Here’s why heart diseases should be made public health priority in India

Agencies
April 7, 2018

New Delhi, Apr 7: Heart Failure is a progressive, debilitating and potentially life-threatening condition, which is responsible for silently killing one-third of patients during hospital admission and one-fourth within 3 months of diagnosis.

On World Health Day 2018, the Cardiological Society of India (CSI) has urged the people to prioritise heart failure as a public health priority. The need of the hour is to develop a comprehensive approach to combat heart diseases in India which is on its way to becoming an epidemic in the country.

Focusing on the ‘Health for all’ theme of World Health Day 2018, the CSI calls for introducing programmes concentrating on screening and detection of symptoms of heart diseases among the rural population as such initiatives need to be scaled up across the country.

It is important that the growing incidence of heart failure should be seen as a public health challenge to further reduce mortality and morbidity due to heart failure. ‘Heart failure’ doesn’t mean that the heart is about to stop working, but it is a potentially life-threatening condition where the heart cannot pump enough blood around the body. This, in most cases, happens because the heart muscle, which is responsible for the pumping action, weakens or stiffens over time.

According to the Non-Communicable Diseases Country Profiles released by the WHO, of the estimated 98.16 lakh deaths in India, NCDs led to nearly 6 million, which is 60% of the total mortality reported annually in the country.

Cardiovascular diseases (CVDs) are the leading cause of mortality, accounting for more than half of all deaths resulting from NCDs. The burden of CVDs is rising at a significantly high rate among middle-income and lower-income geographies.

According to Dr K Sarat Chandra, president, Cardiological Society of India, “Indians have all the reasons to be alarmed over matters of the heart. With the burden of heart failure snowballing in India and the associated high death rates, it is necessary to recognise heart failure as a public health priority in the country. The disease has socio-economic and emotional implications for the patient and his family, impacting the overall quality of life. The need of the hour is for all stakeholders to come together to develop a community-level approach to raise awareness about this condition.”

The increased prevalence of heart diseases in India can be attributed mainly to lifestyle factors like tobacco use, unhealthy diet, physical inactivity and psychosocial stress. Heart failure is a global health problem, affecting about 26 million people worldwide. The disease burden of heart failure is around 10 million in India.

Dr Ambuj Roy, additional professor of cardiology, AIIMS, New Delhi, said, “Untreated Heart Failure is a rapidly progressive and potentially fatal condition, so it is important to recognize the symptoms promptly and get treated at the earliest to prevent a rapidly downhill course. This is especially critical, since there is no way to reverse the damage already done, and treatment helps in containing further damage to the heart and other body organs. Simple medicines and in some cases implantable devices are known to benefit these patients and prolong their survival.”

Data from low-income and middle-income countries like India suggested that mortality in patients with heart failure in these countries is greater than that in high-income countries. It is estimated to have cost about US$100 billion in 2012. The marked variation in mortality is attributed to low awareness, economic disparity, and ease of access to high-quality healthcare facilities, environmental and genetic factors.

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Agencies
March 11,2020

With the sales of chicken and mutton going down due to the coronavirus scare, it is the humble 'Kathal' (jackfruit) is emerging as an acceptable alternative.

'Kathal' is now selling at ₹120 per kilogram -- an increase of more than 120 per cent over the normal ₹50 per kilogram.

The jackfruit, in fact, is now priced higher than chicken which is selling at ₹80 per kilogram due to poor demand.

"It is better having a 'Kathal' biryani instead of a mutton biryani. It tastes reasonably good. The only problem is that 'Kathal' has been sold out in the vegetable market and is difficult to find," said Purnima Srivastava whose family savours non-vegetarian food on a regular basis.

The corona scare has hit poultry business so hard and the Poultry Farm Association recently organized a Chicken Mela in Gorakhpur to dispel the misconception that birds are carriers of the deadly virus.

"In fact, we gave away plateful of chicken dishes for Rs 30 to encourage people to savour the delicacies. We cooked one thousand kilograms of chicken for the Mela and the entire stock was sold out," said Vineet Singh, head of the Poultry Farm Association.

However, the Mela did not do much to dispel the fears about chicken, mutton or fish consumption amid the virus outbreak.

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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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News Network
February 26,2020

New York, Feb 26:  A new wearable sensor that works in conjunction with artificial intelligence (AI) technology could help doctors remotely detect critical changes in heart failure patients days before a health crisis occurs, says a study.

The researchers said the system could eventually help avert up to one in three heart failure readmissions in the weeks following initial discharge from the hospital and help patients sustain a better quality of life.

"This study shows that we can accurately predict the likelihood of hospitalisation for heart failure deterioration well before doctors and patients know that something is wrong," says the study's lead author Josef Stehlik from University of Utah in the US.

"Being able to readily detect changes in the heart sufficiently early will allow physicians to initiate prompt interventions that could prevent rehospitalisation and stave off worsening heart failure," Stehlik added.

According to the researchers, even if patients survive, they have poor functional capacity, poor exercise tolerance and low quality of life after hospitalisations.

"This patch, this new diagnostic tool, could potentially help us prevent hospitalizations and decline in patient status," Stehlik said.

For the findings, published in the journal Circulation: Heart Failure, the researchers followed 100 heart failure patients, average age 68, who were diagnosed and treated at four veterans administration (VA) hospitals in Utah, Texas, California, and Florida.

After discharge, participants wore an adhesive sensor patch on their chests 24 hours a day for up to three months.

The sensor monitored continuous electrocardiogram (ECG) and motion of each subject.

This information was transmitted from the sensor via Bluetooth to a smartphone and then passed on to an analytics platform, developed by PhysIQ, on a secure server, which derived heart rate, heart rhythm, respiratory rate, walking, sleep, body posture and other normal activities.

Using artificial intelligence, the analytics established a normal baseline for each patient. When the data deviated from normal, the platform generated an indication that the patient's heart failure was getting worse.

Overall, the system accurately predicted the impending need for hospitalization more than 80 per cent of the time.

On average, this prediction occurred 10.4 days before a readmission took place (median 6.5 days), the study said.

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