The Express Tribune Magazine - July 6

JULY 6-12 2014

Healthy FAST FOOD When and what to eat in Ramazan

JULY 6-12 2014

Portfolio

A thousand unspoken words

Cover Story Healthy Fast Food

Animals at the Karachi zoo say it all with their eyes

How to maintain health and fitness in Ramazan

38

Feature

Shell-Shock A connoisseur of seashells

44

28

4

Regulars 6 People & Parties: Out and about with beautiful people

46 Reviews: Movies and books 50 Health: Alzheimer’s and its prevention

Magazine In-charge: Sarah Munir, Subeditors: Dilaira Dubash & Mifrah Haq Creative Team: Amna Iqbal, Essa Malik, Jamal Khurshid, Samra Aamir, Munira Abbas, Omer Asim, Sanober Ahmed & Talha Ahmed Khan Publisher: Bilal A Lakhani. Executive Editor: Muhammad Ziauddin. Editor: Kamal Siddiqi For feedback and submissions: magazine@tribune.com.pk Twitter: @ETribuneMag & Facebook: https://www.facebook.com/ETribuneMag Printed: uniprint@unigraph.com

PEOPLE & PARTIES

Maybelline New York launches its new cake powder in Karachi

PhoToS couRTESY LoTuS PR

Jadirah, Cenam and Anila

Zoha and Nikhar

d Hammad

Zohair, Nabiha an

Uzma and Raana

Fatima and Ayesha

6 JULY 6-12 2014

PEOPLE & PARTIES

PhoToS couRTESY LoTuS PR

Farhan and Khursheed

Wajiha and Mrs Sheikh

Sehrish

Sara

Maliha

8 JULY 6-12 2014

PEOPLE & PARTIES

The fashion label Popinjay opens in Lahore

PhoToS couRTESY BILAL MuKhTAR EvENTS ANd PR

Amina and Tabinda

Anum, Hira and Nida

Yasmeen and Samia

Huma Amir Shah

Amna and Samra

10 JULY 6-12 2014

PEOPLE & PARTIES

PhoToS couRTESY BILAL MuKhTAR EvENTS ANd PR

Hamna Arif and Mona

Ayma Noon, Eman Omar and Hamna Khalid

Fatima and Amber Liaqat

Libby

Redah Misbah

Sonu and Sadia

12 JULY 6-12 2014

PEOPLE & PARTIES

chenone opens up at ocean Mall, Karachi

PhoToS couRTESY TAKE II

Mouzam Abbasi With Rayan, Saif And Khoula

Muneera and Amir Lakhani Sharmila Farooqi Abeer Adeel

Hina Lateef

Mehreen and Fakhir

14 JULY 6-12 2014

PEOPLE & PARTIES

PhoToS couRTESY TAKE II

Neera Manzoor and Malina

Mehvish Hayat and Mian Kashif

Falak Shaikh

Sadia Nawabi

Sadaf Kanwal and Sana Sarfaraz

16 JULY 6-12 2014

Healthy FAST FOOD COVER STORY

Healthy lifestyle choices could make this Ramazan a fulfilling bodily experience

BY MIFRAH HAQ AND ISHRAT ANSARI

DESIGN BY ESSA MALIK

Come Ramazan and household kitchens go into overdrive. Samosas and pakoras are downed by the dozens and ghee-soaked parathas are consumed to last us the day. The cravings from the day-long abstinence from food are satisfied with the juiciest, fattiest and most calorie-laden fare our cuisine can offer.

But much of what we traditionally eat is counterproductive to our health. In fact, the benefits derived from month-long fasting, such as detoxification of our bodies and regulation of our metabolism, could easily be reversed by binge eating or an unbalanced diet.

To strike a balance between feasting and fasting, T-Magazine gives you the lowdown on how to maintain health and fitness during Ramazan.

29 JULY 6-12 2014

Nutrition during Ramazan This year, the fasts would last anywhere between 16 hours to 18 hours, depending on where in the world you are, and the trend will continue for the next 10 years to 15 years till the time Ramazan coincides with the summers.

Taxing weather and dietary excesses could take a toll on your body if a healthy eating and hydration plan is not followed.

To ensure that, your diet should include foods which are low in carbohydrates and rich in proteins, good fats and fibre. Plain water and fruit juices are recommended over artificial sweeteners and soft drinks.

Observational studies show a massive correlation between artificial sweeteners and obesity, even though they are calorie-free. But if you insist on satisfying your sweet tooth without having actual sugar, choose the healthier option, stevia.

Dr Mozamila Mughal, clinical dietician at the Aga Khan University Hospital (AKUH), Karachi, advises

and causes discomfort and sleeplessness,” Dr Mughal says, adding that people should eat less at iftar and have a full meal at dinner an hour later.

For children who are fasting, healthier meals such as homemade soups, fresh fruit juices, vegetable salads, noodles and milk shakes should be prepared advises Dr Saima Rashid, lecturer at the Dow University of Medical Sciences, Karachi.

Hydration during Ramazan Doctors recommend drinking eight to ten tall glasses of water a day, which roughly amounts to two litres. If you fail to consume the required quantity of water during the non-fasting hours of Ramazan, you may show signs of dehydration. “Your urine should be pale like straw,” says Dr Rashid.

“Any darker [colour] means you need to slowly increase your fluid intake. Your body will quickly adapt and your trips to the bathroom will lessen.” Insufficient fluid intake can lead to kidney stones or lethargy due of fall in blood pressure.

Water intake during Ramazan has to be

One samosa or a couple of pakoras in a day are enough, she says, as three tablespoons of oil is how much a person should consume in a day Clinical dietician Dr Mozamila Mughal careful planning of sehr and iftar menus, minimising the intake of fried and spicy food items. Sehri should include foods, such as eggs, porridge and wheat, which sustain the body throughout the day. The fast should be broken with a date and a beverage to restore glucose level in the blood, followed by fruit chat and white or black beans, along with one fried item. One samosa or a couple of pakoras in a day are enough, she says, as three tablespoons of oil is how much a person should consume in a day. “Fat and high-calorie food takes time to digest, causes acidity and increases weight and cholesterol. The stomach gets heavy

planned well: drink up to three glasses of water during sehri, while two litres of fluids in the form of water, lassi, milk shakes and fruit juices should be consumed after iftar. If you are already meeting the day’s water intake, you may drink an additional two to four glasses of water to counter the dehydrating effects of air conditioning and extreme outside temperatures, says Dr Rashid.

Fruit and vegetables can be particularly hydrating, and during Ramazan people should try to consume more than five portions of fruit a day — especially watermelon, grapefruit, apples, tomatoes, cucumber, squash, courgettes and lettuce.

Ramazan and diabetes Long fasts during hot and humid weather can be taxing for the healthy body, and you would assume that patients with diabetes should not fast. But a 2004 study of 12,243 people with diabetes from 13 Islamic countries showed that approximately 43% of the patients with type 1 diabetes and 79% of patients with type 2 diabetes fast during Ramazan.

With adequate care and monitoring of blood sugar, a diabetic patient may fast. “It depends on your own situation,” says Dr Jaweed Akhter, head of endocrinology at the AKUH. “If blood sugars leading up to Ramazan are regulated, then they may fast.”

Ideally, the patient should undergo a medical exam at least one or two months prior to Ramazan to ascertain his condition. On the basis of the results, the physician should be able to recommend the appropriate diet and adjustment in medications for Ramazan.

Dr Akhter recommends taking a small dose of diabetes medication at the time of sehri, while a larger dose during iftari, but of course with the doctor’s advice. “It depends on which medicines they are taking. Usually people take a larger dose during the mornings, which is wrong. On a routine day, the morning dose covers breakfast, snack and lunch, while the evening dose covers dinner. In Ramazan, this is reversed, where in the morning a small dose of medicine is enough for sehri, while the larger evening dose covers iftari, dinner and a possible midnight snack.”

Blood glucose levels must be monitored during the fast, once before iftari and then two hours after it, and in times of weakness or hunger. The fast is not broken by the prick of a needle checking for blood sugar or injecting insulin, according to a fatwa issued by the Islamic Fiqh Assembly of the Organization of the Islamic Conference. ent to break his fast is The best way for a diabetic patient

Recommended diet for diabetes patients: Foods to take: Foods rich in fibre and complex sugars (which digest slowly and do not lead to instant blood sugar spikes), such as whole grains, fruits, chickpeas, lentils, salads, cereals, meat, lemonade, lassi and dates (maximum two in a day).

Foods to avoid: Foods involving simple sugars such as mangoes (only one small or half of a large mango allowed), fruit juices, refined grains such as white rice (limit to three times a week) and white bread, and fried items.

by exercising discipline. Dr Akhter suggests breaking the fast with one or two dates, taking an insulin shot if required, offering prayers (which would give the desired 15 minute break between the shot and the meal) and then having dinner, as opposed to snacks.

Risks of fasting for diabetic patients If a patient has fluctuating levels of blood sugar, is pregnant with diabetes, or suffers from associated kidney problems, then fasting should be avoided. In fact, if blood sugar levels fall below 60mg/dl or surpass 300mg/dl, the fast should immediately be broken.

The risks arising from fasting with uncontrolled diabetes can vary from moderate to severe. The patient may suffer from hypoglycemia — low blood sugar (less than 60 mg/dl) resulting from high insulin, a hormone that allows your body to absorb sugar from food to make energy or store it for later use. The symptoms are weakness, fatigue, palpitations, sweating and hunger pangs. In severe cases, with blood glucose levels of less than 30mg/dl, the patient may suffer from blurred vision, poor responsiveness and even coma and death.

Hyperglycemia occurs when blood sugar rises to more than 300 mg/dl due to low insulin. This could be a result of inappropriate diet or non-adjustment of medication. It could lead to dehydration as the body loses fluids to dilute the sugar concentration in the blood, putting pressure on the kidneys, or leading to clots from increased blood viscosity.

Diabetic ketoacidosis usually results from the excessive reduction of insulin dosages based on the assumption that food intake is reduced during the month. The body switches to burning fat instead of glucose for energy, resulting in high blood sugar.

COVER STORY

Ramazan and heart patients Heart patients suffering from high cholesterol or hypertension, whose condition remains controlled with medication, are encouraged to fast, with small modifications to the dosage and timings of the medicines.

“It increases compliance to therapy,” says Dr Aamir Hameed Khan, cardiologist at AKUH. Age is no inhibition for fasting, unless your condition is frail. A blood pressure medicine can be taken without sehri as well, but should not be missed. There are certain medicines, however, which are diuretics, meaning they make the body produce more urine. Such medicines can be taken at the time of iftar to minimise bathroom trips during fasting.

The good news is that diet affects the heart in the long term. “As long as weight is not gained or the waistline is not increased, a month of indulgent eating doesn’t make a difference,” says Dr Khan. “A jalebi would not hurt.”

But that doesn’t give you the excuse to eat recklessly. In fact, Dr Khan says that, “The patient should not change his routine or diet, but the whole family should, because they are all at risk of heart ailments due to genetics.”

His recommended method of breaking the fast: take two dates and milk, pray and then have routine dinner for iftar. “Make dinner and iftar one event,” he says. This prevents binge eating, ensures adequate nutrition for the body and leaves the stomach empty before sleeping.

Risks of fasting for heart patients “Only patients in an unstable condition are asked to refrain from fasting,” says Dr Khan. This includes people who suffer from heart failure and irregular heartbeat, and those who have angina pains during walking, bathing or 32 eating.

JULY 6-12 2014

The patient should not change his routine or diet, but the whole family should, because they are all at risk of heart ailments due to genetics Cardiologist Dr Aamir Hameed Khan

Recommended diet for heart patients: Foods to take: Fruits, salads, vegetables, whole grains, fish, chicken, beans and lentils and beef and mutton in moderation.

Foods to avoid: Fried food items, too much chutney and pickle (they are high in salt and spice) refined and processed carbohydrates (have less fibre and instantly dissolve in blood) such as white bread, white rice and tea and coffee (because they are diuretics and dehydrate the body).

Weight gain and exercise during Ramazan The long hours of fasting may not be enough to burn out those few extra pakoras from the previous iftar, and your body may start showing signs of a bulging belly and tightening pants. The increase in the consumption of fried food items during Ramazan often leads to weight gain. Some doctors assert that physical training during Ramazan is not necessary as prayers, five times a day, and taraweeh are enough exercise.

But the fitness team at one of Lahore’s popular gyms, Shapes, states that a month-long gap in fitness training for people who regularly work out, sets them back a great deal.

The trick is to maintain your existing exercise programme, but not intensify the routine by increasing weights, sets, repetitions, speed or distance. According to the Shapes team, the ideal time for exercise is 90 minutes before iftar or, as Dr Khan recommends, two hours after it. Thirty minutes of exercise is enough on a fasting day, says Dr Mughal.

There are, of course, exceptions for people who suffer from injury or chronic diseases. The Shapes team does not allow patients with Type 1 diabetes to exercise at all since physical activity may lead to insulin suppression in the body. Type 2 diabetics, however, can do aerobic exercises

and low-intensity strength training for a maximum of 30 minutes. For heart patients, Dr Khan insists that the exercise regimen must not change. Ideally, they should do aerobic exercises five times a week for 30 minutes, either before iftar or two hours after it.

The diet effect Controlling one’s diet is equally important for maintaining a healthy weight. Do not mistake a loss in weight during Ramazan as necessarily a result of eating less; fasting could lead to dehydration and hence the change in weight, warns the Shapes fitness team. Eat foods that digest slowly, such as fibrous foods or those rich in complex carbohydrates, as these keep the stomach full for a long time. Eating too much will not last us the whole day because we cannot store food like camels. Instead, go for a protein breakfast, because calories from it are broken down slower than from carbohydrates. Have sweets only after eating your meal and drinking water, and when your stomach tells your brain that you still have space. Avoid late night snacking as it is more likely to be stored as fat. T Mifrah Haq is a sub-editor for The Express Tribune Magazine.

Ishrat Ansari works at The Express Tribune Karachi desk.

She tweets @Ishrat_ansari

PORTFolIo

A thousand

unspoken words

Animals at the Karachi zoo relay their misfortune through the sadness in their eyes

by DIlaIra Dubash PhoTos by ammar haq DesIgn by sanober ahmeD

July 6-12 2014

If you are tender-hearted, the Karachi zoo is not a place for you to visit. The general callousness towards the animals will scar you for life. While zoos across the world attract hundreds of millions of visitors each year, the Karachi zoo today is the image of a forsaken animal prison. Few people visit and even fewer animals remain, whiling away their time behind rusty iron bars, waiting to bite the dust.

PORTFolIo

Established in 1878, the zoo today is a shadow of its former self, faintly meeting its objective as a place for public recreation

40 July 6-12 2014

Despite having come under increasing criticism in the recent past, the Karachi zoo continues to keep its doors open, persistently violating all standards of animal welfare. Established in 1878, the zoo today is a shadow of its former self, faintly meeting its objective as a place for public recreation. Home to one of the oldest zoological gardens in the country, it is now a sight of negligence with patchy lawns strewn with ice cream wrappers and chips packets. And the plight of its animals is similar, their fate seemingly murkier than the water in the duck pond.

In the stagnating stench of urine and feces, animals are kept in cramped enclosures. With no objects or space to exhibit their natural behaviour, they either lie lethargically on the scorching concrete floor or pace up and down their unkempt enclosures. And the only reaction one can muster from them is either a blank or a wistful stare.

With no legislation or a specific Zoo Act in Pakistan for wildlife in captivity, the animals who are subjected to prodding with sticks from visitors goes unnoticed and unpunished. Like with all other government incompetences that are solved with privitisation, it would be better to hand the care of these animals in the hands of someone who understands the value of life. t Dilaira Dubash is a senior subeditor on The Express Tribune magazine desk.

She tweets @DilairaM July 6-12 2014

41

Feature

Shell-Shock Muhammad Usman Khan shows off his sea of shells

By MuhaMMad adil Mulki Photos By aMeer haMza

They say that the seaside has a way of seeping into the soul and remaining there. This could not be truer for Muhammad Usman Khan. When his father, a doctor, was deputed to Abu Dhabi in the early 1970s, a time when the Emirate was only a desert by the sea, five-year-old Khan would accompany his grandfather on his daily walks over the sand dunes by the sea. Fascinated by the seashells that lay there glistening in the sun, Khan started collecting them and discussing each new find with this grandfather during the course of their walks. Back at home, his grandmother would use the shells to create objects which served to motivate him to go looking for more.

Decades passed by, and today, Khan is a corporate trainer and an adventure enthusiast living in Pakistan, but his love for seashells hasn’t lost any depth.

Khan’s collection is large enough to fill up a small room entirely. It ranges from polished cowries, bivalves, murex, cockles, angel wings, conchs, mother of pearl and other curiosities such as sea urchins, sand dollars, starfish and a minor collection of fossils. All major groups of shells are well represented.

As a die-hard conservationist and qualified travel guide, Khan does not believe in gathering corals from his frequent snorkeling trips. Some overzealous junior fans, however, gifted him some along with sea fans that they had picked up years ago. Although Khan does not approve of the practice, these nature’s masterpieces from the ocean’s abyss are now an integral part of his collection. And there is just a glint of pride as he displays them.

“The things to look out for in a shell are its natural beauty and condition,” says Khan. A specimen that has no broken spikes or edges is a good find. “Sometimes I pick up a shell only to find a live creature inside it. I put those down,” he says, adding that he does not like displacing a creature for his hobby. For a shell to make it in his collection, it has to be dead.

44 “They do not require much maintenance, [only] a good July 6-12 2014

Muhammad usman khan developed this love for shells while growing up in abu dhabi.

angel wings

Cowry

The things to look out for in a shell are its natural beauty and condition. Sometimes I pick up a shell only to find a live creature inside it. I put those down Shell collector Muhammad usman khan

Conch

sand dollar

starfish

Bivalve shell

Cockles

Murex

a small portion of khan’s collection.

wash after they are picked, and then a little drying and airing under the sun,” says Khan. It is only when he and his wife decide to create something artistic with the shells that they treat the selected shells with a diluted bleach solution. The solution has to be carefully prepared or it might risk dissolving the calcium-rich shell. For the rest of his collection, an occasional dusting does the trick.

Unlike many other hobbies that require one to shell out large sums of money, Khan assures that his does not come at a price. He simply goes on collecting specimens whenever he visits the beach. Khan being the cowry-crazed collector, however, does not hesitate to purchase specimens from other collectors whenever he comes across a unique piece.

Since childhood, Khan has always had an eye for beautiful things. The day he discovered these jewels, he just couldn’t pull away from them. Once when his grandfather refused to take a walk with him, he decided to traverse the dunes himself in search for shells. But he ventured further out than he had intended and lost sight of his house. Disoriented, he climbed the highest dune and located his house from the top. These were the early signs of an avid shell collector in the making.

Although initially Khan’s wife did not approve of her husband carrying bagfuls of shells back home, especially mollusks, she eventually grew fond of them. Today she designs ornaments using those very shells.

“Pakistan is blessed with a rich shoreline that offers different kinds of shells,” says Khan, admitting that over the years, however, with urban growth and increasing pollution, there has been a visible decline in the variety. The number of shell pickers has also increased, making it more difficult to retrieve larger varieties. As a snorkeler, however, Khan adds, almost as if revealing a well-kept secret, “The prospects beneath the surface are still quite bright.”

At present, Khan is exploring ways to show off his shells.

And the rate at which his collection is expanding, it won’t come as a surprise if it selected to be exhibited at a museum soon.

Muhammad Adil Mulki is a Certified Information Systems Auditor, works for a private bank and is interested in the outdoors, wildlife and science.

July 6-12 2014

45

FILM

Not your typical fare A sports flick that delves much deeper than the stereotypical treatment meted out to most in this genre

BY SAMRA MUSLIM

Hollywood’s newfound fetish with Indiaoriented films continues. With films such as The Namesake, Bride and Prejudice and The Best Exotic Marigold Hotel, emotional family dramas and ‘exotic’ cultural displays have dominated most of this genre, making it predictable in its treatment.

From the moment the first trailer hit the screens, one could easily make Million Dollar Arm to be a mix of Slumdog Millionaire and Jerry Macguire. Moreover, sports movies can be really clichéd because there are really only two options for the ending — success or failure (with wisdom acquired). However, despite the obvious predictability, Million Dollar Arm works.

The film is a biopic drama about an American sports agent, J B Bernstein (played

by Mad Men’s Jon Hamm), who is supported

by Aash (Aasif Mandvi), as they fail to sign on any clients and are on the brink of losing their office.

Their solution is to go to India, find fresh baseball talent (basically find cricket players

and develop them as major league pitchers) and sign them on to big moneymaking contracts. Bernstein sets up a reality competition across India called the ‘Million Dollar Arm’; the top two throwers then get to come to America to try out for a Major League Baseball team.

The focus of the movie is never on the extraordinary success of the two selected baseball players; it is about relationships.

Bernstein is a single man who only means business, and does not realise that he has uprooted the lives of the two people he has brought halfway across the world.

The Indian boys (played by Suraj Sharma and Madhur Mittal) are teenagers who have never been away from home and are lonely, scared and nervous in a foreign land where they don’t even know the local language. This is an emotional rollercoaster for everyone involved, and watching it unfold is both touching and beautiful.

Million Dollar Arm is a solid character study of Bernstein.

As a down-and-out, dealhungry, self-centred sports agent, he is easily agitated and comes across as cold and uptight. But as the film

progresses, you realise that Bernstein is on a personal journey, evolving into an overall better person with empathy and emotions.

The film works due to its protagonists’ strong performances. Jon Hamm gives a superb, heartfelt performance and looks very charismatic on screen. Pitobash (from Bollywood films Shor in the City and Shanghai) is a scene-stealer and extremely loveable as the Indian wannabe baseball coach who is taken by Hamm rather reluctantly under his wing. The Million Dollar Arm contestants, Suraj Sharma (Pi Patel from Life of Pi) as Rinku and Madhur Mittal (previously seen in Slumdog Millionaire) as Dinesh, are the stars of the movie. From the very beginning, you become emotionally invested in them: you cheer for them when they perform well; you are devastated when they slip. Lake Bell, Aasif Mandvi, Alan Arkin, Bill Paxton and Tzi Ma deliver well as supporting cast. Director Craig Gillepsie beautifully captures the contrasts between the lifestyles, cultures and colours of America and India, underscored by AR Rehman’s music.

Million Dollar Arm is a feel-good movie for audiences of all ages.

Rating: Samra Muslim is a digital marketing professional, an avid reader and a movie buff. She tweets @samramuslim

The Biz-ness

of Twitter

BOOK

Even when Biz Stone was erratically calling it quits to stable jobs, there was a method to his madness. He was systematically moving towards creating an internet paradigm-shift called Twitter

By Faiza RaHman

available at Liberty Books for Rs995

author Biz Stone

48 July 6-12 2014

You’d expect the founder of Twitter to be a dry, donnish computer whizz, having obscure essays to his credit — not an art school dropout with a flair for creative writing and graphic design. But surprise, surprise, Biz Stone, the co-founder of Twitter, never finished college and never wrote his essays on time. He was, in fact, making art for books when he stumbled into the IT world. Things a little bird told me, a 222-page volume, delves into such details of his life, which either leave you utterly aweinspired or simply annoyed.

You will be annoyed because he does not shy away from lending generous recognition to himself in a tone which borders on being pompous. “I think I have a genius idea,” he says at one point, while talking to his friend about a new tech venture he thought of. His short, crisp sentences convey a nipping sense of certitude. He sprints from job to job, abandons his education, crafts an alternative world out workof his blog and refuses to waste time in work creativplaces that he feels are inhibiting his creativ ity no matter how stable or lucrative the job might be. He eventually ends up with a team that invents Twitter as a small, side project.

Starting off with an account of how he and his girlfriend Livia were trudging past life, Northburdened with debt, he tells how he, a North eastern University dropout, cracked Google’s notoriously exhaustive recruitment process by “believing in himself”. At first, you will not believe it, but when you do, you will feel happy for him. That said, a few sentences later, you will recoil. “I needed a new source of energy, so I quit Google,” he writes in a drop-of-a-hat reafashion, without citing any other plausible rea sons. Irritated? Impressed? Read and decide.

You may be awe-inspired if you understand that this is the story of a man who has always taken pride in his choices; who was sure of

himself and made no secret of it. Even when he was erratically calling it quits to stable jobs, there seemed to be a method to his madness.

After all, the end result of it all was nothing less than an internet paradigm-shift that is Twitter.

Moreover, you might slowly forgive his aplomb when you realise that Biz Stone embraces his failures as enthusiastically as his successes. He refuses to accept failure with humble resign; instead, he continues to acknowledge his own talents and treats failure as mere ‘gaps’ which give one room to manufacture opportunities. His theories on sustaining the creative thought process are remarkable; the lens through which he sees failure and success is unusual.

Success to Biz Stone is not being able to pay his credit card debt or buying a car, or finally having a bed to sleep on. Success for him is the sheer pleasure of creating something. His progress at school, his family life, and life with Livia, all help the reader know Biz Stone, the man, most intimately.

The time when he surreptitiously designed a book jacket for a publisher while working as his labourer, helps us understand him. Who else would abandon the work they are being paid for, sneak into a stranger’s workstation and do their work? Someone for whom fulfillment is about ‘creating’, for sure.

The tidbits of advice on how to get around difficult times in one’s career are invaluable.

Accounts of how the team designing Twitter sorted out the many technical glitches will be thoroughly enjoyed by tech enthusiasts. All in all, Things a little bird told me is a good motivational read. T Faiza Rahman is a subeditor for the Editorial pages at The Express Tribune.

Blurred Lines What to expect with Alzheimer’s and how to prevent it

BY NISMA CHAUHAN DESIGN BY SAMRA AAMIR

Memory slips are common with age but sometimes they could be an early sign of Alzheimer’s, the most common type of dementia. According to the World Alzheimer Report 2013, the total number of older people with care needs will nearly treble from 101 million to 277 million between 2010 and 2050, declaring the disease a national health priority that needs immediate attention. And since out of 193 countries in the World Health Organization, only 13 have national dementia plans, many people are left tackling with the disease on their own.

“In simple terms, patients lose their cognitive functions.

This does not only include impaired memory but also reasoning, judgment, problem solving and other thought processes,” says Mughis Sheerani, a consultant neurologist and clinical neurophysiologist at the Aga Khan University Hospital. In its early stages, an individual loses the ability to retain and recall past events. A sense of disorientation prevails, causing anxiety or depression.

Despite copious amounts of research, scientists still do not have a clear idea as to what causes the disease, explains Sheerani. “Whatever the cause, the brain seems to shrink and lose nerve cells. The cells start to die with the deposition of abnormal material in the brain called amyloid [a starchlike protein which is deposited in the liver, kidneys, spleen or other tissues in certain diseases],” he says. “[And] neurons are the only cells that our body cannot reproduce,” adds Safdar Arain, neurosurgeon at Zubeida Medical Centre.

“The patient, because of the cognitive loss, does not understand its implications and devastation. As the disease progresses, the patient becomes more and more dependent on the family for daily activities,” explains Sheerani, adding that it affects the entire family and the caretaker rather than

just the patient. “Initially, the patient may have simple problems like difficulty in calculating, driving and cooking.

But in the advanced stage, the patient is almost totally dependent on family members even for daily needs like eating and toileting.”

“There is no cure, but there are treatment options available to slow the progression and severity of symptoms,” says Arain, adding that Donepezil and Rivastigmine are drugs prescribed to patients to help reduce the progressive symptoms of the disease and to stabilise the dead brain cells for a moderate period of time. Creating a safe and supportive environment is imperative for constructing a treatment plan. Patients should follow routine habits and minimal memory-related activities should be encouraged. Exercises and keeping count of nutrition intake will also help boost brain cells.

People with a family history of Alzheimer’s often fear inheriting the disease as experts believe that genetics plays a crucial role in the development of early-onset or late-onset Alzheimer’s. But by avoiding or treating the following environmental and lifestyle factors, one can reduce the chances of acquiring the disease: — Lack of exercise — Smoking — High blood pressure — High blood cholesterol — Elevated homocysteine level (hardening and narrowing of the arteries) — Poorly controlled diabetes — Lack of fruits and vegetable in the diet Research carried out by the Alzheimer’s Association identifies that lifelong learning and social engagement also minimise the risk of acquiring the disease.

Nisma Chauhan is pursuing a Bachelor of mass communication degree with a major in print. She tweets @ChauhanNisma

Challenges in planning or solving problems Confusion with time or place Trouble understanding visual images or spatial relationships Withdrawal from work or social activities Memory loss

Early warning signs

Misplacing things and inability to retrace steps New problems with spoken or written words Repeating the same stories or questions Decreased or poor judgments Changes in mood or personality