https://speciality.medicaldialogues.in/nice-2018-guideline-on-management-of-stable-copd/
UNICEF
Early PET-CT shall reduce Pancreatic cancer surgery by 20% : NICE
The U.N.’s Terrible Dilemma: Who Gets To Eat?
Women carry sacks of food, airdropped by the World Food Programme, this past summer in Jonglei, South Sudan.
The U.N. is facing a terrible dilemma.
“Basically, when we haven’t got enough money, we have to decide who’s not going to get food,” says Peter Smerdon, a spokesman for the U.N.’s World Food Programme in East Africa.
And even though the program’s budget is at a record high, it’s not enough to keep up with the number of refugees and people in other crisis situations who need emergency food aid. Continuing conflicts in countries like Syria and Yemen and other crises led to the agency’s multibillion-dollar budget shortfall last year. It received a total of $6.8 billion from countries, organizations and private donors when it needed $9.1 billion to do its job.
WFP has already made cutbacks to the number of people it assists in some places. In Somalia, food aid was suspended for 500,000 people in December. In Ukraine, the agency plans to stop giving food to about 40,000 people in February. And in Syria, WFP is providing 2.8 million people with food aid this month, down from 4 million in 2017.
In other places, WFP has reduced the amount of calories that rations contain. “We can do a shallow cut, like 10 percent, 20 percent of the full ration,” says Smerdon. “Or we can do a deep cut if we think the contributions will not be coming in anytime soon.”
In refugee camps, a full daily ration contains 2,100 calories. That is pretty much the bare minimum for adults — to avoid losing weight, women need an estimated 1,600 to 2,400 calories a day while men need 2,000 to 3,000, according to current U.S. dietary guidelines.
The rations vary from country to country, and even within countries, explains WFP spokeswoman Challiss McDonough. In East Africa, the rations would include a cereal grain such as corn or wheat, dried peas or lentils, a fortified flour blend (usually eaten as a hot cereal), some cooking oil and iodized salt.
If funding for a particular region is not “coming in anytime soon,” says Smerdon, “we can do a deep cut.”
In Yemen, the difficulty of providing food rations has been exacerbated by the ongoing civil war and further complicated by blockades that slow down the process of getting food into the country. There have been 40 percent calorie cuts to half of the rations being distributed, says WFP.
The deeper the cuts, the greater the burden on people who are already living in crisis situations, McDonough says.
WFP is usually “the provider of last resort,” McDonough says. When it reduces the number of people it serves or shrinks the size of the daily ration, there is no guarantee that other agencies or organizations will be able to step in to fill the gap. In more stable countries, local branches of organizations such as the Red Cross or Red Crescent societies can help, she explains.
As food aid is reduced or suspended, people might have to sell some of their possessions, using money for school fees or going into debt to buy food.
“When people are trying to figure out how to survive and put dinner on the table every night, it doesn’t allow that family to think about longer-term investments like education, building jobs and businesses and things that will help them in the future,” she says.
The reductions may hit some people harder than others, depending on how much they rely on food aid. In many cases, they get all of their food from WFP, Smerdon says. In Uganda, refugees get a plot of land they can use for growing crops.
And when the cuts are sustained — or deep — there is an increased risk of malnutrition and a suite of other health problems for refugees.
“Their immune systems will be suppressed, and if cuts continue or they’re getting absolutely no food from WFP, inevitably over time, they will fall sick and ultimately many people will perish,” Smerdon says.
Apart from being a source of life-sustaining calories, food rations become key bargaining tools for people living in camps, says Peter Hailey, nutrition expert and founding co-director of the Nairobi-based Centre for Humanitarian Change. He led UNICEF Somalia’s nutrition response during the country’s 2011 famine.
“Parents might decide to reduce the number of meals they [eat] so some of the food can be used not just to feed their kids, but also to pay for health care for those kids or for access to education,” Hailey says.
McDonough and her colleagues are trying to stay positive. “We hope that any cuts like this are temporary,” she says. “That gap between what we want to do, what we think we need to be doing and what we have the resources to do is far too wide for anybody’s comfort.”
One Country Has Eliminated HIV Transmission to Newborns
IN BRIEF
- Thailand has become the first Asian country to completely eliminate mother to child transmission of HIV
- Since HIV is still a global pandemic, it is important for other countries to take note of the enormous success that Thailand has found through government support of health guidelines
MOTHER-TO-CHILD TRANSMISSION
While the virus existed earlier, the first case of HIV to be officially diagnosed in Thailand was in 1984. Since the first diagnosis in Thailand, the disease quickly spread, became epidemic throughout the country, and by the mid-90s, the rate of mother-to-child transmission (MTCT) had reached 20 to 40 percent.
A decade later, the country has managed to pull down these alarming numbers to 1.9 percent. Thailand has even lowered the annual number of women infected with HIV by 87 percent (from 2000 to 2014 ), and by 2016, Thailand became the first Asian country to eliminate MTCT of HIV.
Thailand’s success against MTCT transmission of HIV was recently published in the study: Elimination of mother-to-child transmission of HIV: lessons learned from success in Thailand.
Their success against the virus, experts believe, can be credited to their dedication to following a four-pronged approach to reduce MTCT transmissions recommended by the World Health Organization (WHO) and UNICEF:
- Primary prevention of HIV infection among women of childbearing age
- Prevent unintended pregnancies among women living with HIV
- Prevent HIV transmission from a woman living with HIV to her infant
- Provide appropriate treatment, care and support to mothers living with HIV and their children and families
Using these guidelines, the country implemented the 100% Condom Programme, which promotes 100% condom use with men soliciting commercial sex workers. This effort has significantly reduced HIV infection among women of reproductive age. Sustaining such initiatives is possible with guidance and support from Thailand’s government, who increased investment and focus for HIV/AIDS prevention and eradication. Voluntary HIV testing with same-day results, re-testing among pregnant HIV-negative women, and antiretroviral therapy (ART) for HIV-infected mothers are now accessible to women in Thailand thanks to stronger legislative support.
A CONCERTED EFFORT
Thailand’s achievements can stand as a benchmark for other countries who are trying to address continued and rising HIV infection.
As UNAIDS Executive Director, Michel Sidibé points out in a statement:
Thailand has turned around its epidemic and transformed the lives of thousands of women and children affected by HIV. Thailand’s progress shows how much can be achieved when science and medicine are underpinned by sustained political commitment.
Around the world, there are 36.7 million people living with HIV. 78 million people have become infected since the epidemic began, and 35 million have already lost their lives due to AIDS-related complications. Barely half of those infected have access to treatment, and in 2015 alone, 2.1 million people became newly infected.
Women who are infected with HIV have a 15 to 45 percent chance of transmitting the virus to their children during pregnancy, labor, delivery, or through breastfeeding. These odds significantly drop to just a little over one percent once antiretroviral therapy is given to both mother and child. But because treatment isn’t 100 percent effective, a simultaneous preventative approach to lowering transmission is also important.
Hopefully, as the spread of HIV continues to be a global pandemic, other countries will take note of Thailand’s success. They have proven that proper government support and a clear set of guidelines can create enormous change, even in the most dire of situations.
Source:futurism.com/
UNICEF study reveals two-thirds of rural Indian children who die below the age of five are lost to treatable conditions like premature birth, infection, and diarrhoea
Despite the government’s efforts to curb child mortality, children under the age of five continue to die due to medical negligence and lack of timely medical aid.
A study, funded by the Ministry of Health and Family Welfare, USAID and UNICEF, conducted in rural areas of 16 districts from eight states across India, revealed that even today newborns suffer from infections, acute respiratory infection (ARI) and diarrhoea, which accounts for approximately 63 per cent of deaths in children under the age of five.
The study conducted by the Department of Biostatistics, All India Institutes of Medical Sciences (AIIMS), along with the INCLEN Trust International, was published in the latest issue of Indian Journal of Community Medicine.
Children under the age of five continue to die of diseases such as acute respiratory infection and diarrhoea
The survey conducted in around 216,794 households revealed that more than 1,656 children under the age of five die due to various reasons.
The autopsies were analysed to learn the specific causes of deaths. In newborns, these were shown to be birth asphyxia, premature birth, and infection.
All this contributed to more than 67.5 per cent of the neonatal deaths, while in children aged 29 days to 59 months, ARI and diarrhea accounted for 54.3 per cent of deaths.
Shockingly, the families of 52.6 per cent of newborns and 21.7 per cent of infants and children under the age of five, did not seek any medical care.
The study said that substantial delays in seeking medical attention led to deaths either at home or during transit.
Little girls continue to be ignored in the Indian households, as the study revealed that baby girls born at home, or born in a health center run by unskilled health workers and caregivers with less than primary education were at a higher risk.
States such as Bihar, Madhya Pradesh, Rajasthan, Uttar Pradesh and Andhra Pradesh have recorded high mortality rates in children below five, and these were dubbed high-burden states in India.
Low birth weight and premature birth were the leading causes of neonatal mortality in Karnataka, Maharashtra, and Odisha. In Uttar Pradesh and Haryana, children largely died in the post-neonatal period due to diarrhoea.
“The majority of these deaths could have been prevented with the interventions offered in primary and secondary care,” the study revealed.
The study has indicated that arranging for transportation and social support for accompanying and deciding health care needs are interlinked and these were reported to be the major difficulties faced by families living in remote villages.
A contrary report was released by the National Family Health Survey (NFHS).
This survey was conducted in four of the 15 states and union territories, and it concluded that fewer children were dying in infancy and early childhood.
The Health Ministry recently said after the last round of NFHS in 2005-06, the infant mortality has declined in all the states/union territories.
The Ministry also said that all the 15 states/union territories have low death which is 51 deaths per 1,000 children born each day. It also added that there is a considerable variation among the states and the union territories.
Google teams with UNICEF to map Zika virus spread
Google today said that it is working with UNICEF to map the spread of Zika and pitching in a million dollars to support the group’s efforts on the ground.
A volunteer team of Google engineers, designers and data scientists is helping UNICEF build a computer platform to analyze data from sources such as weather and travel patterns to predict potential outbreaks, the director of the Internet giant’s charitable arm said in a blog post.
“Ultimately, the goal of this open source platform is to identify the risk of Zika transmission for different regions and help UNICEF, governments and NGO’s decide how and where to focus their time and resources,” said Google.org director Jacquelline Fuller.
“This set of tools is being prototyped for the Zika response, but will also be applicable to future emergencies.”
The million-dollar grant to UNICEF was intended to go toward cutting mosquito populations; developing diagnostics and vaccines; awareness, and prevention, according to Fuller.
Google also launched a campaign to match employee donations, with a goal of providing an additional $500,000 for UNICEF and the Pan American Health Organization efforts to fight Zika.
Google ramped the amount of Zika-related health information, and the number of languages in which they are provided, at its search engine and backed YouTube videos aimed at raising awareness, Fuller said.
The rapidly spreading Zika virus, which has affected more than 20 Latin American countries, is suspected to be the cause of a sudden increase in cases of neonatal microcephaly, a severe deformation of the brain and skull among newborns. Brazil has been hardest hit.
Countries throughout the region have launched operations to eliminate pools of stagnant water where the mosquitoes, which also spread dengue and chikungunya viruses, can breed.
Cuba has detected the first case of Zika in a Venezuelan doctor who came to the island for postgraduate studies, the health ministry said Wednesday.
The 28-year-old woman, who arrived in Cuba on February 21, is hospitalized at the Pedro Kouri Tropical Medicine Institute in the capital Havana.
Polio Eradication by the Numbers.
Machine turns sweat into drinking water for Unicef.
A machine that takes sweat-laden clothes and turns the moisture into drinking water is in use in Sweden.
The device spins and heats the material to remove the sweat, and then passes the vapour through a special membrane designed to only let water molecules get through.
Since its Monday launch, its creators say more than 1,000 people have “drunk other’s sweat” in Gothenburg.
They add the liquid is cleaner than local tap water.
The device was built for the United Nation‘s child-focused charity Unicef topromote a campaign highlighting the fact that 780 million people in the world lack access to clean water.
Moist cyclists
The machine was designed and built by engineer Andreas Hammar, known locally for his appearances on TV tech show Mekatronik.
He said the critical part of the sweat machine was a new water purification component developed by a company named HVR in collaboration with Sweden’s Royal Institute of Technology.
“It uses a technique called membrane distillation,” he told the BBC.
“We use a substance that’s a bit like Goretex that only lets steam through but keeps bacteria, salts, clothing fibres and other substances out.
“They have something similar on the [International] Space Station to treat astronaut’s urine – but our machine was cheaper to build.
“The amount of water it produces depends on how sweaty the person is – but one person’s T-shirt typically produces 10ml [0.3oz], roughly a mouthful.”
The kit has been put on show at the Gothia Cup – the world’s largest international youth football tournament.
Mattias Ronge, chief executive of Stockholm-based advertising agency Deportivo – which organised the stunt – said the machine had helped raise awareness for Unicef, but in reality had its limitations.
“People haven’t produced as much sweat as we hoped – right now the weather in Gothenburg is lousy,” he said.
“So we’ve installed exercise bikes alongside the machine and volunteers are cycling like crazy.
“Even so, the demand for sweat is greater than the supply. And the machine will never be mass produced – there are better solutions out there such as water purifying pills.”
Source: BBC
Beating the Child Killers.
Ask most people to name the two biggest causes of death among children, and they will most likely say malaria and HIV. In fact, it is pneumonia and diarrhea – the “forgotten killers” – that are responsible for the highest death toll, claiming more than two million of the most vulnerable lives every year.
Together, these two diseases account for 29% of all deaths of children under five years old.& That is more than double the total for HIV and malaria combined, and nearly as many as all other infectious diseases, injuries, and other post-neonatal conditions put together.
Yet as shocking as these statistics are, what is perhaps even more surprising is just how preventable pneumonia and diarrhea are – so much so that it would be quite feasible to introduce measures that by 2025 would reduce their death toll to almost zero. That is precisely what we are now aiming to do.
An ambitious new plan, called the Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhea, launched this month by the World Health Organization and UNICEF, aims to step up existing interventions and pool global efforts, with the goal of reducing the number of deaths from pneumonia to less than three children per 1,000, and of diarrhea-related deaths to below one in 1,000. This would effectively end the preventable deaths of more than two million children every year.
For any other infectious disease or global health threat, achieving this kind of reduction in incidence rate and mortality would be nothing short of miraculous. Yet, for pneumonia and diarrhea, we have every reason to believe that we can succeed, because we already know what works.
For example, infants who are not exclusively breastfed for the first six months have a ten-fold increase in the risk of death from diarrhea, and are 15 times more likely to die from pneumonia. Similarly, basic sanitation, such as improved hand washing and access to clean water, and better nutrition can also produce significant risk reduction, much of which can be achieved through simple education programs.
Immunization is also highly effective. Vaccinating children against rotavirus, for example, can protect them from a pathogen that is responsible for 37% of all diarrhea deaths in children under five, thus saving 450,000 lives every year. Similarly, vaccines exist to protect against pneumococcal disease, which accounts for a half-million pneumonia-related deaths annually.
When combined, these interventions significantly reduce both pneumonia and diarrhea; the problem is that, too often, they do not reach the children most at risk, such as those living in extreme poverty or hard-to-reach communities in the world’s poorest countries. That is why we now need the Integrated Global Action Plan.
The two diseases share so many common causes and risk factors, prevention strategies and interventions, and delivery platforms for care in clinics, communities, and schools that it makes sense to bring them together. But, if those hard-to-reach children are to benefit, our efforts must be scaled up significantly.
Until recently, this simply would not have been possible, at least not on the immunization front. The vaccines protecting against rotavirus and pneumococcal disease are both barely more than a decade old. In the past, such new vaccines would take, on average, 15 years to reach developing countries – and then at prices that would place them beyond the reach of those most in need.
This is one of the reasons why my organization, the GAVI Alliance, was created: to help accelerate the introduction of new vaccines and make them more affordable and accessible in developing countries. Through our unique public-private business model, we have worked with our partners to help increase supplies of these vaccines while simultaneously bringing down their price. Indeed, since 2006, the price of rotavirus vaccine has fallen by 67%, to just $2.50 per dose, while the price of a dose of pneumococcal conjugate vaccine has plummeted by 90%, to $3.50.
Such price reductions have and will continue to play a crucial role in saving the lives of millions of children and achieving the Millennium Development Goal of reducing child mortality by two-thirds. To date, GAVI has helped countries immunize more than 13 million children against pneumococcal disease and five million children against rotavirus, with plans to strengthen its efforts in countries where immunization coverage is below 70%.
None of this means that we will not still face significant obstacles. But the one thing that we know about immunization is that we can reach everyone. We did it with smallpox, which has now been eradicated, and we are doing it with polio (with less than 100 cases worldwide this year). The challenge now is to do the same with all of our life-saving vaccines – particularly those that target the biggest killers of children.
Source: project syndicate
ARYAN'S BLOG 