Month: July 2014

Now, toolkit to help treat menopause

Now toolkit to help treat menopause

A first of its kind toolkit can be used by doctors to help manage menopausal conditions for women globally – from Madras to Manhattan, scientists say. Created at Monash University, the toolkit is designed for general practitioners (GPs) to use with women from the age of 40.

The Practitioner Toolkit for Managing the Menopause includes a diagnostic tool, as well as a compendium of approved hormone therapies. Led by Professor Susan Davis, the research team from the School of Public Health and Preventative Medicine, combined existing research on menopause, diagnostic algorithms and extensive clinical experience to develop the diagnostic tool.

Designed for use in a GP surgery, it also works through a patient’s medical history and risk factors to arrive at the best treatment solution. Davis said the toolkit fills the void of clear guidelines on menopause diagnosis and management, equipping doctors with the fundamentals to care for any woman who walks through the door.

“Based on feedback from patients and doctors we realised there’s widespread confusion, not only in how to determine when menopause starts but also prescribing appropriate treatment to help with side effects,” Davis said. Menopause marks the end of the monthly cycle of menstruation and reproductive years in a woman’s life.

Most women reach menopause between the ages of 45 and 55. Davis said due to hormonal changes, menopausal symptoms, which include hot flushes, anxiety and depression and joint pain, vary widely from none at all to debilitating, making a straightforward diagnosis difficult.

The kit includes a flow chart of standardised questions for doctors to ask, and assess women who are potentially experiencing menopause.

The kit also flags safety concerns, provides a list of all hormone therapies approved by regulators in different countries and lists non-hormonal therapies that have evidence to support their use.

“Hormone therapy is commonly prescribed to women, but its success varies according to symptom type and severity, personal circumstances and medical background,” Davis said.

“This toolkit has the potential to change that because it’s designed to work as just as well for a 41 year old woman in Madras as it will for the 48 year old in Manhattan,” she said. The toolkit can be downloaded for free from the journal Climacteric.

Source: The financial express

25 Minutes of This Will Get Rid of Your Stress

25 Minutes of This Will Get Rid of Your Stress

In just half an hour, by focusing on your breathing, you can start to relax and melt away your cares.

Researchers at Carnegie Mellon University investigated how effective mindfulness meditation can be in countering the body’s stress response. For that type of meditation, you need a laser-like focus on your breathing, and, some advocates say that as your body fills up with air, your muscles contract. That helps you to push out other distractions — like deadlines or your to-do list — and start to relax.

They randomly assigned 66 volunteers to either participate in mindful meditation for 25 minutes for three days, or go through a cognitive training program in which they learned how to analyze poetry passages. The people who meditated reported less stress, and even showed that they were better at coping with stress compared to those who relied on their behavior training.

The new study, published in the journal Psychoneuroendocrinology, is not the first to show the positive effects of mediation. An analysis from February showed that Transcendental Meditation (TM)–a 20 minute mediation that simply requires closing your eyes and quieting down outside thoughts — sometimes by repeating a mantra — significantly lowered teacher stress and burnout. Fans of TM include chef Mario Batali, music mogul Russell Brand, Paul McCartney, Arianna Huffington, and Dr. Mehmet Oz. Now it looks as if there’s some promising science to back them up

Source: Time

Alzheimer’s research in ‘major step’ towards blood test

Alzheimer's research in 'major step' towards blood test

British scientists have made a “major step forward” in developing a blood test to predict the onset of Alzheimer’s disease.

Research in more than 1,000 people has identified a set of proteins in the blood which can predict the start of the dementia with 87% accuracy. The findings, published in the journal Alzheimer’s & Dementia, will be used to improve trials for new dementia drugs.

Experts warned that the test was not yet ready for doctors’ surgeries. Research into treatments for Alzheimer’s disease has been plagued by failure. Between 2002 and 2012, 99.6% of trials aimed at preventing or reversing the disease flopped.

Doctors believe the failure is down to treating patients when it is already too late, since symptoms appear around a decade after the start of the disease. Identifying patients earlier is one of the priorities for dementia research.

Blood test
The research group, which combines university and industry scientists, looked for differences in the blood of 452 healthy people, 220 with mild cognitive impairment and 476 with Alzheimer’s disease.

They were able to tell with 87% accuracy which patients with mild cognitive impairment would go on to develop Alzheimer’s disease in the next year.

“We want to be able to identify people to enter clinical trials earlier than they currently do and that’s really what we’ve been aiming at,” said lead researcher Prof Simon Lovestone from the University of Oxford. However, he said it may find a place in doctors’ surgeries in the future.

“As long as there is no treatment one can question the value of a test, but people come to the clinic because they want to know what’s happening to them and I currently can’t tell them.” He said he was forced to tell patients to come back in a year and see if their memory problems were any worse.

Prof Lovestone added: “That’s grim, it’s horrible, you can only imagine what that’s like for patients. “Although I have some real reservations about doing a test, all I can say is there are some people who come to clinics asking precisely that question.”

Dr Ian Pike, chief operating officer at Proteome Sciences, said: “Having a protein test is really a major step forwards. “[It] will take several years and need many more patients before we can be certain these tests are suitable for routine clinical use, that process can start fairly quickly now.”

Dr Eric Karran, director of research at Alzheimer’s Research UK, described the study as a “technical tour de force”. However, he warned the current accuracy levels risked telling healthy people they were on course to develop Alzheimer’s which may lead to anxiety and depression.

It is unlikely that the test would be used in isolation if it eventually makes its way into clinics. A positive result could be backed up by brain scans or testing spinal fluid for signs of Alzheimer’s.

However, Dr Karran did argue this was a step towards making Alzheimer’s a preventable disease. “I think it does, but not immediately.

“This gives a better way to identify people who will progress to Alzheimer’s disease, people who can be entered into clinical trials earlier, I think that will increase the potential of a positive drug effect and thereby I think we will get to a therapy, which will be an absolute breakthrough if we can get there.

“It’s not a simple journey. We all wish it was.”

Source: bbc news

Your Next Crash Might Be With a Drowsy Driver

Your Next Crash Might Be With a Drowsy Driver

Drunk drivers and texting teenagers are bad enough, but the latest report from the federal government shows that sleepy drivers are putting us all at risk, also. Fully 4 percent of drivers surveyed by the Centers for Disease Control and Prevention confessed to having fallen asleep at the wheel in the past month. Drowsy driving plays a role in as many as 7,500 fatal crashes — 25 percent of all crashes

Drowsy drivers who don’t fall all the way asleep can still cause accidents, by missing exits or drifting out of their lanes, Wheaton’s team wrote. Drinking’s still the biggest single cause of road deaths, however.

“In 2012, nearly one third (10,322) of the 33,561 traffic fatalities occurred in alcohol-impaired driving crashes,” the CDC team wrote. “In addition, half of vehicle occupants killed were not wearing seatbelts.”

Source: nbc news

Childhood vaccines are safe. Seriously

Flu Shots

Children should get vaccinated against preventable and potentially deadly diseases.

That’s what a project that screened more than 20,000 scientific titles and 67 papers on vaccine safety concludes this week. The review appears in the latest edition of the medical journal Pediatrics.

The evidence strongly suggests that side effects from vaccines are incredibly rare, the study authors said. They found no ties between vaccines and the rising number of children with autism, as a small but vocal group of anti-vaccine activists, including actors Jenny McCarthy and Jim Carey, have said.

The review also found no link between vaccines and childhood leukemia, something that was suggested in earlier studies. The researchers found that some vaccines did cause a few adverse effects but it was only for a tiny fraction of the population.

There was evidence that the meningococcal vaccine can lead to anaphylaxis — a severe, whole-body allergic reaction — in children allergic to ingredients in the vaccine. Other studies found the MMR vaccine was linked to seizures.
“Vaccines, like any other medication, aren’t 100% risk free,” said Dr. Ari Brown an Austin, Texas-based pediatrician and author of the popular book “Baby 411,” who was not involved with the study.

“You have a sore arm, redness at the injection site. Those are the things we see commonly. Fortunately the serious adverse effects is extremely rare.” Brown said parents ask her how safe vaccines are all the time. Some patients also ask if they should delay or stagger the vaccinations. She counsels against that practice. She said the younger the child, the more danger these diseases present.

“By delaying the vaccines you’re putting your child at risk,” Brown said. The positive effects of vaccines dramatically outweigh the bad, experts said.

An editorial accompanying the study calls vaccines “one of the most successful public health achievements of the 20th century.” Because of vaccines, many diseases that plagued children for centuries have all but been eliminated.

“There were good reasons that these diseases were targeted for vaccine development since they are so life-threatening,” said Dr. Carrie Byington, vice-chair for research in the University of Utah’s pediatrics department, and the new chair for the American Academy of Pediatrics committee on infectious diseases.

Millions of Americans live longer on average because of the protection vaccines provide. Life expectancy has gone up in the United States by more than 30 years. Infant mortality decreased from 100 deaths per 1000 to 7 between the 1900s and 2000.

A vaccine for smallpox led the Centers for Disease Control and Prevention to declare the disease eradicated in 1978. Prior to a vaccination for diphtheria, it was one of the most common causes of illness and death among children.  Now it is rarely reported in the United States.

What vaccines do children need? Experts: vaccines are necessary
Yet research shows there is still doubt among some medical residents about the effectiveness of vaccinations.

“That is particularly concerning for me,” Byington said. “Young residents may be in the same position as young parents who have trained at a time, or lived at a time, when these diseases were extremely rare, and they may not have ever seen how serious a vaccine-preventable infection can be.”

An increasing number of parents over the years have opted out of getting their children vaccinated. And that may be having a negative impact on the community’s health.

A study found that large clusters of children who had not been vaccinated were close to the large clusters of whooping cough cases in the 2010 California epidemic. While California typically has higher vaccination rates than the rest of the country, that state is dealing with yet another whooping cough epidemic.

This spring also saw an 18-year high number of measles cases in the United States. The largest outbreak was in Ohio where the virus spread quickly among the Amish, who are mostly unvaccinated. This outbreak was a real surprise to health officials who thought that the infectious disease was thought to have been eliminated from the United States in 2000.

The editorial accompanying this latest study suggests doctors, who parents typically trust to tell the truth about medical information, need to use this study to speak with confidence about the importance of vaccinating children.
“Looking at all these mounds of data — there is still no data that show an association that shows vaccine and autism,” said Brown. “I would love it to close this chapter and move on. I don’t think it will. But the more research, the more we learns about autism, the more we can reassure parents that there are no links here.

Source: cnn news

Simple Solutions Can Save Babies in Kenya – Report

Simple Solutions Can Save Babies in Kenya - Report

Kenya’s high newborn death rate of 31 out of every 1,000 live births can be greatly reduced through simple solutions. These include cheap investments in quality care, according to a global action plan launched today at the Partners’ Forum in Johannesburg.

The Every Newborn action plan (ENAP), approved in May by the World Health Assembly, says investing just Sh100 ($1.15) per person every year in 75 high burden countries would prevent three million deaths of women and babies.

Still births in Kenya have been decreasing slowly, but the country still has some of the highest rates in the world, the WHO says.

Still births are deaths occurring in the last three months of a pregnancy.

The report gives two specific targets for all countries to achieve by 2035. These are reducing neonatal mortality rates to 10 or fewer newborn deaths per 1,000 live births and reducing stillbirth rates to 10 or fewer stillbirths per 1,000 total births.

“The day of birth is the time of greatest risk of death and disability for babies and their mothers– contributing to around half of the world’s 289,000 maternal deaths,” the report says.

UN boss Ban Ki-moon said in a statement the progress should well documented. “Let us do all we can to ensure a healthy start for all mothers and newborns. This will open the way for progress across the development agenda and around the world,” he said.

The report says most newborn deaths result from three preventable and treatable conditions: prematurity, complications around birth and severe infections.

It says more than 71 percent of newborn deaths could be avoided without intensive care, mainly though quality care around birth and care of small and sick newborns.

This care requires skilled health workers, especially midwives, and essential commodities, such as steroid injections costing less Sh100 per treatment, or cheap resuscitation devices like a bag and mask.

“The Every Newborn Action Plan is explicit acknowledgement that even the smallest and newest babies have a right to live and that we are going to do our utmost to see that they do,” said Dr Mickey Chopra, Chief of Health, UNICEF, and Co-Chair of the Countdown to 2015.

Source: all africa

Genes May Be Key to Great Musicians

Genes May Be Key to Great Musicians

Chopin, Vivaldi and Bach may have had natural musical talent, and then some. A new study suggests accomplished musicians are genetically programmed to commit to the long hours of practice needed to become skilled musicians.

The findings add to growing evidence that both nature and nurture help develop expertise, according to the researchers.

“The nature versus nurture debate has raged since the beginning of psychology,” study leader Zach Hambrick, a professor of psychology at Michigan State University, said in a university news release. “This makes it very clear that it’s both. Not only in the sense that both nature and nurture contribute, but that they interact with each other.”

He and his colleagues looked at 850 sets of twins and found that accomplished musicians practiced much more than those who didn’t attain the same level of musical skill, according to the study published online in the June issue of Psychonomic Bulletin & Review.

By comparing identical twins (who share 100 percent of their genes) and fraternal twins (who share 50 percent of their genes), the researchers concluded that an inclination to practice more was driven partly by genetics.

In terms of musical achievement, they also found that genes had a larger effect on those who practiced than on those who didn’t.

The findings challenge the widely held view that a lack of natural ability can be overcome with enough practice and/or training, according to the study authors.

“Contrary to the view that genetic effects go away as you practice more and more, we found that genes become more important in accounting for differences across people in music performance as they practice,” Hambrick said.

Source: web md

OxyContin and other opioids tied to 1 in 8 deaths in young adults

OxyContin and other opioids tied to 1 in 8 deaths in young adults

Use of opioids such as OxyContin and codeine is a leading cause of death in young adults, say researchers in Ontario who reviewed coroner reports from a period of nearly 20 years.

Rates of opioid-related deaths are increasing rapidly in the province and are concentrated among the young — a substantial burden of disease, the researchers say in Monday’s issue of the journal Addiction.

“We found that among those individuals aged between 25 and 34 years, that approximately one out of every eight deaths were related to opioid overdoses,” said study author Tara Gomes, a scientist at the Li Ka Shing Knowledge Institute at St. Michael’s Hospital and the Institute for Clinical Evaluative Sciences.

“We hadn’t quite anticipated that there would be such a large prevalence of opioid-related deaths in these younger populations and that it would be really one of the leading causes of death in these younger adults.”

The findings underline the urgent need to change perceptions on the safety of the medications, the researchers concluded.

Gomes and her team reviewed 5,935 opioid-related deaths in Ontario between 1991 and 2010, based on whether opioid-related or another drug were present in toxicological tests at concentrations high enough to cause death, excluding heroin. They found:

Rates of opioid-related death increased in Ontario between 1991 and 2010, rising from 12.2 deaths per million in 1991 (127 deaths annually) to 41.6 deaths per million in 2010 (550 deaths annually) – an increase of 242 per cent.
About 1 of every 170 deaths in Ontario is now related to opioid use.

The loss of life caused by opioid overdoses has a significant burden on society, since those who die at an early age cannot be productive members of society. Specifically, opioid-related deaths result in more than 20,000 years of potential life lost annually, exceeding that due to alcohol use disorders, pneumonia, HIV/AIDS and influenza.
Data on deaths isn’t readily available in other provinces, but Gomes expects the findings are transferable across Canada.

Part of the issue is there’s evidence of a fair amount of recreational use of opioids by high school and university students, said Gomes, who is also a scientist at the Institute for Clinical Evaluative Sciences. There may be a perception that they are safer than other drugs because they are prescribed, but the results clearly show there are substantial risks of overdoses and deaths.

‘You don’t even think about prescriptions’

Betty-Lou Kristy of Georgetown, Ont., west of Toronto, became an advocate for narcotic addiction and mental health and serves on provincial committees. She lost her son, Peter Beattie, in 2001 when he was 25 after he became addicted to OxyContin that was originally prescribed for pain. He accidentally overdosed after mixing the opioid with psychiatric medications.

“I as a mother was looking for street drugs. You don’t even think about prescriptions,” Kristy said.

While there is more awareness now than when her son died, Kristy said prescribers such as doctors and dentists, parents and young people themselves need to be educated about the dangers and warning signs of overdose.

“If you’re getting prescribed an opioid, have a good, solid discussion with your doctor. Make sure it’s an informed choice. For students and youth, don’t experiment. These are unforgiving.”

As a bereavement facilitator and advocate for parents, Kristy said opioid deaths are staggering, whether from fentanyl, heroin, OxyContin and its generic form, or other such drugs.

Gomes said the findings suggest to her that clinicians and policy makers need to remain vigilant and to ensure that the appropriate programs and services are available. These include information sharing for patients and electronic health records so prescribers know if people are obtaining prescriptions from other sources.

“These are risky medications,” said Gomes. “They can be effective but you need to use them appropriately. You should not be sharing them with friends and you should be protecting them in your household to make sure that they’re not falling into the hands of youth or other individuals who might inadvertently end up overdosing.”

Last month, Health Canada announced it plans to require drugs at high risk for abuse, such as controlled-release oxycodone, to have tamper-resistant properties. The goal is to prevent people from crushing, snorting or injecting the drugs to get a quick high

Source: cbc news

Black armband silent protest on Doctor’s Day by UCMS doctors

Black armband silent protest on Doctor’s Day by UCMS doctors

As India celebrated Doctors Day on July 1, doctors at the University College of Medical Sciences (UCMS) here sat quite gloomy while trying to find out reasons to celebrate.

“This observance is a way to show the society how important doctors are in our lives but has everybody thought how, even, we are denied our basic rights by the autocratic Delhi University administration,” said the aggrieved faculty members in a statement.

“Being doctors, we realise our duty towards patients and that’s why we deliberately avoided the options of strike and disruption of OPD and emergency services. We only wore black bands to raise our issues. In the evening we once again gave our representation in MHRD,” said Dr Satendra Singh, assistant professor of physiology at the UCMS.

According to the statement, the UCMS doctors are under the University of Delhi and henceforth the University Grants Commission (UGC) and the Ministry of Human Resource Development (MHRD), while other sister medical institutions like Maulana Azad Medical College (MAMC), Lady Hardinge Medical College (LHMC) and even all other state run medical colleges are under the Centre or State run Ministries of Health and Family Welfare (MOHFW). There the faculty can concentrate on quality of medical teaching and patient care as the promotions and pay scales of teaching medical faculty are determined by the Dynamic Assured Career Progression [DACP] scheme as laid down by the 6th Central Pay Commission Report, i.e. time bound promotions.

“The terms and conditions of DACP were brought into enforcement vide notification to UGC gazetted on 18th September 2010. The notification categorically directed UGC under clause no 1.1.1 that all medical faculties appointed medical teachers in Central Universities shall be governed by the norms of MOHFW i.e. time bound promotions. This was to be made effective for medical teachers of UCMS, AMU (Aligarh Muslim University) and BHU (Banaras Hindu University) from 31st December 2008. However, the dictatorial administrations of DU have not taken any heed to this constitutional right of medical teachers of UCMS,” it said.

“Being under DU, no pay protection is given to doctors who have to join at salaries lower than what they were given under the residency scheme of MOHFW. Unlike medical colleges under MOHFW which safeguard the financial and promotional interests of medical faculty, DU equates medical faculty to any other faculty in colleges under DU,” according to the faculty members.

“The VC of BHU provided pay protection to medical faculty in BHU, but the VC of DU even denied that. Faculty members having completed even upto eight years of service are given salaries less than resident doctors. This has made UCMS one medical college with the highest faculty attrition rate. In the last three months, 17 permanent faculty members have left UCMS and joined as assistant professor by sacrificing their current experience on which they should have been either associate professor or professor. In the past three years, almost 25 faculty members have left for Centre or State run MOHFW medical institutes like MAMC, LHMC, new AIIMS, state medical colleges and even private practice,” said the faculty members.

“The university system focuses purely on research for promotion of their faculty, while as medical teachers, faculty at UCMS and all medical colleges should be focussing on teaching medical students and patient care. Lack of transparency in the promotions in DU has made it one of the worst career options for medical faculty, who quit UCMS for greener pastures which offer them time bound promotions and better salaries. Every doctor is under the Hippocrates Oath, swearing for patient care and teaching his peers and juniors. But we are humans too and not demigods. Denial or delay of our constitutional rights has forced many to seek judicial help and tangent us away from the oath,” they added.

Source: India Medical Times

With hormonal changes in body, 17-year-old girl transforms into a boy

With hormonal changes in body, 17-year-old girl transforms into a boy

In a bizarre incident that occurred in Bokaro district of Jharkhand, a 17-year-old girl was ‘transformed’ into a boy due to chromosomal changes in her body.

The girl-turned-boy has named himself as Server Haider. Doctors of the medical board have confirmed the news of the transformation.

Acording to a Bhaskar report, Server’s father, Haider Ali, sent him to the medical board to get him examined for his medical fitness. After conducting Server’s medical check-up, a team of three doctors were surprised to realise that the boy’s name was registered in the ‘female’ category.

Witnessing this, they sent him to the women’s medical department in Sadar hospital, where the doctors transferred his reports to higher authorities for proper examination of his choromosomal activities.

Doctors have said that such situation arises, when the body starts taking shape into a different form, due to chromosomal changes, which results in conversion of a girl into a boy.

Source: News 18