January is cervical cancer awareness month: let that be your excuse to get screened, vaccinate your girl

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January is cervical cancer awareness month: let that be your excuse to get screened, vaccinate your girl

Last year Union Budget talked of “encouraging” HPV vaccination but rollout limited to some states

Every year an estimated 77000 Indian women die of cervical cancer – the second most common form of cancer among females in the country. Yet less than 2% Indian women have ever been screened for the disease, show official data. 

Cervical cancer is also that one rare form of cancer that can be prevented by a vaccine. But India’s record in that too remains patchy with the conversation about inclusion of the Human Papilloma Virus (HPV) vaccine in the Universal Immunisation Programme (UIP) stuttering at various stages since 2017 when the National Technical Advisory Group on Immunisation first recommended that India should start using the vaccine in young girls. Last year the Union Budget had announced a policy to “encourage” HPV vaccinations but a planned initiative is limited only to some states like Delhi, Punjab and Sikkim.  

As the world observes January 2025 as cervical cancer awareness month, public health agencies the world over are calling upon women to come and get screened. Australia meanwhile has announced that it is well on course to become the first country in the world to eliminate cervical cancer, thanks largely to a robust vaccination programme.

Last year a study in The Lancet Regional Health estimated that the five year age standardised survival rate in Indian women detected with cervical cancer stood at about 51%. While the figure had significant regional variations, how early the disease had been detected was one of the predictors of survival. Population based cancer registries in Tripura, Pasighat and Kamrup urban – all in northeast India – saw worse survival figures. Ahmedabad (urban), Thiruvananthapuram and Kollam had comparatively better survival rates.

When Serum Institute of India launched its HPV vaccine Cervavac in 2023, there were high expectations of a countrywide HPV vaccine rollout as it brought down the costs to almost half of what vaccines made by foreign companies charge. However that has not happened though top industry sources say SII is currently sitting on a stockpile of 5 million HPV vaccines. In preparation for a national rollout, the Federation of Gynaecological and Obstetric Societies of India (FOGSI) along with UNICEF brought out last year a guidebook for master trainers for HPV vaccination. The World Health Organisation recommends a90-70-90 approach to cervical cancer elimination – 90% girls to be fully vaccinated within 15 years, 70% women to be screened using a high performance test by the time they are and treatment for 90% women with pre-cancer/cancer.

A quarter of Indian women do not have adequate access to sanitary pads; numbers higher in villages

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A quarter of Indian women do not have adequate access to sanitary pads; numbers higher in villages

Family of a class XI girl in Uttar Pradesh’s Bareilly district has alleged that she was punished in school for asking for a sanitary napkin

The shocking incident in Bareilly where a class XI girl was allegedly punished for asking for a sanitary napkin and forced to go home with blood on her clothes has laid bare the continued barriers to women’s access to hygienic period products in India.

The girl, according to the complaint, had gone to school on January 25 to sit for an examination when her periods started. She had asked for a sanitary napkin but that allegedly upset the principal so much that she was made to stand outside the classroom. The family has complained to the District Magistrate, the District Inspector of Schools (DIOS), the State Women’s Commission, and the Department of Women’s Welfare. The incident comes despite a directive issued last year by the ministry of education that mandated that schools must make sanitary napkins available for girls at all times, including during class X and class XII examinations. “Menstrual hygiene management is a significant aspect of a girl’s overall well-being and should not come in the way of her academic performance,” schools had been told.

A study published last year in Nature had found that 76.15% of Indian women aged between 15-24 years used hygienic period products only. In rural India the number was found to be 72.32%. This means that nearly 24% Indian women and over 27% rural Indian women use other unhygienic options like cloth sometimes or all the time when they are menstruating. Menstruating women are more vulnerable to infections of the respiratory tract and use of unhygienic products may increase their chances of contracting an infection.

“…the persistent stigma surrounding menstruation continues to pose significant challenges for women, adversely impacting their health and educational outcomes. Government schemes exist, but there are still gaps in menstrual hygiene that need greater and more nuanced attention. Neglecting proper hygiene practices during menstruation can lead to various health problems such as cervical cancer, reproductive tract infections, Hepatitis B infection, yeast infections, and urinary tract infections. In more severe cases, toxic shock syndrome can even lead to death. Moreover, the lack of access to clean toilets and sanitary products in schools contributes to school dropout rates among girls, particularly in rural areas,” researchers had reported.

Menstruation remains a period shrouded in stigma in many parts of the country. The practice of isolating menstruating women continues in many parts of the country; in some areas they are required to sleep in a separate structure outside their homes during these days when they are considered “impure”.

 

Weight loss surgery in obese patients with cirrhosis can lower risk of liver complications

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Weight loss surgery in obese patients with cirrhosis can lower risk of liver complications

A Cleveland Clinic study shows that patients with obesity and fatty liver-related problems had lower chances of liver complications post bariatric surgery 

Scientists at Cleveland Clinic have found that obese patients with cirrhosis have lower risk of liver complications if they have undergone weight loss surgery. They reported their findings in the  Nature Medicine journal. 

Lead investigator Ali Aminian, M.D., director of Cleveland Clinic’s Bariatric & Metabolic Institute said that the results opened up avenues for bariatric surgery to become a treatment option in patients with cirrhosis and obesity. “Bariatric surgery was associated with a 72% lower risk of developing serious complications of liver disease and an 80% lower risk of progression to decompensated stage among patients with compensated cirrhosis and obesity,” he said. 

Obesity and diabetes are the leading causes of metabolic dysfunction-associated steatohepatitis (MASH).  Accumulation of fat within liver cells triggers a cascade of events ultimately leading to liver scarring. About 20% of people with MASH can progress to late-stage liver scarring which is called cirrhosis. 

“Patients with MASH-related cirrhosis have extremely limited treatment options. Currently, no therapeutic interventions have demonstrated efficacy in mitigating the risk of severe liver complications within this patient population,” said Sobia Laique, M.D., a transplant hepatologist and the study coinvestigator at Cleveland Clinic. “This underscores a critical unmet need for the development of effective therapies specifically targeting patients with compensated MASH-related cirrhosis.”  

The aim of the SPECCIAL (Surgical Procedures Eliminate Compensated Cirrhosis In Advancing Long-term) study was to examine the long-term outcomes of bariatric surgery on the risk of developing major liver complications in patients with obesity and compensated MASH-related cirrhosis, compared with nonsurgical management.  

A group of 62 Cleveland Clinic’s patients with compensated MASH-related cirrhosis and obesity who had bariatric surgery were compared with a control group of 106 nonsurgical patients and followed for 15 years. Study participants had similar characteristics such as severity of liver disease at their baseline liver biopsy. 

Fifteen years after enrollment, study results show that 20.9% in the surgical group and 46.4% in the nonsurgical group developed one of the major complications of liver disease including liver cancer and death.  

 

What is Guillain-Barré Syndrome that is sweeping through Pune? All you need to know

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What is Guillain-Barré Syndrome that is sweeping through Pune? All you need to know

One person was reported dead from the disease while the Maharashtra government has now announced free treatment for patients

In an unusual phenomenon, over 100 cases of Guillain-Barré Syndrome (GBS) including one death, have now been reported fromMaharashtra, causing concern among residents and the government. The Maharashtra government has now announced that treatment for the disease will be free even as Pune municipal authorities are examining the cause of the outbreak.

The Union Ministry of Health and Family Welfare, meanwhile has deputed a high-level multi-disciplinary team to Pune, Maharashtra for supporting the State health authorities in instituting public health interventions and management in view of the spurt in suspected and confirmed cases of GBS.

The Central team to Maharashtra comprises of seven experts drawn from National Center for Disease Control (NCDC) Delhi, NIMHANS Bengaluru, Regional Office of Health & Family Welfare and National Institute for Virology (NIV), Pune.

One death in Solapur is suspected to have been caused by GBS but it is yet to be confirmed. Officials have said that the most likely source of the infections may be contaminated water. 

A Medibulletin explainer:

What is Guillain-Barré Syndrome?

GBS is a neurological disorder, typically caused as a reaction to an infection in which the body’s own immune system, in a state of heightened activity, starts attacking the body’s own cells, mostly of the nervous system. The most common infections associated with GBS are GI infections, respiratory infections or a Zika infection. The patient typically starts complaining of a tingling sensation in the limbs but may quickly progress to difficulty in walking and other activities. It can also be caused by vaccination. During the COVID19 pandemic, some vaccines were associated with a higher risk of the recipient developing GBS.

How serious is the disease?

As the immune system’s attack on the nervous system spreads, patients can report varying degrees of muscular weakness or even paralysis. It can take months or even years for the patient to get back to normal though the disease is rarely fatal. In some patients there may be lasting symptoms of the disease such as fatigue and muscle weakness.

What is the treatment for GBS?

There is no specific treatment for GBS except medications to mitigate the symptoms to whatever extent possible. “Several treatment options can ease symptoms and help speed recovery. Most people recover completely from Guillain-Barre syndrome, but some serious illnesses can be fatal. While recovery may take up to several years, most people are able to walk again six months after symptoms first began,” says Mayo Clinic.

How expensive is the care of a GBS patient?

The most commonly used option used for GBS patients are immunoglobulin injections that can cost an estimated Rs 20,000 per shot. Maharashtra deputy chief minister Ajit Pawar has now announced: “The treatment for this issue is very expensive. After discussions with officials from the district administration and municipal corporation, we have decided to provide free treatment to affected citizens. Those from Pimpri-Chinchwad will be treated at YCM Hospital, while patients from Pune Municipal Corporation areas will receive treatment at Kamla Nehru Hospital. For citizens from rural areas, free treatment will be provided at Sassoon Hospital in Pune.”

Two Cases of Human Metapneumovirus (HMPV) in Karnataka, govt says no reason to worry

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Two Cases of Human Metapneumovirus (HMPV) in Karnataka, govt says no reason to worry

No Unusual Surge in ILI or SARI cases in the country, assures ministry of health

Two cases of Human Metapneumovirus (HMPV) have been detected in Karnataka, both of them through routine surveillance for multiple respiratory viral pathogens. This initiative is a part of ICMR’s ongoing efforts to monitor respiratory illnesses across the country.

In a statement, the ministry of health and family welfare emphasized that HMPV is already in circulation globally, including in India, and cases of respiratory illnesses associated with HMPV have been reported in various countries. Reports have now also surfaced about a third case of the respiratory ailment from Ahmedabad.

HMPV infection causes symptoms similar to cold. Most cases are mild but people with existing illnesses or the very young or very old have a risk of being more sick. Over the last few weeks, many cases of HMPV have been reported from China with some suggesting that hospitals and crematoriums there are overwhelmed.

Based on current data from ICMR and the Integrated Disease Surveillance Programme (IDSP) network, there has been no unusual surge in Influenza Like Illness (ILI) or Severe Acute Respiratory Illness (SARI) cases in the country. The two cases in Bangalore are of  a 3-month-old baby girl, who was diagnosed after being admitted to Baptist Hospital with a history of bronchopneumonia and a 8 month old boy who tested positive earlier this month, also in the same hospital. The girl has been discharged. 

Neither of the affected patients have any history of international travel. The Union Health Ministry is monitoring the situation through all available surveillance channels. ICMR, the government said, will continue to track trends in HMPV circulation throughout the year. 

The World Health Organization (WHO) is already providing timely updates regarding the situation in China to further inform ongoing measures. The recent preparedness drill conducted across the country has shown that India is well-equipped to handle any potential increase in respiratory illnesses and public health interventions can be deployed promptly if needed

Artificial Intelligence can be trained to determine location, size of tumours

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Artificial Intelligence can be trained to determine location, size of tumours

Algorithms are already being used to analyse medical imaging data; it can be made more refined 

 

Artificial Intelligence can be trained to analyse images generated by positron emission tomography (PET) and computed tomography (CT) in a way that they can determine the location and size of tumours.

This is the result of AutoPET, an international competition in medical image analysis, where researchers of Karlsruhe Institute of Technology (KIT) were ranked fifth. The seven best autoPET teams report in the journal Nature Machine Intelligence on how algorithms can detect tumor lesions. Imaging options such as PET and CT are widely used for the diagnosis of cancer. To decide the right therapy, precision in identifying the contours and location of a tumour is very important. Cancer patients can have hundreds of lesions.

“Automated evaluation using an algorithm would save an enormous amount of time and improve the results,” explains Professor Rainer Stiefelhagen, Head of the Computer Vision for Human-Computer Interaction Lab at KIT.

AI is already being used for the diagnosis of cancer using imaging techniques but it is still a nascent technology in the field. However this new paper holds out prospects for making it more efficient and targetted to better treatment outcomes. 

As the researchers explain in their publication, an ensemble of the top-rated algorithms proved to be superior to individual algorithms. The ensemble of algorithms is able to detect tumor lesions efficiently and precisely. 

“While the performance of the algorithms in image data evaluation partly depends indeed on the quantity and quality of the data, the algorithm design is another crucial factor, for example with regard to the decisions made in the post-processing of the predicted segmentation,” explains Stiefelhagen. 

 

VIP treatment for VIP constituency; WB launches health programme for Diamond Harbour

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VIP treatment for VIP constituency; WB launches health programme for Diamond Harbour

Sebaashray is a doorstep programme designed to provide professional healthcare services to all residents of Lok Sabha MP Abhishek Banerjee’s constituency

West Bengal government has launched a doorstep health programme for the residents of Diamond Harbour in South 24 Parganas – the constituency of Lok Sabha MP Abhishek Banerjee. Under the programme health camps will be conducted across the constituency and those in need of higher levels of care will be referred to 12 designated hospitals.

Abhishek is the nephew of Trinamool supremo and West Bengal chief minister Mamata Banerjee and is widely perceived as the heir apparent who will eventually take over the reins of the party.

Under the programme health camps will be organised for ten days in each Assembly constituency of the Parliamentary constituency – 280 camps aiming to reach all 23 lakh residents. A total of 1,200 doctors (2 per regular camp, 3 per model camp) supported by 1,500 volunteers, 500 diagnosticians and an adequate number of nurses and healthcare workers will be part of the programme. All camps will have standby ambulances with facilities for six basic diagnostic tests – BMI, blood pressure, blood sugar, hemoglobin, malaria, dengue, and ECG. There will also be additional facilities for Digital X-ray, cardiac monitors, eye clinic, cancer screening (last 3 days), ultrasound (color Doppler), and bone mineral density tests (last day).

The referral hospitals include Bangur Institute of Neuroscience, Calcutta Medical College & Hospital, Chittaranjan National Medical College & Hospital, Diamond Harbour Medical College & Hospital, Garden Reach Super Speciality Hospital and Institute of Neuroscience, Kolkata.

In his announcement about the programme on Thursday, Abhishek Banerjee said that he would support such an initiative in any constituency where the local representative is keen to organise it. “I believe that this initiative will show the way to not just Bengal, but the whole nation. We will be giving free of cost treatment to over 23 lakh people. We have tried our level best to incorporate all possible facilities. One camp covers 6-7 booths so that one camp can address only 6,000-7,000 people,” he said.

 

97% reduction in malaria puts India out of WHO group of high burden countries

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97% reduction in malaria puts India out of WHO group of high burden countries

The latest World Malaria Report 2024, released by the World Health Organization (WHO), celebrates India’s significant progress

Just 83 people died in India of malaria in 2023, signifying the impressive strides that the country has made in its efforts to control incidence of the vector borne disease. The World Malaria Report 2024 shows that India is now out of WHO’s group of high burden countries.

Malaria cases and deaths have dropped by around 80% from 2015-2023, with cases going down from 11,69,261 in 2015 to 2,27,564 in 2023, while deaths falling from 384 to just 83. This dramatic decline reflects the relentless efforts to combat the disease. Simultaneously, intensified surveillance efforts have led to a significant rise in the Annual Blood Examination Rate (ABER), increasing from 9.58 (2015) to 11.62 (2023). This strengthened surveillance has ensured early detection, timely intervention, and more effective treatment.

From 2015 to 2023, numerous states have transitioned from the higher-burden category to the significantly lower or zero-burden category. In 2015, 10 States and Union Territories were classified as high burden (Category2), of these, in 2023 only two states (Mizoram & Tripura) remain in Category 3, whereas 4 states such as Odisha, Chhattisgarh, Jharkhand, and Meghalaya, have reduced the case-load and moved to Category 2. Also, the other 4 States, namely, Andaman & Nicobar Islands, Madhya Pradesh, Arunachal Pradesh, and Dadra and Nagar Haveli have significantly reduced the caseload and moved to Category 1 in 2023. 

In 2015 only 15 states were in Category 1, whereas in 2023, 24 states and UTs (progressed from high/medium-burden categories to Category 1, reporting an API of less than 1 case per 1000 population). As of 2023 Ladakh, Lakshadweep and Puducherry are in Category 0 i.e. zero indigenous Malaria cases. These areas are now eligible for subnational verification of malaria elimination. Additionally, in 2023, 122 districts across various states reported zero malaria cases, which demonstrates the efficacy of targeted interventions.

Indian scientists devise way to bypass blood brain barrier to deliver TB drugs to the brain

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Indian scientists devise way to bypass blood brain barrier to deliver TB drugs to the brain

Scientists at Institute of Nano Science and Technology (INST) used tiny particles made of a natural material called chitosan

Delivering tuberculosis drugs to the brain is a complicated proposition thanks to the presence of the blood brain barrier – a membrane that prevents parts of the brain to come in direct contact with blood. 

In an exciting new development, researchers have created a unique way to deliver Tuberculosis (TB) medicines directly to the brain bypassing the challenging blood-brain barrier (BBB) that limits the effectiveness of many brain TB medicines. This innovative drug delivery method can effectively treat brain TB, a life-threatening condition with high mortality rate.

Scientists at Institute of Nano Science and Technology (INST), Mohali, an autonomous institute of the Department of Science and Technology (DST) used tiny particles made of a natural material called chitosan, to deliver TB medicines directly to the brain through the nose. Tuberculosis (TB) that affects the brain, called Central Nervous System Tuberculosis (CNS-TB), is one of the most dangerous forms of TB, often leading to severe complications or death.

By delivering the drug through the nasal route, the nano-aggregates can transport the drugs directly into the brain, significantly improving drug bioavailability at the infection site.

Besides, chitosan is known for its mucoadhesive properties, and sticks to the nasal mucosa, which helps the nano-aggregates stay in place and prolongs the time they can release the drug, enhancing its therapeutic effectiveness.

The spray-drying process used to form the nano-aggregates also ensures that they are stable, easy to administer intranasally, and can be efficiently absorbed into the brain tissues. 

 

Sports for health: New report builds on lessons from 2022 football World Cup in Qatar

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Sports for health: New report builds on lessons from 2022 football World Cup in Qatar

The report “Changing the Game: Strengthening Health and Well-Being through Sport Events”, is the product of the 3-year Sport for Health partnership

Can mega sporting events with worldwide viewership serve as an avenue to better health? A partnership instituted in 2021 to explore this question and tested out during the FIFA World Cup in Qatar 2022 has come up with a report that emphatically endorses the idea.

The report, titled Changing the Game: Strengthening Health and Well-Being through Sport Events”, is the product of the 3-year Sport for Health partnership established in 2021 by  Qatar and WHO, in collaboration with FIFA and Qatar’s Supreme Committee for Delivery and Legacy, to deliver and ensure the legacy of a healthy and safe FIFA World Cup Qatar 2022.

Dr Hanan Mohamed Al Kuwari, Minister of Public Health for Qatar, said: “The collaboration between Qatar, WHO and FIFA can inspire organisers of major global sporting events to integrate health into the planning and execution of their events. The Sport for Health model reflects a commitment to harness the transformative power of mega-sports events to create lasting improvements in public health and well-being.” said Dr Al Kuwari. The report was unveiled during a Ministerial event titled Strengthening Health and Well-being Through Sport Events, held in Doha during the ongoing 71st WHO Eastern Mediterranean Regional Committee.

Dr Tedros Adhanom Ghebreyesus, WHO Director-General said, “Sport has the unparalleled ability to inspire, unite, and transform lives. By promoting both physical and mental well-being during the FIFA World Cup Qatar 2022, the Sport for Health initiative has shown how sport can lead to healthier lives for everyone, setting a valuable model for future global events.”

The Sport for Health Partnership culminated in the staging of a range of health-related activities during the FIFA World Cup Qatar 2022, dealing with health promotion (tobacco control, healthy diets, mental health, and physical activity), health security, and advocacy and communications.

 

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