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

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1 DAILY NEWS BULLETIN LEADING HEALTH, POPULATION AND FAMILY WELFARE STORIES OF THE Day Friday Pollution: Delhi pollution: In smog city, smoker s cough haunts non-smokers too (The Indian Express: ) 100% spike in number of patients with respiratory disorders: Doctors at Sir Ganga Ram Hospital Battling dirty air in Delhi: Government gasps; Odd-Even is back, next weekbattling dirty air in Delhi: Government gasps; Odd-Even is back, next week Amid clamour to save Delhi, many cities with worse air quality are forgottenamid clamour to save Delhi, many cities with worse air quality are forgotten What Delhi hasn t learnedwhat Delhi hasn t learned A sore throat, itchy eyes and a smoker s cough the smog has residents of Delhi gasping for every breath. Since Diwali, the out patient department (OPD) at Sir Ganga Ram Hospital one of the busiest in the capital has seen a 100 per cent rise in the number of patients with respiratory disorders. In 85 per cent cases, based on their X-ray reports, patients did not show symptoms of chronic respiratory ailments. Most have no history of respiratory diseases. As these otherwise healthy people are inhaling highly polluted air, irritants are causing inflammation and displaying symptoms such as sore throat, watery eyes and dry cough, Dr Arup Basu, senior consultant, Department of Chest Medicine at the hospital, said. As air quality in the national capital remained severe for the third day in a row, doctors manning OPDs at top hospitals across the city said more and more people have been coming in with chronic cough, sore throat and itchy eyes a reaction to the rise in pollution levels.

2 Elaborating that at least 80 per cent of at least 25 cases he handles on a daily basis are related to the deteriorating weather condition, Dr Basu said, Those who have a history of respiratory diseases such as asthma and chronic bronchitis they are leaning towards getting hospitalised. Some of them required an increased dosage of medicines they take regularly to treat the symptoms. However, there has been a 100 per cent spike in the number of people who have no history of such ailments. Moreover, we have also seen many patients complaining of lethargy and fatigue. This entire thing has picked up in the last one week. Explaining the reason, he said, When a person inhales toxic air, PM (particulate matter) 2.5 affects their brain and cardiovascular system. It is a gradual numbing of the system. Our eyes are sensitive to these pollutants and dust, which causes irritation and burning. IMA Declares Public Health Emergency State In Delhi Dr Tarun Sahni, who specialises in Internal and Hyperbaric Medicine at Indraprastha Apollo Hospital said since October 19, his OPD has seen an approximate increase of 35 per cent in the number of cases related to respiratory ailments. He pointed out that smoker s cough a chronic cough that presents itself only in those who smoke has been noticed among nonsmokers as well over the past week. A 16-year-old student had come to me with chronic cough. He is not a smoker. When we carried out a lung function test on him, we found that the chronic cough was due to the rise in pollution levels. This is how it is manifesting in most patients, Dr Sahni said. The two main pollutants PM 2.5 and PM 10 are very small. These particles go deep into the lungs and settle there. As a result, what happens to smokers is happening with almost everyone. As people are exposed to this air for a prolonged time period, foreign bodies enter the lungs and cause irritation. They damage the lungs and compromise immunity. People who are vulnerable children and the elderly are worst affected. But even those with strong immunity will get affected if the intake of this air is for a prolonged period, he added. Air pollution Air pollution kills 30,000 in Delhi every year (Hindustan Times: ) 8V6MbjDh6JC2PifATbSutO.html Air pollution is responsible for 10,000-30,000 deaths in Delhi annually and is the fifth largest cause of death in the country, states the Body Burden 2015 report released by the Centre for Science and Environment (CSE) on Tuesday. Air pollution is responsible for 10,000-30,000 deaths in Delhi annually and is the fifth largest cause of death in the country, states the Body Burden 2015 report released by the Centre for

3 Science and Environment (CSE) on Tuesday. Outdoor air pollution kills 6,20,000 people and indoor air pollution kills 1.5 million people in India annually. The report states that 53% of days in November were in the very poor air quality range and 47% were in the severe range, as per the National Air Quality Index. The way forward would be to reduce the source of air pollution. Currently, 60% of people in Delhi uses public transport, cycles or walks. It is important to revamp our transportation system and add to these numbers, said Sunita Narain, director general of CSE. The report says the use of solid fuels needs to be avoided in order to reduce indoor air pollution. As of 2010, 700 million Indians use solid fuels to light chullahs, which release smoke equivalent to 400 cigarettes every hour. Non-communicable diseases (NCDs) are a major killer with 98,16,000 succumbing to a lifestyle disease in Non-communicable diseases account for 40% of all hospital stays and 35% of recorded out-patient visits. The report says lack of clean drinking water facilities, climate change, degradation of forests, and use of fertilisers have taken a toll on the health of Indians. In India, 37.7 million people are affected by water-borne diseases annually and around 1.5 million children succumb to diarrhoea alone. In fact, on an average, every child below the age of 6 has 1.71 episodes of diarrhoea in rural India and 1.09 episodes in urban India. Climate change is another major problem leading to an increase in vector-borne diseases such as dengue and malaria. The report says the potential period of the spread of malaria has increased to months, which is up from 4-6 months a year.

4 Alzheimer s, dementia. A responsibility to care (The Indian Express: ) India must have a plan for looking after those stricken by Alzheimer s, dementia. Alzheimer s disease, which accounts for 60 to 80 per cent of dementia cases, is a progressive, degenerative brain disease affecting a person s memory, thinking, and the ability to interact socially. Unfortunately, there is yet no cure for it and scientists are still searching for causes of this disease which affects about one in 10 people over the age of 65 and almost one in four over 85 years. People under the age of 65 years also are prone to the disease which is known as early onset of Alzheimer s.

5 Certain estimates indicate there are over four million affected by dementia in India and as per the India Dementia Report 2010 about Rs 43,000 annually per family is spent to take care of a person affected by dementia. The cost is high for many. As the ageing of the population is rapidly increasing, the economic and social burden of the disease is going to rise in the coming years. Ways to reduce the burden of the disease need urgent attention particularly in countries like India, which along with China, has the highest number of older people and where geriatric services are under-developed and talking of mental health issues carries stigma. The World Health Organisation (WHO) global plan on dementia adopted at the 70th World Health Assembly in May this year prompts nations to take action now. It calls on governments to meet targets for the advancement of dementia awareness, risk reduction, diagnosis, care and treatment, support for care partners and research. Only 29 out of 194 WHO member countries have a plan of action on dementia, with India not having taken the initiative yet. Critically, countries need to take immediate steps to fight the disease as the treatment gap in most countries is huge and particularly in developing nations where the WHO estimates that only about 10 per cent of individuals are diagnosed Current treatments merely address the symptoms and not the underlying biological cause of the disease. Next year, dementia is projected to become a trillion-dollar disease and Alzheimer s Disease International (ADI) recommends spending at least 1 per cent of the global cost of dementia on public funding for dementia research. In India too, Alzheimer s and Related Disorders Society of India (ARDSI) calls for the government to have its plan or policy on dementia which must be implemented in all states and funded and monitored by the health ministry. ARDSI has been successful at in initiating a Kerala State Initiative on Dementia which is the first public-private partnership for dementia care and awareness. Kerala has the highest proportion of older persons in the country. It is also a state where many young people migrate leaving older parents behind to fend for themselves. Residential care centres for dementiaaffected people are limited. There is an urgent need to include dementia as a national health and social priority with provisions to identify dementia as early as possible and have adequate services for its treatment with sensitivity towards the care-givers, who are mostly from the family and ageing themselves. Garnering support from the corporate sector to fund programmes, especially training of care givers and initiatives for research on the disease, is the need of the hour. Support from the Ministry of Social Justice and Empowerment becomes crucial in India as the disease has many social aspects which need awareness and service facilities at the community level. Action on dealing with dementia calls for public health approach where social, health, legal and economic components for facing the various aspects of the disease need to be integrated. Legal provisions to safeguard and protect the rights, dignity and respect of those affected and in minimising economic costs and the burden of the disease, building public campaigns and

6 dementia-friendly initiatives are necessary in the next few years as the number of those affected by dementia will reach alarming proportions from 50 million people worldwide currently to three times the number by The Global Plan of Action on the Public Health Response to Dementia , adopted by 194 countries of the WHO, calls for a national dementia policy, recognition of human rights of people with dementia and the potential of dementia friendly-communities to give those rights practical effect. It is pertinent for India that the framework provided by the UN Convention of the Rights of Persons with Disabilities (CRPD) is monitored with regard to guaranteeing the rights of people with dementia. Living well with dementia is a health and social goal which should be maintained as part of the national response to the disease. An important aspect of action in dealing with dementia is to work towards risk reduction of the disease. The non-communicable diseases plan of action should include building resources for strengthening brain health by associating it with physical and spiritual health. Above all, it is important that there be focus on supporting people with dementia to maintain their independence as much as they can and retain their inclusion in families, community and society. Stop discrimination against them. The writer is associate professor, department of sociology, Maitreyi College, Delhi University and chair, Asia, International Network for Prevention of Elder Abuse (INPEA). Home Remedies (Hindustan: )

7 Diseases (Hindustan: ) 10&ed_code=1&ed_page=15

8 Cervical Cancer (Hindustan: )

9 Artificial Insulin (Hindustan: )

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11 Pollution Delhi smog raises number of patients with breathing problems (The Tribune: ) The alarming pollution in Delhi has led to at least 20 per cent increase in the number of persons complaining of cardiac/respiratory problems this week, officials said on Thursday. "There has been around 15 to 20 per cent increase in number of patients seeking treatment for respiratory and cardiac issues," All India Institute of Medical Sciences (AIIMS) Director Randeep Guleria told IANS. Similarly, Safdarjung Hospital witnessed a 15 per cent rise in number of patients while Fortis Hospital in Vasant Kunj area recorded 25 per cent increase in patients with breathing problems Sir Ganga Ram Hospital had on Wednesday indicated rise in number of such patients by 2530 per cent. The city has witnessed record pollution levels, including smog, affecting normal life and leading to closure of educational institutions in Delhi till Sunday. The Central Pollution Control Board data indicated average Air Quality Index (AQI) of Delhi on Tuesday at with major pollutant PM 2.5, or particles with diameter less than 2.5 mm, recorded at 418 units. It was the worst AQI after 403 recorded for October 20, a day after Diwali. Speaking to reporters earlier, the AIIMS Director had warned that about 30,000 persons may lose their lives in the National Capital Region alone due to current pollution levels, numbers which, he said, he had extrapolated from the number of hospital admissions. Guleria also likened the current environmental situation in Delhi with the "Great Smog of London in 1952" that was "estimated to have killed nearly 4,000 persons within a week". IANS

12 Food and Nutrition Long live the beans (The Tribune: ) A staple in almost every vegetarian household, this vegetable is fun to eat in more ways than one The good thing about people at work knowing my affinity towards food is that they usually offer me their food at all times. This in turn has broadened my horizon about how every household cooks one ingredient in different ways, especially when it comes to vegetables. So, when a colleague offered me phulkas with long beans curry, I chose to look the other way. I have never been a fan of long beans. Even when it was rustled with spicy pork fat, I would give it a miss. However, my colleague was hell-bent on making me taste his food and narrated how the aroma of the beans curry drew an elderly neighbour to his house. On hearing this I took a tiny bite, then I tore a quarter of the phulka, and then I reached for more. Long beans have got a new fan now. A vegetarian household like my colleague s will make sure they make hay while the sun shines. Long beans, known as lobia in Hindi, karamani in Tamil, alasanda kayalu in Telugu, lesera in Assamese, borboti in Bengali and alasande kayi in Kannada, is winter s gift to mankind. This is one vegetable which will show up only during the winter season. Doctors, health specialists and nutritionists mention long beans as a dietary must for vegetarians. Even though it comes in two varieties light green and red it is the green long beans which is mostly seen in the markets.

13 These beans, also known as Chinese snake beans, are also good to be eaten raw if they are grown in your own vegetable garden. Crunchy and full of soluble and insoluble fibres, they taste like sprouted moong. These fleshy, pendulous pods are usually harvested while they are immature and eaten as green vegetables. It helps provide sufficient amount of dietary fibre which can help reduce LDL cholesterol. They are also one of the finest sources of folates.also, long beans provide an average amount of minerals such as iron, copper, manganese, calcium and magnesium. The best way to choose long beans while buying is by twisting one end to see if it breaks easily just the way one selects their okra. Pneumonia Not Just Children but Adults too can't Escape the World's Leading Infectious Killer: Pneumonia (New Kerala: ) Despite being easily preventable and treatable, Pneumonia remains one of the leading causes of deaths in children and adults as well. Pneumonia is a disease which is generally associated with young patients, however, it majorly effects adults as well. According to the Center for Disease Control, 1 out of 20 adults who get pneumonia dies. Preventing pneumonia in the elderly a serious matter. Although vaccines and other preventative efforts are decreasing the burden of the disease, much more work is still required. Those living in poor communities are at highest risk of pneumonia. Patient with infectious pneumonia often has a productive cough, fever accompanied by shaking chills, shortness of breath, sharp or stabbing chest pain during deep breaths, and an increased rate of breathing. In the elderly, confusion may be the most prominent sign. According to Dr. Chandrashekhar Tulasigeri, Consultant Intensivist & Critical Care Physician, Fortis Healthcare, "Pneumonia cases can differ from each other because of many other factors that come into play. They can differ according to the 'Illness-Causing Agent', according to 'Where the Infection Was Acquired' and then there are other types of pneumonia that don't fall under the categories listed above. Regardless, it's still important to be vigilant and consult a physician or health expert when you notice symptoms of these infections since some diseases might lead to further harm." One of the most common infectious diseases which is an important cause of mortality and morbidity worldwide is community-acquired pneumonia (CAP). CAP is acquired in the

14 community, outside of health care facilities or within 48 hrs of admission to a hospital. In 2008, the WHO reported the highest burden of pneumonia to be from Asia. Majority of the cases i.e. 43 million were from the Indian subcontinent. 600,000 patients being hospitalized with pneumonia every year. Approximately 20% of patients are hospitalized due to a severe CAP, with the mortality rate being another 20%. Dr. Chandrashekhar Tulasigeri, Fortis Healthcare also mentioned, "Community-acquired pneumonia (CAP) is defined as pneumonia not acquired in a hospital or a long-term care facility. Despite the availability of potent new antimicrobials and effective vaccines. The annual incidence of CAP varies from 5-11 per 1,000 population with the rates being higher in the elderly." The mortality of CAP in India is comparable to that reported elsewhere in the world. The mortality rates are less than 1 5% in the outpatient setting but may be as high as 12% in hospitalized patients. In a study of 150 patients hospitalized with CAP, 8% (12) patients died in the hospital, while 2.7% (4) succumbed within 30 days of discharge. In another study consisting of 72 patients with CAP over 18 months, 14% of young and 35% of elderly patients died due to fulminant sepsis or respiratory failure. Other studies from India reported a variable mortality between 3.3% and 11%. Among hospitalized patients, the incidence of bacteremic pneumonia is 25% with a mortality rate of 20%. The incidence of infection peaks in winter and spring. India accounts for 23% of the global pneumonia burden and 36% of the WHO regional burden. National estimates may, however, hide significant sub-national disparities. Indian reports on the etiological agents of CAP are very few. CAP may be prevented by treating underlying illnesses increasing its risk, by smoking cessation and vaccination of children and adults. Smoking appears to be the single biggest risk factor for pneumococcal pneumonia in otherwise healthy adults. Pneumonia is a serious concern amongst adults and one needs to act fast to fight back this infectious killer. Diabetes: Men more prone to diabetes: Analysis (New Kerala: )

15 Men, beware! A retrospective data analysis reveals that men are more prone to diabetes than women. The data analysis done by SRL Diagnostics on more than 6.3 million samples collected to check blood sugars over past 3.5 years (2014 till mid-2017), unveiled that men accounted for 21% diabetes level blood sugar against 17.3% for women. Adults between the age of and (across genders) showed the highest prevalence of diabetes (26.71% and 27.01% respectively) across four zones in India. While, as per the city-wise analysis, Mumbai and Kolkata revealed the highest prevalence of diabetes (23.74% and 22.07%, respectively) as compared to other cities of India. "If diabetes continues to rise at its present fast pace, India may regain the ignominy of being the diabetic capital of the world, from China. It is a terrible prospect because the most affected would be the working population, which directly impacts their families. A joint study by Harvard School of Public Health and the World Economic Forum indicates global GDP loss due to diabetes is projected to be USD1.7 trillion between 2011 and As per International Diabetes Federation there are more than 69 million people in India suffering from diabetes, with about 3.5 lakh deaths attributed to this disease annually." Dr B.R Das, Advisor and Mentor - R and D and Molecular Pathology commented. "From tests to medicines, most of the cost for diabetes is directly borne by the individual. With rising healthcare costs and diabetes afflicting the near-retirement and post-retirement populace the most, the situation can worsen the disease's mortality rate. Extensive campaigns are required to boost awareness about the disease. It should be highlighted that diabetes can be controlled by adhering to a disciplined lifestyle and healthy eating habits," Dr Das added. As per the analysis amongst the four zones, western region of India showed higher percent (20.47%) of diabetes candidates. The analysis unveiled a total of 19.22% of all individuals tested in SRL Diagnostics across India have diabetes. The common tests used for diagnosing diabetes are Fasting Blood Sugar (FBS), Post Prandial Blood Sugar (PPBS) and Glycosylated Haemoglobin (HbA1c). The American Diabetes Association (ADA) 2017 guidelines were followed to declare a sample positive for diabetes. Higher than internationally-accepted-threshold values on any two of the three tests (abnormal: =126 mg/dl for FBS; =200 for PPBS or =6.5 for HbA1c) were considered to determine if an individual was diabetic.

16 Rheumatoid arthritis Study lists 33 foods proven to relieve rheumatoid arthritis (Medical News Today: ) Prunes are a great source of polyphenols and can help to ease inflammatory symptoms. A review of existing research, published in the journal Frontiers in Nutrition, lists foods that have been proven to relieve the symptoms of rheumatoid arthritis in the long-term. Rheumatoid arthritis is an autoimmune disease that affects approximately 1.3 million adults in the United States. The fact that it is an autoimmune disorder means that the body does not recognize its own healthy cells and attacks them as though they are foreign. This causes inflammation in the joints, which translates into stiffness, swelling, pain, and sometimes even misshapenness. So-called disease-modifying antirheumatic drugs are normally the first line of treatment for this condition, for which there is no known cure at the moment. If a person living with rheumatoid arthritis does not react well to these drugs, so-called biological response modifiers, or "biologicals," are the second-line treatment option. However, as the authors of the new review point out, biologicals are expensive and can have serious side effects. So, researchers from the Kalinga Institute of Industrial Technology (KIIT) in Bhubaneswar, India, set out to explore dietary alternatives to medication. Dr. Bhawna Gupta, together with Shweta Khanna and Kumar Sagar Jaiswal at KIIT's Disease Biology Lab in the School of Biotechnology, reviewed "research from several laboratory experiments under different conditions." They narrowed down their findings to 33 foods proven to ease rheumtoid arthritis symptoms and slow down the progression of the disease. The study is only the second one to make an overall dietary assessment for this disease, and these researchers strictly picked out the foods that were clearly proven to have long-lasting benefits. "Supporting disease management through food and diet does not pose any harmful side effects and is relatively cheap and easy," Dr. Gupta explains.

17 Whole grains, legumes, fruits, and spices The authors list the foods, grouping them under eight categories: fruits, cereals, legumes, whole grains, spices, herbs, oils, and "miscellaneous." Fruits include prunes, grapefruits, grapes, blueberries, bananas, pomegranate, mango, peaches, and apples. Cereals include whole oatmeal, whole-wheat bread, and whole rice, while the whole grains section adds corn, rye, barley, millets, sorghum, and canary seed to the mix. Early signs and symptoms of rheumatoid arthritis Early signs and symptoms of rheumatoid arthritis Rheumatoid arthritis often goes undetected and can progress quickly in the first few years. Here's our guide to the first signs and symptoms. READ NOW Spices including turmeric and ginger olive oil, fish oil, green tea, and yogurt are also among those listed as beneficial. These can reduce the level of cytokines, or substances secreted by the immune cells that can cause inflammation in people with rheumatoid arthritis, and reduce oxidative stress, thereby improving the body's ability to fight off toxins. "Regular consumption of specific dietary fibers, vegetables, fruits, and spices, as well as the elimination of components that cause inflammation and damage," says Dr. Gupta, "can help patients to manage the effects of rheumatoid arthritis." "Incorporating probiotics into the diet can also reduce the progression and symptoms of this disease," she adds. "Patients suffering from rheumatoid arthritis should switch from omnivorous diets, drinking alcohol, and smoking to [adhering to] Mediterranean, vegan, elemental, or elimination diets, as advised by their doctor or dietician." Dr. Bhawna Gupta "Our review focused on specific dietary components and phytochemicals from foods that have a proven beneficial effect on rheumatoid arthritis," says Dr. Gupta. The researchers also suggest that their findings could be used to develop alternative medicines. "Pharmaceutical companies may use this information to formulate 'nutraceuticals.' Nutraceuticals have an advantage over chemically tailored medicines as they are not associated with any side effects, originate from natural sources, and are cheaper," explains Dr. Gupta.

18 However, the authors also caution people with rheumatoid arthritis against incorporating these foods into their diet too readily, or on their own. "Dietary components vary according to geography and weather conditions," says Dr. Gupta, "so patients should be aware of their nutritional requirements, allergies, and any other foodrelated disease history." "We strongly suggest [that] the general public consult doctors and dieticians before following any diet program or food compounds discussed in the study," she concludes. Dementia risk? Could lupus raise dementia risk? (Medical News Today: ) People living with lupus may be at significantly greater risk of developing dementia than those without the autoimmune disease, a new study suggests. Lupus is a chronic condition wherein the immune system mistakingly attacks the body's healthy cells and tissues. It is estimated that around 1.5 million people in the United States have lupus, and around 16,000 new cases of the disease are reported across the country each year. Lupus is more likely to strike women than men, and most people who develop the condition are between the ages of 15 and 44. Systemic lupus erythematosus (SLE) is the most common form of lupus. This can cause damage to the joints, skin, lungs, kidneys, and blood vessels, which may lead to conditions such as kidney failure, arthritis, and seizures. Research has also previously suggested that people with lupus are more likely to have problems with memory. The new study builds on such findings, after uncovering a possible link between lupus and an increased risk of dementia. Study co-author Daniela Amital, of the Sackler Faculty of Medicine at Tel Aviv University in Israel, and colleagues recently reported their results in the International Journal of Geriatric Psychiatry. Dementia risk increased by 51 percent The team came to its findings by analyzing information from the Clalit Health Care database, which includes the data of more than 4.4 million people in Israel.

19 The researchers identified 4,886 individuals who had received a diagnosis of SLE, and these were matched by age and sex in a 1:5 ratio to 24,430 people without the condition (the controls). The incidence of dementia was assessed for each group. Lupus risk almost three times higher after trauma Lupus risk almost three times higher after trauma Researchers suggest that trauma could triple the risk of lupus. READ NOW The study revealed that people with SLE were 51 percent more likely to develop dementia than people without SLE, and this association persisted across all age groups. Based on their results, the researchers conclude that "systemic lupus erythematosus is significantly associated with dementia." Dementia is an umbrella term for a plethora of conditions that affect cognitive abilities, including learning and memory. Alzheimer's disease is the most common form of dementia, accounting for around percent of all cases. According to the World Health Organization (WHO), there are around 47 million people living with dementia across the globe, and this number is expected to soar to 75 million by The precise causes of dementia are still unclear, but Amital and colleagues suggest that SLE could be one culprit. They say: "This finding should give rise to search for SLE in patients with an ambiguous cause for dementia, especially those with an early-onset cognitive decline." Biomedical Science (Dainik Gagaran: )

20 Health Care: (Dainik Gagaran: )

21 Dental Health (Dainik Gagaran: )

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