Mental health might not be on the priority list of public health practitioners in India, but an analysis of government data shows that around 20 per cent of all patients seen by primary healthcare doctors in India have one or more mental disorders.

The findings show that one in four families is likely to have at least one member with a behavioural or mental disorder.

These disorders account for 10.5 per cent of the global burden of disease in 1990.

This burden increased to 12 per cent in 2000 and an analysis of trends in the World Health Report--2001 indicates this burden will increase to 15 per cent by 2020.

According to the National Family Health survey, in India, at a given point of time, nearly 15 million people suffer from serious psychiatric illness and another 30 million from mild to moderate psychiatric problems.

In order to address these issues, the Government launched the National Mental Health Programme in 1996 in four districts as a pilot project.

Subsequently, in 2003, this was enhanced to include upgrading of psychiatry-wings of Government Medical Colleges or General Hospitals and modernisation of state-run mental hospitals.

The outlay for the National Mental Health Programme has been increased from Rs 140 crore in the last plan to Rs 1,000 crore for the present plan period, senior health ministry officials said.

The government is also planning community mental health camps and is looking to develop partnerships for the same.

Minister for Health and Family Welfare Ghulam Nabi Azad will inaugurate an international conference-cum-workshop on Asia Pacific Community Mental Health.

The conference will be organised in collaboration with Asia Australia Mental Health, a consortium of Department of Psychiatry and Asia Link of University of Melbourne and St Vincent's Health, a leading healthcare provider of Australia.

The workshop-cum-conference will be attended by mental health leaders from 17 countries of Asia and Pacific region as well as state nodal officers of National Mental Health Programme, member secretaries of State Mental Health Authorities, leading mental health institutes, prominent NGOs working in mental health and users of mental health services from India.

The conference will provide an opportunity to the delegates to share their experiences and learn from one another for developing better models of community-based mental health care. It will also strengthen the leadership role of India in community mental health development, the officials said.

A "preventer" inhaler containing corticosteroid is part of many asthma sufferers' daily routine, but it can result in reduced growth and children often forget to take it.

This study, published in The Lancet, shows that it is possible to manage the symptoms without a daily dose.

Asthma UK said daily treatment was still the most effective, and concerned patients should speak to their doctor.

The disease causes inflammation of the tubes which carry air to and from the lungs. If they become irritated, then the airways narrow, sticky mucus is produced and breathing becomes difficult.

More than 5 million people in the UK are being treated for the illness and Asthma UK estimates 1.1 million have asthma which is mild and under control.
Missing doses

Researchers at the University of Arizona believe there is a problem with the way the disease is managed.

Two types of inhalers are used: "relievers" which are used when breathing is difficult and "preventers" which are taken every morning and evening.

However, the researchers said that many children stop taking the daily medication if their symptoms disappear.
Continue reading the main story

If you have any concerns about your asthma treatment, Asthma UK recommends you speak to your doctor or asthma nurse

End Quote Dr Samantha Walker Asthma UK

Professor Fernando Martinez, from the University of Arizona, told the BBC: "If you have a daily drug and a very significant number are not taking it, then that tells you it's a losing strategy."

"We want to find something which is more child- and parent-friendly as well as avoid the growth effect."

In all, 288 children and teenagers with mild and persistent asthma took part in the 44-week trial.

The study showed that taking corticosteroids twice a day was still the most effective treatment, However, those taking the medication grew by 1.1cm (0.5in) less than children not taking the drug during the trial.
Potent combination

Importantly, asthma was also managed without daily treatment if the corticosteroids were combined with the "reliever" inhaler.

This eliminated the effect on growth and the researchers say it would be an easier form of treatment for children.

Further clinical trials will be needed to verify the results.

Professor Martinez said: "I'm continuing to recommend daily corticosteroid to my patients, but I know some of them will not take it."

Asthma UK said the study confirmed that daily inhaled corticosteroids were the most effective treatment.

Dr Samantha Walker, executive director of research and policy at Asthma UK, said: "We know that long-term adherence to medicine treatment plans can be difficult, particularly when a child's asthma seems to be under control.

"The use of combined 'preventer' and 'reliever' medicines as rescue therapy appears to be superior to 'reliever' inhalers alone and offers a new 'step-down' approach to the management of mild, well-controlled asthma in children and young people who find it difficult to adhere to long-term daily treatment with inhaled steroids.

"Many parents have concerns about their child's steroid intake. However, research shows that children on low daily doses of 'preventer' medicines show no difference in growth. At higher doses, the picture is less clear. For all children, treatment plans should be reviewed at least every six months.

"If you have any concerns about your asthma treatment, Asthma UK recommends you speak to your doctor or asthma nurse."

A new study suggests that there may be profound connections between hearing impairment and the risk of developing dementia, the degenerative condition which is characterized by a progressive deterioration of cognitive function and the ability to process thought intelligently.

The researchers found the risk of cognitive decline was nearly double in older people with mild hearing loss and it quintupled in those exhibiting severe hearing impairment compared with those with normal hearing.

Lead author of the study, Dr. Luigi Ferrucci, chief of the U.S. National Institute on Aging's Longitudinal Studies Section, as well as director of the Baltimore Longitudinal Study of Aging, stated, "This work suggests that there is a strong predictive association between hearing loss as an adult and the likelihood of developing cognitive decline with aging."

Link between hearing loss and dementia assessed
In a bid to determine if hearing loss could be identified as a risk factor for dementia, the researchers conducted a study.

They focused on 639 adults aged 36 to 90 who were without dementia at the onset of the study in 1990.

All the study subjects underwent cognitive and hearing testing over a period of 4 years. They were then monitored for the development of dementia and Alzheimer's through May 31, 2008.

It was noted that 125 had mild hearing loss (25 to 40 decibels), 53 had moderate hearing loss (41 to 70 decibels) while six exhibited severe hearing loss (more than 70 decibels).

Revelations of the study
A follow-up at 11.9 years found 58 participants were diagnosed with dementia, including 37 who had Alzheimer's disease.

It was noticed that the risk of dementia elevated in those with hearing loss of greater than 25 decibels.

After taking into account age and other risk factors, the investigators found that the danger of cognitive decline was two fold higher in those with mild hearing impairment.

Additionally, the risk of being diagnosed with dementia was three times higher in those with moderate hearing loss which rose five-fold for severe impairment compared with normal hearing.

Dr Lin stated, "Hearing loss may be causally related to dementia, possibly through exhaustion of cognitive reserve, social isolation, environmental deafferentation [elimination of sensory nerve fibres or a combination of these pathways.

"If confirmed in other independent cohorts, the findings of our study could have substantial implications for individuals and public health."

The research was published in the 'Archives of Neurology.'

A class action lawsuit has been filed against Procter & Gamble, makers of Fixodent, alleging that the company failed to warn consumers sufficiently about the zinc contained in their denture cream.

According to attorneys, the adhesive contains high levels of zinc which has poisoned the users causing them serious nerve damage.

Fixodent is widely used by millions of people in the United States in order to keep their dentures secure in place.

Many users are completely oblivious of the fact that their denture cream contains zinc or that excessive use of the product can leave them with severe and debilitating neurological damage such as neuropathy, numbness, tingling, pain, loss of sensation, loss of balance, paralysis, and breathing difficulties.

Two customers involved in the lawsuit
Lead plaintiff Mark Jacoby, a 41-year-old construction worker who has worn dentures for 20 years gradually started losing balance, became unsteady and was eventually confined to the wheel chair.

His doctors tied his debilitating neurological illness to the high levels of the zinc found in his body which came from his denture cream, Fixodent.

"I started getting tingling in my fingertips. And then it started happening in my toes," said Mark Jacoby. "I started getting weaker and, you know, I couldn't walk right, off balance and I'm at this point now."

He added, "I can almost guarantee you it was the Fixodent. It's soaked into your body and it messes with the nerves."

Another client, Anne Coffman, 48, is suffering from drowsiness, tingling in the arms and legs and burning sensations. She also has problem maintaining her balance.

According to the doctors, all her symptoms are linked to neuropathy, a nerve disorder that affects the entire central nervous system that has been linked to excessive use of denture cream.

Coffman now uses a wheelchair and finds it difficult to tackle everyday tasks because of the weakness in her limbs.

"I started getting numbness in my toes. I wasn't sure so I kind of didn't do anything about it at first," Coffman said. "Then it started moving over to both feet and then ... up to my knees."

She added,"[Fixodent] is the only product that I've ever used that had zinc in it."

Connection between denture cream and nerve damage made 5 years ago
The connection between the product and zinc was made by researchers at the University of Texas nearly five years ago when they assessed four denture users with neurological disease.

Dr Sharon Nations, author of the study stated, "They had high zinc levels that we could measure in the blood. And all of them reported that they were using very large amounts of denture cream."

The company's defense
Procter & Gamble subsequently updated the Fixodent packaging to list zinc as an ingredient and warn the customers that ""prolonged zinc intake may be linked to adverse health effects."

Even in the face of the lawsuit, Procter & Gamble stand by their product.

They stated, "Procter & Gamble is committed to providing safe and effective products for all consumers. That is who we are and what we stand for. We go to great lengths to ensure that our products safely deliver best-in-class performance, so consumers can choose our products with total confidence.

"Fixodent is safe for use as directed, as supported by the experience of millions of consumers over many years. Our Fixodent formula has undergone extensive scientific testing, and we continuously monitor for its safe use. ...

"We know of no valid scientific evidence that using Fixodent as directed causes any ill health effects."

If you suffer from allergies, take heart: Researchers say you may be less likely to develop a tough-to-treat brain cancer, possibly because your immune system is on high alert.

It's not clear how this knowledge might improve prevention or treatment of brain cancer, but the study's lead author said the findings pave the way for further research.

"We need to do more studies to really get at that underlying mechanism. Then we might be able to do things that would influence people who might have a higher risk or may have a family history," said Bridget J. McCarthy, a research associate professor of epidemiology at the University of Illinois at Chicago.

The lesions studied are known as gliomas, the most common type of adult brain tumor. They account for more than half of the 18,000-plus malignant brain tumors diagnosed in the United States every year, according to the U.S. National Cancer Institute.

Gliomas -- which led to the death of Sen. Edward Kennedy -- often cause death within months, despite surgery or treatment with chemotherapy or radiation.

Researchers have published conflicting studies about whether people with allergies and autoimmune disorders (which cause the immune system to attack the body) have a lower risk of developing the tumors, McCarthy said. "We wanted to look at the spectrum and see if we found the association with any type of allergy," McCarthy explained.

In the study, published Feb. 7 in the journal Cancer Epidemiology, Biomarkers & Prevention, McCarthy and colleagues examined surveys filled out by 419 patients with gliomas and 612 cancer-free patients from North Carolina and Illinois. All of the patients were asked if they had doctor-diagnosed allergies -- seasonal, medication, food, pet or any other -- and whether they took antihistamines.

The researchers found that patients with both high- and low-grade tumors were more likely to report no allergies than the other patients. And the more allergies someone had, the lower their odds of having gliomas. Antihistamine use didn't affect the results, the authors said.

However, the study didn't specify exactly how much more likely it is that an allergy-free person will develop a glioma compared to someone who has allergies.

What might allergies -- or the lack of them -- have to do with brain tumors? McCarthy said overactive immune systems may cause allergies and also allow people to fight off cancer. Figuring out what to do about this is the tough question.

"Obviously, it's not like allergies are a modifiable risk factor," she said. "You can't tell people to go out and develop allergies. That's not going to happen. And you can't tell people with allergies that, 'You're doing a good thing, and don't try to get rid of them.'"

The study doesn't prove a cause and effect -- that allergies directly lower the risk of brain tumor. It only shows a possible connection, one that doesn't sway Dr. Eugene S. Flamm, chairman of the department of neurosurgery at Montefiore Medical Center in New York City.

Flamm said the study is small and draws conclusions "far beyond the observational data."

"As the authors point out, there are several conflicting reports in the literature, and this paper does not resolve the issue in any way," Flamm said.

One reason for the conflicting reports, the authors said, was that "allergy" was defined differently in various studies -- sometimes broadly and sometimes narrowly, as in seasonal allergies alone. Further studies are essential, they said.