Press releases Saturday 3 April 2004
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(1) SOCIAL PROBLEMS LINKED TO MENTAL ILLNESS IN PAKISTAN
(2) POOREST IN INDIA ARE BIGGEST CONSUMERS OF TOBACCO
(3) GENDER BIAS LEAVES SOUTH ASIA'S WOMEN IN POOR HEALTH
(4) UNETHICAL PROMOTION OF MEDICINES IS RIFE IN INDIA
(5) IMPROVING HEALTH FOR MOTHERS AND CHILDREN IN SOUTH ASIA
(6)
HAS CRICKET HELPED TO UNITE SOUTH ASIA?
(1) SOCIAL PROBLEMS LINKED TO MENTAL ILLNESS IN PAKISTAN
(Risk factors, prevalence,
and treatment of anxiety and depressive disorders in Pakistan: systematic
review)
http://bmj.com/cgi/content/full/328/7443/794
In Pakistan, relationship problems and financial difficulties are linked to anxiety and depression, whereas supportive family and friends may protect against the development of these disorders, finds researchers in this week's BMJ.
These disorders are an emerging public health threat in low income countries.
Researchers analysed 20 studies conducted in Pakistan that focused on anxiety and depressive disorders in adults.
Relationship problems, financial difficulties, and low education level were all linked to these disorders, whereas supportive family and friends were not. The overall prevalence of anxiety and depressive disorders was 34%, but this figure may not apply to the whole population. Pakistan's population has been exposed to sociopolitical instability, economic uncertainty, violence, and conflict for at least the past three decades. These are risk factors for psychiatric disorders and may help explain the findings of this review, say the authors.
The time is right for Pakistan to build on this research effort and develop a national strategy to tackle mental illness, they conclude.
Contact:
Ilyas Mirza, Specialist Registrar
in Adult Psychiatry, Royal London Hospital, UK
Email: ilyasmirza@blueyonder.co.uk
(2) POOREST IN INDIA ARE BIGGEST CONSUMERS OF TOBACCO
(Patterns and distribution
of tobacco consumption in India: cross sectional multilevel evidence from
the 1998-9 national family health survey)
http://bmj.com/cgi/content/full/328/7443/801
(Editorial: Tobacco related
harm in South Asia)
http://bmj.com/cgi/content/full/328/7443/780
The view that many poor families in South Asia are going without food to get tobacco is raised in this week's BMJ. A study from India finds that those with the lowest standard of living smoke and chew tobacco more than others do.
The analysis is based on the 1998-9 national family health survey of over 300,000 adults across 26 Indian states. Factors such as age, sex, education, caste, and standard of living were considered.
Men were more likely to consume tobacco than women. Higher levels of education, standard of living, and social caste status were all associated with lower rates of smoking and chewing tobacco.
Tobacco consumption was greater in rural areas and towns than in large cities, and large differences were also observed between states. Tobacco consumption is likely to contribute to maintaining or worsening the current social and economic differences in India, say the authors.
Interventions aimed at changing tobacco consumption should consider the social, economic, and geographical aspects of people's susceptibility to consume tobacco, they conclude.
Contacts:
SV Subramanian, Assistant Professor,
Harvard School of Public Health, Boston, USA
Email: svsubram@hsph.harvard.edu
or
George Davey Smith, Professor of
Clinical Epidemiology, Department of Social Medicine, University of Bristol,
UK
Email: George.Davey-Smith@bristol.ac.uk
(3) GENDER BIAS LEAVES SOUTH ASIA'S WOMEN IN POOR HEALTH
(Role of gender in health disparity:
the South Asian context)
http://bmj.com/cgi/content/full/328/7443/823
Gender discrimination in South Asia has led to a systematic devaluing and neglect of women's health, say researchers in this week's BMJ.
They believe that a human rights based approach may help to overcome gender related barriers and improve the wellbeing of men, women, and children.
Gender discrimination at each stage of the female life cycle contributes to health differences in South Asia, write the authors. Sex selective abortions, neglect of girl children, death during pregnancy and childbirth, and poor access to health care for women and girls have all been cited as reasons for this difference.
The violation of fundamental human rights, and especially reproductive rights of women, also plays an important part in perpetuating gender inequality.
Policy makers, programme managers, health professionals, and human rights workers in South Asia need to be aware of and responsive to the detrimental health effects that gender plays throughout the life cycle, they conclude.
Contact:
Fariyal Fikree, International Program
Division, Population Council, New York, USA
Email: ffikree@popcouncil.org
(4) UNETHICAL PROMOTION OF MEDICINES IS RIFE IN INDIA
(Editorial: Marketing of medicines
in India)
http://bmj.com/cgi/content/full/328/7443/778
The Indian government has failed to prevent the unethical and illegal promotion of prescription drugs, according to an editorial in this week's BMJ.
Government policies adopted in the 1970s permitted manufacturers in India to produce generic versions of branded drugs discovered abroad. This has led to an unprecedented growth of companies with little incentive to undertake research to make new drugs.
As such, companies resort to unconventional methods to sell their brands, and ethics take a back seat. Expanding indications, exaggerating efficacy, ignoring contraindications, and underplaying adverse effects have become routine practice, writes Chandra Gulhati.
Companies also create "novel" products by mixing two or more medicines. Such combinations are often irrational, and some pose danger, he says.
It is easy to find fault with policies adopted decades ago. Nevertheless, the government has failed in its duty of preventing unethical promotion that has already resulted in misery, illness, and death, he concludes.
Contact:
Chandra Gulhati, Editor, Monthly
Index of Medical Specialties (MIMS India), New Delhi, India
Email: indianmims@yahoo.co.in
(5) IMPROVING HEALTH FOR MOTHERS AND CHILDREN IN SOUTH ASIA
(Maternal and child health:
is South Asia ready for change?)
http://bmj.com/cgi/content/full/328/7443/816
(Effect of maternal mental
health on infant growth in low income countries: new evidence from South
Asia)
http://bmj.com/cgi/content/full/328/7443/820
BMJ Volume 328, pp 820-3
(Integrating healthcare for
mothers and children in refugee camps and at direct level)
http://bmj.com/cgi/content/full/328/7443/834
What can be done to improve the health of mothers and children in South Asia? Several articles in this week's BMJ review the evidence and suggest interventions that may make a difference.
A third of the world's child deaths occur in South Asia. The region is also home to more than half of all the underweight children in the world, and maternal death rates are high.
Female illiteracy, poverty, and lack of empowerment of women are major barriers to improvement, say doctors. Yet, they show how substantial improvements have been achieved in some places by focusing resources on low cost primary care strategies and tackling socioeconomic issues.
A second article reveals that high levels of postnatal depression among South Asian women are affecting their children's health and development.
The authors suggest that not only will nutritional programmes need to be strengthened to ensure that poor children and their mothers have access to an adequate diet, but interventions for preventing and treating postnatal depression may be required.
In the final article on this topic, researchers argue that health care for mothers and children is seriously inadequate, both in refugee camps and in the government hospitals of most poorly resourced countries. They call for the urgent integration of hospital and home based health care.
Contacts:
Zulfiqar Bhutta, Professor of Paediatrics
and Child Health, Aga Khan University, Karachi, Pakistan
Email: zulfiqar.bhutta@aku.edu
Vikram Patel, Senior Lecturer, London
School of Hygiene and Tropical Medicine and Chair, Sangath, Goa, India
Email: vikpat_goa@sancharnet.in
David Southall, Honorary Medial Director,
Child Advocacy International, Newcastle under Lyme, UK
Email: davids@doctors.org.uk
(6) HAS CRICKET HELPED TO UNITE SOUTH ASIA?
(India versus Pakistan and
the power of a six: an analysis of cricket results)
http://bmj.com/cgi/content/full/328/7443/800
How have India and Pakistan fared against each other in cricket? What effect did one dramatic match in 1986 have on the performance of the teams? And could the answer to this question allow peace to blossom in South Asia?
In this week's BMJ, researchers compared 50 years of test matches and one day matches between India and Pakistan.
They analysed all 133 matches between 1952 and 2003 before and after one shot in 1986 when Pakistan batsman Javad Miandad scored a dramatic match-winning six off the last ball in a one day match that his side had looked like losing until that delivery.
It has been suggested that this shot may have galvanised the emotions of these two nations in a manner unparalleled in sport.
Overall, Pakistan was more likely to win after Miandad's six. Factors such as venue, winning the toss, and batting first were not associated with outcome.
These data suggest that in one day matches, Miandad's six inspired an improvement in Pakistan's performance or a decline in India's, or both, but this effect was small in test cricket, say the authors.
They believe that these data support their hypothesis that a single shot had an enduring influence. "Now India must have a landmark victory of its own ? it may have already," they conclude.
Contact:
Kamran Abbasi, Deputy Editor, BMJ,
London, UK
Email: kabbasi@bmj.com
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