalam, J. (2006). Studies of
mercury pollution in a lake due to a thermometer factory situated in a tourist resort:
Kodaikkanal, India. Environmental pollution, 143(1), 153-158.
Krishna, P. V., Jyothirmayi, V., & Rao, K. M. (2014). Human health risk assessment of heavy
metal accumulation through fish consumption, from Machilipatnam Coast, Andhra Pradesh,
India. International Research Journal of Public and Environmental Health, 1(5), 121-125.
Leermakers, M., Baeyens, W., Quevauviller, P., & Horvat, M. (2005). Mercury in
environmental samples: speciation, artifacts and validation. TrAC Trends in Analytical
Chemistry, 24(5), 383-393.
Masih, A., Taneja, A., & Singhvi, R. (2016). Exposure profiles of mercury in human hair at a
terai belt of North India. Environmental geochemistry and health, 38(1), 145-156.
Ng, C. K. Y., Lam, J. C. W., Zhang, X. H., Gu, H. X., Li, T. H., Ye, M. B., ... & Lam, I. K. S. (2018).
Levels of trace elements, methylmercury and polybrominated diphenyl ethers in foraging
green turtles in the South China region and their conservation implications. Environmental
Pollution, 234, 735-742.
Park, J. D., & Zheng, W. (2012). Human exposure and health effects of inorganic and
elemental mercury. Journal of preventive medicine and public health, 45(6), 344.
Ramasamy, E. V., Jayasooryan, K. K., Chandran, M. S., & Mohan, M. (2017). Total and methyl
mercury in the water, sediment, and fishes of Vembanad, a tropical backwater system in
India. Environmental monitoring and assessment, 189(3), 130.
Scheuhammer, A., Braune, B., Chan, H. M., Frouin, H., Krey, A., Letcher, R., ... & Wayland, M.
(2015). Recent progress on our understanding of the biological effects of mercury in fish
and wildlife in the Canadian Arctic. Science of the Total Environment, 509, 91-103.
Sreelakshmi, K. S., & Ramachandran, P. N. (2015). River water mercury content analysis at
palakkad district and the design of mercury adsorbing cfl disposal system. International
Research Journal of Engineering and Technology, 2 (5), 729 -733.

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 STUDIES ON THE TRENDS IN BODY MASS INDEX AMONG TEENAGE GIRLS
OF THE SAME AGE GROUP OVER YEARS

DR. THANUJA A MATHEW

Assistant Professor, Department of Zoology, Little Flower College, Guruvayoor

In developed and developing countries, the body weight gained during adolescence
tends to linger into adulthood with the risk of developing chronic diseases in later life (1)
The trend to increase the Body Mass Index (BMI) among teenagers is considered to be an
important health issue leading to overweight and obesity. As per the National Institute of
Health For women desirable body mass index is 21-23. Obesity (20% above the desirable
range) begins at 27.5. Serious obesity (40% above) begins at 31.5. But studies of
Kesavachandran et al (2012) show that in Indian women higher body fat percentage is
observed within WHO proposed normal limits of BMI. High BMI in adolescence could
seriously impair successful transitions into adulthood. Previous studies show that there is a
prevalence of obesity among adolescents of age group between twelve to nineteen years and
the bad side of it is it may cause social and behavioral changes during transition into
adulthood. This becomes more complex when trends are compared according to
socioeconomic indicators. Despite that poor physical health, less social skills, susceptibility to
diseases etc are associated with this. On the other side, the decreased BMI due to underweight
and improper nutrition also poises severe health problems.
Every year when new students enter into our department we calculate their
BMI and record it. The objective was to examine trends in BMI among the teenage students
of the same age group. For the present study the BMI values of students of last seven years
were compared to find the trends in BMI values over the time period. Body Mass Index (BMI)
is a measure of body weight adjusted for height and it is calculated by dividing Weight in
kilograms by square meter of Height. The mean BMI value of each year was calculated for
comparison.

Mean BMI falls in Normal Range in all Years

2011- 2012- 2013- 2014- 2015- 2016- 2017-
14 15 16 17 18 19 20
20.17 20.9 21.15 20.35 20.55 21.26
20.87

% of students falling under different BMI Ranges over the years

BMI 2011- 2012- 2013- 2014- 2015- 2016-

Range 14 15 16 17 18 19 2017-20
< 18.5 34.38 23.53 21.7 21.21 23.33 19.44 21.62
18.5-
24.9 56.25 76.47 95.65 63.63 76.60 66.67 64.86
25-29.9 9.38 0 0 12.12 0 11.11 10.81
>30 0 0 0 3.03 0 2.77 2.70

Percentage of students under different BMI Ranges in the First and last year of the present
study

BMI Range 2011-14 2017-20

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 < 18.5 34.38 21.62
18.5-24.9 56.25 64.86
25-29.9 9.38 10.81
>30 0 2.70

Over the years there is a 12.76 % reduction in the number of students with low BMI .
There is 8.61 % increase of students with normal BMI range. 1.43 % increase of students
with above normal BMI range and 2.70 % increase of students with high BMI. Several
recent reports that have shown a plateau in the prevalence of overweight and obesity among
adolescents [2-4] Previous studies have shown that increased BMI value is associated with
life-style factors. Being overweight or obese is a growing public health threat because of its
significant contribution to the burden of chronic diseases, including type 2 diabetes,
cardiovascular disease, hypertension, and some types of cancers (5,6) It is assumed that in the
present study also the increasing trend of BMI over time period might be due to changed
lifestyles of the present day teenagers. It is believed that many qualitative and quantitative
factors like increased morbidity, lack of exercise, junk food, lethargic life style, prolonged
sitting with mobile phones, spending hours and hours in front of TV and computers,
reduced quality of life etc. would have played a role. The follow up studies will include
recommendations for balanced and nutritious diet with low calorie intake, healthy habits
and life styles.

References
1. Gloria Valeria da Veiga, PhD, Adriana Simone da Cunha, MPH, and Rosely Sichieri,
Trends in Overweight Among Adolescents Living in the Poorest and Richest Regions of
Brazil. Am J Public Health. 2004 September; 94(9): 1544–1548.
2. Olds TS, Tomkinson GR, Ferrar KE, Maher CA. Trends in the prevalence of childhood
overweight and obesity in Australia between 1985 and 2008. Int. J. Obes.
(Lond) 2010;34:57–66.
3. .Ogden CL, Carroll MD, Flegal KM. High body mass index for age among US children and
adolescents, 2003–2006. JAMA. 2008;299:2401–2405.
4. .Peneau S, Salanave B, Maillard-Teyssier L, Rolland-Cachera MF, Vergnaud AC, Mejean
C, Czernichow S, Vol S, Tichet J, Castetbon K, Hercberg S. Prevalence of overweight in 6-
to 15-year-old children in central/western France from 1996 to 2006: trends toward
stabilization. Int. J. Obes. (Lond) 2009;33:401–407.
5. World Health Organization Obesity: preventing and managing the global epidemic.
Report of a WHO consultation. World Health Organ. Tech. Rep. Ser. 2000;894:1–
253. (pubmed)
6. Diet, Nutrition and the Prevention of Chronic Disease Joint WHO/FAO Expert
Consultation. World Health Organization; Geneva, Switzerland: 2003. pp. 1–143.

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 CANCER A SERIOUS TREAT TO MANKIND

FRENY JACOB*

ASSISTANT PROFESSOR, DEPT OF ZOOLOGY

VIMALA COLLEGE (AUTONOMOUS) THRISSUR

Cancer is the second leading cause of death in the world after cardiovascular diseases.
Today, millions of cancer people extend their life due to early identification and treatment.
Cancer is not a new disease and has afflicted people throughout the world. The word cancer
came from a Greek words karkinos to describe carcinoma tumors by a physician Hippocrates
(460–370 B.C), but he was not the first to discover this disease. Some of the earliest evidence
of human bone cancer was found in mummies in ancient Egypt and in ancient manuscripts
dates about 1600 B.C. The world’s oldest recorded case of breast cancer hails from ancient
Egypt in 1500 BC and it was recorded that there was no treatment for the cancer, only
palliative treatment. According to inscriptions, surface tumors were surgically removed in a
similar manner as they are removed today.Cancer develops when normal cells in a particular
part of the body begin to grow out of control. There are different types of cancers; all types of
cancer cells continue to grow, divide and re-divide instead of dying and form new abnormal
cells. Some types of cancer cells often travel to other parts of the body through blood
circulation or lymph vessels (metastasis), where they begin to grow. Generally cancer cells
develop from normal cells due to damage of DNA. Most of the time when ever DNA was
damaged, the body is able to repair it, unfortunately in cancer cells, damaged DNA is not
repaired. People can also inherit damaged DNA from parents, which accounts for inherited
cancers. Many times though, a person’s DNA becomes damaged by exposure to something in
the environment, like smoking.Cancer generally forms as a solid tumor. Some cancers like
leukemia (blood cancer) do not form tumors. Instead, leukemia cells involve the blood and
blood forming organs and circulate through other tissues where they grow. Not all tumors are
cancerous, some tumors are benign (non-cancerous). Benign tumors do not grow and are not
life threatening. Different types of cancer cells can behave differently. The risk of developing
many types of cancers can be reduced by changes in lifestyle by quitting smoking and eating
low fat diet. If cancer is identified in early stage it is easy to treat and may have better chances
for living many years.

Discovery of Oncogenes and Tumor Suppressor Genes

By the middle of the 20th century, scientists began solving the complex problems of
chemistry and biology behind cancer. Watson and Crick were received Nobel Prize in 1962 for
the discovery of DNA helical structure. Later scientists learned how genes were worked and
how they could be damaged by mutations. Scientists identified that cancer could be caused by
chemicals (carcinogens), radiation, viruses and also inherited from ancestors. Most
carcinogens damage the DNA, which led to abnormal growth of cells. Cancer cells with
damaged DNA do not die, where as normal cells with damaged DNA die. During the 1970s,
scientists discovered 2 important families of genes
Oncogenes are genes that cause normal cells to grow out of control and become cancer
cells. They are formed by the mutations of certain normal genes of the cell called
protooncogenes (genes that normally control how often a cell divides and the degree to which
it differentiates). Tumor suppressor genes are normal genes that control cell division, DNA
repair and inform cells when to die. When a tumor suppressor gene doesn’t work properly,
cells can grow out of control, which can lead to cancer. Scientists identified oncogenes and
tumor suppressor genes that are damaged by chemicals or radiation. For example, the
discovery of breast cancers genes BRCA1 and BRCA2. Other genes have been discovered that

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are associated with cancers that run in families, such as thyroid, pancreas, rectum, colon,
kidney, ovary and skin cancers.

Modern Carcinogens
In 1911 Peyton Rous discovered a type of cancer in chickens that was caused by Rous
sarcoma virus. In 1915, cancer was induced for the first time in rabbits by coal tar applied to
skin. 150 years had passed since the most destructive source of chemical carcinogens known
to man, tobacco (nicotin) was rediscovered as a carcinogen. As of today more than 100
carcinogens (chemical, physical, and biological) were identified. From many of these
carcinogens associations recognized long before, scientists understood the mechanism by
which the cancer was produced. The continuing research is discovering new carcinogens,
explaining how they cause cancer and providing insight into ways to prevent it.

Cancer causing viruses

(1) Hepatitis B or C viruses cause liver cancer. (2) Epstein-Barr viruses cause non-Hodgkin
lymphomas and nasopharyngeal cancer. (3) The human immunodeficiency virus (HIV) is
associated with Kaposi Sarcoma and non-Hodgkin lymphoma. (4) Human papilloma viruses
(HPVs) are associated with cervix, vulva and penis cancers.

Cancer screening and early detection

The first cancer screening test to be widely used was the Pap test. The test was first developed
by George Papanicolaou as a method in understanding the menstrual cycle. He also identified
Pap tests potential for early detection of cervical cancer. In 1960s mammography was
developed for identification of breast cancer. Later early detection of cervix, breast, colon,
rectum, endometrium, prostate, thyroid, oral cavity, skin, lymph nodes, testes, and ovaries
cancers were identified and practiced in the clinic.

Cancer Treatment Methods

Surgery and use of modern technology
Ancient surgeons knew that cancer would usually come back after it was removed by surgery.
Many people even today consider that many types of cancers are incurable and may delay to
consult a doctor in early stage. After anesthesia was invented in 1846, surgeons Bilroth,
Handley and Halsted led cancer operations by removing entire tumor together with lymph
nodes. Later Paget a surgeon reported that cancer cells were spread from primary tumor to
other places through the blood stream (metastasis). Understanding the mechanism(s) of
cancer spreading became a key element in recognizing the limitations of cancer surgery. In
the beginning of 1970s, progress in ultrasound (sonography), computed tomography (CT
scans), magnetic resonance imaging (MRI scans) and positron emission tomography (PET
scans) have replaced most exploratory operations. Using miniature video cameras and
endoscopy, surgeons can remove colon, esophagus and bladder tumors through tubes.
Recently, less invasive ways of destroying tumors without removing them are being studied
including liquid nitrogen spray to freeze and kill cancer cells (cryosurgery). Lasers also can be
used to cut the tumor tissue of cervix, larynx, liver, rectum, skin and other organs.

Chemotherapy
During the last decades of the 20 th century, surgeons developed new methods for cancer
treatment by combining surgery with chemotherapy and/or radiation. Roentgen discovered
X-rays after 50 years of anesthesia was discovered. Later doctors identified that nitrogen
mustard can kill rapidly proliferating lymphoma cancer cells. Over the years, use of many
chemotherapy drugs has resulted in the successful treatment of many types of cancers. Now

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new approaches are being studied to reduce the side effects of chemotherapy including use of,
(a) new combinations of drugs, (b) liposomal and monoclonal antibody therapy to target
specifically cancer cells, (c) chemoprotective agents to reduce chemotherapy side effects, (d)
hematopoietic stem cell transplantation and (e) agents that overcome multidrug resistance.

Hormonal therapy
In 1878 Thomas Beatson discovered that the breasts of rabbits stopped producing milk after
he removed ovaries. Later scientists identified that dramatic regression of metastatic prostate
cancer following removal of the testes. Now new classes of drugs (aromatase inhibitors, LHRH
analogs) are being used to treat prostate and breast cancers. How hormones influence growth
of cancer has guided progress in developing as well as reducing the risk of breast and prostate
cancers.

Radiation therapy
In 1896 Roentgen discovered “X-ray” and after 3 years later radiation was used for cancer
diagnosis and in treatment. In the early 20th century, researchers discovered that radiation
could cause cancer as well as cure it. Now several radiation therapies are being used, these
include: (a) conformal proton beam therapy (proton beam will be used for killing tumor cells
instead of X-rays); (b) stereotactic surgery and stereotactic therapy (gamma knife can be used
to deliver and treat common brain tumor); (c) intra-operative radiation therapy (cancer has
been removed surgically followed by radiation to the adjacent tissues).

Adjuvant therapy
It is the use of chemotherapy after surgery to destroy the few remaining cancer cells in the
body. Adjuvant therapy was used in colon and testis cancers.
Immunotherapy
Use of biological agents that mimic some of the natural signals that body uses to control tumor
growth is called immunotherapy. These natural biological agents can now be produced in the
laboratory including interferons, interleukins, cytokines, endogenous angioinhibitors and
antigens. In 1990s scientists produced therapeutic monoclonal antibodies rituximab and
trastuzumab that specifically targeted lymphoma and breast cancer cells. At present scientists
are developing vaccines to boost the body’s immune response against cancer cells.
Targeted Cancer Treatments
Until late 1990’s most of the drugs used in cancer therapy worked by killing cancer cells.
Unfortunately chemotherapy agents used, also killed some normal cells and had a greater
effect on cancer cells.
Growth signal inhibitors
Growth factors will inform cells when to grow and divide. Around 1960s growth factors role
in fetal growth and tissue repair was recognized and later scientists realized that abnormal
levels of growth factors contribute to the growth of cancer cells. During 1980’s scientists
recognized that changes in growth factors signaling leads to abnormal behavior of cancer
cells. Present targeted therapies that block growth factor signals are trastuzumab, gefitinib,
imatinib and cetuximab.
Drugs that induce apoptosis
Apoptosis is a natural process through which cellular DNA gets damaged and cells ultimately
will die where as apoptosis induced drugs can force cancer cells to die without DNA repair.
Endogenous angioinhibitors
Angiogenesis is the formation of new blood vessels from existing vessel. Normally
angiogenesis is a healthy process, that help the body to heal wounds and repair damaged body
tissues, whereas in cancerous condition this process supports new blood vessel formation
that provide a tumor with its own blood supply, nutrients and allow it to grow.

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Angioinhibition is a form of targeted therapy that uses drugs to stop tumors from making new
blood vessels. This concept was first proposed by Judah Folkman from Harvard Medical
School, but it wasn’t until 2004 that the first angioinhibitor bevicizumab was approved for
clinical use. At present there are about 25 endogenous angioinhibitors in clinical trials and
many more in preclinical studies for the treatment of cancer. There are two general categories
of angioinhibitors: (i) antibodies or small molecules that target pro-angiogenic factors of
tumor cells such as VEGF, bFGF or PDGF, and (ii) endogenous angioinhibitors such as
thrombopondin-1, angiostatin, interferons, endostatin, arresten, canstatin and tumstatin that
inhibit angiogenesis by targeting vascular endothelial cells. We have discovered several
angioinhibitors signaling mechanisms and their significance for the treatment of cancer.

References
1.Angiogenesis inhibitors from Wikipedia, the free encyclopedia.
2. Angiogenesis Inhibitors Therapy: National Cancer Institute. A fact sheet that describes the
process of eliminating the blood supply to tumors. Web site accessed at:
www.cancer.gov/clinicaltrials/digestpage/angiogenesis-inhibitors.
3. Contran R, Kumar V, Robbins S. Pathologic Basis of Disease. 4 1989.
4. Diamandopoulus GT. Cancer. An historical perspective. Anticancer Res. 1996;16:1595–
1602.
5. Kufe DW, Pollock RE, Weichselbaum RR, Bast RC, Jr, Gansler TS. Cancer Medicine. Decker
Inc; 2003.
6. Encyclopedia Britannica. See entries on Medicine, History of Cancer.
7. Gallucci BB. Selected concepts of cancer as a disease. From the Greeks to 1900. Oncol Nurs
Forum. 1985;12:67–71.
8. Kalluri R. Basement membranes: structure, assembly and role in tumour angiogenesis. Nat
Rev Cancer. 2003;3:422–433.
9. Kardinal C, Yarbro JA. Conceptual history of cancer. Semin Oncol. 1979;6:396–408.
10. Lyons AS, Petrucelli RJ. Medicine: An Illustrated History. New York: Harry N. Abrams
Publishers; 1978.
11. Progress against cancer. 2009. Web site accessed at:
http://www.cancer.net/patient/Advocacy%20and%20Policy/Treatment Advances
Timeline.pdf.
12. Shimkin MB. For sale by the Superintendent of Documents. U.S. Printing Office;
Washington D.C: 1976. Contrary to Nature: Cancer; p. 20401. DHEW Publication No (NIH) 76–
720.
13. Sudhakar A, Boosani CS. Signaling mechanisms of endogenous angiogenesis inhibitors
derived from type IV collagen. Gene Regulation and System Biology. 2007;1:217–226.
14. Sudhakar A, Boosani CS. Inhibition of tumor angiogenesis by tumstatin: insights into
signaling mechanisms and implications in cancer regression. Pharm Res. 2008;25:2731–2739.
15. Sudhakar A. The matrix reloaded: new insights from type IV collagen derived endogenous
angiogenesis inhibitors and their mechanism of action. J Bioequiv Availab. 2009;1:52–62.
16. The history of cancer. 2009. Web site accessed at:
http://www.bordet.be/en/presentation/history/cancer_e/cancer1.htm.
17. Timeline: Milestones in cancer treatment. CureToday. 2009. Web site accessed at:
http://www.curetoday.com/index.cfm/fuseaction/article.show/id/2/article id/631.
18. Halsted WS, Young HH, Clark JG. Early contributions to the surgery of cancer. Johns
Hopkins Med J. 1974;135:399–417.

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 A STUDY ON THE THERAPEUTIC BENEFITS OF READING IN RELATION TO
DEPRESSION AND WELL BEING

JISNA JOSE

Librarian,Vimala College (Autonomous) Thrissur – 9

Introduction
In the modern age, change in the standard of living leads to life style diseases. Then
proper work outs become essential to reduce the fat in the body. Just like muscles, the brain
benefits from good work out. And reading is more neurobiologically demanding than
processing images or speech. Reading has immense impact on brain. It is like a super food to
brain. Reading refreshes the mind as the rain refreshes the plants. It not only refreshes the
mind but keeps the memory sharp, reduces stress level, improves brain function, increases
the attention span of brain, your learning capacity nimble, etc. A literate mind is a more
complex one. ‘There’s a richness that reading gives you’, Wolf says, “An opportunity to probe
more than any other medium I know of. Reading is not being content with the surface.” This
article will highlight to you about the importance of reading, how reading helps your brain
and your brain in turn benefits you as genuine and authentic human being.
Effective Reading and Its Importance in Life
Reading is a complex activity that involves both perception and thought. Reading
consists of two related processes: word recognition and comprehension. Word recognition
refers to the process of perceiving how written symbols correspond to one’s spoken language.
Comprehension is the process of making sense of words, sentences and connected text. In
other words reading is a complex cognitive process of decoding symbols in order to construct
or derive meaning. It is a means of language acquisition, of communication, and of sharing
information and ideas. Like all language, it is a complex integration between the text and the
reader which is shaped by the readers’ prior knowledge, experiences, attitude, and language
community which is culturally and socially situated. The reading process requires continuous
practice, development and refinement.
Reading plays a fundamental role in the development of a human mind. It enhances
imagination and develops creative side of people. So a pen is mightier than a sword. Good
reading helps to build up a positive self image. So reading is considered as a very good
exercise of mind. It keeps our mental faculties constantly engaged and it helps to overcome all
depressed feeling of mind. Reading also hones language skills and improves the vocabulary.
Creativity stems from diverse reading and the ability to think out the box. It is how we
discover new things
Different Kinds of Reading
Reading is a vital skill, without reading it is difficult to gain knowledge almost every
person can benefit from some type of reading. Reading is not that simple. It is not only about
looking though the content, but also to understand and comprehend it. The various types of
reading are given below.
 Skimming
Skimming is where the reader reads quickly taking minimum pauses, and do
not attempt to look in to all the details and focus on the central idea and connected
details of the text message. While skimming the focus is just on the starting line or the
last of any paragraph and quickly viewing the subheadings and pictures, to get an
overall idea.
 Scanning

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 Scanning is a type of leading that gives the reader sufficient time to look into the
central idea and the supplementary ideas linked with it. The reader should carefully
look for necessary details. This is an advanced skill that can be polished.
To gain expertise in scanning:
 The first step is to know the purpose before you read
 Adequate concentration is also an essential requirement
 The ability to use guides and aids, and ability to understand the organizational
procedures
All this may help in improving scanning skills.
 Intensive Reading
Intensive reading is used on shorter texts in order to extract specific
information. It includes very close accurate reading for detail. Intensive reading skill is
applied to grasp the details of specific situation. In this case, it is important that to
understand each word, number or fact. A book keeping report, an insurance claim, a
contract are examples of intensive reading.
 Extensive Reading
Extensive reading is used to obtain a general understanding of a subject and it
includes reading longer texts for pleasure, as well as subject books. Extensive reading
helps to improve general knowledge and it assists to keep the mind happy. There is no
need of understand each word but it increases the mental power and also helps to
forget all depressed thoughts to improve mental health.

Book is the Super Food of Brain

Here’s a simple question-answer it honestly, because your response could boost the
amount of pleasure in your daily life, delay dementia, and even help you live longer: How
many hours did you spend reading books last week? This question has arrived in thousands of
U.S. homes every other year since 1992 as part of the University of Michigan’s Health and
Retirement Study (HRS). A minor item on a massive survey of more than 20,000 retirees, it
had long gone ignored in the analysis of elder brain health. But in 2016, when researchers at
the Yale School of Public Health dug into 12 years of HRS data about the reading habits and
health of more than 3,600 men and women over the age of 50, a hopeful pattern emerged:
People who read books—fiction or nonfiction, poetry or prose—for as little as 30 minutes a
day over several years were living an average of two years longer than people who didn’t read
anything at all. Odder still, book readers who reported more than three hours of reading each
week were 23 percent less likely to die between 2001 and 2012 than their peers who read
only newspapers or magazines.
If you’re reading this, it’s safe to assume you don’t need to be sold on the merits of the
written word. You may already be familiar with recent findings that suggest children as young
as six months who read books with their parents several times a week show stronger literacy
skills four years later, score higher on intelligence tests, and land better jobs than nonreaders.
But recent research argues that reading may be just as important in adulthood. When
practiced over a lifetime, reading and language-acquisition skills can support healthy brain
functioning in big ways. Simply put: Word power increases brain power.
To understand why and what each of us can do to get the most out of our words, start
by asking the same question the Yale team did: What is it about reading books in particular
that boosts our brain power whereas reading newspapers and magazines doesn’t? For one,
the researchers posit, chapter books encourage “deep reading.” Unlike, say, skimming a page
of headlines, reading a book (of any genre) forces your brain to think critically and make
connections from one chapter to another, and to the outside world. When you make
connections, so does your brain, literally forging new pathways between regions in all four

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lobes and both hemispheres. Over time, these neural networks can promote quicker thinking
and may provide a greater defense against the worst effects of cognitive decay.
Reading books, especially fiction, has been shown to increase empathy and emotional
intelligence. One 2013 study found that participants who read just the first part or chapter of
a story showed a noticeable increase in empathy one week later, while news readers showed
a decrease. These findings may sound trivial, but they’re not; developing social tools such as
empathy and emotional intelligence can lead to more (and more positive) human interaction,
which in turn can lower stress levels both of which are proved to help you live longer and
healthier.
That’s not to say that magazines, newspapers, and Web articles are without merit.
Reading anything that fills your mind and exposes you to new words, phrases, and facts seems
to carry mental benefits. New research indicates that a large vocabulary may lead to a more
resilient mind by fueling what scientists call cognitive reserve. One way to think about this
reserve is as your brain’s ability to adapt to damage. Just as your blood cells will clot to cover
a cut on your knee, cognitive reserve helps your brain cells find new mental pathways around
areas damaged by stroke, dementia, and other forms of decay. This could explain why, after
death, many seemingly healthy elders turn out to harbor advanced signs of Alzheimer’s
disease in their brains despite showing few signs in life. It’s their cognitive reserve,
researcher’s suspect that may allow some seniors to seamlessly compensate for hidden brain
damage.

Scientific Reasons for Reading is Amazing for Your Health

Since you were a little kid, parents, teachers, and other adults have been telling you
how important reading is — heck, half of my job as a books writer is to convince you how
important it is. But why exactly does it matter so much? Aside from the fact that reading offers
great entertainment, promotes deep thinking, and has the ability to take you anywhere in the
world with the turn of a page, there are also scientific reasons that reading is amazing for your
health.
It’s easy to rattle off all of the reasons we like reading. It's fun, it's relaxing, it's emotional, etc.
But what are the benefits of reading, really? Does turning the pages burn calories and build
muscle? Does reading improve your eyesight? No, it isn't a magic path to weight loss or a cure
for nearsightedness, but believe it or not, there are many links between certain health benefits
and reading. Books have the power not only to inspire, educate, and move people, but also to
make your life better and healthier.
I know that it all sounds too good to be true, but it is, and it turns out that all those
years you've spent curled up on the couch with a book instead of running on the treadmill
might not have been as bad for you as you thought. Don't believe me? Here are six scientific
reasons reading is amazing for you. And just think, you don't even need to sign up for the gym
to do it!

1. It Can Improve Your Memory

According to Ken Pugh, President and Director of Research at Yale's Haskins
Laboratories, reading can be great for your memory. Reading works different parts of the
brain than watching a movie or listening to music does, including those dealing with vision,
language, and associative learning. People who read more have more complex brains. What
does that mean, exactly? Among other things, it means that the mental activity of reading
helps to keep memory sharp.
In addition to helping improve your memory in general, reading can help prevent
Alzheimer's, according to a study at the Rush University Medical Center in Chicago. The study

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shows a link between exercising your brain in mentally challenging ways, like reading, and a
slower rate of decline in memory. In other words, the more you read and stimulate your brain,
the more you can help protect your memory.

2. It Reduces Your Stress Level

You know when you curl up with a good book at the end of the day and you just feel
your stress start to melt away? Well, it turns out there's actually a scientific reason behind it.
According to researchers at the Mindlab International at the University of Sussex, reading for
just six minutes can help reduce stress levels by up to 68 percent. The study found that
participants who read after having their stress elevated became more relaxed than
participants who tried other stress relievers, like walking or listening to music.
According to Dr. Lewis, the person behind the tests, "It really doesn't matter what book
you read, by losing yourself in a thoroughly engrossing book you can escape from the worries
and stresses of the everyday world and spend a while exploring the domain of the author's
imagination." Don't you just feel more relaxed thinking about it?
3. It Can Be Therapeutic
According to consumer behavior researcher Cristel Russell, rereading is especially
good for you. In a study about "re-consumption" — the practice of rereading a book,
rewatching a movie, etc. — researchers found that people who engaged in it weren't just
looking to enjoy their favorite book or film over again, but were instead trying to find new
meaning in them. In other words, revisiting something familiar as a new person offers a new
perspective, and when done right, plenty of therapeutic benefits and an opportunity for self-
reflection as well.
4. It Improves Brain Function
Memory isn't the only part of the brain that can be enhanced by reading. According to a
study at Emory University published in Brain Connectivity, reading has been found to enhance
connectivity in the brain, which in turn improves brain function. The study also found that
when a person is reading fiction, their ability to empathize was improved. Like the
visualization of muscle memory in sports, engaging with fiction helped the reader use their
imagination and put themselves in someone else's shoes.
5. It Increases Your Attention Span
With so many modern distractions, it isn't a surprise people have shorter attention
spans than we used to. But according to neuroscientist Baroness Susan Greenfield, reading
can help with that, at least when it comes to children. Because of the structure of stories (a
beginning, a middle, and an end), reading helps kids' brains process things in sequence and
link cause to effect, which in turn helps them think more clearly and hold their attention
longer.
6. It Can Help You Live Longer
While we still haven't discovered the Fountain of Youth, researchers have discovered
that reading can help keep you young. According to Harvard Medical School's Family Health
Guide, reading, like other mentally stimulating activities, requires mental effort that creates
new connections between nerve cells. Reading can even help you build up a "reserve" that can
come in handy with brain cell loss later in life.
And while it can't help reduce wrinkles, researchers in the United Kingdom have found
that reading in a book club can help you live longer. For people of retirement age, a book club
helps you keep your social connections and makes you engage when you would otherwise be
at risk of withdrawing, providing you with a good support system when needed and an overall
better quality of life.

Therapeutic Benefits of Reading

 Reading is proven to reduce stress and increase relaxation.

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 Reading books, particularly fiction, fully engages the mind and imagination. Any
activity that possesses meditative qualities in which the brain is fully focused on a single
task is proven to reduce stress and enhance relaxation. In a study conducted by the
University of Sussex, individuals who had read for merely six minutes exhibited slower
heart rates, less muscle tension, and reduced stress levels. Dr. David Lewis, the
neuroscientist who conducted the study, reported that reading “is more than merely a
distraction but an active engaging of the imagination as the words on the printed page
stimulate your creativity and cause you to enter what is essentially an altered state of
consciousness.” It turns out getting lost in a good book truly is the ultimate form of
relaxation!
 Reading combats mental decline and Alzheimer’s with old age.
The benefits of reading expand beyond reduced anxiety and stress. Studies have
linked reading to good brain health in old age. Individuals who read regularly across their
lifespan showed increased mental capacity as they aged. Those individuals who read less
frequently throughout their life and did not continue to engage their brains in old age
experienced a mental decline rate that was 48 percent faster than those who kept their
brains active across their lives.
One study found a positive association between cognitive based activities such
as reading and a decreased chance of developing Alzheimer’s disease. Just like the heart,
the brain is a muscle that needs to be taken care of in order to function at its fullest
capacity throughout our lifetimes.
 Doctors have prescribed reading as a treatment for certain mental health
conditions.
One in five adults in the United States experiences a mental illness at some point
in their lives. Reading self help books has proven to be an effective method for helping
adults cope with mental illness. In the UK, doctors have embraced the approach of using
bibliotherapy, or treatment through the use of books, for patients with mental health
conditions. Doctors have been incorporating required reading as part of a patient’s
prescription. The goal is to bring the benefits of reading to millions of patients with
anxiety and depression.
 People, who read often, become more empathetic.
As if stress reduction, improved mental health, and healthy brain function
weren’t enough, reading can also help individuals become more empathetic and increase
their self-awareness. In particular, reading literary fiction can increase one’s
understanding of others and improve relationships. As readers become engrossed in a
storyline, they empathize with characters and learn their motivations and behavior
patterns. This increases a person’s understanding of human behavior which is knowledge
that carries over to life outside of a novel. Furthermore, when readers select novels that
are set in locations with cultures other than their own, they further develop an awareness
of diverse human populations and perspectives.
Effects of Books on Our Brain
Many book lovers will tell you that diving into a great novel is an immersive experience
that will make your brain come alive with imagery and emotions and even turn on your
senses. Similarly reading a spiritual book will make you a peaceful and awesome person. It
sounds thrilling, imaginative and romantic but truth lies behind it. The support and
encouragement books gives to your brain can change the structure of your brain, making it
more effective, enthusiastic, and compassionate and above all you experience and become
what you’ve read. 10 things that happen to your mind when we read:
1. We Capture Images in Our Minds Even without being Prompted:
Reading books allows us to create our own world with vivid imagination. It
allows us to have fun being one with the book and story we are in it. Researchers have

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 said that visual images are simply automatic. Participants can focus better pictures in
their mind if they have read a sentence of it before hand. So when we read we
automatically capture the images of our reading in our mind.

2. Brine Works on Spoken World:

Research has shown that the act of listening a story can boost up our mind.
When a story is told to us our brain get activated with the story and our sensory cortex
light up bringing fresh thoughts and imagination. If we go on reading we experience
what we read and that come alive in our brain. Researcher Jeremy Hsu shares,
“Personal stories and gossip make up 65% of our conversations.” So we should go
ahead, listen to motivating thoughts and read on relevant books we ought to be.
3. Reading About Experience is Almost the Same as Living It:
You must have experienced or felt the story read have an effect in your re in al
life. That is because your brain has experienced it for the brain can’t distinguish
between reading about an experience and actually living it. Reading is the original
reality experience than visual seen. The same neurological regions are stimulated
whether you read or experience it.
4. Different Styles of Reading Create Different Patterns in the Brain:
Your brain is benefited by any type of reading in any Styles but benefits varies
stand ford university researchers have found that close literary reading in particular
gives your brain a workout in multiple complex cognition function and blood flow to
different parts of brain is being increased Reading the book for literary study and
thinking about its value is a good brain exercise, more valuable than just reading for
pleasure.
5. Your Brain can be Expanded by Language:
If you really want to give your brain a work out then just pick out a foreign
language novel. Researchers have tested students from Swedish Armed Forces
Interpreter Academy, where intensive language learning is the norm, and medicine and
cognitive science students at Umea University. Both groups underwent brain scans just
prior to and right after a three month period of intensive study. Interestingly, the
language leaning student’s brain have grown better both in hippocampus and cerebral
cortex within that particular period of time. The brain growth of at different levels in
language students is brought about by efforts in reading.
6. Reading e-books in Seven Days can be Adapted by Your Brain:
If your nature is of reading paper book at first you may feel awkward when your
pick up an e-book. But your brain has the ability and capacity to adapt new technology
within seven days. And the benefit is yours.
7. E-books lack in spatial navigability:
Although your brain can adapt to e-books quickly, that doesn’t mean they offer
the same benefits as a paperback. Specifically, they lack what’s called “spatial
navigability,” physical cues like the heft of pages left to read that give us a sense of
location. Evolution has shaped our minds to rely on location cues to find our way
around, and without them, we can be left feeling a little lost. Some e-books offer little in
the way of spatial landmarks, giving a sense of an infinite page. However, with page
numbers, percentage read, and other physical cues, e-books can come close to the same
physical experience as a paper book.
8. Story structure encourages our brains to think in sequence, expanding our
attention spans:
Stories have a beginning, middle, and end, and that’s a good thing for your brain.
With this structure, our brains are encouraged to think in sequence, linking cause and
effect. The more you read, the more your brain is able to adapt to this line of thinking.

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 Neuroscientists encourage parents to take this knowledge and use it for children,
reading to kids as much as possible. In doing so, you’ll be instilling story structure in
young minds while the brain has more plasticity, and the capacity to expand their
attention span.
9. Reading changes your brain structure (in a good way):
Not everyone is a natural reader. Poor readers may not truly understand the joy
of literature, but they can be trained to become better readers. And in this training,
their brains actually change. In a six-month daily reading program from Carnegie
Mellon, scientists discovered that the volume of white matter in the language area of
the brain actually increased. Further, they showed that brain structure can be
improved with this training, making it more important than ever to adopt a healthy
love of reading.
10. Deep reading makes us more empathetic:
It feels great to lose yourself in a book, and doing so can even physically change
your brain. As we let go of the emotional and mental chatter found in the real world,
we enjoy deep reading that allows us to feel what the characters in a story feel. And
this in turn makes us more empathetic to people in real life, becoming more aware and
alert to the lives of others.
Conclusion
In the eighteenth century, essayists Joseph Adolison and Sir Richard Steele wrote,
“Reading is to the mind what exercise is to the body.” Hundreds of years later, this quote could
not be true. Studies conducted our last few decades have proven the scientific benefits of
reading. Curling up with a good book is not only enjoyable it can positively impact your
mental and emotional health. In today’s world reading a good book is used as a treatment for
mental health. Getting lost in a good book is the ultimate form of relaxation. Reading reduces
stress and anxiety and its effect is the total well being of a person. It is a good habit to be
cultivated, for it will never lead you down but one should be mindful while choosing the kind
of book which will benefit you. Reading good books will make you whole. Individual who read
more books has stronger mental power as they age.

References
1. http://www.oprah.com/health/how-reading-can-improve-your-memory
2. https://www.bustle.com/articles/145922-6-scientific-reasons-reading-is-amazing-
for-your-health
3. https://readingpartners.org/blog/four-compelling-reasons-shut-off-screen-open-
good-book/
4. https://www.rd.com/culture/benefits-of-reading/
5. https://oedb.org/ilibrarian/your-brain-on-books-10-things-that-happen-to-our-
minds-when-we-read/

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 EFFECTS OF SUNSCREEN ON SKIN

LITTY IRIMPAN

Assistant Professor in Physics, St. Mary’s College, Thrissur

littyirimpan@yahoo.co.in

Abstract
In this paper, we discuss about some natural and synthetic sunscreen materials and their effects
on skin. Ultraviolet (UV) radiations causes aberrations in skin. Sunscreens protects the skin
against side effect of the UV radiations. There are natural and synthetic sunscreens. Natural
sunscreens have more absorption than synthetic ones. Among three natural sunscreens, Aloe
vera has maximum UV absorption. Natural sunscreens have less skin aberration compared to
synthetic ones.
Keywords: Ultraviolet radiations, sunscreen, absorption, skin aberration

We are often advised to wear a sunscreen when going out in the sun. Sun protection is
essential, especially to prevent skin cancers, sunburn and premature aging. But, chemical
sunscreens can have side effects and pose risks due to some medications used in them such as
tetracyclines, sulfa drugs, phenothiazines etc. It can cause skin irritation such as redness,
swelling, irritation and itching. Some people develop severe allergic reactions with rashes and
intense itching. This allergic reaction can be the result of chemicals found in sunscreens like
fragrances and preservatives.

Getting sunscreen into the eye can cause pain and irritation. This can also lead to
burning and temporary sensitivity to light. Some claim that chemical sunscreens can also
cause blindness. Sunscreen includes ingredients that can have estrogenic effects on breast
cancer cells. Some sunscreens can have effects on blood estrogens levels. Avoid using
chemical sunscreens on your children, as their skin tends to absorb the chemicals
instantly.Some sunscreens can lead to tightening or drying of the skin and can cause pain in
hairy areas.Sunscreens can cause itchy spots on the skin that tend to develop into bumpy red
rashes. Sometimes, these also turn into pus-filled blisters around the hair follicles.

As mentioned above, there are numerous side effects of sunscreen. The best way to get
rid of such problems is to use natural products that are chemical-free. You can choose from
titanium oxide or zinc oxide or cerium oxide-based sunscreens to keep allergic reactions or
estrogenic effects at bay.
Skin is the largest organ of the body. Skin protects us from microbes and the elements. It helps
to regulate body temperature. It permits the sensations of touch, heat and cold. Skin has three
layers namely epidermis, dermis and hypodermis. Epidermis is the outermost layer of skin
and it provides a waterproof barrier and creates our skin tone. The skin’s colour is created by
melanocytes which are located in the epidermis. Dermis is beneath the epidermis, contains
tough connective tissue, hair follicles, and sweat glands. Hypodermis is the deeper
subcutaneous tissue and is made of fat and connective tissue. Exposure to UV radiation is a
major risk factor for most skin cancers.

Sunlight is the main source of UV rays.There are 3 main types of UV rays namely UVA,
UVB And UVC. UVA radiations include radiations of wavelength ranging from 400-320 nm and
that of UVB radiations is 320-290 nm whereas UVC radiations from 290-200 nm. Almost 95%
of UV radiation in sunlight are UVA and it causes skin damage, tanning effect, skin ageing, skin
cancer. UVB radiations are less than 5% and it causes sunburn and skin cancer. UVC is the

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most damaging type of UV radiation and fortunately it is completely filtered by the
atmosphere and does not reach the earth's surface.

UVB radiations penetrate only to the epidermis whereas UVA radiations penetrate deep into
the epidermis and dermis. If we use a sunscreen, it will either absorb or block the UV
radiation penetration into the skin. So sunscreens are necessary and use of natural sunscreens
avoid side effects to the skin. The natural materials used as sunscreens should be nontoxic,
transparent, economic, easily available and possess high UV absorption.
We selected three natural sunscreens such as aloe vera, cucumber and tender coconut
pulp having the above properties. It is compared with the sunscreen available in the market.
The absorption spectra of the selected sunscreens are studied using spectrophotometer. It is
found that natural sunscreens have more absorption than synthetic ones. Among three
natural sunscreens, Aloe vera has maximum UV absorption. The effects of sunscreen on skin
was studied by the cytology of root- tip cells of onion. It is found that artificial sunscreens
induce mitotic abnormalities. Natural sunscreens have less skin aberration compared to
synthetic ones.

Acknowledgments
The author acknowledge Departments of Botany,Chemistry& Zoologyof St. Mary’s College,
Thrissur for providing Experimental Facility.I thank Ms. Adheena Joshy, M Sc student of St.
Aloysius College for conducting the experiment.

References
1. Kazue T Sukahara et.al., Biol. Pharm. Bull.28(12) 2302—2307 (2005)
2. FredrikPontén et.al., Journal of Investigative Dermatology, 105(3), 402-406 (1995)
3. David Hill et.al., The Lancet, 354(9180), 699-700 (1999)
4. Michelle R. Iannacone et.al., Photodermatology, Photoimmunology & Photomedicine,
30:55–61(2014)

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 SYNTHESIS AND PHARMACOKINETIC STUDIES ON COORDINATION
COMPOUNDS OF CO(II), NI(II), CU(II), ZN(II), CD(II), HG(II), PT(IV) AND PD
(II) WITH A HETEROCYCLIC SCHIFF BASE

BINCY JOSEPH

Department of Chemistry, St. Marys College, Trichur, Kerala

bincychemjoseph@gmail.com

A new heterocyclic Schiff base (E)-4-(2-chlorobenzylideneamino)-6-methyl-3-thioxo-3,

4-dihydro-1, 2, 4-triazin-5(2H)-one (CBMTDT) has been synthesized from 4-amino-6-methyl-
3-thioxo-3, 4-dihydro-1, 2, 4-triazin-5(2H)-one (AMT) and o-chlorobenzaldehyde. Eight
different transition metal complexes of the ligand were prepared. The pharmacokinetic
properties of the synthesized Schiff base and its complexes were studied.

Keywords: Heterocyclic Schiff base, 1, 2, 4-triazine, pharmacokinetic studies

1. Introduction
Schiff bases play an important role in the development of coordination chemistry, as they
readily form stable complexes with most of the transition metal ions. Metal complexes of N
and S containing chelating ligands have attracted considerable attention [1-2] because of their
interesting physicochemical properties, pronounced biological activities and as models of the
metalloenzyme active sites. It is well known that N and S atoms play a key role in the
coordination of metals at the active sites of numerous metallobiomolecules [3-4]. One of the
interesting properties of mercapto substituted triazine is the existence of thiol and thione
tautomeric forms [5]. Triazine derivatives provide a wide range of applications in the field of
optics, herbicides and pharmaceuticals [6-9]. Schiff bases containing different donor atoms
find extensive use as corrosion inhibitors for different metals [10-11].The success of a drug’s
journey through the body is measured in the dimensions of absorption, distribution,
metabolism, and elimination (ADME).The results of ADME prediction obtained from
PreADMET is used to find out toxicity, drug likeness and adme properties of the ligand and its
complexes [12].

The present work illustrates the preparation, and adme studies of a Schiff base ligand,
(E)-4-(2-chlorobenzylideneamino)-6-methyl-3-thioxo-3,4-dihydro-1,2,4-triazin-5(2H)-one
(CBMTDT) and its transition metal complexes of Co(II), Ni(II), Cu(II), Zn(II), Cd(II), Hg(II),
Pt(IV) and Pd(II) ions.

2. Experimental
2.1. Materials
All chemicals used in this study were of analytical grade. The metal salts (acetates/chlorides)
and starting materials for the synthesis of the ligand were obtained from E. Merck.

2.2. Synthesis of the ligand

The ligand (E)-4-(2-chlorobenzylideneamino)-6-methyl-3-thioxo-3, 4-dihydro-1, 2, 4-triazin-
5(2H)-one (CBMTDT) was synthesized in two stages. In the first stage, thiocarbohydrazide
[18] was refluxed with pyruvic acid for 1 hour. The off-white colored product, 4-amino-6-
methyl-3-thioxo-3, 4-dihydro-1, 2, 4-triazin-5(2H)-one (AMT) was filtered washed and
recrystallized. In the second stage, an equimolar mixture of AMT (0.1mol) and o-
chlorobenzaldehyde (0.1 mol) in 250 ml absolute alcohol containing 2 drops of conc. HCl was
heated under reflux for about 3 hours. The reaction

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mixture was cooled, filtered, washed and recrystallized from alcohol. The reaction is shown in
Scheme1.
2.3. Synthesis of complexes
To a hot solution of cobalt acetate (0.01 M) in water, a hot ethanolic solution of CBMTDT (0.02
M) was added drop wise. The mixture was shaken well and refluxed for 5 hours. The resulting
solution was cooled, filtered and washed with water, ethanol and dried. The obtained reddish
brown coloured complex obtained was soluble in DMSO.

2.4. Pharmacokinetic properties

Around half of all drugs in clinical development fail to commercialize because of poor ADME
and toxicity properties. There is increasing interest in the early prediction of ADME
properties, in order to increase the success rate of compounds reaching development. Using
the PreADMET the result of ADME prediction can be used as the most outstanding and
practical guidance for the early drug discovery. The ADME properties of a drug, together with
its pharmacological properties are conventionally viewed as part of drug development—the
process of making a molecule as effective as possible as a medicine. Toxicology—the T in
ADMET—is the art of making sure that the molecule causes no harm. Pharmacokinetic
properties like drug likeness ADME Prediction and Toxicity Prediction were determined using
PreADMET. It is a web-based application for predicting ADME data and building drug like
library using in silico method.

3. Results and discussion

The analytical and physical data of the ligand and its complexes are given in Table1.This
shows that all the metal ions used in this study form 1:2 type complexes with CBMTDT. The
Co(II), Ni(II) and Pt(IV) complexes contain two molecules of water coordinated to the metal,
which are confirmed by thermal and IR data.
3.1. Pharmacokinetic Properties (ADME studies)
The pharmacokinetic properties of the ligand and its selected metal complexes are studied
using ADME and the results are presented in the Tables 5-7.

3.1.1. Drug likeness

PreADMET is an important tool for predicting drug-likeness and discriminating drug-like
compounds and non-drug compounds using certain rules like Lipinski rule/Rule of five, Lead
like rule etc. These rules are based on number of hydrogen bond donors, number of hydrogen
bond acceptors, molecular weight etc to test the solubility and permeability of the compounds
to act as drug. The obtained results are compared with a standard. From these results (Table
5) it is clear that the synthesized schiff base ligand obeys most of the rules and exhibit drug
like property where as the drug-likeness of the metal complexes are very poor [13-16].

3.1.2. ADME Prediction

Adme means absorption, distribution, metabolism and excretion, which are major part of
pharmacokinetics. Among the various in vitro methods for the prediction of oral drug
absorption, caco-2 cell model and MDCK cell models are quite reliable. Human intestinal
absorption data are the sum of bioavailability and absorption, evaluated from the ratio of
excretion or cumulative excretion in urine, bile etc. is very important for identifing the drug
nature. PreADMET predict the percent human intestinal absorption (%HIA) of the
compounds. The results given in Table.6 shows that only the ligand exhibits fairly good
values and all the metal complexes are violating most of the rules and possess out of range
values (* marks) and hence decided not to undergo in vivo drug activation studies and
discarded [17-20].

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 3.2.3. Toxicity Prediction
Preadmet predicts mutagenicity and carcinogenicity of a compound and helping us to avoid
toxic compounds for biological drug likeness studies. Ames test is a simple method to test
mutagenicity of a compound.Generally carcinogenic tests requires long time, PreADMET
predicts the results from its model, which is built from the data of NTP (National Toxicology
Program) is the results of the in vivo carcinogenicity tests of mice and rat from 2 years. From
Table 7, it is seen that all the tested compounds show clear evidence of carcinogenic and
mutagenic activity and hence rejected [21s].

4. Conclusion
The synthesized Schiff base (CBMTDT) act as a bidentate ligand and coordinate through
azomethine nitrogen and thiol sulfur after deprotonation. Pharmacokinetic properties of the
synthesized Schiff base and its complexes were studied using Preadmet, and all the metal
complexes have been rejected for drug likeness studies.

REFERENCES
[1] Z.H. Chohan, M.A. Farooq, A.Scozzafava, C.T.Supuran. J Enzyme Inhib.Med.Chem., 17, 1
(2002).
[2] K. Singh, M.S Barwa, P Tyagi. Eur. J. of Med. Chem., 42, 394 (2007).
[3] J.A Ibres, R.H.Holm. Science., 209, 223 (1980).
[4] M.Sebastian, V.Arun,P.P Robinson, K.K.Mohammed Yusuff. Synth.React.Inorg
.Met.Org.Chem., 40, 541 (2010).
[5] A Siwek,M Wujec. M Dobosz., P Paneth. Heteroatom Chem.,19, 713 (2008).
[6] J.R.G Mascaros, J.M.Clemente-Juan,K.R Dunbar,J.Chem.Soc.,Dalton Trans.,2710 (2002).
[7] J.M.Lehn, Supramolecular Chemistry: Concepts and Perspectives, VCH, Germany, (1995).
[8] M.D. Milton, J.D Singh. Design and Synthesis of Organoselenium Based Multidonors, IIT,
Dept of chemistry. New Delhi (2002).
[9] B.Kebede, N.Retta, V.J.T Raju, Y.Chebude.Trans Met Chem., 31, 19 (2006).

[10] S. John, B. Joseph, K.K Aravindakshan, A. Joseph. Mtaer. Chem. and phy., 122, 374 (2010).
[11] B.Joseph, S.John, K.K Aravindakshan, A. Joseph. Ind.J.Chem.Tech, 17, 425 (2010) .
[12] J. Hodgson, Nature. Biotechnology. 19, 722 (2001).
[13] C.A Lipinski et al.Adv. Drug Deliv.Rev., 23, 3, (1997).
[14] S.J Teague et al., Angew Chem.Int.Ed. 38, 3743 (1999).
[15] T. I .Oprea, J.Comput.Aid.Mol.Des., 14, 251 (2000).
[16] R.D.Brown et al.Tools for designing diverse, drug-like cost-effective combinatoriallibraries',
in computational library design and Evaluation, Marcel Dekker, Inc., New York, 328
(2001).
[17] A.P.Beresford et al.DDt. 7 , 109 (2002).
[18] S.Yamashita et al. Eur. J Pharm., 10, 195 (2000).
[19] Yazdanian, M.Pharm Res 15, 1490 (1998)
[20] Y Zhao.Het al.J.Pharm Sci., 90, 749 (2001).
[21] Ma X.et al.Acta Pharmacologica Sinica., 26, 500 (2005).

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 MEDICINAL PLANTS FOR BETTER LIVING

DR. REGI RAPHAEL K

Department of Botany, St. Mary’s College, Thrissur-20

Introduction
Plants continue to be a major source of medicines, as they have been throughout
human history. The use of plant-based drugs for the treatment of various ailments is
increasing worldwide as they are considered much safer compared to synthetic drugs (Sahoo
N et al ,2010). India is a veritable and rich emporium of medicinal and aromatic plants. India
has more than 17,500 wild plant species and out of these 4000 species have medicinal value
(Sen P et al, 2008). The market sales and research activities of herbal products are growing
steadily (Chen et al, 2011). As compared to allopathic drugs, herbal medicines are claimed to
be non-toxic, or generally regarded as safe because they are obtained from natural origin and
their reported long-term use as folk medicine (Zhou et al, 2004). Moreover, some plants
consider as important source of nutrition and as a result of that these plants recommended
for their therapeutic values.
Alternative medicine
These days the term “Alternative Medicine” became very common in western culture,
it focus on the idea of using the plants for medicinal purpose. But the current belief that
medicines which come in capsules or pills are the only medicines that we can trust and use.
Even so most of these pills and capsules we take and use during our daily life came from
plants. Medicinal plants frequently used as raw materials for extraction of active ingredients
which used in the synthesis of different drugs. Like in case of laxatives, blood thinners,
antibiotics and anti-malaria medications, contain ingredients from plants.
Future of Medicinal Plants
Medicinal plants have a promising future because there are about half million plants
around the world, and most of them their medical activities have not investigate yet, and their
medical activities could be decisive in the treatment of present or future studies.
Characteristics of Medicinal Plants
Medicinal plants have many characteristics when used as a treatment, as follow:
• Synergic medicine- The ingredients of plants all interact simultaneously, so their uses can
complement or damage others or neutralize their possible negative effects.
• Support of official medicine- In the treatment of complex cases like cancer diseases the
components of the plants proved to be very effective.
•Preventive medicine- This will help to reduce the use of the chemical remedies which will be
used when the disease is already present i.e., reduce the side effect of synthetic treatment.
Medicinal plants play an essential role in the development of human culture.
Cultivation and preservation of medicinal plants protect biological diversity of Kerala. Here
are some of the medicinal plants used in Ayurveda for making medicines.

Menthonni

Scientific Name: Gloriosa superba

Family: Liliaceae
Medicinal Properties: Rhizome pacifies vitiated kapha, indigestion, fever, arthritis,
obstructed labor, cardio-myopathy, skin diseases, in higher dose or without purification, it is
highly poisonous.

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Nelli

Scientific Name: Emblica officinalis

Family: Euphorbiacae
Medicinal Properties: Emblica officinalis is aperient, carminative, diuretic, aphrodisiac,
laxative, astringent and refrigerant. It is the richest known source of vitamin 'C'. It is useful in
anaemia, jaundice, dyspepcia, haemorrhage disorders, diabetes, asthma and bronchitis. It
cures insomnia and is healthy for hair. It is considered as one of the most rejuvenating drugs,
imparting a long healthy life and weight gain. It also acts as an antacid and antitumor agent.
All parts of the plant are used in various herbal preparations, including the fruit, seed, leaves,
root, bark and flowers.
Muthanga

Scientific Name: Cyperus rotundus

Family:Cyperaceae
Medicinal Properties: In modern ayurvedic medicine uses plant tuber for treating fevers,
digestive system disorders, dysmenorrhea and other maladies. Plant pacifies vitiated kapha,
pitta, diarrhea, indigestion, anorexia, fever, and urinary retention. Increases and purifies
breast milk. Recent studies recommend the plant to treat nausea, fever and inflammation; for
pain reduction; for muscle relaxation and many other disorders.

Karalakam

Scientific Name: Aristolochia indica

Family: Aristolochiacae
Medicinal Properties: The plant has a number of historical medicinal uses. This plant
contains Aristolochic acid is a rodent carcinogen . In addition to its carcinogenicity,
aristolochic acid is also highly nephrotoxic and may be a causative agent in Balkan
nephropathy. In Ayurveda, plant pacifies vitiated kapha, vata, poison, skin diseases, intestinal
worms, colic, arthritis and ulcers.

Karingali

Scientific Name : Acacia catechu

Family: Leguminosae

Medicinal Properties: The tree's seeds are a good source of protein. The extract of the plant
called catechu is used to treat sore throats and diarrhoea. In Ayurveda, plant pacifies vitiated
pitta, kapha, skin diseases, cough, pruritus, and obesity. Useful in tooth ache, increases the
strength of teeth.
Kanikonna

Scientific Name: Cassia fistula

Family: Leguminosae

Medicinal Properties: Its fruit pulp is used as a mild laxative, against fevers, arthritis,
vatavyadhi (nervous system diseases), all kinds of rakta-pitta (bleeding, such as hematemesis
or hemorrhages), as well as cardiac conditions and stomach problems such as acid reflux. The
root is considered a very strong purgative.

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Sathavari

Scientific Name: Asparagus racemosus

Family: Liliaceae
Medicinal Properties: Its main use has been as a galactagogue to increase milk secretion
during lactation. It is helpful in cases of low milk production, low sex drive, menopause, PMS,
and infertility. It helps to balance hormonal system of women and regulates menstruation and
ovulation. It is also useful for decreasing morning sickness, infertility, menopause,
leucorrhoea, inflammation of sexual organs, and general sexual debility. It can be used in
cases of sexual debility, impotence, spermatorrhoea, and inflammation of sexual organs. The
powdered dried root of sathavari is also used in Ayurveda for dyspepsia. The herb is also
useful in gastric ulcers, hyperacidity, dysentery, bladder infections, chronic fevers,
rheumatism, inflamed membranes of the lungs. It also used as a nervine tonic and is good for
heart. It also strengthens and increases muscle tone and increases general body strength and
used as an Aphrodisiac in India.

Sarpagandha
Scientific Name :Rauvolfia serpentina
Family: Apocynaceae
Uses: Rauvolfia roots are used for treating various central nervous system disorders.
Reserpine is the most important alkaloid, which is used for its sedative action in mild anxiety
states and chronic psychoses. It has a depressant action on central nervous system produces
sedation and lowers blood pressure. The root extracts are used for treating intestinal
disorders, particularly diarrhoea and dysentery and also anthelmintic. It is used for the
treatment of cholera, colic and fever. The juice of the leaves is used as a remedy for opecity of
the cornea. The total root extracts exhibits a variety of effects, viz., sedation, hypertension,
brodyeardia, myosis, ptosis, tremors, which are typical of reserpine (Selvam, 2018)

Kanjunni
Scientific name: Eclipta Alba
Family: Compositae
Traditional Uses: Bhringaraj is commonly used as a deobstruent to promote bile flow and to
protect the liverparenchymal tissue in viral hepatitis and other conditions involving hepatic
enlargement. The fresh juice of the leaves is given in the treatment of edema, fevers, liver
disorders, and rheumatic joint pains;it is also used to improve the appetite and to stimulate
digestion. The juice is given with honey to treat upper respiratory congestion in children. A
hair oil prepared from boiling the fresh leaves with either coconut or sesame oil renders the
hair black and lustrous. It is popularly used to enhance the memory and has a reputation as an
antiaging agent in Ayurveda. The leaf juice is also effective when applied externally to treat
minor cuts, abrasions, and burns (Kapoor ,1990)

Chakkarakkolli
Scientific name: Gymnema sylvestre
Family: Asclepiadaceae
Traditional Uses: Diabetes mellitus, snakebites (root powder), fever, and cough and also to
treat somatic burning sensations, biliousness, hemorrhoids, and urinary disorders. When
chewed the leaves have the remarkable property of abolishing the ability to taste sweet and
bitter substances. It also has a mild laxative effect, probably due to its anthraquinone content
which irritates the bowel walls (Gupta et al 1962,1965).

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Adalodakam
Scientific Name:Adhatoda vasica
Family: Acanthaceae
Traditional Uses: The juice expressed from the leaves and the decoction of the leaves and
roots are useful in asthma, bronchitis, and other chronic coughs. Dried leaves are used in
dhoomapana (smoking) in the treatment of bronchial asthma. The leaf decoction is an
excellent expectorant when decocted with punarnava (Boerhaaviadiffusa) and then combined
with ginger juice and black pepper. .Vasa has also been used to treat skin conditons by
combining it with triphala and using the decoction both internally and externally. Vasa was
also indicated in the treatment of internal hemorrhage.

Indian lotus
Scientific Name: Nelumbo nucifera.
Family: Nympheaeceae
Traditional Uses: The leaf paste is applied to the body in fever and inflammatory skin
conditions;young leaves are taken with sugar to treat rectal prolapse . The stamens are mixed
with ghee and jaggery and used in treating hemorrhoids. The leaves and flowers are both
useful in many varieties of raktapitta, or bleeding disorders. The flowers are sometimes
prescribed to promote conception. The petals alleviate thirst and inflammations. The seed
powder mixed with honey is given in cough. The roots are said to be health for teeth. Taken
with ghee, milk, and gold it is a general tonic said to promote strength, virility, and intellect.
Thulsi
Scientific Name: Ocimum sanctum
Family: Labiatae
Traditional Uses: The leaf infusion or fresh leaf juice is commonly used in cough, mild upper
respiratory infections, bronchospasm, stress-related skin disorders and indigestion. It is
combined with ginger and maricha (black pepper) in bronchial asthma. It is given with
honeyin bronchitis and cough. The leaf juice is taken internally and also applied directly on
cutaneous lesions in ringworm. The essential oil has been use d in ear infections. The seeds
are considered a general nutritious tonic (Sen,1990).

Koovalam
Scientific Name :Aegle marmelos
Family-Rutaceae

Uses: Bilva is a very good source of protein which is 5.12 per cent of the edible portion.Fresh
half-ripe Bilva fruit is mildly astringent and is used for dysentery and diarrhea. The pulp may
be eaten or the decoction administered. Bilva is said to cure without creating any tendency to
constipation. Bilva leaves, fruits and root can be used as tonic and coolant with antibiotic
properties
Vayampu
Scientific Name :Acorus calamus
Family:Araceae
Uses: The rhizomes contain aromatic oil that has been used medicinally since ancient times
and has been harvested commercially. The rhizomes are considered to possess
anti-spasmodic, carminative, anthelmintic, aromatic, expectorant, nauseate, nervine, sedative,
stimulant properties and also used for the treatment ofepilepsy, mental ailments, chronic
diarrhoea, dysentery, bronchial catarrh, intermittent fevers, glandular and abdominal tumors
(Paithankaret al,2011)

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Conclusion
In the next few decades, herbal medicine may become a new era of medical system for the
management of human diseases. About 80% world population rely on traditional medicine for
primary health care. Over the past decade, there has been a resurgence of interest in the
investigation of medicinal plant as a source of potential herbal medicine. There is a need to
advance research for the development and characterization of new natural drugs with the aid
of better screening methods from plants and other natural sources.

References

Chen XW, Serag ES, Sneed KB, Zhou SF. Herbal bioactivation, molecular targets and the
toxicity relevance. ChemBiol Interact 2011;192(3):161-76.
Gupta SS, Seth, CB, Exprimental studies on pituitary diabetes, Ind J Med Res., 50, 708, 1962.
Gupta, SS, et al., Effect of gurmar and shilajit on body weight of young rats, Ind J Physiol.
Pharm., 9, 87, 1965.
Kapoor LD CRC Handbook of Ayurvedic Medicinal Plants 169, 1990.
Paithankar VV, Belsare SL, Charde RM, Vyas JV. Acoruscalamus: An overview. Int J Biomed Sc.
2011;2:518-29.
Rasool Hassan BA (2012) Medicinal Plants (Importance and Uses).Pharmaceut Anal Acta 3:
10.
Sahoo N, Manchikanti P, Dey S. Herbal drugs: Standards and regulation. Fitoterapia
2010;81(6):462-71

Selvam ABD (2012). Pharmacognosy of Negative ListedPlants pp 183-193.

Sen P, Dollo M, Choudhary MD, Choudhary D. Documentation of traditional herbal knowledge
of Khamptis of Arunachal Pradesh. Indian J TraditKnowl 2008;7:438-42.
Sen P. Therapeutic potential of Tulsi: From experience to facts. Drug News Views. 1993;1:15–
21.
Zhou S, Koh HL, Gao Y, Gong ZY, Lee EJ. Herbal bioactivation: The good, the bad and the ugly.
Life Sci 2004;74(8):935-68

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 CAESALPINIASAPPAN (PATHIMUGHAM) – THE NEUTRACEUTICAL THIRST
QUENCHER FOR A HEALTHY SOCIETY

DR SR MEENA K CHERUVATHUR

Assistant Professor in Botany, St. Mary’s College, Thrissur-680 020,

e. id: srsantra@gmail.com

Abstract
Naturalproductshaveprovidedavarietyofleadstructures,whichserve as
templatesforthedevelopmentofnew drugs.Thewaterkeptin Caesalpiniasappan,
Linn.(Pathimugam)heartwoodisbeingusedin Kerala asherbal drinkingwaterforitsanti-
thirst,bloodpurifying,antidiabetic, anti-ageingand severalotherproperties.The plant is
likewise being utilized worldwide for countless restorative purposes.
Moderndayresearch confirms its cytotoxic, antitumor, antimicrobial, antiviral,
immunostimulant and several other activities. Triterpenoids, flavonoids, oxygen
heterocycles, etc.wereisolated from its heartwood. Severalofitsbiologicalactivities are
due to the presence of its major constituent Brazilin. The decoction of this plant is a
traditional thirst quencher in Kerala. This can act both as a beverage and neutraceutical
agent which can be exploited in the market for the production of natural health-
enhancing formulations.

Keywords:Caesalpiniasappan, sappan wood, heartwood, the colouring agent, brazilin,

traditional medicines, neutraceutical agent

Ayurveda is a traditional system of medicines native to India. In Ayurveda, regulation

of diet is crucial, since it examines the whole human body as the product of food. Ayurveda
illustrates how an individual can recuperate by establishing the connection between
elements of life, food, and body. According to Ayurvedic concepts, food is responsible for
different aspects of an individual including physical, temperamental, and mental states. To
stay healthy, maintaining a stable healthy diet routinely is essential. The body absorbs the
nutrients as the result of digestion. But Ayurveda states that the food first converts into rasa
(plasma), and then followed by successive conversion into blood, muscle, fat, bone marrow,
reproductive elements, and body fluids. Imbalance of mind, body, and spirit are referred to
as diseases.
The Indians, Egyptians, Chinese and Sumerians are just a few civilizations that have
provided evidence suggesting the food can be effectively used as medicine. Ayurvedic herb
infused water is a common ancient practice that has been used for years by naturopaths to
heal ailing bodies. Due to the easy availability of herbs and spices, these healing waters can be
conveniently made at home. The idea to prepare healing water by infusing ayurvedic herbs
and spices is to extract important oils from the plant which have several healing properties.
Water is considered as a powerful therapeutic tool in Ayurveda and soaking certain herbs or
spices can enhance its healing power.

Pathimugam (Indian redwood) Water

Pathimugam or Indian redwood soaked in water is a popular thirst quencher in Kerala.
The bark of the tree is used to attain medicinal benefits. The healing water that turns light
pink in colour is used as a cure for kidney disorders, skin diseases, cholesterol, blood
purification and diabetes. All you need to do is to boil the water with Pathimugam for 2-3

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minutes, strain the water and consume it with meals or any time of the day.This healing water
must be consumed according to the needs of the body.
Tea lovers know that they get their daily dose of antioxidants from tea. But tea can also
cause severe acidity and caffeine addiction. Sappan wood teais a great tea substitute that will
give you all the antioxidants without its demerits. A study has shown that sappanwood
provides more antioxidants and better protection from free radicals than quercetin found in
antioxidant-rich foods.
The Pathimugham water has several properties. It is rich in cancer prevention agents.
The extracts of sappan wood possess phenolics, flavonoids, tannins and the little bit of
saponin. It was potential for use it as a component infunctional food what given for fever.Its
dried heartwood has been used as the traditional ingredient of food or beverages (Toegel et
al., 2012). It is used in Thai folk medicine to treat tuberculosis, diarrhoea, dysentery, skin
infections and anaemia(Sireeratawong et al., 2010). Those with allergy problems should gulp
down copious amounts of sappan wood water. Studies have shown that the compounds in
sappan wood, especially sappanchalcone has powerful anti-allergicproperties.Those who
suffer from convulsions due to epilepsy and other disorders should reap the benefits of
sappan wood. Research has concluded that extracts of pathimugam have shown
anticonvulsantactivities.It is good for the heart. Drink a cup of sappan wood water is good
for heart health. Studies have shown that Brazilein, the red pigment in the wood has positive
effects on cardiac health.In traditional Chinese medicine, brazilin is used for the treatment of
increased blood circulation, promotes menstruation and exhibit analgesic and anti-
inflammatory potentials (China Pharmacopoeia Commission, 2010). Brazilin have been
reported to possess various biological activities including antibacterial (Xu et al., 2004), anti-
inflammatory (Washiyama et al., 2009), anti-photoaging(Lee et al., 2012) hypoglycemic (You
et al., 2015; Khil et al., 1999), vasorelaxant( Hu et al., 2003); Xie et al., 2000) , anti-allergic
(Yodsaoue et al., 2009), antiacne (Nirmal And Panichayupakaranant, 2014), antioxidant
(Sasaki et al. 2007) and nuclease activity (Yun et al., 2006). A decoction of the wood is a
powerful emmenagogue and, because of its tannic and gallic acids, is an astringent used in
mild cases of dysentery and diarrhoea. It is also given internally for certain skin ailments. The
sappan is given as a tonic to women after confinement and to relieve vomiting of blood. It is
one of the ingredients in a mixture prescribed for malaria. The dried heartwood is widely
used in oriental medicine, particularly against inflammation.
Chemicalconstituent's investigation of sappan wood resulted in theisolation of various
structural types of phenolic componentsincludingxanthone, coumarin, chalcones, flavones,
homoisoflavonoids, and brazilin etc. Brazilin is themajor compound naturally occurring in the
heartwood and isused as a red dye for histological staining (Bae et al.,2005). The heartwood
contains water-soluble flavonoids namely, brazilin, protosappanin and haematoxylin. Brazilin
is the main homo isoflavonoid constituent found in the heartwood, which is well known as the
natural red colour dye for staining(Bae et al.,2005; NirmalAndPanichayupakaranant, 2014).
Brazilin also exhibits different industrial applications. Therefore, extraction and purification
of brazilin are one of the important steps to achieve high extraction yield and purity,
respectively. The decoction of heartwood has anti-thirst and cardiotonic properties. In
Northern Thailand, especially in Chiang Mai, heartwood decoction is used asan anti-
inflammatory agent for the treatment of traumatic diseaseand arthritis (Saenjum et al.,2010).
The Northern Thai community hasthe history of using the decoction of heartwood for
localconsumption including health promotion and diseasetreatment.
In Ayurveda, the heartwood is used for vitiatedconditions of pitta which includes skin
rashes, burningsensations, peptic ulcers, excessive body heat, heartburn andindigestion. It
also used as the blood purifier and in the treatment ofwounds, diarrhoea, epilepsy, diabetes
etc. Heartwood is alsoused to reduce pain and swelling caused by external injuriesand
improvement of complexion (Srilakshmi et al., 2010). In Chinese folkmedicine, it is mainly

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used asa hemostatic,analgesic and anti-inflammatory for the traumatic disease andblood flow
promoting agent (Wang et al., 2011). Additionally, decoction of heartwood is used for the
treatment of blood pressure, burning sensations, cancer, cataract, digestion,
dysmenorrhea,ear diseases, gonorrhoea, heart diseases, jaundice, nervousdisorders, obesity,
ophthalmic diseases, spermatorrhoea,stomach aches, syphilis, urinary diseases and vascular
diseases.Caesalpiniasappan induces cell death by increasing the expression of p53 and
p21WAF1/CIP1 in head and neck cancer cells (Kim et al., 2005). Significant antioxidant nature
of Caesalpiniasappan heartwood extracts has been reported by Badami et al., (2003).
Caesalpiniasappan is awidely used thirst quencher as well as a medicine for various
ailments. According to Defelice, a nutraceutical is any substance that is a food or a part of food
that provides medical or health benefits, including the prevention and treatment of disease.
Such products may range from isolated nutrients, dietary supplements and specific diets to
genetically engineered designer food and herbal products.Caesalpiniasappan can be included
under this category. Nutraceutical industry is growing at a rate far exceeding expansion in the
food and pharmaceutical industries. In tomorrow’s market, the most successful nutraceutical
players are likely to be those companies in which functional product are just a part of a broad
line of good satisfying both conventional and health value point. Future demand for
nutraceuticals depends on consumer perception of the relationship between diet and disease.
Nutraceuticals are presenting excellent opportunities for research scholars and industry
people to exploit their usefulness. The use of nutraceuticals, as an attempt to accomplish
desirable therapeutic outcomes with reduced side effects or compound with another
therapeutic agent, has met with great monetary success.Ayurvedic herb infused water is a
common ancient practice. In the age of modern medicines, where one would run to take a pill
to cure even minor health ailments, it's nice to stop it and think of healthier older practices
that promote a stronger immunity.
Conclusion
Caesalpiniasappan heartwood extract has been used in oriental folk medicine in
Southeast Asia. Its heartwood extracts have been known as safe natural plant extract and long
been used as food and medicinal ingredient.Brazilin is the major phytochemical found in the
heartwood andis responsible for most of the pharmacological activities of
Caesalpiniasappanheartwood. Brazilin shows various biological activitiesincluding
antioxidant, antibacterial, anti-inflammatory, hypoglycemic, hepatoprotective, and
vasorelaxation etc. Brazilinhas the potential to develop into a drug and also act as a
nutraceutical. Therefore, we suggest that Caesalpiniasappan can be used as a medicament or
food additive. Its neutrasuitical properties will help our body to stay healthy and defend many
diseases due to cell degeneration and exposure to stress.

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Khil LY, Han SS, Kim SG, Chang TS, Jeon SD, So DS, Effects of brazilin on GLUT4 recruitment in
isolated rat epididymal adipocytes. BiochemPharmacol 1999; 58(11): 1705-1712.
Kim EC, Hwang YS, Lee HJ, Lee SK, Park MH, Jeon BH, Jeon CD, Lee SK, Yu HH, You YO 2005.
Caesalpiniasappan induces cell death by increasing the expression of p53 and p21WAF1/CIP1
in head and neck cancer cells. Am J Chin Med.; 33(3):405-14.
Nirmal NP, Panichayupakaranant P. Anti-Propionibacterium acnes assay-guided purification
of brazilin and preparation of the brazilin rich extract from Caesalpiniasappanheartwood.
Pharm Biol 2014; 52(9): 1204-1207.
Nirmal NP, Rajput MS, Rangabhatla GS, Prasad V, Ahmad M (2015), Brazilin from
Caesalpiniasappan heartwood and its pharmacological activities: A review, Asian Pacific
Journal of Tropical Medicine, http://dx.doi.org/10.1016/j.apjtm.2015.05.014
Saenjum C, Chaiyasut C, Kadchumsang S, Chansakaow S, Suttajit M. Antioxidant activity and
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Saenjum C, Chaiyasut C, Kadchumsang S, Chansakaow S, Suttajit M. Antioxidant activity and
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J ExperBiol 2010; 48(9): 905-910.
Toegel S, Wu SQ, Otero M, Goldring MB, LeelapornpisidP, Chiari C, et al. Caesalpiniasappan
extract inhibits IL 1b-mediated overexpression of matrix metalloproteinases in human
chondrocytes. Genes Nutri 2012; 7(2): 312-318.
Wang YZ, Sun SQ, Zhou YB. Extract of the dried heartwood of Caesalpiniasappan L. attenuates
collagen-induced arthritis. J Ethnopharmacol 2011; 136(1): 271-278
Wetwitayaklung P, Phaechamud T, Keokitichai S. The antioxidant activity of
CaesalpiniasappanL. heartwood in various ages.NaresuanUni J 2005; 13(2): 43-52.
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Caesalpiniasappan L. heartwood in various ages. NaresuanUni J 2005; 13(2): 43-52.
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Xie YW, Ming DS, Xu HX, Dong H, But PPH. Vasorelaxing effects of Caesalpiniasappan
involvement of endogenous nitric oxide. Life Sci 2000; 67(15): 1913-1918.
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Yodsaoue O, Cheenpracha S, Karalai C, Ponglimanont C, Tewtrakul S. Anti-allergic activity of
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You EJ, Khil LY, Kwak WJ, Won HS, Chae SH, Lee BH, Effects of brazilin on the production of
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 DOMINANCY OF BIOGENIC NANOPARTICLES OVER ITS SYNTHETIC
COUNTERPARTS

KAYEEN VADAKKAN

Assistant Professor, Department of Biotechnology, St. Mary’s College Thrissr,680020.

Introduction
Nanotechnology is one among the most promising research area in applied sciences due to its
peculiar properties related to size, shape, distribution and morphology than large particles
from which the nanoparticles are made(Suresh et al., 2011).Nanotechnologyencompasses the
construction, operation and use of materials ranging in size less than a micron to that of
individual atoms. The synthesis of nanoparticles with precise size, shape, composition has
explored the possibility of their applications in various fields including agriculture, cosmetics,
textiles, food, medicine and environment(Kumar et al., 2014). The surface area ratio of
nanoparticles is inversely proportional to their size, due to which it is explored in
optoelectronics, in catalysis, photonics, biological tagging and pharmaceuticals. Despite of
having several methods for the synthesis of nanoparticles, it is essential to develop more
efficient and low cost methods(Mariselvam et al., 2014). Biogenic nanoparticles have evolved
dominant over its synthetic counterparts due to its elevated biocompatibility and immediate
synthesis. In this review we are discussing about some of the major biogenic approaches of
nanoparticle fabrication and its biotechnological applications.

Microbial mediated nanoparticles synthesis

Several microorganisms such as bacteria, fungi, yeast and algae have been reported for its
ability to synthesis nanoparticles by reducing metal ions into nanoparticles. The nanoparticles
synthesized from this microorganisms have found application in various fields and more
biocompatible compared with chemically synthesized counter products (Krishnaraj et al.,
2014). There are two various methods through which microbial nanoparticles are formulated,
intracellular synthesis and extracellular synthesis(Davis et al., 2003). Intracellular synthesis
method involves a specific ion transportation system in the microbial cell. In this the cell wall
of the microorganism plays an important role in biosynthesis of metallic nanoparticles(Cai et
al., 2011). The main mechanism behind cell wall mediated intracellular nanoparticles
synthesis is the electric charge of metal ions and cell wall. The cell wall of microorganism is
negatively charged and the metal ions contain positive charge, so that there will be an
electrostatic interaction force between this two opposite charges(Du et al., 2007) due to
which both will be attracted to each other after which the enzymes present in the cell wall of
microorganisms reduce these metal ions into nanoscale to form nanoparticles. Hence
formulated nanoparticles will be later diffused out through cell wall. The mechanism of
extracellular synthesis of nanoparticles involves the action of nitrate reductase enzyme which
will convert the metal ions to nanoparticles (Luo et al., 2014). However, several
microorganisms have been found secreting nitrate reductase enzyme which assist the
conversion of metal to metallic nanoparticles.

Biodiversity of microorganisms fabricating nanoparticles

There have been many bacterial isolates that are delineated for its ability to synthesis
nanoparticles. A Geobacter sp. Magnetospirillummagnetotacticum have found to produce

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metal nanoparticles through reduction of Fe (III) where it intake toxic metals like Fe (III)
through reduction, where iron is actively taken by the cell, re-oxidized to hydrous oxide (low
density) to Fe(III) oxide (ferrihydrite), which is of high density. The Fe(III) ions in the last step
is reduced and magnetite is produced from dehydration within the magnetosome vesicles. An
intracellular protein Ferritin, accumulates the iron within the vesicles keeping it in non-toxic
and soluble form. The nanoparticles produced have following characteristics like high purity,
little crystalline defects, narrow size, mono-dispersive etc. Similarly the thermophilic bacteria
can be an excellent tool for the extracellular synthesis of both gold and silver nanoparticles as
the extracellular systems produce an environment-friendly alternative for huge quantities of
nanomaterials reducing the downstream processing of these metals(Gomathy and
Sabarinathan, 2010). The MDR (multi-drug resistance) bacteria that have gained its
importance due to antibiotic resistance can also be exploited for the synthesis of
nanoparticles that can act against pathogenic strains (Menon et al., 2017).Likewise, fungal
strains can also be used for the synthesis of nanoparticles. The property of fungi to secrete
large amount of enzymes could be of good aid in nano particle fabrication(Fayaz et al.,
2011).The filamentous fungi have unique advantages over other microorganisms like bacteria
and algae, as they have high metal tolerance and have the capability of bioaccumulation. They
are helpful in the scaleup, handling of biomass, downstream processing, economic viability
and they also secrete extracellular enzymes, of which large scale production is easily possible.
The biochemical composition, shape and size distribution of the nanoparticles are controlled
by the active biomolecules produced by the fungal organisms. The gold ions were absorbed by
them and that led to the formation of the gold nanoparticles produced intracellularly. The
active molecules involved can be reducing sugars, proteins, like ATPase, glyceraldehyde-3-
phosphate dehydrogenase, 3-glucan binding proteins; all are involved in the energy
metabolism of the cells of the fungi. The Au-fungal cells ultrathin sections when studied, it was
found that gold nanoparticles were gathered in the vacuoles of the cells(Suganya et al., 2015).

The actinomycetes are exploited in a large amount for the synthesis of nanoparticles as it can
be easily undergo genetic modification for the attainment of better size and poly-dispersed
nanoparticles(Ahmad et al., 2003). The actinomycetes have a closer resemblance with the
fungi and the prokaryotes characteristics like the bacteria (mycobacteria and the
coryneform). They are currently being used in the nanotechnology as they have the ability to
produce secondary metabolites like antibiotics(Zhang et al., 2011).Algae, the
photoautotrophic, eukaryotic, aquatic, oxygenic microorganism has the ability to accumulate
heavy metals, due to this fact; researchers are finding cleaner techniques for the preparation
of nanoparticles. This represents a good advantage of using algae as an abundant raw material
source(Castro et al., 2012). Fucoidans are polysaccharide secreted from the cell walls of
marine brown algae and that has proved to possess many applications in diverse fields like
the anti-coagulant, anti-inflammatory, anti-viral and also anticancer. They are also being used
in the cosmetic industries as an anti-aging or whitening agents. The synthesis of gold
nanoparticles from these fucoidans has proved to a fruitful alternative to the chemical
methods(Lirdprapamongkol et al., 2014). The brown algae has been exploited more as
compared to other species due to its ability of uptake of heavy metals. They have a complex
cell wall which is rich in mucilaginous polysaccharides, which explain the heavy metal uptake
clearly. Also, it contains functional groups like the carboxyl groups, which are involved in the
uptake(Venkatesan et al., 2014). There have been many more microorganisms with the ability
to synthesis nanoparticles and some of them are elaborated in Table 1.

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Biotechnological application of metallic nanoparticles

The AgNPs were effectively disrupting the polymer subunits of cell membrane in pathogenic
organisms. The reciprocal action of nanoparticles subsequently breaks the cell membrane and
disturbs the protein synthesis mechanism in the bacterial system(Sondi and Salopek-Sondi,
2004). The increasing concentrations of silver nanoparticles have faster membrane
permeability than the lower concentrations and consequently rupture the cell wall of
bacteria(Kasthuri et al., 2009). The maximum conductivity was observed in
Rhizophoraapiculata reduced silver nanoparticles shown a low number of bacterial colony in
the experimental plate compared with AgNO3 treated cells, which may be due to the smaller
size of the particles and larger surface area which leads to the increase of membrane
permeability and cell destruction (Antony et al., 2011). The interactions of bacteria and the
metallic silver and gold nanoparticles have been binding with active site of cell membrane to
inhibit the cell cycle functions(Kim et al., 2007). The biosynthesized silver nanoparticles were
achieved in a single step procedure by using Citrus sinensispeel extract as a reducing and a
capping agent. C. sinensispeel extract reduced silver nanoparticles effectively and the activity
against Escherichia coli, Pseudomonas aeruginosa(gram-negative) and Staphylococcus
aureus(gram-positive) has been identified (Kaviya et al., 2011).

Anti-inflammation is a cascade process that produces immune responsive compound such as

interleukins and cytokinins which can be produced by keratinocytes including T lymphocytes,
B lymphocytes and macrophages(Jaco et al., 2012). Various inflammatory mediators such as
enzymes, antibodies are secreted from the endocrine system. Other potential anti-
inflammatory agents such as cytokines, IL-1, IL-2 are secreted from the primary immune
organs. These anti-inflammatory mediators induce the healing process(Satyavani et al., 2011).
Also, the inflammatory mediators are involved in biochemical pathways and control the
expansion of diseases. Biosynthesized gold nanoparticles achieved positive wound repair
mechanisms and tissue regeneration in inflammatory function(Gurunathan et al., 2009). The
studies proved that biosynthesized gold and platinum nanoparticles are alternative sources
for treating inflammation in a natural way.

The overexpression of cellular growth will be arrested and regulated with systematic cell
cycle mechanisms in cancerous cell by using bio-based nanoparticles as novel controlling
agents(Akhtar et al., 2013). Also the plant mediated nanoparticles have great effect against
various cancer cell lines such as Hep 2, HCT 116 and Hela cell lines. Recently, many studies
reported that plant derived nanoparticles have potential to control tumour cell growth.The
improved cytotoxic effect is due to the secondary metabolites and other non-metal
composition in the synthesizing medium(Raghunandan et al., 2011)The plant derived silver
nanoparticles regulate the cell cycle and enzymes in bloodstream(Alt et al., 2004) Moreover,
the plant synthesized nanoparticles relatively control the free radicals formation from the cell.
Free radicals commonly induce cell proliferation and damage the normal cell function. The
moderate concentration of gold nanoparticles induces the apoptosis mechanism in malignant
cells(Dipankar and Murugan, 2012). Similarly, Ag nanoparticles treated MCF-7 cancer cell line
has retained the biomolecules concentration in the cells, and subsequently the cell
metabolism was regulated(Das et al., 2013). The metallic nanoparticles have proved their
novel applications in medical field to diagnose and treat various types of cancer and other
retroviral diseases. Thebiobased nanoparticles are new and revolutionized to treatmalignant
deposit and without interfering the normal cells.

Conclusions

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Biosynthesis of metal nanoparticles is extremely studied in the last two decades. The natural
metabolites induce the production of metallic nanoparticles in ecofriendly manner. As a
prospect, the ecofriendly synthesis of nanoparticlesin a large scale could enhance the
biotechnological applications,

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Marine algae-mediated synthesis of gold nanoparticles using a novel Ecklonia cava.
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 ROLE OF POLYPHENOLS & FLAVONOIDS IN CANCER PREVENTION.

SHAFNA JOSE

Assistant Professor on contract, St. Mary’s College, Thrissur-680 020

E ID: srjovitmaria@gmail.com

INTRODUCTION
Polyphenols are one of the most important and certainly the most numerous coming under
the groups of phytochemicals present in the plants which is a wide variety of molecules that
can be divided into many subclasses, subdivisions that can be made on the basis of their
origin, biological function, or chemical structure. Chemically, they are compounds with
structural phenolic features, which can be associated with different organic acids and
carbohydrates.
In the human diet, they are the most abundant natural antioxidants. They are mostly
present in fruits, vegetables, tea, cocoa and other plants that possess certain health benefits.
In plants, the most part of them are linked to sugars, and therefore they are in the form of
glycosides. Carbohydrates and organic acids can be bound in different positions on
polyphenol skeletons. Polyphenols show antioxidant, anti-inflammatory, anti-carcinogenic
and several other biological properties.
Although several classes of phenolic molecules, such as quercetinflavonol, are present in most
plant foods (tea, wine, cereals, legumes, fruits, fruit juices, etc.), other classes are found only in
a particular type of food (e.g. flavanones in citrus, isoflavones in soy, phloridzin in apples,
etc.).
Role of Green tea in Cancer Prevention
Green tea is consumed worldwide, especially in East Asian countries. The health-promoting
effects of green tea are mainly attributed to its polyphenol content. Recently, many of the
aforementioned beneficial effects of green tea were attributed to its most abundant catechin,
(-)-epigallocatechin-3-gallate (EGCG).
EGCG is attributable to its antioxidant properties. (-)-EGCG is also known to directly initiate
apoptosis as demonstrated by loss of mitochondrial membrane potential l, cytochrome C
release, DNA laddering, and dramatic increase in caspase-3 activity(106). However, it has
been demonstrated that (-)-EGCG can generate oxidative stress. HT-29 colon carcinoma cells,
pre-treated with antioxidants (reduced glutathione and N-acetyl-L-cysteine) and
subsequently treated with (-)-EGCG, demonstrated reduced mitogen-activated protein kinase
activation and reduced cytochrome C release and apoptosis although this could not be
blocked by catalase (Chen and et.al.,2003).

Role of Annona muricatain cancer Prevention.

Annona muricata Linn which comes from Annonaceae family possesses many therapeutic
benefits and has been used in many cultures to treat various ailments including headaches,
insomnia, and rheumatism to even treating cancer.
Annona muricata crude extract samples exhibited the different level of cytotoxicity toward
breast cancer cell lines. The selected B1 AMCE reduced the tumour's size and weight, showed
anti-metastatic features and induced apoptosis in vitro and in vivo of the 4 T1 cells.
Furthermore, it decreased the level of nitric oxide and malondialdehyde in a tumour while
also increased the level of white blood cell, T-cell, and natural killer cell population. (Syed
najmuddinand et.al .,2016)

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Role of carrot in Cancer Prevention
New therapies for leukaemia are urgently needed. Carrots have been suggested as a potential
treatment for leukaemia in traditional medicine and have previously been studied in other
contexts as potential sources of anticancer agents.
Carrots contain many bioactive compounds, which show potential in leukaemia therapies. The
effects of five fractions from carrot juice extract (CJE) on human lymphoid leukaemia cell
lines, together with five purified bioactive compounds found in Daucus carota L, including
three polyacetylenes (falcarinol, falcarindiol and falcarindiol-3-acetate) and two carotenoids
(beta-carotene and lutein). Their effects on induction of apoptosis using Annexin V/PI and
Caspase 3 activity assays analysed via flow cytometry and inhibition of cellular proliferation
using Cell Titer Glo assay and cell cycle analysis were investigated.
Treatment of all three lymphoid leukaemia cell lines with the fraction from carrot extracts
which contained polyacetylenes and carotenoids was significantly more cytotoxic than the 4
other fractions. Treatments with purified polyacetylenes also induced apoptosis in a dose and
time responsive manner. Moreover, falcarinol and falcarindiol-3-acetate isolated from Daucus
carota L were more cytotoxic than falcarinol. In contrast, the carotenoids showed no
significant effect on either apoptosis or cell proliferation in any of the cells investigated. This
suggests that polyacetylenes rather than beta-carotene or lutein are the bioactive components
found in Daucus carota land could be useful in the development of new leukaemia therapies.
(Zaini and et.al.,2012)
Role of Phyllanthus emblicain Cancer Prevention.
Phyllanthus emblica Linn or EmblicaofficinalisGaertn was commonly known as Indian
gooseberry or Amla is one of the most important medicinal plants in Indian traditional
systems of medicine (Ayurveda, Unani and Siddha). It is a well-known fact that all parts of
amla are useful in the treatment of various diseases. Among all, the most important part is
fruit. Amla fruit is widely used in the Indian system of medicine as the diuretic, laxative, liver
tonic, refrigerant, stomachic, restorative, anti-pyretic, hair tonic, ulcer preventive and for the
common cold, fever; as alone or in combination with other plants.
Phytochemical studies on amla disclosed major chemical constituents including tannins,
alkaloids, polyphenols, vitamins and minerals. Gallic acid, ellagic acid, emblicanin A & B,
phyllembein, quercetin and ascorbic acid are found to be biologically effective. Research
reports on amla reveal its analgesic, anti-tussive, antiatherogenic, adaptogenic; cardio, gastro,
nephron and neuroprotective, chemopreventive, radio and chemo modulatory and anticancer
properties. Amla is also reported to possess potent free radical scavenging, antioxidant, anti-
inflammatory, anti-mutagenic, immunomodulatory activities, which are efficacious in the
prevention and treatment of various diseases like cancer, atherosclerosis, diabetes, liver and
heart diseases. (Dasaroju and et.al.,2014)
The dried fruit juice of Phyllanthus Emblica showed a dose-dependent inhibition of cancer cell
growth. It inhibited fifty percent of the HL60 cancer cells and the total cell growth at the dose
of 35.6 µg/ml and 75.8 µg/ml respectively, it suggests that at the higher dose it may show
significant cytotoxicity, which is in accordance with the study reported that extract enhances
cytotoxicity in a dose-dependent manner.
Role of Artocarpusheterophyllusin Cancer Prevention.
Artocarpusheterophyllus (Jackfruit), grows in tropical and subtropical regions throughout the
world.It containsphytonutrients like lignans, saponins, and isoflavones, which have
anticancer, antihypertensive, anti-ulcer, antioxidant, and anti-ageing properties. The results of
the cytotoxicity study of the methanolic extract of Artocarpusheterophyllus showed
significant cytotoxicity against A549 cell line, whereas this extract had no activity against
HeLa, MCF-7 cell lines. This methanolic extract of Artocarpusheterophyllusis nontoxic to
normal cells but showed excellent toxicity on cancer cells. The cytotoxicity of methanolic
extract of Artocarpus heterophyllusmay be due to the presence of flavonoids having mono to

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polyphenolic groups in the structure. The flavonoids have reported for their cytotoxic activity
due to the presence of phenolic groups.
(Matsuo M., 2005).

Conclusion.
Cancer is one of the life-threatening diseases in the world.fruits and vegetables show anti-
cancer activity due to the presence of Secondary metabolites present in it. Secondary
metabolites inhibit the DNA damage, arrest the cell cycle, inhibits the tumour cell
angiogenesis and induce apoptosis thus prevents cancer. This review paper provides
information regarding fruit tea and vegetables which are anti-cancerous.
References.

Zhigan Wang Sheng Biao Wan WaiHar Lam Tak Hang Chan and Q. Ping douGreen tea and tea
polyphenols in cancer prevention Frontiers in Bioscience 9, 2618-2631, September 1, 2004.
Chen, C., G. Shen, V. Hebbar, R. Hu, E.D. Owuor& A.N. Kong: Epigallocatechin-3-gallate-induced
stress signals in HT-29 human colon adenocarcinoma cells. Carcinogenesis
24, 1369-1378 (2003).
zaini, Rana & Brandt, Kirsten & Clench, Malcolm & Le Maitre, Christine. (2012). Effects of
Bioactive Compounds from Carrots (Daucuscarota L.), Polyacetylenes, Beta-Carotene and Lutein
on Human Lymphoid Leukaemia Cells. Anti-cancer agents in medicinal chemistry. 12. 640-52.
10.2174/187152012800617704.
Syed Najmuddin SUF, Romli MF, Hamid M, Alitheen NB, Nik Abd Rahman NMA. Anti-cancer
effect of Annona Muricata Linn Leaves Crude Extract (AMCE) on breast cancer cell line. BMC
Complementary and Alternative Medicine. 2016;16(1):311. doi:10.1186/s12906-016-1290-y.)
Dasaroju, S & Mohan Gottumukkala, K. (2014). Current trends in the research of
Emblicaofficinalis (Amla): A pharmacological perspective. International Journal of
Pharmaceutical Sciences Review and Research. 24. 150-159.
Matsuo M, Sasaki N, Saga K, Kaneko T. Cytotoxicity of flavonoids toward cultured normal
human cells. Biol. Pharm. Bull. 2005; 28(2) 253—259.

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 DEFYING SILENCE: A STUDY ON SELECTED VERBAL AND VISUAL
NARRATIVES OF CANCER

REHNA MOL.S

JRF scholar , Fatima Mata National College, Kollam.

DR. CLARA B. RESHMA

Research Guide, Fatima Mata National College

In her book, The Body in Pain, Elaine Scarry makes the following assertion: "Because the pers
on in pain is ordinarily so bereft of the resources of speech, it is not surprising that the langua
ge for pain should sometimes be brought into being by those who are not themselves in pain b
ut who speak on behalf of those who are." (Scarry,4) Needless to say, there is a clear distinctio
n between incipient pain and its last stages, where one's language as well as one's body's stam
ina are devoid of power and significance, rendered almost, if not completely, unspeakable. W
hile Scarry endeavor is to bring into discussion instances of those who are in pain either in tor
ture or at war, my paper examines the fundamental birth into embodiment through the pain o
f cancer as experienced by two women: Vivian Bearing in Margaret Edson's play Wit, Audre Lo
rde in The cancer Journal.
What is the connection between medicine and art? As Thomas G. Couser asserts, "The word
‘pathography’ first caught my attention not in its clinical context, in which it simply refers to
writing about illness, but in the context of 'autopathography,' i.e., autobiographical narratives
of
illness or disability." (Couser,65) For Ellis, during the process of autoethnography, one reveals
one’s vulnerability, and that is a courageous act because, once we reveal our vulnerability, we
cannot "[t]ake back what [we]'ve written," just as we cannot have "[a]ny control over how re
aders interpret it."( Ellis,738).Finally, since an autoethonography "[i]s an autobiographical
genre of writing and research that displays multiple layers of consciousness, connecting the p
ersonal to the cultural," (Ellis,739). It helps meto keep focus my motivations andconcerns in
writing this paper; in order to feel thatthe other as being part of the community, we should list
en to his/her story as experienced in a rather isolated environment, i.e., the hospital. If we do
not listen
to such stories, then we risk facing the consequences of what I call "cultural loss".

Margaret Edson's Wit

In The Body in Pain: The Making and Unmaking of the World, Elaine Scarry argues, "[w]ork
and its artifacts are names that are given to the phenomena of pain and the imagination as
they begin to move from being a self-contained loop within the body to becoming the
equivalent loop now projected into the external world." (Scary 170) In Margaret Edson's play
Wit, the stage is empty, bare. Vivian Bearing--the protagonist--has advanced ovarian cancer.
The emptiness of the stage parallels the baldness of the patient, as well as the simplicity of her
hospital gowns. They are now parts of who she has become: a stranger to/in her own body.
Vivian is completely dependent on the machines (IV poles and others), and on chemically
induced treatments. These are the outside markers of her new identity. Her inside identity is
challenged, too. According to Sontag, "In cancer, non-intelligent cells are multiplying, and you
are being replaced by the non you." (Sontag,66) Can these "non-intelligent cell" completely
replace/erase one person's/patient's identity?

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The first part puts into spotlight the last days of a woman whose former individuality comes t
o her through flashbacks, and the protagonist's reactions to her cancer, hospitalization, and t
he loss of contact with the outside world. Tom Chambers writes that "Ellipses usually occur [...
] between periods of entrance into the medical setting. [...] The farther the character goes fro
m the medical world, the greater the chance of ellipses." (Chambers,179) In Vivian's case, the
protagonist is notgoing to get out of the hospital. Her ellipses occur only at the level of her min
d when she recollects fragments of her former identity.
who is Vivian? She is a professor specialized in the 17th century poetry, particularly in John D
onne's metaphysical poems. Because of her cancer, she is now a student in illness. Furthermor
e, because her ovarian cancer is in an advanced stage, the doctors propose to her a very drasti
c
treatment , of which they do not know much, if anything at all. As Vivian sadly admits, "Shrink
ing in metastatic tumors has not been documented." (Edson,37) Therefore, incapable to
still have control over her body, unable to teach her students the beauty and difficulty of Donn
e's poems, Vivian performs one final role: that of a patient who has been isolated in a cold and
mechanized environment, practically forgotten by everybody.
On her deathbed, Vivian says, "I am like a student and this is the final exam and I don't know
what to put down because I don't understand the question and I am running out of time." (70)
The unwritten, unspoken, yet understood meanings of Vivian's degenerating body, raise the f
ollowing questions: What is cancer? Does cancer have a meaning? Could we understand cance
r other than through the physicality of the one in pain? According to Barbara Rosenblum,
When you have cancer, you are bombarded by sensations from within that are not anchored in
meaning. They float in a world without words, without meanings. You do not know from moment
to moment whether to call a particular sensation a 'symptom' or 'side effect or a 'sign.' [...]
Words and their referents are uncoupled, uncongealed, no longer connected. (22)

Cancer almost makes language meaningless.Wordslike cancerous cells that spread all over
one’ bodyare eaten up by silences, interrupted by short sentences, and then continued by
Somemore unbearable silences. I read Vivian's pain and her inevitable death through the signs
inscribed on her body: she is bald, "has a central catheter over her left breast, so
that the IV tubing goes there, not in her arm," (23) vomits constantly, and has lost considerabl
e weight .
VIVIAN. In everything I have done, I have been steadfast, resolute-some would say in the
extreme. Now, as you can see, I am distinguishing myself in illness. I have survived eight treatmen
ts of Hexamethophosphacil and Vinplain at the full dose ... I have broken the record. I think Kelek
ian and Jason [his intern] foresee celebrity status for themselves upon the appearance of the jour
nal article they will no doubt write about me. But I flatter myself. The article will not be about m
e, it will be about my ovaries. (24)
What we could infer from this passage is that the one in pain not only succumbs to pain itself
eventually (when the body does not have resources to fight against the illness anymore), but a
lso that the body of the ill person is unjustly claimed by the medical staff. After all, Kelekian an
d his interns will most likely write an article about Vivian's ovaries. Consequently, Vivian is n
ot treated as a whole body. The focus of the doctors' research has switched to her ovaries, thu
s treating Vivian metonymically.
I think that while medicine tries to find a norm for our bodies, ironically or not, our bodies con
stantly prove the endeavor futile. We are bodies within bodies. Not one body, but multiple em
bodiments that change their morphology constantly accompanied by multifarious sensations
and myriad of reactions. To diagnose someone means to put that person's/patient's illness in
one category. However, to treat one him/her means to find a cure for his/her special case of ill
ness. The role of the doctor is to attentively collect and interpret the information received abo
ut his/her person/patient. (This information comes to him/her through routine and/or sophi

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sticated clinical tests, dialogues with the persons/patients, and collaborations between a doct
or and his/her staff) As it has often been argued, doctors play the role of historians. But, when
the events did not happen in the more or less remote past, but are present, then, in a shift of re
flexivity, the person/patient becomes a historian. Narrating his/her "presentpast," the person
/patient may be willing to do it succinctly or with abundant details, may be able to recollect in
depth the events "as they happened," or may not be willing to share too much of his/her sudd
en invaded intimacy. From history textbooks, we have learned that, if an event has at least two
interpretations, then each one claims supremacy over the other. Put differently, when one's b
ody is analyzed by the doctoras historian and by oneself
historian, then inevitably there occurs conflicts in interpreting the events "as they happened."
I believe that these conflicts are a pertinent example to show that there are limitations in med
icine and the way it views its patients, just as there are limitations in any other science of the
humanities. In Edson's Vivian's case, having been diagnosed late in her life, the doctors knew t
hat they would not be able to save her life. Their mistake, however, was to treat Vivian just as
a case, and not as a human being. As Leonardo Cassuto points out, "The case study relies on th
is continuing tension between the abstract (and general) and the concrete (and individual)." (
123) But Vivian sadly admits, "Medical terms are less evocative [i.e., than John Donne's metap
hysical conceits]. Still, I want to know what the doctors mean when they ... anatomize me. [...]
My only defense is the acquisition of vocabulary." (Edson44) Unlike her former fascinating ac
quisition of Donne's terms such as "ratiocination," "concatenation," "coruscation" which have
taken her a lifetime to taste the flavor of their multiple connotations, now Vivian feels not only
is she running out of time, but also she is refused a genuine dialogue with her doctors. As she
says, "In isolation, I am isolated. For once I can use a term literally." (47) Instead, she regrets t
he fact of not having been given the opportunity to communicate effectively with the medical s
taff, and, thus, to understand more things about her cancer. She realizes that there is a more p
erverse dimension to isolation. She is isolated because her immune system is so low, defensel
ess, that it may actually attack her body. When she is put in that isolated room, she is literally l
eft alone with her body, which she finally sees more clearly. It is not her body anymore, but so
mething accompanied, surrounded and sustained by an orchestrated set of machines. Ironicall
y, she justifies the existence and meaning of those machines. In other words, the machines cou
ld function without Vivian; they could be plugged and unplugged effortlessly, with a simple to
uch of a button. Sadly, it is Vivian who cannot function without them. This is the ultimate defin
ition of isolation which comes as a shock to her.
Through Vivian's nakedness, Edson may propose a way in which persons/patients could recla
im their personhood. Vivian enters, if not becomes, the invisible yet pervasive light. I could be
totally wrong, but for me Vivian's tearing of her hospital gown at the end of the play has positi
ve meanings. Only when she tears them apart, only when she is naked again, can she finally br
eak off the cocoon of her hospitalized identity.
Audre Lorde's The Cancer Journals
If Margaret Edson introduced a fictitious character diagnosed with cancer to us, as an example
of the enactment of cancer, Audre Lorde's The Cancer Journals documents this woman's strug
gle with cancer. Moreover, if having ovarian cancer is biased on the implication of a total inter
nal affliction, and consequently it is less "effective" for the public eye, breast cancer raises all s
orts of questions. The fetishism of the female breast has been construed socioculturally, and s
hould definitely be scrutinized and reflected upon.
Having one breast surgically removed, Lorde finds herself lost, but, at the same time, tries to fi
nd persuasive means to communicate her most intimate feelings: "I want to write rage, but all
that come is sadness. [...] I am not supposed to exist. I carry death around in my body like a co
ndemnation. But I do live. There must be some way to integrate death into living, neither igno
ring it nor giving in to it." (13) Losing a breast to mastectomy provides an opportunity to dem

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ystify the myth that a woman is whole only if she is symmetrical, narrowly understood as havi
ng two breasts. As Lorde recollects,
In September 1978, I went into the hospital for a breast biopsy for the second time. [...] I knew it
was malignant. [...] The gong in my brain of 'malignant,' 'malignant,' and the icy sensations of
that frigid room, cut through the remnants of anesthesia like a fine hose trained on my brain.
(27)
Prior to finding out whether or not her tumor was malignant, Lorde sensed fear all over her b
ody.Actually, the adjective malignant seems to have spread all over her being, obsessively addi
ng apsychical pain to a physical one. According to Scarry, "[t]o have pain is to have certainty; t
o hearthat another person has pain is to have doubt." (Scarry,7) Could we honestly agree with
Scarry's point of view? Doesn't it deny our capacity to empathize with the other? All her life, a
nd particularly after discovering her cancer, Lorde tried to express her anxieties and stop thes
e tyrannies of silence." (Lorde,58) As she writes reflecting upon her cancer,
What I most regretted were my silences. [...] Death is the final silence. And that might be coming
quickly, now, without regard whether I had ever spoken what I needed to be said, or had only
betrayed myself into small silences, while I planned someday to speak, or waited for someone
else to say the words for me. (57)
Her life took a dramatic turn when she discovered that it could have been saved only if her bre
astwas to be surgically removed. After the surgery, she remembers,"My breast which was no l
onger there would hurt as if it were squeezed in a vise. [...] The euphoria and the numbing effe
cts of the anesthesia were beginning to subside." (38)
Although after the mastectomy Lorde tried to lift her spirits by making the rather unusual
comparison between her situation and that of the Amazonsthose famous mythological female
archers whose one breast was cut to allegedly make them more combative/precise in fights
nevertheless she knew she was more than an Amazon. She was a carnal, vibrant, real woman,
and not a mythological creature. Furthermore, to her bitter disappointment, she found out tha
t there were few documents related to other women who had lost a breast because of cancer.
What happens when women are convinced to wear a prosthesis, and thus fit into a "norm"? In
this instance of "normalization," does the hyphened space of doctorperson/patient bear the
marks of scarification and pressure of those aberrant rules that say a woman is a woman only
if she has two breasts? As Lorde admits, "To imply to a woman that yes, she can be the 'same'
as before surgery, with the skillful application of a little puff of lambswool, and/or silicone ge
l, is to place an emphasis upon prosthesis which encourages her not to deal with herself as ph
ysically and emotionally real, even though altered and traumatized." (39) In addition, "[a]rtifi
cial limbs perform specific tasks, allowing us to manipulate or to walk. Dentures allow us to c
hew our food. Only false breasts are designed for appearance only." (40) Furthermore, accordi
ng to Thatcher Carter, "Normalization is the key component in prosthetic breast sales; there is
no medical reason to have a prosthetic breast, and the breast is shaped to fit the norms of our
society." (71) There are two key words in this succinct, yet powerful passage: "(breast) sales"
and "to fit." When women are convinced, after mastectomy, that they should return to "norma
l," this normality implies not only an integration into consumer society, but also an artificial r
econstruction performed on the site of a female body. But how could such a "breast" be consi
dered healthy, when it is artificial?.
Finally, as Ellis remarks, "Arthur Frank says in The Wounded Storyteller that it is important to
think with a story, not just about a story. Thinking with a story means allowing yourself to re
sonate with the story, reflect on it, become part of it." (66) In other words, thinking with a stor
y allows us simultaneously to become the author, the character, and the critic of that story, th
us viewing ourselves from multiple perspectives, accepting our strengths, and facing our wea
knesses. To be human is to cry, laugh, and make time for us and our dear ones. To be human is
also to make time to listen to what others have to say/share to/with us. This is the very first t

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ime I let my wounds be printed in an academic journal. I hope my paper becomes inspirationa
l to other women and men "out there," who, most likely, have a story to tell.

Works Cited
Carson, Roland A. "The Hyphened Space: Liminality in the DoctorPatient Relationship." Stories
Matter: The Role of Narrative in Medical Ethics. Ed. Rita Charon. Routledge, 2002. Pp.171-181.
Chambers, Tom. "What to Expect from an Ethics Case." Stories and their Limits: Narrative App
roaches to Bioethics. Ed. Hilde Lindemann Nelson. New York : Routledge, 1997: 171-184.
Couser, Thomas G. "Autobiography: Women, Illness, and Lifewriting." Auto/biography Studies.
Vol.6,no.1 ,1991,pp 65-75.
Edson, Margaret. Wit. Faber and Faber, 2000
Ellis, Carolyn and Arthur P. Bochner. "Autoethnography, Personal Narrative, Reflexivity: Rese
archer as Subject”. Handbook of Qualitative Research. Eds. N. K. Denzin & Y. S. Lincoln Thousa
nd Oaks, Sage Publications, Inc., 2000,pp. 733-768.
Kimmich, Allison. "Writing the Body: From Abject to Subject." Auto/biography Studies.vol.13,
no.2, 1998,pp. 223-234.
Lorde, Audre. The Cancer Journals. Aunt Lute Books, 1992.
Scarry, Elaine. The Body in Pain: The Making and Unmaking of the World. Oxford UP, 1985.
Sontag, Susan. Illness as Metaphor. Farrar, Straus and Giroux, 1978.

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 SMALL INDIGENOUS FISHES OF RIVERS – ROLE IN FOOD AND NUTRITION
SECURITY FOR HEALTHY LIVING.

DALIE DOMINIC A.A, SWAPNAJOHNYB

A(Presenting Author)Department of Zoology, St. Mary’s College, Thrissur-680 103. E-Mail Id:
domdal243@gmail.Com
B Department of Zoology, Little Flower College Guruvayoor

Introduction
Food security is an issue of great concern and measures need to be taken to improve food and
nutrition security, a focus on resource identification and harvest of small fish is essential to
provide for poverty alleviation and food security.
Small indigenous fishes have been used from time immemorial as a food resource for well
being of man. Small indigenous freshwater fish species (SIF) are fishes that have a size of 25-
30 cm. They are found in large amounts in all the rivers of India. But there is meagre literature
with their role in livelihood security.
The present study reveals that the river is a rich source of fishes suitable for improving the
livelihood standards and healthy living of the local people. Small fish are consumed whole
including bones which are a good source of calcium and other minerals. Fish is rich in
nutrients. Many nutrients like vitamins, iron, calcium, zinc and iodine are not found in rice but
Small indigenous fish are an important source of these nutrients.Many species are also rich
source of vitamin A. However improper exploitation of the resource without concern on
conservation strategies have created severe decline in SIFFS, whereas it is highly essential for
the long run.
Today they are under severe threat and to achieve sustainable utilisation, management
strategies are of utmost importance. This article deals with this untapped resource and their
role in food security.

River as a resource
India is a land of rich biodiversity. It is a home for a variety of organisms both endemic and
exotic. Fishes form an important component of the aquatic system. Rivers are the cradle of
human civilization, the river resources of India comprising Ganga, Brahmaputra, Indus, East
coast and West coast system run to a collective length of 27359 km. These rivers are treasure
houses of rich Icthyofaunal diversity whose sustainable exploration would boost the health
industry.
It is estimated that 27,977 valid species of fishes exist in the word today (Nelson, 2006). In
India 2,319 species of finfish have been recorded asper the database developed by NBFGR of
which 838 are from freshwater, 113 brakishwater and 1,368 from the marine environment
(Sarkar&Lakra, 2010).

Fish as a source for food security

Small fish are eaten frequently in small amounts and are more equally distributed among
family members than big fish of which men get the larger share (Thilsted, et.al.,1997).It is
identified that Wild SIS is an important source of vitamin A and calcium in Bangladesh (Roos,
et.al.,2003).
According Hossain et.al.(1999) to SIS are good source of protein and minerals especially
calcium and phosphorus. Small fish are reported to be more affordable and accessible than
the larger fish and other usual animal-source foods and vegetables according
toKawarazuka&Béné (2011).

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While the small indigenous fish are easily available and present in abundant they together
makeup for the nutrient content of larger fish. Composition of different small indigenous fish
more or equal to other larger carp species, though the price of SIS is very lower than larger
species of fish. Therefore, small indigenous fishes can play a significant role to fulfill the
nutrientdemand of poorer sections of people of the country according toMazumderet.al.
(2008). Awareness of the importance of nutrient-dense fish species to combat vitamin A and
mineral deficiencies should be raised at the household level as well as all levels in the
agriculture, health, and nutrition sectors. Rooset,al.(2007).

In the current scenario it is highly essential that all inland resource are enhanced for the
production of aquatic organisms to meet the increasing demand for food. SIS can be included
in pond aquaculture systems, and on-farm experiments show this can complement carp
production by increasing production and cash returns. Thompson et.al.(2002).

Role of fish in healthy living

Consumption of fish has been identified to improve the livelihood standards of the common
man.Inspite of providing rich nutrients it is also found to decrease the probability of various
diseases.
Fish plays an important role in enhancing the nervous system and prevents neurological
disorders. According to Tanskanenet.al. (2001) likelihood of having depressive symptoms was
significantly higher among infrequent fish consumers than among frequent consumers.
Fish consumption was inversely associated with the risk of incident Alzheimer disease,
consumption of fish and n-3 fatty acids was associated with reduced risk of Alzheimer disease
Morris et.al.(2003). Fish consumption also reduses the risk of various kinds of cancer
according to Kaizeret.al.(1989), omega‐3 fatty acids contained in certain fish may protect
against breast cancer. It is identified that consumption of fatty fish might reduce the risk of
prostate cancer,Terryet.al.(2001). Fish consumption is associated with protection against the
later promotional stages of colorectal carcinogenesis according to Caygill& Hill (1995).

It is also found to decrease mortality factors causing coronary diseases, consumption of fish
was inversely associated with the risk of coronary death Shekelle et.al.(1985). Chowdhury
et.al. (2012), identified that there is inverse associations of fish consumption and long chain
omega 3 fatty acids with cerebrovascular risk. A Fish diet is identified to be a nutrient
component that creates a protective effect and reduces autoimmune disorders, Shapiro et.al.
(1996) identified that omega-3 fatty acids may help prevent rheumatoid arthritis. The
components in fish is found to prevent asthma in man and it was identified that consumption
of oily fish may protect against asthma in childhood according toHodge et.al. (1996).

Threats to small indigenous fish resource of rivers.

The food fish industry is an endeavor relying on fish biodiversity, population dynamics, fish
transportation and marketing. The present work analysed the important value of this rich
diversity that could be exploited for alleviation of poverty and livelihood standards. As far as
the rivers of India are concerned it is a gold mine outfitted with all the potencys required for
the industry. The present findings reveal potential of fish resource.
Although there is rich resource of biodiversity it is under threat. The pressure of globalization
thrust upon the soul of the river and streams. Increased rice production and changing
agricultural patterns have resulted in a large decline in inland fisheries
Rooset.al.(2007).However it is dentified that many SIF’s of Indian rivers are cultivable with
high demand. Puntius sarana, puntiusparrah, Channamarulius, C. striatus, Nandusnandus,

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Anabas testudineus, Esomusdanricus, Clariusbatrachus, Heteropnustesfossilis Puntius chola,
Glossogobiusgiuris, Danio devario are some examples

Freshwater aquatic environments are experiencing serious threats to both biodiversity and
ecosystem stability and many strategies and priorities have been proposed to solve this crisis.
The current major threats to the SIF’s are as, loss of natural habitats, use of small mesh sized
gears, dewatering, use of insecticides and pesticides, industrial and domestic pollution,
invasion of exotics and disease,Mining operation, Habitat destruction, industrialization, saline
intrusion, overindulgence in fertilizer, accidental fires along banks of the river, clay mining for
Brick work, Increased sedimentation due to removal of riparian vegetation, entry of
agricultural runoff, modification of channels and network of roads across the river. These
cause severe habitat change and loss in diversity of fish.

Conservation and management

Management of small indigenous fish require conservation strategies. Development of
Database, Breeding Techniques, prevention of Introduction of Exotic Fishes &Regulation of
Catch,Steps should be taken to enhance SIF’s in floodplains, rivers, ponds and lakes.
Awareness about conservation of indigenous fish diversity should be provided to locals and
Traditional Knowledge need to be recorded on small indigenous fish species.

Conclusion
Small indigenous freshwater fish species (SIF) are fishes that are easily available,
Low in Cost they are rich source of high nutrient, they are available fresh from rivers and are
important source of Riparian Community Livelihood. They are a source of Vital protein, Fatty
acids &Micro-nutrients-phosphorus, calcium, zinc, iron and therefore need to be conserved
and their production increased.

References

1. Caygill, C. P., & Hill, M. J. (1995). Fish, n-3 fatty acids and human colorectal and breast
cancer mortality. European journal of cancer prevention: the official journal of the
European Cancer Prevention Organisation (ECP), 4(4), 329-332.
2. Chowdhury, R., Stevens, S., Gorman, D., Pan, A., Warnakula, S., Chowdhury, S., ... &
Franco, O. H. (2012). Association between fish consumption, long chain omega 3 fatty
acids, and risk of cerebrovascular disease: systematic review and meta-analysis. Bmj,
345, e6698.
3. Hodge, L., Salome, C. M., Peat, J. K., Haby, M. M., Xuan, W., &Woolcock, A. J. (1996).
Consumption of oily fish and childhood asthma risk. The Medical journal of Australia,
164(3), 137.
4. Hossain, M. A., Afsana, K., & Azad Shah, A. K. M. (1999). Nutritional value of some small
indigenous fish species (SIS) of Bangladesh. Bangladesh Journal of Fisheries Research,
3(1), 77-85.
5. Kaizer, L., Boyd, N. F., Kriukov, V., &Tritchler, D. (1989). Fish consumption and breast
cancer risk: an ecological study.
6. Kawarazuka, N., &Béné, C. (2011). The potential role of small fish species in improving
micronutrient deficiencies in developing countries: building evidence. Public health
nutrition, 14(11), 1927-1938.
7. Mazumder, M. S. A., Rahman, M. M., Ahmed, A. T. A., Begum, M., & Hossain, M. A. (2008).
Proximate composition of some small indigenous fish species (SIS) in Bangladesh.
International Journal of sustainable crop production, 3(4), 18-23.

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8. Morris, M. C., Evans, D. A., Bienias, J. L., Tangney, C. C., Bennett, D. A., Wilson, R. S., .&
Schneider, J. (2003). Consumption of fish and n-3 fatty acids and risk of incident
Alzheimer disease. Archives of neurology, 60(7), 940-946.
9. Roos, N., Islam, M. M., &Thilsted, S. H. (2003). Small indigenous fish species in
Bangladesh: contribution to vitamin A, calcium and iron intakes. The Journal of
nutrition, 133(11), 4021S-4026S.
10. Roos, N., Wahab, M. A., Chamnan, C., &Thilsted, S. H. (2007). The role of fish in food-
based strategies to combat vitamin A and mineral deficiencies in developing countries.
The journal of Nutrition, 137(4), 1106-1109.
11. Roos, N., Wahab, M. A., Hossain, M. A. R., &Thilsted, S. H. (2007). Linking human
nutrition and fisheries: incorporating micronutrient-dense, small indigenous fish
species in carp polyculture production in Bangladesh. Food and Nutrition Bulletin,
28(2_suppl2), S280-S293.
12. Sarkar, U. K., &Lakra, W. S. (2010). Small indigenous freshwater fish species of India:
significance, conservation and utilization. Aquaculture Asia, 15(3), 34-35.
13. Shapiro, J. A., Koepsell, T. D., Voigt, L. F., Dugowson, C. E., Kestin, M., & Nelson, J. L.
(1996). Diet and rheumatoid arthritis in women: a possible protective effect of fish
consumption. Epidemiology, 256-263.
14. Shekelle, R. B., Missell, L., Paul, O., Shryock, A. M., Stamler, J., Vollset, S. E., ... & Greaves,
M. (1985). Fish consumption and mortality from coronary heart disease. New England
Journal of Medicine, 313(13), 820-824.
15. Tanskanen, A., Hibbeln, J. R., Tuomilehto, J., Uutela, A., Haukkala, A., Viinamäki, H., ...
&Vartiainen, E. (2001). Fish consumption and depressive symptoms in the general
population in Finland. Psychiatric Services, 52(4), 529-531.
16. Terry, P., Lichtenstein, P., Feychting, M., Ahlbom, A., &Wolk, A. (2001). Fatty fish
consumption and risk of prostate cancer. The Lancet, 357(9270), 1764-1766.
17. Thilsted, S. H., Roos, N., & Hassan, N. (1997). The role of small indigenous fish species
in food and nutrition security in Bangladesh. Naga, the ICLARM quarterly, 20(3-4), 82-
84.
18. Thompson, P., Roos, N., Sultana, P., &Thilsted, S. H. (2002). Changing significance of
inland fisheries for livelihoods and nutrition in Bangladesh. Journal of Crop Production,
6(1-2), 249-317.

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 MATHEMATICS IN CANCER RESEARCH

ALPHY JOSE

Asst. Professor, Dept. Of Mathematics, Little Flower College, Guruvayoor

Abstract: This paper introduces the advantages of mathematical tools such as Mathematical
oncology, Fuzzy set theory and Digital topology in extraction techniques for cancer diagnostic
methods.Applications of these branches in cancerdetection and therapy are used to increase
the imaging accuracy to classify the cancer images into cancer or non-cancer.

MATHEMATICAL ONCOLOGY: WHERE MATH MODELING MEETS CANCER RESEARCH

Many oncologists might think that there's no place for mathematical analysis in the
treatment of cancer. Russell Rockne is a mathematical oncologist who uses Mathematics as
the means of discovery in cancer research.
In addition to investigating questions of cancer biology, Rockne uses outcomes data
from large groups of patients to create predictive mathematical models, or algorithms, in the
hope of generating effective stand-alone or combination therapies for individual patients. The
algorithms loaded with clinical data essentially create a more precise treatment map for
individuals experiencing similar cancers.
Mathematical oncology is an emerging field that tries to use mathematical models to
understand and predict how cancer evolves and responds to therapy. Cancer is a complex
process that changes in space and in time. Even the “same” cancer can be different between
two patients. Mathematics, as the language of the physical universe, is very good at describing
and predicting phenomena that change over time. A major challenge in cancer research is that
the data is a static snapshot of a dynamic process and we use mathematics to understand the
dynamics.The goal of mathematical oncology is to improve patient care and drug selection
utilizing all components of the data collected on the clinical scale.
The kind of data (MRI, genomic, outcomes) that is now available to researchers is
unprecedented in its scope and nature. Mathematical modeling enables us to synthesize and
examine these complex data sets, how they interact or may be predictive in suggesting
courses of treatment or even cures.MRI (magnetic resonance imaging) data is particularly
important in the treatment of brain cancer because it provides a useful image of the organ and
disease in a situation where you can’t just go inside to take out or observe the cancer itself.
The MRI basically takes a picture of the disease as it changes over time, and one can utilize
that data to observe and model that growth in terms of the relative response of that patient to
a particular therapy.
FUZZY C-MEANS ALGORITHM
Breast cancer is one of the major causes of death among women. Small clusters of
micro calcifications appearing as collection of white spots on mammograms show an early
warning of breast cancer. Primary prevention seems impossible since the causes of this
disease are still remaining unknown. An improvement of early diagnostic techniques is critical
for women's quality of life. Mammography is the main test used for screening and early
diagnosis. Early detection performed on X-ray mammography is the key to improve breast
cancer prognosis. In order to increase radiologists’ diagnostic performance, several computer
aided diagnosis (CAD) schemes have been developed to improve the detection of primary
signatures of this disease: masses and micro calcifications. Many researches on
mammography images using Morphological operators and Fuzzy c-means clustering for
cancer tumor mass segmentation are vgoing on to increase the efficiency in this field. The first
step of the cancer signs detection should be a segmentation procedure able to distinguish

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masses and micro calcifications from background tissue using Morphological operators and
finally fuzzy c- means clustering (FCM) algorithm has been implemented for intensity based
segmentation.

DIGITAL TOPOLOGY IN MEDICAL IMAGE PROCESSING

The primary endgoal of most medical imaging research program isto collect
information about function and physiology of internal human organsor tissues through a
variety of imaging techniques. Often,medical imaging techniques suffer from limited spatial
and temporal resolution, noise, background in homogeneity and other artifacts leading to
fuzzy representationsof target objects in acquired images. Digital topology and geometry
playimportant roles in medical image processing either by expanding the scope oftarget
information or by providing a strong theoretical foundation to a processenhancing its
stability, fidelity, and efficiency. The notions of digital topologyand geometry are often
knotted in medical imaging applications and sometimeit is difficult to draw a dividing line
between them. Recent researches and overviews of theory and computation of several fuzzy
digital topologic and geometric approaches and describe their applications tomedical imaging
are being conducted. Topics related to threedimensionalsimple points, local topological
parameters, fuzzy skeletonization,characterization of local structures are applied to research
and clinicalstudies.
Digital topology and geometry have been applied in medical imaging to solve
differentimportant task. For example, component labeling and border tracking havebeen
applied in medical image visualization, manipulation, and analysis. Digitalconnectivity and
minimum cost path has been widely used in medical image segmentation. Digital topology has
been applied to characterize local structure, eg.,classification of plates and rods in a trabecular
bone imaging. Topology has also beenused for correction of anatomic structures segmented in
acquired images in thepresence of noise, partial voluming, and other artifacts. Skeletonization
hasbeen used to solve several medical imaging purposes, including, representation
ofanatomic structure, path planning, feature extraction, disease identification etc.
CONCLUSION
What we have today is the intersection of mathematics and biology, and increasingly in
the research setting, the push to have engineers and mathematicians talking to biologists, thus
improving communication among the disciplines. This paper presents recent advancements
and overviews of theory and computation of several fuzzy digital topologic and geometric
approaches and describes their applicationsto medical imaging

REFERANCES
1. AUTOMATIC DETECTION OF BREAST CANCER MASS IN MAMMOGRAMS USING
MORPHOLOGICAL OPERATORS AND FUZZY C -MEANS CLUSTERING. Journal of
Theoretical & Applied Information Technology. 6/1/2009, Vol. 5 Issue 6. BASHA, S.
SAHEB; PRASAD, K. SATYA
2. A FUZZY C-MEANS (FCM)-BASED APPROACH FOR COMPUTERIZED SEGMENTATION
OF BREAST LESIONS IN DYNAMIC CONTRAST ENHANCED MR IMAGES CONTRAST-
ENHANCED MR IMAGES, Academic Radiology, Vol. 13 Issue 1, Jan 2006Weijile Chen,
Maryellen L Giger
3. MATHEMATICAL ONCOLOGY: HOW ARE THE MATHEMATICAL AND PHYSICAL
SCIENCES CONTRIBUTING TO THE WAR ON BREAST CANCER?,
Current Breast Cancer Reports, September 2010, Volume 2, Issue 2, ISSN: 1943-4588
4. INTRODUCTION TO MATHEMATICAL ONCOLOGY,Journal of Biological Dynamics,
Vol.10, 2016, Issue 1, CHRISTIAN T.K.-H. STADTLÄNDER

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 Bamboo – The Natural Healer

DR. LAKSHMI C.J.

Assistant Professor (FDP vacancy), Botany Department, Little Flower College, Guruvayoor

Introduction

Bamboos are perennial evergreen arborescent grasses belonging to the family Poaceae and
grouped under the subfamily Bambusoideae. Most of the woody bamboo species are
monocarpic and die after seed setting, while herbaceous bamboos flower annually and seed
setting is regular (Oscar, 2003). There are about 110 genera and 1500 species of bamboos
distributed in various parts of humid tropical, sub-tropical and temperate regions of the
world (Orhnberger and Goerrings, 1985; Subramaniam, 1998). India is one of the leading
countries of the world, only second to China in bamboo production with an annual production
is about 32, 30,000 tonnes (Pathak, 1989). India is the second largest diversity centre for
bamboos with 122 species belonging to 26 genera (Kumar et al., 2007).
Bamboo has played a major role in human civilization since ancient times and is an integral
part of the cultural, social and economic conditions of rural and tribal populations from times
immemorial. It helps people to meet their basic needs and as a widespread, renewable,
productive, versatile, easily accessed and environment-friendly resource. It has great
potential to improve life, especially in the rural areas of the developing world (Sastry, 2008).
Hence, they have been variously called as “The Cradle to Coffin Plant,” “The Poor Man’s
Timber,” “Friend of the People,” “Green Gasoline,” “The Plant with Thousand Faces,” and “The
Green Gold” (Tewari, 1988 & 1992; Madhab, 2003).This green gold is adequately cheap and
abundant to meet the vast needs of human populations from the “child’s cradle to the dead
man’s bier.” There are more than 1500 different documented traditional uses of bamboo
(INBAR, 1997; Shrestha, 1999). Bamboo is considered to be a unique raw material for
construction of rural houses, ladders, mats, baskets, pipes and handicrafts. It has become a
major source of raw material for the Indian Pulp and Paper Industry during the last few
decades (Seethalakshmi and Kumar, 1998). Bamboo sheaths provide substitute material for
lining hats and sandals and also used for packing food (Oscar, 2003). Bamboo leaves are rich
in nutrients. Roots, leaves, sprouts and grains of bamboos are used in the Ayurveda for the
treatment of various diseases (Seethalakshmi and Kumar, 1998). A few reports are available
on nutritive value of Bambusa, DendrocalamusandOchlandraseeds. The average nutritive
value of Bambusabambos seeds excelled both rice and wheat (Raoet al., 1955).

Recent researches has showed the immense potentialof bamboo as a medicinal plant which is
used in various traditionalsystems like Ayurveda, Unani etc. Many bamboo species have been
found to have beneficial uses and are used by tribal people from ancient times. The present
paper discusses the ethanomedical, pharmacological and therapeuticpotential of Bamboo.

Nutritive value of bamboo

Singhalet al., 2011 conducted studies on bamboo leaf and found that leaf is highly nutritive
and contains important raw materials like crude protein, crude fiber, ash and other minerals.
It was also found that leaves were rich in calcium, magnesium, copper, and manganese;
moderate in zinc, while poor in phosphorous, potassium and sodium. According to Kirubaet
al., 2007, bamboo seeds have a good profile of minerals like calcium,phosphorous, iron. These
are good source of vitamin B 1,nicotinic acid, riboflavin and carotene. Seeds are rich

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incarbohydrates (73.4%), crude protein (12%), fiber (2.6%), ash(1.1%) and moisture (10%).
Studies on shoots also confirmed the presence proteins, saccharides, aminoacids, minerals,
low in fat, inorganic salts and the water contentmay be as high as 90% (Table 1). Shoots are
rich in dietary fiberand low in calories.

Table I: Nutritive value of bamboo shoots (modified from Chongthamet al., 2011 and Hu
et al., 1984).

CONSTITUENTS AMOUNT
Moisture 90 g
Protein 2.65 g
Fat 0.49 g
Saccharine 2.50 g
Soluble saccharine 1.53 g
Coarse fiber 0.58 g
Ash 0.88 g
Phosphorous 60 mg
Iron 0.8 mg
Calcium 12.8 mg

Ethanomedical Uses

Kani tribe living in the Western Ghats area of Kerala uses the seedsof Bambusaarundinaceafor
enhancing the fertility. This has increasedthe demand of Bambusaarundinaceaseeds in
pharmaceutical industry tomanufacture drugs to improve fertility. Bambusa leaf juice is
givenfor strengthening the cartilage in osteoarthritis and osteoporosis.It has a vital role in the
integrity of the bones, arterial walls, skin,teeth, gums, hair and nails and has been used to
alleviate eczema andpsoriasis (Vanithakumariet al., 1989).Pleioblastusamarus, a tall bamboo
growing in Southern Chinahas slightly bitter, pungent taste leaves, which are used in treating
fever, fidgeting,and lung inflammation (Kirubaet al., 2007).Buds of Bambusabambosare
reported to haveestrogenic activity. The extract of the bud has shown antifertility activity in
rats and very soft shoots of this species are used for birth control in north Lakhimpur, Assam,
India(Tewari, 1992).

Therapeutic potential of bamboo

Nam et al., 2013, conducted an experiment in diabetic mice using Sasa borealis leaf extract. It
was found that S. borealisextract exerted the anti-diabetic effect through the activation of
AMP-activated protein kinase (AMPK) AMPK and improvement of insulin signaling.
Phyllostachyspubescensleaves protective effect against palmitic acid induced
lipoapoptosis,reduction in the serum cholesterol. Experiments conducted on rats showed that
flavonoids rich bamboo could significantly lower the blood triglycerides and cholesterol
(Panee, 2008).Singhalet al., 2011 found that bamboo is a good source of natural antioxidants
and also have great pharmaceutical potential. Flavonoids, lactones and phenolic acid. It
contains Flavonoids - flavones C- glycosides which include homoorientin, isovitexin, orientin
and vitexin. The flavonoid content is 3.44% in different bamboo leaves species. Singh et al,
2010 concluded that Bambusaarundinaceae, Phyllostachyspubescens, Dendrocalamusasper and
Gigantochloashowed antibacterial activity against Staphylococcus aureus, Escherichia coli,
Pseudomonas aurenginosa and Bacillus sp.Sasaquelpaertensis leaves is also used in the

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treatment of inflammation related diseases.They documented the hot water extract of S.
quelpaertensis could ameliorate inflammation related diseases by suppressing nitric oxide
production in pathological event (Hwang et al., 2007). Jimmy et al., 2015 studied on the
antihypertensive activity of bamboos. It was found that bamboo shoots from aqueous extract
contain angiotensin converting enzyme inhibitory peptide (bamboo shoot peptide [BSP])
fractions.The fraction was identified which showed that Asp-Tyr was the key compound and it
reduces systolic blood pressure as the phenolic compound which was present in BSP has
vasodilatory effect, which decreases hypertension.
Anti-cancerous effect

Seki et al., 2010 based on his experiments in mice, found that the leaf extract of
Sasasenanensisincrease the immune stimulating activity, which induces activation of human
natural killer (NK) cells, macrophages and presence of 1,3-β-glucan and free radical
scavenging effects in mice. So the leaf extract of Sasa may be the primary immuno potentiating
factor which plays an important role in cancer prevention. Lin et al., 2008 studied the
inhibitory effect of Phyllostachysedulisextract on the development of breast cancer and it was
found that the extract delayed the onset of mammary tumor by 1 week, decreased the tumor
incidence by 44% and tumor multiplicity by 67%.The effects of Bambusae caulis in taeniam
(BCT), on the metastatic potential ofmalignant cancer cells and the mechanism of anti-
metastatic activitywas studied by Kim et al., 2013. Theycarried out studies using the aqueous
extract of Bambusae caulis which inhibitsPMA-induced tumor cell invasion and pulmonary
metastasis.Pretreatment with AE-BCT efficiently inhibited cell migration,invasion and
adhesion. Therefore the results demonstrated that AEBCTsignificantly reduced the metastatic
activity of highly malignantcancer cells by suppressing MMP-9 activity via inhibition of
ROSmediatedNF-kB activation. These results concluded that AE-BCT maybe a safe natural
product for treatment of metastatic cancer.

Sarijang is a bamboo salt soy sauce which has been demonstratedto exert anti-inflammatory
and antitumor activity (Sangeetaet al., 2015). The pro-apoptoticeffects of sarijang in vitro
were carried out in U937 human leukemiacell model. Choi et al., 2013 conducted an
experiment on inducing apoptosisby sarijang in U937 human leukemia cells through the
activation ofcaspases. The apoptosis induced by sarijang was significantly inhibitedby z-VED-
fmk, a pan-caspase inhibitor, which demonstrated theimportance of caspases in the process.
These results concluded thatsarijang can be a potential chemo therapeutic agent for the use
incontrol of U937 leukemia cells; hence they are required to identify theactive compounds.
Paneeet al., 2008 studied the effect of leaves of Pseudosasa japonicaon the development of
DMBA (7,12-Dimethylbenz[a] Anthracene)to induce breast cancer in Sprague-Dawley rats. It
wasfound that oral administration of bamboo extract for 3 weeksprior to DMBA injection
delayed the onset of breast cancer by oneweek as compared to the control. Further the extract
also showed thepotential of decreasing the incidence of occurrence of tumor by 44%and
restricting the growth rate of the tumor by 67% after 11weeks ofDMBA treatment.

Conclusion

Bamboo is a less explored plant with ethanomedical, pharmacological and therapeutic

potential. The uses of bamboo need to be substantiated with strong scientific validation and
experimentsfor its extensive usage in various therapies. So it is necessary to promote bamboo
cultivation through appropriate methods and to carry out extensive research on the
therapeutic potential of Bamboo.

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References

Choi EA, Park C, Han MH, Lee JH, Kim GY, et al. 2013. Induction of apoptosis by sarijang, a
bamboo salt sauce, in U937 human leukemia cells through the activation of caspases.
Experimental and therapeutic medicine 6: 381-387.

Chongtham N, Bisht MS &Haorongbam S,2011. Nutritional properties of bamboo shoots:

potential and prospects for utilization as a health food. Comprehensive Reviews in Food Science
and Food Safety, 10(3), 153-168.

Hu CZ,1984.Nutrients in Bamboo Shoot.Journal of Zhejiang Forestry College, 1(1), 1-13.

Hwang Joon-Ho HJH, Choi Soo-Yoon CSY, Ko, Hee-Chul KHC, Jang Mi-Gyeong JMG, Jin Young-
Jon JYJ, Kang Seong -Il KSI .2007. Anti-inflammatory effects of the hot water extract from
Sasaquelpaertensisleaves. Food Science and Biotechnology, 16(5), 728-733.

INBAR, 1997.International Network for Bamboo and Rattan. News Magazine, 5(3): 56 p.
Jimmy DO, Priyanka P .2015. Antihypertensive Activity of Bamboo Shoot: A Review. Asian
Journal of Pharmacologicaland Clinical Research 8: 46-47.

Kim A, Im M, Yim N-H, Jung YP, Ma JY .2013. Aqueous Extract of Bambusae caulis in Taeniam
Inhibits PMA-Induced Tumor Cell Invasion and Pulmonary Metastasis: Suppression of NF-kB
Activation through ROS Signaling. PLoS ONE 8: e78061.

Kiruba S, Jeeve S, Manohardas S, Kannan D .2007.Bamboo seed as a mean to sustenance of the

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Kumar, M., Remesh, M. and Stephen Sequiera. 2007. Field identification key to the native
bamboos of Kerala, India. Bamboo Science and Culture, 15(1): 35-4.

Madhab, J. 2003. The green gold: under-exploited wealth of north-east India. Dialogue,
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Orhnberger, D. and Goerrings, T. 1985. The bamboos of the world.International Book

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Pathak, P. S. 1989. Bamboo Resources in the World Proc. Seminar on Silviculture and
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Shrestha, K. 1999. Distribution and status of bamboos in Nepal. In: Rao A.N. and Rao V.R.,
editors. Proceedings of a training course cum workshop; 1998 May 10—17; Kumming and
Xishuangbanna, Yunnan, China and IPGRI-APO, Serdang, Malaysia: Bamboo- conservation,
Diversity, Ecogeography, Resource, Utilization and Technology.
Singhal P, Satya S &Sudhakar P, 2011.Antioxidant and pharmaceutical potential of bamboo
leaves.Bamboo Science and Culture, 24(1), 19-28.

Subramaniam, K.N. 1998. Bamboo Genetic Resources in India. In: K. Vivekanandan, A. N. Rao
and V. RamanathaRao (eds.), Bamboo and Rattan Genetic Resources in Asian Countries, IPGRI-
APO, Serdang, Malaysia.

Tewari, D.N. 1988. Bamboo as poverty alleviator.Indian Forester, 114:610 pp.

Tewari, D. N. 1992. A Monograph on Bamboos. International Book Distributors, Dehra Dun:

498 p.
Vanithakumari G, Manonayagi S, Padma S, Malini T,1989. Antifertility effect of
Bambusaarundinacea shoot extracts in male rats. J Ethnopharmacol25:173-180.

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 BIOMEDICAL APPLICATIONS OF NANOFLUIDS

ROSE PAUL

Department of Mathematics, Little Flower College, Guruvayoor, KeralaEmail:

rosebewishrr@gmail.com

INTRODUCTION

Nanofluid is a suspension of solid nanoparticles (1-100nm diameter) in conventional liquids

like water,oil or ethylene glycol.The emergence of nanofluids as a new field of nano scale heat
transfer in liquids is related directly to miniaturization trends and nanotechnology.
Nanofluids owe its history to the Advanced Fluids Program (AFP) at Argonne National
Laboratory (ANL) that encompassed a wide range (meters to nanometers) of size regimes and
eventually the wide research road became narrow, starting with large scale and descending
through micro scale to nano scale, culminating in the invention of nanofluids.The goal of
nanofluids is to achieve the highest possible thermal properties at the smallest possible
concentrations by uniform dispersion and stable suspension of nanoparticles in host fluids.
When used as coolants, nanofluids can provide dramatic improvements in the thermal
properties of host fluids. The novel nanofluids enable a more efficient, effective and uniform
heat removal capability for systems requiring highly accurate temperature control at high
heat fluxes.

In the development of energy-efficient heat transfer fluids, the thermal conductivity of the
heat transfer fluids has a specific role to play. Though numerous development efforts and
considerable previous research have took place, major improvements in cooling capabilities
have been constrained because traditional heat transfer fluids used in today’s thermal
management systems, such as, water, oils, and ethylene glycol, have inherently poor thermal
conductivities, orders-of-magnitude smaller than those of most solids. It is well known that at
room temperature, metals at room temperature in solid form have higher thermal
conductivities than those of their fluids (Touloukian et al., 1970). The thermal conductivity of
metallic liquids is much higher than those of non metallic liquids. As a consequence, the
thermal conductivities of fluids that contain suspended solid metallic particles could be
expected to be significantly higher thanthose of conventional heat transfer fluids.

MATERIALS AND METHODS

Nanofluid is defined as a colloidal solvent containing dispersed nanometer-sized particles

(~1-100 nm). Researchers have found out manymaterials that can be used as base fluids and
nano particles.Stable and highly conductive nanofluids are produced by one step and two step
production methods. Both approaches for creating nano particle suspensions suffer from
agglomeration of nano particles, which is a key issue in all the technology involving nano
powder. Therefore, synthesis and suspension of nearly non agglomerated or mono dispersed
nanoparticles in liquids is the key to significant enhancement in thermal properties of
nanofluids.

Nano structured or nano phase materials made of nanometer sized particles enhanced
physical properties not exhibited by conventional bulk solids. All physical mechanisms have a
critical length scale below which the physical properties of materials are changed. Thus the
particles smaller than100 nm exhibit properties different from those of conventional solids.

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The noble properties of nanophase materials come from the relatively high surface area or
volume ratio which is due to high proportion of constituent atoms residing at the grain
boundaries. The thermal, mechanical, optical, magnetic and electric properties of nanophase
materials are superior to those of conventional materials with coarse grain structures.

Nanoparticles used in nanofluids have been made of various materials such as

oxide ceramics (Al2O3, CuO), nitride ceramics (AlN, SiN), carbide ceramics (SiC, TiC), metals
(Cu, Ag, Au), semiconductors (TiO2, SiC), carbon nanotubes, and composite materials such as
alloyed nanoparticles Al70Cu30 or nanoparticle core-polymer shell composites. In addition to
the nonmetallic, metallic and other materials for nanoparticles, completely new materials and
structures such as materials ‘doped’ with molecules in their solid liquid interface structure
may also have desirable characteristics.

Many types of liquids like water, ethylene glycol and oil have been used as host liquids in
nanofluids.

MILESTONES IN EXPERIMENTAL DISCOVERIES ON NANOFLUIDS

Experimental work in nanofluids research groupsworld-wide has discovered that nanofluids

exhibit thermal properties superior to those of base fluids or conventional solid-liquid
suspensions. Studies have shown that copper and carbon nano tube (CNT) nanofluids possess
extremely high thermal conductivities compared to those of their base liquids without
dispersed nanoparticles and CNT nanofluids have a nonlinear relationship between thermal
conductivity and concentration at low volume fractions of CNTs. The distinctive features like
strong temperature-dependent thermal conductivity ( Das et al., 2003b) and strong size-
dependent thermal conductivity were contributed by thermal conductivity measurement
experiments of nanofluids.

The potential impact of the discoveries on heat transfer applications made nanofluids
promising coolants for the industrial and electronic world. As a consequence of these
discoveries, research and development on nanofluids has drawn caring attention from
industry and academia over the past several years.

APPLICATIONS OF NANOFLUIDS

Nanofluids find most of their applications in thermal management of industrial and consumer
products as efficient coolingis vital for realizing the functions and long-term reliability of the
same. There are a large number of tribological and medical applications for nanofluids. Recent
studies have demonstrated the ability of nanofluids to improve the performance of real-world
devices and systems such as automatic transmissions. This paper specifically discusses the
cooling applications of nanofluids in medical field.

Biomedical Applications
Nanofluids can be formulated for a variety of uses for faster cooling. Nanofluids are now being
developed for medical applications, including cancer therapy. As traditional cancer treatment
methods have significant side effects, Iron-based nanoparticles can be used as delivery
vehicles for drugs or radiation without damaging nearby healthy tissue by guiding the
particles up the bloodstream to a tumour with magnets. Moreover, nanofluids could be used
for safer surgery by cooling around the surgical region, thereby enhancing a patient’s chance
of survival and reducing the risk of organ damage. In contrast to cooling,nanofluids could be

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used to produce higher temperatures around tumours; to kill cancerous cells without
affecting nearby healthy cells ( Jordan et al.,1999).

Nano drug Delivery

Most bio-MEMS studies were done in academia in the 1990s, while recently
commercialization of such devices have started. Examples include an electronically activated
drug delivery microchip; a controlled delivery system via integration of silicon and
electroactive polymer technologies; a MEMS-based DNA sequencer developed by Cepheid;
and arrays of in-plane and out-of-plane hollow micro-needles for dermal/transdermal drug
delivery as well as nanomedicine applications of nanogels or gold-coated nanoparticles An
objective of the advanced endeavors in developing integrated micro- or nano-drug delivery
systems is the interest in easily monitoring and controlling target-cell responses to
pharmaceutical stimuli, to understand biological cell activities, or to enable drug development
processes.
While conventional drug delivery is characterized by the ‘‘high-and-low” phenomenon,
microdevices facilitate precise drug delivery by both implanted and transdermal techniques.
This means that when a drug is dispensed conventionally, drug concentration in the blood will
increase, peak and then drop as the drug is metabolized, and the cycle is repeated for each
drug dose. Employing nano-drug delivery (ND) systems, controlled drug release takes place
over an extended period of time. Thus, the desired drug concentration will be sustained
within the therapeutic window as required.
Ananodrug-supply system, that is, a bio-MEMS was introduced by Kleinstreuer.
(Kleinstreuer et al.,2008). Their principal concern were the conditions for delivering uniform
concentrations at the microchannel exit of the supplied nano-drugs. A heat flux which
depends on the levels of nano-fluid and purging fluid velocity was added to ascertain that
drug delivery to the living cells occurs at an optimal temperature, that is, . The added wall heat
flux had also a positive influence on drug-concentration uniformity. In general, the nano-drug
concentration uniformity is affected by channel length, particle diameter and the Reynolds
number of both the nanofluid supply and main microchannels. Since the transport
mechanisms are dependent on convection— diffusion, longer channels, smaller particle
diameters as well as lower Reynolds numbers are desirable for best, that is, uniform drug
delivery.

Cancer Treatment
There is a new initiative which takes advantage of several properties of certain nanofluids to
use in cancer imaging and drug delivery. This initiative involves the use of iron-based
nanoparticles as delivery vehicles for drugs or radiation in cancer patients. Magnetic
nanofluids are to be used to guide the particles up the bloodstream to a tumor with magnets.
It will allow doctors to deliver high local doses of drugs or radiation without damaging nearby
healthy tissue, which is a significant side effect of traditional cancer treatment methods. In
addition, magnetic nanoparticles are more adhesive to tumor cells than non-malignant cells
and they absorb much more power than microparticles in alternating current magnetic fields
tolerable in humans; they make excellent candidates for cancer therapy.
Magnetic nanoparticles are used because as compared to other metal-type nanoparticles,
these provide a characteristic for handling and manipulation of the nanofluid by magnetic
force. This combination of targeted delivery and controlled release will also decrease the
likelihood of systemic toxicity since the drug is encapsulated and biologically unavailable
during transit in systemic circulation. The nanofluid containing magnetic nanoparticles also
acts as a super-paramagnetic fluid which in an alternating electromagnetic field absorbs

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energy producing a controllable hyperthermia. By enhancing the chemotherapeutic efficacy,
the hyperthermia is able to produce a preferential radiation effect on malignant cells.
There are numerous biomedical applications that involve nanofluids such as magnetic cell
separation, drug delivery, hyperthermia, and contrast enhancement in magnetic resonance
imaging. Depending on the specific application, there are different chemical syntheses
developed for various types of magnetic nanofluids that allow for the careful tailoring of their
properties for different requirements in applications. Surface coating of nanoparticles and the
colloidal stability of biocompatible water-based magnetic fluids are the two particularly
important factors that affect successful application
.
Nanofluids could be applied to almost any disease treatment techniques by reengineering the
nanoparticles’ properties. In their study, the nanoparticles were laced with the drug docetaxel
to be dissolved in the cells’ internal fluids, releasing the anticancer drug at a predetermined
rate. The nanoparticles contain targeting molecules called aptamers which recognize the
surface molecules on cancer cells preventing the nanoparticles from attacking other cells. In
order to prevent the nanoparticles from being destroyed by macrophages—cells that guard
against foreign substances entering our bodies—the nanoparticles also have polyethylene
glycol molecules. The nanoparticles are excellent drug-delivery vehicles because they are so
small that living cells absorb them when they arrive at the cells’ surface.
For most biomedical uses the magnetic nanoparticles should be below 15 nm in size and
stably dispersed in water. A potential magnetic nanofluid that could be used for biomedical
applications is one composed of FePt nanoparticles. This FePtnanofluid possesses an intrinsic
chemical stability and a higher saturation magnetization making it ideal for biomedical
applications. However, before magnetic nanofluids can be used as drug delivery systems,
more research must be conducted on the nanoparticles containing the actual drugs and the
release mechanism.

Cryopreservation

Conventional cryopreservation protocols for slow-freezing or vitrification involve cell injury

due to ice formation/cell dehydration or toxicity of high cryoprotectant (CPA) concentrations,
respectively. a novel cryopreservation technique to achieve ultra-fast cooling rates using a
quartz micro-capillary (QMC)was developed.The QMC enabled vitrification of murine
embryonic stem (ES) cells using an intracellular cryoprotectant concentration in the range
used for slowing freezing. More than 70% of the murine ES cells post-vitrification attached
with respect to non-frozen control cells, and the proliferation rates of the two groups were
alike. Preservation of undifferentiated properties of the pluripotent murine ES cells post-
vitrification cryopreservation was verified using three different types of assays. These results
indicate that vitrification at a low concentration of intracellular cryoprotectants is a viable
and effective approach for the cryopreservation of murine embryonic stem cells.

Nanocryosurgery
Cryosurgery is a procedure that uses freezing to destroy undesired tissues. This therapy is
becoming popular because of its important clinical advantages. Although it still cannot be
regarded as a routine method of cancer treatment, cryosurgery is quickly becoming as an
alternative to traditional therapies.
Simulations were performed on the combined phase change bioheat transfer problems in a
single cell level and its surrounding tissues, to explicate the difference of transient
temperature response between conventional cyrosugery and nanocyrosurgery (Yan and Liu,

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2008). According to theoretical interpretation and existing experimental measurements,
intentional loading of nanoparticles with high thermal conductivity into the target tissues can
reduce the final temperature, increase the maximum freezing rate, and enlarge the ice volume
obtained in the absence of nanoparticles. Additionally, introduction of nanoparticle enhanced
freezing could also make conventional cyrosurgery more flexible in many aspects such as
artificially interfering in the size, shape, image and direction of iceball formation. The
concepts of nanocyrosurgery may offer new opportunities for future tumor treatment.
With respect to the choice of particle for enhancing freezing, magnetiteand diamond are
perhaps the most popular and appropriate because of their good biological compatibility.
Particle sizes less than 10μm are sufficiently small to start permitting effective delivery to the
site of the tumor, either via encapsulation in a larger moiety or suspension in a carrier fluid.
Introduction of nanoparticles into the target via a nanofluid would effectively increase the
nucleation rate at a high temperature threshold.

Magnetic Nanofluids
Magnetic nanofluids are prominent materials inengineering as well as biomedical
applications. In medical applications, for example, ferrofluid provides new cancer treatment
techniques by employing iron based nanoparticles as delivery vehicles for drugs or radiation.
Our group synthesizes magnetic nanofluids by decorating carbon based nanostructures with
magnetic materials. The thermal conductivity of these nanofluids has been measured with
magnetic field and without magnetic field.With magnetic field the nanofluid shows more
enhancements in thermal conductivity than that without magnetic field. This anomalous
enhancement is due to the alignment of magnetic dipole in the direction of magnetic field.
When magnetic dipoles will align in the direction of magnetic field, there will be thermal
continuity between the particles, which increases the thermal conductivity.
In the medical field nanofluids are sometimes referred to as nano-scale colloidal solutions.
Nanofluidsis used biosensors, which is one medical application of nanofluids. The two biggest
applications to date are in cancer research and optofluid control of fluid motion. Once again,
many of these concepts are still in the laboratory stage, but the initial results are promising.

For cancer research there are two (related) major areas: nanovectors and nanofluid
hyperthermia (i.e. heat treatment). With nanovectors, the particles can range from magnetic
materials (e.g. iron-oxide based particles for MRI) to liposomes. Liposomes are ideally
designed with drug or gene therapy imbedded in them and a surface which will be selectively
attracted to the area of interest. For imaging applications, the goal is to image early stage
diseases. Again, particles designed such that they will selectively image the area of interest
(cancer cells, viral particles, antherosclerosis, etc.). Quantum dots when dispersed in a fluid
(i.e. in medical imaging), can also be considered an application of nanofluids since they range
from 1-10 nm in size.

The other important area which has seen a lot of interest in recent years is hyperthermia
treatments using in-vitro nanoparticles (i.e. nanofluids). The basic idea again requires the
particles to selective attach to diseased regions or cells. Next, the region is irradiated – usually
with a magnetic field. Since magnetic nanoparticles are highly absorbing compared to the
surrounding fluid, the nanoparticles can heat up enough cause severe damage
(thermoablation) to the adjacent cells. This is a simple idea, but controlling the process
enough to leave healthy tissues unharmed is a challenge.

Another exiting idea that employs nanoparticles is optofluidic or magnetic control of fluid
flow. Among other applications, this shows potential for biomedical applications - to assist the
above selective treatments or to control microfluidic mixing/separation. In this area of

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research, nanoparticles are again the absorbing medium which becomes input energy for
driving fluid flow. For example, through a process of evaporation and condensation,
researchers have been able to drive flow. Optical tweezers are another way of controlling
nanoparticles in solution. Wang et al. demonstrated that particles can be controlled finely
enough to be rotated about their axis . Alternatively, magnetic fields can be used to control
magnetic nanofluids. In a magnetic flow scheme, pH controls influences the magnetophoretic
velocity of smart‘ magnetic nanoparticles – which is an intriguing way to control
mixing/separation.

In medical applications, nanofluids (even though they may not be called such) are finding a
myriad of applications. Based on the publications, it is safe to say that the potential market
and the growth of applications in this field matches or surpasses any conductive/convective
heat transfer nanofluid applications.

CONCLUSION
One of the goals of theoretical research on nanofluids is to develop a theory of nanofluids to
explain how nanoparticles change the thermal properties of nanofluids. A theory of nanofluids
would also provide a theoretical foundation for physics and chemistry based predictive
models.
Numerous studies conducted on nanofluids have made scientific breakthrough not only in
discovering unexpected thermal properties of nanofluids, but also in proposing new
mechanisms behind the enhanced thermal properties of nanofluids and thus identifying
unusual opportunities to develop them as next generation coolants for computers and safe
coolants for nuclear reactors. Applied research in nanofluids has demonstrated in the
laboratory that nanoparticles can be used to enhance the thermal conductivity and heat
transfer performance of conventional heat transfer fluids. Some researchers took the concept
one step into practical applications and demonstrated the ability of nanofluids to improve the
performance of real world devices and systems such as automatic transmissions. Thus,
nanofluid research has made the initial transition from our laboratory to industrial research
laboratories. This important work has provided guidance as to the right direction, the first
step in the development of commercial nanofluid technology. With continued collaboration
between basic and applied nanofluid researchers in academia and industry on thermal
properties, performance, theory, mechanisms, modeling, development and eventual
commercialization of nanofluids, nanofluid research is expected to bring breakthroughs in
nanotechnology-based cooling technology and have a strong impact on a wide range of
engineering and biomedical applications. In future, promising nanofluids should be studied
not only under real- world conditions of use, but also over a longer period of time. Nanofluids
will be in number one position for the contribution of the humanity to the newer horizons.
Concluding, we can remark that surely, coming days are for the nanofluids.

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 REDEFINING THE TRAUMATIC ENIGMA OF SELF: A GLIMPSE OF
‘MANICHITRATHAZHU’

MS. RASMI PRAHLADAN

Assistant Professor on Contract

Department of Functional English,Little Flower College, Guruvayoor

Dissociation can simply be defined as the action of disconnecting or separating or the

state of being disconnected. It refers to the separation of normally related mental
progressions, resulting in one group functioning independently from the rest, leading in
extreme cases to disorders such as multiple personality. In short, it is the detachment from
real world or losing connection with one’s own identity like Dissociative Identity Disorder
(DID).
DID is a condition characterized by identity fragmentation rather than a formation of
separate personalities. As a result those personalities fail to integrate different aspects of
identity, memory, and consciousness into a single unit or self. Generally, primary identity
suggests the individual's given name which is inert, dependent, remorseful, and depressed.
The alters’ characteristics containing name, age, gender, language, general knowledge, and
prominent mood contrast with those of the primary identity. Certain situations or stimulus
can cause a particular alter to occur. The multiple identities may deny knowledge of one
another, be critical of one another or appear to be in open conflict.
According to International Society for the Study of Trauma and Dissociation, DID is the
most severe and chronic manifestation of dissociation, characterized by the presence of two
or more distinct identities or personality states that recurrently take control of the
individual’s behavior, accompanied by an inability to recall important personal information
that is too extensive to be explained by ordinary forgetfulness.
Symptoms considered indicative of DID particularly hallucinations, daydreaming are
strongly associated with childhood abuse and abandonment from friends and family. Several
psychological and biological mechanisms by which childhood trauma upsurges risk for DID
and many other mental health problems.As a result of this disease, the subject is confronted
with so many threats – in the areas of work, interests, desires, future life which further leads
to seclusion from social circle like peer group, family and even relatives. It is said that
When children are not adequately cared for during their early
years of dependency and vulnerability and their safety and
survival needs are compromised, children may experience a
series of painful or horrific events (referred to as “traumatic
experiences”), either directly at the hands of their adult
caregivers or indirectly due to their negligence. As a result,
these children fail to learn the cluster of behaviors referred to
as “attachment”, and learn an entirely different set of behaviors
in their interactions with adults. (Prather, 59)
In the well-known movie Manichitrathazhu,Shobana plays the role of Ganga who is an
embodiment of this disorder. She seems to be a very normal woman in the beginning of the
movie, gradually unfolds the mysteries behind her behavior. The movie exposes Ganga as a
subject suffering from DID. The secluded life portrayed in Ganga’s childhood has enough signs
to establish roots of the disease. She becomes a victim of alienation and strives to live in that
tharavadu with her grandmother in her past. She experienced the agony and pain in a place
where she find herself alienated. It is said that

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 Trauma happens when any experience stuns us like a bolt of the
blue; it overwhelms us, leaving us altered and disconnected from
our bodies. Any coping mechanisms we may have had undermined,
and we feel utterly helpless and hopeless. It is as if our legs are
knocked out from under us. (Levine, 4)
The only relief was the storiestold by her grandmother which have been passed from
generation to generation, constructing bondage of traditional value with present day culture.
These stories are meant for children especially in the context of the family, the y play a vital
role in the child’s psychological education in forbidden feelings.
According to A.K. Ramanujan, stories give rise to more complicated set of principles by
which aptness depends upon a mixture of factors especially those of individuality and
personhood, such as birth, life stage, karma(the sum of a person’s action in this and previous
states of existence, viewed as deciding their fate in future existences), dharma (the eternal law
of the cosmos, inherent in the very nature of things) and so on. Ganga after grasping the
essence of all stories creates new meaning to her life by interconnecting different aspects like
myths, customs, rituals, moral values, traditions and superstitions.
Moreover, the movie has recordedstrong themes around the dejection from Nakulan
which also triggered split personality in Ganga’s adulthood. In a significant scene, Ganga
passionately speaks about opening Thekkini,Nakulan nods his approval without looking at her
and again starts his work. Another prominent scene was her desire to go with family members
in order to buy ornaments for the marriage of Alli. Nakulan dejected the wishes of Ganga
which results in the burst of her split personality.Certain types of cousin relations are
preferred as sexual and marital associates in many families. In this movie, we can witness the
emotional bond between Nakulan and his cousin ShriDevi which could have generated
possessiveness in her. Nakulan’s neglect towards Gangaand her casting her into utter
loneliness can see a reason for Nakulan being targeted by Ganga’s alter ego.
Dr.Sunny , the psychiatrist starts finding Ganga’s past and comes to know about her
having undergone a childhood trauma of isolation- first from her parents and later from her
grandmother who brought her up till the age of fifteen. She was neglected in the childhood as
her parents had left her with the grandmother which results a kind of identity crisis
throughout in life. Ganga in fact unconsciously puts on the temperament of Nagavalli, to
unravel her own issues, because she, in her own personality is helpless to resolve her trauma.
The keenly observant Dr. Sunny realizes the psychological trauma she suffered in her past
which is reflecting in her present life. Both Ganga and Nagavalli have been wronged at some
point of their lives and as Ganga came to know about the pathetic story of Nagavalli she
compares her own personality with the dancer. Ganga’s imbalanced psyche reacts very
strongly, the sympathy she felt for the dancer eventually transformed to empathy.Just as
Nagavalli had been wronged by SankaranThampi, the patriarch, Ganga’s inner self places
Nakulan,the reason for her emotional abandonment as her perpetrator. She recalls her past
emotional conflicts which contributes the return of her repressed memories and results in a
more severe traumatic experience.
There needs to be a holistic approach to secure community cohesion by means of the
harmony of families.Family cohesion necessitates the emotional acquaintance that family
members have with one another. Family members from cohesive family environments feel
integrated and emotionally linked with the family. Family solidarity is believed to have a
strong positive effect on the outcome of children with early emotional experiences playing a
critical role in affecting adult behavior. Healthy family solidity is not only strength, but a
source for families, that will aid them in facing the daily challenges of raising a child,
supporting and maintaining a healthy marriage, and in providing a nurturing environment for
all the children in the family.

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 In India, the most commonly preferred residential unit is the joint family, ideally
consisting of three and four patrilineal related generations, all living under one roof, working,
eating, worshipping and cooperating together in mutually beneficial social and economic
activities. Family has a significant part in everyone’s life and the love and affection gain from
there builds the character of a person. A fact we observe within families and within all
intimate relationships is when a person begins to heal mainly a parent then the children also
experience a point of healing. It must instigate with each person understanding the need for
very high-quality relationships, and then acting at all levels of society to push for a more
family-friendly society. When the families are strong, society is strong, as a rule. When
families are weak, societies begin to break down.

BIBLIOGRAPHY

Kennerley, Helen. An Introduction to Coping with Childhood Trauma. UK: Constable, 2011.
Print.
Levin, Peter. A and Maggie Kline.Trauma through a Child’s Eyes.USA: ERGOS IP, 2007. Print.
Manichithrathazhu.Screenplay by MadhuMuttam.Dir. Fazil. Perf.ShobhanaChandrakumar.
Swargachithra, 1993.Film.
MarriyaBerk, Belga. “Repression, Return, Revictimization and Reconnection: Trauma Reading
of Manichitrathazhu.” New Man International Journal of Multidisciplinary Studies
2.1(2015):18-26.Web. 11 June 2018.
Prather, Walter and Jeannie A. Golden.“A Behavioral Perspective of Childhood Trauma and
Attachment Issues: Toward Alternative Treatment Approaches for Children with a History
of Abuse.”International Journal of Behavioral and Consultation Therapy5.1(2010): 56-74.
Web. 10 June 2018.

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 CARPE DIEM AS A LIFE FORCE: EXPLORING THE FAULT IN OUR STARS

PARVATHY C S

Assistant Professor on Contract, Department of Functional English

Little Flower College, Gurvayoor

“Where there is hope, there’s life. It fills us fresh courage and makes us strong again” Anne
Frank

The value of life may be acute for cancer survivors, numbers of them get down,
frustrated, and frightened beyond belief. Even, they stop believing in the existence of the
Almighty as a result of their sufferings. Virtually, misery and dying are indeed not good
circumstances. The sweet and extraordinary couple in the work I have taken, The Fault in Our
Stars have different schemes to fight against cancer. The deadly malignant four stage cancer is
unbelievably an eye opener for them within the meaning of life and human existence. We find
these main characters, Hazel and Augustus, wrestling against the will of God.
The Fault in Our Stars, published in January 2012, is the sixth novel by author John
Green. The title is inspired from Shakespeare's play Julius Caesar, in which the nobleman
Cassius says to Brutus: "The fault, dear Brutus, is not in our stars, / But in ourselves, that we
are underlings" [Act 1, Scene 2]. Everyone has faults, even the stars. The title suits the book
perfectly. Someone's fault may be Cancer, as the people in this book, or someone's fault may
be less severe than Cancer. But in all, there's a fault in our everything. The novel has universal
connotations as it depicts the picture of the cancer patients all over the world.
Green’s art of characterization is unique in that the young and imaginary characters
leave an indelible impression on the hearts of the readers. The readers feel intrigued not only
by their tenacity, their acceptance of mortality, but also by the exuberance elicited by the
characters-Hazel and Augustus, however ephemeral their livers are. Hazel, the central
narrator and the protagonist, is a sixteen-year-old girl, suffering from a terminal form of
thyroid cancer for the last three years. Cancer has spread to her lungs, and she is confined to
breathe through the four walls of an oxygen cylinder. The reader not only identifies with the
character of Hazel very closely but also arouse pity in his heart for the cancer patients. Green
makes use of a powerful visual image by showing how she has to drag the oxygen cylinder
round the clock. The cylinder contains her life, and to a great extent her life depends on it. The
image of her carrying the cylinder makes the reader aware of her imminent mortality,
wherein she can burst like a bubble of oxygen any moment.
Hazel is a conscientious girl, far mature for her tender years. She is aware of her
impending death, and this is the reason she has confined herself to her parents and her home.
She knows the pain the death of a beloved cause to the parents and other concerned ones. She
is determined not to scar the lives of others by her death, and keeps herself aloof and
alienated from others. Green makes use of another visual image to show how the persistently
gnawing sense of mortality has got the better of Hazel. She considers herself a
“Grenade” which is going to explode very soon, annihilating all around in its train. Since she is
aware of her mortality, she does not want others to cry for her when she is dead.
In order to while away her time and engross herself with things other than the
mortality of a cancer patient, she reads a fictional novel, An Imperial Affliction written by Van
Houten. It is a book within the book. Both the book and its author are fictional as they were
created by John Green himself for his book. The novel has captivated her as it deals with the
mortality of a young girl, Anna, who is also a cancer patient. Although the character of Anna is
only a sub plot, it further adds into the theme of mortality, wherein the reader can draw a
parallel between the characters of Hazel and Anna. Hazel is enthralled as well as deluded by

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the novel, since the novel ends mid sentence leaving her feel disturbed. Hazel is bent upon
discovering the fate of Anna's parents after the girl dies. The main reason she hankers for
learning the end of this incomplete novel can be connected with her own fate. She wants to
discover what happens to Anna’s parents at the end; a fact that she will assimilate into her
own parents. If Anna’s parents can brave with her death, her parents, the Lancasters may as
well do with hers. Hazel takes Anna too serious as she finds herself in Anna.

Hazel’s mortality has made her love her parents passionately, and it is for the sake of
their happiness that she joins a support group, despite her severe bouts of depression. It is
here at the support centre that her stars take hold of hers, and she initiates a journey into the
unknown. She is accosted by an eighteen-year-old lively, handsome and enthusiastic boy,
Augustus Waters. He suffers from osteosarcoma, and as a result of it, wears prosthesis. He is a
romantic boy who falls in love with Hazel at first sight. He weaves his gossamer of a heroic
life, and wants to do something, which will be remembered by humanity forever. He fears
oblivion, and is desperate to do something that will make him a hero. During a video game -
The Price of Dawn, he sacrifices himself by jumping on a grenade in order to save the innocent
children. He takes pride in declaring that may be the minute that buys them an hour, which is
the hour that buys them a year. These words clearly show his realisation of the value of each
moment in life.
A happening basketball player, Augustus, is now a handicapped individual, and this
serves a guiding force in the life of Hazel. He fills enthusiasm and magnetism into her life,
through his romantic gestures and theatrical grandiosity, quite ignorant of the fact that cancer
is eating into his body. He is dying but he is determined to make the life of Hazel meaningful
through his love, sincerity ad exuberance.

Green uses another visual image of Augustus holding a cigarette between his lips, an
image that makes him aware of his vulnerability and mortality. His main contribution in the
life of Hazel starts when he gives a concrete shape to her most cherished desire of meeting the
author of An Imperial Affliction. Through the character of Peter Van Houten, Green makes
Hazel’s reason get the better of her emotions. His character plays a significant role in restoring
Hazel back from the dream world to the real world. Like her, Houten also turns out to be a
victim of the stars. His character Anna is not a fictitious one, but takes after his daughter Anna,
who died of cancer at eight.

Like any other novel of the times, Green has also introduced twist to the plot. It
happens so that when Augustus goes back into remission, a twist is added to the story and
Hazel becomes the healthier partner in their relationship. But when in this worse situation
one finds Gus giving hope to Hazel. He gives her hope with these words, "I'll fight it. I'll fight it
for you. Don't you worry about me, Hazel Grace. I'm okay. I'll find a way to hang around and
annoy you for a long time." (TFIOIS, 215) do suggest it. Hazel and Augustus’s love is put to the
test as Augustus’s health deteriorates more and more each day. Readers are sitting on the
edge of their seats, as they must wait to see what the fate of this courageous couple will be.
The book also uses many themes in order to teach life lessons to young-adults reading this
book. John Green shows that love conquers all things, even cancer and death.
The characters of this novel Hazel and Gus teaches the reader, how to live in the
moment as we all live for a greater unknown, future. The mantra “LIVING OUR BEST LIFE
TODAY” (TFIOS, 14) is seen embraced by each of the characters. This mantra reminds us that
we must cherish the time spent with people in our present. Even in the darkest moments,
Augustus is seen having that fiery desire to carry on and take life for all it's worth. Like the
characters in this book, we must learn to fully embrace the uncertainties of what lies ahead
and face everything with a smile of hope. As John Green originally wrote - The world is not a

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wish-granting factory. World is full of enigma. It is a profoundly unjust place in which you are
put to suffer one or the other kind of misery. There might be events in life that would turn up
unexpectedly. But it all depends upon how we take them. An optimistic approach with hope
would always help us face all situations. This book teaches us to face the harsh realities of life
we have been handed in this world.

This book teaches readers to live fully and in the present, because you never know how
much time you really have left. This novel also teaches one that love can overpower anything,
and sometimes it can even make you stronger in order to make another person happy. Hazel
Lancaster and Augustus Water’s love is one of the most powerful romances and sets a good
example of what true love really is, The reader who reads it, would definitely receives a
different perspective on life, death, and living in the moment.

BIBLIOGRAPHY
Green, John. The Fault In Our Stars. New York : Penguin Publication, 2013. Print
The Fault In Our Stars. Screenplay by Scott Neustadter and Michael H. Weber. Director.
Josh Boone.Cast. Shailene Woodley and Ansel Elgort, 2014 . Film

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 STEPHEN HAWKING AND ALS: EXPLORING THE PLACEBO EFFECT OF A
HOPEFUL PSYCHE IN MY BRIEF HISTORY

NAIR ANUSHRI RAJASEKHARAN

Assistant Professor on Contract,Department of Functional English

Little Flower College , Guruvayoor

“Remember that hope is a good thing, Red, maybe the best of things, and no good thing
ever dies.”
(King 71)
Since time immemorial, disease has seen its place in the bad books of people. It is
never welcomed and is generally termed an unpleasant visitor. By tagging along pathetic and
agonizing days, it barges in on normalcy and leaves life grim overcast by hopelessness. It
succeeds as an intruder in completely destroying the morale of the victim leaving him in the
blues for days on end. It debilitates his inner sanctum sanctorum with such poise that the
sufferer finds it hard to gather himself together. Literature, unfolded over the ages, has been
able to provide us with ample number of heroes and heroines haunted by a disease, be it
Bertha Mason who faces madness in Jane Eyre, the woman narrator in The Yellow Wallpaper
who suffers from bouts of sickly depression, or Ophelia’s actual madness and even Hamlet for
that matter, who feigns madness in Shakespeare’s Hamlet. Many illness narratives choose to
portray mental and physical well-being as significant elements contributing to the science of a
plot. Much is concealed within the microcosum of a “diseased” individual and as the reader
progresses, he deciphers interesting plot revelations and eventually the ingenuity of the
writer.
Through careful perusal of some works we realize often the overpowering nature of an
illness. It is capable of transforming the healthiest of individuals into the weakest of beings
within a short span of time. Confronting a terminal illness is even harder since it preys over
whatever little confidence the sufferer has of making a return to rich health. What adds to the
pain is the fact that he/she falls deeper and deeper into the abyss of uncertainty and gloom,
dwelling constantly upon the discomfort that his body and soul is made to endure. At such a
juncture in life, “hope” is direly relied on. People going through a long-term sickness find
solace in “hoping” that in course of time everything will be alright. Hope in literature
therefore, has been a trope for a belief that there will be light after the emotional distress. It
helps people find strength in moving on; a rejuvenating force that help them to strive towards
a positive outcome despite adversities. Hope is an abstract yet soothing phenomenon that
leads victims to conceive a different outlook; a gentle push taking you closer to moments of
positivity and away from dubiousness; a huge helping hand for troubled minds.
Narratives of the miraculous often emphasize that hoping for the impossible, or
for what merely seems impossible according to earthly knowledge, is a sign of
one’s moral rectitude and spiritual faith. The theme of hope directly addresses
one of the foremost characteristics of humans especially anxiety about the
uncertainty of the future. Hope is an important part of moral character because
it stands fast in times of great adversity, and because it allows courage to
triumph over fear.
(“Literary Hope” )
Archetypes of hope help in eradicating, for the most part, the unsolicited tendencies in
a person with disabilities. Hope restores faith in a victim who leans more towards succumbing
to the limitations that a disability brings on him. The victim’s fears of being “powerless” and
“incomplete” are brushed aside by the warmth of an optimistic mental framework. Such a

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hopeful stance is seen taken by Stephen Hawking in his book My Brief History, an
autobiographical sketch of his life, his confrontation with ALS and also his scientific
explorations that made him a renowned intellect of the 21 st century.
Born on January 8th, 1942, Hawking was an inquisitive child, with an urge to know the
working of “systems”, keen on understanding the nuances of things. Though he had a vibrant
intellect, his physical health was never good enough. He fell sick often and by the time he
moved into Cambridge he found himself even clumsier. Soon after his 21st birthday, he was
diagnosed with Amyotrophic Lateral Sclerosis (ALS) otherwise called Lou Gehrig’s disease. In
medical terms, this refers to a very rare neurological disease that causes a gradual
deterioration of motor neurons; a disease that unfortunately has no cure. To add to the
despair, Hawking was told by his doctors that he had not more than a few years to live. This
piece of news derailed his thoughts and he felt he had reached a dead end. He wallowed in
self-pity, with hopelessness looming majestically over his future. His dreams of completing his
Ph. D, getting a job, marrying the woman he loved, all of this seemed a very remote possibility.
The realization that I had an incurable disease that was likely to kill me in a few
years was a bit of a shock. How could something like this happen to me? It was
hard to focus when I might not live long enough to complete my Ph.D. I felt
somewhat of a tragic character. Not knowing what was going to happen to me
or how rapidly the disease would progress, I was at a loose end.
(Hawking 28)
But even while he felt that the ground beneath him was slipping away, he was
determined to make the most of whatever time he had left. Though the illness and the
longevity of it shocked him and left his body, mind and soul fragmented, he decided that he
might as well do some good while he’s alive. While being hospitalized, he had disturbing
dreams. But by consciously working on his attitude towards the same, he realized that he
mustn’t indulge in the pains of what he had no control over. So as a proactive measure, he
channelized his energy towards more productive activities like formulating and writing
theses. He also got engaged to Jane Wilde whom he had met about the time he became sick. All
this, in his own words, gave him “something to live for” (Hawking 28)
But I didn’t die. In fact, although there was a cloud hanging over my future, I
found to my surprise that I was enjoying life. When you are faced with the
possibility of an early death, it makes you realize that life is worth living and
that there are lots of things you want to do.
(Hawking 23)
His existence was shrouded with the fatality of the illness; he was fully aware that his
is a progressive disability which would rage siege over his body’s motor mechanisms one day;
but his interest in elucidating theories of the universe never waned. He journeyed on
undettered even when he lost his ability to communicate and had to rely on facial gestures
and (later assistive technology) to lay forth his views and opinions.
My disability has not been a serious handicap in my scientific work. In fact, in
some ways I guess it has been an asset. The minuses are more than outweighed
by the pluses. It has been a glorious time to be alive and doing research in
theoretical physics. I’m happy if I have added something to our understanding
of the universe.
(Hawking 63)
As a reader, I feel that My Brief History is representative of two aspects. Firstly, his
perennial scientific and intellectual drive. Throughout the book, the theorist in him is kept
alive and vibrant. It shows that even when slowed down by an illness/ disability, man can still
be profoundly creative and steer forward. He tries to conquer the rigidness of his disability
through his enthusiasm in physics and cosmology. Though he was initially shaken, Hawking
transcends medical prognosis by focusing on his HAVES rather than on his HAVE NOTS.

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Secondly, the fire of hope that he sought in his life. Though he gives an account of his disability
in his book, he neither exaggerates the extent of the disease nor does he write to lure
sympathy. He talks of it as a fated voyage in his life; a phase he had to endure as part of the
dynamics of life. He projects a sense of self-reflexivity, wherein he assimilates with his
“disability” and tries to reconcile with his other “abilities” that can help him ensure a
satisfying outcome. So unwittingly, Hawking employs a humanistic psychoanalytical approach
in order to survive. Though his “body” succumbed to the enormity of the disease, he sought
freedom through his intellect. Though his physique crouched under the limitations, his will
and determination remained unmarred. Instead of allowing himself to be corroded mentally,
he looked unto himself which led to the strengthening of his ambitions and goals. This
therapeutic stratagem paved the way for self-discovery, drove out the negative and eventually
helped in sustaining a positive aura around him. By fusing what can be called ‘hope at its best’
and ‘consistent efforts’, he was successful enough in making his life a fruitful one. This is what
reverberates in his assertion, “I have had a full and satisfying life.” (Hawking 63)
We thus see that the book encapsulates Hawking’s conviction to endure on towards his
scientific journey despite his disability. This work demonstrates how the austerity of a
terminal illness can be defeated or at least slowed down by a good blend of staunch optimism,
humour and undying interest in scientific pursuits. The worth of life lies hidden in our efforts
to make it worthwhile. Obstacles are difficult, sure thing, but our attitude towards them is
what makes all the difference. Hawking clearly stands as an example of how a positive mental
framework can prevent life from losing ground and toppling over. The subtle beauty of life can
be understood by equating life with the “no-boundary condition” of the universe proposed by
Hawking. He says thus,
The no-boundary proposal predicts that the universe will start out almost
completely smooth, but with tiny departures. These will grow as the universe
expands, and will lead to the formation of galaxies, stars and all the other
structures in the universe, including living beings. The no-boundary condition is
the key to creation, the reason we are here.
(Hawking 62)
Similarly, if one has the audacity to view life as being bound by a no-boundary
principle, it gets easier to adapt to the illnesses because they then become “tiny departures”.
We learn that these fissures in life later lead to new “galaxies and stars” viz., “new
perspectives of life, fresh beginnings and a harmonious well-being on the whole.”

BIBLIOGRAPHY
“Eric Fromm and Humanistic Psychoanalysis.” Exploring your mind, 27 November. 2017,
www.exploreyourmind.com. Accessed 15July 2018.
Hawking, Stephen. My Brief History. Bantam Books, 2013. www.vsiastronomy.weebly.com.
Accessed 16 July 2018.
King, Stephen. ‘Rita Hayworth and Shawshank Redemption’. Different Seasons. Hodder and
Stoughton, 2012. Pg.71. Print.
“Literary Hope.” 20 August. 2012, www.literacle.com/literary-hope . Accessed 14 July
2018.

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 Beyond the Onscreen Role, a Role for life: an Analysis of the Experience
and Survival of Manisha Koirala

SHERIN KURIAKOSE. V

Assistant Professor on Contract,Department of Functional English

Little Flower College, Guruvayoor

“Cancer is not the death sentence, there is hope.”

Manisha Koirala

Being diagnosed with cancer is scary! You may feel anxious, afraid and wonder how to
cope with it .But remember, CANCER CAN BE BEATEN! If you have will power, mentally
prepare yourself to fight for your life .Actress Manisha Koirala, who bravely battled ovarian
cancer, is an inspiration for all cancer survivors .She keeps on sharing various post and
motivational videos on healthy mind and life style habits on her social media profiles. Here
Iam going to share and discuss about Manisha Koirala’s quotes and motivational videos which
are the most inspiring thoughts to cancer diagnosed persons.
We celebrated World Cancer Day on 4th Feb. 2018. This year’s theme for World Cancer
Day is “we can I can”. On this special occasion, we remember all the strong men and women
who have suffered from this indomitable spirit that inspires us to fight through the tragedies
of life. This year, its estimated that nearly 8 million people worldwide will die from cancer.
Human body is made up of trillions of living cells. Normal body cells grow, divide, and
die in an orderly fashion. During the early years of a person’s life, normal cells divide faster to
allow the person to grow. After the person becomes an adult, most cells divide only to replace
worn-out or dying cells or to repair injuries. Cancer begins when cells in a part of the body
start to grow out of control. There are many kinds of cancer, but they all start because of out-
of-control growth of abnormal cells. Cells become cancer cells because of damage to DNA. One
out of five people will develop cancer at some point during their life time.
Cancer has almost become one among the lifestyles diseases today. But with the
advancements in treatment there is a growing number of survivors. Are these survivors living
a healthy life afterwards? No doubt, the family and society’s support towards the patient are
very important. But ultimately, a lot depends upon your lifestyle, food choices, physical
activity and dietary supplements to improve the quality of life and long term survival.
Those who act like heroes on screen aren’t the real ones, but those who battle off it. If
you have will power, mentally prepare yourself to fight for your life. Actress Manisha Koirala,
who bravely battled ovarian cancer, is an inspiration for all cancer survivors. She keeps on
sharing various post on healthy food and lifestyle habits on her social media profiles. Manisha
Koirala is a Nepalese actress who mainly appears in Hindi films, through she has worked in
several south Indian and Nepalese films. She was diagnosed with ovarian cancer in 2012,for
which she underwent a gruelling treatment for six months in USA. After being diagnosed with
cancer, one is in a lot of fear and anxiety about the anticipated pain and the painful treatment.
She said, “at times, after surviving from a disease like cancer, people looks changes. After my
chemotherapy, I lost my hair, eyebrows and lashes. Looking at the mirror, I felt like an alien. All I
knew was that I had to mentally prepare to fight it and I got a huge support from my family”

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(Retrieved from: http://m.famousfix.com/topic/Manisha-koirala/quotes). Well, since 2015,
she has been completely free of the deadly disease, and return to work with films.
Manisha opened upon how cancer helped her become a better person. The brave and
beautiful actress said, “When I came out of it, I literally started seeing joy in small things like
walking on the grass, the breeze on my face, looking out of my bed at the sky and clouds, sunsets
and sunrises. I started noticing small things, because tomorrow I don’t know whether I would be
alive to see it(Retrieved from: http://m.famousfix.com/topic/Manisha-koirala/quotes).
”Manisha never misses a chance to raise awareness on the rising incidence of cancer and all
that can be done to eradicate the disease. In one of the recent interviews, she shared her post
cancer diet. “I am a foodie but my antennas are always up regarding the healthy and nutritional
values of food. I cannot digest too much junk food. I just have it once in a blue moon,” said the
actress.
Manisha Koirala gives life’s lesson to those who find life difficult. She quotes “you have
a beautiful soul, and you have trust in yourself and faith in yourself and you born in a reason and
you must find out the reason and find your own path” (from the motivational speech by
Manisha Koirala)In 17 may 2017 Mumbai mirror reported that Manisha Koirala will be
writing a book about cancer with another survivor. Manisha wants to help other by telling
them about her journey and encouraging them with her motivational quotes; (How to find
meaning when reality hits you | Manisha Koirala | TEDxJaipur . (2018, July, 15)
1.”I found that this life is a gift and everything that comes with it is a gift and life will
always find away to surprise you.”
2. “The important of introspection we need to die to death of our being and self are
discover is truth. Our time limited we want to motivate, compare to leave great life. Every day
we can live with clarity and passion.”
3. “How we want to prepared they will always be a surprise. Life will through challenge
from somewhere that will not be prepared. But we have a choice, we can either turned.”
4.”Realization of the value of service and contribution.”
“If we get a chance to our life, I will give my attention and service whatever capacity I
can big or small it is really doesn’t matter”
Manisha Koirala is opening her mind and said in her motivational speech that is “I had
developed an unhealthy life style and start wrong company, restless bad life relationship and
another one after that my marriage broke and soon after I was diagnosed with aggressive
form of cancer. Through this cancer I lost everything; my beauty, my glamour and my career,
etc. But she says that I should overcome all through my will power.
Steps to a Cancer free lifestyle
1. Regular cancer screening
2. Maintain healthy weight
3. Exercise regularly
4. Eat healthy
5. Avoid tobacco
6. Limit alcohole
Manisha said,” I eat more of fresh fruits, vegetables; a lot of greens, broccoli and palak
(spinach) is a must in all my meals. I try and eat less of white rice. I sometimes eat red rice and
quinoa. If I am eating carbs, then there needs to be a lot of fiber in it.”
Cancer fighting vegetables
1. Cabbage
2. Broccoli
3. Tomato
4. Cauliflower
Cancer fighting fruits
1. Grapes

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 2. Strawberry
3. Avocado
4. Orange
The film fare award- winning actress shared her experience- “I don’t eat meat. My mom
was feeding me papaya soup for strength during my treatment and I had decided that once my
treatment is over, I will become a vegetarian because during treatment I had started disliking
non- veg, for a long time, I was a vegetarian, but just recently I have started eating fish and eggs.
I am a’ fishetarian’ now but I am very mindful of that also and take very little .Cancer survivors
should try to eat at least 2.5 cups of fruits and vegetables each day. Make sure to have citrus
fruits and in vegetables, dark-green and deep-yellow veggies are good. Eat plenty of high-fiber
foods, like whole-grain breads and cereals.”
I conclude my paper by saying that Manisha Koirala is a high thinking woman; that’s
how she overcame the disease when she was diagnosed with it. She stated that
I think cancer plays a key role in transforming a person. It affected me to such an
extent that I started to appreciate my life and honour my body which I should have
otherwise too. Don’t get appalled by the despair and hardships that life brings along,
find out the sense behind them. You will be able to tackle them better.
(“Read these 5 profound life lessons by Manisha Koirala if you are low on
inspiration”, 2017)
Manisha’s tough attitude towards such a big disease is a role model for us. We should
try to therefore face any disease with a beautiful smile just like that of Manisha Koirala’s.

Works Cited

Ignatavicius, Donna. D. Medical Surgical Nursing. Canada: Elsevier, 2016. Print.

How to find meaning when reality hits you / Manisha Koirala / TEDxJaipur .2018, July, 15
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koirala quotes/&hl=en-in; 2018 July
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 REVIEW ON DISEASES CAUSED ON CLIMATE CHANGE

NIMMY M V

Assistant Professor On Contract, Department Of Zoology

Humans have known that climatic conditions affect epidemic diseases from long before
the role of infectious agents was discovered, late in the nineteenth century.Roman aristocrats
retreated to hill resorts each summer to avoid malaria. South Asians learnt early that, in high
summer, strongly curried foods were less likely to cause diarrhoea.Infectious agents vary
greatly in size, type and mode of transmission. There are viruses, bacteria, protozoa and
multicellular parasites. Those microbes that cause “anthroponoses” have adapted, via
evolution, to the human species as their primary, usually exclusive, host.
In contrast, non-human species are the natural reservoir for those infectious agents
that cause “zoonoses”. There are directly transmitted anthroponoses (such as TB,HIV/AIDS,
and measles) and zoonoses (e.g., rabies). There are also indirectly transmitted, vector borne,
anthroponoses (e.g., malaria, dengue fever, yellow fever) and zoonoses (e.g. bubonic plague
and Lyme disease).
Vector-borne and water-borne diseases important determinants of vector borne disease
transmission include:(i) vector survival and reproduction,(ii) the vector’s biting rate, and
(iii)the pathogen’s incubation rate within the vector organism.
Three components are essential for most infectious diseases: an agent (or pathogen), a
host (or vector) and transmission environment. Some pathogens are carried by vectors or
require intermediate host to complete their lifecycle. Appropriate climate and weather
conditions are necessary for the survival, reproduction, distribution and transmission of
disease pathogens, vectors, and hosts. Vectors, pathogens and hosts each survive and
reproduce within a range of optimal climatic conditions:
Temperature and precipitation are the most important, while sea level elevation, wind,
and daylight duration are also important.Rainfall can influence the transport and
dissemination of infectious agents, while temperature affects their growth and survival.
Communicable diseases, including dengue, malaria, Hantavirus and cholera, are evident
widely. Other infectious diseases, such as salmonellosis,cholera and giardiasis, may show
increased outbreaks due to elevated temperature and flooding.

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 The climate changes may impact the survival, reproduction, or distribution of disease
pathogens and hosts, as well as the availability and means of their transmission
environment.The health effects of such impacts tend to reveal as shifts in the geographic and
seasonal patterns of human infectious diseases, and as changes in their outbreak frequency
and severity.The impact of climate change on pathogens can be direct, through influencing the
survival, reproduction, and life cycle of pathogens, or indirect, through influencing the habitat,
environment, or competitors of pathogens. As a result, not only the quantity but also the
geographic and seasonal distributions of pathogens may change.
Temperature may affect disease through impacting the life cycle of pathogens. First, a
pathogen needs a certain temperature range to survive and develop. For example, the two
thresholds, maximum temperature of 22–23 °C for mosquito development and minimum
temperature of 25–26 °C for Japanese Encephalitis Virus (JEV) transmission.Excessive heat
can increase the mortality rates for some pathogens. The development of Malaria parasite
(Plasmodium falciparum and Plasmodium vivax) ceases when temperature exceeds 33°–39 °C.
Second, rising temperature can influence the reproduction and extrinsic incubation period of
pathogens.Salmonellas is a food-borne disease; the reproduction of the bacteria increases as
temperature rises in that range between 7 °C and 37 °C. Lastly, rising temperature may limit
the proliferation of a pathogen through favoring its competitors.

 MALARIA
There is much evidence of associations between climatic conditions and infectious
diseases.Malaria is of great public health concern, and seems likely to be the vector-borne
disease most sensitive to long-term climate change.Malaria varies seasonally in highly
endemic areas. The link between malaria and extreme climatic events has long been studied
in India.Excessive monsoon rainfall and high humidity was identified early on as a major
influence, enhancing mosquito breeding and survival. Malaria killed 627,000 in 2012 alone.
According to the Intergovernmental Panel on Climate Change (IPCC), climate change will be
associated with longer transmission seasons for malaria in some regions of Africa and an
extension of the disease’s geographic range. As temperatures warm, the Plasmodium parasite
in the mosquito that causes malaria reproduces faster and the vector (the organism that
transmits a disease), i.e. the mosquito, takes blood meals more often. Rain and humidity also
provide favorable conditions for young mosquitoes to develop and adult mosquitoes to
survive
 EBOLA VIRUS
This disease is commonly found in West Africa.Ebola can live in animals for years
without making them sick; it is transmitted to humans through contact with an infected
animal. Once in a human, the disease is spread by direct contact with the bodily fluids of the
infected person, and as yet there is no vaccine. Scientists think that climate change, with its
increase in sudden and extreme weather events, plays a role in Ebola outbreaks: dry seasons
followed by heavy rainfalls that produce an abundance of fruit have coincided with outbreaks.
When fruit is plentiful, bats (the suspected carriers of the recent Ebola outbreak) and apes
may gather together to eat, providing opportunities for the disease to jump between species.
Humans can contact the disease by eating or handling an infected animal.According to Kris
Murray, senior research scientist at EcoHealth Alliance, an organization that researches and
educates about the relationships between wildlife, ecosystems and human health, climate
change has strong potential to play a role in increasing the risk for Ebola.
 DENGUE FEVER
Dengue fever infects about 400 million people each year, and is one of the primary
causes of illness and death in the tropics and subtropics.The IPCC projects that the rise in
temperatures along with projected increases in population could put 5 to 6 billion people at

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risk of contracting dengue fever in the 2080s. The reproductive, survival and biting rates of
the Aedesaegypti mosquitoes that carry dengue and yellow fever are strongly influenced by
temperature, precipitation and humidity.
 HANTAVIRUS
The Hantavirus broke out in the southwest U.S. in 1993 after a six-year drought ended
with heavy snows and rainfall.The precipitation allowed plants and animals to grow
prolifically, which resulted in an explosion of the deer mice population. The mice may have
carried Hantavirus for years, but suddenly many more mice were coming into contact with
humans. People became infected through contact with infected mice or their droppings.
Hantavirus Pulmonary Syndrome has now been reported in 34 states. Through 2013, 637
cases were reported in the U.S., and approximately 230 people have died.
 WEST NILE VIRUS
In 1999, the West Nile virus, transmitted to humans by mosquitoes, made its first
appearance in the Western Hemisphere in New York, after a drought followed by heavy rains.
Since then, over 1,600 people have died of the disease. The number of reported cases of West
Nile virus is 1,993 including 87 deaths. Since it arrived in the U.S., with Texas being hardest
hit. A recent study suggests that in the future, higher temperatures and lower precipitation
will lead to a higher probability of West Nile cases in humans, birds and mosquitoes.
 Conclusion
Changes in infectious disease transmission patterns are a likely major consequence of
climate change.Infectious diseases are spatially and temporally restricted by climatic
variables. Sudden and dramatic changes in weather conditions due to extreme weather events
and meteorological hazards have profound effects on many infectious diseases.Due to our
incomplete knowledge to some of these extreme weather events, being able to accurately
predict their patterns and their health impacts remains challenging.

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Abdelwhab et al., 2010
E. Abdelwhab, A. Selim, A. Arafa, S. Galal, W. Kilany, M. Hassan, M. Aly, M.
HafezCirculation of avian influenza H5N1 in live bird markets in Egypt
Avian Dis., 54 (2010), pp. 911-914
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Acuna-Soto et al., 2002
R. Acuna-Soto, D.W. Stahle, M.K. Cleaveland, M.D. TherrellMegadrought and
megadeath in 16th century MexicoRev. Biomed., 13 (2002), pp. 289-292
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Ahern et al., 2005
M. Ahern, R.S. Kovats, P. Wilkinson, R. Few, F. MatthiesGlobal health impacts of
floods: epidemiologic evidenceEpidemiol. Rev., 27 (2005), pp. 36-46
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Akhtar et al., 2002
R. Akhtar, A. Dutt, V. WadhwaHealth Planning and the Resurgence of Malaria in
Urban IndiaR. Akhtar (Ed.), Urban Health in the Third World, S.B.Nangia and A.P.H.
Publishing Corporation (2002)
Altekruse et al., 1998
S.F. Altekruse, D.L. Swerdlow, N.J. SternMicrobial food borne pathogens
Vet. Clin. North Am. Food Anim. Pract., 14 (1998), pp. 31-40
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 S. Altizer, R.S. Ostfeld, P.T.J. Johnson, S. Kutz, C.D. HarvellClimate change and
infectious diseases: from evidence to a predictive frameworkScience, 341 (2013),
pp. 514-519
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Bai et al., 2014
L. Bai, A. Woodward, Q. LiuTemperature and mortality on the roof of the world: a
time-series analysis in three Tibetan countiesSci. Total Environ., 485 (2014), pp.
41-48
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Beck-Johnson et al., 2013
L.M. Beck-Johnson, W.A. Nelson, K.P. Paaijmans, A.F. Read, M.B. Thomas, O.N.
BjørnstadThe Effect of Temperature on Anopheles Mosquito Population Dynamics
and the Potential for Malaria Transmission(2013)
Bissell, 1983
R.A. BissellDelayed-impact infectious disease after a natural disaster
J. Emerg. Med., 1 (1983), pp. 59-66
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Bouma, 2003
M.J. BoumaMethodological problems and amendments to demonstrate effects of
temperature on the epidemiology of malaria. A new perspective on the highland
epidemics in Madagascar, 1972–1989Trans. R. Soc. Trop. Med. Hyg., 97 (2003), pp.
133-139
ArticleDownload PDFCrossRefView Record in Scopus

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 PSYCHOLOGICAL DISORDERS

FEMINA VINSON C

II M.Sc.Zoology, Little Flower College Guruvayoor

A mental disorder, also called a mental illness or psychiatric disorder is a behavioral,

mental or emotional state that causes significant distress or impairment of personal
functioning, relapsing and remitting or occur as a single episode which may endanger other
community as well.Common symptoms include
agitation,anxiety,depression,mania,paranoia,psychosis etc.
Here are some rare and interesting sometimes terrifying psychological disorders.
Alice in wonderland syndrome, Capgrassyndrome, Alien hand syndrome,Cotarddelusion,
Dissociative identity disorder, Stendhalsyndrome, Self cannibalism, Erotomania.

 Alice in wonderland syndrome:It is a rare condition that cause temporary episode of

distorted perception and disorientation. It was first identified by Dr. John Todd in
1950.Hence it is also called as “Todd’s Syndrome”.
 Capgras delusion syndrome:It was named after Joseph Capgras, a French psychiatrist
who first described the disorder in 1923.A person with this syndrome irrationally
believes that someone they knows has been replaced by an imposter.Hence it is also
called as”Imposter syndrome”.
 Alien hand syndrome:It is also called “Dr.Strangelove Syndrome”.It was first recorded
in 1909.It is an unusual neurological disorder where by one of the suffer’s hand seems
to take a life of its own.
 Cotard delusion:It is also known as “Walking Corpse Syndrome”.It was proposed by
Jules Cotard in 1880.The affected person holds the delusional belief that they are
already dead.
 Dissociative Identity disorder:It is also known as “Multiple personality disorder”.It is
a severe condition in which two or more distinct identities or personality states are
present in alternatively take control of an individual.
 Stendhal syndrome: Also called as “Florence syndrome”. Affected person cause rapid
heartbeat, dizziness, fainting, confusion and even hallucination when an individual is
exposed to an experience of great personal significance.
 Self-cannibalism: It is also called as “Auto sarcophagy”.It is a practice of eating
oneself.
 Erotomania: Affected person has a delusional believes that another person is in love
with him or her despite clear evidence against it.

The causes for psychological disorders may be genetical or environmental factors.

Psychotherapy and medication such as Antidepressants, antipsychotics and mood stabilizers
can also be used as a treatment for psychological disorders.
REFERENCE:
1.Longmore M, etal.(2007)Oxford handbook of clinical medicine.Oxford.P.686.
2.Aziz V.M,Warner (2005).”Capgras Syndrome of Time”.Psychopathology.
38(1):49-52
3.Mark, Victor W (November 29, 2014).”Alien hand syndrome on stuff you should
know”(

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4. Barrios G.E; LuqueR (1995)” Cotard’s delusion or syndrome?”Comprehensive psychiatry,
36:218-223.
5.Brand BL: Lowenstein,RJ; Spiegel, D(2014).”Dispelling myths about dissociative identity
disorder treatment: an empirically based approach”. Psychiatry 77(2):169-189
6.Nicholson,T.R.J, Pariante,C, M.C Laughlin,D(2009).”Stendhal syndrome;A case of cultural
overload”.
7.Mikellides A.P (October 1950).”Two cases of self cannibalism(autosacrophagy)”.
8.Oliveira etal., (2016) “Erotomania-A review of De clerambault’s Syndrome”. The journals of
the European psychiatric association.33:664

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 PSYCHO-SOCIAL APPROACH TO CANCER CARE: NEED FOR A PARADIGM
SHIFT

Author I: MR LIMS THOMAS, Assistant Professor, Department of Social Work, Vimala College
(Autonomous), Thrissur. Email: limsthomas09@gmail.com

Author II: DR JERYDA GNANAJANE ELJO, Assistant Professor, Department of Social Work,
Bharathidasan University, Tiruchirappalli Email: jerydaanand@gmail.com

Introduction
World Health Organization (WHO) projections estimate the incidence of cancer to increase
exponentially by the year 2030, with the annual number of new cases rising from 14.1 million
in 2012 to 21.6 million in 2030 and deaths due to cancer rising from 8.8 million worldwide in
2015 to more than 12 million in 2030 (WHO,2017). At the same time, earlier diagnoses and
improvement in cancer therapies have also led to an increase in survival that includes more
than 300 million cancer survivors around the world. A broad implication of these figures
involves the psychosocial impact of the disease, including emotional consequences,
supportive care needs, and quality of life of cancer patients and their families. It is a fact that
cancer is not only a series of very different diseases needing complex and multidisciplinary
treatment but also a very stressful event with significant psychosocial implications related to
physical, emotional, spiritual, and interpersonal dimensions. All aspects of life, including the
parameters of time (e.g. the past, the present, and the future), space (e.g. one’s own individual
space, one’s own home, and one’s own world context), and existence (e.g. confrontation with
mortality) are altered by the diagnosis and treatment, recovery and long-survivorship,
recurrence, or transition to palliative and end-of-life care. (L, Grassi et al, 2017).
Psycho-Social Aspects of Cancer
Although its well recognised that the diagnosis of cancer and exhausting treatment are
extremely stressful events and emotional burdens for the patient, it is only the last decade or
two that the specific characteristic of psychosocial problems secondary to cancer has been
studied in more detail (Grassi et al. 2000). For the last 20 years, psycho-oncology has rapidly
developed and has produced a model that integrates psychological domain into oncology. The
main purpose of psycho-oncology is to investigate psychological factors within the
multidimensional understanding of malignant diseases which implies psychiatric diagnostics,
therapeutic, educational and research activities in oncological institutions i.e. oncology team
(Gregurek 2006). Psycho-oncology addresses (Holland & Friedlander 2006): 1) Psychological
reactions to cancer among patients, members of family and caregivers. Quality of relationship
between physician and patient significantly effects on patients at each appointment with a
physician, at all levels of care, at all stages of cancer and during all methods of treatment. 2)
Psychological, behavioural, biological and social factors that affect risk occurrence of cancer,
its detection, treatment and survival. Numerous psychoneuroimmunological mechanisms
have been investigated and their possible relationship with psychological and biological
aspects of genesis and course of the disease. Especially, the way that cytokines affect “disease
behaviour” this might represent the biological basis for symptoms for fatigue, depression,
anxiety, weakness and cognitive change among oncology patients (Cleeland et al. 2003). The
very beginning of psycho-oncology development was closely connected to psychoanalytic
concepts. Those conceptions made etiological links between the occurrence of cancer and
early family dynamic, traumatic events, unconscious sexual conflicts and personality traits.
This approach led to the development of two very important fields in psycho-oncology: many
studies were conducted on the psychobiology of stress and occurrence of liaison psychiatry.

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Psychological consequences of cancer diagnostics and treatment can be very significant. On
the physical level, cancer can cause great changes in body image and in the way patients
perceive their body. Oncology patients have various psychological problems such as
emotional lability, changes in future perspectives, feelings of solitude, abandonment,
marginalisation, stigmatisation, interpersonal problems, and all these problems can occur
during different disease stages and during treatment with a variety of psychological
consequences (Braš 2008).
Recent researches and clinical practice indicate that about third to half of the oncology
patients have different psychiatric/psychological comorbidity disorders. There are many
predisposing factors for psychiatric disorders among oncology patients such as the nature of
the disease, reduced fertility, different organic factors, prior stress and psychiatric disorders,
communication with family etc (Braš 2008). Psychiatric/psychological problems that can
usually be seen among oncology patients are primarily depressive disorder, adjustment
disorder, posttraumatic stress disorder and others are anxiety disorders, sexuality
dysfunctions (low sex drive, erectile dysfunction, anorgasmia, experience of unattractiveness),
delirium and other cognitive disorders provided that the psychiatrist meets with number of
other problems (suicidal thoughts, results of lack of family and social support, personality
disorders which causes problems in state of extreme stress, question of ability to make
decisions, mourning, quality of life, spiritual and religious questions, etc.) (Kadan-Lottick et al.
2005).
Anxiety associated with cancer amplifies feelings of pain, interferes with sleep habits, causes
nausea and vomiting, and negatively affects on patients quality of life (Stark & House 2000).
Unless it is treated serious anxiety can affect the length of patients’ life. Anxiety symptoms are
common at the initial stage of cancer diagnosis, during treatment decisions, as well as with
concerns about the return of the disease or disease progression but the rate of fully developed
anxiety disorders is not significantly higher from the one in general population. Contrary to all
assumptions patients with advanced cancer have less fear of death but greater from
uncontrollable pain, state of loneliness and dependence on others. The experience of life-
threatening disease, as cancer, can lead to the development of PTSD. Some of the risk factors
for PTSD occurrence after cancer include past experience of stressful life events, history of
psychological disorders, high level of distress prior to cancer diagnosis, coping through
avoidance, poor social support and worse physical functioning (Braš 2009).
There is strong evidence of cancer-depression association, with depression prevalence from
20 to 50 % at substantial tumours. There are many scientific studies that tried to explain
possible connections between psychological factors, especially depression, and development
and progression of cancer (Spiegel et al. 2003) but often with very different results and very
contradictory conclusions. Some studies show that depressive symptoms are linked with a
higher prevalence of cancer and higher mortality risks. Depression is also connected with
worse pain control, poorer compliance and less desire for long-time therapy. Some depressive
symptoms can be a normal reaction, psychiatric disorder or physical consequence of cancer
and treatment. Since cancer can cause anorexia, weight loss, fatigue and other vegetative
symptoms, diagnosis of clinical depression is associated more with psychological symptoms
such as social withdrawal, anhedonia, dysphoric mood, feelings of worthlessness or guilt, low
self-esteem and suicidal thoughts. It is important to emphasise that in the assessment of
depressive symptoms there is a risk of non-recognition (estimating depressive symptoms as
normal reactions) or overdiagnosis (estimating normal reactions or symptoms connected to
cancer as a part of depression) (Bailey et al. 2005). Cancer patients much more frequently
have passive suicidal thoughts than real suicidality, although it can be present among
uncooperative patients or among those who refuse treatment. The effects of depression on
mortality are not definitively confirmed although depression is linked to rapid progression of
disease (Prieto et al. 2005). Possible reasons are neuroimmunological changes, reduced

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compliance with treatment, behavioural changes and effects of depression on social, labour
and family functioning.
Under the influence of palliative and supportive care experts, major changes in oncology
professionals’ attitudes and behaviours surrounding patient death and dying have occurred.
As oncology professionals pay increasing attention to medical and psychosocial end-of-life
issues, they address the patient experience of terminal illness in a multidisciplinary,
multidimensional, patient- and family-centered way. Supportive care experts help alleviate
physical, psychological and spiritual suffering, offering competent compassionate care during
the dying and grieving process. They can also act as facilitators and coordinators for patients
and families in navigating health care systems and in finding available palliative and hospice
care services. Cancer patients’ experiences in dying need to be understood and integrated
within the context of their cultural values and community, which entail different meanings,
life narratives, and spiritual and religious elements. Supportive and palliative care specialists
most often work together as part of teams where all dimensions of the person are addressed
with utmost respect for the individual preferences and vulnerabilities of the dying patient and
his or her family and loved ones. Across different cultures, in fact, cancer patients’ families
assume the role and the burden of providing care toward the end of the patient’s life.
Functional interactions among families, patients, and oncology professionals are, therefore,
essential. Equally important is to consider the emotional, social, and financial tolls that
caregiving takes on family members and to assess the quality of life of caregivers and provide
them with psychological and social assistance.
Every person is born into a family and dies within a fantasized or real family. The experience
of chronic illness is inseparable from the family life history and is embedded within cultural,
religious, and historical contexts that shape families’ appraisal and value orientations towards
cancer. The family has been described as the basic social and ethical unit of cancer care since
all confrontations with patients’ illnesses and with their death and dying belong to the moral
realm of family boundaries.
The threat that cancer poses to the family can be understood in light of how different
members, individually and as a whole, construct and share meanings about specific stressful
situations, their identity as a family, and their view of the world. Neither patients nor their
families can ever return to a pre-illness situation. Successful coping with the separations and
losses that accompany cancer patients in their illness trajectory is dependent on solid and
mature family relationships. Providing emotional or instrumental support to cancer patients’
families during the entire illness is based on a thorough assessment of their cohesiveness,
mutuality, flexibility, and shared needs. Supportive care professionals can help to identify
adaptive, functional, and non-adaptive family coping mechanisms, as well as family conflicts.
Both patients and family members can benefit from various forms of psychological
intervention.
Multidisciplinary Approach to Cancer Care
As early as the 1990s it was becoming clear that multidisciplinary care clinics provide an
effective way to deploy expertise while simultaneously being more cost-efficient.
Theoretically, a multidisciplinary approach provides a rational and coordinated way to
evaluate and treat patients with complex diseases by bringing healthcare providers in the
surgical, medical, and radiation oncology disciplines together. In reality, each discipline
functions in a different environment with different requirements and incentives that can
undermine seamless coordination. For the most part, the practice of medicine relies on
consulting different speciality services concerning individual patient problems, however,
there has been a growing movement towards integrating multiple specialities into a
multidisciplinary approach. This approach has been playing an increasingly prominent role in
cancer care, both in the community and in academic cancer centres. The multidisciplinary

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team includes an oncologist, a physician, psychiatrist, psychologist, social worker,
occupational therapist, physiotherapist etc.
The make-up of the team varies depending on the tumour stream and on the health service.
Nurse coordinators are often the team members who bring patient information and concerns
to the meeting. Communication with the patient's primary care provider is important. In most
Western countries, the MDT recommendations are also discussed with each patient by an
appropriate member of the care team after the meeting is concluded.
There are some guidelines for operating an effective MDT have been published in several
countries. Some of them are
Leadership: Good leadership is integral to the operation of an effective MDT. The MDT chair
needs to ensure that all voices are heard, will be well respected and will be able to make a
casting decision. Further, effective leadership is necessary in order to encourage inclusiveness
and open discussions, thereby helping to avoid both the marginalization of team members
and poor decision making.
Team Dynamics: The team needs to agree upon mutual respect and trust, valuing different
opinions and the encouragement of constructive discussion. As indicated above, nurses play a
crucial role in coordinating care, as well as in representing the patient's views and
psychological aspects of care, especially as psychological concerns are often neglected in
favour of medical information.
Administrative Support: Administrative support is a key component of good MDT operation,
to ensure good organization and coordination. Documentation is an important aspect of MDT
meetings. The MDT coordinator assists in timely and complete patient information transfer
between a specialist and a GP.
Involvement of the Patient: Opinions differ on the involvement of the patient in MDT
meetings. In Western societies, there is general agreement that patients need to be informed
that their case will be discussed at an MDT meeting. The Cancer Care Ontario guidelines state
that ‘patients or their representatives should not attend the MDT meeting, to ensure unbiased
case review’.
A multidisciplinary team can benefit in the following ways
 They become the initial contact point for all patients who come into contact with the
healthcare system. They remain an ongoing, consistent point of contact for patients
and families through the full continuum of their care.
 They support patients as they move through different points of the healthcare system,
including hand-offs between inpatient and outpatient settings, speciality consultations,
research, hospice, and/or palliative care. Smoother hand-offs across all phases of care
translate into fewer delays in treatment, improved communication between
caregivers, and less confusion for the patient and family.
 They provide valuable education to patients and families on a variety of treatment,
nutritional, financial, or social issues.
 They can help decrease ER visits associated with complications in care by identifying
complications sooner and directing earlier interventions at the clinical level.
 They link patients and families to community resources such as transportation,
housing assistance, financial assistance, and/or support groups.
 They optimize access to financial resources to assist patients and families with
treatment-related costs, including drugs. This access is particularly critical for indigent,
uninsured, and under-insured patients.
 They offer emotional support to patients and families during difficult and stressful
times.
 They can help match patients to potential research protocols.
 They can provide a valuable link between the cancer centre and the community
physicians referring into the cancer centre.

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Conclusion
The paper signifies the importance of a multidisciplinary approach to the psychosocial care of
Cancer treatment. A combined, holistic and customised approach can be adopted for every
patient in care. Addressing the psychosocial aspects of disease will definitely create an impact
on the cure of the disease and each member of the team has to play a vital role in the
treatment plan of the patient.
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Jacobsen PB, Loscalzo MJ, McCorkle R, Butow PN, editors. Psycho-Oncology: Oxford University
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Tang PL, Wang HH, Chou FH: A Systematic Review and Meta-Analysis of Demoralization and
Depression in Patients With Cancer. Psychosomatics. 2015;56(6):634–43.
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of psychosocial research at the end of life. J Palliat Med 11:627–632
Rousseau P (2003) Death denial. J Clin Oncol 21:52–53

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care: a personalist approach. Supp Care Cancer 9:335–343
Mook E, Chan F, Chan V et al (2003) Family experience caring for terminally ill patients with
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Cohen R, Leis AM, Kuhl D, Charbonneau C, Ritvo P, Ashbury FD (2006) QOLLTI-F: measuring
family carer quality of life. Palliat Med 20:755–767
Baider L, Cooper CL, Kaplan De-Nour A (eds) (2000) Cancer and the family (2nd revised edn).
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Boszormenyi-Nagy I, Ulrich DN (1981) Contextual family therapy. In: Gurman AS, Knistern D
(eds) Handbook of family therapy. Brunner-Mazel, New York, pp 159–186
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 A REVIEW ON FOOD ALLERGIES

HRIDHYA K S.

Assistant Professor On Contract, Department Of Zoology, Little Flower College, Guruvayur

In the present day, it is becoming difficult to handle the diseases caused by food.
Everyone likes having variety of food. What if we are denied our favorite food? It would be a
very embarrassing situation.This is the situation of many kids and grownups in our present
world. In order to understand more about such conditions, we need to understand several
terms. Hypersensitivity refers to objectively reproducible symptoms or signs initiated by
exposure to a defined stimulus at a dose tolerated by normal subjects. Hyper Reactivity is the
exaggerated normal response to a stimulus. Allergy is the hypersensitivity reaction initiated
by immunologic mechanism. Anaphylaxis is the severe, life threatening, generalized or
systemic hypersensitivity reactions. Excluding food ,there are some more causes of such
reactions. Reactions caused by drugs are also common today.This is here the solution tends to
be the problem.A drug used to treat another disease gives rise to a dangerous situation
itself.Some hypersensitive reactions due to drug may turn anaphylactic too. Pollen and dust
allergies are also common. A person having dust allergy or pollen allergy may also be
susceptible to invertebrate dust and some raw vegetables also. Some reactions due to insect
sting that inject poisons are also common cause of anaphylaxis that turn fatal.Food allergies
and sensitivities are becoming an epidemic. It is now estimated that 1 in 5 Americans now
have some sort of food allergy! Some of these allergic reactions are caused by ingestion such
as food allergies, some by direct contact of skin such as poison plants, animal scratches, some
by injections such as insect stings and some others by inhalation such as pollen, dust, animal
dander etc.
ALLERGIC REACTION PROCESS
On first exposure, Ig E specific to allergen is produced in our body and it enters in our
circulation. It then attaches to mast cells especially in nose,throat,lungs,skin,GI tract, etc.Ig E
also attaches to Basophils found in blood and tissues inflamed by allergic response. On second
exposure Ig E binding to allergen signaling the cells to release large amount of
histamine.Depending upon the tissues in which they are released, various symptoms
occur(mild to severe).Theprocess of eating and digesting food and the location of mast
cells,both affect the reaction time and location.Children with allergic parents have a greater
chance to suffer from allergies.People with other atopic diseases(Allergic Rhinitis[Hay
fever],Atopic Dermatitis[eczema],Asthma) are more likely to have food allergies also.Leaky
gut syndrome is also considered as a factor that initiates allergic responses in an individual.
ALLERGIC SYMPTOMS
Skin shows symptoms like Hives, Angioedema, Eczema, Itching andFlushing.Nose
shows symptoms such as congestion, Itch or sneeze, runny nose.Throatshows symptoms like
tightness, tongue swelling, unable to speak etc. Allergic symptoms that affect chest include
Shortness of breath, Tightness, Wheeze, Coughing etc. Nausea, vomiting, cramps and
diarrhoea are the symptoms commonly associated with gastrointestinal tract.Low blood
pressure and Fainting are the systemic effects that affect the whole body.
FOOD ALLERGY Vs FOOD INTOLERENCE
There occurs a slight confusion on talking about food allergies and food
intolerances.Lactose Intolerance is commonly found food intolerance in adults.It is caused due
to theabsence of lactase enzyme in the gut,thus resulting in the breakdown of lactose by our
gut fauna and forming gas causing bloating, abdominal pain and sometimes diarrhea. It
usually occurs in adults because of the decrease in lactose rich diet hen compared to
infants.Food Additives such as Mono Sodium Glutamate(tastemaker) causes flushing,

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sensation of warmth, headache and chest discomfort. This is also a common type of food
intolerance. Sulphites used to increase crispiness and to prevent mould growth in packed food
items causes breathing problems that are a part of food allergies. Gluten Intolerance is also a
commonly seen food intolerance. Gluten is a part of wheat, barley,rye which causes gluten
sensitive enteropathy in some individuals.Food poisoning due to bacterial toxins that
contaminate meat and dairy products cause abdominal cramping.Histamine Toxicity
orScombroid Food Poisoning is caused due to bacteria contaminated tuna and mackerel that
were not refrigerated properly and that have high levels of histamine.Cancers and ulcers of
gastrointestinal tracts also causes same symptoms as food allergy.
SEA FOOD ALLERGY
Seafood plays an important role in human nutrition and health. As international
marketing of sea food has gained importance, it has become the source of income and destiny
of several populations.The productions and consumption of seafood has proportionally
increased with which there is an increase in the frequency of adverse reactions is generated
as a part of seafood allergies.Countries or states that are situated near to sea or oceans are
more prone to sea food allergy.Occupational sea food allergy is also common in people who
get a lot of exposure to allergens present in raw seafood.Fish allergy has higher prevalence in
fish eating countries such as cod related problems in Scandinavian countries.Cross reactivity
with other fishes has also been observed.Parvalbumin in cod is a major cause of fish allergies.
SHELLFISH ALLERGY
Allergic reactions to a group of crustaceans and molluscs range from mild skin
irritations and oral allergy syndromes to life threatening anaphylactic reactions.Studies have
revealed that tropomyosin is the major allergen in crustaceans that induces cross reactivity
between crustaceans and molluscs and also to other inhaled invertebrate dust, insects and
mites.Preservatives added with these food items may also induce our immune system to
exhibit allergic response.
DIAGNOSIS
Skin prick test is the first test used to determine whether the patient is actually allergic
or not. Here, intradermal injections of small quantities of suspected allergens are given on
different areas of skin and the reactions are observed within a particular time period.Blood
test is the next step to diagnose allergies in patients where skin prick test isnot successful.In
blood test, the amount ofIgE in blood is estimated and the intensity of allergy can be estimated.
Double blind and single blind food challenge is another method.In double blind food
challenge,both the doctorand the patient is unaware of the food that the patient is asked
tohave and the afterward reactions are observed.Here a third party is assigned for this task.
This type of diagnosis may turn fatal if the person shows anaphylaxis to that particular food.In
single blind challenge,the patient is not allowed to see the food item provided bu the doctor is
aware of this and observes the patient for a time period.Elimination diet is another technique
to diagnose food allergies.This is done by avoiding one by one of the suspected food and
consuming all others and then observing the patient.This way one can find out which
ingredient in the diet causes the allergy.
If one suspects of being allergic,there are several measures to be taken.It
includeskeeping track of personal and family history of allergic diseases as there are more
chancesof the person to have allergy.Patients should look out for the signs and symptoms of
the allergy and keep a note on the place,time and type of symptoms.Prior exposure to the
quantity of the suspected food eaten and time sequence of symptoms is also important.
FOOD ALLERGY THERAPY
Hope, compassion, empowerment and education are the important areas to be
stressed upon.Avoidance of triggers and maintenance of good nutrition helps to overcome
such situations.There are several medications for reducing reactionsof allergy.Allergy
immunotherapies are also used.

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 About 50 years ago, these allergies were rare but now they have become a burden for
each household.Still now no concrete basis has beenfound for this fate.Some theories have
come forward which includes the destruction of normal intestinal fauna due to stress, sterile
environment, illness, prescription medications, antibiotics, genetically modified food etc.
leading to leaky gut syndrome.Leaky gut syndrome is due to the destruction of usualgut fauna
that prevents the movement of food into the blood before proper digestion.The absorption of
food particles into the blood at the wrong time makes all the problems.Medications to gut
problems are inefficient until the gut is healed.Avoiding the culprit is not the cure. Some
simple ways include eating homemade fermented food or beverages.Lactose fermentation
helps to restore good bacteria.Probiotics are used to colonise those bacteria and Prebiotics
are used for feeding the gut fauna.Eating gelatinous food helps in healing and sealing digestive
tract.Proper amount of sleep is also required formaintaing an allergy free life.
REFERENCES
1.www.foodallergy.org
2.Fish and shellfish allergy,Laurianne G. Wild MD, Samuel B. Lehrer PhD
Current Allergy and Asthma Reports-January 2005, Volume 5, Issue 1, pp 74–79
3.Arevisednomenclatureforallergy -S.G.O.Johanssonet.al. ,Allergy2001:56:813-824

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 AN INQUIRY INTO THE PROBLEMS AMONG PRIMARY CAREGIVERS OF THE
CANCER PATIENTS: INSIGHTS FROM SOCIAL WORK PRACTICE

JORZALIN GEORGE

Asst. Professor, Dept. of Social Work, Vimala College (Autonomous) Thrissur.

INTRODUCTION
Cancer is the uncontrolled growth of abnormal cells in a body. The incidence of cancer and
cancer types are influenced by many factors such as age, gender, race, environmental
factors, diet, and genetics. Feeling exhausted and lacking energy for daily activities is the most
usual side effect of cancer treatment. According to ICMR, over 7.36 lakh people are expected
to surrender to the disease in 2016. When the caregiver is trained in how to help
the patient manage side effects of treatment and symptoms such as pain and fatigue,
the patient is more likely to have the energy and will to continue with treatment. The fore
mentioned roles along with other roles of the caregiver, can make him/her burdened. It is
necessary to address the needs of the caregivers and the improvement in this area will
increase the Quality of Life of the cancer patients indirectly. The varied techniques in Social
work will help the social worker to take some effective measures for the caregivers under
stress. Precisely, with the approach of the social worker, the caregivers of the cancer patients
can cope up with the struggles they face and will be able to make an improvement in the living
conditions of the cancer patients.
CANCER
Cancer is the uncontrolled expansion of abnormal cells in a body. These are named as cancer
cells, malignant cells, or tumor cells. These cells are able to penetrate normal body tissues.
Some cancers and the cells which compose the cancer tissue are again branded by the name of
the tissue from which the abnormal cells originated. (For example: breast cancer, lung cancer,
colon cancer etc…) When the injured or undestroyed cells do not die and survive to become
cancer cells, to have uncontrolled division and growth, cancer cells increases in a huge
amount.
The most common types of cancers seen in men women and children are as follows:
 Men: Prostate, lung, and colorectal
 Women: Breast, lung, and colorectal
 Children: Leukemia, brain tumors, and lymphoma
Every year the number of individuals affected by this disease is mounting higher and the
studies shows its diverse effect on the society. The following table (National Cancer Institute
2016) gives the estimated numbers of new cases and deaths for each common cancer type:

ESTIMATED ESTIMATED
CANCER TYPE
NEW CASES DEATHS
Bladder 76,960 16,390
Breast (Female -- Male) 246,660 -- 2,600 40,450 -- 440
Colon and Rectal 134,490 49,190
(Combined)
Endometrial 60,050 10,470
Kidney (Renal Cell and 62,700 14,240
Renal Pelvis) Cancer
Leukemia (All Types) 60,140 24,400
Lung (Including Bronchus) 224,390 158,080

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 Melanoma 76,380 10,130
Non-Hodgkin Lymphoma 72,580 20,150
Pancreatic 53,070 41,780
Prostate 180,890 26,120
Thyroid 64,300 1,980

The occurance of the types of cancer is influenced by varied factors such as age, gender, race,
environment, food and genetics. Therefore, the frequency of cancer and its types change as
per the variables.
The World Health Organization (WHO) gives the following general information about cancer
worldwide:
 Presently, Cancer is considered as the leading cause of death worldwide. It accounted
for 8.2 million deaths.
 Lung, stomach, liver, colon, and breast cancer cause the most cancer deaths each year.
 Deaths from cancer worldwide are projected to continue rising, with an estimated 13.1
million deaths in 2030 (about a 70% increase).
The American Cancer Society provides seven warning signs to understand about the presence
of cancer cells in the body. They are: Alteration in bowel or bladder habits, A sore throat that
does not cure, Abnormal bleeding or discharge (for example, nipple secretions or a "sore" that
will not heal that oozes material), Thickening or lump in the breast, testicles, or elsewhere,
Indigestion (usually chronic) or difficulty in swallowing, Obvious change in the size, color,
shape, or thickness of a wart or mole, Nagging cough or hoarseness.

CANCER TREATMENT
The treatment for the cancer is provided on the ground of what type of cancer and its stage.
For some, the diagnosis and treatment may occur simultaneously. Even if patients may
receive a unique series treatment, or procedure for their cancer, most medications have one
or more following components: surgery, chemotherapy, radiation therapy, or combination
treatments (a combination of two or all three treatments).Patients obtain variations of these
treatments for cancer. The combination therapy- the composition determined by the cancer
type and stage, is applied for the individuals with cancers which will not be cured.
The patients who undergo cancer treatment are subjected to depression and many health
issues. And these factors are frequently under-diagnosed and undertreated. Well-established
biological indicators for major depression are proposed as diagnostic adjuncts in patients
with cancer. Many psychological, physical and mental complications evolve in the life of the
individual after having diagnosed with cancer. They seem exhausted and worn-out at least
after certain stages of treatment. The support and assistance are essential at this time of
illness. Most of the time primary or secondary caregivers meet these basic needs. The
caregivers attend to the first to the last needs of the patients and become an inspiring and
supporting factor. Their presence can both be positive and negative on the position of the
work done to the patient.
CAREGIVERS
Mostly the physical, mental and psychological complexities of life of the cancer patients are
met by the caregivers, who become the responsible agents in the recovery of the patient.
Throughout their ill health cancer patients are supported by these caregivers. They can be the
individuals, spouses, partners, relatives, children, friends, neighbors or any person hired for
the same purpose. The family caregivers or the primary caregivers are those who assist the

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patients from the direct relationship like spouses, children or other family members. It is
important that the family caregiver is a part of the team right from the start.
Many cancer patients get the care from the home, since the stay at the hospital became
shorter than they used to be. There are even treatments which do not need an overnight
hospital stay. People with cancer are living longer and many patients want to be cared for at
home as much as possible. This care is often given by family caregivers. The family caregiver
or the primary caregiver works with the health care team and has got an important role in
improving the patient’s health and quality of life. Today, family caregivers do many things that
used to be done in the hospital or doctor's office by health care providers. Care giving includes
everyday tasks such as helping the patient with medicines, doctor visits, meals, schedules, and
health insurance matters. It also includes giving emotional and spiritual support, such as
helping the patient deal with feelings and making hard decisions.
ROLES OF CAREGIVERS
A good caregiver is a vital health care resource. In many cases, the caregiver is the one person
who knows everything that’s going on with the patient. Care giving is a hard job. And many
caregivers are there for their loved one 24 hours a day for months or even years. Caregivers
have many roles. These roles change as the patient’s needs change during and after cancer
treatment. Today a lot of cancer care is done in outpatient treatment centers and doctors’
offices. This means that sicker people are being cared for at home.
1) Family caregiver is a part of the team right from the start.
The family caregiver has the very important job of observing for changes in the patient's
medical condition while giving long-term care at home. Family caregivers can help plan
treatment, make decisions, and carry out treatment plans all through the different parts of
treatment.
The caregiver is part of a cancer care team made up of the patient, other family and friends,
and the medical staff. A caregiver work closely with the cancer care team, doing things like:
 Giving drugs
 Managing side effects
 Reporting problems
 Trying to keep other family members and friends informed of what’s happening
 Helping to decide whether a treatment is working
2) Caregivers are problem solvers
The person with cancer faces many new challenges. The caregiver can help the patient deal
with the challenges and get through any problems that come up.
The caregiver can:
 Help address patient’s concerns by pointing out that the patient will need to be in the
hospital for only a short time until antibiotic treatment has the infection under control.
 Make sure that the patient has everything they need while in the hospital, including
doctor’s prescriptions for non-cancer related medicines taken at home, such as thyroid
or blood pressure medicine.
 Call all the doctors involved in the patient’s care and tell them about the infection and
that the patient is in the hospital.
 Check that arrangements have been made for the patient to stay on the antibiotics at
home or as an outpatient after leaving the hospital.
These kinds of tasks may be too much for the patient to tackle while fighting infection. This
kind of help is valuable. It’s a reassuring sign for the patient that this short-term problem can
be managed and solved.
3) Caregivers take care of day-to-day tasks
There are other day-to-day tasks a caregiver might do. Here are a few things caregivers might
help the person with cancer do, or in some cases even do for them:
 Shop for and prepare food

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  Eat
 Take medicines
 Bathe, groom, and dress
 Use the bathroom
 Clean house and do laundry
 Pay bills
 Find emotional support
 Get to and from doctor’s appointments, tests, and treatments
 Manage medical problems at home
 Coordinate cancer care
 Decide when to seek health care or see a doctor for new problems
All of this work costs caregivers time and money. There may also be a cost to the caregiver’s
health and well-being, but often the caregiver just keeps doing what needs to be done and
may suffer in silence.
4) Caregivers involve the patient
Good communication with the person you are caring for is the most important part of the role.
It may be hard for the patient to take part in daily planning and decision-making because
they’re dealing with the physical, emotional, and social effects of cancer and treatment. The
job of the care giver is to involve the patient as much as possible, so they know they’re doing
their part to get better. The care giver finds many means to involve the patient in the day to
day life situations.
5) Long-distance care giving
Care giving at a distance can be even harder to do and can cost more, too. The cost of time,
travel, phone calls, missed work, and out-of-pocket expenses are higher when the caregiver
doesn’t live close to the person needing care. Sometimes paid “on-site” caregivers are needed,
and this can be another large expense. There’s often increased stress and greater feelings of
guilt with long-distance care giving.
CAREGIVER STRESS AND BURNOUT
Taking care of another person can be stressful. Everyone has some stress, but too much can
harm one’s health, relationships, and enjoyment of life. Caregiver stress happens when the
person doesn’t have time to do all that’s asked or expected of him/her. Caregiver burnout
happens when one is in a state of stress or distress for a prolonged period of time. Caregiver
stress and burnout can affect the person’s mood, and make feel
tense, angry, anxious, depressed, irritable, frustrated, or fearful. It can make the care giver feel
out of control, unable to focus, unsatisfied with work, or lonely. Caregiver stress and burnout
can also cause physical symptoms like sleep problems, muscle tension (back, shoulder, or
neck pain), headaches, stomach problems, weight gain or loss, fatigue, chest pain, heart
problems, hair loss, skin problems, or a colds and infections. It can lead you to abuse alcohol
or other substances.
CAREGIVER STRESS AND BURNOUT - CAUSES
These things can lead to caregiver stress or make it worse:
 Fear & uncertainty: Cancer treatment isn’t certain. It’s hard not to worry about the
person with cancer, and the future.
 Shifting roles: Care giving can change relationships. This isn’t bad. But, it can be
upsetting when someone who has been a source of strength is suddenly vulnerable, or
when you find yourself making decisions somebody else used to make.
 Too much to do: As a caregiver, one may feel overwhelmed by all he/she has to do,
and as though everything is falling on their shoulders.
 Financial pressure: The costs of cancer care can be a source of stress. Also, the patient
and the care giver may be unable to work full-time—or at all.

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  Loneliness & isolation: Caregiving takes time. Care giver does’t has time to spend
with friends, take part in outside activities, or pursue hobbies.
 Little time alone: Everyone needs time for themselves. This can be difficult to get
when a person who is caring for someone with cancer.
 Constant demands: Being on call around-the-clock can be especially hard.
 Guilt: You may feel bad that you can’t give more, or you may feel that you are short-
changing other family members and friends.
CARE GIVING AND SOCIAL WORK
Iris Cohen Fineberg (ICF): The role of the oncology social worker is to help patients, families,
and caregivers deal with the experience of facing cancer. Social workers are educated and
skilled to assist with the psychological, social, emotional, and spiritual issues that people have
to deal with in oncology. Social workers are there to help people with practical needs, like
finding resources in the institution and the community, and with such complex needs such as
adjusting to an illness, dealing with transitions and decision-making, navigating cultural
issues, and communicating with family members, friends, and health care providers. Social
workers meet with patients and family members individually and/or as a family, run support
and education groups, and work as part of oncology care teams. And, oncology social workers
are becoming more involved in research, designing, conducting, and leading studies that aim
to advance knowledge that ultimately will help improve people’s quality of life.
The fundamental task of oncology social work is to facilitate patient and family adjustment to
a cancer diagnosis, its treatment and rehabilitation.
PSYCHOSOCIAL CARE PROVIDER
The primary role of the oncology social worker is that of psychosocial care provider. The
oncology social worker is attentive to the psychological, social spiritual/existential, and
practical concerns of patients and families. Thus, the tasks of oncology social work are multi-
faceted and must be comprehensively framed at each stage of illness. In the realm of direct
service, these tasks include: 1. screening, evaluation, and assessment; 2. adjustment to illness
counseling, and individual, family, or group psychotherapy; 3. discharge planning; 4. referral;
5. Advocacy.
In this role, the oncology social worker is trained in a philosophy of care which is framed by
the following basic tenets.
 First, the patient and family are viewed as a unit of care. Social work theory supports a
systems focus through its emphasis on working with a person-in-environment
approach. This view maintains that all individuals are part of an intricate web whose
central ties begin with the family. Understanding this allows for an enhanced
assessment of the psychosocial dynamics of the patient's illness and its effects on the
family. Training in the biological, psychological, and social theories of development and
adaptation, therefore, best prepares social workers to assist individuals and. Social
work's focus on the larger system of community and society extend the role beyond
that of individual counselor or family therapist to ensure that the health care system
and the larger community are responsive to the needs of individual units. Outreach
prevention programs, community-based psycho-educational groups, and church-based
health fairs for cancer screening are but a few examples of the ways oncology social
workers work collaboratively to intervene at the community level.

 Second, the biopsychosocial model ensures an understanding that the continuum of

psychosocial care is necessarily affected by the medical condition of the patient. An
intervention that might be appropriate at one particular stage of the illness may
actually be detrimental at another. Comprehending this fundamental principle is at the
core of the oncology social worker's ability to listen to and to follow the patient's
needs. Starting where the patient is, is a core social work value.

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  Third, psychosocial needs change over time and are influenced by many factors. The
medical condition of the patient is not the only factor influencing the type of care that
would be most effective. Life events such as marriages, divorces, births, graduations,
etc. have an impact on the cancer patient and the patient's family, which change the
type or level of psychosocial care actually needed by the patient. Social work's
systems perspective allows for the consideration of the effects of such life events.

 Fourth, individual differences require multi-modal approaches for support, problem

solving, and rehabilitation. Awareness of diversity is at the heart of social work
practice. Social workers understand that patient receptivity to treatment is influenced
by psychological and social factors. Cultural and developmental factors influence the
patient/family's view of the patient role, their reactions to illness, and the meaning
they make of asking for or accepting help. Focus in training on multiculturalism
prepares social workers to address the broad spectrum of people affected by cancer,
particularly ethnic, gender, or cultural groups that may not receive as much attention
in the training of other professional groups.
REFERENCES
1) Bryan J, Greger H, Miller M, et al. An evaluation of the transportation needs of
disadvantaged cancer patients. J Psychosoc Oncol. 1991; 9:23-36.
2) https://www.medicinenet.com/cancer/article.htm#what_is_cancer
3) https://www.medicinenet.com/cancer/article.htm#are_there_home_remedies_or_alte
rnative_treatments_for_cancer.
4) https://jamanetwork.com/journals/jamapsychiatry/article-abstract/496944
5) https://www.cancer.gov/about-cancer/coping/family-friends/family-caregivers-pdq
6) https://www.cancer.org/treatment/caregivers/what-a-caregiver-does/who-and-
what-are-caregivers.html
7) https://www.helpforcancercaregivers.org/content/caregiver-burnout
8) http://www.cancer.ca/en/cancer-information/cancer-journey/if-you-re-a-
caregiver/?region=on
9) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2988637/

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 AN ANECDOTE OF VANQUISHED DEATH: REVISITING CARCINOMA
NARRATIVES

SOUMYA

Ph.D, Reearch Scholar, Department of English, University of Calicut

Death they say is the only constant in life. Every living organism is bound to face death
once they are born. Various diseases hasten the natural pace and occurrence of death.
However, this ubiquitous existence of death is often visibly challenged by discourses and
narratives by authors who with a sense of hope for survival have fought successfully to live
on beyond the grave realities of illness. Illness narratives, as they are called, refer to a
branch of writing which includes memoirs, autobiographies or life writings which narrate
and describe the woes of dealing with a particular kind of endemic. Such writings which
broadly have a base in the theory of disability studies address myriad questions pertaining
to how an individual survives an illness and also how readers confront such narratives as
observers. Studies in this field have in the recent times been of great importance in the
medico-literary and cultural areas of thought and practices. The topic for this seminar,
‘Horizons of Hope, Can Survive’ that primarily deals with the issue of the malady of cancer,
adaptation and surviving cancer, care giver’s strain as well as the pangs and pains of living
on through the illness is an area which needs crucial deliberations and discussions by
bridging a gap between literature and scientific knowledge. I would begin my presentation
with a poem I wrote a couple of years ago titled Cance-R-ealisation which is about a woman
who suffers from breast cancer and is required to undergo mastectomy.
Cance-R-ealisation
My breasts….
Twins they were….
One died!
Murdered, and brutally cut off from the body.
The other handicapped by the loss.
Nights passed,
He turned away from me….
Never returning to his journey up and down the hill…
That he once cherished and relished!
The child sucked at the left,
As his tiny fingers searched for the right,
A black scar took its place!
Fated to be the wicked demoness,
Cancerous at heart,
Stealthily shifting from others’ glances
I accepted,
I had not breasts, but just a breast!

Owing to technological advancements we are always confronted with advertisements

and pamphlets which seek to spread awareness about cancer, its early detection and
consequent treatment. However, such information and awareness camps unfortunately fail to
impact the audience beyond the few minutes that it is aired or read as one always likes to
believe that we or our dear ones would never be inflicted by the disease. Thus, what is being
said pertains to the ‘other’ or the sufferer whom we merely empathize with but do not think
beyond providing sympathy. The entire discourse of feeling sorry or sympathetic and trying
to evade even talking about cancer, changes dimensions when suddenly one fine day one is

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told that you or a dear one is suffering from it. The whole world seems to crumble down then,
with a feeling of being pushed to the corner of a dark room with death being the only hope or
the inevitability.
This paper seeks to place a personal account of the care giving strains of a dear one
diagnosed with cancer within the mould of a survival narrative titled Oraal Jeevithathilekku
Thirichu Nadanna Vidham translated as Ways In Which He Walked Back To Life written by Dr.
Sunil Kumar, whose work, which quite contrary to the usual narratives of cancer survival that
stir a sense of empathy for the patient, helped to understand the intricacies, difficulties and
nuances of confronting and dealing with cancer. As pointed out earlier, we all like to believe
that one would never be required to confront with cancer at the personal level at any point in
our lives. In July 2017 as part of the hospital visits with my Uncle, I and his wife, my aunt,
firmly believed that he would recover and be back home soon. After a series of endoscopic
tests, ultra sounds and scans, one fine morning the treating doctor in a very blunt and coarse
voice breaks the news that the tests suggest a tumor in the gall bladder which is most
probably malignant. Shocked and unable to digest the revelation, all I could ask was whether
there were any chances that the tumor turns out to be benign, that is, non malignant. The
doctor responded in the negative and persuaded me to keep the news to myself till future
tests confirm the nature of the tumor. The eager eyes of my aunt and uncle in the room
waiting to hear what the doctor said about his condition cut through me as I slipped away to
brood and digest the news in solitude. The situation brought back the pages of the book titled
Oraal Jeevithathilekku Thirichu Nadanna Vidham by Dr Sunil Kumar, a close acquaintance and
a vetenerary doctor by profession who was diagnosed with a very rare kind of carcinoma
called Plasma Cell Leukemia. This book with an introduction by the famous oncologist Dr. V.P.
Gangadharan who treated him, chronicles Dr. Sunil's experiences of living through and finally
successfully surviving cancer to come back to lead a normal life. As pointed out by Dr.
Gangadharan in the Introduction to the book, “right from the time we are born, one walks
towards death… that is the rule of nature… hence there is nothing extra ordinary about it…
What matters and is noteworthy is when one walks back to life. Sunil’s anecdotes serve to
share not just his own experiences but also are surely a source of hope, comfort and revival
for cancer patients”. Studies suggest that illness narratives are forms of cultural criticism as
they describe the political role of autobiographical illness narratives or pathographies in
expressing not only the subjective experience of the illness as suffered by the survivor but
also seek to illuminate ideological differences between the patient and health care cultures,
reveal the dominance of health care ideologies, and explicate patient’s moral and political
claims. Such narratives much like life writing, by expounding the reality as lived by the
patient, also attempt to provide a sense of positivity and hope of survival from cancer and
coming back to life to the readers. As the title of the book suggests, it is the journey of how he
manages to walk back towards life. In the preface to the book, he points out at how he was not
prepared to leave behind his loved ones and his dreams in life and die. His passion for life kept
him going and he refused to submit to death. As suggested by the famous metaphysical poet,
John Donne, in his collection titled Holy Sonnet, ‘Death be not Proud’…was Dr. Sunil’s motto
which helped him to fight back. The account which he began writing after his recovery and
getting back to normalcy, charts out an honest and real chronicle of how he was in a sense
reborn and had a second life. His first person narrative of the extreme pain, trauma, bouts of
dejection and depression, the side effects of chemotherapy sessions, phases of being unable to
even get up without external support, fits of chills, the weakening body, dampening hopes and
consequent revival and how there were times when he literally crawled back to his bed are
anecdotes spelt out in graphic details which imbue not a sense of empathy but impart a vigor
and energy to fight back and survive against all odds.
Studies suggest that the therapeutic benefits of writing are reported as not just ways of
making sense of living through death like situations due to illness but is also combined with a

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strong sense of purpose in sharing the story with others to strive to hold on to the inner flame
to survive. Thus, autobiographies such as Living to tell the Tale by Gabriel Garcia Marquez
sought to narrate the pain and the agony to be passed on to posterity. Illness narratives are a
means of studying not only the world of biomedical reality, but also the illness experience and
its social and cultural underpinnings. Ann Jurecic, a literary theorist examines Susan Sontag’s
lifelong exploration of how to respond ethically to representations of suffering in her analysis
of Sontag’s work Illness as Metaphor which explores how “literature documents and shapes
the cultural meaning and experience of illness, pain, and suffering”. Sunil’s documentation of
his journey from death to life not just inspires but motivates the audience to have faith and
hold on to life. A narrative of great literary merit provides a peep into the psyche of the
patient as well as a road map to how one should deal with a patient suffering from the deadly
disease. The reading provided the necessary fuel to remain headstrong while taking the
rounds of the oncology ward for my uncle’s chemotherapy cycles for Stage III Neuro-
endocrine Carcinoma. Each cycle with its various sets of side effects was different in its own
way which, my uncle with his sheer will power and desire to live on could overcome and
survive. Dr Sunil’s narrative had the power to persuade not to lose hope and opened up
avenues that proved that indeed cancer could be defeated. As my uncle continues to lead his
life of normalcy, Dr. Sunil, who lived on to tell the tale had a pre mature death due to multiple
organ failure, many years after his successful survival from carcinoma. His work, published
posthumously, continues to inspire sufferers not to succumb to cancer which, with the right
combination of medical assistance as well as a strong will power can surely be cured and one
can continue a life of normalcy.

Bibliography
 Ann. "Illness as Narrative." African Studies Review. Cambridge University Press, n.d.
Web. 25 June 2018. <https://muse.jhu.edu/book/13467>.

 Chandramathi. An Interval in the Land of the Crabs : Cancer memoirs. Kottayam: DC

Books, 2006.Print.

 Innasent̲, and Ś r̲īkā nt Kō ṭṭakkal. Kānsar Vārḍile Ciri: Ōrmakkur̲ ippukaḷ. Kozhikode:
Mathrubhumi, 2014. Print.
 Jurecic, Ann. "Illness as Narrative. U of Pittsburg P:." N.p., 13 Jan. 2010. Web. 23 June
2018. <https://www.uc.edu/content/dam/uc/journals/composition-
studies/docs/bookreviews/40-2/Trauth.pdf>.
 Marquez, Gabriel Garcia. Living to Tell the Tale. N.p.: Penguin, 2014. Print.
 Mukherjee, Siddhartha. The Emperor of All Maladies a Biography of Cancer. Detroit:
Gale, Cengage Learning, 2012. Print.
 Sontag, Susan. Illness as Metaphor ; and AIDS and Its Metaphors. London: Penguin, 2004.
Print.
 "The Implications of Plot Lines in Illness and Memoir." Nieman Storyboard Dan Koeppel
and Narrative Tension Popular Mechanics Not for the Faint of Heart Comments. N.p., n.d.
Web. 25 June 2018.

************

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 ROLE OF OXIDATIVE STRESS AND INFLAMMATION IN ATHEROSCLEROSIS

INDU M. S

Assistant Professor, Department of Zoology, Vimala College, Thrissur

Introduction
Atherosclerosis is a slow progressive degenerative disease of arteries that accounts for most
cardiovascular and cerebrovascular death. Deposition of lipids or cholesterol on the arterial
walls their causes thickening of walls resulting in narrowing of lumen (Chapman, 2010) and
the blood supply to subsequent organs gets compromised generating a condition called
ischemia. The disease starts as a fatty streak during early child hood and gradually progresses
into a calcified plaque. As the size of plaque increases it often becomes vulnerable and may get
dislodged to form emboli (Croce and Libby, 2007) initiating intravascular thrombosis that
interferes with the blood supply to brain or heart culminating in sudden cardivascular or
cerebro vascular events. Even though atherosclerosis is considered by most as a lipid
disorder, it has to be noted that atherosclerotic vascular disease has chronic oxidative stress
and associated inflammatory reactions at all stages of its disease pathology.

Pathophysiology of atherosclerosis
The most accepted explanation regarding the pathophysiology of atherosclerosis considers
oxidative stress and inflammation as the most important causative agents. They are
contributed by other risk factors like hypertension, hyperlipidemia, diabetes, cigarette
smoking, obesity and lack of physical exercise, age and gender. The risk factors produce free
radicals and induce oxidative stress in the endothelium and promote the expression of cell
adhesion molecules and pro-inflammatory chemokines resulting in leukocyte recruitment and
inflammatory response (Alexander et al., 1995). Atherosclerosis starts asa result of excessive
circulating LDL which causes endothelial injury and enters the sub-endothelial space (Al-
Benna et al., 2006). The body with its immune mechanism recruits monocytes to the injured
site to resist this invasion (Libby, 2012). At the same time in the sub-endothelial space the
LDL gets acted upon by enzymes like lipoxygenase and myeloperoxidase and gets modified
into oxidised LDL (Glass and Witztum, 2001). Monocytes once it reaches the sub-endothelial
space get converted into macrophages and these macrophages engulf the oxidised LDL (ox-
LDL) to form lipid laden macrophages or foam cells (Sakakura et al., 2013; Yu et al., 2013).
Foam cell formation is considered as the hall mark for atherosclerosis. Initially the activated
macrophages tend to release growth factors and other inflammatory cytokines that attract
more monocytes to this area. Also smooth muscle cell proliferation and recruitment of
calcium to this cite can occur. When the blood LDL remains increased more and more foam
cell will be produced and also there will be gradual deposition of the foam cells on the already
formed fatty streaks increasing the size of deposits resulting in plaque formation. Plaques can
get calcified and enlarged reducing size of the lumen resulting in diminished blood supply to
the organ concerned. More over when the vulnerable plaques get ruptured by any means,
intravascular thrombosis can occur suddenly leading to myocardial infarction or stroke.

Oxidative stress and atherosclerosis

Oxidative stress is as an important agent in the etiology of degenerative diseases like arthritis,
cancer, and atherosclerosis. Free radicals and reactive oxygen species (ROS) are produced in
the tissues as a result of various metabolic reactions and conditions like hypertension,
hyperlipidemia and diabetes are also associated with increased production of ROS.
Environmental factors like ionising radiations, heavy metals and cigarette smoking can also
act source of free radicals. The excessive levels of reactive oxygen species results in the

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condition called oxidative stress where these free radicals initiate chain of unintended
reactions at the cellular level, which can cause injuries to critical cell biomolecules like
membrane lipids, proteins, enzymes and nucleic acids (Van Eck et al., 2003) and peroxidation
of proteins and lipids produces carbonyls and malonyldialdehye (MDA).
Key molecular events in atherogenesis such as oxidative modification of lipoproteins and
phospholipids, endothelial cell injury and activation, macrophage infiltration/activation,
expression of molecules that induce vascular inflammatory response and production of
protein carbonyls for plaque progression are facilitated by vascular oxidative stress. Healthy
endothelium is maintained and regulated by the balance between the production and
bioavailability of endothelium-derived relaxing factors (EDRFs) and endothelium-derived
contractile factors (EDCFs). Endothelial dysfunction occurs when there is an imbalance
between these factors as a result of increased bioavailability of ROS and decreased
antioxidant capacity characterized by oxidative stress (Silva et al., 2012).Different ROS
producing systems in endothelium are NADPH oxidase (NOX), Xanthine oxidase (XO),
uncoupled endothelial nitrous oxide synthase (eNOS) and Myeloperoxidase
(MPO).Endogenous antioxidants present in the body like superoxide dismutase, catalase etc.
and nutritional compounds like ferritin, transferrin, cereruloplasmin, tocopherol, carotene
and ascorbic acid act for the benefit of the body by its antioxidant and free radical scavenging
properties. Balance between the reactive oxygen species and the antioxidants are essential for
the maintenance of healthy body.
Inflammation and atherosclerosis
Inflammation is the body’s primary detection and alarm system produced as response to
injury and for the containment and removal of foreign agents. Normally endothelial lining
does not support leukocyte adhesion but the activation of endothelium due to atherogenic
stimuli or endothelial injury induce degenerative and inflammatory changes resulting in
proliferation within the vessel wall. Inflammation in the vessel wall begins with endothelial
cell activation resulting in expression of mononuclear leukocyte recruitment mechanism and
adhesion molecules like vascular cell adhesion molecules - 1 (VCAM-1), intracellular cell
adhesion molecules - 1 (ICAM-1) and pro-inflammatory cytokines like monocyte chemo-
attractant protein 1( MCP-1) and monocyte colony stimulating factors (mCSF). In normal
endothelium the endothelium derived nitrous oxide possesses antiinflammatory property
that prevents the expression of cell adhesion molecules (De Caterina et al., 1995), but in
dysfunctional endothelium there is reduced production of this nitrous oxide resulting in
increased expressions of VCAM-1 and ICAM-1 (Nagel et al., 1994). MCP-1 helps in the
migration of monocyte into the intimal layers (Gu et al., 1998) and mCSF helps in the
differentiation of monocytes to macrophages (Smith et al., 1995).
Conclusion
Reactive oxygen species (ROS) or lipid derived radicals are well described classes of oxidants
that cause oxidative imbalance and reactions of these free radicals to blood components as
well as endothelial lining lead to local injury, inflammation and permeability changes in the
arterial wall which are the initial events in atherosclerotic vascular diseases. Immune cells of
blood as well as LDL thus enter into sub-endothelial space where monocyte derived
macrophages engulf ox-LDL to form foam cells which progress slowly to vulnerable plaque.
The entire process of atherosclerotic plaque development is thus guided by chronic
inflammation. Various researches are under way in the development of anti atherosclerotic
drug and agents that possess excellent antioxidant and anti-inflammatory efficacies are
considered as promising candidates in the drug development and expected to give favorable
results in the treatment of atherosclerosis.
References
Chapman, M.J., 2010. Cardiovascular diseases. Introduction. Atheroscler Suppl. 11, 1-2.

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Croce, K., Libby, P., 2007. Intertwining of thrombosis and inflammation in atherosclerosis.
Curr Opin Hematol. 14, 55-61.
Alexander, R.W., 1995. Hypertension and the Pathogenesis of Atherosclerosis. Oxidative Stress
and the Mediation of Arterial Inflammatory Response: A New Perspective. Hypertension. 25,
155-161.
Al-Benna, S., Hamilton, C.A., McClure, J.D., Rogers, P.N., Berg, G.A., Ford, I., Delles, C.,
Dominiczak, A.F., 2006. Low-density lipoprotein cholesterol determines oxidative stress and
endothelial dysfunction in saphenous veins from patients with coronary artery disease.
Arterioscler Thromb Vasc Biol. 26, 218-223.
Libby, P., 2012. Inflammation in atherosclerosis. Arterioscler Thromb Vasc Biol. 32, 2045-
2051.
Glass, C.K., Witztum, J.L., 2001. Atherosclerosis. the road ahead. Cell. 104, 503-516.
Sakakura, K., Nakano, M., Otsuka, F., Ladich, E., Kolodgie, F.D., Virmani, R., 2013.
Pathophysiology of atherosclerosis plaque progression. Heart Lung Circ. 22, 399-411.
Yu, X.H., Fu, Y.C., Zhang, D.W., Yin, K., Tang, C.K., 2013. Foam cells in atherosclerosis. Clinica
Chimica Acta. 424, 245-252.
Van Eck, M., Twisk, J., Hoekstra, M., Van Rij, B.T., Van der Lans, C.A., Bos, I.S., Kruijt, J.K.,
Kuipers, F., Van Berkel, T.J., 2003. Differential effects of scavenger receptor BI deficiency on
lipid metabolism in cells of the arterial wall and in the liver. J Biol Chem. 278, 23699-23705.
Silva, B.R., Pernomian, L., Bendhack, L.M., 2012. Contribution of oxidative stress to endothelial
dysfunction in hypertension. Front Physiol. 3, 441.
De Caterina, R., Libby, P., Peng, H.B., Thannickal, V.J., Rajavashisth, T.B., Gimbrone, M.A., Shin,
W.S., Liao, J.K., 1995. Nitric oxide decreases cytokine-induced endotheliacl activation. Nitric
oxide selectively reduces endothelial expression of adhesion molecules and proinflammatory
cytokines. J Clin Invest. 96, 60-68.
Nagel, T., Resnick, N., Atkinson, W.J., Dewey, C.F., Jr., Gimbrone, M.A., Jr., 1994. Shear stress
selectively upregulates intercellular adhesion molecule-1 expression in cultured human
vascular endothelial cells. J Clin Invest. 94, 885-891.
Gu, L., Okada, Y., Clinton, S.K., Gerard, C., Sukhova, G.K., Libby, P., Rollins, B.J., 1998. Absence of
monocyte chemoattractant protein-1 reduces atherosclerosis in low density lipoprotein
receptor-deficient mice. Mol Cell. 2, 275-281.
Smith, J.D., Trogan, E., Ginsberg, M., Grigaux, C., Tian, J., Miyata, M., 1995. Decreased
atherosclerosis in mice deficient in both macrophage colony - stimulating factor (op) and
apolipoprotein E. Proc Natl Acad Sci. 92, 8264-8268.

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 APPLICATION OF FUZZY SOFT SET IN MEDICAL DIAGNOSIS

ANJU S MATTAM

Assistant Professor, Department of Mathematics, Little Flower College Guruvayoor

Abstract:
The concept of fuzzy soft set is one of the recent topics developed for dealing with
theuncertainties present in most of our real life situations. The parameterizationtool offuzzy
soft set theory enhances the flexibility of its applications. In this paper we extendSanchez’s
approach for medical diagnosis using fuzzy soft sets and exhibit the technique with a
hypothetical case study.

Keywords: fuzzy soft set, complement of fuzzy soft set, patient symptom matrix.

1. Introduction

Most of our real life problems in medical sciences, engineering,

management,environment and social sciences often involve data which are not necessarily
crisp, precise and deterministic in character due to various uncertainties associated with
these problems. Such uncertainties are usually being handled with the help of thetopics like
probability, fuzzy sets, intuitionistic fuzzy sets, interval mathematicsand rough sets etc.
However, Molodtsov [6] has shown that each of the abovetopics don’t possess of their
parameterization tools and to overcome thisshortcoming, introduced a concept called ‘Soft Set
Theory’ having parameterizationtools for successfully dealing with various types of
uncertainties. The absence of any restrictions on the approximate description in soft set
theory makes this theory quite convenient and easily applicable in practice.
Maji et al. [5] have developed a theoretical study of the ‘Fuzzy Soft Set’. Recently,Yang
et al.[10] introduced the interval-valued fuzzy soft set(IVFSS). De et al.[3] have studied
Sanchez’s[9] method of medical diagnosis using intuitionistic fuzzy set. Also, Saikia et al. have
extended method in [3] using intuitionistic fuzzy soft set theory. Our proposed method is an
attempt to improve the results in[3,8]using the complement concept of FSS to formulate a
pair of medical knowledge, hereafter called soft medical knowledge. In this article, we
propose a method to study Sanchez’s approach of medical diagnosis through FSS obtaining an
improvement of the same presented in Deyet. al.[3].

2. Preliminaries
Definition 2.1

Let IX denote set of all fuzzy sets in X. A pair (f,A) is called the fuzzy soft set if f is a mapping
from A to the set of all fuzzy sets in X. i.e. for each a  Afa: X → IX

Definition: 2.2
Let (f,A) and (g,B) be two fuzzy soft sets over a commonuniverse X. Then (f,A)  (g,B) if
1. A B 
2. for each a A, fa ≤ ga

(f,A) is equal to (g,B) if (f,A) (g,B) and (g,B) (f,A)

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Definition: 2.3
Complement of a fuzzy soft set (f,A) over a common universe X is given by(f,A)c= (fc, A) where
fca(x) = 1-fa(x),∀a ∈ A
3. Application of Fuzzy Soft Set in Medical Diagnosis
In this section we present an application of fuzzy set theory in Sanchez's approach for
medical diagnosis. In a given pathology, suppose S is a set of symptoms, D is a set of diseases
and P is a set of patients.

Algorithm:
1) Input the fuzzy soft sets (F,d) and (F,d)c over the set S of symptoms. Also write the soft
medical knowledge R1and R2representing the relational matrices of the fuzzy soft set
(F,d) and (F,d)crespectively.
2) Input the fuzzy soft sets (F1,S) over the set P of patients and write its relational matrix
Q.
3) Compute the relational matrices T1=Q∘ R1 and T2=Q∘ R2 where
UT1(Pi,dj)= V[U Q(Pi,ek) ᴧU R1(ek,dj)] and UT2(Pi,dj)= V[U Q(Pi,ek) ᴧU R2(ek,dj)], where
V=max and ᴧ=min.
4) Compute T1-T2.
5) If max{ UT1(Pi,dj)- UT2(Pi,dj)} occurs for exactly (Pi,dk) only then we conclude that the
acceptable diagnostic hypothesis for patient Pi is the disease dk.
6) In case there is a tie the process has to be repeated for patient P i by reassessing the
symptoms.
4. Case study
Suppose there are 3 patients P1, P2, P3 in a hospital with symptoms temperature (e1),
headache (e2), cough (e3) and stomach problem(e4). Let the possible diseases relating to the
above symptoms be viral fever (d1) and Malaria (d2). We consider the set S={e1, e2, e3, e4}as
universal set. Consider the following fuzzy soft set (F,d) determined by the expert medical
documentation .
(F,d)={F(d1)={ e1/.9, e2 /.4, e3 /.5, e4 /.2}
F(d1)={ e1/.6, e2 /.5, e3 /.2, e4 /.8}}
This fuzzy soft set and its complement are represented by two relation matrices R 1 and
R2called symptom disease matrix and non symptom disease matrix respectively, given by

. 9 .6 . 1 .4
. 4 .5 . 6 .5
R1=[ ]and R2=[ ]
. 5 .2 . 5 .8
. 2 .8 . 8 .2
The relational matrix called patient symptom matrix corresponding to the fuzzy soft set (F 1,S)
be given by

. 8 .4 .6 .3
Q =[. 7 .3 .4 .6]
. 4 .5 .4 .7

Then combining the relation matrices R1 and R2 seperately with Q we get two matrices T 1 and
T2 called patient disease and patient non disease matrices respectively given by

. 8 .6 . 5 .6 . 3 .0
T1=Q∘ R1=[. 7 .6]T2=Q∘ R2=[. 6 .4] and T1-T2[ . 1 .2 ]=
. 4 .7 . 7 .5 −.3 .2

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From the matrix T1-T2 it is clear that the patient P1 is suffering fromdisease d1 and patient P2
and P3 are both suffering from disease d 2.

5.Conclusion

The notion of fuzzy soft set is applied in Sanchez’s method of medical diagnosis. A case study
has been taken to exhibit the simplicity of the technique.

6.References

[1] M.F. Abbod, D.G. von Keyserlingk, D. A. Linkens and M. Mahfouf, Survey of utilization of
fuzzy technology in medicine and healthcare, Fuzzy Sets and Systems,120(2001),331-349.
[2] K.P.,Adlassing, Fuzzy set theory in medical diagnosis, IEEE Trans. On System, Man and
Cybernatics,16(2),(1986),260-265.
[3] S .K., De, R.Biswas and A.R.Roy ,An application of intuitionistic fuzzy sets in medical
diagnosis, Fuzzy Sets and Systems,117(2001), 209-213.
[4] J. G., Klir, and Bo,Yuan Fuzzy Sets and Fuzzy Logic, Theory and Application, PHI Private
Ltd., New Delhi (2000).
[5] P.K., Maji.,R.Biswas and A.R.Roy Fuzzy Soft Sets., The Journal of Fuzzy Mathematics
9(3)(2001), 677-692.
[6] D.,Molodtsov, Soft Set Theory-First Results, Computers and Mathematics with
pplication.37(1999), 19-31.
[7] M.K,Roy, R,,Biswas, I-V fuzzy relations and Sanchez’s approach for medical diagnosis,
Fuzzy Sets and Systems,47(1992),35-38.
[8] B.K., Saikia, P.K.,Das, and A.K.,Borkakati , An application of Intuitionistic fuzzy soft sets in
medical diagnosis, Bio Science Research Bulletin,19(2)(2003),121-127.
[9] E.,Sanchez, Inverses of fuzzy relations, Application to possibility distributions and medical
diagnosis, Fuzzy Sets and Systems.2(1) (1979),75-86.
[10] X. Yang, T. Y. Lin, J. Yang, Y.Li and D. Yu, Combination of interval valued fuzzy set and soft
set, Computers and Mathematics with Application.58(2009), 521-527.

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 A DISCOURSE ON THE JOURNEY FROM ROBUST STRAWBERRY YEARS TO
SERENE DAYS OF NICHIREN BUDDHISM THROUGH RELENTLESS COMBAT
WITH C

LAKSHMI PRIYA B.

Guest Faculty,Department of English,St. Teresa’s College

Uncertainty is a word that covertly recurs in life and adds a tinge of adventure to the
mundane activities of men. But it sometimes ushers a sudden u-turn in one’s life. Such a
shudder takes place when a person is diagnosed with Cancer. It engulfs human life, devouring
human body to the very last morsel. As in a battlefield, some of the victims succumb to their
enemy but there are a few who prove them to be invincible through their compatibility. Such
triumphant people engage in discourses that help them vent out their experiences that added
a renewed meaning to life as such. Indeed such narratives are eye openers to the readers who
get a firsthand experience of the cancerous days that the survivors had undergone.
Cancer discourses have a cultural dimension when survivors narrate their experiences.
Such narratives generally take a grim tone and the trauma associated with the malady would
be explicit in each and every line. But here is a book that stands aloof from the other cancer
discourses. The title To Cancer, with Love: My Journey of Joy assures the readers that this
narrative is joyful saga amidst all adversities. And the blurb of the book promises the readers
that it is a joyful yet passionate memoir by a corporate training professional, Neelam Kumar.
And ironically humour lingers throughout the narration. I would like to assign the letter C to
indicate cancer in this discourse as it would add on to the lighthearted narration given by
Neelam in her book. It would be adequate to have a glimpse of her, as those experiences have
shaped her identity. Her memoir passionately guides the readers through her eventful life.
Neelam Kumar is a multifaceted personality who is a corporate trainer, life skills coach,
communications professional and above all a gifted writer. Through her meticulous efforts,
Neelam now owns the company “9 to 5 Corporate Lounge – The Training Hub”. She was twice
partly devoured by the letter C, but miraculously escaped from its clutches. In an interview
that she had given to the Hindu, Neelam remarked, “love life and laugh in the face of death not,
once but twice” (Rodricks). It is interesting to unravel the writer in Neelam. She was born to
proficient and skillful writer parents, who were well versed in Russian language Young
Neelam spent her childhood days in Russia and growing up there was a highly enriching
experience to her. Neelam had her “Strawberry Years” – living in harmony with nature,
picking strawberries, swimming in crystal clear water, caressing the shrubs and blossoms in
her garden. (Kumar TCL 25) This instilled a romantic spirit in her. Her family returned to
India and she had to face a huge challenge of learning English in the Indian Educational
System, as she had not learned English in Russia.
Successfully Neelam completed her school education and became proficient in English
language to the astonishment of her teachers. Soon Neelam pursued B.A. English Honours and
she was enthralled by the writings of English literary doyens. She began have a fascination to
write and thus started her writing career. Initially Neelam wrote short stories and thrillers
and eventually published her works. This was followed by a few events in her life like her
marriage and years later the unexpected death of her husband due to medical negligence. All
this was too much for Neelam and she felt dejected and downcast. In an interview that she
gave to Piyush Vir, Neelam says, “Writing became my solace… my refuge. Through words I
constructed a new meaning to life.”

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 Her writings became popular and grabbed the attention of literary giants. Khushwant
Singh called her as “Unforgettable Neelam” in one of his literary columns (Vir). All on a sudden
life came to standstill when the letter C encroached into her life. It was in 1996 that Neelam
was diagnosed with breast cancer. A persistent numbness was unleashed into her body and
mind. Thoughts regarding her survival, the future of her children, single parenting and
financial hardships tormented her day and night. Her body underwent drastic changes due to
the treatment procedures. It was Khushwant Singh, who pursued her to continue writing
amidst all adversities. He was like a saviour to her. In line with her treatment she carried out
research in order to restart her writing career. She along with Khushwant Singh wrote and
published the book, Our Favourite Indian Stories, which became a huge success.
A friend of her’s suggested Neelam to resort to Buddhism. This instilled a new sense of vigour
and vibe in Neelam. Her perception towards life as well as world changed tremendously.
Neelam retraces the incident thus,
“She suggested that I change the horror script of my life into a happily ever after
one… I followed her advice and immediately benefits started pouring in. Just
with deep faith, I began to see the kind of victories I had never imagined.” (Vir)
Meanwhile the letter C returned to her life. But by now she had become a different individual
who had amassed invincible strength to survive and fight. During her chemotherapy and
radiation cycles, Neelam spend time to write down her thought. Neelam found comfort in the
philosophy of Nichiren Buddhism and used the words Nam Myoho Renge Kyo as her chanting
mantra (Chatterjee). Nichiren Buddhism is a form of Buddhism practiced by members of SGI
(Soka Gakkai International), a figure in Japanese social and religious history. Nichiren was a
priest who established this form of Buddhism. He declared that the heart of Shakyamuni’s
enlightenment is to be found in the lotus sutra, to which the Buddha had awakened. Nichiren
defined this law as “Nam-myoho-renge-kyo”(Kumar).

She chose humour as her vehicle for narration. An alter ego called Carol was born and
it soon found expression in her book To Cancer, with Love: My Journey of Joy. Neelam
recuperated on a quick pace and she recorded those experiences in this book. She like a
triumphant warrior mocks the letter C that symbolizes the engulfing nature of cancer. Neelam
embarks on a new journey after being afflicted with cancer. She treats those grim and
despondent days with humour and joy unlike other writers. And this makes her book the first
of its kind and the first humorous book on cancer in India. The book not only deals with
cancer instead it discusses in general, a step by step mechanism of how to face challenges and
adversities in life. She has divided the book into two parts as “Carol and Me” and “The Sea and
Me”. Part one of the book deals with Neelam and her alter ego, Carol and this is structured and
narrated in a fairy tale format similar to the bed time stories told to young children. On the
contrary Part two deals with the qualities like courage, abundance, fluidity, stillness and
vastness that the sea offers. Neelam has titled her first chapter of Part one as “How I met Carol
on Valentine’s Day” (Kumar TCL 06)
Another interesting aspect is the publication of this book in the format of a graphic
novel. She has a few reasons for bringing out the novel in the graphic novel form. Firstly
people now-a-days have become so impatient to read lengthy write ups and attention lasts for
only a short span. Secondly everyone needs affirmative and productive perspectives that
impart joy, hope, and courage to handle personal issues. Thirdly no one in India has ever
written a comic book on cancer. All this triggered in Neelam the idea of creating her comic
book (Kumar). This graphic novel is a fifty page pictorial representation, in which Neelam’s
alter ego, Carol pontificates readers to how to handle life especially during hard times with a
humorous and joyous outlook. And it is executed in form of a conversation between Neelam’s
self and alter ego The alter ego urges Neelam to introspect and raises a few questions like
Who is she?; What is her identity?; What is life and its purpose?; These queries instigate a

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positive urge in her. Side by side the book also attempts to raise awareness about cancer and
the importance of early diagnosis.
To quote Suryasarathi Bhattacharya, the National Cancer Registry has reported to the
TOI thus:
Breast cancer accounts for 27 percent of all cancers in women in India, with the
incidence rising in the early 30s and peaking at ages 50-64 years. It is estimated
that 1 in 28 women is likely to develop breast cancer during her lifetime.
Neelam responds to this statistical data by endorsing the idea and accounts to the
reason for the increase in breast cancer thus
There are many reasons – shyness, ignorance, going in late for treatment,
ignoring symptoms. What happens in the case of breast cancer is that women
feel that they come last in the family hierarchy. First of all, nobody talks about
the breasts and when they do they are too shy to discuss it articulately. When
they discover that there is a lump and that maybe it is something to be
concerned about, first the shyness comes in, second, they hold their husband’s
tour, children’s exams, and everything else over their health – what we Indian’s
love to label as ‘sacrifice’. (As qtd by Bhattacharya)
Neelam is of the opinion that it is mainly due to the societal outlook and taboos associated
with female body parts that women fail to diagnose breast cancer right at the initial stage.
Suryasarathi Bhattacharya remarks that Neelam emphatically urges our society to:
Please stop glorifying ‘sacrifice’ as an Indian woman’s virtue. And let’s stop
considering the breasts as ornaments and rather as parts of the anatomy that
can require medical treatment. Why push it under carpet? We need to
completely deglamorise, demystify and demonetize the breasts.
Neelam affirms that though the letter C instilled initial despair in her. It was soon
overpowered by her will of optimism, spirit of survival that she could amass as a treasure
during the malady stricken days. She urges cancer afflicted individuals to change their
perception from that of victims to victors there by enduring and overcoming the challenges
that life showers on them.

Works Cited
Bhattacharya, Suryasarathi. “To Cancer with Love: How Neelam Kumar Beat Cancer, and
Help Others to Do It.” First Post, 05 Dec. 2017, https://www.firstpost.com/living/to-
cancer-with-love-how-neelam-kumar-beat-cancer-and-helped-others-do-it-too-
4230313.html
Chatterjee, Saumitra K. “A Full Life: Neelam Kumar’s Saga of Two Cancers, Five Books and
One Undying Spirit.” Your Story, 26 Dec. 2015, https://yourstory.com/2015/12/neelam-
kumar
Kumar, Neelam. To Cancer, with Love: My Journey of Joy. Hay House, 2015.
---. “Comic Book on ‘To Cancer, with Love-My Journey of Joy’”. Wishberry, 02 June
2016,www.wishberry.in/campaign/indias-1st-graphic-novel-comic-book-
cancer/#/campaign-new
Rodricks, Allan Moses. “Laughing in the Face of Cancer.”The Hindu-ePaper, 18 Sep.
2015,www.thehindu.com/features/metroplus/laughing-in-the-face-of-
cancer/article7664868.ece
Vir, Piyush. “From a Cancer Afflicted Widow to a Bestselling Author: Neelam Speaks on
her Inspiring Journey.” Women’s Web,19 Sep. 2016,
www.womensweb.in/2016/09/neelam-kumar-journey-cancer-afflicted-widow-to-
bestselling-author

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 NANOTECHNOLOGY FOR HEALTHCARE

MOLY P. P.

Assistant Professor, Department of Chemistry, Little Flower College, Guruvayoor

Nanoparticles
Particles having size between 1 and 100 nanometers (nm) with a surrounding
interfacial layer which consists of ions, inorganic and organic molecules known as stabilizers,
capping and surface ligands etc1 are called nanoparticles. The fine particles are sized between
100 and 2,500 nm and coarse particles cover a range between 2,500 and 10,000 nm. Although
nanoparticles are associated with modern science, they have a long history. Nanoparticles
were used by artisans as far back as Rome in the fourth century in the famous Lycurgus
cup made of dichroic glass as well as the ninth century in Mesopotamia for creating
a glittering effect on the surface of pots. In modern times, pottery from the middle ages and
renaissance often retains a distinct gold or copper colored metallic glitter. This luster is
caused by a metallic film that was applied to the transparent surface of a glazing2.
Nanoparticles are of great scientific interest as they are, in effect, a bridge between
bulk materials and atomic or molecular structures. A bulk material should have constant
physical properties regardless of its size, but at the nano-scale size-dependent properties are
often observed. Thus, the properties of materials change as their size approaches the
nanoscale and as the percentage of the surface in relation to the percentage of the volume of a
material becomes significant3. Nanoparticles often possess unexpected optical properties as
they are small enough to confine their electrons and produce quantum effects. For
example, gold nanoparticles appear deep-red to black in solution. Nanoparticles of yellow
gold and grey silicon are red in color. Gold nanoparticles melt at much lower temperatures
(~300 °C for 2.5 nm size) than the gold slabs (1064 °C). Other size-dependent property
changes include quantum confinement in semiconductor particles, surface plasmon resonance
in some metal particles and super paramagnetism in magnetic materials4. What would appear
ironic is that the changes in physical properties are not always desirable. Ferromagnetic
materials smaller than 10 nm can switch their magnetisation direction using room
temperature thermal energy, thus making them unsuitable for memory storage5,6.
There are several methods for creating nanoparticles, including gas
condensation, attrition, chemical precipitation, ion implantation, pyrolysis, hydrothermal
synthesis, etc. In attrition, macro or micro-scale particles are ground in a ball mill, a
planetary ball mill, or other size-reducing mechanism7. Scientific research on nanoparticles is
intense as they have many potential applications in medicine, physics, optics, and electronics 8-
10.

Nanomedicine
Nanomedicine ranges from the medical applications of nanomaterials and biological
devices, to nano-electronic biosensors, and even possible future applications of molecular
nanotechnology such as biological machines11. Current problems for nanomedicine involve
understanding the issues related to toxicity and environmental impact of nanoscale
materials (materials whose structure is on the scale of nanometers, i.e. billionths of a meter).
Functionalities can be added to nanomaterials by interfacing them with biological molecules
or structures. The size of nanomaterials is similar to that of most biological molecules and
structures; therefore, nanomaterials can be useful for both in vivo and in vitro biomedical
research and applications. Thus far, the integration of nanomaterials with biology has led to
the development of diagnostic devices, contrast agents, analytical tools, physical therapy
applications, and drug delivery vehicles12.

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 Nanotechnology has provided the possibility of delivering drugs to specific cells using
nanoparticles. The overall drug consumption and side effects may be lowered significantly by
depositing the active agent in the morbid region only and in no higher dose than needed.
Targeted drug delivery is intended to reduce the side effects of drugs with concomitant
decreases in consumption and treatment expenses. Drug delivery focuses on
maximizing bioavailability both at specific places in the body and over a period of time. This
can potentially be achieved by molecular targeting by nanoengineered devices. A benefit of
using nanoscale for medical technologies is that smaller devices are less invasive and can
possibly be implanted inside the body and hence the time of reaction is much shorter. These
devices are faster and more sensitive than typical drug delivery.13

Imaging
The small size of nanoparticles endows them with properties that can be very useful
in oncology, particularly in imaging. In vivo imaging is another area where tools and devices
are being developed14. Favorable distribution and improved contrast for images such as
ultrasound and MRI (magnetic resonance imaging) can be achieved using
nanoparticle contrast agents. Quantum dots (nanoparticles with quantum confinement
properties, such as size-tunable light emission), when used in conjunction with MRI, can
produce exceptional images of tumor sites. Nanoparticles of cadmium selenide (quantum
dots) glow when exposed to ultraviolet light. When injected, they seep into cancer tumors.
The surgeon can see the glowing tumor, and use it as a guide for more accurate tumor
removal. These nanoparticles are much brighter than organic dyes and only need one light
source for excitation. This means that the use of fluorescent quantum dots could produce a
higher contrast image and at a lower cost than todays organic dyes used as contrast media.
The downside, however, is that quantum dots are usually made of quite toxic elements, but
this concern may be addressed by use of fluorescent dopants. In cardiovascular imaging,
nanoparticles have potential to aid visualization of blood pooling,
ischemia, angiogenesis, atherosclerosis, and focal areas where inflammation is present15.
Blood Purification
Magnetic nanoparticles are proven research instruments for the separation of cells and
proteins from complex media (magnetic-activated cell sorting or dynabeads). More recently, it
was shown in animal models that magnetic nanoparticles can be used for the removal of
various noxious compounds including toxins, pathogens and proteins from whole blood in
an extracorporeal circuit similar to dialysis16. In contrast to dialysis, which works on the
principle of the size related diffusion of solutes and ultrafiltration of fluid across a semi-
permeable membrane, the purification with nanoparticles allows specific targeting of
substances. Additionally, larger compounds which are commonly not dialyzable can be
removed.
The purification process is based on functionalized iron oxide or carbon coated metal
nanoparticles with ferromagnetic or superparamagnetic properties. Binding agents such
as proteins, antibodies, antibiotics or synthetic ligands are covalently linked to the particle
surface. These binding agents are able to interact with target species forming agglomerate.
The particles can be separated from the bulk fluid by the application of an external magnetic
field gradient thereby cleaning it from the contaminants. The small size (< 100 nm) and large
surface area of functionalized nanomagnets leads to advantageous properties compared
to hemoperfusion, which is a clinically used technique based on surface adsorption for the
purification of blood. The other advantages include, high loading and accessible for binding
agents, high selectivity towards the target compound, fast diffusion, small hydrodynamic
resistance, and low dosage17.
Tissue Engineering

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 Nanotechnology can be used to reproduce or repair or reshape damaged tissue using
suitable nanomaterials based scaffolds and growth factors. Tissue engineering if successful
may replace conventional treatments like organ transplants or artificial implants.
Nanoparticles such as graphene, carbon nanotubes, molybdenum disulfide and tungsten
disulfide are being used as reinforcing agents to fabricate mechanically strong biodegradable
polymeric nanocomposites for bone tissue engineering applications. The addition of these
nanoparticles in the polymer matrix at low concentrations (~0.2 wt%) leads to significant
improvements in the compressive and flexural mechanical properties of polymeric
nanocomposites18. These nanocomposites are used as a novel, light weight and mechanically
strong composite as bone implants. A flesh welder was demonstrated to fuse two pieces of
chicken meat into a single piece using a suspension of gold-coated nanoshells activated by an
infrared laser. This could be used to weld arteries during surgery 19. Another example
is nanonephrology, the use of nanomedicine on the kidney.
Medical Devices
Neuro-electronic interfacing is a visionary goal dealing with the construction of
nanodevices that will permit computers to be joined and linked to the nervous system. This
idea requires the building of a molecular structure that will permit to control and detect the
nerve impulses by an external computer. A refuelable strategy implies energy is refilled
continuously or periodically with external sonic, chemical, tethered, magnetic or biological
electrical sources, while a non-refuelable strategy implies that all power is drawn from
internal energy storage which would stop when all energy is drained. Nanoscale enzymatic
biofuel cell for self-powered nano-devices have been developed that uses glucose from
biofluids including human blood and watermelons20. Molecular nanotechnology is subfield of
nanotechnology regarding the possibility of engineering molecular assemblers, machines
which could reorder matter at a molecular or atomic scale. Nanomedicine would make use of
these nano-robots introduced into the body to repair or detect damages and infections. Future
advances in nanomedicine could give rise to life extension through the repair of many
processes thought to be responsible for aging. Advanced medical nano-robotics could
completely remedy the effects of aging by 203021
Nanomedicine has the potential to enable early detection and prevention and to
drastically improve diagnosis, treatment and follow up of many diseases including cancer.
Overall, Nanomedicine has nowadays more than 70 products under clinical trials, covering all
major diseases including cardiovascular, neuro-degenerative, musculoskeletal and
inflammatory. Enabling technologies in all healthcare areas, nanomedicine is already
accounting for marketed products, ranging from nano delivery and pharmaceutical to
imaging, diagnostics and biomaterial. Beyond that, Nanomedicine provides new important
tools to deal with the grand challenge of an ageing population and is thought to be
instrumental for improved and cost effective healthcare which is one of the crucial factors for
making medicines and treatments available and affordable to all.
Cancer Treatments
The area of nanotechnology for cancer treatments is already a reality providing a wide
range of new tools and possibilities, from earlier diagnostics and improved imaging to better,
more efficient, and more targeted therapies. Iron oxide nanoparticles are one of the useful
tools against cancer because, when nanoengineered with a specific coating, they bind
particularly well to the tumors. Their magnetic properties make them suitable imaging agents
with MRI scans while their size and concentration in the tumor gives a very high resolution
and an accurate mapping of lesions. Surgeons can thus rely on this to select properly patients
and plan the surgical removal of the tumor. In therapy, nanotechnology is at the forefront of
both targeted drug delivery and intrinsic therapies. For instance, nanoparticles can already be
injected into the tumor and then be activated to produce heat and destroy cancer cells locally
either by magnetic fields, X-rays or light. Meanwhile, the encapsulation of existing

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chemotherapy drugs or genes allows much more localized delivery both reducing significantly
the quantity of drugs absorbed by the patient for equal impact and the side effects on healthy
tissues in the body22.
Conclusion
Nanotechnology involves manipulating properties and structures at the nanoscale,
often involving dimensions that are just tiny fractions of the width of a human hair.
Nanotechnology is already being used as the basis for new, more effective drug delivery
systems and is in early stage development as scaffolding in nerve regeneration research.
Nanotechnology medical developments over the coming years will have a wide variety of uses
and could potentially save a great number of lives.
References
1. Batista, Carlos A. Silvera; Larson, Ronald G.; Kotov, Nicholas A. (2015-10-
09). "Nonadditivity of nanoparticle interactions". Science. 350 (6257): 1242477.
2. Reiss, Gunter; Hutten, Andreas (2010). "Magnetic Nanoparticles". In Sattler, Klaus
D. Handbook of Nanophysics: Nanoparticles and Quantum Dots. CRC Press. pp. 2–
1. ISBN 9781420075458.
3. Hewakuruppu, Y. L.; Dombrovsky, L. A.; Chen, C.; Timchenko, V.; Jiang, X.; Baek, S.;
Taylor, R. A. (2013). "Plasmonic "pump–probe" method to study semi-transparent
nanofluids". Applied Optics. 52 (24): 6041–6050.
4. Kim, YH; Kwak, KA; Kim, TS; Seok, JH; Roh, HS; Lee, JK; Jeong, J; Meang, EH; Hong, JS;
Lee, YS; Kang, JS (June 2015). "Retinopathy Induced by Zinc Oxide Nanoparticles in
Rats Assessed by Micro-computed Tomography and Histopathology". Toxicological
research. 31 (2): 157–63.
5. Kim, YH; Kwak, KA; Kim, TS; Seok, JH; Roh, HS; Lee, JK; Jeong, J; Meang, EH; Hong, JS;
Lee, YS; Kang, JS (June 2015). "Retinopathy Induced by Zinc Oxide Nanoparticles in
Rats Assessed by Micro-computed Tomography and Histopathology". Toxicological
research. 31 (2): 157–63
6. Heim, J; Felder, E; Tahir, MN; Kaltbeitzel, A; Heinrich, UR; Brochhausen, C; Mailänder,
V; Tremel, W; Brieger, J (21 May 2015). "Genotoxic effects of zinc oxide
nanoparticles". Nanoscale. 7 (19): 8931–8
7. "The Textiles Nanotechnology Laboratory". nanotextiles.human.cornell.edu.
Retrieved 6 December 2016
8. Belloni, J.; Mostafavi, M.; Remita, H.; Marignier, J. L.; Delcourt, A. M. O. (1998).
"Radiation-induced synthesis of mono- and multi-metallic clusters and
nanocolloids". New Journal of Chemistry. 22 (11): 1239–1255
9. Stephenson, C.; Hubler, A. (2015). "Stability and conductivity of self assembled wires in
a transverse electric field". Sci. Rep. 5: 15044.
10. Wang, Zhenming; Wang, Zhefeng; Lu, William Weijia; Zhen, Wanxin; Yang, Dazhi; Peng,
Songlin (2017-10-06). "Novel biomaterial strategies for controlled growth factor
delivery for biomedical applications". NPG Asia Materials. 9 (10): e435
11. Nanomedicine, Volume I: Basic Capabilities, by Robert A. Freitas Jr. 1999, ISBN 1-
57059-645-X
12. Nanomedicine overview". Nanomedicine, US National Institutes of Health. 1 September
2016. Retrieved 8 April 2017
13. 75 Kurzweil, Ray (2005). The Singularity Is Near. New York City: Viking
Press. ISBN 978-0-670-03384-3. OCLC 57201348
14. Minchin, R (2008). "Nanomedicine: Sizing up targets with nanoparticles". Nature
Nanotechnology. 3 (1): 12–3.
15. Syn, Nicholas L.; Wang, Lingzhi; Chow, Edward Kai-Hua; Lim, Chwee Teck; Goh, Boon-
Cher (2017-03-29). "Exosomes in Cancer Nanomedicine and Immunotherapy:
Prospects and Challenges". Trends in Biotechnology. 35 (7): 665–676.

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16. Berry C. C.; Curtis A. S. G. (2003). "Functionalisation of magnetic nanoparticles for
applications in biomedicine". J. Phys. Appl. Phys. 36 (13): R198.
17. Herrmann, I. K., Grass, R. N. & Stark, W. J. High-strength metal nanomagnets for
diagnostics and medicine: carbon shells allow long-term stability and reliable linker
chemistry. Nanomed. 4, 787–798 (2009)
18. Lalwani, Gaurav (September 2013). "Tungsten disulfide nanotubes reinforced
biodegradable polymers for bone tissue engineering". Acta Biomaterialia. (9): 8365–
8373.
19. Nanomedicine, Volume IIA: Biocompatibility, by Robert A. Freitas Jr. 2003, ISBN 1-
57059-700-6
20. Freitas, Robert A., Jr. (2005). "Current Status of Nanomedicine and Medical
Nanorobotics" (PDF). Journal of Computational and Theoretical Nanoscience. 2 (4): 1–
25
21. Kurzweil, Ray (2005). The Singularity Is Near. New York City: Viking Press. ISBN 978-
0-670-03384-3.
22. Chidambaram, M.; Manavalan, R.; Kathiresan, K. (2011). "Nanotherapeutics to
overcome conventional cancer chemotherapy limitations". Journal of Pharmacy &
Pharmaceutical Sciences. 14 (1): 67–77

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 NEUTROPENIC DIET: HOPE FOR CANCER SURVIVORS

MS.SIMLA THOMAS

M.Sc (Nutrition and Dietetics), VimalaCollege (Autonomous), Thrissur

INTRODUCTION
Cancer can be defined as a disease in which a group of abnormal cells grow uncontrollably by
disregarding the normal rules of cell division. Normal cells are constantly subject to signals
that dictate whether the cell should divide, differentiate into another cell or die. Cancer cells
develop a degree of autonomy from these signals, resulting in uncontrolled growth and
proliferation. If this proliferation is allowed to continue and spread, it can be fatal. In fact,
almost 90% of cancer-related deaths are due to tumour spreading – a process called
metastasis. Initiation and progression of cancer depends on both external factors in the
environment (tobacco, chemicals, radiation and infectious organisms) and factors within the
cell (inherited mutations, hormones, immune conditions and mutations that occur from
metabolism). These factors can act together or in sequence, resulting in abnormal cell
behaviour and excessive proliferation.
CANCER AND NUTRITION
Nutrition is a process in which food is taken in and used by the body for growth, to keep the
body healthy, and to replace tissue. Good nutrition is especially important for people with
cancer. Eating a variety of foods and well-balanced meals can help you feel better and stay
stronger. Eating well during treatment helps to maintain your body weight, improve your
strength and energy, decrease the risk of infection and assist body in healing and recovery
from cancer treatments.
Cancer and treatments may affect taste, smell, appetite, and the ability to eat enough food or
absorb the nutrients from food. This can cause malnutrition, which is a condition caused by a
lack of key nutrients. Alcohol abuse and obesity may increase the risk of malnutrition.
Malnutrition can cause the patient to be weak, tired, and unable to fight infectionor finish
cancer treatment. Malnutrition may be made worse if the cancer grows or spreads. Some
cancer treatments work better when you are well nourished. People with cancer who are well
nourished and able to maintain a healthy body weight often have a better prognosis.
Eating the right amount of protein and calories is important for healing, fighting infection, and
having enough energy.A healthy diet includes eating and drinking foods and liquids with
nutrients that your body needs – proteins, carbohydrates, fats, vitamins, minerals and
water.Healthy eating may help you:
 Get the nutrition you need
 Tolerate the side effects of treatment
 Lower your risk of infection
 Prevent and manage other health problems, such as diabetes, high blood pressure and
osteoporosis
 Maintain a healthy weights
 Feel your best
DIETETIC CHALLENGES
Due to the side effects of cancer treatments people may lead to have decreased food intake
which is mainly because of dysphagia, nausea, vomiting, early satiety, mucositis, anorexia,
taste alterations and GI malabsorption, Less food intake further lead to weight loss,
malnutrition and cancer cachexia.
As a complex syndrome, cachexia has different clinical manifestations; anorexia appears to be
one of the most frequentfindings, together with weight loss. Anorexia is the cause and partly
the consequence of metabolic changes and of progressive undernourishment. In cancer

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cachexia, weight loss is associated with a marked decrease of food intake and severe
alteration of body composition. Malnourished cancer patients show a marked loss of adipose
tissue and protein mass with BIA evidence of decreased body cell mass and expansion of
extracellular water. As a result of the multifactorial etiology of cancer cachexia/anorexia,
therapies that stimulate appetite and promote greater food intake, coupled with factors that
influence metabolism and cytokine production may be an optimal therapeutic strategy.
NEUTROPENIA
Neutropenia is a condition in which the number of neutrophils (a type of white blood cell) in
the bloodstream is decreased, affecting the body's ability to fight off infections. Neutropenia is
defined as an absolute neutrophil count(ANC) of less than 1500 per microliter
(1500/microL); Neutropenia reduces the body's ability to fight off bacterial infections.An ANC
of less than 1500 per microliter (1500/microL) is the generally accepted definition of
neutropenia. Neutropenia is sometimes further classified as:
 Mild if the ANC ranges from 1000-1500/microL,
 Moderate with an ANC of 500-1000/microL, and
 Severe if the ANC is below 500/microL.
Neutrophils are a type of white blood cell also known as polymorphonuclear leukocytes or
PMNs. Neutrophils contain enzymes that help the cell kill and digest microorganisms it has
engulfed by a process known as phagocytosis. The mature neutrophil has a segmented
nucleus (it is often called a 'seg' or 'poly'), while the immature neutrophil has a band-shape
nucleus (it is called a band).
Neutropenia may be caused by or associated with numerous medical conditions including
congenital disorders of the bone marrow, cancer chemotherapy, infections, certain
medications (drug-induced neutropenia), and autoimmune disorders.Most infections that
occur as complications of neutropenia are due to bacteria that are normally present on the
skin or in the gastrointestinal or urinary tract. Treatment depends upon the cause and
severity of the condition as well as the underlying disease state responsible for the
neutropenia.
NEUTROPENIC DIET
A neutropenic (nu-tro-PEE-nik) diet is for people with weakened immune systems.It is a diet
that limits certain types of foods to limit the exposure of certain types of bacteria and limit
food borne infection in an already immune compromised patient.A neutropenic diet
otherwise called the “sterile diet,” the “low-bacteria diet,” or the “low-microbial diet” because,
cooking foods completely makes sure that all bacteria are destroyed. This diet helps protect
them from bacteria and other harmful organisms found in some food and drinks. If your
immune system is not working well, your body may have a hard time protecting itself from
these bacteria. Cooking foods (like beef, chicken, fish, and eggs) completely makes sure that all
bacteria are destroyed.
Neutropenic diet isrecommended before and after certain types of chemotherapy and other
cancer treatments. A blood test called an absolute neutrophil count (ANC) can help determine
the body’s ability to fight off infection. Many cancer patients have this blood test done
routinely. When the ANC is less than 500 cells/mm3, the patient is often instructed to follow a
neutropenic diet. This diet should be followed until the doctor tells the patient to resume his
or her regular diet.
Patients undergoing autologous stem cell transplants typically follow this diet during the pre-
transplant chemotherapy and for the first 3 or more months after transplant. Patients
undergoing allogeneic stem cell transplants typically follow this diet during the pre-transplant
chemotherapy and continue on it until they no longer take immunosuppressive drugs. The
transplant team will tell the patient how long to follow this diet.People who have had an organ
transplant or who are being treated for HIV/AIDS also may need to follow this diet.

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French et al. [2001]surveyed 10 bone marrow transplant centers in Canada and northwestern
United States and reported that 5 of the 7 responding hospitals used a neutropenic diet.
However, the timing of the start of the diet and the food choices that were allowed varied with
each institution.
Smith and Besser [2000] surveyed 400 members of the Association of Community Cancer
Centers (ACCC) and reported that 78% of the responding hospitals restricted diets of patients
with neutropenia. The most commonly prohibited food items in these institutions were fresh
vegetables and fruits, fresh juices, and raw eggs.
Foods to be included
Some foods you’re allowed to eat on the neutropenic diet include:
 Dairy. All pasteurized milk and dairy products including cheese, yogurt, ice cream, and
sour cream.
 Starches. All breads, cooked pastas, chips, french toast, pancakes, cereal, cooked sweet
potatoes, beans, corn, peas, whole grains, and fries.
 Vegetables. All cooked or frozen vegetables.
 Fruit. All canned and frozen fruit and fruit juices. Thoroughly washed and peeled
thick-skinned fruits such as bananas, oranges, and grapefruit.
 Protein. Thoroughly cooked (well-done) meats and canned meats. Hard-cooked or
boiled eggs and pasteurized egg substitutes.
 Beverages. All tap, bottled, or distilled water. Canned or bottled drinks, individually
canned sodas, and instant or brewed tea and coffee.
Foods to be avoided
Some foods you should eliminate while following the neutropenic diet:
 Dairy. Unpasteurized milk. Unpasteurized yogurt or yogurt made with live or active
cultures. Soft cheeses (Brie, feta, sharp cheddar), cheeses with mold (gorgonzola, blue
cheese), aged cheeses, cheese with uncooked vegetables, and Mexican-style cheeses
such as queso.
 Raw starches. Bread with raw nuts, uncooked pasta, raw oats, and raw grains.
 Vegetables. Raw vegetables, salads, uncooked herbs and spices, and fresh sauerkraut.
 Fruit. Unwashed raw fruit, unpasteurized fruit juices, and dried fruits.
 Protein. Raw or undercooked meat, deli meats, sushi, cold meat, and undercooked
eggs with runny yolk.
 Beverages. Sun tea, cold-brewed tea, eggnog made with raw eggs, fresh apple cider,
and homemade lemonade.
ADVANTAGES AND DISADVANTAGES OF NEUTROPENIC DIET
 Reduce rate of infections (Bacterial, food borne)
 Help to prevent malnutrition
 Prevent GI problems
 Prevent cancer cachexia
 Promote quality of life
 High cost
 Nutrient losses
 Lack of clinical research
CONCLUSION
A neutropenicdiet is mainly useful for people with weakened immune systems. This diet helps
protect them from bacteria and other harmful organisms found in some food and drinks. If
your immune system is not working well, your body may have a hard time protecting itself
from these bacteria. Cooking foods completely makes sure that all bacteria are destroyed. Ifits
usefulness has never been scientifically proven,neutropenic diets remain in place in many
institutionsand found that, it will improve the overall nutritional status and quality of life in
cancer patients.

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REFERENCES
 French MR, Levy-Milane R, Zibrik D. A survey of the use of low microbial diets in
pediatric bone marrow transplant programs. J Am Diet Assoc. 2001;101:1194–1198.
 Smith LH, Besser SG. Dietary restrictions for patients with neutropenia: a survey of
institutional practices. OncolNurs Forum. 2000;27:515–520
 https://www.ncbi.nlm.nih.gov/pubmed
 http://www.upmc.com/patients-visitors/education/cancer/Pages/neutropenic-
diet.aspx
 https://www.healthline.com/health/neutropenic-diet#safety
 https://www.cancer.gov/about-cancer/treatment/side-effects/appetite-
loss/nutrition-pdq
 http://www.cancer.ca/en/cancer-information/cancer-journey/living-with-
cancer/nutrition-for-people-with-cancer/?region=on
 https://www.medicinenet.com/neutropenia/article.html

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 THE WAY OF PRESENTATION AND PUBLIC RESOLUTION OF THEMOVIES
‘NJANDUKALUDE NAATTIL ORIDAVELA’ AND ‘AAKASHADOOTHE’

LITTY PIOUS

Guest Lecturer, Little Flower, College, Guruvayoor

INTRODUCTION
Media is considered as a medium for communication. Medias are carriage for language and
culture. We can see that Medias like newspapers, magazines, radio, television, movies and
internet had huge influence on society’s different phases like social, cultural and personal
aspects on different time. In sense of value, Medias should be careful about the existence and
nutrition of our culture. Although today expansion of the concept of world citizenship and
communication through technologies is necessary for cultural hybrid. Today, Visual media
have a great influence in society. Movie has grown as a medium of entertainment for majority
of normal people. Movie is capable to visualize any subject. As a media, it can discuss anything
based on knowledge, personal or society. So as a popular media among people, Movie have a
huge responsibility on selection of theme. When we analyses the growth of movie in each
period, we can see that themes were based on literature, contemporary relevant and
enjoyable are selected.
MOVIES-THEMES
‘Njandukalude Naattil Oridavela’ and ‘Aakashadoothe’ are the two movies made on the basis
of contemporary relevance. Cancer is subject which discusses in both movies. These movies
discusses about the after effects and approach towards cancer. Aakashadoothe was released
in 1993 was directed by Sibi Malayil and written by Dennis Joseph. When this movie was
released, cancer is not much popular disease among people in Kerala. At that time, cancer is
considered as a rare disease. Lead actors in the movie Aakashadoothe was Murali and
Madhavi. Storyline of the movie is that a normal Christian family facing an unexpected death
of father and the cancer get caught to mother which destroys the happiness in the family. The
film is based on the 1983 American made-for-television biographical film Who Will Love My
Children? with some changes. One of the most influential melodramas of the nineties, the film
tells the tale of a widow suffering from leukemia. The story revolves around Johnny (Murali)
and Annie (Madhavi), a married couple who had both grown up together in an orphanage,
fallen in love and had got married. The couple have four children. One child, Rony is physically
handicapped. Johnny is a jeep driver by profession and Annie a violin teacher. Though the
family struggles to live and make ends meet, they lead a happy life together, except for the
moments when Johnny, a recurrent alcoholic spends most of his daily earnings at the
local toddy shop. During an altercation between Johnny and the local milk delivery man
Keshavan, the latter is humiliated in front of his family. Keshavan therefore decides to take
revenge on Johnny.
One day, he sees Johnny's son Tony riding a bicycle on his way home. Keshavan increases the
speed of the van he is driving and knocks Tony off the road. Some bystanders bring the
injured Tony to the hospital. Despite being in a not so critical condition, Tony has lost a lot of
blood and requires blood transfusion. While looking for suitable donors, it is discovered that
Annie's blood sample has some abnormal characteristics and she cannot donate her blood.
After further analysis, it is revealed that Annie is suffering from a late stage of leukaemia and
that she only has a couple of months to a year to live. The news shocks both Johnny and Annie.
Johnny reforms from his alcoholic demeanor and becomes more responsible. However, as fate
takes a turn, one day when Johnny is on his way home with medicine for Annie, he gets into a
fight with Keshavan and is killed. Annie is devastated but remains strong willed to take care of
the family. She deeply worries about the future of her children. She does not want her

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children to grow up in an orphanage like she and Johnny did, growing up with the label as
orphans. She decides to give her children up for adoption. She lies to her kids that the money
she gets out of her classes is not sufficient for them to live and therefore she is going to
Germany very soon, so they have to go to new houses and there will be new parents to love
and take care of them. By now Meenu has come to know about her mother's condition and
asks her about it. Annie is totally broken down. Both of them keeps this a secret between
them.
Annie, with the help of the priest of their church – Father Vattappara– makes arrangements
for the adoption of the kids. But they find it difficult to get people ready to accept the disabled
boy. The only one left is Rony, the handicapped child. Annie and father Vattappara try hard to
find someone to take care of him. Mean time Annie's doctor give her a hint that days are
counted for her. She wishes to celebrate Christmas at her home with her kids and makes
arrangements for the it. She writes a letter to Meenu asking her to always keep in touch with
her brothers so that the bond between the siblings remain for ever. On the day before
Christmas, Annie dreams that all her children have come to see her. She wakes up and happily
runs to the door, only to realize that was a dream. She starts bleeding from her nose and
understands that there isn't much time left for her, she prays in front of the Crucifix begging
for a day more to live so that she can see her kids for the last time. She finds real blood flowing
from the wounds of Jesus in the Cross and realizes that death has come for her. Later that
night Rony finds her dead.

Njandukalude Nattil Oridavela (English: An Intermission In the Land of Crabs) is a 2017

Indian Malayalam-language dramedy filmdirected and co-written by Althaf Salim. It
stars Nivin Pauly, Shanthi Krishna, Lal, Aishwarya Lekshmi, and Ahaana Krishna. The film is
based on writer Chandramathi's memoirs of the same name, which narrates her long fight
with cancer. Co-written by George Kora, the film was produced by Nivin. Njandukalude Nattil
Oridavela released on 1 September 2017.
Sheela Chacko has a doubt that she is developing cancer after finding a lump on her body. She
discloses this to her husband Chacko and they contact their eldest son Kurien Chacko, settled
in London, and force him to come back home, still without disclosing the secret. Kurien
misunderstands that it was his marriage matter. Chacko and Sheela decide to go for a checkup
at Dr. Saiju's oncology clinic at Aster Medcity in Kochi, where Dr. Saiju tells them to come back
after a few days when the results are available. A few days later, Dr. Saiju tells Sheela that she
has Stage II breast cancer, but there isn't a problem and she can undergo chemotherapy. They
realise they have to disclose the matter to the whole family, including Kurien, daughters Sarah
and Mary, and son-in-law Tony Edayady. Everybody in the family goes gloomy and they agree
for chemotherapy sessions including a lump removal surgery. In one of the chemotherapy
sessions, as Chacko was petrified about going with Sheela, Kurien goes instead and there he
meets Rachel in a funny situation. They then get to know each other and also that they have
similar situations.
Sheela starts losing her hair as a side effect. So, she trims her head and temporarily quits her
lecturing job. So, they decide to conduct Sara's engagement. At that occasion, Sara asks if
Sheela has the confidence to go through the disease. Then Kurien explains a story about her
during the Gulf War in 1990. Iraqi soldiers invaded Kuwait and they somehow escape to India
via Jordan without her confidence going down even by a little bit.One day, she develops a
fever and the children take her to the hospital thinking it as serious. 80-year-old Appappan
dies instantly as his eardrum bursts. After that the family plans for a trip to Kodaikanal and
when they reach there, Kurien gets a call from the doctor. He smiles after attending the call,
signifying that Sheela has been cured of the disease. The following scenes show flashbacks
where each family member cried behind closed doors, hiding their tears from Sheela. The last

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scene of the movie shows Kurien crying and when Sheela calls him, he wipes his tears and
goes.

DIFFERENTIATION IN POINT OF VIEWS

Movies like ‘Njandukalude Naattil Oridavela’ and ‘Aakashadoothe’ are viewing cancer
from two epoch. These movies discusses about the moments which happened to us or our
social environment. Sheela of ‘Njandukalude Naattil Oridavela’is going through the same
emotional phases of Aani from ‘Aakashadoothe’. Sheela symbolizes the majority of women
who faced cancer in their life. The movie ‘Aakashadoothe’ released in a period were cancer is
considered as an incurable disease (lack of technological and medical advancements may be
reason). Aani the cancer diagnosing mother, had to let all their 3 children to be adopted but
Ronnie who is handicapped which get lonely with the mother are very serious situations
which was created by the disease leads to the total destruction of the family. The disasters
happen in the movie from beginning to end reached to the stage of tragedy.
The ‘Njandukalude Naattil Oridavela’ movie begins with small doubts. The theme of the
movie is continuation of doubts and unexpected situations which comes after the doubts. She
says to her kurian who stays in London to come home because of the doubt. What will be the
doubt of sheela? .Like Kurian, audience too are excited to know about doubt. From a doubt of
having breast cancer to its realization leads to the emotional moments of family is presented
as bitterly sweet. The director has succeeded in the mission of humorously presenting the
changes in the life of family members when Sheela, an integral part of the family diagnosed for
breast cancer.
Now society realizes that cancer is a curable disease. The disease of cancer is pictured
asultra-emotional in the movie ‘Aakashadoothe’. The movie is pushing audience to extreme
sadness however ‘Njandukalude Naattil Oridavela’ is preparing minds of people to face
disease more positively. The financial situation of both families are widely different. The
problems will be vastly different when cancer is found in a financially sounded family and a
normal family. With some excemptions, the movie ‘Njandukalude Naattil Oridavela’ is
showing us how one should face cancer.

CONCLUSION
We can witness from earlier movies that when major diseases like cancer and such increases
the mental tension among people and this leads to emotional distress in family. Such type of
movie is ‘Aakashadooth’. Nevertheless ‘Njandukalude Naattil Oridavela’ is a variety movie
which shows when cancer came to family as an uninvited guest the movie teaches how to face
it with self-confidence and courage.The movie teaches us to face cancer with a smile not with
tears. What makes it different from others is the humor sequences between the tensions.
‘Njandukalude Naattil Oridavela’ is book by writer Chandramathi, who is a cancer victim.
What the director is portraying by the title is that the increasing amount of cancer patient in
Kerala and how to react to cancer mentally and emotionally.

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REFERENCES
1. Gopalakrishnan, Adoor, Cinemaute Lokam. The State Institute of Languages. Kerala.
Thiruvananthapuram. 2008.

2. Ramachandran Nair, Panmana. Madhyamapatanangal. Current Books. Kerala.

Kottayam. 2013.

3. Vijayakrishnan. Chalachithrathinte Porul. The State Institute of Language. Kerala.

Thiruvananthapuram. 1996.

Movies
4. Akashdootu. Dir. Sibi Malayil. Pro. Thomas Korah. Anupama. 1933.
5. Njandukalude Nattil Oridavela. Dir. Althaf Salim. Pro. Nivin Pauly. Chakkalakel Films.
2017.

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 READING HUMOUR AS A THERAPY IN INNOCENT’S LAUGHING CANCER
AWAY

DR. SANEESH C.S.

Assistant Professor on Contract, Little Flower College, Guruvayoor

“Man can help other poeple in many different ways- financially, through extending a
helping hand and consolations. I have only one means of helping people, which is making
them laugh. Having returned from the aisle between life and death, I have only one thing to
give them: These excerpts of humour culled from the Cancer Ward.”- Innocent
‘Laughing Cancer Away’ is the heart warming stroy of Innocent, an eminent film actor,
writer and member of the parliament who, by sheer courage, determination and an
incomparable sense of humour, withstood the onslaught of cancer and emerged victorious
from its claws. Innocent’s story inspires countless despondent people around the globe and
also acts as a guiding force to them.
Innocent was born in Iringalakkuda on 28 th February, 1948 as the son of Thekkethala
Vareeth and Margaleetha. He stopped studies in the eighth class. His roles in Mazhavilkavadi,
Kilukkam, Devasuram, Ramji Rao Speaking, Godfather, Vietnam Colony, Manasinakkare
received great acclaim in the minds of viewers. He has acted in more than six hundred films.
He has been the president of AMMA, the association of actors and actress, for the past
seventeen years. He has authored many books namely, Mazhakannadi (stories), Njan Innocent
and Chirikku Pinnili (autobiography) He was elected to Chalakkudi Constituency in 2014.
Innocent is a man with high sense of humour and presence of mind. He has successfully
faced many problems in his life with an aura of humour. He could do that even in the face of
death. ‘Laughing Cancer Away’ narrates how humour helped Innocent to recover from cancer.
Amidst the happiness and celebrations did Innocent realise the severity of the disease
that had taken away control of him. Soon after, his wife also suffered the same fate. This book
is a memoir of their hardships and yesteryear troubles. But rather than evoking sadness this
book exudes humour and dedication. It pits humour against the inevitability of death. It is
through confrontation and not through despair we jump the hurdles of life.
Innocent was an integral part of the activities of Alpha Pain and Palliative Clinic which
aim to care cancer patients. He worked so hard to raise fund for Alpha. But, during those days
he could never imagine himself as a cancer patient. Like us, Innocent too had a belief that
diseases affect only others.
Most people fall in such situations. This lost in hope may lead them to death itself.
Edwin Louis Cole once said, “You don’t drown by falling in the water; you down by staying
there”. Innocent was not ready to drown. He decided to swim with all his might. He asks “how
can we die when life waits for you?”
On the outset of the book, Dr. V.P. Gangadharan, the renowned oncologist who
diagnose, treated and cured Innocent’s cancer states that ‘Innocent’ now means ‘a remedy for
cancer. He says that even when he knew that he was suffering from Cancer, it did not shatter
him much as would ordinary patients. There was only some gloom in him. But during any
stage of treatment, Innocent did not suffer from the sort of depression that Cancer patients
would generally exhibit. Perhaps, he would have had some anguish within, and he was not
showing outwardly. He was cured so fast perhaps because he had maintained certain
pleasantness in his mind throughout. He was disturbed only when he came to know that his
wife Alice was also inflicted by Cancer.
Dr. Gangadharan appreciates Innocent that he openly declared to the world that he
was suffering from Cancer. The fact is usually is hidden by even ordinary people. When the
news spread all over Iringalakkuda day by day, one day Alice told him about this very

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hesitantly. He consoled her: “See, I didn’t bring home this Cancer stolen from any temple or
bishop’s house, you know. It affected me as would anybody else. That’s all!”
Another thing is that he was not caught in the pitfalls of any treatment not approved by
science. Many people who professed to cure him with onetime remedies and black magic
approached him, especially because he was a famous personality. People would generally fall
in to this trap. But innocent, in his own style avoided them without insulting anyone and
continued with the scientific treatment.
A typical example from the book is that some gospel workers came from Bangalore and
told him: “Jesus Christ came to us in our dream yesterday and told us to pray for Innocent.”
“Do you know the time when He had come to you in the night?” Innocent asked them.
“It might have been around eleven thirty – twelve.” They said.
“There is no chance for that. He was here with me till twelve thirty.”
They sat astounded on hearing his reply. They didn’t continue their gospel for long.
Dr. Gangadharan remarks he has no doubt about Innocent’s 916 witticisms about
Cancer would be more effective than the words of a doctor. He tells authentically that the
sense of humour with which he handled Cancer hastened his cure more than by the treatment
itself. Many unknown chemical reactions might have taken place in immunising his body
because of that. Many side effects of the medicine had been averted by this approach. He
transfers his own mental attitude to people in the same condition through these memoirs.
Hence, this doctor says that ‘Innocent’ is now a ‘remedy for Cancer’. And, he authentically
recommends this medicine as a doctor to all genres of patients.
The title of the book in Malayalam ‘Cancer Wardile Chiri’ (Laughter in the Cancer
Ward) itself is paradoxical because a Cancer Ward is never a place which blooms laughter. But
innocent could bloom the flowers of laughter even there. That sprouted lives in him and the
people around him. Here we can review how Innocent used humour as a therapy to overcome
his deadly disease.
On the day Innocent was diagnosed Cancer (Lymphoma), everyone in his house burst
into tears and a thick silence surrounded everywhere in the house. It was too much for him.
He said to them: “If you continue to sit around me always crying, I will leave this house and go
around somewhere else. I come home to be happy, only to be happy.” His statement that he
would leave home was a shock to all. They began to calm down gradually. But the old
brightness never returned to their faces.
That night when he was lying sleepless on the bed, with my mind full of sorrow, he
took a strong decision: “Anyhow, I am a patient now. I will face it, if possible, with pleasure. I
was one who could find mirth in anything. Why I could not do that even in illness? Let the doctors
treat me; along with that, I would continue my own treatment with laughter as the elixir of life! I
was not prepared to pledge my Being to Cancer.”
Once the doctors asked Innocent to pedal a machine like a cycle as an exercise. He
climbed on to the bicycle and started pedalling. Soon, he was surrounded by a crowd, who
were intent on enjoying the fun of Innocent’s drill. When he was being torn between two
major diseased, they were all laughing to their heart’s content! He told them: “Warn me if
some lorry or bus comes from behind!” On hearing that, they roared with laughter while he
carried on with his exercise.
In Lake Shore Hospital, Dr. Gangadharan had designated Dr. Lissi to supervise over
Innocent’s affairs. When he told him so, he had replied that it was nice, because she was a
Christian herself. Gangadharan beamed gracefully through his beard on hearing his comment.
Dr. Lissi gave him special care in the ensuing days. She was a respectable and compassionate
middle-aged lady; and the pain they suffered. When someone wriggled in pain, she would
comfort them like an angel.
The process of extracting bone marrow from the vertebra was by inserting a thick
needle. This was done after pulling both the hands backwards forcefully and bending the body

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like a cage. He would get dead tired after that; He saw her too panting after the process. Once,
when he was lying on the bed in such stupor, he asked her: “Aren’t you a Christian Lady for
sure? Or are you Lady Judas?” She laughed on hearing that. Thus, two or three times
Chemotherapy was done Dr. Lissi became a close friend of Innocent and his family.
One day when he reached Lake Shore for the next Chemo, Dr. Gangadharan said in a
muffled voice: “Innocent, there is something I have to tell you.” Innocent gazed at his face
unable to comprehend. “Our Dr. Lissi is in the grip of Cancer - Multiple Myeloma.” He felt
dizzy. Sweat ran down his body. Words failed him. He felt as if he was struck by lightning.
Shaking off the agony and tears from the mind, he asked Gangadharan: “See Gangadharan! I
am suffering from Cancer. Lissi, the doctor who treated me, has also got it. Now, suppose you
also get it, who will be there to treat me?” On hearing that Dr. Gangadharan sprang out from
the gloom and pain he was in and beamed a pleasant smile. Innocent opines how dreary and
horrible human life would have been if things like laughter and humour were not there!
Laughter is the best medicine, the most powerful shield, he realized.
The news that Innocent was suffering from Cancer had begun to spread like wildfire all
around. The first to know were his relatives. They started visiting him. All those who visited
him brought with them some food items. There was a relative and his family who visited him
repeatedly more than once a week. They bought something with them by force of habit every
time they came. Once when they left after a visit, he heard Alice groaning: “How many time do
they come! However I tried to prevent from bringing these things, they wouldn’t listen. When
is it that I would be able to do something in return for this?” Innocent heard this from his
room and prayed hard for their well being.
When Innocent was carrying on with his Chemotherapy, Alice started to feel a back
pain. She was bedridden. Both husband and wife had become sick. One day, Nedumudi Venu
came visiting along with his wife Suseela. The moment he began conversation Innocent
understood that his plan was to give him enough strength of mind through consoling him.
Venu narrated with great vigour the episodes of those who had overcome Cancer with their
will power. Finally he revealed the history of an actor named Siddharth Shiva who recovered
completely from pancreatic Cancer. When he was ill he was involved in a love affair. That
became his energy during his illness, he said. He wanted Innocent to face the disease in a
similar manner. His wife Suseela showed herself proud for her husband’s power to persuade.
Innocent was lying on his bed, listening to all that he said. Innocent told him:
“All these people had their own expectation in life. Take the incident of Siddarth Shiva,
for example. There was a girl waiting for him on the other side of his disease. That is what
showed him the way. But look at my situation. Even if I get cured from this disease, am I not
destined to live with this woman, who is down with back pain?” Venu exploded with laughter
at my comment. Alice also enjoyed the joke, covering her face with the blanket.
Such moments made him forget that he was a patient. While bedridden, he tried his
best to see laughter in anything and make everything amusing. His soul experienced how
laughter could turn into a medicine.
It was when his relatives, friends and colleagues had almost visiting him that the turn
of the politicians and social activists came. Oommen Chandy, V.S. Achuthanandan, Ramesh
Chennithala, Pinarayi Vijayan... the line of VIPs went unendingly. When Ramesh Chennithala
was about to go back, he wished Innocent a fast recovery.
“Should the recovery be so fast? Let it prolong a little more.” He said.
Ramesh couldn’t grasp what Innocent said. He stood aghast.
“I mean a few more visitors are yet to come. Bring that boy also to see me.” He said.
“Which boy?” Ramesh asked.
“Oh, that Rahul Gandhi! We will think of Sonia Ghandi later” he completed. He burst out
with his natural smile, this time a bit louder.

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 Such things in combination with the medicines caused his cure. He could discern in the
beginning itself that the disease was a fact. I knew that there was no meaning in resenting or
sidestepping it. It deserved to be faced with confidence, and humour. If that could be done,
even Cancer will have to give away. His experience is his witness.
One day when Innocent and his wife were sitting in the hospital room watching each
other face to face, he told Alice:
“Alice, anyhow our life is now in the hospital. You do one thing. Just get a test done. The
test for Cancer is called ‘Mammogram’, which all women get done these days.”
She dismissed his suggestion with the comment that there is nothing wrong with her.
He compelled her again, when she said:
“Now, if we get the test done and they find that there is nothing wrong, all the money
spent on that will be a waste, won’t it?”
He kept on looking at her on hearing her reply. He could not read her face. He could not
make out whether she meant it seriously or as a joke.
As a result of repeated compelling, she agreed finally and got the test done.
The result turned out positive. The illness of Alice was name in situ, the first stage of
breast cancer. Doctor said “You were fortunate to have checked mammogram that day. This
can now be cured with a minor operation. We will do it tomorrow.”
No one in his family had any food that night Alice was diagnosed with breast cancer.
Alice and Innocent were left alone in the bedroom. Alice was laying facing away from him. She
was not sleeping. Her breath was accompanied by some sobbing too.
He held her close to him. He could feel her sobs beating on his chest. Bearing its pain in
the mind, I whispered in her ears:
“Alice, now we don’t have to worry that Cancer will pass on to you. You also don’t have
to bother that the money spent on testing is wasted. The money spent on your test has been
spent profitably. It has been fully realized. Let us thank God for that. We are now a happy
Cancer family!”
She didn’t laugh as usual, but her sobbing stopped for some time. She might have
laughed within herself.
A guest, who visited Innocent’s house when it was known that Alice was afflicted soon
after he was cured, commented:
“Everything happens because of your unity of mind. Alice also got Cancer when
Innocent got it. Has anyone heard of such things anywhere else?”
“It was good that it was Alice who was inflicted. You would have said the same thing
even if our neighbour Eliyamma had got it!” I quipped. He said nothing more.
Just before he gets busy in his acting career after his and his wife’s completely recovery
from Cancer he proclaims “The only thing I have to tell the patients who read this book is that
they have to mentally admit that the disease is a fact. Get proper and regular treatment. Take
the medicine systematically. The most important thing is that they should never think that the
disease signals the end of life. Is it not better to think that you will be cured than thinking that
it will take your life? Be aware of the truth and pass through the stage of illness with full
optimism.
Remember, Life is waiting for you on the other side, with much greater charm!”

Bibliography
Abootty, O. (2006). The funny side of English: A read-n-laugh manual for the English language.
New Delhi: Pustak Mahal.Academic Press.
Englisch-hilfen.de. (2013, january 8). Retrieved from sentences change their meanings:
http://www.englisch-hilfen.de/en/grammar/tenses_satz.htm
English Articles.English-at-home.com. (2011, August, 20). Retrieved from Web. 201120 Aug.
http://www.english-at-home.com/grammar/articles/

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English language - Wikipedia, the free encyclopedia. (2010, July, 18). Retrieved from:
http://en.wikipedia.org/wiki/English_language
English-grammar/verbs/present-tense. (2013, Janaury 3). Retrieved from British Council.com:
https://learnenglish.britishcouncil.org/en/english-grammar/verbs/present-tense
English-Tenses. (2013, March 15). Retrieved from
https://www.coursehero.com/file/9213513/English-Tenses/

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 FOOD AND DISEASE

SANDRA LISHIKUMAR

II M.Sc Zoology, Little Flower College, Guruvayoor

Food is any substance consumed to provide nutritional support for an

organism.It is usually of plant or animal origin,and contains essential nutrients such
as,carbohydrate,fats,proteins,vitamins or minerals.
A disease is any condition which results in the disorder of structure and function in an
organism that is not due to any internal injury.

Food borne illness:Is any illness resulting from the food spoilage of contaminated
food,pathological bacteria,virus or parasites that contaminate food as well as toxins such as
poisonous mushroom and various species of beans that have not been boiled for at least 10
minutes.
Dangerous food combinations to avoid: Crabs and animal protein,high proteins,food and
water/juice,fruit with meal,yogurt with fruit,cereal with milk and orange juice,banana and
milk,beans and cheese,tomatoes and pasta,cheese and meat.
Foods that boost your mood:These are some of the foods to eat to stay healthy and
happy:Foods containing proteins,vitamins,sunlight before sun shine,fiber etc.
Top ten cancer causing foods:Genetically modified foods,micro wave popcorn,canned foods,
grilled meat,refined sugar,salted pickle,white flour,farmed fish,hydrogenated oils etc.
CONCLUSION:
Avoid chemical containing foods and prefer more organic foods.Prevention is
better than cure.

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 HEALTH ISSUES OF AGED WOMEN IN KERALA
A CASE STUDY OF VENKITANGU PANCHAYATH

SR.J.BINCY

Assistant Professor, Department Of Economics, Little Flower College, Guruvayoor

ANJU M.R

IVth Semester, M.A. Economics, Department Of Economics,Little Flower College, Guruvayoor

INTRODUCTION
Aged women refer to women age 50 and older. Ageing
women make up a significant proportion of the world population and their numbers are
growing. In India, women have never found themselves at the centre stage. They have always
been marginalized from the mainstream of society. Living as second class citizens for
centuries, their mindset has also developed accordingly and never enjoyed privileges of
development. Due to social and traditional family structure they are forced to live within four
walls of house. They worked very hard throughout their life, they dedicated every moment of
her life for the sake of her children and husband, and they poured love, compassion, and
empathy on her family and remained ready for any kind of sacrifice. But when she becomes
old and need family support from her family members, children and others, they left her
alone physically, socially and psychologically.
Old age has different implications for men and women effect
of family cycle is more traumatic for women than for men because of their deeper
involvement in the family matters. Joint family support is fast disappearing from the society,
aged one most vulnerable and high risk groups in terms of health and social status in the
society. Complicated problem is that children start neglecting them. Various factors such as
food sharing practices, eating the left overs, poor medical facilities, as well as low levels of
education may be responsible for poorer nutritional and health status of elderly
women.Added to this, incidence of widowhood is much higher among the female aged than
among the males. The position of elderly women in the family is depended upon her
economic position, support systems available, marital and health status.
AGED POPULATION IN INDIA
Till few decades the percentage of older persons was negligible in overall population of
India. Its population has approximately tripled during the last 60 years, but the number of
elderly Indians has increased more than four fold. Better medical facilities, care and liberal
family planning policies made the elderly the fastest growing section of the society in India.
About 48.2% of elderly persons are women. India is one of the few countries in the world in
which the sex ratio of the aged favours females. It is interesting to note that up to population
census 1991, the number of elderly males exceeded the number of females. The last two
decades, however, the trend has been reversed and the elderly females outnumbered the
elderly males. In 2001, there are 38 million males and 39 million females in the age 60and
over.

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AGED POPULATION IN INDIA (2011) Table: No: 1
TOTAL
AGE GROUP

PERSON FEMALE MALE

60 - 64 3.1 3.2 3.0

65 - 69 2.2 2.3 2.1

70 - 74 1.6 1.6 1.5

75 - 79 0.8 0.8 0.7

80 + 0.9 1.0 0.8

Source: population census 2011

The table shows that the number of females exceeds the number of males. They constitute
8.9%. There are nearly 104 million elderly persons in India, out of this 53 million are females
and 51 males.
KERALA
Kerala is moving fast towards an “aged society”. The percentage of aged population is
hence close to that of the developed countries of the world. According to 2011 census there
are 12.6% of older persons. The growth rate is high among the elderly aged 70 or 80 and
above. In 2001 there are 3.1 million older persons in the state and it is projected to increase 4
million in 2011 and 5.7 million in 2021. State wise data on elderly population divulge that
Kerala has maximum proportion of elderly people in its population. In Kerala females have
the highest life expectancy.
THRISSUR
The table shows that the maximum number of elderly females in the age group of 60– 64. The
least number of aged women is in the age group of 75 – 79. However the number of aged
women is increasing tremendously.

AGED POPULATION IN THRISSUR DISTRICT (2011)

AGE NUMBER OF ELDERLY WOMEN
60 - 64 174952
65 - 69 54647
70 - 74 44626
75 - 79 32543
80 + 36038
Source: The website of village profile in Kerala\Thrissur.
PROBLEMS OF AGED WOMEN
Older women have more critical problem than older men. Most elderly women were terribly
marginalized, first as women, second as aged women and third as widows.
 Isolation:-Marginalization or isolation in old age is among the most common issues
that are affecting older women constantly. Due to fast paced modern life style and
rapid urbanization across the country younger generations hardly interact with their

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 elderly family members. Popularity of nuclear family system has virtually crushed
strong traditional bond between grandchildren and grandmothers.
 Social insecurity:-older women, who live in cities, are prone to social alienation in
comparison to older women of villages. Joint family system still alive in rural areas.
Due to lack of social protection, older women are forced to lead a life full of distress.
 Financial insecurity:-many older women have property / money but they cannot
possibly use the money or take financial decision on their own. Social tradition don’t
allow them to use their ancestral property for their own welfare. They sacrificing their
own interest for the good of other family members.
 Medical problems:-due to negligence, lack of awareness, financial support and
religious mindset of women, older women often have to face acute health problems.
Most of their health problems remain unnoticed. Their family ignores these – saying
that in old age diseases are common. Most of them believe more in divine powers
instead of medical science.
 Emotional insecurity:-in old age most of the older women face family problems like
uncomfortable relations with son and daughter -in-law, limited interaction with
children, grandchildren. Their daughters-in-law don’t like their interference in family
matters, children are busy with their jobs etc. .
RATIONAL OF THE STUDY
Now with fast growing elderly population, increased life expectancy and higher percentage of
elderly women in India, elderly population, issues concerning elderly women cannot be
ignored. They dedicated a lion share of their life for us. Older women have more critical
problem than older men. Their world revolved around their families, and when they get old
they get sidelined by the same family. The problems of aged women are of a great concern in
India, because they need intervention different from young women and their tribulation
completely different from others. So the topic is very relevant. We make an attempt to study
the health related issues of aged women with the following OBJECTIVES
To study the socio economic status of aged women.
To analyze the health related problems of aged women
We focus on the socio economic conditions of aged women in Venkitangu
panchayath. 60 old women’s are surveyed. The survey reveals the socio economic status and
health related problems of aged women. They face socio, economic, psychological and health
related problems. They are not satisfied in their old age. Old age is a period of distress and
misery. They are the silent suffers of the family. The study will help us to know the various
problems faced by old women.
The study is based on both primary and secondary data. The primary
data collected from a sample of 60 aged women in Venkitangupanchayath. Questionnaire
technique is the main tool of data collection. Primary data which are collected through pre-
structured questionnaire and interview. Secondary data were collected from journals and
website. The data and findings are displaced through sample analysis.
DATA ANALYSIS
Data is analyzed by using simple arithmetic and statistical applications like
averages, tables, charts and diagrams etc. Aged women were the respondents of the study. We
have 60 samples. Here we assess their socio- economic status, and health problems of aged
women.

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AGE WISE CLASSIFICATION Table: NO: 3
Age Number of respondents Percentage
60 – 70 15 25%
70 – 80 25 41.7%
80 – 90 11 18.3%
90 – 100 9 15%
Total 60 100%
Source: primary survey
The age wise classification shows that, the majority of the respondents are in the age
group of 70-80. The number of respondents are 25 (41.7%) followed by the age group 60-70
the respondents are 15 (25%). The age group 80-90 corresponding 11 respondents (18.3%).
And only 9 respondents are in the age group of 90-100.
FINANCIAL STATUS OF OLDER WOMEN
The table shows the financial status of older women. Their main source of income is
from the family or relatives (53.33%). Followed by old age pension (33.33%). Only 5%
receives assistance from charitable institutions.

Table: NO: 4
Source of income Number Percentage
Old age pension 20 33.33%
Income from property 5 8.33%
Family/relatives 32 53.33%
Assistance from charitable 3 5%
institution
Total 60 100%
Source: primary survey

4.10 FINANCIAL DEPENDENCY IN OLD AGE Table: NO:5

Category Number Percentage

Son 32 53.33%

Daughter 16 26.7%
Self/husband 8 13.33%

Others 4 6.7%

Total 60 100%
Source: primary survey
The table 4.10 shows the financial dependency of aged women. 53.33% of them are
depends their sons to meet their financial needs. 26.7% depends their daughters, 13.3%
depends their husbands and only 6.7% depends on others for their financial needs.

4.11 HEALTH PROBLEMS

PHYSICAL STATUS OF OLDER WOMEN
From the table, it was found that there are 36.7% of older women have good health
even at old age. 48.3% suffering from various health related problems. 6.7% older women are
in a bed ridden condition, whereas 5% older women are disabled physically or
psychologically.

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Table: No: 6
Types Number Percentage
Healthy 22 36.7%
Poor health condition 29 48.3%
Bed ridden 4 6.7%
Disabled 3 5%
Total 60 100%

Source: primary survey

Diagram:

Health problem

5%
7%

Healthy
38%
Poor health condition
Bed ridden
Disabled

50%

Source: primary survey

4.12 SYSTEM OF MEDICINE Table: No: 7

Types Number Percentage

Allopathy 39 65%

Ayurveda 12 20%
Homeo 9 15%
Total 60 100%
Source: primary survey

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The table gives the information about the system of medicine preferred by the selected aged
women. Among them 65% prefers Allopathyand 20% of them go for Ayurvedic treatments.
Only 15% Homeo.

4.13 EYE SIGHT CONDITION Table: No: 8

Category Number Percentage

Good without glass 38 63.3%

Good with glass 18 30%
Difficulty in seeing 4 6.7%
Total 60 100%
Source: primary survey
HEARING CONDITION Table: No: 9
Category Number Percentage

Good 48 80%

Difficult 12 20%

Total 60 100%
Source: primary survey
From the table we can see that 80% of the aged women have good hearing condition.
20% of them are facing hearing problem.

PSYCHOLOGICAL PROBLEMS
EMOTIONAL ATTACHMENT TOWARDS LIFE Table: No: 10
Category Number Percentage

Yes 22 33.7%

No 38 66.3%

Total 60 100%

Source: primary survey

The table shows the emotional attachment of aged women towards their life. 66.3% of
aged women are found emotionally detached towards their life, 33.7% of them are
emotionally attached towards their life.
LIFE IN OLD AGE
The table shows that most of the women are dissatisfied with their life in the old age. 48.3%
opined that their interpersonal relationship is very low. Most of them have differences of
opinion with in law. 20% of them have acute financial problem. 13.33% said that they are not
satisfied with their life due to the prevalance of chronic illness

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Table: No: 11
Reasons for dissatisfaction Number Percentage

No family support in need 6 10%

Unsuccessful children 5 8.33%

Acute financial problem 12 20%

Chronic illness 8 13.33%

Inter personal relationship 29 48.33%

Total 60 100%

Source: primary survey

RELATIONSHIP WITH FAMILY MEMBERS

The table shows that 53.3% opined that their family members are not so affectionate to
them. 46.7% said that their family members are affectionate and loving.
Table: No: 12
Relationship Number Percentage

Affectionate & loving 28 46.7%

Not so affectionate 32 53.3%

Total 60 100%

Source: primary survey

Relationship with family

members
55.00%
Percentage of respondents

50.00%

45.00%

40.00%
Affectionate&loving Not so affectionate
Relationship

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5.1 SUMMARY OF FINDINGS AND SUGGESTIONS
The study “socio-Economic Conditions of Aged women” was conducted in Venkitangu
Gramapanchayath, based on primary survey of 60 aged women..Most of them face
many problems like isolation, social insecurity, financial insecurity and emotional
insecurity. They are not getting proper care and attention from their family members
often they are neglected. They face psychological problems. Health problems are
another serious issue. 23.33% of women did not get any respect from their families.
Only 18.33% are the head of their families. Majority of the elderly women depend
their sons for meeting their financial requirements (53.33%). Physical status of older
women analysis shows that most of the women have poor health condition. 48.33%
have miserable health. 5% of them are disabled. Majority of the respondents seems to
mentally unhappy (66.33%). .48.33% revealed that their life in old age is miserable.
The health care needs of older women are and will be an increasing
concern and issue of the our society. A subcommittee of the Public Health Service Task
Force on Women's Health, which studied the health issues related to older women,
observed that many factors relate to the health care of this group Several factors, such
as the homogeneity of the population over 65 years, the distinction between normal
aging and disease, and the impact of socioeconomic concerns on physical and mental
health, are important for developing preventive and treatment strategies.

BIBLIOGRAPHY

SarasaKumari.R.S (2001)1 “Socio-economic conditions, morbidity pattern and social

support among the elderly women in a rural area”,www.ror.isrj.org
Rama Murthy (2003)2 “Issues and problems of older women”, Routledge International
& Cross Cultural Perspective, page no-8 – 10.
Dr.N.Prabhavathy Devi and Dr.P. ThamilarasiMurugesan (2006) “Ageing in India
concerns and challenges”,
Madhumathur (2008) “Depression and life style in Indian ageing women”, Journal of
Indian academy of applied psychology: vol – 35, no-1, page no-73-77.
Dr. Alexander Kalache and Irene Hosking (2010) “Women, ageing and health: A frame
work for action: world health organization report, page no-57.
Sumanth.S. Hiremath (2012) “The health status of rural elderly women in India”,
International journal of criminology & sociology theory: vol 5, no-3, page no-960-963.
Mary sahela.B (2013) “Problems of elderly women in India- An over view”, Southern
Economist, vol- 6, page no- 31.
Agewell Foundation (2015) “Gender discrimination among older women in India”,
www.agewell foundation .org
Ganeshappa.K. and Suresh Ramanamayya (2015) “Problems of aged women”, Southern
Economist, vol-8, page no-24.
Shantha.P.R (2015) “Ageing towards self-reliance problems of aged women in India”,
International Journal of academic research, vol-2, issue-6, page no- 29-31.
www.agewell foundation.org
www.mospi.gov.in
Mospi annual report 2011-12, page no-29.

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 A REVIEW ON SURVIVING CANCER

SHEEJA C

Assistant Professor on Contract, Department of Zoology,

Little Flower College, Guruvayoor

A cancer survivor is a person with cancer of any type who is still living. Whether a
person becomes a survivor at the time of diagnosis or after completing treatment, whether
people who are actively dying are considered survivors, and whether healthy friends and
family members of the cancer patient are also considered survivors, varies from group to
group.
How many people are cancer survivors depends on the definition used. Currently nearly 65%
of adults diagnosed with cancer in the developed world are expected to live at least 5 years
after the cancer is discovered. A cancer survivor as someone who is “living with or beyond
cancer”namely someone who
 Has completed initial cancer management and has no apparent evidence of
active disease
 Is living with progressive disease and may be receiving cancer treatment but
is not in the terminal phase illness.
 Has had cancer in the past.
The National Coalition for cancer survivorship (NCCS) pioneered the definition of survivor as
being any person diagnosed with cancer from the time of initial diagnosis until his or her
death.
NEEDS OF SURVIVOR
People who have finished cancer treatment often have psychological and physical medical
challenges. These effects can vary from person to person; change over time range in intensity
from mild and fully disabling. They commonly include fatigue, pain, sleep problems, weight
gain, anxiety and depression, fear of cancer recurrence and impaired quality of life.
When a doctor says “you have cancer” the world seems to turn upside down. Worry
immediately sets in your mind. You may find yourselfoverwhelmed by questions like
 Will I need chemotherapy
 Will I lose my hair
 Will radiation hurt or burn
 Will I need surgery
 Will I still be able to work during treatment
 Will I be able to take care of myself and family
 Will I die
What surviving means within the medical community, surviving cancer meant
 You are still alive
 You are going through the steps from diagnosis to treatment.
 You have multiple options with the expectation of positive result.
 You are striving for a cure.
 You are not expected to die
Survival has also depends on factors beyond the disease itself include
 Treatments
 Relationship with the doctor
 Relationship with the rest of the medical team.
 Quality of life outside of medical condition.

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SURVIVAL PERCENTAGES
In the past cancer was considered to be fatal. However nowadays it has come to be recognized
as a curable illness.
 Breast cancer: the most common tumor in women, presents a high survival
percentage. 83% of patients have survived this type of cancer after five years.
 Lung cancer: Is one of the most aggressive tumor and survival after five years is very
law. Only 10% of patients diagnosed with a malignant neoplasm survive for more than
five years.
 Colorectal cancer: The most common malignant tumor. If we group men and women
together, present an average survival rate of 50-55% five years after diagnosis,
meaning that half the patients survive this form of cancer.
 Prostratecancer:today the most common tumor in men has an increasingly favorable
prognosis with a global survival rate of 76% which is higher in young adults.
 Ovarian cancer: Presents a very varied prognosis depending on age. 70% of the group
between 15 and 44 years survive this form of cancer, this is the case for only 19% of
those over 74years old
 Testicular cancer : the rare malignant tumor that mainly affects middle aged males is
the tumor with the best prognosis with a 95% survival rate five years after diagnosis
 Skin melanoma : Displays one of the highest survival rates, reaching values over 85%
although there are European countries where recovery exceeds 90%
 Hodgkin’s lymphoma: displays high recovery with survival greater than 92% among
young people. Although amongst elderly groups it fails to reach 50%
Cancer survived statistics are typically expressed as the proportion of patients alive at some
point subsequent to the diagnosis of their cancer.

Top 5 deadliest types of cancer

While better screening methods and treatments are saving lives, some forms of cancer remain
terribly lethal. The cancers on this list are the ones most likely to result in death within 5
years of diagnosis, according to the latest National cancer institute.
Cancer 5 year survival rate Life time risk
Pancreatic cancer 7.2% 1 in 65
Mesothelioma 9.2% 1 in 140 for men
1 in 710 for women
Liver and bile duct cancer 17.2% 1 in 100
Lung cancer 17.4% 1 in 14 for men
1 in 17 for women
Gall bladder cancer 17.9% 1 in 1300 for men
1 in 550 for women

HOW TO SURVIVE CANCER

It’s a scary thing to be diagnosed with cancer many people have lost friends or family
to this disease. However an increasingly number of people does survive cancer due to earlier
and more accurate diagnoses and more effective treatments. The main medical therapies used
to treat cancer are surgery, chemotherapy, radiation therapy, targeted therapy and
immunotherapy. Other factors that improve your odds of surviving cancer include a good diet,
regular physical activity, a caring support network and a positive attitude. With good medical
care, self-care and the support of others, you can increase your chances of surviving cancer.
 Talk to your doctor about a tissue biopsy: Biopsies can not only detect if cancer
cells are present in some area of the body, but they can also give your doctor an
idea of cancer type and general degree of aggressiveness.

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  Discuss curative and preventative surgeries with your doctor: The best time to
remove a cancerous tumor is in its early stages before it spreads to other sites via
the blood. Preventive surgery is done to remove tissue that likely to become
cancerous, despite not showing any signs of cancer.
 Ask your doctor about radiation therapy: Very effective for lymphomas, lung cancer
and various skin cancer.
 Consult your doctor about chemotherapy: Involves using medicines or drugs to kill
cancer cells. It can also kill healthy cells in the body, which can lead to negative side
effects.
 Consider targeted cancer therapy instead: Targeted drugs can be used as the main
therapy for some cancers, but typically they are given along with standard
chemotherapy, surgery and radiation therapy.
 Learn about cancer immunotherapy as a treatment: Uses certain parts of your
immune system to combat cancer cells. This can be done either by boosting your
own immunity to attack the cancerous cells or by giving your body immune system
components,such as special proteins.
 Investigate stem cell transplant for cancer: Most effective for cancer affecting your
blood or immune system, such as leukemia, lymphoma and multiple myeloma.
 Make an effort to eat well
 Get lots of regular exercise
 Surround yourself with a loving support group
 Keep a positive attitude.
 Get regular checkups or follow up care
 Combat stress
 Keep your weight under control

REFERENCE
 You Can Survive And Thrive With Cancerby Anna Renault
 The Mental And Emotional Challenges Of Surviving Cancerby Ann MacDonald

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 MANAGING ANOREXIA AND NAUSEA DURING CANCER TREATMENT

SWAPANA JOHNY

Assistant Professor, Dept of Zoology, Little Flower College, Guruvayoor

The term cancer, which means “crab” in Latin, was coined by Hippocrates in the fifth
century BC to describe a family of diseases in which tissues grow and spread unrestrained
throughout the body, eventually choking off life. Although the disease has therefore existed
for at least several thousand years, its prevalence has been steadily increasing. In just the past
50 years, a person’s chance of developing cancer within his or her lifetime has doubled and
doctors are now seeing more cases of the disease than ever before. Cancer is one of the major
causes of deaths all over the world where communicable diseases have been controlled.
Cancer can occur in any part or any tissue of the body and can involve any type of body cells.
The good news is that enormous progress has been made in the past few decades in
unraveling the cellular and molecular mechanisms that underlie the development of cancer. It
is reasonable to expect that our growing understanding of the principles that govern the
behavior of cancer cells will eventually lead to better approaches for cancer diagnosis,
treatment and prevention.
In spite of all the advancements in the treatment of cancer with better results and
higher life expectancy there are some unavoidable stages while going through the treatment
schedule. They are anorexia, weight loss and nausea which forms the inevitable part of
treatment regime. Cancer patients frequently develop loss of appetite and weight loss. Weight
loss is a common complication of cancer and cancer treatments that can result in a poor
prognosis for patients. Anorexia is a loss of appetite or aversion to food, which can lead to
drastic weight loss. Anorexia can compromise your ability to get adequate nutrition through
food sources. When you do not take in adequate calories and nutrients, your body is forced to
“burn” fat and muscle stores, which is why you lose weight.
While not all cancer patients will develop anorexia and subsequent weight loss,
anorexia and weight loss are very common. Anorexia may result from the cancer,
chemotherapy, radiation or a variety of other causes, including physical and psychological
causes.Both chemotherapy and radiation therapy cause a variety of side effects that can lead
to anorexia and weight loss, such as nausea and vomiting, fatigue, changes in how things taste
and a dry mouth. In addition, cells in the body release tumor necrosis factor (TNF) and
interleukin-1 in an attempt to fight the cancer, both of which cause anorexia. Destruction of
cancer cells by radiation therapy increases levels of TNF and interleukin-1, resulting in
anorexia and weight loss.
Anorexia and the resulting weight loss compromises your health, often weakening
your immune system and causing great discomfort and dehydration. As a result, cancer
treatment may need to be reduced or delayed, which results in the delivery of treatment that
is not optimal.The best way to manage anorexia and weight loss is to prevent them from
occurring in the first place. However, sometimes these symptoms are inevitable results of
cancer and cancer treatment. Some approaches that may help prevent anorexia and weight
loss may include:Control of nausea and vomiting, Maintain adequate nutrition and Stimulate
appetite.
Both chemotherapy and radiation therapy can cause nausea and vomiting, which lead
to anorexia and weight loss. The key to controlling nausea and vomiting is to prevent it before
it occurs. Many new anti-vomiting drugs, called antiemetics, are very effective for preventing
or decreasing nausea and vomiting. Since anorexia can compromise your ability to get
adequate nutrition through food sources, you may benefit from treatment with nutritional

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support. All cancer patients should meet with a nutritionist or registered dietician prior to
and throughout their treatment to help maintain their health through appropriate alterations
to their diet.Your nutritionist may recommend that you focus on eating higher calorie foods,
such as protein-rich foods. For example, you may try including more of the following in your
diet:protein drinks (powdered protein supplement mixed with fruit, milk and/or yogurt),
milk, dairy products, eggs, meat, sauces or gravies and oil.
In some situations, you may require caloric supplementation beyond what you can get
through altering your diet. Nutritional support is beneficial to patients both prior to and
during treatment. Nutritional support may be administered into the veins through parenteral
nutrition or directly into the intestines with enteral nutrition. Both of these types of
nutritional support appear to be most beneficial to patients undergoing stem cell
transplantation.
Total parenteral nutrition: Total parenteral nutrition refers to the intravenous (into your
vein) delivery of a nutritionally adequate solution. Total parenteral nutrition is used for
patients who cannot eat and may be beneficial in the perioperative setting for cancer patients
with severe malnutrition; however, long-term of total parenteral nutrition for patients
undergoing chemotherapy is strongly discouraged, as it does not appear to offer any benefit.
Patients undergoing stem cell transplantation appear to receive the greatest benefit from total
parenteral nutrition.
Enteral nutrition: Enteral nutrition refers to the delivery of nutrients directly into the
gastrointestinal tract and is used when a patient cannot ingest, chew, or swallow food, but can
digest and absorb nutrients. Enteral nutrition appears to be beneficial for patients undergoing
stem cell transplantation.
When side effects of cancer or cancer treatment affect normal eating, changes can be
made to help the patient get the nutrients they need. Eating foods that are high
in calories, protein, vitamins, and minerals is important. Meals should be planned to meet the
patient's nutrition needs and tastes in food.
The cancer anorexia syndrome is prevalent in patients with cancer, often precedes a
decline in functional status and is an indicator of poor prognosis. Weight loss results in
psychological distress for both patients and their caregivers who feel the need to intervene in
order to “fight” the illness. Since the anorexia syndrome in cancer involves multiple
pathophysiologic derangements, careful systematic patient assessment is needed. The
foundation of multimodality treatment and also the least harmful of interventionsconsist of
“best supportive care,” which encompasses careful attention to the assessment and treatment
of nutritional impact symptoms, nutritional counseling and psychosocial support, and the
potential addition of an exercise regimen for motivated cancer patients.
References
1. Dewys WD, Begg C, Lavin PT, Band PR, et al. Prognostic effect of weight loss prior to
chemotherapy in cancer patients. Eastern Cooperative Oncology Group. Am J Med.
1980 Oct; 69(4): 491-7.
2. RonyDev, Angelique Wong, David Hui, Eduardo Bruera, The Evolving Approach to
Management of Cancer Cachexia., Jan 15, 2017., Oncology Journal. 31(1):23–32.
3. Hutton JL, Martin L, Field CJ, et al. Dietary patterns in patients with advanced cancer:
implications for anorexia-cachexia therapy. Am J ClinNutr. 2006;84:1163-70.
4. Bosaeus I, Daneryd P, Svanberg E, Lundholm K. Dietary intake and resting energy
expenditure in relation to weight loss in unselected cancer patients. Int J Cancer.
2001;93:380-3.
5. Wilson MM, Purushothaman R, Morley JE. Effect of liquid dietary supplements on
energy intake in the elderly.Am J ClinNutr. 2002; 75:944-7.

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HOPE FOR THE HOPELESS: PALLIATIVE CARE AWARENESS AMONG NURSES
– A SOCIAL CONCERN

Author I: SIJO JOSE, Research Scholar Social Work, Bharathiar University. Email:
sijojosephd2015@gmail.com

Author II: Dr. Mary Veenus C. J, Dean & Administrator, Rajagiri College of Social Sciences,
Kalamassery, Ernakulam. Email: maryvenusrcss@gmail.com

Introduction

Hope has been said to be associated with a good sense of well-being and psychological state,
decreasing distress and stress, as well as increasing coping ability, and having a positive effect
on physical health. Hope has been described as being closely related to spiritual well-being in
terms of providing a sense of meaning and purpose to life. Hope has been described as
something that allows people to think about death and life after death without “entering into
utter despair” (Cutcliffe and Herth 2002), and as something “to be present in all stages of life,
including dying” (Cutcliffe 1995). It appears therefore that hope may be something of great
relevance to those who are terminally ill. With respect to palliative care in particular, hope has
become an increasingly important aspect of care and research (Herth and Cutcliffe 2002).

Although much of research available for palliative care is with respect to cancer patients,
some authors have studied hope in relation to other illnesses such as HIV or motor neuron
disease. Hall (1990) stated that “it is just as important to have hope in the hour before one’s
death as it is to have hope in other stages of one’s life”. ”General acceptance that hope is
multidimensional in character and dynamic in nature and that it provides an energising force
which allows individuals to cope with their current life situation and also provides the
opportunity for personal growth” (p.119).

Herth in 1990 studied hope more specifically in the terminally ill and found that for this group
hope was described as: “An inner power directed toward a new awareness and enrichment of
‘being’ rather than ‘rational expectations’” (Herth 1990; p.1257). More recently, Flemming
(1997), in a phenomenological study of four participants, explained the meaning of hope to
palliative care cancer patients. He found that areas influential in maintaining hope included
(a) control of disease progression underpinned by a hope for cure; (b) positive interest in the
individual by doctors and nurses by “being there”; and (c) third and most important was the
presence of family members, and the anticipated future with them. Loosing control over any
of the above factors was further identified as a cause for loss of hope. For patients within
palliative care it has also been said that hope is associated with more than just hope for cure,
and that patients develop different “goal-directed hopes” such as “hope for cure, hope for
relief from pain, hope to accomplish a specific task before dying, hope for a peaceful death”
(Nekolaichuk and Bruera 1998). Benzein and Saveman (1998) studied nurses’ perspectives of
hope in patients with cancer, and found that nurses had problems defining hope in a simple
way, but expressed it as a “realistic and future-oriented phenomenon”. Hope was found to be
related to inner strength and energy, significant events, support from relatives and staff,
and/or familiar environment, confidence in medical treatment, and nursing actions and
treatments. Their results highlighted the importance of a good relationship with staff. It’s an

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important matter that hopeless persons in the society be supported and motivated with hope,
for which the healthcare team especially nurses be educated. This paper is intended to
provide Hope for the Palliative care patients in the society by giving awareness to nurses.

Palliative care

“It is an approach that improves the quality of life of patients and their families facing the
problems associated with life threatening illnesses, through the prevention and relief of
suffering by means of early identification, impeccable assessment and treatment of pain and
other problems, physical, psychosocial, and spiritual” (WHO, 2002). The goal of palliative care
is to improve the quality of life of both patients and families by responding to pain and other
distressing physical symptoms, as well as to provide nursing care and psycho-social and
spiritual support.

According to Cassell, “Hope is one of the necessary traits of a successful life. It ties into what
we expect out of life as well as what the meaning of life is for us.” Nuland says that “hope is the
anticipation of a good that is yet to come.” According to Sullivan, hopelessness is not an
absence of hope, but rather an attachment to a form of hope that is lost. The absence of hope is
not a state of “no hope,” but rather one of fear and despair, the root of which is often related to
losing a sense of life’s meaning and purpose. A number of sources of distress can lead to
hopelessness and increased suffering. The concept of total suffering is described by Woodruff
as encompassing the entire illness experience, including physical pain, other physical
symptoms, psychological distress, social distress, and spiritual distress.

Multidisciplinary Team

The multidisciplinary team involved in the healthcare development of patients is Physicians,

Nurses, Psychologists, Social workers, Occupational Therapists, Music Therapists and Pastoral
care workers. The team of healthcare members has to involve effectively in the betterment of
the patients. The collaborative practice, clear communication clear definition of tasks and
responsibilities, clear goals, objectives and strategies, recognition of and respect for the
competence and contribution of each team member, competent leadership, clear procedures
for evaluating the effectiveness of the team, support for team members as required,
recognition of the contribution of team members experience are all the key attributes of
effective and efficient multidisciplinary team.

Nurses

The team member’s roles do overlap between disciplines and generally the team will share
the information and work interdependently. While the patient and family may only see one or
two members of the team, those members will be supported the interdisciplinary team in
which they practice (Care search- Palliative care knowledge network). The American Nurses
Association (ANA, 2015) defines nursing as “the protection, promotion, and optimization of
health and abilities, prevention of illness and injury, facilitation of healing, alleviation of
suffering through the diagnosis and treatment of human response” (para.1). Nursing practice
is based on shared sciences (e.g., biology, psychology), and many nursing actions
(e.g.,assessment of respirations, dressing changes) may be performed by more than one
healthcare professional. However, nursing practice is unique and definable. Palliative care is
about caring for physical, psychological, social and spiritual needs of the patients suffering
from incurable and life limiting illnesses. These diseases can be cancer, AIDS, chronic low back

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pain, peripheral vascular diseases, psychiatric disorders, geriatric problems, neuromuscular
(Khosla Divya, 2012) diseases and end stage diseases of heart, liver and kidney.

The art of nursing care as well as science has to be acknowledged in the healthcare. Each
nurse has to cultivate and maintain the art of nursing in palliative care. The nurse has to bring
awareness to holistic care in areas other than physical care which is particularly relevant in
palliative care. The art of nursing includes integrating head, heart and hands with proper
awareness. Each person is a unique individual. The nurse is required to treat every patient
without prejudice. It is important for nurses to challenge self and take courage in doing so.
Nurses must develop inner strength to deal with fear aspects so as to meet the true needs of
the patient. It might be helpful to facilitate this by creating a climate for growth and change.
Nursing care plans includes creating and implementing a holistic care plan for the patient and
family.

According to Kerala Nursing Council (KNC) 2017 the no. of Registered nurses in Kerala are
4,00,000c.a. Nurses are closer to palliative care patients, family & multidisciplinary team in
healthcare administering. They are more familial figures of the healthcare for patients &
society. The proper level of knowledge towards the present healthcare scenario by the nurses
will create awareness in the society. This would even help to avoid stigma of the society
regarding palliative patients like cancer, HIV/AIDS, chronic fatal diseases, etc. Nurses close
approach in the palliative care will ultimately improve patient’s quality of life. Since palliative
care is a Human Right for each one in need it’s the duty too of a healthcare worker especially
the nurse to fulfil the task.

Palliative care Present Scenario

The World Health Organization [WHO] (1990) and the Barcelona Declarations (1996) both
called for palliative care to be included in every country’s health services. WHO has
recognized palliative care as an integral and essential part of comprehensive care for cancer,
HIV, and other diseases. Fifty-two million people die each year; of which about five million
people die of cancer each year, to which can be added the numbers of patients dying with
AIDS and other chronic progressive diseases. That many of them die with needless suffering
has been well documented in many studies and published in scientific papers and reports.

The Indian Association of Palliative Care [IAPC] was formed in 1994 in consultation with
World Health Organisation and Government of India. Its activities are aimed at the care of
people with life limiting illness such as Cancer, AIDS and end-stage chronic medical diseases
including access to pain relief, palliative care capacity building and advocacy. The coverage of
services in terms of availability, accessibility and affordability of palliative care are grossly
inadequate. It is estimated that: only 1% of patients that need palliative care receive it; the
majority of all palliative care services in the country are available in one state; Kerala. There
are few states in the country without a single centre for Palliative care service provision
(National Palliative care strategy, 2012).

In India, currently there are approximately 908 palliative care services delivering palliative
care through either through home care, outpatient basis and in patient service. More than 841
of these centres are in Kerala. Therefore, for the vast majority of Indians across the country,
there is extremely limited access to quality palliative care services. The State of Kerala has a
Palliative care Policy on 2009. Two centres of excellence in the country have been recognised
as WHO Collaborating Centres. Thiruvananthapuram [Kerala] has WHO Collaborating Centre

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for Training and Policy on Access to Pain Relief and Calicut [Kerala] has the WHO
Collaborating Centre for Community Participation in Palliative Care and Long Term Care. The
facilities and faculty of these centres may be leveraged for guidance and support in the
implementation and monitoring of the tenets of the national program.

People with life-limiting diseases including cancer, other non-communicable diseases and
communicable diseases like HIV / AIDS have pain, other symptoms and psychosocial distress
which can dramatically decrease quality of life, place a burden on the family’s economy and on
health care system. For example, cancer has become one of the leading causes of death in
India. There are approximately 28 lakh cancer cases at any time and more than 10 lakh
Indians are diagnosed with cancer each year. There are approximately 5 lakh cancer deaths
per year in the country. These chronic disease states require management of their distresses
based on chronic care principles in continuum with acute episodic care. Approximately 80%
of these patients with cancer are diagnosed in advanced stage and more than 1 million cancer
patients are estimated to be suffering from moderate to severe pain every year. There are
approximately 2.7 million people are living with HIV in India and about 1.89 million suffer
from pain. The large number of bed-bound people with non-communicable diseases in the
community has poor access to health care and when available, the care may not be
appropriate.

Educational Awareness to Nurses

In the healthcare team, the nurses being attached more to the patients, family and society it
would be more feasible if they are more educated regarding the palliative care and its
approach towards patients. The need of palliative care education as understood from the
above reports is a highly needed healthcare requirement and suggested for the nurses and
healthcare team. If the nurses are aware through proper education and training, the society
including the family and public will make available awareness. The quality of life improves
for the patients as well as a positive environment is created in the society. The family
members of palliative care patients too get awareness and joint in palliative care. The
awareness of nurses and involvement within the multidisciplinary team will fasten treatment
procedures. This will help to avoid the stigma and create a positive attitude in the society.

Nurses Fostering Hope in Patient Encounters

Hope is not something that can be forced. Its development might require great patience.
Perhaps one of the most important things we give to our patients is our time. Active listening
requires time. By listening to and trying to understand our patients’ stories, we validate them,
providing a safe place to allow the process of grieving to begin or develop. Finding out who a
patient is (his or her past and present) and discovering what is important to the patient is key
to what has been described as dignity-conserving care. As we listen to our patients, it is
helpful to identify our own issues and feelings and set them aside so they do not get in the
way of the development of our patients’ hope.

Nurses while having encounter with patients in fostering hope should increase self awareness
of the patient. They must learn to be attuned to the issues the patient wants to address and
discuss them. The nurses being with patients should take time to help them to acknowledge
fears and listen with an openness to learn from patients. They should acknowledge the person
behind the symptoms and communicate honestly in ways that enhance trust. Proper help

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shall be given to use available resources and also encourage celebrating small successes.
These shall be supported with proper follow-ups.

Hope for the Family and Society

Within palliative care, hope should also be considered for those who are close to the patients
either personally or professionally. Caring for someone close can be very stressful and has
been associated with causing psychological and social distress in carers, and therefore with
caregiver burden (Kissane et al. 1997; Pitceathly and Maguire 2003; Siegel et al. 1991).

In terms of psychological effects on the carer, Pitceathly and Maguire (2003) found, in their
review of the psychological impacts of cancer on patients’ partners and other key relatives,
that most people can cope with the role of caregiver, but that there are an important few that
become highly distressed or develop an affective disorder. Farran et al. (1991) suggested that
hope was one of the important factors in supporting the ability of carers to cope with the care-
giving role under difficult circumstances.

The importance of hope to families and caregivers alike has been supported in other research
(Herth 1993; Hickey 1990), and it is believed that the presence of hope in caregivers can
directly impact the sense of hope for those who are ill, suggesting that maintaining hope in
family members and caregivers can additionally maintain hope for those who are ill.

Conclusion

The present paper highlights on the need for the importance of awareness creation in
palliative care knowledge to the nurses of the multidisciplinary team and its social concern.
Each individual human has its own human right and the palliative care giving right should not
be discriminated due to the lack of awareness and stigma in the society. The social condition
being altering in the current period needs a drastic modification in promoting the palliative
care needs of the patients in the society.

References

Ann M. Berger, J. L. (2013). Principles and Practice of Palliative Care and Supportive Oncology
(4th ed.). Philadelphia, USA: Lipincott Williams & Wilkins, a Wolters Kluwer Business.

Berg, B. L. (2001). Qualitative Research Methods for Social Sciences (4th ed.). London: Allyn &
Bacon.

Care, I. A. (2012). Handbook for certificate course in essentials of palliative care.

David J Ketchen Jr., D. D. (Ed.). (2004). Research Methodology in Strategy and Management
(Vol. One). Oxford, UK: Elsevier.

David W. Kissane, B. D. (Ed.). (2017). Oxford Textbook of Communication in Oncology and

Palliative Care (2 ed.). New York, USA: Oxford University Press.

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Derek Doyle, G. W. (Ed.). (1998). Oxford Textbook of Palliative Medicine (2 ed.). New York, USA:
Oxford University Press.

Dhooper, S. S. (1997). Social Work in Healthcare in the 21st Century. Delhi: Sage Publications.

Divya Khosla, F. D. (2012). Palliative Care in India: Current Progress and Future Needs. Indian
Journal of Palliative Care , 149-154.

Emanuel, E. J. (2012). Palliative and End of Life Care. In D. L. Longo (Ed.), Harrison's Principles
of Internal Medicine (18 ed., Vol. Vol:1 , pp. 67-84). USA: Mc Graw Hill.

Faull, C. &. (2002). Palliative Care. New York: Oxford University Press.

Gamlin, e. S. (2001). Palliative Nursing – Bringing Comfort & Hope. London: Bailliere Tindall.

Health, F. b. (n.d.). PCC4U. Retrieved 12 5, 2017, from http://www.pcc4u.org:

http://www.pcc4u.org/learning-modules/focus-topics/topic-1-multidisciplinary-care/2-
planning-multidisciplinary-care/activity-5-the-multidisciplinary-team/

Johann Mouton, H. C. (Ed.). (1996). Basic Concepts in the Methodology of the Social Sciences
(5th Impression Revised edition ed.). South Africa: HSRC.

John R Cutcliffe, Herth Kaye. (2002). The Concept of Hope in Nursing: Its Origins, Background
and Nature.

Khosla Divya, P. F. (2012, September - December). Journal of Family and . Retrieved July 18,
2017, from https://www.ncbi.nlm.nih.gov:
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Kim K Kuebler, M. P. (2005). Palliative Practices- An Interdisciplianry Approach. Missouri:

Elsevier Mosby.

Nalini Vadivelu, A. D. (Ed.). (2013). Essentials of Palliative Care. New York, USA: Springer
Science & Business Media.

O'Neill, M. F. (Ed.). (1998). ABC of Palliaitive Care. London, UK: BMJ Books.

Perry, P. &. (2017). Fundamentals of Nursing. Elsevier.

Ramanayake R. P. J. C., D. G. (2016, April-June 10). Journal of Family Medicine and Primary care.
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WHO. (1999). Cancer Pain Relief and Palliative Care in Children. New Delhi, India: Prentice Hall
of India.

WHO. (2007). Palliative Care Module - Cancer Control; Knowledge into Action WHO Guide for
Effective Programmes . WHO.

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Diagnosis & Treatment. Switzerland: World Health Organization.

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 CONSTITUENTS OF NORMAL DIET & THEIR DAILY REQUIREMENTS

ALFIYA THOMAS

Assistant Professor on Contract, Department of Zoology, Little Flower College,

Guruvayoor
Nutrition is the process of taking in food and using it for growth, metabolism and
repair of body. It is obtained through food or diet. Food helps us to obtain sufficient
energy&heatfor various activities, growth, repair & maintenanceof bodily activities.Adding
bulk to dietkeep digestive system work well.Nutrients are constituents in food that must be
supplied to the body in suitable amounts through diet. A balanced diet is defined as one which
contains different types of foodin such quantities and proportions that are need for calories,
amino acids, carbohydrates, fats,vitaminsand other nutrients is adequately met for
maintaining health, vitality, and general wellbeing and also makes a small provision for extra
nutrients to withstand short durations of starvation.If diet the lacks one or more of the
nutrients, the condition known asMalnutrition. A balanced diet is maintained by 7components
of nutrition. They are: Carbohydrates, Proteins, Fats, Minerals, Vitamins, Dietary fibres and
Water.
Carbohydrates:Carbohydrates are made up of carbon, hydrogen and oxygen atoms. These
atoms form chemical bonds that follow the laws of nature.Cheapest source of energy in animal
foodinclude starches & sugars. Sugars are classified in toMonosaccharaides, disaccharides and
polysaccharides. Carbohydrates can be simple or complex.Simple carbohydrates includefruits,
sugars & processed grains such as white rice or flour.They digest quickly.Complex
carbohydrates include green & starchy vegetables and pulses.They digest only
slowly.Monosaccharaides are single sugars (most are hexoses). Glucose serves as the essential
energy source, and is commonly known as blood sugar or dextrose. Fructose is the sweetest
sugar and occurs naturally in honey and fruits, and is added to many foods in the form of high-
fructose corn syrup. Maltose consists of two glucose units. It is produced during the
germination of seeds and fermentation.Fructose is refined from sugarcane and sugar beets,
tastes sweet, and is readily available.Galactose rarely occurs naturally as a single sugar. It is
found in milk and milk products.Functions of carbohydrates are: they are theMain source of
energy, and they have somemetabolic role,source of reserve foo. E.g.glycogen- in animals and
starch in plants, they perform Protein spacing action andsynthesis of most of non-essential
amino acids occur from the intermediate products of carbohydrate. Most common disorders
associated with carbohydrate metabolism are diabetic ketoacidosis, hypoglycaemia etc. Sugar
poses no major health problem except dental caries. Excessive intakes may displace nutrients
and contribute to obesity. Consuming foods with added sugars should be limited. Naturally
occurring sugars from fruits, vegetables and milk are acceptable sources.Nutrient deficiencies
may develop from the intake of empty kilo calories. Just because a substance is natural does
not mean it is nutritious. (Example: honey)Dental caries may be caused by bacteria residing in
dental plaque and the length of time sugars have contact with the teeth.Excessive sugar intake
can contribute to the development of body fat.Sugar may be able to alter blood lipid levels and
contribute to heart disease in some.There is no scientific evidence that sugar causes
misbehavior in children and criminal behavior in adults. There is a theory that sugar increases
serotonin levels, which can lead to cravings and addictions.Reduce the risk of type 2 diabetes
by decreasing glucose absorption. Enhance the health of the GI (gastrointestinal) tract which
can then block the absorption of unwanted particles may protect against colon cancer by
removing potential cancer-causing agents from the body.
Proteins:Proteins are Complex organic nitrogenous compounds containing Carbon,
Hydrogen, Oxygen, Nitrogen, & Sulphur. They are formed of amino acids.Among 22 amino
acids known,10 are essential amino acids (from diet).The rest 12 are non-essential amino

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acids. Amino acids are the building blocks of body tissue and can also serve as a fuel source.
Proteins are polymer chains made of amino acids linked together by peptide bonds. During
starvation, these proteins will break down in to simpler molecules by hydrochloric acid and
protease action. Dietary source of protein include meats, fishes, eggs,grains, legumes and nuts.
Proteins can be simple or conjugated. Simple proteins include Albumins, Globulins, and
Histones etc. Conjugated proteins includePhospho-proteins, Chromo proteins, Glycoproteins
etc.Sources of protein— meat, fish, egg, soya beans. The nutritive value of a protein is based
on factors, namely amino acid composition and digestibility.First class proteins are those
proteins which contain a complete set of essential amino acids. They have high nutritive value.
Eg.,almost all animal proteins.Second class proteins are the proteins which are deficient in any
one of the amino acids. Eg: cereals, pulses. Protein deficiency leads to diseases like
Kwashiorkor, Fatty liver, Edema etc.
Fats:All fats are called as lipids. Its main constituents are Carbon, Hydrogen, and Oxygen. Fats
are available in ghee, butter, oils. Double calorific value than carbohydrates & they are
absorbed very slowly. Two types of Healthy fats are monounsaturated fats (Nuts and olives)
andpolyunsaturated fats (Fish & sea food).Dietary fibres are partially or fully fermented in
large intestine. Functions of fats include: It can act as a source of storage food in adipose
tissues. Lipids are responsible for cell permeability & cell organisation. It is the second source
of energy.Vitamins A, D, E,and K are fat soluble vitamins.Adrenal corticoids & sex hormones
are synthesized from fat derivatives, so they are highly important for diet. Fat deposition
below skin acts as insulator against heat. Supply essential fatty acids like Linoleic acid for our
bodily activities.Fats provide a support for many organs in the body such as heart, kidney and
intestine. Essential fatty acid deficiency is rare, occurring most often in infants. Its sign
includesscaly dermatitis, alopecia, thrombocytopenia etc.
Minerals: Mineral is a naturally occurring chemical compound, usually of crystalline form and
not produced by life process. Minerals are vital for human health. They include Calcium, Zinc,
Chromium, Iron, Iodine etc. Its deficiencies can result in brittle bones, poor blood oxygenation
etc. Minerals can be of two types, micro and macro elements.Macro elements include elements
that are required to be present in diet in more than 1mg. They constitute 60%-80% of
elements present in our body. They include C, H, O, N, K, Na, S,Cl etc.Micro elements include
elements that are needed by our body in very small amounts. E.g.Chromium. Sources of
minerals include Meat, Fish, Cereal, eggs, milk, cheese, etc.Overdosing of minerals can result in
life threatening events. For eg:Potassium overdose can cause kidney failure. Functions of
minerals includedMetabolism of fats & carbohydrates,Calcium& Phosphorus are needed for
the strong built of teeth& bones.Magnesium is needed for the stimulation of nerve muscles
&maintenance of ionic balance, Iron is needed for manufacture of haemoglobin & chromatin,
Iodine is an important component of thyroxin,Sulphur is anti-biotic& forms sulfo - proteins in
the body. Most common disorders associated with mineral consumptions areOsteopenia and
Osteoporosis, Anaemia, Mg deficiency problems like fatigue, weakness, and loss of
appetite,Potassium deficiency problems like muscle cramping and weakness,Zinc deficiency
problems like decreased functions of immune system, slow growth etc.
Vitamins: Vitamins are organic molecules whish are essential micronutrients for the proper
functioning of human metabolism. These organic molecules cannot be synthesized by the
body, therefore it must be obtained through the diet. Vitamins are classified by their biological
or chemical activity, not their structure. The 13 vitamins required by human metabolism are:
Vitamin A, Vitamin B complex (B1,B2,B3,B5,B6,B7,B9,B12), Vitamin C, Vitamin D, Vitamin E and
Vitamin K. vitamins have diverse biochemical functions as regulators cell and tissue growth
and differentiation. The B complex vitamins function as an enzyme cofactors or precursors for
them. Vitamin D has a hormone like function as a regulator of mineral metabolism and is anti-
proliferative. Vitamin E and vitamin C function as an antioxidant. Both deficient and excess
intake of a vitamin can potentially cause clinically significant illness. The major sources of

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vitamins include leaves, liver, carrot, citrus fruits, egg yolk, tomatoes etc. Functions of
vitamins are as follows Vitamin A is a component of rhodopsin which providesvision and it is
essential for protein synthesis, mucopolysaccharides and DNA metabolism.Vitamin D is
essential for Calcium & phosphate metabolism. Vitamin K is an anti-haemorrhagic
vitamin.Vitamin B complex is needed for metabolism of carbohydrates, transketolase
reactions of HMP(hexose monophosphate pathway) Pathway and Important in maturation of
RBC. Vitamin C is needed for the formation of fibroblasts & osteoblasts.
Dietary fibres:It is a type of carbohydrate found in vegetable and fruits. It absorbs water &
increases bulk of intestinal contents.it is also known as roughage or bulk, included the parts of
plant foods your body cannot digest or absorb. Function of dietary fibres are as follows it
helps in intestinal movements & prevents constipation, it Lowers Cholesterol andweight
reduction. It bulks stool & keeps you feeling full for hours after a meal, it normalizes bowel
movements and helps maintaining bowel health, it controls blood sugar levels and aids in
achieving healthy weight. Lack of dietary fibre causes GI (gastrointestinal) tract disorders,
heart diseases, diabetes etc.
Dietary water: Water is essential for the human body to function properly. Being dehydrated
can degrade physical and mental functions. Dehydration cause daytime fatigue, inability to
concentrate on mental tasks, nausea and reduction in work and exercise performance. 15%
dehydration is likely to result in death. Water is essential to the functioning of every cell and
organ system in the body. It plays a key role in all of the chemical processes that occur in the
body. Water is an excellent solvent, and this allows it to act as a carrier fluid within the body
for a wide range of substances. Water plays a key role in the thermoregulation of the body
through perspiration. Its high specific heat capacity means that a relatively large amount of
heat energy is needed to evaporate the thin layer of perspiration that forms on the skin in hot
conditions or during exercise. This loss of body heat energy helps to keep the core body
temperature at a steady 37oC. Without water, the functioning of all organ systems within the
body will fluctuate a lot. Depending on conditions, the body usually cannot survive longer
than 1 week without water.
Take in required amount of food to prevent malnutrition & be careful to not to over eat in
order to prevent obesity. Follow balanced diet...lead a healthy life…..
References
1. Wenk, Hans-Rudolf; Bulakh, Andrei (2004). Minerals: Their constitution and origin.
Cambridge University Press. P. 10
2. Armstrong LE, Costill DL, Fink W.J. (1985). Influence of diuretic – induced dehydration
on competitive running performance. Med Sci Sports Exerc. P. 456- 461
3. Hooper et al., (2015). Reduction in saturated fat intake for cardiovascular diseases.
Cochrane Database. P.11737
4. https://www.mri.bund.de
5. https://www.nature.com
6. http://www.ncbi.nlm.nih.gov

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 THE FAULT IN OUR STARS: NOVEL / FILM AS A STORY OF SURVIVAL.

SIVYA VASUDEVAN K K

Assistant Professor, Dept. of English, MES Keveeyam College, Valanchery.

Cinema was considered as an inferior medium and reading a classic was considered
superior. However matters have changed over time; mainly because cinema as an art
includes characters, plots, narrative techniques, etc. just like texts. Cinema began to
introduce those works to the common people using language and situations familiar to
them. They could blend the story to the scenario that was familiar to the general public.
So, more and more people became familiar with the literary works of the period. Thus
gradually, films attained the status of a popular medium of art.
Literary scholars were challenged for many years together with the problem of
understanding a text better with its various nuances. Breaking or questioning a text;
thereby ‘adapting’ it helps them to assimilate a text better. This is where adaptation of
novels comes into play. Changing a text completely or partly and critically examining it
helps to easily analyse it. It gives an opportunity to interpret and evaluate various
forms of literary works and involve in a critical reading of the text and thus, provides a
framework for analysing any work. Thus, a text can be understood more effectively.
Film, as one of the forms of aesthetic communication, bears a lot of similar
characteristics as to the history of narrative theory; since narratology deals with the
study of different narrative structures, aesthetic conventions, types of stories and their
symbolic implications. John Green’s novel, The Fault in Our Stars, tells the story of a girl
named Hazel Grace Lancaster, who is a cancer survivor, and the events of her life. She
had thyroid cancer and is sent to a support group, where she meets and falls in love with
Augustus, also called Gus, who was a basket ball player, but now an amputee. Both these
characters are strong willed and highly brave. Hazel is too jaded because of her disease
and this jadedness in her character is revealed in the selection of her friends. At the
support group’s camp, she develops friendship with Isaac, another member of the group,
through the moans and groans that they both make after hearing the conversations of
their peers, who are free from the grip of cancer. It is this attitude of hers that befriends
her with Augustus, and later on they both fall in love with each other. Apart from physical
appearance, it is the theory that both of them have, that attracts them to each other in
the first place. Augustus feared oblivion; he was afraid to die and feared that people
would forget him. Hazel, on the other hand, believed strongly that, man once born, should
certainly die whether he likes it or not. Hazel, as well as the others, finds the emotional
and intellectual dishonesty of the support group unbearable. She openly defies the idea of
hailing survivors of the disease as super-heroes; she preferred honesty in the first place.
She advocates that honesty is precisely the reason she loves An Imperial Affliction, the
book she considers her personal bible. She was sure about her impeding death;
imagining death and trying to find meaning in the world aren't just intellectual
exercises for Hazel and the others, but very real concerns in their everyday lives.
Hazel spends her time reading and her favorite book, as mentioned above, is An
Imperial Affliction by Peter Van Houten. This is mainly because; this novel is about a
cancer-stricken girl, named Anna, who in many ways is similar to Hazel. It is this book
that she recommends to Gus when they reveal their hobbies; in turn, he gives her
Counter Insurgence. The two grow closer through these books. Augustus complains
Hazel about the book’s abrupt ending; Hazel explains to him that the novel’s
mysterious author, Van Houten, retired to Amsterdam, after the publication of the
novel. Hazel, too, is disturbed thoroughly by the abrupt ending of the novel and had

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 umpteen questions in stock to ask the author if ever she had a chance to meet him in
person. This secret wish of her’s is made real by Augustus. He procures flight tickets to
Amsterdam and makes arrangements with Houten’s assistant Lidewij, to meet him in
person. There, Hazel is disillusioned by the physical appearance as well as the behavior
of Houten towards them. To her disappointment, Houten is a drunkard and belittles
Hazel for asking serious questions regarding a piece of fiction and also upon her
medical condition. It’s during this journey that both Hazel and Gus grow close to each
other and make love for the first time.
Cigarette forms a major symbol throughout the novel. Gus holding the unlit cigarette in
his mouth explains his attitude towards the disease as a whole. He opinions that, by
keeping the unlit cigarette in his mouth, he is actually controlling the thing that is able
to destroy him. Here, the cigarette stands for cancer. Generally speaking, all these
symbols and metaphors allow the characters to deal with emotionally fraught topics,
like death and the emotional devastation their deaths will ultimately have on the
people around them. In certain instances, the metaphors give the characters a little
emotional distance from these topics. In Augustus's case, he places the cigarette in his
mouth to regain a sense of control rather than having to stop and think through his
cancer with all the emotional baggage that involves.
Based on this best-selling novel by John Green, an American romantic tragedy film was
directed by Josh Boone, which was released in 2014. The film stars Shailene Woodley
(as Hazel Grace Lancaster), Ansel Elgort (as Augustus/Gus Waters) and Nat Wolff
(Isaac, Augustus’s best friend) in the lead roles. The film bagged critical acclaim and
drew upon mixed responses from various viewers. As we all know, an adaptation will
definitely follow certain omissions, additions, exclusion or inclusion of certain scenes,
etc. depending upon the time constraints. A novel can indulge in the detailed
description of the physical appearance or characteristics of certain characters. But a
film has certain limitations regarding this factor of detailed description. This difference
is mainly because, a novel is meant to be read; the readers form an idea about various
characters through the description that the narrator provides; whereas, a film is meant
to be viewed. The character and the various characteristics are offered in the first place
itself for the viewers to view and they form an idea by themselves. The difference
between a novel and its filmic adaptation arises due to many reasons; time constraints
being one among them. Some of the basic differences between the novel The Fault in
Our Stars and its adaptation, a film of the same name released in 2014, are as follows:

NOVEL FILM
Hazel notices Gus for the first time when she Hazel notices Gus for the first time when she
occupies a seat at the support group. chooses to take the stairs and collided into
Gus on the way.
V for Vendetta is the name of the film that The name of the film is not mentioned.
Gus wants Hazel to watch.
Gus introduces Hazel to a band called Hectic There is no mention of such a band except
Glow of which both Gus and Isaac are fans for a poster on Hazel’s wall.
of.
Hazel and her parents pick up Gus and drive Gus arrives in a limo as he wanted to travel
to the airport. in ‘style’.
Hazel refers to herself as a grenade to her She speaks about it only to Gus.
parents alone and never to Gus.
Hazel’s mom celebrates a variety of holidays There is no mention of her mother
like Bastille Day and Hazel’s half birthday. celebrating any additional holidays.

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The author has written a beautiful tale about cancer and its survival and the director has
created a film adaptation that portrays the theme with equal gravity. Our eyes fill with tears
when we see Hazel, Gus and Isaac struggle with pain and the disease. Though Hazel was
admitted to the ICU once or twice in the novel, and considered to meet her death, ultimately
she survives; whereas Augustus, who remained a staunch support to Hazel through the thick
and thin of her days, dies in the end. Love abounds in this wonderful film. The audience
literally cries when Hazel utters to Gus while she was considerably struggling:

“Some infinities are bigger than other infinities… there are days, many of them, when I
resent the size of my unbound set, but my love, I cannot tell you how thankful I am for
our little infinity.”

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 INVITROCYTOTOXIC STUDY OF SILVER NANO PARTICLES FROM THE LEAF
OF Spondias Dulcis

LOVELY JACOB A

Department of Chemistry ,L.F.College,Guruvayur

INTRODUCTION
In recent years, the convergence of nanometre size scale technologies and biological
technologies has produced the new field of Nano biotechnology. This relatively new field is
decisive on the creation, manipulation, and use of materials at the nanometre scale for
advanced biotechnology. Nanoparticles are of great interest due to their novel
physicochemical, magnetic, and optoelectronic properties that are governed by their size,
shape, and size distribution. It is principally the nanoparticles extremely small size and large
surface area to volume ratio that leads to the momentous differences in properties not seen in
the same material at larger scales in their bulk form. Because of these unique physicochemical
and optoelectronic properties, nanoparticles are of particular interest for a number of
applications ranging from as catalysts, chemical sensors, electronic components, medical
diagnostic imaging, pharmaceutical products, and medical treatment protocols [1]. For
example, metallic nanoparticles of noble metals such as gold, silver, platinum, and palladium
have been widely used in products ranging from cosmetic to medical and pharmaceutical [2].
Gold nanoparticles have been widely used in biomedical applications, separation sciences,
disease diagnostics, and pharmaceuticals. Silver nanoparticles have been found to have both
anti-bacterial and anti-inflammatory properties that can promote faster wound healing.
Because of these advantageous properties, silver nanoparticles have been incorporated into
commercially available wound dressings, pharmaceutical preparations, and medical implant
coatings. In addition, non-noble metallic nanoparticles such as iron, copper, zinc oxide, and
selenium have also been used in medical treatments, cosmetic formulations, and anti-bacterial
applications [3]. Natural products have historically and continually been investigated for
promising new leads in pharmaceutical development [4]. Many of the plant substances are
used in traditional medicine because they are readily available in rural areas and cheaper
compared to modern therapeutic agents. The World Health Organization (WHO) has reported
that about 80% of the world population depends on traditional medicine for their primary
health care Out of total 250,000 plant species existing on earth approximately one thousand
have anticancer activities. Cancer is one of the most dangerous diseases in humans and
presently there is a considerable amount of new anticancer agents from natural products [5].
The potential of using natural products as anticancer drugs was recognized in 1950’s by U.S
National Cancer Institute (NCI). Since 1950 major contributions have been made for the
discovery of naturally occurring anticancer drugs [6].In a recent report, about 60% of the
currently used anticancer drugs have been isolated from natural products, mostly of plant
origin. The use of medicinal plants is believed to contain a wide spectrum of polyphenolics,
flavonoids, alkaloids, terpenoids and saponin compounds, which might have therapeutic
properties and hinder cancer formation. [7] The effect of plant extracts as anti cancer was
widely studied due to their low toxicity and side effects. Due to the aforementioned concerns,
such studies investigating medicinal herbs have been steadily held with interests.

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Spondias Dulcis

Spondias dulcis (syn. Spondias cytherea), known commonly as ambarella, or jew plum is
an equatorial or tropical tree, with edible fruit containing a fibrous pit. This fast-growing tree
can reach up to 20 m (66 ft) in its native range of Melanesia and Polynesia; however, it usually
averages 10–12 m (30–40 ft) in other areas. Spondias dulcis has deciduous, pinnate leaves,
20–60 cm (8–24 in) in length, composed of 9 to 25 glossy, elliptic or obovate-oblong leaflets
9–10 cm (3.5–3.9 in) long, which are finely toothed toward the apex. The tree produces small,
inconspicuous white flowers in terminal panicles. Its oval fruits, 6–9 cm (2.4–3.5 in) long, are
borne in bunches of 12 or more on a long stalk. Over several weeks, the fruit fall to the ground
while still green and hard, then turn golden-yellow as they ripen[8].
MATERIALS AND METHODS
Preparation of Aqueous Plant Extracts
About 10 gram of plant material was mixed with 100 ml of double distilled
water and boiled in water bath for 20 mins for the formation of plant extract. The
obtained plant extract was filtered through whatman no 1 filter paper then centrifuged at
6000 rpm for 20 mins. The centrifuged samples were transferred into autoclaved vials
and stored at 4°C for further analysis.

Preliminary Phytochemical Analysis

Sl. No. PHYTOCHEMICALS REAGENTS

1 Alkaloids Mayer’s Reagent

2 Phenols Aqueous FeCl

3
3 Flavonoids dil.HCl + Mg

4 Tannins FeCl
3
5 Glycosides aq. NaOH

6 Steroids Chloroform + H SO
2 4
7 Terpenoids Chloroform + H SO
2 4
8 Saponins Shake in an arrest tube

9 Quinine NaOH

10 Xanthoprotein Conc.HNO
3
11 Anthraquinone aq.NH
3

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 12 Coumarin Methanol + alc. NaOH

Synthesis of Silver Nanoparticles

To synthesis silver nanoparticles, 90 ml of 1mM AgNO3 solution was taken in a sterile

conical flask and 10 ml of aqueous plant extract was added to it. The solution was mixed well
and kept in a rotator shaker for overnight. As a result, a brown to black coloursolution was
formed, indicating the formation of silver nanoparticles. It showed that aqueous silver ions
could be reduced by aqueous extract of plants part to generate extremely stable silver
nanoparticles in water.
CHARACTERIZATION OF SILVER NANOPARTICLES
Morphology and the size distribution of silver nanoparticles were performed using
scanning electron microscopy (SEM) and transmission electron microscopy (TEM) from
CUSAT –STIC.
IN VITRO CYTOTOXICITY STUDY
For the invitrocytoxicity study of silver Nano particles and the water extract of
Spondiasdulcis leaf we sent the sample to Amala Institute of Research Center,Thrissur.
The test compounds were studied for short term in vitro cytotoxicity using Dalton's
iymphoma ascites cells (DtA).The tumour cells aspirated from the peritoneal cavity of
tumour bearing mice were washed thrice with PBs or normal saline, Ceil viability was
determined by trypan blue exclusion method. Viable cell suspension (1x10 6 cells in 0,1 ml)
was added to tubes containing various concentrations of the test compounds and the volume
was made up to 1ml using phosphate buffered saline . Control tube contained only cell
suspension.These assay mixture were incubated for 3 hour at 37 0c. Further cell suspension
was mixed with 0.1 ml of 1% trypan blue and kept for 2-3 minutes and loaded on a
haemocytometer. Dead cells take up the blue colour of trypan blue cells do not take up the
dye. The number of stained and unstained cells was counted separately.
% cytotoiicity = (No.of dead cells/(No.of live cell + No.of dead cell ))×100
RESULTS
Phtocal Chemical Analysis of Plant Extract

The qualitative analysis of plant extract was performed to determine the presence of
secondary metabolites.

SECONDARY METABOLITES WATER EXTRACT

ALKALOIDS -
PHENOLS +
FLAVANOIDS +
TANNINS +
CARDIAC GLYCOSIDES +
STEROIDS -
TERPENOIDS +
SAPONINS +
XANTHOPROTIENS +
CAUMARIN +
QUININE -
ANTHRAQUINONE -

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 SEM AND TEM ANALYSIS OF SYNTHESIZED SILVER NANOPARTICLES
The powdered sample was analysed for the determination of structure and morphology of
the synthesized nanoparticles using SEM at different magnification levels including 10μm and
50μm. SEM images revealed that the synthesized silver nanoparticles were in poly dispersive
nature and spherical in shape.
However, to obtain a clear size, shape and structural image of the nanoparticles the samples
were analysed using Transmission Electron Microscopy (TEM). Transmission electron
microscope image revealed that the sizes of the synthesized silver nanoparticles are in the
range of 20nm to 50nm and with a smooth surface morphology.
SEM image TEM image

INVITROCYTOTOXICITY

Drug Percent cell death (DLA)

concentration
(µg/ml) X Y
200 µg 98% 30%
100 µg 90% 15%
50 µg 85% 10%
20 µg 70% 2%
10 µg 62% 0%

From the comparative study of cytotoxic property of silver Nano particles and the water
extract of SpondiasDulcis (leaf),the silver nanoparticles has greater value than the water
extract is determined.

120%
percent cell death

100%
80%
60% x
40%
y
20%
0%
200µg 100µg 50µg 20µg 10µg
Drug concentration

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 X-Silver nanoparticles synthesised from SpondiasDulcis
Y-Water extract of SpondiasDulcis

CONCLUSION

In the present study, the biological approach of synthesis of silver nanoparticles using
Spondiasdulcis leaf extract appeared to be eco-friendly and cost effective alternative to
conventional chemical and physical methods and would be suitable for developing large-scale
production. The characteristics of the obtained silver nanoparticles were studied by using
SEM and TEM analysis. Plant extracts may have clinical and therapeutic proposition in the
most life threaten disease like cancer and further studies are required to investigate these
plant samples. This green method of synthesizing silver nanoparticles could also be extended
to fabricate other industrially important metal oxides. This simple, low cost and green method
for development of nanoparticles may be valuable in environmental, biotechnological and
biomedical applications.
BIBLIOGRAPHY

1. 1 Van den Wildenberg W: Roadmap report on nanoparticles. W&W Espanasl, Barcelona,

Spain; 2005.
2. Gratzel M: Photoelectrochemical cells. Nature 2001, 414: 338–344. 10.1038/35104607
3. Okuda M, Kobayashi Y, Suzuki K, Sonoda K, Kondoh T, Wagawa A, Kondo A, Yoshimura
H: Self-organized inorganic nanoparticle arrays on protein lattices. Nano
Lett 2005, 5: 991–993. 10.1021/nl050556q
4. Yaacob N, Hamzah N, Kamal NN et al. Anticancer activity of a sub-fraction of
dichloromethane extracts of Strobilanthescrispus on human breast and prostate cancer
cells in vitro. BMC Complement Altern Med 2010;10:42-55
5. Moglad EH, Abdalla OM, Koko WS, Saadabi AM. In vitro Anticancer Activity and
Cytotoxicity of Solanumnigrum on Cancer and Normal Cell Lines. Int J Cancer 2014;10:74-
80
6. Latif A, Amer HM, Homad ME, Alarifi SA, Almajhdi FN. Medicinal plants from Saudi Arabia
and Indonesia: In vitro cytotoxicity evaluation on Vero and Hep-2 cells. J Med Plants Res
2014;8:1065-1073
7. Bibi Y, Nisa S, Zia, M, Waheed A, Ahmed S, Chaudhary MF. In vitro cytotoxic activity of
Aesculusindica against breast adenocarcinoma cell line (MCF-7) and phytochemical
analysis. Pharm Sci 2012;25:183-187
8. Morton, J. Ambarella. Center for New Crops & Plant Products. Purdue University. 1987.

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 FROM MACHINE LEARNING TO CANCER PROGNOSIS AND DIAGNOSIS

SINDHU.K.S

Assistant Professor (F.D.P),Department of Computer Science

Little Flower College, Guruvayoor

1. Introduction
Over the past decades, a continuous evolution related to cancer researchhas been
performed. Scientists applied different methods, such as screening in early stage, in order to
find types of cancer beforethey cause symptoms. Moreover, they have developed new
strategiesfor the early prediction of cancer treatment outcome. With the adventof new
technologies in the field of medicine, large amounts of cancerdata have been collected and are
available to the medical researchcommunity. However, the accurate prediction of a disease
outcome isone of the most interesting and challenging tasks for physicians. As a result,ML
methods have become a popular tool for medical researchers.These techniques can discover
and identify patterns and relationshipsbetween them, from complex datasets, while they are
able to effectivelypredict future outcomes of a cancer type.Given the significance of
personalized medicine and the growingtrend on the application of ML techniques, here
present a reviewof studies that make use of these methods regarding the cancer
predictionand prognosis. In these studies prognostic and predictive featuresare considered
which may be independent of a certain treatment orare integrated in order to guide therapy
for cancer patients, respectively [2]. In addition, discuss the types of ML methods being used,
thetypes of data they integrate, the overall performance of each proposedscheme while we
also discuss their pros and cons.
An obvious trend in the proposed works includes the integration ofmixed data, such as clinical
and genomic. However, a common problem that we noticed in several works is the lack of
external validation ortesting regarding the predictive performance of their models. It is
clearthat the application of MLmethods could improve the accuracy of cancersusceptibility,
recurrence and survival prediction. Based on [3], theaccuracy of cancer prediction outcome
has significantly improved by15%–20% the last years, with the application of ML
techniques.However,before gene expression profiling can be used in clinical practice,
studieswith larger data samples and more adequate validation are needed.In the present
work only studies that employed ML techniques formodeling cancer diagnosis and prognosis
are presented.

2. ML techniques
ML, a branch of Artificial Intelligence, relates the problem of learningfrom data
samples to the general concept of inference [10–12]. Everylearning process consists of two
phases: (i) estimation of unknown dependenciesin a system from a given dataset and (ii) use
of estimateddependencies to predict new outputs of the system. ML has also beenproven an
interesting area in biomedical research with many applications,where an acceptable
generalization is obtained by searchingthrough an n-dimensional space for a given set of
biological samples,using different techniques and algorithms [13]. There are two
maincommon types of ML methods known as (i) supervised learning and(ii) unsupervised
learning. In supervised learning a labeled set of trainingdata is used to estimate ormap the
input data to the desired output.In contrast, under the unsupervised learningmethods no
labeled examplesare provided and there is no notion of the output during thelearning process.

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As a result, it is up to the learning scheme/model tofind patterns or discover the groups of the
input data. Two other common ML tasks are regressionand clustering.

Fig. 1.Classification task in supervised learning. Tumors are represented as X and classified as
benign or malignant. The circled examples depict those tumors that have beenmisclassified
Another type of ML methods that have been widely applied issemi-supervised learning,
which is a combination of supervised andunsupervised learning. It combines labeled and
unlabeled data inorder to construct an accurate learning model. Usually, this type oflearning
is used when there are more unlabeled datasets than labeled.When applying a ML method,
data samples constitute the basiccomponents. Somedata-related issues refer to the quality of
the data and the preprocessingsteps tomake themore suitable forML. In addition, inorder to
make the raw data more suitable for further analysis, preprocessingsteps should be applied
that focus on the modification of thedata. A number of different techniques and strategies
exist, relevant todata preprocessing that focus on modifying the data for better fittingin a
specificMLmethod. Among these techniques some of themost importantapproaches include (i)
dimensionality reduction (ii) feature selectionand (iii) feature extraction.
The main objective of ML techniques is to produce a model whichcan be used to
perform classification, prediction, estimation or anyother similar task. The most common task
in learning process is classification.As mentioned previously, this learning function classifies
thedata item into one of several predefined classes. When a classificationmodel is developed,
by means of ML techniques, training and generalizationerrors can be produced. A formal
methodfor analyzing the expected generalization error of a learning algorithmis the bias–
variance decomposition.
Once a classification model is obtained using one or more ML techniques, it is
important to estimate the classifier's performance. The performanceanalysis of each proposed
model is measured in terms ofsensitivity, specificity, accuracy and area under the curve
(AUC).On the contrary, AUC is ameasure of the model's performance which is based on the
ROC curvethat plots the tradeoffs between sensitivity and 1-specificity .Amongthe most
commonly used methods for evaluating the performance ofa classifier by splitting the initial
labeled data into subsets are:(i) Holdout Method, (ii) Random Sampling, (iii) Cross-Validation
and(iv) Bootstrap.
When the data are preprocessed and we have defined the kind oflearning task, a list of
ML methods including (i) ANNs, (ii) DTs,(iii) SVMs and (iv) BNs is available. Based on the
intension of this reviewpaper, wewill refer only to theseML techniques that have been
appliedwidely in the literature for the case study of cancer prediction and prognosis.We
identify the trends regarding the types ofML methods that areused, the types of data that are
integrated as well as the evaluationmethods employed for assessing the overall performance
of themethods used for cancer prediction or disease outcomes.
ANNs handle a variety of classification or pattern recognition problems. They are
trained to generate an output as a combination betweenthe input variables. Multiple hidden
layers that represent the neuralconnections mathematically are typically used for this
process. Eventhough ANNs serve as a gold standard method in several classification tasks [19]

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they suffer from certain drawbacks. Their generic layeredstructure proves to be time-
consuming while it can lead to very poorperformance. Additionally, this specific technique is
characterized as a “black-box” technology. Trying to find out how it performs the
classificationprocess or why an ANN did not work is almost impossible to detect.

Fig. 3.An illustration of the ANN structure. The arrows connect the output of one node to
the input of another.
DTs follow a tree-structured classification scheme where the nodesrepresent the input
variables and the leaves correspond to decision outcomes.DTs are one of the earliest and most
prominent ML methods that have beenwidely applied for classification purposes. Based on
the architecture of the DTs, they are simple to interpret and “quick” to learn.When traversing
the tree for the classification of a new sample we are able to conjecture about its class. The
decisions resulted from their specific architecture allow for adequate reasoning which makes
theman appealing technique.

Fig. 4.An illustration of a DT showing the tree structure. Each variable (X, Y, Z) is
representedby a circle and the decision outcomes by squares (Class A, Class B). T(1–3)
representsthe thresholds (classification rules) in order to successfully classify each variableto
a class label.

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Fig. 5.A simplified illustration of a linear SVM classification of the input data. Figure was
reproduced from the ML lectures of [21]. Tumors are classified according to their size and the
patient's age. The depicted arrows display the misclassified tumors

SVMs are a more recent approach of ML methods applied in the field of cancer
prediction/prognosis. Initially SVMs map the input vector into a feature space of higher
dimensionality and identify the hyperplanethat separates the data points into two classes. The
marginal distance between the decision hyperplane and the instances that are closest to
boundary is maximized. The resulting classifier achieves considerable generalizability and can
therefore be used for the reliable classification of new samples. It is worth noting that
probabilistic outputs can also be obtained for SVMs [20]. Fig. 5 illustrates how an SVM might
work in order to classify tumors among benign and malignant based on their size and
patients' age. The identified hyperplane can be thought as a decision boundary between the
two clusters. Obviously, the existence of a decision boundary allows for the detection of any
misclassification produced by the method.

3. ML and cancer prediction/prognosis

The last two decades a variety of differentML techniques and featureselection
algorithms have been widely applied to disease prognosis andprediction. Most of these works
employ ML methods formodeling the progression of cancer and identify informative
factorsthat are utilized afterwards in a classification scheme. These techniques used topredict
(i) cancer susceptibility, (ii) recurrence and (iii) survival. The informationwas collected based
on a variety of query searches in theScopus biomedical database.The success of a disease
prognosis is undoubtedly dependent on thequality of a medical diagnosis; however, a
prognostic prediction shouldtake into accountmore than a simple diagnostic decision.When
dealingwith cancer prognosis/prediction one is concerned with three predictivetasks: (i) the
prediction of cancer susceptibility (risk assessment),(ii) the prediction of cancer
recurrence/local control and (iii) the predictionof cancer survival. In the first two cases one is
trying to find (i) thelikelihood of developing a type of cancer and (ii) the likelihood
ofredeveloping a type of cancer after complete or partial remission. Inthe last case, the
prediction of a survival outcome such as diseasespecificor overall survival after cancer
diagnosis or treatment is themain objective. The prediction of cancer outcome usually refers
to thecases of (i) life expectancy, (ii) survivability, (iii) progression and(iv) treatment
sensitivity [3].
Major types of ML techniques including ANNs and DTs have beenused for nearly three
decades in cancer detection a growingtrend is noted the last decade in the use of other
supervised learningtechniques, namely SVMs and BNs, towards cancer prediction and
prognosis. All of these classification algorithms have beenwidelyused in a wide range of
problems posed in cancer research.The integration offeatures such as family history, age, diet,
weight, high-risk habits andexposure to environmental carcinogens play a critical role in

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predictingthe development of cancer. Even though this type of macroscaleinformation
referred to a small number of variables so that standardstatisticalmethods could be used for
prediction purposes, howeverthese types of parameters do not provide sufficient information
formaking robust decisions. With the rapid advent of genomic, proteomicand imaging
technologies a new kind of molecular information can beobtained. Molecular biomarkers,
cellular parameters as well as the expressionof certain genes have been proven as very
informative indicatorsfor cancer prediction. The presence of such High
ThroughputTechnologies (HTTs) nowadays has produced huge amounts of cancerdata that
are collected and are available to the medical research community.However, the accurate
prediction of a disease outcome is oneof the most interesting and challenging tasks for
physicians. As a result,ML methods have become a popular tool formedical researchers.
Thesetechniques can discover and identify patterns and relationships betweenthem, from
complex datasets, while they are able to effectivelypredict future outcomes of a cancer type.
Furthermore, the development of a communityresource project, namely The Cancer
Genome Atlas ResearchNetwork (TCGA) has the potential support for personal medicine as
itprovides large scale genomic data about specific tumor types. TCGA provideswith the ability
to better understand the molecular basis of cancerthrough the application of high-throughput
genome technologies.
5. Discussion
In the present review, the most recent works relevant to cancer prediction/prognosis
by means of ML techniques are presented. After a brief description of the ML branch and the
concepts of the datapreprocessingmethods, the feature selection techniques and the
classificationalgorithms being usedhowever, the identification of potential drawbacks
including the experimental design, the collection of appropriate data samples and the
validation of the classified results, is critical for the extraction of clinical decisions.Moreover, it
should be mentioned that in spite of the claims thatthese ML classification techniques can
result in adequate and effective decision making, very few have actually penetrated the
clinical practice.Recent advances in technologies paved the way to further improveour
understanding of a variety of diseases; however more accuratevalidation results are needed
before gene expression signaturescan be useful in the clinics.
A growing trend was noted in the studies published the last 2 yearsthat applied semi-
supervised ML techniques for modeling cancer survival.This type of algorithms employs
labeled and unlabeled data fortheir predictions while it has been proven that they improved
the estimatedperformance compared to existing supervised techniques can be though as a
great alternative to the other two types of MLmethods (i.e. supervised learning and
unsupervised learning) that use,in general, only a few labeled samples.
Among the most common applied ML algorithms relevant to theprediction outcomes of
cancer patients, we found that SVM and ANNclassifiers were widely used. In addition,SVMs
constitute a more recent approach in the cancer prediction/prognosis and have been used
widely due to its accurate predictiveperformance. However, the choice of the most
appropriate algorithmdepends on many parameters including the types of data collected,the
size of the data samples, the time limitations as well as the type ofprediction outcomes.
Concerning the future of cancer modeling new methods should bestudied for
overcoming the limitations discussed above. A better statisticalanalysis of the heterogeneous
datasets used would provide moreaccurate results and would give reasoning to disease
outcomes. Furtherresearch is required based on the construction of more public
databasesthat would collect valid cancer dataset of all patients that have beendiagnosed with
the disease. Their exploitation by the researcherswould facilitate their modeling studies
resulting in more valid resultsand integrated clinical decision making.

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6. Conclusions
In this review, we discussed the concepts of ML while we outlinedtheir application in
cancer prediction/prognosis. Most of the studiesthat have been proposed the last years and
focus on the developmentof predictive models using supervised ML methods and
classificationalgorithms aiming to predict valid disease outcomes. Based on the analysisof
their results, it is evident that the integration ofmultidimensionalheterogeneous data,
combined with the application of different techniquesfor feature selection and classification
can provide promisingtools for inference in the cancer domain.

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