ANNUAL (2018-2019 & 2019-2020)REPORT

“Towards the development of outmatching health professionals”

The Year Gone By

Foreword

From the President’s Pen

Acknowledgements

Testimonials

Who we are: Our Mission, Vision, Values and Objectives

Our Collaborators

Key Activities in 2019-2020

Annexures

CONTENTS

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In the current health scenario, civil society organizations play a vital role in contributing to accelerating the development of the society. Strategic Institute for Public Health Education and Research (SIPHER) has been playing a crucial role in promoting the health of our citizens and their overall development. We require some dedicated organizations like SIPHER who strive to better the country’s performance in the health sector, as health is the backbone for achieving success in all other areas of human development. For this reason, I appreciate and admire the careful planning intellectual rigor, and meticulous execution by the committed team from SIPHER. They have brought together various reputed stakeholders such as PGIMER Chandigarh in holding consultations, workshops and awareness generation activities in the interest of Public Health Education and Research. Since its inception in 2018, I have been associated with its advocacy, capacity building and public awareness activities, which are commendable and deserve appreciation. The unique nature of working and openness of SIPHER has won it accolades from different sectors of the society. The current report summarizes the highlights of important activities undertaken by SIPHER during the year 2018-2019 & 2019-2020, which are highly creditable and are detailed in this annual report.

I give my best wishes to the SIPHER team for its even higher achievements in the coming years for promoting public health education and research in the country.

“We know only too well that what we are doing is nothing more than a drop in the ocean. But if the drop were not there, the ocean would be missing something.”-Mother Teresa

FOREWORD

2Dr. Sanjiv Kumar

Strategic Institute for Public Health Education and Research (SIPHER) was established in 2018 with a fundamental purpose of creating a specialised public health workforce who can plan, execute and monitor national health programs and public health initiatives for tackling emerging public health challenges.

It is a unique institution which intends to provide trans-disciplinary, multi-sectoral training & recommendations to the government, in order to overcome broader challenges in public health. The institute also undertakes advocacy on various public health issues and carry-out policy-focused research.

The Institute has significantly contributed in the area of tobacco control, corneal blindness, creating awareness about NCDs especially hypertension by organising consultations on Protecting minors from the tobacco/nicotine, Endorsing ban on ENDS/E-cigarettes and Hospital Cornea Retrieval Program (HCRP) and workshops on Hypertension for various stakeholders.

Our mission is to contribute to the health and well-being of all people through strengthening public health education and research.

I am fortunate to have the support of a very distinguished General Body of the organization. I also heartedly laud the valuable contribution of our partners towards achieving the overall aim of advancing public health education and research. I seek support of all partners and stakeholders, especially the government, in placing the vision of SIPHER in India’s development. I feel greatly privileged to be a part of this family and look forward to rejoice in its successes.

“For he who has health has hope; and he who has hope, has everything.”

-Owen Arthur

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FROM THE PRESIDENT’S DESK

Dr. Rakesh Gupta

SIPHER acknowledges a sincere gratitude to all partners and stakeholders who contributed to the organisation’s achievement from 2018-2020- Director PGIMER Chandigarh; Department of Community Medicine and School of Public Health PGIMER Chandigarh; Department of Health and Family Welfare Punjab; Food & Drug Administration Punjab; Cybercrime wing Punjab Police; Commission for Protection of Child Rights Chandigarh and Haryana; Municipal Corporation Chandigarh; Rotary International; State Bank of India; Indus Ind Bank; Ojas Hospital Panchkula; Indian Medical Association Chandigarh and Indian Dental Association Chandigarh. The commitment of these organizations was crucial in achieving organizational aim of promoting Public Health Education and Research in the country. The organisation will continue to build on its objectives by transparent dialogue with its potential partners in the year 2020-21. We also recognize the invaluable guidance and leadership of public health experts of repute associated with activities of SIPHER.

ACKNOWLEDGEMENTS

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SIPHER has a pivotal role in supporting urgently needed transformational shift in public health system across states in India. I am glad to be a part of and contribute to successful journey of SIPHER in strengthening public health education, capacity building, policy focused and implementation research. I offer my services and best wishes to the institute.

Dr. Sanjiv Kumar

SIPHER has significantly contributed in the area of tobacco control, corneal blindness, creating awareness about NCDs especially Hypertension by organising consultations on Protecting minors from the tobacco/nicotine, Endorsing ban on ENDS/E-cigarettes and Hospital Cornea Retrieval Program (HCRP) and workshops on Hypertension for various stakeholders.

Dr. Mira Aghi

SIPHER is tackling the problem of hypertension, an upcoming epidemic in Punjab in collaboration with PGIMER Chandigarh and GHAI. In a short time of 5 months of the project it has already organised Events on World Heart day, workshops and consultations for advocacy and awareness about the risk factors and the complications related to Hypertension.

Dr. Yash Paul Sharma

TESTIMONIALS

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Ex- Director, IIHMR, Delhi

Freelance Behavioural Scientist

Professor and Head, Department of Cardiology PGIMER, Chaandigarh

To develop, design and conduct capacity building programs for public health managers, health care professionals, academicians, civil societies, policy makers and other relevant stakeholders on need-based diverse public health issues.

To promote implementation and policy-focused research in order to develop and reinforce policies, strengthen monitoring and evaluation of national programs, and address gaps in their implementation.

To establish a technical resource center for public health issues to support and build capacities of stakeholders in India and the South-East Asia Region.

To develop technical resources like journals, books, magazine, newsletters and other health education materials on various public health issues in print or electronic form.

To organize or participate in academic or research related seminars, workshops, conferences, consultative meetings etc. at state, national or international level.

To collaborate with institutions of repute or experts on different public health issues.

To receive donations/grants and acquire/purchase any moveable or immovable property from any govt./semi govt. or individuals in the name of society for furtherance of its objectives.

To support and collaborate with national and sub-national governments to identify gaps in program implementation for overall Health System Strengthening.

Our mission is to contribute to health and well-being of all people through strengthening public health education; supporting, developing and implementing evidence - based public health programmes and scaling-up locally relevant research in India beyond our overall achievement of health-related goals and targets as defined under Sustainable Development Goals (SDGs) 2030.

We envision supporting public health actions for accelerating progress towards achieving healthy lives and promoting well-being of all.

WHO WE ARE?

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MISSION

VISION

AIMS & OBJECTIVES

THE YEAR GONE BY

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1 Consultation on Health Effects of Electronic Nicotine Delivery Systems (ENDS)/ E-Cigarettes with Subject Experts, Decision Makers and Implementers

2nd February, 2019

16th March, 2019

4th May, 2019

29th June, 2019

28th to 30th September, 2019

30th November, 2019

15th February, 2020

17th March, 2020

13th March, 2020

Consultation on Protecting Minors from Tobacco/Nicotine: Going beyond Cigarettes and other Tobacco Products Act (COTPA) 2003

Consultation on Reinvigorating Eye Banking through promotion of Hospital Cornea Retrieval Programme

Consultation on Tobacco 21- Why legal age to buy tobacco and legal nicotine products should be increased from 18 years to 21 years?

World Heart Day Campaign Celebrations

State Level Inception Workshop on Hypertension Prevention and Management

Seminar on Hypertension: Prevention and Management

State Level Workshop for Media Persons entitled Combating Hypertension, a Silent Epidemic – the Role of Media

Seminar on Theoretical Connotation of The Importance of Human Relationships in Managing Substance Abuse

CONSULTATION/ACTIVITYDATE

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OUR COLLABORATORS

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KEY ACTIVITIES IN 2019-2020

BACKGROUNDThe Strategic Institute for Public Health and Education Research (SIPHER) in collaboration with Parmar Hospital organized a Consultation on Electronic Nicotine Delivery Systems (ENDS)/ E-Cigarettes with subject experts and decision makers on 2nd February, 2019.

COLLABORATORS/PARTICIPANTS Private and PGIMER experts from the departments of Cardiology, Pulmonology, Neurology, and Psychiatry participated in the consultation. The State Cyber Crime Cell Punjab, members of Civil Society, Officials from FDA Punjab, IMA Mohali & Chandigarh were also present during the meeting. Parmar Hospital, Rupnagar funded the consultation.

Duration and Venue One day consultation meeting was held at Seminar Hall, Department of Community Medicine and School of Public Health, PGIMER, Chandigarh.

Consultation on Health Effects of Electronic Nicotine Delivery Systems (ENDS) / E-Cigarettes with Subject Experts, Decision Makers and Implementers.

ACTIVITY 1

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DELIBERATIONS AND RECOMMENDATIONSSubject experts and decision makers from the region shared their concern,views and developed a Chandigarh Declaration on ENDS to be shared with the Ministry of Health and Family Welfare (MoH&FW) and Public Health community, to tackle this alarming upcoming menace in view of increasing use by teenagers, youth and habitual smokers. Dr Sonu Goel, Additional Professor School of Public Health PGI briefed about the purpose of consultation and the public health impact and said that ENDS usage is also promoting dual usage as per GATS-2 Data. Dr Astha Sharma, an Oral Surgeon and a cessation expert and Technical Advisor, SIPHER gave a brief overview on ENDS.

Dr. Rakesh Gupta, Deputy Director, Dept. of Health and Family Welfare, Punjab who has been working on ENDS consistently since 2013, deliberated further on the process that started with Punjab declaring these as unapproved products under Drugs and Cosmetics Act in 2013 followed by Govt. of India issuing an Advisory to all states in August, 2018 to act against the sale of ENDS.

Sh. K.S.Pannu, IAS, Commissioner- FDA Punjab also addressed the group and shared his views on ENDS. He said he will also follow-up with the remaining states to act upon the advisory issued by Govt. of India and would also request MoH&FW to initiate action to get the products banned in pan-India under Drugs and Cosmetics Act. Dr. L. Swasticharan, CMO, MoH&FW also apprised the house members about the salient features of advisory issued by GOI in this regard. Subject experts which included Cardiologists, Pulmonologists, Neurologists, Psychiatrists and clinical psychologists from PGIMER and the corporate sector shared their views on harmful effects of electronic cigarettes on the human body.

Astt. Commissioner from Drug Administration Punjab, shared his views about health effects of nicotine and additives like Propylene Glycol and flavours in e-cigarettes and the provisions available under Drugs and Cosmetics Act as applicable to sale of unapproved products like E-Cigarettes. Mr. H.S. Mann, IPS, DIG, State Cyber Crime Cell,Punjab told that notices were issued to all e-commerce sites asking them to desist from promoting and selling unapproved harmful products like e-cigarettes. He urged all states should come forward to follow suit. He requested all participants to inform him if there is any violation.

OUTPUTThe prohibition of electronic cigarettes (Production, manufacture, import, export, transport, sale, distribution, storage and advertisement) Act, 2019 No. 42 of 2019 [5th December, 2019.]

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Consultation on Protecting Minors from Tobacco/Nicotine: Going beyond Cigarettes and other Tobacco Products Act (COTPA) 2003.

ACTIVITY 2

BACKGROUND Department of Community Medicine and School of Public Health, PGIMER, Chandigarh and Strategic Institute for Public Health Education and Research (SIPHER) organised a consultation on protecting minors from Tobacco/Nicotine on March 16, 2019.

COLLABORATORS/PARTICIPANTSThe consultation was attended by the chairperson of Commission for Protection of Child Rights (CPCR) Chandigarh, Haryana and officials of CPCR; Commissioner FDA Punjab, Haryana; Chandigarh Municipal Commissioner and officials from FDA Punjab, Haryana and Chandigarh, Municipal Commissioner and officials from MC Chandigarh; Member Secretary CPCB; IMA; IDA; Cyber Crime Cell; officials from Police, Education and Health departments; Local Government; Public Health Specialists and Civil Society members.

DURATION AND VENUEOne day consultation meeting was held at Seminar Hall, Department of Community Medicine and School of Public Health, PGIMER, Chandigarh.

DELIBERATIONS AND RECOMMENDATIONSSmt. Harjinder Kaur, Chairperson CCPCR and Smt. Jyoti Bainda, Chairperson CPCR Haryana, opined that minors (less than 18 years of age) should be protected against harms of Tobacco/Nicotine as there is sufficient evidence about its increasing harmful effects among this group. Therefore, a comprehensive awareness strategy should be planned with all concerned stakeholders to reduce harms due to tobacco use. Police, Health, Education and Local Govt departments along with other stakeholders need to strictly implement anti-tobacco laws and Juvenile Justice Act strictly along with other stakeholders’ departments.

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Dr. Sonu Goel, Professor, Department of Community Medicine and School of Public Health PGI emphasized that there is a need for targeted and focused tobacco use prevention interventions by adopting a comprehensive approach by increasing awareness and providing health education to varied stakeholders so that Anti-Tobacco Laws can be implemented effectively and prevent minors getting addicted to Tobacco/Nicotine. Parents and teachers need to be role models for children and should not use tobacco especially in the presence of children.

Dr. Nirlep Kaur, State Nodal Officer NTCP, Dept. of Health and Family Welfare, Punjab shared state’s good practices like declaration of state as Tobacco smoke free, strict implementation of Section 6 of COTPA to curb sale to minors and penalizing tobacco vendors within 100 yards of education institutes, Ban on Hookah Bars and Electronic cigarettes, close monitoring of tobacco control activities at district and state level.

Dr. Rakesh Gupta, Deputy Director, Dept. of Health and Family Welfare, Punjab said that, a one-hour session in Hookah bar is equivalent to smoking 100 cigarettes, so it is hazardous to health especially for minors. Hookah bars violate all provisions of COTPA, FSSAI, Drugs and Cosmetics Act, IPC 268,269.278 and JJ Act (if minors are provided Hukkahs). So, strict action should be initiated by Police and Health departments. As done in Punjab, section 144 can be promulgated against Hukkah bars by DC or Commissioner of Police. CPCR may ensure closure of these illegal Hukkah Bars by coordinating with local administration. Carbon Monoxide produced by Hukkahs pollute the air in the premises, even if only flavours are used.

Sh. K.S. Pannu, IAS, Commissioner- FDA Punjab also addressed the group and shared his views on E-Cigarettes, which contain nicotine and flavours, etc. and smokeless/chewable tobacco. He said that on our initiative many states have already banned E-Cigarettes and MoHFW has been requested to initiate action to get the products banned pan-India under Drugs and Cosmetics Act. He also said that flavoured/scented chewable tobacco has been banned in Punjab and FSOs have been asked to regularly seize the banned material. Many cases have been launched in courts of law.

Sr. KK Yadav, Municipal Commissioner, UT Chandigarh assured that COTPA will be implemented effectively within Municipal limits of Chandigarh. He also agreed with the suggestion that, licensing may be made mandatory for all Tobacco wholesalers and vendors as has already been done in some states and that Sanitation Certificates may not be issued by MC to any Govt. and private establishments without ensuring that they follow all anti-tobacco laws especially COTPA.

Officials from education department assured that Tobacco Free Guidelines by CBSE and UGC will be followed by all educational institutions including Colleges and Universities.

The recommendations were sent to the Government of India suggesting a strict implementation of all Anti-tobacco laws, especially JJ Act, to be ensured by all stakeholders.

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OUTPUT

Consultation on Reinvigorating Eye Banking through promotion of Hospital Cornea Retrieval Programme.

BACKGROUNDStrategic Institute of Public Health Education and Research (SIPHER) and Rotary Eye Bank, Hoshiarpur, joined hands with Department of Community Medicine and School of Public Health, PGIMER, Chandigarh to reinvigorate eye banking movement in India. A consultation regarding reinvigorating eye banking through promotion of Hospital Cornea Retrieval Programme was held on 4th May, 2019.

COLLABORATORS/PARTICIPANTSPGIMER, Chandigarh; RP Centre AIIMS-Delhi; Rotary Eye Bank, Hoshiarpur, and NPCB Punjab were among the collaborators. State Programme Officers (SPOs), National Programme for Control of Blindness (NPCB) Punjab and Chandigarh; faculty from Department of Hospital Administration of government and corporate hospitals; representatives of Eye Banks, PGI, GMCH Chandigarh and Eye Bank Society of Rajasthan; and representatives of Sight life and various NGOs active in eye donation participated in the consultation.

ACTIVITY 3

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DELIBERATIONSDr. Rakesh Gupta, Deputy Director, Health, Punjab and Dr. Areet Kaur, SPO, NPCB Punjab shared the details about the Cornea Blindness Backlog Free initiative of Punjab Government, which has been appreciated at various national and international conferences and adopted by some states. In the years 2017-18 and 2018-19, 2452 eye balls/cornea tissue was procured and 1505 Cornea Transplant surgeries were performed in Punjab as per reports received from all districts.

Dr. Radhika Tandon told about the current situation of corneal blindness in India and how can Hospital Cornea Retrieval Programme (HCRP) help India achieve 100,000 tissue collection by 2025 and Recommendations of Eye Bank Leadership Summit organized by Eye Bank Association of India (EBAI), supported by WHO and NPCB. She said that we need to look into the mechanism and provide a blue print recommendation to augment national resources for increasing availability of healthy donor corneas for successful corneal transplantation. As per EBAI data 58,000-60,000 eye balls/cornea were procured and 28,000-29,000 cornea transplants were performed in India.

Dr. Sudesh Arya, Prof. and Head, Deptt. of Ophthalmology, GMCH Chandigarh shared the progress made in eye donation (quantitative and qualitative) by Eye Bank, GMCH/32, Chandigarh.

Dr. Vipin Koushal, Nodal Officer, Regional Organ and Tissue Organization (ROTTO) PGI, and Dr. Ravi Gupta, MS, GMCH Chandigarh told about their initiatives in promoting HCRP. In PGI, there is a mention in death certificate about mandatory counseling of family members regarding eye donation and there is a phone based Mandatory Death Notification to promote HCRP.

Dr. Sonu Goel, Professor, Deptt. of Community Medicine, and school of public health PGIMER talked about the public health implications of promotion of eye donations through HCRP.

Mr. J B Bahl, President, Rotary Eye Bank, Hoshiarpur enumerated the activities under taken to promote eye donations and getting free Cornea Transplant Surgeries of 2300 patients since 1998, in Punjab,Delhi and nearby states.

DURATION AND VENUEOne day consultation meeting was held at Seminar Hall, Department of Community Medicine and School of Public Health, PGIMER, Chandigarh.

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There is a need to strengthen existing eye banks instead of opening new ones. Criteria of collection of at least 50 corneas per year should be strictly followed for recognition/approval as an eye bank. Existing registered eye banks which are defunct can be reinvigorated with the help of active NGOs through Public Private Partnership.

IEC material regarding eye donation and list of eye banks/KP centres may be displayed in all Govt./Corporate hospitals and mortuaries.

DGPs of all states and UTs may send circular to all Distt. Police Heads to allow removal of eye balls/cornea before the post mortem examination is undertaken and also motivate families of the deceased and inform local eye specialist or hospital authorities.

Govt. of India may consider providing grief counselors in all the govt. medical colleges and govt. hospitals with more than 200 bed strength and latest state of the art equipment for Keratoplasty Surgery for eye banks under NPCB.

All Chief Medical Officers and Civil Surgeons should ensure facilitation of eye donations, prompt payment to grant-in-aid to eye banks and KP Centres.

MCI should ensure that working eye bank/eye donation centre should be mandatory for recognition of a new medical college.

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RECOMMENDATIONS

BACKGROUNDStrategic Institute of Public Health Education and Research (SIPHER), Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, and Department of Health and Family Welfare, Punjab organised a consultation on Tobacco 21- Why legal age to buy and use tobacco and legal nicotine products should be increased from 18 years to 21 years on 29th June, 2019.

COLLABORATORS/PARTICIPANTS Hon’ble Health Minister, Punjab; representatives from NTCP Punjab, Haryana, Chandigarh; Department of Education and Local government; Public Health experts, Police Officials, Officials from Local government department, State Tobacco Control Cell Punjab, IMA Chandigarh and NGOs.

DURATION AND VENUE One day consultation meeting was held at Seminar Hall, Department of Community Medicine and School of Public Health, PGIMER, Chandigarh.

DELIBERATIONS AND RECOMMENDATIONSShri.Balbir Singh Sidhu, Health Minister, Punjab assured the house that existing anti-tobacco laws will be implemented strongly and strictly. He also agreed with the proposal that the legal age to buy tobacco shall be increased beyond the present limit of 18 years and assured to expedite the process of licensing the tobacco vendors. He agreed to recommend an increase in the age to buy and use tobacco & legal nicotine products.

Consultation on Tobacco 21- Why legal age to buy and use tobacco and legal nicotine products should be increased from 18 years to 21 years?

ACTIVITY 4

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Dr. Rana J Singh, Deputy Regional Director, The Union, said that worldwide, tobacco use is the leading cause of preventable deaths and is reaching epidemic levels among children and adolescents. It is reported that nearly 5500 children start using tobacco daily in India and about half of them would continue to use it to adulthood. If the current smoking trends continue, tobacco will kill nearly 250 million of today's children. Thus, there is an urgent need to curb the tobacco epidemic among children and adolescents. The new emerging culture of Hookah Bars and Electronic Cigarettes is another major cause of concern and there is an urgent need to focus on these issues. He emphasized the need to increase the legal age to buy and use tobacco beyond 18 years as an estimated 35% of users start using tobacco before they are 18 years and 70% before 21 years of age.

Dr. Rakesh Gupta, Director Chemical Examiner Lab, Punjab opined that minors (less than 18 years of age) should be protected against the harms of Tobacco/Nicotine as there is sufficient evidence about its increasing harmful effects among this group. Therefore, a comprehensive awareness strategy should be planned with all concerned stakeholders to check harms due to tobacco use. Police, Health, Education and Local Govt. Departments along with other stakeholders need to strictly implement anti-tobacco laws and Juvenile Justice Act. He presented the good practices of some states in which there is a licensing of tobacco vendors and also some countries of the world, e.g. USA and Singapore in which legal age to buy tobacco has already been increased beyond 18 years. He also added that MC Mohali has already passed a resolution to license tobacco vendors. He further suggested that nicotine in tobacco is as addictive as Heroin, so should be taken up under the flagship of De-Addiction programme of the state govt.

Dr. Sonu Goel, Professor, Department of Community Medicine and School of Public Health, PGIMER emphasized that there is a need for targeted and focused tobacco use prevention interventions by adopting a comprehensive approach by increasing awareness and providing health education to varied stakeholders so that anti-tobacco laws can be implemented effectively and prevent minors from getting addicted to Tobacco/Nicotine. Parents and teachers need to be role models for the children and should not use tobacco especially in the presence of children.

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Recommendations were sent to the Government of India that the only solution to reducing tobacco use among youth is increasing the minimum sale age for tobacco products to 25 years instead of 18 years. It is also the legal age to buy liquor in Punjab. Changing the sale age to 25 complements other strategies to reduce tobacco use.

Dr. Nirlep Kaur, State Nodal Officer NTCP, Dept. of Health and Family Welfare, Punjab shared state’s good practices like a declaration of state as Tobacco smoke-free, strict implementation of Section 6 of COTPA to curb sale to minors and penalizing tobacco vendors within 100 yards of education institutes, ban on Hookah Bars and Electronic cigarettes, close monitoring of tobacco control activities at the district and state level. She also said that a one-hour session in Hookah bar is equivalent to smoking 100 cigarettes, so it is hazardous to health, especially for minors. There is already a ban on Hookah bars in Punjab under COTPA. These Hookah bars also violate FSSAI, Drugs and Cosmetics Act, IPC 268,269.278 and JJ Act (if minors are provided Hookahs). Carbon Monoxide produced by Hookahs pollutes the air in the premises, even if only flavours are used.

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BACKGROUNDStrategic Institute for Public Health Education and Research (SIPHER) organised a three-day long, World Heart Day Campaign, in September 2019.

ACTIVITIESA cyclothon was flagged off by Padma Shri Prof. Dr Jagat Ram, Director PGIMER, Chandigarh. The campaign was conducted in collaboration with PGIMER, IMA-Chandigarh, and Ojas Multi-specialty Hospital, Panchkula. The members of Chandigarh Cycling and Run club joined the rally from PGIMER to Sukhna lake. The highlight of the campaign was an audio-visual publicity van for generating awareness on public health importance of various activities for a disease-free heart. While appreciating the efforts of Dr. Rakesh Gupta, Director, Chemical Examiner Lab, Punjab; Dr. Sonu Goel Professor, Department of Community Medicine and School of Public Health, PGIMER, Chandigarh and entire team of SIPHER in organizing the campaign, Dr. Jagat Ram elaborated about the importance of stopping use of tobacco, nicotine and e-cigarettes along with balanced diet and regular exercise for a healthy heart, besides, urging people to be ‘Heart Heroes’ by making a heart promise to someone they love or care about.

Various activities were conducted on the occasion at Sukhna Lake Chandigarh which included talks by Dr. Anurag Sharma, Cardiologist, Ojas Hospital and Dr. Ajay Singla, Secretary Transport, UT Administration on the role of exercise and diet in maintaining a healthy heart. Dr. Rakesh Gupta and Dr. Sonu Goel who have been conducting a relentless campaign against electronic cigarettes for the last 6 years applauded Ministry of Health, Government of India for its complete ban in the entire country which will save hearts of millions of citizens. Laughter Yoga session was conducted by Dr. Nidhi Jaswal from Department of Community Medicine and School of Public Health, PGIMER which was thoroughly enjoyed by the participants. More than 150 persons got their blood sugar and blood pressure checked at the special counters

World Heart Day Campaign Celebrations

ACTIVITY 5

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COLLABORATORS/PARTICIPANTS Padma Shri Prof. Dr. Jagat Ram, Director PGIMER, Chandigarh, IMA-Chandigarh, and Ojas Multi-specialty Hospital, Panchkula and the members of Chandigarh Cycling and Run club.

BACKGROUNDA State Level Inception Workshop for Prevention and Management of Hypertension was organised by the Department of Community Medicine and School of Public Health, PGIMER, Chandigarh in collaboration with the Strategic Institute for Public Health Education and Research (SIPHER) and Global Health Advocacy Incubator (GHAI) on November 30, 2019. The workshop was focused on sensitizing and engaging elected representatives and bureaucrats at state level to place hypertension on the priority list of the state government. It also envisaged orienting media professionals and seeking their contribution for the wide media coverage of the issue in the state of Punjab.

COLLABORATORS/PARTICIPANTS The Hon’ble Health Minister of Punjab, Sh. Balbir Singh Sidhu was the Chief Guest and Sh. K S Pannu, Commissioner FDA was the Guest of Honour for the event. Dr. GB Singh, State Programme Officer, National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) Punjab and Dr. Areet Kaur, State Programme Officer, Health & Wellness Centres (HWC), Punjab were key speakers during the workshop. Experts from the departments of Cardiology, Internal Medicine, Endocrinology, Dietetics, Radiology from PGIMER and other private hospitals; civil society organizations; medical professionals participated in the workshop.

DURATION AND VENUE One Day Advocacy Meeting was held at Hotel Parkview, Sector-24, Chandigarh.

State Level Inception Workshop on Hypertension Prevention and Management

ACTIVITY 6

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The delegates shared their ideas and recommendations for dealing with various risk factors for Hypertension and Cardiovascular Diseases. The consultation began with the welcome address of Dr. Sonu Goel, Professor, Dept. of Community Medicine and School of Public Health, PGIMER, Chandigarh who introduced the Chief Guest, Hon’ble Health Minister of Punjab, Sh. Balbir Singh Sidhu and the Guest of Honour, Sh. KS Pannu, Commissioner FDA, Punjab. It was followed by the introduction to the consultation, wherein he mentioned that it is a part of the GHAI funded project namely ‘Strengthening of management of hypertension services through capacity building, media and communication, and stakeholders engagement in state of Punjab’ (SMHSP). The rationale of the consultation was

Dr. Om Parkash Bera, Country Coordinator, India, GHAI presented the brief history and principles of GHAI to the audience. He mentioned that the organization aims at policy change, and has built on a 20-year track record of success across multiple issues like Cardiovascular Health, Civil Registration and Vital Statistics, Drowning Prevention, Maternal and Reproductive Health, Obesity Prevention, Preventing Epidemics, Road Safety and Violence against Women in multiple countries.

Dr. Bhawna Sharma, Country Director, RTSL, India gave an introduction of the ongoing projects under RTSL in India. She mentioned various risk factors influencing cardiovascular diseases. She showcased multiple scientific public health interventions that were implemented in resource constraint settings for effective reduction of cardiovascular burden. She stressed upon the idea of catastrophic economic implications of not controlling risk factors such as hypertension at an earlier stage, which is highly preventable.

Dr. Sonu Goel

Dr. Om Parkash Bera

Dr. Bhawna Sharma

DELIBERATIONS AND RECOMMENDATIONS

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Mr. Arun Verma, Director, Finance and Operations, SIPHER, Chandigarh introduced the audience to the vision, aims and objectives of the organization. He highlighted various activities conducted so far under the aegis of the organization. Till now, the organization has carried around five major events including advocacy to ban e-cigarettes, increasing the age from 18 to 21 for tobacco users; protecting minors from tobacco or nicotine use; reinvigorating eye-banking and celebration of World Heart Day, 2019.

Dr. GB Singh, State Programme Officer, NPCDCS, Punjab stated that 60% of the population in Punjab is suffering from hypertension. Lifestyle factors such as diet, alcohol use, obesity, stress, etc. are making the inhabitants of Punjab prone to hypertension. Surprisingly, 50% of the people in the state are not aware of their diagnosis, thus, they are not following any treatment for the same. He expressed that there is a need for additional initiatives to prevent and manage hypertension across the state. He offered his full support to this initiative in the State of Punjab.

Dr. Areet Kaur, State Programme Officer, Health and Wellness Center, Punjab highlighted various initiatives undertaken to screen and treat hypertension under Health and Wellness Center of Punjab. She mentioned that wellness activities like Yoga and Health talks are being undertaken at each center every week to prevent and manage hypertension. She mentioned that HWC is a wonderful platform for initiating prevention and management of hypertension and offered her support in the current initiative in order to reduce the rising burden of hypertension in Punjab.

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Mr. Arun Verma

Dr. GB Singh

Dr. Areet Kaur

The inaugural session was followed by an address by the Chief Guest. Hon’ble Health Minister, Sh. Balbir Singh Sidhu appreciated this initiative of Department of Community Medicine and School of Public Health, PGIMER, Chandigarh and the partners- SIPHER and GHAI for prevention and management of hypertension in the state of Punjab. He said that people in Punjab need to make changes in their lifestyle pattern. He further advocated developing contextual based health messages for the general public to fight the issue of hypertension in the state. He further promised that he would be actively involved in the hypertension awareness camps organised across the state. He added that every individual residing in the state of Punjab should be made aware of hypertension and how to prevent it. He recommended the use of HWC in raising awareness and active screening /follow-up of population for hypertension. He assured to implement all the feasible recommendations coming out of this important consultation to decrease the prevalence of hypertension in the state.

An expert discussion for dealing with various risk factors for Cardiovascular Diseases was moderated by Dr. Rakesh Gupta, Chief Chemical Examiner, Punjab and Dr. Sonu Goel, Professor, Dept. of Community Medicine and School of Public Health, PGIMER. The discussion was focused on prevention and control of risk factors for hypertension including tobacco, obesity, physical inactivity and stress. Experts from the departments of Cardiology, Internal Medicine, Endocrinology, Dietetics, Radiology, Neurology, Yoga and AYUSH along with the Media professionals participated in the discussion.

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Dr. Ashish Bhalla, Professor, Dept. of Internal Medicine, PGIMER, Chandigarh explained that blood pressure has to be recorded before taking medicine in the morning so that 24-hour control could be measured. There is also a need to address several other issues including stress and use of drugs in Punjab. He suggested developing tailor-made interventions for the management of hypertension and emphasized the role of population-based screening of hypertension at village level followed by its management. He highlighted that a change in the lifestyle pattern can help a person to get rid of the disease, subsequently, the need for medicines will drastically fall down.

Dr. SS Sodhi, Senior Cardiologist, President IMA Mohali suggested inclusion of the private sector in the Hypertension Control Program. He emphasised on the need to strengthen the awareness and screening services for hypertension and the need for creation of facilities for regular exercise. Crucial role of schools was also discussed. Schools need to be proactive as childhood obesity is a major issue. In a bid to bring down childhood obesity, there is a dire need to ban the junk food available in the markets. He highlighted that medication adherence is necessary. Exercise, yoga and meditation are important to lay the foundation of healthy life and should be promoted.

Dr. TP Singh, Associate Director, Cardiology, Max Super Speciality Hospital, Mohali mentioned that there is an urgent need to make people aware about the causes of hypertension. People need to understand that the levels of blood pressure vary from person to person. A modification in lifestyle pattern is highly recommended. He stressed that people should stop following ‘word of mouth’ when it comes to medications. Apart from that, a person, suffering from hypertension, should never stop his medication abruptly. The most basic yet highly important step that is required to be taken is everyone should track their blood pressure levels regularly.

Dr. Ashish Bhalla

Dr. SS Sodhi

Dr. TP Singh

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Dr. Rana J Singh, Deputy Regional Director, The Union, said that worldwide, tobacco use is the leading cause of preventable deaths and is reaching epidemic levels among children and adolescents. It is reported that nearly 5500 children start using tobacco daily in India and about half of them would continue to use it to adulthood. If the current smoking trends continue, tobacco will kill nearly 250 million of today's children. Thus, there is an urgent need to curb the tobacco epidemic among children and adolescents. The new emerging culture of Hookah Bars and Electronic Cigarettes is another major cause of concern and there is an urgent need to focus on these issues. He emphasized the need to increase the legal age to buy and use tobacco beyond 18 years as an estimated 35% of users start using tobacco before they are 18 years and 70% before 21 years of age.

Dr. Rakesh Gupta, Director Chemical Examiner Lab, Punjab opined that minors (less than 18 years of age) should be protected against the harms of Tobacco/Nicotine as there is sufficient evidence about its increasing harmful effects among this group. Therefore, a comprehensive awareness strategy should be planned with all concerned stakeholders to check harms due to tobacco use. Police, Health, Education and Local Govt. Departments along with other stakeholders need to strictly implement anti-tobacco laws and Juvenile Justice Act. He presented the good practices of some states in which there is a licensing of tobacco vendors and also some countries of the world, e.g. USA and Singapore in which legal age to buy tobacco has already been increased beyond 18 years. He also added that MC Mohali has already passed a resolution to license tobacco vendors. He further suggested that nicotine in tobacco is as addictive as Heroin, so should be taken up under the flagship of De-Addiction programme of the state govt.

Dr. Sonu Goel, Professor, Department of Community Medicine and School of Public Health, PGIMER emphasized that there is a need for targeted and focused tobacco use prevention interventions by adopting a comprehensive approach by increasing awareness and providing health education to varied stakeholders so that anti-tobacco laws can be implemented effectively and prevent minors from getting addicted to Tobacco/Nicotine. Parents and teachers need to be role models for the children and should not use tobacco especially in the presence of children.

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Dr. Akshay Anand, Professor, Department of Neurology, PGIMER, Chandigarh stated that food adulteration is also associated with the increased risk of hypertension. He explained about one of his projects, ‘PAN Protocol’ which will include screening of pre-hypertensive followed by three-month yoga interventions for pre-hypertensive. He recommended a protocol which incorporates physical exercise, meditation, Yoga, and deep breathing etc.

Dr. Nancy Sahni, Dietician (APC), Department of Dietetics, PGIMER, Chandigarh strongly recommended that there should be zero trans fat and no use of palm oil in the food products. Total sodium level per serve of all namkeen, chips, kurkure etc. should not be more than 140 mg. Sodium content should be mentioned on the labels of various food items including biscuits. She highlighted that there should be strict norms for all fast food joints serving ready to eat food to keep sodium at less than or equal to 140 mg per serve, zero trans fats, less than 10 ml fat and 1 gm fibre per 15 gm carbohydrate. Stringent norms should be there for all bakery shops to use pure dairy cream instead of hydrogenated fat as cream in cakes, pastries, cream rolls etc.

Mr. Shivinder Sehdev, Programme Officer IEC-BCC, Punjab shared some recommendations on behalf of all the media professionals. He revealed that it is very important for doctors or physicians to understand the kind of simple language to be used in media coverage as general people do not understand medical terminology. Thus, crisp and concrete information should be provided to them. He suggested exclusive media workshops on such key issues by experts on a regular basis.

Dr. Akshay Anand

Dr. Nancy Sahni

Mr. Shivinder Sehdev

The Guest of Honour of the event, Sh. KS Pannu, IAS, Commissioner FDA, Punjab said that in order to treat the problem of hypertension across Punjab, we need to align the treatment with the geography and culture of the state. People need to stop relying on Doctor ‘Google’. He also stressed that one should never ignore if there is something wrong with their bodies. He recommended that camps to check blood pressure should be organised in different villages across Punjab. He suggested incorporating easy to perform yoga and even enjoyable Bhangra or laughter yoga. He assured that the food safety department would take all possible steps to curb trans-fat content in the food products.

(From left to right: Dr. GB Singh, SPO, NPCDCS, Punjab; Dr. Sonu Goel, Professor, DCMSPH, PGIMER; Hon’ble Health Minister Sh. Balbir Singh Sidhu; Sh. KS Pannu, IAS, Commissioner FDA; and Dr. Rakesh Gupta, Chief Chemical Examiner, Dept. of Home Affairs and Justice, Punjab.)

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RECOMMENDATIONS FOR PREVENTION AND MANAGEMENT OF HYPERTENSION IN THE STATE OF PUNJAB

NCD COMMITTEE: A committee may be constituted at the state and district level to monitor the implementation of NPCDS programme with focus on control of preventable risk factors. Representatives of Medical Colleges and NGOs working in the field of NCDs may be selected as members this committee will be responsible for proactive screening for hypertension by organising special camps and ensuring availability of medicines in

FDA: It will ensure monitoring of the strict implementation of FSSA i.e. restriction in sale of high Trans Fat, Sodium and Sugar products especially near the educational institutes and strict implementation of ban on flavoured and scented tobacco and electronic cigarettes, as Tobacco/Nicotine is one of the important preventable risk factors.

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NATIONAL TOBACCO CONTROL PROGRAMME: State Level Coordination Committee, STCC and DTCCs to monitor strict implementation of anti-tobacco /nicotine laws by all stakeholder departments.

HEALTH AND WELLNESS CENTRES to ensure regular monitoring of screening of all OPD patients for hypertension and availability of medicines.

AYUSH to be actively involved in management of hypertension especially by popularising Yoga and meditation.

POSTS OF DIETICIAN may be created at various levels to guide patients in dietary management of diseases.

THE MEDIA AND DEPT. OF PUBLIC RELATIONS should create awareness about Hypertension. Everyone should avoid preventable risk factors like obesity, high salt, sugar, trans fat intake and desist from Tobacco/Nicotine in any form. Role of exercise has to be emphasised from childhood. Stress management with traditional sports, yoga should be permoted.

Seminar on Hypertension: Prevention and Management

ACTIVITY 7

BACKGROUND Department of Community Medicine and School of Public Health, PGIMER, Chandigarh in collaboration with Department of Internal Medicine, PGIMER organised a seminar on ‘Hypertension: Prevention and Management’ on February 15, 2020 in Advanced Cardiac Center, PGIMER, Chandigarh.

COLLABORATORS/PARTICIPANTS Global Health Advocacy Incubator (GHAI), USA and Strategic Institute of Public Health Education and Research (SIPHER) were the collaborating partners in the seminar. The subject experts included Dr. Vikas Suri, Additional Professor, Dept. of Internal Medicine, PGIMER; Dr. Rajesh Vijayvergiya, Professor, Department of Cardiology, PGIMER, Chandigarh; Dr. Sonu Goel, Professor, Department of Community Medicine and School of Public Health, PGIMER; Dr. Vivek Kumar, Assistant Professor, Department of Nephrology, PGIMER; Dr. Kathirvel S., Assistant Professor, Department of Community Medicine and School of Public Health, PGIMER; Dr. Atul Arora, Senior Resident, Dept. of Ophthalmology, PGIMER, Chandigarh. The participants were Healthcare professionals (Faculty, Medical Officers, Program Managers), Postgraduate medical students, PhD Research Scholars, MPH Students, and Paramedical students among others. Around 100 participants attended the seminar.

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Dr. Vikas Suri, Additional Professor, Department of Internal Medicine, PGIMER, Chandigarh briefed the audience regarding the definitions and screening guidelines of hypertension. He suggested that every individual above 18 years of age should have their blood pressure checked regularly. While discussing upon the correct methods of measuring hypertension, he enumerated common errors made by the residents or staff nurses while measuring the blood pressure of the patients and suggested measures which could be taken to reduce these errors. He further shared the guidelines to measure the blood pressure in the accurate manner.

Dr. Sonu Goel

Dr. Vikas Suri

DURATION AND VENUEOne Day seminar was held at Conference hall, Advanced Cardiac Centre PGIMER, Chandigarh.

The seminar began with a welcome note and presentation of Dr. Sonu Goel, Professor, Dept. of Community Medicine and School of Public Health, PGIMER, Chandigarh regarding the burden of hypertension in India. Highlighting the alarming prevalence of hypertension in the state of Punjab, he stated that more than 35.7% of the population has high blood pressure, which is much higher than the national average of 25.3%. Most people are unaware of their blood pressure levels, particularly the younger population. He also mentioned the Government of India initiatives to control hypertension in the country. He emphasized that it is a public health concern and the Department of Community Medicine and School of Public Health, PGIMER is promoting physical activity to contain this epidemic.

DELIBERATIONS AND RECOMMENDATIONS

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Dr. Kathirvel S, Assistant Professor, Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, shared his experience on population-based screening of hypertension in the city of Naraingarh, Haryana. He mentioned that the Govt. of India rolled out a population-based approach for screening of NCDs in the country recently. As per the national guidelines, 30 years and above are enrolled for screening of hypertension and diabetes under NPCDCS program. However, in Naraingarh, they covered the population of 18 years and above to screen for hypertension and diabetes. It was found that hypertension was also prevalent in the age-group of 18-30 years. Based on his study, it was recommended that the age criteria for selecting the population for screening should be reduced from 30 to 18

Talking about the alarming rise in cardiovascular mortality which results in 20-50% of all deaths across India and in Punjab, Dr. Rajesh Vijayvergiya, Professor, Department of Cardiology, PGIMER, Chandigarh enumerated various types of cardiovascular diseases (CVDs), which are directly or indirectly related to hypertension. He further added that hypertension is directly responsible for 51% of all stroke deaths and 45% of all coronary heart disease (CHD) deaths in India. He also led a discussion on modifiable (diet, cigarette smoking, hypertension, alcohol consumption, physical inactivity) and non-modifiable risk factors (genetics, age, gender, etc.) of cardiovascular diseases. He emphasized that the risk of CVDs could be reduced to a significant level by controlling the modifiable risk factors. It was suggested that control of hypertension level could be achieved by low salt intake, appropriate body weight maintenance and medication adherence. He concluded the session by recommending the guidelines for risk factor screening.

Dr. Kathirvel S

Dr. Rajesh Vijayvergiya

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Dr. Atul Arora, Senior Resident, M.Ch., Vitreo Retina and Uveitis, Department of Ophthalmology, PGIMER, Chandigarh discussed the ophthalmic changes in hypertension. He described the three stages of hypertensive retinopathy along with its different classifications. It was suggested that retinal examination of a hypertensive patient should be done on routine basis.

Dr. Vivek Kumar, Assistant Professor, Department of Nephrology, PGIMER, Chandigarh, discussed the renal complications in hypertension. Initiating with the role of kidneys in the normal functioning of the body system, he explained the relationship of hypertension and kidney dysfunction. He expressed that it is equally important to suspect the secondary causes of hypertension.

Decoding the role of healthy diet in managing hypertension, Dr. Nancy Sahni, Dietician, Department of Dietetics, PGIMER, Chandigarh, shared that certain dietary patterns and individual dietary elements play a prominent role in the development of hypertension. She suggested replacing the unhealthy carbs with healthy carbs. It was recommended to consume 2gm of sodium or <5gm of salt in a day. She added, “Weight loss of 4kg by diet reduces Systolic and Diastolic blood pressure (BP) by 4.5- and 3.2-mm Hg respectively”. She also emphasized that a moderate increase in protein intake, along with low salt and sugar intake, has been identified as a possible lifestyle change that can help lower high blood pressure.

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Dr. Atul Arora

Dr. Vivek Kumar

Dr. Nancy Sahni

Explaining the role of yoga in prevention and management of hypertension, Dr. Akshay Anand, Professor, Department of Neurology, PGIMER, Chandigarh highlighted the concept of ‘Mind-Body Medicine’ (MBM) for hypertension. He said that the MBM will contribute to the development of non-pharmacological treatment approaches to hypertension. The ultimate goal will be to build a standardized MBM programme for hypertensive patients. Explaining the importance of this concept to control hypertension, he mentioned the 8-fold path of yoga to the audience. Narrating findings of one of the research studies highlighting the importance of yoga intervention in control of hypertension, he mentioned that three yoga interventions (Meditation, Pranayama and Yoga) were conducted with essential arterial hypertension patients and found significant clinical and statistical correlations between these interventions and control of hypertension. In the concluding remarks, he endorsed Integrated Healthcare Delivery and requested the fraternity of PGIMER to integrate Ayurveda, Yoga and Allopathy in

A question-answer round of 10 minutes was conducted. The round was open for the audience to make clarifications and raise questions for the speakers. Questions pertaining to diet, type of oil to be used, use of intermittent fasting, blood pressure measurements, role of aspirin in treating hypertension, yoga intervention in community, etc. were asked from the speakers.

Dr. Akshay Anand

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Before calling off the seminar, Dr. Nidhi Jaswal, Technical Coordinator, SMHSP Project, Department of Community Medicine and School Public Health, PGIMER, Chandigarh conducted a 10-minute laughter yoga session with the participants and resource persons. She emphasized that this technique is useful group activity which is full of fun and yet effective to control hypertension.

LAUGHTER YOGA SESSION

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PRESS COVERAGE

State Level Workshop of Media Personnels on Combating Hypertension, a silent epidemic - the Role of Media.

ACTIVITY 8

BACKGROUND The Department of Community Medicine and School of Public Health, PGIMER in collaboration with the Chandigarh Press Club, Chandigarh organized a State Level Workshop for Media Persons entitled “Combating Hypertension, a Silent Epidemic – the Role of Media” on 13th March, 2020 in Chandigarh Press Club, Sector-27, Chandigarh. The workshop aimed at making the media persons aware regarding the prevailing epidemic of hypertension and the lifestyle modifications required to control it.

COLLABORATORS/PARTICIPANTS The workshop was supported by the Strategic Institute for Public Health and Research (SIPHER), Chandigarh and Global Health Advocacy Incubator, (GHAI), USA. Experts from the departments of Cardiology, Community Medicine and School of Public Health, Neurology, Psychiatry, Yoga and Dietetics were invited to share their insights on risk factors leading to hypertension among media personnel. Journalists and media persons from across the state of Punjab and Chandigarh attended the workshop.

DURATION AND VENUEOne day Workshop was held in Chandigarh Press Club, Sector-27, Chandigarh

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DELIBERATION AND RECOMMENDATIONS The workshop started with a short skit, which was performed by Mr. Naresh and team from Department of Indian Theatre, Punjab University, Chandigarh. The skit portrayed the lives of media personnel and their relationships with their employers. The artists showcased the factors leading to stress among the media persons which eventually resulted in hypertension among one of the employees. The skit also highlighted the objectives of the workshop to the participants.

A screening camp for hypertension and diabetes was also organised for the media persons. Due to their professional obligations, the media personnel have to work at odd hours and their job is stressful. In addition to the unhealthy lifestyle, the use of tobacco was also observed in a few participants and thus, they were identified as a high-risk group for hypertension.

The screening consisted of filling a questionnaire regarding their profession and the current health status, measurement of height, weight, BMI, BP and blood sugar levels. Accordingly, colour coding of the participants was done.

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N o r m a l B o r d e r l i n e n e w l yd i a g n o s e d

p r e v i o u s l yd i a g n o s e d

D i a g n o s e d w i t h c o m p l i c a t i o n s

GREEN YELLOW BLUE ORANGE RED

Mr. Saurabh Duggal

Spread awareness regarding hypertension.

Orient them towards the rise of non-communicable diseases and to encourage adoption of a healthy lifestyle.

Make them aware about the risk factors for NCDs and the appropriate measures to curb their progression.

Engage the media personnel in conducting health promotion activities at their own level and through their resources, disseminating reliable and accurate information regarding NCDs.

Mr. Saurabh Duggal, General Secretary, Chandigarh Press Club presented the welcome note. He thanked the organising team for choosing the Chandigarh Press Club as their venue to disseminate information on hypertension among media persons of the state of Punjab and Chandigarh. Dr. Sonu Goel, Professor, Department of Community Medicine and School of Public Health PGIMER Chandigarh also welcomed the resource persons and the participants.

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THE MAIN OBJECTIVES OF THE SCREENING WAS TO

PANEL DISCUSSION 1 Factors affecting the hypertension among media personnel- Perspective of Cardiologist, Neurologist and Public Health expert

PANELISTS Dr. Amarjeet Singh, Professor and Head, Department of Community Health and School of Public Health, PGIMER, Chandigarh; and Dr. Yash Paul Sharma, Professor and Head, Department of Cardiology, PGIMER, Chandigarh

The session was moderated by Dr. Sonu Goel, Professor, Dept. of Community Medicine and School of Public Health, PGIMER, Chandigarh and Dr. Om Prakash Bera, Country Coordinator, Global Health Advocacy Incubator, USA

To make the workshop more interactive, two panel discussions were conducted which represented the perspectives of different experts on factors affecting hypertension among media persons. Dr Amarjeet Singh, Professor and Head, Department of Community Medicine and School of Public Health, PGIMER; Dr Yash Paul Sharma, Professor and Head, Department of Cardiology; Dr Sandeep Grover, Professor, Department of Psychiatry, PGIMER, Chandigarh; Dr Akshay Anand, Professor, Department of Neurology; and Ms. Sunita Malhotra, Chief Dietician, Department of Dietetics were among the key panelists.

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DISCUSSION Dr. Yash Paul Sharma, Professor and Head, Department of Cardiology, PGIMER, Chandigarh explained the after taking cautions, the primary and secondary hypertension can be cured. He added that keeping a check on your blood pressure levels would save a person from the manifestations of uncontrolled BP including heart attack, renal failures, and blindness. He further recommended the media personnel to keep a track of their blood pressure levels. He said most of the people are unaware of their blood pressure status putting them at higher risk of hypertension. He also stressed that hypertensive patients should try to maintain their appropriate weight, adding a proper diet is very necessary for any person having high blood pressure.

Highlighting the data from a Global Research, Dr. Sharma noted that Covid-19 patients with hypertension, cardiovascular diseases, diabetes, chronic respiratory diseases, and cancer had fatality rate of 8.4%, 13.2%, 9.2%, 8% and 7.6%, respectively.

Dr. Amarjeet Singh, Professor and Head, Department of Community Medicine and School of Public Health, PGIMER, Chandigarh underscored that media plays an important role in doing health promotion and it is necessary that you should take care of yourselves in the first place.

Calling for making swift lifestyle changes, Dr. Singh, Professor and Head, said that high blood pressure does not come with any warning sign. It can cause disability or death if left untreated. We must make people aware of the importance of getting their blood pressure checked at regular intervals. Besides maintaining a healthy lifestyle and diet, it is equally important to continue to take medications regularly, he added.

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OPEN HOUSE DISCUSSION After the completion of first plenary session, an open house discussion was conducted during which the media persons were asked to clarify their queries at the experts from the resource persons.

On being asked about the relationship of gastritis with heart attack, Dr. Yash Paul Sharma noted that 50% of heart attack cases barely make it to the hospital and the person eventually dies. Speaking on gastritis, Dr. Sharma said that it is common because of the food habits and at times people mistake issues with heart as gastritis. He advised that if a person feels gas frequently then he/she should get ECG and other heart-related tests done. One should always opt for preventive screening.

Commenting on making lifestyle modifications, Dr. Amarjeet Singh said that making changes in your daily routine is of utmost importance and should be done as soon as possible. He advised the participants to add more fruits to their diet, walk for 30 minutes regularly and reduce their salt/sodium intake. He further suggested that it would be really helpful to have friends who will support you and motivate you for making lifestyle changes. Adding to this, Dr. Sharma advised them to avoid having late night dinner.

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PANELISTS Dr. Sandeep Grover, Professor, Department of Psychiatry, PGIMER, Chandigarh; Dr. Akshay Anand, Professor, Department of Neurology, PGIMER, Chandigarh; and Mrs. Sunita Malhotra, Chief Dietician, Department of Dietetics, PGIMER, Chandigarh.

This session was moderated by Dr. Rakesh Gupta, President and Director Public Health, SIPHER, Chandigarh and Mr. Arun Verma, Director Finance and Operations, SIPHER, Chandigarh.

PANEL DISCUSSION 2Factors affecting the hypertension among media personnel- Perspective of Psychiatrist, Dietician and Yoga expert.

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Dr. Sandeep Grover, Professor, Department of Psychiatry, PGIMER, Chandigarh started the discussion by highlighting the role of media in generating awareness regarding hypertension and other risk factors including depression, anxiety and stress. He emphasised that media persons have also been affected by these disorders. Enlisting the symptoms of anxiety and depression, Dr. Grover said that the basic symptoms include loss of interest in daily stuff, loss of sleep, anorexia, negativity in brain. It also includes confused personality, stress on heart, and uneasiness at times. He further underscored that over 40-50% of depressed patients have suicidal tendencies.

Speaking on stress management, Dr. Grover said stress is mainly compiled of two factors- Jealousy and multi-tasking. A person who is not satisfied with himself eventually becomes stressed and along with that job, work-life, lifestyle and other general issues are the secondary causes of stress and anxiety.

Mrs. Sunita Malhotra, Chief Dietician, Department of Dietetics, PGIMER, Chandigarh apprised the gathering about Body Mass Index (BMI). She said that BMI is a reliable indicator of body fat based on your height and weight and places you in the three categories – Normal (18.52-22.9), overweight (More than 22.9), and obese (More than 27).

Ms. Malhotra further answered the queries on salt intake and recommended other elements that should be taken into consideration to make up for a healthy diet. Ms. Malhotra said that there is sodium in all dietary products, but extra salt is added in our food. Moreover, sodium is taken in the form of preservatives, processed foods etc. Also, red meats have more sodium and lean meat have less sodium.

Speaking on transfats, Ms Malhotra said that as name sounds, these elements transform its original source. Baking industry use transfats in biscuits, cakes etc. to increase the shelf life. Widely favourite snack- samosa uses same oil repeatedly, which increases Thyroid peroxidase (TPO) and the TPO levels should not exceed 20%.

Dr. Sandeep Grover

Mrs. Sunita Malhotra

OPEN HOUSE DISCUSSION During the open house discussion, Dr. Grover was asked for tips to maintain proper lifestyle to which he recommended reading and exercise to fill up the leisure gap. He suggested not to sit idle for a long time as it would add to stress and nothing else. He further stressed managing office hours to avoid stress and anxiety and motivated to make lifestyle changes. Adding to this, Dr. Yash Paul Sharma advised them to avoid having late night dinner.

A media person raised his query to Dr. Anand regarding what would be an appropriate time for yoga to be practiced for a media person to which Dr. Anand replied that there is no specific time to perform Yoga. It is effortless and there is no exact time for the same.

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Dr. Akshay Anand, Professor, Department of Neurology, PGIMER, Chandigarh spoke at length on importance of yoga. Speaking about Power Yoga, Dr. Anand said that power yoga basically is like going to gym, and having six abs. Yoga asanas and power yoga are more or less the same thing, only the thin line between the two is asanas are pretty much long and has less sweating, and more interactive.

Dr. Akshay Anand

This is simply the relationship of mind and soul which can be established at any part of the routine. Apt time is 2.00-2.30 hours before eating. Meditation is preferred if done 30 minutes before eating.

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Mrs. Malhotra also took different queries related to diet and lifestyle. When asked about adding rice to regular diet, Mrs. Malhotra said that protein in wheat have gluten. Some are sensitive to gluten. Whole wheat flour is better for health.Indian diet is rich in protein for instance dal, milk, soya, pulses, beans. In fact, soya has more protein than dal, around 2:1, said Mrs. Malhotra on being asked about the rich sources of protein for vegetarians. While explaining the role of fibre in combating hypertension, Mrs. Malhotra said fibres are lower in calories and eventually help in decreasing obesity. Whole wheat has fibre and remain in body for long time which restrains the hurdles.

The panel discussion was followed by an exclusive Laughter Yoga session by Dr. Nidhi Jaswal, Technical Coordinator, SMHSP Project, PGIMER, Chandigarh. The participants performed some laughter exercises, relaxation breathing exercises and a new form of dance called banana dance. It was a 10-minute session which rejuvenated all the participants and the hall was full of laughter and fun.

Before concluding the workshop, the brochure of upcoming National Conference on Tobacco or Health scheduled from 25th to 27th September, 2020 was released by the invited guests from Press Club, PGIMER, and SIPHER, Chandigarh. Dr. Sonu Goel proposed a vote of thanks followed by distribution of certificates and souvenirs to the participants.

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The brochure of National Conference on Tobacco or Health (NCTOH 2020) to be held at PGIMER, Chandigarh from 25-27th September

2020 was released during the event.

RELEASE OF NCTOH-2020 BROCHURE

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GLIMPSE OF LAUGHTER YOGA SESSION

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PARTICIPANTS RECEIVING CERTIFICATES

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PRESS COVERAGE OF THE WORKSHOP

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The seminar was commenced with a welcome note by Dr. Sonu Goel, Professor, Department of Community Medicine and School of Public Health, PGIMER, who has been working in the field of tobacco control for the past ten years. He said, “It is very difficult to persuade someone to quit tobacco. Every substance user has million reasons to not to quit, however, human relationship could be really helpful in managing substance abuse”. shared with the participants.

Dr. Sonu Goel

DELIBERATIONS AND RECOMMENDATIONS

Dr. Amarjeet Singh, Professor and Head, Department of Community Medicine and School of Public Health, PGIMER, apprised participants on the prime role of human relationships in ensuring de-addiction. He further apprised participants on the convergence of different behaviour change constructs to ensure better results.

Dr. Amarjeet Singh

Seminar on Theoretical Connotation of the Importance of Human Relationships in Managing Substance Abuse.

ACTIVITY 9

BACKGROUND Department of Community Medicine and School of Public Health, PGIMER, Chandigarh on 17th March 2020 organised a seminar aiming at promoting the importance of human relationships in managing substance abuse. The seminar on Theoretical Connotation of the Importance of Human Relationships in Managing Substance Abuse was held on the occasion of World Social Work Day, 2020.

COLLABORATORS/PARTICIPANTS The seminar was being organised in collaboration with Strategic Institute of Public Health and Education Research (SIPHER), Association of Professional Social Workers & Development Practitioners (APSWDP), and Integrated Association of Medical Basic and Social Scientists (IAMBSS). The participants included students from Master of Public Health, Master of Social Work, PhD in Social Work/Community Medicine.

DURATION AND VENUEOne day Seminar was held in the Seminar Hall, Department of Community Medicine and School of Public Health, PGIMER, Chandigarh

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Explaining the role of social work professionals in manging substance abuse, Mr. Vivek Trivedi, Founder, APSWDP, said, “Every community across the country is struggling with substance abuse. In order to combat the issue, we need to initiate a dialogue on community level.”

Dr. Rakesh Gupta, former Director Health Services (DHS), Punjab & President, SIPHER, underscored the role of civil society in harnessing human relationships to manage substance abuse. “We should always try to develop a relationship with a substance user to help him quit,” he noted. He further pressed raising taxes on drugs to regulate the prevalence of drug abuse in the country.

Dr. Jitender Gairolla, Research Scientist, IAMBSS, explained the importance of integrated solutions towards substance abuse. He emphasized that Yoga, Ayurveda and other traditional methods in India would be really helpful in combating the issue of substance abuse.

Dr. Goel also briefed the participants on the upcoming 5th National Conference on Tobacco or Health (NCTOH) 2020. He noted that the 5th NCTOH, which is scheduled to take place from September 25th-27th, 2020, is a multi-sectoral convergence focussed on making India tobacco-free by 2020. He also informed that the registration process for the national conference has already been commenced and invited the interested participants to enrol them in.

Mr. Vivek Trivedi

Dr. Rakesh Gupta

ANNEXURES

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PHOTO GALLERY

ANNEXURES

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SOCIAL BUZZ