Mumbai’s XXtreme TB is neither new nor sudden

Mumbai has been in a state of panic for the last two weeks after doctors at Hinduja Hospital reported the first cases from India of Extremely Drug Resistant TB (XXDR), which is immune to all first-line and second-line drugs used in the disease’s treatment. The panic stems from the idea that we are facing a new kind of bacteria and the possibility that it may spread among a large section of people in the city.

It’s worth pointing out, therefore, that the earliest reported case of XXDR TB was way back in 2003 in Italy, according to a 2007 article in medical journal, Eurosurvelliance. In this article, GB Migliori, director, WHO Collaborating Centre for TB and Lung Diseases, discussed the cases of two patients who initially had a less severe form of TB but it developed into XXDR TB due to mismanagement of the disease at the earlier stage. One of them underwent treatment for five years, while the other was treated for almost eight years. Drug susceptibility tests (DST) were performed on both patients, which indicated that the TB was resistant to all known anti-TB activity, wrote Migliori. “Both (women) died in 2003, before 50 years of age, after a long, unsuccessful treatment with all available drugs without achieving bacteriological conversion.”

In 2003, the only known forms of the disease were the primary TB and multi-drug resistant TB (MDR TB). When the bacteria developed resistance to the first line of drugs for primary TB, patients with MDR TB would then be treated with second-line drugs.

However, doctors started noticing that some MDR TB patients too were showing resistance to some of the second-line drugs. “In 2006, WHO officials met in Geneva to define XDR TB (extensively drug-resistant TB). In the same meeting, XXDR TB too was discussed, and the term was accepted unofficially,” said Migliori.

According to Migliori, it is difficult to identify XXDR TB, since the patient has to be tested against all available drugs. This is expensive and “the test results are open to interpretation. Moreover, there are few labs in the world who can conduct such tests,” he said. What this implies is that over the years many XXDR cases may not have been documented; so it may be fallacious to think that there has been a sudden emergence or spike in XXDR TB.

Doctors in India agree. “DST (drug susceptibility testing) for all the drugs is costly and not effective for treatment. So the testing is done only for the primary drugs. DST for other drugs is also dubious right now. The same test carried out by different labs yields different results, and the technology is non-standardised,” said SK Jindal, chairman of the Expert Advisory Committee on Management of Tuberculosis.

Only three labs in India are accredited to carry out DST for all available TB drugs, which is needed to confirm XXDR TB. Other labs can only diagnose MDR TB and XDR TB.

Bacteria strains are rarely tested for sensitivity against all drugs, said experts. “We can only classify a strain as XXDR if we can get it tested from an accredited lab, of which there are very few in India. Moreover, these labs only accept samples from patients who are being treated via the Revised National Tuberculosis Control programme, and not from private parties,” said KC Mohanty, HOD, Chest Medicine, KJ Somaiya Hospital.

While Hinduja tested and found 12 XXDR TB cases, Jindal concedes that there may be several others which have gone unreported. With the government now moving to accredit more laboratories to carry out DST for all drugs, you can expect more XXDR cases to surface.

So, then, are we in the middle of an XXDR TB outbreak? “No,” says Jindal, “TB is not as virulent as the H1N1 virus (swine flu). It spreads mostly when there is close contact with the patient. And XXDR TB is no different.”

[This article originally appeared in DNA]

The funniest Bollywood villain names

Colonel Chikara
Rami Reddy
Colonel Chikara is dangerous, but not very smart. Any self-respecting villain would have applied for a name change. Then there’s his uniform. A black-coloured uniform in the sweltering Indian heat? This man is deranged. Chikara also has this weird soundtrack around him. It is like the call of an animal that is a spawn of a hyena and a crow. He also repeats himself: “I am a king without a kingdom. Chikara samrat hai, par uske paas samrajya nahin haiSamrajya haasil karne ke liye mujhe chaiye Krypton bomb. Krypton bomb. Krypton bomb woh takat hai jisse duniya ki koi takat takra nahin sakti.”

Bulla
Mukesh Rishi
A man with a sword stuck in his stomach is running. This man is brave and he is determined to live, and perhaps he will. But then he meets his boss who says, “Mera naam hai Bulla, rakhta hoon khulla.” Unable to hear such dialogues the man dies. And with him the audience dies… of laughter, that is. Seriously, with a name like Bulla we wouldn’t be so proud. Anyway, Bulla is ferocious to all but his brother Chutiya, who is the only one who calls his elder brother “Bulli, kahan hai teri ungli.” Too bad Bulla has to see his brother killed and sister raped in the story.

Pralaynath Gendaswamy
Dilip Shirke
Pralaynath Gendaswamy knows that his name exudes death and destruction like all good villain names must. His wants to become India’s supreme leader by deploying missiles aptly named Pralay 1, Pralay 2, Pralay 3, and Pralay 4. He is very meticulous and knows safety comes first – he wears a helmet even while riding a horse. No wonder he is enraged when the hero smokes a pipe in front of his missiles. He snatches it and throws it away only to discover it is a smoke bomb. And all his plans come undone.

General Dong
Amrish Puri
General Dong is the leader of Dongrilla, which lies between India and China. Unlike other villains who make vamps dance, General Dong steps on to the dance floor himself. His choice is a strange fusion of Chinese and Indian folk music. And he loves samosa. That’s why he sings, “Shom Shom Shom Shamosa Sa” Pioneer of the human bomb, when he isn’t singing and dancing, Dong is hypnotising young girls to blow themselves up. The Indian army is sending a team to mess up Dong’s. But what they don’t know is, “Dong kabhi wrong nahin hota”.

Tapasvi Gunjal
Gulshan Grover
In the film Vishwatma, the main villain Azghar Jurhad makes several mistakes. And no, we aren’t talking about the ones that lead him to downfall. We are talking about his son. First he names him Tapasvi Gunjal (are you kidding me). Then he allows him to keep a weird hairdo and colour it blonde. Not to mention the shiny suits to go with the hair. Oh, we wish the list would end here. But, no, Azghar had to fund his son’s flute classes. All this ensures that Gunjal makes a complete ass of himself.

Touch me, touch me not

Looks good when mounted on the wall

Asus Eee Top ET 1602 looks good and is functional when mounted on the wall (Image courtesy: Asus Tek)

 After the success of touch phones like the iPhone, an increasing number of PC makers are slowly introducing touch-enabled devices. So is it time to throw out the mouse and keyboard?

In January 2007, two devices using touch interface were introduced to the public. One was a PC, the other a phone. Today, one is restricted to a niche segment, the other has transformed the entire cell-phone industry. One is the HP Touchsmart PC, the other is the Apple iPhone.

It’s a stark contrast. Few PCs have touch capability unlike cell-phones where it has become a coveted feature – the iPhone was followed by string of devices, collectively dubbed the iClones or ‘iPhone killers’. 

So, why have PC manufacturers shied away from this seemingly addictive technology? For one, attempts in the past have failed to take off in a big way. Tablet PCs (high-end laptops, with a distinctive swivelling screen) manufactured by the likes of Toshiba, Lenovo, Dell, and HP feature touch screens. But companies manage to sell only about 150-200 units per quarter, according to Diptarup Chakraborti, principal research analyst, Gartner India.

In the PC segment, the major player currently is HP. The TouchSmart series is a stylish all-in-one PC. It is a high-end performer boasting great specs in terms of processor, memory, and multimedia. The monitor, of course, is touch enabled. But with a price tag of about Rs90,000 it’s clearly meant for the enthusiasts.

The new Asus EEE Top ET1602, which launched in India last month retails at almost half the price, Rs44,000. What you lose in the bargain is the high-performance specs, but you can easily use the PC for basic functions like editing office documents, browsing the internet, and playing movies. You can also mount this PC on your wall. However, for performing such functions, ET1602 is indeed too expensive.

In short, you are basically forking out extra money for the touch-screen interface. So, does it make a meaningful difference to user experience?

We tried out the ET1602 to find out. The ET1602 is an all-in-one PC, and though not as stylish as HP Touchsmarts, it definitely will draw attention. It uses Windows XP as opposed to Vista in HP.

Almost immediately you realise that having a touch interface by itself is not enough. It has to be applied in a way that truly makes a difference. Even in cell-phones, touch screens were around much before the iPhone. But the difference between a normal and touch phone was just a matter of pressing the screen with a stylus instead of a button. The iPhone’s software transformed the way you accessed data on the phone: Whether it was the sweeping thumb gesture to browse through photographs, or using two fingers to zoom in and out of a webpage.

Back to the ET1602, the ability to tap a link on a webpage with your finger instead of using the mouse isn’t a transformational change (in fact, it’s a bit cumbersome). In the absence of software that takes advantage of touch interface, you are simply not compelled to lean forward from your chair and reach out for the screen – you might as well use the conveniently placed keyboard or mouse instead. We found it difficult to click links on web pages which used small fonts and even normal desktop icons on Windows XP.

No wonder, both HP and Asus have developed custom interfaces of their own. The Asus ET1602, for example, starts in what is called the Easy Mode. You can access your basic applications (from your web browser to office applications and also some games) from the Easy Mode screen. The large icons help and its much easier to tap on using your fingers. But you see a real difference in an application called theS Eee Memo which is used for leaving virtual post-its on the screen. Once you start it, the post-its come in four colours. You can scribble the note using the stylus (which tucks in neatly under the keyboard). As Vinay Shetty, country manager, components, Asus, points out, “such a feature is very handy if the PC is mounted on a kitchen wall.” Once done, the post-its can be picked up using your finger and dropped into the dust-bin on the screen.

But get out of the Easy Mode and try using normal applications, the experience immediately becomes ordinary. The experience is similar for the HP Touchsmart series. Here’s what one reviewer at Gizmodo (gizmodo.com), a popular gadget review website, had to say about his experience with the Touchsmart iQ506: “…while the touchscreen works well within the interface, trying to control the rest of Vista can be maddening. Buttons and icons in Vista are too small for finger taps on the screen, resulting in hitting the wrong button, or not hitting anything at all. I basically gave up on navigating Vista with the touchscreen after the first 30 minutes.”

The bottom line as Diptarup Chakraborti of Gartner puts it, “Current way of using PC doesn’t aid touch. Touch screen works beautifully you are playing games, making phone calls using Skype… basically whenever you are doing minimal typing. Plus, it’s a cool thing to show off. But if you use your PC to type a lot, touch screen becomes more uncomfortable.”

It’s telling that despite the iPhone’s success, Apple is silent when it comes to introducing touch interface on its PCs. But other manufacturers are optimistic: “Even when the mouse was introduced more than 20 years ago, there weren’t any application to take advantage of the device. All games were keyboard-based,” says Vinay Shetty of Asus. Admitting that touch may not replace input devices like keyboard and mouse since every user has different requirement, Rajiev Grover, director, consumer products, personal systems group, HP said, “once touch becomes enabled in more devices, programs that take advantage of it will also emerge. Everything from fun apps such as putting together an animated jigsaw puzzle to mimicking the turning of a page when scrolling through a web site could be fun. Therefore the concept of ‘Touch’ has only one way to go and that is upwards.”

For now at least, look beyond touch to get the best bang for your buck.

Last week seemed like a film festival

Saw four movies last week. Brief thoughts on each one:

The Curious Case of Benjamin Button: Didn’t live up to the hype. Yup, the acting’s good, the story interesting… but the narrative is a tad slow. The movie has a Forrest Gumpish feel to it — but Forrest had way better and interesting experiences than Benjamin. Of course Benjamin is interesting from the birth itself (you know, since he is born old n all). What I found most thought provoking though is that just as aging ain’t easy (many find it terrifying), growing young too isn’t that different.Taraji Henson’s acting is the best according to me.

Pink Panther 2: Lots of funny sequences held together by a loose script. Great actors like Andy Garcia and Jean Reno completely wasted. Absolutely no mystery in the script. Oh and Aish’s performance is horrible. She anyway doesn’t have much of a role to play and she couldn’t pull that off too.

Pineapple Express: We wanted to see Milk, but couldn’t reach the cinema in time thanks to the traffic. Instead we decided to get together at a colleague’s house and rented a DVD. And the DVD guy’s recommedation Pineapple Express turned out to be great. Starring Seth Rogen and James Franco it is one of the best junkie movie I’ve seen. Lemme not say anything more, but here’s a dialogue in the movie where James Franco (the seller) is describing pineapple express (a type of marijuana) to Seth Rogen (the buyer):

“This is like if that Blue Oyster shit met that African Kush I had – and they had a baby. And then, meanwhile, that crazy Northern Light stuff I had and the Super Red Espresso Snowflake met and had a baby. And by some miracle, those two babies met and fucked – this would the shit that they birthed.”

Milk: How does one act without moving any part of the body… just with eyes? Well, you gotta watch Sean Penn in Milk to find out. His acting is just sublime. Otherwise is film is ok. But watch this one for Sean Penn.

Flower sellers of Matunga

Visiting Matunga to see the Ganesha murtis is an annual ritual for me. I love clicking photographs of the beautifully decorated pandals. This time though I also turned my lenses on stalls that sell garlands in Matunga. Matunga, as some of you may know, is the temple district of Mumbai. Here’s one of the photographs. The rest on Zooomr.

This guy was hesitant to face the camera, let alone smile. A comment from his colleague however had him in splits

This guy was hesitant to face the camera, let alone smile. A comment from his colleague however had him in splits --R Krishna