1. HEALTH AND DISEASES a) TUBERCULOSIS

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1 1. HEALTH AND DISEASES a) TUBERCULOSIS i) Tuberculosis is an infectious disease that usually affects the lungs. Compared with other diseases caused by a single infectious agent, tuberculosis is the second largest cause of deaths. ii) It was discovered by the German microbiologist Robert Koch in iii) The World Health Organization estimates that 9 million people a year get sick with TB, with 3 million of these go untraced. iv) TB is an airborne pathogen. Types of tuberculosis Latent TB - the bacteria remain in the body in an inactive state. They cause no symptoms and are not contagious, but they can become active. About 33% people in the world are believed to have latent TB. There is a 10 percent chance of latent TB becoming active, but this risk is much higher in people who suffer from HIV or malnutrition, or people who smoke. Active TB - the bacteria do cause symptoms and can be transmitted to others. The symptoms of active TB include the following: Coughing, sometimes with mucus or blood Chills Fatigue Fever Loss of weight Loss of appetite Night sweats Multidrug-resistant TB (MDR-TB) - Some TB strains have become resistant to the antibiotics used against them over a period of time. This has given rise to MDR-TB. Multidrug-resistant TB (MDR-TB) arises when an antibiotic fails to kill all of the bacteria, with the surviving bacteria developing resistance to that antibiotic and often others at the same time. What causes tuberculosis? The Mycobacterium tuberculosis bacterium causes TB. It is spread when a person with TB coughs, sneezes, spits, laughs, or talks. TB is contagious, but it is not easy to catch. The chances of catching TB from someone you live or work with are much higher than from a stranger. Most people with active TB who have received appropriate treatment for at least 2 weeks are no longer contagious. TB affects organs other than lungs too TB infecting the bones can lead to spinal pain and joint destruction TB infecting the brain can cause meningitis

2 TB infecting the liver and kidneys can impair their waste filtration functions and lead to blood in the urine TB infecting the heart can impair the heart's ability to pump blood, resulting in a condition called cardiac tamponade that can be fatal Diagnosis of tuberculosis The most common diagnostic test for TB is a skin test where a small injection of PPD tuberculin, an extract of the TB bacterium, is made just below the inside forearm. The injection site should be checked after 2-3 days, and, if a hard, red bump has swollen up to a specific size, then it is likely that TB is present. Unfortunately, the skin test is not 100 percent accurate and has been known to give incorrect positive and negative readings. Treatments for tuberculosis The majority of TB cases can be cured when the right medication is available and administered correctly. Antibiotics are usually required to be taken for a relatively long time. The standard length of time for a course of TB antibiotics is about 6 months. Directly observed therapy (DOT) may be recommended. This involves a healthcare worker administering the TB medication to ensure that the course of treatment is completed. Prevention of tuberculosis If you have active TB, a face mask can help lower the risk of the disease spreading to other people. A few general measures can be taken to prevent the spread of active TB. Avoiding other people by not going to school or work, or sleeping in the same room as someone, will help to minimize the risk of germs from reaching anyone else. Wearing a mask, covering the mouth, and ventilating rooms can also limit the spread of bacteria. The new diagnostic tool The diagnostic tool, Truenat MTB, which uses sputum samples for diagnosing TB is being tested in the field in 100 designated microscopy centres in 50 districts in 10 States. The one-month study will look at nearly 18,000 samples and the results are expected next month. The diagnostic tool has already been installed in 80% of designated microscopy centres for testing. Comparison between GeneXpert and Truenat FACTOR GeneXpert Truenat Amount of sample required 1 ml 0.5 ml Cost comparison Costlier Cheaper by approx. 50% Technology Cartilage-based Chip-based (thus environmental friendly) Retest (if required) Patient to be recalled, thus chances of drop-out as the patient may not return Portion of the initially acquired sample can be used, hence drop-out can be avoided.

3 Analysis India According to the Out of Step report released by Médecins Sans Frontières (MSF) and the Stop TB Partnership, in 2015, following observations have been made: 1. India accounted for nearly 2.8 million (27%) of the 10.4 million new tuberculosis (TB) cases in the world, and 0.48 million (29%) of the 1.8 million TB deaths globally. 2. Both the private and public sector in India heavily rely on smear microscopy as the initial diagnostic test despite smear microscopy s ability to diagnose only about 50% of the positive cases. 3. India continues to use intermittent dosing (thrice weekly) during the intensive phase of treatment. Compared to the daily regimen, the thrice-weekly approach increases the drug resistance risk by more than three times. 4. Only 21% of people with multidrug-resistant TB (MDR-TB) in India are on treatment relative to the estimated incidence. India is yet to make the shorter MDR-TB regimen as part of India s national TB control policy. 5. India has a huge gap between the estimated and detected cases (41%). The gap between estimated and notified cases is made up of two groups one is the undiagnosed TB, and the other is the group that is managed in the private sector but not notified to the national TB control programme. b) DENGUE Dengue fever, also known as breakbone fever is a mosquito-borne infection that causes a severe flulike illness. There are currently no vaccines for dengue fever. The best way to prevent the disease is to avoid being bitten by mosquitoes altogether. Dengue is transmitted between people by the mosquitoes Aedes aegypti and Aedes albopictus, which are found throughout the world. Symptoms of dengue fever vary depending on the severity of the disease. Mild dengue fever The symptoms of mild dengue fever are: aching muscles and joints body rash that can disappear and then reappear high fever intense headache pain behind the eyes vomiting and feeling nauseous Dengue shock syndrome This is the worst form of dengue and can also result in death; mild dengue fever symptoms may appear, but others likely to appear are: intense stomach pain

4 disorientation sudden hypotension (fast drop in blood pressure) heavy bleeding regular vomiting blood vessels leaking fluid death Why in news? Polymerase Chain Reaction (PCR) Laboratory has tied up with the Indian Institute of Technology, Bombay to track down some biomarkers in order to predict how dengue will progress in a particular patient. Biomarkers are indicators that help in determining the presence or severity of a disease. The advantage of using biomarkers in this case is that we can know in advance how a disease will progress. This will bring down unnecessary hospitalisations and help in avoiding unnecessary platelet transfusion. C) Increasing Drug-resistance in Swine Flu cases Oseltamivir and Zanamivir were taken off the restrictive Schedule X of the Drugs and Comestics Rules and have been placed under Schedule H1. Doctors have also been advised by the central health authorities to prescribe the drugs based on strong symptoms, without opting for the swab test. Medical experts say these decisions could lead to misuse and eventually, severe drug resistance. Oseltamivir and Zanamivir are antiviral drugs that block the actions of influenza virus types A and B in the body. While Oseltamivir is available as tablets, Zanamivir comes in powder form. Schedule X Drugs Schedule X is a class of prescription drugs in India appearing as an appendix to the Drugs and Cosmetics Rules introduced in 1945.These are drugs which cannot be purchased over the counter without the prescription of a qualified doctor. Also, the retailer has to preserve the prescription for a period of two years. Schedule H1 Drugs The schedule is primarily intended to control the rampant use (that probably includes a large component of misuse through over-the-counter (OTC) dispensing) of antibiotics in India. 2. CLIMATE CHANGE a) Mangroves Mangrove Forest Cover Changes in Indian Sundarban ( ) Using Remote Sensing and GIS, a publication by the School of Oceanographic Studies, Jadavpur University, reveals that from 1986 to 2012, sq. km. mangrove forest cover has been lost. The loss in the mangrove forest in the Indian Sunderbans is about 5.5 %.

5 Reasons: 1. Climate change and sea level rise has contributed to the phenomenon of losing land, including mangrove forests in the Sundarbans, in the last part of the 21st century. 2. A critical minimal inflow of freshwater is necessary for the growth of mangroves. When freshwater inflow is missing, there is a change in mangrove succession, and freshwater loving species of mangroves are replaced by salt-water loving ones. Possible Impacts: 1. The continuation of this process in response to climate change and sea level rise poses a serious threat to the carbon sequestration potential and other ecosystem services of this mangrove forest in future. 2. The immediate impact of salinity will be on the fishing community, where commercially sought after fish species will be replaced by fish that does not have as much market value. 3. Mean sea level rise can be considered a driving factor for coastal erosion, coastal flooding, and an increase in the number of tidal creeks. 3. GOVT SCHEMES a) Jigyasa 1. The programme will be carried out by the Council of Scientific and Industrial Research and Kendriya Vidyalaya Sangathan. 2. It will to enable KV students a hands-on experience of working in CSIR laboratories across the country and will inculcate a culture of inquisitiveness, on the one hand, and scientific temper, on the other, among school students and their teachers. 3. The programme will connect 1,151 Kendriya Vidyalayas with 38 CSIR laboratories and benefit one lakh students and nearly 1,000 teachers annually.