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Liver diseases often go undetected; doctors call for early screening and awareness
Liver diseases often go undetected; doctors call for early screening and awareness

The Hindu

time2 days ago

  • Health
  • The Hindu

Liver diseases often go undetected; doctors call for early screening and awareness

An estimated 304 million people worldwide live with chronic hepatitis B or C, according to the World Health Organization (WHO). Of these, 254 million have hepatitis B and 50 million have hepatitis C. The disease causes about 1.3 million deaths annually over 3,500 each day. India accounts for over 11.6% of the global burden, with around 29.8 million people living with hepatitis B and 5.5 million with hepatitis C. Hepatitis is inflammation of the liver, most commonly caused by viral infections, mainly hepatitis A, B, C, D, and E. Among these, hepatitis B and C can become chronic, potentially leading to cirrhosis, liver failure or cancer. Transmission can occur through unsafe injections, blood transfusions, sexual contact or from mother to child during childbirth. Despite the scale, most infections remain undiagnosed until complications arise. Doctors say this is due to vague early symptoms, inadequate screening, and widespread misconceptions. 'In the early stages, liver trouble may show up as fatigue, appetite loss or mild abdominal pain - symptoms that are easily overlooked,' said Vivekanandan Shanmugam, Lead Liver Transplant Surgeon, SIMS Hospital, Chennai . 'Even signs like dark urine or yellowing of the eyes are ignored. As a result, patients often present late.' He added that screening for hepatitis B and C is recommended for high-risk groups - those who had blood transfusions before the 1990s, dialysis patients and healthcare workers, but implementation remains patchy. 'Many people don't know they should get tested. There is stigma and poor access, especially in peripheral areas,' he said. Dr. Shanmugam also flagged the impact of over-the-counter painkillers and unregulated herbal supplements. 'The liver filters everything we consume. Long-term misuse of common drugs like paracetamol or herbal concoctions can silently damage the liver.' Radhika Venugopal, Senior Consultant - Hepatology, Liver Disease & Transplantation, Rela Hospital, Chennai, said symptoms such as nausea, fatigue, or weight loss are often ignored. 'By the time jaundice, swelling or bleeding appears, damage is usually advanced. Liver function tests and scans can help detect problems early,' she said. She noted that hepatitis testing is not well integrated into routine healthcare, particularly in rural settings. 'Pregnant women, people with HIV, and those undergoing surgery or dialysis must be screened, but enforcement is weak.' Dr. Venugopal also flagged the rise in 'lean MAFLD' (metabolic-associated fatty liver disease) in people with normal weight but underlying metabolic issues. 'Tools like FibroScan help detect this early.' Doctors recommend hepatitis B vaccination, avoiding excessive alcohol, limiting self-medication, and routine check-ups. 'The liver is silent until it's too late,' said Dr. Shanmugam.

Retired govt employees left in the lurch
Retired govt employees left in the lurch

Hans India

time3 days ago

  • Politics
  • Hans India

Retired govt employees left in the lurch

On July 24, some unstarred questions were raised in the Rajya Sabha by Vailko and Shanmugam on enhancement of minimum pension amount to EPS-95 retirees, who have been receiving a measly Rs 1,000 monthly pension since 2014. The same old reply was given by Minister of State for L&E Sushri Shobha Karandla. How long will this dilly-dallying tactic continue? The GOI says that there is no money with it or with the EPFO. Every month GST income that is generated from the public is over Rs one and half lakh crore and crores is stocked with EPFO. Where is the money coming to pay exorbitant amounts to pay the abnormal salaries and perks to MPs and which are enhanced at periodical intervals? Loads of money and material is transported to the calamity affected nations and for freebies to lower income Indian citizens. These retirees are not being treated as human beings. Thousands of retirees are already dead, and the living ones are on ventilation waiting for their exit but the government shows no consideration for them. Dr N S R Murthy,Secunderabad

Commentary: As cyber threats grow, Singapore walks a careful line on identifying state actors
Commentary: As cyber threats grow, Singapore walks a careful line on identifying state actors

CNA

time5 days ago

  • Politics
  • CNA

Commentary: As cyber threats grow, Singapore walks a careful line on identifying state actors

SINGAPORE: The recent disclosure that a cyber threat group, identified as UNC3886, was attacking critical infrastructure in Singapore took many by surprise. The announcement was made by Coordinating Minister for National Security and Minister for Home Affairs K Shanmugam during a speech at the 10th anniversary of the country's Cyber Security Agency (CSA) last Friday (Jul 18). He warned that Singapore was actively dealing with a "highly sophisticated threat actor" capable of conducting espionage and 'major disruption to Singapore and Singaporeans'. UNC3886 has been described by Google-owned cybersecurity company Mandiant as a group with a China nexus. Understandably, the Chinese embassy in Singapore was dissatisfied that UNC3886 was described as being linked to China. One question that may intrigue readers more was why the minister did not link UNC3886 to a particular country. Was this a perfunctory attempt to publicly attribute a cyber threat, or was it a policy decision by Singapore based on careful strategic calculations? In his announcement, it was apparent that Mr Shanmugam deliberately focused on only naming the threat group, rather than directly pointing to any country. When he was asked the following day about UNC3886's alleged links to China, he said this was "speculative". "What Mandiant does is what Mandiant does ... Who they (UNC3886) are linked to and how they operate is not something I want to go into," he said. TECHNICAL VS POLITICAL ATTRIBUTION Past cases suggest that when it comes to cyberattacks, Singapore prefers technical attribution over political attribution. The former is based on forensic evidence of tactics, while the latter is based on intelligence to name and shame a country. Without direct state attribution, it is often the media and analysts who examine potential links and broader implications as part of their reporting and analysis. For example, when Singapore telecommunications company Singtel disclosed a malware attack in November 2024, it was a Bloomberg report that attributed it to Volt Typhoon, a group allegedly sponsored by China. Similarly, when Singapore blocked roughly 100 social media accounts for circulating disinformation in July 2024, including those linked to a right-wing group created by former Donald Trump adviser Steve Bannon, it made no mention of the United States. During peacetime, technical attribution offers a more pragmatic way to deter cyber threats. Cyberspace is a complex environment, and non-state threat groups, which may or may not act on the behest of a state, are the dominant actors there. This method allows authorities to expose threat groups without directly shaming the country from which they may be operating. Arguably, not shaming the country where the threat group operates from could risk emboldening future attacks and invite scrutiny from security partners who expect transparency. More importantly, it may make public education about the seriousness of cyber threats more challenging. The public may not understand the full context, for example, of the motivation or geopolitical implications of an attack. WHY NAMING WITHOUT SHAMING While Singapore avoids attributing cyber threats to specific states, naming and shaming is the preferred approach for many Western countries and some of their Asian allies, particularly those that view China as a preeminent threat. For countries not directly involved in adversarial relations or those that pursue a foreign policy of non-alignment, it may be more prudent to deter cyber threats without exacerbating geopolitical animosity. The cost of escalation may be too high a risk to bear. Moreover, it remains debatable whether naming and shaming helps to curb cyber threats in a meaningful way. In Singapore's context, there could also be other plausible strategic considerations. First, Singapore is a cosmopolitan country made up of locally born citizens, naturalised citizens and foreigners. Social cohesion is the glue that keeps its people together and maintains communal harmony. Publicly identifying another country as a threat carries the risk of fuelling racism and xenophobia, including Sinophobia. For example, in 2021, the fear that the Singapore-India Comprehensive Economic Cooperation Agreement (CECA) posed a threat to the livelihood of citizens raised the ugly head of xenophobia. Second, there is an observable trend in which Western cybersecurity companies often attribute cyber threat groups to China following incidents involving Western digital networks. Even if there is forensic evidence to link these groups to China, these companies often hold contracts with the US government, creating both commercial and political incentives to focus blame on China. If Singapore is seen as endorsing these companies' attributions, it risks making the impression that Singapore has shifted its foreign policy of non-alignment and is siding with the US in the strategic rivalry with China, which involves cyber contestation. Third, while Singapore and China may have differing views on certain issues, both countries at the political level are keen to deepen their bilateral relations. During an official visit to Beijing in September 2024, Singapore Foreign Affairs Minister Vivian Balakrishnan described Singapore-China relations as a 'very bright spot' in a more volatile and less predictable world. Such a world is even less black and white, and similar to dealing with the US tariff threat, countries must find a balance between resisting compulsion and promoting cooperation. It is prudent not to let one issue define the overall state of bilateral relations. Furthermore, Singapore is a member of the Association of Southeast Asian Nations (ASEAN), and China is a dialogue partner of ASEAN. One essential area where ASEAN and China are cooperating is the signing of the ASEAN-China Free Trade Area (ACFTA) 3.0 in October 2025, aimed at building economic resilience. ASEAN countries, therefore, need to consider both national and regional interests. In the same vein, the overall state of bilateral relations - as well as factors such as motivation, attack impact and international law - would determine how Singapore responds to cyber threats originating from other countries. The world is witnessing a growing militarisation of cyberspace where countries in the West, Middle East and Asia are developing military cyber capabilities. Some may be more willing to conduct offensive cyber operations if their interests with Singapore diverge. WHEN NAMING MIGHT BE NECESSARY However, these considerations do not necessarily preclude non-aligned countries like Singapore from naming and shaming any country as a cyber threat actor should the situation justify it. A careful examination of what constitutes Singapore's most vital national interests may provide insight into how and when such a shift in posture might occur. Plausible scenarios could include external military threats operating in both physical and cyberspace domains, as well as a cyberattack that is not for espionage purposes but creates a disruptive impact that endangers the lives of people in Singapore. For example, imagine a scenario where Singapore faces military coercion and concurrently a cyberattack by a state-linked threat actor that shuts down the digital infrastructure and electrical systems of hospitals nationwide, resulting in deaths. These are extreme scenarios that, hopefully, Singapore will never have to deal with but must prepare for in the unlikely event that they occur.

TN ordered to maintain status quo on removal of flagpoles of parties
TN ordered to maintain status quo on removal of flagpoles of parties

New Indian Express

time7 days ago

  • Politics
  • New Indian Express

TN ordered to maintain status quo on removal of flagpoles of parties

Senior counsel N G R Prasad, who represented Shanmugam, told the bench that the issue involves the rights of political parties, communal bodies or associations etc. To ensure that an opportunity of hearing is provided to all political parties, communal and religious associations etc., before taking a final decision on the matter, the full bench therefore directed the chief secretary of TN to issue a public notification enabling the political parties, communal parties or associations etc., to file impleading petitions to get impleaded in the appeal. The notification should be published in two English and two Tamil dailies that have wide circulation across the state, on or before July 25, the judges added. The impleading petitions should be filed on or before August 5, they further said, and adjourned the matter to August 6. After Prasad expressed fear that existing flagpoles may be removed in the meantime to implement the single judge's order, the judges ordered the government to maintain status quo until further orders.

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