Deprecated (16384): The ArrayAccess methods will be removed in 4.0.0.Use getParam(), getData() and getQuery() instead. - /home/brlfuser/public_html/src/Controller/ArtileDetailController.php, line: 73 You can disable deprecation warnings by setting `Error.errorLevel` to `E_ALL & ~E_USER_DEPRECATED` in your config/app.php. [CORE/src/Core/functions.php, line 311]Code Context
trigger_error($message, E_USER_DEPRECATED);
}
$message = 'The ArrayAccess methods will be removed in 4.0.0.Use getParam(), getData() and getQuery() instead. - /home/brlfuser/public_html/src/Controller/ArtileDetailController.php, line: 73 You can disable deprecation warnings by setting `Error.errorLevel` to `E_ALL & ~E_USER_DEPRECATED` in your config/app.php.' $stackFrame = (int) 1 $trace = [ (int) 0 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Http/ServerRequest.php', 'line' => (int) 2421, 'function' => 'deprecationWarning', 'args' => [ (int) 0 => 'The ArrayAccess methods will be removed in 4.0.0.Use getParam(), getData() and getQuery() instead.' ] ], (int) 1 => [ 'file' => '/home/brlfuser/public_html/src/Controller/ArtileDetailController.php', 'line' => (int) 73, 'function' => 'offsetGet', 'class' => 'Cake\Http\ServerRequest', 'object' => object(Cake\Http\ServerRequest) {}, 'type' => '->', 'args' => [ (int) 0 => 'catslug' ] ], (int) 2 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Controller/Controller.php', 'line' => (int) 610, 'function' => 'printArticle', 'class' => 'App\Controller\ArtileDetailController', 'object' => object(App\Controller\ArtileDetailController) {}, 'type' => '->', 'args' => [] ], (int) 3 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Http/ActionDispatcher.php', 'line' => (int) 120, 'function' => 'invokeAction', 'class' => 'Cake\Controller\Controller', 'object' => object(App\Controller\ArtileDetailController) {}, 'type' => '->', 'args' => [] ], (int) 4 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Http/ActionDispatcher.php', 'line' => (int) 94, 'function' => '_invoke', 'class' => 'Cake\Http\ActionDispatcher', 'object' => object(Cake\Http\ActionDispatcher) {}, 'type' => '->', 'args' => [ (int) 0 => object(App\Controller\ArtileDetailController) {} ] ], (int) 5 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Http/BaseApplication.php', 'line' => (int) 235, 'function' => 'dispatch', 'class' => 'Cake\Http\ActionDispatcher', 'object' => object(Cake\Http\ActionDispatcher) {}, 'type' => '->', 'args' => [ (int) 0 => object(Cake\Http\ServerRequest) {}, (int) 1 => object(Cake\Http\Response) {} ] ], (int) 6 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Http/Runner.php', 'line' => (int) 65, 'function' => '__invoke', 'class' => 'Cake\Http\BaseApplication', 'object' => object(App\Application) {}, 'type' => '->', 'args' => [ (int) 0 => object(Cake\Http\ServerRequest) {}, (int) 1 => object(Cake\Http\Response) {}, (int) 2 => object(Cake\Http\Runner) {} ] ], (int) 7 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Routing/Middleware/RoutingMiddleware.php', 'line' => (int) 162, 'function' => '__invoke', 'class' => 'Cake\Http\Runner', 'object' => object(Cake\Http\Runner) {}, 'type' => '->', 'args' => [ (int) 0 => object(Cake\Http\ServerRequest) {}, (int) 1 => object(Cake\Http\Response) {} ] ], (int) 8 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Http/Runner.php', 'line' => (int) 65, 'function' => '__invoke', 'class' => 'Cake\Routing\Middleware\RoutingMiddleware', 'object' => object(Cake\Routing\Middleware\RoutingMiddleware) {}, 'type' => '->', 'args' => [ (int) 0 => object(Cake\Http\ServerRequest) {}, (int) 1 => object(Cake\Http\Response) {}, (int) 2 => object(Cake\Http\Runner) {} ] ], (int) 9 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Routing/Middleware/AssetMiddleware.php', 'line' => (int) 88, 'function' => '__invoke', 'class' => 'Cake\Http\Runner', 'object' => object(Cake\Http\Runner) {}, 'type' => '->', 'args' => [ (int) 0 => object(Cake\Http\ServerRequest) {}, (int) 1 => object(Cake\Http\Response) {} ] ], (int) 10 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Http/Runner.php', 'line' => (int) 65, 'function' => '__invoke', 'class' => 'Cake\Routing\Middleware\AssetMiddleware', 'object' => object(Cake\Routing\Middleware\AssetMiddleware) {}, 'type' => '->', 'args' => [ (int) 0 => object(Cake\Http\ServerRequest) {}, (int) 1 => object(Cake\Http\Response) {}, (int) 2 => object(Cake\Http\Runner) {} ] ], (int) 11 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Error/Middleware/ErrorHandlerMiddleware.php', 'line' => (int) 96, 'function' => '__invoke', 'class' => 'Cake\Http\Runner', 'object' => object(Cake\Http\Runner) {}, 'type' => '->', 'args' => [ (int) 0 => object(Cake\Http\ServerRequest) {}, (int) 1 => object(Cake\Http\Response) {} ] ], (int) 12 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Http/Runner.php', 'line' => (int) 65, 'function' => '__invoke', 'class' => 'Cake\Error\Middleware\ErrorHandlerMiddleware', 'object' => object(Cake\Error\Middleware\ErrorHandlerMiddleware) {}, 'type' => '->', 'args' => [ (int) 0 => object(Cake\Http\ServerRequest) {}, (int) 1 => object(Cake\Http\Response) {}, (int) 2 => object(Cake\Http\Runner) {} ] ], (int) 13 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Http/Runner.php', 'line' => (int) 51, 'function' => '__invoke', 'class' => 'Cake\Http\Runner', 'object' => object(Cake\Http\Runner) {}, 'type' => '->', 'args' => [ (int) 0 => object(Cake\Http\ServerRequest) {}, (int) 1 => object(Cake\Http\Response) {} ] ], (int) 14 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Http/Server.php', 'line' => (int) 98, 'function' => 'run', 'class' => 'Cake\Http\Runner', 'object' => object(Cake\Http\Runner) {}, 'type' => '->', 'args' => [ (int) 0 => object(Cake\Http\MiddlewareQueue) {}, (int) 1 => object(Cake\Http\ServerRequest) {}, (int) 2 => object(Cake\Http\Response) {} ] ], (int) 15 => [ 'file' => '/home/brlfuser/public_html/webroot/index.php', 'line' => (int) 39, 'function' => 'run', 'class' => 'Cake\Http\Server', 'object' => object(Cake\Http\Server) {}, 'type' => '->', 'args' => [] ] ] $frame = [ 'file' => '/home/brlfuser/public_html/src/Controller/ArtileDetailController.php', 'line' => (int) 73, 'function' => 'offsetGet', 'class' => 'Cake\Http\ServerRequest', 'object' => object(Cake\Http\ServerRequest) { trustProxy => false [protected] params => [ [maximum depth reached] ] [protected] data => [[maximum depth reached]] [protected] query => [[maximum depth reached]] [protected] cookies => [ [maximum depth reached] ] [protected] _environment => [ [maximum depth reached] ] [protected] url => 'latest-news-updates/averting-deaths-in-muzaffarpur-t-jacob-john-4687396/print' [protected] base => '' [protected] webroot => '/' [protected] here => '/latest-news-updates/averting-deaths-in-muzaffarpur-t-jacob-john-4687396/print' [protected] trustedProxies => [[maximum depth reached]] [protected] _input => null [protected] _detectors => [ [maximum depth reached] ] [protected] _detectorCache => [ [maximum depth reached] ] [protected] stream => object(Zend\Diactoros\PhpInputStream) {} [protected] uri => object(Zend\Diactoros\Uri) {} [protected] session => object(Cake\Http\Session) {} [protected] attributes => [[maximum depth reached]] [protected] emulatedAttributes => [ [maximum depth reached] ] [protected] uploadedFiles => [[maximum depth reached]] [protected] protocol => null [protected] requestTarget => null [private] deprecatedProperties => [ [maximum depth reached] ] }, 'type' => '->', 'args' => [ (int) 0 => 'catslug' ] ]deprecationWarning - CORE/src/Core/functions.php, line 311 Cake\Http\ServerRequest::offsetGet() - CORE/src/Http/ServerRequest.php, line 2421 App\Controller\ArtileDetailController::printArticle() - APP/Controller/ArtileDetailController.php, line 73 Cake\Controller\Controller::invokeAction() - CORE/src/Controller/Controller.php, line 610 Cake\Http\ActionDispatcher::_invoke() - CORE/src/Http/ActionDispatcher.php, line 120 Cake\Http\ActionDispatcher::dispatch() - CORE/src/Http/ActionDispatcher.php, line 94 Cake\Http\BaseApplication::__invoke() - CORE/src/Http/BaseApplication.php, line 235 Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65 Cake\Routing\Middleware\RoutingMiddleware::__invoke() - CORE/src/Routing/Middleware/RoutingMiddleware.php, line 162 Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65 Cake\Routing\Middleware\AssetMiddleware::__invoke() - CORE/src/Routing/Middleware/AssetMiddleware.php, line 88 Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65 Cake\Error\Middleware\ErrorHandlerMiddleware::__invoke() - CORE/src/Error/Middleware/ErrorHandlerMiddleware.php, line 96 Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65 Cake\Http\Runner::run() - CORE/src/Http/Runner.php, line 51 Cake\Http\Server::run() - CORE/src/Http/Server.php, line 98
Deprecated (16384): The ArrayAccess methods will be removed in 4.0.0.Use getParam(), getData() and getQuery() instead. - /home/brlfuser/public_html/src/Controller/ArtileDetailController.php, line: 74 You can disable deprecation warnings by setting `Error.errorLevel` to `E_ALL & ~E_USER_DEPRECATED` in your config/app.php. [CORE/src/Core/functions.php, line 311]Code Context
trigger_error($message, E_USER_DEPRECATED);
}
$message = 'The ArrayAccess methods will be removed in 4.0.0.Use getParam(), getData() and getQuery() instead. - /home/brlfuser/public_html/src/Controller/ArtileDetailController.php, line: 74 You can disable deprecation warnings by setting `Error.errorLevel` to `E_ALL & ~E_USER_DEPRECATED` in your config/app.php.' $stackFrame = (int) 1 $trace = [ (int) 0 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Http/ServerRequest.php', 'line' => (int) 2421, 'function' => 'deprecationWarning', 'args' => [ (int) 0 => 'The ArrayAccess methods will be removed in 4.0.0.Use getParam(), getData() and getQuery() instead.' ] ], (int) 1 => [ 'file' => '/home/brlfuser/public_html/src/Controller/ArtileDetailController.php', 'line' => (int) 74, 'function' => 'offsetGet', 'class' => 'Cake\Http\ServerRequest', 'object' => object(Cake\Http\ServerRequest) {}, 'type' => '->', 'args' => [ (int) 0 => 'artileslug' ] ], (int) 2 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Controller/Controller.php', 'line' => (int) 610, 'function' => 'printArticle', 'class' => 'App\Controller\ArtileDetailController', 'object' => object(App\Controller\ArtileDetailController) {}, 'type' => '->', 'args' => [] ], (int) 3 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Http/ActionDispatcher.php', 'line' => (int) 120, 'function' => 'invokeAction', 'class' => 'Cake\Controller\Controller', 'object' => object(App\Controller\ArtileDetailController) {}, 'type' => '->', 'args' => [] ], (int) 4 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Http/ActionDispatcher.php', 'line' => (int) 94, 'function' => '_invoke', 'class' => 'Cake\Http\ActionDispatcher', 'object' => object(Cake\Http\ActionDispatcher) {}, 'type' => '->', 'args' => [ (int) 0 => object(App\Controller\ArtileDetailController) {} ] ], (int) 5 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Http/BaseApplication.php', 'line' => (int) 235, 'function' => 'dispatch', 'class' => 'Cake\Http\ActionDispatcher', 'object' => object(Cake\Http\ActionDispatcher) {}, 'type' => '->', 'args' => [ (int) 0 => object(Cake\Http\ServerRequest) {}, (int) 1 => object(Cake\Http\Response) {} ] ], (int) 6 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Http/Runner.php', 'line' => (int) 65, 'function' => '__invoke', 'class' => 'Cake\Http\BaseApplication', 'object' => object(App\Application) {}, 'type' => '->', 'args' => [ (int) 0 => object(Cake\Http\ServerRequest) {}, (int) 1 => object(Cake\Http\Response) {}, (int) 2 => object(Cake\Http\Runner) {} ] ], (int) 7 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Routing/Middleware/RoutingMiddleware.php', 'line' => (int) 162, 'function' => '__invoke', 'class' => 'Cake\Http\Runner', 'object' => object(Cake\Http\Runner) {}, 'type' => '->', 'args' => [ (int) 0 => object(Cake\Http\ServerRequest) {}, (int) 1 => object(Cake\Http\Response) {} ] ], (int) 8 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Http/Runner.php', 'line' => (int) 65, 'function' => '__invoke', 'class' => 'Cake\Routing\Middleware\RoutingMiddleware', 'object' => object(Cake\Routing\Middleware\RoutingMiddleware) {}, 'type' => '->', 'args' => [ (int) 0 => object(Cake\Http\ServerRequest) {}, (int) 1 => object(Cake\Http\Response) {}, (int) 2 => object(Cake\Http\Runner) {} ] ], (int) 9 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Routing/Middleware/AssetMiddleware.php', 'line' => (int) 88, 'function' => '__invoke', 'class' => 'Cake\Http\Runner', 'object' => object(Cake\Http\Runner) {}, 'type' => '->', 'args' => [ (int) 0 => object(Cake\Http\ServerRequest) {}, (int) 1 => object(Cake\Http\Response) {} ] ], (int) 10 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Http/Runner.php', 'line' => (int) 65, 'function' => '__invoke', 'class' => 'Cake\Routing\Middleware\AssetMiddleware', 'object' => object(Cake\Routing\Middleware\AssetMiddleware) {}, 'type' => '->', 'args' => [ (int) 0 => object(Cake\Http\ServerRequest) {}, (int) 1 => object(Cake\Http\Response) {}, (int) 2 => object(Cake\Http\Runner) {} ] ], (int) 11 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Error/Middleware/ErrorHandlerMiddleware.php', 'line' => (int) 96, 'function' => '__invoke', 'class' => 'Cake\Http\Runner', 'object' => object(Cake\Http\Runner) {}, 'type' => '->', 'args' => [ (int) 0 => object(Cake\Http\ServerRequest) {}, (int) 1 => object(Cake\Http\Response) {} ] ], (int) 12 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Http/Runner.php', 'line' => (int) 65, 'function' => '__invoke', 'class' => 'Cake\Error\Middleware\ErrorHandlerMiddleware', 'object' => object(Cake\Error\Middleware\ErrorHandlerMiddleware) {}, 'type' => '->', 'args' => [ (int) 0 => object(Cake\Http\ServerRequest) {}, (int) 1 => object(Cake\Http\Response) {}, (int) 2 => object(Cake\Http\Runner) {} ] ], (int) 13 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Http/Runner.php', 'line' => (int) 51, 'function' => '__invoke', 'class' => 'Cake\Http\Runner', 'object' => object(Cake\Http\Runner) {}, 'type' => '->', 'args' => [ (int) 0 => object(Cake\Http\ServerRequest) {}, (int) 1 => object(Cake\Http\Response) {} ] ], (int) 14 => [ 'file' => '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Http/Server.php', 'line' => (int) 98, 'function' => 'run', 'class' => 'Cake\Http\Runner', 'object' => object(Cake\Http\Runner) {}, 'type' => '->', 'args' => [ (int) 0 => object(Cake\Http\MiddlewareQueue) {}, (int) 1 => object(Cake\Http\ServerRequest) {}, (int) 2 => object(Cake\Http\Response) {} ] ], (int) 15 => [ 'file' => '/home/brlfuser/public_html/webroot/index.php', 'line' => (int) 39, 'function' => 'run', 'class' => 'Cake\Http\Server', 'object' => object(Cake\Http\Server) {}, 'type' => '->', 'args' => [] ] ] $frame = [ 'file' => '/home/brlfuser/public_html/src/Controller/ArtileDetailController.php', 'line' => (int) 74, 'function' => 'offsetGet', 'class' => 'Cake\Http\ServerRequest', 'object' => object(Cake\Http\ServerRequest) { trustProxy => false [protected] params => [ [maximum depth reached] ] [protected] data => [[maximum depth reached]] [protected] query => [[maximum depth reached]] [protected] cookies => [ [maximum depth reached] ] [protected] _environment => [ [maximum depth reached] ] [protected] url => 'latest-news-updates/averting-deaths-in-muzaffarpur-t-jacob-john-4687396/print' [protected] base => '' [protected] webroot => '/' [protected] here => '/latest-news-updates/averting-deaths-in-muzaffarpur-t-jacob-john-4687396/print' [protected] trustedProxies => [[maximum depth reached]] [protected] _input => null [protected] _detectors => [ [maximum depth reached] ] [protected] _detectorCache => [ [maximum depth reached] ] [protected] stream => object(Zend\Diactoros\PhpInputStream) {} [protected] uri => object(Zend\Diactoros\Uri) {} [protected] session => object(Cake\Http\Session) {} [protected] attributes => [[maximum depth reached]] [protected] emulatedAttributes => [ [maximum depth reached] ] [protected] uploadedFiles => [[maximum depth reached]] [protected] protocol => null [protected] requestTarget => null [private] deprecatedProperties => [ [maximum depth reached] ] }, 'type' => '->', 'args' => [ (int) 0 => 'artileslug' ] ]deprecationWarning - CORE/src/Core/functions.php, line 311 Cake\Http\ServerRequest::offsetGet() - CORE/src/Http/ServerRequest.php, line 2421 App\Controller\ArtileDetailController::printArticle() - APP/Controller/ArtileDetailController.php, line 74 Cake\Controller\Controller::invokeAction() - CORE/src/Controller/Controller.php, line 610 Cake\Http\ActionDispatcher::_invoke() - CORE/src/Http/ActionDispatcher.php, line 120 Cake\Http\ActionDispatcher::dispatch() - CORE/src/Http/ActionDispatcher.php, line 94 Cake\Http\BaseApplication::__invoke() - CORE/src/Http/BaseApplication.php, line 235 Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65 Cake\Routing\Middleware\RoutingMiddleware::__invoke() - CORE/src/Routing/Middleware/RoutingMiddleware.php, line 162 Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65 Cake\Routing\Middleware\AssetMiddleware::__invoke() - CORE/src/Routing/Middleware/AssetMiddleware.php, line 88 Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65 Cake\Error\Middleware\ErrorHandlerMiddleware::__invoke() - CORE/src/Error/Middleware/ErrorHandlerMiddleware.php, line 96 Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65 Cake\Http\Runner::run() - CORE/src/Http/Runner.php, line 51 Cake\Http\Server::run() - CORE/src/Http/Server.php, line 98
Warning (512): Unable to emit headers. Headers sent in file=/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Error/Debugger.php line=853 [CORE/src/Http/ResponseEmitter.php, line 48]Code Contextif (Configure::read('debug')) {
trigger_error($message, E_USER_WARNING);
} else {
$response = object(Cake\Http\Response) { 'status' => (int) 200, 'contentType' => 'text/html', 'headers' => [ 'Content-Type' => [ [maximum depth reached] ] ], 'file' => null, 'fileRange' => [], 'cookies' => object(Cake\Http\Cookie\CookieCollection) {}, 'cacheDirectives' => [], 'body' => '<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd"> <html xmlns="http://www.w3.org/1999/xhtml"> <head> <link rel="canonical" href="https://im4change.in/<pre class="cake-error"><a href="javascript:void(0);" onclick="document.getElementById('cakeErr67f9c9ef02b54-trace').style.display = (document.getElementById('cakeErr67f9c9ef02b54-trace').style.display == 'none' ? '' : 'none');"><b>Notice</b> (8)</a>: Undefined variable: urlPrefix [<b>APP/Template/Layout/printlayout.ctp</b>, line <b>8</b>]<div id="cakeErr67f9c9ef02b54-trace" class="cake-stack-trace" style="display: none;"><a href="javascript:void(0);" onclick="document.getElementById('cakeErr67f9c9ef02b54-code').style.display = (document.getElementById('cakeErr67f9c9ef02b54-code').style.display == 'none' ? '' : 'none')">Code</a> <a href="javascript:void(0);" onclick="document.getElementById('cakeErr67f9c9ef02b54-context').style.display = (document.getElementById('cakeErr67f9c9ef02b54-context').style.display == 'none' ? '' : 'none')">Context</a><pre id="cakeErr67f9c9ef02b54-code" class="cake-code-dump" style="display: none;"><code><span style="color: #000000"><span style="color: #0000BB"></span><span style="color: #007700"><</span><span style="color: #0000BB">head</span><span style="color: #007700">> </span></span></code> <span class="code-highlight"><code><span style="color: #000000"> <link rel="canonical" href="<span style="color: #0000BB"><?php </span><span style="color: #007700">echo </span><span style="color: #0000BB">Configure</span><span style="color: #007700">::</span><span style="color: #0000BB">read</span><span style="color: #007700">(</span><span style="color: #DD0000">'SITE_URL'</span><span style="color: #007700">); </span><span style="color: #0000BB">?><?php </span><span style="color: #007700">echo </span><span style="color: #0000BB">$urlPrefix</span><span style="color: #007700">;</span><span style="color: #0000BB">?><?php </span><span style="color: #007700">echo </span><span style="color: #0000BB">$article_current</span><span style="color: #007700">-></span><span style="color: #0000BB">category</span><span style="color: #007700">-></span><span style="color: #0000BB">slug</span><span style="color: #007700">; </span><span style="color: #0000BB">?></span>/<span style="color: #0000BB"><?php </span><span style="color: #007700">echo </span><span style="color: #0000BB">$article_current</span><span style="color: #007700">-></span><span style="color: #0000BB">seo_url</span><span style="color: #007700">; </span><span style="color: #0000BB">?></span>.html"/> </span></code></span> <code><span style="color: #000000"><span style="color: #0000BB"> </span><span style="color: #007700"><</span><span style="color: #0000BB">meta http</span><span style="color: #007700">-</span><span style="color: #0000BB">equiv</span><span style="color: #007700">=</span><span style="color: #DD0000">"Content-Type" </span><span style="color: #0000BB">content</span><span style="color: #007700">=</span><span style="color: #DD0000">"text/html; charset=utf-8"</span><span style="color: #007700">/> </span></span></code></pre><pre id="cakeErr67f9c9ef02b54-context" class="cake-context" style="display: none;">$viewFile = '/home/brlfuser/public_html/src/Template/Layout/printlayout.ctp' $dataForView = [ 'article_current' => object(App\Model\Entity\Article) { 'id' => (int) 39264, 'title' => 'Averting deaths in Muzaffarpur -T Jacob John', 'subheading' => '', 'description' => '<div align="justify"> -The Hindu<br /> <br /> <em>All it would have taken was to ensure that the children had a meal at night<br /> </em><br /> Along with my colleagues, I had investigated the so-called mystery disease in Muzaffarpur, Bihar, during its outbreak in 2012, 2013 and 2014. The local name for it was acute encephalitis syndrome, but we found that the disease was not encephalitis but encephalopathy. This distinction is important. Encephalitis results from a viral infection, unless proved otherwise. The pathology is primarily in the brain. Encephalopathy is a biochemical disease, unless proved otherwise. The primary pathology is not in the brain. Specific treatment is scanty for viral encephalitis, but encephalopathy is eminently treatable.<br /> <br /> Hypoglycaemia (when the level of glucose in the blood falls below normal) is usually due to an overdose of insulin in children with diabetes. It is easily corrected with oral sugar or intravenous glucose. The easily available 5% glucose solution suffices. Hypoglycaemic encephalopathy, however, is different from simple hypoglycaemia.<br /> <br /> <em>The disease pathway<br /> </em><br /> We found that the disease broke out during the months when litchi was harvested, i.e. April, May and June. Muzaffarpur is full of litchi orchards. The illness started suddenly &mdash; children were found vomiting, displayed abnormal movements, were semi-conscious, and were convulsing between 4 a.m. and 7 a.m. The disease progressed fast &mdash; children went into coma and died within a few days. When sick children were tested, the blood glucose level was always below normal.<br /> <br /> This disease was reminiscent of the Jamaican Vomiting Disease, a form of hypoglycaemic encephalopathy. It is triggered when unripe ackee fruits are eaten. These fruits contain a substance, methylene cyclopropyl alanine, which blocks a biochemical process called fatty acid oxidation, or gluconeogenesis.<br /> <br /> There are two essential steps: gluconeogenesis is turned on and is then blocked midway by methylene cyclopropyl alanine. The back-up molecules of the unfinished process are certain amino acids that are highly toxic to the brain cells. Ackee and litchi belong to one plant family. My toxicology colleague, Dr. Mukul Das, found generous quantities of methylene cyclopropyl glycine in litchi fruit pulp.<br /> <br /> The disease affected only malnourished children between the ages of two and 10. A majority of them were from families camping in orchards for fruit harvesting. No child from the nearby towns fell ill. Children of well-to-do families never fell ill.<br /> <br /> Litchi harvest usually begins by 4 a.m., which means that families are awake before that. They go to sleep early. If children go to sleep without dinner, parents usually do not wake them up and feed them. Litchis are collected in bunches and sent to the collection points, but single fruits fall to the ground. Children are free to collect and share the fruits with their friends.<br /> <br /> Please <a href="https://www.thehindu.com/opinion/op-ed/averting-deaths-in-muzaffarpur/article28067239.ece?homepage=true">click here</a> to read more. <br /> </div>', 'credit_writer' => 'The Hindu, 19 June, 2019, https://www.thehindu.com/opinion/op-ed/averting-deaths-in-muzaffarpur/article28067239.ece?homepage=true', 'article_img' => '', 'article_img_thumb' => '', 'status' => (int) 1, 'show_on_home' => (int) 1, 'lang' => 'EN', 'category_id' => (int) 16, 'tag_keyword' => '', 'seo_url' => 'averting-deaths-in-muzaffarpur-t-jacob-john-4687396', 'meta_title' => null, 'meta_keywords' => null, 'meta_description' => null, 'noindex' => (int) 0, 'publish_date' => object(Cake\I18n\FrozenDate) {}, 'most_visit_section_id' => null, 'article_big_img' => null, 'liveid' => (int) 4687396, 'created' => object(Cake\I18n\FrozenTime) {}, 'modified' => object(Cake\I18n\FrozenTime) {}, 'edate' => '', 'tags' => [ [maximum depth reached] ], 'category' => object(App\Model\Entity\Category) {}, '[new]' => false, '[accessible]' => [ [maximum depth reached] ], '[dirty]' => [[maximum depth reached]], '[original]' => [[maximum depth reached]], '[virtual]' => [[maximum depth reached]], '[hasErrors]' => false, '[errors]' => [[maximum depth reached]], '[invalid]' => [[maximum depth reached]], '[repository]' => 'Articles' }, 'articleid' => (int) 39264, 'metaTitle' => 'LATEST NEWS UPDATES | Averting deaths in Muzaffarpur -T Jacob John', 'metaKeywords' => 'Acute Encephalitis Syndrome,Muzaffarpur,Bihar,Low Blood Sugar,Sri Krishna Medical College Muzaffarpur,Hypoglycaemic encephalopathy', 'metaDesc' => ' -The Hindu All it would have taken was to ensure that the children had a meal at night Along with my colleagues, I had investigated the so-called mystery disease in Muzaffarpur, Bihar, during its outbreak in 2012, 2013 and 2014. The local...', 'disp' => '<div align="justify">-The Hindu<br /><br /><em>All it would have taken was to ensure that the children had a meal at night<br /></em><br />Along with my colleagues, I had investigated the so-called mystery disease in Muzaffarpur, Bihar, during its outbreak in 2012, 2013 and 2014. The local name for it was acute encephalitis syndrome, but we found that the disease was not encephalitis but encephalopathy. This distinction is important. Encephalitis results from a viral infection, unless proved otherwise. The pathology is primarily in the brain. Encephalopathy is a biochemical disease, unless proved otherwise. The primary pathology is not in the brain. Specific treatment is scanty for viral encephalitis, but encephalopathy is eminently treatable.<br /><br />Hypoglycaemia (when the level of glucose in the blood falls below normal) is usually due to an overdose of insulin in children with diabetes. It is easily corrected with oral sugar or intravenous glucose. The easily available 5% glucose solution suffices. Hypoglycaemic encephalopathy, however, is different from simple hypoglycaemia.<br /><br /><em>The disease pathway<br /></em><br />We found that the disease broke out during the months when litchi was harvested, i.e. April, May and June. Muzaffarpur is full of litchi orchards. The illness started suddenly &mdash; children were found vomiting, displayed abnormal movements, were semi-conscious, and were convulsing between 4 a.m. and 7 a.m. The disease progressed fast &mdash; children went into coma and died within a few days. When sick children were tested, the blood glucose level was always below normal.<br /><br />This disease was reminiscent of the Jamaican Vomiting Disease, a form of hypoglycaemic encephalopathy. It is triggered when unripe ackee fruits are eaten. These fruits contain a substance, methylene cyclopropyl alanine, which blocks a biochemical process called fatty acid oxidation, or gluconeogenesis.<br /><br />There are two essential steps: gluconeogenesis is turned on and is then blocked midway by methylene cyclopropyl alanine. The back-up molecules of the unfinished process are certain amino acids that are highly toxic to the brain cells. Ackee and litchi belong to one plant family. My toxicology colleague, Dr. Mukul Das, found generous quantities of methylene cyclopropyl glycine in litchi fruit pulp.<br /><br />The disease affected only malnourished children between the ages of two and 10. A majority of them were from families camping in orchards for fruit harvesting. No child from the nearby towns fell ill. Children of well-to-do families never fell ill.<br /><br />Litchi harvest usually begins by 4 a.m., which means that families are awake before that. They go to sleep early. If children go to sleep without dinner, parents usually do not wake them up and feed them. Litchis are collected in bunches and sent to the collection points, but single fruits fall to the ground. Children are free to collect and share the fruits with their friends.<br /><br />Please <a href="https://www.thehindu.com/opinion/op-ed/averting-deaths-in-muzaffarpur/article28067239.ece?homepage=true" title="https://www.thehindu.com/opinion/op-ed/averting-deaths-in-muzaffarpur/article28067239.ece?homepage=true">click here</a> to read more. <br /></div>', 'lang' => 'English', 'SITE_URL' => 'https://im4change.in/', 'site_title' => 'im4change', 'adminprix' => 'admin' ] $article_current = object(App\Model\Entity\Article) { 'id' => (int) 39264, 'title' => 'Averting deaths in Muzaffarpur -T Jacob John', 'subheading' => '', 'description' => '<div align="justify"> -The Hindu<br /> <br /> <em>All it would have taken was to ensure that the children had a meal at night<br /> </em><br /> Along with my colleagues, I had investigated the so-called mystery disease in Muzaffarpur, Bihar, during its outbreak in 2012, 2013 and 2014. The local name for it was acute encephalitis syndrome, but we found that the disease was not encephalitis but encephalopathy. This distinction is important. Encephalitis results from a viral infection, unless proved otherwise. The pathology is primarily in the brain. Encephalopathy is a biochemical disease, unless proved otherwise. The primary pathology is not in the brain. Specific treatment is scanty for viral encephalitis, but encephalopathy is eminently treatable.<br /> <br /> Hypoglycaemia (when the level of glucose in the blood falls below normal) is usually due to an overdose of insulin in children with diabetes. It is easily corrected with oral sugar or intravenous glucose. The easily available 5% glucose solution suffices. Hypoglycaemic encephalopathy, however, is different from simple hypoglycaemia.<br /> <br /> <em>The disease pathway<br /> </em><br /> We found that the disease broke out during the months when litchi was harvested, i.e. April, May and June. Muzaffarpur is full of litchi orchards. The illness started suddenly &mdash; children were found vomiting, displayed abnormal movements, were semi-conscious, and were convulsing between 4 a.m. and 7 a.m. The disease progressed fast &mdash; children went into coma and died within a few days. When sick children were tested, the blood glucose level was always below normal.<br /> <br /> This disease was reminiscent of the Jamaican Vomiting Disease, a form of hypoglycaemic encephalopathy. It is triggered when unripe ackee fruits are eaten. These fruits contain a substance, methylene cyclopropyl alanine, which blocks a biochemical process called fatty acid oxidation, or gluconeogenesis.<br /> <br /> There are two essential steps: gluconeogenesis is turned on and is then blocked midway by methylene cyclopropyl alanine. The back-up molecules of the unfinished process are certain amino acids that are highly toxic to the brain cells. Ackee and litchi belong to one plant family. My toxicology colleague, Dr. Mukul Das, found generous quantities of methylene cyclopropyl glycine in litchi fruit pulp.<br /> <br /> The disease affected only malnourished children between the ages of two and 10. A majority of them were from families camping in orchards for fruit harvesting. No child from the nearby towns fell ill. Children of well-to-do families never fell ill.<br /> <br /> Litchi harvest usually begins by 4 a.m., which means that families are awake before that. They go to sleep early. If children go to sleep without dinner, parents usually do not wake them up and feed them. Litchis are collected in bunches and sent to the collection points, but single fruits fall to the ground. Children are free to collect and share the fruits with their friends.<br /> <br /> Please <a href="https://www.thehindu.com/opinion/op-ed/averting-deaths-in-muzaffarpur/article28067239.ece?homepage=true">click here</a> to read more. <br /> </div>', 'credit_writer' => 'The Hindu, 19 June, 2019, https://www.thehindu.com/opinion/op-ed/averting-deaths-in-muzaffarpur/article28067239.ece?homepage=true', 'article_img' => '', 'article_img_thumb' => '', 'status' => (int) 1, 'show_on_home' => (int) 1, 'lang' => 'EN', 'category_id' => (int) 16, 'tag_keyword' => '', 'seo_url' => 'averting-deaths-in-muzaffarpur-t-jacob-john-4687396', 'meta_title' => null, 'meta_keywords' => null, 'meta_description' => null, 'noindex' => (int) 0, 'publish_date' => object(Cake\I18n\FrozenDate) {}, 'most_visit_section_id' => null, 'article_big_img' => null, 'liveid' => (int) 4687396, 'created' => object(Cake\I18n\FrozenTime) {}, 'modified' => object(Cake\I18n\FrozenTime) {}, 'edate' => '', 'tags' => [ (int) 0 => object(Cake\ORM\Entity) {}, (int) 1 => object(Cake\ORM\Entity) {}, (int) 2 => object(Cake\ORM\Entity) {}, (int) 3 => object(Cake\ORM\Entity) {}, (int) 4 => object(Cake\ORM\Entity) {}, (int) 5 => object(Cake\ORM\Entity) {} ], 'category' => object(App\Model\Entity\Category) {}, '[new]' => false, '[accessible]' => [ '*' => true, 'id' => false ], '[dirty]' => [], '[original]' => [], '[virtual]' => [], '[hasErrors]' => false, '[errors]' => [], '[invalid]' => [], '[repository]' => 'Articles' } $articleid = (int) 39264 $metaTitle = 'LATEST NEWS UPDATES | Averting deaths in Muzaffarpur -T Jacob John' $metaKeywords = 'Acute Encephalitis Syndrome,Muzaffarpur,Bihar,Low Blood Sugar,Sri Krishna Medical College Muzaffarpur,Hypoglycaemic encephalopathy' $metaDesc = ' -The Hindu All it would have taken was to ensure that the children had a meal at night Along with my colleagues, I had investigated the so-called mystery disease in Muzaffarpur, Bihar, during its outbreak in 2012, 2013 and 2014. The local...' $disp = '<div align="justify">-The Hindu<br /><br /><em>All it would have taken was to ensure that the children had a meal at night<br /></em><br />Along with my colleagues, I had investigated the so-called mystery disease in Muzaffarpur, Bihar, during its outbreak in 2012, 2013 and 2014. The local name for it was acute encephalitis syndrome, but we found that the disease was not encephalitis but encephalopathy. This distinction is important. Encephalitis results from a viral infection, unless proved otherwise. The pathology is primarily in the brain. Encephalopathy is a biochemical disease, unless proved otherwise. The primary pathology is not in the brain. Specific treatment is scanty for viral encephalitis, but encephalopathy is eminently treatable.<br /><br />Hypoglycaemia (when the level of glucose in the blood falls below normal) is usually due to an overdose of insulin in children with diabetes. It is easily corrected with oral sugar or intravenous glucose. The easily available 5% glucose solution suffices. Hypoglycaemic encephalopathy, however, is different from simple hypoglycaemia.<br /><br /><em>The disease pathway<br /></em><br />We found that the disease broke out during the months when litchi was harvested, i.e. April, May and June. Muzaffarpur is full of litchi orchards. The illness started suddenly &mdash; children were found vomiting, displayed abnormal movements, were semi-conscious, and were convulsing between 4 a.m. and 7 a.m. The disease progressed fast &mdash; children went into coma and died within a few days. When sick children were tested, the blood glucose level was always below normal.<br /><br />This disease was reminiscent of the Jamaican Vomiting Disease, a form of hypoglycaemic encephalopathy. It is triggered when unripe ackee fruits are eaten. These fruits contain a substance, methylene cyclopropyl alanine, which blocks a biochemical process called fatty acid oxidation, or gluconeogenesis.<br /><br />There are two essential steps: gluconeogenesis is turned on and is then blocked midway by methylene cyclopropyl alanine. The back-up molecules of the unfinished process are certain amino acids that are highly toxic to the brain cells. Ackee and litchi belong to one plant family. My toxicology colleague, Dr. Mukul Das, found generous quantities of methylene cyclopropyl glycine in litchi fruit pulp.<br /><br />The disease affected only malnourished children between the ages of two and 10. A majority of them were from families camping in orchards for fruit harvesting. No child from the nearby towns fell ill. Children of well-to-do families never fell ill.<br /><br />Litchi harvest usually begins by 4 a.m., which means that families are awake before that. They go to sleep early. If children go to sleep without dinner, parents usually do not wake them up and feed them. Litchis are collected in bunches and sent to the collection points, but single fruits fall to the ground. Children are free to collect and share the fruits with their friends.<br /><br />Please <a href="https://www.thehindu.com/opinion/op-ed/averting-deaths-in-muzaffarpur/article28067239.ece?homepage=true" title="https://www.thehindu.com/opinion/op-ed/averting-deaths-in-muzaffarpur/article28067239.ece?homepage=true">click here</a> to read more. <br /></div>' $lang = 'English' $SITE_URL = 'https://im4change.in/' $site_title = 'im4change' $adminprix = 'admin'</pre><pre class="stack-trace">include - APP/Template/Layout/printlayout.ctp, line 8 Cake\View\View::_evaluate() - CORE/src/View/View.php, line 1413 Cake\View\View::_render() - CORE/src/View/View.php, line 1374 Cake\View\View::renderLayout() - CORE/src/View/View.php, line 927 Cake\View\View::render() - CORE/src/View/View.php, line 885 Cake\Controller\Controller::render() - CORE/src/Controller/Controller.php, line 791 Cake\Http\ActionDispatcher::_invoke() - CORE/src/Http/ActionDispatcher.php, line 126 Cake\Http\ActionDispatcher::dispatch() - CORE/src/Http/ActionDispatcher.php, line 94 Cake\Http\BaseApplication::__invoke() - CORE/src/Http/BaseApplication.php, line 235 Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65 Cake\Routing\Middleware\RoutingMiddleware::__invoke() - CORE/src/Routing/Middleware/RoutingMiddleware.php, line 162 Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65 Cake\Routing\Middleware\AssetMiddleware::__invoke() - CORE/src/Routing/Middleware/AssetMiddleware.php, line 88 Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65 Cake\Error\Middleware\ErrorHandlerMiddleware::__invoke() - CORE/src/Error/Middleware/ErrorHandlerMiddleware.php, line 96 Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65 Cake\Http\Runner::run() - CORE/src/Http/Runner.php, line 51</pre></div></pre>latest-news-updates/averting-deaths-in-muzaffarpur-t-jacob-john-4687396.html"/> <meta http-equiv="Content-Type" content="text/html; charset=utf-8"/> <link href="https://im4change.in/css/control.css" rel="stylesheet" type="text/css" media="all"/> <title>LATEST NEWS UPDATES | Averting deaths in Muzaffarpur -T Jacob John | Im4change.org</title> <meta name="description" content=" -The Hindu All it would have taken was to ensure that the children had a meal at night Along with my colleagues, I had investigated the so-called mystery disease in Muzaffarpur, Bihar, during its outbreak in 2012, 2013 and 2014. The local..."/> <script src="https://im4change.in/js/jquery-1.10.2.js"></script> <script type="text/javascript" src="https://im4change.in/js/jquery-migrate.min.js"></script> <script language="javascript" type="text/javascript"> $(document).ready(function () { var img = $("img")[0]; // Get my img elem var pic_real_width, pic_real_height; $("<img/>") // Make in memory copy of image to avoid css issues .attr("src", $(img).attr("src")) .load(function () { pic_real_width = this.width; // Note: $(this).width() will not pic_real_height = this.height; // work for in memory images. }); }); </script> <style type="text/css"> @media screen { div.divFooter { display: block; } } @media print { .printbutton { display: none !important; } } </style> </head> <body> <table cellpadding="0" cellspacing="0" border="0" width="98%" align="center"> <tr> <td class="top_bg"> <div class="divFooter"> <img src="https://im4change.in/images/logo1.jpg" height="59" border="0" alt="Resource centre on India's rural distress" style="padding-top:14px;"/> </div> </td> </tr> <tr> <td id="topspace"> </td> </tr> <tr id="topspace"> <td> </td> </tr> <tr> <td height="50" style="border-bottom:1px solid #000; padding-top:10px;" class="printbutton"> <form><input type="button" value=" Print this page " onclick="window.print();return false;"/></form> </td> </tr> <tr> <td width="100%"> <h1 class="news_headlines" style="font-style:normal"> <strong>Averting deaths in Muzaffarpur -T Jacob John</strong></h1> </td> </tr> <tr> <td width="100%" style="font-family:Arial, 'Segoe Script', 'Segoe UI', sans-serif, serif"><font size="3"> <div align="justify">-The Hindu<br /><br /><em>All it would have taken was to ensure that the children had a meal at night<br /></em><br />Along with my colleagues, I had investigated the so-called mystery disease in Muzaffarpur, Bihar, during its outbreak in 2012, 2013 and 2014. The local name for it was acute encephalitis syndrome, but we found that the disease was not encephalitis but encephalopathy. This distinction is important. Encephalitis results from a viral infection, unless proved otherwise. The pathology is primarily in the brain. Encephalopathy is a biochemical disease, unless proved otherwise. The primary pathology is not in the brain. Specific treatment is scanty for viral encephalitis, but encephalopathy is eminently treatable.<br /><br />Hypoglycaemia (when the level of glucose in the blood falls below normal) is usually due to an overdose of insulin in children with diabetes. It is easily corrected with oral sugar or intravenous glucose. The easily available 5% glucose solution suffices. Hypoglycaemic encephalopathy, however, is different from simple hypoglycaemia.<br /><br /><em>The disease pathway<br /></em><br />We found that the disease broke out during the months when litchi was harvested, i.e. April, May and June. Muzaffarpur is full of litchi orchards. The illness started suddenly — children were found vomiting, displayed abnormal movements, were semi-conscious, and were convulsing between 4 a.m. and 7 a.m. The disease progressed fast — children went into coma and died within a few days. When sick children were tested, the blood glucose level was always below normal.<br /><br />This disease was reminiscent of the Jamaican Vomiting Disease, a form of hypoglycaemic encephalopathy. It is triggered when unripe ackee fruits are eaten. These fruits contain a substance, methylene cyclopropyl alanine, which blocks a biochemical process called fatty acid oxidation, or gluconeogenesis.<br /><br />There are two essential steps: gluconeogenesis is turned on and is then blocked midway by methylene cyclopropyl alanine. The back-up molecules of the unfinished process are certain amino acids that are highly toxic to the brain cells. Ackee and litchi belong to one plant family. My toxicology colleague, Dr. Mukul Das, found generous quantities of methylene cyclopropyl glycine in litchi fruit pulp.<br /><br />The disease affected only malnourished children between the ages of two and 10. A majority of them were from families camping in orchards for fruit harvesting. No child from the nearby towns fell ill. Children of well-to-do families never fell ill.<br /><br />Litchi harvest usually begins by 4 a.m., which means that families are awake before that. They go to sleep early. If children go to sleep without dinner, parents usually do not wake them up and feed them. Litchis are collected in bunches and sent to the collection points, but single fruits fall to the ground. Children are free to collect and share the fruits with their friends.<br /><br />Please <a href="https://www.thehindu.com/opinion/op-ed/averting-deaths-in-muzaffarpur/article28067239.ece?homepage=true" title="https://www.thehindu.com/opinion/op-ed/averting-deaths-in-muzaffarpur/article28067239.ece?homepage=true">click here</a> to read more. <br /></div> </font> </td> </tr> <tr> <td> </td> </tr> <tr> <td height="50" style="border-top:1px solid #000; border-bottom:1px solid #000;padding-top:10px;"> <form><input type="button" value=" Print this page " onclick="window.print();return false;"/></form> </td> </tr> </table></body> </html>' } $maxBufferLength = (int) 8192 $file = '/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Error/Debugger.php' $line = (int) 853 $message = 'Unable to emit headers. 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The local name for it was acute encephalitis syndrome, but we found that the disease was not encephalitis but encephalopathy. This distinction is important. Encephalitis results from a viral infection, unless proved otherwise. The pathology is primarily in the brain. Encephalopathy is a biochemical disease, unless proved otherwise. The primary pathology is not in the brain. Specific treatment is scanty for viral encephalitis, but encephalopathy is eminently treatable.<br /> <br /> Hypoglycaemia (when the level of glucose in the blood falls below normal) is usually due to an overdose of insulin in children with diabetes. It is easily corrected with oral sugar or intravenous glucose. The easily available 5% glucose solution suffices. Hypoglycaemic encephalopathy, however, is different from simple hypoglycaemia.<br /> <br /> <em>The disease pathway<br /> </em><br /> We found that the disease broke out during the months when litchi was harvested, i.e. April, May and June. Muzaffarpur is full of litchi orchards. The illness started suddenly &mdash; children were found vomiting, displayed abnormal movements, were semi-conscious, and were convulsing between 4 a.m. and 7 a.m. The disease progressed fast &mdash; children went into coma and died within a few days. When sick children were tested, the blood glucose level was always below normal.<br /> <br /> This disease was reminiscent of the Jamaican Vomiting Disease, a form of hypoglycaemic encephalopathy. It is triggered when unripe ackee fruits are eaten. These fruits contain a substance, methylene cyclopropyl alanine, which blocks a biochemical process called fatty acid oxidation, or gluconeogenesis.<br /> <br /> There are two essential steps: gluconeogenesis is turned on and is then blocked midway by methylene cyclopropyl alanine. The back-up molecules of the unfinished process are certain amino acids that are highly toxic to the brain cells. Ackee and litchi belong to one plant family. 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The easily available 5% glucose solution suffices. Hypoglycaemic encephalopathy, however, is different from simple hypoglycaemia.<br /><br /><em>The disease pathway<br /></em><br />We found that the disease broke out during the months when litchi was harvested, i.e. April, May and June. Muzaffarpur is full of litchi orchards. The illness started suddenly &mdash; children were found vomiting, displayed abnormal movements, were semi-conscious, and were convulsing between 4 a.m. and 7 a.m. The disease progressed fast &mdash; children went into coma and died within a few days. When sick children were tested, the blood glucose level was always below normal.<br /><br />This disease was reminiscent of the Jamaican Vomiting Disease, a form of hypoglycaemic encephalopathy. It is triggered when unripe ackee fruits are eaten. 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The local name for it was acute encephalitis syndrome, but we found that the disease was not encephalitis but encephalopathy. This distinction is important. Encephalitis results from a viral infection, unless proved otherwise. The pathology is primarily in the brain. Encephalopathy is a biochemical disease, unless proved otherwise. The primary pathology is not in the brain. Specific treatment is scanty for viral encephalitis, but encephalopathy is eminently treatable.<br /> <br /> Hypoglycaemia (when the level of glucose in the blood falls below normal) is usually due to an overdose of insulin in children with diabetes. It is easily corrected with oral sugar or intravenous glucose. The easily available 5% glucose solution suffices. Hypoglycaemic encephalopathy, however, is different from simple hypoglycaemia.<br /> <br /> <em>The disease pathway<br /> </em><br /> We found that the disease broke out during the months when litchi was harvested, i.e. April, May and June. 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The local...' $disp = '<div align="justify">-The Hindu<br /><br /><em>All it would have taken was to ensure that the children had a meal at night<br /></em><br />Along with my colleagues, I had investigated the so-called mystery disease in Muzaffarpur, Bihar, during its outbreak in 2012, 2013 and 2014. The local name for it was acute encephalitis syndrome, but we found that the disease was not encephalitis but encephalopathy. This distinction is important. Encephalitis results from a viral infection, unless proved otherwise. The pathology is primarily in the brain. Encephalopathy is a biochemical disease, unless proved otherwise. The primary pathology is not in the brain. Specific treatment is scanty for viral encephalitis, but encephalopathy is eminently treatable.<br /><br />Hypoglycaemia (when the level of glucose in the blood falls below normal) is usually due to an overdose of insulin in children with diabetes. It is easily corrected with oral sugar or intravenous glucose. The easily available 5% glucose solution suffices. Hypoglycaemic encephalopathy, however, is different from simple hypoglycaemia.<br /><br /><em>The disease pathway<br /></em><br />We found that the disease broke out during the months when litchi was harvested, i.e. April, May and June. Muzaffarpur is full of litchi orchards. The illness started suddenly &mdash; children were found vomiting, displayed abnormal movements, were semi-conscious, and were convulsing between 4 a.m. and 7 a.m. The disease progressed fast &mdash; children went into coma and died within a few days. When sick children were tested, the blood glucose level was always below normal.<br /><br />This disease was reminiscent of the Jamaican Vomiting Disease, a form of hypoglycaemic encephalopathy. It is triggered when unripe ackee fruits are eaten. These fruits contain a substance, methylene cyclopropyl alanine, which blocks a biochemical process called fatty acid oxidation, or gluconeogenesis.<br /><br />There are two essential steps: gluconeogenesis is turned on and is then blocked midway by methylene cyclopropyl alanine. The back-up molecules of the unfinished process are certain amino acids that are highly toxic to the brain cells. Ackee and litchi belong to one plant family. My toxicology colleague, Dr. Mukul Das, found generous quantities of methylene cyclopropyl glycine in litchi fruit pulp.<br /><br />The disease affected only malnourished children between the ages of two and 10. A majority of them were from families camping in orchards for fruit harvesting. No child from the nearby towns fell ill. Children of well-to-do families never fell ill.<br /><br />Litchi harvest usually begins by 4 a.m., which means that families are awake before that. They go to sleep early. If children go to sleep without dinner, parents usually do not wake them up and feed them. Litchis are collected in bunches and sent to the collection points, but single fruits fall to the ground. Children are free to collect and share the fruits with their friends.<br /><br />Please <a href="https://www.thehindu.com/opinion/op-ed/averting-deaths-in-muzaffarpur/article28067239.ece?homepage=true" title="https://www.thehindu.com/opinion/op-ed/averting-deaths-in-muzaffarpur/article28067239.ece?homepage=true">click here</a> to read more. <br /></div>' $lang = 'English' $SITE_URL = 'https://im4change.in/' $site_title = 'im4change' $adminprix = 'admin'</pre><pre class="stack-trace">include - APP/Template/Layout/printlayout.ctp, line 8 Cake\View\View::_evaluate() - CORE/src/View/View.php, line 1413 Cake\View\View::_render() - CORE/src/View/View.php, line 1374 Cake\View\View::renderLayout() - CORE/src/View/View.php, line 927 Cake\View\View::render() - CORE/src/View/View.php, line 885 Cake\Controller\Controller::render() - CORE/src/Controller/Controller.php, line 791 Cake\Http\ActionDispatcher::_invoke() - CORE/src/Http/ActionDispatcher.php, line 126 Cake\Http\ActionDispatcher::dispatch() - CORE/src/Http/ActionDispatcher.php, line 94 Cake\Http\BaseApplication::__invoke() - CORE/src/Http/BaseApplication.php, line 235 Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65 Cake\Routing\Middleware\RoutingMiddleware::__invoke() - CORE/src/Routing/Middleware/RoutingMiddleware.php, line 162 Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65 Cake\Routing\Middleware\AssetMiddleware::__invoke() - CORE/src/Routing/Middleware/AssetMiddleware.php, line 88 Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65 Cake\Error\Middleware\ErrorHandlerMiddleware::__invoke() - CORE/src/Error/Middleware/ErrorHandlerMiddleware.php, line 96 Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65 Cake\Http\Runner::run() - CORE/src/Http/Runner.php, line 51</pre></div></pre>latest-news-updates/averting-deaths-in-muzaffarpur-t-jacob-john-4687396.html"/> <meta http-equiv="Content-Type" content="text/html; charset=utf-8"/> <link href="https://im4change.in/css/control.css" rel="stylesheet" type="text/css" media="all"/> <title>LATEST NEWS UPDATES | Averting deaths in Muzaffarpur -T Jacob John | Im4change.org</title> <meta name="description" content=" -The Hindu All it would have taken was to ensure that the children had a meal at night Along with my colleagues, I had investigated the so-called mystery disease in Muzaffarpur, Bihar, during its outbreak in 2012, 2013 and 2014. The local..."/> <script src="https://im4change.in/js/jquery-1.10.2.js"></script> <script type="text/javascript" src="https://im4change.in/js/jquery-migrate.min.js"></script> <script language="javascript" type="text/javascript"> $(document).ready(function () { var img = $("img")[0]; // Get my img elem var pic_real_width, pic_real_height; $("<img/>") // Make in memory copy of image to avoid css issues .attr("src", $(img).attr("src")) .load(function () { pic_real_width = this.width; // Note: $(this).width() will not pic_real_height = this.height; // work for in memory images. }); }); </script> <style type="text/css"> @media screen { div.divFooter { display: block; } } @media print { .printbutton { display: none !important; } } </style> </head> <body> <table cellpadding="0" cellspacing="0" border="0" width="98%" align="center"> <tr> <td class="top_bg"> <div class="divFooter"> <img src="https://im4change.in/images/logo1.jpg" height="59" border="0" alt="Resource centre on India's rural distress" style="padding-top:14px;"/> </div> </td> </tr> <tr> <td id="topspace"> </td> </tr> <tr id="topspace"> <td> </td> </tr> <tr> <td height="50" style="border-bottom:1px solid #000; padding-top:10px;" class="printbutton"> <form><input type="button" value=" Print this page " onclick="window.print();return false;"/></form> </td> </tr> <tr> <td width="100%"> <h1 class="news_headlines" style="font-style:normal"> <strong>Averting deaths in Muzaffarpur -T Jacob John</strong></h1> </td> </tr> <tr> <td width="100%" style="font-family:Arial, 'Segoe Script', 'Segoe UI', sans-serif, serif"><font size="3"> <div align="justify">-The Hindu<br /><br /><em>All it would have taken was to ensure that the children had a meal at night<br /></em><br />Along with my colleagues, I had investigated the so-called mystery disease in Muzaffarpur, Bihar, during its outbreak in 2012, 2013 and 2014. The local name for it was acute encephalitis syndrome, but we found that the disease was not encephalitis but encephalopathy. This distinction is important. Encephalitis results from a viral infection, unless proved otherwise. The pathology is primarily in the brain. Encephalopathy is a biochemical disease, unless proved otherwise. The primary pathology is not in the brain. Specific treatment is scanty for viral encephalitis, but encephalopathy is eminently treatable.<br /><br />Hypoglycaemia (when the level of glucose in the blood falls below normal) is usually due to an overdose of insulin in children with diabetes. It is easily corrected with oral sugar or intravenous glucose. The easily available 5% glucose solution suffices. Hypoglycaemic encephalopathy, however, is different from simple hypoglycaemia.<br /><br /><em>The disease pathway<br /></em><br />We found that the disease broke out during the months when litchi was harvested, i.e. April, May and June. Muzaffarpur is full of litchi orchards. The illness started suddenly — children were found vomiting, displayed abnormal movements, were semi-conscious, and were convulsing between 4 a.m. and 7 a.m. The disease progressed fast — children went into coma and died within a few days. When sick children were tested, the blood glucose level was always below normal.<br /><br />This disease was reminiscent of the Jamaican Vomiting Disease, a form of hypoglycaemic encephalopathy. It is triggered when unripe ackee fruits are eaten. These fruits contain a substance, methylene cyclopropyl alanine, which blocks a biochemical process called fatty acid oxidation, or gluconeogenesis.<br /><br />There are two essential steps: gluconeogenesis is turned on and is then blocked midway by methylene cyclopropyl alanine. The back-up molecules of the unfinished process are certain amino acids that are highly toxic to the brain cells. Ackee and litchi belong to one plant family. My toxicology colleague, Dr. Mukul Das, found generous quantities of methylene cyclopropyl glycine in litchi fruit pulp.<br /><br />The disease affected only malnourished children between the ages of two and 10. A majority of them were from families camping in orchards for fruit harvesting. No child from the nearby towns fell ill. Children of well-to-do families never fell ill.<br /><br />Litchi harvest usually begins by 4 a.m., which means that families are awake before that. They go to sleep early. If children go to sleep without dinner, parents usually do not wake them up and feed them. Litchis are collected in bunches and sent to the collection points, but single fruits fall to the ground. Children are free to collect and share the fruits with their friends.<br /><br />Please <a href="https://www.thehindu.com/opinion/op-ed/averting-deaths-in-muzaffarpur/article28067239.ece?homepage=true" title="https://www.thehindu.com/opinion/op-ed/averting-deaths-in-muzaffarpur/article28067239.ece?homepage=true">click here</a> to read more. <br /></div> </font> </td> </tr> <tr> <td> </td> </tr> <tr> <td height="50" style="border-top:1px solid #000; border-bottom:1px solid #000;padding-top:10px;"> <form><input type="button" value=" Print this page " onclick="window.print();return false;"/></form> </td> </tr> </table></body> </html>' } $reasonPhrase = 'OK'header - [internal], line ?? Cake\Http\ResponseEmitter::emitStatusLine() - CORE/src/Http/ResponseEmitter.php, line 148 Cake\Http\ResponseEmitter::emit() - CORE/src/Http/ResponseEmitter.php, line 54 Cake\Http\Server::emit() - CORE/src/Http/Server.php, line 141 [main] - ROOT/webroot/index.php, line 39
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The local name for it was acute encephalitis syndrome, but we found that the disease was not encephalitis but encephalopathy. This distinction is important. Encephalitis results from a viral infection, unless proved otherwise. The pathology is primarily in the brain. Encephalopathy is a biochemical disease, unless proved otherwise. The primary pathology is not in the brain. Specific treatment is scanty for viral encephalitis, but encephalopathy is eminently treatable.<br /> <br /> Hypoglycaemia (when the level of glucose in the blood falls below normal) is usually due to an overdose of insulin in children with diabetes. It is easily corrected with oral sugar or intravenous glucose. The easily available 5% glucose solution suffices. Hypoglycaemic encephalopathy, however, is different from simple hypoglycaemia.<br /> <br /> <em>The disease pathway<br /> </em><br /> We found that the disease broke out during the months when litchi was harvested, i.e. April, May and June. Muzaffarpur is full of litchi orchards. The illness started suddenly &mdash; children were found vomiting, displayed abnormal movements, were semi-conscious, and were convulsing between 4 a.m. and 7 a.m. The disease progressed fast &mdash; children went into coma and died within a few days. When sick children were tested, the blood glucose level was always below normal.<br /> <br /> This disease was reminiscent of the Jamaican Vomiting Disease, a form of hypoglycaemic encephalopathy. It is triggered when unripe ackee fruits are eaten. These fruits contain a substance, methylene cyclopropyl alanine, which blocks a biochemical process called fatty acid oxidation, or gluconeogenesis.<br /> <br /> There are two essential steps: gluconeogenesis is turned on and is then blocked midway by methylene cyclopropyl alanine. The back-up molecules of the unfinished process are certain amino acids that are highly toxic to the brain cells. Ackee and litchi belong to one plant family. 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The easily available 5% glucose solution suffices. Hypoglycaemic encephalopathy, however, is different from simple hypoglycaemia.<br /><br /><em>The disease pathway<br /></em><br />We found that the disease broke out during the months when litchi was harvested, i.e. April, May and June. Muzaffarpur is full of litchi orchards. The illness started suddenly &mdash; children were found vomiting, displayed abnormal movements, were semi-conscious, and were convulsing between 4 a.m. and 7 a.m. The disease progressed fast &mdash; children went into coma and died within a few days. When sick children were tested, the blood glucose level was always below normal.<br /><br />This disease was reminiscent of the Jamaican Vomiting Disease, a form of hypoglycaemic encephalopathy. It is triggered when unripe ackee fruits are eaten. These fruits contain a substance, methylene cyclopropyl alanine, which blocks a biochemical process called fatty acid oxidation, or gluconeogenesis.<br /><br />There are two essential steps: gluconeogenesis is turned on and is then blocked midway by methylene cyclopropyl alanine. The back-up molecules of the unfinished process are certain amino acids that are highly toxic to the brain cells. Ackee and litchi belong to one plant family. My toxicology colleague, Dr. Mukul Das, found generous quantities of methylene cyclopropyl glycine in litchi fruit pulp.<br /><br />The disease affected only malnourished children between the ages of two and 10. A majority of them were from families camping in orchards for fruit harvesting. No child from the nearby towns fell ill. Children of well-to-do families never fell ill.<br /><br />Litchi harvest usually begins by 4 a.m., which means that families are awake before that. They go to sleep early. 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The local name for it was acute encephalitis syndrome, but we found that the disease was not encephalitis but encephalopathy. This distinction is important. Encephalitis results from a viral infection, unless proved otherwise. The pathology is primarily in the brain. Encephalopathy is a biochemical disease, unless proved otherwise. The primary pathology is not in the brain. Specific treatment is scanty for viral encephalitis, but encephalopathy is eminently treatable.<br /> <br /> Hypoglycaemia (when the level of glucose in the blood falls below normal) is usually due to an overdose of insulin in children with diabetes. It is easily corrected with oral sugar or intravenous glucose. The easily available 5% glucose solution suffices. Hypoglycaemic encephalopathy, however, is different from simple hypoglycaemia.<br /> <br /> <em>The disease pathway<br /> </em><br /> We found that the disease broke out during the months when litchi was harvested, i.e. April, May and June. Muzaffarpur is full of litchi orchards. The illness started suddenly &mdash; children were found vomiting, displayed abnormal movements, were semi-conscious, and were convulsing between 4 a.m. and 7 a.m. The disease progressed fast &mdash; children went into coma and died within a few days. When sick children were tested, the blood glucose level was always below normal.<br /> <br /> This disease was reminiscent of the Jamaican Vomiting Disease, a form of hypoglycaemic encephalopathy. It is triggered when unripe ackee fruits are eaten. These fruits contain a substance, methylene cyclopropyl alanine, which blocks a biochemical process called fatty acid oxidation, or gluconeogenesis.<br /> <br /> There are two essential steps: gluconeogenesis is turned on and is then blocked midway by methylene cyclopropyl alanine. The back-up molecules of the unfinished process are certain amino acids that are highly toxic to the brain cells. Ackee and litchi belong to one plant family. My toxicology colleague, Dr. Mukul Das, found generous quantities of methylene cyclopropyl glycine in litchi fruit pulp.<br /> <br /> The disease affected only malnourished children between the ages of two and 10. A majority of them were from families camping in orchards for fruit harvesting. No child from the nearby towns fell ill. Children of well-to-do families never fell ill.<br /> <br /> Litchi harvest usually begins by 4 a.m., which means that families are awake before that. They go to sleep early. If children go to sleep without dinner, parents usually do not wake them up and feed them. Litchis are collected in bunches and sent to the collection points, but single fruits fall to the ground. 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The local...' $disp = '<div align="justify">-The Hindu<br /><br /><em>All it would have taken was to ensure that the children had a meal at night<br /></em><br />Along with my colleagues, I had investigated the so-called mystery disease in Muzaffarpur, Bihar, during its outbreak in 2012, 2013 and 2014. The local name for it was acute encephalitis syndrome, but we found that the disease was not encephalitis but encephalopathy. This distinction is important. Encephalitis results from a viral infection, unless proved otherwise. The pathology is primarily in the brain. Encephalopathy is a biochemical disease, unless proved otherwise. The primary pathology is not in the brain. Specific treatment is scanty for viral encephalitis, but encephalopathy is eminently treatable.<br /><br />Hypoglycaemia (when the level of glucose in the blood falls below normal) is usually due to an overdose of insulin in children with diabetes. It is easily corrected with oral sugar or intravenous glucose. The easily available 5% glucose solution suffices. Hypoglycaemic encephalopathy, however, is different from simple hypoglycaemia.<br /><br /><em>The disease pathway<br /></em><br />We found that the disease broke out during the months when litchi was harvested, i.e. April, May and June. Muzaffarpur is full of litchi orchards. The illness started suddenly &mdash; children were found vomiting, displayed abnormal movements, were semi-conscious, and were convulsing between 4 a.m. and 7 a.m. The disease progressed fast &mdash; children went into coma and died within a few days. When sick children were tested, the blood glucose level was always below normal.<br /><br />This disease was reminiscent of the Jamaican Vomiting Disease, a form of hypoglycaemic encephalopathy. It is triggered when unripe ackee fruits are eaten. These fruits contain a substance, methylene cyclopropyl alanine, which blocks a biochemical process called fatty acid oxidation, or gluconeogenesis.<br /><br />There are two essential steps: gluconeogenesis is turned on and is then blocked midway by methylene cyclopropyl alanine. The back-up molecules of the unfinished process are certain amino acids that are highly toxic to the brain cells. Ackee and litchi belong to one plant family. My toxicology colleague, Dr. Mukul Das, found generous quantities of methylene cyclopropyl glycine in litchi fruit pulp.<br /><br />The disease affected only malnourished children between the ages of two and 10. A majority of them were from families camping in orchards for fruit harvesting. No child from the nearby towns fell ill. Children of well-to-do families never fell ill.<br /><br />Litchi harvest usually begins by 4 a.m., which means that families are awake before that. They go to sleep early. If children go to sleep without dinner, parents usually do not wake them up and feed them. Litchis are collected in bunches and sent to the collection points, but single fruits fall to the ground. Children are free to collect and share the fruits with their friends.<br /><br />Please <a href="https://www.thehindu.com/opinion/op-ed/averting-deaths-in-muzaffarpur/article28067239.ece?homepage=true" title="https://www.thehindu.com/opinion/op-ed/averting-deaths-in-muzaffarpur/article28067239.ece?homepage=true">click here</a> to read more. <br /></div>' $lang = 'English' $SITE_URL = 'https://im4change.in/' $site_title = 'im4change' $adminprix = 'admin'</pre><pre class="stack-trace">include - APP/Template/Layout/printlayout.ctp, line 8 Cake\View\View::_evaluate() - CORE/src/View/View.php, line 1413 Cake\View\View::_render() - CORE/src/View/View.php, line 1374 Cake\View\View::renderLayout() - CORE/src/View/View.php, line 927 Cake\View\View::render() - CORE/src/View/View.php, line 885 Cake\Controller\Controller::render() - CORE/src/Controller/Controller.php, line 791 Cake\Http\ActionDispatcher::_invoke() - CORE/src/Http/ActionDispatcher.php, line 126 Cake\Http\ActionDispatcher::dispatch() - CORE/src/Http/ActionDispatcher.php, line 94 Cake\Http\BaseApplication::__invoke() - CORE/src/Http/BaseApplication.php, line 235 Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65 Cake\Routing\Middleware\RoutingMiddleware::__invoke() - CORE/src/Routing/Middleware/RoutingMiddleware.php, line 162 Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65 Cake\Routing\Middleware\AssetMiddleware::__invoke() - CORE/src/Routing/Middleware/AssetMiddleware.php, line 88 Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65 Cake\Error\Middleware\ErrorHandlerMiddleware::__invoke() - CORE/src/Error/Middleware/ErrorHandlerMiddleware.php, line 96 Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65 Cake\Http\Runner::run() - CORE/src/Http/Runner.php, line 51</pre></div></pre>latest-news-updates/averting-deaths-in-muzaffarpur-t-jacob-john-4687396.html"/> <meta http-equiv="Content-Type" content="text/html; charset=utf-8"/> <link href="https://im4change.in/css/control.css" rel="stylesheet" type="text/css" media="all"/> <title>LATEST NEWS UPDATES | Averting deaths in Muzaffarpur -T Jacob John | Im4change.org</title> <meta name="description" content=" -The Hindu All it would have taken was to ensure that the children had a meal at night Along with my colleagues, I had investigated the so-called mystery disease in Muzaffarpur, Bihar, during its outbreak in 2012, 2013 and 2014. The local..."/> <script src="https://im4change.in/js/jquery-1.10.2.js"></script> <script type="text/javascript" src="https://im4change.in/js/jquery-migrate.min.js"></script> <script language="javascript" type="text/javascript"> $(document).ready(function () { var img = $("img")[0]; // Get my img elem var pic_real_width, pic_real_height; $("<img/>") // Make in memory copy of image to avoid css issues .attr("src", $(img).attr("src")) .load(function () { pic_real_width = this.width; // Note: $(this).width() will not pic_real_height = this.height; // work for in memory images. }); }); </script> <style type="text/css"> @media screen { div.divFooter { display: block; } } @media print { .printbutton { display: none !important; } } </style> </head> <body> <table cellpadding="0" cellspacing="0" border="0" width="98%" align="center"> <tr> <td class="top_bg"> <div class="divFooter"> <img src="https://im4change.in/images/logo1.jpg" height="59" border="0" alt="Resource centre on India's rural distress" style="padding-top:14px;"/> </div> </td> </tr> <tr> <td id="topspace"> </td> </tr> <tr id="topspace"> <td> </td> </tr> <tr> <td height="50" style="border-bottom:1px solid #000; padding-top:10px;" class="printbutton"> <form><input type="button" value=" Print this page " onclick="window.print();return false;"/></form> </td> </tr> <tr> <td width="100%"> <h1 class="news_headlines" style="font-style:normal"> <strong>Averting deaths in Muzaffarpur -T Jacob John</strong></h1> </td> </tr> <tr> <td width="100%" style="font-family:Arial, 'Segoe Script', 'Segoe UI', sans-serif, serif"><font size="3"> <div align="justify">-The Hindu<br /><br /><em>All it would have taken was to ensure that the children had a meal at night<br /></em><br />Along with my colleagues, I had investigated the so-called mystery disease in Muzaffarpur, Bihar, during its outbreak in 2012, 2013 and 2014. The local name for it was acute encephalitis syndrome, but we found that the disease was not encephalitis but encephalopathy. This distinction is important. Encephalitis results from a viral infection, unless proved otherwise. The pathology is primarily in the brain. Encephalopathy is a biochemical disease, unless proved otherwise. The primary pathology is not in the brain. Specific treatment is scanty for viral encephalitis, but encephalopathy is eminently treatable.<br /><br />Hypoglycaemia (when the level of glucose in the blood falls below normal) is usually due to an overdose of insulin in children with diabetes. It is easily corrected with oral sugar or intravenous glucose. The easily available 5% glucose solution suffices. Hypoglycaemic encephalopathy, however, is different from simple hypoglycaemia.<br /><br /><em>The disease pathway<br /></em><br />We found that the disease broke out during the months when litchi was harvested, i.e. April, May and June. Muzaffarpur is full of litchi orchards. The illness started suddenly — children were found vomiting, displayed abnormal movements, were semi-conscious, and were convulsing between 4 a.m. and 7 a.m. The disease progressed fast — children went into coma and died within a few days. When sick children were tested, the blood glucose level was always below normal.<br /><br />This disease was reminiscent of the Jamaican Vomiting Disease, a form of hypoglycaemic encephalopathy. It is triggered when unripe ackee fruits are eaten. These fruits contain a substance, methylene cyclopropyl alanine, which blocks a biochemical process called fatty acid oxidation, or gluconeogenesis.<br /><br />There are two essential steps: gluconeogenesis is turned on and is then blocked midway by methylene cyclopropyl alanine. The back-up molecules of the unfinished process are certain amino acids that are highly toxic to the brain cells. Ackee and litchi belong to one plant family. My toxicology colleague, Dr. Mukul Das, found generous quantities of methylene cyclopropyl glycine in litchi fruit pulp.<br /><br />The disease affected only malnourished children between the ages of two and 10. A majority of them were from families camping in orchards for fruit harvesting. No child from the nearby towns fell ill. Children of well-to-do families never fell ill.<br /><br />Litchi harvest usually begins by 4 a.m., which means that families are awake before that. They go to sleep early. If children go to sleep without dinner, parents usually do not wake them up and feed them. Litchis are collected in bunches and sent to the collection points, but single fruits fall to the ground. Children are free to collect and share the fruits with their friends.<br /><br />Please <a href="https://www.thehindu.com/opinion/op-ed/averting-deaths-in-muzaffarpur/article28067239.ece?homepage=true" title="https://www.thehindu.com/opinion/op-ed/averting-deaths-in-muzaffarpur/article28067239.ece?homepage=true">click here</a> to read more. <br /></div> </font> </td> </tr> <tr> <td> </td> </tr> <tr> <td height="50" style="border-top:1px solid #000; border-bottom:1px solid #000;padding-top:10px;"> <form><input type="button" value=" Print this page " onclick="window.print();return false;"/></form> </td> </tr> </table></body> </html>' } $cookies = [] $values = [ (int) 0 => 'text/html; charset=UTF-8' ] $name = 'Content-Type' $first = true $value = 'text/html; charset=UTF-8'header - [internal], line ?? 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Specific treatment is scanty for viral encephalitis, but encephalopathy is eminently treatable.<br /> <br /> Hypoglycaemia (when the level of glucose in the blood falls below normal) is usually due to an overdose of insulin in children with diabetes. It is easily corrected with oral sugar or intravenous glucose. The easily available 5% glucose solution suffices. Hypoglycaemic encephalopathy, however, is different from simple hypoglycaemia.<br /> <br /> <em>The disease pathway<br /> </em><br /> We found that the disease broke out during the months when litchi was harvested, i.e. April, May and June. Muzaffarpur is full of litchi orchards. The illness started suddenly — children were found vomiting, displayed abnormal movements, were semi-conscious, and were convulsing between 4 a.m. and 7 a.m. The disease progressed fast — children went into coma and died within a few days. When sick children were tested, the blood glucose level was always below normal.<br /> <br /> This disease was reminiscent of the Jamaican Vomiting Disease, a form of hypoglycaemic encephalopathy. It is triggered when unripe ackee fruits are eaten. These fruits contain a substance, methylene cyclopropyl alanine, which blocks a biochemical process called fatty acid oxidation, or gluconeogenesis.<br /> <br /> There are two essential steps: gluconeogenesis is turned on and is then blocked midway by methylene cyclopropyl alanine. The back-up molecules of the unfinished process are certain amino acids that are highly toxic to the brain cells. Ackee and litchi belong to one plant family. My toxicology colleague, Dr. Mukul Das, found generous quantities of methylene cyclopropyl glycine in litchi fruit pulp.<br /> <br /> The disease affected only malnourished children between the ages of two and 10. A majority of them were from families camping in orchards for fruit harvesting. No child from the nearby towns fell ill. Children of well-to-do families never fell ill.<br /> <br /> Litchi harvest usually begins by 4 a.m., which means that families are awake before that. They go to sleep early. If children go to sleep without dinner, parents usually do not wake them up and feed them. Litchis are collected in bunches and sent to the collection points, but single fruits fall to the ground. Children are free to collect and share the fruits with their friends.<br /> <br /> Please <a href="https://www.thehindu.com/opinion/op-ed/averting-deaths-in-muzaffarpur/article28067239.ece?homepage=true">click here</a> to read more. <br /> </div>', 'credit_writer' => 'The Hindu, 19 June, 2019, https://www.thehindu.com/opinion/op-ed/averting-deaths-in-muzaffarpur/article28067239.ece?homepage=true', 'article_img' => '', 'article_img_thumb' => '', 'status' => (int) 1, 'show_on_home' => (int) 1, 'lang' => 'EN', 'category_id' => (int) 16, 'tag_keyword' => '', 'seo_url' => 'averting-deaths-in-muzaffarpur-t-jacob-john-4687396', 'meta_title' => null, 'meta_keywords' => null, 'meta_description' => null, 'noindex' => (int) 0, 'publish_date' => object(Cake\I18n\FrozenDate) {}, 'most_visit_section_id' => null, 'article_big_img' => null, 'liveid' => (int) 4687396, 'created' => object(Cake\I18n\FrozenTime) {}, 'modified' => object(Cake\I18n\FrozenTime) {}, 'edate' => '', 'tags' => [ [maximum depth reached] ], 'category' => object(App\Model\Entity\Category) {}, '[new]' => false, '[accessible]' => [ [maximum depth reached] ], '[dirty]' => [[maximum depth reached]], '[original]' => [[maximum depth reached]], '[virtual]' => [[maximum depth reached]], '[hasErrors]' => false, '[errors]' => [[maximum depth reached]], '[invalid]' => [[maximum depth reached]], '[repository]' => 'Articles' }, 'articleid' => (int) 39264, 'metaTitle' => 'LATEST NEWS UPDATES | Averting deaths in Muzaffarpur -T Jacob John', 'metaKeywords' => 'Acute Encephalitis Syndrome,Muzaffarpur,Bihar,Low Blood Sugar,Sri Krishna Medical College Muzaffarpur,Hypoglycaemic encephalopathy', 'metaDesc' => ' -The Hindu All it would have taken was to ensure that the children had a meal at night Along with my colleagues, I had investigated the so-called mystery disease in Muzaffarpur, Bihar, during its outbreak in 2012, 2013 and 2014. The local...', 'disp' => '<div align="justify">-The Hindu<br /><br /><em>All it would have taken was to ensure that the children had a meal at night<br /></em><br />Along with my colleagues, I had investigated the so-called mystery disease in Muzaffarpur, Bihar, during its outbreak in 2012, 2013 and 2014. The local name for it was acute encephalitis syndrome, but we found that the disease was not encephalitis but encephalopathy. This distinction is important. Encephalitis results from a viral infection, unless proved otherwise. The pathology is primarily in the brain. Encephalopathy is a biochemical disease, unless proved otherwise. The primary pathology is not in the brain. Specific treatment is scanty for viral encephalitis, but encephalopathy is eminently treatable.<br /><br />Hypoglycaemia (when the level of glucose in the blood falls below normal) is usually due to an overdose of insulin in children with diabetes. It is easily corrected with oral sugar or intravenous glucose. The easily available 5% glucose solution suffices. Hypoglycaemic encephalopathy, however, is different from simple hypoglycaemia.<br /><br /><em>The disease pathway<br /></em><br />We found that the disease broke out during the months when litchi was harvested, i.e. April, May and June. Muzaffarpur is full of litchi orchards. The illness started suddenly — children were found vomiting, displayed abnormal movements, were semi-conscious, and were convulsing between 4 a.m. and 7 a.m. The disease progressed fast — children went into coma and died within a few days. When sick children were tested, the blood glucose level was always below normal.<br /><br />This disease was reminiscent of the Jamaican Vomiting Disease, a form of hypoglycaemic encephalopathy. It is triggered when unripe ackee fruits are eaten. These fruits contain a substance, methylene cyclopropyl alanine, which blocks a biochemical process called fatty acid oxidation, or gluconeogenesis.<br /><br />There are two essential steps: gluconeogenesis is turned on and is then blocked midway by methylene cyclopropyl alanine. The back-up molecules of the unfinished process are certain amino acids that are highly toxic to the brain cells. Ackee and litchi belong to one plant family. My toxicology colleague, Dr. Mukul Das, found generous quantities of methylene cyclopropyl glycine in litchi fruit pulp.<br /><br />The disease affected only malnourished children between the ages of two and 10. A majority of them were from families camping in orchards for fruit harvesting. No child from the nearby towns fell ill. Children of well-to-do families never fell ill.<br /><br />Litchi harvest usually begins by 4 a.m., which means that families are awake before that. They go to sleep early. 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Children are free to collect and share the fruits with their friends.<br /><br />Please <a href="https://www.thehindu.com/opinion/op-ed/averting-deaths-in-muzaffarpur/article28067239.ece?homepage=true" title="https://www.thehindu.com/opinion/op-ed/averting-deaths-in-muzaffarpur/article28067239.ece?homepage=true">click here</a> to read more. <br /></div>', 'lang' => 'English', 'SITE_URL' => 'https://im4change.in/', 'site_title' => 'im4change', 'adminprix' => 'admin' ] $article_current = object(App\Model\Entity\Article) { 'id' => (int) 39264, 'title' => 'Averting deaths in Muzaffarpur -T Jacob John', 'subheading' => '', 'description' => '<div align="justify"> -The Hindu<br /> <br /> <em>All it would have taken was to ensure that the children had a meal at night<br /> </em><br /> Along with my colleagues, I had investigated the so-called mystery disease in Muzaffarpur, Bihar, during its outbreak in 2012, 2013 and 2014. The local name for it was acute encephalitis syndrome, but we found that the disease was not encephalitis but encephalopathy. This distinction is important. Encephalitis results from a viral infection, unless proved otherwise. The pathology is primarily in the brain. Encephalopathy is a biochemical disease, unless proved otherwise. The primary pathology is not in the brain. Specific treatment is scanty for viral encephalitis, but encephalopathy is eminently treatable.<br /> <br /> Hypoglycaemia (when the level of glucose in the blood falls below normal) is usually due to an overdose of insulin in children with diabetes. It is easily corrected with oral sugar or intravenous glucose. The easily available 5% glucose solution suffices. Hypoglycaemic encephalopathy, however, is different from simple hypoglycaemia.<br /> <br /> <em>The disease pathway<br /> </em><br /> We found that the disease broke out during the months when litchi was harvested, i.e. April, May and June. Muzaffarpur is full of litchi orchards. The illness started suddenly — children were found vomiting, displayed abnormal movements, were semi-conscious, and were convulsing between 4 a.m. and 7 a.m. The disease progressed fast — children went into coma and died within a few days. When sick children were tested, the blood glucose level was always below normal.<br /> <br /> This disease was reminiscent of the Jamaican Vomiting Disease, a form of hypoglycaemic encephalopathy. It is triggered when unripe ackee fruits are eaten. These fruits contain a substance, methylene cyclopropyl alanine, which blocks a biochemical process called fatty acid oxidation, or gluconeogenesis.<br /> <br /> There are two essential steps: gluconeogenesis is turned on and is then blocked midway by methylene cyclopropyl alanine. The back-up molecules of the unfinished process are certain amino acids that are highly toxic to the brain cells. Ackee and litchi belong to one plant family. 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The local...' $disp = '<div align="justify">-The Hindu<br /><br /><em>All it would have taken was to ensure that the children had a meal at night<br /></em><br />Along with my colleagues, I had investigated the so-called mystery disease in Muzaffarpur, Bihar, during its outbreak in 2012, 2013 and 2014. The local name for it was acute encephalitis syndrome, but we found that the disease was not encephalitis but encephalopathy. This distinction is important. Encephalitis results from a viral infection, unless proved otherwise. The pathology is primarily in the brain. Encephalopathy is a biochemical disease, unless proved otherwise. The primary pathology is not in the brain. Specific treatment is scanty for viral encephalitis, but encephalopathy is eminently treatable.<br /><br />Hypoglycaemia (when the level of glucose in the blood falls below normal) is usually due to an overdose of insulin in children with diabetes. It is easily corrected with oral sugar or intravenous glucose. The easily available 5% glucose solution suffices. Hypoglycaemic encephalopathy, however, is different from simple hypoglycaemia.<br /><br /><em>The disease pathway<br /></em><br />We found that the disease broke out during the months when litchi was harvested, i.e. April, May and June. Muzaffarpur is full of litchi orchards. The illness started suddenly — children were found vomiting, displayed abnormal movements, were semi-conscious, and were convulsing between 4 a.m. and 7 a.m. The disease progressed fast — children went into coma and died within a few days. When sick children were tested, the blood glucose level was always below normal.<br /><br />This disease was reminiscent of the Jamaican Vomiting Disease, a form of hypoglycaemic encephalopathy. It is triggered when unripe ackee fruits are eaten. These fruits contain a substance, methylene cyclopropyl alanine, which blocks a biochemical process called fatty acid oxidation, or gluconeogenesis.<br /><br />There are two essential steps: gluconeogenesis is turned on and is then blocked midway by methylene cyclopropyl alanine. The back-up molecules of the unfinished process are certain amino acids that are highly toxic to the brain cells. Ackee and litchi belong to one plant family. My toxicology colleague, Dr. Mukul Das, found generous quantities of methylene cyclopropyl glycine in litchi fruit pulp.<br /><br />The disease affected only malnourished children between the ages of two and 10. A majority of them were from families camping in orchards for fruit harvesting. No child from the nearby towns fell ill. Children of well-to-do families never fell ill.<br /><br />Litchi harvest usually begins by 4 a.m., which means that families are awake before that. They go to sleep early. 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Averting deaths in Muzaffarpur -T Jacob John |
-The Hindu
All it would have taken was to ensure that the children had a meal at night Along with my colleagues, I had investigated the so-called mystery disease in Muzaffarpur, Bihar, during its outbreak in 2012, 2013 and 2014. The local name for it was acute encephalitis syndrome, but we found that the disease was not encephalitis but encephalopathy. This distinction is important. Encephalitis results from a viral infection, unless proved otherwise. The pathology is primarily in the brain. Encephalopathy is a biochemical disease, unless proved otherwise. The primary pathology is not in the brain. Specific treatment is scanty for viral encephalitis, but encephalopathy is eminently treatable. Hypoglycaemia (when the level of glucose in the blood falls below normal) is usually due to an overdose of insulin in children with diabetes. It is easily corrected with oral sugar or intravenous glucose. The easily available 5% glucose solution suffices. Hypoglycaemic encephalopathy, however, is different from simple hypoglycaemia. The disease pathway We found that the disease broke out during the months when litchi was harvested, i.e. April, May and June. Muzaffarpur is full of litchi orchards. The illness started suddenly — children were found vomiting, displayed abnormal movements, were semi-conscious, and were convulsing between 4 a.m. and 7 a.m. The disease progressed fast — children went into coma and died within a few days. When sick children were tested, the blood glucose level was always below normal. This disease was reminiscent of the Jamaican Vomiting Disease, a form of hypoglycaemic encephalopathy. It is triggered when unripe ackee fruits are eaten. These fruits contain a substance, methylene cyclopropyl alanine, which blocks a biochemical process called fatty acid oxidation, or gluconeogenesis. There are two essential steps: gluconeogenesis is turned on and is then blocked midway by methylene cyclopropyl alanine. The back-up molecules of the unfinished process are certain amino acids that are highly toxic to the brain cells. Ackee and litchi belong to one plant family. My toxicology colleague, Dr. Mukul Das, found generous quantities of methylene cyclopropyl glycine in litchi fruit pulp. The disease affected only malnourished children between the ages of two and 10. A majority of them were from families camping in orchards for fruit harvesting. No child from the nearby towns fell ill. Children of well-to-do families never fell ill. Litchi harvest usually begins by 4 a.m., which means that families are awake before that. They go to sleep early. If children go to sleep without dinner, parents usually do not wake them up and feed them. Litchis are collected in bunches and sent to the collection points, but single fruits fall to the ground. Children are free to collect and share the fruits with their friends. Please click here to read more. |