DAILY NEWS BULLETIN LEADING HEALTH, POPULATION AND FAMILY WELFARE STORIES OF THE Day Thursday

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1 DAILY NEWS BULLETIN LEADING HEALTH, POPULATION AND FAMILY WELFARE STORIES OF THE Day Thursday HIV Get voluntary donor for blood transfusion to cut infection risk (The Times of India: ) Study Finds Replacement Donations Hike Chances Of HIV Contraction New Delhi: If you need blood transfusion, it s better to get a voluntary donor than depend entirely on hospital stock. That s because blood collected through replacement donations have a high rate of infection. A retrospective study conducted at Guru Tegh Bahadur Hospital, which is the regional blood transfusion centre for east Delhi, has confirmed it. Data published in the latest issue of Indian Journal of Medical Research shows the centre received 2.2 lakh units of blood in six years, from January 2008 to December Nearly 75% of the blood was collected through voluntary donations (VD) while the rest of it was through replacement donations (RD). Simply put, RD refers to blood donated by a relative or friend in lieu of blood transfused to a patient from the hospital stock. When these blood samples were tested for infections, doctors found transfusion-transmitted infection rates very high in case of RD as compared to VD a concern raised by many experts in the past. In 2014, for example, 81 units of blood collected at GTB Hospital tested positive for HIV. Of these, 76 were RDs. Prevalence of hepatitis B, hepatitis C, syphilis and malaria was also found to be four to five times higher in case of RD as compared to VD (see graphic).

2 Patients often arrange for professional donors if they cannot find someone from among family and friends. They conceal medical history, which makes it difficult to rule out infection, said a doctor. GTB doctors have stressed on the need to increase public awareness about VD and its benefits. Also, they have called for meticulous donor screening and use of highly sensitive techniques for detection of transfusion-transmitted infections to prevent the spread of diseases. National Blood Bank Policy 2002 also calls for phasing out of RDs. But an RTI reply accessed by TOI showed the practice of seeking RDs was prevalent across the country. It also revealed that Delhi hospitals collected nearly a million units as RDs in five years from to , which is the third highest across all states. At lakh, Uttar Pradesh had the highest rate of blood collection through RD, followed by Karnataka (9.88 lakh). Dr Vijay Kumar from the geriatric division of AIIMS said hospitals seek RDs because there is a scarcity of VDs and hospitals have to maintain their stocks. There is an urgent need for a registry of VDs and giving them incentives. We must do away with this practice of RDs because it is fraught with risks and causes avoidable stress to a patient s family, Kumar said. Delhi has 69 blood banks of which 34 are run by private hospitals, 11 by Delhi government hospitals, nine by central government hospitals, eight by voluntary organisations and three by municipal corporations. There are four private blood banks. Dr Bharat Singh, who heads Delhi State Blood Transfusion Cell, said RDs are higher in private hospitals as compared to government hospitals and blood banks. DSBTC can only recommend or suggest hospitals to seek more blood through donation. We do not have staff or infrastructure to organise camps for VD, he said. Singh is one of the authors of the study.

3 Dengue S corp starts dengue fight early (The Times of India: ) New Delhi: The rising number of mosquito-borne cases early in the season has prompted the south corporation to prepone its modified vector-borne disease programme by almost two months. Several measures are being taken to avoid a scenario in which the dengue-chikungunya incidence turns into a crisis. We started with a workshop where experts from WHO, neighbouring states, the Centre and the health ministry discussed key steps to tackle the menace, mayor Kamaljeet Sehrawat said on Wednesday. The civic body has decided to implement several precautionary measures this year. Unlike previous years, the dengue tackling programme will kick in in May itself. We have already sent a demand of 900 detection kits instead of earlier 600 from manufacturer NIV Pune, said an official. Each kit can test 98 cases. The corporation has also decided to ask the students from all corporation, government and private schools to assess their homes through homework cards. From April, we will distribute dengue homework cards to over five lakh students. The cards are meant to gather information related to precautionary measures taken to stop mosquito breeding. It will be treated as primary information, an official said. The civic body is working with experts from AIIMS to ascertain which strain of virus would be prevalent this year. Although there is no medicine for dengue, this information will help us in scaling up and modifying our plan, a public health official said. The mayor also announced that indoor residual spraying would be carried out in two rounds May-June and July-August. Alpha cyper methene will be sprayed, which can eliminate breeding of mosquitoes continuously. The drive, instead of being sporadic, will focus on JJ and rehabilitation colonies. Two additional mobile dispensaries will also be deployed in these areas. The mayor added that SDMC would test blood with the help of ELISA kit at a rate cheaper than that at government hospitals. The government charges Rs 600 while we will take Rs 299 for dengue and Rs 399 for chikungunya tests. Two new insecticides for spray medicines will also be used before the dengue season.

4 Stop talking, take action: SC on dengue scare (Hindustan Times: ) Supreme Court pulls up Delhi government for failing to provide details of preparations it has made to enforce waste management and prevent outbreak of dengue this summer, says no action has been taken From page 3 NEW DELHI: The Supreme Court came down heavily on the Delhi government on Wednesday for failing to provide details of the preparations it has made to enforce waste management and prevent the outbreak of dengue this summer. What are you authorities waiting for, an atom bomb of garbage to explode, the bench led by Justice MB Lokur said, apparently angry over the additional solicitor general representing the Delhi government having no idea about the steps taken. The lawyer only had minutes of a two-month old meeting to discuss the issue. This meeting was held on January 12 and the minutes were prepared on February 9. Still you say you do not know what steps have been taken. You keep discussing matters. But no action is taken, the judge said. The remarks come amid growing concerns that this year might see a spike in infections caused by mosquitoes. On March 5, HT reported warnings from scientists that a warmerthan-usual winter and an earlier-than-usual summer could spur breeding of mosquitoes responsible for dengue and chikungunya.

5 Justice Lokur asked the counsel to gather the information and present it on March 19. You are also a resident of this city. Please do not take this lightly, he said. The country s top court is hearing a case related to implementation of Solid Waste Management Rules 2016 across the country. It had on December 12 last year asked the Centre to follow up on the issue and furnish details. The issue regarding solid waste management arose in 2015 when the SC took cognizance of death of a seven-year-old boy in Delhi due to dengue. The child was allegedly denied treatment by five private hospitals. That year, 38 people died due to dengue alone. In 2016, the fatalities stood at 16. The death triggered concern over diseases like dengue and chikungunya that are spread by mosquitoes and the court identified a lack of waste management as the cause of several lives being lost across the country due to such infections. Additional solicitor general ANS Nadkarni, representing the Centre, told the bench that it received details from 28 of the 36 states and union territories on solid waste management. South civic body launches action plan early to tackle mosquito-borne diseases NEW DELHI: The South Delhi Municipal Corporation (SDMC), anticipating an early outbreak of vector-borne diseases this year, has launched its action plan for preventing the spread of dengue, chikungunya a month in advance. Till March 3, Delhi hospitals under South Delhi Municipal Corporation had reported 15 cases of dengue. On Wednesday, south corporation mayor Kamaljeet Sehrawat shared details of the civic body s plan that included adopting various new measures to combat cases of vector-borne diseases. Arrangements made by the SDMC s health department this year includes mass level indoor residual spraying to control breeding of mosquitoes for twothree months, early purchase of dengue detecting kits, obtaining by the month end report about serotypes of the dengue virus in circulation this year from All India Institute of Medical Science (AIIMS) and deploying mobile medical vans in slums. Till March 3, Delhi hospitals under South Delhi Municipal Corporation had reported 15 cases of dengue, five more than last year when the mosquitoborne disease infected 9,271 people and killed 10. To deal with the situation, the municipal authorities had in February held a workshop on prevention and control of vectorborne diseases to finalise a comprehensive action plan. DENGUE KITS

6 SDMC has already ordered 900 dengue detecting kits from the National Institute of Virology, Pune, 300 more than the total ordered last year by April end, said an official. We are coordinating with agencies to ensure purchase of medicines and machinery, said Sehrawat. She said that with one kit 96 people can be tested for the symptoms of vector borne diseases. Other exercises include training of dengue breeding checkers (DBCs) and sharing the use of new equipment and machines, said senior SDMC official. INDOOR SPRAYING TO STOP BREEDING The SDMC will arrange for fogging of alpha cypermethrine inside houses extensively. The spray can eliminate breeding of mosquitoes for two-three months, said an official. We introduced the spray last year on a pilot basis at two three areas. Seeing the encouraging response we have decided to use it in all wards this year. It has no side effects, said the official. Spraying will be done in two phases the first in the month of May and second in the month of July. We will emphasise on spraying in slum clusters and rehabilitation colonies, said the south Delhi mayor. TEST AT LOW RATES The SDMC officials said the municipality will provide testing through Elisa kits at minimum prices. This year, SDMC has decided to charge 299 for dengue test and 399 for chikungunia tests. In comparison, the city government has been charging 600 for the same tests, said Sehrawat. Civic agency will deploy mobile vans in localities which are far away from dispensaries to help locals. ROPING IN SCHOOL KIDS It has been decided to give homework cards to five lakhs students of all schools to gather information related to precautionary measures taken at their homes to stop breeding of mosquitoes. The data would be treated as primary information, on which the prevention plans in neighbourhoods will be executed, said officials.

7 Cervical Cancer Advanced cervical cancer needs chemo-radiotherapy, not surgery (The Times of India: ) Mumbai: An eleven-yearlong trial by the Tata Memorial Hospital (TMH) has established that women with advanced cervical cancer should not be treated with surgery, which is widely offered the world over. Instead, a combination of chemotherapy and radiotherapy increases fiveyear survival chances. The findings assume significance in India, where 60% of cervical cancer cases are detected at an advanced stage. The trial highlights the need for India to vastly increase radiotherapy centres from the meagre 530 that exist today, that too mostly in metro cities. The five-year disease-free survival rate in women with second-stage cervical cancer who received chemo-radiotherapy combo was 77% against 70% in those who underwent cycles of chemo and surgery, clearly established non-surgical treatment as the better plan. The study was published in the February edition of Journal of Clinical Oncology. Apart from saving valuable time, experts said the findings should save scores of women from undergoing botched-up, unnecessary surgeries. Across India, every year, nearly 1.3 lakh women are detected with cervical cancer, while 70,000 succumb to it. Oncologist and principal investigator Dr Sudeep Gupta said the study has put to rest one of the longest standing controversies about the best way to tackle locally advanced cervical cancer. If a tumour is more than 4 cm, surgery is absolutely not an option. There is a tendency among doctors to shrink the tumour first with chemotherapy and then attempt surgery. Our study has proved that it s not ideal and the standard way is a combination of radiotherapy and chemotherapy, he said. Another sister study led by Dr Shyam Srivastava and Dr Umesh Mahantshetty, radiation oncologists of TMC, found that even in advanced cervical cancer stage 3, radiotherapy with simultaneous chemotherapy is superior that giving patients radiotherapy alone. It showed that addition of once per week chemotherapy to radiotherapy achieved significant reduction in cancer relapse and death in women.

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9 Diet/Nutrition (The Asian Age: )

10 Ebola (The Asian Age: )

11 Women Empowerment A strong message of gender justice (Hindustan Times: ) Empowerment is not possible without justice for social wrongs and a disruption of the old order Every parent who has a girl at home, asks her where she is going and when she will return. But have you ever asked your sons where they are going, why they are going and who their friends are? After all, the person committing a crime is also someone s son. In the first Independence day speech from the ramparts of the Red Fort after the historic mandate of 2014, the prime minister managed to break a major gender stereotype. For the millions of people who didnot follow debates on social media, this could have been the most undiluted message of gender justice that they could receive. The message that the safety of women is not the onus of the woman alone had been shared by the prime minister himself and at an event that the whole country was a part of. This is the sort of justice and empowerment of women that the country needs and deserves. This is empowerment without the shackles of labels, freed from othering of genders and one that not only critiques situations but equips women to change these situations. In the course of the past four years, the government has tried to reinforce this brand of women s empowerment through targeted interventions for women. This empowerment has made space for female leaders to thrive, has acknowledged women achievers, has disrupted status quo for gender justice, has created avenues for social and economic empowerment of women and has tailored policies to address discrimination. Empowering women means equipping them with the best opportunities which could break old barriers. More than 16 crore women have been connected to the banking system under the Jan Dhan Yojana. This massive financial inclusion of women has been the bedrock on which women have now benefitted from direct cash transfers for multiple schemes, including the flagship Ujjwala Yojana and the Swachh Bharat Mission. Today, it is women who are writing the story of New India where 7.88 crore women have taken loans under MUDRA and have become job creators. At the launch of the Beti Bachao, Beti Padhao programme in Haryana, the prime minister said that as a country we have regressed because we do not even allow girls to be born. Today, 104 districts, including the most affected districts in Haryana, have reported an improved sex ratio. The Sukanya Samridhi scheme targets the perception that girls lead to economic insecurity in the family. The scheme allows parents to save money at a higher rate of interest for the higher education or wedding of the girl child. Sustainable change towards

12 bringing in gender equality lies in understanding local barriers and working around them rather than importing solutions from outside. Empowerment of women is not possible without justice for social wrongs and that demands disruptions of the old orders in which women are victims. One of the landmark judgments of 2017 was the Supreme Court s ban on instant triple talaq. This victory truly belongs to the Muslim women of this country and the government has stood with them in their struggle for justice and dignity. The government brought in the triple talaq legislation to criminalise the act. But, as expected, political considerations made the opposition stall the bill in Parliament. Invoking the ancient Indian culture of respecting Kinnars, the government has brought in the Transgender Person Rights Bill (2016). This bill intends to end the indifference towards the community, challenge dogma and address the discrimination meted out to transpeople in access to education, employment and healthcare This government is dedicated to taking forward the individual aspirations of women, and making them an intrinsic part of the development story of the country. In fact, no development is possible if women are not equal partners in the process of development. Today, women lead the defence and the foreign affairs ministries, allowing thousands of young girls to believe that their gender can never limit their potential. Today, women do not have to walk for hours to fetch firewood and suffer with smoke in their lungs and eyes. Today, women are leading the Swachh Bharat Campaign across villages because it was they who had to undergo the indignity of open defecation. Today, women are not only managing their families, but are setting up their own businesses and defining new India s aspirations. Today, women do not have to make an uncomfortable choice between motherhood and economic security because of the Maternity Benefit Act. In the declining rate of maternal mortality, in the improved sex ratio, in the smoke-free kitchens of women, in the toilets in the schoolyard for girls, in the small shop set up by a woman, we see the new story of women empowerment defining the New India. Alzheimer's disease Boosting the brain's Today: ) immune cells may stop Alzheimer's (Medical News The results of two new studies both published in the journal Neuron suggest that the brain's immune cells may hold the key to future treatments for Alzheimer's disease.

13 Your brain contains immune cells called microglia, which can be boosted to clear up Alzheimer's-related brain damage, suggests new research. Alzheimer's disease affects more than 5 million people in the United States, and the condition ranks as the 6th leading cause of death in the country. Among a range of other hallmarks, Alzheimer's is characterized by neurological damage that is thought to be caused by plaques from a "sticky" protein called beta-amyloid. Beta-amyloid is normally found in the membrane around nerve cells, but when it clumps together into small lumps or plaques between neurons, it can stop them from communicating with each other and impair brain function. For years, researchers have been trying to understand exactly how the production of betaamyloid triggers the symptoms of Alzheimer's disease. Some researchers have even tried to develop anti-beta-amyloid drugs, but clinical trials of these pharmacological interventions have largely proven unsuccessful. Now, researchers led by Prof. Huaxi Xu the director of the Neuroscience Initiative at the Sanford Burnham Prebys Medical Research Institute in La Jolla, CA offer a potential new strategy for eradicating the excessive buildup of the brain protein. Prof. Xu and his team studied the behavior of a triggering receptor found on a type of cell called microglia or the immune cells of the central nervous system in two mouse studies. Their findings can be accessed here. Helping immune cells to fight beta-amyloid The receptor is called TREM2. As Prof. Xu explains, "Researchers have known that mutations in TREM2 significantly increase Alzheimer's risk, indicating a fundamental role for this particular receptor in protecting the brain." But what the new research reveals is "specific details about how TREM2 works," adds Prof. Xu. Specifically, the first study shows that amyloid beta binds to the receptor, triggering a chain reaction that may culminate with slowing down the progression of Alzheimer's. Blocking enzyme 'dramatically reverses' Alzheimer's in mice Blocking a key enzyme could one day "completely reverse" the buildup of beta-amyloid plaque in people with Alzheimer's disease. Once bound to the amyloid beta, the triggering receptor TREM2 then "tells" the immune cells to start breaking down and clearing out amyloid beta, "possibly slowing Alzheimer's disease pathogenesis," explains Prof. Xu. The first study also demonstrates that TREM2 binds to so-called amyloid beta oligomers, which are molecular complexes that have been receiving more and more attention in specialist literature for their role in Alzheimer's progression.

14 Also, the study showed that removing TREM2 in mice altogether interfered with the electrical currents that normally activate microglia. TREM2 may stop Alzheimer's progression The second study strengthened the findings of the first; it showed that "increasing TREM2 levels renders microglia more responsive and reduces Alzheimer's disease symptoms," says Prof. Xu. More specifically, the researchers added TREM2 to mice that had been genetically modified to develop an aggressive form of Alzheimer's. More TREM2 signaling stopped the disease from advancing and even reversed some of the cognitive decline, the study authors report. "These studies are important," explains Prof. Xu, "because they show that in addition to rescuing the pathology associated with Alzheimer's disease, we are able to reduce the behavioral deficits with TREM2." "To our knowledge," he continues, "this provides convincing evidence that minimizing amyloid beta levels alleviates Alzheimer's disease symptoms." Prof. Xu also emphasizes that these findings offer a new therapeutic avenue. "Going after microglia, rather than amyloid beta generation, may be a new research avenue for Alzheimer's disease [...] We could use brain immune cells to solve what's becoming a public health crisis." Prof. Huaxi Xu However, he also cautions against potential pitfalls. "It could be beneficial in early stages to activate microglia to eat up amyloid beta [...], but if you over-activate them, they may release an overabundance of cytokines (causing extensive inflammation) damaging healthy synaptic junctions as a side effect from over-activation."

15 Anxiety Anxiety: Does waist size have anything to do with it? (Medical News Today: ) Anxiety, a common mood disorder, has many risk factors such as genetic makeup and stress. Recently, researchers have been revealing the relevance of some more surprising risk factors. A new study from Latin America suggests that waist size may be one of them. New research investigates the link between waist measurements and the risk of anxiety. Anxiety disorders are now the "most common" mental condition among adults in the United States, confirm the Anxiety and Depression Association of America. Women are twice as likely to be diagnosed with anxiety as men, and they are also more likely to overeat due to stress. Moreover, anxiety has also been associated with the advent of cardiometabolic diseases, such as coronary heart disease and diabetes. A new study from Latin America that focused on postmenopausal women now suggests that the risk of developing a form of anxiety later in life may have something to do with the size of a woman's waistline. The researchers, who hail from many institutions across Latin American countries including Peru, Chile, and Ecuador found correlations between women's waist-to-height ratio and her chance of being diagnosed with anxiety. The paper whose first author is Dr. Karen Arroyo, from the School of Medicine at Universidad Peruana de Ciencias Aplicadas in Lima, Peru that reports the researchers' findings has been published in the journal Menopause. Waist-to-height ratio and risk of anxiety Dr. Arroyo and her colleagues worked with 5,580 women with a mean age of 49.7 years. Of these participants, 58 percent were postmenopausal, and 61.3 percent said that they lived with anxiety. The scientists examined data related to women's weight and height to determine whether or not there was any association between waist size and the risk of developing anxiety. Mood swings during menopause: Causes and treatments Learn how to manage mood swings during menopause.

16 According to the researchers, this is the first time that waist-to-height ratio, specifically, has been examined to uncover a link with anxiety disorders. The waist-to-height ratio has previously been looked to as an indicator of cardiometabolic risk which, as aforementioned, has been tied to mood disorders including anxiety. The waist-to-height ratio is determined by dividing waist circumference measurements by height measurements, and a woman is typically obese if her waist size equals more than half her height measurements. In the current study, Dr. Arroyo and colleagues divided the participants into three groups lower, middle, and upper tertile based on their calculated waist-to-height ratios. To begin with, the team found that the women in the middle and upper tertiles were at significantly higher risk of having anxiety than their peers in the lower tertile. However, after adjusting for relevant factors, they saw that only the women in the uppermost tertile were more likely to exhibit telling signs of anxiety. In short, the larger a woman's waistline, the more likely she is to experience anxiety. Better care for women Previous studies have shown that postmenopausal women are more likely to have anxiety and that their quality of life is sometimes severely affected by it, and some research suggested an overlap between the physiological effects of menopause, such as hot flashes, and symptoms of anxiety. Dr. JoAnn Pinkerton who is the executive director of the North American Menopause Society explains that this study's findings may help to improve the health guidelines offered to women at later stages in life. "Hormone changes," she explains, "may be involved in the development of both anxiety and abdominal obesity because of their roles in the brain as well as in fat distribution." "This study provides valuable insights for healthcare providers treating middle-aged women, because it implies that waist-to-height ratio could be a good marker for evaluating patients for anxiety." Dr. JoAnn Pinkerton

17 Gastrointestinal Natural remedies for gastritis (Medical News Today: ) Home remedies Symptoms Prevention Seeing a doctor Gastritis is a condition that affects a person's stomach lining, causing it to become inflamed. Some cases of gastritis can be treated at home with simple remedies. There are many factors that can cause a gastritis flare-up. These include: excessive alcohol consumption using pain medication for an extended period Helicobacter pylori (H.pylori) bacteria infections stress While there are instances where medical treatment is necessary to treat gastritis, many people find they can manage the symptoms at home. Eight best home remedies for gastritis Not all remedies will work for everyone, so a person may need to try several of these before finding what works best for their case. 1. Follow an anti-inflammatory diet Broccoli salad in bowl with quinoa and radish and sweetcorn. A diet to prevent gastritis should include broccoli and olive oil. Gastritis refers to inflammation of the stomach lining, so consuming a diet that helps to minimize inflammation may provide relief over time. However, research has not conclusively shown that eating a certain diet causes or prevents gastritis. By keeping a food diary, people can identify which foods trigger their symptoms. They can then begin to reduce their intake or avoid certain foods altogether. Foods that commonly contribute to inflammation are: processed foods

18 gluten acidic foods dairy products sugary foods spicy foods alcohol Diet tips for gastritis and stomach ulcers Many people can find relief from gastritis symptoms by following a special diet. Learn more. 2. Take a garlic extract supplement Some research suggests that garlic extract can help reduce the symptoms of gastritis. Crushing raw garlic and eating it can also work well. If a person does not like the taste of raw garlic, they can try chopping the garlic and eating it with a spoonful of peanut butter or wrapped in a dried date. The sweetness of the peanut butter or date will help mask the garlic flavor. 3. Try probiotics Probiotics can help improve digestion and encourage regular bowel movements. Probiotic supplements introduce good bacteria into a person's digestive tract, which may help stop the spread of H. pylori. Eating foods that contain probiotics may also improve the symptoms of gastritis. These foods include: yogurt kimchi kombucha sauerkraut kefir 4. Drink green tea with manuka honey Green tea and honey. Green tea and manuka honey may help to soothe the stomach. One study showed that drinking green or black tea at least once a week could significantly reduce the prevalence of H. pylori in the digestive tract.

19 Manuka honey may also be beneficial, as it contains antibacterial properties that help fight infection. Some people believe drinking warm water alone can soothe the stomach and aid digestion. 5. Use essential oils Essential oils, such as lemongrass and lemon verbena, were found to help increase resistance to H. pylori in laboratory tests. Other oils that can have a positive effect on the digestive system include peppermint, ginger, and clove. Essential oils should not be ingested and should always be diluted with a carrier oil if applied to the skin. People may wish to use the oils in a diffuser or consult a doctor on how to use them safely to help relieve gastritis. It is important to note that the United States Food and Drug Administration (FDA) do not regulate essential oils or alternative medicine. 6. Eat lighter meals Eating large, carbohydrate-heavy meals can put a strain on a person's digestive system and aggravate gastritis. Eating small meals regularly over the course of the day can help ease the digestive process and reduce the symptoms of gastritis. 7. Avoid smoking and overuse of painkillers Smoking can damage a person's stomach lining and also increases a person's risk of developing stomach cancer. Taking too many over-the-counter pain medications, such as aspirin or ibuprofen, can also damage the stomach lining and make gastritis worse. 8. Reduce stress Stress can cause gastritis flare-ups, so reducing stress levels is an important way to help manage the condition. Stress management techniques include: massage meditation yoga

20 breathing exercises Symptoms Man with gastritis leaning over and holding his stomach in pain. Gastritis may cause a burning sensation in the stomach and feeling full after eating a small amount of food. Although unpleasant, gastritis is not usually thought of as a serious condition. Symptoms of gastritis include: nausea vomiting a gnawing or burning sensation in the stomach feeling full after eating only a small amount Prevention While the cause of gastritis varies among individuals, there are some steps people can take to avoid bothersome symptoms. Steps to prevent gastritis include: avoiding known trigger foods quitting smoking managing and reducing stress avoiding alcohol maintaining a healthy weight avoiding abuse of over-the-counter pain medications Home remedies can help many people manage gastritis. However, if symptoms do not go away, it is essential to speak to a doctor. When to see a doctor People with gastritis should see a doctor if they experience: a gastritis flare-up that lasts more than a week vomiting blood blood in the stool

21 A doctor will ask questions, perform an examination, and may wish to carry out certain tests. Common medications prescribed for gastritis include: Histamine 2 (H2) blockers, which help decrease acid production. Both prescription and overthe-counter varieties are available Proton pump inhibitors (PPIs), which also work to reduce acid production and are available both over the counter and on prescription Antibiotics, which are used to treat H. pylori infections Depression Antidepressants: Do they really work? (Medical News Today: ) Recently, there has been one major health issue dominating the mainstream media: antidepressants. More specifically, do they actually work? A bottle of pills spilling onto a table Are antidepressants safe and effective? This question has been widely debated in recent years. The global debate on this issue was kick-started earlier this year, when British author Johann Hari published his book, Lost Connections: Uncovering the Real Causes of Depression and the Unexpected Solutions. Hari used antidepressants for 13 years, starting when he was a teenager, and the new book is his attempt to answer some of the questions that had plagued him for years. In particular, what causes depression? And, why did antidepressants not cure my depression? Lost Connections was launched to a fanfare of endorsements from celebrities, including musicians Elton John and Brian Eno, political activist Naomi Klein, and even Hillary Clinton. It posed a radical question: "Is everything we know about depression wrong?" It suggested radical solutions. For these reasons, the work immediately sparked controversy.

22 The antidepressant debate Lost Connections surrounds the plentiful claims that antidepressants are mostly ineffective, that this ineffectiveness has been concealed by the pharmaceutical industry thanks to inefficient regulatory systems, and that the physiological mechanisms sometimes suggested as triggering depression are not supported by evidence. "Telling people, as I was told by my doctor, that depression is caused by a problem in your brain is, firstly, untrue," said Hari to The Guardian. Why antidepressants fail to work in some people Learn more about exactly why antidepressants don't work for all patients. "[A]nd," he adds, "it is also really problematic because it cuts people off from finding the real causes of their depression and anxiety. We've been telling ourselves this chemical story for 35 years and every year depression and anxiety gets worse." These claims alarmed health professionals and journalists, who are now concerned that the book will prompt mental health patients to stop taking their medication without consulting a doctor. Meanwhile, others were more worried about the veracity of the claims that Hari used particularly his soundbite that "between 65 and 80 percent of people on antidepressants are depressed again within a year" and questioned whether they could be supported by peerreviewed scientific papers. Though Lost Connections has definitely struck a populist nerve, critics of Hari are quick to point out that this is only his second major work following a career-threatening plagiarism scandal in 2011, which forced him to withdraw from the public eye for an extended period. The Lancet review: The final word? The debate raged on across social media and in countless editorial columns until last month, when the results of a 6-years-in-the-making systematic review assessing the efficacy of antidepressants was published in The Lancet. The review assessed all of the scientific data both published and unpublished that researchers from Oxford University in the United Kingdom could find. This exhaustively researched analysis was interpreted by some commentators to be the final word on the antidepressant controversy. For instance, Prof. Carmine Pariante spokesperson for the Royal College of Psychiatrists in the U.K. commented: "This meta-analysis finally puts to bed the controversy on antidepressants, clearly showing that these drugs do work in lifting mood and helping most people with depression."

23 "Importantly," Prof. Pariante adds, "the paper analyzes unpublished data held by pharmaceutical companies, and shows that the funding of studies by these companies does not influence the result, thus confirming that the clinical usefulness of these drugs is not affected by pharma-sponsored spin." The review does acknowledge that the short-term benefits of antidepressants are, on average, modest, but it concludes that all of the 21 antidepressants studied are more effective than placebo for the treatment of major depressive disorder in adults. Some drugs were discovered to be more effective than others. Escitalopram (Lexapro), mirtazapine (Remeron), paroxetine (Paxil, Brisdelle, Pexeva), agomelatine (Valdoxan), and sertraline (Zoloft) all had a higher response rate and lower dropout rate than other antidepressants, the researchers report. The paper's authors draw particular attention to the global burden of depression; it affects around 350 million people and is becoming more common, with substantial increases in the number of depressed people since 1990 which are thought to be driven by an expanding and aging population. In the U.S. alone, the financial burden of depression comes in at $210 billion per year, comprising 50 percent workplace costs, 45 percent direct costs, and 5 percent suicide-related costs. We don't know how antidepressants work Most of the antidepressants that were included the study belong to a class of drugs called selective serotonin reuptake inhibitors (SSRIs). chemical formula for serotonin It is believed that antidepressants work by boosting serotonin levels, but this has not been confirmed. They are thought to work by raising levels of the neurotransmitter serotonin, but the researchers admit that evidence to support this mechanism of action is not definitive. Really, no one quite knows exactly how antidepressants work. Serotonin has been linked to maintaining mood balance, appetite, and motor, cognitive, and autonomic functions. Since the late 1980s, low serotonin levels were thought to be a main driver of depression. But this position has been questioned and not just by Johann Hari. In 2015, Medical News Today reported on an editorial published in The BMJ from a prominent critic of SSRIs called Prof. David Healy. He argued the idea that depression is caused by low levels of serotonin, and that SSRIs restore serotonin levels is a myth originating in pharma marketing.

24 The Oxford-based researchers argue that more research and newer, more precise antidepressants are required, admitting that the identification of new molecular targets has been made difficult precisely because of the lack of clear evidence on how antidepressants work. The lack of research assessing the long-term use of these medicines has led to some concerns that antidepressants may contribute to unacceptably high health risks compared with their modest benefits. Can antidepressants raise early death risk? Recently, MNT looked at a study suggesting that common antidepressants may drastically increase the risk of mortality. a description of antidepressants and a person holding a pill Research has suggested that antidepressants may increase the risk of premature death. The team behind this study, at McMaster University in Ontario, Canada, conducted a metaanalysis of 16 studies involving a total of around 375,000 participants. They found that people taking antidepressants have a 33 percent higher risk of premature death compared with people who aren't. In addition, people using antidepressants were found to be 14 percent more likely to have a stroke, heart attack, or other cardiovascular event. The meta-analysis did not find a significant difference in outcomes between people taking SSRIs and those using tricyclics, an earlier generation of antidepressants. However, as this research was an observational study, the scientists were unable to prove that antidepressants cause premature death; they could only record a link between the two. Speaking to MNT, lead study author Marta Maslej speculated on possible mechanisms that could drive this association. "Antidepressants disrupt the functioning of monoamines (important biochemicals such as serotonin and dopamine), and these monoamines have important functions not only in the brain, but all over the body." Marta Maslej "For example," she added, "serotonin affects growth, reproduction, digestion, immune function, and many other processes, and it is found in almost every major organ." "Disrupting the functioning of serotonin can therefore have different adverse effects, which can contribute to a risk of death in many different ways."

25 It is estimated that around 1 in 10 U.S. adults now take antidepressants, and with the incidence of depression on the rise, it seems unlikely that these numbers will reverse any time soon. It is also unlikely that the intense debate over the role these medicines play in our society will die down or become any less controversial despite the new data. But one thing that all voices from Hari to the research teams in this debate firmly agree on is that if you are taking antidepressants and you are concerned about their effects, you should not stop taking them without consulting your doctor first. Always speak to your doctor before making any changes to your medication. We pick these items based on the quality of the products, and list the pros and cons of each to help you determine which will work best for you. We partner with some of the companies that sell these products, which means Healthline UK and our partners may receive a portion of revenues if you make a purchase using a link(s) above.

26 Kidney Disease (Dainik Jagran: )

27 Ǒ ȡǑ Ǒ ȡj Ȳक ह थ Ʌ È ȧ ȧच ब (Dainik Jagran: ) Ǒ ȡj Ȳक पर पर गत ȡ क ख च स ब हर Ǔ ȡ कर ] ǓǕ और Ȣ ȧ ȡ क स थ ज ड़न ȧ Ǿ ह Ʌऐस म ह ल बन न ह ग जह Í ɉ Ʌ ɇ भ दभ व ȧ भ वन ȣ न पनप तभ Ǒ ȡ È Ȣ ह ग Ǒ ȡj Ȳक ` ȡ पर ȡ Ʌबह त ह त ɇ ȯ ` Û Ʌअमल Ʌ ȣȳल य ज त å ȡ ȡǐ Ǿ स ] [ è Ȳğ ȡ È Ȣ ȧ ȣ Ȣ±ȣ ह और Ǒ ȡf Ȳभ ^ Ʌअपव द ȣȳ@ Ǒ Ǒ ȡj Ȳक ] [ Ȫ ȶपर \ अवसर Ʌत इसस ` ȧस म जक ĤǓ ç ȡत बढ़ ग ȣ द श क ज ड प क भ द ग न Ǔ ȯ Ȣ È ɉ अभ भ तम म Ǒ ȡf Ȳक मक ज ] ȡ ȣ क Ǒ è ȡ ȣȳ ɇ@` Û Ʌय अवसर द न क f सम ज क भ अपन स च बदलन ह ग महज एक Ǒ ȧम हत ज ȣȳ Ǒ ȡ स श ल क म र Ȳ 1 È Ȣ Ʌ] [ è Ȳğ ȡ बह त म यन रखत ह ^ Ʌ Ǒ ȡf Ȳभ अपव द ȣȳ ɇ@तम म उद हरण ^ ȧ Ǖǔç भ करत ɇ@ ȡǑ स ब त ह आज \ Ȳ ȡçĚȣ पर Ǒ ȡj Ȳक ` ȡ ȧ ब त Ʌइस पहल क भल क स नजरअ द ज ȡ ज सकत ह असल Ʌ इसक द हर फ यद ɇ@एक त ] [ Ǿ स È ह न स Ǒ ȡj Ȳ Ʌ] æ ȡ बढ़ ग ज ` ȧस म जक Ȱ Ʌभ Ǚƨ कर ग त दस र ] [ Ǔ ɉ Ʌ Ǒ ȡj Ȳ ȧ ȡ Ȣ ȡ ȣ स सकल घर ल ` ȡ भ बढ़ ग जसस Ē \ å [ è ȡक ल भ ȯ ȡ@ æ ɇ न भ कह ह Ǒ भ रत क द \ Ȳ ɉ Ʌ] [ Ǚƨ दर ȡ करन ह त उस Ǒ ȡj Ȳक f ] [ अवसर बढ़ न ɉ ȯ@ ȡ ȡǐ Ȫ [क अन स र भ रत Ʌक वल 27 ĤǓ Ǒ ȡf Ȳ ȣ Đ Ǿ स ȫ ȣ ȧ तल श कर ȣ ɇ@ ǓǕ ȡ ȧ सबस त ज स बढ़त \ å [ è ȡ क f यह ȣ स क त ȣȳह यह भ è ç ह ǓǕ ȡभर Ʌक मक ज ȧ ɉपर ब हतर ɇ स त लन बन न पर उतन ज र ȣȳथ जतन ब त क छ Ⱦस द खन क रह ह भ रत य Į ब ज र Ʌ Ǒ ȡj Ȳ

28 ȧǒ è ȯ ȡ ȣबह त कम ह Ē Ȣल न क ब द 65 ȧ स \ Ǒ ȡf ȲĮ ǔè क Ǒ è ȡ ȣȳ बन ȣ ɇ ȡȲÊ ȡ ȯ Ʌयह आ कड़ 41 ĤǓ और ^Ȳ Ȫ ȯ ȡएव Ħȡ Ȣ Ʌ25 ĤǓ ह [2007 क ब द भ रत Ʌक मक ज Ǒ ȡj Ȳ ȧ ȲÉ ȡघटन क स क त ȯ ɇ@ 1^ Ʌक ई द र य ȣȳ Ȣ ȧ ȡ न पर पर गत ȡ क पछ ड़ Ǒ ȡ ह अब चन त इस ब त ह ] ǓǕ एव Ȣ ȧ ȡस Ǒ ȡj Ȳक क स ज ड़ ज ए बदलत ह ल त आग ह कर रह ɇ प र न ȶ\ [ ȣ और \ Ĥȡ Ȳ ह रह ɇऔर इसक सबस Ï ȡ ȡच ट èğȣ ȡपर ह ई ह ȡǑ ह Ǒ Ǒ ȡf Ȳ Ȣ ȧ और र जग रपरक ȡ स दर Ʌ Ȣ त न क वल ` Ʌ ȯ Ȫ ȡ ȣ å ȡÜ ह ग, ǔã एक बड़ म नव Į क ल भ ल न स भ भ रत Ȳ रह ज एग Ǒ द श ȧ70 ȧ ȣ Ǒ ȡ Į क ^è ȯ ȡ ȡ ज ए त द श क ज ड प Ʌस ढ़ च र ĤǓ ȧ Ǚƨ ह सकत ह 1\ ȯǐ ȧ ȡçĚ Ǔ Ȫ ȡã ĚȲ ȧ ȯ ȣएव å ȡ^ ह उस Ʌसल हक र इव क ĚȲ न ह ल Ʌभ रत य Ǒ ȡj Ȳ ȧ` ǔþ ɉ ȧĥ Ȳ ȡ करत ह ए ` ȧ ȡ Ȣ ȡ ȣबढ़ न ȧ Ǿ बत ई थ Ǒ सब क छ ȡ ȡÛ रह त [2025 तक भ रत क \ Ǖ ȡǓ ज ड प द ग न ह सकत ह यह Ǒ ȡj Ȳक Đ य गद न स ȣस भव ह सक ग भ रत क ज ड प Ʌ Ǒ ȡj Ȳक य गद न ȡğ 17 ȧ ȣह च न Ʌ41 ȧ ȣ, \ ȯǐ ȡ Ʌ33 ȧ ȣह इतन ȣ ȣȳभ रत इस म मल Ʌ37 ĤǓ क Ȱǔæ औसत स भ भ रत ȡ ȧ प छ ह भ रत Ʌ Ǒ ȡ Į क भरप र उपय ग ȣȳह प रह ह ȣ वजह भ ह तम म Ȫ ɉ क ब वज द द श Ʌ\ ȯ ] [ ȡ ȣȳह प रह ह 1इस ǔè Ǔ क पलटन क f कई Ȫ Ⱦपर कदम उठ न ɉ ȯ@ यह Ø Ǔ [ ȡ Ǿ स ह सम ज Ʌ Ǒ ȡj Ȳ ȧ ` ȯ ȡ ȧ ज त ह ȡ ȡ, ȡ, ` ɮ ȡ स ल कर क शल ȡ एव Ǔ Ȫ ] Ǒ Ʌ Ǒ ȡj Ȳ ȧ Ǘ ȡ कई गन बढ़ ई ज सकत ह Ǒ ȡ È Ȣ क ल कर ɉ स ȡ Đ[ चल ए ज रह ɇ@ ȡ ȡȲ इनस कई ǐ [ ह ए भ ɇ, ȯ ` ȧ Ý ȡ ȡ ȡ ȧह स थ ȣ È Ȣ ȡ Đ[ ɉ Ʌकई ȡȲ भ ɇ@ब त क छ Ⱦस Ǒ रह ह ɉन ȡऔर र जग र क म मल Ʌè Ȳक è ȡ करन ȧ ह ड़ Ʌत Ǒ ȣ ɇ@10व और 12व ȧ Ȫ [ ȣ ȡ Ʌट पर ȣ ȣȳ^ȳ ȢǓ ǐ Ȳ, ȯ और स व ȣ ȡ Ʌ Ʌ ȡȲ\ å आ ȣ ɇ@थ ड़ द र क f यह म न भ ȡज ए ǐ [ ȡ [ ह पर ^ ȧसमझ सब जगह पर å ȡÜ ȣȳह ȡ[ ȡऔर ȧ Ȳ ȡहर ` Ʌबन रहत ह भ रत य Ȳè ǙǓ और Ȳè ȡ क ढ न ȧǔ à ȯ ȡ ȣभ ` Û ȣȳ ȧ ह ǐ ȡ क f ȡ Ʌभ ` Û ȣȳक आग रख ज त ह Ǒ ȡf Ȳभल ȣ` Í ȡĤ ȡÜ कर Ʌ, ȡ ȣ, Ȱ ȡ ȣ ȫ ȣकर Ʌ, ȯ व गह Ǖ ȣȳह प ȣ ɇ@स थ ण ȧ Ǘ ȡस È ȣघर ल हस स Ĥ ȡ ह न पर भ \ Ü ɇ@आ कड़ त यह भ बत त ɇ हर Ǘ ȣ Ǒ ȡ इस Ǒ Ȳ ȡ ȧकभ न कभ ȡ ह ई ह ȡ ȡस ल कर ȡतक, श ध स ल कर ब ध तक और

29 ख ल क म द न स ल कर f ȯè ȧ ऊ च ई ȣ ȣȳ, ǔã \ Ȳ ǐ तक पह चन ȡ ȣ Ǒ ȡj Ȳ ȧ भरम र ह इस ȡ स æ ɇ क यह कथन भ रत ȧ È ȧ ȧच ब Ǒ ȡj Ȳक ह थ Ʌ ह, ȣȳस ग र Ǖ ȡ ब त Ĥ Ȣ ȣȳह त 1द श Ʌ Ǒ ȡf Ȳ ȡçĚ Ǔ, Ĥ ȡ Ȳğ Ȣऔर ल कसभ \ Ú ज स ` Í ɉपर पह च Ǖ ȧ ɇ@ ǓǕ ȡक कई ȯ ɉ Ʌ Ǒ ȡj Ȳक Ȳ ȡ ɮ ȡ ȡ] ȧå è ȡ ȣगई ह, ȯ हम र यह ऐस क छ ȯ ȣȳह ȣȳ33 ȧ ȣ Ǒ ȡ] क ल कर ȡ ȢǓ ^Í ȡ ǔè ȣȳǒ ȡ_ जसक नत ज ȣह आ यह आज भ अधर Ʌलटक ह आ ह \ ȶ ȣ ȡ Ʌ30 ȧ ȣ, \ ȡǓ è ȡ और ȡ è ȡ ज स ȯ ɉ Ʌ Ǒ ȡj Ȳक Đ : 27 और 30 ȧ ȣ ] ȡ ह पड़ स ȡȲÊ ȡ ȯ भ इस म मल Ʌप छ ȣȳह ǔæ Ȣ द श ȯ ȡ [, ȡ ȶ, è Ȣ सम त कई यर प य द श इस स च Ʌ ȡ ɇ@ Ȳ [Ǔ Ǒ å ȡÉ ȡयह भ ह क न स क म Ǒ ȡf Ȳ ȣȳकर सकत आज हर तरह ȧ ȫ ȣऔर क मक ज क स थ Ǒ ȡf Ȳ प र न ध रण क त ड़ नई Ȣ±ȣ क f ȡ बन ȣ ɇ@ ȡǑ ह Ȱǔæ ǐ Ǻæ Ʌ Ǒ भ रत क अपन त कत स म जक और ] [ त र पर और ब ल द करन ह त सकल घर ल ` ȡ स ल कर Į ब ज र तक Ʌ Ǒ ȡj Ȳ ȧ Ǘ ȡक द न ह ग 21व ȣक दस र दशक Ʌबड़ बदल व और ȡ क सतत करन और स थ ȣसम व श ध रण स È Ǖ ह न ह त Ǒ ȡj Ȳक स थ ल कर चलन ȣ ह ग 1(ल खक व इएस ǐ Ǔ ȯ ɇ)ड. ऋत [ फ उ ड शन ऑफ ǔþ f Ǔ èěȯ क ȡ è 1\ Ȳ ȡçĚȣ ǓǕ ȡ ȧ Ǒ ȡj Ȳक f एक Ĥ Ȣ बन चक ह उनक सम नत क Ȳ [क नक रन सहज ȣȳह 1909 Ʌ ǕǾ ह आ यह Ǒ ȯğ ɉ Ʌ Ǒ ȡj Ȳक ĤǓ æ क Û à ȡ, Ĥ Ȳ ȡ और Ü ȡ Ĥ करत ह ए इस Ǒ क Ǒ ȡj Ȳक ] [, ȡ ȢǓ और स म जक ` ǔþ ɉक ` क त र पर मन य ज त ह पर Ĥ æ यह उठत ह È ȡएक Ǒ क `, Ǒ ȡj Ȳक सम न ȡ Ȣ ȡ ȣ द प रह ह सम न व तन क \ ȡ क Ȳ [आज भ è Ǘ क यम ह त ȡ ȢǓ क Ĥ प यद न पर प व रखन अस भव स Ĥ Ȣ ह त ह, È ɉ Ǖǽ 1 Ȳ ȯ क ȡ ȡ सम ज अपन Ȳȡ क छ ड़न क f त य र ȣȳ@ ȡ[करन सहज ȣȳ, È ɉ सम ज क क बचपन स ȣ ȡ ȡज त ह Ȫ करन Ȳ Ǘ [ढ च ȣऐस ह ɉ Ȳè ȡ ȣ ह न ह यह ǔè Ǔ æ क Ĥ ȯ भ ग Ʌक यम ह ǒħ ȯ ȧएक Ǒ ȡĤè Ȫ ȡक उनक श स \ è ȡ_ Ǿ स हट Ǒ ȡगय ह, È ɉ ` Û ɉ ȯ ȡ [ Ǔ Ǿ स Ǒ ȡव Ǖǽ [ ȡǐ ɉक व तन Ʌअसम नत क ǕƧ ȡउठ य थ ऐस न त ȣब र ह आ ह और न ȣ] ȣब र च द Ǒ ȡj Ȳ ȧसफलत पर गदगद ह न ȡ ȣ ȡ ȡन, ȡ ȯपर Ʌरह ȣआध ] ȡ ȣक ȡè Ȳ [क लगभग नक र स Ǒ ȡ ह, È ɉ ɇ भ दभ व न एक म नद ड è ȡ कर Ǒ ȡ ह जह ɉ क f उनक

30 ȡ [ ȯğ, द यर और यह तक ȫ ȯभ Ǔ ǔæ ɇ@ऐस ɅÈ ȡयह सहज ह इस भ द क हट य ज सक Anaemia (Hindustan: )

31 Contraceptive Pills (Hindustan: ) High BP (Hindustan: )