India has the highest number of TB patients across the world

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Missing doses can defeat the purpose of DOTS therapy

New Delhi, 12 December 2017: According to recent reports, with 2.79 million cases, 4.23 lakh deaths, and an average of 211 new infections diagnosed per 100,000 people, India currently has the highest number of tuberculosis (TB) patients across the globe. India also has the most number of MDR-TB patients in the world as well as the largest number of ‘missing’ TB patients. There are several million who have not been identified, notified, or treated and these people remain off radar.

TB is a highly infectious disease cured by providing proper medication at the right time for the full duration of the treatment. The drug regimen is called DOTS and is provided free under the Revised National TB Control Programme (RNTCP). It is based on the principle that a regular and uninterrupted supply of high-quality anti-TB drugs must be administered to cure the disease and prevent the occurrence of the MDR-TB.

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, “TB is a major public health concern in India. Not only is it a major cause of morbidity and mortality but also poses a huge economic burden on the country. Elimination, which is defined as restricting new infections to less than one case per 100,000 people, is possible only when patients get diagnosed and cured without any break in treatment. Any interruption in treatment can exponentially raise the patient’s risk of developing MDR-TB, which is harder to treat. Missing doses defeats the very purpose of DOTS therapy, which is meant to ensure strict compliance through supervised consumption of medicines. As many as 900,000 people with TB do not have access to proper treatment, which means they risk developing drug-resistant TB and infecting others.”

Reporting is important to trace contacts of the person with infectious TB. All contacts of the patient should be screened for TB and put on treatment if required. This cascade of screening of contacts, at home and workplace, identifies individuals at risk and prevents further spread of TB, including MDR TB.

Adding further, Dr Aggarwal, said, “The approach to all notifiable diseases should be based on DTR: Diagnose, Treat, and Report. Diagnose early, using sputum Gene Xpert test; Treat: Complete and effective treatment based on national guidelines, using FDC; and Report: Mandatory reporting.”

Here are some tips that can help avoid TB infection from spreading.

  • Wash your hands after sneezing, coughing or holding your hands near your mouth or nose.
  • Cover your mouth with a tissue when you cough, sneeze or laugh. Discard used tissues in a plastic bag, then seal and throw it away.
  • Do not attend work or school.
  • Avoid close contact with others.
  • Sleep in a room away from other family members.
  • Ventilate your room regularly. TB spreads in small closed spaces. Put a fan in your window to blow out air that may contain bacteria.

Increased exposure to perchlorate in pregnant women can hamper fetal brain development

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Imperative to reduce exposure and increase consumption of iodine rich food

New Delhi, 09 December 2017: As per a recent study, expecting mothers, who are exposed to elevated levels of a common environmental pollutant, perchlorate, had lower levels of a thyroid hormone crucial for normal fetal brain development. It is important to minimize exposure to this chemical in pregnant women to prevent potential neurodevelopmental abnormalities in children. Perchlorate is a common environmental pollutant found in water, milk, some foods and everyday chemicals, including fertilizers and air bags.

Perchlorate is known to reduce absorption of iodine from the blood into the thyroid, where iodine is needed to make the thyroid hormone, T4. Since T4 is essential for normal fetal brain development, this suggests that perchlorate exposure could decrease maternal thyroid hormone levels, which may lead to brain development defects in babies.

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, “Manufactured perchlorate is used as an industrial chemical and can be found in rocket propellant, explosives, fireworks and road flares. Natural perchlorate is found in some drinking water and some foods. In addition, trace amounts of perchlorate may be used as a component in some food packaging. During the 1st trimester, a developing fetus is completely dependent on its mother for thyroid hormone. During the 2nd and 3rd trimesters, the fetus receives approximately 30% of its thyroid hormone from the mother. Any deficiency has an adverse effect on the fetus.Drinking water with 5 ppb perchlorate can reduce maternal thyroid to a level that causes abnormal fetal brain development.”

Newborns must produce thyroid hormone on their own because breast milk provides almost none. Infants also use up their thyroid hormone quickly and have very little in reserve. These factors make infants especially vulnerable to disruptions.

Adding further, Dr Aggarwal, said, “Iodine is a building block of thyroid hormone. Low iodine levels, and/or the gland’s inability to absorb iodine can prevent the thyroid from producing enough thyroid hormone, resulting in an underactive thyroid, or hypothyroidism. Babies of mothers who have hypothyroidism are at increased risk of cognitive and developmental problems, or, in more severe cases, cretinism and birth defects.”

The following are some good sources of iodine.

  • Most dairy products are iodine enriched. Two varieties of cheese that are rich in this mineral include Cheddar and Mozzarella.
  • Iodine is found in seafood. One of the richest sources is a seaweed called kelp.
  • Eggyolk is one of the safest and simplest sources of iodine.
  • Milk Studies indicate that every 250ml of milk has about 150 micrograms of iodine.
  • A single cup of yoghurt can meet half of the daily iodine requirement giving close to 70 micrograms of iodine. It is also good for the stomach and rich in calcium and protein.
  • Apart from the above food items, some others that are good sources of iodine include fruits like bananas, strawberries; vegetables such as green leafy vegetables, onions, and sweet potatoes; and grains, nuts and legumes like peanuts, barley, etc.

Viral hepatitis is a deadly condition

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Hepatitis B and C cause the most fatal infections

New Delhi, 08 December 2017: About 1.5 lakh people die of hepatitis every year in India, as per reports and this condition affects 60 million people in the country. Viral hepatitis infection is also the leading cause of liver cancer and liver failure. Despite these alarming facts, only few people are aware of this condition that infects and kills more people in India than HIV, malaria and tuberculosis combined. There are five viral hepatitis strains of which hepatitis B and C cause the most fatal infections.

Hepatitis is an inflammation of the liver cells and damage to the liver. There are different types and causes, but the symptoms can be similar. The liver helps in detoxifying blood, storing vitamins, and producing hormones. Hepatitis can disrupt these processes and create severe health problems throughout the body.

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, “It is imperative to not underestimate the threat of hepatitis. More than 80% cases of liver cancer are due to viral hepatitis. Many people are not aware even when they are infected as majority of people doesn’t even know they are infected because symptoms of jaundice such as yellowing of skin, whites of the eye, and urine happen in the later stages of the disease. Both the fatal infections (Hepatitis B and C) spread through contaminated blood and other fluids, with unsafe blood transfusion, tattoos or dental procedures using unsterilized tools, unprotected sex, sharing razor, etc. This further leads to the infection spreading from an infected person to a healthy person. Progression of liver disease is faster in individuals with HIV and viral hepatitis coinfection; also, they may not respond as well to treatment.”

The signs and symptoms of acute hepatitis appear quickly and include fatigue, flu-like symptoms, dark urine, pale stool, abdominal pain, loss of appetite, unexplained weight loss, and yellow skin and eyes, which may be signs of jaundice.

Adding further, Dr Aggarwal, said, “The WHO has recognized viral hepatitis as a serious public health problem. There is a need for urgent and immediate action against this deadly condition as also raising awareness about its symptoms. It is also important to complete the vaccine regimen failing which the complications can exacerbate.”

The following precautions can help in preventing the risk of infection.

  • Unnecessary and unsafe injections
  • Unsafe blood products
  • Unsafe waste collection and disposal
  • Use of illicit drugs and sharing of injection equipment
  • Unprotected sex with hepatitis C-infected people
  • Sharing of sharp-edged personal items like razors that may be contaminated with infected blood
  • Tattoos, piercing and acupuncture performed with contaminated equipment

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