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

[email protected] (Agencies)
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
March 16,2020

New Delhi, Mar 16: A recent survey across 140 districts of the country shows that about 54 per cent of Indians are finding travelling to be unsafe as the deadly coronavirus (COVID-19) pandemic sweeps globally.

The big worry that people have is community transmission, something that researchers from around the world have approximated at 10 per cent of total infections and more common in places like Wuhan in China, South Korea, Iran and Italy.

The months of March to June have historically been high travel season for most Indians, largely due to the summer vacations in schools. "But it seems that Indians do not want to take a chance with this rather scary virus and are either cancelling or postponing their travel plans," concluded the survey by LocalCircles.

The survey gathered more than 22,000 responses from participants in tier one, two and three cities. It said 48 per cent Indians plan to cancel their international business travel for the next four months.

Besides, nearly 38 per cent of respondents said they had to pay cancellation fee to the website, travel agent, airline or railways.

"These are testing times for the entire travel and tourism industry -- airlines, hotels, travel agents as well as small tour and taxi operators. The best solution at this point is to adjust cost structures, stay flexible and work with a collective approach to minimise the period of impact to both citizens and business," said LocalCircles.

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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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Agencies
June 29,2020

Washington DC, Jun 29: Young children with narrow retinal artery diameters were more likely to develop higher blood pressure, and children with higher blood pressure levels were more likely to develop retinal microvascular impairment during early childhood, according to a new study.

The first study to show this connection in children was published today in Hypertension, an American Heart Association journal.

High blood pressure, the main risk factor for the development of cardiovascular disease (CVD), can manifest as early as childhood, and the prevalence of high blood pressure among children continues to rise. In previous studies, analysis of blood vessels in the retina has shown promise as a predictor of CVD risk among adults. In the study titled, "Retinal Vessel Diameters and Blood Pressure Progression in Children," researchers sought to predict the development of high blood pressure in children over four years based on retinal blood vessel measurements.

"Hypertension continues as the main risk factor for the development of cardiovascular diseases and mortality," says Henner Hanssen, M.D., the study's lead author and a professor in the department of sport, exercise and health at the University of Basel in Switzerland. 

"Primary prevention strategies are needed to focus on screening retinal microvascular health and blood pressure in young children in order to identify those at increased risk of developing hypertension. The earlier we can provide treatment and implement lifestyle changes to reduce hypertension, the greater the benefit for these children."

Researchers screened 262 children ages six to eight from 26 schools in Basel, Switzerland, in 2014, for baseline blood pressure and retinal arterial measurements. Both measures were taken again in 2018. Blood pressure measurements at both baseline and follow-up were performed in a sitting position after a minimum of five minutes of rest and were categorized based on the American Academy of Pediatrics' blood pressure guidelines. These guidelines utilize the same measurements as the American Heart Association/American College of Cardiology 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults.

Results from the analysis indicate: children with narrower retinal vessel diameters at baseline developed higher systolic blood pressure at follow-up; retinal vessel diameters could explain 29 -31 per cent of the changes in systolic blood pressure progression between 2014 and 2018; children with higher blood pressure levels at baseline developed significantly narrower arteriolar diameters at follow-up, depending on weight and cardiorespiratory fitness; and initial blood pressure measures explained 66-69 per cent of the change in retinal arteriolar diameter from baseline to follow-up.

"Early childhood assessments of retinal microvascular health and blood pressure monitoring can improve cardiovascular risk classification. Timely primary prevention strategies for children at risk of developing hypertension could potentially counteract its growing burden among both children and adults," said Hanssen.

Researchers noted limitations of their study include that they could not confirm blood pressure measurements over a single 24-hour period, so they would not account for "white coat" hypertension, a condition where patients have high blood pressure readings when measured in a medical setting.

Developmental stage including puberty status of each child was not accounted for in the study, as well as genetic factors or birth weight - variables that could impact blood pressure development and microvascular health.

In addition, reference values for appropriate retinal vessel diameters in children do not currently exist, so future studies are needed to determine age-related normal values during childhood.

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