Month: March 2014

IUDs may provide birth control protection for longer than approved duration

Some intrauterine devices (IUDs), already a long-term birth control option, are effective for even longer than recommended, according to a new review of past studies.

The older women are when certain IUDs are inserted, the longer they can leave them in, the review found.

IUDs, small plastic or metal devices inserted into the uterus, prevent pregnancy either by killing or damaging sperm or by releasing hormones that thicken the cervical mucus which does not allow sperm to pass. They are the most effective type of reversible birth control, with lower failure rates than the Pill, implants, patches or condoms.

Although recommendations on IUD use have stayed the same for some time, the finding that the devices are effective for longer than advertised is actually old news, Dr. Justine P. Wu told Reuters Health.

She worked on the study at the Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey.

“We have had these data in our hands for years,” Wu said. “Our hope is that this review will bolster clinician and patient confidence, both in the United States and worldwide, in the safety and benefits of extending use of certain IUDs beyond the manufacturer-approved time period, among select women.” That includes women who have had one or more children and were at least 25 years old when the IUD was inserted.

Among those women, copper IUDs seem to be effective birth control for at least nine years, depending on the brand. ParaGard, a copper IUD recommended for up to 10 years, is effective for at least 12.

Mirena, a plastic IUD which releases the hormone levonorgestrel to prevent pregnancy, is advertised as effective for five years, but is effective for at least seven years, according to the review published in the journal Contraception.

For women who were at least 35 when the IUD was placed, studies indicate ParaGard remains effective until menopause.

There were not enough studies of women under age 25 to determine how long Mirena and ParaGard are effective beyond recommendations in that group, the researchers said.

Extended use of an IUD among women over 25 who have had a child ultimately reduces costs, improves convenience and extends birth control benefits, Wu said.

Source: fox news

Woman’s 90-Pound Mucus-Filled Tumor Surgically Removed

A woman who complained of a rapidly expanding waistline was surprised to discover an unusual cause of her girth: an 88-lb., mucus-filled ovarian tumor.

The 57-year-old Brazilian woman noticed her midsection grew over the course of a year, but other than a heavy feeling in her belly, and breathing that was slightly faster than normal, she had few other symptoms, according to a report of her case, published March 4 in the Journal of Medical Case Reports.

Massive size

The woman — an overweight, postmenopausal 57-year-old from Brazil — first contacted doctors about her rapidly growing waistline in 2003. She had slightly shallow breathing, and a 52-inch (132 centimeters) waistline.

An ultrasound of her stomach revealed a huge, mucus-filled mass. The tumor was so big that it had shoved her uterus to the side, squished her abdominal contents and extended all the way up to her diaphragm.

When doctors began operating on the woman to remove the mass, they found it was a 16.5-inch by 15.7-inch by 11-inch (42 cm by 40 cm by 28 cm), mucus-filled tumor that weighed as much as a small woman, or 88 lbs. (40 kilograms).

The tumor had some signs of early-stage cancer, so the woman underwent several rounds of chemotherapy. Surgeons also removed part of her fallopian tubes, uterus and lymph nodes.

Ten years later, the patient is doing fine and has no more symptoms. Though it’s unusual for such masses to grow so large, Herman said he has seen similar cases. He once operated on a young woman whose ovarian cyst grew to between 20 and 25 lbs. (9 to 11 kg).

“I had to roll it off the table; it was so heavy,” Herman said. Women may miss the symptoms of ovarian cysts because they think they’re just putting on weight, he said.

Source: Yahoo news

2-headed baby born in India

The mother reportedly had no idea she was carrying twins because she could not afford an ultrasound. Doctors say they don’t believe the baby girls, who have two heads but one set of vital organs, will survive.

A woman gave birth to what seemed to be a girl with two heads in northern India on Wednesday. Urmila Sharma, 28, was too poor to afford an ultrasound and had no idea she was carrying conjoined twins, reports said.

“She is presently alive and healthy,” Dr. Ashish Sehgal said of the twins, although doctors do not expect them to survive. The twins each have a head but share one body and all their vital organs, so separation is not possible.

A very “meticulous and challenging” surgery could save the babies’ lives, but doctors cannot operate until the girls are stable, Sehgal — who’s also the CEO of the Cygnus J.K. Hindu Hospital in Sonipat, Haryana. The twins are currently in the hospital’s intensive care unit.

Sehgal said keeping them alive was “a real tough challenge,” but said he is “hoping for success with crossed fingers.”

Doctors said it was too late do anything by the time Sharma delivered the twins via Caesarean section. They were born weighing 7 pounds, 7 ounces and have not been named.
The twins have two necks and two spines.

British papers report the mother’s family is “very distressed.”
Some conjoined twins can be separated — depending on shared organs and where they’re connected — but most are stillborn or die shortly after birth.

Source: daily news

Simple tips to prevent Urinary Tract Infections (UTIs)

A urinary tract infection (UTI) can be defined as an infection involving the kidneys, ureters, bladder, or urethra. While not all urinary tract infections (UTIs) can be prevented, experts suggest one can still reduce the risk by taking certain steps and precautions.

Fluids intake: Drink plenty of water and other liquids, but cut back on caffeine and alcohol, which can irritate the bladder. This will make you urinate frequently, which flushes bacteria from your urinary tract. If the urine appears darker than the usual very pale yellow colour, you should increase the fluid intake.

Cranberry juice has been shown to help prevent urinary tract infections.

Toilet hygiene: Do not hold your urine for a long time, urinate when you have the urge. When you’re done, always wipe from front to back to prevent bacteria from the anus entering the urethra.

Constipation: Try to avoid constipation as it has been linked to increase the chances of getting a UTI. Steps like increasing the amount of fibre in your diets, drinking plenty of water and other natural fluids can help relieve constipation.

Sexual intercourse: Take special precaution when you engage in sexual activity since it may also increase the risk as it can bring bacteria into the bladder area. Practice good hygiene by washing your genitals every day using a mild detergent and before having sex. Make sure that the bladder is emptied after intercourse by drinking plenty of water and other fluids.

Clothing: Avoid wearing tight-fitting undergarments, which is made of non-breathing materials. Instead opt for loose-fitting and cotton materials, which allows a woman’s private part to remain dry preventing from bacteria growth.

Source: Zee news

World Sleep Day: Lack of sleep can cause heart disease

How you sleep is a major determinant of how well your heart functions. A new study carried out on cardiac patients at the Sir Gangaram Hospital here revealed that around 96 percent of patients who have cardiovascular problems have sleep apnea.

Sleep apnea, which is clinically called Obstructive Sleep Apnea Syndrome (OSAS), is a type of disorder characterized by pauses in breathing or instances of shallow or infrequent breathing during sleep.

“Lack of sleep is directly related to cardiac diseases,” Sanjay Manchanda, head of Sir Gangaram Hospital’s Department of Sleep Medicine, told IANS.

“Quality of sleep is very important. A good night’s sleep prevents heart attacks, diabetes as well as road accidents.”

The study, carried out by the hospital in collaboration with Philips Healthcare, also proves the correlation between lack of sleep and heart ailments.

It said that 58 percent of patients of cardiovascular disorders had severe sleep apnea and an estimated 85 percent of them were not aware that sleep apnea and
cardiovascular diseases were correlated.

Removing some of the myths associated with sleep apnea, the study further said that there is no correlation between weight and extent of sleep apnea.

Even thin patients can develop the disorder.

The severity of sleep apnea in cardiac patients was found to increase with age, the study said.

Sleep apnea involves cessation of airflow for 10 seconds or more during the night due to partial or full collapse of the airway in human beings. The reduced or absent airflow results in high carbon dioxide and low oxygen.

The sufferer is forced to increase his breathing effort against the collapsed airway. This means that the sufferer arouses to a lighter stage of sleep, which
leads to sleep fragmentation and the person wakes up unrefreshed.

Added Manchanda: “It is by far the single most common disorder seen at sleep centres and is responsible for more mortality and morbidity than any other sleep disorder.”

He said though there are many reasons that can lead to sleep apnea like alcohol, smoking and use of sedatives, in some people it is due to the structure of their
throat and the upper part of their body.

Snoring, the doctor said, is just an indication of the condition.

According to J.P.S. Sawhney, chairman of the cardiology department at Sir Gangaram Hospital, sleep apnea as a disease is grossly untreated.

He said its correlation with cardiac disease has not been understood by the public as yet.

However, the doctors said that the condition is easily treatable.

Surgical intervention or a machine called C-Pap which ensures trouble-free breathing during the night, can easily help patients.

The C-Pap, one of the most common treatments, derives its name from the application of “continuous positive airway pressure” (or forcing air) through a patient’s nose to prevent limp throat muscles from closing off the airway.

The price of the machines, which have several variants, range between Rs. 35,000 and Rs. 90,000.

Source: Daiji world

Healthy ways to prevent cancer in teens!

CDC’s Division of Cancer Prevention and Control sponsored a supplemental issueExternal Web Site Icon of the Journal of Adolescent Health about ways to prevent cancer, with a focus on youth. The authors are experts from many different professions, showing the importance of working together to protect youth from cancer.

Youth go through many physical and social changes as they grow into adults. These changes create unique opportunities for cancer prevention. By addressing certain exposures and behaviors among today’s youth, we can reduce their chances of getting cancer in the future.

Examples include—

Promoting protective behaviors.

  • Completing the three-dose human papillomavirus (HPV) vaccine series.
  • Eating healthy food.
  • Getting enough physical activity.

Reducing harmful exposures.

  • Avoiding sunbathing and indoor tanning bed use.
  • Quitting smoking and other tobacco use.
  • Limiting alcohol use.
  • Avoiding exposure to certain chemicals.
  • Limiting radiation dose during medical imaging procedures.

Source: CDC

US reports rare case of woman-to-woman HIV transmission

A rare case of suspected HIV transmission from one woman to another was reported Thursday by US health authorities.

The 46-year-old woman “likely acquired” human immunodeficiency virus while in a monogamous relationship with an HIV-positive female partner in Texas, said the Centers for Disease Control and Prevention.

The woman, whose name was not released, had engaged in heterosexual relationships in the past, but not in the 10 years prior to her HIV infection.

Her HIV-positive partner, a 43-year-old woman who first tested positive in 2008, was her only sexual partner in the six months leading up to the test that came back positive for HIV.

She did not report any other risk factors for acquiring the virus that causes AIDS, such as injection drug use, organ transplant, tattoos, acupuncture or unprotected sex with multiple partners.

The strain of HIV with which she was infected was a 98 percent genetic match to her partner’s, said the CDC in its weekly report.

Authorities first learned of the case in August 2012 from the Houston Department of Health.

The couple said they had not received any counseling about safe sex practices, and reported that they routinely had sex without barrier methods.

“They described their sexual contact as at times rough to the point of inducing bleeding in either woman,” said the CDC report.

“They also reported having unprotected sexual contact during the menses of either partner.”

The partner who was infected since 2008 had been prescribed antiretroviral drugs in 2009 but stopped taking them in November 2010, and was lost to follow up in January 2011.

The CDC warned that although such cases are rare, “female-to-female transmission is possible because HIV can be found in vaginal fluid and menstrual blood.”

People with HIV should be under the care of a doctor and take their prescribed medicines to keep their viral load down and reduce the risk of infecting a partner, the CDC said.

Very few cases of this kind have been documented, and confirmation “has been difficult because other risk factors almost always are present or cannot be ruled out,” said the report.

One survey of 960,000 female blood donors found 144 who tested positive for HIV and were therefore blocked from donating.

Of 106 of those women who agreed to interviews, none described female-to-female sexual contact as their only risk factor.

The CDC also described one case of a woman in the Philippines who tested positive for HIV and said she had sex only with women and did not inject drugs, though no source of infection could be confirmed.

One other case is known of a 20-year-old woman who was diagnosed with HIV after a two-year monogamous relationship with a female partner who was HIV positive. While both women had the same drug-resistant HIV mutations, no tests were done to identify if their HIV strains were a genetic match.

Source: Yahoo news

Autism and intellectual disability incidence linked with environmental factors

An analysis of 100 million US medical records reveals that autism and intellectual disability (ID) rates are correlated at the county level with incidence of genital malformations in newborn males, an indicator of possible congenital exposure to harmful environmental factors such as pesticides. Autism rates — after adjustment for gender, ethnic, socioeconomic and geopolitical factors — jump by 283 percent for every one percent increase in frequency of malformations in a county. Intellectual disability rates increase 94 percent. Slight increases in autism and ID rates are also seen in wealthier and more urban counties.

The study, published by scientists from the University of Chicago March 13 in PLOS Computational Biology, confirms the dramatic effect of diagnostic standards. Incidence rates for Autism and ID on a per-person basis decrease by roughly 99 percent in states with stronger regulations on diagnosis of these disorders.

“Autism appears to be strongly correlated with rate of congenital malformations of the genitals in males across the country,” said study author Andrey Rzhetsky, PhD, professor of genetic medicine and human genetics at the University of Chicago. “This gives an indicator of environmental load and the effect is surprisingly strong.”

Although autism and intellectual disability have genetic components, environmental causes are thought to play a role. To identify potential environmental links, Rzhetsky and his team analyzed an insurance claims dataset that covered nearly one third of the US population. They used congenital malformations of the reproductive system in males as an indicator of parental exposure to toxins.

Male fetuses are particularly sensitive to toxins such as environmental lead, sex hormone analogs, medications and other synthetic molecules. Parental exposure to these toxins is thought explain a large portion of congenital reproductive malformations, such as micropenis, hypospadias (urethra on underside of the penis), undescended testicles and others.

The researchers created a statistical baseline frequency of autism and ID across the country. They then looked at the actual rates of these disorders, county-by-county. Deviations from the baseline are interpreted as resulting from local causes. Factors such as age, ethnicity, socioeconomic groups and geopolitical statuses were analyzed and corrected for.

The team found that every one percent increase in malformations in a county was associated with a 283 percent increase in autism and 94 percent increase in ID in that same county. Almost all areas with higher rates of autism also had higher rates of ID, which the researchers believe corroborates the presence of environmental factors. In addition, they found that male children with autism are almost six times more likely to have congenital genital malformations. Female incidence was linked with increased malformation rates, but weakly so. A county-by-county map of autism and ID incidence above or below the predicted baseline for the entire US is included in the study.

Non-reproductive congenital malformations and viral infections in males were also associated with double digit increases in autism and ID rates. Additionally, income appeared to have a weak effect — every additional $1,000 of income above county average was correlated with around a three percent increase in autism and ID rates. An increased percentage of urban population in a county also showed a weak increase in rates.

The most striking negative effect was state regulation. State-mandated diagnosis of autism by a clinician for consideration in special education was linked with around a whopping 99 percent decrease in the rate of incidence for autism and ID. Certain ethnic backgrounds, such as pacific islanders had significantly lower risk for both diseases.

While the effect of vaccines was not analyzed as part of this study, Rzhetsky notes that the geographic clustering of autism and ID rates is evidence that if vaccines have a role, it’s a very weak one as vaccinations are given uniformly across the US.

Rzhetsky acknowledges there are potential confounders to the study, for example ease of access to data could differ between counties or uneven genetic distribution, beyond the factors they controlled for, could have an effect. The team anticipates future studies could leverage data from the Environmental Protection Agency and other sources to identify links between specific environmental causes and increased rates of autism and ID.

“We interpret the results of this study as a strong environmental signal,” Rzhetsky said. “For future genetic studies we may have to take into account where data were collected, because it’s possible that you can get two identical kids in two different counties and one would have autism and the other would not.”

Source: escience news

 

India emerging as liver transplant hub’

India is emerging as a global hub for liver transplant with expanded medical facilities, an expert said here Friday.

“Around 50-60 percent of live transplant patients are from foreign countries,” said Vivek Vij, director, Liver Transplant Programme in Fortis Hospital here.

“The reason India has emerged as a hub for liver transplant is because of the poor medical facilities in countries like Bangladesh, Pakistan, Nepal, Cambodia and other African nations,” he added.

Vij was speaking on the occasion of Fortis Hospital becoming the first hospital in Uttar Pradesh to perform 100 liver transplants.

“Since the inception of the hospital in 2012, Fortis Noida has recorded a 100 percent donor and 97 percent recipient survival rate, surpassing the international standards for safety and establishing the hospital as a coveted centre for liver transplant.”

He said the hospital has also initiated a lot of campaigns and drives to raise awareness about liver-related diseases.

Source: Business Standard

TV time linked to less sleep for kids

The more television children watch, the less total sleep they’re getting, according to a small Spanish study.

Researchers found that a nine-year-old who watched five hours of television a day, for example, slept an average one hour less a night than a nine-year-old who watched television for less than an hour and a half a day, lead author Marcella Marinelli, from the Center for Research in Environmental Epidemiology in Barcelona, told Reuters Health.

The study team followed some 1,700 children for up to three years and found those who increased their TV time got even less sleep as they grew up.

“This study really demonstrated that kids who watch a lot of television and continued to do so continued to have a trajectory of less sleep than they should have,” said Christina Calamaro, from the Nemours Alfred I. duPont Hospital for Children in Delaware, who was not involved in the research.

Marinelli and her colleagues write in JAMA Pediatrics that theirs is the first study to examine the relationship over years between the amount of time toddlers and school-age children spend watching television and the amount they spend sleeping.

The American Academy of Pediatrics estimates the average child spends eight hours a day in front of a screen. AAP recommends that parents limit kids’ daily screen time to one or two hours.

Pre-school age children need a total of 11 to 12 hours of sleep a day and school-aged kids need at least 10 hours a day, according to the National Institutes of Health.

Using data from a larger health study, Marinelli’s team assessed the sleep and television habits of 1,713 children in two Spanish cities and on the Mediterranean island of Menorca.

In the cities of Sabadell and Valencia, researchers asked parents how much time their children slept and how much TV they watched when they were two years old and again when they were four years old. In Menorca, researchers questioned the parents of children when they were six years old and again at nine years old.

The researchers categorized children who watched less than an hour and a half a day of television as “shorter” TV viewers and those who watched more than that as “longer” viewers.

TV viewing times at the beginning of the study period ranged from zero to a maximum of eight hours a day, though the median viewing time was about one hour a day. Sleep times ranged from three to 20 hours a day initially, but the median was about 12 hours for two-year-olds, 10 hours for four-year-olds and 11 hours for the six-year olds.

At all points, kids who were longer viewers got less sleep than kids who were shorter viewers.

Median sleep times dropped by about two hours during the two-to-three year follow-up period for all age groups. But kids who increased their TV viewing during that period lost even more sleep time than the others – an average of 20 percent.

Children who reduced their viewing time during follow-up tended to get more sleep, but that result could have been due to chance, the researchers note.

Marinelli’s team did not look at what kinds of shows the children watched on television, what times of day they watched or where the TVs were located. Their study cannot prove that TV viewing caused the differences seen in sleep times or explain why that might be.

One recent study found slightly older kids, aged 11 to 13, slept significantly less when they frequently watched television before hitting the sack (see Reuters Health story of January 24, 2014 here: reut.rs/1fjXJnq).

The researchers adjusted their findings for other factors that might influence the results – including the kids’ gender, weight, exercise, symptoms of attention-deficit hyperactivity disorder, whether children slept alone or with others, humidity in their bedrooms and the age of their mattresses. Researchers also adjusted for parents’ marital status, educational level and psychopathological symptoms.

“They controlled for all the right variables, and television popped out,” Calamaro said.

“We are not paying attention to how much technology children are using and how much television children are watching and what it’s doing to their sleep.”

Calamaro agreed with the study authors, who theorized that fast-paced television images could disrupt children’s brain development or might cut children’s motivation to play, exercise, draw and do other things that enhance neurodevelopment. She said television time could also simply displace sleep time.

Calamaro stressed the importance of playtime and sleep to children’s development.

“This paper really says, wait a minute, when television viewing starts young, it continues to be an issue for children’s sleep as they get older. It feeds into parents’ need to limit technology at an early age,” she said.

Marinelli said she only allows her three-year-old daughter to watch educational television and limits her to no more than half an hour a day.

“Parents must control the use of television especially in very young children and also the use of other devices, for example mobile phones,” she said.

Source; reuters