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Chris Baker: Bollywood stars should not endorse food of low nutritional quality—but a ban is not the solution

19 Dec, 14 | by BMJ

chris_bakerIn India, the prevalence of overweight and obesity in children aged 5-19 stands at 22%. Tackling this substantial and growing epidemic requires a population level shift away from poor diets and sedentary activity. Such a shift will be more effective if individual lifestyle change is accompanied by upstream modifications that create healthy environments.

Sadly, aspirational advertising is omnipresent in India, and succeeds in creating an appetite for junk food. Household names from Bollywood and the cricket field are frequently employed to attach a sheen of glamour and success to cheap foodstuffs high in fat, sugar, or salt, and low in minerals and vitamins. more…

Shreelata Rao Seshadri: Tracking India’s battle with malnutrition

18 Dec, 14 | by BMJ

For several years now, India has been sharply criticized for being one of the most undernourished nations on earth despite consistently high rates of economic growth. So the First Global Nutrition Report released recently by the International Food Policy and Research Institute (IFPRI) provides a welcome update on the nation’s progress on key nutrition indicators. Using the Indian government’s rapid survey on children (2013-14), the authors of the Global Nutrition Report estimate that under-five stunting in India has reduced on average from 47.9% in 2005-06 to 38.8% in 2013-14. This nine percentage point reduction translates into almost 14.5 million fewer stunted children. Perhaps the World Health Assembly target of reducing under-five stunting worldwide from 162 million children in 2012 to ~100 million in 2025 is feasible after all. more…

Soumyadeep Bhaumik: Snakebite research in India—no longer so neglected

10 Dec, 14 | by BMJ

soumyadeep_bhaumik2In 2009 snakebite was added to the list of neglected diseases by the World Health Organization (WHO)—the first official recognition of it as a health problem.

But the true burden of the disease, particularly in India, came to light only in 2011 when the Million Death Study reported that there were about 46 000 deaths each year owing to snakebites. Other than a few occasional whispers in the academic corridors, and one occasion where snakebite was raised in the Indian parliament, no one was really talking about it. more…

Vaibhav Bagaria: Of God’s “own men”

5 Dec, 14 | by BMJ

Vaibhav BagariaRecently, the medical fraternity of India has been in the spotlight on various accounts. While the highest court of the country proclaimed that medical professionals were “agents of god,” and that they should not engage in striking; another high court in the country informed and “ruled” that “all of us have suffered at the hands of doctors.”

And then there was this heartrending story of how botched up sterilization procedures led to the deaths of 13 women, all of whom were operated upon by one single doctor, who has been dubbed “Dr Death” by the media. more…

Ben Gibbison: “Well, it’s the NHS . . . what do you expect?”

5 Dec, 14 | by BMJ

ben_gibbisonA few years ago, I was climbing in the Indian Himalaya. After driving to the road head, we walked for four days to our base camp. There, one of our group suffered with high altitude cerebral oedema. We carried her back down the valley for 12 hours until we reached the road head and found a car to take us to the nearest hospital.

Once inside the hospital, I asked, “Have you got any oxygen?”

“I don’t know Sir, I’ll go and see,” came the reply from the nurse.

He appeared with a rusty oxygen concentrator, which he wheeled along the ground. We couldn’t start it and so, while I made attempts to fix the concentrator, the nurse wiped down the yellowing pair of nasal speculae with a rag. more…

Yogesh Jain and Raman Kataria: The pathology of a public health tragedy

3 Dec, 14 | by BMJ Group

yj_pic Lessons from the Bilaspur sterilization camp 

The recent deaths of 13 women in India operated on at a sterilization camp in Bilaspur, Chhattisgarh, has thrown up urgent questions on the delivery of these services. As doctors observing health systems for the poor from close quarters in Bilaspur for the last fifteen years, we are convinced this was a tragedy waiting to happen. It is a collective failure of our society as a whole to see the stark inequity that erodes the health system, which these poor women have had to pay for with their lives.


Joseph Borick: A Jogini’s story

9 Oct, 14 | by BMJ

Joseph BorickOur story begins on a warm humid day in a rural village in Andhra Pradesh, India. Our team of six doctors, nurses, and medical students arrived with a mobile health bus to run a community clinic. As the patients rolled in and out of the clinic at a remarkably quick pace, I remember one patient* that immediately struck me. Her complaints of fatigue and weight loss with increased susceptibility to infections alarmed me. A brief physical showed diffuse swelling of her lymph nodes. With the help of a healthcare worker from Operation Mercy India Foundation, I was able to sit with this patient for an extended interview. Her story immediately gripped me. more…

The BMJ Today: Climate change and conflicts of interest: the sound and the fury

7 Oct, 14 | by BMJ

debs“Fury as top medical journal joins the green bandwagon” fumed the Daily Mail last week, which took exception to The BMJ’s publication of an article that, in the words of editor in chief Fiona Godlee, was not medicine or health but “pure climate science.”

“In this unequal battle with big business and political inertia we have a crucial card to play: the knowledge that much of what we need to do to tackle climate change will bring substantial benefits to health,” Godlee charged, adding that the World Health Organization should call a public health emergency.

And how prescient that comment was. Said fury came from Dr Benny Peiser of the Global Warming Policy Forum (GWPF), a think tank founded by former Chancellor Lord Lawson.

“The World Health Organization would become a global laughing stock if they were to follow the ridiculously over-the-top demands of a green alarmist editor. There is a real disconnect between what they are saying and the reality,” he was quoted as saying. more…

Richard Lehman’s journal review—6 October 2014

6 Oct, 14 | by BMJ

richard_lehmanNEJM 2 October 2014 Vol 371
1285  Here is a trial which had me taking my glasses off and scratching my bald patch. Why on earth should a drug company—in this case Boehringer Ingelheim— want to pay for a trial of taking patients OFF a drug? And why in particular should it want to take people with chronic obstructive pulmonary disease off inhaled steroids while keeping them on a long acting beta-adrenergic agent (LABA), when we know that LABAs increase mortality unless you take them with an inhaled steroid? The latest evidence for this came in JAMA a couple of weeks ago. more…

The BMJ Today: More on climate change

3 Oct, 14 | by BMJ

BirteEarlier this year, The BMJ’s editor in chief, Fiona Godlee, was one of 50 senior UK medical professionals to sign a letter in the Times newspaper about the health benefits of ending investment in fossil fuels, and diverting funds instead to alternative energy and more active forms of transport.

On 1 October 2014, The BMJ published an editorial, calling for the World Health Organization to declare a public health emergency. The BMJ has campaigned about climate change for years, and the reactions from our readers have been interesting—indeed, as Godlee writes, “When The BMJ started publishing articles on climate change, some readers told us to stick to our knitting.” more…

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