India still home to quarter of global TB cases

Despite having a strong public sector programme to contain the disease, tuberculosis still remains a cause of concern for India, which has nearly a quarter of the global burden of TB, health experts said.

Experts said measures which can help strengthen the fight against the disease include involvement of the private sector, more political commitment to create awareness and containing risk factors like malnutrition.

“TB is still a cause for concern. It is the sheer numbers in India and the associated problems like poverty which are responsible for this,” Soumya Swaminathan, director, National Institute for Research in Tuberculosis, an organization under the health ministry, told IANS.

According to the World Health Organization (WHO), there are 2.2 million tuberculosis patients in India, which makes it the world’s highest TB-burden country. TB killed 1.3 million people worldwide in 2012 and India alone accounted for 26 percent of the total cases.

She said that China and Brazil have done better in controlling TB in their respective countries and India needs to do more.

“In eight years, India has made tremendous progress as far as containing TB. But it needs to do much more,” she added.

But R. S. Gupta, deputy director general (TB) in the health and family welfare ministry, said: “Treatment success rates have been above 85 percent for several years in the country.”

Gupta told IANS that the overall quality of TB services, including human resources and systems for financial management are being strengthened.

To achieve the National Tuberculosis Programme’s (NTP) ambitious goal of universal health care access for all people with TB by 2017, financial commitments must be maintained by all partners, including international agencies, he said.

The state-run tuberculosis control initiative of the government, NTP provides free of cost, quality anti-tubercular drugs across the country. More than 1.5 million people avail the facility at 13,000 centres.

Gupta said that the private sector should be involved more as most patients are being treated in private clinics.

Agreed Swaminathan, who said that the government needs to work in tandem with the private sector.

“Standard procedures need to be followed for notification of the disease and diagnosis, especially by private practioners,” Swaminathan told IANS.

In 2012, India declared TB to be a notifiable disease. It means that with immediate effect all private doctors, caregivers and clinics treating a TB patient had to report every case to the government.

According to a recent WHO report, India has achieved the Millenium Development Goal (MDG) target for TB which says that the incidence of the disease should be falling. It is on track to reach the 2015 targets for reductions in TB prevalence and mortality.

But it added that India accounts for 31 percent of the estimated 2.9 million missed TB cases — people who were either not diagnosed or diagnosed but not reported to NTP.

It is estimated that about 40 percent of the Indian population is infected with TB bacteria, the vast majority of whom have latent rather than active TB.

Listing the other steps needed, Swaminathan said: “Getting more political commitment and activism from civil society to create awareness about TB like it was done in the case of HIV/AIDS would be a great help.”

India also needs to contain the risk factors associated with the disease. The biggest among them is malnutrition, which makes people more susceptible to the development of active TB. Tuberculosis patients have lower Body Mass Index (BMI), muscle mass and subcutaneous stores of fat.

“Malnutrition is the biggest risk factor and it has been overlooked,” she said, adding that the “disease needs to be fought on a common platform by all stakeholders.”

Source: Zee News


Body Shape Index is Better Predictor of Mortality

In 2012, Nir Krakauer, an assistant professor of civil engineering in City College of New York’s Grove School of Engineering, and his father, Jesse Krakauer, developed a new method to quantify the risk specifically associated with abdominal obesity.

A follow-up study, published in PLoS ONE, supports their contention that the technique, known as A Body Shape Index (ABSI), is a more effective predictor of mortality than Body Mass Index (BMI), the most common measure used to define obesity.

The team analyzed data for 7,011 adults, 18+, who participated in the first Health and Lifestyle Survey (HALS1), conducted in Great Britain in the mid-1980s, and a follow-up survey seven years later (HALS2). The sample was broadly representative of the British population in terms of region, employment status, national origin and age. They used National Health Service records through 2009 to identify deaths and cancer cases: 2,203 deaths were recorded among the sample population.

Then, they compared all-cause mortality from the HALS sample with ABSI and other variables, including BMI, waist circumference, waist – hip ratio and waist – height ratio.

The analysis found ABSI to be a strong indicator of mortality hazard among the HALS population. Death rates increased by a factor of 1.13 (95 percent confidence interval, 1.09–1.16) for each standard deviation increase in ABSI. Persons with ABSI in the top 20 percent were found to have death rates 61 percent than those with ABSI in the bottom 20 percent.

The results tracked closely with the earlier study, which used data from the National Health and Nutrition Examination Survey (NHANES), conducted in the U.S. between 1999 and 2004. This provides stronger evidence that ABSI is a valid indicator of the risk of premature death across different populations. Further, they showed that ABSI outperformed commonly used measures of abdominal obesity, including waist circumference, waist – hip ratio and waist – height ratio.

Also, because the data came from two surveys seven years apart, the researchers were able to assess the effect of change in ABSI on mortality. The found an increase in ABSI correlated with increased risk of death, and that the more recent ABSI measurement was a more reliable predictor. Noting this, the researchers contend that further investigation is warranted into whether lifestyle or other interventions could reduce ABSI and help people live longer.

Source: laboratory equipment

Two in five kids don’t have right BMI: Survey

Two out of five kids in India were found not to have the right Body Mass Index (BMI) levels, according to a health and fitness survey which covered 77,669 children in 176 schools across the country.

The children were in the age group of 7-17 years from 176 schools in 68 cities and 17 states. The fitness parameters were measured over a period of 24 months.

The parameters included flexibility, lower and upper body strength, abdominal strength and BMI which evaluates a person’s body weight in proportion to the height.

“In a comparative study between boys and girls, it was found that 66 percent girls have healthy BMI scores compared to 59 percent boys. The primary causes for higher BMI are sedentary lifestyles, unhealthy eating habits and little or no play,” the report said.

It also states that high BMI is a direct indicator of the onset of obesity which can lead to several health problems including type 2 diabetes, heart ailments and high blood pleasure as early as adolescence.

The fourth edition of Edusports annual school health and fitness survey of school going children in urban India was conducted by EduSports, a school sports and physical education company.

According to the survey, children in all five regions of the country were deemed equally unfit with unhealthy BMI scores of 37 percent (central), 39 percent (east and north), 37 percent (south) and 38 percent (west).

Encouraging schools to increase their physical education periods, and proposing a structured sports programme as a solution, Saumil Majumdar, CEO and co-founder of Edusports said: “A structured sports programme is the way forward, if any change in the fitness levels of children is desired. It is disheartening to witness an unhealthy generation that is otherwise ahead of its time.”

“The alarming fitness standards that have emerged in our annual study, again prove that physical activity/sports in schools should be viewed as an important part of the curriculum for the overall development of a child,” he added.

Source; News Track India

Obesity Linked With Hearing Loss

Obesity is associated with a higher risk for hearing loss, according to a new study in the American Journal of Medicine.

 On the other hand, greater levels of physical activity are associated with a lower risk for hearing loss, found researchers from Brigham and Women’s Hospital.

“We often think of hearing loss as an inevitable part of the aging process, but these findings provide evidence that potentially modifiable risk factors, such as maintaining a healthy weight and staying physically active, may help in the prevention of hearing loss or delay its progression,” study researcher Sharon Curhan, M.D., Sc.M., of the Channing Division of Network Medicine at Brigham and Women’s Hospital, said in a statement.

More than 68,000 women who were part of the Nurses’ Health Study II were included in the study; their physical activity, body mass index, waist circumference and hearing loss were tracked from 1989 and 2009.

Researchers found associations between higher body mass index and waist circumference and hearing loss. Specifically, women who had a body mass index of 30 to 34 (indicative of obesity) had a 17 percent higher risk of hearing loss, compared with women who had a BMI lower than 25 (normal weight is indicated by a BMI of 18.5 to 24.9, while overweight is indicated by a BMI of 25 to 29.9). And people with a BMI of 40 or greater had a 25 percent higher risk of hearing loss.

Women with a waist circumference of 80 to 88 centimeters had an 11 percent higher risk of hearing loss compared with women with a waist circumference less than 71 centimeters. And women with a waist circumference greater than 88 centimeters had a 27 percent higher risk of hearing loss.

Meanwhile, exercise seemed to decrease risk for hearing loss. Women who were the most physically active in the study had a 17 percent lower risk of hearing loss than women who were the least physically active. And it didn’t even have to be especially strenuous activity: Researchers found that walking just two hours or more a week lowered hearing loss risk 15 percent more than walking less than an hour a week.

While the study only showed an association between hearing loss and obesity, this isn’t the first time the two have been linked. A study published earlier this year in the journal The Laryngoscope showed that obese teens have a nearly doubled risk of one-sided low-frequency hearing loss, compared to their peers of normal weight. The researchers of that study speculated that a potential reason for this association is inflammation from obesity; other potential reasons include Type 2 diabetes or heart disease from obesity, which could then lead to hearing loss.

Source: Huffington post

BMI has no role in cardiovascular disease in a healthy woman

obese women have a window of opportunity to lose weight and avoid developing a metabolic disorder, which would increase their CVD risk.

Metabolically healthy women have same cardiovascular disease risk regardless of their having different BMIs, according to a study.

Dr Soren Skott Andersen and Dr Michelle Schmiegelow from Denmark findings in more than 260,000 subjects suggest that obese women have a window of opportunity to lose weight and avoid developing a metabolic disorder, which would increase their CVD risk.

The study used Danish national health databases and followed 261,489 women who had given birth during 2004-2009 with no prior history of cardiovascular disease. The women were divided into four categories according to their pre-pregnancy body mass index (BMI, kg/m2) and presence of metabolic disorders (present/not present). The women`s mean age was 31 years.

The women were followed for an average of 5 years following childbirth. Discharge diagnoses and data on cause of death were used to determine if the women had a heart attack, a stroke, or died.

The researchers found that being overweight ( BMI=25 kg/m2) but metabolically healthy was not associated with an increased risk of a heart attack, stroke or a combination of heart attack/stroke/death in comparison with normal weight, metabolically healthy women.

The investigators found that the metabolically unhealthy, overweight women had an almost 7-fold increased risk of heart attack and a 4-fold increased risk of stroke.