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 25,2020

Singapore, May 25: COVID-19 patients are no longer infectious after 11 days of getting sick even though some may still test positive, according to a new study by infectious disease experts in Singapore.

A positive test "does not equate to infectiousness or viable virus," a joint research paper by Singapore's National Centre for Infectious Diseases and the Academy of Medicine, Singapore said. The virus "could not be isolated or cultured after day 11 of illness."

The paper was based on a study of 73 patents in the city-state.

The latest findings may have implications on the country's patient discharge policy. The discharge criteria is currently based on negative test results rather than infectiousness.

Singapore's strategy on managing COVID-19 patients is guided by the latest local and international clinical scientific evidence, and the Ministry of Health will evaluate if the latest evidence can be incorporated into its patient clinical management plan, according to a report by the Straits Times.

So far, 13,882, or about 45% of the total 31,068 Covid-19 patients in Singapore have been discharged from hospitals and community facilities. Singapore reported 642 new Covid-19 cases as of noon on Saturday.

The government has been actively screening pre-school staff as it prepares to reopen pre-schools from June 2. On Friday, two pre-school employees tested positive for the novel coronavirus, bringing the total number of confirmed cases among pre-school staff to seven, according to the Ministry of Health.

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Agencies
April 21,2020

The Lockdown is not a cure but a critical strategy to prevent the geographical spread of COVID-19.

While pandemics at this level involves actual life threatening situations for individual's or significant others in one's immediate circle, it envisages a marked disruption in routine life. Even after the pandemic has been contained and will come to pass; it's aftermath will leave a trailblazer which demands planning and implementation of a post pandemic reconstruction of society with potentially traumatic experiences varying in intensity, multiplicity and duration.

Degree of Trauma

It would do well for each one of us to realise that the pandemic is "potentially traumatic", since not everyone will experience COVID -19 as a traumatic event in their lives. Yet, there will be those who may develop post pandemic stress reactions, depression and related dysfunction and pathological reactions while still other exhibit healthy reactions to the same set of circumstances.

"Psychological reactions to the pandemic can be distilled into four distinct prototypical patterns, namely, Resilience, Recovery, Chronic and Delayed patterns which may vary in intensity, multiplicity, and duration. Resilient individual have an ability to bounce back from adversity and experience modest or little disruption in normal functioning and are able to maintain a relatively stable, healthy levels of psychological functioning even after enduring the pandemic. Recovery pattern is characterised by relatively rapid reduction in symptoms and return to normal functioning whereas chronic pattern is characterised by symptoms and dysfunction of a long duration," says Pune-based military psychologist Lt Col Dr Samir Rawat.

Challenges at the Individual and Community Levels

From a psychological perspective, post pandemic reconstruction would entail catering to the problems, concerns and needs of those adversely impacted by the COVID -19 with stress symptoms typically characterised by individual's experiencing an overwhelming trauma of the pandemic (for example, recurring nightmares/ breaking into a cold sweat, flashback of stressful events, increasing irritability, low frustration tolerance or emotional numbing).

It could also manifest in depressive symptoms which may result in lack of interest or diminished pleasure in activities and things which you earlier liked to do, feelings of worthlessness or even survivor guilt in case of a loss of a loved one due to COVID-19, fleeting thoughts of death and suicidal ideation. Physical symptoms, on the other hand could be a decrease in appetite, weight and sleep problems, inability to focus and lack of concentration.

Undoubtedly, the pandemic will cause a financial loss of varying magnitude to many, especially the marginalised and economically disadvantaged strata of daily wage earners; it will also lead to loss of jobs (already beginning to show), homelessness, occupational difficulties and new challenges in interpersonal relations at work and on the home front, besides physical health problems and psychological barriers with new norms of accepted social behaviour (social distancing, handshakes, an obsession for cleanliness to name a few).

Emotional battles

Many factors may influence whether individuals come out stronger and more resilient or surrender to the pandemic. Emotion Regulation is one such long term critical factor that can play an important role in contributing to varying degrees of adaptation with negative or positive outcomes. While we know that primary emotions are fear, anger, disgust, joy, anticipation, acceptance, sadness and surprise, other basic emotions include wonder, love, desire, joy, hatred, sadness, attachment, disgust, rage and even expectancy .

To be able to regulate these emotions and avoid negativity , especially on social media platforms is likely to increase efforts in emotion regulation which involves initiating, increasing or maintaining an emotional response.

This means by regulating or on the other hand by stopping, decreasing or avoiding an emotional response, that is, by down-regulating, depending on the individual's objectives and goals or his /her ability to regulate emotions in the valued and given direction.

"One of the best ways to regulate emotions is through cognitive restructuring wherein we change the way we think; after all it is not the event but the interpretation of the event which is perceived as stressful and finding meaning promotes resilience and reduces risk and vulnerability to stress," advises Dr Rawat.

Adding, "Clearly, we need to have a psychological plan to prevent, mitigate and minimise negative outcomes by post pandemic reconstruction of society at an individual and community level all over the country; this has to be integrated by all leaders across verticals in diverse domains."

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Agencies
April 14,2020

There is no evidence that the Bacille Calmette-Guerin (BCG) vaccine, which is primarily used against tuberculosis, protects people against infection with the novel coronavirus, the World Health Organization (WHO) said.

The WHO therefore didn't recommend BCG vaccination for the prevention of COVID-19 in the absence of evidence, according to its daily situation report on Monday, Xinhua news agency reported.

"There is experimental evidence from both animal and human studies that the BCG vaccine has non-specific effects on the immune system. These effects have not been well characterized and their clinical relevance remains unknown," WHO stated.

Two clinical trials addressing the question are underway, and WHO will evaluate the evidence when it is available, it noted.

BCG vaccination prevents severe forms of tuberculosis in children and diversion of local supplies may result in an increase of disease and deaths from the tuberculosis, it warned.

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