Double Bituminous Surface Treatment (DBST)

 Double Bituminous Surface Treatment (DBST)—also called Double Surface Dressing—is a widely used low-cost, flexible pavement surfacing technique, especially popular in countries like Sri Lanka for rural and provincial roads .

Here’s a clear, engineering-style explanation you can use for technical notes, estimates, or approvals.

1. What is DBST?

Double Bituminous Surface Treatment is a pavement surfacing method where:

• Two layers of bituminous binder

• Each followed by a layer of crushed aggregates
  are applied one after the other on a prepared base.

👉 It is not a structural layer; it acts as a wearing course and waterproofing layer.

2. Typical Pavement Structure (Top to Bottom)

1. Second Aggregate Layer (Smaller size)

2. Second Bituminous Binder Spray

3. First Aggregate Layer (Larger size)

4. First Bituminous Binder Spray

5. Prepared Base Course (ABC / WMM / Existing Road)

3. Materials Used

(a) Bituminous Binder

Commonly used:

• Cationic Bitumen Emulsion (CRS-1 / CRS-2)
  or

• Paving Grade Bitumen (60/70 or 80/100)

(b) Aggregates

• First Layer: 12.5 mm or 10 mm crushed aggregates

• Second Layer: 6.3 mm or 5 mm crushed aggregates

• Clean, angular, well-graded, and dust-free

4. Construction Procedure (Step-by-Step)

Step 1: Surface Preparation

• Repair potholes, edge failures

• Clean dust and loose material

• Ensure dry surface

Step 2: Prime Coat (if required)

• Applied on granular base

• Helps binder penetration and bonding

Step 3: First Binder Application

• Spray bitumen/emulsion uniformly

• Typical rate: 1.5 – 1.8 kg/m²

Step 4: First Aggregate Spreading

• Spread larger aggregates

• Immediately rolled with pneumatic / steel roller

Step 5: Second Binder Application

• Applied after first layer sets

• Typical rate: 0.9 – 1.2 kg/m²

Step 6: Second Aggregate Spreading

• Spread smaller aggregates

• Rolling to achieve proper embedment

Step 7: Curing & Opening to Traffic

• Excess loose aggregates swept

• Light traffic allowed after curing

5. Typical Application Rates (Guide Values)

Item	Approx. Quantity
First Binder	1.5 – 1.8 kg/m²
First Aggregate	0.015 – 0.018 m³/m²
Second Binder	0.9 – 1.2 kg/m²
Second Aggregate	0.010 – 0.012 m³/m²

(Actual rates depend on surface condition and specifications)

6. Advantages of DBST

✅ Low construction cost
✅ Quick execution
✅ Improves skid resistance
✅ Seals surface against water
✅ Suitable for low to medium traffic roads
✅ Easy maintenance

7. Limitations

⚠️ Not suitable for heavy traffic
⚠️ Requires good weather (dry conditions)
⚠️ Surface roughness compared to asphalt concrete
⚠️ Needs proper aggregate quality control

8. Typical Uses in Sri Lanka

• Provincial & rural roads

• Access roads

• Agricultural & estate roads

• Road rehabilitation over existing pavements

(DBST is widely adopted by RDA, PRDA, and local authorities)

9. DBST vs Asphalt Concrete (AC)

Aspect	DBST	Asphalt Concrete
Cost	Low	High
Thickness	Very thin	Thick
Traffic Capacity	Low–Medium	High
Construction Speed	Fast	Slower
Maintenance	Frequent	Less frequent

Non-technical explanation of Epigenetics Tests and Hair Root Tests

 Epigenetics Tests and Hair Root Tests, what they measure, and why they matter for understanding your health.

1. What is an Epigenetics Test?

The Epigenetics Test

"How fast are you aging?"

While a standard DNA test (like 23andMe) examines your genetic makeup (which remains constant), an epigenetics test assesses your epigenetic profile (which changes constantly based on your lifestyle choices).

• What it is: A test (usually saliva or blood) that analyses DNA Methylation. It looks for chemical "tags" (methyl groups) attached to your DNA that turn specific genes "on" or "off."

Simple meaning

An epigenetics test looks at how your genes are being switched ON or OFF by your lifestyle and environment—not by changing the genes themselves, but by controlling how they work.

Think of your DNA as a keyboard.
Epigenetics decides which keys are being pressed.

What it tells you:

• Biological Age: You might be 40 years old chronologically (birthdays), but your body might be aging at the rate of a 50-year-old due to stress, diet, or toxins.

• Pace of Aging: Are you currently aging faster or slower than the average person?

• Disease Risk: It can reveal early warning signs for conditions like cancer, diabetes, or heart disease before they physically manifest.

 

What does it measure?

Epigenetics tests typically analyse:

• DNA methylation patterns (chemical tags on DNA)

• Gene expression activity

• Biological pathways related to:

  • Inflammation

  • Aging

  • Metabolism

  • Stress response

  • Detoxification

  • Hormone regulation

What influences epigenetics?

Your epigenetic patterns change based on:

• Diet & nutrition

• Stress & emotional health

• Sleep quality

• Physical activity

• Toxins (pollution, smoking, chemicals)

• Trauma and long-term stress

• Aging

👉 This means epigenetics is dynamic and reversible, unlike DNA.

Why is an Epigenetics Test important?

It helps you understand:

• Why you may develop diseases despite “normal genes”

• How lifestyle choices are affecting your health right now

• Your biological age vs chronological age

• Your risk for:

  • Diabetes

  • Heart disease

  • Cancer

  • Autoimmune disorders

  • Neurodegenerative diseases

Most importantly:
It tells you what you can change to improve your health.

Why it’s important: It proves that biology is not destiny. Unlike a genetic test which might say "You have the gene for Alzheimer's," an epigenetic test can show you if your current lifestyle is actively triggering that gene or keeping it dormant. It allows you to measure if your diet or exercise changes are actually working.

2. What is a Hair Root Test?

"What has your body been exposed to?"

It is important to distinguish between the two main types of hair tests: Standard Toxicology (medical/forensic) and Epigenetic Hair Mapping (wellness/nutrition).

Standard Hair Follicle Analysis (Medical/Forensic)

• What it is: A lab analyzes the hair shaft and the root to detect substances trapped in the hair protein as it grew.

• What it tells you: It provides a timeline (typically 3–6 months) of drug use, heavy metal exposure (like lead or mercury), and mineral imbalances.

• Why it’s important: Blood and urine tests only show what is in your system right now (usually the last 24–48 hours). Hair tests show a long-term history. This is vital for identifying chronic exposure to environmental toxins (e.g., mold or lead in water) that might be causing unexplained fatigue or illness.

Simple meaning

A hair root test examines the root of the hair (follicle) to assess long-term mineral, toxin, and metabolic status of the body.

Blood tests show today’s condition.
Hair root tests show what has been happening for months.

What does it measure?

Hair root analysis can reveal:

• Essential minerals (calcium, magnesium, zinc, iron, selenium)

• Toxic metals (lead, mercury, arsenic, cadmium)

• Mineral ratios (important for hormone and nerve function)

• Cellular metabolism patterns

• Oxidative stress indicators

Why hair roots (not just hair strands)?

• Hair roots are living tissue

• Reflect cellular-level nutrition

• Show chronic deficiencies or toxic exposure

• Less influenced by daily fluctuations than the blood

Why is a Hair Root Test important?

It helps identify:

• Hidden mineral deficiencies

• Heavy metal toxicity

• Reasons for:

  • Chronic fatigue

  • Hair loss

  • Neuropathy

  • Poor immunity

  • Hormonal imbalance

  • Brain fog

• Why treatments or supplements may not be working

This is especially useful in:

• Chronic illness

• Diabetes complications

• Neurological symptoms

• Unexplained health issues

What it is: A newer, popular wellness test (often using a "digitizer" to scan hair bulbs). It claims to use bio-resonance to map epigenetic indicators.

What it claims to tell you: It generates a report on nutritional deficiencies (vitamins/minerals), food intolerances, gut health, and environmental sensitivities (EMF, radiation).

3. How Epigenetics Test & Hair Root Test Work Together

Epigenetics Test	Hair Root Test
Shows gene activity	Shows cellular nutrition
Tells why genes are misbehaving	Tells what the cells lack or accumulate
Focuses on regulation	Focuses on materials
Guides lifestyle change	Guides supplementation & detox

🔹 Epigenetics = Control system
🔹 Hair root test = Raw materials & toxins

Together they give a root-cause health map, not just symptoms.

4. Why These Tests Are Especially Valuable Today

Modern diseases are mostly lifestyle-driven, not genetic:

• Diabetes

• Heart disease

• Cancer

• Autoimmune disorders

• Neurodegeneration

Traditional tests often detect disease after damage is done.
These tests focus on early dysfunction and prevention.

5. Key Takeaway

• Epigenetics Test tells you how your lifestyle is controlling your genes

• Hair Root Test tells you what your cells have been missing or overloaded with

• Together, they help you:

  • Prevent disease

  • Reverse dysfunction

  • Personalize nutrition and lifestyle

  • Understand your body at a deeper level

Metformin - What DOCTORS don't tell you!

Metformin (brand names include Glucophage, Fortamet, Glumetza) is the most widely prescribed medication for Type 2 diabetes worldwide. It belongs to a class of drugs called biguanides.

Here is a comprehensive breakdown of what it is, how it works, and what you need to know if you are taking it.

1. Primary Uses

• Type 2 Diabetes: It is the first-line medication recommended for lowering blood sugar levels. It is often used alone or in combination with other drugs (like insulin).

• Prediabetes (Off-label): Doctors often prescribe it to prevent the progression from prediabetes to full Type 2 diabetes, particularly in people with a high BMI.

• Polycystic Ovary Syndrome (PCOS) (Off-label): It helps lower insulin levels and androgen (male hormone) levels, which can help regulate menstrual cycles and improve fertility/ovulation.

• Gestational Diabetes: Sometimes used during pregnancy when insulin is not an option or not preferred, though insulin remains the gold standard.

2. How It Works

Metformin does not increase the amount of insulin your body makes (so it rarely causes low blood sugar/hypoglycemia on its own). Instead, it works in three main ways:

1. Stops the Liver: It reduces the amount of sugar (glucose) your liver produces and releases into your bloodstream.

2. Boosts Sensitivity: It makes your muscle tissue more sensitive to insulin, allowing your cells to use glucose more effectively.

3. Reduces Absorption: It slightly decreases the amount of sugar your gut absorbs from the food you eat.

3. Side Effects

 

Common (The "Metformin Tummy"):

The most common complaints are digestive. These usually happen when you first start the drug and often go away after a few weeks.

• Diarrhea

• Nausea/Vomiting

• Stomach cramps/bloating

• Metallic taste in the mouth

Serious (Rare):

• Lactic Acidosis: A dangerous buildup of lactic acid in the blood. This is very rare (approx. 1 in 30,000 users) but can be fatal. Symptoms include extreme fatigue, muscle pain, difficulty breathing, and slow heart rate. It is mostly a risk for people with kidney or liver failure.

• Vitamin B12 Deficiency: Long-term use can block the absorption of Vitamin B12. Your doctor may monitor your levels periodically.

4. Important Warnings & Contraindications

• Kidney Function: Metformin is cleared by the kidneys. If you have severe kidney disease (typically eGFR < 30 mL/min), you cannot take it because it increases the risk of lactic acidosis.

• CT Scans/Contrast Dye: If you are having an imaging scan that uses iodinated contrast dye, you may need to stop taking Metformin for 48 hours before and after the procedure to protect your kidneys.

• Alcohol: Excessive alcohol intake (acute or chronic) drastically increases the risk of lactic acidosis.

• Liver Disease: Used with caution or avoided in severe liver disease.

5. Practical Tips for Success

If you have been prescribed Metformin, these strategies can help minimize side effects:

• Take with Food: Always take it in the middle of a meal or immediately after to buffer your stomach.

• Start Low, Go Slow: Doctors usually start you on a low dose (e.g., 500mg once daily) and slowly increase it over weeks. Do not rush this titration.

• Ask for Extended Release (XR/ER): If the standard "immediate release" tablets give you severe stomach upset, ask your doctor for the Extended Release version. It releases the drug slowly and is generally much gentler on the stomach.

6. Research on Longevity

You may hear Metformin discussed in "biohacking" or anti-aging circles. Some research suggests it might mimic the effects of calorie restriction and activate longevity pathways (like AMPK). However, there is currently no definitive clinical evidence that it extends lifespan in healthy humans, and it is not FDA-approved for anti-aging.

Glomerular Filtration Rate (GFR)

 

Glomerular Filtration Rate (GFR) is the primary test used to check how well the kidneys are functioning. It measures the amount of blood that passes through the glomeruli—the tiny filters in the kidneys that remove waste—every minute.

GFR is a key measure of how well your kidneys are filtering blood. It estimates how much blood (in millilitres) the kidneys filter per minute to remove waste and excess fluid.

Why GFR is Important

Your kidneys act as the body's filtration system. A high GFR means your kidneys are efficiently clearing waste, while a low GFR indicates that waste products (like creatinine) are building up in your blood because the filters are damaged or sluggish.

Standard Unit: mL/min/1.73m^2 (millilitres per minute per 1.73 square meters of body surface area).

Normal Range: Roughly 90–120mL/min for healthy adults.

• Detects early kidney disease

• Monitors progression of chronic kidney disease (CKD)

• Helps guide drug dosing

• Assesses overall renal health, especially in people with diabetes or hypertension

eGFR vs. mGFR

In a clinical setting, you will likely see eGFR (estimated GFR) on your lab results rather than a direct measurement.

Measured GFR (mGFR): The "gold standard" involves injecting a substance, such as inulin or Iohexol, into the blood and measuring how quickly the kidneys clear it. This is a complex process and is rarely done outside of research.

Estimated GFR (eGFR): This is a calculated estimate using a mathematical formula. It typically requires:

Serum Creatinine: A waste product from muscle breakdown.

Age and Sex: These factors account for natural differences in muscle mass.

Common Formulas: The CKD-EPI (recommended standard) or the MDRD formula

Normal & Abnormal GFR Values (Adults)

GFR (mL/min/1.73 m²)	Kidney Function CKD	D Stage
≥ 90	Normal (if no protein in urine)	Stage 1
60 – 89	Mild decrease	Stage 2
45 – 59	Mild–moderate decrease	Stage 3a
30 – 44	Moderate–severe decrease	Stage 3b
15 – 29	Severe decrease	Stage 4
< 15	Kidney failure	Stage 5

A low GFR for more than 3 months indicates chronic kidney disease.

How GFR is Calculated

GFR is usually estimated (eGFR) using:

• Serum creatinine

• Age

• Sex

• Body size

• Sometimes cystatin C (more accurate in some cases)

Common formulas:

• CKD-EPI (preferred)

• MDRD (older)

Causes of Low GFR

• Diabetes (most common)

• High blood pressure

• Glomerulonephritis

• Long-term painkiller use (NSAIDs)

• Urinary obstruction

• Dehydration (temporary drop)

Given your earlier discussions around high HbA1c (12), monitoring GFR is very important, as uncontrolled diabetes can silently reduce kidney function.

Symptoms of Low GFR (Often Late)

• Swelling of feet/face

• Fatigue

• Reduced urine output

• Foamy urine (protein)

• Nausea, itching

• Shortness of breath

How to Protect or Improve GFR

(Depends on cause; damage may be slowed, not always reversed)

Medical

• Tight blood sugar control

• Control blood pressure (ACE inhibitors/ARBs often used)

• Avoid unnecessary painkillers

• Treat infections promptly

Lifestyle

• Reduce salt intake

• Moderate protein intake

• Stay well hydrated

• Quit smoking

• Maintain a healthy weight

Alternative Support (Adjunct, not replacement)

• Siddha/Ayurveda: Punarnava, Varuna, Neermulli (only under expert guidance)

• Yoga & breathing to reduce BP and stress

When to See a Doctor Urgently

• Rapid fall in GFR

• GFR < 60 with protein in urine

• Swelling + reduced urine

• Diabetic patient with rising creatinine

Understanding how medications affect GFR requires looking at the "pipes" leading into and out of the kidney's filters (the glomeruli).

To keep the filtration rate steady, the kidney needs a certain amount of internal pressure. It maintains this pressure by adjusting two main vessels: the Afferent Arteriole (the "inlet" pipe) and the Efferent Arteriole (the "outlet" pipe).

1. ACE Inhibitors: Opening the "Outlet"

ACE Inhibitors (like Lisinopril or Enalapril) and ARBs (like Losartan) block Angiotensin II, a hormone that normally constricts the outlet pipe (efferent arteriole).

• The Effect: These drugs cause the outlet pipe to widen (vasodilation).

• Impact on GFR: Because the "exit" is now wide open, the pressure inside the filter drops. This usually causes an initial, small decrease in eGFR (a rise in creatinine).

• Why doctors use them anyway: Even though GFR drops slightly at first, lowering that internal pressure protects the filters from long-term wear and tear. It’s like lowering the water pressure in a delicate pipe to prevent it from bursting over time.

2. NSAIDs: Narrowing the "Inlet"

NSAIDs (like Ibuprofen, Naproxen, or Celebrex) block Prostaglandins, which are chemicals that normally keep the inlet pipe (afferent arteriole) open.

• The Effect: Without prostaglandins, the inlet pipe narrows (vasoconstriction).

• Impact on GFR: Less blood can get into the filter, which reduces the pressure and lowers the GFR.

• The Risk: In healthy people, the body can usually compensate. However, if you are dehydrated or already have kidney issues, NSAIDs can "starve" the kidney of blood, leading to a sudden drop in function.

3. The "Triple Whammy"

The most dangerous scenario for GFR occurs when a patient takes three types of medications together:

1. ACE Inhibitor/ARB: Opens the outlet (lowers pressure).

2. NSAID: Closes the inlet (reduces flow).

3. Diuretic (Water pill): Reduces overall blood volume.

When all three are used, the kidney loses its ability to regulate its own internal pressure. This can lead to Acute Kidney Injury (AKI) because the GFR plummets dangerously low.

Comparison Table: Hemodynamic Effects

Medication	Primary Action	Effect on Vessel	Resulting GFR
ACE Inhibitors	Blocks Angiotensin II	Opens the Outlet (Efferent)	Initial Slight Decrease
NSAIDs	Blocks Prostaglandins	Closes the Inlet (Afferent)	Decrease (risk of AKI)
Normal State	Balance of both	Both vessels adjusted	Stable GFR