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Gaming disorder is characterised by impaired control over gaming and an increasing priority given to gaming over other activities to the extent that it takes precedence over other interests and daily activities, says a World Health Organisation report.

Tubes of a pain relief cream, countless packs of cigarettes and tangled power cables sit atop a table in a dimly-lit room of a residence in the upscale locality of Sushant Lok-1 in Gurugram.

It’s 1pm on a Saturday and 10 young men, aged between 23 and 26, wearing half pants, loose T-shirts and headphones, stare at a computer screen, playing Dota 2, a multiplayer online video game, in which where they battle one another to defend their bases. The room, filled with cigarette smoke, is their home till Sunday night. LAN parties like this – where gamers bring computers and hook it up to the network to take part in multiplayer computer games – often last for entire weekend, with little sleep and sunlight.

One of the gamers in the room revealed how he lost out on relationships due to the time he would spend playing.

“When I was in college, I would start playing at 8am and would continue till 3am the next day. I had more friends online than I had in real life. My online gaming friends, who I had never met before, knew more about my problems than my roommate did. I realised I had a problem when my ex-girlfriend ended our long-term relationship,” the 25-year-old said.

He went on to say that he sometimes took drugs to stay awake at night, so he could play for longer. “One year, I spent 2,000 hours playing a game,” he said. That equals to about quarter of a year.

He said that the number of hours he spent gaming reduced when he started working. “I was playing so much because I had a lot of free time, which reduced when I started prioritising work. I only game on weekends now and it’s a lot more fun,” he added.

On June 18, the World Health Organisation (WHO) classified compulsive gaming as a mental health disorder. According to the WHO, gaming disorder is characterised by impaired control over gaming and an increasing priority given to gaming over other activities, to the extent that it takes precedence over other interests and daily activities. The WHO, in the latest update to its International Classification of Diseases, said that gaming could be as addictive as cocaine and gambling.

Sameer Malhotra, a psychiatrist at Max Hospital, said he has witnessed the effects of gaming on people. “In the last few years, the number of teenagers and young adults coming for counselling over gaming addiction has risen significantly, mostly due to increasing awareness about the problem. The addiction to online gaming is mostly being seen in the age group of 12 to 25 years,” he said.

Malhotra said teenagers who play for long hours at a stretch, often skip school. Describing the competitive nature of online games, Malhotra said, “People get an instant kick. You can tell they stop living in reality. Compulsive gaming super-activates the brain’s rewards pathway. When there is a repeated activation of the reward pathway, things take a turn for worse.”

For many of Malhotra’s young patients, gaming has become a source of misery than escapism. A 13-year-old boy, based in New Delhi, was brought to him as he would play games for hours, without eating or drinking.

“His mother had to feed him at the computer table. He would even pass stool in his clothes while gaming and would not feel the need to clean up. He would complain of fatigue and would often miss school. Teenagers such as him are likely to get addicted to gaming because their prefrontal cortex isn’t fully developed and is unable to overcome impulses,” Malhotra said.

According to Malhotra, the boy had become demanding, irritable and was obsessed with online shopping. “He would get furious and violent if he didn’t get the things he wanted,” said Malhotra.

The boy was diagnosed with obsessive-compulsive disorder and is under treatment through regular medication and psychotherapy.

Roma Kumar, a senior consultant, clinical psychologist, Max Hospital, Gurugram, said that treatment for video game addiction is the same as the treatment for any other addiction. “Counselling is the most effective treatment for video game addiction,” she said.

“Recognising gaming addiction as a mental health disorder was needed. However, it’s important to understand that all gamers are not addicts. Only when you’re becoming dysfunctional and it’s taking over your daily activities is it a problem,” she said.

A 25-year-old Gurugram-based copywriter, who goes by the gaming alias acridoutcast, started playing video games when he was four years old.

“I would play for around three to four hours a day usually, but during Class 10 summer vacations, I spent around 12 hours a day gaming. That set me back in studies. Such was my obsession with gaming that my parents would resort to hiding the keyboard and other computer parts. But I would search the whole house to find it and get a few hours to play when they weren’t home,” he recalled.

“I don’t game as much now as I used to earlier. I was definitely a compulsive gamer, maybe because I wanted to go pro in gaming. Now that I’m over that age group, I don’t play as much,” he said.

India’s online gaming market stands at $360 million, and is expected to grow to $1 billion by 2021, according to a 2017 report titled ‘Online Gaming in India: 2021’ by Google-KPMG. As per the report, an average Indian gamer is a below 24-year male.

Tushar Dhawan, the founder of XOing Café and Game Zone in Sector 14, said that most of his customers are single, young men.

“Not everyone can afford a gaming set-up at their homes. The gaming café is space where people come to cut loose from work,” said Dhawan.

One of India’s best Counter-Strike: Global Offensive players, Simar “psy” Sethi, turned his gaming addiction into a full-time career. Twenty-year-old Sethi started playing in 2013, initially at a gaming café in West Delhi, and today makes more than Rs 30,000 a month doing so.

“In 2014, I qualified for a gaming tournament in Bengaluru for the first time. For that to happen, I had to practice for eight hours a day,” he said.

Sethi suffers from a repetitive strain injury (RSI) that causes pain and numbness in his hands. For a competitive gamer like Sethi, his whole life is dominated by the activity and excessive gaming is a by-product of his job.

“Yes, I am addicted to gaming. But it’s a 9 to 5 job for me that pays the bills,” he said. Source : ht

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Good sanitation stops stunting, child deaths

Written by Monday, 18 September 2017 08:40

Contaminated food and water cause more disease outbreaks than dengue, encephalitis, cholera and chikungunya.

More than 650 people were diagnosed with diarrhoea, and 43 of them were admitted to hospitals across six municipal wards in the south-eastern Kolkata on Sunday.

A week later, what caused the outbreak in India’s third-largest city is still not known.

Stool samples of the sick sent to the National Institute of Cholera and Enteric Disease (NICED) in Kolkata were unviable and threw up no conclusions.

“Sample collection and preservation guidelines were not followed at Bagha Jatin State General Hospital, where they were being treated, and the samples failed to give results,” said Dr Shanta Dutta, director of NICED.

The Kolkata outbreak sums up the diarrhoeal disease situation across India – millions are affected by this preventable water-and food-borne infection each year and thousands die, but life goes on in unhygienic surroundings, leaving people vulnerable.

Acute diarrhoeal disease and food poisoning accounted for a third of the 1,714 laboratory-confirmed disease outbreaks in 2017 – including dengue, encephalitis, cholera and chikungunya, among others, according to the Integrated Disease Surveillance Programme (IDSP).

The IDSP data reflects a small fraction of the real numbers. With about 55% of India’s population seeking treatment outside the public sector — 51.4% in the private sector and 3.4% at home — the majority of cases treated at home and in private clinics do not make it to government surveillance records.

Unsafe drinking water, excreta-contaminated food, open defecation, unusable toilets, untreated sewerage and not using soap for handwashing made diarrhoea the third-biggest cause of premature deaths across ages in India in 2016, after heart and lung diseases, according to data from the Global Burden of Disease. It accounts for roughly 10% of the 962,830 deaths of children under five years old in India.

Contaminants galore

While most recorded diarrhoea deaths are from acute dehydration, the disease kills insidiously by causing chronic malnutrition and lowering immunity, which leads to frequent and potentially fatal infections.

“A malnourished and underweight child is more vulnerable to infections and has higher chances of dying of other infections, including pneumonia and tuberculosis,” said Dr Sanghita Bhattacharya, senior public health specialist at the Public Health Foundation of India.

Most malnourishment-related deaths occur in children between nine months and three years old, with infections and hunger — medically defined as “severe acute malnutrition” – claiming most lives.

Acute malnutrition is more common than one would think. About 38.4% children are stunted (low height for age) and 35.7% are underweight (low weight for age), according to the National Family Health Survey-4 (2015-16), which was released last year.

While the problems of stunting and underweight children fell marginally over the past decade, wasting (low weight for height) went up from 19.8% in 2006 to 21% in 2016.

“Poverty and social exclusion are the biggest barriers to preventing infection, which excludes people from the basic information – handwashing, oral rehydration as solution to treat diarrhoea, exclusive breastfeeding etc -- needed to save the child. Mothers care for and feed their children the best they can, but their best is often not enough,” said Dr Bhattacharya.

Simple solutions work, experts say. “Measures such as handwashing with soap are essential to bring down newborn deaths and increase maternal and child survival, and parents as primary caregivers. The community, including aganwadi workers and school teachers, must be involved. Children need a healthy start because by age 3, malnutrition is irreversible and children have already missed essential growth and developmental milestones,” said Dr Yasmin Ali Haque, a Unicef representative in India.

Clean-up act

While bacteria are the most common faecal contaminants, viruses, protozoa and helminths (parasitic worms) in the stools of infected people infect others through soil, water and food.

The absence of safe water, toilets and sewerage treatment facilities add to contamination.

Handwashing with soap and water prevents the transmission of bacteria that cause diarrhoea, show several studies, while using oral rehydration can prevent hospitalisation.

A comparison of handwashing with water, handwashing with soap, and no handwashing after touching door handles and railings in public spaces showed that bacteria of potential faecal origin remained after no handwashing in 44% of the samples, according to a global study published in International Journal of Environmental Research and Public Health.

Handwashing with only water reduced bacteria to 23%, while plain soap and water lowered it to 8%.

According to a more recent study of food handlers last year, handwashing with antimicrobial soap is more effective in removing bacteria (Escherichia coli and Enterococcus faecalis) from soiled hands than washing with water or plain soap.

“Toilets at anganwadis are filthy. Many do not have water  and there is often no soap and water for handwashing at schools, which feeds the cycle of infection,” said Bhattacharya.

“Apart from setting up Nutritional Rehabilitation Centres to treat severely malnourished children and providing nutritious midday meals to schoolchildren, strong monitoring of hygiene practices and toilets at both aganwadi centres and schools is a must to ensure children stay free of infections,” she said. Source : ht

 

 

 

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According to the researchers, there is no treatment for osteoarthritis. The disease is managed with pain relief and culminates in joint replacement surgery, which has variable outcomes.

Researchers have discovered nine novel genes for osteoarthritis that may open the door to new targeted therapies for this debilitating disease in the future. Of the nine genes associated with osteoarthritis, researchers identified five genes in particular that differed significantly in their expression in healthy and diseased tissue. The five genes present novel targets for future research into therapies, the researcher said.

According to the researchers, there is no treatment for osteoarthritis. The disease is managed with pain relief and culminates in joint replacement surgery, which has variable outcomes. “These results are an important step towards understanding the genetic causes of osteoarthritis and take us closer to uncovering the mechanism behind the disease,” said co-author of the study, Eleni Zengini from the University of Sheffield.

For the study, published in the journal Nature Genetics, researchers investigated the genetics behind osteoarthritis, as well as the diseases and traits that are linked to it. The team studied 16.5 million DNA variations. Following combined analysis in up to 30,727 people with osteoarthritis and nearly 300,000 people without osteoarthritis in total -- the controls -- scientists discovered nine new genes that were associated with osteoarthritis.

The researchers then investigated the role of the nine new genes in osteoarthritis, by studying both normal cartilage and diseased cartilage from individuals who had a joint replacement. The team looked for genes that were active in the progression of the disease by extracting the relevant cells from healthy and diseased tissue, studying the levels of proteins in the tissue and sequencing the RNA -- the messenger that carries instructions from DNA for controlling the production of proteins. Source : ht

 

 

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Do you have beer belly, but are otherwise not overweight? Beware, as experts say it is bad for the heart. Belly fat also reveals a sedentary lifestyle, low muscle mass, and eating too many refined carbohydrates.

Belly fat is really bad for you. Even more so than being overweight. A recent study has revealed that even in people who are not otherwise overweight, belly fat can be bad for the heart. “See your doctor if your waist is bigger than your hips,” said study author Dr Jose Medina-Inojosa from the Mayo Clinic, Rochester, Minnesota. Previous studies have shown that belly fat can hamper lung function and raise risk of cancer.

This study tested the hypothesis that people with normal weight and central obesity would have more heart problems than people with normal weight and normal fat distribution.

Body mass index (BMI), which is weight relative to height in kg/m2, is used to categorise adults as underweight, normal weight, overweight or obese. However, BMI does not account for the amount and distribution of fat and muscle. Central obesity is a store of excess fat around the middle of the body and is a marker of abnormal fat distribution. “The belly is usually the first place we deposit fat, so people classified as overweight BMI but without a fat belly probably have more muscle which is good for health,” he continued. “Muscle is like a metabolic storehouse and helps decrease lipid and sugar levels in the blood.”

What the study shows

The study found that participants with a normal BMI (18.5-24.9 kg/m2) and central obesity had an approximately two-fold higher long-term risk of MACE compared to participants without central obesity, regardless of their BMI. Medina-Inojosa said: “People with a normal weight but a fat belly have more chance of heart problems than people without a fat belly, even if they are obese according to BMI. This body shape indicates a sedentary lifestyle, low muscle mass, and eating too many refined carbohydrates.”

Participants with a normal BMI and central obesity also had a higher risk of MACE than overweight and obese participants with central obesity. Medina-Inojosa said that overweight and obese people with central obesity might also have more muscle mass which could be protective. The study was presented at EuroPrevent 2018, a European Society of Cardiology congress.

How to reduce belly fat

Foods that are high in sugar are commonly linked to type 2 diabetes and fatty liver disease. But many studies have shown a relationship between high sugar intake and increased abdominal fat as well. In a study conducted in 2009, a group of researchers observed a group who drank sugar-sweetened drinks with their meals over an eight-week period. Their diets didn’t otherwise change, but they put on an average of three pounds and their abdominal fat increased as well.

A popular diet to cut out sugar and lose belly fat is the keto diet. It reduces calories by filling you up with protein, vegetables, whole grains and replaces junk food with healthy snacks. Sprinkling cinnamon in your morning coffee or oatmeal can help as well as the spice helps stabilise blood sugar and slows the rate at which food exits the stomach, which helps you feel satiated for longer.

UK-based personal trainer Peter Mac also suggests some simple exercises, such as leg raises, push ups and sit-ups to reduce belly fat. Source : ht

 

 

 

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MMC Act to be implemented in state to control mosquitoes

Written by Thursday, 14 September 2017 06:06

With mosquito-borne diseases on the rise in the state, the public health department is planning to expand the scope of the Mumbai Municipal Corporation Act (MMC Act), 1888, to the entire state to effectively act against offenders allowing mosquito breeding in private spaces.

In a meeting held by state Health Minister Deepak Sawant and senior state health officials on Monday, it was decided to seek the opinion of the law and judiciary department on enforcing sections of the Brihanmumbai Municipal Corporation’s Act in state.

“This will be similar to Bombay Nursing Homes Registration Act initially limited to only Mumbai and later enforced in the entire state,” said Dr Satish Pawar, director at the Directorate of Health Services. The state government plans to pick specific sections from MMC Act, such as reporting of certain communicable diseases, sections on water and sanitation, and legal action taken for allowing mosquito breeding.

The most important section the state hopes to implement is Section 381 of MMC Act that allows civic body to prosecute a person found guilty of allowing mosquito breeding in public or personal space. The fine ranges between Rs 2,000-10,000. Section 381(B) of the Act deals with those who default on making water tanks mosquito proof.
In June, BMC found maximum mosquito breeding in public buildings.

The public works department buildings had 536 non-mosquito proof spots, central railways had 446 spots and central public works department was found with 252 breeding spots. Western railways owned 636 buildings, where 3.7 per cent tanks had no mosquito proofing. Central railways, which owns 577 premises, had a significant 23.5 per cent breeding spots. All government agencies were issued notices by BMC.

“The fine is minimal. Offenders are let off easily which is why we have been asking to increase it to prevent multiple offences,” Dr Rajan Naringrekar, insecticide officer, BMC, said. With monsoon receding and weather conducive for viral infection to multiply, the state is taking special efforts to control malaria and dengue, both spread by mosquito. In Mumbai itself, 271 malaria cases and 102 dengue cases were recorded since September 1.

While malaria is carried by anopheles, dengue is spread by aedes aegypti. Indoors, aedes mosquito breeds in feng-shui plants, flower pots, fish tanks, unused tyres and petri-dishes. “We are expecting a spike in dengue, leptospirosis and gastroenteritis in the coming days because of flooding in Mumbai. Steps have been taken to ensure medicines are adequately stocked,” a civic official said. Dr Pradeep Awate, state epidermiologist, said H1N1 cases have also been high. In the state, 4,628 have been diagnosed with H1N1 infection, including 488 who succumbed until August end.

 

 

 

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Member of Parliament (MP) Kirron Kher has submitted proposals to Union Minister of State for Health and Family Welfare Ashwini Kumar Chaubey, regarding setting up of a 300-bedded trauma centre in Chandigarh, apart from construction of a sports injury centre at Government Medical College and Hospital(GMCH), Sector 32.
A statement issued Tuesday said Kher met Chaubey Monday and submitted the proposals.

“In one of the letter addressed to Chaubey, she mentioned that the Trauma Centre already running at PGIMER is over burdened and not sufficient to cater to the needs of the region (i.e Punjab, Haryana, Himachal Pradesh and Jammu & Kashmir). Construction of the proposed trauma centre is need of the hour. In a separate letter, she has written that Chandigarh Administration has proposed to construct sports injury centre in GMCH, Sector-32,” the statement said. It further said that the project report has already been submitted to the Director General Health Services, Government of India, for approval.

Kher, during the meet, requested Chaubey to look into the matter and arrange requisite approval for the project.
The MP also told Chaubey that Ministry of Health and Family Welfare has already granted its approval regarding setting up of a Trauma Centre as an extension of GMCH. “Chandigarh Administration has already earmarked a plot measuring 9.6 acres for setting up of a Trauma Centre in Sector 53, Chandigarh, and a detailed Project Report (DPR) of the Trauma Centre has also been prepared. Whereas the project related to construction of Sports Injury Centre is pending with the Ministry of Health and Family Welfare, New Delhi, since April 2013,” the statement said.

The statement further stated that GMCH has established itself in the region in the field of sports injuries and on an average is performing 100 surgeries on elite players of different games coming from all over the country.

“Presently, there is only one dedicated Sports Injury Centre in the country which is based at Safdarjung Hospital, New Delhi. Chandigarh Administration has already earmarked a plot measuring 1.43 acres for setting up of this centre. Accordingly, a Detailed Project Report (DPR) of the proposed centre has been prepared. It is felt that setting up of a similar centre in Chandigarh, which caters to the needs of Punjab, Haryana, Himachal Pradesh, Rajasthan, Jammu & Kashmir and Uttarakhand, will go a long way in restoring the health of athletes in the region so that they can go back to the pre-injury level of games at the earliest,” the statement added.

 

 

 

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CHENNAI: AIADMK general secretary V K Sasikala's husband M Natarajan is in a critical condition after sufferingmultiple organ failure on Sunday. Natarajan, 74, has been admitted to Gleneagles Global Health City in Perumbakkam, where he is under intensive care.

According to a medical bulletin released by the hospital administration, Natarajan suffers from chronic liver disease and has been receiving treatment for it for the past six months. "He is admitted at the Liver Intensive Care Unit with decompensated liver disease leading to liver and kidney failure and lung congestion. He is receiving dialysis and other intensive care therapies," the hospital statement said.

Natarajan has been registered with the Tamil Nadu Organ Sharing (TNOS) waiting list for deceased donor liver transplantation. "He is being taken care by a multidisciplinary team of liver specialists headed by Prof. Mohamed Rela," the hospital note said.

According to hospital sources, Natarajan had undergone a dialysis session for more than eight hours on Sunday. This is not the first-time Natarajan has been hospitalised this year. On February 5, he was brought to Apollo Hospitals on Greams Road after complaining of breathing problems.

 

 

 

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Swine flu spurts in Delhi: 1,066 cases last month

Written by Saturday, 19 August 2017 06:15

 

Swine flu has surged sharply in the capital with 1,066 cases being confirmed in the last one month, which is more than four times the number reported during the rest of this year.

The total number of cases till August 13 this year stands at 1,307, more than six times the corresponding period of 2016.

Nationally, 18,855 cases of theH1N1 influenza have been reported this year, claiming 929 lives.

But despite the spurt in cases in the capital, the number of deaths has not risen significantly. "Only four deaths have been reported: two from Delhi and two patients from outside have died," Delhi health minister Satyendra Jain said in the assembly last week. At a review meeting on Friday , Delhi health department officials told their counterparts in the Centre that the city has sufficient training and stocks of medicines to tackle the swine flu outbreak.

Health experts said there was no cause for panic over the sudden spurt in swine flu in Delhi. "People should not panic if they suffer normal viral infection. The high risk groups include people with heart diseases, pregnant women, children below eight years of age, senior citizens, diabetics and kidney disease patients. These patients need special treatment," said a doctor.

Dr Jagdish Prasad, director general of health services, told TOI that the Centre had offered to train doctors of Delhi government and private hospitals on treating swine flu cases. "If any hospital wants training, we can send our doctors," he said. Delhi health minister Sandar Jain said in the as tyendar Jain said in the assembly last week that the government had enough stocks of medicines and vaccines to tackle the outbreak.

"Adequate facilities for treatment are available in Delhi. We have placed orders for advance purchase of medicines," Jain said. He added that there were reserved beds for patients in government hospitals and not even 5% of these beds had been occupied.

The spike in the cases at this time of the year has come as a surprise because swine flu usually peaks in the postmonsoon season and early winter. Some health conscious people have started maintaining caution when they are in public places because the H1N1 virus, which causes swine flu, transmits from human to human.

"The spike in swine flu at this time is also due to infection coming in from states where a very high number of cases have been reported.Such a big outbreak in the month of August is a matter of concern since swine flu usually rises in October and November," said Dr K K Aggrawal, national president of the IMA. The association has planned to launch a poster campaign against swine flu."

 

 

 

 

 

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A study has warned that cloudy drinking water is linked to increased cases of gastrointestinal illness. Cloudiness in water is caused by material floating in it. The undissolved particles may actually provide some protection for harmful pathogens against disinfectants.

Researcher Anneclaire De Roos from Drexel University in Philadelphia, US found associations between acute gastrointestinal illness (AGI) and water turbidity, a term meaning cloudiness or opacity. Turbidity is the cloudiness or haziness of a fluid caused by large numbers of individual particles that are generally invisible to the naked eye, similar to smoke in air.

The results revealed that exposures through drinking water caused a low but detectable number of AGI cases in the regions. There is no clear, alternative explanation for the patterns of associations — particularly when a similar pattern was seen multiple times. Acute gastrointestinal illness could be caused by waterborne pathogens like norovirus, Giardia, or Cryptosporidium and carry symptoms like diarrhoea and vomiting. Researchers looked into a collection of studies that had been done on the topic.

These studies were designed to evaluate risks from contamination of source waters (usually rivers in the cities studied), before the water entered cities’ distribution systems. They found that turbidity of drinking water was linked to increased AGI in multiple studies, and not just when there was increased cloudiness. “As expected, the association between turbidity and AGI was found in cities with relatively high turbidity levels, often in unfiltered drinking water supplies,” De Roos noted.

 

 

 

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AHMEDABAD: Gujaratgovernment and theAhmedabad Municipal Corporation (AMC) once again got a rebuke from Gujarat high court on Wednesday "for taking its direction lightly" in response to a petition seeking prompt measure to curb spread of swine flu, which has already claimed over 200 lives across the state.

A bench headed by Justice M R Shah told government's law officers that everything looks all right on paper, but the reality is different. The court asked the state government to state what measures have been taken to curb the spread of the disease.

The court said that so many people dying of the disease is really serious, and the authorities must take prompt steps in public interest. The court has sought a report in this regard by Monday.

The court also expressed concern about testing facilities and commented whether there is a provision to provide this facility free of cost to the poor.

The court's chiding came after advocate K R Koshti urged the court to issue directions to arrest further damage due to swine flu spread in absence of proper facilities. By adding the issue of swine flu in his last year's PIL to curb vector-borne diseases, the lawyer submitted that the state government and AMC machinery was never prepared to fight against H1N1 virus, and to prevent loss of life.

The PIL has demanded appointment of a committee of experts for field visit to take stock of the situation and to report to the court about the reality.

It seeks directions for creating facilities of diagnosis and free treatment for the poor. It has also asked for compensation for the victims.

Meanwhile, Justice Shah recalled the directions issued last week to AMC to clear roads of stray cattle and garbage.

The judge said that heaps of garbage have not been removed yet, though the authorities had promised to bring in visible change in a week's time.

The PIL stated that despite World Health Organization (WHO) warning, no effective measure has been chalked out by the administration to tackle the outbreak. Till August 15, 208 people died out of total 1,883 swine flu patients in Gujarat.

The petitioner complained that the government has not set up laboratories at districts across the state for testing the virus, and delay caused in diagnosis proves fatal in most cases. The PIL has complained that AMC does not have enough staff in its health department to deal with the situation.

 

 

 

 

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