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Health Bulletin


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  1. #2131
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    Re: Health Bulletin

    The contraceptive pill may increase stroke risk


    Birth control pills cause a small but significant increase in the risk of the most common type of stroke, according to a new report. For healthy young women without any stroke risk factors, the risk of stroke associated with oral contraceptives is small, researchers said.

    But in women with other stroke risk factors, "the risk seems higher and, in most cases, oral contraceptive use should be discouraged," said report co-authors Marisa McGinley, Sarkis Morales-Vidal, and Jose Biller, of Loyola University Medical Center and Loyola University Chicago Stritch School of Medicine.

    Worldwide, more than 100 million women currently use oral contraceptives or have used them in the past.

    Strokes associated with oral contraceptives were first reported in 1962. Early versions of the pill contained doses of synthetic estrogen as high as 150 micrograms. Most birth control pills now contain as little as 20 to 35 micrograms. None contain more than 50 micrograms of synthetic estrogen.

    Oral contraceptives increase the risk of ischemic strokes, which are caused by blood clots and account for about 85 per cent of all strokes, researchers said. In the general population, oral contraceptives do not appear to increase the risk of hemorrhagic strokes.

    There are about 4.4 ischemic strokes for every 1,00,000 women of childbearing age. Birth control pills increase the risk 1.9 times, to 8.5 strokes per 100,000 women, according to a well-performed meta-analysis cited in the report.


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  2. #2132
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    Re: Health Bulletin

    Meat meal not needed for 'feeling of fullness'

    Do you feel that only beef-based diet can provide the "feeling of fullness" which vegetarian diet can never match? Your assumption may not be true, new research suggests. The study found that a bean-based meal provided a similar feeling of fullness as compared to a beef-based meal.

    Researchers from the University of Minnesota had 28 participants (14 men and 14 women) consume two test lunches containing a "meatloaf " made from either beef or beans. The beef meal provided 26 grams of protein and three grams of fibre, while the bean meal provided 17 grams of protein and 12 grams of fibre.Both meals were matched in weight, calories, and total fat. All the participants showed no difference in appetite ratings between the beef and bean meals over three hours. In addition they consumed the same amount of calories at the next meal eaten.

    Protein is considered to be the number one nutrient that induces the feeling of fullness, with fibre coming in a close second. The findings of this study support the idea that plantbased proteins with high fibre may offer similar appetite regulation as animal protein.The study was published in the Journal of Food Science.


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    Re: Health Bulletin

    Large-sized tableware tied to overeating

    If you want to watch your weight, avoid using large-sized tableware! People consume more food or non-alcoholic drinks when offered jumbo portions or when they use larger items of tableware, a new study has found.

    The research carried out by the University of Cambridge suggests that eliminating larger-sized portions from the diet completely could reduce energy intake by up to 16% among UK adults or 29% among US adults. Overeating increases the risks of heart disease, diabetes, and many cancers, which are among the leading causes of ill health and premature death.

    However, the extent to which this overconsumption might be attributed to 'overserving' of larger-sized portions of food and drink has not been known. As part of their systema tic review of the evidence, researchers combined results from 61 high quality studies, capturing data from 6,711 participants, to find the influence of portion, package and tableware size on food consumption. The data showed that people consistently consume more food and drink when offered larger-sized portions, packages or tableware than when offered smaller-sized versions.


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    Re: Health Bulletin

    Kids given medicines, but does ADHD exist?

    Most epidemics are the result of a contagious disease. ADHD -Attention Deficit Hyperactivity Disorder -is not contagious, and it may not even be a genuine malady, but it has acquired the characteristics of an epidemic. New data has revealed that UK prescriptions for Ritalin and other similar ADHD medications have more than doubled in the last decade, from 3,59,100 in 2004 to 9,22,200 last year. In America, the disorder is now the second most frequent long-term diagnosis ma de in children, narrowly trailing asthma. It generates pharmaceutical sales worth $9 billion per year. Yet clinical proof of ADHD as a genuine illness has never been found. Sami Timimi, child psychiatrist at Lincolnshire NHS Trust, is a vocal critic of the Ritalin-friendly orthodoxy within the NHS.

    While he is at pains to stress that he is "not saying those who have the diagnosis don't have any problem", he is adamant that "there is no robust evidence to demonstrate that what we call ADHD correlates with any known biological or neurological abnormality".

    The hyperactivity, inattentiveness and lack of impulse control that are at the heart of an ADHD diagnosis are, according to Timimi, simply "a col lection of behaviours". Any psychiatrist who claims that a behaviour is being caused by ADHD is perpetrating a "philosophical tautology" -he is doing nothing more than telling you that hyperactivity is caused by an alternative name for hyperactivity .

    There is still no diagnostic test -no marker in the body -that can identify a person with ADHD. The results of more than 40 brain scan studies are described by Timimi as "consistently inconsistent".

    No conclusive pattern in brain activity had been found to explain or identify ADHD. The diagnosis, in other words, is simply a label to attach to certain behaviours -not an explanation for what may have caused those behaviours, or an indicator of any physiological difference to a non-sufferer.

    Matthew Smith, of University of Strathclyde, and author of 'Hyperactive: The Controversial History of ADHD', goes further in his criticism of the medical orthodoxy .

    He believes the diagnostic threshold is now so low that it has led us to a place where we have pathologised naughtiness as a mental disorder requiring medication.


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    Re: Health Bulletin

    Birth defects in TN undereported by health workers

    Tamil Nadu boasts about halving the number of infant deaths in the state but the hidden truth is that 20% of all cases of infant mortality are unreported. A study has now nailed the villain, prompting a harder look at the numbers.

    Birth defects, which are responsible for a substantial number of childhood hospitalisations and death, are largely unreported in the state. A survey by nonprofit trust Fetal Care Research Foundation in Tiruvallur found less than 39% of government primary healthcare centres report congenital birth defects.

    The study covered 54 PHCs in Turuvallur district. Only 21 reported birth defects; 23 were not aware they had to make the reports or did not because of tight schedules. Among the PHCs that reported birth defects, eight reported internet connectivity problems, two said that they were short of manpower and four said they were not interested in entering data.

    "The government screens babies and the data is mostly about live and still births, underweight and overweight babies," said project consultant R Sujatha."During the survey, many doctors, nurses and health workers said they had each come across at least two or more infants born with defects but did not record the cases."

    They were just referred to Institute of Child Health, Chennai, she said.

    Birth defects are disorders present from birth that may sometimes be diagnosed later. Experts attribute cases to unplanned pregnancies, poor antenatal care and maternal nutritional status and consanguineous marriages.

    Chennai-based Fetal Care Research Foundation has since 2001 been in charge of Birth Defects Registry of India (BDRI), which has a network of 300 hospitals, with more than 50 in Tamil Nadu. According to the data, congenital birth defects occur in 0.7% of the population in the state.

    "The number could be much higher as cases are unreported," Sujatha said.Spinal cord defects are most common, followed by adbominal wall defects and anomalies with fingers and toes and in the genital area, cleft lip and palate.

    Worldwide prevalence is around 20030010,000 births but, due to poor reporting, BDRI has been able to estimate it at only 5710,000 in India and 49.910,000 in the state.

    "We lack training module for health workers to detect and report birth defects," said geneticist Dr Sujatha Jagadeesh. "A birth defects registry can help better planning in public health." The study was submitted to the state planning commission, which directed the department of public health to make reporting of birth defects mandatory. "We screen newborns but we are yet to finalise a module to record birth defects," a senior official said.


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    Re: Health Bulletin

    High haemoglobin warning sign in dengue

    The city is in the midst of a dengue outbreak and people are rushing to get their platelet count checked at the first sign of fever, but, doctors say, high haemoglobin levels may also point to a severe dengue infection.

    A falling platelet count is thought to increase the risk of death from dengue but doctors have observed that nearly 20 per cent of the patients show a stable platelet count although their haemoglobin levels increase, indicating severe dehydration and the need for immediate medical attention.

    In men, 13-16g of haemoglobin per 100ml of blood is considered normal, while in women the level should be 11-13g, said Dr Navin Dang, director of Dr Dang's Lab. Haemoglobin is a protein molecule in red blood cells that carries oxygen to the body's tissues.

    A patient should be rushed to hospital if his or her haemoglobin count increases beyond 10% of the average level, said Brig (Dr) Ajay Sharma, professor and head, department of medicine and clinical hematology at the Army (Research and Referral) Hospital.


    "If haemoglobin is high, it is a danger sign even if the platelet count is normal. Most people, including doctors, keep waiting for the platelet count to fall, telling patients not to worry as their platelet count is normal. But this is wrong," he added.

    Doctors say people with higher levels of haemoglobin need to be given fluids rapidly, either orally or intravenously. "When their temperature becomes normal, patients feel better but their platelet count is likely to go down. It is not a dangerous sign if there is no active bleeding. There is no role of platelet transfusion in a patient who has no active bleeding," said Brig (Dr) Sharma.

    "In dengue, patients tend to consume less fluids which causes dehydration," said Dr Anoop Misra, chairman, Fortis C-doc Center Of Excellence for Diabetes, Metabolic Diseases and Endocrinology. "When this increases to alarming levels, the blood tissues dry up causing increase in packed cell volume or hematocrit and increase in haemoglobin levels. It can lead to ascites—collection of fluid in the abdomen."

    Dr Misra added that medical attention and awareness about the warning clinical symptoms can help save many lives. Till Saturday, dengue had claimed 17 lives in the city and another 3,791 people had been infected, data with the municipal corporations showed.

    On Tuesday, at least two more dengue deaths were confirmed taking the toll to 19. Shivam Dubey (14) from West Delhi and Ram Babu (24) from East Delhi died at Sanjay Gandhi Memorial Hospital and Lal Bahadur Shastri Hospital, respectively, on Monday.


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    Re: Health Bulletin




  8. #2138
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    Re: Health Bulletin

    India to supply generic cancer drug to US


    India has agreed to supply to the United States generic cancer drugs at a time there is outrage in America about the predatory practices by the US pharma industry, one of whose leaders is getting hammered for increasing the price of life-saving drugs by as much as 5000 per cent overnight.

    Martin Shkreli, CEO of Turing Pharmaceuticals, is being dubbed the ''poster child for price gouging in the pharma industry'' and BBC has asked if he is the ''the most hated man in America'' after he bumped up the price of Daraprim, a drug used to treat a parasitic diseases, from an already high $13.50 to $750. Daily Beast called him an ''asshole.''

    Although Turing has walked back from the price rise in the face of public anger, his actions have drawn attention to the strategy adopted by Big Pharma to buy out older drugs that are nearing patent loss and hike their price massively, with the argument that the money is needed to fund new research.

    On Tuesday, Hillary Clinton stepped up to the plate, offering proposals to control drug prices, even as her challenger Bernie Sanders and others have called for eliminating corporate restrictions on generics. Such a move will help both American patients and Indian drug manufacturers, who have constrained by Big Pharma with the familiar argument that it needs to recoup money spent on research, and generic makers profit from the work of Big Pharma.

    The full details of the US-India agreement was not disclosed, but Indian officials confirmed that New Delhi had agreed to supply an ''off-patent'' cancer drug. Such a move could be a template for the supply of life-saving pharmaceuticals to a US system that is overpriced and overburdened, causing untold suffering to millions of poor and middleclass Americans.

    The Pharma lobby is the biggest contributor of money to the US political systems and it is widely believed that many lawmakers are beholden to it in lieu of campaign contributions.

    India is the second largest exporter of drugs to the United States. In 2014, India held 13% share of the total 64,170 imported lines of pharmaceuticals, according to a US fact sheet. The United States spends close to $3 trillion - some 17% of its GDP - on healthcare, an expense that far exceeds even military spending.

    The two countries also agreed to a raft of measures, including creating and growing a cadre of field epidemiologists in India to prevent, detect, and respond to infectious disease threats. The US also pledged to engage with India on traditional medicine, health information systems, and agreed to launch a new collaboration on mental health.


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    Re: Health Bulletin

    Girls today taller by 1 cm and boys by 3 cm: Study

    Compared to eight years ago, 18-year-old boys and girls from India's middle and upper classes are 3 cm and 1 cm taller, respectively, according to the latest growth charts published this year for children aged five to 18. The growth figures -- last updated in 2007, using data collected more than two decades ago -- reveal upsides and downsides.

    The new charts reflect the rise of taller and heavier urban children. Girls are taller earlier, but stop growing once they hit puberty, which is happening sooner.

    "Boys and girls are heavier than before, and modern India is seeing a huge epidemic of obesity," said Vaman Khadilkar, consultant paediatric endocrinologist at Jehangir Hospital, Pune, and convener of the Indian Academy of Pediatrics' (IAP) growth-chart committee.

    Convened in January 2014, the committee worked on the revisions and published its findings and charts in the journal Indian Pediatrics this year. The new charts are based on contemporary data on growth and development of 33,991 children of upper and middle socio-economic groups living in 14 Indian cities.

    Growth charts answer questions that often plague parents: Is my child growing well or not? Is she gaining enough weight and height? The problem with those questions is, no matter how much we fuss, worry and compare with peers, we continue to doubt the answers.

    A simple way to get rid of ambiguity and anxiety is to use a growth chart - an old but little-used statistical tool. Growth charts are graphs that show the ideal weight and height of a child at a given age.

    Growth charts are great diagnostic tools, as they not only let you monitor your child's growth in normal conditions, they also make it easier to spot irregularities.

    The charts are like a "standard that every child should attain and if she is not doing so, we need to find the reasons", says Sanjay Wazir, director of neonatology, Cloudnine Hospital, Gurgaon. He cites the example of a baby whose growth curve started faltering from the age of one, despite adequate nutrition. It emerged that the child had celiac disease.

    Over the past few decades, for a certain section of society, good nutrition has ceased to be a problem. Financial security has not only made sure that our plates are full, it has also caused a change in dietary patterns for many Indians.

    As a result, obesity and the huge burden of lifestyle diseases that tag along have become rampant, as IndiaSpend previously reported.

    Obese children have a greater chance of becoming obese adults burdened by lifestyle disorders. "The new growth charts are the best tools to diagnose obese and overweight [children] sooner," said Khadilkar.

    However, while some Indian children are overweight and obese, many are malnourished. So, how do these charts help children from both categories, and are they valid for poorer children, since they were created using data on children from the upper and middle socio-economic classes? Paediatricians advocate the use of IAP charts irrespective of socio-economic group.

    "These charts should be used across all socio-economic classes, as they are prepared from a set of children who are believed to be living in an optimal nutritional environment in India," said Archana Dayal Arya, senior consultant paediatric endocrinologist, Sir Gangaram Hospital, New Delhi.

    If paediatricians want to account for the nutritional divide between rich and poor and urban and rural children, "presently no growth charts are available that account for them or adjust for them".

    We do not have options other than to use one of these charts, said Neelam Kler, chairperson, Department of Neonatology, Institute of Child Health, Sir Ganga Ram Hospital, New Delhi. Wazir concurred. "Given the limitation of ideal growth charts, the IAP charts are our best bet," said Wazir.

    The World Health Organisation (WHO) also provides growth charts for children in the 5-18 age group to be used worldwide. But Khadilkar and his associates on the growth-chart committee believe IAP charts are better suited for Indian kids.

    "Growth patterns differ amongst different populations, especially in children above the age of five, as nutritional, environmental and genetic factors, and timing of puberty seem to play a major role not only in the attainment of final height but also in the characteristics of the growth curve." they write in their paper.

    Hence, the need for country-specific growth charts. Many paediatricians appear to agree with this view. In an unrelated study, Vijaylakshmi Bhatia, paediatric endocrinologist at Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, advises against using WHO charts for five to 18-year-olds as they are derived from "a group of children who are ethnically taller and heavier than our own high socio-economic group children".

    Some paediatricians differ. The methodology used for the IAP charts is "not very robust", said Kler, although it has the advantage of "recent data and accounts for change in growth pattern in a developing country with changing economic conditions".

    WHO growth references are based on a dataset, that is "old but uniform", uses "robust statistical methods" and "allows merging of the curve with under-5 growth charts", said Kler.

    For children under five, IAP also recommends WHO charts, which appear to have universal acceptability among the paediatricians.

    While there may exist a debate about which charts to use, India does not have a great track record in monitoring children's growth. "Although, there is no national data available, my estimate is only about 20-30 percent pediatricians plot growth", said Khadilkar.

    Parents and schools must also pitch in. Many schools record height and weight of children annually, but they fail to connect with a doctor to plot and interpret this data on a chart.

    For younger children, especially under the age of two, frequent measurements are needed. Beyond the age of five, annual measurements are enough. Rajesh Chandwani, a pediatrician and professor at IIMA has developed an app called Babysteps, to monitor the growth and development of children under the age of two.

    Chandwani said older children, too, require height and weight monitoring, as many "growth-related disorders and nutritional deficiencies can be detected and managed".

    In their concern about their children looking smaller than their peers, sometimes parents give food supplements to their children. This is not a good idea because it may "lead to diabetes, blood pressure and heart attacks later in life, especially for babies who were born small at birth," said Wazir.


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    Re: Health Bulletin

    'Neglecting arthritis can lead to stress fracture'

    Leelaben Raval, 65, from Visnagar had been experiencing severe joint pain, stiffness and weakness in muscles for the past two years. Raval kept neglecting osteoarthritis symptoms and eventually had stress fracture in both her knees.

    Naranpura resident Rama Patel, 72, also suffered wear and tear of muscles with age. It started with a pain localised to the knee but worsened when she climbed the stairs and stood up from a sitting position. As the disease progressed, the pain made even walking difficult.

    Both patients recently underwent a customized implant for total knee replacement that could have been avoided had they acted promptly. As doctors are receiving a high number of patients with advanced knee arthritis, they warn against consulting experts late.

    "If you have a harrowing time climbing stairs or if your joints hurt early in the morning, then don't ignore the signs. Not consulting experts on time can affect your mobility," said senior orthopedic surgeon and joint replacement specialist Dr H P Bhalodiya.

    Osteoarthritis occurs when the protective cartilage on the ends of your bones in the joints wears down with age. The disorder most commonly affects joints in hands, neck, lower back, knees and hips. "Common symptoms for all forms of arthritis include excruciating or constant pain, swelling and joint stiffness. Arthritis, especially osteoarthritis, now even affects women in their early 30s. Therefore, the message we want to extend is that timely operation is key to better results," he stressed.

    Dr Bhalodiya said that if arthritis affects the knee, it can have a huge impact on general health. "Thus, exercise and lifestyle change can prevent a knee replacement," he added.


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