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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
May 17,2020

Geneva, May 17: Spraying disinfectant on the streets, as practised in some countries, does not eliminate the new coronavirus and even poses a health risk, the World Health Organization (WHO) warned on Saturday.

In a document on cleaning and disinfecting surfaces as part of the response to the virus, the WHO says spraying can be ineffective. "Spraying or fumigation of outdoor spaces, such as streets or marketplaces, is... not recommended to kill the Covid-19 virus or other pathogens because disinfectant is inactivated by dirt and debris," explains the WHO.

"Even in the absence of organic matter, chemical spraying is unlikely to adequately cover all surfaces for the duration of the required contact time needed to inactivate pathogens." The WHO said that streets and pavements are not considered as "reservoirs of infection" of Covid-19, adding that spraying disinfectants, even outside, can be "dangerous for human health".

The document also stresses that spraying individuals with disinfectants is "not recommended under any circumstances".

"This could be physically and psychologically harmful and would not reduce an infected person's ability to spread the virus through droplets or contact," said the document.

Spraying chlorine or other toxic chemicals on people can cause eye and skin irritation, bronchospasm and gastrointestinal effects, it adds.

The organisation is also warning against the systematic spraying and fumigating of disinfectants on to surfaces in indoor spaces, citing a study that has shown it to be ineffective outside direct spraying areas.

"If disinfectants are to be applied, this should be done with a cloth or wipe that has been soaked in disinfectant," it says.

The SARS-CoV-2 virus, the cause of the pandemic that has killed more than 300,000 people worldwide since its appearance in late December in China, can attach itself to surfaces and objects.

However, no precise information is currently available for the period during which the viruses remain infectious on the various surfaces.

Studies have shown that the virus can stay on several types of surfaces for several days. However, these maximum durations are only theoretical because they are recorded under laboratory conditions and should be "interpreted with caution" in the real-world environment.

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Dr G K Sudhakar Reddy
August 4,2020

Being overweight or obese is now recognised as a serious cause of ill health and disability. There is a significant positive association between orthopaedic disorders and the level of obesity causing pain, deformity and difficulty in walking.

Excess body weight accumulation increases pressure on joints, particularly the hips, knees and ankles.

Here are a few type of  arthritis:

Osteoarthritis

It is a condition of damage/ wear and tear of the joint lining or cartilage. Obesity triggers this by loading excessive weight on the weight bearing joints like the knee and the hip. 

Knee Osteoarthritis

This is the most common arthritis especially in the Indian subcontinent.

While walking, an individual exerts 3 to 6 times pressure that of the body weight on the weight-bearing knee joint, which means in an obese with excess body weight, larger forces are exerted, which lead to higher risk of deterioration of cartilage.

In addition, there are excessive fat tissues that produce hormones and other factors that affect the joint cartilage metabolism and cause inflammation of the joints giving rise to joint pathology.  Leptin is one of the hormones causing knee osteoarthritis. 

Hip osteoarthritis

The force exerted across the hip is 3 times that of body weight. Hip osteoarthritis is caused by factors such as joint injury, increasing age and being overweight.    

Hand osteoarthritis

The observation that obese individual has a higher risk in having hand osteoarthritis has led to a hypothesis that the metabolic effect produced by fat tissue is the underlying factor. 

Osteoporosis

It is a progressive bone condition of decrease in bone mass and density (Bone Mineral Density or BMD) which can lead to an increased risk of fracture. Recent research suggests that obesity may accelerate bone loss. It is the amount of muscle mass which is seen in an active person, which accounts for bone strengthening effects and not due to the fat seen in a heavy person.

Low back pain

Low back pain from degenerative disc disease of the lumbar spine is one of the most disabling conditions in the community and overweight and obesity have the strongest association with seeking care for low back pain.

Managing Hip and Knee Osteoarthritis

Life style changes

If one is overweight, try to lose weight by doing more physical activity and eating a healthier diet. Regular exercise keeps you active and mobile and builds up muscle, thereby strengthening the joints and can improve symptoms. 

Pain Killers

Painkillers help with pain and stiffness for short term. They don’t affect the arthritis itself and won’t repair the damage to your joint. Creams and gels can be applied directly onto painful joints.

Nutritional Supplements

Glucosamine and chondroitin are nutritional supplements. Animal studies have found that glucosamine can both delay the breakdown of and repair damaged cartilage. However, there is insufficient evidence to support the use of glucosamine in humans and one can expect only a mild-to-moderate reduction in pain

Joint injections

If pain from osteoarthritis is severe joint steroid injections are injected into the joints that can reduces swelling and pain. The injections can start working within a day or so and may improve pain for several weeks or months. 

Hyaluronic acid injections, which help to lubricate your knee joint also give short term relief. In early stages. Stem cell treatment or cartilage regeneration procedures are being tried in young people with small defects, however it is still experimental and lacks long term evidence.

Surgery

May be recommended if you have severe pain or mobility problems.

Arthroscopy

If one has frequent painful locking/stiffening episodes especially in the knee joint, an operation to wash out loose fragments of bone and other tissue as joint can be performed by a minimally invasive key hole procedure called Arthroscopy.

Arthrodesis

If hip or knee replacement is not suitable, especially in young people who do heavy manual work, one can consider an operation known as an arthrodesis, which fuses your joint in a permanent position. This means that your joint will be stronger and much less painful, although you will no longer be able to move it.

Osteotomy

In young, active people in whom a knee joint replacement would fail due to excessive use one can consider an operation called an osteotomy. This involves adding or removing a small section of bone either above or below your knee joint.  This helps realign your knee so your weight is no longer focused on the damaged part of your knee. An osteotomy can relieve your symptoms of osteoarthritis, although you may still need knee replacement surgery eventually as you grow old

Joint replacement surgery

Joint replacement therapy is most commonly carried out to replace hip and knee joints. It involves replacing a damaged, worn or diseased joint with an artificial joint made of special plastics and metal.

For most people, a replacement hip or knee will last for at least 20 years, especially if it is cared for properly and not put under too much strain.

Dr G K Sudhakar Reddy is a Sr Consultant Orthopaedic Surgeon at Citizens Speciality Hospitals, Hyderabad

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Agencies
April 17,2020

Washington DC, Apr 17: In recent research, scientists have linked the emotional, social and psychiatric problems in children and adolescents with higher levels of genetic vulnerability for adult depression. The study implies that the genetics passed from parents may be linked with psychiatric problems in children and adolescents and may also leading to depression in adults.

University of Queensland scientists made the finding while analysing the genetic data of more than 42,000 children and adolescents from seven cohorts across Finland, the Netherlands, Norway, Sweden and the UK.

Professor Christel Middeldorp said that researchers have also found a link with a higher genetic vulnerability for insomnia, neuroticism and body mass index.

"By contrast, study participants with higher genetic scores for educational attainment and emotional well-being were found to have reduced childhood problems," Professor Middeldorp said.

"We calculated a person's level of genetic vulnerability by adding up the number of risk genes they had for a specific disorder or trait and then made adjustments based on the level of importance of each gene We found the relationship was mostly similar across ages," Middeldorp added.

The results indicate there are shared genetic factors that affect a range of psychiatric and related traits across a person's lifespan.

Middeldorp said that around 50 per cent of children and adolescents with psychiatric problems, such as attention deficit hyperactivity disorder (ADHD), continue to experience mental disorders as adults, and are at risk of disengaging with their school community among other social and emotional problems.

"Our findings are important as they suggest this continuity between childhood and adult traits is partly explained by genetic risk," the Professor said.

"Individuals at risk of being affected should be the focus of attention and targeted treatment," Middeldorp continued.

"Although the genetic vulnerability is not accurate enough at this stage to make individual predictions about how a person's symptoms will develop over time, it may become so in the future, in combination with other risk factors. And, this may support precision medicine by providing targeted treatments to children at the highest risk of persistent emotional and social problems," Middeldorp added.

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