Knee pain is a common reason to visit the doctor. Patellofemoral pain syndrome is a condition in which pain occurs at the front of the knee during or after exercise. Symptoms usually start during adolescence when participation in sporting activities is high. Also, women are more likely to be affected than men.

General medical advice is to rest during periods of pain and to avoid pain provoking activities. This "wait and see" approach is considered as standard care.

The findings of a recent study suggest there is limited evidence on the effectiveness of exercise therapy with respect to pain reduction. There are inconsistent facts with respect to functional improvement.

In order to find out more, researchers based in the Netherlands investigated the effectiveness of supervised exercise therapy. They compared it with usual care in 131 patients aged between 14 and 40 years with patellofemoral pain syndrome.

From the total of 131 participants included in the study, 65 were assigned to a supervised exercise program (intervention group) and 66 to usual care (control group). Both groups received similar written information about the syndrome and similar instructions for home exercises. All participants were instructed to refrain from painful activities.

At the start of the study, patients rated their recovery, pain at rest, pain on activity, and function scores. They did so again after three and twelve months.

After three months, the intervention group reported considerably less pain and better function than the control group. At twelve months, the intervention group continued to show superior outcomes than the control group with regard to pain at rest and pain on activity, but not function.

A higher proportion of patients in the exercise group than in the control group reported recovery (42 percent compared to 35 percent at three months and 62 percent compared to 51 percent at twelve months). However, these results were not considerably different between the two groups.

The authors say that the findings of this study give indication that supervised exercise therapy for patellofemoral pain syndrome in general practice is more effective than usual care for pain at rest, pain on activity, and function at three and twelve months. On the other hand, supervised exercise therapy had no effect on perceived recovery.

They say in closing that further research is necessary in order to understand how exercise therapy results in better outcome.

Colombo: Facing criticism over the death of a school girl allegedly after being administered with Rubella vaccine, Sri Lanka has said the drug imported from India was of international standard and its quality is good.

Health Minister Nimal Siripala De Silva said the rubella vaccine, an anti-measles drug, being administered in Sri Lanka is purchased from Pune-based Serum Institute of India.

"There is no problem about the quality. The dates for the use of the vaccine had not expired when it was administered," he told Parliament yesterday reacting to reports that a school girl in Wariyapola in northern Sri Lanka died after being administered the vaccine.

In March, a school girl had died under similar circumstances in Matara in southern coast of Sri Lanka forcing the Serum Institute to get the product tested from the Maharashta Government.

"The test proved that there was nothing wrong in the rubella vaccine and it was not sub-standard," the state run Daily News quoted Dr Firdos Rustom Mehta, World Health Organisation Representative to Sri Lanka, as saying.

The diabetes bomb is ticking in India and experts say massive awareness campaigns should be launched by both government and educational institutions. Healthy eating habits should be taught from childhood to curb the growing threat of the lifestyle disease that has already impacted 50 million people in the country.
India, which has been dubbed the diabetes capital of the world, is also seeing a number of children and those living in rural areas suffering from the disease.


Diabetes no longer remains an urban phenomenon or restricted to adults, Nikhil Tandon, professor of endocrinology at the All India Institute of Medical Sciences (AIIMS), told IANS.


He said due to urbanisation and industrialisation, villages were now becoming towns. "Small towns have been industrialised. So the urban and rural divide has been blurred. And this means lifestyle changes," said the endocrinologist.


He said he agrees with the findings of the latest report by the International Diabetic Federation (IDF) that said India leads the world in the looming epidemic of diabetes.


The report, which was presented at the 20th annual World Diabetes Conference in Montreal Monday, said India currently has the highest number of people (50.8 million) suffering from diabetes, followed by China (43.2 million) and the US (26.8 million). The report projected 58.7 million diabetes cases in India by 2010 - almost seven percent of its adult population.


By 2030, over 8.4 percent of the Indian adult population will suffer from diabetes, thanks to the increasing life expectancy and urbanisation, the report predicted.


Tandon said: "Massive awareness campaigns should be started both in rural and urban areas. It should not be limited to metros alone. The message should reach the remotest parts of India."


"The best way is to take initiatives now. This can only happen when we target people right from school to college, workplace and at the community level," he added.


"We are seeing young children suffer from diabetes. It is only through education that we will be able to communicate the dangers of the chronic disease. Good habits start from childhood. Teachers and parents have to understand that physical exercise is important," Tandon said.


He said small steps such as not serving junk food in school cafeterias, parents sending wholesome food for lunch and teachers and parents ensuring time for children to play would make a difference.


Rekha Sharma, a director and a dietician at the Diabetes Foundation of India (DFI), said: "India has become the diabetic capital of the world. The sedentary lifestyle and unhealthy eating habits are the most important factors leading to an increase in diabetes in the country."


"There is a need to bring changes in our lifestyle and eating habits. We have to shift to a more wholesome diet rather than refined and junk food and follow an active lifestyle," she said.


The IDF report warns that diabetes will impose a huge economic burden on India and other countries. Apart from losing billions in productivity, the report said, India will also be spending $2.8 billion annually on diabetes control measures by 2010.


There are estimated to be 285 million diabetic cases worldwide, accounting for seven percent of the world's population.


Diabetes, along with cardiovascular disease, cancer and chronic respiratory diseases, accounts for 60 percent of all deaths worldwide.


N.K. Pandey, general surgeon and chairman Asian Institute of Medical Science, said: "Diabetes will become the largest workload on the health care sector in the coming years due to our sedentary nature of work, growth in average incomes, and the spread of westernisation."


"There is a global shift in diet towards increased intake of energy-dense foods that are high in fat and sugars but low in vitamins, minerals and other micro nutrients," he said.


"It is high time we change our lifestyle, before it is too late," Pandey said.

India leads the world in the looming epidemic of diabetes, the 20th annual World Diabetes Congress of the International Diabetic
Federation (IDF) was told here on Monday.

In its annual report, the IDF said India currently has the highest number of 50.8 million people suffering from diabetes, followed by China with 43.2 million and the US with 26.8 million. The report projected 58.7 million diabetes cases in India by 2010 - almost 7 per cent of its adult population.

By 2030, over 8.4 per cent of the Indian adult population will suffer from diabetes, thanks to the increasing life expectancy and urbanisation, the report said.

Warning Indian policy makers, the report said, "Evidence suggests that in more affluent parts of the country, the rural prevalence is higher than in less affluent rural areas, indicating that increasing economic growth will raise diabetes prevalence in India even more than these possibly conservative estimates have indicated."

The rampaging diabetes will impose a huge economic burden on India and other countries, it added. Apart from losing billions in lost productivity, the report said, India will also be spending $2.8 billion annually on diabetes control
measures by 2010.

There are estimated to be 285 million diabetes cases worldwide, accounting for seven per cent of the world's population.

Diabetes, along with cardiovascular disease, cancer and chronic respiratory diseases, accounts for 60 per cent ff all deaths worldwide.

"Diabetes imposes a large economic burden on the individual, national healthcare system and economy. Healthcare expenditures on diabetes are expected to account for 11.6 per cent of the total healthcare expenditure in the world in 2010," the report said.

"Estimated global healthcare expenditures to treat and prevent diabetes and its complications are expected to total at least $376 billion in 2010."

Addressing the congress, Martin Silink, outgoing president of the International Diabetic Federation, said the epidemic of diabetes will increase from 7 million new cases a year in 2007 to 10 million new cases this year.

The epidemic is getting out of control, said incoming IDF president Jean-Claude Mbanya. He said if the trend continues unchecked, there will be 435 million people with diabetes worldwide by 2030.

More than 12,000 delegates and 400 speakers from around the world are attending the congress.

Beijing: India has asked developing countries to maintain steadfast unity on the issue of climate change to ensure that developed nations take due responsibility for scaling down greenhouse gas emissions.

With the world gearing up to meet for a major climate summit in Copenhagen this December, union health minister Ghulam Nabi Azad said that developing countries were not responsible for concentration of green house gases in the atmosphere and hence Western nations should take lead in combating climate change.

Azad said that the countries of the 'south', whose per capita emissions are still very low, should unite to ensure that these obligations are met by the developed countries.

"We, the countries of the south should maintain steadfast unity to ensure that these obligations are met by the developed countries," he said while addressing the 5th Asia Pacific Conference on Reproductive and Sexual Health and Rights (APCRSHR).

"The United Nations Framework Convention on Climate Change has specifically recognised that parties should take action to protect the climate system on the basis of equity and in accordance with their common but differentiated responsibilities and respective capabilities," he said.

He said that accordingly the developed country parties should take the lead in combating climate change and the adverse effects thereof.