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1 DAILY NEWS BULLETIN LEADING HEALTH, POPULATION AND FAMILY WELFARE STORIES OF THE DAY Friday कसर कसर क पत लग न ह आ आस न, कम खच म य रन ट ट स ह ग पहच न (Hindustan: ) कसर क 100 स अधक क र ह अधकतर कसर क न म उस अ ग य क शक ओ क न म पर रख ज त ह जनम व श ह त ह आजकल ल ग सबस $य द प ट क कसर स पर श न ह इसक म मल ब त कई स ल स ध र -ध र क फ+ बढ़ गए ह प ट क कसर क ल.ण क ब र म ब त कर त श 0आत म इसक ल.ण 1प2ट नह3 ह त ह. ल 4कन व 6 7नक न ह ल ह3 म एक ऐस श ध 4कय ह जसक+ मदद स अब कसर क पत उसक श आत द र म ह3 लगय ज सक ग अब एक आस न य ;रन ट 1ट क+ मदद स कसर क+ पहच न क+ ज सक ग इस ट 1ट म य ;रन क र ग बदलन स कसर क+ पहच न ह ग व 6 7नक क अन स र भ>व2य म इस ट 1ट क+ मदद स इस ज नल व ब म र3 क+ ज?द पहच न करन आस न ह ग न तकन क स स1त ह ग : च ह पर 4कए गए अAययन म द ख गय 4क जन च ह क क ल न कसर थ उनक य ;रन ट 1ट क द र न न ल र ग क ह गय व 6 7नक क उCम द ह 4क यह ट 1ट एक नए न द 7नक उपकरण क >वकसत करन म मदद कर ग ज न तकन क स क फ+ स1त ह ग

2 कसर क+ ज?द पहच न ह न स मर3ज क बचन क+ स भ वन बढ़ ज त ह Dय4क इल ज ज?द स ज?द श 4कय ज सकत ह इ प ;रयल क ल ज ऑफ ल दन और म स च स Hस इ 1ट3Hय ट ऑफ ट Dन ल ज क श Iव र 4कए गए अAययन क पJKक न चर न न ट Dन ल ज म क शत 4कय गय ह श फ सर म ल3 1ट3व स न कह, यह ट 1ट मह ग ल ब उपकरण क Jबन आस न स 4कय ज सक ग एक र स य7नक 7त4Lय क+ मदद स र ग म आन व ल बदल व स ह3 कसर क+ पहच न क+ ज सक ग इस अAययन म 28 च ह क य ;रन सपल क पर3.ण 4कय गय इनम 14 च ह म क ल न कसर क+ पहच न क+ गई

3 Cancer (Hindustan: ) _18_i_1_sf.html

4 क प षण क प षण क द यर : क प षत ब च! क बड़ #हस य प म ह (Amar Ujala: ) प र द श क क प >षत, न ट, कम वजन व ल और ख न क+ कम स Nसत बOच क बड़ Qह1स उRतर द श म ह सरक र3 ;रप बत त ह 4क द श क 48 7तशत बOच कम वजन क ह र $य म गर3ब क घर म श च लय त ज स बन रह ह, पर बOच क क प षण द सर3 कह न बय न कर रह ह क छ ह3 Qदन पहल ज ल न जल क आत. K म एक दलत लड़क+ क स थ बल Rक र ह आ, उस म र भ ड ल गय बत य ज रह ह 4क वह घर स ब हर अ ध र म श च करन 7नकल3 थ, जब उस घस ट लय गय थ >पछल मह3न ग रखप र स सट क श नगर जल म भ ख और क प षण स न म त क+ खबर आई, जनम प च स ल क+ एक बOच भ थ जब उन ग व म पKक र पह च, त पत चल 4क श च लय क म ह3 नह3 कर रह थ और श च क लए ल ग ख ल म ज त थ र शन न मलन क+ भ बड़ सम1य बत ई गई ब ल श. और प षण स 7न Vचत करन क लए सरक र3 थमक 1क ल म Qदन क भ जन सरक र क+ तरफ स Qदय ज त ह इस बड़ Qह1स कW सरक र स मलत ह कई सरक र वषX स बOच क अ ड भ Yखल रह3 ह सरक र3 स 1थ ओ क+ र य ह 4क अ ड Yखल न क प षण स 7नपटन क सबस आस न तर3क ह ओZडश क म [यम K न अ ड क मड ड म ल म श मल करत ह ए कह थ 4क द ल, च वल, र ट3 स\ज क+ च र3 क+ ज सकत ह, पर अ ड क स थ ऐस नह3 4कय ज सकत बOच क अ ड Yखल न व ल तम म र $य म अ ड न ख न व ल बOच क क ल Qदय ज त ह उRतर द श म भ बOच क अ ड मलन लग थ, पर य ग ज क म [यम K बनन क ब द अ ड ब द कर Qदय गय अधकतर भ जप -श सत र $य म यह3 1थ7त ह इसक असर बOच क 1व 1]य पर ज र पड़त ह ग मज क+ ब त यह ह 4क बOच क अ ड Yखल न स परह ज करन व ल3 उRतर द श सरक र न एक अ^य य जन क तहत क प षण द र करन क लए ब द लख ड क ग व क गर3ब घर म म ब ट3 थ गर3ब क लए म ग_ प लन बह त म Vकल ह उस पर ब द लख ड म प न क+ कम ह नत जतन $य द तर म मर च क+ ह र क एक 1क ल स खबर आई 4क बOच क

5 र ट3 क स थ नमक Qदय ज रह थ एक पKक र न इसक व Zडय बन कर उस व यरल कर Qदय, त हड़क प मच गय बOच क ख न म स ध र ह आ य नह3, इसक पत त नह3 चल प रह, ल 4कन पKक र पर स ग न ध र ओ क अ म कदम ठ क Qदय गय क छ ल ग न यह कहन क+ क शश क+ 4क म मल स जश स ;रत ह, पर 1क ल म पढ़न व ल एक बOच क >पत न बत य 4क इसस पहल बOच क च वल-नमक भ Yखल य ज च क ह उRतर द श क सरक र3 1क ल म मड ड म ल य जन क 4Lय ^वयन अज ब ह बलय क एक 1क ल म दलत बOच अलग ब ठकर ख न ख त ह और बOच घर स अपन ल त ह जब इसक+ ज च करन क छ दलत न त पह च, त जल धक र3 न उ^ह अपम 7नत 4कय, ह ल 4क ब द म उ^हन म फ+ भ म ग बलय क ह3 एक अ^य 1क ल स ज नक र3 मल3 4क वह म 1लम बOच क पRतल म ख न पर स ज त ह और अ^य बOच क थ लय म लगत ह 4क उRतर द श क बOच क वल क प षण क ह3 शक र नह3 ह उ^ह 1क ल म र ट3-नमक क स थ स द 7यकत और ज त य- भ द भ व भ पर स ज रह ह Eat Right Campaign (Navbharat Times: )

6 Junk Food (Hindustan: ) _18_i_1_sf.html

7 Medical Technology (Hindustan: ) _18_i_1_sf.html

8 Ageing We need to be more caring towards elderly (The Tribune: ) Rajesh GillIn the absence of any social security system, the elderly primarily depend upon their family members, whether living with them or away. However, this expectation from the younger generation is proving to be a farce as parents are no longer preparing their children as care-givers, and hence the contradiction. According to the State of World Population 2019 report recently released by the United Nations Population Fund, currently 6 per cent of the total population in India comprises the elderly, i.e. 60-plus persons. It has projected that the proportion is likely to increase to 20 per cent by This calls for a serious discussion to initiate a process of social reconstruction, since only policies are not going to bear fruit. A recent incident at Chandigarh, wherein an elderly couple was found dead the man had slit his wife s throat before killing himself indicates the dismal situation that is likely to aggravate. It has been observed that the wellbeing and care of the elderly population, especially in India, is more of a social than a legal or administrative issue, primarily for the following reasons: One, unlike the West, our society has had a tradition of placing primacy upon the parentchild unit within the family, instead of the spousal relationship. Therefore, parents invest enormously in their children, both financially and socially/psychologically, with an expectation that they would be looked after by them in their old age. Secondly, the parent-child relationship is considered a private affair, and even in cases of extreme harassment by one's children, parents find it socially unacceptable to take the legal recourse. That is why the number of cases filed by parents against children under the Maintenance and Welfare of Parents and Senior Citizens Act, 2007, is extremely low. Average parents keep on bearing the indifference and even misbehaviour of their children silently to avoid the social stigma. Many elderly couples boast of how well they are taken care of by their children since that serves as a status symbol. That is why, barring a section among the urban upper middle classes, it is considered a social stigma to move to an old age home while children are around. Another reason is the absence of any social security system, which often makes the family the only support system in old age. It is a daunting task for the elderly persons, especially when frail and unwell, and when they are living alone, to access the healthcare system, despite various concessions and facilities made available to them. The problem is more severe for the elderly women due to their greater dependence financial, physical and social and they

9 generally have little access to health and other services available to senior citizens. In a recent research study conducted by me in Punjab and Haryana, elderly women were found to be incapable of moving to the bank to get their old-age pension due to their physical immobility and dependence upon the younger members in the family, who often took a large chunk of the money in return for the favour of taking them to the bank. Last, but probably the most relevant factor that aggravates the problems of elderly, is their over-indulgence in children, so much so that once the children leave for greener pastures, parents are left with no purpose in life, no hobbies, no life without children. They keep waiting for telephone calls from the children, who are miles apart, busy in their own lives, and, as a result, a large proportion among them ends up with depression and isolation. A number of studies conducted on the elderly in India have indicated that more than 30 per cent of the elderly suffer from fear of fall (FoF) and, thus, are physically and mentally vulnerable. Studies also confirm a higher incidence of verbal abuse among the elderly by their young relatives. In the absence of any social security system, the elderly primarily depend upon their family members, whether living with them or away. However, this expectation from the younger generation is proving to be a farce as parents are no longer preparing their children as caregivers, and hence the contradiction. The family today makes a huge investment, financially, psychologically and socially, both for sons and daughters in order to ensure a good career for them, providing them with comforts. Unlike our generation, wherein children were made to participate in the household and social activities, the children today are not disturbed and are encouraged to enjoy their privacy till they complete their education and adopt a career. While parents pamper the children, the market and media join in injecting a kind of individualism with a high dose of indulgence towards self-pampering. Consumerism thrives on this new-found sense of freedom, howsoever pseudo it might be, resulting in a generation that has never been trained to give care by sacrificing their own comfort, career or ambitions. It would, however, be inappropriate to blame our young children because the onus lies on us as their parents and teachers. We define success for them; we train them to always be ahead of others; we send them away so that they can earn status, money and success for themselves and for us. We forget that they would not be in a position to return when we need them. It is not possible to eat the cake and have it too. The social isolation and depression among the elderly need to be handled with a two-pronged strategy: One, the spousal unit has to be prioritised so that even after children are gone, one enjoys life being together. It is fascinating to watch elderly couples in the West, travelling, drinking, moving around together and enjoying life. Why is it that our sense of humour gets wiped out as we grow old? After all, why should it be considered a sin, particularly for the elderly women, to be enjoying their hard-earned freedom after having completed their family responsibilities?

10 Secondly, our children must be trained to be care-givers so that like their parents and grandparents, they too are capable of keeping a balance between their own life and that of their elderly parents, ready to sacrifice a bit of their success, time and affection. Rather than letting the media and market teach them, our children must receive the first lessons of individualism and freedom from us parents and teachers so that they understand how self-destructive privacy can be in the long run. Anaemia NGO works with government to alleviate anaemia among kids in Raigad (The Hindu: ) Swades Foundation tests children for anaemia in six blocks, starts them on supplements; new MoU with government to help them cover villages across State In a unique initiative, a non-profit organisation is helping the State government identify anaemic children and start them on the required supplements. Swades Foundation has been working in this area in six blocks of Raigad district over the past few years. With a new Memorandum of Understanding (MoU) signed with the State, the foundation is all set to expand its work in other areas. Anaemia is a condition wherein one lacks healthy red blood cells to carry adequate oxygen to the body s tissues. Anaemic children, therefore, are weak, fatigued and unable to grow to their full potential. While iron deficiency is one of the major triggers, the government already has a preventive programme under which iron supplements are distributed in schools every week. But despite these supplements, many children continue to be anaemic. The main reason is they don t eat wholesome, nutritious meals at home. Their diet largely consists of rice and dried fish in this region, and there is no intake of leafy vegetables and other nutrientrich vegetables. Ragi is widely grown in the area but they don t consume it, Neeta Harmalkar, general manager, health, Swades Foundation, said. To plug this gap, the foundation has been testing haemoglobin levels of all schoolchildren once a year. Children with severely low haemoglobin are referred to the rural hospital where they are put on injections and are also given blood transfusions. They are monitored until the

11 levels are normal. Children with mild and moderate haemoglobin levels are put on a daily dose of 45 mg iron supplements for 60 to 90 days, Ms. Harmalkar said. While the government provides the medication, the foundation provides the testing machine, kits and training, and helps create awareness among parents and teachers, which is crucial. The therapeutic management of anaemia is focussed on schoolchildren in the age group of five to 16. Till August, the foundation has tested 43,578 children, of whom 16,129 were found to be anaemic. Of the 5,518 children who have completed treatment so far, 75% have been cured of anaemia and nearly 10% have shown progress in their haemoglobin levels. At present nearly 2,000 children are under treatment. Collaborative approach Founded by Ronnie and Zarina Screwvala in 2013, Swades Foundation looks at a problem with a 360-degree view. When we talk about health, we have to look at clean drinking water, access to toilets and all other such issues in the backdrop, Ms. Screwvala said. Problems in rural Maharashtra are complex and need a collaborative effort, she said. One cannot work in isolation. We are working strategically with the government to create sustainable solutions and eco-systems that can function on their own. The MoU, signed on August 27, enables the foundation to work across the State. We have already expanded our work to the seventh block, which is Sudhagad, Ms. Screwvala said. The six blocks that the foundation has been working in covered 2,000 villages in Mangaon, Mahad, Mhasla, Poladpur, Shrivardhan and Tala. Besides anaemia, the foundation works in the field of eye care and paediatric cardiac care. It has carried out over 14,500 cataract surgeries and distributed over 78,800 spectacles till date. Dr. Anup Yadav of the Directorate of Health Services, Maharashtra, said the government realises the potential of public-private partnerships to offer holistic health services. With the aim of taking this forward and encouraging NGOs participation, we have signed an MoU with Swades Foundation, he said.

12 Hepatitis B A weak chase: On controlling hepatitis B (The Hindu: ) Controlling the hepatitis B virus calls for universal vaccination of newborns On September 3, Bangladesh, Bhutan, Nepal and Thailand became the first four countries in the World Health Organization s southeast Asia region to have successfully controlled hepatitis B. The virus is said to be controlled when the disease prevalence is reduced to less than 1% among children less than five years of age. Despite the introduction of hepatitis B vaccine in the Universal Immunisation Programme in 2002 and scaling-up nationwide in 2011, about one million people in India become chronically infected with the virus every year. According to the Health Ministry, as on February 2019, an estimated 40 million people in India were infected. Hepatitis B infection at a young age turns chronic, causing over 1,00,000 premature deaths annually from liver cirrhosis or liver cancer. A study published in 2013 found lower coverage of hepatitis B vaccine in eight of the 10 districts surveyed. But the coverage has witnessed an increase with the introduction of a pentavalent vaccine on a pilot basis in Kerala and Tamil Nadu in December 2011 and national roll-out in According to the WHO, the coverage of hepatitis B third dose had reached 86% in However, despite the high vaccination coverage, disease prevalence in children aged less than five years has not dropped below 1%. One of the reasons for this is the sub-optimal coverage of birth dose in all infants within 24 hours of birth. Hepatitis B birth dose, given in the first 24 hours, helps prevent vertical transmission from the mother to child. The compulsion to increase birth dose to cut vertical transmission arises from two important reasons about 70-90% newborns infected this way become chronic carriers of hepatitis B, and about 20-30% carriers in India are due to vertical transmission. But even seven years after the Health Ministry approved the birth dose in 2008, its coverage remained low 45% in 2015 and 60% in 2016 according to a 2019 Health Ministry report. What is indeed puzzling is that even in the case of institutional delivery, the birth dose vaccine coverage is low 76.36% in Incidentally, institutional delivery accounts for about 80% of all deliveries in the country. The birth dose coverage when delivery takes place outside health-care institutions is not known. One of the reasons for the low coverage is the fear of wastage of vaccine when a 10-dose vial is used. Unfortunately, health-care workers are very often unaware of the WHO recommendation that allows hepatitis B open-vial policy. Opened vials of hepatitis B vaccine can be kept for a maximum duration of 28 days for use in other children if the vaccine meets certain conditions. There is also a need to increase public awareness about the merits of the birth dose.

13 Measles and rubella WHO South-East Asia Region plans to banish measles, rubella by 2023 (The Hindu: ) Member-countries of the World Health Organisation (WHO) South-East Asia Region have resolved to eliminate highly infectious childhood killer diseases measles and rubella by The new target to eliminate both the diseases will leverage the existing momentum and a strong political commitment, which is being demonstrated through unprecedented efforts, progress and successes in recent years, said Dr. Poonam Khetrapal Singh, Regional Director, WHO South-East Asia. A resolution to eliminate the diseases was adopted at the 72nd session of the WHO Regional Committee for South-East Asia in Delhi. Measles is particularly dangerous for the poor, as it attacks malnourished children and those with reduced immunity. It can cause serious complications, including blindness, encephalitis, severe diarrhoea, ear infection and pneumonia, while rubella/ congenital rubella syndrome (CRS) causes irreversible birth defects. Eliminating measles will prevent 500,000 deaths a year in the region, while eliminating rubella/ CRS would avert about 55,000 cases of rubella and promote health and wellbeing of pregnant women and infants, Dr. Singh said. Measles elimination and rubella control has been a regional flagship priority since Bhutan, DPR Korea, Maldives, Sri Lanka and Timor-Leste have eliminated measles and Bangladesh, Bhutan, Maldives, Nepal, Sri Lanka and Timor-Leste have controlled rubella. To achieve the new targets, the member-countries resolved to strengthen the immunisation systems for increasing and sustaining high level of population immunity against the two diseases at both the national and sub-national levels. The resolution calls for ensuring a highly sensitive laboratory supported case-based surveillance system better evidence for appropriate planning and response. It also emphasises on preparedness for outbreak response activities. All countries pledged to mobilise political, societal and financial support to ensure the interruption of transmission of indigenous measles and rubella virus by 2023.

14 Congo fever 10 Congo fever cases in Raj, Guj in August (Hindustan Times: ) idsp report Spread of disease under control, says monitoring body New Delhi : The National Institute of Virology (NIV) has confirmed 10 cases of Crimean- Congo Hemorrhagic Fever (CCHF) in Rajasthan and Gujarat in August. The CCHF is a tick-borne zoonotic viral disease transmitted from animals to humans. It kills up to 30% of those infected. Of the 80 samples that we received for confirmatory testing, 78 samples were from Gujarat and two from Rajasthan. Most of the positive cases are from Gujarat, and only one case tested positive from Rajasthan, said a source in the NIV. The NIV is country s apex laboratory running under the Indian Council of Medical Research. It receives samples from states for confirmatory tests during any outbreaks. The spread of the disease is under control, according to the union health ministry s Integrated Disease Surveillance Programme (IDSP) that monitors the situation. A team of experts from the health ministry reached Jodhpur in Rajasthan, which first reported cases, on Tuesday to assist the state government. We have sent a two-member team of epidemiologists (who investigate patterns and causes of disease and injury in humans) to the state that would provide the necessary help to local experts, said a health ministry official, requesting anonymity. IDSP runs a robust surveillance mechanism that picks up cases almost immediately and follows up on people in close contact with positive cases, the official said. The team was sent to Rajasthan because the state first reported cases. Gujarat has been reporting Congo fever cases since 2011 and has an established protocol in place that they follow. Rajasthan is facing the situation first time, said the official.

15 PCOS PCOS nutrition AND diet: Foods to eat AND AVOID (Hindustan Times: ) As the world observes PCOS awareness month every September, know more about how to deal with it One of the best lifestyle changes is including yoga and meditation in your daily routinephoto: images bazaargood quality fats like virgin oils, avocado, nuts and desi ghee helps your brain regulate the endocrine system perfectlyspinach, strawberry, tomatoes, almonds and walnuts helps in the balanced production of hormones in your body At the age of 16, Sneha Anand, now 35, noticed that she was rapidly gaining weight which, despite all her efforts, seemed impossible for her to lose. Coupled with an irregular menstrual cycle and early signs of excess hair growth on her face, she went to a local GP who diagnosed her with Polycystic ovary syndrome or PCOS. It is a health problem that affects one in every 10 women of the childbearing age. I didn t realise my symptoms ovulation pain and painful period weren t normal until after I was diagnosed. I used to feel like a hairy, ugly and moody defect. There s nothing more unwomanly than having to shave your face every day, says Sneha. Though the exact cause and cure for this condition is a bit difficult, there are specialists who agree that diet and lifestyle play a major role in managing it. As the world observes PCOS awareness month, let us know more about the condition and how to fight it with the right diet. What is PCOS? PCOS can be defined as a health condition which causes hormonal imbalance and metabolism problems in a woman that may affect their overall health and appearance. It causes irregular periods as ovaries do not release eggs or ovulate regularly. The condition also releases high levels of male hormones in the body, which may result in excess facial or body hair. It also makes them harder to get pregnant, says Dr Mira, gynaecologist. She adds, One of the most common and saddest scenarios I often encounter is where a young woman often comes in and says I ve been told I ve got PCOS and I won t be able to have children. However, a right diet can treat the symptoms. symptoms of PCOS and how does it affect you? Dietician Reena Arora says, Symptoms of PCOS may begin shortly after puberty, but can also develop during the later teen years and early adulthood. People with PCOS typically have irregular periods as a result of irregular ovulation. Although some people may develop cysts on their ovaries, many people do not. Adding to that, Esther John, dietician says,

16 Irregular ovulation makes it difficult to get pregnant. It also results in excessive hair growth (Hirsutism) usually on the face, chest, back or buttocks, weight gain, thinning hair and hair loss from the head and oily skin or acne. According to her, PCOS patients are at a higher risk of type 2 diabetes, acidity, insomnia, high blood pressure, heart problems, and endometrial cancer. dietary role in PCOS A proper diet and nutrition can help PCOS patients. Arora says, Nutrition plays an important role in managing PCOS. About 67% to 85% of women with PCOS were observed to have vitamin D deficiency. Supplementing with vitamin D is thus important to improve menstrual regularity and insulin resistance. Vitamin C-rich food like amla, lemon, and hibiscus also helps to produce oestrogen. Types of food Dietician Nisha Bareja, lists out following food groups to help your body produce all the hormones in a balanced way. Wholesome cereals: Try to include all the cereals in their whole form because whole grains like whole wheat, parboiled rice, and whole oats provide B complex vitamins and carbohydrates as a source of energy. Quality proteins: Try to add foods in your diet which contain amino acids - essential and nonessential so that your body can use them to produce hormones. For example nonpasteurised dairy, eggs, meat, legumes, soaked nuts and seeds. Good quality fats: Try to consume good quality fats like virgin oils, nuts, seeds, avocados, and desi ghee to help your brain regulate the endocrine functioning in a perfect way. Vitamins and minerals: Add all the essential vitamins and minerals like selenium, zinc and chromium to improve your body s insulin sensitivity. High fibre and low fat: Include tomatoes, kale, spinach, almonds and walnuts, olive oil, fruits, such as blueberries and strawberries. Dr Mickey Mehta, holistic health guru and corporate life coach, adds that food should be very alkaline in nature. Eat as many vegetables, fruits, dry fruits, sprouts, seeds and natural food as you can. Chewing well is important. In PCOS, the timings of eating are also important. Avoid big portion meals and finish your dinner preferably by 7pm. What to avoid? Esther mentions the list of food you should avoid if you have PCOS. Sweetened juice, canned fruit in heavy syrup, or sweetened applesauce. Starchy vegetables such as potatoes, corn and peas.

17 Refined grains made with white flour such as white bread and pasta, bagels, or white rice. Sugary drinks and foods such as soda, juice, cookies and candies. Snacks such as potato chips, Doritos, and tortilla chips. Lifestyle changes to consider PCOS, like many disorders, responds positively to proactive lifestyle choices. Arora and Mehta give some tips for that. 1. Fix PCOS by regular breathing coupled with regulated breath. It helps to reduce insulin resistance, especially when coupled with a limited intake of unhealthy carbohydrates. 2. Many experts agree that at least 150 minutes per week of exercise with an inclusion of long walks is ideal. 3. The symptoms associated with PCOS can cause stress. Stress reduction techniques, which help calm the mind and let you connect with your body, can help. These include yoga and meditation. 4. Lots of sleep, alkaline diet, regular massages, swimming, dancing, and regular bowel movements is also helpful. 5. Speaking with a therapist or other medical professional may also be

18 Ayush Grid (The Asian Age: )

19 Diet/Nutrition (The Asian Age: )

20 Vitamin D (The Asian Age: )

21 Autism New evidence challenges 'extreme male brain' theory of autism (Medical News Today: ) A new study has challenged suggestions that the male sex hormone testosterone reduces cognitive empathy, or the ability to read other people's emotional states. Lower cognitive empathy is a feature of autism, a condition that predominantly affects males. New research challenges one theory about autism and the brain. The new research takes the form of two large-scale randomized controlled trials that included a total of 643 adult males. It is the largest work of its kind. The investigators, who hail from institutions in the United States and Canada, report their findings in a recent Proceedings of the Royal Society B: Biological Sciences paper. They explain that earlier studies that have found links between testosterone and lower cognitive empathy had relied on very small samples and so had insufficient statistical power to establish a direct link. "Our results unequivocally show that there is not a linear causal relation between testosterone exposure and cognitive empathy," states first study author Amos Nadler, Ph.D., who worked on the study while at Western University, in Canada. Cognitive empathy and ASD In the United States, around 1 in 59 children have autism spectrum disorder (ASD), and males are four times more likely to have it than females, according to the Centers for Disease Control and Prevention (CDC). Although it has been clear for some time that ASD affects more males than females, scientists do not understand why. Autism and the gut microbiome: Further evidence strengthens link A study in mice suggests that gut microbes have a direct influence on the development of autism-like behavior. "Of course," says senior study author Gideon Nave, Ph.D., assistant professor of marketing at the Wharton School of the University of Pennsylvania, in Philadelphia, "the primary suspect when we have something that is sharply differentiated by sex is testosterone."

22 He and his colleagues define cognitive empathy as "the ability to interpret others' emotions and understand their behaviour vis-a-vis their emotional state." They distinguish cognitive empathy from emotional empathy, which they define as "the vicarious feeling of others' emotions along with them." People with ASD typically have lower cognitive empathy and this impairs their ability to interact socially with others. Extreme male brain model and 2D:4D ratio In the new study paper, the authors summarize a popular model about ASD called the extreme male brain (EMB) hypothesis. Advocates of the EMB hypothesis propose that people with ASD have an extreme male cognitive style that favors systemizing over empathizing. They suggest that exposure to higher than normal levels of testosterone before birth impairs cognitive empathy "through its masculinizing effect on the developing brain." The strongest evidence in support of the EMB model comes from a 2011 study that found that giving testosterone to healthy adult females appeared to reduce their ability to read others' emotions. Much research that supports the EMB model also relies on a measure called the 2D:4D ratio, which is the ratio of the length of the second finger to that of the fourth finger of the hand: the index and ring fingers. Some scientists believe that the 2D:4D ratio reduces with greater exposure to testosterone before birth. This assumption has led them to use the ratio as a proxy for pre-birth exposure to testosterone in researching links between cognitive empathy and ASD. However, these studies have yielded conflicting results. Nadler, Nave, and colleagues note, however, that previous studies have mainly used small samples and relied on observational data, which at most can only establish a connection, it cannot prove cause and effect. 'No evidence' of an effect on empathy So, the team decided to conduct a more rigorous investigation to overcome the drawbacks of earlier research. This took the form of two randomized controlled trials in which 643 healthy adult males received either testosterone or placebo in gel form. As well as receiving the gel treatment, the participants filled in questionnaires and underwent tests of cognitive empathy. The researchers also measured their 2D:4D ratios.

23 The cognitive empathy tests involved looking at photographs of actors' eyes and matching them to descriptions of emotional states. The researchers observed that although those males who received testosterone showed raised levels of the hormone, it had no effect on their cognitive empathy. Also, there was no correlation between performance on cognitive empathy tests and 2D:4D ratios. "We found that there is no evidence to support this effect of testosterone, but that doesn't rule out any possible effects," Nave concludes. He does point out, however, that absence of evidence is not the same as evidence of absence. "From what we know, though, it seems that if testosterone does have an influence, the effect is complex, not linear." Gideon Nave, Ph.D. Premature Death Just 2 glasses of soft drinks daily tied to higher death risk (Medical News Today: ) A new study looking at hundreds of thousands of individuals has linked higher consumption of soft drinks with greater risk of premature death. The researchers saw that the association held for both artificially and sugar sweetened drinks. Most soft drinks pose a health risk, and new research finds that two glasses of soft drinks per day may raise early death risk. Because the findings are that of an observational study, they do not prove that regular soft drink consumption drives early death. However, the research team concludes that the results endorse health initiatives to reduce public consumption of such beverages. A recent paper in JAMA Internal Medicine describes how the international study group analyzed data on 451,743 adults from 10 European countries.

24 The data came from the European Prospective Investigation into Cancer and Nutrition (EPIC). EPIC is an ongoing cohort whose participants enlisted between 1992 and 2000 and who live in Denmark, France, Germany, Greece, Italy, the Netherlands, Norway, Spain, Sweden, and the United Kingdom. On enrolment, the participants gave information about their food and drink consumption, either by filling in questionnaires or in interviews. Their average age was 51 years old, and 71% were female. None had heart disease, cancer, diabetes, or stroke at the outset. Of the participants taking part in the analysis, 41,693 died during a follow-up that averaged 16.4 years and ranged from 11.1 years in Greece to 19.2 years in France. Fruit juice not among the 'soft drinks' The researchers compared deaths during the follow-up in those who said that they drank soft drinks every day with those who said that they consumed hardly any that is fewer than one glass per month. The team defined one glass as 250 milliliters (8.5 fluid ounces). Soft drink consumption included drinking of fizzy soft drinks such as cola and lemonade; isotonic or energy drinks; diet and low-calorie soft fizzy drinks; and diluted syrups, such as fruit cordial or squash. Soft drink consumption did not include fruit juice. Their analysis revealed that consuming two or more glasses per day of total, sugar sweetened, and artificially sweetened soft drinks was linked to a higher risk of death from all causes in comparison to consuming hardly any soft drinks. The team observed the link in both males and females. At the study outset, the participants also answered questions about their health and lifestyle. Red wine in moderation may protect gut health An observational study has linked moderate red wine consumption to greater health and diversity of gut bacteria. From this information, the researchers were able to rule out any influence from factors such as physical activity, body mass index (BMI), education, smoking, and diet. A further analysis also revealed that in comparison to consuming hardly any, drinking two or more glasses per day of artificially sweetened soft drinks was tied to a higher risk of circulatory diseases. In the cases of sugar sweetened soft drinks, the link was to a higher risk of death from digestive diseases. "No association," write the authors, "was observed between soft drink consumption and overall cancer death."

25 'Marker of overall unhealth[ful] diet'? In a discussion of the findings, the researchers note that regardless of whether they included or removed the potential influence of BMI, the results were unchanged. They also found positive links between total, artificially, and sugar sweetened soft drinks with deaths from all causes, as well as deaths from circulatory and digestive diseases among participants whose BMI was in the healthy range. Such results would suggest that the links that they observed were likely not related to body fat. They support the idea that the link between soft drinks and premature death occurs through other routes. In a comment to the Reuters news organization, study co-author Neil Murphy, Ph.D., of the Section of Nutrition and Metabolism at the International Agency for Research on Cancer, in Lyon, France, suggests that "high soft drink consumption may be a marker of overall unhealth[ful] diet." According to the Centers for Disease Control and Prevention (CDC), there is an association between the consumption of sugar sweetened beverages and less healthful behaviors in the United States. Heart Disease Differences in gut bacteria may predispose to heart attacks (Medical News Today: ) A small study has recently made two breakthrough discoveries. First, that the bacteria present in coronary (heart) plaques are pro-inflammatory, and second, that some people with heart disease harbor different sets of gut bacteria that may contribute to their risk of a heart attack. Some researchers believe that gut bacteria may hold clues about who is more at risk of experiencing a heart attack. According to data from the Centers for Disease Control and Prevention (CDC), approximately 735,000 individuals in the United States experience a heart attack each year.

26 Heart attacks can occur when a person has developed heart disease. A key feature of heart disease is the buildup of plaque in the arteries. Plaque is made up of fat, calcium, and other substances. However, some people are more predisposed to heart attacks than others, even within a cohort whose members all have heart disease. So, researchers have been trying to understand why this happens. Last week, Eugenia Pisano from the Catholic University of the Sacred Heart in Rome, Italy, and her colleagues presented their findings on this topic at the European Society of Cardiology Congress. This year, the congress took place in Paris, France. In a small study, Pisano and team investigated how bacteria might influence the stability of coronary plaques. Coronary plaques form in the heart's arteries, and when they become unstable, a heart attack can follow. A new lead for therapeutic research? For the study, the researchers worked with 30 individuals who had acute coronary syndrome. Coronary syndrome refers to a multitude of conditions and events characterized by reduced blood flow to the heart. These conditions and health events include unstable angina and myocardial infarction (heart attack). Additionally, the researchers also recruited 10 participants with stable angina, which is a heart condition characterized by chest pain and discomfort. The team collected fecal samples from all the participants so that they could isolate gut bacteria. They also extracted and analyzed coronary plaque bacteria from angioplasty balloons. Doctors use angioplasty balloons to widen coronary arteries to improve blood flow. First of all, the researchers found that the bacteria present in coronary plaques were proinflammatory, primarily belonging to species, such as Proteobacteria and Actinobacteria. "This suggests a selective retention of pro-inflammatory bacteria in atherosclerotic plaques, which could provoke an inflammatory response and plaque rupture," says Pisano. In comparison, fecal samples had a heterogeneous bacterial composition, featuring mainly bacterial strains, such as Bacteroidetes and Firmicutes. The researchers also discovered that the gut bacteria populations differed between the two groups of participants. Individuals with acute coronary syndrome had a higher proportion of Firmicutes, Fusobacteria, and Actinobacteria in their guts, whereas people with stable angina had a stronger Bacteroidetes and Proteobacteria presence. "We found a different make-up of the gut microbiome in acute and stable patients," notes Pisano. This suggests that "[t]he varying chemicals emitted by these bacteria might affect plaque destabilisation and consequent heart attack."

27 Could bone-like particles in blood contribute to artery clogging? New research has discovered the existence of bone-like particles in blood, giving rise to new questions about the formation of buildup material in arteries. "Studies are needed to examine whether these metabolites do influence plaque instability," the researcher advises, since, so far, it remains unclear to what extent bacteria present in the gut or on coronary plaques influence the development of a heart attack. However, Pisano, adds: "While this [current] study is a small study, the results are important because they regenerate the notion that at least in a subset of patients, infectious triggers might play a direct role in plaque destabilization." "Further research will tell us if antibiotics can prevent cardiovascular events in certain patients. Microbiota in the gut and coronary plaque could have a pathogenetic function in the process of plaque destabilization and might become a potential therapeutic target."

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