World Cancer Day, a day to renew vow to implement preventable strategies in India

February 4, 2017

New Delhi, Feb 4: World Cancer Day is being observed today (February 4) to raise cancer awareness and to encourage its prevention, detection and management.

CancerCancer accounts for more deaths worldwide than AIDS, malaria, and tuberculosis combined.

According to the World Economic Forum (WEF),"Cancer is among one of the three greatest risks to the global economy".

In India, cancer is one of the 10 leading causes of deaths in India and is an increasing public health challenge. With a prevalence of three million and annual incidence of one million, the statistics are alarming. It kills around five lakh people annually. In 2011, the UN resolution declared 4 key strategies to curb rising burden of cancers - tobacco control, controlling unsafe use of alcohol, obesity control and better nutrition.

Dr Vedant Kabra, Director of Surgical Oncology, Fortis Memorial Research Institute, Gurugram and a Voice of Tobacco Victims (VoTV) patron, says, "To have a clean and safe campus is every child's right. We must work on preventable strategies along with the treatments. It is a misery to see youngsters impacted by tobacco use and families getting destroyed mentally, financially and socially due to cancers."

Dr.Kabra further elaborates that "Hazards of tobacco are unlimited. There's no body part which is not affected by it. Smokeless tobacco contains nicotine, which is highly addictive. There are 3095 chemical components in tobacco, among them 28 are proven carcinogen. The major and most abundant group of carcinogens is the tobacco-specific N-nitrosamines (TSNA) and N-nitrosoamino acids."

"The nitrosamine level is directly related to the risk of cancer. Scientific evidence has established that tobacco chewing causes cancer of mouth, oesophagus (food pipe), larynx and pharynx (throat), pancreas, stomach, kidney and lung. It can also cause high blood pressure and other life threatening cardiovascular conditions like myocardial ischemia (heart attack), brain stroke etc. The use of smokeless tobacco during pregnancy can cause still birth, low birth weight, premature delivery, anaemia of mother and several complications during delivery," he adds.

As per the Global Adult Tobacco Survey (GATS) released by the MoHFW (2010), around 43 lakhs people above the age of 15 in Haryana (i.e. one in every four individual) are consuming tobacco in some or the other form. One-third of them will be diseased by the serious illnesses such as cancer, heart diseases, lung cancers among others and will die premature deaths.

Dr.Pankaj Chaturvedi, Professor Surgical Oncology, Tata Memorial Hospital, said, "It is a mammoth task to improve the nutritional status of a nation of one billion people. However, importantly control on tobacco / areca nut / alcohol / junk food is well within the reach of our policy makers."

While the cancer causing effects of tobacco are well known, most are still unaware of harmful effects of Alcohol, areca nut and obesity. The only way to discourage their usage is to strictly implement the Cigarette and Tobacco Product (COTPA) Act that aims to prohibit smoking in public places, prohibit sale to minors, stop direct and indirect advertising.

In India, every year in India, around one million new cancer cases are diagnosed and around 600,000 to 700,000 people die from cancer. In a report of April 2014, around two-fifths (40 percent) of all cancers in India are attributable to tobacco use and the economic costs of illness and premature death due to tobacco consumption exceed combined government and state expenditure and state expenditure on medical and public health, water supply and sanitation[i].

In India, 5500 children initiate tobacco use every day. Indeed, a very alarming statistic. A very effective strategy to prevent the 90 percent of oral cancers and 40 percent of all cancers is controlling the initiation of tobacco from childhood. Implementation of Section 4 & 6 of the Cigarettes and Other Tobacco Products Act (2003) would leave children with no access to tobacco products and have a clean and safe campus. If we make youngsters aware right from the childhood about the hazards of tobacco, the initiation rates would be very less thereby preventing these cancers.

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Agencies
May 19,2020

Researchers have found that patients with peripheral artery disease or stroke were less likely to receive recommended treatments to prevent heart attack than those with coronary artery disease. All three are types of atherosclerotic cardiovascular disease.

Depending on the location of the blockage, atherosclerosis increases the risk for three serious conditions: coronary artery disease, stroke and peripheral artery disease.

"Our study highlights the need for public health campaigns to direct equal attention to all three major forms of atherosclerotic cardiovascular disease," said senior study author Erin Michos from the Johns Hopkins University in the US.

"We need to generate awareness among both clinicians and patients that all of these diseases should be treated with aggressive secondary preventive medications, including aspirin and statins, regardless of whether people have heart disease or not," Michos added.

Since atherosclerosis can affect arteries in more than one part of the body, medical guidelines are to treat coronary artery disease, stroke and peripheral artery disease similarly with lifestyle changes and medication, including statins to lower cholesterol levels and aspirin to prevent blood clots.

Lifestyle changes include eating a healthy diet, being physically active, quitting smoking, controlling high cholesterol, controlling high blood pressure, treating high blood sugar and losing weight.

What was unclear was if people with stroke and peripheral artery disease received the same treatments prescribed for those with coronary artery disease.

This study compared more than 14,000 US adults enrolled in the 2006-2015 Medical Expenditure Panel Survey, a national survey of patient-reported health outcomes and conditions, and health care use and expenses.

Slightly more than half of the patients were men, the average age was 65, and all had either coronary artery disease, stroke or peripheral artery disease.

These individuals were the representative of nearly 16 million US adults living with one of the three forms of atherosclerotic cardiovascular disease.

Compared to participants with coronary artery disease, participants with peripheral artery disease were twice more likely to report no statin use and three times more likely to report no aspirin use.

Additionally, people with peripheral artery disease had the highest, annual, total out-of-pocket expenditures among the three atherosclerotic conditions.

The findings showed that participants with stroke were more than twice as likely to report no statin or aspirin use.

Moreover, those with stroke were more likely to report poor patient-provider communication, poor health care satisfaction and more emergency room visits.

"Our study highlights a missed opportunity for implementing life-saving preventive medications among these high-risk individuals," Michos said.

The study was presented in the virtual conference at the American Heart Association's Quality of Care & Outcomes Research Scientific Sessions 2020.

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Agencies
May 6,2020

Washington D.C., May 5: Working from home has become the new normal ever since the outbreak of coronavirus and in today's time the work duties can be easily dealt with by means of mobile devices at home.

However, this easy use of technology, mobile devices for that matter, has the potential to blur the fine line between work and the other daily life routines.

But, contrary to the belief, a study at the University of Jyvaskyla reveals that the mixing of work and other daily life routines may have more benefits than previously assumed, and points to the importance of boundary-spanning communication.

A smartphone enables phone calls, email, and file transfers from the comfort of home. The study shows that there may be more effective ways to maximise the benefits of smartphone use, without diminishing employees' flexibility and the use of these technologies.

"People often forget to talk about positive effects, such as autonomy and freedom the employees gain when they have the flexibility to schedule their work," said Postdoctoral Researcher Ward van Zoonen from JYU, who with his colleagues examined the use of smartphones for work matters outside working hours.

The study paid special attention to the benefits of talking about domestic matters with the immediate supervisor outside the working hours given to an employee.

"This reduces the conflict between work and other life," van Zoonen said.

"If people in an organisation strive for more dialogue between employees' different life domains, it is possible to create a functional environment where people can talk about different matters."

The research findings show that when employees communicate across boundaries and talk at work about their life in other respects, they can receive new kinds of support and understanding from their immediate supervisor.

"This kind of communication creates a low threshold for contacting one's supervisor, which helps employees build a balance between the different domains of their lives and strengthens their organisational identification," said Professor Anu Sivunen describing the findings.

This means that tight working time restrictions to protect employees might not be beneficial after all, if they hinder reaching the positive results indicated in this research.

For the study, a survey was taken of 367 employees who were asked questions such as -- how much they talk about their work with their family, and how much they talk about their family with their immediate supervisor.

"Both supervisors and their employees answered the surveys, and the study actually focused on their mutual communication," Sivunen said.

"Usually people at workplaces are interested in how communication within the work community is succeeding. It is often forgotten how an immediate supervisor can take an employer's other life into account and thereby help the employee gain work-related benefits."

"Communication with one's immediate supervisor during flexible working hours, also on matters other than work, could ease the daily lives of many employees if they could share the possible challenges of their family life or free time with their supervisor in these settings," Sivunen added.

According to the study, such a practice could make the supervisor aware of the employee's situation as he/she works from home and the related impacts on their work performances.

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Agencies
July 7,2020

The World Health Organization (WHO) is reviewing a report that suggested its advice on the novel coronavirus needs updating after some scientists told the New York Times there was evidence the virus could be spread by tiny particles in the air.

The WHO says the Covid-19 disease spreads primarily through small droplets, which are expelled from the nose and mouth when an infected person breaths them out in coughs, sneezes, speech or laughter and quickly sink to the ground.

In an open letter to the Geneva-based agency, 239 scientists in 32 countries outlined the evidence they say shows that smaller exhaled particles can infect people who inhale them, the newspaper said on Saturday.

Because those smaller particles can linger in the air longer, the scientists - who plan to publish their findings in a scientific journal this week - are urging WHO to update its guidance, the Times said.

"We are aware of the article and are reviewing its contents with our technical experts," WHO spokesman Tarik Jasarevic said in an email reply on Monday to a Reuters request for comment.

The extent to which the coronavirus can be spread by the so-called airborne or aerosol route - as opposed to by larger droplets in coughs and sneezes - remains disputed.

Any change in the WHO's assessment of the risk of transmission could affect its current advice on keeping one-metre physical distancing. Governments, which also rely on the agency for guidance policy, may also have to adjust public health measures aimed at curbing the spread of the virus.

"Especially in the last couple of months, we have been stating several times that we consider airborne transmission as possible but certainly not supported by solid or even clear evidence," Benedetta Allegranzi, the WHO's technical lead for infection prevention and control, was quoted as saying in the New York Times.

WHO guidance to health workers, dated June 29, says that SARS-CoV-2, the virus that causes Covid-19, is primarily transmitted between people through respiratory droplets and on surfaces.

But airborne transmission via smaller particles is possible in some circumstances, such as when performing intubation and aerosol-generating procedures, it says.

Medical workers performing such procedures should wear heavy-duty N95 respiratory masks and other protective equipment in an adequately ventilated room, the WHO says.

Officials at South Korea's Centers for Disease Control said on Monday they were continuing to discuss various issues about Covid-19, including the possible airborne transmission. They said more investigations and evidence were needed.

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