Three die suddenly from rare Lyme disease complication

One was found dead in a car that veered off the road. Two others collapsed and died suddenly without warning. All three may have been killed by an infection known for causing long-term misery, but not one usually considered a killer — Lyme disease.

The Centers for Disease Control and Prevention reports Thursday on the cases of three people who literally dropped dead from a heart infection known as Lyme carditis. The two men and a woman were young, aged 26 to 38, and had not been treated for Lyme disease.

And no one suspected an infection until an astute pathologist readying heart tissue for a possible transplant noticed something wrong.

The first case was one of those inexplicable deaths, when a young, seemingly healthy person dies suddenly from heart disease.

“In November 2012, a Massachusetts resident was found unresponsive in an automobile after it veered off the road. No evidence of traumatic injury was found,” the CDC team and state department of health investigators write in the report. The driver was dead.

In the second case, a New York state resident had chest pain and collapsed and died at home last July. This patient did have an unusual heart condition called Wolff-Parkinson-White syndrome, but no one suspected something else might have been involved.

The same month, a Connecticut resident died suddenly while on an out-of-town visit. “The patient had complained of episodic shortness of breath and anxiety during the 7–10 days before death. The patient lived on a heavily wooded lot and had frequent tick exposure; there was no known history of cardio­vascular disease,” experts wrote in the report, published in the CDC’s weekly report on disease and death.

All three were tissue donors. A pathologist at the Cryolife tissue lab in Kennesaw, Ga. noticed something unusual when he was examining the heart valve from one of the victims as it was being prepared for a transplant. “He noticed the histopathology was similar to what he had seen in Lyme carditis,” said Dr. Joe Forrester, a CDC epidemiologist in Ft. Collins, Colo. who helped write the report.

The Ft. Collins lab checked the blood; the CDC in Atlanta checked the tissue and found the characteristic Borrelia burgdorferi bacteria. “We began investigating,” Forrester said.

The Massachusetts victim may have had symptoms of Lyme disease. “Interviews with next-of-kin revealed that the patient had described a nonspecific illness with malaise and muscle and joint pain during the two weeks preceding death. The patient lived alone with a dog that was reported to have ticks frequently,” the report reads.

Forrester said the victim almost certainly did not think anything serious was wrong. “If I had muscle aches and joint pains, I don’t know if I would go to the doctor right away,” Forrester told NBC news.

Only four other deaths from Lyme disease have ever been reported, CDC says — two in Europe and two in the United States. “Pathologists and medical examiners should be aware that Lyme carditis can be a cause of sudden cardiac death,” the agency advises.

Lyme disease is common, and this deadly complication remains very unusual. “We believe it’s rare. We are trying to find out how rare,” Forrester said.

CDC says while 30,000 Lyme cases are reported a year, it’s probably much more common than that — perhaps as high as 300,000 cases a year.

It’s most common in Connecticut, Delaware, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Minnesota and Wisconsin.

It’s not clear what the message for the general public might be – people are already cautioned to avoid being bitten by ticks, especially in areas known to have high rates of Lyme disease. Lyme is caused by the bacteria Borrelia burgdorferi and antibiotics usually clear it up. And Forrester says only 1 percent of people infected with Lyme disease get carditis.

There is not a vaccine against Lyme, so CDC recommends using insect repellants — those containing DEET are best — and wearing long sleeves, pants and socks when in wooded areas where ticks might be found.

Source: nbc news


A stone baby found in 82 years old colombian woman

An 82-year-old woman complaining of stomach pain was revealed to have a 40-year-old fetus inside her body.

Multiple news agencies reported that when the Colombian woman when to a doctor in Bogota, they found a lithopedion, or a calcified fetus, inside her stomach.

Also known as a “stone baby,” a lithopedion happens when a mother has a pregnancy that doesn’t develop in the uterus, according to an article in the Canadian Medical Association Journal. Typically the fetuses are more than three months old and found in the abdomen. The fetus lacks circulation, which leads to extra calcium buildup.

Because it is so large, it cannot be absorbed by the body. Instead the fetus becomes calcified until it is removed.

According to the Irish Independent, about one out of every 11,000 pregnancies will turn into a lithopedion. Most women do not know what happened or that they were even pregnant, so it can remain inside them for quite some time.

An article in the Journal of the Royal Society of Medicine explained that the first known case of a lithopedion was found in 1582 in a 68-year-old woman from Sens, France. The fetus was estimated to be about 28 years old.

The Colombian woman was reportedly transferred to a different hospital to have the fetus surgically removed.

Source: Cbs news


98, 000 Nigerian Women Die Annually From Firewood Smoke – Health Official

Nigerian women are being discouraged from using firewood. No fewer than 98,000 Nigerian women die annually from smokes inhaled during cooking with firewood, an official of the Federal Ministry of Environment, Bahijjahtu Abubakar, has said.

Ms. Abubakar, who is the National Coordinator, Renewable Energy Programme, told newsmen at the official launch of RUWES and the 4th Annual Nigeria Renewable Energy Day in Abuja on Wednesday.

She said the death from the sector contributed to 10 per cent of global annual death, according to the World Health Organisation (WHO) study.

“The WHO says that over 98,000 Nigerian women die annually from the use of firewood. “If a woman cooks breakfast, lunch and dinner, it is equivalent to smoking between three and 20 packets of cigarette a day.

“The death from this sector contributes to 10 per cent of global annual death and it is bigger than tuberculosis, HIV and AIDS and malaria combined, and it is only killing women,” the official said.

The coordinator said there was so much energy poverty in Nigeria, especially in the rural areas in a country that was blessed with abundant energy resources.
She said there was no way Nigeria would be contributing 10 per cent to global annual death without addressing it. According to her, the ministry has just launched a Rural Women Energy Security (RUWES) programme to prevent the trend and to create awareness on the dangers of using dirty energy.

Ms. Abubakar said the ministry had registered over 1.6 million Nigerians under the RUWES programme. She, however, said the ministry had been harnessing renewable energy to provide clean cooking energy for the rural women.

“Harnessing renewable energy is a tool to mitigate the impact of climate change tool, to address poverty and it is about economic empowerment and also contribution to the environment.

“So, we are looking at the lighting solution, heating and cooking solution,” she said. The coordinator said the ministry had been reaching out to women-based organisations through RUWES.

“We are reaching out to faith-based organisations such as the Federation of Moslem women and the Catholic Women Organisation.
“We hope through the market women organisation and all the professionals that are women- based, we are reaching out to every nook and cranny of Nigeria.’’

On the affordability of the cooking stoves provided under RUWES, she said it would be a single digit interest rate for the facilities.
“The women have two years to pay back. All they need is to belong to cooperative and they are given lighting, cooking and heating solution facility to use.

“A woman can get a stove and pay over seven months and we know that the poorest woman will be able to afford it.
The Nigeria Renewable day is “embracing the green movement’’.

Source: premium times


Medical Schools in Nigeria to Begin Learning Through Simulation By 2015

Medical schools in Nigeria will begin the teaching and learning of medical sciences through simulation by 2015, Eugene Okpere, a visiting Professor at the National Universities Commission (NUC), has said.

Okpere disclosed this on Tuesday in Abuja at a stakeholders meeting to discuss the enhancement of medical education through the utilisation of new technologies.

The don, who said the simulation centres would be sited in some selected schools across the country, explained that the meeting was to sensitise stakeholders and to seek their opinion on the adoption of the new technology to medical education.

He said that the NUC would need to liaise with the provosts of medical schools, vice chancellors, chief medical directors and other stakeholders to get their opinion on the new technology.

“The NUC has recognised that it is time that all stakeholders, provosts of medical schools and vice chancellors are carried along on the new technology as well as their opinions on how it can be adopted.”

Okpere explained that the use of simulation in teaching medical education is the safest way to train medical students competently.

He said that the use of electronic human body would enable students to identify forms of disease components or clinical signs.

According to him, students who go through thorough training in simulation technology will have 35 per cent competency before their physical contact with live patients.

“More importantly, patients are now getting very smart and wise. They know their rights and not many patients will be happy to be used as materials for experiments.

“Basically, the whole idea, is to ensure that in the next two years, most medical schools in the country have simulation complexes or regional centres, where medical students can move around and spend time learning adequately,” he said.

Source: all africa


‘Nuances of childhood TB are never taught in medical schools’

If diagnosing tuberculosis in children, particularly those aged under five years, is fraught with problems, health-care workers at different levels who are unaware of the latest advancements in childhood TB diagnosis and treatment make it even worse.

“Tuberculosis is a part of the training programme when doctors go through a M.D course. So a basic training is provided,” Dr. Soumya Swaminathan, Director of National Institute for Research in Tuberculosis (NIRT), Chennai said. “But we are talking about in-depth training on the recent advances in TB diagnostics and treatment. They [doctors] are not aware of these.”

There is a lack of awareness in India despite the National Revised Tuberculosis Control Programme (RNTCP) and the Indian Academy of Paediatricians (IAP) working together to develop the diagnosis and treatment guidelines.

This brings to the fore the compelling need for ongoing training in childhood TB. “Constant upgradation of knowledge is what is needed,” she said. “Private practitioners are generally not well informed compared with government doctors. So there is a need to reach out to private practitioners and train them.”

“Unfortunately, even in high TB burden countries, many paediatricians know little about TB and do not diagnose it in a timely fashion. TB is often poorly taught in medical schools and the nuances of childhood TB are virtually never taught,” Dr. Jeffrey R. Starke, Professor of Paediatrics, Baylor College of Medicine, Houston, Texas said in an email to this Correspondent. “As a result, paediatricians do not consider TB diagnosis and a child is not referred to the NTP [national tuberculosis programme] where TB-specific care is provided.”

The need for an engagement with health-care providers of different specialisations and at different levels cannot be overemphasised. “The engagement of all who provide care to children (including paediatricians and other clinicians) is crucial,” the 2006 WHO report on Guidance for National Tuberculosis Programmes on the Management of Tuberculosis in Children notes.

The recently released WHO’s Roadmap for Childhood Tuberculosis report emphasises the same point. “There is an urgent need for greater awareness of and increased screening for TB in children, particularly by services that serve children… Children with TB often present at primary- and secondary-care settings where there is a lack of guidance on how to address the challenges of diagnosing and managing childhood TB,” the Roadmap states.

The Roadmap has identified the need to engage four health-care programmes including maternal and child health services and private health-care sector.

“Overall, training of medical and nursing health workers on childhood TB seems to be variable, but often poor. It is quite good in South Africa, because TB is so common and so it [training] is a part of pre-service curriculum,” Prof. Steve Graham said in an email to this Correspondent. “In so-called developed countries, the general public and the health services lack knowledge of childhood TB because it is so uncommon.”

Prof. Graham is from the University of Melbourne and Murdoch Children’s Research Institute, Australia, and also The Union, France. He was the Chair of the Childhood TB subgroup of the Stop TB Partnership that led the Roadmap.

According to Prof. Graham, the awareness level of the latest developments in childhood TB should trickle down to the lowest level in the health-care system to increase the number of children who would get diagnosed and treated for TB on time. This includes “any health worker who cares for an adult case of TB or any health worker at a primary- and secondary-care level that diagnoses TB in children.”

Source: the hindu

 


Long-term use of antacids linked to vitamin B12 deficiency

A new study has found that people who took commonly prescribed heartburn and ulcer medications for long term were at higher risk of vitamin B12 deficiency.

Left untreated, vitamin B12 deficiency can increase the risk of dementia, nerve damage, anemia, and other medical complications, some of which may be irreversible. Stomach acid aids in vitamin B12 absorption; suppressing the acids can lead to the health-threatening vitamin deficiency.

Researchers examined the electronic health records (including diagnoses, pharmacy orders, and laboratory results) of 25,956 adult Kaiser Permanente patients diagnosed with vitamin B12 deficiency in Northern California between January 1997 and June 2011, and compared them with 184,199 patients without B12 deficiency during the same time period.

“Patients who took PPI medications for more than two years had a 65 percent increase in their risk of B12 deficiency,” Douglas A. Corley, MD, PhD, a gastroenterologist and research scientist with the Kaiser Permanente Division of Research, said. “Higher doses also were associated with an increased risk, compared with lower doses. Kaiser Permanente’s electronic health records allowed us to look at what happens in the real world for these commonly used medications.”

Among the 25,956 patients who had vitamin B12 deficiency, 12 percent used PPIs for at least two years, compared with 7.2 percent of the control patients. The impact of taking any daily dosage of H2RA medications was less pronounced but also significant: 4.2 percent of patients with B12 deficiency used these medications versus 3.2 percent of control patients.

The study is published in the Journal of the American Medical Association.

Source: health

 


Recycled plastic turned into ‘nanofibers’ to attack fungal infection

Scientists say they have made a “nanomedicine breakthrough” by creating “antifungal nanofibers” from recycled plastic materials that are able to target and attack specific fungal infections. This is according to a study published in the journal Nature Communications.

Researchers from the International Business Machines Corporation (IBM), based in the US, and the Institute of Bioengineering and Nanotechnology (IBN) in Singapore, say they created the technology by converting plastic materials such as polyethylene terephthalate (PET) – commonly used in plastic bottles – into non-toxic biocompatible materials that act as “antifungal agents.”

Fungal infections are extremely common all over the world and cover a broad number of conditions. Mild fungal infections include athlete’s foot, a rash or a mild respiratory illness. But other fungal infections, such as fungal pneumonia or bloodstream infection, can be severe.

According to the researchers, a person is more likely to develop a fungal infection if they possess an altered immune system as a result of antibiotic treatment, or have conditions such as HIV/AIDS or cancer.

Although there are antifungal drugs available to treat these infections, there is the issue of drug resistance.

The investigators explain that traditional antifungal drugs work by attempting to get into cells to attack the infection. However, the drugs find it difficult to target and break through the membrane wall of the fungi.

They also note that fungi are similar to mammalian cells in terms of metabolism. This means the antifungal drugs that are currently used have difficulty determining the difference between infected and healthy cells.

With these factors in mind, the investigators looked to develop a new antifungal agent that could combat the issue of drug resistance.

How does the technology work?
The scientists transformed PET into completely new antifungal molecules using a hydrogen-bonding process that causes them to self-assemble.

The researchers explain that the way these molecules stick together is “like molecular velcro in a polymer-like fashion to form nanofibers.” They note that this process is important because the antifungal agents only work in their “fiber or polymer-like form.”

Explaining how the agents, or “nanofibers” work, the researchers say they possess a positive charge that is able to specifically target a fungal membrane that is negatively charged, and attach to these alone through “electrostatic interaction.”

Dr. Yi Yan Yang, of IBN and leader of the study, says:

“The ability of these molecules to self-assemble into nanofibers is important because unlike discrete molecules, fibers increase the local concentration of cationic charges and compound mass.

This facilitates the targeting of the fungal membrane and its subsequent lysis, enabling the fungi to be destroyed at low concentrations.”

Nanofibers ‘proved successful in fungi eradication’
The assembly of the antifungal nanofibers was simulated in order to predict which different structures could destroy fungi.

From this, the researchers found that the lowest concentration that stops the visible growth of fungi – known as the minimum inhibitory concentration (MIC) – proved the most effective against a variety of fungal infections.

Further research revealed that the nanofibers erased 99.9% of Candida Albicans (C. albicans) – a fungus that is a cause of oral and genital infections in humans, as well as the third most common bloodstream infection in the US.

The fungi was eradicated after 1 hour of incubation and demonstrated no sign of resistance after 11 treatments.

Comparing these results to traditional antifungal drugs, the researchers note that traditional therapeutics developed resistance after 6 hours and were only able to suppress additional fungal growth.

Further studies also looked at the activity of the nanofibers in mouse models. This was done using a C. albicans biofilm infection linked to use of contact lenses.

The researchers found that the nanofibers were able to significantly reduce the number of fungi, prevented new structural growth of fungi in the cornea, and decreased inflammation in the eye.

Commenting on the findings, Prof. Jackie Y. Ying, executive director of IBN, says:

“A key focus of IBN’s nanomedicine research efforts is the development of novel polymers and materials for more effective treatment and prevention of various diseases.

Our latest breakthrough with IBM allows us to specifically target and eradicate drug-resistant and drug-sensitive fungi strains and fungal biofilms, without harming surrounding healthy cells.”

Source: Medical news today


Baby steps to saving lives

 

Each year, one in 10 babies around the world will be born prematurely and over a million of those will die. But could measuring the size of a baby’s feet help save lives?

In the final weeks of pregnancy, the idea of going into early labour might not seem like such a bad thing.

But giving birth prematurely – officially classed as before 37 weeks gestation – can lead to long-term health effects.

Depending on quite how early the baby is born, infants can either be completely unaffected or left with permanent disability and learning difficulties.

The issue of prematurity is particularly pronounced in South Asian and Sub-Saharan Africa, which accounts for over 80% of the deaths caused by pre-term birth complications.

In rural Tanzania, for example, about one in every 30 premature babies won’t make it past four weeks.

However, most of those lives could be saved with simple advice for mothers.

And that advice, says an international group of researchers, could start with just a footprint.

Foot chart with side rule

The larger foot on the yellow card represents a full term baby’s foot size. If a newborn’s feet are smaller than th

Sizing upe small foot on the card, the baby is probably premature and the advice is to take the baby to hospital immediately. Side rule added for scale.

Most mothers in high-income countries will give birth surrounded by medical equipment or with the support of a highly-skilled midwife.

This means that any problems, such as a low birth-weight or the mother’s waters breaking early, can be dealt with immediately.

In contrast, around 40% of women giving birth in low-income countries will do so without the help of a trained medical professional.

And due to inaccurate dating of pregnancy, many of those women will have no way of telling if their baby is too early or too small.

However, measuring the baby’s footprint could be used as a simple proxy for birth weight.

“There’s this grey area when the baby is between around 2.4kg (5lbs 5oz) and 2.1kg (4lbs 10oz) when the baby is more vulnerable to infection and other issues,” says Dr Joanna Schellenberg of the London School of Hygiene and Tropical Medicine.

“But when a baby is born at home, there is no way of weighing them,” she told the BBC.
The BBC’s Tulanana Bohela has been to see the project in action
To help solve the problem, Schellenberg and her colleagues at the Ifakara Health Institute in Tanzania have implemented a strategy called Mtunze Mtoto Mchanga – which means “protect the newborn baby”.

It includes using a picture of two footprints on a piece of laminated card and a local volunteer placing the baby’s foot against the images.

If the baby has feet smaller than the smallest foot, around 67mm, then the mother is advised to take the baby to hospital immediately. If it measures in between the big and the small image, then the mother is told about the extra care she needs to provide to increase the baby’s chances of survival.

Although the card is fairly accurate for five days after birth, it should be used it to identify small babies in their first two days of life, which is when they’re most at risk of dying without specialist care.

Mariam Ulaya is one of the volunteers at Namayakata shuleni village and visits the women before and after the birth.

“If I’ve measured the child’s footprint and seen that the child is smaller than usual, then I instruct them to carry the child skin-to-skin so that the child can share and feel the mother’s warmth,” says Ulaya.

“I also carry a small doll with me called Opendo. I use the doll to illustrate the proper way to breastfeed the child.”

‘It has helped my child to survive’
Such advice may seem simple but can really be the difference between life and death.

A report by the World Health Organization (WHO) says that of the 15 million premature births globally each year, more than 80% will occur between 32 and 37 weeks’ gestation.

Risks factors for premature birth

There is no clear cause of premature birth and there tend to be many different risk factors involved.
These include infections of the genital and urinary tract, pre-eclampsia, problems with the placenta and gestational diabetes.
Obesity is another major risk factor for premature birth.

Fetal fibronectin is a protein which can be used as a reliable indicator of preterm birth. It normally appears around 22 weeks and then again at the end of pregnancy. If it appears between these dates, early labour often follows.
Research also suggests that low levels of the hormone progesterone in the saliva could also help spot women at risk of sudden premature labour.

Most of these babies will survive if given extra warmth through skin-to-skin contact and very regular breastfeeding to help fight off infection.

In fact, the report states that an estimated 75% of deaths in preterm infants can be prevented in this way – without the cost and emotional upset of intensive care.

Salima Ahmad is 25 and has three children who live with her in Namahyakata dinduma village, Tanzania. Her youngest son, Alhaji, was born prematurely.

“I was a little bit shocked because many premature babies end up dying but I was also happy because I had a live baby,” says Salima.

Although Alhaji was born at the local hospital, Salima was given advice and support by volunteers from Mtunze Mtoto Mchanga about how to care for him once she got home.

“Carrying skin-to-skin was good but difficult in the beginning. But when the volunteer was visiting me and encouraging me, I could see myself managing it slowly. It is good, it has helped my child to survive,” she says.

Salima also feels that understanding more about premature birth helps mothers like herself to deal with it properly.

“It helps a lot for the mother not to be surprised when having a premature birth. It is useful to know in advance as you get good knowledge on how to handle the premature. Myself, I do thank the volunteer who talked about it when I was pregnant and she even taught me how to carry skin to skin.”

Source: BBC


NYC requires flu shots for all daycare, preschool children

If your child wants to attend daycare or preschool in New York City, he or she will now be required to get a flu vaccine.

New York City’s Board of Health voted unanimously Wednesday to require all children under 5 attending one of these facilities to receive the vaccine before Dec. 31, right before flu season peaks.

Young children often pass influenza to other children and family members, who then spread the infection to others in the community. This mandate will help protect the health of young children, while reducing the spread of influenza in New York City,” the board said in an emailed statement.

City health officials told CBS News Tuesday they anticipate this effort would affect 150,000 children and, based on traditional vaccine effectiveness rates, prevent more than 20,000 cases of flu in young kids.

“A lot of people have a misconception that the flu is just like the common cold and nothing that needs to be worried about,” said Dr. Jay Varma, deputy commissioner of the New York City Department of Health and Mental Hygiene. “In fact, flu is common and can be very serious for children under the age of 5.”

In New York City, children of these ages are already required to receive common vaccines including the MMR (measles, mumps, rubella), polio, pertussis (whooping cough), chickenpox and tetanus shots, so flu will just add one more shot to this list.

The rule will be enforced by the facilities, which may choose to exclude a child if he or she doesn’t get the vaccine. If the facility does not keep up to date vaccination records for its kids — as it’s required to do for all childhood vaccines — it could be subject to a fine.

Flu season typically begins as early as October, with the number of cases increasing dramatically by December and often peaking from January through March.

A flu season can range in severity, but children and the elderly are often most likely to be hospitalized or die from disease complications, even kids who were previously healthy.

Last year’s severe flu season killed at least 165 children. In the prior 10 seasons, between 43 and 153 kids died.

Since Dec. 31 is only weeks away, this mandate would not go into effect until next year’s 2014-2015 flu season.

Parent’s can only opt out of the flu vaccine if their child has medical reasons for not being able to take it, which are rare, or for religious exemptions. Philosophical exemptions, such as over vaccine concerns, are not allowed in New York State.

Children entering family daycare, which are held in people’s homes, won’t be subject to the requirement.

According to Varma, only New Jersey and Connecticut have similar requirements for flu vaccinations.

The new rule takes effect in 30 days, according to CBS New York.

“We feel strongly that we are doing something that’s always been done to protect the health of children,” he said.

Source: cbs news


$17.5 bn global investment needed for optimal breastfeeding: Report

A global annual investment of $17.5 billion in interventions to universalize optimal breastfeeding can prevent millions of babies from infant deaths due to diarrhoea and pneumonia besides impaired development and reduce the risk for diabetes, hypertension, cancer and cardiac diseases in adult life, suggests a report.

The report “The Need to Invest in Babies – A Global Drive for Financial Investment in Children’s Health and Development through Universalizing Interventions for Optimal Breastfeeding” was published by the International Baby Food Action Network (IBFAN), an international non-governmental organization that monitors and tracks the implementation of the World Health Organization’s (WHO) Global Strategy for Infant and Young Child Feeding.

The report was formally released here Tuesday by Montek Singh Ahluwalia, deputy chairman of the Planning Commission.

The report has been launched simultaneously in Canada, Mexico, Egypt, Colombia, Costa Rica, Guatemala and Nepal.

The report notes that out of the 135 million babies born every year, 83 million babies and their mothers are not enabled to optimally breastfeed as recommended by the WHO.

The report challenged the current estimate of $2.9 billion given by the World Bank in 2010.

“Even though breastfeeding has been identified as the most vital intervention to reduce infant deaths and malnutrition in children, it is extremely under-funded. Earlier estimates covered only parts of promotion of breastfeeding and were too low to fund all the necessary interventions of ‘protection’ and ‘support’ to women, which are so critical,” it said.

The report calls the transfer of a minimum of $2 per day for 180 days for lactating women to enable them to remain with their infants during the critical early months without economic pressure to go back to work. This assistance, which globally comes to $12.6 billion annually, is based on World Bank’s poverty line. India and UK have already begun such schemes to support women, it said.

Source: daijiworld