ALS is a degenerative and debilitating condition

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Stephen Hawking was a rare case in which the disease progressed slowly and he survived for a longer period

New Delhi, 17 March 2018: Amyotrophic lateral sclerosis incurable, neurodegenerative disorder that causes muscle weakness, disability, and eventually death.  ALS has an annual incidence of one to three cases per 100,000 people that is believed to be the same worldwide. There appears to be no ethnic or racial predisposition to ALS.

The median survival from the time of diagnosis is three to five years. However, about ten percent of ALS patients can live 10 years or more.

Survival beyond 20 years is possible but rare and in part depends on treatment decisions made by patients and their families. Stephen Hawking was a rare case and survived over 50 years since he was diagnosed with ALS at the young age of 21.

ALS is a rare condition that progressively damages motor neurons in the brain and spinal cord, stopping them from sending messages to muscles. The muscles gradually weaken, waste away, and twitch. Eventually the ability of the brain to start and control voluntary movement is lost.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, President Heart Care Foundation of India (HCFI) and Immediate Past National President Indian Medical Association (IMA), said, “Each muscle in the brain is controlled by motor neurons in the frontal lobe. These are located in three areas of the nervous system – the frontal lobe, the lower brain, and the spine. Motor neurons in the brain are called upper motor neurons and the ones in the spine are called lower motor neurons. ALS leads to the weakening of either of these or both together. There are two ways in which patients suffering from ALS can possibly die: respiratory failure and deterioration of swallowing muscles which can lead to dehydration and malnutrition. Hawking’s survival was probably due to a slower progression of the condition, which also indicates why one should not lose hope.”

Early symptoms of ALS include muscle weakness or stiffness. As the condition progresses, all muscles under voluntary control are affected, and individuals lose their strength and the ability to speak, eat, move, and even breathe.

Adding further, Dr Aggarwal, who is also the Group Editor of IJCP, said, “There is no cure for ALS as on date. However, the primary aim is to control symptoms, prevent unnecessary complications, and make living with the disease easier. Medications may be prescribed to manage symptoms such as muscle cramps, stiffness, excess saliva and phlegm; help individuals with pain, depression, sleep disturbances, and constipation. Speech therapy, and nutritional and breathing support is also provided.”

Research suggests that increased consumption of foods containing colorful carotenoids, particularly beta-carotene and lutein, may prevent or delay the onset of ALS. Vitamin C or carotenoids are also antioxidants and studies have shown that those who have a high intake of antioxidants, have a reduced ALS risk.


  1. The clinical hallmark of amyotrophic lateral sclerosis is the combination of upper motor neuron and lower motor neuron signs and symptoms.
  2. Upper motor neuron findings of weakness, hyperreflexia, and spasticity result from degeneration of frontal motor neurons.
  3. The lower motor neuron findings of weakness, atrophy or amyotrophy, and fasciculations are a direct consequence of degeneration of lower motor neurons in the brainstem and spinal cord.
  4. Spectrum of motor neuron disease includes progressive muscular atrophy, primary lateral sclerosis, and progressive bulbar palsy, all of which may be variants of ALS, or represent different patterns of evolution to ALS.
  5. Asymmetric limb weakness is the most common presentation of ALS (80 percent).
  6. Bulbar onset, usually manifested as dysarthria or dysphagia, is the next most common pattern (20 percent).
  7. Cognitive impairment, typically related to frontotemporal executive dysfunction, may precede or follow the onset of upper motor neuron and/or lower motor neuron dysfunction in patients with ALS.
  8. Frontotemporal dementia may be associated with ALS in 15 to 50 percent of cases.
  9. ALS is a relentlessly progressive disorder with a clinical course that is nearly always linear.
  10. He progressive course of ALS eventually produces one or both of the life-threatening aspects of the disease, neuromuscular respiratory failure and dysphagia.

Leading bottled water brands are contaminated with plastic particles says study

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These can prove hazardous to human and animal health alike and cause a range of health complications.

New Delhi, 16th March 2018: A major study conducted across nine countries has indicated that the world’s leading brands of bottled water are contaminated with tiny plastic particles that are likely seeping in during the packaging process. The study found widespread contamination with plastic, an outcome of testing 250 bottles of water in Brazil, China, India, Indonesia, Kenya, Lebanon, Mexico, Thailand, and the United States.

Plastic was identified in 93% of the samples and the debris found included nylon, polyethylene terephthalate (PET) and polypropylene, which is used to make bottle caps.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, President Heart Care Foundation of India (HCFI) and Immediate Past National President Indian Medical Association (IMA), said, “Bottled water means safety and convenience for people around the world. At a time when public health is a major area of concern, the fact that this source has also been found to be contaminated with plastic, is seriously alarming. Particle concentration ranging from zero to more than 10,000 likely plastic particles in a single bottle can mean extreme risk to human health over a period of time. From cancer to ADHD and lower sperm count to problems in newborns, the dangers are many – a situation that will need to be addressed at the earliest.”

Water bodies already suffer contamination, something that is eventually likely to seep down to humans through consumption of sea food or other sources. Single-use plastic bottles must be discarded immediately albeit safely.

Adding further, Dr Aggarwal, who is also the Group Editor of IJCP, said, “Bio-accumulation of plastic inside animals is one of the most dangerous outcomes of plastic pollution. Over many years, the accumulated plastic releases harmful chemicals, and breaks down into small pieces, causing extreme discomfort to the animals. After their death, the body might decompose, but the plastic fragments may remain as a threat to other animals – and humans as well.”

HCFI food for thought.

If just one human being switched to reusable bags for their entire lifetime, it would remove roughly 24 thousand plastic-based bags from our planet. Instead of using plastic water bottles, invest in a metal, reusable water container. Not only will that be safer for the environment but also sustainable for human health. Perhaps the best course of action individuals can take is to raise awareness. It is up to us to decide what kind of a world we wish to leave back for the future generations.

Ambitious target of TB-free India by 2025 will require continuous and consistent efforts

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There is a need to mobilize resources further and increasing awareness on the importance of immunization

New Delhi, 14th March 2018: Year 2025 has been set as the deadline for a tuberculosis (TB)-free India by Prime Minister Shri Narendra Modi. This is five years ahead of the global deadline set by the WHO. About 25 years, TB was declared as an emergency, and since then, different countries have adopted varied strategies to keep it under check.

The number of TB-related deaths in India in 2016 was more than 4 lakh, a number that is one-third of the global toll.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, President Heart Care Foundation of India (HCFI) and Immediate Past National President Indian Medical Association (IMA), said, “The target set for a TB-free India sounds ambitious and promising. However, it remains to be seen what efforts go into actualizing the same. TB is the third leading cause of years of life lost (YLLs) lost, in the country. It is caused by bacilli spread through droplet nuclei (less than 5 microns) infection. Droplet nuclei can remain suspended in the air for extended periods, and thus are a source of exposure to susceptible individuals. Split AC is not the right atmosphere for sputum-positive cases. Natural windows and fans are better alternatives. TB does not spread through handshakes, using public toilets, sharing food and utensils, blood transfusion and casual contact. TB can be of lungs (pulmonary), or outside the lungs (extra pulmonary). In 85% of cases, lungs are involved.”

Contact tracing increases community awareness about the disease and interrupts the chain of transmission of the disease through early diagnosis of cases.

Adding further, Dr Aggarwal, who is also the Vice President of CMAAO, said, “Early diagnosis and complete treatment is important to prevent and control TB. To address the problem of rising drug resistance, TB is a notifiable disease. The approach to all notifiable diseases should therefore be based on DTR “Diagnose, Treat & Report”: Diagnose early, using sputum GeneXpert test; Treat: Complete and effective treatment based on national guidelines, using FDC; and Report: Mandatory reporting.”

Some tips from HCFI.

  • 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 you window to blow out air that may contain bacteria.

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