Published in IJCP April 2019
News and Views
April 10, 2019 |

One in Four Health Care Facilities Lacks Basic Water Services

One in four health care facilities around the world lacks basic water services, impacting over 2 billion people, according to a new report by WHO and UNICEF Joint Monitoring Program for Water Supply, Sanitation and Hygiene (JMP).

The WHO/UNICEF JMP report, WASH in Health Care Facilities, is the first comprehensive global assessment of water, sanitation and hygiene (WASH) in health care facilities. It also finds that one in five health care facilities has no sanitation service, impacting 1.5 billion people. The report further reveals that many health centers lack basic facilities for hand hygiene and safe segregation and disposal of health care waste. These services are crucial to preventing infections, reducing the spread of antimicrobial resistance and providing quality care, particularly for safe childbirth… (WHO, April 3, 2019)

FDA Proposes New Fluoride Standard for Bottled Water

The US Food and Drug Administration (FDA) is proposing a lower concentration level standard for fluoride in bottled water, yet some scientists and environmental groups believe that the proposed limit is still too high and poses a danger to human health.

If finalized, the new regulation will lower allowable levels of fluoride in domestically packaged and imported bottled water to 0.7 mg/L, a slight reduction from the current standard range of between 0.8 and 1.7 mg/L allowed by the FDA. The proposed standard would apply only to bottled water with added fluoride. It would not affect allowable levels of fluoride in bottled water that may contain fluoride from source water… (CNN, April 2, 2019)

A New Fixed-dose Combination Inhaler for COPD

The US FDA has approved a fixed-dose combination of aclidinium bromide 400 µg (long-acting muscarinic antagonist [LAMA]) and formoterol fumarate 12 µg (long-acting beta-agonist [LABA]) for the maintenance treatment of chronic obstructive pulmonary disease (COPD). It is to be administered twice-daily via the breath-actuated inhaler.

NIH Begins First-in-human Trial of a Universal Influenza Vaccine Candidate

The first clinical trial of an innovative universal influenza vaccine candidate is examining the vaccine’s safety and tolerability as well as its ability to induce an immune response in healthy volunteers. Scientists at the National Institute of Allergy and Infectious Diseases (NIAIDs), part of the National Institutes of Health (NIH), developed the experimental vaccine, known as H1ssF_3928.

H1ssF_3928 is designed to teach the body to make protective immune responses against diverse influenza subtypes by focusing the immune system on a portion of the virus that varies relatively little from strain to strain… (NIH)

Antiviral Treatment Prevents HCV Infection in Transplant Recipients from Infected Donors

In patients without hepatitis C virus (HCV) infection who received a heart or lung transplant from donors with hepatitis C viremia, treatment with an antiviral regimen for 4 weeks, initiated within a few hours after transplantation, prevented the establishment of HCV infection. These conclusions from the DONATE HCV Trial Team were published April 3, 2019 in the New England Journal of Medicine.

USDA, EPA and FDA Recognize April as Winning on Reducing Food Waste Month

The US Department of Agriculture (USDA), the US Environmental Protection Agency (EPA) and the FDA kick off Winning on Reducing Food Waste Month by calling for greater collaboration with public, private and nonprofit partners as well as state and local officials to educate and engage consumers and stakeholders throughout the supply chain on the need to reduce food loss and waste…

Dana-Farber Opens First Center Devoted to Lynch Syndrome

The Dana-Farber Cancer Institute in Boston, Massachusetts, has opened the Lynch Syndrome Center, with the goal of providing genetic counseling and testing to those at risk for the syndrome as well as delivering a new model of coordinated care. It is the first such center.

Lynch syndrome remains a largely unknown genetic disease, and most carriers are either undiagnosed or are diagnosed only after they have developed cancer. It is an autosomal dominant genetic disorder that is associated with germline mutations in DNA mismatch repair genes. It increases the lifetime risk for colorectal cancer by up to 80%, for endometrial cancer, by up to 60%; the risks for cancers of the stomach, ovary, small bowel, hepatobiliary tract, urinary tract, brain, and skin…. (Medscape)

CDC’s Successful “Tips from Former Smokers” Campaign Returns this Month

New emotionally powerful ads kick off the 8th year of the CDC's “Tips from Former Smokers” campaign. The new ads share personal stories of Americans suffering from smoking-related illnesses—and the devastating impact of these illnesses on smokers’ families.

One of the new ads features Susan Nimoy, the wife of Leonard Nimoy, the American actor best known for his role as Spock on Star Trek. Mr Nimoy quit smoking cigarettes after 37 years, but those years of smoking damaged his lungs. He suffered from COPD, as a result of smoking, until his death in 2015. Nimoy’s desire to educate the public about the dangers of smoking will now live on as part of CDC’s Tips campaign.

Beginning April 1, Tips ads will run for 27 weeks on national and cable television, online and in magazines… (CDC)

Long-distance Commuting During Pregnancy Adversely Affects Health of the Baby

The first study on the effects of long commutes during pregnancy on infant health has shown that a 10-mile increase in travel distance raises the probability of low birth weight by 0.9 percentage points. A 10-mile increase in travel distance raises the probability of intrauterine growth restriction by 0.6 percentage points. These findings are published online in Economics & Human Biology.

Monocytes may Predict Prognosis in Patients with Idiopathic Pulmonary Fibrosis

Increased monocyte count was associated with poorer outcomes in patients with idiopathic pulmonary fibrosis (IPF), according to a retrospective, multicenter analysis reported in Lancet Respiratory Medicine. Estimated CD14+ classical monocyte percentages above the mean were found to be associated with shorter transplant-free survival times in the analysis, while higher T-cell and B-cell percentages were not associated with shorter transplant-free survival times.

FDA Approves Ambrisentan Generics for PAH

The US FDA has approved four generic versions of ambrisentan, an endothelin receptor antagonist indicated for treatment for pulmonary arterial hypertension (PAH).

CDC Modifies its Travel Advisory for India on Zika Virus Disease

The CDC has modified its travel advisory for India on Zika virus disease on 27th March 2019. The status of India has now been changed from “ongoing outbreak” to “current or past transmission but no current outbreak.”

In December 2018, CDC, USA had issued a travel health notice on Zika virus in India, which depicted that India has an ongoing outbreak of Zika virus disease in Rajasthan and its surrounding states. The advisory further cautioned pregnant women not to travel to areas with ongoing Zika outbreaks. Women planning pregnancy were also alerted on travel. Such an advisory could have serious implications on travel and trade in India.

Ministry of Health and Family Welfare, Govt. of India expressed serious concern over the whole issue. Prof. Balram Bhargava, Secretary, Department of Health Research and Director General, Indian Council of Medical Research (ICMR), wrote to CDC to withdraw or modify the travel advisory providing evidence of the contained outbreak in India. This communication provided data on human and vector surveillance for Zika virus disease in India … (ICMR, April 2, 2019)

HC Refuses to Hear Plea on Generic Drugs

The Delhi High Court declined to entertain a petition seeking directions to the Centre and the Medical Council of India (MCI) to ensure that doctors prescribe generic medicines.

The plea by advocate Amit Sahni said that the MCI had on January 21, 2013, issued a circular addressed to the deans of all medical colleges, directors of all hospitals, presidents of all state medical councils, whereby the doctors practicing medicine were called upon to prescribe drugs with generic name as far as possible. But the authorities have failed to ensure that doctors write only generic medicines in their prescription despite clear statutory directions. Generic medicine works and provides the same clinical benefit as brand-name versions, and generic medicines cost 5% and 60% less than their branded

Mr Sahni had argued that citizens belonging to the lower-middle class and economically backward section may not be in a position to approach the court due to lack of awareness, and would benefit from a court direction to doctors to prescribe generic medicines…
(The Hindu)

NPPA Approves Hike in Prices of Coronary Stents

Drug price regulator National Pharmaceutical Pricing Authority (NPPA) has approved hike in prices of cardiac stents by 4.2% in line with the wholesale price index (WPI) of the previous calendar year, as per an official statement.

As per the new prices notified by the NPPA, a bare metal stent (BMS) would now cost Rs. 8,261, while the drug-eluting stent (DES) will cost Rs. 30,080.

“After considering the WPI at 4.26% for the year 2018 over 2017, it has been decided to revise the ceiling prices of coronary stents with effect from April 1, 2019,” the NPPA said in a statement.

The drug pricing authority had earlier revised the prices of stents in February last year. It had increased the prices of BMS from Rs. 7,400 to Rs. 7,660. On the other hand, it had reduced the price of DES to Rs. 27,890 from Rs. 30,180.

Providing a major relief to lakhs of cardiac patients, the government had for the first time cut prices of life-saving coronary stents by up to 85% in February 2017. BMS used to cost as much as Rs. 45,000 and DES Rs. 1.21 lakh prior to the imposition of the price cap in February 2017.

The NPPA also said in a separate statement that it has revised ceiling/retail prices of 871 formulations under Drugs (Price Control) Order, 2013.

US Measles Cases at Second Highest Since Disease was Eliminated in 2000

A total of 387 individual cases of measles have been confirmed in 15 states from January 1 to March 28, according to the US CDC. This is the second-greatest number of cases reported in the United States since measles was declared eliminated in 2000, reported CNN. The highest number of reported cases since elimination was 667 in 2014. The states reporting cases are Arizona, California, Colorado, Connecticut, Georgia, Illinois, Kentucky, Michigan, Missouri, New Hampshire, New Jersey, New York, Oregon, Texas and Washington.

The CDC says six outbreaks - defined as three or more cases - are ongoing in California (Santa Cruz and Butte County), New Jersey, New York (Rockland County and New York City) and Washington. These outbreaks are linked to travelers who brought measles back from other countries such as Israel, Ukraine and the Philippines, where large measles outbreaks are occurring… (CNN, April 1, 2019)

Better Glycemic Control with Oral Semaglutide vs. Sitagliptin in PIONEER-3

Among adults with type 2 diabetes uncontrolled with metformin with or without sulfonylurea, oral semaglutide, 7 mg/day and 14 mg/day, compared with sitagliptin, resulted in significantly greater reductions in HbA1c over 26 weeks, according to findings from the randomized, double-blind controlled PIONEER-3 trial published online in JAMA.

Noninvasive Brain Stimulation is a Feasible Alternative Treatment in Resistant Depression

Findings of a new systematic review and network meta-analysis published online in BMJ show nonsurgical brain stimulation is a viable alternative or add-on treatment for major depressive disorder in adults.

Govt. Extends Deadline for Linking PAN with Aadhaar Till September 30

The government has extended the deadline for linking Permanent Account Number (PAN) with biometric ID Aadhaar by 6 months till September 30, an official statement said.

This is the sixth time the government has extended the deadline for individuals to link their PAN to

In June last year, the government had said that PAN has to be linked with the biometric ID by March 31. “....Now the cut-off date for intimating the Aadhaar number and linking PAN with Aadhaar is September 30, 2019, unless specifically exempted,” the Central Board of Direct Taxes (CBDT) said in a statement. However, quoting of Aadhaar will be mandatory while filing income tax returns (ITRs) with effect from April 1, 2019… (The Pioneer-PTI)

Testosterone Therapy can Help Men with Hypo­gonadism Lose Weight

Long-term testosterone therapy can help men with hypogonadism lose weight and maintain their weight loss, according to 10-year results from a study presented at ENDO 2019, the Endocrine Society’s annual meeting in New Orleans, Louisiana. Over 10 years, the testosterone-treated men lost 20.3% of their baseline weight (50.5 lb; 22.9 kg); their waist circumference dropped by 12.5 cm (4.9 in). Body mass index (BMI) decreased by 7.3 kg/m2, and the waist-to-height ratio decreased by 0.07. By contrast, the untreated men gained 3.9% of their baseline weight (3.2 kg; 7.1 lb), and their waist size increased by 4.6 cm (1.8 in). In this group, BMI increased by 0.9 kg/m2 and waist-to-height ratio increased by 0.03.

First Gene Therapy for -thalassemia Gets the Go-ahead in Europe

The Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) has recommended approval of the first gene therapy for transfusion-dependent β-thalassemia (TDT), a rare inherited blood condition that causes chronic severe anemia.

Autologous CD34+ cells encoding β A-T87Q-globin gene is for people 12 years and older with TDT who do not have a β0/β0 genotype, for whom hematopoietic stem cell (HSC) transplantation is appropriate but a human leukocyte antigen-matched related HSC donor is not available.

Climate change could Expose 1 Billion More People to Bug-borne Diseases

As the planet gets warmer, scientists say, diseases like Zika, chikungunya and dengue will continue spreading farther north. The authors of the new study, published in the journal PLOS Neglected Tropical Diseases, created a model that includes data on predicted temperature changes and the known range of the day-biting, disease-carrying mosquitoes Aedes albopictus and Aedes aegypti.

Europe will probably see some of the biggest increases in diseases from both of these species, the researchers say. The United States, East Asia, high-elevation parts of Central America, East Africa and Canada will also see large increases in risk for these diseases. The much warmer climates in Southeast Asia and West Africa will not be as suitable for the albopictus
species… (CNN)

Fewer Reproductive Years in Women Linked to an Increased Risk of Dementia

According to a new study published in the journal Neurology, women who start their period later, go through menopause earlier or have a hysterectomy may have a greater risk of developing dementia. Women who had their first menstrual cycle at age 16 or older had a 23% greater risk of dementia than women who had their first menstrual cycle at age 13. Women who went through natural menopause before age 47 had a 19% greater risk of dementia than women who went through menopause at
age 47 or older.

Omega-3 and Omega-6 fatty Acids may Play Opposite Roles in Childhood Asthma

Dietary intake of two fatty acids, omega-3 and omega-6, may have opposite effects on the severity of asthma in children and may also play opposite roles in modifying their response to indoor air pollution, according to new research published online in the American Journal of Respiratory and Critical Care Medicine. In the study, higher levels of omega-6 in the children’s diet correlated with higher percentages of neutrophils in response to particulate pollution.

A New Oral Treatment for Multiple Sclerosis

The US FDA approved cladribine tablets to treat relapsing forms of multiple sclerosis (MS) in adults, to include relapsing-remitting disease and active secondary progressive disease. The drug is not recommended for MS patients with clinically isolated syndrome. Because of its safety profile, the use of cladribine is generally recommended for patients who have had an inadequate response to, or are unable to tolerate, an alternate drug indicated for the treatment of MS.

Beetroot, Nitrate Supplements could help Prevent Salt-induced Hypertension

Adding tiny amounts of beetroot or dietary nitrate to salty food products might help prevent high blood pressure (BP), according to a preliminary study of rats reported in the journal Hypertension. Both the juice and the nitrate supplement were more than 100 times more potent than potassium in protecting rats against salt-induced increases in BP.

New UN Global Climate Report ‘Another Strong Wake-up Call’ Over Global Warming

The increasing number of natural disasters and dangers linked to climate change, highlighted in a major UN report represents “another strong wake-up call” to the world, which must be countered by finding sustainable solutions quickly, UN Secretary-General António Guterres has said. Speaking at the launch of the State of the Global Climate report by the World Meteorological Organization (WMO), Mr Guterres reiterated his call for action, underlining that the alarming conclusion that climate change is accelerating, “proves what we have been saying: climate change is moving faster than our efforts to address it.” (UN)

Artesunate Now First-line treatment for Severe Malaria in the US

CDC is issuing new guidance to clinicians for the treatment of severe malaria cases in the US. This change in treatment protocol is necessary because the only FDA-approved intravenous (IV) antimalarial drug in the US, quinidine, has been discontinued by the manufacturer and will no longer be available. As of April 2019, artesunate, the World Health Organization (WHO)-recommended first-line treatment of severe malaria, will become the first-line treatment for severe malaria in the US… (CDC)

Diseases Cost the African Region $2.4 Trillion a Year, Says WHO

The WHO estimates that nearly 630 million years of healthy life were lost in 2015 due to the diseases afflicting the population across its 47 Member States in Africa, now amounting to a loss of more than 2.4 trillion international dollars ($) from the region’s gross domestic product value annually.

Noncommunicable diseases have overtaken infectious diseases as the largest drain on productivity, accounting for 37% of the disease burden. Other culprits for lost healthy years are communicable and parasitic diseases; maternal, neonatal and nutrition-related conditions and injuries. Around 47%, or $ 796 billion, of this lost productivity value could be avoided in 2030 if the Sustainable Development Goals related to these health conditions are achieved, WHO found… (WHO Africa)

HIV-positive Woman Donates Kidney to HIV-positive Recipient

An Atlanta woman became the first living HIV-positive kidney donor in the world when surgeons at Johns Hopkins Medicine in Baltimore transferred her organ to a recipient who is also HIV-positive, according to a statement from the medical center. Both the donor and the recipient, who wishes to remain anonymous, are doing well.

The 36-year-old public health consultant acquired HIV as a 6-week-old in 1983, when she received a blood transfusion in the years before blood banks began routine testing for the virus. HIV damages the immune system and interferes with the body’s ability to fight the organisms that cause disease.

“She met the standard donor criteria: She was otherwise healthy without hypertension, without diabetes, so her only additional risk factor for kidney disease was HIV. And we had determined from our research that was an acceptable and small additional risk,” said Dr. Christine Durand, Associate Professor of Medicine and Oncology and member of the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center and the HIV team specialist for Martinez’s
surgery… (CNN)

FDA Approves Treatment for Patients with a Type of Inflammatory Arthritis

The US FDA has approved certolizumab pegol injection for treatment of adults with a certain type of inflammatory arthritis called nonradiographic axial spondyloarthritis (nr-axSpA), with objective signs of inflammation. This is the first time that the FDA has approved a treatment for nr-axSpA.

Study Shows Safety of Metformin in Psoriasis Patients with Diabetes Mellitus

Metformin can be prescribed for psoriasis patients with diabetes without safety concerns as reported in The Journal of Clinical Endocrinology & Metabolism. The metformin group and the non-metformin group did not significantly differ in the risk of all-cause mortality, severe psoriasis, psoriasis-related admission and any-cause re-admission.

Participation in Sport can Improve Children’s Learning and Skills Development

Participation in sport improves children’s educational attainment and skills development including empowerment, leadership and self-esteem – contributing to their overall well-being and future prospects, according to new research “Getting into the Game: Understanding the Evidence for Child-Focused Sport for Development”  released by the Barça Foundation and UNICEF.

“It’s long been understood that sport promotes children’s health and physical development, but now we have solid evidence to suggest that sport can have a powerful impact on their overall education and life skills development,” said UNICEF Deputy Executive Director Charlotte Petri Gornitzka. “We must use this evidence to inspire investment in sports for children, especially the most

The new report features analyses from global research literature and data from more than 300 sports for development (S4D) programs in 100 countries. Other highlights from the report include:

Successful sport for development initiatives involve multi-sectoral cooperation, such as the inclusion of education and social components.

Coaches play a critical role in safeguarding children and mitigating possible negative influences.

There is little evidence to suggest involvement in sport reduces a child’s risk of abuse and exploitation. In fact, when not done well, there are indications that some sports can increase exposure to violence.

Better evidence is needed for the monitoring of sport for development initiatives, including more research on effective implementation.

More meaningful child participation in program design and evidence building is needed.   


Improving TB Patient Care in the Russian Federation with Video-observed Treatment

To help tuberculosis (TB) patients keep to their gruelling treatment regimens, WHO recommends that the intake of medicines is observed, in person, by a health care worker, to support the patient in taking the medication regularly. However, ensuring daily face-to-face contact at a health facility can be challenging for both patients and health service providers. Digital technologies, such as video-observed treatment (VOT) can help meet this challenge.

In 2016, the city of Tomsk in Siberia, Russian Federation, started supporting TB patients using VOT, which allowed patients to take TB drugs under the care of a nurse via video calling software on smart phones. Each patient signs an informed-consent form to begin VOT and agrees to be available for their daily session in a quiet room. Based on the agreed schedule, a health worker initiates the call. The health worker also advises the patient on the appropriate storage of medicines, which is an important aspect of treatment success.

The program started with 6 patients and has grown to 88. Following the example of Tomsk, VOT is now available in other regions of the country, including Tyumen, Voronezh, Vladimir, Ivanovo and Arkhangelsk Oblast.

This treatment approach is considered a step forward in making care more people-centred and is valued by patients and nurses alike. VOT has been shown to improve access to TB treatment, support regular intake of drugs and treatment adherence, decrease the risks of occurrence of drug resistance and the spread of infection, and improve the overall quality of life for patients… (WHO Europe)

A New Oral Testosterone Capsule for Treatment of Men with Certain Forms of Hypogonadism

The US FDA approved testosterone undecanoate, an oral testosterone capsule to treat men with certain forms of hypogonadism. These men have low testosterone levels due to specific medical conditions, such as genetic disorders like Klinefelter syndrome or tumors that have damaged the pituitary gland. The drug should not be used to treat men with “age-related hypogonadism,” in which testosterone levels decline due to aging, even if these men have symptoms that appear to be related to low testosterone.

AAP Report Advises on Therapy Services for children with Disabilities

?An American Academy of Pediatrics (AAP) clinical report “Prescribing Physical, Occupational and Speech Therapy Services for Children with Disabilities” published online has described how health care providers can best connect the rising number of children who have disabilities with evidence-based therapy services in hospital, community, home and school settings. The report highlights the importance of coordinating care with therapists to help children gain or recover key skills. 

Eating Later in the Day may be Associated with Obesity

Eating later in the day may contribute to weight gain, according to a new study presented at ENDO 2019, the Endocrine Society’s annual meeting in New Orleans, Louisiana. On average, participants consumed food throughout an 11-hour timeframe during the day and slept for about 7 hours a night. People who ate later in the day slept at a later time, but they slept for about the same amount of time as those who finished eating earlier. Later meal timing was associated with a higher BMI as well as greater body fat.

Low-dose, Low-frequency PUVA Treatment Safe and Effective in Mycosis Fungoides

Low-dose, low-frequency oral psoralen-ultraviolet A (PUVA) treatment, followed by maintenance, was safe and effective and can be used to treat early-stage mycosis fungoides with extended disease-free intervals as shown in a study reported in JAMA

Govt. Notifies New Rules for Drugs and Clinical Trials

Aimed at promoting clinical research in the country, the Health Ministry notified New Drugs and Clinical Trials Rules, 2019 reducing the time for approving applications to 30 days for drugs manufactured in India and 90 days for those  developed outside the country. The new rules will ensure patient safety, as they would be enlisted for trials with informed consent. The ethics committee will monitor the trials and decide on the amount of compensation in cases of adverse events, Drugs Controller General of India (DCGI), S Eswara Reddy said.

“In case of injury to clinical trial subject, medical management will be provided as long as required as per the opinion of the investigator or till such time it is established that the injury is not related to the clinical trial.”Also, compensation in cases of death and permanent disability or other injury to a trial subject will be decided by the Drug Controller General,” Reddy said.

These rules will apply to clinical trial, bio-availability or bio-equivalence study, new drugs and regulation of ethics committee relating to clinical trial and biomedical health research. “The aim is to promote clinical research in India, have predictable, transparent and effective regulations for such trials and also make faster accessibility of new drugs to Indian population,” he said… (ET Health-PTI)

Ebola Outbreak in Eastern Democratic Republic of Congo Tops 1,000 Cases

As of March 24, 2019, public health officials documented that the Ebola outbreak in eastern Democratic Republic of Congo (DRC) had surpassed 1,000 cases; the total number of confirmed and probable cases being 1009, including 625 deaths and 318 survivors. The outbreak is the largest in DRC’s history and the second largest outbreak recorded of Ebola ever (after the 2014-2016 outbreak in West Africa).

“This is a disappointing milestone. This remains a highly complex Ebola outbreak with active transmission in 13 of the 21 affected health zones,” said CDC Director Robert R Redfield, MD “Despite this, CDC will continue to work 24/7 with our partners in DRC, in DRC’s neighboring countries, and around the world to prevent the spread of Ebola and bring this outbreak to an end.”

Cabo Verde Launches First “Solidarity Chain” in Africa with a Flash Mob Promoting Universal Health Coverage

Led by the Cabo Verde’s Minister of Sports and the WHO Regional Director for Africa, hundreds of people held hands and stood side by side in an umbrella shape on Quebra Canela beach in Praia to show their solidarity for universal health coverage.

The flash mob was organized through word of mouth and social media and was the first in Africa of many similar global events leading up to World Health Day on 7 April, with the “solidarity chain” reflecting the 2019 themes of solidarity and equity … (WHO Africa)

Walking Downhill after Meals Boosts Bone Health in Postmenopausal Women with Diabetes

Walking downhill after eating can reduce bone resorption, the process in which old bone is broken down and removed from the body, in postmenopausal women with diabetes, according to research presented at ENDO 2019, the annual meeting of the Endocrine Society, in New Orleans, Louisiana. Walking uphill does not have the same benefit, the study found. An easy way to walk downhill is to walk down stairs.

AAP/AHA Policy Statement to Reduce Consumption of Sugary Drinks in Children

In a joint policy statement published in Pediatrics, the American Academy of Pediatrics (AAP) and the American Heart Association (AHA) endorsed a suite of public health measures including excise taxes, limits on marketing to children, and financial incentives for purchasing healthier beverages designed to reduce kids’ consumption of sugary drinks. As per authors, teens who drink more than 10% of their daily calories from added sugars are more likely to have abnormal cholesterol levels, including higher “bad” LDL (low-density lipoprotein) cholesterol, higher triglycerides and lower heart-protective HDL (high-density lipoprotein) cholesterol.

The AAP and AHA recommend:

Local, state and national policymakers should consider raising the price of sugary drinks, such as via an excise tax, along with an accompanying educational campaign. Tax revenues should go in part toward reducing health and socioeconomic disparities.

Federal and state governments should support efforts to decrease sugary drink marketing to children and teens.

Healthy drinks such as water and milk should be the default beverages on children’s menus and in vending machines, and federal nutrition assistance programs should ensure access to healthy food and beverages and discourage consumption of sugary drinks.

Children, adolescents and their families should have ready access to credible nutrition information, including on nutrition labels, restaurant menus, and advertisements. Hospitals should serve as a model and establish policies to limit or discourage purchase of sugary drinks.

Children Develop PTSD when they ‘Overthink’ Their Trauma

Children are more likely to suffer post-traumatic stress disorder (PTSD) if they think their reaction to traumatic events is not ‘normal’, according to a new research published in the Journal of Child Psychology and Psychiatry. Children begin down this route when they have trouble processing their trauma and perceive their symptoms as being a sign that something is seriously wrong.

Avocados Recalled in Six US States Over Listeria Concerns

CNN reported on March 25, 2019 that California-grown avocados sold in bulk to retail stores in six states by the Henry Avocado Corporation are being recalled due to potential contamination with the bacterium Listeria monocytogenes, the company announced recently.

“Henry Avocado is issuing this voluntary recall out of an abundance of caution due to positive test results on environmental samples taken during a routine government inspection at its California packing facility,” reads the company’s statement. There have been no reported illnesses associated with the recall at
this time.

Listeria bacteria is especially concerning in pregnant women because they can cause miscarriage, stillbirth, premature delivery or a life-threatening infection in a newborn.

Others at risk for listeria infection are the elderly and individuals with weakened immune systems. Symptoms of listeriosis include fever, muscle aches, headache, stiff neck, confusion and loss of balance. Patients may experience diarrhea or other gastrointestinal symptoms, as well as convulsions. It can be treated with antibiotics… (CNN)

Health Ministry Commemorates World TB Day

The Ministry of Health and Family Welfare commemorated the World TB Day with a function to mark the occasion, and reiterated the commitment to eliminating TB in the country by 2025.

Ms Preeti Sudan, Health Secretary, presided over the function. She stressed on the importance of more sensitive and responsive doctors, paramedics, frontline health workers and community partners, while dealing with TB patients. The systems of care for TB patients should be patient-centric, and sympathetic to their well-being, she emphasized. She stated that India has been able to be free of Polio, Yaws, MNTE due to the sturdy health systems, especially at the primary health care levels. She stated that partnerships with all stakeholders hold the key to making India TB-free.

Various presentations made at the event highlighted the key changes introduced in the policy landscape of TB in the country.

·         India is now closest ever to covering all TB cases with 21.5 lakh new TB patients notified in 2018. With the aim of universal access to free diagnostics and treatment services, path breaking policy changes have been introduced.

·         Universal drug susceptibility testing has been rolled out, and shorter and newer treatment regimen has been expanded countrywide.

·         India is moving towards an injection-free regimen.

·         Private sector engagement has been elevated as one of the highest priorities with strengthened regulatory measures, collaborative incentives and scale up of successful Patient Provider Support Agency (PPSA) interventions, which led to a 35% increase in TB notification from the private sector. The Nikshay Poshan Yojana has benefited 15 lakh TB patients for nutrition support with Rs. 240 cores disbursed as DBT since April 2018.

·         A comprehensive call centre (1XXX-XX-6666) for information, addressing grievance, patient linkages and provider relationship has been established. Institutional system of award for TB-free status has been introduced to generate federal competitiveness, motivate and to bring about proactive actions from States and Districts.

·         As on date, 15 lakh patients have been initiated in the Fixed-dose Combination (FDC) regime.

(PIB, Ministry of Health and Family Welfare)

 Replacing Sitting Time with Physical Activity Associated with Lower Risk of death

A new study from the American Cancer Society suggests that replacing modest amounts of sitting time with even light physical activity may have the potential to reduce the risk of premature death among less active adults. For those who get the least amount of physical activity, replacing a half hour of sitting time with physical activity was associated with up to a nearly 50% reduction in mortality. These findings are published in the American Journal of Preventive Medicine.

Avelumab + Axitinib Improves Progression-free Survival for Advanced Renal-cell Carcinoma

Progression-free survival was significantly longer with avelumab + axitinib than with sunitinib among patients who received these agents as first-line treatment for advanced renal-cell carcinoma in a trial published in the New England Journal of Medicine.

Paternal Smoking may Increase the risk of Congenital Heart Defects in Children

Fathers-to-be who smoke may increase the risk of congenital heart defects in their offspring, according to a meta-analysis published in the European Journal of Preventive Cardiology. All types of parental smoking were associated with the risk of congenital heart defects, with an increase of 74% for men smoking, 124% for passive smoking in women, and 25% for women smoking, compared to no smoking exposure.

Ovary Function is Preserved in Transgender Men at 1 Year of Testosterone Therapy

Transgender men preserve their fertility potential even after 1 year of treatment with the male hormone testosterone, according to a study presented at ENDO 2019, the Endocrine Society’s annual meeting in New Orleans, Louisiana. Even with the expected increase in testosterone blood levels and decrease in estrogen at 1 year of therapy, anti-Mullerian hormone (AMH) levels remained in the normal range for fertility. AMH levels are used to assess the ovarian reserve.

Uterine Fibroid Embolization as Effective as myomectomy

Uterine fibroid embolization (UFE) effectively treats uterine fibroids with fewer post-procedure complications compared to myomectomy, according to new research presented at the Society of Interventional Radiology’s 2019, Annual Scientific Meeting. After an average 7-year follow-up, women who underwent myomectomy had a higher rate of post-procedural complications, including a 2.9% rate of blood transfusion versus 1.1% rate for women who were treated using UFE. 

Bond Service after MBBS not Necessary for PG Admissions

MBBS students in government medical colleges (GMCs) will be eligible for admissions to post graduate (MD/MS) courses without completing the 1-year bond service, at least for the next 3 years starting 2019-20.

The Bombay High Court has ordered that students who have been admitted to MBBS course up to October 12, 2017, can seek admission to PG courses without fulfilling the requirement of 1-year compulsory bond after MBBS course. They will complete their bond service after the PG course. The HC has clarified that students who have taken admission to MBBS course after October 2017 would have to complete their bond service before seeking admissions to PG. However, such candidates will apply for PG only after completion of their 4-year MBBS course, which is not before 2021-22. So, effectively, bond service after MBBS will not be a necessary clause till then… (ET Health)

Study Shows Significant Rise in Psychiatric ED Visits for Children and Young Adults

A study in the April 2019 issue of Pediatrics shows that there has been a significant increase in psychiatric emergency department (ED) visits for children and young adults. Overall psychiatric visits were found to have increased 28% among children and young adults, ages 6-24 years. The largest increases occurred among teens, young adults and non-white youths.

Optimizer Implant Now Available for CRT-ineligible Heart Failure

The US FDA has approved another device therapy for patients with chronic moderate-to-severe heart failure, the Optimizer Smart System. The specified indication is for improving 6-minute walk distance, quality of life, and other aspects of functional status of patients with symptomatic heart failure in sinus rhythm despite optimal medical therapy.