5 AILMENTS THAT ARE KILLING MUMBAI

What Can You Do To Ward Off Cardiac Diseases, TB, HIV/AIDS, Renal Failure And Cancer? TOI Speaks To Doctors KILLER NO 1: HEART ATTACK TOLL between 2004 and 2006 in Mumbai's hospitals: 37,193      It is an established medical fact that Indians are genetically more prone to heart diseases. What is worrying doctors is that Indians — especially those in urban hubs like Mumbai — are getting it at a younger age. It is also presumed that a worringly high 9 per cent to 11 per cent of persons above the age of 45 in urban India have heart disease.  DOCTORSPEAK      Avast majority of patients who get admitted to the intensive care units of hospitals with acute heart attacks are totally asymptomatic. Most of them say they were healthy till the day before their heart attack. Some even mention that they have competed in a marathon or two or climbed 10 flights of stairs without gasping for breath. Yet, suddenly, they collapse.      It is now known that if a person has over 70 per cent obstruction of blood flow, then s/he will experience pain or symptoms.      But, in these patients, there is a sudden rupture of this plaque (the obstruction) that leads to a clot formation and the obstruction becomes 100 per cent, leading to a sudden heart attack. There is no way to detect such obstruction on a mass-screening basis as the tests are invasive and expensive. But what Mumbaikars can do is undergo a health check-up once every year after they are 35.      People who have at least two risk factors for heart diseases (among smoking, hypertension, diabetes) should be more vigilant.  Ashwin Mehta | HEAD OF CARDIOLOGY  DEPARTMENT OF JASLOK HOSPITAL  KILLER NO 2: TUBERCULOSIS TOLL between 2004 and 2006 in Mumbai's hospitals: 26,951      It is estimated that 2 million cases of tuberculosis are reported in India every year. India also accounts for around 30 per cent of the world's cases. What has been worrying Mumbai's doctors is the changing form of the disease: tuberculosis of various organs (like bone and spine) has increased phenonomenally in the last few years. There also is evidence that Mumbai is home to many patients with MDR (multi drug-resistant) and XDR (extremely drug-resistant) forms of tuberculosis.  DOCTORSPEAK      India has the maximum number of patients suffering from tuberculosis and so it does not exactly come as a surprise that it is a leading killer in the city as well.      Besides, with so much filth in the city and because of the fact that twothirds of Mumbaikars stay in slums and a huge number travels by crowded trains, it is even less surprising that tuberculosis is so rampant in Mumbai.      When a tuberculosis patient coughs, s/he releases over 300 million bacilli in one go. People around inhale the germs, becoming susceptible to the disease. Air pollution is going up. The concentration of dust is going up, construction work is on; all these are good mediums for the tuberculosis germs to spread. It is not surprising that the, too, rich are no longer immune to it. It is time people stopped depending on the administration and took it upon themselves to clean up their surroundings.  Rohini Chowghule | CHEST PHYSICIAN AT  BOMBAY HOSPITAL KILLER NO 3: CANCER  TOLL between 2004 and 2006 in Mumbai's hospitals: 18,107      Cancer cases in India are likely to go up by 50 per cent by 2020, say studies. Mumbai, with its stress-ridden lifestyle, dietary changes and substance abuse (tobacco), is not going to fare any differently.  DOCTORSPEAK      Cancer is the second leading cause of death across the world. If it is among the top five killers in Mumbai then it is a reflection of our rapidly urbanising society. Cancers are also related to lifestyle reasons.  It is now a well-known medical fact that factors like smoking, poor dietary habits and obesity increase the probability of the disease.  There are two important lessons for Mumbaikars; first, Mumbaikars should look at preventive steps like lifestyle changes (cutting down smoking) that can reduce the chances of getting cancer by 25 per cent; second, massscreening programmes are not the answer to beat cancer.  We need to focus on cancer awareness. If people can recognise the symptoms, then they have a better chance at treatment and life.  When a Hollywood actor spoke about undergoing a colonoscopy on TV, it resulted in massive awareness about colon cancer. As a result, over the years, the US has registered a drop in number of colon cancer cases.  P Jagannath | CANCER SURGEON FROM LILAVATI  HOSPITAL  KILLER NO 4: KIDNEY FAILURE TOLL between 2004 and 2006 in Mumbai's hospitals: 6,533      Kidneys have become synonymous with rackets but the disease is among the fastest-growing ones in the country. India is the diabetes capital of the world and the incidence of kidney diseases is also likely to rise. It is estimated that 150-200 in every 10 lakh suffer from end-stage renal disease.  DOCTORSPEAK      There is an increasing trend of lifestyle diseases like blood pressure and diabetes. Kidney failure is an effect of these diseases. As there are more cases of diabetes and hypertension, there is a higher incidence of kidney failure.      Moreover, there is not a single item that is not adulterated. Be it water, milk, fruits or masalas, everything has a percentage of adulteration. Some of these materials are metallic and poisonous.      As all of these elements pass through the kidney (which is an organ that removes toxicity in blood), there is bound to be an effect on the organ. What can people do to stay healthy? They should not become obese and should eat good food and drink enough water.  Vatsala Trivedi | HEAD OF THE ZONAL TRANSPLANT COORDINATION CENTRE FOR KIDNEY  TRANSPLANTS      KILLER NO 5:      HIV/AIDS TOLL between 2004 and 2006 in Mumbai's hospitals: 3,826 It is often said that Mumbai exports HIV/AIDS to the rest of the country. The migrant labourer is supposed to be the most vulnerable to this sexually transmitted disease, which cripples the immune system. In Mumbai, the incidence of the disease is low (less than 1 per cent) in the general population but it is a whopping 42 per cent among commercial sex workers.  DOCTORSPEAK      Since Mumbai has 74 HIV/AIDS-testing centres, people who have indulged in high-risk behaviour can walk in any time for a test. Even if a person tests positive for the virus, he or she can avail of free medicines and free treatment for opportunistic ailments for up to Rs 3 lakh.      There are two things that people can do to prevent the spead of this disease: first, adopt means to prevent the disease (use a condom, for instance); second, don't take medicines from quacks who promise a cure. It must be remembered that HIV/AIDS was the number one killer a decade back.      But, due to awareness, it became the number 10 killer (nationally) last year.  Harish Pathak | JOINT DIRECTOR, MUMBAI  DISTRICT AIDS CONTROL SOCIETY THE WORST 10  These 10 diseases have been responsible for the maximum number of deaths in BMC- and state-run hospitals in Mumbai between 2006 and 2008

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