E-drugs: They could endanger your health
Consumers could be endangering their health by buying drugs on the internet, Australian doctors said on Monday. Not all websites provide enough information on the products they sells so that consumers may not have all they need to know about the products they are buying.
“Consumers cannot make an informed decision about purchasing a medicine using information provided by e-pharmacies because balanced information about the benefits and risks of taking medicines ws largely unavailable or of poor quality,” said Dr. Tracey Bessell, of Monash University in Victoria.
In a survey of 104 internet pharmacy websites, published in Quality & Safety in Health Care they found that 41 e-pharmacies gave no information about their products. About two-thirds of the websites had some data, but on 53 of the sites the quality was so poor that it was of little benefit to consumers.
Only 30 sites in the poll in 13 conuntries, including the US and the UK, had links to other sites and fewer than a third had any information about diseases.
Twenty-seven e-pharmacies sold St.John’s wort, a complementary medicine to treat mild depression, but only three warned consumers about interactions with other medications for heart disease, epilepsy and the contraceptive pill.
Australia, Canada, New Zealand, the UK and the US have introduced e-pharmacy practice standards but Bessell said e-pharmacies selling non-prescription and complementary medicines are failing to up hold them.
What’s ailing Mumbaikars
Lifestyle Diseases Take A Toll On Sedentary Citizens
Lagging behind heart ailments –the “rich man’s disease”is tuberculosis – the “poor man’s disease, which in comparison had a relatively lower fatality of 9,930 deaths in 2008. But the government is losing the battle against TB: a five-year analysis of data provided by the BMC shows a 15% rise in TB deaths. In 2004, there were only 8,625 deaths, but the numbers subsequently rost to 9,940 in 2006, and 2,850 in 2007.
“The rise in tuberculosis cases does not come as a surprise as Mumbai is a congested city. As the disease spreads when affected people cough sneeze or spit, the chances of the patient’s family member catching TB is very high,”saidDr. G.T.Ambe, executive health officer of BMC.
The shocker is the 20.17% increase in deaths due to respiratory tract infections. While it claimed the lives of 2,687 Mumbaikars in 2007, the number jumped to 3,229 in 2008. Rising pollution levels, construction activity and smoking are the main culprits behind lung-related diseases, say doctors.
Explaining why respiratory tract infections and pneumonia were slotted separately, Dr. Ambe said: “There are codes given to each disease by the WHO, which we have to follow.”
Pneumonia, which is described as an abnormal inflammatory condition of the lung, is the fourth biggest killer, with 4, 352 victims. There was a 6.09% rise in deaths due to pneumonia.
The third killer on the list, cancer, has extended its ten tackes rapidly in the span of one year, there has been a 9.32% rise in cancer deaths. BMC’s senior statistical officer, P.K. Shrivastav said: “Most people suffering from cancer come to Mumbai from other parts of the country for treatment. Many are the last stage. Also, you cannot ignore the fact that there are different types of cancer, which is the reason why it has more victims than singular diseases.”
Incidentally, death due to AIDs did not make it to the top five. BMC officials said it was eighth on the list.
What’s hard to ignore is that lifestyle diseases have emerged as to killers. At least three killer diseases may be caused due to stress. According to doctors, even stress can indirectly tigrger diseases such as COPD and pneumonia. The onus also rests on the shoulders of Mumbaikars. There is an urgent need for citizens to eat healthy and exercise regularly, say doctors.
Watch out for the Big 5 Killers.
Heart Diseases: Risk factors for heart disease include smoking, high blood pressure (hypertension), high cholesterol, diabetes, family history, peripheral artery disease, obesity or smoking
Death/Toll
2007/23,200
2008/23,849
Tuberculosis: TB is caused by various strains of Mycobacteria, usually Mycobacterium Tuberculosis, and spreads through the air, when people who have the disease cough, sneeze, or spit.
2007/9,850
2008/9,930
Cancer : Research shows that certain factors increase the chances of a person developing cancer. These include tobacco use, family history of cancer, poor diet and lack of physical activity 2007/6,112
2008/6,682
Pneumonia : Infective pneumonia causes inflammation and infection of the lungs and bronchial tubes. Inflammation of the lungs caused by inhaling bodily fluids causes aspiration pneumonia 2007/4,102
2008/4,352
Respiratory Tract Infections: Respiratory tract infections include Chronic Obstructive Pulmonary Disorders (COPD) and bronchial asthma. Increasing pollution levels, and smoking (passive and active) are taking a toll on people’s lungs say city doctors 2007/2,687
2008/3,229
Watch out for the Big 5 Killers. |
Heart Diseases: Risk factors for heart disease include smoking, high blood pressure (hypertension), high cholesterol, diabetes, family history, peripheral artery disease, obesity or smoking |
Death/Toll |
2007/23,200
2008/23,849 |
Tuberculosis: TB is caused by various strains of Mycobacteria, usually Mycobacterium Tuberculosis, and spreads through the air, when people who have the disease cough, sneeze, or spit. |
2007/9,850
2008/9,930 |
| Cancer : Research shows that certain factors increase the chances of a person developing cancer. These include tobacco use, family history of cancer, poor diet and lack of physical activity |
2007/6,112
2008/6,682 |
| Pneumonia : Infective pneumonia causes inflammation and infection of the lungs and bronchial tubes. Inflammation of the lungs caused by inhaling bodily fluids causes aspiration pneumonia |
2007/4,102
2008/4,352 |
| Respiratory Tract Infections: Respiratory tract infections include Chronic Obstructive Pulmonary Disorders (COPD) and bronchial asthma. Increasing pollution levels, and smoking (passive and active) are taking a toll on people’s lungs say city doctors |
2007/2,687
2008/3,229 |
Pollution & Smoking take a toll on lungs
Mumbai: The more than 20% rise in deaths due to respiratory tract infections such as COPD has not come as a surprise. According to the recent Maharashtra State Health Family Welfare Bureau, asthma alone-that can be controlled with daily puffs of inhalers-accounted for 8% of all deaths in the 15 to 49 age group of Maharashtra’s women in 2008.
Rising pollution levels, rising construction activity, and smoking (passive and active) are taking a toll of people’s lungs. “In a private set up, we see around 400 people with respiratory and chest problems. Nearly 50% of these people are suffering from Chronic Obstructive Pulmonary Diseases (COPD). Any obstruction which affects the air flow from the lungs, and does not improve even with treatment is called COPD,” said chest physician Dr. Ashok Mahasur.
Dr. Rohine Chowghule, head of medicine at Bombay Hospital says that almost 9% of Mumbaikars suffer from COPD. “The quality of air itself has deteriorated. Even though smoking is one of the major reasons, one cannot discount the high levels of pollution. While the city has to breathe in the polluted air, those with weak lungs or lower immunity fall prey to these obstructive disorders,” Dr Chowghule said. COPD also includes emphysema, a disorder of the lung that causes it to lose its elasticity.
India may be hub of chronic illness
According to World Health Organization report Preventing Chronic Diseases- A Vital Investment, 350 million people will die in the next 10 years of chronic disease and a significant proportion of these will be in India.
To help fight such diseases is an initiative launched by the Piramal group with the Associated Chambers of Commerce and Industry of India. Help your body, a nationwide campaign against chronic diseases, was inaugurated by former president APJ Abdul Kalam at KC College in Churchgate on Saturday. Helpyourbody will kick off in three phases, comprising a panel of experts in diabetology, cardiology and orthopaedics, as crusaders in the first phase. “Each doctor will impart information to patients on risk factors for chronic diseases, diagnosis and management,” said Dr. Swati Piramal, director, Piramal Healthcare Ltd.
The campaign will focus on ailments like hypertension, heart disease, diabetes, arthritis, cancer, addiction and mental health. Tests will be carried out at 90 diagnostic centres across 47 cities and detection camps will be orgainsed in 20 cities across India reaching out to 10,00,000 people.
“India is expected to be the chronic disease capital in the world. The government, private sector, NGOs and medical fraternity should help combat these diseases,” said Primal.
Kalam Said,”Corporates should carry out periodic check-sups of employees over 40 years. Students should become ambassadors for this cause. Rural areas need to have mobile clinics and awareness among taxi-drives and dabbawallahs should be increased.”
Overtreated: More medical care isn’t always better
Washington: More medical care won’t necessary make you healthier- it may make you sicker. It’s an idea that technology-loving Americans find hard to believe.
Anywhere from one-fifth to nearly one-third of the tests and treatments we get are estimated to be unnecessary, and avoidable care is costly in more ways than the bill: It may lead to dangerous side effects.
It can start during birth, as some of the United States’ increasing C-sections are triggered by controversial fetal monitors that signal that a baby is in trouble when really everything’s fine. It extends to often futile intensive care at the end of the life. For example, Americans get the most medical radiation in the world, much of it form repeated CT scans. Too many scans increase the risk of cancer.
Then there are thousands who get stents for blocked heart arteries when they should have tried medication first.
Again, doctors prescribe antibiotics millions of times for viruses such as colds that the drugs can’t help. .
Back pain stands out as the No.1 over treated condition, from repeated MRI scans that can’t pinpoint the trouble to spine surgery on people who could have gotten better without it. About one in five who gets that first back operation will wind up having another in the next decade.
Overtreatment means someone could have fared as well or better with a lesser test or therapy, or may be even none at all.
Experts say that avoiding overtreatment is less about knowing when to say no, than knowing when to say,”Wait, doc, I need more information!” .
MILIONS DIE FROM SURGERIES EVERY YEAR :WHO
234 million World Go Under The Knife Annually, Finds UN Body
New Delhi: More than seven million people across the globe suffer from preventable surgical injuries every year, a million of them even dying during or immediately after the surgery, a WHO study has said.
The UN body has, for the first time, quantified the number of sugeries taking place every year globally-234 million. It said surgeries had become common, whith 1 in every 25 people undergoing it at any given time.
In the study-An Estimation of the Global Volume of Surgery published in the The Lancet journal on Wednesday, WHO said safety of patients during surgery had emerged as a public health concern.
According to it, China conducted the highest number of surgeries followed by Russia and India. The study said nearly 3-16% of all inpatient surgical procedures in developed countries resulted in unnecessary complications with death rates being nearly .8%.
In developing countries, the death rate was nearly 10% for a major surgery. Mortality from general anaesthesia affected one in 150 patients while infections were reported in 3% of surgeries with the mortality rate being 5%. Nearly 50% of the adverse effects of surgery were preventable.
This made WHO's 'Safe Surgery Saves Lives' initiative come out with a 24 point checklist on Wednesday, which helps to improve anesthetic safety practis, avoid infections and improve communication among members of surgical teams. When followd, this could halve the rate of surgical complications.
A pilot study involving 3,600 patients in eight hospitals including St. Stephen's Hospital in Delhi was conducted to see whether using a checklist could help reduce surgical comlication rates. Data from the first 1,000 patients announced on Wednesday showed that the use of a checklist increased adherence to standards of care to 68% from 36%.
Speaking to TOI, Dr Atul Gawande from the Harvard School of Public Health said a guideline on the checklist calls for all members of the surgical team to identify themselves and their roles and ask simple questions like "Does everyone agree that this is patient X and he needs a particular surgery?"
Other recommendations call for marking the correct site for surgery, giving an antibiotic with in 60 minutes of making an incision to reduce infections checking for allergies, inserting two intravenous lines for operations with risk of substantial blood loss and counting sponges and needles to ensure that none are left in a patient.
"In nearly 64% or two-thirds of the cases, we saw that surgical teams miss such vital steps in both developed and the devloping countries. The checklist will be like what a pilot does before taking off. An initial project to see its effectiveness in hospitals in Delhi, London, Toronto, Manila, Jordan, Tanzania, Seattle and Auckland saw surgery failure rates being cut down by half," Dr Gawande said.
Worldwide, WHO, aims to have the checklist operating in 2,500 hospitals in the most populous countries by the end of next year.
Heart disease: Heart attack and heart related problems such as stroke and cerebrovascular disease are on the top of the list of killer diseases. The WHO statistics reveal that 31.5% women die of heart disease while the rate is 26.8% in men. Lack of physical activity, obesity, eating more fat and salt are the main culprits.
Cancer
As per the 2008 World Cancer Report, the global cancer cases and deaths would double by the year 2030; 27 million people would suffer from cancer by 2030 resulting in 17 million deaths every year. Experts blame it on smoking and lifestyles including poor diet, lack of exercise.
Infectious diseases
Infectious diseases are now the world’s biggest killer of children and young adults; they lead to 16.2% of worldwide deaths. Disease-causing germs such as bacteria, viruses, parasites or fungi spread diseases directly or indirectly from one person to the other - sexually transmitted diseases (STDs), HIV etc. There are others, which are transmitted from animal to person for instance bird flu, swine flu etc. In spite of a number of newer drugs being available to treat infections, these remain ineffective because of the increasing resistance of microbes to drugs.
Tuberculosis
Around 2 million people die of tuberculosis (TB) every year. The WHO figures reveal that almost one-third of the world’s population is infected with Mycobacterium tuberculosis, the bacteria that cause tuberculosis. The disease is the main killer in people with AIDS. It spreads by coughing and sneezing.
Although BCG vaccine is used as a preventive measure against TB, the multidrug-resistant TB is on the rise. Directly Observed Therapy Short-course - DOTS - is an internationally recommended approach to TB control. The health workers closely monitor treatment to ensure that patients complete the full course of medication. The Global Plan to halt and reverse the spread of TB is an action from 2006 up until 2015.
Chronic obstructive pulmonary disease (COPD)
COPD includes lung diseases that make breathing difficult. It is estimated that by 2020 it will be the third biggest killer in the world. In the majority of cases, smoking is to be blamed for COPD. Occupational exposure to dust, air pollution and certain inherited diseases too are risk factors. The lung damage due to COPD can be slowed with lung exercises and a healthy diet.
Lower respiratory tract infections
Diseases of the lungs, such as pneumonia, kill more than 4 million people each year. The lower respiratory tract infections also include tuberculosis and whooping cough. The infections are often associated with AIDS and are more common in children under five. The U.N.-sponsored Millennium Development Goals aims at cutting global poverty and calls for a reduction in child mortality by two-thirds by 2015.
HIV/AIDS
According to the latest data from the Joint United Nations Programme on HIV/AIDS (UNAIDS) and WHO, an estimated 2.7 million people became newly infected with HIV in 2008, and 2.0 million people died of AIDS-related causes in 2008. Women have been estimated to comprise 50 per cent of adults living with HIV/AIDS worldwide. This is because of a combination of biological, social, cultural and economic factors. Young people under the age of 25 are estimated to account for more than half of all new HIV infections worldwide.
Although there is no vaccine for HIV/AIDS, the good news is that HIV-positive people can live on life-prolonging antiretroviral drugs for decades.
Malaria
Malaria, a parasitic disease, is spread by female anopheles mosquitoes. It is preventable, treatable and curable and yet it causes between 1 and 5 million deaths each year. Fortunately malaria can be prevented by using insecticides, mosquito nets and taking sanitary measures to stop the breeding of mosquitoes. Anti-malarial drugs are available to treat malaria. Governments and NGOs are working towards educating, preventing and treating the disease.
Diarrhoea
Dysentery, cholera – infection from virus, bacteria or parasitic worms cause diarrhoea. According to the WHO’s Department of Food Safety and Zoonoses, the new estimate of diarrhoea is on par with global annual deaths for malaria; it kills around 2.2 million people each year and infects around 4 billion people in a year. Most deaths occur in children particularly due to dehydration.
Since diarrhoea is spread through contaminated water and food, improvement in food safety, sanitation and hygiene are essential for its prevention. Goal number 10 of the UN - Millennium Development Goals is to halve the proportion of people without sustainable access to safe drinking water and basic sanitation by 2015.
Measles
Measles is one of the leading causes of death among young children; WHO estimates 530,000 deaths each year. The disease makes children susceptible to pneumonia and diarrhea and if left untreated can be fatal. The measles vaccine protects the child against the infection and is often incorporated with rubella and/or mumps vaccines.
MONSOON -RELATED AILMENTS
MALARIA A mosquito-borne disease, it is caused by a parasite and is usually of two types, vivax or falciparum, the second being more worrying and could even be life threatening Symptoms: Fear with chills, resembling flu incubation period: 3-5 days.
Preventive measures: Empty out all water collected in flower pots, old tyres, pans or odd buildings, and use mosquito nets and insecticides.
Cases: 4 deaths, 950 persons hospitalized
DENGUE
It is an infectious disease carried from person to person by tiger mosquitoes (Aedes aegypti )
Symptoms: Sudden onset of fever, severe headache, falling platelet count which could occasionally cause shock and haemorrhage (bleeding), leading to death
Incubation period: 5-7 days
Preventive measures: Keep mosquitoes away and avoid collection of water.
Cases: 1 death, 23 persons hospitalised
LEPTOSPIROSIS
It is a bacterial infection caused by the leptospira bacteria which is spread through water is spread through water contaminated with the urine of rats and dogs.
Symptoms: High fever, muscle aches, severe headaches, abdominal pain and vomiting or loose motions, if left untreated the patient could have kidney damage or respiratory distress.
Symptoms: High fever, muscle aches, severe headaches, abdominal pain and vomiting or loose motions. If left untreated the patient could have kidney damage or respiratory distress
Incubation period: 5 days to four weeks
Preventive measures: Avoid wading through flood waters especially if you have cuts or abrasions on your feet/legs. Wash your feet clean after walking through muck.
Cases:1 death,11 persons hospitalised.
GASTROENTERITIES
It is an infection or inflammation of the digestive tract and may be caused by a virus or bacteria.
Symptoms: Vomiting, watery diarrhoea, fever
Incubation period: 12-14 hours
Preventive measures: Avoid ice, roadside food, open cut fruits, and boil your drinking water
Cases: 828 persons hospitalized
JAUNDICE
It is a condition associated with an increase of bilirubin in the blood, which can cause liver disease. It is caused by the Hepatitis virus
Symptoms: Yellowness of eyes and skin, vomiting
Incubation period: 15-20 days Preventive measures: Drink boiled water; there are hepatitis vaccines available
CONJUNCTIVITIS
Inflammation of the conjuctiva (eye membrane), caused by a virus or bacteria Symptoms: Redness if the eye, itchiness, watery discharge
Incubation period: 1-3 days (bacterial);2-19 days(viral)
Prevention: Wash your hands often. Avoid sharing towels or eye drops with an infected person. Antibiotic eyedrops should give relief within a week. If the irritation persists, consult an eye specialist.
Lifestyle diseases may kill 7 Indians by 2020
DOCS blame it on lack of physical activity
New Delhi: In a little over a decade from now, chronic diseases like diabetes, hypertension, cancer and AIDS would account for over 65% of deaths in India compared to 50% in 2005. By 2020, chronic diseases are expected to claim 7.63 million lives in India, compared to 3.78 million in 1990, a study said.
While ailments like leprosy poliomyelitis and tetanus has been declining due to concerted government efforts and higher awareness, there has been an increase in lifestyle or chronic disease like hypertension, cancer. AIDS and diabetes. The shift in the profile of killer diseases is also a result of marked changes in demographics, a study by pricewaterhouse Coopers said.
India that is already home to the largest number of diabetes patients is projected to have 30 million diabetics by 2020, of which 6.6 million or 22% would suffer from complications such as diabetic nephropathy.
Doctors blame sedentary lifestyle, lack of physical activity, obesity, stress and consumption of a diet rich in fat and sugar for the high incidence. Similarly tress both a t work and a home is going to take a further toll with the number of people suffering from hypertension estimated to rise 213.5 million in 2025, compared to 118 2 million in 200 representing an 80% rise in a span of a quarter century.
A recent study had estimated that nearly 11% of India’s urban population above the age of 15 have diabetes. The world health Organization estimates that mortality from diabetes and heart disease cost India about $210 bilion every year and is expected to increase to $335 billion in the next 10 years. These estimates are based on lost productivity, resulting primarily from premature death.
While traditionally the government’s focus was on combating infectious disease, it has now decided to address the issues related to chronic or lifestyle disease, along with private sector.
But it’s the private sector which accounts or 70% of the hospitals I n the country, providing about 60% of all outpatients care and as much as 40% of inpatient care. And, by 2010, It is expected to notch up around 80% of the healthcare market, comprising hospitals and diagnostic centres.
While the growth of private healthcare facilities in India vis-à-vis public healthcare facilities is an emerging trend, the sector requires investment of $25.7 billion over the next three years. BY 2010,an additional 4.5 lakh hospital beds will be required, the study adds. Today, the value of the healthcare sector is over $34 billion, transplanting to roughly 6% of GDP and the sector is projected to grow to nearly $40 billion by 2012.
While the government is drawing up plans to build at least half-a dozen AIIMS-like multi-specialty hospitals, the study said, the government was expected to chip in with only 15-20% of the investment requirement.
There are however significant challenges that need to be addressed. The lack of adequate healthcare insurance for a vast number of people is a fundamental problem. Currently 11% of the population has any form of health insurance coverage but with growing public-private partnership in this sector, many more people can be brought under insurance coverage.
EYE OPENER
• Chronic diseases like diabetes, hypertension, cancer and AIDS would account for over 65% of deaths in India by 2020 compared to 53% in ‘05
• Who estimates that mortality from diabetes and heart disease cost India about $210 billion every year and is expected to increase to $335 billion in the next 10 years.
• By 2010, an additional 4.5L hospital beds will be required. Value of the healthcare sector is projected to grow to nearly $40 billion by 2012
