My story in Science Magazine about whether India's climate pledge is inclusive enough
Tuesday 8 December 2015
Friday 20 November 2015
An Indian organization is training quacks to do good medicine. Here's why
My article for Mosaic Science, which subsequently got republished in Gizmodo, The Atlantic, Scroll.in, The Wire, Newsminute and Digg. Hurray for the Creative Commons License!
Sunday 19 July 2015
Why the Rotavac controversy probably shouldn't be one
My article in Firstpost that examines the arguments of a researcher who says the Rotavac clinical trial data points to a high risk of side effects from the vaccine. No paywall, so please read. http://www.firstpost.com/living/doubts-rotavac-anti-diarrhoea-vaccine-may-overblown-2349788.html
Monday 13 July 2015
Interview with an anti-medical-corruption crusader
The president of the Punjab Medical Council (PMC) is an year into his job now, but has been written about in several news publications for his actions against corrupt doctors. One much-publicized achievement of his is his action against ghost teachers at medical colleges: doctors who don't work full-time at colleges, but pretend to, after taking money from the college. Then, they appear at college premises during inspections by the Medical Council of India, allowing the colleges to meet regulatory requirements for faculty numbers and to receive clearance for functioning. Grewal, the new president of PMC, has rounded up 400 such teachers and has initiated action against them.
The problem is that Grewal inherits a broken system of state medical councils that hardly function, as he has himself admitted. He also faces opposition from within his own council, some members of which say Grewal isn't doing as much as he claims. Plus, all news reports about him portray him as a one-man-army against corruption. All these are expected problems when one is taking on a problem as massive and systemic as medical corruption in India. This makes Grewal's work truly commendable, although it also raises questions about the sustainability of his approach, If all his actions as president of the Punjab Medical Council (PMC) are merely those of a single conscientious individual, the PMC will revert to its formal state once his tenure ends. It is a story that has been repeated an untold number of times in the Indian medical scene (consider the dissolution of the MCI after the Ketan Desai scam. The MCI was reconstituted again, but problems continue to persist).
I interviewed Grewal for The BMJ and tried to find out how much he is doing and can do as a president for three years to mitigate medical corruption in Punjab. Here is a link (paywalled) to the interview: http://www.bmj.com/content/351/bmj.h3694
The problem is that Grewal inherits a broken system of state medical councils that hardly function, as he has himself admitted. He also faces opposition from within his own council, some members of which say Grewal isn't doing as much as he claims. Plus, all news reports about him portray him as a one-man-army against corruption. All these are expected problems when one is taking on a problem as massive and systemic as medical corruption in India. This makes Grewal's work truly commendable, although it also raises questions about the sustainability of his approach, If all his actions as president of the Punjab Medical Council (PMC) are merely those of a single conscientious individual, the PMC will revert to its formal state once his tenure ends. It is a story that has been repeated an untold number of times in the Indian medical scene (consider the dissolution of the MCI after the Ketan Desai scam. The MCI was reconstituted again, but problems continue to persist).
I interviewed Grewal for The BMJ and tried to find out how much he is doing and can do as a president for three years to mitigate medical corruption in Punjab. Here is a link (paywalled) to the interview: http://www.bmj.com/content/351/bmj.h3694
Wednesday 24 June 2015
Indian rotavirus vaccine concern over intussusception is unfounded, say researchers
Researchers testing an Indian rotavirus vaccine have said that concerns linking it to an increased risk of intussusceptions are unfounded. They were responding to an online campaign that has called for them to release raw data on the rates of intussusception seen during the trial.1
Gagandeep Kang, professor of gastrointestinal sciences at Christian Medical College, Vellore, who worked on the trial, said that the trial data cannot be used to estimate the risk of intussusception from the vaccine as the campaigners have argued. “This was not a study powered to detect rare events. If you want to find the rate of intussusception, you need to evaluate the vaccine in hundreds of thousands of children,” she told The BMJ. Read the rest of my article here
Two Indian states promise to enforce the medical protection act
Doctors’ associations across India have scored a victory in their campaign for better implementation of the Medical Protection Act, with the state governments of Uttar Pradesh and Tamil Nadu agreeing to educate their police forces about the provisions of the act. The government of Haryana has promised similar action in the coming weeks, leading the state branch of the Indian Medical Association (IMA) to cancel a strike scheduled for 20 May.
The Medical Protection Act makes attacks on doctors and clinical property a non-bailable offence, punishable by imprisonment of up to three years and a penalty of Rs50 000 (£500; €690; $785). It is currently in force in 17 states. But, although it is widely implemented in some states such as Andhra Pradesh, the first state to pass the act, others such as Uttar Pradesh and Bihar haven’t seen state-wide adoption. Read more on TheBMJ here:
Tuesday 12 May 2015
The Lamjung earthquake---what does it mean for future earthquakes in the region?
Seismologists worried about the prospect
of a massive earthquake in the
shadow of the Himalayas, where it
could devastate cities such as Kathmandu
and Delhi, have long cast a
wary glance at an eerily calm region
called the central seismic gap (CSG). A massive
earthquake in southwestern Tibet in
1505 C.E., researchers proposed a decade
ago, relieved enough strain to quiet that
stretch of the restive Himalayas. But new
findings now suggest that the 1505 temblor
was smaller than thought and was just one of
a cluster of potent quakes to rattle the region
within a few centuries. If so, major quakes
in the Himalayas, unlike in many other seismic
hot spots, may not relieve enough strain
to forestall later quakes—meaning that authorities
must gird for a mega earthquake
anywhere at any time.
Thrust up by the continuing collision of the Indian subcontinent with Asia, the Himalayas are frequently rattled by major earthquakes. But for several centuries, the CSG, a 600-kilometer-long region extending northeast of Delhi, has been quiet, even though it straddles major faults. In 2003, the late Greek geologist Nicholas Ambraseys and Roger Bilham, a geophysicist at the University of Colorado, Boulder, proposed that a large earthquake on 6 June 1505, known from Tibetan annals and the Akbarnama, a chronicle of the 16th century Mughal emperor Akbar’s reign, could have relieved some of the strain building up at the CSG.
Based on severe structural damage to Tibetan monasteries located nearly 700 kilometers apart, Ambraseys and Bilham estimated that the 1505 quake would have registered at 8.2 or so on the moment magnitude scale, which measures the energy released during an earthquake. The geological smoking gun for the quake seemed to materialize a few years later. After digging six trenches at points along a 250- kilometer stretch of the CSG in 2006, geologist Senthil Kumar, who was then at the University of Nevada, Reno, and colleagues uncovered faults that could be radiocarbon dated using charcoal in the sediments. They attributed the faults to an earthquake between 1400 and 1422 C.E. But written records do not mention a major quake during this period, and because the charcoal dating’s error bars encompassed 1505 C.E., Kumar’s group chalked up the findings to the 1505 Tibetan quake.
Also cited as evidence for that quake was a trench in western Nepal described only in an abstract in 2006. Other experts, however, have doubted the 1505 earthquake’s potency. Many medieval monasteries in the region are built from rock masonry without mortar, making them vulnerable to even moderate earthquakes, says Chittenipattu Rajendran, a paleo seismologist at the Jawaharlal Nehru Centre for Advanced Scientific Research here. Such damage, therefore, “is not realistic to use as an indicator of magnitude,” says Rajendran, who adds that there is no historical record of extensive damage in Indian cities like Agra and Delhi in 1505.
To get a fresh perspective on the CSG’s seismic history, Rajendran’s group dug a new trench in the Uttarakhand district of Ramnagar, adjacent to a trench Kumar’s team had excavated. They got lucky, uncovering a colluvial wedge of sediment— the geological signature of any quake that ruptures the earth’s surface. The rupture briefly pushes up a scarp, which crumbles to form a wedge. Rajendran’s team found that the material in the wedge had been ruptured not once, but twice, which could only mean two earthquakes, they say. Carbon dating linked both ruptures to earthquakes in 1255 C.E. and 1344 C.E. that are known from historical records, the team reports in an article posted online last month in the Journal of Geophysical Research: Solid Earth. Yet the trench showed no sign of a later, large earthquake.
R. Jayangondaperumal, a geologist at the Wadia Institute of Himalayan Geology in Dehradun and a member of Kumar’s team in 2006, says a reanalysis he has conducted on their 2006 trenches also suggests a pair of earthquakes rather than a single one. The finding not only casts doubt on the extent of the strain-relieving quake in 1505 but also “confirms an irregular cycle for the earthquakes in Himalaya,” says Jean-Louis Mugnier, a geologist at the University of Savoy, Bourget-du-Lac, in France who wasn’t part of the study. Bilham declined to comment on the new findings.
But Laurent Bollinger, a geologist at France’s Alternative Energies and Atomic Energy Commission, argues that the evidence so far is not persuasive enough to verify the clustering hypothesis or rule out the big 1505 quake. “There is a risk that there are some very big earthquakes that are being missed in the historical chronicles,” he says. What’s needed, he says, are more data from more trenches. In the meantime, Mugnier says, disaster management authorities need to recognize that a massive temblor can strike anywhere in the Himalayas, at any time. “The level of risk is stable: always high.” In 2013, India’s National Disaster Management Authority estimated that an earthquake of magnitude 8 or greater just about anywhere in the rapidly urbanizing Himalayas would kill, on average, about 800,000 people. ■
This story appeared in Science Magazine in February 2015
Thrust up by the continuing collision of the Indian subcontinent with Asia, the Himalayas are frequently rattled by major earthquakes. But for several centuries, the CSG, a 600-kilometer-long region extending northeast of Delhi, has been quiet, even though it straddles major faults. In 2003, the late Greek geologist Nicholas Ambraseys and Roger Bilham, a geophysicist at the University of Colorado, Boulder, proposed that a large earthquake on 6 June 1505, known from Tibetan annals and the Akbarnama, a chronicle of the 16th century Mughal emperor Akbar’s reign, could have relieved some of the strain building up at the CSG.
Based on severe structural damage to Tibetan monasteries located nearly 700 kilometers apart, Ambraseys and Bilham estimated that the 1505 quake would have registered at 8.2 or so on the moment magnitude scale, which measures the energy released during an earthquake. The geological smoking gun for the quake seemed to materialize a few years later. After digging six trenches at points along a 250- kilometer stretch of the CSG in 2006, geologist Senthil Kumar, who was then at the University of Nevada, Reno, and colleagues uncovered faults that could be radiocarbon dated using charcoal in the sediments. They attributed the faults to an earthquake between 1400 and 1422 C.E. But written records do not mention a major quake during this period, and because the charcoal dating’s error bars encompassed 1505 C.E., Kumar’s group chalked up the findings to the 1505 Tibetan quake.
Also cited as evidence for that quake was a trench in western Nepal described only in an abstract in 2006. Other experts, however, have doubted the 1505 earthquake’s potency. Many medieval monasteries in the region are built from rock masonry without mortar, making them vulnerable to even moderate earthquakes, says Chittenipattu Rajendran, a paleo seismologist at the Jawaharlal Nehru Centre for Advanced Scientific Research here. Such damage, therefore, “is not realistic to use as an indicator of magnitude,” says Rajendran, who adds that there is no historical record of extensive damage in Indian cities like Agra and Delhi in 1505.
To get a fresh perspective on the CSG’s seismic history, Rajendran’s group dug a new trench in the Uttarakhand district of Ramnagar, adjacent to a trench Kumar’s team had excavated. They got lucky, uncovering a colluvial wedge of sediment— the geological signature of any quake that ruptures the earth’s surface. The rupture briefly pushes up a scarp, which crumbles to form a wedge. Rajendran’s team found that the material in the wedge had been ruptured not once, but twice, which could only mean two earthquakes, they say. Carbon dating linked both ruptures to earthquakes in 1255 C.E. and 1344 C.E. that are known from historical records, the team reports in an article posted online last month in the Journal of Geophysical Research: Solid Earth. Yet the trench showed no sign of a later, large earthquake.
R. Jayangondaperumal, a geologist at the Wadia Institute of Himalayan Geology in Dehradun and a member of Kumar’s team in 2006, says a reanalysis he has conducted on their 2006 trenches also suggests a pair of earthquakes rather than a single one. The finding not only casts doubt on the extent of the strain-relieving quake in 1505 but also “confirms an irregular cycle for the earthquakes in Himalaya,” says Jean-Louis Mugnier, a geologist at the University of Savoy, Bourget-du-Lac, in France who wasn’t part of the study. Bilham declined to comment on the new findings.
But Laurent Bollinger, a geologist at France’s Alternative Energies and Atomic Energy Commission, argues that the evidence so far is not persuasive enough to verify the clustering hypothesis or rule out the big 1505 quake. “There is a risk that there are some very big earthquakes that are being missed in the historical chronicles,” he says. What’s needed, he says, are more data from more trenches. In the meantime, Mugnier says, disaster management authorities need to recognize that a massive temblor can strike anywhere in the Himalayas, at any time. “The level of risk is stable: always high.” In 2013, India’s National Disaster Management Authority estimated that an earthquake of magnitude 8 or greater just about anywhere in the rapidly urbanizing Himalayas would kill, on average, about 800,000 people. ■
This story appeared in Science Magazine in February 2015
The investigation into the Muzzaffarpur encephalopathy
My article in Science Magazine about how a mysterious disease afflicting young children, undiagnosed for almost two decades, is being pinned to a toxin in litchi seeds.
Friday 27 February 2015
Tuesday 10 February 2015
World Medical Association sticks to its decision to retain tainted Indian doctor as president
But former Central Vigilance Commission officer said Indian Medical Association was perpetrating lies about Desai's legal status. My article in BMJ
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