23rd Apr 2015, 03:25 PM #1861
Re: Health Bulletin
Obesity occurs due to carbs you eat, not sitting idle
Even if you keep fit and exercise regularly, you can't beat obesity if you can't control eating sugar and carbs.
According to the researchers, it's the bad diet, not physical inactivity, behind the surge in obesity. Regular exercise is key to staving off serious disease, such as diabetes, heart disease, and dementia, but our calorie laden diets now generate more ill health than physical inactivity, alcohol, and smoking combined.
The evidence now suggests that up to 40 percent of those within a normal weight (BMI) range will none the less harbour harmful metabolic abnormalities typically associated with obesity.
The authors said that celebrity endorsement of sugary drinks and the association of junk food and sport must end, adding that health clubs and gyms need to set an example by removing the sale of these products from their premises.
The food environment needs to be changed so that people automatically make healthy choices, suggest the authors. This "will have far greater impact on population health than counselling or education. Healthy choice must become the easy choice," they say.
The researchers concluded by saying that it was time to wind back the harms caused by the junk food industry's public relations machinery.
The study is published online in the British Journal of Sports Medicine.
26th Apr 2015, 02:48 PM #1862
Re: Health Bulletin
How our brain decodes sound
In an interesting discovery, scientists have found that when we hear a sound, neurons fire in sync with the rhythmic structure of the sound, exactly encoding its original structure in the timing of spikes.
When people hear the sound of footsteps or the drilling of a woodpecker, the rhythmic structure of the sounds is striking.
Even when the temporal structure of a sound is less obvious, as with human speech, the timing still conveys a variety of important information, said Michael Wehr from the University of Oregon.
When a sound is heard, neurons in the lower subcortical region of the brain fire in sync with the rhythmic structure of the sound, almost exactly encoding its original structure in the timing of spikes.
"As the information progresses towards the auditory cortex, however, the representation of sound undergoes a transformation.
"There is a gradual shift towards neurons that use an entirely different system for encoding information," said Wehr.
For neurons in the auditory thalamus - the part of the brain that relays information from the ears to the auditory cortex - this takes the form of temporal coding.
Neurons fire in sync with the original sound, providing an exact replication of the sound's structure in time.
In the auditory cortex, however, about half the neurons use rate coding, which instead conveys the structure of the sound through the density and rate of the neurons' spiking, rather than the exact timing.
Neuroscientists previously have speculated that the transformation from temporal coding to rate coding may explain the perceptual boundary experienced between rhythm and pitch.
Slow trains of clicks sound rhythmic, but fast trains of clicks sound like a buzzy tone.
It could be that these two very different experiences of sound are produced by the two different kinds of neurons, Wehr said.
The study was published in the journal Neuron.
27th Apr 2015, 01:29 PM #1863
Re: Health Bulletin
Swollen neck glands may indicate cancer
Persistent swollen neck glands indicate a high risk of lymphoma, a type of cancer, according to a new research.
The findings suggested that those patients with unexplained swollen neck glands should be referred for specialist investigations.
"Our research has revealed the importance of persistent swollen lymph glands, particularly in the neck, as part of cancer," said professor Willie Hamilton from University of Exeter Medical School in Britain.
"Of course swollen glands are common with throat infections, but in cancer, they are usually larger and painless. It has been known for a long time that this could represent cancer - this study shows that the risk is higher than previously thought," Hamilton noted.
Each year, more than 14,500 people in Britain are diagnosed with a form of lymphoma, and nearly 5,000 die from the disease, according to the researchers.
The researchers from University of Exeter Medical School worked with colleagues in Universities of Oxford, Cambridge and Bangor in two associated studies.
Both papers focussed on patients over the age of 40. The first was a large-scale assessment of symptoms which were markers of non-Hodgkin Lymphoma. The team used data from 4,799 cases, with more than 19,000 controls.
The second study assessed 283 patients over the age of 40 with Hodgkin Lymphoma, comparing them with 1,237 control cases.
The findings were remarkably similar in both studies - demonstrating the importance of swollen lymph glands - particularly in the neck.
No blood tests were really helpful in confirming or refuting the diagnosis.
The study was published in the British Journal of General Practice.
28th Apr 2015, 01:20 PM #1864
Re: Health Bulletin
Obesity in pregnancy puts child at diabetes risk: Study
Women who are obese while pregnant may put their offspring at risk of childhood diabetes, a condition that requires lifelong insulin therapy, Swedish researchers said Tuesday.
A study of more than 1.2 million children born in Sweden between 1992 and 2004 and monitored for several years, found a 33-percent higher risk for the disease among children whose mothers were obese during the first trimester of pregnancy, but were not diabetic themselves
"Maternal overweight and obesity in early pregnancy were associated with increased risk of type 1 diabetes in the offspring of parents without diabetes," a team wrote in Diabetologia, the journal of the European Association for the Study of Diabetes.
The highest risk was still for children of parents who had diabetes themselves, the study found. There was no additional risk for children of mothers who were obese on top of having diabetes.
Over 5,700 children from the study group were diagnosed with type 1 diabetes by 2009.
Type 1 diabetes is usually found in children and young people -- a chronic condition caused when the pancreas does not produce insulin to control blood sugar levels. It requires lifelong insulin treatment, and constitutes about 10 percent of all diabetes cases -- though the number is growing.
And the increase "may partly be explained by increasing prevalence of maternal overweight/obesity," said the study.
People with a BMI (body weight index, a ratio of weight to height) of 25 and higher are classified overweight, and 30 and over obese.
Obesity, too, is soaring, having more than doubled worldwide since 1980. By 2014, more than 1.9 billion adults were overweight, of whom 600 million were obese, according to the World Health Organization.
Type 2 diabetes is much more common than type 1, and is believed to be caused by lifestyle factors, and controlled through healthy diet, exercise and medication.
"Prevention of overweight and obesity in women of reproductive age may contribute to a decreased incidence of type 1 diabetes," the study concluded.
28th Apr 2015, 01:20 PM #1865
Re: Health Bulletin
5 billion people worldwide have no access to surgery: Report
Five billion people worldwide do not have access to safe and affordable surgery and anaesthesia when they need it, and access is worst in low-income and lower-middle income countries, where as many as nine out of ten people cannot access basic surgical care, a new report by a Commission says. The report is published in the journal Lancet.
Just under a third of all deaths in 2010 (32·9%, 16·9 million deaths) were from conditions treatable with surgery - well surpassing the number of deaths from HIV / AIDS, TB, and malaria combined. Yet, surgery has been overlooked as a critical need for the health of the world's population.
"In the absence of surgical care, common, easily treatable illnesses become fatal," says Andy Leather, Director of the King's Centre for Global Health, King's College London, UK, and another of the Commission's lead authors. "The global community cannot continue to ignore this problem - millions of people are already dying unnecessarily, and the need for equitable and affordable access to surgical services is projected to increase in the coming decades, as many of the worst affected countries face rising rates of cancer, cardiovascular disease, and road accidents."
Of the 313 million operations done worldwide each year, just one in 20 occur in the poorest countries, where over a third of the world's population lives. New estimates produced for the Commission find that there is a global shortfall of at least 143 million surgical procedures every year, with some regions needing nearly twice as many additional operations as others.
The Commission also finds that a quarter of people worldwide who have a surgical procedure will incur financial catastrophe - costs that they can't afford and which drive them into poverty - as a result of seeking care. The burden of catastrophic expenditure on surgery is highest in low-income and lower-middle-income countries and, within any country, lands most heavily on poor people.
Despite the overwhelming magnitude of the problem, the Commission estimates that the countries where access to surgery is weakest could be scaled up to acceptable, and achievable, levels of access to surgery by 2030 with an investment of $US 420 billion, a cost far outweighed by the devastating economic cost to countries, communities, and families incurred by the current global shortfall in access to surgery. This highly cost-effective investment in surgery needs to be accompanied by sustainable financing mechanisms across the health care system, say the authors, and a firm commitment to universal health coverage.
The Commission was written by a group of 25 leading experts from across the fields of surgery and anaesthesia, with contributions from more than 110 countries. The report examines the case for surgery as an integral component of health care, focusing on low- and middle-income countries, where need is greatest.
The Commission also provides a much-needed set of indicators and recommendations to improve access to safe and affordable surgery and anaesthesia, and a policy template for national surgical plans.
"There is a pervasive misconception that the costs of providing safe and accessible surgery put it beyond the reach of any but the richest countries. But our work for this Commission clearly shows that not only are the costs of providing these essential services lower than might have been thought, but that scale-up of surgical and anaesthesia care should be viewed as a highly-cost-effective investment, rather than a cost," says Commission lead author John Meara, Kletjian Professor in Global Surgery at Harvard Medical School, and Associate Professor of Surgery at Boston Children's Hospital, USA.
28th Apr 2015, 02:21 PM #1866
Re: Health Bulletin
What Happens to Your Body after You Stop Smoking?
So how does your body react when you stop smoking?
Well, some beneficial effects occur almost immediately, and several other good things happen over time.
- After 20 minutes, your blood pressure and pulse rate return to normal.
- After 24 hours, the carbon monoxide is removed from your body.
- After 48 hours, the nicotine is expelled from your body.
- Between 2 and 21 weeks, your circulation improves.
- After one year, your risk of a heart attack falls to half that of a smoker.
- After ten years, your risk of lung cancer falls.
30th Apr 2015, 03:05 PM #1867
Re: Health Bulletin
Low awareness, stigma delay autism diagnosis
It took five years for Sushant Sharma to understand that what he considered poor learning abilities of his child were in reality the initial signs of a neurodevelopment disorder called autism. It affects nearly 10 million children in India and the numbers are increasing significantly.
Doctors say lack of awareness about the disorder is the primary cause for delayed diagnosis, which further leads to delay in picking up the abnormal behaviours and interventions to modify them.
"There is no cure for autism but there are many therapies, for example behavioural intervention, structured teaching and sensory integration that can help improve the symptoms," said Dr Sheffali Gulati, professor and chief, division of child neurology at AIIMS. She said at present most cases are identified at the age when the child starts going to the school when ideally the disorder should be picked by time he or she is 18 months old.
AIIMS is organizing a public health lecture on Wednesday to create awareness about autism. The institute's autism clinic, doctors said, has over 600 children on regular follow-up and on an average 180 to 200 children are diagnosed every year with the disorder.
"Till about a decade ago autism was considered a rare disorder, but recent trends indicate a dramatic increase in the number of such cases which cannot be explained by the increased availability of health facilities alone. Scientists are also looking into the role of genetic factors, pollution, toxins and increased age of the parents (particularly the father of the child)," said another senior doctor.
According to Dr Deepak Gupta, psychiatrist at Sir Ganga Ram hospital, disorders of the brain are less understood in Indian society. "Many times these concerns are brushed under the carpet by parents. There is an urgent need to change this mindset," he said.
30th Apr 2015, 03:07 PM #1868
Re: Health Bulletin
In America, desis beat diabetes
In what could hold important lessons for bringing down diabetes prevalence in India, a study published recently shows that Indians in America have been able to delay or prevent the disease largely through healthy lifestyle modifications.
Not too long ago, research studies showed that many Indians who moved to the US became obese and developed type-2 diabetes at a very young age. Their genetic predisposition to the disease and the adoption of American lifestyle - high fat diet and sedentary life -- was a dangerous combination.
The study published in the April issue of medical journal Diabetes Care compared the health status of Indians living in India with those living in the US. Researchers compared data relating to 2,305 people in Chennai who were a part of a Centre for Cardiometabolic Risk Reduction in South-Asia study (CAARS) with 757 Asian Indians who were part of a Mediators of Atherosclerosis in South Asian Living in America (MASALA) study. The results showed that the prevalence of diabetes was up to 38% in India when compared to 24% in the US in the 40-84 years age group although pre-diabetes was higher in the US (33%) when compared to India (24%).
There are no data to pinpoint the reasons for the difference, but the first author of the research Unjali P Gujral of Emory University in Atlanta says that Indians in America - or at least the study participants - may be highly aware of diabetes prevention as well as have better access to healthcare and insurance than those in India. "That is big enough to bring in behavior changes that made the difference," she said.
The situation was quite the opposite a few decades back. As Indian immigration to the US surged during the IT boom in the 1990s, diseases like diabetes showed an uptick in the Indian population.
Salaries soared and many Indians could afford cars, had more choices in food and their lifestyle become more comfortable - all potential contributors to lifestyle-related diseases. Many Asians including the Chinese and the Japanese faced similar problems.
"We saw a lot of that within our family. At one point all of us were so obese that we began not just to worry about our looks but also about our health status," says Madhavi M, a software professional who grew up in California.
Now, as a result of awareness programmes by the government, she like many Indians, has begun to lead healthier lifestyles. Her family eats healthy food that includes two servings of vegetables and fruits every day. They use brown basmati rice or millets like quinoa instead of white rice.
"My health insurance company is even paying for gadgets like pedometers that track the exercises we do," she said.
Much like their affluent white American colleagues, desis in America are frequenting gyms, yoga and swimming classes, and zumba sessions.
"If Indians in America can do it, so can Indians in India. They belong to the same genetic pool and are exposed to similar environmental triggers. It is the awareness to exercise regularly and eat healthy that is delaying diabetes among Indians in America," says Dr V Mohan of the Madras Diabetes Research Foundation.
In contrast, Indians in India are increasingly leading diabetes-promoting lifestyles. Since the 1970s there has been a nearly 10-fold increase in the prevalence of diabetes in Chennai alone. Indians are increasingly taking to a high-fat, low-protein fast food diet and there is a huge increase in the number of people who smoke and drink. In addition, studies have found that less than 10% of Indians do any kind of physical activity.
A recent survey conducted by the Indian Council of Medical Research in Tamil Nadu, Maharashtra and Jharkhand and the Union territory of Chandigarh showed that 54.4% of their population was physically inactive. The highest recreational activity was reported in Chandigarh where 11.6% of the people said they did some physically intense recreational activity, followed by Maharashtra (8.8%), Tamil Nadu (6.9%) and Jharkhand (5.2%). Most people said they spent their free time watching television. "That is not a pretty picture," said diabetologist Dr R M Anjana, who was a part of both these research papers.
One of the authors of the study published in Diabetes Care, Dr Alka Kanaya, professor of medicine at the University of California in San Franciso, says that a highlight of the study is the impact of lifestyle on diabetes.
"Indians should focus on diabetes prevention because these rates of pre-diabetes and diabetes are staggering in both India and the US," she said.
1st May 2015, 02:05 PM #1869
Re: Health Bulletin
Don't sleep on it, read the signs
A prominent lawyer known for closing cases at breakneck speed recently visited a hospital complaining of poor performance and fatigue. The 51-year-old's pace had been flagging and he had even been caught napping by judges in court. Tests showed he suffered from sleep apnea requiring immediate medication attention.
With today's fast-paced lifestyles, 24x7 activity and increasing screentime at night, sleep disorders are widespread. "Sleep loss and related disorders are a silent epidemic affecting adults as well as children," says Dr Nevin Kishore, pulmonologist at Max Hospital, Saket. In severe cases, these can kill, but they also increase the risk of road accidents, heart failure, obesity and memory impairment.
Low awareness about sleep problems means people don't take their snoring and breathing difficulties seriously. Often, they are in denial. "Some are brought to hospital by their spouse with video clips of their snoring pattern and actions during sleep," says Kishore.
Clinical psychiatrist Dr Jitender Nagpal says snoring is a major cause of marital discord. People who snore or have breathing difficulty during sleep always feel tired and avoid intimacy. "Many divorces take place because a partner snores a lot and is not willing to get treated for it." Neeta Jha's (name changed) marriage was saved because her husband agreed to see a doctor for his snoring. "My husband used to snore a lot but would never accept it. When we started sleeping in separate rooms he thought I was cheating on him.It took me months to convince him to consult a doctor and when the sleep study results came out even he was shocked to see that his oxygen levels went down severely." Three months of continuous positive airway pressure (CPAP) therapy cured him.
Dr J C Suri, who heads the department of sleep medicine at Safdarjung Hospital and founded the country's first sleep lab in 1995, says there are more than 70 sleep disorders but insomnia and sleep apnea are but insomnia and sleep apnea are the most common. "When I started working on sleep patients, few people, including doctors, knew about it. Every day, we get over a dozen cally referrals of criti ill patients who suffer from breathing difficulty during sleep."
Studies show that 30-40% of the working population, particularly those in high-stress jobs such as corporate executives, medical professionals and cops, don't sleep well. Obstructive sleep apnea (OSA), characterized by respiratory difficulties during sleep, affects 9-21% of women and 24-31% of men. It has been linked to heart disease, obesity, hypertension, dyslipidaemia (abnormal levels of cholesterolfat in blood) and insulin resistance.
Accidents and occupational injuries are other risks associated with poor quality sleep. Experts say, by 2020, the number of fatalities in vehicle accidents will double to 23 lakh, of which 2.3 lakh to 3.5 lakh will result from sleepiness or fatigue. "Sleep disorder is a silent epidemic. Few people suffering from it know about the condition and fewer still seek treatment for it," says Kishore.
Many Indians felt proud when US President Barack Obama complimented Prime Minister Narendra Modi for sleeping less than him. Some even felt inspired. But doctors dealing with sleep disorders were not impressed.
Dr Sanjay Manchanda, senior consultant, department of sleep medicine at Sir Ganga Ram Hospital, says seven to eight hours of sleep is a must for most adults. "Prime Minister Modi can do with lesser sleep because he practises meditation and pranayama which help in rejuvenation of the body. Also, he has a strict diet regimen. Most of us do not follow that. So we should focus on getting a good night's sleep and reducing risk factors such as obesity and hypertension that aggravate sleep problems."
1st May 2015, 02:38 PM #1870
Re: Health Bulletin
Hospital-at-home is the new trend in healthcare
When Martin Fernandez came into Mount Sinai Hospital's emergency room one recent afternoon, with high fever and excruciating abdominal pain, he and his family were asked an unexpected question.
Fernandez, 82, would have to be officially admitted to receive intravenous antibiotics for his urinary tract infection. But he could stay at Mount Sinai, or he could receive treatment at home.
If he chose to be hospitalized at home, doctors and nurses would visit daily. He would receive lab draws and intravenous medications, even X-rays or ultrasound scans if he needed them. The costs would be no greater than if he were physically in hospital. In three or four days, he would be discharged — and he would not have to go anywhere.
For Fernandez, a retired house painter from Venezuela who lives with his wife on Manhattan's Upper West Side, the choice was clear. He was hospitalized at his daughter's apartment, just a couple blocks away, a few hours later.
He had a urinary catheter, but Fernandez could still wear his own clothes during the day and his pajamas at night. His wife and his daughter cooked him meals of arepas, vegetables and black beans and served them to him in bed.
Under pressure to reduce costs while improving quality, a handful of hospital systems have embarked on an unusual experiment: they are taking the house call to the extreme, offering hospital-level treatment at home to patients like Fernandez.
Back in the late 1980s, as part of his primary care training at the Johns Hopkins University School of Medicine, Dr Bruce Leff noticed that for many patients hospitals were a scary proposition.
So Leff and his colleagues had an idea. What if patients could be hospitalized in their own beds?
The first task was to determine which common conditions required admission but could be treated with technologies placed in the home. Leff and his colleagues settled on four diagnoses: heart failure, exacerbations of emphysema, certain types of pneumonia, and cellulitis, a bacterial skin infection.
With a grant from the John A Hartford Foundation, Leff and his team offered outpatient hospital-level care to nearly 150 patients with these four diagnoses who would otherwise have been treated at one of three hospitals and compared those patients with a similar group who were hospitalized in the usual way. They called their program `Hospital at Home'.
The findings, published in The Annals of Internal Medicine, were promising. Offered the opportunity, most patients agreed to be treated at home. They were hospitalized for shorter periods, and their treatments cost less. They were less likely to develop delirium or to receive sedative medications, and no more likely to return to the emergency room or be readmitted.
But even with the most careful admitting criteria, the unexpected happens. Home-hospital providers have had to move patients to the hospital for worsening conditions. Still, it is an infrequent occurrence: only 2.5% of these patients must be moved into the traditional hospital.