News and Notes
Managing attention deficit disorder by training the brain
Scientists explored a technique called 'neurofeedback,' which enables ADHD patients to train their attention, based on instant feedback from the level of their brain activity. The team of neuroscientists found that not only did the training have a positive effect on patients' concentration abilities, but also that the attention improvement was closely linked to an enhanced response from the brain -- the P3 wave -- which is known to reflect integration of
information in the brain.
Attention Deficit Hyperactivity Disorder (ADHD) affects about 7% of children, with a two out of three chance of persisting into adulthood. This neurodevelopmental disorder is characterised by concentration difficulties, increased distractibility, impulsivity and hyperactivity. Today, ADHD is treated with pharmaceutical drugs that may have unwanted side effects. This is why scientists from the University of Geneva (UNIGE) and the University Hospitals of Geneva (HUG), Switzerland, explored a new technique called 'neurofeedback', which enables ADHD patients to train their attention, based on instant feedback from the level of their brain activity. The team of neuroscientists found that not only did the training have a positive effect on patients' concentration abilities, but also that the attention improvement was closely linked to an enhanced response from the brain- the P3 wave -- which is known to reflect integration of information in the brain, with higher P3 amplitudes indicating greater attention towards detected targets.
Journal Reference: Marie-Pierre Deiber, Camille Ammann, Roland Hasler, Julien Colin, Nader Perroud, Tomas Ros. (2021) .Electrophysiological correlates of improved executive function following EEG neurofeedback in adult attention deficit hyperactivity disorder. Clinical Neurophysiology, 132 (8), 1937 DOI: 10.1016/j.clinph.2021.05.017
Air pollution exposure linked to poor academics in childhood
Children exposed to elevated levels of air pollution may be more likely to have poor inhibitory control during late childhood and poor academic skills in early adolescence, including spelling, reading comprehension, and math skills. Difficulty with inhibition in late childhood was found to be a precursor to later air pollution-related academic problems. Interventions that target inhibitory control might improve outcomes.
"Children with poor inhibitory control are less able to override a common response in favor of a more unusual one -- such as the natural response to say 'up' when an arrow is facing up or 'go' when a light is green -- and instead say 'down' or 'stop,'" says first author Amy Margolis, PhD, associate professor of medical psychology in the Department of Psychiatry at Columbia University Irving Medical Center. "By compromising childhood inhibitory control,
prenatal exposure to air pollution may alter the foundation upon which later academic skills are built."
"When evaluating student's learning problems and formulating treatment plans, parents and teachers should consider that academic problems related to environmental exposures may require intervention focused on inhibitory control problems, rather than on content-related skill deficits, as is typical in interventions designed to address learning disabilities," Margolis adds.
"This study adds to a growing body of literature showing the deleterious health effects of prenatal exposure to air pollution on child health outcomes, including academic achievement," says co-author Julie Herbstman, PhD, CCCEH director and associate professor of environmental health sciences at Columbia Mailman School. "Reducing levels of air pollution may prevent these adverse outcomes and lead to improvements in children's academic achievement."The new findings align with prior Columbia research finding a DNA marker for PAH exposure was associated with altered development of self-regulatory capacity and ADHD symptoms.
Journal Reference: Amy E. Margolis, Bruce Ramphal, David Pagliaccio, Sarah Banker, Ena Selmanovic, Lauren Thomas, Pam Factor-Litvak, Frederica Perera, Bradley S. Peterson, Andrew Rundle, Julie Herbstman, Jeff Goldsmith, Virginia Rauh.(2021) Prenatal exposure to air pollution is associated with childhood inhibitory control & adolescent academic achievement. Environmental Research, 111570 DOI: 10.1016/j.envres.2021.111570
Physical activity does the brain good: It fosters its ability to change and adapt.
The dual beneficial effect of physical activity in depression is confirmed by a study at the University Clinic for Psychiatry and Psychotherapy at Ruhr-Universität Bochum (RUB). Physical activity not only reduces depressive symptoms, It also increases the brain's ability to change, which is necessary for adaptation and learning processes. The results show that the brain's ability to change is lower in people with depression than in healthy people. Following the programme with physical activity, this ability to change increased significantly and achieved the same values as healthy people. At the same time, depressive symptoms decreased in the group. "The more the ability to change increased, the more clearly the clinical symptoms decreased," summarises Karin Rosenkranz.
Journal Reference: Wanja Brüchle, Caroline Schwarzer, Christina Berns, Sebastian Scho, Jessica Schneefeld, Dirk Koester, Thomas Schack, Udo Schneider, Karin Rosenkranz.(2021). Physical activity reduces clinical symptoms and restores neuroplasticity in major depression. Frontiers in Psychiatry, 12 DOI: 10.3389/fpsyt.2021.660642
Childhood cognitive problems could lead to mental health issues in later life
Children experiencing cognitive problems such as low attention, poor memory or lack of inhibition may later suffer mental health issues as teenagers and young adults, a new study reveals. Targeting specific markers in childhood for early treatment may help to minimise the risk of children developing certain psychopathological problems in adolescence and adult life, such as borderline personality disorder, depression and psychosis.
Cognitive deficits are core features of mental disorders and important in predicting longterm prognosis -- the researchers' work indicates that individual patterns of such deficits predate specific mental disorders.Analysing data from an initial UK cohort of 13,988 individuals born between April 1991 and December 1992, researchers discovered a number of key and specific links between childhood cognitive problems and mental health issues in later life,
● Deficits in sustained attention in eight-year-olds precede development of borderline personality disorder (BPD) symptoms at 11-12 years and depression at 17-18 years;
● Difficulties with inhibition in eight-year-olds were associated with psychotic experiences at 17-18 years; and
● Working memory deficits in 10-year-olds were related to hypomania at 22-23 years.
The leading author of the study Dr. Isabel Morales-Muñoz, from the University of Birmingham's Institute for Mental Health and the Finnish Institute for Mental Health, in Helsinki, commented: "Our study highlights the potential impact of childhood cognitive deficits on young people's mental health, suggesting specific associations with certain conditions. Prevention strategies focussed on easing these specific cognitive issues could help to reduce the likelihood of such children developing linked mental health problems in adolescence and early adulthood."
Deficits in sustained attention at eight years being associated with BPD symptoms at 11-12 years is consistent with similar deficits in adult BPD patients linked to difficulties in sticking to therapy programmes.The study also supports the theory that lack of inhibition in childhood precedes later psychotic experiences, with a lack of inhibitory control common in psychotic disorders such as schizophrenia.Researchers found that working memory deficits in childhood were linked to hypomania in young adults, but when they checked for co-existing psychopathological conditions this association disappeared -- indicating that further investigation is needed.
Mental disorders cause a significant disease burden globally and at least 10% of children and adolescents worldwide have a mental disorder. 75% of mental disorders diagnosed in adults have their onset in childhood and adolescence.Bipolar disorder, depression and psychosis commonly emerge during adolescence and continue in young adulthood -- potentially related to anomalies in the way adolescents mature caused by psychosocial, biological or environmental factors. "It's crucial to study the onset of mental disorders at these early stages and evaluate which risk factors predate these conditions and in what way. These factors are core features of mental disorders such as psychosis and mood disorders," commented co-author Professor Matthew Broome. "Deficits in cognitive function, ranging from decreased attention and working memory to disrupted social cognition and language, are common in psychiatric disorders. They severely compromise quality of life and could potentially predate serious mental health conditions by several years," commented the senior author of the study Professor Steven Marwaha.
Journal Reference: Isabel Morales-Muñoz, Rachel Upthegrove, Pavan K. Mallikarjun, Matthew R. Broome, Steven Marwaha (2021). Longitudinal associations between cognitive deficits in childhood and psychopathological symptoms in adolescence and young adulthood. JAMA Network Open, 4 (4), e214724 DOI: 10.1001/jamanetworkopen.2021.4724
Antibiotics in early life could affect brain development
Antibiotic exposure early in life could alter human brain development in areas responsible for cognitive and emotional functions.
Penicillin and related medicines (like ampicillin and amoxicillin) are the most widely used antibiotics in children worldwide. In the United States, the average child receives nearly three courses of antibiotics before the age of 2. Similar or greater exposure rates occur in many other countries.
"Our previous work has shown that exposing young animals to antibiotics changes their metabolism and immunity. The third important development in early life involves the brain. This study is preliminary but shows a correlation between altering the microbiome and changes in the brain that should be further explored," said lead author Martin Blaser, director of the Centre for Advanced Biotechnology and Medicine at Rutgers. A growing body of evidence links phenomena in the intestinal tract with signalling to the brain, a field of study known as the "gut-brain-axis." If this pathway is disturbed, it can lead to permanent altering of the brain's structure and function and possibly lead to neuropsychiatric or neurodegenerative disorders in later childhood or adulthood.
"Early life is a critical period for neurodevelopment," Blaser said. "In recent decades, there has been a rise in the incidence of childhood neurodevelopmental disorders, including autism spectrum disorder, attention deficit/hyperactivity disorder and learning disabilities. Although
increased awareness and diagnosis are likely contributing factors, disruptions in cerebral gene expression early in development also could be responsible."
Journal Reference: Angelina Volkova, Kelly Ruggles, AnjeliqueSchulfer, Zhan Gao, Stephen D. Ginsberg, Martin J. Blasé r(2021). Effects of early-life penicillin exposure on the gut microbiome and frontal cortex and amygdala gene expression. iScience, 102797 DOI: 10.1016/j.isci.2021.102797
Having a good listener improves your brain health
Supportive social interactions in adulthood are important for your ability to stave off cognitive decline despite brain aging or neuropathological changes such as those present in Alzheimer's disease.
Researchers observed that simply having someone available most or all of the time whom you can count on to listen to you when you need to talk is associated with greater cognitive resilience -- a measure of your brain's ability to function better than would be expected for the amount of physical aging- or disease-related changes in the brain, which many neurologists believe can be boosted by engaging in mentally stimulating activities, physical exercise, and positive social interactions. One of the longest running and most closely monitored community-based cohorts in the U.S., the Framingham Heart Study (FHS), is used as the source of the study's 2,171 participants, with an average age of 63. FHS participants self-reported information on the availability of supportive social interactions including listening, good advice, love and affection, sufficient contact with people they're close with, and emotional support. Study participants' cognitive resilience was measured as the relative effect of total cerebral brain volume on global cognition, using MRI scans and neuropsychological assessments taken as part of the FHS. Lower brain volumes tend to associate with lower cognitive function, and in this study, researchers examined the modifying effect of individual forms of social support on the relationship between cerebral volume and cognitive performance.The cognitive function of individuals with greater availability of one specific form of social support was higher relative to their total cerebral volume. This key form of social support was listener availability and it was highly associated with greater cognitive resilience.
Journal Reference: Joel Salinas et al. (2021). Association of social support with brain volume and cognition. JAMA Network Open, DOI: 10.1001/jamanetworkopen.2021.21122
Lonely adolescents are susceptible to internet addiction
Loneliness is a risk factor associated with adolescents being drawn into compulsive internet use. The risk of compulsive use has grown in the coronavirus pandemic: loneliness has become increasingly prevalent among adolescents, who spend longer and longer periods of time online.
A study investigating detrimental internet use by adolescents involved a total of 1,750 Finnish subjects, who were studied at three points in time: at 16, 17 and 18 years of age. Adolescents' net use is a two-edged sword: while the consequences of moderate use are positive, the effects of compulsive use can be detrimental. Compulsive use denotes, among other things, gaming addiction or the constant monitoring of likes on social media and comparisons to others.
It was found in the study that the household climate and parenting also matter: the children of distant parents have a higher risk of drifting into detrimental internet use. If parents are not very interested in the lives of their adolescents, the latter may have difficulty drawing the lines for their actions.In the study participants, compulsive internet use had a link to depression. Depression predicted problematic internet use, while problematic use further increased depressive symptoms.Additionally, problematic use was predictive of poorer academic success, which may be associated with the fact that internet use consumes a great deal of time and can disrupt adolescents' sleep rhythm and recovery, consequently eating up the time available for academic effort and performance.
Journal Reference: IstvánTóth-Király, Alexandre J.S. Morin, Lauri Hietajärvi, Katariina Salmela Aro (2021). Longitudinal trajectories, social and individual antecedents, and outcomes of problematic internet use among late adolescents. Child Development, DOI: 10.1111/cdev.13525
Usage of the word ‘disability’ essential to support disability culture
In the study published in Rehabilitation Psychology, Pilarski and colleagues challenge a trend toward removal of the term disability in the hope of improving disability cultural competency.
Researchers are now encouraging the use of the term ‘disability’ in order to recognise disability as a valued aspect of diversity and identity. Pilarski said that while the term disability is widely used and universally accepted, often there are other terms substituted, such as ‘differently-abled’, ‘special needs’, and ‘physically challenged’. “People use these terms because they see them as accentuating the strengths of people with disabilities. But despite the good intention, these terms are euphemisms that deny recognition of disability as a valued aspect of diversity and identity,” she said.
“The study was a natural discussion among female psychologists with disabilities who recognise the importance of supporting disability culture both personally and professionally,” she added.
In the study, Pilarski and her co-authors analysed the history of disability language, attitudes around disability language and disability as an identity, to demonstrate why the term ‘disability’ is an important part of disability culture. While Pilarski noted that avoiding the term disability has the unintended consequence of reinforcing ideas that disability is negative, the authors also explained the harmful effects of focusing on individuals with disabilities as inspirational.
“We want readers to understand that there is such a thing as ‘inspiration porn’ and this serves to objectify individuals with disabilities for inspiration. We also discuss balancing using person-first and identity-first language to help support the recognition that disability is an aspect of identity,” Pilarski said.
“Failure to recognise disability as an aspect of diversity, similar to other marginalised groups, has unintended consequences of reducing supports available for individuals with disabilities and their formation of positive disability identity. Psychologists and other providers or mentors should honour others’ language preference while opening up a dialogue about the underlying attitudes and beliefs that shape their preferred selection of terminology,” said Pilarski. She added, “We hope that future research can centre on disabled voices in order to support solidarity in the disability community, pride in disability identity and activism for social justice with reclaiming equal access and rights in legislation and policies.”
Courtesy : Asian News International
Researchers Discover 102 Genes Associated With Autism
According to the World Health Organisation (WHO), one in 160 children has an autism spectrum disorder (ASD).
In the largest genetic sequencing study of autism spectrum disorder (ASD) to date, researchers have identified 102 genes associated with risk for autism. The discovery shows significant progress towards teasing apart the genes associated with autism from those associated with intellectual disability and developmental delay, conditions which often overlap.
According to the World Health Organisation (WHO), one in 160 children has an autism spectrum disorder (ASD). ASDs begin in childhood and tend to persist into adolescence and adulthood. In most cases the conditions are apparent during the first five years of life.
"This is a landmark study, both for its size and for the large international collaborative effort it required. "With these identified genes we can begin to understand what brain changes underlie ASD and begin to consider novel treatment approaches," said Joseph D Buxbaum, Director of the Seaver Autism Center for Research and Treatment at Icahn School of Medicine at Mount Sinai.
For the study published in the journal Cell, an international team of researchers from more than 50 sites collected and analyzed more than 35,000 participant samples, including nearly 12,000 with ASD, the largest autism sequencing cohort to date. Using an enhanced analytic framework to integrate both rare, inherited genetic mutations and those occurring spontaneously when the egg or sperm are formed, researchers identified the 102 genes associated with ASD risk. Of those genes, 49 were also associated with other developmental delays.
The larger sample size of this study enabled the research team to increase the number of genes associated with ASD from 65 in 2015 to 102 today. In addition to identifying subsets of the 102 ASD-associated genes, the researchers showed that ASD genes impact brain development or function and that both types of disruptions can result in autism.
"Through our genetic analyses, we discovered that it's not just one major class of cells implicated in autism, but rather that many disruptions in brain development and in neuronal function can lead to autism," said Buxbaum.
It's critically important that families of children with and without autism participate in genetic studies because genetic discoveries are the primary means to understanding the molecular, cellular, and systems-level underpinnings of autism. "We now have specific, powerful tools that help us understand those underpinnings, and new drugs will be developed based on our newfound understanding of the molecular bases of autism," the researchers noted.
Courtesy : IANS
A shorter IQ test for children with special needs
Researchers reduce IQ exam length while maintaining accuracy
For decades, neuropsychologists have used the Wechsler Intelligence Scale for Children test as the gold-standard intelligence quotient (IQ) test to determine the intellectual abilities of children with special needs. However, this comprehensive test can take up to 2 hours to complete, and many children with special needs have a difficult time participating in such long tests.
To solve this problem, researchers at the University of Missouri's Thompson Center for Autism and Neurodevelopmental Disorders identified measures in the test that appeared to be repetitive and succeeded in shortening the test by up to 20 minutes while still maintaining its accuracy in determining a child's IQ.
"As neuropsychologists, we spend a considerable amount of time -- usually a full day or a full afternoon at least -- with patients to really get to know them, and that can be a lot for a child with a neurological disorder like autism or attention deficit hyperactivity disorder (ADHD)," said John Lace, a doctoral student who is completing an internship in clinical neuropsychology in the MU School of Health Professions. "If we can efficiently maximize the information we get from our patients during this test without overburdening them, we can save time and money for both clinicians and patients, which reduces the overall health care burden on families with neurodevelopmental disabilities."
Neuropsychologists use the Wechsler Intelligence Scale for Children test to not only assist in diagnosing individuals with neurodevelopmental disorders, but also to help inform decisions about treatment and educational plans.
"Our overall goal is to help people understand any cognitive or learning differences they may have, which can lead to treatment options such as behavioral therapy or interventions at school," said Lace. "As neuropsychologists, our profession is at the crux of addressing these challenges both academically and practically to help clinicians streamline what they do and positively impact patient care."
Courtesy :University of Missouri-Columbia
43% of children with disabilities plan to drop studies due to problems faced in online education: survey
The survey was conducted by Swabhiman, a community-based organization working for the rights of persons with disability, in Odisha, Jharkhand, Madhya Pradesh, Tripura, Chennai, Sikkim, Nagaland, Haryana and Jammu and Kashmir in the month of May.
About 43 per cent of children with disabilities are planning to drop out of studies due to difficulties faced by them in online education, according to a survey conducted with 3,627 respondents. The survey was conducted by Swabhiman, a community-based organization working for the rights of persons with disability, in Odisha, Jharkhand, Madhya Pradesh, Tripura, Chennai, Sikkim, Nagaland, Haryana and Jammu and Kashmir in the month of May, 2020.
A total of 3,627 people, including students, parents and teachers, participated in the survey. According to the survey, 56.5 per cent of children with disabilities were struggling yet attending classes irregularly, while 77 per cent of students said they would not be able to cope and would fall behind in learning due to their inability to access distance learning methods.
The survey found that 56.48 per cent students are continuing their study, while the rest 43.52 per cent are planning to drop out. Thirty-nine per cent visually impaired students were unable to understand lessons with many students talking simultaneously, it said. About 44 per cent children with disabilities complained that no sign language interpreters were present in the webinars, the survey said. The parents of 86 per cent children with disabilities (CwD) said they did not know how to use technology and around 81 per cent of teachers said they did not have accessible educational material with them.
"The teachers also reported that 64 per cent of students (CwD) did not have smartphones or computers at home. As many as 67 per cent of students (CwD) said they needed tabs or computers or comparable devices for online education," the survey said. Seventy-four per cent of children with disabilities said they needed data/Wi-fi support for educational purposes while 61 per cent expressed a need for scribes, escorts, readers and attendants, it said.
A report based on the survey made detailed recommendations to policy changes and revisions required "in the new normal" in times of the COVID-19 pandemic. "Creating curricula which are suitable for different forms of disability is a non-negotiable and the starting point for any education for the children with disability," the report said.
"Policy changes are required to ensure that children are supported by suitable curricula in alternate formats suitable for them, and have the hardware and data to make online learning feasible. At the same time, an investment in special educators and parents to adapt to the changed environment is necessary so that they can support children with disabilities better," it said.
The report also recommended that education budgets should be suitably amended. "At the same time, there is a need to explore alternative mediums such as community radio and television for education. Since children with disabilities relied on mid-day meals for their nutritional well-being, it is important that they continue to get this support," it said.
Swabhiman founder and chief executive Sruti Mohapatra said all children with disabilities cannot be clubbed as one group as they are persons with different disabilities and therefore different needs. "The current pandemic has the potential of leaving students with disabilities behind. If adequate measures are not taken urgently, they are likely to suffer irrecoverable losses in their quest for education and a life of dignity," she said. "Alternate course material must cater to different disabilities. Our recommendations include empowering students, teachers and parents so that they can play their roles more effectively," Mohapatra added.
The lockdown induced by COVID-19 in March prompted schools and colleges to move to the virtual world for teaching and learning activities. But weak internet penetration has turned e-education into a distant dream for many children. As per official statistics, there are over 35 crore students in the country.
Courtesy : PTI
Unmarried disabled sons of ECHS beneficiaries eligible for Medicare facilities even after 25 years age
The defence ministry on 8th July,2020 decided that unmarried permanently disabled and financially dependent sons of Ex-servicemen Contributory Health Scheme (ECHS) beneficiaries will be entitled to medical benefits even after they have attained 25 years of age. Till now they were not eligible for availing medical facilities under the scheme. The decision is as per the Central Government Health Scheme (CGHS) Rules which are followed by the ECHS. It has now been decided by the Ministry of Defence (MoD), Department of Ex-Servicemen Welfare (DESW), to similarly treat unmarried permanently disabled and financially dependent sons of ECHS beneficiaries who have become disabled after attaining the age of 25 years as dependant. They will now be eligible for availing benefits under the ECHS, subject to fulfilment of conditions laid down in the health ministry office dated May 5, 2018.
Courtesy : The Economic Times
Sports Authority Of India To Appoint Differently-Abled Coaches For Hearing And Speech Impaired Athletes
The Sports Authority of India (SAI) may soon appoint differently-abled coaches to work with hearing and speech impaired athletes after Sports Minister Kiren Rijiju "agreed in principle" to the recommendation of All India Sports Council for Deaf (AISCFD). In a virtual meeting with the Sports Minister, which was also attended by 16 other National Sports Federations (NSFs), the AISCFD on Thursday highlighted the need for differently-abled coaches for its athletes for clear communication. "The All India Sports Council for Deaf highlighted the communication problems of their athletes with able-bodied coaches and requested the Minister to consider employing differently-abled coaches for hearing and speech impaired athletes," an NSF official told. "The Minister applauded the suggestion and agreed in principle. He asked the Sports Authority of India officials to look into the matter on an urgent basis."
Courtesy : PTI
LEPROSY makes a comeback in India
Between April and Dec 2018, 362 cases of leprosy were detected in Mumbai. In the last 5 years, the city recorded nearly 2500 new cases, and total 10,000 cases since its elimination in 2005.
Nearly 14 years after leprosy was eliminated from India, lakhs of persons continue to be infected with the bacterial infection, known to affect the skin and peripheral nerves and in advanced stages cause deformity and disfigurement. In 2017-18, an estimated 1.26 lakh people were detected with leprosy in India,home to 60% of the world's new cases. Almost 50% of the new cases are multibacillary, and nearly 40% afflicted are women. At least 12,000 (8-9%) of the infected are children. Bihar, UP and Maharashtra account for more than a third of the country's new detections. These states record anything between 12,000 to 16,000 cases annually. They are followed by states like West Bengal, Odisha and Chhattisgarh. prosy with deformity indicates we are missing early diagnosis, and infection in children...both are bad news if we are looking at eradication
Caused by mycobacterium leprae
100% curable. Bacilli has incubation period of 3-6 years
Infected people don't feel pain as no toxins are produced
Disease affects nerves
If not treated early, can lead to deformities
Leprosy is transmitted by...
Healthy person breathes droplets containing bacteria
Prolonged, close contact with someone with untreated leprosy
95% people are naturally immune
Leprosy does not spread
By shaking hands or hugging
Sitting next to an infected person on a bus or train
Sitting together for a meal
Leprosy can be prevented by
Early diagnosis, treatment of infected people
Preventive doses available for households with infected people
Annual examinations recommended for at least five years
Leprosy cases worldwide in 2017
Southeast Asia - 153,487
Americas - 29,101
Africa - 20,416
Western Pacific - 4,084
Eastern Mediterranean - 3,550
Migration is one of the biggest challenges in leprosy...It makes it difficult to trace the index case as well as follow-up with patients. "Migration is one of the biggest challenges in leprosy, like in any health programme. It makes it difficult to trace the index case as well as follow-up with patients," said Dr Raju Jotkar, assistant director, Maharashtra's state health services. Around 25 of the 362 cases found in the year 2017-18 in Mumbai were from Bainganwadi alone. “Till leprosy is wiped out from places like Baiganwadi, Mumbai can never eradicate the disease as the infection will continue to travel,” said Swapnadip Jadhav, programme coordinator at LSS. He says the slums have hundreds of people moving in every day. “Even if you screen the entire population today, there will be new residents tomorrow. It's a vicious cycle.”In several instances, leprosy has also been found to infect multiple members from a single household, a phenomenon normally associated with more virulent communicable diseases such as tuberculosis or chicken pox.
Leprosy on rise, Bihar may see all-time high of 50,000 new cases in 2018. Health dept says aggressive campaign led to more cases; experts blame poor living conditions.
Under Leprosy Case Detection Campaign (LCDC) of the National Leprosy Eradication Programme (NLEP), funded jointly by the Centre and the state government, all people from Scheduled Caste (SC) communities across Bihar's 38 districts approximately 2 crore people were surveyed for leprosy detection between January 9 and 13 in 2018. Although the survey result will be published only in the first week of February, sampling of collections and initial reports indicate nearly 50,000 new leprosy cases, according to Dr Bijoy Kumar Pandey, additional director (headquarters), health services, and state programme officer for leprosy.If that projection turns out to be true, it will be an all-time high detection of new leprosy cases in the state.
Poor living conditions lead to leprosy cases in SC households
More leprosy cases are emerging among people from SC communities in districts bordering Jharkhand and West Bengal due to their poor living conditions, according to officials. In 2017-18, 15 out of Bihar's 38 districts showed a prevalence rate of more than 1 per 10,000. Banka, for instance, reported prevalence rate of 3.40 - 1,457 new cases, including 779 women, were detected in the district. Of these, 248 infected people are from SC and 79 from ST communities. The main cause of concern, according to experts, was detection of 488 multibacillary MB) cases, which can cause deformity. Fifty-four cases Grade II deformity were found. Supaul district reported a prevalence rate of 3.07, followed by Jamui (2.64).
“It is a projected figure based on initial findings of the survey. We decided to conduct the survey after our first pilot project of 12,500 SC people in Samastipur, Motihari and Munger (districts) early this year yielded 125 new cases,” said Dr Pandey, who plans to survey the entire population of the state in the next financial year.
Leprosy cases in Bihar had a prevalence rate of 0.79 (cases per 10,000 people) in 2015-16 with detection of 16,185 new cases. In 2016-17, that prevalence rate went up to 1.10 with 21,818 cases, and to 1.18 (21,353 new cases) in 2017-18.
People on the ground - accredited social health activist (ASHA) workers, volunteers and specialist doctors - attribute this rise to a variety of factors: unhygienic living condition, too many people living in one room and sharing the bed, and a more active search and increased level of awareness, among others. Sandhya Devi, an ASHA worker in Naubatpur town, about 25 km from state capital Patna, where several new cases were detected in the recent round of survey, said, “If any patch or mark on the body is not congenital and does not hurt and give sensation after being pinched or pricked, it could be signs of leprosy.”
The percentage of children among the cases detected across the state was 14.20 in 2015- 16, 13.70 in 2016-17, and 12.56 in 2017-18, it was informed. Dr R K Singh, who has attended to several leprosy patients in Hajipur district, said, “One obvious reason leprosy cases are going up in Bihar is the lack of single-dose rifampicin (SDR) programme for people living in close contact of an affected patient. Lack of sanitation and general awareness of hygiene are the other reasons.”
An official associated with NLEP said lack of infrastructure is also a hurdle in the way of monitoring cases. “In some districts, such as Gopalganj, there is no NLEP staff. One non- medical staff has to look after several primary health centres (PHCs),” the official said. “Posts of leprosy consultant and physiotherapist remain vacant. Very few vacancies out of the sanctioned 434 paramedical workers have been filled. We have to depend on ASHA workers and other volunteers. We get technical assistance from four NGOs: NLR India, The Leprosy Mission, DFIT and Lepra Society.
Dr Pandey, the state programme officer (SPO) for leprosy, however, said it should not be called a rise in the number of cases. The increased numbers, he said, is due to the “active search undertaken by our sustained campaign, especially after launch of LCDC in 2015-16. We take entire Bihar as endemic.”Asked why cases are going up despite a sustained NLEP, Dr Pandey said, “Maybe 20 per cent population was not covered under the previous survey. The people not covered could have been from SC communities.”
In the case of leprosy, though, what is worrying is that it is seeing transmission into newer areas. And that's not the only scary part. In the fresh detections, 63% were multibacillary cases, meaning the person had more than five patches, indicative of the disease's advanced stage. Another sign of missed or late detection is deformities -- 11% of the cases had some deformity at the time of diagnosis. Worryingly, 12% of the freshly infected were children. A microanalysis shows the city is detecting cases from every nook and corner.
10% of Indian patients develop pure neural leprosy, where there are no external signs such as skin patches or nodules. Dr Pai says such manifestation is typical to India. For instance, UP native Sheikh Mohammed (33), who works at a meat shop in Chembur, was perplexed when he couldn't grip things with his right hand. “The mug would slip out of my hand while bathing. I struggled to tear chapati or button my shirt. Gradually, I realised my right hand couldn't feel heat, burns or cold,” he said. The shop owner removed him from the job of cutting meat fearing that Sheikh may hurt himself and not feel a thing. It was only after he developed clawed fingers that a doctor suspected leprosy. Pai added that to detect such presentations swiftly there has to be a paradigm shift in training doctors, nurses, community workers, who may not look beyond the obvious external signs.
Leprosy Has Been Curable Since 1980, Don't Treat Leprosy Survivors As Disabled Persons : SC
The Supreme Court in July,2018 recommended that the Union of India, as well as the states, take steps to repeal such provisions of legislations that represent leprosy as being non- curable and contagious. Hearing two PILs praying for statutes which attach a stigma with leprosy, ultimately resulting in a disability, to be declared as being violative of Articles 14, 19(1)(b) and 21, a bench of Chief Justice Dipak Misra, Justice AM Khanwilkar and Justice DY Chandrachud issued a slew of directions.
That the Union of India in the Department of Health and other departments concerned carry out awareness campaigns so as to sensitize the public about its curability and non-contagiousness; That a separate wing be created to expand the sphere of awareness and authorities concerned may be nominated for the said duties;
That specific programmes be aired on All India Radio and Doordarshan at the Central and state level and the regional channels so as to educate the public that leprosy is non-communicable;
That the programme be displayed at an appropriate time so that the majority of people may watch That hospitals shall not refuse treatment and to administer the first injection under the Multi-Drug Therapy. It has to be remembered that a person has a right to health and to obtain treatment at government hospitals; That there must be a holistic approach to awareness and the campaigns shall extend from the urban areas to the Panchayat level;
That the state government shall take steps for the rehabilitation of persons who are suffering or have suffered from leprosy, it shall be the primary duty of the state to see that these people do not suffer from any kind of stigma.
The Apex court bench proceeded to appreciate the order dated November 28, 2014, in Pankaj Sinha v UOI- “...this is a cause which can be taken on a priority basis by the States, for what has been agitated before us is that the leprosy, as on today, is curable. Yet, because of apathy shown by the concerned authorities, it still remains a stigmatic disease in the society. It is inconceivable as it affects the human dignity and the basic concept of humanness.” “There is no doubt that a person suffering from leprosy also has a right to live with dignity...after he has been cured totally, there is no need to treat him as disabled person...it has to be understood in today's context and the sufferer of a curable disease may not be treated in a stigmatic manner...no person can be denuded of humanness and cannot be treated as an 'unperson'...there has to be a social awakening...sympathy from the concerned authorities and then the members of the society must acknowledge and accept that they deserve to be treated with equality...,” observed the bench. Chief Justice Misra remarked, “Leprosy has been curable since 1980...the laws should be declared unconstitutional by now......”
Leprosy & Divorce
A bill seeking to remove leprosy as a ground for divorce was passed by Lok Sabha on Jan 7, 2019. It sought to remove leprosy as a ground for divorce in 5 personal laws - Hindu Marriage Act, Dissolution of Muslim Marriages Act, Divorce Act (for Christians), Special Marriage Act and Hindu Adoptions and Maintenance Act - since the disease is curable.
Poor care for lower back pain -scans, painkillers &mismanagement leads to disability,low productivity nd poor quality of life
Iron-deficiency anaemia, migraine and other musculo-skeletal conditions (that include everything other than osteoarthritis and rheumatoid arthritis) are the top three causes of disability in India, according to the Lancet series author and now, low back pain has become the fourth highest cause of disability. World wide Low back pain affects 540 million people and is the leading cause of disability and too many patients receive the wrong care. Evidence suggests that low back pain should be managed in primary care, with the first line of treatment being education and advice to keep active and at work. The Lancet series highlights “However, in reality, a high proportion of patients worldwide are treated in emergency departments, encouraged to rest and stop work, are commonly referred for scans or surgery or prescribed painkillers including opioids, which are discouraged for treating low back pain,” .
The series also reviewed evidence from high- and low-income countries that suggests that many of the mistakes of high-income countries are already well established in low-income and middle-income countries. Low back pain results in 2.6 million emergency visits in the US each year, with high rates of opioid prescription. In India, studies suggest that bed rest is frequently recommended, and a study in South Africa found that 90% of patients received pain medicine as their only form of treatment, the series has highlighted. “India was no different from the rest of the world. Indian clinicians manage back pain just as poorly as the rest of the world. For instance a 2008 survey of all 186 registered physiotherapists in Maharashtra showed that 46% advised patients with low back pain to rest. 63% of Indians believe that bed rest is the mainstay of therapy. This is a misconception as bed rest delays recovery,”.
Imaging for low back pain also seems to be highly prevalent in several low-income and middle-income countries, including India. A study in 2008-10 showed that among 251 patients with chronic low back pain reviewed in an Indian orthopaedic clinic, all underwent imaging, with 76% diagnosed with non-specific low back pain and 10% with spondylosis. “Most people do not need imaging. It can be harmful including radiation, anxiety as well as risks increased use of unnecessary tests and treatments which might also be harmful,”. In terms of burden of low back and neck pain in India — it accounts for almost 7% of years lived with disability. This is the extent to which the condition is mistreated, often against best practice treatment guidelines.
The Global Burden of Disease study (2017) found that low back pain is the leading cause of disability in almost all high-income countries as well as in many regions. Globally, years lived with disability caused by low back pain increased by 54% between 1990 and 2015, mainly because of population increase and ageing, with the biggest increase seen in low-income and middle-income countries. Dr Arvind Chopra, director of the Centre for Rheumatic Diseases, Pune, and senior research professor at SRM Medical College, Chennai, said that in the WHO community programme for control of rheumatic diseases, an India survey of 56,546 persons from 11 sites found the prevalence of back pain at 7%, and 13% among those aged over 65. “This would mean that millions of Indians suffer from back pain which leads to disability, low productivity and poor quality of life,” he said.
Landmark Pune study on diabetes begins testing the third generation
Thin Indian babies ‘fatter’ than European babies and are at greater risk of diabetes: A study carried out by Chittaranjan Yajnik, head of the Diabetes Research Centre at KEM Hospital and followed up for long 25 years in three generations.
This landmark research led by Dr. Yajnik’s team to embark upon the Pune Maternal Nutrition Study launched in Twenty five years ago in the year 1993 and being last followed up in December, 2017 has helped in explaining why diabetes was so widely prevalent in India, even among malnourished populations, when, globally, the disease was very commonly associated with obesity. “We showed that the ‘small and thin’ Indian babies were ‘fatter’ than the Europid babies and the risk of future diabetes was present at birth itself. Evidence also showed that the role of maternal micronutrient nutrition for the baby’s growth was crucial,” Yajnik told. Twenty five years later, it has led to pioneering ideas in the field of fetal programming.
The first stage of the study that began in 1993 included 814 women from six villages in Pune district. Between 1994 and 1996, a total of 770 of these women delivered babies. The weight and size of these babies were monitored every six months. Their insulin resistance was observed at the age of six, 12 and 18 years. These children were followed up by social workers who ensured that they did not drop out of the study. The observations showed that children born to mothers with high homocysteine and low vitamin B12 levels had lower birth-weight and higher insulin resistance.
By 2012, the research team had been following up on 577 children born to the mothers of the 1993 cohort. They started providing them Vitamin B12 supplements in order to reduce the future diabetes risk in their own offspring. Till December 2017, 107 of this group of 577 had given birth to children, forming the third generation of subjects under observation. The newly born babies will now be studied for various metabolic parameters as the researchers have stored the babies’ cord blood, placenta and other samples at the unique bio-bank. The researchers are waiting for this third-generation sample size to grow up to 200 before doing data analysis.
The Yajnik’s Centre has been successful in monitoring three generations so far, retained the study participants, got consent from the in-laws after the girls got married to continue in the study and now their babies will be assessed. Dietary patterns are being analysed and other physical changes are being documented. Counselling is provided for each participant and after a total of 200 deliveries the data will be further analysed. There has been more than 90 per cent follow-up rates which documented the nutritional and socioeconomic transition in the society. The unique bio-bank has samples stored for measurements of DNA, RNA, metabolites, hormones, and so on. This will be a unique legacy for future investigators.
Yajnik’s centre now collaborates with researchers Indian Institute of Science Education and Research (IISER) in Pune, Centre for Cellular and Molecular Biology (CCMB) in Hyderabad and Indian Institute of Science (IISc) in Bangalore.
These findings can have important implications in controlling diabetes and heart disease epidemic in the country.
In India, six per cent have diabetes, 20-25 per cent hypertension
A study led by researchers at Harvard TH Chan School of Public Health has found hypertension more prevalent among young adults in India than previously thought, and rates of diabetes and hypertension among middle-aged and elderly people high across all geographical areas and socio demographic groups. Described by the authors as the first nationally representative study of these conditions, it was published online in JAMA Internal Medicine. It looked at health data, which included plasma glucose and blood pressure measurements, from 1.32 million adults in 27 states (except Gujarat and J&K) and five UTs between 2012 and 2014.
Standardised for age, diabetes prevalence in India was 6.1% among women and 6.5% among men; for hypertension, it was 20% among women and 24.5% among men. For comparison, the paper cites corresponding estimates for prevalence in the US — for diabetes, 6.4% among women and 8.1% among men; for hypertension, 10.8% among women and 15.5% among men. The prevalence of both conditions among middle-aged adults in the poorest households in rural areas, too, was high (5.9% had diabetes and 30% had hypertension), contrary to the perception that these are conditions affecting the city wealthy.
Diabetes was most prevalent in Andhra Pradesh, Goa, Karnataka, Kerala, Tamil Nadu, Delhi and West Bengal. The hypertension prevalence tended to be highest in Punjab, Himachal Pradesh, Kerala, Sikkim and Nagaland. The prevalence of diabetes varied from 2.33% among women in Madhya Pradesh to 17.90% among men in Goa. Hypertension was higher among adults under 45 but common even among younger groups — for example, at 12.1% in age group 18-25.
Understanding how diabetes and hypertension prevalence varies within a country as large as India is essential for targeting of prevention, screening, and treatment services. This study is the latest reaffirmation of India’s dual burden of rising non communicable diseases and continuing communicable diseases. India has a window of opportunity to invest in its health system to effectively tackle hypertension and diabetes — both major killers. The potential for harnessing new technologies to reverse the course of these epidemics is real. However, because the epidemics are worsening rapidly, now is the time for immediate action. The diagnosis of hypertension and diabetes is straightforward, but mostly gets untapped due lack of awareness and regular medical checkups. There is urgent need to focus on these two silent killers as well as other non communicable diseases to reduce the burden of preventable premature morbidity and mortality. If unchecked, we will see a lot more victims of these two diseases in next two decades.
India ranks 145th among 195 countries in healthcare, disparity among states
India ranks a lowly 145th among 195 countries in terms of healthcare access and quality in 2016, as assessed in a Global Burden of Disease study published in The Lancet. The study used an index based on 32 causes of death that should be preventable with effective medical care. Each country was given a healthcare access and quality (HAQ) score between 0-100. India’s HAQ score is 41.2, up from 24.7 in 1990. For the first time, the study also analysed healthcare access and quality between regions of seven countries including India. China and India had the widest disparities of 43.5 and 30.8 points, respectively, while Japan had the narrowest of 4.8 points. In India, the 30.8-point difference marks an increase in disparity from 23.4 points in 1990. Goa and Kerala had the highest scores in 2016, both over 60, whereas Assam and Uttar Pradesh had the lowest, both below 40.
While India has seen improvements since 1990, its HAQ score was lower than 50 for 23 of the 32 causes of death. Particularly low were scores like 12 for skin cancer, 24 for neonatal deaths and adverse medical treatment, and 30 for tuberculosis and chronic kidney ailments which is really disappointing – well behind BRICS countries. India’s low score in TB is because it is often missed by practitioners, and MDR-TB is diagnosed very late. In the public system, patients are lost along the entire care cascade, and this means only 1 in 2 TB patients make it to the finish line. With MDR-TB, only 1 in 5 patients cross the finish line and successfully complete therapy. All this makes for a poor HAQ score. The bottom line, simply focusing on coverage of TB services is not enough. We need to also improve quality of TB care, in both private and public sectors.
The reason for India’s poor show is also due to low density of health workers in the poorly performing states. For instance, the Janani Suraksha Yojana has registered a rise in the number of institutional deliveries, however there is no demonstrable correlation with lowering of maternal mortality in certain states. This scorecard clearly shows that the health system is weak and while centrally funded schemes have provided health access in some areas, quality has not improved in certain states.
Why 77% of the elderly in Delhi don't report abuse
A survey on the abuse faced by the elderly in the capital highlighted that most victims do not report the matter to authorities concerned because of the taboo associated with the issue, often citing it as a “confidential family matter”. While at least 33% of 218 respondents in Delhi — which was among the top five cities with highest incidents of elderly abuse —have experienced some form of abuse. Only 0.5% of them said they had availed benefits available to them under Maintenance and Welfare of Parents and Senior Citizens Act that makes it legally binding for children and heirs to provide maintenance to senior citizens.
The most striking feature of the report was that the respondents had been facing abuse for the last six years but 77% of the participants did not report it, thinking of it as a “confidential family matter”. Other reasons included lack of awareness of the process of reporting the abuse, fear of “retaliation” or “lack of confidence” in themselves or agencies dealing with abuse, including police helplines and MWPSC tribunals. The study states that while verbal abuse (58%), disrespect (48%), neglect (34%), economic exploitation (11%) and even physical violence (10%) remained the top factors contributing to abuse, social media and technology have widened the generation gap between senior citizens and their children, leading to further alienation. The primary perpetrators of the abuse were sons (62%), followed by daughter-in-law (44%), spouse or partner (11%) and grandchildren (7%).
Delhi: AIIMS explores link between yoga and mental health
Since there is huge potential for yoga in preventive medicine, 20 different research projects at AIIMS are currently focusing on a yoga-based lifestyle, ranging from its effects on patients with migraine to those with chronic bronchitis to rehabilitation for those who have suffered a stroke.
One such recent study is a result of a five-year research project conducted by the lab for molecular reproduction and genetics at the department of anatomy. Published in Restorative Neurology and Neuroscience in March 2018, the study found that meditation and a yoga-based lifestyle could result in a “decrease in depression severity” and improvement in “systemic biomarkers of neuroplasticity”, and, hence, could be “considered a therapeutic intervention” in the management of depression.
The study, which looked at 236 subjects, saw that the introduction of yoga into lifestyle resulted in a decrease in cortisol, the body’s main stress hormone; increased levels of melatonin, a hormone that regulates sleep and wakefulness; and balanced oxidative stress, a reflection of the body’s ability to detoxify. It also increased serotonin levels — a chemical that nerves produce, a deficiency of which can result in depression —and decreased DNA damage.
“While depression is a global pandemic, not everyone responds to drugs and there are a lot of side-effects. Our research found that after just 12 weeks, there was a reduction in symptoms of depression. This was a randomised controlled trial, where we had two groups — one that took the medicines, and the other which practiced yoga alongside it,” said Dr Rima Dada, author of the study.
Dr Gautam Sharma, professor in charge at the Centre for Integrated Medical Research at AIIMS, said they were conducting 27 clinical trials. “Of the 27, 16 are ongoing trials. For instance, we have a trial looking at the benefits of stress reduction in nurses who are in ICUs… The results from the trials have been encouraging,” said Dr Sharma.
300 Community Health Centres in UP’s 75 districts to get a psychologist each
The Centre has sanctioned 300 posts for appointment of psychologists in community health centres (CHCs) of Uttar Pradesh to tackle growing cases of mental illness. People living in the rural areas of the state at present have no access to psychologists as only district hospitals have such a facility besides three government mental hospitals in Bareilly, Agra and Varanasi. According to National Mental Health Survey report of 2015-16, families had to spend nearly Rs 1,000-1,500 a month mainly for treatment and travel to access care. The hidden and intangible costs are difficult to monetize and add to this burden, said the report.. It will be now easier to reach out to patients suffering from mental illnesses at the grassroots level and help them.
A community psychologist appointed for CHC will get a monthly honorarium of Rs 25,000 and he or she should hold a postgraduate degree in clinical psychology or psychology. Those with a masters degree in plain psychology will be first given training before they join any CHC. Community psychologists at CHCs will help in creating awareness and conducting basic diagnosis of mental disorders, including depression, mania, mood disorder, obsessive compulsive disorder and schizophrenia. They can prescribe treatment for mild depression, anxiety and provide counselling for drug and alcohol abuses, tobacco control and marital discord. Even psychiatrists will visit CHCs and psychologists can also refer patients to district hospitals.
Under National Mental Health Programme, UP has set up mental health cells in 45 districts. Each cell has psychiatrists, a clinical psychologist, a social worker and other staff. District mental health cell’s out-patient department (OPD) is functional for three days in a week (Monday, Wednesday and Friday) while the staff visits CHCs on Tuesday and Thursday on a rotational basis. On Saturdays, the staff visits schools to create awareness about mental illness among children. The Centre has now sanctioned mental health cells in remaining 30 districts of the state.
The country’s mental healthcare suffers from an acute shortage of staff. Minister of state for health and family welfare Anupriya Patel had recently informed Lok Sabha that there are only 898 psychologists against 20,250 required in the country and less than 900 psychiatric social workers against the 37,000 needed. Also, as of January 2015, there were 3,827 psychiatrists against the 13,500 required in the country. According to the 2011 Census, more than 7.22 lakh people across the country were suffering from “mental illness”, while over 15 lakh were “mentally retarded”. With 76,603 people suffering from some sort of mental illness, Uttar Pradesh has the highest number in the country followed by West Bengal at 71,515, Kerala at 66,915 & Maharashtra at 58,753.
New evidence for viruses’ role in Alzheimer’s disease
Herpes virus genes found in patients’ brains provide unprecedented evidence for a connection, but the viruses’ exact role remains unclear.
Results of a recent study breathe new life into an old hypothesis: that viruses, herpes viruses in particular, could play a role in Alzheimer's disease. Researchers analysed DNA and RNA sequencing data from brain tissue donated by 622 people who had Alzheimer’s disease and 322 people who didn’t. They found that specific herpes viruses were more abundant in the brains of patients who had Alzheimer’s when they died. For two of the viruses, HHV-6A and HHV-7, the association with Alzheimer’s was particularly strong, even when compared to tissue samples of people with other neurodegenerative diseases. The idea that viruses could somehow be involved in Alzheimer’s isn’t new. Previous studies have examined HSV-1, the virus that causes cold sores, but this evidence was less compelling. “Earlier studies focused on the presence of anti-HSV-1 antibodies, which meant that those with antibodies had encountered HSV-1 at some time during their lives. This new study showed HHV-6 and HHV-7 viral genes in the brains of Alzheimer’s disease patients at the time they died,” explains Sam Gandy, an Alzheimer’s disease specialist at the Ichan School of Medicine at Mount Sinai and one of the study’s senior authors.
The researchers also modelled how the viruses’ genes interacted with human genes. “We were surprised to find that expression of a half dozen recognizable Alzheimer's genes was apparently modulated by HHV6/7,” said Gandy, “We tend to think of viral causes and genetic causes separately, but it is possible that viral proteins are acting as transcription factors that turn on Alzheimer’s disease genes.” The study does not suggest that Alzheimer’s disease is contagious. HHV-6A and HHV-7 are extremely common viruses. Nearly everyone above the age of six has at least one of them circulating in their blood. In most cases, the viruses are latent. "There are still a lot of unanswered questions around how we go from being able to detect it circulating in someone's blood to knowing whether it's active in a state that might be relevant to Alzheimer's disease," said Readhead, one of the lead author of the study. "While these findings do potentially open the door for new treatment options to explore in a disease where we've had hundreds of failed trials, they don't change anything that we know about the risk and susceptibility of Alzheimer's disease or our ability to treat it today," said Gandy.
Others in the Alzheimer’s research community are also cautious in their assessments of the study’s significance. David Reynolds, who was not involved in the study, is Chief Scientific Officer at Alzheimer’s Research UK. He points out that the part of the study involving actual human brain tissue does not provide any evidence for cause and effect. Still, Renyolds says the study is an important step forward: “This detailed analysis of human brain tissue takes this research further [than previous studies], indicating a relationship between the viruses and the activity of genes involved in Alzheimer’s, as well as brain changes, molecular signals, and symptoms associated with the disease. This was a well-conducted study, and the authors’ findings were supported by evidence drawn from three independent sources of donated brain tissue.”
More research will be needed to determine why people with Alzheimer’s have more of these herpes viruses in their brains, and what role (if any) they play in the onset and progression of the disease. If scientists can solve these puzzles, they may uncover new ways to treat Alzheimer’s with antiviral medicines. Based on previous studies looking at HSV-1, clinical trials with the antiviral medicine Valtrex are already underway.
Beyond highlighting HHV-6A and HHV-7 as viruses of interest, the new study also demonstrates a promising path to progress in Alzheimer’s research. The researchers drew not only on samples and data from multiple brain banks, but also from cohort studies and raw genetic data. Richard Hodes, Director of the National Institute on Aging, which funded the study, said: “This research highlights the importance of sharing data freely and widely with the research community."
Is Autism Linked To Food Allergies?
Could there be a link between autism and food allergies? A new study from the University of Iowa suggests one, but researchers are still trying to discover how and why.
The study, published in June 2018, found that children with autism are more than twice as likely to experience a food allergy than children who do not have ASD. Researchers analyzed the health information of nearly 200,000 children between the ages of 3 and 17 collected by the U.S. National Health Interview Survey, an annual Centre for Disease Control and Prevention survey of American households. The data covered 1997 to 2016.
The study found that 11.25 percent of children reportedly diagnosed with ASD have a food allergy, compared with the 4.25 percent of children who are not diagnosed with ASD and have a food allergy. The findings, researchers said, add to a growing body of research that already suggests immunological problems as a possible risk factor for developing autism. Because the study is observational, though, researchers couldn’t identify a cause-and-effect relationship between food allergies and autism, said Wei Bao, an author of the study and assistant professor of epidemiology at the university. “We don’t know which comes first, food allergy or ASD,” Bao indicated. Previous studies about a possible link between autism and allergies focused mainly on respiratory and skin allergies, and yielded inconclusive results, Bao said.
The Iowa study found 18.73 percent of children with ASD also had respiratory allergies, compared with 12.08 percent of children without ASD who had them. It also found that 16.81 percent of children with ASD had skin allergies, compared with 9.84 percent of children without ASD. That suggested to researchers some type of mechanical link between the two. But more study will be needed to understand how allergies and autism, both on the rise, could be connected, paediatric allergist Scott H. Sicherer at the Icahn School of Medicine at Mount Sinai in New York, told the American Journal of Managed Care. “I wouldn’t want people to misinterpret this to say that a food allergy is causing autism,” nor should children with ASD be routinely screened for food allergies, Sicherer told the Journal.
One issue: Parents of children with autism might report their children have a food allergy, but it’s not always possible to know whether it’s really an allergy or simply a behavioural preference, Sicherer said. Still, Thomas Frazier, chief science officer for the advocacy group Autism Speaks, told Health Day News that parents and physicians need to be aware “of the increased prevalence and ensure that individuals receive appropriate evaluation for allergies with subsequent treatment. “This is particularly true for very young children and nonverbal or minimally verbal children who may not be able to express to parents or providers the effects of allergies.” The findings suggest allergies could be a contributing factor to challenging behaviours, such as irritability and mood shifts, in people with autism.
The study, “Association of Food Allergy and Other Allergic Conditions with Autism Spectrum Disorder in Children,” was published in JAMA Network Open.
Bill proposes affordable treatment to Autism-affected
The Autism Spectrum Disorders (Recognition and Treatment) Bill, 2017 proposes that treatment of ASD including counselling, therapeutic sessions and rehabilitative care shall be provided free of cost at public health centres.
Autism Spectrum Disorders refer to an umbrella group of developmental disorders, resulting from a delay in the maturation of the central nervous system. The Bill is aimed at recognising the rights of individuals suffering from autism spectrum disorders and making its treatment accessible and affordable.. At the same time, state governments shall recruit more mental health care professionals in public hospitals to maintain the doctor-patient ratio. i.e. at least a doctor for every 40 patients suffering from ASD, it says. The proposed legislation also says that the central government shall provide funds for medical research, which will ascertain the causes of ASD & other developmental disorders. In majority of the cases, ASDs manifest themselves in children below 1 year. "The government can mitigate the incidence of ASDs through many measures such as encouraging screening of pregnant women and ensuring that they get their vaccination and maintain their haemoglobin levels,".
AIIMS, RML doctors delve into effects of yoga on migraine and schizophrenia
Studies done by AIIMS and RML indicate that the ancient Indian discipline can improve cognitive functions in a person suffering from mental disorder and can be an add-on therapy to reduce migraine attacks. Yoga can improve cognitive functions in a person suffering from mental disorder and can be an add-on therapy to reduce migraine attacks, two separate studies by top hospitals in the city indicate. Research at RML Hospital suggests that mentally ill persons could benefit from simple yoga exercises if these are incorporated into their treatment regimens. This cognitive improvement may help them in their rehabilitation and adjustment in society.
The study has now been published in the Journal of Acta Neuropsychiatric, was sponsored by National Institute of Health (NIH), United States. Researchers across the world have been trying to determine the effectiveness of the ancient Indian discipline as a complementary intervention for conditions such as cancer, schizophrenia, asthma, and heart disease. Dr Triptish Bhatia, principal investigator of Indo-US projects at the Department of Psychiatry, RML Hospital, told MAILTODAY, "This was a random study on 286 patients with schizophrenia admitted at RML. It was done to evaluate whether yoga training or any type of physical training enhance cognitive functions in schizophrenia." Patients above 18 years who attended RML psychiatry clinics from 2010 to 2014 were included. "The results confirmed greater improvement in the speed index of 'attention cognitive domain' after yoga therapy in individuals with schizophrenia than physical exercise at six months followup," said Dr Bhatia.
YOGA CAN BE CONSIDERED COGNITIVE ENHANCEMENT THERAPY
Dr Smita Deshpande, head, psychiatry department, RML Hospital, added impaired cognition is a hallmark of schizophrenia. "Current pharmacologic treatments produce improvement in psychotic symptoms, but do not improve cognitive impairments substantially. As yoga includes mindfulness training and physical exercise, it can also be considered cognitive enhancement therapy (CET)."
While yoga therapy improved "attention domain" among patients with schizophrenia, it showed good improvement in cognitive domain such as abstraction and mental flexibility, face memory, spatial memory, spatial ability, working memory, sensorimotor, emotions among such patients. These cognitive functions were assessed with the University of Pennsylvania's computerised neurocognitive battery (CNB). Patients were on mediation and also practising yoga every day. Firstly, cognitive parameters were evaluated on 21 days and they showed improvement. With the same figures accessed on CNB, doctors evaluated their cognitive domain at the third month, which again showed much improvement, and at the end of sixth month, there was greater improvement in yoga following patients. Dr Randeep Guleria from AIIMS said yoga was found to be as effective as standard pulmonary rehabilitation in improving dyspnoea, inflammatory markers and chronic obstructive pulmonary disease. "We are studying 160 patients with migraine who are following yoga practice along with medicine. Right now, what we can hypothesise is that yoga can be an add-on therapy to reduce migraine attacks as the relaxation techniques are believed to have a positive impact on certain chemicals in the body and brain," Dr Rohit Bhatia, neurologist at AIIMS, told MAIL TODAY.
Over 300 Million People Suffer From Depression Globally: WHO
Depression is characterised by persistent sadness and a loss of interest in everyday activities and work. Depression is now the leading cause of ill health and disability worldwide with more than 300 million people suffering from it, the World Health Organization (WHO) said ahead of World Health Day.
Rates of depression have risen by more than 18 per cent since 2005, but a lack of support for the mental health combined with a common fear of stigma means many don't get the treatment they need to live healthy, productive lives. "These new figures are a wake-up call for all countries to re-think their approaches to mental health and to treat it with the urgency it deserves," WHO Director-General Margaret Chan said. The report further indicated that the declining mental health has been a major cause of suicides, especially in the low and middle-income countries. The figures were far from being a relief even closer home, it stated that more than five crore Indians suffered from depression in 2015, and over three crore dealt with anxiety disorders. Latest estimates from WHO show that by 2030, depression will be the leading cause of disability worldwide, drawing attention to the fact that immediate measures must be taken by all countries to address depression and prevent it. The WHO is running a mental health campaign to tackle stigma and misconceptions. "For someone living with depression, talking to a person they trust is often the first step towards treatment and recovery," said Shekhar Saxena, director of the WHO's mental health department.
Depression is a mental disorder where the person suffers from prolonged period of sadness, which disrupts not just their mood but daily activities as well. Patients find it even difficult to wake up and get out of bed in the morning. You can also notice visible changes in the person's behaviour, feelings and sense of well-being. We all feel low sometimes, but this negative state of being can trigger suicidal tendencies and various health problems like diabetes and heart disease, which are themselves among the world's biggest killers . As we go about with our day, we often fail to realise that some of our silly habits can be putting us at risk of depression. After all, our lifestyle choices play a big role for our overall health, and sedentary lifestyle or unhealthy habits can lead to the onset of various ailments in the long run.
The WHO expressed concern that in many countries there is little or no support for people with mental health disorders, and said only around half of people with depression get treatment in wealthier nations. On an average just three per cent of government health budget is spent on mental health, varying from less than one per cent in poor countries to five percent in affluent ones, according to the WHO. "A better understanding of depression and how it can be treated ... is just the beginning," said Mr Saxena. "What needs to follow is sustained scale-up of mental health services accessible to everyone, even the most remote populations."
Here are some habits we need to We Need to Cut Down Today
1. Binge Eating
When the hunger pangs kick in, some of us just lose control and go on a binge eating spree, savouring pizzas with extra cheese, king-size burgers and fries, sugar loaded beverages, etc. Binge eating doesn't just add extra kilos around your belly, but may put you at depression risk, says a study. Binge eating episodes lead to obesity which, in turn, causes depression owing to weight stigma, poor self-esteem and reduced mobility.
2. Taking Stress
The hectic lives we lead today, stress is almost inevitable. But is comes with severe health consequences. Serotonin is a chemical compound in the body, which is popularly referred to as the happiness hormone. It plays a significant role in a person's mental and psychological well-being. Due to stress, the level of serotonin secretion could reduce, contributing to the development of depression.
3. Internet Addiction
According to a study done by McMaster University in Canada, excessive use of internet may significantly increase the risk of mental health problems such as depression and anxiety, especially among college-going students. The findings showed that individuals with internet addiction had more trouble dealing with their day-to-day activities, including life at home, at work/school and in social settings.
4. Daytime Sleepiness
We have all been found guilty of being drowsy in the middle of the day, despite a good night's sleep. While you may think it has much to do with your body's need for a caffeine boost, in reality it could also indicate obesity and depression. A common symptom of depression is improper sleep. Physiological sleep disturbances, including taking longer to fall asleep and waking up in the middle of the night, explains daytime drowsiness in people undergoing depression.
5. Fatty Foods
Let's admit it. We love fried and fatty foods knowing very well that they are harmful for health. The thought of biting into samosas, French fries, greasy burgers, and cheesy pizzas make our mouth water instantly, but let's not give into temptation. In a study done by researchers at the Louisiana State University, they found that a high-fat diet can alter behaviour and produce signs of brain inflammation. Further, it may also increase the risk for depression and other psychiatric disorders.
6. Lack of Exercise
The importance of physical activities for our well-being is not a new thing. A few minutes of walking, jogging or dancing and other activities can charge you up instantly, releasing those happy hormones. The more tied up we get with our work, giving into stress and letting go of exercise, we put ourselves at risk of various health issues, including mental diseases.
Differently-abled category kids shine
As many as 3,335 students from the differently-abled category passed their CBSE Class X exam this year, bringing the pass percentage to 95.18%.The category included visually impaired, hearing impaired, orthopaedic impaired, spastic, dyslexic and autistic students, among others. The number of orthopaedically impaired students was bigger compared to others with different disabilities.
Unnat Dave, who has cerebral palsy, did not let anything come in his way of success. The bright student of Rajhans Vidyalaya in Andheri scored 93.1%. "I never faced any problem while preparing for my board exams. I used to go for my physiotherapy sessions everyday. So after school hours, I wasn't left with much time to study. I tried to make full use of the time I got to study and my tuition teacher was also very dedicated. My school also cooperated and supported me throughout the year. I am planning to go for the engineering stream."
Nimilika Puppala, a differently-abled student from Rajhans Vidyalaya, has secured 8.8 CGPA in her CBSE examination. Her parents and teachers were very happy with her performance. Puppala has autism, which makes it difficult for her to have social interactions. She never took any tuition classes. "I like writing poems and stories in Marathi and English. Language is not an issue for me, though many people have this misconception about my disorder. I aspire to become a writer. My grandmother has always supported me and she helped me score this much."
Visually Impaired Girl Cracks UPSC in First Attempt. Will Become IAS Officer.
She could not see with her eyes but that did not stop her from visualizing a dream and working hard to make it come true. Pranjal Patil, a 26-year-old visually-impaired Ulhasnagar resident, cleared the Union Public Service Commission (UPSC) exams in 2016, getting an All-India ranking of 773.
Pranjal was just 6 years old when a student in her class hit one of her eyes with a pencil. After this, Pranjal lost vision in this eye. Doctors warned her parents that she might soon lose vision in the other eye too. And unfortunately, the warning proved to be right just after a year. But her parents never let her blindness come in the way of her education. They sent Pranjal to Smt. Kamla Mehta School for the Blind in Dadar, Mumbai. After passing Class 10 with flying colours, Pranjal also secured 85% in Class 12 and stood first in the Arts section of Chandibai College. After this, she took admission in St. Xaviers College, Mumbai to do B.A. After finishing her graduation, Pranjal did her MA from JNU, Delhi. Pranjal started preparing for UPSC in 2015, along with pursuing her degree in MPhil. Technology played a big role here. She installed software called Job Access with Speech (JAWS), a computer screen reader program that allows blind and visually impaired users to read the screen either with a text-to-speech output or with a Refreshable Braille display.She used to get the books, get them scanned and then use JAWS to listen to them. She couldn’t use those hand-written notes which saves time as JAWS only reads printed documents. Her next challenge was to find a writer who could match her speed. And Vidushi was the perfect answer. The main exam paper is three hours long. People who have to write it with the help of a writer get four hours to finish. She had perfect tuning with Vidushi. Although Pranjal does not know as yet where she will be posted, this brave lady is full of determination and wants to be an inspiring officer. She believes every single individual is important for the betterment of the nation. “Success doesn’t give inspiration; the struggle behind success gives you the inspiration. But success is important because only then people will be interested to know your struggle. The attitude and the approach to do something matters and each individual can become a building block for a beautiful society,” she concludes. We wish a great future for this brave girl.