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Patient with multiple flexion deformities walks again

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After a sabbatical of one year, I am back. This news would be of interest and a blessing to those who advised to go for hip and knee replacement surgery. Last month on August 11th 2010, Manipal Hospital performed hip replacement surgery along with bilateral knee replacement surgery and soft tissue release surgeries on a single patient – 10 surgeries in one single sitting

For the first time in India and the world, The Department of Orthopaedics at Bangalore based Manipal Hospital performed 10 surgeries on a patient in the same sitting with minimal blood loss with excellent results. The patient was stable throughout the intra-operative period and did not require post-operative ICU care. Patient recovered and took her first steps on the second post-operative day.

Mrs. Nagamma, 59 years old, complained of pain in both her hips and knees since 15 years and was unable to walk or sit for the past 6 months. The pains were gradual in onset and progressed with time. It was associated with gradually progressive Flexion Deformity; i.e. Bent hips and knees. She was able to move at home with the aid of a walker for the past 2 years and since the last 6 months, she was completely bedridden. She is a known case of Rheumatoid Arthritis but has no other illnesses. On examination, she was found to have Fixed Flexion Deformities of 50 degrees in both the hips and 60 degrees in the Right Knee and 50 degrees in the Left Knee. After thorough investigations and evaluation along with Medical and Rheumatology clearance she was

taken up for surgery on 11th August, 2010, wherein ten surgeries were performed on her viz. Bilateral Hip Replacement surgery along with Bilateral Knee Replacement surgery and 6 soft tissue release surgeries.


Fig: Mrs. Nagamma with the doctors of Department of Orthopaedics at Bangalore based Manipal Hospital

According to Dr. R.D Chakravarty, HOD, Orthopaedic Department, Manipal Hospital who spearheaded the surgical team, “First, she was placed flat on her back and Adductor Tenotomies were carried out on both her Hips, to correct the Hip Adductor deformities. Later, she was turned over to prone position and Hamstring Release procedure was done on both her Knees to correct the Knee Flexion deformities. Next, she was placed in a Right Lateral Position, i.e. on her right side with left side up and a Total Hip Replacement was done on her Left Hip. Similarly, she was shifted to a Left Lateral position, and a Total Hip Replacement was done on her Right Hip. After this, she was again placed Spine and Total Knee Replacement Surgeries were done on both her Knees. Total blood loss during the surgery was 800 ml. She was transfused two Units of Whole Blood to make up this loss. She tolerated the procedure well and post operatively was shifted to the ward as she was stable. She was put on Parenteral Antibiotics and Analgesics along with Anticoagulants and Anti DVT therapy.

She was made to get up from bed and walk on the second postoperative day and she responded well. With rigorous Physiotherapy and encouragement for Rehab, she is now moving with the help of a walker to meet her daily requirements and is also able to bend her knees comfortably till 90 degrees.”

Dr. S.C. Nagendra Swamy, COO, Bangalore Region, Director Shared Strategic Services noted, ” Keeping in mind that such an extensive surgery has never been attempted anywhere in the world before and also remembering the foreseeable risks associated with such an undertaking, we took care to perform a very thorough and meticulous preoperative planning. I applaud Manipal Hospital Orthopaedic team for competently performing such a delicate and rare surgery successfully and with such amazing results.”

Speaking to media persons Dr. H. Sudarshan Ballal, Medical Director, Manipal Hospital said, “In the West, surgeons rarely face these kinds of cases. Whereas in India, the patient tends to neglect due to financial and social reasons and finally comes at the last stage with such gross deformities. Correcting such deformed joints involves great technical skill and straightening a deformed joint can result in neurovascular damage if done without proper expertise and equipment. We are indeed blessed to have a professionally competent team and the best facilities to be able to perform a surgery of this magnitude without a hitch.”

Manipal Hospital, Bangalore is India’s first hospital to be ISO 9001:2000 certified for Clinical, Nursing, Diagnostics and Allied Areas. Manipal Hospital has been repeatedly ranked amongst the ten best hospitals in India.


Current warning labels on Indian tobacco products ineffective¬¬ – concludes an international expert on tobacco control

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India’s new warning labels on tobacco products fall short of the international standards for strong warning labels, according to Professor Geoffrey Fong, of the University of Waterloo in Canada, who is in India with his research team to meet with researchers at the Healis-Sekhsaria Institute for Public Health.

A world expert in tobacco control, Professor Geoffrey Fong made this conclusion based on research that he and his international team of experts have conducted on the impact of warning labels in a massive project across 20 countries.

“Warning labels that include graphic and clear images of the devastating diseases due to tobacco use are known to increase thoughts about quitting and to be used by smokers,” Professor Fong, whose research on warning labels has examined the impact of graphic warnings in Canada, Thailand, Malaysia, Brazil, Uruguay, and Australia, compared to text-only warnings in the other countries, including United States, China, France, Germany, Netherlands.

In July 2006, India introduced new warnings on cigarette and bidi packs and on packages of Gutkha and on tins of loose tobacco used for paanmasala. The original law for picture warnings was passed in 2003 and called for graphic photos of mouth cancer due to tobacco use. The new warnings would also include skull and crossbones, which is an international sign of poison.

“The skull and crossbones is a universal warning sign that the substance or product is very dangerous,” said Professor Fong. “And this is true of tobacco products. For example, we know that between one-third and one-half of all regular smokers will die of a smoking-related disease. It is the only product that kills people when used as intended.”

However, due to extreme pressure from the tobacco industry in India, especially the bidi industry, the implementation of the law was delayed 6 times over 5 years.

Then in March 2008, in an unprecedented move, the strong graphic warnings that had already been notified by the Government in 2006 and 2007 were changedto be weaker. The widely understood symbol of Skull and Crossbones was replaced by a scorpion. The vivid colour photos of real examples of mouth cancer due to tobacco use were changed to a fuzzy image of a chest x-ray.

“Healis has been one of the dedicated organizations in India that has been actively involved in research to facilitate implementation of much more effective warning labels on tobacco products.” said Professor Fong.

But even these new weakened warnings were delayed in their introduction. And they were made smaller (from 50% to 40%), limited (from both sides of the pack to just the back of the pack).

Professor Fong commented on the power of graphic warnings in other countries: “Countries such as Canada, Brazil, Singapore, and Mauritius have introduced very powerful warnings that have helped motivate smokers to quit and prevent young people from starting to smoke.”

“The tobacco industry knows how effective the warnings are, and that’s why they try their best to prevent warnings, weaken them, and delay their introduction.” The fact that the warnings have been so attacked by the tobacco industry in India is a sure sign that they are afraid of the impact of graphic warnings, Professor Fong says.

Close to one million people in India will die this year because of tobacco use. And since the graphic warnings were originally proposed and approved by the Government 6 years ago, about 5 million people have died.

Professor Fong commented on these delays. ”We know that strong graphic warnings are effective in increasing knowledge, motivating quitting, and preventing young people from tobacco use. How many of those that died could have been saved by the knowledge and vivid displays on the warnings that show what tobacco really does to people?”



Copper can help combat Swine Flu

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Another method to prevent the spread of H1N1 virus. The International Copper Association Ltd. has provided the following details.

Copper touch surfaces have self-sterilizing properties that can prevent the spread of H1N1 virus

 

The recent threat of Swine flu has emerged as the most important health concern in India and has triggered the need to use the most protective and efficient measures to reduce its spread in public places. While we have been advised to be alert, wash our hands regularly, avoid crowded places like cinema halls, shopping complexes, malls etc. International Copper Promotion Council (India) would also like to educate the public about the capability of Copper to combat the spread of the H1N1 virus.

A recent UK study1 has found that copper touch surfaces can significantly reduce the concentration of Influenza A virus on them, raising hopes that it may also be effective against other strains of the virus. The research found that 75 percent of Influenza A are knocked out in 1 hour on a copper surface and almost completely in 6 hours. The work, which was led by Professor Bill Keevil from the University of Southhampton, was presented at the BIT Life Sciences’ 2nd Annual World Summit of Anti-virals in Beijing on July 18. The findings are timely given the current Influenza H1N1 ( more commonly known as Swine Flu ) pandemic currently sweeping the world. But even more common forms of flu are a major global health issue.

The role of surfaces in spreading influenza is now well known. In fact it has been shown that once surfaces are contaminated, fingers can transfer viral particles to up to seven other clean surfaces. Professor Keevil makes it clear that preventing the spread of any strain of Influenza is a very complex process and no one option is likely to be 100 percent successful. “There is no single answer to controlling the spread of pathogenic microorganisms,” Prof Keevil
et al state in the paper. The current study shows that copper surfaces may contribute to the number of control barriers able to reduce transmission of the virus.

H1N1 virus appears to be transmitted the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.

 

Last year, the U.S. Environmental Protection Agency (EPA) approved the registration of antimicrobial Copper alloys, with Public Health Claims acknowledging that Copper, Brass and Bronze are capable of killing harmful, potentially deadly bacteria. Copper and Copper alloy surfaces kill greater than 99.9% of (specific) bacteria within two hours, and continue to kill more than 99% of (these) bacteria even after repeated contamination. Therefore, it has been recognized that the use of Copper touch surfaces in hospitals, educational institutions, public buildings, public transport and food preparation areas can reduce the spread of harmful infections.

Copper and its alloys are available in a variety of forms like door handles, grab rails and bathroom fixtures etc. which are regular touch surfaces and can work to demonstrate reduced build-up and transfer of infectious pathogens.

Mr. Ajit Advani, Dy. Regional Director Asia, International Copper Association Ltd. & CEO, International Copper Promotion Council (India) said: “In India, we have known about the protective properties of Copper since the vedic ages. This has now been corroborated by modern Science. Use of this wonder metal in public touch surfaces can go a long way in reducing the spread of infections such as Influenza”.

Dr. Anu Kant Mital, Associate Professor & Head of Department, Rajiv Gandhi Medical College, and President Indian Association of Biological Psychiatry said, “Touch surfaces such as Taps, Door handles, Railings etc. are the first portals of entry for any infection into the pool of becoming The Epidemic. This is especially significant in our country as we have a large population and the numbers that would be involved in the touch and spread model are mind boggling. In this context The Anti-Microbial or more descriptively put Self Sterilizing (self cleansing) properties of COPPER, established scientifically and accepted by the authorities world over now,( that we have known since eons) would be heaven sent. All the surfaces that are touched by thousands daily, if made of copper would not be aiding the spread of any infection, especially like the H1N1.”

Note:
The use of a Copper alloy surface is a supplement to and not a substitute for standard infection control practices; users must continue to follow all current infection control (hygienic) practices including those practices related to cleaning and disinfection of environmental surfaces.


 

Written by sreelakshmi

23 August, 2009 at 8:24 am

Busting Swine Flu Myths- Dr. Mukesh Batra

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The death toll thanks to the H1N1 viral flu is increasing. Famous homeopath Dr. Mukesh Batra talks about homeopathy treatment for the disease.

 

Swine flu is creating panic all over the world and there are many myths, misconceptions, and rumours going around that are only making matters worse. Under these circumstances, it is therefore important for people to stay calm and composed so that they act responsibly and appropriately. Many think that a vaccine for swine flu will do the trick and protect against the virus. However, the truth is that no one can be sure about this because viruses are known to mutate easily, thereby rendering such a vaccine useless. Some scientists are even afraid about the possibility of another mutation taking place when the swine flu virus H1N1 comes into contact with the Bird flu virus H5N1. This again is just a remote possibility and not a certain outcome. People were under the impression that just because bird flu spread by eating infected poultry, swine flu could spread by eating infected pork. It is now confirmed by the Centres for Disease Control and Prevention that that it is safe to eat hygienically cooked pork. The amount of protection offered by masks is also not very clear. Although they could definitely reduce the likelihood of contracting the infection, they cannot really assure complete protection. Thus, it is safer to avoid coming in close proximity with patients with flu-like symptoms. Another trend is closing down schools, colleges, or other institutions to prevent the spread of the disease and advising people to stay at home. This, however, is not a feasible option and is hence not recommended. The biggest solace is the fact that the infection seems to be moderate in intensity in majority of the patients with only a small section, especially those with underlying pathologies or poor immunity, succumbing to the disease.

 
 

With so much of uncertainty around, giving Homeopathy an opportunity to prevent or treat the disease makes perfect sense for two reasons. Firstly, disease causing organisms can never get resistant to homeopathic remedies because homeopathic medicines do not target the causative organisms directly. They stimulate the body’s defences instead to attack and overpower the invaders. Secondly, being free of adverse side-effects, homeopathic medicines can be safely administered in infants, pregnant women, and the aged. Knowing that conventional medicines are strong, aggressive, and at times even invasive, it goes without saying then that Homeopathy should ideally be the first line of treatment. As homeopathic medicines themselves behave like vaccines by modulating the immunity of an individual, these should be immediately employed in the meanwhile before a successful swine flu vaccine actually enters the market. Antiviral preparations should be used only if the desired curative response is not seen in spite of homeopathic treatment. In acute illnesses like flu, patients usually respond very fast to Homeopathy; and therefore, a homeopath can easily tell within a day or two following the commencement of treatment whether the disease is responding positively, progressing, or heading towards complications. All said and done, one thing is for sure. In pandemics like these, the patient has to be closely monitored by the treating physician, irrespective of his or her specialization, so as to ensure that an unnecessary delay in treatment never occurs. In fact, an approach in which Homeopathy is boldly backed by conventional medicine, where the latter is used wisely and not indiscriminately, seems to be the way to go!

 
 


 
 

What does homeopathy have to say about swine flu?

The fact that diseases are not caused by the mere presence of disease-causing organisms in the internal or external environment, but rather due to the weakening of the body’s defence mechanisms, has always been recognised by homeopathy. Therefore, while the use of antibiotic and antiviral preparations can be rendered useless if the organism gets resistant to them by undergoing a mutation, this can never happen with homeopathic remedies because unlike medicines from other medical systems that target only the disease-causing germs or aim to offer symptomatic relief, homeopathic medicines act upon the immune system and restorative energies of the body so that it heals itself. Other systems simply suppress symptoms and treat the body in parts, whereas homeopathy recognises the body as a unified whole and confronts the problem from deep within. Thus, swine flu for homeopathy is just another type of flu that can be treated by stimulating the immune system to overpower the virus. 

 
 

Which homeopathic medicines should be taken to treat the disease?

In the past, various flu epidemics such as the Spanish flu and bird flu have been successfully treated and prevented by homeopathic remedies like Gelsemium, Bryonia, Influenzinum, and Oscillococcinum. These could certainly be of value even in the prevention or treatment of swine flu. In homeopathy, remedy selection depends upon the disease manifestation and not merely the diagnosis; therefore, the prescription varies from case to case. During epidemics, however, since the disease symptoms are more or less similar in most of the cases, a single remedy may help to treat the disease. Such a homeopathic medicine is termed the ‘genus epidemicus.’ The theory of vaccination borrows from the isopathic concept of homeopathy where medicines prepared from the causative organisms (isodes) or affected tissues themselves (nosodes) are used to treat the same or similar diseases in the same or other patients. Preparing an isode or nosode of the swine flu virus is another option that homeopathic pharmaceutical companies could consider in the prophylaxis or therapeutics of the disease. 

 
 

What precautions should be taken by the affected person?

The affected person should avoid meeting people till the disease runs its course. Covering the nose and mouth with a handkerchief when coughing or sneezing is important to prevent spreading the virus to others. Wearing a mask will also help for the same purpose. The patient should not share his or her clothes, towels, soap, and other personal objects with others and must not eat or drink from the same utensils as others. This is necessary because the virus is usually present in all the secretions of the body such as saliva, sweat, phlegm, urine, and stool. As in all viral infections, the patient should drink a lot of fluids to stay well hydrated. Eating nutritious food and resting adequately is a must to help the body to recover as well as to prevent complications or secondary infections. According to the Centres for Disease Control and Prevention, majority of the cases that require hospitalization or succumb to the disease are those people who concurrently have underlying pathologies like diabetes, cardiovascular disease, asthma, obesity, or extremely poor immunity. Therefore, such patients should be closely monitored.

 
 

Can homeopathic medicines cure the disease?

An acute illness like flu always heals by crisis or lysis, i.e., it runs its natural course leading to recovery, complications, or death. Thus, in such cases, it is the body that cures itself and homeopathic remedies facilitate this curative process. The logic behind the treatment is not just to relieve symptoms. It is to cut short the natural course of the disease or to allow it to run its course uneventfully without any complications or mortality. Viral infections further drop the immunity of an individual so as to lead to secondary bacterial infections or can even evoke abnormal responses from the body to give rise to autoimmune diseases or pave the way for the development of some cancer. Since homeopathic remedies basically correct the imbalances of the immune system, such problems can largely be prevented.  

 
 

Is homeopathy the preferred choice of medication?

Homeopathic remedies, being infinitesimally small doses, are absolutely safe. They are palatable, non-invasive, and do not produce any deleterious side-effects even when taken for prolonged periods of time. Natural and harmless, they can be administered to infants or the aged without any risk of any adverse reactions. Another major advantage is that homeopathic medicines are cost-effective too as thousands of serial dilutions can be created out of a single drop of the source material. homeopathic remedies are curative as well as preventive; besides, a single remedy can treat symptoms related to multiple organs or systems and also offer protection against complications. There is no question of the causative organisms getting resistant to homeopathic drugs as the latter have no direct action on the former. Considering all these plus points, Homeopathy definitely should be the preferred choice of medication

  

Written by sreelakshmi

23 August, 2009 at 8:06 am

India’s first Edentulous Support Society Launched in Pune

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City Doctor Dr. Vijay Tamhane avows to bring better quality life to 62 million toothless Indians

The Edentulous Support Society (ESS), India’s first and only support group for edentulous people, today launched its support services for the edentulous patients in Pune. The support group will conduct seminars and workshops to educate patients afflicted with edentulism on their condition, and the means available to them to recover from their condition to a great extent.

The first of these seminars is being held at Ramkrishna More Sabhagruha Pimpri-Chinchwad on Saturday, 4th July, 09. The support group also has Edentulous Support Society Website (www.essindia.org) and Helpline (02030785050) to help guide the patients for support and guidance, and to identify best dental solutions associated with reduction in psychological distress and dentally disabling symptoms.

Speaking on the occasion Dr. Vijay Tamhane, Founder Director, Edentulous Support Society, said, “Edentulism is the condition of being toothless as a result of tooth loss due to various reasons .Over 19% of the population in India today is edentulous, and these people regularly face the adverse repercussions of a little known, yet extremely detrimental medical condition. The Edentulous Support Society, through the launch of this support group, aims to educate and thereby enable patients afflicted with edentulism to realize that this is a serious medical disability, and give them choices of ways in which they can overcome their condition.”

He further added “Edentulous people today are surviving in the face of extensive disability. These people who cannot chew properly survive with worse health than others, as due to their inability to eat normally; their lives are interspersed with long stretches of hunger punctuated by a rare full meal. Therefore it becomes more imperative and necessary to aid and care for these adults who are edentulous. This support group aims to reach out to more than 1 lakh edentulous people by 2010 by opening counselling centres, appointing dentist affiliated with ESS. This is an initiative which is taken to bring succour to millions of people who are suffering from edentulism”.

Edentulous Support Society is supported by group of eminent dentists & prominent people from society who are dedicating their personal energy, time and money in the exercise.
Edentulous Support Society (ESS) has been the first support group with a vision to alleviate edentulism and enable a community with the choices of a better living. The support group is extremely committed and focused to improve quality of life for edentulous people by reaching them through awareness & guidance on prevention and treatment of edentulism. Edentulous Support Society will equip affected community with better knowledge and hence prepare them for choosing better options for dental treatments

For more details on edentulism and ESS kindly visit website: www.essindia.org

Written by sreelakshmi

23 June, 2009 at 10:13 pm

Homeopathy brings back the fun in the rainy season

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After the scorching summer heat, the monsoon showers come as a welcome relief. However, with unprecedented rains all over the country over the past few years, there is an increasing danger of a host of illnesses.

Here, Dr. Mukesh Batra, Founder and CMD, Dr. Batra’s Positive Health Clinic Pvt. Ltd writes about some of the common monsoon maladies along with a little information about what Homeopathy has to offer in the treatment of these conditions.

Fungal infections: Fungal infections are common during the monsoons because of constant dampness and the possibility of coming in contact with filthy water. The moisture present in the environment helps the fungi to grow and thrive, especially in skin folds such as the groins or between the toes.

Medication:
Chrysarobic acid 6C, 5 pills taken twice daily can help to treat generalized fungal infections. Merc Sol 30C, 5 pills twice daily is recommended for fungal infection in the groins.

Respiratory Allergies: Due to temperature changes and poor hygienic practices that are common during the monsoons, conditions like a runny nose, sneezing, headache, and recurrent throat infections tend to be rampant.

Medication:
Natrum Sulph 6X can be given to treat allergic affections due to dampness.

Asthma: Allergic asthma is more severe in its intensity and frequency during the monsoons because of weather changes and the associated dampness in the environment. Dust mites and pollens also tend to irritate the airways and cause them to tighten, making air exchange difficult and leading to breathlessness. The efficacy of homeopathic medicines has been confirmed by clinical studies.

Medication: A randomized double-blind trial conducted on patients with allergic asthma showed that improvement appeared within 1 week of starting homeopathic treatment and persisted for up to 8 weeks. A double-blind, placebo-controlled trial conducted in the University of Glasgow showed that over 80% of asthmatic patients on Homeopathy showed improved results.

Amoebiasis: This is a very common problem during the monsoons, as the parasite Entamoeba histolytica, which is responsible for it, tends to survive for longer under warm and moist conditions. It enters the body through contaminated food or water and produces diarrhoea or dysentery with blood and mucus.

Medication:
Aloe Soc 30C is known to be helpful to treat amoebiasis.

Gastroenteritis: Gastroenteritis is a general term that refers to infections (bacterial/viral) of the gastrointestinal tract. It gives rise to several problems such as stomachache, diarrhea and vomiting, causing loss of body fluids that in turn lead to dehydration. Children are usually affected. Unhygienic surroundings, contaminated water and food items, and overcrowding are the known culprits. Avoid eating at unhygienic places and drink boiled water to keep gastrointestinal infections at bay.

Medication:
Arsenic Album 30C, 5 pills taken thrice daily can help to treat diarrhoea or vomiting and to prevent further fluid loss from the body.

Leptospirosis: Leptospirosis is a bacterial infection that is common during the rains in tropical countries like India.  These bacteria are carried by water contaminated by rat’s urine and faeces. Flooding after heavy rainfall helps to spread the bacteria around.  Human beings get infected by drinking contaminated water or when their eyes, nose, or any open wounds come in contact with contaminated water. In humans, it causes a wide range of symptoms similar to flu such as fever, headache, chills, nausea, vomiting, and musculo-skeletal aches. In severe cases, it can cause jaundice and lead to liver damage.

Cuban medical researchers have successfully prevented the annual outbreak of Leptospirosis in Cuba among a population of 5 million people across two regions using Homeopathy in both 2007 and 2008. A population of 2.5 million was prescribed homeopathic medicines that brought down the incidence of infection to less than 10 people with no fatalities. Earlier, conventional treatment of the population with a vaccine had yet resulted in thousands of infections and a number of fatalities and that had cost the exchequer nearly USD 2 million. The homeopathic solution on the other hand cost just USD 2,00,000, only 10% of the previous expenditure. This goes to prove that homeopathic medicines are not just effective but are cost-effective too.

Medication: On request

Malaria: Malaria is an infectious disease that spreads through the bite of mosquitoes.  Since stagnant water and dampness favour the breeding of mosquitoes, there is a rise in the number of malaria cases during the monsoons. Every year, there are approximately 350–500 million cases of malaria. Fever with chills followed by sweating is characteristic of malarial fevers. These days, there are increased cases of chloroquine-resistant malaria. Malaria can be prevented by taking precautions like avoiding marshy or stagnant-water areas, wearing full sleeved clothes and using mosquito nets or mosquito repellents.

Medication: Clinical studies have proved that the homeopathic neem (Azadirachita Indica) preparation is effective for the reduction of malarial attacks in highly endemic areas for Plasmodium falciparum. Other medications on request.

The monsoons wash away the pollution in the atmosphere to rejuvenate your entire being, enabling you to breathe in a whiff of fresh air, a rarity these days. Get healthy and stay healthy using the goodness and power of Homeopathy, a holistic healing science that treats you and not just your disease by boosting your immunity. With your defences strong, you can rejoice in the rains without being concerned about diseases at the back of your mind. So, you don’t need to stop yourself from walking or playing football in the rain. Have a happy monsoon!

This is an article by Dr. Mukesh Batra, Founder and CMD, Dr. Batra’s Positive Health Clinic Pvt. Ltd

GOM COUNTING TOBACCO VOTES OVER TOBACCO DEATHS

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Tobacco use is the biggest cause of death, disease and disability. The death clock of tobacco strikes every six seconds globally and the product kills nine lakh Indians every year. Since the first notification of the pictorial health warnings in July 2006, nearly 26, 52,500 Indians have died from tobacco-related diseases.

Studies point that forewarning tobacco users of the ill-effects of tobacco use through pictorial health warnings is one of the most effective measures to contain tobacco use and the consequent death, disease and disability. Evidence from countries having pictorial health warnings have revealed that larger, comprehensive warnings on tobacco packages are more likely to be noticed and rated as effective by tobacco users and contribute to reduction in tobacco use, since more people are willing to quit tobacco after repeatedly seeing the warnings.

However, it seems politics has overtaken scientific evidence and abandoned public health commitments, to sound a retreat from the implementation of a tested measure against a known pandemic. The GoM, mostly comprising of the prominent candidates contesting in the general elections for the 15th Lok Sabha, in the absence of the former Health Minister and under pressure from the tobacco industry – there is no reason to believe otherwise – has disregarded all scientific evidence, undermined an international treaty (Framework Convention on Tobacco Control-FCTC) obligation and transgressed the Model Code of Conduct to derail an important public health measure.

The civil society alliance for tobacco control in India had already voiced this concern when the GoM sought to meet on April 8, though it seems the Election Commission did not grant the permission for the GoM to convene. But no one would have ever imagined that the GoM could go back and alter the minutes of its February 3 meeting to oblige the tobacco industry and to influence the voters in their tobacco dependent constituencies.

It is shocking to believe that the apprehensions expressed by the former Health Minister on Saturday (he has said, “The minutes of that (GoM February 3, 2009) meeting seems to be changed after I quit the government“) have come true. Such a hasty decision by the GoM and the consequent notification by the Ministry of Health is a serious concern for the Government of India and the Election Commission of India should take notice of this politically motivated move and initiate immediate corrective action to uphold the democratic ethos and practices of the country and save an important public health measure from being needlessly diluted.

For very short term political considerations, the GoM must not be allowed to drag the country back from its commitment by diluting rules, breaking promises and endangering India’s image before the international community. The global public health movement which previously applauded and honoured India for its pro-people actions to curtail tobacco consumption will now react with dismay as the Government dishonours its commitments. Besides, this is contrary to the standards set by a pro-public health Government which is responsible for the launch of the National Rural Health Mission and the National Tobacco Control Programme during its regime.

It is unfortunate that the GoM since its constitution, in early 2007, has already delayed the implementation of the pictorial warnings for two years and during this time diluted stronger warnings for milder ones, reduced size of the warnings from 50% of the principal display area to 40% besides exempting large packs from the purview of the packaging labeling rules. As if all this was not sufficient in itself to negate the efficacy of the pictorial warnings, the GoM on Sunday (May 3) cast a death blow to the warnings by making them appear only on one side of the pack – thereby scaling them down to 20% of the principal display area which is below the minimum standard set (30% of the principal display areas) by the FCTC – and only on the packages meant for retail sales.

Speaking on the dilution of the pictorial warnings, Dr. P.C.Gupta, Director – Healis Sekhsaria Institute for Public Health has said, “It is most unfortunate that the GoM since its constitution in early 2007 has already delayed the implementation of the pictorial warnings for two whole years, not to mention having diluted stronger warnings for milder ones. This is a serious issue of concern, considering that the warnings have not only been delayed, but have also been cut down. Serious measures need to be taken at this juncture to highlight the grave irresponsibility of the GoM towards public health through this action”. “I would state that the tobacco control community strongly condemns this irresponsible decision by the GoM to dilute and amend the pictorial warnings notification”.

Evidence from countries like Panama and Brazil with warnings restricted to a single side indicates that industry sabotages the initiative by advising retailers to stack the packs on the retail shelves in a manner that hides the warnings from public view. Further, even as Parties to the FCTC, including India are negotiating a protocol to curb illicit tobacco trade, health warnings on wholesale and export packages are a key marker to track and trace illegal tobacco products across the borders.

The apparent urgency of the GoM to revisit and alter the rules pertaining to the pictorial warnings at a time when the general elections are in progress, with the Model Code of Conduct in force, and above all when the implementation of the rules was to be considered by the Supreme Court of India only two days later (Tuesday, May 5), is uncalled for and amounts to a colourable exercise of power.

The tobacco control community strongly condemns this devious decision by the GoM to dilute and amend the pictorial warnings notification that was to come into force from, May 31, 2009, the World No Tobacco Day the theme of which, ironically, is tobacco pack warnings. We appeal to the Prime Minister of India to urgently intervene and prevent this repudiation of public interest. While politicians may count their success in terms of votes gained, statesmen should count their success in terms of lives saved.