Depressed, Anxious, or Stressed? Know the difference

APRIL 5, 2017 

Each year, the 7th of April is celebrated as the World Health Day to mark the anniversary of the founding of the World Health Organization (WHO). The theme for 2017 World Health Day is ‘Depression: Let’s talk’. Everyone experiences depression, stress, or anxiety at some point or the other.

According to a report by the National Institute of Mental Health and Neurosicences (NIMHANS), Bengaluru nearly 150 million Indians have mental disorders! Due to the stigma attached to mental disorders, about 80 per cent of those with mental disorders start treatment pretty late. A part of this stigma can be reduced by creating better awareness among the public.

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Duplicate publication and the need to strengthen editorial policy of the journal

Duplicate publication and the need to strengthen editorial policy of the journal

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India’s Upper House, the Rajya Sabha, passes the much-awaited Mental Healthcare Bill, 2013

In 2013, the Mental Healthcare Bill had been introduced in the Parliament in an attempt to replace the Mental Health Act, 1987. In August, 2016, after making 134 amendments to it, the Rajya Sabha finally passed the Bill to ensure protection and promotion of the rights of people with mental ailments during healthcare delivery in the community and in institutions.

The Union Health Minister, JP Nadda, called it a ‘patient-centric’ Bill that ensures the treatment and recovery of people with mental illness without interfering with their rights and dignity. Under the new Bill, every person has the right to access mental healthcare and treatment at healthcare facilities that are run or funded by the government. Everyone has the right to be treated equally with dignity and to be protected from inhuman treatment. Patients now have access to their medical records and free legal services, etc.

The Bill focuses on community based treatment with special provisions made for children and women. Electroconvulsive therapy (ECT) has been banned on children; if, for medical reasons, it has to be administered to adults, ECT must be given with muscle relaxant and anesthesia.

The Bill allows adults to make an advance directive and choose how they wish to be treated if they have mental illness in future. They can also nominate a representative who will take care of them during their mental illness.

An attempt to commit suicide will no longer be considered as a criminal offence under Section 309 of the Indian Penal Code. Any person attempting to commit suicide will be presumed to be under stress and to be suffering from a mental disease when committing suicide, unless it is proved otherwise.

In a country where 6 to 7 per cent of the population suffer from some kind of mental illness, this Bill is welcome as a ‘humane and reformative’ move by the government.

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Fat tax: should the government interfere with what you eat?

Fat tax

Recently, Kerala government declared a ‘fat tax’ of 14.5 percent on junk food items served through branded food chains like KFC, McDonald’s, Burger King, Pizza Hut.  The world’s first fat-tax was introduced by Denmark in October 2011. Subsequently, after 15 months, the tax imposition was abolished in the country. Other countries like Hungary and Mexico also have government taxes on eatables high in sugar, salt and fat. However, the evidences gathered from other countries with such tax imposition show that there is very little advantage of food taxation to deal with obesity.

Why the fat tax?

A study involving over 192 countries reports an increase of 45 to 48% in the obese population globally. Obesity has become one of the major challenges for healthcare industry. Common factors attributing to obesity include diet, physical inactivity, social issues, and genetics. Obesity not only increases the morbidity and mortality rates, it is a major economic burden for the nation. The country incurs a significant expense on the health care system to manage it.  Obesity leads to lost production due to improper care, early death, and hampered professionalism due to one’s inability to work.

Kerala has maximum number of obese population in India after the state of Punjab. With the increasing impact of western culture, lifestyle diseases are rising among Indians. Government is thus quite desperately looking for policies that may help to reduce the prevalence of obesity. The main objective of the government for imposing such taxes is to check consumption of foods that predispose to national burden of obese population.

Can fat tax really decline obesity prevalence?

Considering the factors contributing to obesity prevalence, it can be concluded that if there is fluctuation in any of these factors, the impact of tax imposition may become unpredictable or insignificant. Consumers may choose to reduce their consumption of fruits and vegetables or other nutritional food to have this high taxed food item nullifying the main purpose of the tax. Certain people might look for substitute to these food items and opt for local products which may have similar or even higher calories than those served in branded restaurants. Overall, there may be a decline in purchase of such food items but it is very doubtful if it will be an effective measure in the long run.

What measure should the government really take to combat obesity?

There can be other ways by which the government can curb the increase in the obese population.  These may include measures such as encouraging healthy lifestyles and adoption of healthy diets, consumer information on the packed food items, narrowing the marketing of such food and providing subsidy on healthy food.

Hence, it can be concluded that the impact of taxation to reduce obesity is quite uncertain and so far evidences gathered from such policies adopted in other countries have not proved any remarkable achievement. This can put forth multiple dilemmas for consumers in their personal choices and induce further complexities.

References:

  1. Smed S, Scarborough P, Rayner M, Jensen JD. The effects of the Danish saturated fat tax on food and nutrient intake and modelled health outcomes: an econometric and comparative risk assessment evaluation. Eur J Clin Nutr. 2016 Jun;70(6):681–6.
  2. Maniadakis N, Kapaki V, Damianidi L, Kourlaba G. A systematic review of the effectiveness of taxes on nonalcoholic beverages and high-in-fat foods as a means to prevent obesity trends. Clinicoecon Outcomes Res. 2013;5:519–43.
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What makes India the diabetes capital of the world?

7th of April is commemorated as the World Health Day. The theme this year is “Beat Diabetes”. Currently, every fifth diabetic in the world is an Indian! By 2030, over 100 million Indians are expected to have diabetes. 

Did you know Indians are four times more susceptible to diabetes than their European counterparts? Let’s find out what makes Indians so prone to the sugar disease.

We Indians may be more susceptible because of our genetic makeup, diet and lifestyle factors.diabetes

Our genes

There is limited knowledge about the genetics of diabetes. However, our genetic makeup is such that we Indians have a low threshold for diabetes. While Americans develop diabetes when their body mass index (BMI) is 30-35 kg/m2, Indians tend to develop diabetes when they have a BMI of only 25 kg/m2.

Indians tend to have less muscle and more abdominal fat. This increases their insulin resistance. This prevents insulin from helping the cells of the body to take up glucose from the blood and change it to energy.

Even with what is considered as a healthy BMI, Indians tend to have more fat around their organs and in the belly area than westerners with the same BMI. You can be at a high risk for diabetes even if you are not overweight. An “apple-shaped body” with more fat around your waist can put you at higher risk for diabetes even if you have a normal BMI.

Our diet

Like most Asians, we Indians include a lot of white rice and other refined grains in their diet. These are linked to an increased risk of diabetes. Trans fats and saturated fats such as palm oil are often used to cook Indian dishes. A high fat diet increases the risk of diabetes.

If a pregnant mother gets poor nutrition (and this is not very uncommon in India), the child is likely to develop diabetes when he or she grows up, especially if there is rapid transition to a diet rich in refined carbohydrates, sugar and fats.

Our lifestyle

Modernization has led to a more sedentary lifestyle. We walk less, cycle less, and exercise less. Many Indians smoke or chew tobacco regularly. Nearly, 40% of Indian men smoke. Use of tobacco is associated with higher abdominal fat and about 45% increased risk for developing diabetes.

Air pollution, an ever increasing problem in the country, also puts Indians at higher risk of insulin resistance and diabetes.

Our geographical area

A recent study published in 2015 says even among the Asian Indian community, the prevalence of prediabetes and diabetes varies depending on where they live. Asian Indian living in the United States have a 20% higher prevalence of prediabetes while those living in India have 50% higher prevalence of diabetes. Though diabetes is less prevalent among Indians living in US than those living in India, the prevalence rate is considerably higher than in the general American population.

Taking this into account, the American Diabetes Association recommends that Asian Americans should be screened for type 2 diabetes if they have a BMI of 23 kg/m2 or more instead of the usual 25 kg/m2 that is the starting point for diabetes screening.

Source:

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Health benefits of honey

Remember your grandma’s ginger and honey recipe for that irritating cough? Remember how it had a smoothing effect on your throat?

Honey is a very nutritious food product which helps to keep good health. It has antibacterial, anti-inflammatory and antioxidant properties which make it a wonderful medicinal product.

What are the benefits of honey?

1. Helps combat allergies:

Honey is used to treat many forms of allergies. Are you worried about your child’s sore throat and cough that seems to wake him up from his sleep? Try giving him a spoonful of honey!Honey

A single dose of honey taken before bedtime can relieve cough in children as well as in adults. In fact, the World Health Organization and the American Academy of Pediatrics also recommend the use of honey as a natural cough remedy.

Honey also works against dandruff, dermatitis, psoriasis, hemorrhoids, and anal fissure.

2. Relieves acid reflux:

A report published in the British Medical Journal says that honey may help prevent symptoms of gastroesophageal reflux (GERD), commonly called heartburn.  As it is 125.9 times more viscous than distilled water at room temperature, honey forms a coating on the food pipe and prevents symptoms of acid reflux.

3. Shortens the duration of bacterial diarrhea in infants:

Try adding honey in the oral rehydration solution for infants and children with gastroenteritis or infantile diarrhea. Researchers have found that honey shortens the duration of bacterial diarrheal. It may not have any effect on the duration of viral diarrhea but can be safely used as a substitute for glucose in oral rehydration solution containing electrolytes.

4. Promotes wound healing:

Almost all type of wounds seem to respond well to honey therapy. Honey has a cleansing effect on wounds. Honey can be used to heal burns, bed sores, minor abrasions, and even surgical wounds.

5. Helps in reducing weight:

Use of honey can substantially help in reducing weight. It is also found to lower cholesterol levels as well.

6. Works as an anticancer product:

It’s no wonder that this valuable liquid has anticancer properties as well. Honey is being considered as a complementary treatment modality for blood cancer, breast cancer and cervical cancer.

7. Relieves pain due to radiation therapy in cancer patients:

Honey significantly reduces the pain caused by radiation therapy in head and neck cancer patients.  The radiation therapy leads to the swelling and a painful condition of the mouth known as mucositis and stomatitis. Application of honey on the mouth of such patients helps reduce the pain, keeping them away from heavy doses of pain killers.

8. Helps in maintaining healthy and youthful skin:

Regular application of honey on skin keeps the skin hydrated, reduces wrinkles and maintains the skin pH.  No wonder why honey is widely used in cosmetic products.

How to add honey to your diet

  • Use honey as a bread spread.
  • Use honey to sweeten your dessert.
  • Stir honey into your cup of coffee or tea.
  • Drizzle honey on pancakes, parathas etc.
  • Instead of sugar, mix honey to your yogurt, cereal, or cornflakes.
  • Try delicious recipes like honey-glazed potatoes, grilled fruits with honey.

Do you have some innovative ideas of how you could add honey to your diet? Share your ideas with us.

Sources:

1. F. R. Khan; Z. Ul. Abadin; N. Rauf. Honey: Nutritional and Medicinal Value. Int J Clin Pract. 2007;61(10):1705-1707. Available at: http://www.medscape.com/viewarticle/565913_5

2. Ran D. Goldman, MD FRCPC. Honey for treatment of cough in children. Can Fam Physicianv.60 (12); 2014 Dec. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4264806/

3. Burlando B1, Cornara L. Honey in dermatology and skin care: a review. J Cosmet Dermatol. 2013 Dec; 12(4):306-13. Available at: http://www.ncbi.nlm.nih.gov/pubmed/24305429

4. Math MV, Balasubramanium P. Oesophagus: Heart Burn and Honey. BMJ 2001;323:736. Available at: http://www.bmj.com/rapid-response/2011/10/28/oesophagus-heartburn-and-honey

5. Hafejee IE and Moosa A. Honey in the treatment of infantile gastroenteritis. Br Med J (Clin Res Ed). 1985 Jun 22; 290(6485): 1866–1867. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1416773/

6. Jull AB, Rodgers A, Walker N. Honey as a topical treatment for wounds. Rev Lat Am Enfermagem. 2015 Feb-Apr; 23(2): 259–266. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4458999/

7. Whitfield P1, Parry-Strong A, Walsh E, Weatherall M, Krebs JD. The effect of a cinnamon-, chromium- and magnesium-formulated honey on glycaemic control, weight loss and lipid parameters in type 2 diabetes: an open-label cross-over randomised controlled trial. Eur J Nutr. 2015 May 19.Available at: http://www.ncbi.nlm.nih.gov/pubmed/25986159

8. Nik Man NM, Hassan R, Ang CY, Abdullah AD, Mohd Radzi MA, Sulaiman SA. Antileukemic Effect of Tualang Honey on Acute and Chronic Leukemia Cell Lines. Biomed Res Int. 2015; 2015:307094. Available at: http://www.hindawi.com/journals/bmri/2015/307094/

9. Saurabh Samdariya, Shirley Lewis, Heena Kauser,Iqbal Ahmed, and Dewesh Kumar. A Randomized Controlled Trial Evaluating the Role of Honey in Reducing Pain Due to Radiation Induced Mucositis in Head and Neck Cancer Patients. Journal ListIndian J Palliat Carev.21(3); Sep-Dec 2015. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4617032/

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Bentonite or Calendula: Which is better for treating infantile diaper dermatitis?

A recent study published in the Indian Journal of Medical Research shows that in comparison to calendula, bentonite has better healing powers and is more effective in treating infantile diaper dermatitis. [1]

Infantile diaper dermatitis (DD) is an acute inflammatory reaction produced in the skin around the diaper as a result of frequent or prolonged contact with urine, stool or moisture. It may be exacerbated by Candida infection and abrasion. Physical appearance may be in the form of erythema, flakes, papules, or lesions in areas like buttocks, thighs, scrotum and mons pubis.

Bentonite is a mineral form of aluminum phyllosailicate. Formal or mineral soap are the other names of Bentonite in pharmacy. It is used as a moisturizer, skin protector and water absorbent. Earlier studies show that Calendula may be effective in non-complicated cases. [2]

A study was undertaken in Iran to compare the effect of topical application of bentonite and calendula creams in treating infantile diaper dermatitis. It was a double blind randomized control trial in which 100 infants with DD were selected randomly amongst the patients referred to the outpatient pediatric clinics of Imam Khomeini hospital and a healthcare center in Khomein city, Iran. They were divided into two groups of 50 each for test and control studies.

Equal quantities of the two ointments were taken and the contents were validated by 10 faculty members in Kashan and Arak Universities of Medical Sciences.

The affected area was observed on the first visit. Training was given to the mothers about how to apply the cream and then after treatment the affected area was observed again after three days.

The mean age of infants treated with Bentonite was 7.35±6.28 months and for those treated with Calendula was 6.45±5.53 months. In the first six hours overall 88% of diaper rashes in the infants treated with Bentonite started showing improvement while the rate of improvement in infants treated with Calendula was 54%. Infants treated with Bentonite were cured completely in the first three days as compared to 52 per cent of infants treated with Calendula. The mean times of recovery in Bentonite group were 44.14±23.95 and in Calendula group it was 86.34±24.13 hours.

The estimated result showed that Bentonite had faster healing effect than Calendula and improved infantile diaper dermatitis more effectively. Though neither of the groups showed any side effects, the results may not be completely reliable as the study sample was small and the study was conducted on the infants having mild to moderate DD. Further multicenter studies are needed to verify these interpretations on a larger sample.

Sources:

1. Mansoreh Mahmoudi, Mohsen Adib-Hajbaghery, Mahdi Mashaiekhi. Comparing the effects of Bentonite & Calendula on the improvement of infantile diaper dermatitis: A randomized controlled trial. Indian Journal of Medical Research; 2015; 142:742-746.

2. Panahi Y, Sharif MR, Sharif A, Beiraghdar F, Zahiri Z, Amirchoopani G, et al. A randomized comparative trial on the therapeutic efficacy of topical Aloe vera and Calendula officinalis on diaper dermatitis in children. Scientific World Journal 2012; 2012 : 810234.

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