Dr Jyoti HakPregnancy is a physiological state associ-

ated with many alterations in metabolic, bio-chemical, physiological and haematologicalprocesses. If there are no complications, allthese changes are reversible following a fewdays to few months after delivery, Maternalmortality still remains high in developingcountries including India.

Hypertension is the most common med-ical problem encountered during pregnancy,complicating 2-3% of pregnancies. Hyperten-sive disorder of pregnancy represent a groupof conditions with high BP during pregnan-cy,proteinuria and in some cases convulsion.The most serious consequences for the moth-er and baby are the result of preeclampsia andeclampsia.

The working group of National High BloodPressure Education Programme (2000) clas-sified Hypertensive disorders of pregnancyinto following four types:

Gestational Hypertension*Pre-eclampsia and Eclampsia syndrome*Pre-eclampsia superimposed on chronic

hypertensionChronic HypertensionGestational Hypertension Systolic

BP>140 or Diastolic BP>90 for the first timeduring pregnancy. With no proteinuria, BPreturns to normal before 12 weeks in post par-tum period.

Pre eclampsia* Minimum Criteria* BP >140/90 after 20 wks of pregnancy*Proleinuria>300mg/24 hrs or ? (+) on

dipstickSevere Preclampsia*Systolic BP>160 mm of Hg* Diastolic BP>110 mg of Hg* With significant proteinuria>5.0g/day

and evidence of endorgan damage.* Eclampsia-Tonic, clonic convulsions not

caused by coincidental neurological disordersin a patient with pre-eclampsia

* Eclampsia develop in antepartum intra-partum, and post partum period.

Chronic HypertensionBP of > 140/90 mm before pregnancy or

persisting more than six weeks after delivery.Pathophysiology of High BP (Pre-eclamp-

sia) in pregnancyPre-eclampsia is a syndrome which devel-

ops towards the end of pregnancy. Its pathogen-esis is still not clearly defined hence there is nospecific diagnostic tests for its predication.

The general consensus is preeclampsia. Itis an endothetial cell disorder resulting inmild to severe microangiopathy of target

organs such as brain, liver, kidney and placen-ta.

The Pathophysiology of pre-eclampsiainvolve maternal and fetal/placental factors.It has been considered a two stage disease,where the first stage involves abnormal pla-centation and the second the transition to thematernal systemic disor.

Pre eclampsia has been shown to be asso-ciated with platelet activation and excessiverelease of vaso constricting thromboxane pro-ceeding the onset of disease.

There may be diffuse placental thrombo-sis and inflammatory placental decedual vas-culopathy or abnormal trophoblasic invasionof endometrium.

The wide spread endothelial dysfunctionmay manifest in pregnant women as dysfunc-tion of multiple organ systems including CNS,renal, hepatic, pulmonary and heamatologi-cal system. The decrease in perfusion canmanifest clinically as non-assuring fetal heartrate testing, low biophysical profile oligohy-dramnios and intra uterine growth restictionin seven cases.

Calcium and magnestium deficiency hasbeen implicated as a possible cause of gesta-tional hypertension. Dietary intake of calciumand magnesium is recommended for womenduring pregnancy.

Eclampsia Eclampsia may follow pre eclampsia. It is

difficult to predict which pre-eclampticwomen may go on to have seizures the hall-mark of eclampsia.

PreventionLow dose aspirin (80-150mg/day) may

reduce the risk of intra uterine death and peri-natal death. ASA may reduce or modify thecourse of servere pre eclampsia. Sodium,restriction, calcium and magnesum substitu-tion, calcium and magnesium substitution,fish oil substitution.

Anti-oxidants (Vit C and Vit E)Medical managementBed restWhen pre eclampsia develops at 32-34

weeks gestation often attempts are made toprolong pregnancy to allow further fetalgrowth and maturation.

* Monitor both fetal and maternal status.* BP > 160/100 with proteinuria* Decrease BP by drugs* Like*Labetalol (Oran or I/v)* Alpha dopa* Nifedipine* Magnesium sulphate to prevent or reduce

the rate of eclampsia and its complications.* Maintaining a BP of 90mm Hg is the goal

of anti hypertensive therapy.Obstetric managementDelivery is the treatment of choice for severe

pre eclampsia and eclampsia in a pregnancyover 28 weeks. For pregnancies <24 wks, theinduction of labour is recommended, althoughthe likelihood of aviable fetus is minimal

Prolonging such pregnancies results inmaternal complications as well as fetal com-plications.

Saibal Chatterjee

If Jazbaa pulls in the crowds on its openingweekend, it will most likely be on account of thefact that it is Aishwarya Rai Bachchan's first filmsince 2010's Guzaarish.

But if the film lasts beyond the first week andholds firm in the second, the reason will be IrrfanKhan.

Not only does the actor get the best lines andmake the most of them, he demonstrates yet againwhy he is one of the Mumbai movie industry's mostformidable actors.

Sanjay Gupta's crime drama is a middling mixof thrills and spills that is held together by Irrfan'sremarkable ability to inject life and meaning intoeven the most unconvincing of scenes.

That is not to say that Aishwarya does not doher bit to prop up Jazbaa. In fact, if anything, shegoes overboard in the effort to make her presencefelt.

In the frames that she shares with Irrfan, hermelodramatic approach offers a direct contrast tothe male lead's measured underplaying.

Each serves as a counterfoil to the other, mak-ing Jazbaa feel like a two-in-one film in terms ofhistrionic styles.

Aishwarya plays advocate Anuradha Verma, asuper-successful lawyer who has never lost a case.She is now in danger of losing her pre-teen daugh-ter to kidnappers who want her to save a rape andmurder convict from the gallows in lieu of ransom.

Old friend and tainted cop Yohaan (Irrfan), whohas lost his job on charges of corruption, jumpsinto the fray to help the lady extricate herself fromthe tight spot.

Anuradha, who has only four days to secure bailfor the rapist (Chandan Roy Sanyal), also has tocontend with the ire of the victim's mother (Sha-bana Azmi).

Jazbaa is the story of two daughters, one deadand crying out for justice and the other in theclutches of evil captors who cannot be trusted, andtwo mothers who have scores to settle.

The film creates a dark and twisted world inhab-ited by drug dealers and addicts, a powerful politi-cian (Jackie Shroff) determined to save his career

at all cost, and lawyers and cops who are hostagesto a system that grinds down the meek and shieldsthe guilty.

But Jazbaa, a remake of a South Korean thriller,does not go beyond broad superficialities. Its inter-est lies merely in mining the legal situation for itspotential for suspense and intrigue.

The film achieves its end to a certain extent, butfalls way short of delivering the riveting, edge-of-the-seat thriller that it should have been.

In the end, the surface zest visible in Jazbaadoes not quite translate into the sort of fire thatmight have elevated it to a different plane.

Lalit Gupta In times when there is hue and cry about dis-

mal standards of government runs schools inthe state, it will be very difficult for present gen-erations to visualize that around 1950s and 60s,government schools were not only vying witheach other for academic excellence of their stu-dents but also conducted regular calendar ofvarious cultural activities to hone the buddingtalent.

Raghunandan Singh Bali, is one such exam-ple who after being encouraged by his schoolteachers in the field of drama, not only madeacting as lifelong passion but also influencedmany a young person to take up the creativehobby.

The seventy three years old tall, fair andhandsome, in a chance meeting is bound willmake you to take notice of him. His somberexpression along with fluent gestures and bodymovements gives one the feeling that he is athome everywhere. It was due to this very natu-ral gift that right from his school days he waspicked up as a one of the lead participants incultural programs that included dance and dra-ma skits etc. Once he had tasted the thrill of per-formances during national festivals like Repub-lic and Independence Day Parades, school andinter-school competitions coupled with recog-nition and encouragement of his talent by histeachers and even the political elite of the state,Raghunandan Singh Bali knew theatre actingwas going to be his lifelong obsession With theresult since last fifty years, the field of culturehas been an inseparable adjunct of his life.Serving in various capacities as a teacher, head-master and principal of number of schoolswhere he was posted, he has been instrumen-tal in galvanizing their cultural activities. But itwas his skill as an amateur stage, Ramlila, TVand film actor that he has regaled generationsof audiences and touched the lives of many ayoung persons who after being encouraged andtutored by him also took to theatre seriouslyand formed many drama groups.

Born in 1942, to the Mirpuri refugee familyof Balwant Singh and Janaki Devi, who afterPartition made Jammu their home, Raghunan-dan Singh Bali did lot of struggle to build lifeform a scratch. Brought up in conservative fam-ily, sustaining passion for theater has not beenan easy affair for him. It was the inherited artis-tic traits from his mother who was fond ofsinging and a much sought after character forthe ‘swangs’ done by women folk during mar-riages, that fructified as a natural inclination fordance and acting in him.

Being brought up and schooled in JulahakaMohalla, Jammu, in 1950s, Bali like other kidswas always excited about Ramlila performanc-es held at Diwan Mandir. He along with a groupof few friends would often create a makeshiftstage on the roof top with a cot and bed sheetsto enact scenes and battles of rakshas whichthey had seen a night before. It was during 1956,while as 8th standard student he was selectedby his teacher D P Trikha to act in the AgaHashar Kashmiri’s drama ‘Smt. Manju Devi’.

Initially given a small role, he was broughtas a lead actor in the play due to his talent. Hisfriend Mahesh Sharma enacted the role of a‘pagal’. The successful performance of the dra-ma so impressed the officers of the educationdepartment that after six-seven shows in Jam-mu, the play was also staged at Hiranagar andR S Pura. Later, ‘Mrs Manju Devi’ along with

Ramesh Mehta’s play ‘Apradhi Kaun’, werestaged at Srinagar during a camp. Impressed bythe performance of the young actors, the theneducation minister Gulam Mohammad Sadiqnot only felicitated the entire cast but also sanc-tioned scholarship for Bali and Lakshmi KantJoshi ( student/actor, also a musician and hadlearnt music along with from Shiv Kumar Shar-ma from Pandit Uma Dutt).

Back to Jammu, drama became a regularfeature for Bali and he started watching dramaperformances like ‘Buddh Kaam Shuddh’. Per-

formed at a make shift stage at Ajaibgahr(presently State Assembly), the play directedby C Parwana had the cast of actors such asJatinder Sharma, Mahesh Sharma, J C Bharti.Other play which he witnessed was Ved Rahi’s‘Diya Aur Toofan’ at Zanana Park in which Mas-ter Manohar son of Jagat Ram Kalra, did a roleof a lady. Bali became a regular audience at theDiwan Mandir Ramlila where actors likeNarinder Sharma (as Kekayi) and Rishi Kumarwere very well appreciated for their acting. Oth-ers associated persons were Chander KantSharma, Lal Chand, Krishan Dutt. These werethe days when Krishan Lila was also performedfor seven-eight days during the Krishna Jana-mashtmi festival.

Other than encouragement at school, Baligives also credit for honing his performanceskills to a Rasdhari Bawa, who used to live atPacci Dhakki, near his Bua’s home, and whotaught him basics of music and dance throughTalwaaran Wala dance and gymnastic move-ments. In an interesting reflection on the cul-tural life of old Jammu and patronage by citi-zens, Bali recalls that one Krishan Lala ‘thek-dar’ has organized a show of the Rasdhari Bawain a chowgan at Mohalla Malhotra.

After passing matriculation, Bali’s familyshifted to Resham Garh Colony in RefugeeQuarters. But his love for theatre continued.

He and his group under the banner of YoungModerate Club staged ‘Kamini’, a MaheshSharma’s play on Kashmir problem, at Paradeground during an exhibition in 1959. Otheractors were Mahesh Sharma, Rashid Shah,Vijay Suri, Puran Gupta. It was followed by theplay ‘Pagla Janta Hai’ at a Park in Gandhi Nagarwith actors like Subahsh Bali, Ravi Rampal,Prakash Sharma, Som Nath. Bali’s first job wasas a daily wager in Dehat Sudhar Dept was fol-lowed by a short stint as a Lorry cleaner. Thesalary from these jobs enabled him to takeadmission in College. He joined M A M Collegewhich was then functioning from a GGM Sci-ence College. Bali remembers that during thosedays, cchut- putt plays were being staged at aHall in the back side of Secretariat. It was thetime when a drama club was also formed at thehouse of Uma Mahey I niece of Comrade Dhan-vanrtri). After completing B.A. in 1962, Bali’sfirst posting as a teacher was at Gool where heactively participated in school functionsincluding staging plays. He was posted at Gand-hi Nagar Primary School in 1963 and duringthat period he got married.

Being a good actor, he was often invited byother drama groups to perform in their plays.So he acted in the drama clubs of Rattan Shar-ma, Narinder Sharma, C Parwana, FriendsClub, Roop Wani Club etc at venues which alsoincluded Ranbir School. Some of his memo-rable plays include ‘Dail M for Murder’ (GyarahBajae), Kanchan Rang, Nishachar. Other thanacting he along with Subhash Raizada alsodesigned sets for plays like Vijay Suri’s Bali-dan.

One of the significant events in Bali’s life waswhen the newly formed Gandhi Nagar Laksh-mi Narayan Temple Ramlila Club invited himto act as the director. His friendly personalityand passion instilled a new kind of seriousnessamongst the actors. Bali’s childhood friendSubhash Raizada in the role Ravan and he him-self as Dashrath, along with many actors fromGandhi Nagar, gave a new touch of realism toGandhi Nagar Ramalila that it attracted audi-ences from other parts of the city.

Since involvement in Ramlila is limited tothe very days of its rehearsals and perform-ance, Bali remained active by acting anddirecting stage plays (for drama competitionsand other wise). “I was always attracted tostage plays with bold themes, which was dar-ing act in those days when conservative ele-ments in the Jammu society were ruling theroost. These plays included Under Secretary,Aur Aakash Jhuk Gaya, Pati Patni, AakhariSwal, Barf Ki Minar, Prishatt Bhumi (by BaljitRaina), Balwant Gargi’s Abhisarika, LakeerSe Pare (Giddaan Te Loth-Rajneesh Gupta’splay about the problems of an abnormalchild), Baba nahin Jayaan, Dilli Ki AakhriShama etc. His young associates in dramaincluded Surinder Goel and Raj Kumar, San-tosh Sangra, Arun Bakshi, Sweety, VeenaDogra, Shobha, Lalita Tapasavi, J R Sagar.

A fine actor, schooled in traditional style,Raghunandan Singh Bali, is a passionate ama-teur artiste who since more than 50 years hasbeen regularly involved with Ramlila, prosce-nium theatre and since 1990s with TV andfilms. He who laments the downfall of govern-ment schools as premier institutions, is stillactive in the field and driven by innate love andpassion for stage, hopes to stage plays whichalways wanted to perform like Surendra Ver-ma’s Suraj Ki Pehli Kiran Se Antim Kiran Tak.

SUNDAY, OCTOBER 11, 2015 (PAGE-4)

An acting talent honed in Govt SchoolsPERSONALITYMOVIE-REVIEW

HEALTHLINES

Jazbaa: Too much zest, not enough fire

Hypertension in Pregnancy

Maneka Sanjay Gandhi

Last week I started telling you about the terrible tor-ture that rats undergo in laboratories. Stuffed into metalcages and drawers in dark "animal rooms", they are tak-en out into the light only to be tormented. All of it is keptsecret by so called scientists with the excuse that they aretorturing these little creatures in order to help humans.This makes it difficult for someone to protest – just incase they are thought to be anti-human.

But, it is time the DGCI looked at the wasteful and cru-el usage of mice in experiments that have no value at all.

Here are some examples:In 1989 a study was done to determine the carcino-

genicity of fluoride. During a period of two years, dailydoses of fluoride were given to about 520 rats and 520mice. Not a single mouse was adversely affected by thefluoride, but the rats experienced health problems likecancer of the mouth and bone. This study shows how testdata cannot be accurately extrapolated from one speciesto another.

Drugs like thalidomide, Zomax and DES were all test-ed on animals and judged safe but had devastating con-sequences for the humans who used them. More than halfof the prescription drugs approved by the Food & DrugAdministration between 1976 and 1985 were withdrawnfrom the market or re-labelled because of the serious sideeffects they had on humans. They had all been tested onanimals.

-Procter & Gamble is engineering nano soot particlesto develop products that can penetrate skin and hair inways that naturally occurring molecules do not. Thou-sands of hamsters, mice and rats were killed in tests wherethey were placed in sealed containers and forced tobreathe in air contaminated with 'nano' particles. These"tests" are done to produce better hair spray, hand lotionand makeup.

In order to determine young rats, who are bullied, feelstress, babies were exposed to daily aggressive acts fromaggressive male residents. Each rat received pins, kicksfor 10 min per day for 10 days. Researchers then killedthe rats and discovered "stress-evoked CORT levels weresignificantly higher, and adrenal gland weights were sig-nificantly heavier in dominated rats."

In tests that many people don’t realize are still beingconducted, animals are forced to breathe cigarette smokefor up to six hours straight, every day, for up to three years.Rats are forced into tiny canisters, and cigarette smoke ispumped directly into their noses. In other tests, mice andrats have cigarette tar applied directly to their bare skinto induce the growth of skin tumours. Many die duringthe study. Other mice have their skins peel off, and theydevelop skin tumours. All the surviving animals werekilled and dissected.

Every time a cigarette company wants to add newingredients like honey, sugar, molasses, corn syrup, plumjuice, lime oil, chocolate, cocoa, and coffee extract to cig-arettes, thousands of rats go into these canisters thatpump smoke directly into their noses six hours a day for90 consecutive days. They are then killed and dissectedto examine the harm caused to their bodies. This is inspiteof the fact that tobacco products and their ingredients arenot required to be tested on animals because effective invitro (non-animal) tests exist that use human lung tissueto test.

A thousand rats were killed in a study in which theywere forced to breathe either diesel engine exhaust or cig-arette smoke for six hours a day, seven days a week, fortwo years to compare the relative effects of exposure ontheir lungs.

Footage from laboratories shows rats being decapitat-ed with a guillotine and moving during operations.Rodents are also heard squealing as parts of their ears arecut off with scissors for biopsies.

In the course of manufacturing an anti-wrinkle treat-ment, scores of mice are injected with a powerful toxin inorder to determine the dose that will kill 50 percent of theanimals. The animals experience nausea and a wave ofmuscle paralysis, leading to severe distress as they slow-ly suffocate to death over the course of the three to fourday procedure.

In a study, rats were placed in a swimming pool and,without any warning, an escape-proof wire net was placedover their body, forcing them underwater for 30 secondsat a time to create an experience of "underwater trauma."

In another test, experimenters measured the time tak-en for male rats to mount females, insert their penises,and ejaculate. The experimenters then restrained therats, cut into their skulls, implanted tubes into theirbrains, and pumped in a chemical that would block therats’ ability to process sexual pleasure. The experimentersthen watched the rats having sex, withheld sex from therats for seven to 28 days, and noted the rats’ increasedinterest in an amphetamine reward. All the animals werekilled, and their brains were dissected.

Many vivisectors come to India, because in their owncountries they cannot get away with doing the type of ani-mal testing they can do here. Every year, research facili-ties across India – including the Animal Research Cen-

tre, the Patel ChestInstitute, theNational Institute ofNutrition (NIN) andthe All India Insti-tute of Medical Sci-ences (AIIMS)–squander valuabletime and millions ofrupees conductinguseless experi-ments.

-Animals areyelled at, hit, left tosuffer after surgerywithout anyp a i n k i l l e r s ,crammed into smallcages, denied veteri-nary care and more.In India, one of thelargest animal sup-pliers, the National

Centre for Laboratory Animal Sciences (NCLAS) inHyderabad, supplies approximately 50,000 animals tolaboratories every year and to 175 institutions in India,including pharmaceutical companies and educationalinstitutions. Both NCLAS and the NIN have been underfire for years for not maintaining basic animal welfarestandards.

The worst innovation in cruelty to the mouse is thecustom made transgenic lab lab rat. Genetic material isimplanted in female mice. When the mice give birth, thepups are checked to see if they carry the right genes, andthen moved to a special population to breed. Breedingfacilities offer specially designed animals to experimentconductors. In 2009, German researchers announcedthat they successfully implanted human genes associat-ed with language into the brains of mice, causing neuro-logical differences. Ever since then, companies have beenexpanding the kinds of human genes that can be trans-ferred into mice, allowing companies to study theireffects, and drug effects on them, without the danger oftesting on humans or the expense of testing on apes

Diabetes on demand is another mouse model. A geneis knocked out of the mouse, causing it to gain moreweight and metabolize glucose badly. This, in turn, caus-es the mouse to develop diabetes when fed a high-fat dietand is sold to scientists fiddling around with diabetes.

Scientists use mice to test depression medication byordering mice that cannot properly manufacture sero-tonin. These tend to be both anxious and depressed. Oth-er labs can order rats that are prone to drug addiction. Ratswith deficient livers or intestines are available. Rats withdifferent coloured neurons in their brains are available.And more standard animals are being created all the time.

Not one experiment on rats / mice has any bearing onhuman suffering. It has to be done all over again onhumans every time. Why do we do this to them? No idea.Tradition?

What a horrible race we are. I hope I am reborn on adifferent planet next time.

To join the animal welfare movement contact gandhim@nic.in,www.peopleforanimalsindia.org

Terrible tortureNATURE

Serving in various capaci-ties as a teacher, headmasterand principal of number ofschools where he was posted,he has been instrumental ingalvanizing their culturalactivities.