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HIV/AIDS increasing in country

Monday, December 01, 2008
By By Amer Malik
LAHORE

THE menace of HIV/AIDS is gradually creeping among the people in Pakistan, as a large population of children on streets and workplaces, away from their families, is exposed to contracting this infection in a scenario where all government and non-governmental organisations are absolutely clueless about the prevalence of the disease in the country.

On the eve of World AIDS Day (December 1) on Monday (today), Save the Children, UK, released a report conducted with the help of Protection and Health of Children against Abuse and Neglect (PEHCHAN) in Lahore. The estimated number of HIV positive cases is 74,000 people, ranging between 24,000 and up to 150,000 in Pakistan. A couple of children, including Imran and Nasir hailing from Vehari and Multan respectively, while talking to this correspondent here at Ali Park in redlight area, said that almost all the children in the vicinity were addicted to various kinds of drugs as well as involved in often unsafe sexual practices in one way or the other. They didn’t want to return their homes due to attraction towards drugs.

Talking to The News, Dr Naeem Zafar, a representative of PEHCHAN, confirmed that these vulnerable children were absolutely on their own, as everybody, including the officials of government, NGOs and even the media, were exploiting them for their own benefits.

In the report based on 58 respondents, the children’s average age was 15 year, 28 per cent reached up to grade five of their education, worked up to 10-12 hours, 100 per cent reported domestic violence with 8-member average family size with average monthly household income of $160 per month and individual child’s average income is $38 per month.

Out of total 58 respondents, 35 reported addiction to one or more substances and 23 claimed no addiction. The items of addiction include charas (cannabis), heroine, tobacco, alcohol, glue, injection and tablets/cough syrups. At least 36 children, including 28 boys and eight girls, reported one or more symptoms of Sexually Transmitted Infections (STIs) while 22 children, including 20 boys and two girls, did not report any symptoms of STIs.

A total of 19 per cent children said police positively helped them, 60 per cent were of the view that police didn’t help them when they needed it, 15 per cent claimed that the police officials were involved in their sexual exploitation and six per cent of them didn’t respond.

Most of the 15,000-20,000 estimated child sex workers present in Lahore live in areas near bus stands and railway station. Male child prostitution is more common than any other form of commercial sexual exploitation in Pakistan.

Though the trend of selling organs (kidney.) for cash does not seem to have caught hold in Lahore or was not reported, quite a few children were aware of the fact that they could sell their blood for money if the need arose. The limited blood screening facilities make such practice extremely unsafe and can spread HIV/AIDS on a rapid scale. Though not a single child admitted to resorting to this practice, they had come to know about this through adult drug addicts. In Pakistan, demographic vulnerability, high prevalence rates of Hepatitis B (around 10 per cent) and Hepatitis C (6-8 per cent), risky sexual behaviours and low contraceptive use compound the probability for contracting HIV/AIDS in Pakistan.

Since HIV virus spreads fastest among those who have unprotected sex with a large number of partners (especially if they have untreated Sexually Transmitted Infections -STIs) and those who engage in especially risky sexual practices and those who share injecting equipment (syringes and needles) with other people, therefore, children living in an unprotected environment-away from their primary caregivers-are especially vulnerable. Only 45 per cent of Pakistani adolescents surveyed in 14 districts knew about HIV/AIDS while 52 per cent of them believed they could resist peer pressure.

Tattooing, selling blood, organ removal, usage of unsafe dental equipment, ear and nose piercing make children on the streets more vulnerable to contracting HIV. Masochism through piercing oneself with blades, usually while sniffing glue, as a way to release anger is very common in nearly all street children. The report further says early marriage can make girls under 18 vulnerable to contracting HIV. In rural areas, as many as 42 per cent of girls below the age of 19 are married and their husbands, usually older men, were likely to be sexually experienced. Besides, lack of education and poverty also compound vulnerability to HIV/AIDS among the people.

In Pakistan, the estimated population aged below 18 years is 71 million, and 3.6 million children are involved in child labour. About 1.2 million children are on the streets in Pakistan’s large cities, working as beggars, vendors or shoeshine boys.

As many as 15 to 25 per cent children in Pakistan are affected by Child Sexual Abuse (CSA) of varying forms and intensity while only heinous crimes are highlighted by the media. Occupational safety for working children is non-existent. Trash pickers often handle used syringes and children working in auto shops are vulnerable to cuts and injuries from tools handled by everyone.

Furthermore, it is mentioned that a total of 40.3 million people are globally affected by HIV and AIDS out of which two million adolescents and 570,000 children died in 2005. A child dies of AIDS every minute somewhere in the world. Every minute, one child under 15 years becomes HIV positive somewhere in the world.
 
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Midwives constitute backbone of medical services: Princess Zahra

238 midwives awarded certificates

Sunday, December 07, 2008
By our correspondent

Karachi

Midwives are stalwart, backbone and frontline of medical services, said Princess Zahra Aga Khan, daughter of the Aga Khan.

In her video address at the graduation ceremony of 238 midwives across the country managed by Aga Khan Health Service here on Saturday, Princess Zahra said that the midwives were the ones who go out to communities

and carry their knowledge with them to save lives, wherever they go.

They work tirelessly in the cold of winter and the heat of summer; despite often trying circumstances, isolation and loneliness to bring comfort to the most remote rural homes, villages and families, she said, adding: “This is indeed a noble profession”. More.



The cookie diet can entice dieters!

Being hungry and craving sweets are two of the main reasons people fall off their diets.

But what if eating cookies and not being hungry was part of your diet plan?

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By Kathleen M Zelman

The cookie diet: What it is

Being hungry and craving sweets are two of the main reasons people fall off their diets. But what if eating cookies and not being hungry was part of your diet plan? The cookie diet uses cookies to entice dieters into easy weight loss. After all, what could be more appealing than losing weight while indulging in one of our favourite treats?

But these are not your grandmother's cookies. Instead they're designed to be meal replacements made with fiber, protein, and other ingredients intended to keep you full. They're not nearly as sweet as grandma's, though they're certainly palatable. They contain no drugs or secret ingredients, other than amino acids (the building blocks of protein) and fiber that act to suppress hunger.

How it works

On the cookie diet, there are no decisions about what to eat, but which flavour cookie to eat, and what to have for dinner. It's a relatively mindless diet strategy that has reportedly helped half a million of patients lose weight.

The cookies contain select amino acids thought to suppress hunger, fiber, and other ingredients that digest slowly to help keep you feeling full. Eating four to six of the cookies a day will give you somewhere around 500 calories.

Dinners are simple: Lean protein and veggies, or a light dinner and a salad. The dinners range from a low of 300 to a high of about 1,000 calories each, meaning the diet has a grand total of 800-1,500 calories per day.

Anyone following 800-calorie per day plan is sure to lose weight, but medical supervision is recommended for people following very low-calorie diets (less than 1,200 per day), as they are likely to be deficient in nutrients. Most of the very low-calorie cookie diet plans recommend a daily multi-vitamin to fill in the nutritional gaps.

"One of the greatest motivators to sticking to a diet is when you manage hunger, decrease cravings, and watch the weight come off, and virtually everyone will lose weight at 800 calories," Siegal says.

Evan Bass, a physician, has been following the cookie diet for more than a year and has lost upto 45 pounds.

"The first two weeks were the hardest," he says. "I was tired with no energy for exercise but once I got used to it, I felt great and could be more physically active while eating cookies daily for breakfast and lunch." More.



Researchers probe brain's communication infrastructure

Brain signal never switches off and also supports many cognitive functions. Researcher's look at one of the human brain's most fundamental "foundations" is an important step forward in understanding the functional architecture of the brain …

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By Kate Melville

Washington University School of Medicine researchers are taking the first direct look at one of the human brain's most fundamental "foundations": a brain signal that never switches off and may support many cognitive functions. Their findings, appearing in the Proceedings of the National Academy of Sciences, are an important step forward in understanding the functional architecture of the brain.

Functional architecture refers to the metaphorical structures formed by brain processes and interactions among different brain regions. The "foundation" highlighted in the new study is a low-frequency signal created by neuronal activity throughout the brain. This signal doesn't switch off even in dreamless sleep, possibly to help maintain basic structure and facilitate offline housekeeping activities.

"A different, more labile and higher-frequency signal known as the gamma frequency activity has been the focus of much brain research in recent years," says study author Biyu He. "But we found that signal loses its large-scale structure in deep sleep, while the low-frequency signal does not, suggesting that the low-frequency signal may be more fundamental."

"What we've been finding is reorienting the way we think about how the brain works," adds co-researcher Marcus Raichle. "We're starting to see the brain as being in the prediction business, with ongoing, organised carrier frequencies within the systems of the brain that keep them prepared for the work they need to do to perform mental tasks."

Neurologists have spent many years exploring the upper levels of the brain's functional architecture. In these studies, researchers typically ask volunteers to perform specific mental tasks as their brains are scanned using fMRI. Such "goal-oriented" tasks might include looking for or studying a visual stimulus, moving an arm or leg, reading a word or listening for a sound. As the subjects perform these tasks, the scans reveal increases in blood flow to different parts of the brain, which researchers take as indications that the brain areas are contributing to the mental task. More.
 
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He who has health, has hope. And he who has hope, has everything.


Experts call for smoke-free public places

Thursday, January 01, 2009
By our correspondent

Karachi, strict measures must be taken to implement laws banning smoking indoors at all public places, stated members of the National Alliance for Tobacco Control (NATC) at a meeting held at Aga Khan University (AKU).

Dr Javaid Khan, Chairman of NATC, Pakistan, said that the government’s recent announcement to allow designated smoking areas in restaurants, hotels and other public places is going to weaken the implementation of the ordinance. He said that the most important step the government can take to control the tobacco epidemic is to ensure that all public places are completely smoke-free indoors as this would be in line with the Prohibition of Smoking and Protection of Non-Smokers Health Ordinance, 2002.

Dr Khan regretted that the tobacco industry in Pakistan has been given a free hand to promote their products. He appealed to NGOs working in the health sector to step forward and educate society about the hazards of tobacco use. “Tobacco use is the single largest preventable cause of morbidity and mortality in the country. Implementation of clean air laws have been shown to decrease deaths associated with tobacco use in the developed world. Such laws should be strictly implemented in Pakistan also,” said Dr Khan.

He added that tobacco is a major risk factor for lung cancer, heart attack, strokes and other fatal diseases. According to World Health Organisation (WHO) estimates, 5.4 million people died last year because of tobacco. This number is expected to rise to 10 million per year by the year 2025, unless preventive measures are taken.

Shahzad Alam, representative of the World Health Organisation (WHO), Pakistan, expressed concern over the tobacco industry’s attempts to change existing anti-tobacco laws in the country, which prohibit smoking in all indoor public places. He said that WHO, along with the Pakistan Chest Society, the American Cancer Society and other organisations have already recommended to the government that all indoor public places be smoke-free. He criticised the government’s announcement to allow designated smoking areas in public places.More.



Caffeine affects men more

31 Dec 2008

Caffeine produces a greater effect on men than women. The effect begins to make itself felt just 10 minutes after it is drunk.

And contrary to previous thinking, decaffeinated coffee also produces an increased state of alertness.

"Numerous studies have demonstrated the stimulant effects of caffeine, but none of these have looked at their effects in terms of the consumer's gender," said Ana Adan, co-author of a new study on the subject and a researcher in the Psychiatry and Clinical Psychobiology Department of University of Barcelona (UB).

Research into the effects of caffeine tends to be carried out using preparations in which the caffeine level is much higher than normal intake.

The novelty of this study lies in "the difference seen in the effects on men and women, based on the quantities of caffeine people take in 99 percent of cases (espresso coffee and decaffeinated espresso coffee, containing 100 mg and 5 mg of caffeine, respectively)," said Adan.

Scientists used a sample of 668 university students (238 male and 450 female) with an average age of 22 years, said a Plataforma SINC release.

Measurements were taken before and after the caffeine was ingested (10, 20 and 30 minutes) and were carried out at mid-day (11 a.m. to 1 p.m.) and in the afternoon (4 p.m. to 6 p.m.), to act as a control in case of possible differences caused by the time.

"Although both the men and women saw an improvement in their activity levels with the coffee, which increased in later measurements, we observed a greater impact among the males," the researcher said.

When the decaffeinated version was introduced into the study, the authors also found a small subjective improvement in the participants' state of alertness, which did not rise so strikingly in the later measurements.

Caffeine has an almost immediate effect. Previous studies had shown that alertness starts to increase 30-45 minutes after consumption, but the new study shows that the effects begin after as little as 10 minutes.

According to the researcher, "45 minutes is the time needed for maximum caffeine concentration to be reached in the blood, but levels reach half this concentration after just a few minutes."
 
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So many people spend their health gaining wealth, and then have to spend their wealth to regain their health. A. J. Reb Materi


Rs 829.6m for health betterment in FATA

Dec. 31. 2008
Associated Press of Pakistan

PESHAWAR: The fast track development of FATA is the top priority of the government and all out efforts are being made to provide maximum healthcare facilities to the tribesmen.

An allocation of Rs 829.694 million has been made in the current financial year for implementation of 129 development schemes in health sector embracing projects like control of communicable diseases and aids, improvement and rehabilitation of the existing health institutions, strengthening of mobile hospital programme to provide medical facilities to the tribesmen of the far-flung areas at their door steps and a feasibility study for construction of a Medical College in FATA.

According to a handout of FATA Media Cell issued here on Thursday, a total of sixteen Civil Hospitals, Rural Health Centers (RHC) and Basic Health Units (BHU) are being upgraded to type 'D' hospitals at a cost of Rs. 1,162.972 million. Out of this Rs 423.375 million have already been spent while Rs 204.573 million are being spent during the current fiscal year.

The health institutions being upgraded to type 'D' hospitals include Civil Hospital Nawagai and RHC Pashat (Bajaur Agency), BHU Had Kore Ambar and BHU Momad Gat (Mohammad Agency), BHU Dogar (Kurram Agency), Civil Hosptial Kalaya and RHC Dabori (Orakzai Agency), Civil Hospitals Datta Khel and Razmak (North Waziristan Agency) and Civil Hospital Darazinda (FR DI Khan).


Moreover, type 'D' hospitals at Makin and Sarwakai (South Waziristan Agency) and Dara Adam Khel (FR Kohat) have been established, reconstruction of Civil Hospital Jandola (FR Tank) and its up-gradation to type 'D' hospital.

Conversion of BHU Shin Dand and into type 'D' hospital is also included in the scheme of up-gradation while Tehsil Headquarters Hospitals Saddah (Kurram Agency) and Mir Ali (North Waziristan Agency) are being upgraded to type 'C' hospitals. All these development schemes in health sector, FATA are designed to provide best possible treatment facilities to the tribesmen.

A sum of Rs. 7.560 million has been earmarked for establishment of an emergency center in Dara Adam Khel (FR Kohat) to provide immediate medical relief to coal miners in case of an accident.
 
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It is health that is real wealth and not pieces of gold and silver. Mahatma Gandhi.


Eliminating corruption: Chief minister orders filtering of health department

By Mansab Dogar
January 08, 2009

LAHORE: Chief Minister Shahbaz Sharif has ordered Health Secretary Anwar Ahmed Khan to prepare a list of all corrupt doctors to expel them from government services, Daily Times learnt on Wednesday.

Sources said Shahbaz has also ordered hiring well-reputed doctors to appoint them to key administrative posts. The orders were issued after a meeting between the chief minister and senior officials from the health department.

Confirming the instructions had been issued on Tuesday, Task Force on Spurious Drugs Chairman Dr Saeed Elahi said a crackdown against corrupt doctors and negligent Health Department officials would soon be underway. He said such doctors were a hurdle in the Punjab government’s efforts to bring about revolutionary changes in the department. He said all cases concerning corrupt drug inspectors, doctors and negligent quality control officials would be sent to the Anti-Corruption Establishment for speedy trials.More.



Diabetes linked to cognitive decline: study

January 08, 2009

LAHORE: Recent studies show diabetes might affect the brain like other parts of the body, ‘contributing to a decline in mental functioning’, a report on the Time website says. “Studies have shown that diabetes may speed up aging-related deficits in mental function and lead to a two-fold increase in the risk of dementia,” the report says. The report said Roger Dixon, a psychologist at the University of Alberta in Canada, “set out to study exactly how uncontrolled blood sugar affected the brain”.

The report said Dixon and his colleagues studied 41 diabetic adults and 424 healthy adults aged 53 to 90, and reported their findings in the journal Neuropsychology. They tested the participants “on memory, recall, verbal fluency, executive functions involving critical thinking and the speed of their mental faculties, researchers found the most significant deficits in diabetes patients on tasks of executive function and speed”. “Although Dixon’s study failed to add new information on the question of diabetes and Alzheimer’s disease, other experts view these results as useful fodder in the growing field of diabetes research,” the report said. daily times monitor
 
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Rs 4bn Health Insurance Scheme for poor on the cards, NA told

Thursday, January 15, 2009

ISLAMABAD: Minister for Health Mir Aijaz Jakhrani told the National Assembly on Wednesday that the government was considering to introduce a Rs 4 billion Health Insurance Scheme in the next fiscal year to provide health cover to the poor.

In a written reply to a question from Rana Mahmoodul Hassan during the Question-Hour, the minister said the Health Ministry was in contact with the National Rural Support Programme and some insurance companies to develop and design a health insurance policy for the poorest sections of the society.

It was estimated that 40 million people shall be insured during the first year.Under this scheme, the insurance company would cover medical expenses up to Rs 250,000 per household for 4 million households living below the poverty line.

To another question, he said the UAE government had offered to set up a 220-bed state-of-the-art hospital with 8-bed fully digitalised trauma centre in Chak Shahzad, Islamabad.Answering a question from Nisar Tanveer, the minister said a total of 2,650 suspected patients of dengue fever were admitted to hospitals of different cities of the country. Out of these, 1,058 and 1,260 patients were admitted in Lahore and Karachi respectively.

He said 1,759 cases were confirmed by the laboratories while 30 deaths had been reported due to the dengue fever in the country. Replying to a question from Afzal Khokar, he said two centres for liver transplantation were being established at the Sheikh Zayed Hospital, Lahore, and the Pakistan Institute of Medical Sciences, Islamabad.More.



Coffee makes you see things’

January 15, 2009

Drinking too much coffee dramatically increases the risk of hallucinating, according to new research. Healthy young men and women who had more than seven cups of instant coffee a day were three times more likely to hear or see things that were not there. It is thought that caffeine boosts levels of cortisol, a stress hormone. The Durham University researchers asked 219 students to document their caffeine intake, working on the principle that a cup of instant coffee contains 45mg of caffeine.

Coffee brewed at home contains more than twice as much, while that from cafes can have almost 190mg of caffeine. The volunteers were also asked how often they suffered hallucinations. The high caffeine users were three times as likely to have had problems as those who rarely drank coffee. ananova
 
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85,000 die of cancer in Pakistan every year

February 04, 2009
By Muhammad Qasim

Islamabad

Cancer is a leading cause of death globally, particularly in the developing countries like Pakistan where less than 50% of the population is literate and the prospects of having good knowledge about the cancers seem poor.

Cancer is emerging as a major health problem in the country. Pakistan like other developing countries in the region is facing a double burden of diseases with a significant incidence of cancers and a rising trend in risk factor’s profile and incidence itself. The precise incidence, mortality rates, number of new cancer cases and number of deaths annually for Pakistan are not known however according to WHO estimates, as many as 61,624 incident cases and 42,624 cancer deaths annually in males and 75,095 incident cases and 43,188 deaths annually in females are reported.

In Pakistan, a large proportion of cancers presents at an advanced age. Health experts believe that lack of awareness about cancers, their signs and symptoms, is one of the major causes of delayed presentation. Experts say that awareness and education of masses is necessary to combat cancer, which is alarmingly increasing in the country.

“At least one-third to 40% of all cancer cases are preventable, mainly by not using tobacco, healthy diet and being physically active and preventing infections that may cause cancer,” said Professor of Community Medicine at Islamabad Medical and Dental College, Dr. Muhammad Ashraf Chaudhry, while talking to ‘The News’ Tuesday in connection with World Cancer Day which is observed on February 4 all around the globe. “Prevention offers the most cost-effective long-term strategy for the control of cancer.”

Talking of risk factors, Dr. Ashraf said that aging is the fundamental factor for the development of cancer. “The incidence of cancer rises dramatically with age. Lifestyle and environmental factors and the things we eat, drink, whether we smoke or exercise, how much sun we get and where we live have a powerful effect on cancer risk. One possible promoter in food is fat, especially saturated fat from animal products like meat,” he said. Tobacco use, pan, chalia, alcohol use, physical inactivity, being overweight and obese, exposure to occupational (e.g. asbestos) carcinogens, radiation (e.g. ultraviolet and ionising radiation), low fruit and vegetable intake, excessive consumption of red and preserved meat, high fat diet, genetic factors, having unsafe sex, infections from hepatitis B, hepatitis C, HIV, human papiloma viruses, helicobacter pylori, urban air pollution and indoor smoke from household use of solid fuels are major risk factors of cancer.

To a query, Dr Ashraf said that tobacco is the single largest preventable cause of cancer in the world today. “It causes 80-90% of all lung cancer deaths, and about 30% of all cancer deaths in developing countries. A comprehensive strategy including ban on tobacco advertising and sponsorship, tax increases on tobacco products, and cessation programmes can reduce tobacco consumption and can minimise incidence of cancers.” He added that cancer might affect anyone - the young and old, the rich and poor, men, women and children - and it represents a tremendous burden on families and societies.

Cancer is the uncontrolled growth and spread of cells. It can affect almost any part of the body. The growth often invades surrounding tissue and can metastasise to distant sites. Lung, stomach, liver, colon and breast cancer cause the most cancer deaths each year.

Dr Ashraf said that cancer’s seven warning signals (CAUTION) are: change in bowel or bladder habit, a sore that does not heal, unusual bleeding or discharge, thickening or lump in breast or elsewhere, indigestion or difficulty in swallowing, obvious change in wart or mole and nagging cough or hoarseness.

Talking of control on the disease, Dr Ashraf said that four basic components of cancer control are prevention, early detection, diagnosis and treatment, and palliative care. Dietary modification is an important approach to cancer control because there are many promoters and inhibitors in food.

Scientists believe that the food we eat is very important in the growth, or the prevention of cancer. Diets high in fruits, vegetables, whole grains, tomatoes, beans, pulses and legumes and avoiding processed foods high in fat, salt and/or sugar and sugary drinks, have a protective effect against many cancers. “Do not remove skin of fruits, potatoes, pears and apples etc. Avoid fried foods and bakery items. Limit your intake of salty foods such as pickles, nimco, chips etc.

Mothers should breastfeed their infants for at least six months. This practice offers cancer protection to both mother and the child. Drink at least 8 to 10 glasses of water a day,” said Dr Ashraf adding taking multi-vitamin is also not a bad idea.

He added that regular physical activity and maintenance of healthy body weight, along with a healthy diet might considerably reduce cancer risk. “Vaccination against human papiloma virus (HPV) and hepatitis B virus vaccination (HBV) might prevent cervical and liver cancer respectively.” Dr Ashraf believes that avoiding excessive exposure to solar ultraviolet radiation, use of sunscreen, wide-brimmed hats, large sunglasses, and protective clothing are effective preventive measures against skin cancer. “Asbestos can cause lung cancer, aniline dyes have been linked to bladder cancer and benzene can lead to leukaemia. The prevention of certain occupational and environmental exposure to these and other chemicals is another element in preventing cancer.”
 
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Stigma of mental illness

Tuesday, February 10, 2009
Dr Amin A Gadit

According to the World Health Organisation, of the 450 million people around the world who have mental, neurological or behavioural problems, the majority don't have access to appropriate mental-health treatment and care. Thirty percent of countries do not have a specific budget for mental health, and those that do would spend less than one per cent of their total health budget on it. There are regional variations in the number of psychiatrists, from more than 10 per 100,000 to fewer than one per 300,000. Worldwide, 68.6 percent of the psychiatric beds available in hospitals are in mental hospitals.

The problem with the stigma related to mental illness is a major stumbling block almost all over the globe. Those suffering from mental illnesses are more prone to abuse of all kinds and their rights are easily violated. Therefore, mental illness has low priority and is likely to be ignored when it comes to care and attention. There are horrendous stories about the way the mentally ill are treated in the community and psychiatric set ups.

Internationally studies have found lack of mental health treatment to be most severe in the less-developed countries. Even in developed nations, roughly half of those with severe disorders receive no care at all. The British organisation "MIND" reported shockingly high levels of bullying, harassment and exploitation experienced by people with mental-health problems. Generally, people living in mental-health facilities are often exposed to inhuman and degrading treatment. Sometimes they are put in seclusion or restraints for extended periods of time. Many are over-medicated to keep them docile, many are inappropriately admitted to mental health facilities against their will and are given treatments without their consent. Inappropriate use of ECT (electroconvulsive therapy) is widely noticed in a number of psychiatric setups. Many such facilities are not managed according to the guidelines and hence are ******, lacking clean water, proper food, heating/air-conditioning, clean bedding and toilet facilities. Reports of physical and sexual abuse are alarming, but are not being addressed at any level.

Looking at our local scenario in Pakistan, we come across harrowing tales about the fate of mentally ill people by societal atrocities.

Although a small number of people treat mentally ill people well, a large majority find it difficult to come to terms with mental illness in others. Someone who suffers from a mental illness would meet harsh behaviour from siblings and there will either be no effort or delay in seeking treatment because of the fear of stigma. A mentally ill woman may lose the prospects of getting married and the family may get a discriminatory label that would add to social adversity. The needs and emotions of a mentally ill person are generally ignored and love and tender care are often missing. Mental-health patients are teased in the community, are called names, beaten, terrorised and humiliated.

Many rich families where there is a male family member suffering from schizophrenia endeavour to get that member married off to a woman with a poor social background with the notion that this will bring improvement to the mental patient. Likewise, many female sufferers are married to males from lower social background. The marriages remain in doldrums because of lack of coping by the sufferer as marriage brings a lot of social responsibilities and may cause tremendous stress as a result. There are a few examples where mentally ill people were able to sustain meaningful employment, but many of the sufferers are without job and remain on the mercy of their relatives. Many such patients are left abandoned on shrines and there are horrifying pictures and reports of them being chained with trees, which is a gross violation of human-right ethics.

There are two types of setups for chronically ill psychiatric patients in Pakistan: public- and private-sector setups and some philanthropic services.

Public-sector hospitals in many instances present a gloomy picture. The environment is reportedly non-conducive, treatment by the staff is harsh, beatings and abuse are not uncommon. The patients are sometimes subjected to sexual abuse, but such incidents are not reported and at times blocked by political pressures. In a few public and private setups, electroconvulsive treatments are given without protocol that include anaesthesia or muscle relaxants being followed. Hygienic conditions and quality of food is questionable and at times unfit for human beings. There are a number of prisoners in jails who are booked under criminal charges. The prison psychiatric services are far from satisfactory and many convicted prisoners' mental health has not been taken into account when the sentences are passed.

In order to upheld the human rights of the mentally disturbed there is an acute need for understanding mental illness, launching of a de-stigmatisation campaign, education at mass level, improvement and increase in financial and human resources allocated to mental health, familiarity with international and national human rights standards and norms related to people with mental illness, improvement in policy making, implementation of laws related to human rights, respect the dignity, protecting the rights and liberty of mentally ill people, involving families in the treatment plans, denouncing of outdated and inhuman forms of treatment, poor service delivery and care, sensitizing and educating people about mental health and creating awareness on the human rights, establishing community mental health services and seeking collaboration of all concerned agencies will go a long way in addressing the issue of human right violation of people with mental illness. Once this matter is understood, it will not then be difficult to prioritise mental health by policymakers.


The writer is a professor of psychiatry and consultant psychiatrist based in Canada
 
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Sex can provide protection against cancer, cold and flu

February 11, 2009

LAHORE: Sex can help ‘cure cold, prevent heart attacks, stave off cancer, increase longevity and stop mood swings’, according to The Daily Telegraph. The paper said researchers at UK’s Nottingham University had earlier found that “men who keep up a regular sex life into their 50s have a much lower risk in developing prostate cancer”. However, it noted, “too much sexual activity, more than 20 times a month, could increase the risk”. The report said doctors agreed that “regular sexual activity” was like exercise. The paper quoted cardiologist Dr Graham Jackson from Guy’s and St Thomas’ Hospital as saying, “In fitness terms, it’s equivalent is going for a mile-long walk or climbing up and down two flights of stairs.” It quoted Dr Sarah Brewer as saying, “Testosterone levels have been found to increase during and after sex.” The paper said a person’s mood was also boosted during and after sex. The paper quoted Professor Nadir Farid, consultant endocrinologist and founder of the London Endocrine Clinic, as saying a number of endorphins, neurotransmitters and hormones were released during sex. “Oxytocin, in particular, is a hormone released during and after sex that has been shown to make people more generous towards their partners and can also help induce calm and sleep.” The paper said if a person had sex once or twice a week, the immune system was fortified, “thanks to the body producing higher levels of immunoglobulin A – a substance that helps fight colds and flu”. The paper also noted that sex had its disadvantages as well. It noted that unprotected sex resulted in the transmission of venereal diseases. It also noted that “since Viagra was released 10 years ago, the rate of sexually transmitted infections (STIs) in the over-45 group has doubled”. It quoted Professor Janice Rymer, professor of obstetrics and gynaecology at St Thomas’ Hospital in London, as saying the over-45 group was a generation that did not have open access to sex education, leading to a possible rise in STIs. daily times monitor
 
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Health Initiative: Kamal opens infectious diseases teaching institution

February 13, 2009

KARACHI: City Nazim Mustafa Kamal has laid the foundation stone of Pakistan’s first-ever teaching institute for infectious diseases located at Hot Spring in Manghopir.

The institute comprises of a ground plus two-storey project for which the City District Government Karachi (CDGK) has allocated Rs 88.110 million. The institute will be operational by June this year. The institute is established at the CDGK Leprosy Centre in Manghopir, which was established by a philanthropist about 110 years ago and was handed over to the defunct Karachi Municipal Corporation in 1960. Since then the centre was neglected and there were no civic facilities available including roads but Kamal has focused on the centre and now it is going to be an important teaching institution.

Addressing a huge congregation of local residents, Kamal said that just three years ago, he dreamt of converting the leprosy centre into a dedicated teaching institute for infectious diseases and now up to 40 to 50 percent of the centre is complete while the entire centre will become operational in June. CDGK has the honour of establishing Pakistan’s first teaching institute for infectious diseases including Leprosy, Hepatitis, Typhoid, Measles, skin diseases and above all, this centre will provide the citizens free of cost medical facilities including certain high-cost specific diagnostic pathological tests. To facilitate the tests, CDGK has installed the Polymerase Chain Reaction (PCR) diagnostic equipment at the centre, said Kamal. During the past three years, the CDGK has lifted the standard of the neglected Leprosy Centre to that of other health facilities in the city and the data of the centre shows that in 2006, the Out-Patient Department (OPD) catered to 38,663 patients and in 2008 the numbers have increased to 100,127 patients, showing CDGK’s dedication to serve the people. The lab test facility was availed by 1,761 patients in 2006 and 8,210 patients in 2008 and all these facilities were given free of cost, added Kamal. For the first time in the history of the country, the CDGK has not been restricted to only the allocated budget for health but has been kept on an ‘as and when need be’ basis. This is why the fiscal allocations for CDGK’s health services are unlimited, claimed Kamal. staff report



Gum disease could trigger AIDS: study

February 13, 2009

TOKYO: An acid produced in the mouth due to gum disease invigorates the virus leading to full-blown AIDS, a Japanese researcher said on Thursday, billing the finding as the world’s first.

A group of bacteria causes periodontal disease – a chronic inflammation that erodes bony structures in the gum – posing a threat to the teeth and the entire body, the researcher said. “They produce a large amount of butyric acid, which smells like socks you wore for a long time,” said Kuniyasu Ochiai, professor heading the Microbiology Department at the Tokyo-based Nihon University. The acid, which can also exist in sour butter, hinders a kind of enzyme called HDAC that blocks HIV from growing, Ochiai said. “Serious periodontal disease could lead to the development (of AIDS) among HIV-positive people... although the probability largely depends on individual physical strength,” Ochiai said, adding even those unaware of having contracted HIV could develop the epidemic once they had periodontal disease. afp
 
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Dengue’s back?: All residential areas to be sprayed in March: ACS

February 24, 2009

* Health DG says contracts for spray equipment have been awarded
* Health secretary directs speedy installation of ACs at hospitals

Staff Report

LAHORE: Punjab Additional Chief Secretary (ACS) Javaid Aslam on Monday ordered all divisional commissioners and district coordination officers (DCOs) to ensure that all residential areas in March are sprayed with mosquito repellents.

He issued these directions while chairing a special meeting of commissioners and DCOs on Monday. Health Secretary Anwar Ahmad Khan, Local Government Secretary Sohail Amir, Health Additional Secretary Dr Mushtaq Ahmad, Health Director General (DG) Dr Muhammad Aslam Chaudhry, all divisional commissioners and all DCOs were present at the meeting.

Contract: The Health DG gave a briefing regarding the precautionary measures taken by the Health Department against dengue fever. He said a rate contract had been awarded to companies for the purchase of spray pumps and anti-mosquito spray, adding that a spray pump was available for Rs 6,000, Deltamathrine for Rs 590 per kilogramme (kg), Senithrine for Rs 50 per kg and Permethrine for Rs 1,050 per litre. He said it was the ideal time to take precautionary measures against dengue fever, adding that killing one mosquito now was equivalent to killing 700 mosquitoes in the upcoming season. He said it was necessary for all houses to be sprayed before the summer season started.

The ACS directed the commissioners and DCOs to personally monitor the anti-mosquito spraying in their respective divisions and districts to ensure proper implementation of the Health Department’s plan. He said the government would provide additional funds for the purchase of insecticides, spray machines and other equipments, adding that a request had been made to Chief Minister Shahbaz Sharif in this regard. The Lahore commissioner said a media campaign should be launched to effectively control the spread of dengue fever.

Installation: The Health secretary said the government had provided the required funds for the installation of air conditioners and generators at all public hospitals in November 2008. He asked the DCOs to ensure the installation in their respective districts by March to provide relief to patients from the heat in the summer. He said funds had also been released for the provision of free medicines in public hospitals, adding that a rate contract had already been made for the project.
 
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Anger really can kill you: Study

February 24, 2009

CHICAGO: Anger and other strong emotions can trigger potentially deadly heart rhythms in certain vulnerable people, US researchers said. Previous studies have shown that earthquakes, war or even the loss of a World Cup Soccer match can increase rates of death from sudden cardiac arrest, in which the heart stops circulating blood.

"It`s definitely been shown in all different ways that when you put a whole population under a stressor that sudden death will increase," said Dr. Rachel Lampert of Yale University in New Haven, Connecticut, whose study appears in the Journal of the American College of Cardiology.

"Our study starts to look at how does this really affect the electrical system of the heart," Lampert said.

She and colleagues studied 62 patients with heart disease and implantable heart defibrillators or ICDs that can detect dangerous heart rhythms or arrhythmias and deliver an electrical shock to restore a normal heart beat.

"These were people we know already had some vulnerability to arrhythmia," Lampert said in a telephone interview.

Patients in the study took part in an exercise in which they recounted a recent angry episode while Lampert`s team did a test called T-Wave Alternans that measures electrical instability in the heart.

Lampert said the team specifically asked questions to get people to relive the angry episode. "We found in the lab setting that yes, anger did increase this electrical instability in these patients," she said.

Next, they followed patients for three years to see which patients later had a cardiac arrest and needed a shock from their implantable defibrillator.

"The people who had the highest anger-induced electrical instability were 10 times more likely than everyone else to have an arrhythmia in follow-up," she said.

Lampert said the study suggests that anger can be deadly, at least for people who are already vulnerable to this type of electrical disturbance in the heart.

"It says yes, anger really does impact the heart`s electrical system in very specific ways that can lead to sudden death," she said.

But she cautioned against extrapolating the results to people with normal hearts. "How anger and stress may impact people whose hearts are normal is likely very different from how it may impact the heart which has structural abnormalities," she said.

Lampert is now conducting a study to see if anger management classes can help decrease the risk of arrhythmia in this group of at-risk patients.

Sudden cardiac death accounts for more than 400,000 deaths each year in the United States, according to the American College of Cardiology.



Vitamin D deficiency may increase risk of colds, flu

February 24, 2009

Vitamin D may be an important way to arm the immune system against disorders like the common cold, according to a report published on Monday in the Archives of Internal Medicine.

In the biggest and most nationally representative study of the association between vitamin D and respiratory infections, conducted by investigators from the University of Colorado Denver (UC Denver) School of Medicine, Massachusetts General Hospital (MGH) and Children`s Hospital Boston, people with the lowest blood vitamin D levels reported having significantly more recent colds or cases of the flu. The risks were even higher for those with chronic respiratory disorders, such as asthma and emphysema.

"The findings of our study support an important role for vitamin D in prevention of common respiratory infections, such as colds and the flu," Adit Ginde, UC Denver Division of Emergency Medicine and lead author of the study, said. "Individuals with common lung diseases, such as asthma or emphysema, may be particularly susceptible to respiratory infections from vitamin D deficiency."

While vitamin C has been used for the prevention of colds and other respiratory disorders for decades, little scientific evidence supports its effectiveness. In contrast, in recent years evidence has accumulated that vitamin D -- most commonly associated with the development and maintenance of strong bones --may also play a key role in the immune system.

Circumstantial evidence has implicated the wintertime deficiency of vitamin D, which the body produces in response to sunlight, in the seasonal increase in colds and flu; and small studies have suggested an association between low blood levels of vitamin D and a higher risk of respiratory infections, the report said.

The study analyzed data from the Third National Health and Nutrition Examination Survey (NHANES III), conducted by the National Center for Health Statistics. Participants were interviewed in their homes regarding their health and nutrition, and most participants also received a physical examination that included collection of blood and other samples for laboratory analysis. The research team analyzed blood levels of 25-hydroxyvitamin D (25OHD) -- the best measure of vitamin D status -- from almost 19,000 adult and adolescent NHANES III participants, selected to be representative of the overall U.S. population.

Study participants with the lowest vitamin D blood levels -- less than 10 nanogram per milliliter of blood -- were about 40 percent more likely to report having a recent respiratory infection than were those with vitamin D levels of 30 or higher. The association was present in all seasons and even stronger among participants with a history of asthma or chronic obstructive pulmonary disease (COPD), including emphysema. Asthma patients with the lowest vitamin D levels were five times more likely to have had a recent respiratory infection; while among COPD patients, respiratory infections were twice as common among those with vitamin D deficiency.

"A respiratory infection in someone with otherwise healthy lungs usually causes a few days of relatively mild symptoms," Carlos Camargo of the MGH Department of Emergency Medicine and senior author of the study, said.

"But respiratory infections in individuals with an underlying lung disease can cause serious attacks of asthma or COPD that may require urgent office visits, emergency department visits or hospitalizations. So the impact of preventing infections in these patients could be very large," said.

The authors stressed that the study`s results need to be confirmed in clinical trials before vitamin D can be recommended to prevent colds and flu.

"We are planning clinical trials to test the effectiveness of vitamin D to boost immunity and fight respiratory infection, with a focus on individuals with asthma and COPD, as well as children and older adults -- groups that are at higher risk for more severe illness," Ginde said.

"While it`s too early to make any definitive recommendations, many Americans also need more vitamin D for its bone and general health benefits. Clinicians and lay people should stay tuned as this exciting area of research continues to expand," he said.
 
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Young couch potatoes face asthma risk

March 03, 2009

PARIS: Young children who watch a lot of television every day could be at risk of developing asthma, according to a study published on Tuesday. The findings were made in a long-term investigation, by British doctors, of more than 3,000 children, whose respiratory health had been monitored since birth in 1991 and 1992.

In a paper published in the journal Thorax, the investigators looked into an increase in asthma, noticeable between the ages of three and a half and 11 and a half. Six percent of the children, who did not have any asthmatic symptoms at the earlier age, developed them eight years later. But especially prominent was the increase among children who, according to their parents, watched television for two hours or more each day.

In this group, the risk of 11 and a half-year-olds developing asthma was nearly twice than those who watched television for less than two hours. The probe touched on scientists’ suspicions that sedentary behaviour and poor physical fitness had an effect on respiratory development. afp
 
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