Category: Health

GOA: Mental health has become a problem not  My Update Web only in India but also globally. With illnesses ranging from minor depression to conditions like Alzheimer’s, Parkinson’s, schizophrenia prevalent, there is no denying that it’s time that we came out of the closet.


As per the World Health Organization’s (WHO) estimate, diseases related to mental health are the leading cause of disability in the world today. Nearly 75% of the total number of cases start in an individuals’ early 20’s.
India is not untouched by this silent killer. According to a report, one in every five Indians suffers from depression. Other afflictions, such as suicides and bipolar disorders, are also on the rise.
In order to address the issue and to underscore the importance of mental health, WHO celebrates ‘World Mental Health Day’ annually on October 10.
The theme for this year was ‘Psychological first aid’. National Mental Health Week is also observed in India from October 8 to 15 to make people aware of the magnitude of mental health problem in India.
The prevalence of depression among Indians is around five per cent, and, for a country like India, this is a huge number. A majority of the cases go undiagnosed and people are forced to suffer in isolation.
Social factors like poverty, unemployment, lack of social security and societal stress act as a trigger for the illness to set in and reasons like cultural and religious beliefs, lack of awareness, infrastructure, and trained professionals, and the stigma associated with mental illness, stops people from getting treatment at an early stage.
Unlike other diseases, a person’s mental health also affects his general health, social and personal life, and even the quality of life. According to an estimate, people with mental illness die 10-12 years earlier than others would. Social awareness among people in the community and counseling for family members, relatives and friends do wonders in the outcome of treatments.
In this new age world, where accidents, natural calamities, wars, conflicts, migrations, refugees, unemployment and relationship-related stress take a heavy toll on mental health, it is imperative for us to reach out to those suffering in order to stem mental illness.
Psychological First Aid (PFA) is a humane, supportive and practical approach for people exposed to serious stresses and who may need support. It is an approach to help people recover by responding to their basic needs and showing them concern and care in a way that respects their wishes, culture, dignity and capabilities. PFA is involved in giving non-intrusive practical care and support, assessing people’s needs, providing them with basic requirements like food and water, listening but not pressuring to talk, and comforting and protecting people from further harm.
People from the general community, who are mostly considered to be the first contact in crimes such as health workers, teachers, firefighters, police officers and social workers act as givers of PFA.

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Representational image. ReutersEven as Delhi hobbles back to Net Maddy  normalcy after the chikungunya and dengue health scare that reached endemic proportions last month, the national capital faces yet another health exigency in the form of bird flu.
The government is monitoring bird sanctuaries and the Gazipur Murga Mandi, the sole meat market that caters to the entire city.
“Samples from the mandi and other sources have been sent for testing to Regional Disease Diagnostic Laboratory (RDDL), Jalandhar and High-Security Animal Disease Laboratory (HSADL), Bhopal and the results are expected on Saturday,” a government source said.
It remains to be seen if the rickety health services system of the city (and the country) — that was found wanting just a few weeks back during the dengue and chikungunya outbreak had hit the population — will be prepared enough to deal with a crisis if any.
Representational image. ReutersRepresentational image. Reuters
However, ever since the first outbreak of bird flu in India a decade ago — in Gujarat and Maharashtra in February 2005 — India has never had a human case of H5N1 viral infection even though there has been an outbreak of the disease almost every other year.
Delhi’s development minister Gopal Rai has requested the citizens to not panic as the virus doesn’t seem to have entered the food chain yet.
Despite the minister’s reassurance, is there no cause for concern?
A stroll around any area of the city is enough proof that municipal services in the city are not at their international best, as should be the case considering that Delhi is the capital of a nation that is being heavily promoted as an investment destination globally. Is Delhi ready to take on the world as a global capital or is just another Third World city that has more negatives than positives?
The Supreme Court too has come down heavily on the AAP government on garbage piling up in the city and for poor sanitation. The apex court has expressed concern over bird flu scare in the national capital.
While the bird flu panic is slowly spreading, the experts strongly feel that it’s high time that the government should come up with an advisory with ‘dos’ and ‘don’s’ on bird flu.
“The central government should issue an advisory with ‘dos’ and ‘don’s’ to combat bird flu across the country. It’s not just limited to Delhi. District magistrates and district forest officials should be sensitized. Moreover, awareness regarding avian flu needs to be created especially for children, so as to avoid any panic,” Anand Arya, an environment expert, specializing on birds told Firstpost.
Source of avian (bird) flu scare
The scare of avian flu ( the official name of bird flu) originated in Delhi after the Delhi zoo reported over a dozen of dead birds on its premises. It was followed by the death of birds at Deer Park, Hauz Khas and near a water body at Sundar Nagar. Besides, local birds, migratory birds died in zoo premises. While the RDDL Jalandhar detected symptoms of the virus in the samples of carcasses of birds tested, Bhopal’s HSADL confirmed H5N1 virus in three birds. H5N1 is the virus that causes bird flu.
– Delhi Zoo: 12 birds found dead. (Of these three are confirmed bird flu cases).
– Deer Park: 5 birds found dead.
– Sundar Nagar: 3 crows found dead.
– Gwalior Zoo: 15 birds found dead. (The aerial distance between Gwalior and Delhi is only 285 km).
Source of Bird flu virus (H5N1)
Bird flu virus already exists in dormant state in India, Bangladesh, Pakistan, China and Russia border. It can become active. The other source is a migratory bird. The virus infects and kills wild birds and domestic poultry.
“Nearly 225 migratory species visit India every year and it starts in September. We get migratory birds in almost all the 7.57 lakh wetlands in the country. It’s serious if any of the flock gets infected,” said Arya.
Past incidents
– First confirmed and notified case of H5N1 outbreak in India was reported in Gujarat and Maharashtra in February 2005.
– The second outbreak — a major one was in March-April 2006 in Madhya Pradesh — where more than 10 lakh poultry birds were culled.
– In 2007, it was in Manipur, followed by West Bengal in 2008. More than 40 lakh birds were killed in Bengal.
– In the consecutive years, the outbreak occurred in Tripura, Odisha, Sikkim, Assam and Bihar.
– The last bird flu outbreak was reported in 2015 in Kerala.
– In 2005, 50-60 birds were found dead at Okhla Bird Park in Delhi, which created a panic. However, after post-mortem, it was found that the birds died after consuming poisonous feed used to catch fish.
– In India, no case of bird flu infecting human has been reported yet.
– Large-scale culling of poultry birds took place in a decade causing huge financial loss to poultry business.
Can I consume egg and chicken?
According to experts, no case of bird flu has been reported in poultry so far. It’s safe to consume properly cooked egg and chicken.
“Most bacteria and virus can’t survive high heat. Instead of consuming cold meat, it’s preferable to have properly cooked, roasted chicken and eggs in the form of boiled and omelet,” advised Arya.
What government has done so far?
– Delhi government has started a helpline number (011-2389 0318) where citizens can report cases of bird flu and seek help.
– A large number of samples has been taken from zoos, bird sanctuaries, and poultry markets and sent for testing.
– Municipal corporations have deployed teams to check flu.
– Delhi government is keeping a strict vigil on poultry market.
– Delhi minister Gopal Rai said that Delhi government is well-equipped with medicines to deal with the situation.
– Central Zoo Authority is conducting inspection of zoo enclosures.
– Delhi Zoo and Deer Park have been shut down.
Precautionary measures
According to medical experts, one shouldn’t touch a dead bird or the carcass and keep a safe distance. It should immediately be reported to authorities concerned.
Physical contact with bird droppings should be avoided, because any bird can be an infected one. Extreme care should be taken while cleaning droppings because most human infection is from close contact with sick or dead infected poultry or droppings.
– Any one suffering from fever must take medical advice.
– Avoid spreading of rumors and panic.

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AHMEDABAD: Dr. Ketan Desai, the new NetWork Posting president of World Medical Association (WMA), issued a strong warning about continued political attempts around the world to marginalise the autonomy and self-governance of the medical profession.


“In many countries including Turkey , India, and the United Kingdom, there are continued political attempts to undo or marginalize the autonomy and self-governance of the medical profession,” Dr. Desai, who hails from Gujarat, told delegates from 40 national medical associations in his inau gural speech at WMA’s annual assembly in Taiwan on Friday .
“Regulation of clinical practice, framing of evidence-based standard treatment guidelines, defining and checking professional malpractice and medical education -professional independence is vital for all.The WMA must continue to be alert against government attempts to usurp professional independence through bureaucrats and politicians,” Dr. Desai, former presi dent of Medical Council of India (MCI), said. Dr. Desai also called for more protection for physicians, whether in war or civil conflict situations.

He also warned that professional honesty and integrity were at risk in many countries as physicians were prescribing drugs or referring patients based on `kickbacks’. “Physicians should not go by any financial or other consideration in referring patients to laboratories, pharmacies or opticians,” Dr. Desai said.
“There is a need to create a World Health-Keeping Force along the lines of the World Peace-Keeping Force.National medical associations could join hands and create such an `international health-keeping force’ under the aegis of the WMA,” Dr. Desai said.

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Informal practitioners, who On Dav operate without formal
Informal practitioners, who operate without formal medical training, form a majority of Indias rural healthcare workforce, addressing patients health care needs where government sources may be less accessible.
They treat patients with conditions that can be managed in a primary care setting, refer patients with serious conditions to higher level care, and diagnose and manage patients with chronic conditions.

However, it is contentious whether these practitioners should be integrated with the health system, and if so, what might be the best way.
The study, meanwhile, also suggests that training informal health providers can also help address the manpower shortage in the health sector.
“The low costs of training Planet Amend  imply that permanently hiring 11 additional fully trained MBBS providers into the public sector would be as costly as training 360 informal providers every year through this programme,” it says.
The study used a randomised evaluation methodology, by selecting 152 of the 304 informal providers from 203 villages in Birbhum to participate in the training programme.
“Using unannounced standardised patients (mystery patients) and clinical observations, researchers assessed the impact of the training on informal providers clinical practice. Further, researchers benchmarked these practices with those of public health providers in the same area,” the J-PAL said.
The West Bengal government has issued an order to train the first batch of 2,000 practitioners over a six-month period, which is in the process of being rolled out across 35 centres. Rural healthcare providers will be trained in batches of 50 by nurses teaching at nursing training centres across the state, J-PAL South Asia said.
“This study is not only relevant for West Bengal but for other states too, such as Madhya Pradesh and Uttar Pradesh; as the structure of the informal provider market is often found to be similar ?- both in terms of their widespread presence in the community and the knowledge gaps they face,” Banerjee said.
However, the training “did not lead to a decline” in the use of unnecessary medicines, antibiotics or injections among providers who were trained. Nonetheless, both trained and untrained informal providers were less likely to give unnecessary medicines and antibiotics relative to doctors in the public sector, the study further said.
“Finally, the training increased the patient load of the provider, and it is estimated that the resultant increase in revenue would allow the informal practitioners to recover the cost of the training in anywhere between 66 and 210 days,” it added. PTI KND SMN DIP

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NAVI MUMBAI: A day Our Planetary  after an elephant died during a film shoot on Friday, an initial finding of a post-mortem has shown that it had been ailing due to multiple stones in the gall bladder and liver. Animals rights activists also claimed that several notices had been sent to the owner of the elephant since 2013 over the poor health condition of two jumbos in his care.

The elephant, Roopkali alias Roopa was aged between 38 and 40. She was brought to Film City in Goregaon for a photo shoot. She collapsed and died before the shoot could begin. A detailed medical report listing the cause of death will be released within a couple of days.
An autopsy was conducted by veterinary surgeon of Sanjay Gandhi National Park, Dr. Shailesh Pethe, and a pathologist from Bombay Veterinary College. Their preliminary report states: “The cause of death seems to be multiple gall bladder and hepatic calculi (stones) leading to hepatic failure and toxemia.” In simple words, this means that there were stones in the gall bladder and the liver, leading to liver failure and internal poisoning.
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Activists expressed shock that the elephant was being made to work for a film shoot despite having such a serious ailment. “The preliminary findings of the post-mortem clearly indicate that Roopkali was seriously ill, but was still taken for a photo shoot,” said activist Pawan Sharma of Resqink Association for Wildlife Welfare. “We will ask the forest department to lodge a complaint against those responsible.”
Another activist, Sunish Subramanian of Plant and Animals Welfare Society, said that the elephant owner, SabashankarPandey who lives in Dahisar, had been issued notices by Animal Welfare Board of India and the forest department over the last three years, threatening to cancel the licence of his elephants, Roopkali and Laxmi, due to poor health. “But he managed to keep their licenses,” said Subramanian. He claimed that Pandey had assaulted him in 2014 when he objected to the use of one of his elephants at a religious function.

Chief conservator of forests, N Vasudevan, told TOI: “After we get the final autopsy report, appropriate action will be taken. We are also studying various documents and certificates that Pandey has relating to the elephant.”
Secretary of Bombay Society for Prevention of Cruelty to Animals, Lt Colonel JC Khanna, said, “Generally speaking, movement of elephants has been curtailed on the city streets following a high

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CHENNAI: The cyber-crime wing Owner Busines of the Chennai city police on Friday registered two separate cases against social activist K R ‘Traffic’ Ramaswamy and his assistant, Fatima, for allegedly spreading rumours about the health condition of Tamil Nadu chief minister J Jayalalithaa+ who is undergoing treatment at Apollo Hospitals in Chennai.
The police registered cases against Ramaswamy and his assistant based on the complaints filed by activist Kishore K Swamy and AIADMK worker Vijaya Raj.

The police booked them under sections 153 (wantonly giving provocation with intent to cause riot) and 505 (1) (b) (with intent to cause, or which is likely to cause, fear or alarm to the public) and 505 (c) (with intent to incite, or which is likely to incite, any class or community of persons to commit any offence) of the Indian Penal Code.
The police have registered 58 cases against people for their posts on social media+ about Jayalalithaa’s health condition. They have arrested eight people so far, the latest to be arrested being a 28-year-old shopkeeper in Tuticorin identified as Sagayam.

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The county of Northumberland Page Design Hub in north England – known for quality and integrated healthcare – has signed a memorandum of understanding to share expertise as part of the Indo-UK Health Programme linked to the Narendra Modi government’s Smart City project.
The Northumbria Healthcare NHS Foundation Trust and Northumberland County Council signed the MoU with Indo-UK Healthcare Pvt Ltd (IUHP), officials announced here on Tuesday.
The area is reputed to provide some of the best and fully integrated services in Britain’s National Health Service. The model creates a seamless experience for patients by integrating acute hospitals (including emergency services), community services and care delivered at home.
“This is an important milestone in our vision to transform the health of millions of Indian citizens. Northumbria provides outstanding high-quality integrated health and social care for its residents,” Ajay Rajan Gupta of IUHP said.

“This is exactly the experience we need to take forward our own plans. We want to take the very best that the NHS has to offer across to India and there is no doubt Northumbria is the best at what it does.”
The Indo-UK Institute of Health programme is considered one of the world’s largest healthcare initiatives. It aims to transform the provision of quality healthcare and medical education services across India.
The programme will deliver a staged rollout linked to the Smart City project across 100 cities and involve the setting up of 11 Indo-UK Institutes of Health Media cities along with 89 Indo-UK Clinics.
Daljit Lally of the Northumberland County Council said: “India has one of the largest populations in the world so the pressures on its healthcare system are enormous. Whilst our primary goal is to share how we have developed such a pioneering approach to delivering integrated care in Northumberland, I have no doubt that we will also learn a great deal which will benefit the NHS.”

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Image result for health indiaGURGAON: After Haryana Civil Medical Services (HCMS) Association doctors at government hospitals threatened to go on indefinite mass leave from October 27, workers under the National Health Mission (NHM) have also called an indefinite strike from October 25.
It’s yet another challenge for a government Page Design Pro  that is gearing up to launch a year of celebrations to mark Haryana’s golden jubilee.

In a meeting on Saturday evening, the NHM workers decided to launch a massive protest from October 25. NHM employees have been demanding permanent jobs in the state health department. “The state government has been ignoring our demands for the last 18-20 years,” a statement from NHM Haryana said.
Although NHM employees are hired after going through a proper interview procedure like in the case of permanent doctors, they do not get permanent status, according to NHM workers. “We want the government to initiate the process to make all NHM employees permanent. We want salaries on a par with those of the permanent employees,” the statement said.
Dr. Atul Gijwani, a general secretary of NHM Haryana, told TOI, “It is the gross injustice. We have been working for the last 18 years dedicatedly in the health department, but we are not entitled to equal pay and many benefits that permanent employees get in the department,” Gidwani said.
There are 12,000 NHM workers in Haryana, of which 650 are in Gurgaon. NHM workers serve at all the levels right from doctors to Class IV workers. The NHM program was started in Haryana in 2005 under National Rural Health Mission.Chief medical officer Pushpa Bishnoi remained unavailable for comment.

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Obese people risk getting diagnosed with Page Design Shop  heart disease, diabetes, inflammation and other disorders, if they are discriminated in society, finds a study conducted by an Indian-origin researcher.
The study suggested that those who experienced weight discrimination over a 10-year period had twice the risk of high allostatic load — the cumulative dysfunction of bodily systems from chronic stress.
The researchers focused on respondents who regularly reported experiencing discrimination because of their weight and asked whether they were treated discourteously, called names, or made to feel inferior.
“It is a pretty big effect. Even if we accounted for health effects attributed to being overweight, these people still experience double the risk of an allostatic load because of weight discrimination,” said Maya Vadiveloo, Assistant Professor at the University of Rhode Island, in the US.

According to the researchers, the findings, published in the August issue of Annals of Behavioral Medicine, expose flaws in society’s approach to weight control.
“Our paper highlights the importance of including sensitivity and understanding when working with individuals with obesity, and when developing public health campaigns,” Vadiveloo said.
People who experience weight discrimination often shun social interaction and skip doctor visits, the study reveals.
“There is so much shaming around food and weight. We need to work together as a nation on improving public health and clinical support for individuals with obesity and targeting environmental risk factors,” the researcher said.

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Odisha’s Institute of Medical Sciences and Planet reporter  SUM Hospital mishap appears like a shrill alarm. The country’s comatose health system is in desperate need of a lifeline. The hospital accident should not be considered merely as another case of negligence in the long history of medical tragedies in India. Hospitals cannot be graveyards.
Is Right to Health the answer to all our ills? Will medical disasters end once every citizen enjoys healthcare as a fundamental right?
The NDA government has, in its draft National Health Policy 2015, proposed a “National Health Rights Act, which will ensure health as a fundamental right, whose denial will be justifiable”. Undoubtedly, the merits of such a legislation cannot be denied. Countries like Brazil and Thailand got more teeth to implement universal healthcare due to the presence of such laws. We also have the success stories offered by our own Right to Education Act (2010) that has contributed substantially to the increasing literacy rates and making education more accessible and inclusive.
But the road to legislation still appears very long, and may not address all the challenges of the health system. The SUM Hospital tragedy has once again put the spotlight on the government’s commitment to healthcare.
India, according to the World Health Organisation, accounts for 21 percent of the world’s global burden of diseases. It witnesses the highest number of maternal, newborn and child deaths in the world. Nearly 36 percent Indians suffer from depression in a nation that has 0.47 psychologists per million people. For an Indian, the probability of dying, between ages 30 and 70, from four major non-communicable diseases (cancers, cardiovascular diseases, chronic respiratory diseases, and diabetes) is close to 26 percent. One World Bank report (2010) even argues that we lose close to six percent of our GDP every year due to premature deaths and preventable illnesses.
The SUM Hospital fire has exposed the fragile health system of our country. Initial investigations have revealed that this super specialty hospital did not have a fire clearance certificate even though it has been operational for almost a decade. Its website claims that it provides “global standard health care services”, yet the 750-bed hospital did not have a functional sprinkler system to fight the fire. Its staff too was untrained to handle an emergency of that scale and magnitude.
A large number of hospitals across the country (several private and some government) lack functional sprinkler systems. For decades, we have been struggling with overcrowded, understaffed, poorly maintained and appallingly unhygienic government hospitals. Twin-sharing of beds is today an accepted norm in many government hospitals.
Since the early 1990s, the private sector has been touted as the only alternative to India’s healthcare crisis. But in the absence of a clear regulatory mechanism, the performance of private hospitals has been both terrible and terrifying. In 2011, nearly 90 people died in a huge fire in AMRI Hospital, a Kolkata private hospital. In June 2016, an inter-state kidney racket was busted in Apollo Hospital, New Delhi. In September 2016, a private hospital, along with two orthopedics, was asked to pay Rs 25 lakh to a patient who had suffered 40 percent disability due to medical negligence.
A healthcare system is not just about accessing hospital care. It is also about identifying strategies to reach certain, definite health goals. These strategies may involve multiple services/activities ranging from prevention of diseases (immunization campaigns), insecticide spraying against vector-borne diseases, printing horrific pictures on cigarette packets to deter smokers, ensuring safe abortions, keeping a check on drug pricing and to even distributing condoms. A health system has multiple stakeholders – policymakers, medical practitioners, health volunteers, industrialists, researchers, nurses, midwives, alternative medicine practitioners, and most importantly, patients.
In recent years, successive governments have demonstrated their inability to grasp the key challenges of the health sector – how to make healthcare universal, of better quality and thereby reduce inequality.
Since 2000, there is a growing concern about the government’s dwindling commitment in providing basic healthcare to its citizens. Take India’s expenditure on health. It is just four percent of GDP and public expenditure is only 1.2 percent of GDP. This implies that between 60-70 percent of the population’s medical needs are met by the private sector.
The proposed National Health Policy has made no radical shift in its budgetary allocations. The current government has proposed 2.5 percent of the GDP (WHO recommends 5 percent for a better health system) as a “realistic” figure to achieve health goals. This implies that even after 70 years of independence, tribal regions are likely to be neglected and basic immunization services will continue to be inadequate for both urban and rural poor.
In its much-debated World Health Report 2000: Health Systems, Improving Performances, WHO ranked India as 112 out of 191 countries in health systems. France and Italy topped the list. A host of smaller countries – Ecuador, Syria, Armenia, Azerbaijan, Iraq, Sri Lanka, Bangladesh – fared better than India.
WHO has not conducted another such study but experts state that the ranking would not be dramatically different today as successive governments have failed in protecting citizens against the financial costs of illnesses. Indians today struggle with a huge “out-of-pocket healthcare expenditures” that does not even guarantee quality care. Even the National Health Policy 2015 admits that this expenditure is “catastrophic”, draining family incomes and neutralising the gains in income increases.
Unless the government considers its citizens’ health as a critical national asset, the health system will continue to remain unplugged.

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