Exposure to second-hand smoke down in India, but remains major concern – Here are survey details

Agencies
June 9, 2018

New Delhi, Jun 9: Exposure to second-hand smoke remains a major concern in India even though there has been a reduction in such exposure at home and public places since 2009-10, as per the Global Adult Tobacco Survey 2 (GATS 2), released here by the Health Ministry. However, exposure to second-hand smoke at healthcare facilities has increased in this period. The survey showed that little more than one-third (35 per cent) of the non-smokers were exposed to second hand smoke (SHS) at home in India. In urban areas 25 per cent of non-smokers and in rural areas 40.4 per cent of non-smokers were exposed to SHS at home, respectively.

Among all adults, 5.3 per cent were exposed to second hand smoke in government buildings, 3.6 per cent at private work places, 5.6 per cent in healthcare facilities, 7.4 per cent in restaurants, 13.3 per cent in public transport, 2.1 per cent in bar/night club and 2.2 per cent in cinema halls. In all 25.7 per cent of adults were exposed to second hand smoke in any of these seven public places.

Nationally, 37.7 per cent pregnant women were exposed to SHS at home during the one month preceding the survey while 21.0 per cent pregnant women were exposed to SHS at their workplace and 25.9 per cent were exposed to SHS at any of the seven in public places. “The proportion of households in which smoking is allowed has decreased significantly from 60.4 per cent in GATS 1 (2009-10) to 48.8 per cent in GATS 2 (2016-17).

The proportion of non-smokers exposed to SHS at home has decreased significantly from 48 per cent in GATS 1 to 35 per cent in GATS 2,” the report stated. Among all adults, exposure to SHS at government buildings/offices has decreased significantly from 6.6 per cent in GATS 1 to 5.3 per cent in GATS 2 while at restaurants it has decreased from 11.3 per cent to 7.4 per cent.

In public transports, exposure to SHS has decreased significantly from 17.5 per cent in GATS 1 to 13.3 per cent in GATS 2. However, exposure to SHS at healthcare facilities has increased from 5.4 per cent in GATS 1 to 5.6 per cent in GATS 2. The survey showed that 28.6 per cent of people, aged 15 and above, currently use tobacco in some form in India even though the prevalence of tobacco use has declined significantly over the last seven years.

It also showed that every third adult (32.5 per cent) from rural areas and every fifth adult (21.2 per cent) from urban area reported current use of tobacco with the prevalence among men being 42.4 per cent and among women it was 14.2 per cent.

From GATS 1 in 2009-10 to GATS 2 in 2016-17, the prevalence of any form of tobacco use has decreased significantly by six percentage points from 34.6 per cent to 28.6 per cent. The prevalence of daily tobacco use has decreased by 4.2 percentage points (relative decrease of 14.4 per cent) and the prevalence of occasional tobacco use has decreased by 1.7 percentage points (relative decrease of 31.5 per cent).

The decrease in both is statistically significant. ? There is a significant increase of one year in the mean age at initiation of tobacco use from 17.9 years in GATS 1 to 18.9 years in GATS 2, the report highlighted. According to the report, khaini, a tobacco, lime mixture, is the most commonly used with every ninth adult (11.2 per cent) in India using it followed by bidi, which is smoked by 7.7 per cent of adult Indians.

In urban areas, khaini (6.8 pc ) and gutka (6.3 pc ) are the two most commonly used tobacco products, whereas in rural areas khaini (13.5 pc) and bidi (9.3 pc ) are the most prevalent tobacco products. GATS 2 was carried out in 30 states of India and in the two union territories of Chandigarh and Puducherry from August 2016 to February 2017.

The analysis is based on 74,037 completed interviews, among which 33,772 were with men and 40,265 with women. Of these, 47,549 interviews were conducted in rural areas and 26,488 in urban areas.

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Agencies
March 3,2020

Taking multiple courses of antibiotics within a short span of time may do people more harm than good, suggests new research which discovered an association between the number of prescriptions for antibiotics and a higher risk of hospital admissions.

Patients who have had 9 or more antibiotic prescriptions for common infections in the previous three years are 2.26 times more likely to go to hospital with another infection in three or more months, said the researchers.

Patients who had two antibiotic prescriptions were 1.23 times more likely, patients who had three to four prescriptions 1.33 times more likely and patients who had five to eight 1.77 times more likely to go to hospital with another infection.

"We don't know why this is, but overuse of antibiotics might kill the good bacteria in the gut (microbiota) and make us more susceptible to infections, for example," said Professor Tjeerd van Staa from the University of Manchester in Britain.

The study, published in the journal BMC Medicine, is based on the data of two million patients in England and Wales.

The patient records, from 2000 to 2016, covered common infections such as upper respiratory tract, urinary tract, ear and chest infections and excluded long term conditions such as cystic fibrosis and chronic lung disease.

The risks of going to hospital with another infection were related to the number of the antibiotic prescriptions in the previous three years.

A course is defined by the team as being given over a period of one or two weeks.

"GPs (general physicians) care about their patients, and over recent years have worked hard to reduce the prescribing of antibiotics,""Staa said.

"But it is clear GPs do not have the tools to prescribe antibiotics effectively for common infections, especially when patients already have previously used antibiotics.

"They may prescribe numerous courses of antibiotics over several years, which according to our study increases the risk of a more serious infection. That in turn, we show, is linked to hospital admissions," Staa added.

It not clear why hospital admissions are linked to higher prescriptions and research is needed to show what or if any biological factors exist, said the research team.

"Our hope is that, however, a tool we are working for GPs, based on patient history, will be able to calculate the risks associated with taking multiple courses of antibiotics," said Francine Jury from the University of Manchester.

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Agencies
March 15,2020

Should you let your babies "cry it out" or rush to their side? Researchers have found that leaving an infant to 'cry it out' from birth up to 18 months does not adversely affect their behaviour development or attachment.

The study, published in the Journal of Child Psychology and Psychiatry, found that an infant's development and attachment to their parents is not affected by being left to "cry it out" and can actually decrease the amount of crying and duration.

"Only two previous studies nearly 50 or 20 years ago had investigated whether letting babies 'cry it out' affects babies' development. Our study documents contemporary parenting in the UK and the different approaches to crying used," said the study's researcher Ayten Bilgin from the University of Warwick in the UK.

For the study, the researchers followed 178 infants and their mums over 18 months and repeatedly assessed whether parents intervened immediately when a baby cried or let the baby let it cry out a few times or often.

They found that it made little difference to the baby’s development by 18 months.

The use of parent’s leaving their baby to ‘cry it out’ was assessed via maternal report at term, 3, 6 and 18 months and cry duration at term, 3 and 18 months.

Duration and frequency of fussing and crying was assessed at the same ages with the Crying Pattern Questionnaire.

According to the researchers, how sensitive the mother is in interaction with their baby was video-recorded and rated at 3 and 18 months of age.

Attachment was assessed at 18 months using a gold standard experimental procedure, the strange situation test, which assesses how securely an infant is attached to the major caregiver during separation and reunion episodes.

Behavioural development was assessed by direct observation in play with the mother and during assessment by a psychologist and a parent-report questionnaire at 18 months.

Researchers found that whether contemporary parents respond immediately or leave their infant to cry it out a few times to often makes no difference on the short - or longer term relationship with the mother or the infants behaviour.

This study shows that 2/3 of mum's parent intuitively and learn from their infant, meaning they intervene when they were just born immediately, but as they get older the mother waits a bit to see whether the baby can calm themselves, so babies learn self-regulation.

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Agencies
June 4,2020

The World Health Organisation on Wednesday said that anti-malarial drug hydroxychloroquine (HCQ) will return to the solidarity trial for the potential treatment of coronavirus disease.

At a press conference in the WHO headquarters in Geneva, Director General Tedros Adhanom Ghebreyesus said: "On the basis of the available mortality data, the members of the committee recommended that there are no reasons to modify the trial protocol. The Executive Group received this recommendation and endorsed continuation of all arms of the solidarity trial, including hydroxychloroquine."

The world health body had temporarily suspended the usage of HCQ from the solidarity trial for coronavirus treatment on May 25 soon after a study published in one of the most reliable medical journals, which had suggested that the drug could cause more fatalities among COVID-19 patients.

However, the WHO chief said that the decision was taken as a precaution while the safety data was reviewed.

Ghebreyesus also said that the Data Safety and Monitoring Committee will continue to closely monitor the safety of all therapeutics being tested in the solidarity trial.

"So far, more than 3,500 patients have been recruited in 35 countries. WHO is committed to accelerating the development of effective therapeutics, vaccines and diagnostics as part of our commitment to serving the world with science, solutions and solidarity," he said.

Soon after HCQ was suspended from the trial, the Indian government had said that the antimalarial drug has been known for its benefits for a long time and its usage will be continued on the frontline workers, including police and healthcare professionals, as prophylaxis. The government had also said that studies were being conducted and the drug would be included in the clinical trial also for the treatment of coronavirus disease.

US President Donald Trump also had strongly advocated the use of HCQ and called it a "game-changer". He went to the extent of saying that he had taken the medicine.

Launched by WHO and partners, solidarity trial is an international clinical trial to find an effective treatment for COVID-19, including drugs to slow the progression of the disease or improve survival. The trial, which enrols patients from different countries, "will compare four treatment options against standard of care to assess their relative effectiveness against COVID-19", said WHO. 

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