'Heart disease set to spike in India, especially in the south'

October 17, 2012

heart

New Delhi, October 17: India is set to witness a spike in deaths due to heart diseases, far exceeding that of China, with more and more younger people falling victim and a large percentage of patients coming from south India, said an expert.

According to well-known radiologist Harsh Mahajan, by 2020 India will have more than 4.77 million deaths a year due to cardiovascular disease (CVD) and 2.58 million deaths due to coronary heart diseases (CHD).

China, which has the world's largest population at 1.34 billion, will have 4.53 million deaths due to CVD and 1.37 million due to CHD by 2020. The figures are from the Global Burden of Diseases Study conducted by WHO.

While north Indian states - including Jammu and Kashmir, Punjab and Uttar Pradesh - have a high percentage of people suffering from heart diseases, south Indian states of Kerala and Tamil Nadu have a higher prevalence of CHD, he said quoting from a study.

"In south India, a lot of people are vegetarian. But vegetarianism is no safeguard. In fact, coconut oil leads to heart diseases," Mahajan said at a talk Tuesday evening at the India International Centre here.

"In 2004, 14 percent of total deaths in India were due to heart diseases... and the percentage keeps rising," said Mahajan, president of the Indian Radiological and Imaging Association and founder of the city's well-known Mahajan Imaging Centre.

Unlike the "mistaken thought" that heart pain occurs on the left side of the chest, the expert said it occurs in the middle of the chest, and some patients could also feel pain in the shoulder, elbow and jaw. This could be accompanied by shortness of breath, a feeling of light-headedness and even severe sweating.

"It is important to recognize the symptoms, and act... even if it seems a case of overkill,"

said Mahajan.

"I am not saying we should get over-anxious, but let us not ignore the symptoms. The first hour is when most of the deaths occur. It may be worth going to the doctor even if it turns out to be a false alarm," Mahajan said.

Diabetic patients don't get the pain indicative of a heart attack coming on "because their nerves get deadened", he said. "Diabetics may never feel chest pain at all," he said.

Other signs to watch out for are the feelings of constriction and discomfort while jogging or running. "When you feel something you've never felt before, if you have any problem while active that is relieved by rest, you need to see the doctor."

While coronary heart diseases are due to arteries getting narrowed due to blockages, Mahajan said "60-70 percent of heart attack patients don't get significant narrowing of arteries".

"It is generally patients who have 30-40 percent blockage with plaque deposits, who are most prone to heart attacks," Mahajan said.

Listing the efficacy of testing mechanisms, Mahajan said ECG/EKG (Electrocardiography) shows up an angina, while X-rays are useful in detecting abnormalities in heart size.

The treadmill test "is not a great test if done in isolation", said Mahajan. According to the expert, the best machine is the Dual Energy GSI Spectral CT Scanner, which his laboratory has introduced in India - the first to do so.

It is a non-invasive test, which can look inside the heart and vessels - even at the stents to see their condition, it can see the plaque deposits. "It is the ultimate tool. Each and every millimetre of the arteries and segment can be seen, as well as the plaque," Mahajan said.

Japan is the only other country in Asia to have a similar machine, which has just got FDA approval. The radiology exposure due to the machine is negligible, he said.

The machine provides 128 slices of imaging of the body. The cost of an imaging is Rs.15,000

Cardiovascular diseases would be the largest cause of death and disability in India by 2020 as per a World Health Organisation (WHO) report. By 2030, it is expected that 23 million people will die from CVDs annually.

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Agencies
June 26,2020

New Delhi, Jun 26: Over 700 employees of Hindu Rao Hospital would stage a protest against North Delhi Municipal Corporation on Friday morning over non-payment of their salaries since April. The staff includes paramedical, nurses, and Class IV employees of the hospital. However, the employees said that only 40 or 50 people would gather to stage the protest keeping COVID situation in mind, and the norms of social distancing would also be followed.

Tejinder Singh, president of the Paramedical technical staff welfare association, said that the corporation is forcing the employees to go on a protest when they are needed the most. "The government hails us as Corona warriors but do not treat us like one," he commented.

"We all have families. Many amongst us have taken loans, live on rental accommodation, and have children whose schools and colleges are demanding fees. How would we incur our expenses when we are not paid? We repeatedly asked the corporation to clear our dues, but our requests fell on deaf ears. We don't have any option but to go on protest," he said.

Besides, Singh also said that the staff of Hindu Rao had not received arrears of seventh pay commission, bonus and dearness allowances for two years. "These are our rights which we are being denied. The protest is to call out injustice and ignorance we face from the administration," he added.

The nurses of the hospital corroborated with Singh. However, they also added the issues they are facing since the pandemic started that they would be rising through the protest.

Nurses complain lack of facilities despite hospital gearing up as dedicated COVID care

Indumati Jaiswal, president of nurses' welfare association of the hospital, said that apart from salaries, the hospital is not providing many facilities required by the staff to battle the pandemic. The Delhi government had designated the hospital as a dedicated COVID facility on June 16.

"The preparedness for such responsibility is completely shoddy. There is no provision for air conditioners and coolers for us. We have to work wearing PPE kits for six hours straight under ceiling fans. The lack of AC and coolers amplifies our struggle to stay under PPE kits for longer hours. We can't even drink water in that duration. It's just inhumane," Jaiswal said.

Jaiswal also said that the hospital is facing staff crunch, yet, have not prepared a roster for the nurses. "The hospital has 238 nurses on 700 doctors. This is opposite to the prescribed guidelines of the Indian Nurses Council that suggests four nurses per doctor as a healthy ratio. Here, we have less than five nurses per doctor. A complete opposite of an ideal scenario," she complained.

Jaiswal said that the room for donning and doffing the PPE kits should be outside the ward. "In the hospital, it's within the ward, and the nurses have to cross through the patients to wear in and out the PPE suits. It increases the risk of contracting COVID-19 from the patients," she said.

The hospital employees informed that more than 40 healthcare workers from Hindu Rao had contracted the COVID-19 infection.

The corporation argues lack of funds behind delay in salaries

Indu Singhal, the deputy commissioner of North Delhi Municipal Commissioner, told media corporation is in the process to resolve the salary issues of the Hindu Rao Hospital's staff. "We have received their complaints and pursuing the matter. We will release their dues as soon as we receive the funds from the government," she said.

However, a senior official of the corporation revealed that the corporation is reeling under an acute shortage of funds. "Even the employees working in the corporation have not been paid salaries. The employees of A-grade are not paid since March," the official said.

Singhal said that the dispersion of salaries starts from the lower base. "Many officers, including I have not been paid," she added.

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News Network
August 8,2020

The Kozhikode International Airport located at Karipur is not safe for the landing of flights in rainy season, according to an air-safety expert, who had warned the aviation ministry and the civil aviation regulator about this in 2011. 

The warning was particularly about the dangers of permitting passenger aircraft to land on runway 10 of the airport during rains and unfavourable wind conditions. 

Nine years later, on August 7, 2020, the warning became a reality when an Air India Express pilots landed in tailwind conditions and the aircraft overshot the tabletop runway to drop off the end and crash.

 “An aircraft landing on runway 10 in tailwind will experience poor braking action due to heavy rubber deposits … All such flights … are endangering the lives of all on board,’’ said Capt Mohan Ranganathan, in a letter sent on June 17, 2011 to then director general of civil aviation Bharat Bhushan and Nasim Zaidi, chairman of a civil aviation safety advisory committee, which was formed after the May 2010 Mangaluru air crash which killed 158 people.

“My warning issued after the Mangaluru crash was ignored. It is a table-top runway with a down slope. The buffer zone at the end of the runway is inadequate,” Capt Ranganathan said. Given the topography, he pointed out, the airport should have a buffer of 240m at the end of the runway, but it only has 90m (which the DGCA had approved). “Moreover, the space on either side of the runway is only 75m instead of the mandatory 100m,” he added.

Capt Ranganathan said there is no guideline for operations on a table-top runway when it is raining. “Runway 10 approach should not be permitted in view of the lack of runway end safety area (RESA) and the terrain beyond the end of the runway. RESA of 240m should be immediately introduced and runway length has to be reduced to make the operations safe,” his letter said.

If an aircraft is unable to stop within the runway, there is no RESA beyond the end. The ILS localiser antenna is housed on a concrete structure and the area beyond is a steep slope. “The Air India Express accident in Mangalore should have alerted AAI to make the runway conditions safe. We have brought up the issue of RESA during the initial Casac-sub group meetings. We had specifically mentioned that the declared distances for both runways have to be reduced in order to comply with ICAO Annex 14 requirement,” Capt Ranganathan said.

He said the condition of the runway strip was known to DGCA teams that have been conducting inspection and safety assessments. “Have they considered the danger involved? Did the DGCA or the airlines lay down any operational restrictions or special procedures?”

The letter also refers to Approach and Landing Accident Reduction (ALAR) training, which is supposed to be mandatory before every monsoon, but airlines don’t follow it, he said. “70% of accidents take place during approach and landing and that is why this training is essential,” he added.

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News Network
March 7,2020

New Delhi, Mar 7: No country in the world says everybody is welcome, External Affairs Minister S Jaishankar said on Saturday, hitting out at those criticising India over the Citizenship (Amendment) Act.

Jaishankar criticised the United Nations Human Rights Council (UNHRC) for its criticism on the situation in Jammu and Kashmir, saying its director had been wrong previously too and one should look at the UN body's past record on handling the Kashmir issue.

"We have tried to reduce the number of stateless people through this legislation. That should be appreciated," he said when asked about the CAA at the ET Global Business Summit. "We have done it in a way that we do not create a bigger problem for ourselves."

"Everybody, when they look at citizenship, have a context and has a criterion. Show me a country in the world which says everybody in the world is welcome. Nobody says that," the minister said.

The external affairs minister said moving out of the Regional Comprehensive Economic Partnership (RCEP) was in the interest of India's business.

Asked about the UNHRC director not agreeing with India on the Kashmir issue, Jaishankar said: "UNHRC director has been wrong before.

"UNHRC skirts around cross-border terrorism as if it has nothing to do with country next door. Please understand where they are coming from; look at UNHRC's record how they handled Kashmir issue in past," he added.

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