Monday, January 27, 2020

Effect of Curcumin on Periodontis

Effect of Curcumin on Periodontis INTRODUCTION Periodontitis is a chronic inflammatory disease characterized by destruction of the soft and hard tissues supporting the tooth. This tissue destruction appears to result from complex interaction between the bacteria and the host’s immune and inflammatory system. The host immune response identifies these invading pathogens and tries to neutralize or kill these microorganisms. During this process the host response elaborates a variety of mediators such as pro-inflammatory mediators, cytokines and proteolytic enzymes such as matrix metalloproteinases (MMPs). It is now believed that the major component of the soft and hard tissue destruction seen in periodontitis occurs as a result of activation of these mediators.1 Thus this host response which is essentially protective by intent paradoxically can also result in tissue damage. Hence recent therapeutic efforts are now focusing on altering or modulating this host response. This lead to emergence of a new comprehensive treatment str ategy for periodontitis which involves Host modulatory therapy (HMT) which can be combined with traditional periodontal therapies.2 To date, there is one FDA approved, systemic therapy that is prescribed as a host response modifier in the treatment of periodontal disease and that is adjunctive subantimicrobial dose doxycycline (SDD), which down-regulates the activity of MMPs.3 These MMPs are considered to be primary proteinases involved in periodontal tissue destruction synthesized by a variety of infiltrating inflammatory cells (i.e. neutrophils and macrophages), resident cells and some bacteria. Numerous studies have substantiated the relationship between MMPs and periodontal diseases, with findings of significantly higher MMP-9 (neutrophil derived MMPs) levels in patients with periodontitis compared to healthy controls.4, 5 Doxycycline is the most potent tetracycline for inhibition of these MMPs.6 However long term tetracycline therapy has certain disadvantages, the most important being the development of microbial resistance to this drug.7 At present a health care system exists in India where different types of diseases are being treated by Ayurvedic method. Since ancient times Ayurvedic drugs are being used for the treatment of various diseases, including periodontal and other oral diseases.8 They are widely acclaimed for their minimal side-effects and cost-effectiveness. Use of herbal extracts in treating periodontal diseases does not produce side effects of tetracycline compounds as well as other synthetic drugs. Curcuma longa (Turmeric) is a widely used herb which is distributed throughout tropical and subtropical regions of the world and widely cultivated in India, China and Indonesia.9 It has also long been used in both Ayurvedic medicine and Chinese medicine as an anti-inflammatory agent.9 The active constituent in turmeric is Curcumin.9, 10 Curcumin is known to have an anti-inflammatory effect. Studies show that Curcumin limits the activity of two enzymes, lipoxygenase and cyclooxygenase-2 that are involved in promoting and maintaining inflammation.11, 12 Studies have also shown that Curcumin down-regulates the MMP-9 activity.13, 14 Thus it may have a potential role in the treatment of inflammatory periodontal disease. Its anti-inflammatory activity in periodontal diseases has not been extensively investigated. With this background, the study was conducted to evaluate the anti-inflammatory effect of Curcumin by its inhibitory effect on MMP-9 activity and compare the same with Doxycycline, which is known to have an anticollagenase activity. MATERIALS AND METHODS Subjects: A total of 30 sites from 30 subjects (males and females), above 35 yrs of age, diagnosed clinically as having Chronic Periodontitis with pocket depths ranging from 5-8mm were selected for the study. The patients had no history of pervious dental treatment, antibiotic or anti-inflammatory drug therapy for the past 6 months. Patients with any history of systemic diseases / conditions, pregnant patients and smokers were excluded from the study. An informed consent was obtained from the patients prior to their enrollment into the study, and the study has been independently reviewed and approved by the institutional ethical board. Post collection of samples, the patients who participated in this study received the standard treatment protocol for Chronic Periodontitis. Method of Collection of Samples: Gingival tissue samples were obtained under aseptic conditions after administration of local anesthesia from patients who were diagnosed with Chronic Periodontitis. Gingival tissue samples were obtained from sites with pocket depths ranging from 5-8mm. Immediately following excision, these tissue specimens were briefly washed under cold distilled water and blotted dry. Then the specimens were transferred into sterile plastic vials which contained Phosphate Buffer Solution (PBS), pH 7.2, that acted as the transport medium. Specimens were then immediately carried to the laboratory where they were stored at -80à ¯Ã¢â‚¬Å¡Ã‚ °C until use. IN-VITRO STUDY Chemicals Used: Pure extract of Curcumin in powder form (Samy Labs, Bangalore, India) and Doxycycline i.e. pure doxycycline hyclate in powder form (Aristo Pharmaceuticals Limited, Bangalore, India) was used for the purpose of the study. The Curcumin solution was prepared by dissolving 15mg of Curcumin in 10ml of distilled water (1500 ÃŽ ¼g/ml). Preparation of Doxycycline solution was by dissolving 3mg of Doxycycline in 10ml of distilled water (300 ÃŽ ¼g/ml). Extraction of MMP-9: The frozen gingival tissue samples were allowed to thaw to room temperature. Then each tissue sample was homogenized with 2.5% Triton X-100. This was followed by centrifugation of the homogenized samples for 30 mins at 6000 rpm, at 4à ¯Ã¢â‚¬Å¡Ã‚ °C. The resulting supernatant was separated and used for analysis. Detecting the Optimal Curcumin and Doxycycline Concentration: To determine the optimal inhibition of MMP-9 by Curcumin, different concentrations of Curcumin i.e. 300, 500, 1000, 1500 ÃŽ ¼g/ml were added to 50ÃŽ ¼l of gingival tissue extract and incubated at room temperature for 60mins.The addition of increasing concentrations of Curcumin to the gingival tissue extract resulted in decreased MMP-9 activity as shown in Figure 1. Assessing the MMP-9 activity by Densitometric Analysis demonstrated that the concentration of Curcumin required to inhibit more than 50% of MMP-9 activity was 1500 ÃŽ ¼g/ml. Since Curcumin showed more than 50% inhibition of MMP-9 activity at a concentration of 1500 ÃŽ ¼g/ml as compared to the control (without drug), this concentration was used to pretreat the gingival tissue extract in the study. The Curcumin solution with a concentration of 1500 ÃŽ ¼g/ml was freshly prepared prior to processing of each sample of gingival tissue extract. Similarly increasing concentrations of Doxycycline ie 50, 100, 200, 300ÃŽ ¼g/ml were added to 50ÃŽ ¼l of gingival tissue extract and incubated at room temperature for 60mins. Assessing the MMP-9 activity by Densitometric Analysis demonstrated that the concentration of Doxycycline required to inhibit more than 50% of MMP-9 activity was 300ÃŽ ¼g/ml and thus this concentration was used to pretreat the gingival tissue extract in the study. The Doxycycline solution with a concentration of 300ÃŽ ¼g/ml was freshly prepared prior to processing of each sample of gingival tissue extract. Pretreatment of Gingival Tissue Extract with Curcumin and Doxycycline: To compare the inhibition of MMP-9 activity, 50ÃŽ ¼l of gingival tissue extract was preincubated with freshly prepared solution of 50ÃŽ ¼l of Curcumin (1500ÃŽ ¼l/ml) and 50ÃŽ ¼l of Doxycycline (300ÃŽ ¼l/ml) solution for 60mins at room temperature in separate vials. In addition, 50ÃŽ ¼l of extract was also incubated with 50ÃŽ ¼l of distilled water which was used as the control. Assay for MMP-9 Activity: The presence of MMP-9 activity in collected samples was studied by gelatin zymography. Sodium Dodecyl Sulphate-Poly Acrylamide Gel Electrophoresis (SDS-PAGE) on 10% polyacrylamide containing 10% SDS copolymerized with 1g/l gelatin was used to pretreated tissue extracts under non reducing conditions without prior boiling. After electrophoresis, in order to regain the enzyme activity, the gels were rinsed with 2.5% Triton X-100 for 1hr to remove SDS thus allowing the protein to denature. The gels were then immersed in a proteolysis buffer containing Tris- HCl 50 m M/l (pH 7.6) and CaCl2 20mM/l and incubated at 37  ºC for 16 hours. The gels were subsequently stained Coomassie Blue (0.25% Coomassie Brilliant Blue R250, 40% methanol, 10% acetic acid). Gels were destained (30% methanol, 10% acetic acid and 60% water) until white bands appeared clearly from the blue background. These bands of gelatin lysis detected against the blue background as seen in Figure 2, represented enzymatic act ivities. RESULTS The presence of MMP-9 was studied. The enzymatic activities were detected as unstained bands on gelatin gel by zymography technique. In order to measure the relative MMP-9 levels, multi-image gel documentation systems were used to scan the clear zones and the percentage of inhibition was analyzed. Significant differences were found in the MMP activity in treated groups compared to the control. Figure 3 illustrates the reduction in the MMP-9 activity of each sample of gingival tissue extract when incubated with Doxycycline and Curcumin, expressed as percentage of reduction from the control. Table 1 shows the range, mean values and the standard deviation (S.D.) values for Curcumin and Doxycycline. The mean values show 59.58 % reduction in the MMP-9 activity with the addition of Doxycycline and 61.01% reduction in the MMP-9 activity with addition of Curcumin to the gingival tissue extract under identical conditions. Table 2 shows comparison of MMP-9 inhibitory effect between Doxycycline and Curcumin. The results obtained were analysed statistically using students paired t- test. DISCUSSION Periodontal diseases are the result of destruction of the soft and hard connective tissues surrounding and supporting the teeth. Inflammation is the basic cause of initiation of this breakdown. Research in the field of pathogenesis of periodontal disease has shown that various enzymatic activities which are directed towards the destruction of the pathogen also result in destruction of the periodontal connective tissue. Research has shown that, Matrix metelloproteinases (MMP’s) are one group of enzymes which are responsible for this destruction to a large extent. MMPs are involved in a number of physiological events including, tissue remodeling and pathological diseases such as periodontal disease and are the major players in collagen breakdown during periodontal destruction. MMPs are normally tightly regulated and disruption of this regulation leads to the pathologic breakdown of connective tissues. Higher levels of MMPs in the periodontal tissues provoke an imbalance between the production and degradation of collagen, causing tooth attachment loss. Especially, PMN derived MMPs (MMP-8 MMP-9) are the main proteinases related to tissue destruction and remodeling events in periodontal diseases. Numerous studies have substantiated the relationship between MMPs and periodontal diseases, with findings of significantly higher MMP-9 levels in patients with periodontitis as compared to healthy controls.4, 5, 15 With this understanding of the role of host immune response in periodontal destruction the possibility of host modulation so as to reduce the destructive aspects of the host response and hence reduce the damage to the periodontium was investigated. First group of drugs that showed this host modulation activity were Tetracyclines. Studies have demonstrated that tetracycline could significantly inhibit collagenase activity in GCF and gingival tissue, even at lower dosage than traditional antimicrobial dosages ie sub antimicrobial dosage.3 Tetracyclines inhibit collagenases by binding to the Ca2+ or Zn2+ (cations) required for the activation of MMPs such as collagenases and gelatinases.16 It is also possible that tetracyclines can inhibit synthesis of neutrophil-derived oxygen radicals, suppressing neutrophil migration and degranulation.17 However, microbial resistance to tetracyclines has been reported.7 In addition, long term treatment can result in other side- effects such as anorexi a, nausea, epigastric distress and fatty liver. A few recent studies on collagenase inhibition suggested that, like tetracyclines, herbal extracts are also potent inhibitors of pathologically elevated collagenases and hence they may be used as an alternative adjunct in the management of periodontal diseases.18, 19 Ayurvedic drugs like Neem, Triphala, Bakul etc have been used therapeutically since ancient times to treat diseases, including periodontal diseases. With the advent of modern synthetic drugs their convenience of standardized dosage form, dramatic efficacy in acute conditions and most of all simplicity of usage, there was a decline in the use of the plant medicines. But a long term treatment, with these synthetic drugs, has many adverse effects and they are also not cost effective. As Ayurvedic drugs, are widely acclaimed for their minimal side-effects and cost-effectiveness in India, they are now again being used extensively in treatment. Use of herbal extracts in treating periodontal diseases does not produce side effects of tetracycline compounds as well as other synthetic drugs. It has been shown that certain ayurvedic medicines also have the host modulation effect, similar to that of tetracyclines. A few recent studies conducted on collagenase inhibition by herbal extracts suggest that, like tetracyclines, herbal extracts are also potent inhibitors of pathogenically elevated collagenase and hence may be used as an alternative adjunct in the management of periodontal diseases.18, 19, 20 Turmeric which has Curcumin as its active constituent has been shown to have anti-inflammatory, anti-oxidant, anti- bacterial, anti- viral activities etc.10 Its anti- inflammatory activity has not been investigated in periodontal diseases. With the above details in mind the present study was conducted to evaluate the anti-inflammatory property of Turmeric. In the present study the anti-collagenase activity of Curcumin was compared with that of Doxycycline which has proven anti-collagenase activity. In the present study we chose Doxycycline because it has been proved that it is a more potent collagenase inhibitor as compared to minocycline and tetracycline.6 Studies have shown that Curcumin down-regulates MMP-9 activity13, 14, 21 and thus, in the present study we chose Curcumin to find out its anti-collagenase activity by checking its effect on MMP-9 activity. Research has shown that the predominant MMPs in inflamed gingival and periodontal tissues are PMN- type MMPs (MMP-8 MMP-9). Elevated activity of gelatinases (MMP-2 and MMP-9) has also been found in inflamed gingival tissues from chronic periodontitis patients.5, 22 The activity of PMN- type MMPs has been found not only to positively correlate to the severity of inflammation and pocket depth but also the amount of these enzymes recovered in an active rather than latent form appears to increase with greater severity of periodontal disease in the gingival tissue.20 Thus, since the above studies have shown that activity of PMN- type MMPs is increased in inflamed gingival tissues, in the present study we decided to use gingival tissue samples that were obtained from the patients diagnosed clinically with chronic periodontitis. The reduction in the MMP-9 activity of each sample of gingival tissue extract when incubated with the drugs .i.e. Doxycycline and Curcumin, was expressed as percentage of reduction from the control (without drug). The mean values showed 59.58% reduction in the MMP-9 activity with the addition of Doxycycline and 61.01 % reduction in the MMP-9 activity with addition of Curcumin to the gingival tissue extract under identical conditions. These results show that Curcumin has a significant inhibitory effect on PMN-type MMP-9, and this inhibitory effect of Curcumin is comparable to that of Doxycycline when the percentage of inhibition as compared to control was analysed. Curcumin also showed a significant reduction in the MMP-9 activity with an average inhibition of about 61% which is also statistically highly significant (p 23 and 12 g per day.24 But the overall results show that Curcumin has the ability to significantly inhibit the MMP-9 activity. The present study suggested that Curcumin could produce significant inhibition of MMPs at 1500 ÃŽ ¼g/ml concentration, which is well under the safe drug profile confirmed by toxicological studies.23, 24 Thus this study shows that Doxycycline and Curcumin possess anticollagenase activity in vitro. The finding of the present study is significant and confirms the use of Curcumin in treating periodontal diseases. A recent in vivo study showed that Curcumin modulates periodontal disease and had potent anti-inflammatory effects when it was systemically-administered in ligature-induced periodontitis in rats.25 Studies have shown that one of main mechanisms for the anti-inflammatory effects of Curcumin may be the inhibition of NF-ÃŽ ºB (nuclear factor kappa B).13, 25 The Curcumin-mediated inhibition of MMP-9 gene expression appears to occur via NF-ÃŽ ºB and AP-1 (Activator Protein-1) because their DNA binding activities were suppressed by Curcumin.14, 21 When compared to tetracycline, Curcumin has better anti-inflammatory effect, is more cost effective and has minimal side effects and thus can be tried as a substitute for Tetracycline as an anticollagenase agent. Curcumin also allows suppression of collagenase activity well within the safe dosage profile confirmed by toxicological studies. The in vivo environment is substantially different, and inherent limitations of an in vitro replication may constrain our understanding of the systemic effects of Curcumin. Further in vivo studies of Curcumin are needed to define its toxicological profile before making it a part of the therapeutic regimen in periodontal treatment. CONCLUSION In the light of observations from the current study it can be concluded that Doxycycline and Curcumin possess anticollagenase activity in vitro. Since Curcumin has better anti-inflammatory effect compared to Tetracycline, Curcumin being more cost effective and with no side effects can be tried as a substitute for Tetracycline as an anticollagenase agent. Thus Curcumin may have therapeutic potential as a host modulation agent in periodontal diseases.

Saturday, January 18, 2020

Child Marraige Essay

It blocks them from education and any possibility of independent work. It subjects them to pregnancy and childbirth before they have reached physical maturity, a circumstance that often produces serious physical trauma, psychological disturbance, and sometimes lifelong physical and/or emotional incapacities. Confusion about the legal status of child marriages results from widespread ignorance of the law by the majority of society. Even ministers were in many cases, unaware of the actual minimum ages for marriage. In Afghanistan marriage is regulated by civil law, various interpretations of Shariah law, and traditional and customary practices. Civil law sets the minimum marriage age for females at 16, but it permits a father to give his daughter in marriage at age 15, if he chooses. Shariah law sets the minimum age for females at 15. Customary practices approve marriage at earlier ages. In any case, Civil law takes precedence over both Shariah law and customary practice. (Shariah law is applied in matters not specifically set forth in the civil codes. Although the non registration of the marriages and the absence of identification documents do not allow the collection of accurate data on the subject, the Afghanistan Independent Human Rights Commission (AIHRC) consider the non respect of the minimum age requirement to be the major violation of the right to marry or not to marry. In addition, Afghanistan is bound to end child marriage through its ratification of certain internationalconventions including The Convention on the Elimination of Discrimination Against Women (CEDAW) and The Convention on the Rights of the Child (CRC). Based on annual report of AIHRC suicides, self immolations, murders, sexual perversions and psychological disorders are amongst the many negative consequences of child marriage. These also include the increase of maternal and child mortality rates, and the low level of education for women which has a long term effect on the role these play in the country’s political, social and economic life. According to the United Nations Children’s Fund (UNICEF) report, girls who marry during their childhood do not develop properly, neither physically nor psychologically. They are frequently denied access to education and are subject to different types of diseases arising from abnormal births and isolation. Childhood marriages are common place and prevalent in Afghanistan. In this respect, the Afghan Constitution has clear provisions to support families and children. Based on the reports 57% of Afghan girls are forced to marry before the age of eighteen. Pregnancies of sixteen years old girls are relatively common in Afghanistan. Problem statement: Child marriage is a serious problem, and there are frequent cases of young girls being married to the much older men. Many times, children and teenagers are pulled out of school to marry, depriving them of an education and meaningful work. Victims suffer health risks associated with early sexual activity, such as high risks of maternal and child mortality and sexually transmitted infections, such as HIV/AIDS. They are also likely to be victims of domestic, sexual, and/or emotional abuse, and may suffer from social isolation. Child marriages have negative and unexpected consequences like propagation of disease, divorce cases and escaping from home. While parent’s poverty and illiteracy may lead to their marrying daughters as child, these very marriages will prevent the daughters from having access to education and economic progress. Research Questions: 1. What are the Social, Economic and Political consequences of forced and early marriages in rural society? Objective The focus of this concept paper is to know reasons, causes and consequences of early childhood marriages in Afghanistan. In addition this will seek on vulnerabilities which the girls face by forced and early marriages in rural areas and how it is linked with the rural society and contribute with the poverty, violence and isolation of the families. Research method: The Research will included literature review, reviews of existing files in hospitals and schools, interviews with hospital and school directors, interviews with Rural people (Target area), Government officials and NGOs. Forced Marriages in Afghanistan Afghanistan y Tahera Nassrat   |   on April 6th, 2010   |   9 comments Throughout the world, there are 49 countries that have forced marriage or child bride problems. Forced marriage is simply breach of basic human rights. It is a form of domestic violence and child abuse that contributes to a society’s problems. Afghanistan is one of the Islamic countries where people hold strongly tight to customs and traditions. Breaking the tradition of marrying young children, both boys and g irls, is not only difficult, but near impossible in most urban districts. In the rural areas of Afghanistan, girls are mostly married between ages of 7 to 11. It is really rare that a girl reaches the age of 16 and is not married. The customs, traditions and community they live in make it impossible for girls to break free from forced marriages. They do not get ask to speak for self desire. The fathers in the families mostly decide, as the mothers do not get involved in the decisions, because they are women. By marrying   children in early ages, families are putting them in situations of isolation, health problems, abuse, suicide and lack of education. They believe, they are doing best for their children and without their consents, they bond them into marriage contracts. However, they don’t consider that forced marriage affect women and young children adversely. It involves negative situations like threatening behavior, emotional blackmail, physical violence, rape, sexual abuse, suicide and even murder and young children are obviously not in the capacity to handle such pressure. According to a United Nations’ report, between 60 to 80 percent of marriages in Afghanistan are forced marriages. The report states that the reason why girls are dragged into forced marriages are; repayment of debts; to solve a dispute and to pay family expenses. Moreover, It is obvious among Pashtons, that their widow will never marry someone out of their family, as they always marry the brother of their deceased husband. However in a non-Pashton family, the girl is asked to marry her brother-in-law to get support for the children of her sister. Even worse, some sisters are married to pay for the crime of their brothers by marrying the victims. So, people in Afghanistan believe it is part of culture to marry a girl before age of 18th and not let her have a say, but they should consider that forcing a girl to marry cannot be regarded as cultural practice in any society. It is a violation of basic human rights. Therefore, women as part of society should be able to freely express their choices about their lifestyle desires. The video bellow is history of a 12 year girl who was forced into marriage. She ran away to break free from her in-laws, but unfortunately was arrested and in form of punishment by her husband (a Talib) she lost her nose and ear. Child Marriage in Afghanistan October 2, 2011 by Aamozgar01 Filed under Cultural, Featured 5 Comments If the government of Afghanistan does not stop the practice of child marriage, most mothers will lose their children besides their own lives in Afghanistan as a result of under age marriage. Indeed, getting married under the age of eighteen or sixteen is not legal according to any law around world because it is internationally accepted that at least the couples should be sixteen. Although according to the Afghan Civil Law the minimum age of marriage for male is 18 and female 16, according to reports of Medica Mondiale and UNICEF, 57 per cent of Afghan females are married under the age sixteen without their consent because of their parent’s financial problems. Moreover, Getting married under 16 sixteen will result several serious health problems for mothers that cause them not to develop properly, neither physically nor psychologically (Earily Marriage in Afghanistan). For instance, a woman living in Qala-e-Bakhtiar of Kabul with her six children has said to Medica Mondial that she was only 15 when she was married against her will. She hates the noise of her children   because   of   having   psychological   problems. (W. Mukhatari , pg 6). The marriage of children by force is against human rights. Children know nothing about their sexual relationship with their life partners, because they are still child and their parents should take care of them. Therefore, to save the Afghan female hildren from being exchanged for an amount   of   money   to   solve   a   family s   financial   problems,   Afghanistan government   should   educate   and campaign     about   consequences   of   child   marriage,   increase employment opportunities for parents, and enforce the law by making the marriage registration legal. In spite of understanding the childhood condition of children, most of the Afghan parents marry their daughters because financial problems they are facing. Poverty is a challenge, which changes the lives of children besides the culture of early child marriage. According to the report by Millennium Development Goals for Afghanistan, the average income of per member of family is 200$ a year and less than one dollar   a   day. So, they   are   considered   below   the   poverty   line     (Earily     Marriage   in Afghanistan). Thus, to get out of the financial crises the marriage of their daughters before their legal ages such 16 or 18 would be considered for some families the only option for the parents to protect their family honor, pay their debts and take a little amount of money in exchange for their. First of all, one of the reasons of child marriage is to receive an exorbitant amount of money, which is called Toyana (wedding expenses) in Dari. The payment that parents   receive from the groom family is not less than 300,000 Afs. and is not meant to be the wedding expenses, but the price of their child daughter. In a report about the child   marriages   in   Afghanistan   by   the   Women   and   Children   Legal   Research   Foundation (WCLRF) shows that most of the interviewees have said that the only reason they were married in their childhoods was to receive Toyana from the groom’s family (Earily Marriage in Afghanistan). Secondly, the other factor that makes the poor families marry their daughters under the age sixteen, often times in rural areas, is to exchange women for women which is called Badal. The practice of this type of marriage is very common among the afghan people. This kind of marriage saves a huge expense of both sides because of exchanging their child daughters from a family to another family to satisfy both sides. The wedding party of such kind of marriage is often   celebrated at one time to avoid spending an   large amount of money. Indeed, it is the little young female who is devoted for her brother and is victimized for a little amount of money. Third, debt is another function that the females are exchanged for under the age sixteen in Afghanistan. When a family is unable to pay its debt within limited time that agreed, then the family is supposed to pay a huge amount that satisfy the lender, such as building, farming land, in some cases even a daughter otherwise the family is put in jail. So, the only remaining option for the family to protect its ancestors   property would be to sacrifice a daughter as a form of repayment for debt. It does not matter whether the child daughter is 9 or 18 years. As an explicit example, Shahs Family had to marry their 9 year old daughter Khalida   two years ago. Shah had received almost 2000$ from a drug trader to grow opium in his land, but the government crop-eradication team destroyed his poppy field and put the Shah family in debt. So, he had to give his 9 years daughter to drug trader because nothing was left in his life. (Clifford) Forth, the traditional custom of Afghan people is victimizing the child females in most of the rural areas. One of the reasons of child marriage in Afghanistan is Baad, which is a traditional way of having the child females to marry one of males from the family of   enemy and forcing her to accept him as her husband in compensation for the crime that her father or brother has committed against the enemy family, and to stop the enmity between two families. For instance, Aisha, an Afghan female whose nose and ears were cut by her Al-Qaeda husband in Oruzgan province, was just 8 years old when she was given as a Baad to her husband family 10 years ago (Shaming her in-laws costs ). Because her father had killed a member of her husband family, so he had to give his daughter to compensate his crime and to avoid being imprisoned or being killed by his enemy. Unfortunately, when the child female goes to her husband house in Baad marriage she is not going to her in-laws   house as a bride but as a slave. Consequently, the child marriage has several negative impacts on the health of both, mothers and babies. The female children wh o are married under the age of 16 0r 18 would not be prepared for pregnancies and child birth. A statistic of child marriage by Women and Children Legal   Research   Foundation   (WCLRF)   shows   that   28. 7%   mothers   have   physiological   and psychological problems, 34. 1% have physically weak children,   8. 9% have handicapped and disabled children, 1. 6% have children with different types of diseases and disorders, and 40. 4% of these women have suffered from gynecological disease (Earily Marriage in Afghanistan). In addition, the child marriage would result to take the life of the mothers along with losing the babies. Most   of   the   mothers   who   are   dying   at the age of   18-19   are   because   of   their   early regnancies, and the chance of   survival for the babies would be forty per cent comparing to the mothers who married in their proper ages (Sadik). Furthermore, child marriage would result the child brides to be abused by their in-laws family. Most of the child females face various violations after t hey get married, such as no right to choose, no right to go somewhere without the permission of her husband . When the violation increase the child bride is going to be isolated from the families and relatives. Thus, the only options that remains for the child bride is to suicide or escape from home. The interview of female prisoners by   the   Medica   Mendials   legal   staff   shows   that   60%   of prisoners   were   the   escapees   from husbands   houses who were married under the age sixteen. Most of the prisoners have said that they   were   being   abused   or   even   being   threaten   to   dead by   their   in-laws   families (W. Mukhatari , pg 9) . To come out of the child marriage problem and save little young girls in Afghanistan, education and awareness of public are the main keys to prevent from child marriage. The government should provide community education programs to inform the public about negative consequences of child marriage. Such programs can be implemented easily by   Ministry of Women Affairs, which   can   easily   teach   the   women   of   an   area   without   any   problem,   or   in   other   way,   the government should pay the clergymen of mosques to advice the parents on their tribunes. These are the only sources that families can trust on. Moreover, the government should implement public awareness campaigns by international organizations and by holding Shoras and Jirgas with the elders of rural areas to talk about the negative impacts of child marriage (Earily Marriage in Afghanistan). The government of Afghanistan should enforce the law to prevent child marriages. For instance, keeping the marriage registration regularly by the government agencies and receiving the evidence and acquiescence of both sides could be a possible way to reduce the child marriage. For example, in parts of   Indonesia, registration of marriage is dependent on evidence that the marriage is not forced on couples (Sadik). The parents who marry their daughters in their childhood under the age 16 should punished and persecuted seriously by the government as governments of Norway and Kyrgyzstan did. They both have set the minimum age of the girls 17 and the punishment of those who marry the females earlier than the age 17 would be jailed for 2 to 6 years. Weak Economy is another factor, which causes most child marriages in Afghanistan. The government should try to develop the economic situation in rural areas where   women have   cannot   earn   money   for   themselves. For example,   the   project   of Micro finance Investment   Support   Facility   for   Afghanistan,   which   is   donated   by   the   World   Bank   and   is implemented by the Rural Rehabilitation and Development Ministry, should be accessible for all women the Afghanistan. In fact, lending a little amount of money to women can be   the   start   of   their   business   to   provide   their   own   necessities. For example   Saima Mohammad who was about to be divorced by her husband because of having only a daughter and no son. Her husband had borrowed 3,000$, and he was not able to pay it back. So, Saima went to Pakistani micro finance organization called Kashf Foundation, took out only 65$ as loan and bought her 65$ bead and clothes to make embroidery from them and sell them to market in Lahor. She has everything now, and even her husband is working with her (Knistaff). The government should be serious in taking important steps against child   marriages in Afghanistan, because child marriage is dangerous for the health of both, mothers and their babies. People should be informed; the parents who force their child daughters to marry and those who marry females under the age sixteen should be punished. Most importantly, the economic situation of people should be developed to prevent them to not marry their children under the age sixteen in exchange for an amount of money. So, the Afghan government needs to increase peoples’ awareness about the outcome of early marriage, make employment opportunities and persecute those who marry their children before the age sixteen. Written by: Zabiullah Zabi http://www. aamozgar. org/child-marriage-in-afghanistan/ Forced and Child Marriage Forced and child marriages entrap women and young girls in relationships that deprive them of their basic human rights. Forced marriage constitutes a human rights violation in and of itself. Article One of the  Convention on Consent to Marriage, Minimum Age for Marriage and Registration of Marriages  states that â€Å"No marriage shall be legally entered into without the full and free consent of both parties, such consent to be expressed by them in person after due publicity and in the presence of the authority competent to solemnize the marriage and of witnesses, as prescribed by law. † The Marriage Convention addresses the issue of age. According to Article 2 of the  Convention, â€Å"States Parties to the present Convention shall take legislative action to specify a minimum age for marriage. No marriage shall be legally entered into by any person under this age, except where a competent authority has granted a dispensation as to age, for serious reasons, in the interest of the intending spouses. †Ã‚   Under General Assembly Resolution 2018 (XX) of 1 November 1965, â€Å"Recommendation on Consent to Marriage, Minimum Age for Marriage and Registration of Marriages,† Principle II states that the minimum age to marry be set no lower than fifteen years. However, this is only a recommendation and it still allows room for a competent authority to grant â€Å"dispensation as to age for serious reasons. Leaving the minimum age of consent to the discretion of each country and allowing an authority to make exceptions to the minimum age of marriage aggravates the potential for early and forced marriages. Forced marriages differ from arranged marriages. In forced marriages, one or both of the partners cannot give free or valid consent to the marriage. Forced marriages i nvolve varying degrees of force, coercion or deception, ranging from emotional pressure by family or community members to abduction and imprisonment. Emotional pressure from a victim’s family includes repeatedly telling the victim that the family’s social standing and reputation are at stake, as well as isolating the victim or refusing to speak to her. In more severe cases, the victim can be subject to physical or sexual abuse, including rape. In arranged marriages, the parents and families play a leading role in arranging the marriage, but the individuals getting married can nonetheless chose whether to marry or not. Many regard arranged marriage as a well-established cultural tradition that flourishes in many communities, so a clear distinction should be drawn between forced and arranged marriages. However, in some cases the difference between a forced marriage and an arranged marriage may be purely semantic. In her January 2007 report, â€Å"Report of the Special Rapporteur on the Human Rights Aspects of the Victims of Trafficking in Persons, Especially Women and Children,† Sigma Huda states that, â€Å"[a] marriage imposed on a woman not by explicit force, but by subjecting her to relentless pressure and/or manipulation, ften by telling her that her refusal of a suitor will harm her family’s standing in the community, can also be understood as forced. † Prevalence Forced and child marriage mainly affects young women and girls, although there are cases of young men and boys being forced to marry—especially if there are concerns about his sexual orientation. Reliable statistics on forced marriage are difficult to compile due to the unofficial and, therefore, undocumented nature of most forced marriages. In 2003, the International Centre for Research on Women estimated that more than 51 million girls under 18 years were married and they expected the figure to rise to over 100 million within the next ten years. Similarly, in 2006, experts estimated that thirty-eight percent of young women aged 20 to 24 in the fifty least developed countries were married before the age of 18. >>Learn more Causes and Risk Factors No major world religion sanctions forced marriage. It is purely a cultural practice. However, no culture exclusively practices forced marriage. Victims are forced into marriage for many different reasons. In the  United Kingdom, the Working Group on Forced Marriage found that most cases were a result of â€Å"loving manipulation, where parents genuinely felt that they were acting in their children and family’s best interests. †   To families living in poverty or economic instability, a daughter may be seen as an â€Å"economic burden† who must be married as soon as possible to take financial strain off of the family. Marriage can also be used to settle a debt, or to strengthen family or caste status through social alliances. Fears about sexual activity before marriage, or fear of rumors about such activity ruining a daughter’s opportunity to marry well, also fuel early and forced marriages. >> Learn more Consequences and Effects Forced and child marriages have severe psychological, emotional, medical, financial, and legal consequences. Victims tend to be isolated from their peers and friends. They rarely have access to social services that could assist them. Early marriages often interrupt a victim’s education. This deprives them of their right to education, as well as limits any possibility of economic independence from their spouse, making it more difficult to escape from an unwanted marriage. The unofficial nature of many of these marriages means that they often go unregistered, leaving a woman with no legal protections in cases of separation. Forced and child marriages are also more likely to become violent because the relationship is based on the power of one spouse over the other. In addition, complications during childbirth are much more common among young mothers. >>Learn more International and Domestic Law and Policies Numerous international legal instruments prohibit forced and child marriage, including the Universal Declaration of Human Rights, the United Nations Convention on Consent to Marriage, Minimum Age for Marriage and Registration of Marriages, the Convention on the Elimination of All Forms of Discrimination against Women. Although most countries have signed onto these documents, many countries have not taken sufficient steps to implement these treaties. In 2005, the Council of Europe adopted  Resolution 1468  on forced marriages and child marriages. However, only a few countries have criminalized forced marriage.

Friday, January 10, 2020

Reading Response on Four by Veronica Roth

To have a successful fife in the right faction when a boy or girl turns sixteen they must take the aptitude test which helps them pick their faction. However, they may choose their faction based off of opinion or interest. There are five factions to choose from. Abnegation, the ones who value selflessness, Candor, the ones that honor honesty, Amity, the ones that honor the peaceful, Erudite, the ones who honor the intelligent, and Dauntless, the ones that honor the brave. Each faction honors a certain trait. They believe that if a person was brave, or selfless, or kind, there would be no war and only peace.At the Choosing pick their factions. They may choose to stay with Ceremony the teenagers their faction and their families or they can abandon them. Later on, if they prove to be unfit for their new factions they will become factionists; these are the people that have no family, no home. They live together or alone in abandoned buildings or homes, and even on the streets. Tibias Eat on, originally from Abnegation, has turned sixteen and has to decide what he was going to do with his life and what faction he will spend it in. However, one thing is clear for him.He will run from Abnegation, and he will run from his father. Tibias has to escape his father, and find a place where he is safe, and hidden. Tibias is tired of living in fear and is ready to take on his own path in a different faction. When Tibias returns to his plain Abnegation home he goes to his room and reviews his most precious possessions that were given to him by his mother. Tibias was informed that his mother died of child labor when he was a young boy. This made his family fall apart and caused the tension between him and his father.The author made this connection teen Tibias and his mother to show how his mother was the glue of their family and that Tibias was closer to her than he is to his father. When Tibias reviews all of his possessions he is caught by his father and has it all taken away from him. His father throws all of his treasures around the room, destroying them in the process. Tibias is now deprived of the only connection he had to his mother. Yet, we are about to discover more about Tibia's and his fathers relationship. Tibias has developed a fear of his father and this is because of the abuse his father puts on Tibias. His hands oiled with my chest. I stumble back and hit the dresser. Then he draws his hand back by his face to hit me, and say my throat tight with fear ‘ ‘The Choosing Ceremony, Dad! † † tomorrow was Tibia's Choosing Ceremony. His last chance to escape, to be free of fear. â€Å"When we get there, my father puts a hand on my shoulder as we walk to the entrance, sending shocks of pain through my body. Have to get out. † The day of the Choosing Ceremony is the day Tibias changes his life and the person he will become. Tibias is desperate to escape Abnegation and to escape his father.As the ceremony goes on, Tibias is thinking of what faction he will choose. Where will he fit in the most? Where will he be safe? He decides that Candor, Erudite, and Amity are not choices that he can live with. His only choice is Dauntless. â€Å"l open my palm over the coals. Feel like they're burning in my stomach, filling me to the brim with fire and smoke. I am free. † The minute the ceremony is over, Tibias begins initiation. He and the rest of the initiates must prove their bravery by jumping on to a moving train, then jump off of a moving train on a roof, and finally they must jump off of the roof.My stomach drops and my limbs fumble in the air for something, anything to hold onto, but there is nothing, only the drop, the air, the frantic search for the ground. † As initiation goes by Tibias changes his name to Four. After facing his worst fears Tibias and his initiation instructor Mar find out that he only has four fears. This new name gave Tibias new power, a new identity. â€Å"My name is Four,† I say. â€Å"Call me ‘Stiff again and you and I will have a problem. † During initiation, Four makes many friendships and becomes close to Mar. However, he is still quite different from the rest.He likes to be alone, to have a peace of mind once in a while. The first stage of initiation is physical training and combat. Four has the drive and the practice from his childhood abuse to become the best initiate. He proves his bravery by beating the other initiates in combat fights and using his strength and his thinking skills to his advantage. By the end of stage one, Four is ranked first out of his entire class and is considered someone to look out for. In the second stage of initiation Four has to prove that he can overcome his fears mentally using critical, fast thinking and by asking decisions that may be risky but courageous.However, Four thinks differently and beats the system by being aware during his stimulations that it is not reality. By being able t o do this he gets out of the stimulation by realizing that if he jumps he won't die because it's not real. Its just a test. Later on, Mar teaches Four to go through the stimulation like any other Dauntless would; with bravery. At the end of initiation the initiates are ranked to show who has more potential and more strength than others. For Four, his rank surprised him a bit. â€Å"Instantly, some of the tension disappears. I follow he list up, and panic stabs me for just a second when I can't find my own name.But then, there it is, right at the top. 1. Four. † After initiation Four becomes a full pledged Dauntless. Finally, he is rid of Abnegation, rid of his father. When Four gets his apartment he also gets a job offer to become a dauntless leader. Even though Four wanted to have a job where he would be the initiation instructor, like Mar, he was expected to have a more prestigious job since he was ranked first. Four agrees to take the job but his heart isn't with it. Later on, Four realizes that if he becomes a leader he will eve to face his father, an Abnegation leader. My fingers start to go numb. I've faced my fears so many times in simulations, but that doesn't mean I'm ready to face them in reality. † Four has to learn what it would be like to be a Dauntless leader but he also needed to learn the basic lifestyle of the Dauntless and needs to learn that Dauntless is more ‘out there' than Abnegation with their feelings, thoughts, and emotions. When Four goes to the meeting for dauntless leadership he quietly disagrees with the way the leaders handle situations and the changes that they want to make to aunties initiation.As the days go by, Four takes multiple tests that will determine if he has what it takes to become a leader, there is still tension and competition between Four and Eric and the fact that Eric has information that threatens Fours identity, and Four still has the suspicion of an intruder coming into his apartment. Four f inally faces his new life as the new â€Å"best† initiate of Dauntless. After a day of hard work, Four returns home to find that once again somebody was in his apartment. This time they left a note. â€Å"On the day you hated most. At the time when she dies. In the place where oh first jumped on. Four figured out that someone that had some connection to his childhood wanted to meet him. Instinctively, Four thinks its Marcus, his father. Four decides that he needs to know what Marcus wants and why he risked getting caught to contact him. When Four arrives at the platform in the middle of the night, its not Marcus that shows up. Its Evelyn Eaton. His mother. Right away Fours mind races with memories of his mothers the death. The funeral, the gathering, the ashes. The only thing Four can say is â€Å"You're supposed to be dead. † Fours mother tries to explain to IM that she didn't leave to hurt him.She had to get away from Abnegation, from Marcus. Just like Four. The aut hor here shows a similarity where both the mother and the son needed to escape from Fours father and his lifestyle. This show that Marcus might hide his temper and his real self from the public and only shows and acts like him true self at home. However, Four doesn't want to hear her pity story and he acts like she is the last person he wants to talk to. â€Å"Stop wasting my time. What are we doing here? † Evelyn reveals to Four that she is a leader to the factionists and that there is a big chance of a pricing among the factions and that Four should be on her side. Our city is changing, Tibias. The factionists are coming together, and so are Dauntless and Erudite. Sometime soon, everyone will have to choose a side, and I know which one you would rather be on. I think you can really make a difference with us. † Four doesn't care about any Of the problems, really. He just can't let go of the fact that Evelyn hasn't talked or reached out to him in seven years and now she actually wants something from him. A favor. Four chooses to run from her. Like he ran from him. Now that Four is trying to find who he ally is he wants to get a tattoo that will represent him as a person.While Four is getting the tattoo, Tort, the tattoo artist tells him about being Divergent. â€Å"That's a word for people who are aware during simulations, who refuse to categorize. † Four realizes that fits the description of Mar. Mar was aware during the Simi ululations. Divergent fit Mar, and it fit him. When Four meets with the dauntless leadership group again, he proves to have a less strategic protocol for initiates than no one other than Eric. Four realizes that this is his chance to change jobs and to escape leadership. To be honest, sir, I don't think that this is the right place for me.I told you when you first asked me that I'd like to be an instructor, and think I'm realizing more and more that that's where I belong. † Days have passed by after Four's meeti ng with Evelyn. He had time to think if leaving Dauntless, betraying his faction to join the factionists is the best thing he can do right now. He decides that it's not. He has friends that support and understand him and he knows that no way is he leaving them behind. â€Å"If the factions are deteriorating, as my mother loud have me believe, this is not a bad place to watch them fall apart. Four makes the choice to stay loyal to the faction that set him free. Two years later, Four is the initiation instructor for a group of transfer initiates which means that they come from other factions. There were initiates from Candor, Erudite, Amity, and Abnegation. The girl from Abnegation sparked Fours interest. Her name was Tries. She had a small form and looked as if she can snap like a twig in a second. Whenever Four is next to her he acts a certain way. He loses his hard, mean personality and opens up to her like he doesn't veer do to anyone.

Thursday, January 2, 2020

Eating Disorders, Body Image Gender Essay - 1721 Words

GENDER, HEALTH AND RIGHTS (HE6) ASSIGNMENT EATING DISORDERS, BODY IMAGE GENDER Submitted to: Dr. Sivakami Muthusamy Centre for Health and Social Sciences School of Health Systems Studies, TISS, Mumbai. Submitted by: Pallavi Muraleedharan Enrollment Number: M2015HE018 Master of Health Administration (2015-17) Tata Institute of Social Sciences, Mumbai Date: 16/08/2016 INTRODUCTION Eating disorders, body image and gender remain as a very complex interlinked web. Eating disorders affect people from all demographics and are caused by multiple factors. They arise from a combination of a long-standing biological, behavioural, emotional, interpersonal, psychological as well as social factors. Research also suggests that eating disorders impacts some segments of the LGBTQ populations as well. Our society places enormous value on being physically attractive in general and on being thin in particular. Extreme stigmatization confronts those who are regarded as obese. Studies have shown that, although these attitudes affect people of all ages and both genders, these social norms are applied much more rigorously to women than. Consequently, most women in our society are dissatisfied with their bodies and perceive themselves to be overweight regardless of the accuracy of this assessment. Studies have consistently shown that satisfaction with ones’ own body is very much correlated to his or her self esteem. Hence it is highly imperative that further research is to be doneShow MoreRelatedEating Disorders And Body Image Essay1115 Words   |  5 PagesNovember 2016 Typically when covering the topic of eating disorders and body image dissatisfaction athletes and young women are the center of research and are stereotyped to be the only groups of people who suffer from self-image issues. 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