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1 DAILY NEWS BULLETIN LEADING HEALTH, POPULATION AND FAMILY WELFARE STORIES OF THE DAY Thursday व य द षण व य द षण स बच क दम ग वक स क बड़ खतर, बढ़त ह च त और तन व क" सम#य (Dainik Jagran: ) नवज त शश ओ क द षण क स पक म आन स म तक पर द भ व पड़त ह इस क रण वह बड़ ह न पर अवस द और 'च त स )सत ह ज त ह* +य य क, आइएएनएस श धकत ओ क कहन ह 0क व य द षण क स पक म आन स नवज त शश ओ क म तक पर 1य पक भ व पड़त ह यह भ व इतन ह 2नक रक ह त ह 0क शश ओ क म नसक 3वक स म खतर प द करत ह इसस मन र ग स ब ध 3वक र प द ह त ह* श धकत ओ क कहन ह 0क एक स द 7दन क नवज त पर व य द षण क सबस 8य द द भ व पड़त ह ब9च: क म नसक 3वक स पर पड़त ह असर इनव यरमटल ह =थ प?टव जनल म क शत म बत य गय 0क द 3षत थ न: क आस-प स बड़ ह ए ब9च: क 'च त और आAम अवस द स स ब 'धत 3वक र 8य द घ रत ह* अम Cरक कD सनसन टE य 2नवसटE क क ल F क Gप ज इस क म ख ल खक ह*, उ+ह:न बत य 0क ज ब9च लम एCरय क आसप स रहत ह* उनक व Iय पर व य द षण क अAय'धक भ व पड़त ह सनसन टE य 2नवसटE और सनसन टE 'च=J न ह पटल म Kडकल Cरसच सटर क श धकत ओ Mव र 0कए गए त न स ब9च: क म नसक व Iय और व य द षण क ब च स ब ध प य गय ह व य द षण क

2 सबस बड़ क रक N 0फक कD वजह स ह रह द षण (N प) ह N प क क रण हE ब9च: म तन व और 'च त कD समय बढ़ रहE ह इस तरह स 0कय श ध इस म श धकत ओ न N 0फक कD वजह स ह रह व य द षण (N प) स म तक म पड़न व ल भ व: कD +य र इम ज ग कD इस द र न उ+ह म तक म म य -इन सट ल क स+ट शन क तर उ9च मल इसस यह पत चलत ह 0क N प कD वजह स म तक क त RSक त S म भ व पड़ रह ह, जसस उसम स जन आ गई ह बचपन म य ख सत र पर ज+म क ब द क श Uआत 7दन: म N प क स पक म आन स म नसक 3वक र ह त ह जसस बड़ ह न पर आAम अवस द और 'च त कD ब म रE स ज झन पड़त ह श धकत ओ न बत य ह 0क इन स हम द षण क क रण शरEर पर पड़न व ल भ व: और ख सत र पर बचपन म पड़न व ल भ व: क ब र म नय X टक ण मल ह Yदय र ग क लए भ जGम द र ह व य द षण ब त 7दन: एक श ध म बत य गय थ 0क Yदय कD बढ़त ब म Cरय: क एक म ख क रण व य द षण ह कह गय थ 0क इसक लए N प स 8य द जGम द र घर म ह न व ल व य द षण ह यह प?टव अबन ए ड Zरल ए3पड मय ल जक (प य आरई) Mव र 0कय गय थ इसम बत य गय थ 0क आय व ल द श: ( जनम भ रत भ श मल ह ) म Yदय र ग क 12 फDसद म मल घर ल द षण कD वजह स हE ह त ह* ऐस द श: म Yदय र ग क एक और म ख क रण ह इपरटशन य न उ9च र?तच प भ ह इस Cरप ट क 'च0कAस पRSक द ल*स ट म क शत 0कय गय थ

3 5 7नक फट:ग ;स < म हर व=त थक न लगन क" सम#य क न नजरअ द ज, ज इसक" वजह और =य ह इल ज (Dainik Jagran: ) य त \ 2नक फटEग स J म 0कस भ उ] म ह सकत ह ल 0कन यह अध ड़ Sय: क अ'धक पर श न करत ह?य ह* इसक ल^ण और इल ज ज नत ह* यह य त कभ -कभ थक न सभ क महस स ह त ह ल 0कन क छ ल ग: म यह लग त र बन रहत ह हम श थक न बन रहन कD यह थ2त \ 2नक फटEग स J म कहल त ह यह थक न कD एक ऐस थ2त ह, जसम 1य?त क लग त र छह महEन य उसस अ'धक समय स थक न रहत ह और कई ब र यह इतन ग भ र Zप ल ल त ह 0क स म +य क मक ज म भ 7द?कत आत ह भरप र आर म और न द भ र हत महस स नहE ह न द त कब ह त ह यह यह समय य त 0कस भ उ] म ह सकत ह ल 0कन अध ड़ Sय: क अ'धक पर श न करत ह एक अन म न क म त Rबक भ रत म करEब एक 2तह ई Sय लग त र थक न बन रहन कD शक यत करत ह* इनम स आध म7हल ओ क यह समय छह महEन स अ'धक समय स ह ह ल 0क इसक क रण: क अभ तक पत नहE चल प य ह ल 0कन क छ श ध बत त ह* 0क म नसक तन व, व यरल स \मण क अल व कई अ+य क रण इसक लए जGम द र ह त ह* कमज़ र इGय न सटम: खर ब र ग-2तर धक ^मत व ल ल ग: क यह समय aय द भ 3वत करत ह ज़र स ब त य क म क दब व बढ़त हE इ+ह थक न महस स ह न लगत ह इ+फ?श स: क छ ब?टECरयल इ+फ?श स भ \ 2नक फटEग स J म क लए जGम द र ह त ह* cलड शर: ल ब प कD समय स पर श न ल ग: क भ \ 2नक फटEग स J म कD समय ह सकत ह तन व: लग त र तन व म रहन कD वजह स भ स एफएस कD समय ह सकत ह ह मd+स क अस त लन: श ध: क म त Rबक कई ब र शरEर कD ) 'थय: Mव र ह मd+स न बन न य ह मd+स अस त लन कD वजह स भ \ 2नक फटEग स J म 'गरeत म ल सकत ह \ 2नक फटEग स पर श न ल ग: क ह इप थ ल मस, 3पfय NE gल*ड और एKJनल gल*ड म ह मdन अस त लत म S म उAप+न ह त ह*

4 कब ज ए ड?टर क प स च 0क स एफएस ज च क लए क ई म Kडकल ट ट उपलcध नहE ह और इसक ल^ण कई अ+य ब म Cरय: स म ल ख त ह* इसलए ड?टस क लए पहच न म hकल ह त ह 0फर भ जब ल ब समय तक थक न महस स ह और आर म क ब द शरEर म ऊज क स च र न ह त ड?टर स सल ह ल ल इफट इल म कर बदल व \ 2नक फटEग स J म क 2न hचत इल ज न ह न क क रण ज वनश लE म बदल व क ज़Cरय हE इस 2नय RSत 0कय ज सकत ह स एफएस स पर श न ल ग: क क फDन ब हद कम म S म ल न च 7हए ए=क ह ल और 2नक 7टन स भ द रE बरतन च 7हए थक न और स त महस स ह न पर भ 7दन म नहE स न च 7हए?य:0क इसस र त कD न द भ 3वत ह त ह स एफएस स ह न व ल दद स 2नज त प न क लए ड क टर कD सल ह पर क छ दद 2नव रक दव ए ल सकत ह* य ग, त इच और मस ज क ज़Cरय स एफएस क दद स र हत प सकत ह* ल 0कन क ई भ च ज श Z करन स पहल ड?टर स सल ह ज़Zर ल ल^ण 1. प ट म दद, आ त: म समय, मतलE, ड यCरय और प ट फ लन ज स एहस स 2. एलजk अथव ख न कD च ज़: क 2त स व दनश लत, ए=क ह ल, ख शब, क मकल दव ओ और श र क 2त 3. स व दनश लत बढऩ डग, 'चकनग 2नय और मल Cरय म क स कर अ तर, य ह* पहच न क ल^ण डग, 'चकनग 2नय और मल Cरय म क स कर अ तर, य ह* पहच न क लक षण यह भ पढ़ 4. ठ ड लगन और र त म पस न आन 5. छ त म दद, स स ल न म क7ठन ई, और ल ब समय तक ख स रहन 6. Kड शन, 'चड़'चड़ पन, म ड व ग, अवस द आ7द 7. क म करन कD ^मत ब रE तरह भ 3वत ह न कभ -कभ Rबलक ल क म न कर प न 8. लEप Kडस डर

5 9. य दद hत कमज़ र पडऩ 10. ध धल 7दख ई द न, र शन क 2त स व दनश लत, आ ख: म दद य Zख पन चDकEस स व श Gक सरक र: अ#पत ल-#व #Iय इल ज ह आ मह ग, इतन लग ग प ज करण और ज च क श Gक (Amar Ujala: ) डग स पर श न ल ग: क लए ब धव र स समय और बढ़ ज एग श सन क आद श सरक रE अपत ल: म 'च0कAस स व श =क कD नई दर आज स ल ग ह:ग य न इल ज क लए ल ग: क अब 8य द प स खच करन ह:ग अब पच भ मह ग बन ग और ज च क लए भ 8य द प स लगग र जध न क ग ध शत cदe और क र न शन ज स सरक रE अपत ल: म ओप ड क पच बनव न क लए थ न य मरEज: क 23 कD जगह 30 Uपय क भ गत न करन ह ग वहE र 8य क ब हर क मरEज: क 60 Uपय द न ह:ग वहE, थमक व Iय कp: म 15 क बज य 20 Uपय म पच बन ग म qय 'च0कAस अध क षक ड. रम ल न बत य 0क नई दर ल ग ह न क ब द अपत ल: म व Iय स व आ क और अ'धक ब हतर 0कय ज एग नई दर ल ग ह न क ब द अपत ल क ज भ आय ह ग, उसम स 50 फDसदE धनर श अपत ल ब धन क प स ह ग जब0क ब कD 50 फसदE बजट व Iय मह 2नद श लय क ख त म जम कर य ज एग जZरत क म त Rबक 2नद श लय अपत ल: क बजट ज रE कर ग ऐस म अपत ल: क प स अब बजट कD कम नहE ह ग यह ह ग श =क ओप ड प ज करण श =क अपत ल पहल नई दर ब हरE मरEज

6 प एचस स एचस जल अपत ल आईप ड प ज करण श =क अपत ल पहल नई दर ब हरE मरEज प एचस स एचस जल अपत ल ब ड कD दर अपत ल व ड ब ड कD वतम न दर आय म न क ड बह रE मरEज प एचस जनरल व ड स एचस जनरल व ड जल अपत ल जनरल व ड जल अपत ल प rग व ड जल अपत ल इव ट व ड (द ब ड) जल अपत ल इव ट व ड (एक ब ड) जल अपत ल इव ट व डएस जल अपत ल एस Zम प थ ल ज व र Kडय ल ज ज च थ न य मरEज आय म न क ड ब हरE क मरEज cलड य Cरय

7 ए?सर हEम gल Rबन स ब स आरब स cलड ) प sल ट ल fस अ=N स उ ड ईस ज Heart Disease (Navbharat Times: )

8 Family Planning The right count (The Indian Express: ) Sexual and reproductive health data need to be accurate to form effective basis for policy The writer is director-general, Indian Council of Medical Research. There is a need to highlight the importance of Sexual and Reproductive Health and Rights (SRHR), which are fundamental for family planning and the overall well-being of individuals. On World Contraception Day, there is a need to talk about the reproductive health practices and rights of people in India. It is commendable that the government under Prime Minister Narendra Modi has been vocal about the need for a small and healthy family to contribute to India s socioeconomic growth in the long term. To achieve this vision, there is a need to highlight the importance of Sexual and Reproductive Health and Rights (SRHR), which are fundamental for family planning and the overall well-being of individuals. India s family planning programme dates back to the 1950s and it has made significant progress. The recent emphasis on increasing spacing between children and providing access to the basket of contraceptive choices poses the promise of universal access to reproductive health services. The National Family Health Survey (NFHS) 4 shows that the use of modern contraceptive methods (mcpr) continues to be around 48 per cent since In the states which showed mcpr decline, sterilisation contributed to more than 70 per cent of contraceptive use. Further, according to NFHS 4, female sterilisation in India continues to be around 37 per cent since 2006, despite health complications and deaths, highlighting the gender inequality in contraceptive use. This could be because of lack of accessibility or awareness of other contraceptive methods and requires immediate redressal. India has a vast repository of health and demographic data. But such a repository can also be confusing. For instance, contraceptive use data from large-scale surveys show different levels in selected geographies, making planning challenging. These inaccuracies could be due to errors in data collection. The errors in data collection impact the quality of data, which compromises the survey findings. The quality of these findings is crucial for policy planning to address reproductive health and maternal and child health issues. Researchers have pointed out that data quality gets affected due to factors like interviewer bias, which leads to incorrect data entry. This often occurs while collecting female sterilisation data,

9 which is impacted by over-reporting women as non-users and reporting current female non-users as cases of hysterectomy. The level of the bias has been found to be higher in the states that recorded a decline in mcpr, which reflects that the findings were influenced due to errors in data collection. Also, there is difficulty in distinguishing between methods like sterilisation and hysterectomy for some interviewers, which leads to incorrect reporting. Research shows that state-level decline in the utilisation of mcpr and decline in sterilisation acceptance could lead to a reduction in the use of mcpr. There is a need to address data quality issues and introduce technological interventions in data collection, training, and capacity-building of survey officials. The role of the National Data Quality Forum (NDQF), a multi-institutional initiative hosted by Indian Council of Medical Research (ICMR) becomes crucial when it comes to addressing the gaps between data collection and analysis and using that data for advocacy and policymaking. NDQF aims at improving data quality for better and efficient research, identify discordance and errors, and establish protocols and good practices for improving data quality. NDQF plans to create an integrated platform to share new ideas, develop advanced techniques with the use of Artificial Intelligence (AI) and technology, for improving data quality in health and demographic research for effective policy planning. There is a need to promote forums like NDQF to reduce the errors in data collection and bring together the brightest minds for developing robust data quality frameworks. Further, the onus should be on making data collection inclusive of people, choice, agency, awareness, and decisionmaking. It is also crucial to address women s reproductive rights. According to NHFS 4.36 per cent females and only 0.3 per cent males underwent sterilisation which showcases the level of the disparity. With male sterilisation on rapid decline, Ministry of Health and Family Welfare released the National Health Policy 2017 which aims uptake of male sterilisation to 30 per cent. Therefore, the focus should be on improving data for identifying the issues in contraceptive use and addressing gender inequality in SRHR in India. The ICMR-NIRRH Mumbai has taken this up as a priority area of research.

10 Tuberculosis Oral regimen launched for drug-resistant tuberculosis (The Tribune: ) Injection regime to be phased out by year-end; total eradication by 2025 The Centre on Wednesday awarded Himachal Pradesh and Gujarat for anti-tb efforts in the category of states with over 50 lakh population Sikkim and Tripura won the award in the section of states with under 50 lakh population Puducherry and Daman and Diu were declared best for their anti-tb efforts in the UT category Home to the highest number of drug-resistant tuberculosis patients in the world, India today launched oral therapy to meet the challenge, pledging to phase out the current regime of injectables by year-end. Injectables for the treatment of drug-resistant TB are known to be acutely painful with recorded side-effects of the order of hearing loss and kidney damage. We know of drug-resistant TB patients who have had so many injections over the 18-month treatment that a time comes when it is impossible to find a clean spot on their bodies to administer the dose. Injections are painful and have proven side-effects. We have today taken a leap forward towards oral therapy which will last 18 months, but will be simpler and easier to administer, Deputy Director General, Indian TB programme Dr KS Sachdeva told The Tribune as the government today launched an ambitious TB harega desh jeetega campaign to rid India of TB by 2025, five years in advance of the UN SDG target of The oral therapy for drug-resistant TB, the more lethal form of TB, is expected to improve treatment rates to 80 per cent from the current 50 per cent. At present, India accounts for nearly 27 per cent of all new TB cases globally every year. TB incidence in India (new case load annually) is around 27 lakh, but not all cases are reported to the government system for treatment. The challenge is the missing TB patients that make up a whopping 5.5 lakh, Health Minister Harsh Vardhan said today as he recalled how frustrating the disease can be. Vardhan said he, as Delhi Health Minister in 1996, could not save his brother-in-law from the drugresistant strain of TB. I had shifted my entire office to GB Pant Hospital in those days, but could not save my closest relative, my brother-in-law from drug-resistant TB because all medicines had stopped working, he said.

11 To start with, oral therapy regime has been launched in Kerala, Tamil Nadu, Puducherry and Delhi. It will be gradually scaled up nationally by December-end. The government is now bearing the entire cost of treatment of all TB patients, including the drugresistant form, which cost Rs 1 lakh for the entire treatment cycle. We are paying private doctors an honorarium to report TB cases to the government systems and are supplying them with free drugs and diagnostics in our attempt to free India of TB by 2025, Vardhan said. Anaemia 60% girls in Delhi colleges anaemic (The Hindu: ) Detection camps at 12 colleges show incidence higher than national average When 18-year-old Anu (name changed) stood in a queue at Atma Ram Sanatan Dharma College for a blood test, she had no idea that she would be detected with severe anaemia, which is risky, according to doctors. I never thought I had anaemia. I did not feel any of its symptoms, she said. About 60% of female students in Delhi colleges are anaemic well above the national average according to an analysis of data collected from ongoing anaemia detection and awareness camps of the Delhi government accessed by The Hindu. The findings, which are yet to be made public, are based on tests on a total of 5,224 female students in 12 city colleges, of whom 3,128 (59.9%) were found to be anaemic. The national average of anaemia among women between 15 and 49 years is 53% and in Delhi it s 54.3%, according to National Family Health Survey-4. While the national average came down from 55.3% to 53% between NFHS-3 and NFHS-4, it rose from 44.3% to 55.3% in Delhi. Anaemia can cause weakness, breathlessness, lack of concentration and if the haemoglobin level falls quickly over a few days, it can even lead to cardiac failure, said Dr. Nitin Gupta, senior consultant, Sir Ganga Ram Hospital. The students found anaemic during the camps have been referred to nearest government hospitals for treatment. Also, the health department has asked all State government-run hospitals to make sure that students detected with severe anaemia are provided out-of-queue treatment.

12 IFA tablets for colleges State programme officer (adolescent health) Dr. Gautam Singh agreed that the percentage of women with anaemia is indeed very high. We plan to extend distribution of IFA tablets to colleges, he said. During the camps, 94 of the 3,128 female students were detected with severe anaemia. Drug News Drug regulator cautions against over-the-counter use of ranitidine (The Hindu: ) Indian doctors have advised patients here to avoid over-the-counter (OTC) use of popular antacid ranitidine, following concerns over its contamination by cancer-causing substances. State bodies asked to verify products, take appropriate measures for patient safety Indian doctors have advised patients here to avoid over-the-counter (OTC) use of popular antacid ranitidine, following concerns over its contamination by cancer-causing substances, with the Central Drugs Standard Control Organisation (CDSCO) now having started the process of checking for any adverse reactions of the drug. CDSCO has written to State regulators, asking that they communicate to the manufacturers of ranitidine active pharmaceutical ingredient (API) and formulations under your jurisdiction to verify their products and take appropriate measures to ensure patient safety. Other countries The drug regulator notes that it is aware of reports from other countries that some ranitidine medicines contain a nitrosamine impurity called N-nitrosodimethylamine (NDMA) at low levels. The Drugs Controller General of India (DCGI) V.G. Somani in the letter further notes that NDMA has been classified by the International Agency for Research on Cancer as probably carcinogenic to humans. The drug ranitidine is approved for multiple indications in the country and available in various formulations including tablets, injections, etc. The drug is a prescription drug included in Schedule-H and therefore it should be sold by retail only under prescription of Registered Medical Practitioner, noted the letter.

13 Final report awaited Doctors, however, maintained that NDMA causes harm in large amounts. Dr. Lalit Verma, Paediatric Gastroenterologist, Surya Hospitals, Mumbai, said: While there is no need to panic, indiscriminate use of the drug without proper assessment and prescription should be avoided. We are also waiting for the U.S. Food and Drug Administration s (USFDA) final report. Doctors issue warning against heartburn drug On September 13, the USFDA said in a release that it had learned of some ranitidine medicines, including those commonly known by the brand name Zantac, contained low levels of NDMA. It added it was evaluating whether these levels of the substance posed a risk to patients. Dr. Reddy s Laboratories maintained that it was suspending supply of its ranitidine worldwide as a precaution. Environmental contaminant The USFDA had noted that NDMA levels in ranitidine from preliminary tests barely exceed amounts might be expected to be found in common foods. NDMA, an environmental contaminant found in water and foods, has the same impurity that the USFDA had investigated in blood pressure drugs valsartan and losartan over the last year.

14 Mental Health (The Asian Age: )

15 Child Health (The Asian Age: )

16 Alzheimer's disease Fluctuating blood pressure may speed up cognitive decline in Alzheimer's (Medical News Today: ) Just as researchers look for factors that increase the risk of developing Alzheimer's, they are also interested in finding out which factors may hasten the rate of cognitive decline in people who already have this condition. Fluctuating blood pressure could be one of them, a new study suggests. Could blood pressure influence the rate of cognitive decline in Alzheimer's disease? A few recent studies have suggested that Alzheimer's disease and other forms of dementia may have complex links with cardiovascular health. In 2018, a study published in the journal Neurology found that older individuals with high blood pressure were more likely to have toxic tangles of protein in their brains a physiological mark of cognitive decline. And earlier this year, research featured in Acta Neuropathologica suggested that Alzheimer's disease and cardiovascular risk factors could have a common genetic denominator. Now, researchers from the NILVAD study group which involves the participation of several European research institutions have analyzed evidence that seems to suggest that fluctuating blood pressure has links to a faster rate of cognitive decline in people with Alzheimer's disease. The analysis, which appears in the journal Hypertension, looked at data from NILVAD, which is a double-blind, placebo-controlled phase III trial. The trial is looking at whether doctors could use nilvadipine, a hypertension drug, in the treatment of Alzheimer's. Can managing blood pressure aid treatment? For the current study, the researchers first analyzed the data of 460 people from the NILVAD trial. The average age of the people was 72, and each had a diagnosis of mild-to-moderate Alzheimer's disease. At this point, the team only used the data of participants who had provided blood pressure measurements on at least three different visits to the clinical trial center. The team found that after 1.5 years, those who appeared to have the highest blood pressure variability showed a faster rate of cognitive decline than those whose blood pressure did not vary so much. Following this, the researchers also analyzed the data of a subset of 46 participants who had provided daily blood pressure measurements. In this subset, the team found "significant

17 associations" between blood pressure fluctuations and quicker progression of cognitive decline after 1 year. However, the association was no longer there at the 1.5 years landmark for this group of participants. Antibiotic resistance can spread in the absence of drugs A small clinical trial found that an innovative head device was able to reduce memory loss in some people with Alzheimer's disease. "Everybody already knows that it's important to control blood pressure in midlife to reduce your risk of Alzheimer's later, but this tells us it's still important to regulate blood pressure when you already have dementia," says senior author Dr. Jurgen Claassen, from Radboud University Medical Center in Nijmegen, Netherlands. "More fluctuations [in blood pressure] might affect whether cognitive function declines more slowly or rapidly." Dr. Jurgen Claassen Because the current findings presented some inconsistencies, the senior investigator also stresses that "[f]uture research is needed to find out if blood pressure variability is truly causing the dementia to worsen." "If that's true," Dr. Claassen continues, "medication or lifestyle [changes] might help slow down disease progression. But it could also be the other way around [...] that the dementia itself might lead to blood pressure variability, which could be a signal that helps you identify people with Alzheimer's." The researchers also note that the current study faced various limitations, including the relatively small sample size, and the fact that the research was only observational. However, they hope that future studies will be able to build on the current findings and find out which interventions might help people with Alzheimer's the most. "Alzheimer's treatments are limited at this point, and even a small difference in slowing down the disease's progression can mean a lot. It could be the difference between whether or not a [person] is still able to drive a car and live independently," says Dr. Claassen.

18 Antibiotic Resistance 'Antibiotic resistance in farm animals is rising fast' (Medical News Today: ) Researchers have found that antibiotic resistance is on the rise among farm animals in low-to-middle income countries. This could have a severe impact on the animals' well-being and the health of consumers. For this reason, they urge the development of better farming policies around the world. Antibiotic resistance in cattle has doubled in under 20 years. For the past few years, scientists have been sounding the alarm about antibiotic resistance repeatedly. Antibiotic resistance refers to dangerous bacteria's increasing adaptability and imperviousness to the action of antibiotics, which are potent drugs designed to fight bacterial infections. Humans may soon face an antibiotic resistance crisis, as the bacteria we are vulnerable to may stop responding to treatments that used to be effective against them. Now, a new threat has become apparent: the rise of antibiotic resistance among farm animals, including pigs, cattle, and poultry. Previous research has found that an increasing number of farmers are treating farm animals bred for human consumption with antimicrobial drugs. Researchers have expressed concerns about the impact this might have on human health in the lung run. Now, a new study featured in the journal Science confirms that this practice has led to an increased number of antibiotic or antimicrobial resistance cases among farm animals all over the world. Drug resistance peaks in India and China "Antimicrobials have saved millions of human lives, yet the majority (73%) are used in animals raised for food," the study authors write. They also note that in recent years, the production of meat has increased in low-to-middle income countries. Specifically, "Since 2000, meat production has plateaued in high income countries but has grown by 68%, 64%, and 40% in Africa, Asia, and South America, respectively," they write. Antibiotic resistance can spread in the absence of drugs New evidence sheds light on the smart and dangerous mechanisms behind antibiotic resistance.

19 This pattern has also meant that these countries use ever increasing quantities of antibiotics for the treatment of animals bred for food. This practice is linked to the development of an antibiotic resistance crisis in farming, the researchers found. As study co-author Thomas Van Boeckel, from the Swiss Federal Institute of Technology in Zurich, explains: "For the first time, we have some evidence that antibiotic resistance [in farm animals] is rising, and is rising fast in low and middle income countries." He and his team analyzed 901 epidemiological studies that looked at the evolution of a series of widespread bacteria Salmonella, Campylobacter, Staphylococcus, and Escherichia coli in low and middle income countries around the world. They found that the strongest cases of multidrug resistance are occurring among farm animals in India and northeast China, with Kenya, Uruguay, and Brazil following close behind. They also note that farmers tend to use four specific types of antimicrobial drugs usually to stimulate the animals to put on weight. These are tetracyclines, sulfonamides, quinolones, and penicillins. These drugs also happen to be those that bacteria have developed the highest resistance rates against. Van Boeckel and colleagues add that between 2000 and 2018, the quantity of antimicrobial drugs to which bacteria that affect cattle have become resistant has doubled, while for chicken and pigs, it has almost tripled. They say that now is the time for countries to enforce policies that regulate the use of antibiotics more strictly, as some of the countries experiencing this problem such as Brazil are also some of the top exports of meat. "We are largely responsible for this global problem we've created," Van Boeckel concludes. "If we want to help ourselves, we should help others." Obesity Adult obesity: Is childhood sugar intake in the '70s to blame? (Medical News Today: ) Is today's adult obesity epidemic the result of children in the 1970s and 1980s consuming excessive amounts of sugar? New research uses a mathematical model to find the answer. A study might have found the cause of today's high adult obesity rates.

20 In recent years, obesity rates in the United States have skyrocketed. To be specific, around 15% of adults had obesity in By 2016, that percentage had increased to almost 40%. Numerous studies have linked the rise in sugar intake with obesity, and many researchers believe that consuming artificially sweetened beverages and processed foods contribute to the obesity epidemic. However, if this is the case, why did obesity rates continue to rise even after sugar consumption began to decline? In 2014, for instance, obesity rates continued to climb despite the fact that sugar intake among U.S. adults had dropped by 25%. These are some of the questions that researcher Alex Bentley and his colleagues set out to answer in a new study. Their results appear in the journal Economics & Human Biology. Bentley, head of the Department of Anthropology at the University of Tennessee at Knoxville, and team posit that today's adult obesity epidemic is the result of increases in childhood sugar intake that occurred decades ago. Dietary habits from years ago are key "While most public health studies focus on current behaviors and diets, we took a novel approach and looked at how the diets we consumed in our childhood affect obesity levels now that we are adults," says Bentley. Study co-author Damian Ruck, a postdoctoral research fellow in the Department of Anthropology, adds, "Up to this point, no studies have explicitly explored the temporal delay between increased sugar consumption and rising obesity rates." To fill this gap, Bentley and team devised a mathematical model for the increase in adult obesity rates since the 1990s "as a legacy of increased consumption of excess sugars among children of the 1970s and 1980s." Study reveals 6 top exercises for offsetting 'obesity genes' Jogging may be the best exercise for lowering obesity risk. They then tested their model using data that the Centers for Disease Control and Prevention (CDC) had gathered in , and by comparing them with U.S. Department of Agriculture data on annual sugar intake since Using a stochastic process, the model shows how the rising consumption of excess sugar increased obesity rates in each age cohort. "Our results indicate that past U.S. sugar consumption is at least sufficient to explain adult obesity change in the past 30 years," say the researchers. Their model, they say, explains the years of delay between sugar consumption (cause) and increasing obesity rates (effect).

21 "Our results suggest that the dietary habits learned by children 30 or 40 years ago could explain the adult obesity crisis that emerged years later." Damian Ruck More specifically, the model suggests that "for each age cohort, [...] the current obesity rate will be the obesity rate in the previous year plus a simple function of the mean excess sugar consumed in the current year." "With just these inputs," the researchers add, "the model can replicate the timing and magnitude of the national rise in obesity." Poverty main driver of excess sugar intake The study's other significant observations include the importance of the rise in consumption of high fructose corn syrup. Most of the increase in excess sugar consumption before 2000 was due to this artificial sweetener, which had become very prevalent in processed foods and soft drinks. "Because 75-year-old [people] experienced childhood before the large-scale increase of sugar in processed foods, they may have developed less lifelong preference for added sugars in foods," write the study authors. However, they add that more research is necessary in this age group. They also speculate that poverty is the main driver behind excessive sugar consumption. "Economically, sugar is an inexpensive source of calories, and sweetened beverages have been a substantial portion of expenditures for low income households," they say. Finally, they note that childhood obesity rates have dropped since the Special Supplemental Nutrition Program for Women, Infants, and Children halved the daily juice allowance in "If our model is correct, the effect of this 2009 change will follow these children into adulthood," conclude Bentley and colleagues. Cancer Scientists evaluate cancer risk of US drinking water (Medical News Today: ) Carcinogens in drinking water could be the cause of more than 100,000 cases of cancer in the United States, according to a recent study. Is tap water safe? New research investigates.

22 Researchers from the Environmental Working Group (EWG) in Washington, DC, used a new approach to analyze cumulative cancer risk due to cancer-causing chemicals in tap water across the U.S. They report the findings in a recent Helyion paper. They note that the study is the first to apply a "cumulative cancer risk framework" to the analysis of tap water contaminants for the whole of the U.S. The analysis drew on water quality data from 48,363 community water systems across the country. The dataset did not include private wells, which supply drinking water to around 14% of the U.S. population, or about 13.5 million households. The analysis revealed that the most significant impact on cancer risk came from arsenic, followed by byproducts of disinfection. "Drinking water contains complex mixtures of contaminants, yet government agencies currently assess the health hazards of tap water pollutants one by one," says first and corresponding study author Sydney Evans, an EWG science analyst. "In the real world," she adds, "people are exposed to combinations of chemicals, so it is important that we start to assess health impacts by looking at the combined effects of multiple pollutants." Calculating cumulative lifetime cancer risk In their study paper, the authors explain that since the 1990s, scientists and health organizations in the U.S. and elsewhere have been urging that risk assessments should focus on cumulative impact rather than just the effect of one contaminant at a time. Indeed, in the U.S., it is already standard practice to use a cumulative approach to assess the risk of developing both "cancer and other serious health effects" from exposure to toxic air pollutants. WHO publish report on microplastics in drinking water WHO say there is an urgent need to study the health impacts of microplastics in drinking water as current knowledge is very limited. The new study builds on a model that the state of California used to assess the cumulative cancer risk of drinking water contaminants. The team obtained cancer risk benchmarks for each of the 22 contaminants that they analyzed from the U.S. Environmental Protection Agency and the California Office of Environmental Health Hazard Assessment (California OEHHA). These benchmarks give the level of a contaminant that corresponds to the risk that 1 person per million of the population exposed to the contaminant could develop cancer during their lifetime. Government agencies use 70 years as the approximate statistical lifespan in the U.S.

23 From the average results of water quality tests that each community had conducted on their water systems during , the researchers could see which had exceeded the benchmark threshold for each of the contaminants. Therefore, for each community in which the contaminant had exceeded the threshold, the estimated number of cases would be the lifetime cancer risk multiplied by the size of the population. Building a national picture At a national level, the estimated number of lifetime cancer cases due to a given contaminant would then be the sum of estimated cases in communities that exceeded the threshold. In the case of arsenic, for example, the California OEHHA defines the level of contaminant that corresponds to a lifetime cancer risk of 1 case in 1 million as micrograms per liter (mcg/l). From the water quality and population data for each community, the researchers calculated that 141 million people across the U.S. live in areas in which levels of arsenic are above this threshold. The calculation yields a national figure of 45,300 estimated number of lifetime cancer cases due to arsenic in drinking water. The cumulative lifetime cancer risk is, therefore, the sum of the estimated number of lifetime cancer cases due to each contaminant. 'Need to prioritize source water protection' "Overall," conclude the authors, "tap water exposure to the carcinogenic contaminants analyzed in this study corresponds to 105,887 estimated lifetime cancer cases." They point out that this magnitude of cumulative cancer risk is on a par with that of cancer-causing air pollutants. The highest risk came from water systems that rely on groundwater and supply mostly smaller communities. However, larger surface water systems also account for a sizeable share of the overall risk, note the researchers. This is because they have a persistent presence of disinfection byproducts in them and serve more people. "We need to prioritize source water protection," says senior study author Olga Naidenko, Ph.D., vice president for science investigations at EWG, "to make sure that these contaminants don't get into the drinking water supplies to begin with." Important to see findings in context Jim Smith, professor of environmental science at the University of Portsmouth in the United Kingdom, was not involved in the study.

24 He acknowledges that while the study tries to "model cancer risks from drinking water," it fails to explain them in their proper context. For example, it does not make any comparisons with other environmental risk factors. "The comparison," he notes, "of carcinogenic risk from drinking water and those from air pollution fails to mention that carcinogenic risk from organic contaminants is only a very small factor in total air pollution risk." Such a comparison could mislead people who are not familiar with these types of studies into believing that the health risks of drinking tap water are similar to those of exposure to air pollutants. Without appropriate context, scientific results can lead to an "understandable public overreaction to risks and to wrong policy decisions," he concludes. Asthma Asthmatic children with anxiety, depression likely to visit ER more (New Kerala: ) Washington D.C., Sept 25 : Children with asthma are more likely to be affected by anxiety and depression and those with all the three conditions are twice as likely to seek Emergency Room care, than patients only with the respiratory condition, finds a new study. In a study published in the journal Pediatrics, researchers incorporated more than 65,000 children and youth with asthma, aged between 6 to 21, and found that 7.7 per cent of participants with both depression and anxiety had a rate of 28 ER visits per 100 child years, controlling for age, gender, insurance type and other chronic illnesses. This is almost twice the rate of those without depression and anxiety ER visits per 100 child years. For asthma patients who just had depression, the rate was lower, with 22 visits per 100 child years, and for those asthma patients who just had anxiety, the rate was 19 visits per 100 child years. "Asthma self-management is complex, requiring recognition of symptoms, adherence to medication and avoidance of triggers," said first author Naomi Bardach, MD, MAS, of the University of California, San Francisco, Department of Pediatrics and the Philip R. Lee Institute for Health Policy Studies.

25 "The symptoms of anxiety and depression can make it more challenging to follow treatment, leading to more ER visits," she added. The authors noted that anxiety and depression are more common in children with asthma. In their study, among those with asthma, 11.2 per cent had anxiety and 5.8 per cent had depression, versus 7.1 per cent and 3.2 per cent in those without. Children were aged between 3 to 17, according to data from the Centers for Disease Control and Prevention. To qualify for the study, the 65,342 participants had to have had asthma-related doctor visits or hospitalizations, or prior use of preventive medications with an asthma-related doctor visit. They were identified with anxiety and depression if they had at least one inpatient, outpatient or ER visit for either condition. In some children with asthma, depression and anxiety, it can be difficult to tease out which symptom is attributed to which condition, said senior author Michael Cabana, MD, MPH, formerly of UCSF and currently with Children's Hospital at Montefiore. The research results confirm studies in adults with asthma who also had depression and anxiety. This group of patients was also found to have a higher likelihood of visits to the ER, urgent care clinics and unscheduled visits with their providers, compared to adults with asthma alone.

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