31 December, 2016

Shoulder pain may indicate heart disease risk

If you are having shoulder problems, they may be due to some heart disease risk factors - not just physical strain, warns a new study.

"If someone has rotator cuff problems, it could be a sign that there is something else going on. They may need to manage risk factors for heart disease," said the study's lead author Kurt Hegmann, Professor at University of Utah School of Medicine in the US.

For the study, the researchers examined data from 1,226 skilled labourers.

The more heart disease risk factors that each of the study participants had racked up -- including high blood pressure, high cholesterol, diabetes -- the more likely they were to have had shoulder trouble.

The participants with the most severe collection of risk factors were 4.6 times more likely than those with none of the risk factors to have had shoulder joint pain.

They were also nearly six times more likely to have had a second shoulder condition, rotator cuff tendinopathy. Participants with mid-level heart risk were less likely to have had either shoulder condition, showed the findings published in the Journal of Occupational and Environmental Medicine.

"What we think we are seeing is that high force can accelerate rotator cuff issues but is not the primary driver," Hegmann said. "Cardiovascular disease risk factors could be more important than job factors for incurring these types of problems," he added.

It is possible that controlling blood pressure and other heart risk factors could alleviate shoulder discomfort, too, Hegmann noted.

Source: www.timesofindia.com

31.12.2016

Good people are good because they've come to wisdom through failure

William Saroyan

29 December, 2016

Homeless people sleep less and are more likely to have insomnia

Homeless individuals — living on the street, in short-term shelters, small social services-paid hotels and other facilities for homeless people with children — tend to sleep less and are more likely to have insomnia and daytime fatigue, a study said. Sleep is part of good health, but the homeless often have no access to safe and warm beds at night, said Damien Leger from the Paris Descartes University. For the study, the team analysed responses from 3,453 people in French cities. Most of the participants were men and had an average age of almost 40. The findings showed that the homeless had less than four hours of total sleep and 41 per cent showed insomnia. Homeless women were also twice as likely as men to report that they slept less than four hours.

In addition, 33 per cent of the homeless reported daytime fatigue and 25 per cent also reported regularly taking a drug to help them sleep. The study suggested more attention needs to be paid to improving sleep for this vulnerable population. ‘We believe that improving sleep deserves more attention in this vulnerable group. More careful control of noise, lighting, heating and air conditioning at night and addressing issues of personal security should promote better sleep,’ the researchers stated, in the paper published online by JAMA Internal Medicine. 

Source: www.thehealthsite.com

29.12.2016

If you don't stand for something you will fall for anything

 Gordon A. Eadie

28 December, 2016

Delayed procedure of cutting the umbilical cord after delivery gives your baby numerous health benefits, say physicians

New Delhi: If you're pregnant and/or about to deliver soon, then make sure you get your umbilical cord clamped and cut after some time.

Most hospitals cut the umbilical cord right after delivery, but now, a group of physicians have suggested that delaying the procedure bears a huge amount of health benefits for the baby.

According to VOA News, the American Congress of Obstetricians and Gynecologists, in an opinion from its Committee on Obstetric Practice that was published on the ACOG website, said that instead of quickly clamping off the cord that connects the newborn to its placental sac, doctors should wait an additional 30 to 60 seconds. Those extra seconds for babies born at term are associated with an increase in hemoglobin levels in newborns, the statement said.

In 2015, a similar recommendation was issued, suggesting that the umbilical cord should not be cut earlier than 30 to 60 seconds after birth, when it comes to term and preterm infants. However, the World Health Organization recommends delaying the procedure by an entire minute in the same conditions.

The main reason for the recommended delay is because the transfer of blood from the placenta takes place approximately a minute after birth and is extended for a total of three minutes thereafter. Moreover, the first breaths that the newborn takes have been correlated with this process. Furthermore, the blood contains essential quantities of iron, which help provide the newborns with the requisite amount of iron for the first year of their life. This in turn helps build the baby's cognitive, motor and behavioral strength.

The longer the placental transfusion, the greater the benefits. The connection also facilitates immunoglobulins, as well as stem cells, which are indispensable for tissue and organ repairs.

VOA News further reported that waiting several seconds more to clamp off the umbilical cord also has benefits for premature babies, ACOG said. The practice improves circulation in the newborn just after birth and decreases the need for blood transfusion due to a decrease in red blood cell volume. In addition, delaying clamping lowers the risk of brain hemorrhage and intestinal disease.

However, the opinion issued by ACOG on delayed clamping noted that there is a slight risk of jaundice in the newborn. But the problem is manageable and doctors and other health care professionals should have proper procedures in place to handle it.

Source: www.zeenews.india.com

28.12.2016

Raise your words, not voice. It is rain that grows flowers, not thunder

Jalal ad-Din Rumi

27 December, 2016

Child malnutrition, India's future in risk

The joint child malnutrition estimates for the 1990-2015 period provided by the Unicef, the WHO and the World Bank Group’s 2016 report underscore the magnitude of the global malnutrition crisis. Despite concerted efforts to address malnutrition, around 156 million children under the age of five are stunted, 42 million are overweight and wasting is threatening the lives of 50 million worldwide. Some children suffer from more than one nutrition-related problem; thus, a child who is wasting could also be stunted and while stunting and wasting are caused by consuming under-nutritious food, children become overweight and obese when they live on junk food or expend too few calories for the amount of food they consume. Asia bears the bulk of the global burden of malnutrition with around 56% of the stunted, 48% of the overweight and 68% of the world’s wasted children under the age of 5 belonging to this continent. The situation in Southern Asia is a reason for serious concern. Stunting rates among children exceed 30% in the region. The report says that the wasting rate here “is approaching a critical public health emergency.”

There is little understanding about the true nature of malnutrition. It is not as simple as it seems. For one, malnutrition is not just about lack of food (macronutrients) but about the quality (micronutrients) as well as the capacity to absorb and utilise nutrients. These are affected by the quality of water and sanitation. Many believe that stunting is merely a problem of shortness. It is thought that a stunted child is just shorter than the other children of his age group. But, it is more complex. Stunting not only impacts the height and physical development of a child but also his mental abilities and the capacity to learn. Thus, a stunted child performs poorly at school, suffers from self-esteem issues, etc. As an adult, his interactive skills are adversely affected as is his capacity to earn a living and lead a normal life. Likewise, an obese child’s self-confidence and physical activity are low and he is prone to develop diabetes and hypertension early in life. Worryingly, the damage done by stunting, for instance, is often irreversible. Early intervention is necessary to be effective.

India has put in place an array of programmes like the Integrated Child Development Services (ICDS) and the midday meal scheme to improve child nutri­tion. There are initiatives for pregnant and lactating mot­hers, too. While these are laudable efforts, they are insufficient. More funds are clearly needed; current budget allocations remain way below par. It is impor­tant that our decision makers realise that child nutri­tion is a priority issue. Investment in child nutrition, after all, is an investment in India’s future.

Source: www.deccanherald.com

27.12.2016

Start with what is right rather than what is acceptable

Peter F. Drucker

26 December, 2016

Female doctors better at treating elderly, finds Harvard study

Female doctors are better than male doctors in treating elderly patients in hospitals, according to a new study led by researchers from Harvard University. They found that chances of patients dying or getting readmitted in the next 30 days went down if the doctors were women. It is the first time that a study has documented how male and female physicians' treatment leads to different outcomes for patients in the U.S.

The researchers estimated that if male physicians could achieve the same outcomes as their female colleagues, there would be 32,000 fewer deaths each year among Medicare patients alone—a number comparable to the annual number of motor vehicle accident deaths in the US. The study, which included Indian origin senior author Ashish Jha, was published online in JAMA Internal Medicine.

The researchers found that the patients, if treated by a female physician, had a 4% lower relative risk of dying prematurely and a 5% lower relative risk of being readmitted to a hospital within 30 days. The association was seen across a wide variety of clinical conditions and variations in severity of illness.

"The difference in mortality rates surprised us," said lead author Yusuke Tsugawa, research associate in the Department of Health Policy and Management. "The gender of the physician appears to be particularly significant for the sickest patients. These findings indicate that potential differences in practice patterns between male and female physicians may have important clinical implications."

The researchers analyzed data from more than 1 million Medicare beneficiaries, age 65 years or older hospitalized with a medical condition and treated by general internists between 2011 and 2014. They adjusted for differences in patient and physician characteristics, and considered whether differences in patient outcomes varied by specific condition or by severity of illness.

Female physicians now account for approximately one third of the U.S. physician workforce and comprise half of all U.S. medical school graduates. There are important gender differences in how women physicians are treated—they are less likely to be promoted and are generally paid less, said senior author Ashish Jha, K.T. Li Professor of Health Policy and director of the Harvard Global Health Institute.

"There was ample evidence that male and female physicians practice medicine differently. Our findings suggest that those differences matter and are important to patient health. We need to understand why female physicians have lower mortality so that all patients can have the best possible outcomes, irrespective of the gender of their physician," said Jha.

Source: www.timesofindia.com           24.12.2016

Don't be pushed by your problems,

be led by your dreams

Ralph Waldo Emerson

24 December, 2016

Lay counselling needs govt attention

Two studies published recently in the medical journal, The Lancet, confirm that lay counselling in primary healthcare can help tackle symptoms of severe depression and reduce harmful drinking. This should convince the government to roll out at the earliest lay counselling services in primary healthcare facilities across the country. Depression and alcoholism are the two most common mental health problems in India. According to the National Mental Health Survey, one in 20 adults suffers from depression and one in 10 adult men indulges in harmful drinking. Around 65 million adults are affected by the two disorders. Daily life is a living hell for those suffering from depression and alcoholism. These disorders have an immense social impact and the economic burden they impose on the individual, his family and society is enormous. Yet, most people suffering from depression and harmful drinking do not receive treatment. The treatment gap for both disorders is a shocking 85%. Social stigma attached to the two disorders is partly to blame.

However, an important reason is that medical expertise and infrastructure for treatment of mental health problems is extremely limited in India. For instance, there are only 0.3 psychiatrists per 100,000 people in India. Most of them are located in the major cities. India has 443 government-run mental hospitals which are concentrated in the western and southern states. Six states, mainly in the northern and eastern regions with a combined population of 56 million people, are without a single mental hospital. The majority of mental health patients have to travel long distances to avail treatment in district or state capitals. This lack of easy access to facilities deters patients from seeking help. While it is important to increase the number of psychiatrists, nurses and professional counsellors in primary healthcare facilities, this is a big challenge in terms of costs. Not to mention, ramping up these numbers over a short period is difficult.

It is in this context that the findings of the studies on lay counselling provide hope. They provide evidence that lay counselling works. It has resulted in remission in depression, decrease in suicidal thoughts and domestic violence among those who received the counselling. Additionally, it is a cost-effective intervention. The training is provided to the community workers over a period of a few weeks, which means it would be possible to staff primary healthcare facilities with trained counsellors in a short time. The government and NGOs working in the field of community and mental health should collaborate to train community workers. Once the system is in place, monitoring the work and updating the skills of lay counsellors is necessary.

Source: www.deccanherald.com      

24.12.2016

Lose as if you like it; win as if you were used to it

Tommy Hitchcock

23 December, 2016

Everyday Pain Relievers May Be Linked to Hearing Loss in Some Women

Long-term use of over-the-counter pain relievers may be associated with increased risk of hearing loss in some women, a new study says.

Women who used ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) for six years or more were more likely to suffer hearing loss than those who used the pain relievers for a year or less, said researchers from Brigham and Women's Hospital in Boston.

They found no significant association between long-term aspirin use and hearing loss.

"Although the magnitude of higher risk of hearing loss with analgesic use was modest, given how commonly these medications are used, even a small increase in risk could have important health implications," study senior author Dr. Gary Curhan said in a hospital news release.

"Assuming causality, this would mean that approximately 16.2 percent of hearing loss occurring in these women could be due to ibuprofen or acetaminophen use," said Curhan, a physician in the division of network medicine.

The study doesn't establish a cause-and-effect relationship, however.

For the study, Curhan's team analyzed data from more than 54,000 women, ages 48 to 73, in the Nurses' Health Study.

Longer use of ibuprofen or acetaminophen was associated with potentially higher risk of impaired hearing.

The researchers noted that most of the women in the study were older and white. They said larger studies that include other groups of people are needed to learn more about the possible link between pain relievers and hearing loss. The research team previously found that higher use of acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDS) was associated with increased risk of hearing loss in men and younger women.

"Hearing loss is extremely common in the United States and can have a profound impact on quality of life," Curhan said. "Finding modifiable risk factors could help us identify ways to lower risk before hearing loss begins and slow progression in those with hearing loss."

The study results were published Dec. 14 in the American Journal of Epidemiology.

Source: www.medicinenet.com

23.12.2016

Accept what is, let go of what was and have faith in what will be

Sonia Ricotti

22 December, 2016

63% Indians not aware that diabetes can spoil retina too

As many as 63 percent of the Indians are not aware that diabetes affects the retina too apart from other body parts, revealed a survey on Tuesday.

"It was found that 63 per cent tested positive for diabetes were not aware that the disease affects the retina too. As many as 92 per cent diabetics sought a retinal examination only when their vision got affected," said the survey.

The survey also reveals that 86 per cent did not seek a retinal examination as they could see everything.  "Also, 68 per cent did not know that Diabetic Retinopathy could be prevented and treated," said the survey.

"Asymptomatic burden of blindness which is preventable due to diabetic retinopathy can be tackled by increasing awareness and screening of individuals living with diabetes. 

"The survey was conducted with the aim to not only create awareness but also to reduce the number of diabetics who will need laser treatment, anti VEGF injections and Virectomy by early detection and management," said Kiran Shah, Consultant Diabetologist, Diabetes and Thyroid Care Centre.

A total of 6,000 Type 2 Diabetics were screened at city's Diabetes and Thyroid Care Centre for the survey.

She said that out of those surveyed and detected with Diabetic Retinopathy, 60.8 per cent were from the working class age group of 40 to 70 years and 21.8 per cent had vision threatening diabetic retinopathy. 

"As many as 52.2 per cent male smokers were detected as having Diabetic Retinopathy. As the duration of diabetes increased, so was the risk of diabetic retinopathy," said Shah.

"Diabetics having uncontrolled hypertension and cholesterol had increased prevalence of diabetic retinopathy. All diabetics with advanced diabetic kidney disease had diabetic retinopathy, whereas those in the initial stages were at increased risk," said Shah.

Source: www.zeenews.india.com

22.12.2016

Nothing ever becomes real till it is experienced

John Keats

21 December, 2016

Beware, shortness of breath may be a sign of heart failure

Suffering from chronic shortness of breath? Beware, you may be at risk of a potential heart failure or COPD (Chronic Obstructive Pulmonary Disease), a study has found. Shortness of breath, which is medically known as dyspnea, is often defined as an intense tightening in the chest, air hunger or a feeling of suffocation. ‘Shortness of breath is often a sign of heart or lung disease because these two organs are most closely involved in the respiratory system,’ said Nasser Ahmadi, research student at University of Gothenburg in Sweden, in a statement. Chronic shortness of breath can also be considered as an equally important warning signal as high blood pressure, the researchers said. However, shortness of breath is an often overlooked symptom as people tend to associate it with ageing.

‘The fact that people do not seek medical advice for their breathlessness is often due to people associating their symptoms with the natural process of ageing. But if you notice that you experience increased shortness of breath during exertion, you should seek medical attention,’ Ahmadi added. The study showed that the faster the detection, the better prognosis. With early intervention, patients can avoid suffering and the need for hospitalisation decreases. In the study, people with shortness of breath for six weeks or more who sought medical advice for their breathlessness were found to have underlying diseases like a potential heart failure or a hidden obstructive lung disease that was developing.

Source: www.thehealthsite.com

21.12.2016

Expect nothing and appreciate everything

20 December, 2016

Survey: 50% doctors at risk of cardiovascular diseases

A study covering 250 doctors and nurses in a medical college hospital close to Chennai found that around 50% of the medical practitioners surveyed were at high risk for cardiovascular diseases (CVDs) -close to double than that of the general population.

A team from the SRM Medical College Hospital and Research Centre calculated the risk based on the physical parameters of these white-coats, and after studying their dietary pattern and physical activity. Among doctors at high risk, 42.1% were predisposed to CVDs because of lack of physical activity, and 19.8% owing to erratic dietary pattern. While the average age of doctors was around 40, the nurses surveyed were around 29 years.

The study , published in the Journal of Family Medicine and Primary Care, said one of the many reason for this unsettling trend was the sedentary lifestyle followed by doctors and long hours at work. "The high prevalence of obesity among doctors say a lot about our lifestyle," said Dr K Kannan, professor and head of the department of cardiology at Stanley Medical College and Hospital. He said when he entered the profession, it wasn't as competitive as it is now."Practice seems to be more number-driven now and it's taking a toll on doctors' health by keeping them awake longer," he said, adding, sometimes doctors end up working for up to 80 hours a week, including on their days off.

Diabetologist Vijay Viswanathan said a similar study done by his team 10 years ago, covering 3,000 doctors in Tamil Nadu, found high prevalence of diabetes among the group."Many of them were also at high risk for CVDs. Clearly little has changed since then," he said.

Doctors say erratic dietary and sleep patterns are mostly related to stress. A study recently published in the Indian Journal of Critical Care Medicine found that four out of every 10 doctors in India suffer from moderate to severe stress levels. Around 21% doctors use alcohol, 18% anxiolytic or antidepressants and 14% smoke to cope with the stress.

Taking note of this uptick the IMA has directed all its district branches to set aside one day to screen their members.

Source: www.timesofindia.com

20.12.2016

To live a creative life, we must lose our fear of being wrong

Joseph Chilton Pearce

12 December, 2016

Mothers with diabetes have bigger babies, says study

A recent research conducted by the European Society of Cardiology has found that blood flows preferentially to the placenta instead of the brain in fetuses of mothers with diabetes, hence increasing the size of the infant. ‘We know that maternal diabetes mellitus affects the fetal organs,’ said lead author of the study, Aparna Kulkarni. Adding, babies born to mothers with diabetes are sometimes bigger, especially if the diabetes is uncontrolled, and the placenta is larger. There is data to suggest that some other organs such as the pancreas and the kidneys in the foetus might be affected.’ Kulkarni’s previous research identified subclinical changes in the heart muscle of foetuses of mothers with diabetes. In the current study she investigated whether these foetuses had changes in blood circulation.

The study included 14 foetuses of mothers with type 1 or 2 diabetes and 16 foetuses of mothers without diabetes (control group). Nine of the diabetic mothers used insulin, three took oral medications, and two used diet alone to control their glucose levels. The researchers used foetal Doppler echocardiography to measure blood flow to the brain, the left and right outflow tracts of the heart, the aorta and the placenta. The data was plugged into a computerized model, developed by Patricia Garcia-Canadilla that mimics the fetal circulation. This research found that, compared to fetuses in the control group, in fetuses of diabetic mothers more blood flowed to the placenta and was diverted away from the brain. Specifically, fetuses of diabetic mothers had lower placental resistance and compliance, lower blood flow to the arteries in the brain (measured from the cerebral artery radius), a reduced proportion of blood flow to the brain than the placenta and a lower cardiac output.

Kulkarni said: ‘The computational model equivalent of the fetal circulation is an electrical circuit where there are resistances and compliances. It is easier for blood to flow to the placenta, and harder for blood to flow to the brain.’ Adding, the placenta in fetuses of diabetic mothers have changes in their blood vessels and are known to be large; therefore likely receive more blood supply. But she added that the lower proportion of blood supplying the brain is an interesting finding and could have bigger implications. ‘The placenta gets taken away after a baby is born so it’s no longer a part of the circulation,’ she said.

Source: www.thehealthsite.com

12.12.2016

The only thing worse than being blind is having sight and no vision

 Helen Keller

10 December, 2016

Inhale through nose to enhance memory: Study

A recent study reveals that inhaling through nose heightens memory and response to fearful stimuli, whereas the effects disappear while mouth breathing.

The study was published in the Journal of Neuroscience.

According to Northwestern Medicine, the rhythm of breathing creates electrical activity in the human brain that enhances emotional judgments and memory recall. They found that individuals were able to identify a fearful face more quickly, if they encountered the face when breathing in compared to breathing out.

Individuals were also more likely to remember an object if they encountered it on the inhaled breath than the exhaled one. The effect disappeared if breathing was through the mouth.

"One of the major findings in this study is that there is a dramatic difference in brain activity in the amygdala and hippocampus during inhalation compared with exhalation," said lead study author Christina Zelano at Northwestern University Feinberg School of Medicine.

"When you breathe in, we discovered you are stimulating neurons in the olfactory cortex, amygdala and hippocampus, all across the limbic system," Zelano added.

They suggested that the amygdale- a roughly almond-shaped mass of grey matter inside each cerebral hemisphere, involved with the experiencing of emotion - is strongly linked to emotional processing, in particular fear-related emotions.

"When you inhale, you are in a sense synchronizing brain oscillations across the limbic network," Zelano noted.

Source: www.timesofindia.com

10.12.2016

Try not. Do, or do not. There is no try

Yoda

9 December, 2016

Time to heed cries of India's newborns

India is not doing enough to protect its youngest citizens. According to ‘Vital Statistics of India based on Civil Registration System 2014’ report, around 1.89 lakh infants died in 2014 and around 80,190 of them were girls. Though there was a reduction in the number of infant deaths - 1.87 lakh infants died the previous year, including 80,609 girls – the drop was very marginal. Several of India’s most prosperous districts, including Ahmedabad, Mumbai, Chandigarh and Bengaluru registered the highest number of infant deaths in 2014. Mumbai and Ahmedabad lead the country in the number of infant girl deaths too, with Bengaluru not far behind.The actual number of infant deaths in 2014 is likely to be far higher than reported. For one, the report does not include figures from Jharkhand. Additionally, the report deals with registered deaths only. Although the number of people registering infant deaths has grown over the years, around 25% of infant deaths continue to go unreported, the 2014 report points out. Non-registration of infant deaths is particularly serious in rural India; registered rural infant deaths were just 31.4% of total infant deaths in the country in 2014. Besides, stillbirths are not counted as neo-natal deaths in India.

India has been successful in halving the infant mortality rate (IMR) over the last 25 years. Between 1990 and 2015, the country’s IMR dipped from 80 infant deaths per 1,000 live birth to 39 in 2015. While the drop is impressive, an IMR of 40 per 1,000 is still too high
especially since many of these deaths are preventable. India contributes more than any other country to global under-5 and newborn deaths.

Some 80% of all newborn deaths in India result from three treatable conditions – complications during childbirth (including birth asphyxia), newborn infections, and complications associated with premature deaths. Besides neo-natal health conditions, other factors that contribute to poor health and thus the death of newborns, are illiteracy, poverty, poor maternal health and nutrition. Another main reason for the large number of neo-natal deaths in India is that a large number of deliveries (67%) take place without skilled personnel in attendance. Studies indicate that the presence of trained healthcare providers at the time of birth can substantially increase a newborn’s chances of survival. Just teaching a new mother thermal care practices – that is, how to wrap newborns to prevent exposure to cold, for instance - can save the lives of
many infants. India has around 9 lakh Accredited Social Health Activists (ASHAs), who are playing a crucial role in improving neo-natal health. Their numbers need to be increased. Importantly, the India Newborn Action Plan and the Janani Suraksha Yojana deserve more attention.

Source: www.deccanherald.com

09.12.2016

If there is no struggle, there is no progress

Frederick Douglass