Thursday, 23 February 2017

This 70-Year-Old Lost Her Voice Box to Throat Cancer, but Continues to Inspire Hundreds

Diagnosed with vocal chord cancer in early 2010, Nalini Satyanarayan underwent a surgery successfully in April 2010 and took radiation therapy subsequently. But due to the location of the cancer, they had to remove her voice box, and she was fitted with a provox prosthesis during surgery. The prosthesis is a valve between the food pipe and the wind pipe. It helps one to speak by modulation of air. The international varieties of the prosthesis cost anywhere between ₹20,000 – 30,000. Currently Nalini uses the AUM prosthesis developed by an Indian oncologist, costing only ₹50.

Nalini’s husband was a heavy smoker (making her an inadvertent passive smoker) who passed away due to cardiac ailments before her cancer was diagnosed. Despite the harrowing experience of conquering cancer, she very soon bounced back to a new normal life with confidence and determination.

Fortunately enough, her son, daughter, and grandchildren stood by her in this difficult time and are supportive till date, encouraging her each step of the way.

Tobacco use kills around 6 million people globally each year, of which almost 1 million people are from our country alone. In India, the economic burden of tobacco-related diseases was ₹1,40,500 crore for the year 2011-12, which is about 1.16 % of our GDP, and 12 % more than the combined State and Central Government expenditure on health in the same year.

It is unfortunate that innocent family members are subjected to the harms of tobacco apart from the user, who might or might not make an informed choice. Second-hand smoke is the combined mix of the smoke that comes from burning tobacco products such as cigarettes, beedis, cigars etc., and the smoke exhaled by the smoker. Studies have found this second-hand to contain more than 7,000 chemicals, of which 250 are harmful, and at least 69 are carcinogenic. Globally, about 6,00,000 deaths are due to exposure to second-hand smoke.

This smoke leads to a variety of ailments including cancers, heart and respiratory diseases, strokes, etc.

The above statistics do not convey the emotional suffering caused by tobacco use. Apart from the economic and financial impacts, tobacco cultivation also has significant environmental impacts, leading to large amounts of deforestation. Curing a kilogram of tobacco leaves requires 7-8 kg. of wood, and causes nutrient depletion in the soil.

Since her recovery, Nalini has reached out to as many individuals as possible, spreading the word on cancer prevention. She volunteers for trainings conducted on tobacco control for children, law enforcers, and other relevant audiences. She also counsels patients recovering from surgeries similar to hers who have lost voices and are learning to speak again.

Nalini helps them navigate this crucial time by instilling confidence in them and being a true role model.

Nalini is a proud member of the Voice of Tobacco Victims, and the Pink Hope Support Group in HCG Global. Able to reach out to fellow survivors, she helps cancer patients lead a life of hope after the treatment. She is also a member of the University Women’s Association. She runs two hostels for girls and women from rural areas who come to the city to study or work.

Very few victims of tobacco-related illnesses come back to mainstream society after undergoing disfiguring surgeries. Life has given Nalini a second chance, and she has grabbed it with both hands, becoming an inspiration for many. The Institute of Public Health is proud to associate with volunteers like her. These volunteers lend themselves to the cause of cancer prevention, protecting lakhs of young productive lives from this deadly addiction.

Cooking, cleaning, gardening, using public transport, inspiring children, sensitizing officials, or addressing the media—Nalini does it all with flair. She truly lives up to her motto, “Learn from yesterday, live for today, and hope for tomorrow!”

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Tuesday, 21 February 2017

From cancer-causing crop to organic vegetables

A small group of progressive farmers in Santhanuthalapadu in the Prakasam district of Andhra Pradesh has quit the cultivation of tobacco, the principal commercial crop in the district, to grow organic fruits and vegetables.

After burning their fingers growing the “negative” crop — tobacco— the price of which is governed more by the global demand-supply situation, they decided to go in for organic fruits and vegetables.

A satisfied lot
Now, they are satisfied as they no longer grow the “cancer-causing tobacco”, they said in a conversation with The Hindu. They use only natural fertilizer “'ganajeevamrutham,'” produced with cow-dung and cow urine, and biopesticides made from neem and other leaves.

“There is no problem in marketing the organic vegetables and fruits, as health-conscious people come to our farms from Ongole and other places to buy the farm fresh produce,” says farmer D. Yellamanda Reddy, who grows among other vegetables, cabbage, cauliflower, capsicum, brinjal and tomato. “We also have the satisfaction of contributing our mite to fighting climate change and global warming,” says Mr. Reddy, displaying the just-harvested healthy brinjal, free of insect infestation.

‘No’ to chemicals
The organic farmers in the village have installed micro irrigation systems such as sprinklers and drip irrigation to ensure the much-needed water for the crop.

This is significant at a time when a majority of farmers are struggling to save their crops following a severe drought in the district for the third successive year.

Organic practices adopted by the select group of progressive farmers in the village include residue mulching, composting and crop rotation to maintain soil health, adds Rajagopala Reddy, who focusses on growing greens, particularly fenugreek — highly sought-after by those having high cholesterol, diabetes and renal diseases.

According to farmer D. Chennappa Reddy, this system of cultivation helps in restoring the severe biodiversity loss associated with inorganic, chemical-based farming.

Chemical farming kills useful insects, rats, frogs and snakes upsetting the food-chain in the ecosystem, he says. It took him three years to restore the soil health which was affected because of the repeated use of chemical fertilizers.

Source: The Hindu
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Saturday, 18 February 2017

Smoking and atherosclerosis

The image shows how smoking can affect arteries in the heart and legs. Figure A shows the location of coronary heart disease and peripheral artery disease. Figure B shows a details view of a leg artery with atherosclerosis - plaque buildup that's partially blocking blood flow. Figure C shows a detailed view of a coronary (heart) artery with atherosclerosis. 

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Friday, 17 February 2017

പുകയിലയ്ക്ക് പരമാവധി നികുതി വേണം: വിദഗ്ധര്‍ കേന്ദ്രമന്ത്രിക്ക് കത്തയച്ചു

പുകയില ഉല്‍പ്പന്നങ്ങളുടെ വര്‍ഗീകരണം സംബന്ധിച്ചു തീരുമാനമെടുക്കുന്ന, ജിഎസ്ടി സമിതിയുടെ നിര്‍ണായക യോഗം ഫെബ്രുവരി 18നു ചേരാനിരിക്കെ, ബീഡി ഉള്‍പ്പെടെ എല്ലാ പുകയില ഉല്‍പ്പന്നങ്ങളെയും അധമ ഉല്‍പ്പന്നങ്ങളുടെ പട്ടികയിലുള്‍പ്പെടുത്തണമെന്ന് പുകയില നിയന്ത്രണ സംഘടനയായ ടുബാക്കോ ഫ്രീ കേരളയുടെ നേതൃനിരയിലുള്ള വിദഗ്ധര്‍ ആവശ്യപ്പെട്ടു. 

വിവിധ പുകയില ഉല്‍പ്പന്നങ്ങളെ കുറഞ്ഞ നിരക്കിലെ നികുതി സ്‌ലാബില്‍ ഉള്‍പ്പെടുത്തുന്നത് ദുരുപയോഗത്തിനും പുകവലിക്കാര്‍ വില കുറഞ്ഞ പുകയില ഉല്‍പ്പന്നങ്ങളിലേക്കു തിരിയുന്നതിനും ഇടയാക്കുമെന്ന് കേന്ദ്ര ധനമന്ത്രി ശ്രീ. അരുണ്‍ ജയ്റ്റ്‌ലിക്ക് അയച്ച കത്തില്‍ പുകയില നിയന്ത്രണരംഗത്തെ വിദഗ്ധര്‍ ചൂണ്ടിക്കാട്ടി. 

 പുകയില ഉപയോഗവും കാന്‍സറും തമ്മിലുള്ള ബന്ധത്തിന് അടിവരയിടുന്ന തെളിവുകള്‍ നിരന്തരം പുറത്തുവന്നുകൊണ്ടിരിക്കുമ്പോള്‍ ഉപയോഗം നിരുത്സാഹപ്പെടുത്തുന്ന തരത്തില്‍ പുകയില ഉല്‍പ്പന്നങ്ങള്‍ക്ക് ഉയര്‍ന്ന വില ഈടാക്കേണ്ടതുണ്ടെന്ന് തിരുവനന്തപുരം റീജനല്‍ കാന്‍സര്‍ സെന്റര്‍ ഡയറക്ടറും ടുബാക്കോ ഫ്രീ കേരള ചെയര്‍മാനുമായ ഡോ. പോള്‍ സെബാസ്റ്റ്യന്‍ പറഞ്ഞു. കേന്ദ്ര ബജറ്റില്‍ പുകയില ഉല്‍പ്പന്നങ്ങള്‍ക്കുള്ള തീരുവ വര്‍ധന ആറു ശതമാനമായി പരിമിതപ്പെടുത്തിയത് അങ്ങേയറ്റം നിരാശാജനകമാണ്. വില കൂടിയ ഉല്‍പ്പന്നത്തില്‍നിന്നു വില കുറഞ്ഞവയിലേക്കുള്ള മാറ്റം തടയാനായി എല്ലാ പുകയില ഉല്‍പ്പന്നങ്ങള്‍ക്കും ഒരേ നിരക്കില്‍ നികുതി ഏര്‍പ്പെടുത്തണമെന്നും അദ്ദേഹം നിര്‍ദേശിച്ചു. 

പ്രതീക്ഷിക്കപ്പെട്ട 10-15 ശതമാനം വര്‍ധനയ്ക്കു പകരമുണ്ടായ വെറും ആറു ശതമാനം വര്‍ധന പുകയില വ്യവസായത്തിന് അനുഗ്രഹമായിരിക്കുകയാണെന്ന് ജോധ്പൂര്‍ ഐഐടി അസിസ്റ്റന്റ് പ്രഫസര്‍ ഡോ. റിജോ എം.ജോണ്‍ പറഞ്ഞു. വരാനിരിക്കുന്ന ചരക്കുസേവന നികുതി നിര്‍ണയത്തില്‍ എല്ലാ പുകയില ഉല്‍പ്പന്നങ്ങള്‍ക്കും 28 ശതമാനത്തിന്റെ പരമാവധി അധമനികുതിയും പരമാവധി ഉയര്‍ന്ന സെസും ഏര്‍പ്പെടുത്തിയില്ലങ്കില്‍ രാജ്യത്തെ ആരോഗ്യമേഖലയ്ക്ക് വന്‍ തിരിച്ചടിയുണ്ടാകുമെന്നും അദ്ദേഹം ചൂണ്ടിക്കാട്ടി. 

 വിവിധ പുകയില ഉല്‍പ്പന്നങ്ങള്‍ക്കു മേല്‍, അധിക എക്‌സൈസ് തീരുവയും അടിസ്ഥാന എക്‌സൈസ് തീരുവയുമുള്‍പ്പെടെ, മൊത്തം എക്‌സൈസ് തീരുവയില്‍  ആറു ശതമാനം വര്‍ധന മാത്രമാണ് കേന്ദ്രബജറ്റില്‍ പ്രഖ്യാപിച്ചിട്ടുള്ളത്. കടലാസ് തെറുപ്പുബീഡികളുടെ എക്‌സൈസ് തീരുവയില്‍ 25 ശതമാനം വര്‍ധനയാണു വരുത്തിയത്. മൊത്തം ബീഡി വിപണിയില്‍ കടലാസ് തെറുപ്പു ബീഡികള്‍ തുച്ഛമായ സാന്നിധ്യമാണ്. രാജ്യത്തു വിറ്റഴിയുന്ന മൊത്തം ബീഡി ഉല്‍പ്പന്നങ്ങളുടെ 98 ശതമാനവും കയ്യടക്കുന്നത് ഇലയില്‍ തെറുക്കുന്ന ബീഡികളാണ്.  

ഗ്ലോബല്‍ അഡല്‍ട്ട് ടുബാക്കോ സര്‍വേ(ഗാറ്റ്‌സ്) പ്രകാരം ഇന്ത്യയില്‍ ഏറ്റവും വില്‍ക്കപ്പെടുന്ന പുകയില ഉല്‍പ്പന്നമാണു ബീഡി. ആകെ പുകയില ഉപഭോഗത്തിന്റെ 64 ശതമാനമാണിത്. ബീഡി വലിക്കുന്നവരില്‍ ഭൂരിപക്ഷവും നിര്‍ധനരാണ്. പാവപ്പെട്ടവന്റെ സന്തോഷമെന്നു കണക്കാക്കപ്പെടുന്ന ബീഡി, യഥാര്‍ഥത്തില്‍ അവനെ നശിപ്പിക്കുകയാണെന്നും ഉപഭോഗം കുറയ്ക്കാനായി കനത്ത നികുതി ഏര്‍പ്പെടുത്താത്തത് ദ്രോഹകരമായ നടപടിയാണെന്നും കത്തില്‍ പറയുന്നു.   

 പുകയില ഉപയോഗം മൂലമുള്ള ദുരന്തത്തെ ചെറുക്കാന്‍ ഏറ്റവും ഫലപ്രദമായ മാര്‍ഗം പുകയില ഉല്‍പ്പന്നങ്ങളുടെ നികുതി വര്‍ധനയാണെന്ന് ലോകാരോഗ്യ സംഘടന വ്യക്തമായി നിര്‍ദേശിക്കുന്നുണ്ട്. വില്‍പ്പന വിലയുടെ 75 ശതമാനമെങ്കിലും നികുതി ഈടാക്കണമെന്നും സംഘടന നിര്‍ദേശിക്കുന്നു. 

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Monday, 13 February 2017

Nicotine exposure may cause hearing problems in kids: study

The research from Freie Universitat Berlin in Germany found, for the first time, that the auditory brainstem, an area of the brain which plays a role in analysing sound patterns, may develop abnormally in offspring when pregnant mothers are exposed to nicotine before and after giving birth.
Children with impaired auditory brainstem function are likely to have learning difficulties and problems with language development.
The researchers added nicotine to the drinking water of pregnant mice to reach blood nicotine levels similar to heavy human smokers.
The offspring of the mice were exposed to nicotine before birth and via the mothers milk until they were three weeks old - an age that is approximately equivalent to primary school children.
The scientists then analysed the brains of the offspring mice by measuring the firing properties and signalling abilities of their neurons.
These results were compared to a control group of offspring from pregnant mice with no nicotine exposure.
Neurons that get input from the cochlea (sensory organ in the ear) were less effective at transmitting signals to other auditory brainstem neurons in mice exposed to nicotine. Moreover, these signals were transmitted with less precision, which deteriorates the coding of sound patterns.
These could be part of the underlying causes for auditory processing difficulties in children of heavy smoking mothers.
"We do not know how many other parts of the auditory system are affected by nicotine exposure," said Ursula Koch, professor at the Freie Universitat Berlin.
"More research is needed about the cumulative effect of nicotine exposure and the molecular mechanisms of how nicotine influences the development of neurons in the auditory brainstem," said Koch.
"If mothers smoke during pregnancy and their children show learning difficulties at school, they should be tested for auditory processing deficits," she said.
The study was published in The Journal of Physiology.

India Today
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Ministry report: ‘COTPA implementation poor in films, TV shows’

The latest report released by the Ministry of Health and Family Welfare (MoHFW) finds television shows and films lacking in implementation of “film rules” under the Cigarette and Other Tobacco Products Act (COTPA) that makes it mandatory to display static messages and anti-tobacco health spots of 30 seconds for programmes airing use of tobacco products. Of 308 movies that were screened, there were 149 scenes where tobacco usage was shown. Of 45 TV channels studied, 22 per cent TV shows depicted tobacco use, the findings of the report indicated.

The “film rules”, implemented from October 2012, under the COTPA make it mandatory for scenes where tobacco or cigarette is shown to display a health warning to viewers. It also demands an “editorial justification” to show tobacco in a scene. Additionally, the film or TV programme should show a 30-second anti-tobacco health spot at the beginning and middle of the programme.

The study, conducted by World Health Organisation (WHO) and Vital Strategies, found that only 27 per cent films implemented all rules of this act. Of 3,080 people interviewed after these films, most agreed that such warnings help in raising awareness against tobacco.

The study focused on regional and national channels and viewed content stretching over 413 hours. The awareness among TV channels was found to be lower than films which go through censor board for certification. “Cigarettes are most often shown in scenes. We found that only 4 per cent TV shows implemented two out of three major film rules,” said Dr Nandita Murukutla, country director of Vital Strategies. Even if static warnings were displayed in scenes, they were hardly visible, the report noted.

Tobacco depiction was also higher in films in South India. Of the 149 scenes that showed tobacco or cigarettes, 32 per cent were found in South Indian films followed by 28 per cent in Bollywood, 21 per cent in films made in Eastern India and 20 per cent in North India.

The film rules legislation was introduced in 2012 after social activists red-flagged rising oral cancer cases due to high tobacco consumption in India. Cancer is one of the 10 leading causes of deaths in India, ahead of malaria and tuberculosis.While secretary for MoHFW, C K Mishra, on Friday stressed on increased cooperation of film and TV industry claiming it influences masses the most, several film industry members lashed out at the government for harsh regulations that curb their “creative freedom”, in the meeting.

“The government should first ban tobacco in the country. We must not be accused for using our creative freedom. The film and television bashing must end,” said filmmaker Ashoke Pandit, who was present at the launch of the report.

According to producer Siddharth Roy Kapur, films only depict what is happening on ground. “There is no attempt to glamourise it,” he said. According to Pahlaj Nihalani, chairperson of the Central Board of Film Certification, cinema halls must also be asked to show anti-tobacco films after the national anthem.

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Thursday, 9 February 2017

Third-hand smoke may affect growth of baby

Exposure to the sticky residue of tobacco smoke -- or third-hand smoke -- left behind on the furniture and walls of your home may significantly affect your baby's growth and immunity system, researchers have found.

The findings showed that the residue of the smoke puts babies and toddlers at much greater risk because they come into contact with contaminated surfaces while crawling or teething during their critical period of immune system development.

"We suspected the young are most vulnerable because of their immature immune systems, but we didn't have a lot of hard evidence to show that before," said lead author Bo Hang, scientist at Lawrence Berkeley National Laboratory (Berkeley Lab) in California, US.

Further, the dangers associated with smoking continues for a long time, even after the cigarette is snuffed out, the researchers said.

For the study, appearing in the journal Scientific Reports, the team studied the changes to body weight and the hematopoietic system after three weeks of exposure for two age groups of mice: birth to 3 weeks (neonatal) and 12-15 weeks (young adult). 

They were compared to a control group of mice that were not exposed to smoke.

The results revealed newborn mice exposed to smoke weighed significantly less than mice born in a control group. 

In addition, newborn and adult mice exposed to third-hand smoke showed persistent changes in blood cell counts. 

There were lower levels of platelets and specific types of white blood cells -- associated with inflammation and allergic reactions -- in the smoke-exposed mice. 

"The effects on blood cell count persisted even after exposure ended. Changes remained at least 14 weeks after exposure ended for the neonatal group and two weeks after it ended for the adults," Hang said.
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Saturday, 4 February 2017

Friday, 3 February 2017

Smoking Costs Nearly 2% of World's GDP, Tobacco Control Measures Needed

Smoking consumes almost six per cent of the world's total spend on healthcare and nearly two per cent of global GDP, a new research has found.

In 2012 the total cost amounted to $1,436 billion, with nearly 40 per cent of this sum borne by developing countries. The four BRIC countries -- Brazil, Russia, India and China -- accounted for 25 per cent of it, the findings showed.

These findings highlight the urgent need for all countries to implement comprehensive tobacco control measures to address these economic costs," the researchers said.

The detrimental impact of smoking on national health systems and economies has been widely studied since the 1960s, but most of these studies have focused exclusively on high income countries, the researchers noted.

So Mark Goodchild from World Health Organization (WHO) and colleagues wanted to include low and middle income countries to come up with more accurate estimates of the total global cost.

And so they included data from 152 countries representing 97 per cent of the world's smokers.

They used the 'cost of illness' approach, first devised in 1960. This divides the economic impact of an illness into direct costs, such as hospital admissions and treatment, and indirect costs representing the value of productivity lost to death and disability in current and future years, for a given year.

The direct and indirect costs are then added up to provide the overall societal cost, usually expressed as a percentage of annual gross domestic product (GDP).

The researchers used data from sources such as the WHO and the World Bank to uncover information on the proportion of ill health and death attributable to smoking, national employment rates, and GDP for each of the 152 countries, to inform their calculations.

These showed that in 2012, diseases caused by smoking accounted for 12 per cent (2.1 million) of all deaths among working age adults aged 30-69, according to the study published in the journal Tobacco Control.

This figure included 1.4 million adults who would have been in the workforce.

The number of working years lost because of smoking related ill health added up to 26.8 million, 18 million of which were lost to death with the remainder lost to disability.

In terms of health spend attributable to smoking, this totalled $422 billion, equivalent to nearly six per cent of the global total.

The researchers pointed out that their calculations did not include the health and economic harms caused by second hand smoke or smokeless forms of tobacco, and that their estimates of lost productivity applied only to those who were economically active.

Source: News18
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