Summary:

India has been experiencing a significant cancer burden, ranking third globally in cancer cases according to the Global Cancer Care Observatory Data. In 2022, the cancer mortality to incidence ratio in India reached 64.47%, the highest among the ten countries with the most considerable cancer burden. Cancer care has been a component of India’s national healthcare framework for over five decades, being systematically addressed since the launch of the Indian Council of Medical Research (ICMR) Cancer Registry programme in the early 1980s.

Despite this long-standing focus, the landscape of cancer care in India is complicated and evolving, primarily due to the absence of a comprehensive data framework regarding cancer. An analysis conducted by national investigators, comprising researchers from prestigious medical institutions, of 43 cancer registries across the country, aims to fill some gaps in understanding cancer demographics and risks across regions and genders. Notably, the findings revealed that women constituted 51% of the cancer cases reported, a figure that departs from global trends. This discrepancy is concerning and warrants the attention of policymakers, as it underscores a challenge emphasized by cancer specialists for years.

Breast and cervical cancers, which account for over 40% of female cancer cases, have a higher detection and treatment success rate, suggesting the observed reporting patterns. Conversely, oral, lung, and gastric cancers are often identified at more advanced stages, indicating that many cases may not be reported. The study revealed high instances of oral cancer particularly in the Northeast region of India, with Mizoram exhibiting the highest lifetime cancer risk of 21% for men and nearly 19% for women, significantly above the national average of 11%.

The data highlighted from the ICMR registries, which only encompass less than 20% of India's population, points out significant regional disparities. Unlike infectious diseases, where reporting to the government is mandatory, cancer data reporting lacks a legal framework in many states. Although 17 states have regulations that require hospitals and healthcare providers to relay cancer-related data, populous states such as Uttar Pradesh, Maharashtra, and Bihar do not impose such mandates.

The findings from the cancer registry study are crucial as they advocate for improved data collection and reporting. Strengthening cancer data could enhance understanding of preventable cancer causes, optimize resource allocation, and increase the efficacy of governmental healthcare initiatives. These improvements could ultimately lead to a higher cancer survival rate across the country.

Important Sentences:

• India ranks third in the world for the number of cancer cases, with a cancer mortality to incidence ratio of 64.47% in 2022.
• The Indian Council of Medical Research has addressed cancer care within national healthcare programs for over five decades.
• An analysis of 43 cancer registries has revealed that women make up 51% of cancer cases in India.
• Breast and cervical cancers account for over 40% of cases among women and generally have better treatment outcomes.
• A significant burden of oral cancer was noted in regions like India's Northeast, particularly in Mizoram.
• The ICMR registries cover less than 20% of the population, lacking mandatory reporting requirements for cancer data in many states.
• Improved data collection is essential for fostering better understanding of cancer and enhancing government healthcare initiatives, which may improve survival rates.

In a groundbreaking study conducted in Assam, a team of zoologists and health specialists reported the first documented cases of envenoming from deceased monocled cobras and kraits. Their findings, published in the journal "Frontiers in Tropical Disease," reveal that these snakes can still inject venom even three hours after death.

Key Details:

• Research Team: The study was authored by zoologist Susmita Thakur, biotechnologist Robin Doley, anaesthesiologist Surajit Giri, and pediatricians Gaurav Choudhary and Hemen Nath.
• Research Title: “Death to bite: A case report of dead snake envenoming and treatment.”
• Envenoming Cases: The research documents three cases of post-death envenoming:
  • Two victims bitten by monocled cobras (Naja kaouthia) in Sivasagar district.
  • One victim bitten by a lesser black krait (Bungarus lividus) in Boko, southwestern Assam.
• Victims' Response: All individuals received 20 vials of anti-snake venom and spent up to 25 days in the hospital for recovery.
  • The victim of the krait bite, which occurred three hours after the snake's death, required additional medications and mechanical ventilation.

Incident Summaries:

1. First Case: A 45-year-old man beheaded a monocled cobra that had been preying on his chickens. While discarding the snake's body, its head struck and bit him.
2. Second Case: Another individual was bitten while inspecting a monocled cobra that had been crushed under his tractor.

Scientific Implications:

• Nervous System Activity: The study highlighted that the brains of cold-blooded snakes function differently than those of warm-blooded mammals. While the latter’s brain ceases functioning within 6-7 minutes after decapitation, snakes retain active brain function for up to four to six hours post-mortem, potentially allowing them to react reflexively to external stimuli.
• Global Significance: Dr. Surajit Giri emphasized that these envenoming incidents from deceased snakes are unprecedented and mark a significant revelation in the understanding of snake biology and first aid responses in such cases.

Conclusion:

The findings of this research not only add to the limited knowledge surrounding snake behavior post-death but also pose important implications for public safety and health strategies in regions where such species are prevalent. The necessity for awareness campaigns and training in handling snake-related incidents, especially in agricultural communities, may be critical.

Important Points:

• First documented cases of envenoming by dead monocled cobras and kraits in Assam.
• Published findings in "Frontiers in Tropical Disease" revealed the potential danger posed by deceased snakes.
• Victims treated with anti-snake venom had to endure extended hospital stays.
• Cold-blooded snakes can exhibit reflexive biting for hours post-mortem due to sustained brain function.
• Call for increased awareness and safety training in snake-rich habitats.