Tuesday, 21 November 2017

Health Ministry defines maximum permissible limits of antibiotics in food animals

Health Ministry defines maximum permissible limits of antibiotics in food animals

Antibiotic resistance has become a major public health threat worldwide. Use of antibiotics in food animals is emerging as a major cause of emergence of antibiotic resistance. The WHO has also recently published guidelines recommending farmers and the food industry to stop using antibiotics routinely to promote growth and prevent disease in healthy animals.

The Ministry of Health and Family Welfare has notified amendment to Food Safety & Standards (Contaminants, Toxins & Residues) Regulations, 2011 on 7th November, 2017.

Now called the Food Safety and Standards (Contaminants, toxins and Residues) Amendment Regulations, 2017, the notification contains maximum permissible limits of various antibiotics in meat and meat products including chicken. Maximum permissible limits of 37 antibiotics and 67 other veterinary drugs are prescribed for chicken.

“(2) No person shall use any of the following antibiotics and other pharmacologically active substances in any unit which processes sea foods including shrimps, prawns or any variety of fish and fishery products, namely. 1. Nitrofurans including- (i) Furaltadone; (ii) Furazolidone; (iii) Nitrofurnatoin; (iv) Nitrofurazone. 2. Chloramphenicol. 3. Sulphamethoxazole. 4. Aristolochia spp and preparations thereof. 5. Chloroform. 6. Chloropromazine. 7. Colchicine. 8. Dapsone. 9. Dimetridazole. 10. Metronidazole. 11. Ronidazole. 12. Ipronidazole and other nitromidazoles. 13. Clenbuterol. 14. Diethylstibestrol. 15. Glycopeptides. 16. Stilbenes and other steroids. 17. Crystal Violet. 18. Malachite Green.”

The tolerance limits of various antibiotics used in human beings and animals, exclusively used in animals and other various veterinary drugs have been specified in the notification.

The draft notification is available on FSSAI website. Objections and suggestions have been invited from all the stakeholders including general public within 30 days of the notification i.e. by 6th December, 2017.

(Source: Press Information Bureau, Ministry of Health & Family Welfare, November 20, 2017)

Indians consume less of fruits and vegetables

Indians consume less of fruits and vegetables
Eating patterns are a primary reason for increase in non-communicable diseases

New Delhi, 20 November 2017: As per a recent nation-wide study that assessed urban nutrition, it has been found that Indians consume far less than the recommended amounts of several micro-nutrients and vital vitamins, despite the food diversity that exists in the country. Statistics indicate that the recommended dietary intake of green-leafy vegetables is 40g/CU/day. However, it is only 24g/CU/day in the country. The average intake of cereals and millets was found to be 320g/CU/day. The intake of pulses and legumes was about 42g/CU/day.

The beneficial effects of fruits and vegetables on health are well-recognized. And, several studies have established the advantages of eating a fruit and vegetable-rich diet.

People who eat more fruits and vegetables are 42% less likely to be at risk of heart failure than those who consumed fewer plant-based foods.[2] Eating plenty of fruits and vegetables, cutting down on salt, and maintaining a healthy weight are all important parts of a balanced diet that can help lower the risk of heart disease and stroke as also other non-communicable diseases such as type 2 diabetes.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, "The burden of non-communicable diseases in on the rise today. One of the major factors that can be attributed to this is an unhealthy diet that is also lacking in fruits and vegetables. India is undergoing an ‘epidemiological transition’ from communicable to non-communicable or so-called lifestyle disease. An unhealthy diet is also the basis for metabolic risk factors such as obesity, and raised blood pressure, blood glucose and blood cholesterol levels. A well balanced diet includes all seven colors and six tastes. As per research, affluent Indians are getting 30% of their daily energy intake from fat and are consuming half the amount of dietary fibre than previous generations. Indians are largely ignoring certain warning signs and this poor choice is showing up in mortality data.”

Heart disease has become the top killer in India, followed by diabetes and cancer. While there is a need for concerted action on public health awareness by the government, what is also needed is an effort at an individual level.
Adding further, Dr Aggarwal, said, “We have slowly but steadily turned to lives dictated by technology, busy work schedules, long working hours, ignorance, and a sedentary lifestyle, not to mention a diet rich in fast and processed food. So-called health conscious individuals consume ready-to-eat breakfast options and a majority skip this most important meal of the day altogether! At least five servings of fruits and vegetables should be taken daily. ”
Given below are some WHO guidelines on the intake of fruits and vegetables.

  • One adult portion of fruit or vegetables is 80 g. As a rough guide, one child portion is the amount they can fit in the palm of the hand.
  • To get the most benefit, the five portions should include a variety of fruit and vegetables.
  • Potatoes and other tubers cannot count towards the five-a-day because they contribute mainly starch.
  • Beans and pulses can supply a maximum of one portion a day, irrespective of how much you eat. Three heaped tablespoons of chickpeas (chana) or kidney beans (rajma) make a portion.
  • Dried fruit like figs and prunes can contribute to the five-a-day. A portion of dried fruit is 30 g.
  • Fruit/vegetable juices and smoothies are best limited to a combined total of 150 ml a day.

Monday, 20 November 2017

Adequate care to the mother and newborn can prevent infant mortality

Adequate care to the mother and newborn can prevent infant mortality
Quality care for small and sick newborns around the time of birth may help prevent about 80% of newborn deaths

New Delhi, 19 November 2017: About 70 of every 1000 newborn babies in India die during the first year of life. The first 4 weeks of life or the neonatal period are the most crucial for a newborn as two-thirds of all newborn deaths occur during the first week of life. In India, the period from 15th to 21st November is marked as the New Born Care Week with the aim of generating awareness and suggesting measures to improve the health of new born and increase child survival rates.

Infections, lack of oxygen to fetus in the womb and new born baby, premature deliveries, delivery complications, and birth defects are some of the factors that can cause newborn deaths. As per the IMA, it is important to raise awareness about the need for adequate and exclusive care for the expectant mother before delivery; and for both the mother and the new born after delivery to improve the chances of survival.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “There is a need for skilled care during birth and postnatal checkups, both of which are essential for the well-being of the mother and the newborn. A newborn requires thermal and cord care, and immediate breastfeeding. The postnatal period is the time following delivery until six weeks after birth, and health checks during this time – especially the first two days after delivery – are absolutely essential. Postnatal care can help in checking for and averting any danger signs such as insufficient feeding, fast breathing (a breathing rate of more than 60 per minute), severe chest in drawing, lethargy, fever, low body temperature, or jaundice. This is also the time when mothers are advised on how to identify and respond to these symptoms, as well as the benefits of exclusive breastfeeding and immunization.”

Proven high-impact interventions and quality care for small and sick newborns around the time of birth may help in preventing about 80% of newborn deaths. Proper and timely vaccinations are very important.
Adding further, Dr Aggarwal, said, “India has seen a significant decline of 8% in the number of infant deaths this year compared to that in the year 2016. This has largely been the result of countrywide efforts to expand health services coverage, including reproductive, maternal and newborn health services. However, there is a still a long way to go in terms of expanding the reach of such efforts into the remote areas and ensuring access to postnatal healthcare to mothers and newborns there.”

The following points are a must to remember after childbirth.

·   Wash your hands with soap or use a hand sanitizer before handling the baby.
·   Be careful to support the baby's head and neck.
·   Start breastfeeding within an hour of birth.
·   Ensure that the baby is exclusively breastfed for the first 6 months.
·   Child should be fed on demand or at least 8 times in 24 hours.
·   Avoid feeding honey, water or things other than breast milk in lieu of a ritual as it can be a source of infection to a baby.
·   Give the baby a sponge bath until the umbilical cord falls off and the navel heals completely (1-4 weeks).

·   Kangaroo Mother Care especially for low birth weight infants, wherein the baby is held in a special way stuck with the chest to provide skin to skin contact with the mother along with exclusive and frequent breastfeeding

Expanding urban tree cover can reduce asthma hospitalization

Expanding urban tree cover can reduce asthma hospitalization

People living in polluted urban areas are far less likely to be admitted to hospital with asthma when there are lots of trees in their neighborhood, suggests a new study published in the journal Environment International.

The study which evaluated more than 650,000 serious asthma attacks over a period of 15 years found that green space and gardens were associated with reductions in asthma hospitalization when pollutant exposures were lower but had no significant association when pollutant exposures were higher.

In contrast, tree density (an extra 300 trees per square km) was associated with fewer emergency asthma hospitalizations- 50 fewer emergency asthma cases per 100,000 residents over the study period in a typical urban area with a high level of background air pollution - 15 µg of PM 2.5 per cubic meter, or a nitrogen dioxide concentration around 33 µg per cubic meter.

Planting trees does not simply improve the esthetics of any city. More importantly, planting trees also helps the environment as trees improve the air quality. Air pollution is not only a major environmental hazard but also a major health hazard, in particular from cardiovascular and respiratory illnesses.

The prevailing high pollution levels should be a matter of concern for us and each one of us should do our bit to help reduce air pollution. Expanding tree cover in areas of high pollution in cities, as suggested in this study, can improve respiratory health.

Each one of us can do something every day to prevent or at least help control the air pollution levels and keep the environment healthy. Planting trees is one way of doing so. It is also an economical way to curb the growing problem of air pollution.

We need to plant more trees to save our environment.

Sunday, 19 November 2017

WMA European Region Meeting on End-of-Life Questions

WMA European Region Meeting on End-of-Life Questions
On Thursday and Friday, 16-17 November 2017, medical professionals, legal authorities, experts in palliative care and medical ethics, theological scholars and philosophers from over 30 countries gathered in the Aula Vecchia del Sinodo in the Vatican for the World Medical Association European Region Meeting on End-of-Life Questions.

Hosted by the World Medical Association (WMA), the German Medical Association (GMA) and the Pontifical Academy for Life (PAV), this two-day event provided a platform for debating the different policies and perspectives on end-of-life issues in Europe, for exploring patient rights, treatment limitations, and palliative care, and for better understanding public opinion on these complex topics.

On the first day, the Congress was introduced by a meaningful and rich message from His Holiness Pope Francis, read by Cardinal Turkson, Prefect of the Dicastery for promoting integral human development. In his words, Pope Francis developed a deep reflection about the frailty of life and the need to support it with good practices. 
Opening remarks were also delivered by WMA President Dr Yoshitake Yokokura, GMA President Prof. Dr. Frank Ulrich Montgomery and PAV President Archbishop Msgr. Vincenzo Paglia. The program continued with a look at three different perspectives on end-of-life questions by Professor Montgomery, Dr René Héman, Chairman of the Royal Dutch Medical Association, and Dr. Yvonne Gilli, Board Member of the Swiss Medical Association.

The subsequent session highlighted insights on end-of-life questions from different religious and theological backgrounds.

Rounding out the first day of programming was a session focused on examining legal aspects of euthanasia and physician-assisted suicide, which included a contribution from Prof. Dr. Volker Lipp, Professor of Civil Law, Civil Procedure, Medical Law and Comparative Law at Georg-August-Universität. This was followed by an overview of the Council of Europe’s Guide on the decision-making process regarding medical treatment in end-of-life situations as illustrated by Dr. Laurence Lwoff, Head of the Bioethics Unit of the Council of Europe’s Human Rights Directorate, and a series of presentations, including a talk by Prof. Dr. Leonid Eidelman, President of the Israeli Medical Association, exploring various aspects of compassionate use and conscientious objection.

Day two of the conference opened with an ethical debate surrounding the question of whether there is a right to determine one’s own death, after which Dr. Anne de la Tour, President of the French Society of Palliative Care, shared her expertise on treatment limitations and end-stage decisions about sedation.

Representing the patient’s perspective was Dr. Marco Greco, President of the European Patients’ Forum, who delivered a presentation on public opinions of key end-of-life issues.

The final day closed with a plenary panel discussion featuring six speakers from Switzerland, Italy, Germany and the Netherlands, representing an extensive range of opinions and policy viewpoints. 

The in-depth discussions held over the course of the two-day conference were intended to contribute to an overarching debate on end-of-life issues recently initiated by the WMA’s Medical Ethics Committee. To capture the global scale of this debate, the WMA set out to co-organize a series of regional meetings on nearly every continent. Previous meetings have been held in Tokyo and Rio de Janeiro. The WMA African Region Meeting on this subject will take place in early 2018 in Nigeria.

(Source: WMA, November 17, 2017)

About 60 million people around the world have Computer Vision Syndrome

About 60 million people around the world have Computer Vision Syndrome
Increasing amount of screen time has led to this condition exacerbating further, even in toddlers

New Delhi, 18 November 2017: As per recent statistics, the incidence of Computer Vision Syndrome ranges from 64% to 90% among computer users. About 60 million people globally suffer from this condition, with another million new cases occurring every year. According to research, our blinking frequency, which is supposed to be 15 to 20 times per minute, goes down by approximately 60% while using a computer.
Computer Vision Syndrome refers to a group of eye and vision-related problems that result from the prolonged usage of computers, tablets, e-readers and cell phones. The level of discomfort apparently increases with the amount of digital screen use.
Using a computer or staring at a screen for prolonged periods can cause symptoms such as dryness, watering, and itching in the eyes, blurred vision, headaches, neck and back pain.
Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, "Screen usage has increased everywhere today, be it among students or adults. Even toddlers are given mobile phones to watch videos and cartoons, etc. When we gaze at any screen, the eyes converge to focus on a point and this position is maintained for longer periods of time. On an average, a person spends about 4.4 hours of leisure time in front of screens. Add to this, the 8 to 10 hours spent on laptops and desktops in offices. That is how pervasive this phenomenon is. When a person is focusing on the screen, the eyes move back and forth. In an office setting, one may need to also look down at papers and then back up to type. The eyes react to changing images on the screen to create so the brain can process what is seen. All this puts a lot of strain on the eye muscles. To make things worse, unlike a book or piece of paper, the screen adds contrast, flicker, and glare.”
Uncorrected vision problems like farsightedness and astigmatism, inadequate eye focusing or eye coordination abilities, and aging changes of the eyes, such as presbyopia, can all contribute to the development of visual symptoms when using a computer or digital screen device.
Adding further, Dr Aggarwal, said, “Another issue is that people often use their mobiles before they go to sleep. This can disturb sleep and also put a lot of stress on the eyes and the brain. It is better to listen to good music or even meditate an hour before hitting the bed. The first step to prevention is an awareness of the problem. There is a need to consciously wean ourselves away from screens.”
The following tips can help prevent computer vision syndrome.

  • It is good to take a full one-week social media holiday if you are addicted to various social media.
  • Everybody should have 30 minutes of electronic curfew before they sleep. This means not using mobile phones and other mobile devices for 30 minutes before sleep.
  • Use mobile only when mobile.
  • Limit mobile talk time to less than 2 hours a day.
  • Once the battery is discharged, call it a day for mobile use.
  • Follow the formula of “20-20-20 to prevent dry eyes: every 20 mins, focus the eyes on an object 20-feet (6 meters) away for 20 seconds or close the eyes for 20 seconds, at least every half hour.
  • Spend less than 3 hours on a computer at a stretch.

Saturday, 18 November 2017

Treatment gap and social stigma, the biggest barriers for those with epilepsy

Treatment gap and social stigma, the biggest barriers for those with epilepsy 
Need to remove misconceptions and myths associated with the condition

New Delhi, 17th November 2017: About 80% of those with epilepsy live in low and middle-income countries, as per reports by a global health body(WHO). Over 50 million people around the world suffer from this condition and about three-fourth of these live in low- and middle-income countries. The ‘treatment gap’ and the social stigma associated with the disorder in India further exacerbate conditions for people with epilepsy.

Epilepsy is a chronic disorder of brain characterized by recurrent ‘seizures’ or ‘fits’. The seizures are caused due to sudden, excessive electrical discharges in the neurons (brain cells). The condition can affect people at any age and each age group has unique concerns and problems.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, "The International League Against Epilepsy (ILAE) has expanded the definition of epilepsy to incorporate a single unprovoked seizure with a probability of future seizures. The new definition also specifies that epilepsy can be considered ‘resolved’ if a patient has been seizure-free for 10 years, with no seizure medicines for the last 5 years. The previous definition stipulated that a patient needs to have 2 unprovoked seizures more than 24 hours apart. Epilepsy is mostly treatable with medications. The critical thing about epilepsy is that treatment should not be delayed. Start the treatment as soon as it is diagnosed. This prevents further deterioration of the condition.”

Some causative factors for epilepsy include brain damage from prenatal and perinatal injury, congenital abnormalities, brain infections, stroke and brain tumors, head injury/accidents, and prolonged high fever during childhood.

Adding further, Dr Aggarwal, said, “A lot of progress has been made in the country for treating epilepsy and controlling the onset of seizures. Many effective new anti-epileptic drugs are available in the market today. India also many centres that offer treatment facility for this condition. Only mass awareness can dispel the associated myths with epilepsy. It is important to create awareness that those with epilepsy can lead a normal life, get married, have children, and even work. This is not a contagious condition and does not spread through contact.”

One of the major reasons for incomplete control of seizures is non-compliance. Some tips to prevent onset of seizures and the condition from getting worse are as follows:

  • Adhere to the prescribed medication
  • Following a regular sleep cycle to remain stress-free
  • Keep yourself hydrated
  • Eat a balanced diet
  • Get regular medical checkups done