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Nov 19
Truth about Vitamin D
Vitamin D is not a vitamin but indeed a hormone. Vitamin D was discovered nearly a hundred years ago and since then, several claims have been made of its role in areas other than bone and calcium metabolism. In the 1920s, it was found that a compound in cod liver oil prevented childhood rickets, a condition associated with severe bone deformities and mobility. This substance was later named Vitamin D, since vitamins A, B, and C were already known by then.

Around the same time, it was also found that ultraviolet radiation helped in Vitamin D synthesis, leading the public at large to expose themselves to sunlight, believing that 'tan is beautiful'. Nearly three decades later, evidence accumulated for adverse effects of excessive sunlight exposure - increased incidence of melanoma and other skin cancers in such individuals.

Awareness about the prevalence of Vitamin D deficiency and the role of its supplementation needs to be emphasised among the medical fraternity and general public. The Department of Pediatrics, Bangalore, Baptist Hospital, Hebbal, and ANBAI and IAP-BPS recently held a medical education programme by Dr P Raghupathy, Prof of Pediatrics at Indira Gandhi Institute of Child Health and eminent Pediatric endocrinologist. The session was chaired by Dr Alexander Thomas, CEO of Bangalore Baptist Hospital and Dr Achamma Thomas, Senior Pediatircian, BBH.

Dr Raghupathy said, "We are all Vitamin D deficient and this is because consumption of normal food does not supply Vitamin D, unless we have milk, butter, margarine, orange juice, specifically fortified with Vitamin D, as it is practised in many developed nations."
The skin is also a poor source for us, as we actively avoid the sun. Besides, pigmentation is also an impediment in facilitating Vitamin D synthesis.

This deficiency is commonly prevalent even in countries where sunshine is normally present throughout the year. For the production of active Vitamin D, well functioning intestines, liver and kidneys are required. Bone formation, calcium and phosphorus levels are dependent on adequacy of Vitamin D. Vitamin D deficiency in infants and young children causes muscle pain, difficulty and delay in standing and walking. Adults may suffer from vague muscle aches and bone pain, and tend to have an increased risk of bone fractures. They may also sway while walking (waddling gait), and may fall frequently.

Cancer of the colon, rectum, prostate and breast are known to develop more often in those who are Vitamin D deficient. Vitamin D is known to cut off blood supply to the malignant cells, thereby killing it. Children and young adults exposed to sunlight and with sufficient level of Vitamin D are known to have considerably lower risk of developing non-Hodgkin's lymphoma. It has been noted that people living in nations at a higher latitude with reduced sunshine have increased risk of cancers involving several organs.

Osteoarthritis, hypertension and cardiovascular diseases occur more often in higher latitudes. Schizophrenia, depression are observed to be less in individuals protected by adequate Vitamin D levels during their intrauterine life. Lung function improves with normal Vitamin D levels, while deficiency is associated with wheezing.

In the elderly, Vitamin D protects them against the risk of falls and fractures. One should also remember that Vitamin D must not be used in excess as it can cause Vitamin D toxicity. Undiagnosed Vitamin D deficiency is common. Vitamin D supplementation is essential for all ages in the right doses, as none of the foods that we normally eat can provide our daily requirement of this important vitamin.

Nov 19
How the U.N. Can Undo Damage From Chronic Disease
More than three of every five people who die today will do so because of a chronic, non-communicable disease ("NCD") such as diabetes, cardiovascular disease, cancer or lung disease. NCDs account for 75 percent of health care spending globally and cause hundreds of billions of dollars in productivity losses in developing countries alone. The human and economic costs are staggering.

Fortunately, the world is taking action. The United Nations just finished its first-ever High-Level Meeting on NCDs, potentially moving the world's most deadly and debilitating diseases to the top of the global agenda -- exactly where they belong.

Until recently, governments, donors and multilateral agencies like the World Health Organization have focused their attention on acute, infectious illnesses rather than NCDs.

Preventing the explosion of NCDs will not be easy. And positive outcomes from the U.N. meeting are unlikely without constructive engagement by the private sector.

In the past, some governments and multilateral agencies have tended to endorse regulation and mandates as the primary solution to global health challenges.

But government intervention isn't enough. The scope of this global health challenge calls for solutions far beyond the scope of any single institution.

Earlier this year, U.N. Secretary General Ban Ki-moon called on the world's businesses to help address NCDs. The private sector stands ready.

Governments, multilateral agencies, academia, non-governmental organizations (NGOs) and the private sector must join forces and pursue a wide range of innovative strategies, including multi-stakeholder partnerships, incentives, education and awareness campaigns to improve the way the world prevents, diagnoses and treats NCDs.

The private sector must make good on its social contract to help. We all share humanitarian concerns about improving public health. Yet businesses also have a vested interest in maintaining healthy and productive workforces. Nearly 50 percent of deaths occur among people in their most productive years.

Businesses also benefit from healthy consumers and economies -- which allow them to fulfill their responsibility to be profitable and competitive.

Delegates to the U.N. meeting must recognize the critical role businesses play in bringing valuable innovations to market, delivering tangible solutions, closing resource gaps and addressing the causes of poor health and disease.

While some NCDs arise from genetic and environmental factors, others result from unhealthy behaviors and lifestyle choices. As a result, they can often be combated with health promotion initiatives. Reducing tobacco, salt, sugar and alcohol consumption and improving diet and physical activity are practical, cost-effective approaches that can make a real difference.

Employers have tremendous power to lead on this front. Many companies have implemented health education and screening programs, no-smoking policies, workplace exercise campaigns, and community outreach initiatives.

Already, more than 40 organizations have joined the Workplace Wellness Alliance. Established by the World Economic Forum, this pioneering program supports the fight against NCDs by promoting best-in-class employee wellness programs through information-sharing and the use of standardized metrics.

Governments, multilateral agencies and donors must also prioritize their efforts, as roughly 80 percent of NCD-related deaths occur in low- or middle-income countries.

In developing countries, overcoming NCDs requires a different approach -- one that starts with establishing basic health systems and primary care infrastructures. Fortunately, we don't need to reinvent the wheel. The global campaign against AIDS, TB, and malaria has already put in place some of the health care infrastructure needed to tackle NCDs.

Partnerships, often led by NGOs and the private sector, have been particularly effective in this area. For example, the Boston-based non-profit Partners in Health, working in collaboration with the Rwandan Ministry of Health, has done a tremendous job controlling infectious diseases in Rwanda. Rwandans now have access to more than 400 health centers, 42 district hospitals, and 45,000 community health workers - and are living longer.

Now, Partners in Health is working with the Rwandan government to create a model for integrating NCD management into this existing primary care infrastructure, helping train nurses and community healthcare workers around a cluster of chronic diseases.

Efforts like this cannot succeed without a committed and diverse group of partners, including many from the private sector. Indeed, the most successful efforts are often powered by governments, NGOs and businesses working together to develop sustainable, locally-driven solutions.

About 36 million people die every year from NCDs. This number is set to increase to 52 million by 2030. That's a major challenge for the global community. Overcoming it will require an enlightened, inclusive approach that embraces and encourages partnerships among public and private organizations. The United Nations' meeting represents the opening volley in that pursuit.

Nov 18
TV viewing not PC hurts your heart more
A recent study has revealed that different kinds of sedentary activities may have different consequences on children's health, and high levels of TV viewing posses higher cardio-metabolic risk than high computer use.

"Even if a child is physically active, this activity is really only making up a short period of their whole day, so it's important to look at other aspects of their day to see what's going on. Part of that is the kind of sedentary behaviours they engage in," said Valerie Carson, a doctoral candidate in the School of Kinesiology and Health Studies at Queen's.

Previous research has identified high volumes of sedentary behaviour as a risk factor for cardiovascular diseases in adults.

But among the children she surveyed, Carson found no general connection between the volume of sedentary behaviour and the risk of developing diabetes or coronary heart disease.

Instead, she noticed some types of sedentary activities having a greater impact on children's health than others. Specifically, high levels of TV viewing predicted higher cardio-metabolic risk, whereas high computer use did not.

One possible explanation is that TV viewing falls near the bottom on the scale of energy expenditure, according to some research.

Another is that activities like snacking between meals that usually go hand-in-hand with specific kinds of screen times may be causing the associated health risks.

"The take home message is that we want children to be more physically active, but then, at the same time, we need to think about what they're doing the rest of the time," explained Mr. Carson.

"Our study suggests we should also limit children's television viewing time," she added.

Nov 17
Now cancer vaccine awaits human clinical trial
A therapeutic vaccine against cancer could well be on the way. After successfully undergoing animal tests, it is all set to undergo human clinical trial in a few months.

The vaccine, developed by scientists at the National Institute of Immunology (NII) here, may prove to be a boon to those suffering from breast, ovarian, cervical, thyroid and blood cancer.

Anil Suri, who heads the team that has developed the vaccine, said it would be put to clinical trials at the Cancer Institute at Adyar in Chennai and Memorial Sloan-Kettering Cancer Centre in the U.S.

The trial at Sloan-Kettering would be conducted under an agreement signed between the NII and the National Cancer Institute under the U.S. government's National Institutes of Health.

Speaking to a group of journalists on the sidelines of an international conference on cancer research at the NII, Dr. Suri said the trial in Chennai would focus on cervical cancer, while that in the U.S. on ovarian cancer.

Scientific Director of the Cancer Institute in Chennai T. Rajkumar said the trial would be conducted on 18 patients with stage III cervical cancer. The institute had received one round of approval from its ethics committee, but wanted to have another clearance before applying for the green signal from the Drug Controller-General of India. The trial could start around March next.

The vaccine centres around a new cancer treatment modality called dentiritic cell therapy, in which a patient's own immune cells are used to fight cancer. These cells, which are a kind of immune cells, are present in the body in small quantity. The therapy involves taking out blood cells from the patient and processing them in the laboratory to produce the dentiritic cells in large quantities and with improved efficacy.

They will then be primed with an antigen called SPAG-9, discovered by the NII scientists and given back to the patients in the form of a vaccine.

Nov 16
How to detect early signs of Alzheimer's
Scientists have come up with a cutting edge technology that would help in detecting Alzheimer's disease with almost perfect precision.

The new brain- scanning technique gives new hope for diagnosing the disease in its initial stages, even before symptoms develop completely and also indicates that there will be fewer chances of misdiagnosis.

The test is presently in the final clinical trial stages and if the results continue to prove successful, it could be rolled out by the end of 2012, the Daily Mail reported.

So far, the only way to diagnose Alzheimer's (AD) was by ruling out other diseases like cancer, depression or even a vitamin deficiency.

Definitive conclusion came only after the death of the individual, when the brain samples containing high levels of beta amyloid plaques, the growths that characterise AD, were found.

But now a new compound called Flutemetamol, which highlights areas of the brain that are affected by the disease when scanned, is showing hopeful results in clinical studies.

The compound is injected into the arm of the patients and those who show symptoms of AD undergo a Positron Emission Tomography (PET) scan.

If beta amyloid plaques are present in the brain, Flutemetamol makes them glow red, which confirms the patient has AD.

The second phase of the Flutemetamol study was finished earlier this year. In the study, 65 patients suffering with AD and other degenerative mental-health conditions with less than a year to live were given Flutemetamol to observe what PET scans revealed.

Post-mortem results divulged that when a specialist alone tried to diagnose each case, 15% of diagnoses were wrong. However, by using Flutemetamol there was only a seven per cent failure rate.

Any errors during the scan were because low levels of beta amyloid plaques do not essentially mean a patient has developed full-blown AD.

However, many experts believe that having a positive amyloid scan may signify the risk of developing AD in the future.

"What makes the results so revolutionary is that it makes both a correct and an earlier diagnosis possible for the first time," said Dr Francois Nicolas, director of neurology at GE Health, the company that is developing Flutemetamol.

"This could significantly increase the quality and even the length of a patient's life."

"Equally, those whose scan shows no signs of AD can be given the appropriate treatment they need too," he added.

Nov 15
Taj lit blue to create awareness about diabetes
Taj Mahal, the monument of love, was illuminated in blue light as a gesture to create awareness about diabetes on the eve of the World Diabetes Day. The foundation of Taj Mahal last night turned blue as lights, wrapped in translucent coloured paper and placed at various places in the monument, were lit. The move, permitted by the Archaeological Survey of India (ASI), was in response to a call by a number of organisations, including the Union Health Ministry, to create awareness about diabetes. "Turning the Taj Mahal blue was just a token gesture and neither the security nor the beauty of the monument was compromised," Superintending Engineer, ASI, Agra Circle, Indudhar Dwivedi told PTI. He said the permission to give a blue look to the Taj was restricted to the lower portion of the monument (little above the marble platform) and the dome area. The Akshardham temple in New Delhi along with the Fatehpur Sikri and Agra Fort were fully lit up yesterday, a day before the World Diabetes Day.

Nov 14
Type 2 diabetes rise due to stressful lifestyle
An Alarming rise in Type 2 diabetes, traditionally known to affect adults, is worrying scientists. In fact, the focus of this year's diabetes day is on children and adolescents.

"From school I return at 2. At 2:45 our tuitions are there and at 5 I return and have my snacks. Then I study till 9. I watch TV for one and half hours and then I sleep," said 12-year-old Hargun.

Hargun was diagnosed with diabetes and a sedentary and high level of stress proves to be a trigger.

Doctors blame the rise in Type 2 diabetes on the stressful lifestyle.

"South Asians are more prone to Type 2 diabetes. If because of your lifestyle you are putting on weight, you can develop Type 2 diabetes," said Dr Ambrish Mittal.

The International Diabetes Foundation finds that there has been an increment of 30 per cent in Type 2 diabetes in children in last two decades. In India a study on obese children in AIIMS found that out of 400 obese children four have got diabetes and almost 37 children were pre-diabetic between the age of 10 and 18.

There are some warning signs what parents can watch out for like increased thirst, increased need to urinate, increased appetite and fatigue, even blurred vision and frequent and slow healing infections.

Type 2 diabetes is not curable. It is a life long condition but you can learn how to manage it with a complete change in the lifestyle.

Apart from counseling, one can go for regular exercise, small frequent meals, high fibre, more of vegetables, low fats. This means avoiding fast food. One can also go for medication like Metfommin which is the key stone in treating Type 2 diabetes.

Change of lifestyle is especially important. If you have a history of diabetes that coupled with obesity increases your child's chances of getting diabetes by 50 per cent. There is no cure so prevention really is the key.

Nov 12
Bihar undertakes one of the largest kids' deworming program
Over 17 million children of Bihar have been provided with deworming treatment as part of one of largest school-based efforts ever conducted in the world, which has also helped reduce absenteeism by 25 per cent. Disclosing this here today, Alissa Fishbane, managing director of Deworm the World, a global initiative in this regard, said the programme was carried out by Bihar government with technical assistance and training provided by them. The programme was implemented from February through April 2011. Bihar, she said, has a very high rate of parasitic worm infection with all school-age children at risk. Over 50 per cent of school-age children are infected in most districts, according to prevalence surveys conducted by Deworm the World. She claimed that it has helped reduce school absenteeism by as much as 25 per cent. As worm infections damage children's health, education and development, all school-age children in Bihar nearly 21 million were targeted for deworming by this programme. She said infected children are more likely to suffer from malnutrition and anaemia and research has shown that children who remain infected earn 43 per cent less as adults, and are 13 per cent less likely to be literate. During the programme, nearly 140,000 teachers throughout Bihar were trained to deliver the medication, supported by 20,000 healthcare staff trained. The programme treated children between the ages 6 and 14 through network of 67,000 government schools state-wide. Deworm the World previously supported the Government of Andhra Pradesh to launch a school-based deworming programme.

Nov 12
India among four pneumonia laggards
India records the highest number of child pneumonia deaths globally, but is among the only four of the 15 countries with the highest child pneumonia death toll that is yet to introduce the newest generation of pneumoccal vaccines.

A Pneumonia progress report, 2011, released by the International Access Vaccine Centre (IVAC) and John Hopkins Bloomberg School of Public Health on Wednesday shows that India recorded 3.71 lakh child pneumonia deaths in 2008, but till 2010 had "not introduced" the HIB vaccine against pneumonia.

It had also not taken "any action" to introduce PCV10 and PCV - the newest-generation of pneumococcal vaccines. The report says last year alone, 10 of the 15 countries have either introduced PCV10 or PCV13, have been approved for introduction, or have applied to the GAVI Alliance for introduction support.

It is estimated that by 2013, 11 of the 15 countries will have introduced the pneumococcal vaccines in their national immunization programmes. India is among the four countries that haven't taken much action. Together, these 15 countries account for approximately 75% of the global toll of child pneumonia.

The report says in India, while 69% of children suspected to have pneumonia were taken to a health facility, only 13% were administered antibiotics.

Feeding infants only breast milk in the first six months of life is a key protection intervention highlighted in the report. Breast milk alone provides all of the essential nutrients babies need to thrive and grow. Exclusive breastfeeding has multiple positive effects, and chief among them is its ability to bolster an infant's immunity to help combat disease, protecting babies from not only pneumonia but also diarrhoea and other infections.

However, the report says that only 46% of children in India are exclusively breastfed by their mothers in the first six months, which is abysmally low.

It explains, "Pneumonia remains the leading killer of young children around the world, according to the most recent WHO estimates. Every year, pneumonia claims the lives of more than one million children before their fifth birthday - accounting for more young deaths annually than AIDS, malaria and tuberculosis. In the 15 focus countries alone, an additional half a million more children were vaccinated against pertussis, more than 1 million additional children were vaccinated against measles and about 155,000 more children were vaccinated against HIB pneumonia, as compared to the previous year."

It is estimated that as many as 3-4 million child deaths could be prevented by accelerating pneumococcal vaccines in all developing countries over the next decade.

"However, even more children can be saved from pneumonia if additional gains are made in the following areas "promoting exclusive breastfeeding, recognizing the signs and symptoms of pneumonia early and ensuring proper treatment with antibiotics and limiting exposure to indoor smoke," it adds.

Every four minutes, one child dies of pneumonia-causing diseases in India even before reaching their fifth birthday.

Global toll count

1. India: 371, 605

2. Nigeria: 177, 212

3. Congo: 112, 655

4. Pakistan: 84, 210

5. Afghanistan: 80, 694

6. China: 62, 229

Nov 11
Gautam Gambhir lends a hand to a noble cause
Extending his support to spreading awareness about organ donation in the country, cricketer Gautam Gambhir, leading by example, has pledged to donate his organs and also promised to speak and encourage other Indian cricketers to follow suit.

He took the pledge here on Thursday after launching 'Gift a Life' initiative - a website supported by the Apollo Transplant Institutes -- to encourage people to take a pledge for donating organs to save countless lives in the process.

"Thousands die every year for want of organs and I feel that through this initiative we can do the society good as it helps us bridge the gap between the demand for these organs and their availability, I appeal to the media to create awareness about organ donation and would like to urge everyone to make this decision to donate their organs," he said.

The cricketer also inaugurated the website www.giftalife.org, a one stop destination for all questions about organ donation where the general public can also pledge to donate their organs. He also signed a 'travelling wall' that will be taken around schools and colleges encouraging students to take the pledge.

The mission 'Gift a Life' is an endeavour to ensure that no person in India dies for want of an organ. This public awareness initiative aims to bring together information and awareness on the issue of organ donation. The website endeavours to start and then sustain a movement on organ donation and awareness.

Apollo Hospital group medical director Dr. Anupam Sibal said: "We need to create awareness about organ donation in India. While in Spain 33 per million population organ donations take place, in our country the rate is 0.1 per million population. It is now more than 15 years since the law declaring brain death came into effect in India, yet there is limited awareness that one individual can gift lives to at least eight patients with organ failure. As a clinician it really pains to lose a child for the want of an organ."

Leading specialists from Apollo Hospitals were present at the inauguration of the website to extend their support to the programme.

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