Category: Health

F.P. Report

KARACHI: Nineteen more dengue fever cases were detected across Karachi in a week, taking the reported cases toll to 669 in the city since 1st January 2018. According to the weekly report issued by Prevention and Control Program for Dengue in Sindh, at least 20 new dengue fever cases emerged throughout Sindh province out of which 19 were in Karachi and one in other district of the province in a week.

In August, 39 dengue positive cases were detected across the province out of them, 38 were in Karachi and one fin other district of the province. This year, a total of 710 dengue cases surfaced across the province out of them, 669 happened in Karachi and 41 in rest of Sindh.

A death due to dengue was also reported in Karachi city this year.

 

Monitoring Desk

NEW YORK: Researchers at the Alzheimer’s Association International Conference (AAIC) in Chicago revealed some interesting research for women approaching menopause.

New research has found a link between dementia and estrogen levels — the more estrogen a woman receives from pregnancy, for example, the less the risk of diseases like Alzheimer’s.

Additionally, there’s new evidence that hormone replacement therapy (HRT) may affect cognition in some subgroups of women.

“I think it’s very interesting,” said Dr. Verna R. Porter, director of programs for dementia, Alzheimer’s disease, and neurocognitive disorders at Pacific Neuroscience Institute at Providence Saint John’s Health Center in California.

The recent findings reported at the AAIC in July included a large-scale epidemiological investigation in the United States by researchers, including Paola Gilsanz, ScD, staff scientist at Kaiser Permanente Northern California Division of Research in Oakland, California, and Rachel Whitmer, PhD, a professor at UC Davis.

The team looked at women’s first menstrual period, the number of children they had, and when they started menopause to see what link there may be to dementia risk.

The researchers found that women in the study with three or more children had a 12 percent lower risk of dementia compared to those with only one child.

Also, women who reported having their first menstrual period at 16 or older had a 31 percent greater risk of developing dementia than those who reported having their first period at 13.

And, there was a 28 percent greater dementia risk for women experiencing menopause at 45 or younger compared to women who started after age 45.

Another study reported at the conference, from researchers at the Wisconsin Alzheimer’s Disease Research Center and other institutions, found no negative cognitive effect in women who had started hormone therapy between ages 50 and 54.

However, those who started hormone therapy between ages 65 and 79 did show reductions in global cognition, working memory, and executive functioning.

Women on hormone therapy with type 2 diabetes also demonstrated a higher risk of cognitive impairment compared to women without diabetes on hormone therapy and women with diabetes who were given a placebo.

“It may be that it’s critical when you give it,” said Porter regarding determining success or failure of hormone replacement therapy (HRT), and adding that risk factors like diabetes may also provide some context in whether to prescribe HRT.

These findings join previous research which found that estrogen and progestin therapy actually increased the risk for dementia in postmenopausal women 65 years and older.

Porter said the question remains whether estrogen is directly affecting cognitive function or if it’s something else.

She said that women experience an increase in certain immune cells during pregnancy, promoting regulatory T cells.

Alzheimer’s patients have fewer regulatory T cells, which promotes inflammation. Could the T cell increase during pregnancy be involved with the lower dementia risk?

“I think one of the main possibilities that is being postulated based on all these different studies [is] it’s not that it’s female sex hormones on their own,” said Porter.

Instead, it may be that these hormones have additional effects on other factors that influence cognition, said Porter.

Porter said based on the new findings, there may be some cognitive benefit of hormone replacement therapy when given at the right time.

This could mean giving HRT during the transition into menopause, as long as women don’t have risk factors for dementia, like bad cardiovascular health.

But any decisions about HRT should be based on gynecological history, including menopausal symptoms like hot flashes — not just potential cognitive benefit.

She said it should be something where many factors are taken into account.

“This new information is one important piece of the puzzle,” said Porter.

Dr. William R. Shankle, The Judy & Richard Voltmer endowed chair in memory and cognitive disorders at Pickup Family Neurosciences Institute at Hoag in California, recommends that women get a second opinion if their doctor says to not take estrogen because it’s bad for you.

However, there are certain circumstances when estrogen replacement therapy (ERT) can’t be prescribed, including for women with estrogen-sensitive breast cancer.

“If you are approaching menopause, are in menopause, or have completed it within the past five years, get a gynecologist who is knowledgeable about ERT so you can decide whether to take it,” said Shankle. “If you have not taken ERT and [are] more than five years past menopause, the current science indicates that ERT is not helpful and may increase risk of dementia due to [Alzheimer’s disease] or other causes.”

Dr. Russell Swerdlow, director of the University of Kansas Alzheimer’s Disease Center, said there are still no firm answers on the question of whether estrogen can help prevent dementia.

“This [research] adds to the list of reported associations between female hormones, such as estrogen, and cognitive performance,” said Swerdlow. “Associations such as these have spurred interest into the question of whether hormone replacement can benefit cognition.”

Swerdlow pointed out currently “the aggregate of results is not promising” but said that continuing research may eventually help clarify the benefits and risks.

BENI (AFP): Ten people have died in an outbreak of Ebola in eastern Democratic Republic of Congo, according to a toll issued Friday that said 27 other deaths were suspected to be Ebola-related. Forty-four confirmed and probable cases have been recorded since the disease broke out in the province of North Kivu on August 1, the health ministry said.

Two suspected cases in Goma, a city of about a million people, “turned out to be negative” on Thursday after lab tests, it said. The outbreak is the country’s 10th since 1976, when the disease was first identified in the DRC near the Ebola River, a tributary of the Congo. The latest outbreak is centered in North Kivu’s Beni region, which shares borders with Uganda and Rwanda.

The area is plagued by violence — a problem that the World Health Organization (WHO) has said will hamper the emergency response. Targeted vaccination, aiming primarily at front-line health workers, began on Wednesday. Ebola causes serious illness including vomiting, diarrhea and in some cases internal and external bleeding. It is often fatal if untreated.

In the worst Ebola epidemic, the disease struck the West African states of Guinea, Liberia and Sierra Leone in 2013-15, killing more than 11,300 people. The outbreak in North Kivu was declared a week after WHO and the Kinshasa government hailed the end of a flareup in northwestern Equateur province which killed 33 people.

 

F.P. Report

PESHAWAR: Participants at workshop stressed media persons to create awareness among the masses to counter the persistent dilemma of mal-nutrition in the country and stressed a strong political-well to allocate funds for the most vulnerable districts of the country.

Role of media for highlighting impact of malnutrition was discussed in a meeting organized by Scaling-Up Civil Society Alliance Pakistan and Nutrition International with the collaboration of United Rural Development Organization, Peshawar.

The journalists pledged to actively play their role for prioritizing nutrition agenda at the policy and program levels at Khyber Pakhtunkhawa as well as raise public awareness on the adverse effect of malnutrition to bring about behavior change.

Speaking on the occasion, Chief Guest; Dr. Kashif Nazeer, Chief Health/ SUN focal Point, Planning and Development Department, Khyber-Pakhtunkhwa highlighted the importance of media’s role for public opinion making.

He shared the initiatives taken by the provincial government for implementation of Khyber Pakhtunkhwa Multi sectoral Integrated Nutrition Strategy- launched in December 2014- and progress made for addressing the malnutrition situation in the province. Today’s session would be productive and media will play its crucial role for overcoming malnutrition challenge, he added.

Ms. Aliya Habib, Coordinator-SUN Civil Society Alliance Pakistan presented the overall context of malnutrition and status at national and Khyber Pakhtunkhawa level. She highlighted that malnutrition not only effects individuals but has dire economic and developmental impacts for the community and nation as well.

Khyber Pakhtunkhwa has high rate of stunting among children under-five at 47.8 per cent as compared to 43.7 per cent of the national average. The current malnutrition had been estimated to cost the Pakistan’s economy $7.6 billion (3% of GDP) annually. She emphasized that a multi-sectoral and holistic approach including short term and long term evidence based approaches to address malnutrition.

She also shared the purpose of Scaling Up Nutrition Movement and briefed participants about the role and achievement of SUN Civil Society Alliance Pakistan (SUNCSA, Pak). It is a network of over 150 civil society organizations from all federating unit of Pakistan, working for the promotion of nutrition agenda and improving the nutrition indicators of the country.

While discussing the role media can play, journalists expressed their resolve for tackling the malnutrition challenge head on. They suggested writing news articles; blogs, and case studies, media feeds on nutrition and food security issues. They said that emphasizing the human side of malnutrition through focused case studies is the way to attract and sustain attention of public and policy makers.

Zaheer Khattak, Executive Council Member of SUNCSA, Pak and Executive Director of United Rural Development organization thanked all the participants particularly media for their time and attention and requested to highlight the malnutrition issue through their platform.

The meeting was attended by a considerable number of journalists from print and electronic media, representatives from P&DD Kp and Directorate of Ex-FATA and civil society organizations.

Monitoring Desk

ISLAMABAD: Women who work for 45 hours or more a week may be associated with nearly 70 per cent increased risk of diabetes as compared to men or women who worked for 30 to 40 hours a week, a study has found. Longer-working men however did not face this risk.

While it is an observational study, the researchers noted, that the reason may be because women might work longer hours, when all the household chores and family responsibilities are taken into account, the researchers said.

Long working hours might also prompt a chronic stress response in the body, so increasing the risk of hormonal abnormalities and insulin resistance.

Interestingly, the length of the working week wasn’t associated with a heightened risk of the disease among men. If anything, the incidence of diabetes tended to fall, the longer a man’s working week was, the results showed.

“Considering the rapid and substantial increase of diabetes prevalence worldwide, identifying modifiable risk factors such as long work hours is of major importance to improve prevention and orient policy making, as it could prevent numerous cases of diabetes and diabetes related chronic diseases,” said the team including Mahee Gilbert-Ouimet from the Research Center of the Quebec University Hospital — Laval University, in Canada.

For the study, published in the journal BMJ Open Diabetes Research and Care, the researchers tracked the health data of 7,065 workers aged between 35 and 74 years for a period of 12 years.

Based on weekly working paid and unpaid hours, the participants’ were grouped into four time bands: 15-34 hours; 35-40 hours; 41-44 hours; and 45 or more hours.

The results showed that overworking among women was associated with 63 per cent of higher risk of diabetes among women where as incidence of diabetes in men was found mainly among older age groups, and those who were obese.

Global estimates indicate that 439 million adults will be living with diabetes by 2030 — an increase of 50 per cent on the figures for 2010. In 2015 alone, diabetes cost the global economy $1.31 trillion.

Monitoring Desk

NEW YORK: The mainstream understanding of diabetes developing in a pregnant woman — known as gestational diabetes — is that the largest problem it can lead to is simply a large, unusually “fat” baby.

But any type of diabetes in a pregnant woman poses a variety of much more complex threats to a growing fetus.

A recent study published in the American Journal of Physiology-Cell Physiology reports a significantly higher risk of heart disease in babies born to women with gestational diabetes. Gestational diabetes is similar to type 2 diabetes in that it is not an autoimmune condition like type 1 diabetes, but instead a metabolic disorder.

“Previous research has found that levels of a protein called transgelin are higher in offspring of women with gestational diabetes,” explained the recent report. “Transgelin is found in the endothelial colony of forming cells (ECFCs) that line the walls of blood vessels.”

When researchers from the Indiana University School of Medicine compared blood samples taken from the umbilical cords of babies born to women with gestational diabetes versus babies born to nondiabetic women, the higher levels of transgelin and protein levels demonstrated a very clear dysfunction in the development of healthy blood cells.

These cells are critical for both wound healing and for building blood vessel “networks,” a crucial part of a human’s overall cardiovascular system.

Without healthy and adequate ECFCs, the long-term development of that child’s blood vessel health can be significantly impaired and lead to a diagnosis of heart disease later in life.

“It’s not surprising,” explains Jennifer Smith, a certified diabetes educator and pregnancy coach for patients with diabetes at Integrated Diabetes Services. “Higher blood glucose levels in a pregnant woman pose a significant risk to the formation of every critical system in the development of a fetus.”

Gestational diabetes is generally diagnosed during the 2nd or 3rd trimester, explains Smith, as pregnancy-related hormones and overall body weight both rise, which leads to varying levels of insulin resistance.

“While it isn’t entirely known why gestational diabetes develops in some women and not others, the risk factors — including women over 25 years old, with a family history of type 2 diabetes, and a body mass index over 30 — definitely increases the likelihood in any pregnant woman,” explains Smith, co-author of “Pregnancy with Type 1 Diabetes.”

After diagnosis, however, mitigating the risks it poses to a growing fetus is very doable and ultimately comes down to the pregnant mother. Taking several short walks each day after eating and focusing on a diet made up mostly of whole, real foods can have a tremendous impact on overall insulin sensitivity and blood glucose levels.

“If you’ve been diagnosed with gestational diabetes, you can have a healthy pregnancy and a healthy baby, but the goal is to immediately start managing your blood glucose levels closely with a glucometer as soon you become aware of the issue,” explains Smith.

Even aside from the most recent research on the baby’s future risk of heart disease, Smith adds that babies born to a woman with gestational diabetes are also at risk for preterm birth, abnormally large birth weights, respiratory distress syndrome, low blood glucose levels during the first few hours or days of life immediately after birth, and a much higher risk for developing type 2 diabetes later in life.

“Whether a woman has been diagnosed with gestational diabetes or not, healthy habits and healthy blood glucose levels reduce a pregnant woman’s risk of high blood pressure, pre-eclampsia, and their own long-term diagnosis of type 2 diabetes.”

The Centers for Disease Control & Prevention reports that as many as 10 percent of pregnant women develop gestational diabetes, and 50 percent of those women go on to maintain that level of insulin resistance, which leaves them with a diagnosis of type 2 diabetes.

The baby’s healthcare team should also be paying close attention to their heart health over the first decade of their life in order to prevent any small issues from becoming far larger.

“Unfortunately, these [conditions] often go undiagnosed until children present with disease later in life, at which time the opportunity for prevention has ended,” explained researchers.

This new understanding of the risk gestational diabetes poses to a child’s evolving heart health means primary care doctors can monitor them more closely and refer these patients to cardiologists for further testing if concerns arise.

Monitoring Desk

ISLAMABAD: Examining stress and inflammation in the heart may be key to predicting risk of Parkinson’s disease, say researchers, as it may help physicians test new therapies and delay the progression of the disorder.

According to researchers, by the time Parkinson’s patients are diagnosed — typically based on the tremors and motor-control symptoms — about 60 per cent of them also have serious damage to the heart’s connections to the sympathetic nervous system.

When healthy, those nerves spur the heart to accelerate its pumping to match quick changes in activity and blood pressure.

“This neural degeneration in the heart means patients’ bodies are less prepared to respond to stress and to simple changes like standing up. They have increased risk for fatigue, fainting and falling that can cause injury and complicate other symptoms of the disease,” said Marina Emborg, from the University of Wisconsin-Madison, US.

For the study, published in the journal npj Parkinson’s Disease, the teams used rhesus macaque monkeys as models for Parkinson’s symptoms, who received neurotoxin doses that caused damage to the nerves in their hearts in the same way as Parkinson’s affects human patients.

The team found that tracing the progression of nerve damage and the progression of potential causes of that damage, the radioligands can also be used to test the efficacy of new treatments to protect the neurons that regulate the activity of the patients’ hearts.

“We know there is damage in the heart in Parkinson’s, but we haven’t been able to look at exactly what’s causing it. Now we can visualize in detail where inflammation and oxidative stress are happening in the heart, and how that relates to how Parkinson’s patients lose those neuronal connections in the heart,” said lead author Jeanette Metzger, from the varsity.

F.P. Report

PESHAWAR: A five-day polio eradication campaign will be launched in Khyber Pakhtunkhwa (KP) from August 6 (Monday).

The provincial health ministry said polio, or poliomyelitis, is a crippling childhood disease caused by the polio virus, and preventable through immunisation.

Affecting mostly children under the age of five, polio which has no cure and can only be prevented by giving a child multiple vaccine doses can lead to irreversible paralysis. The anti-polio campaign will target 16 high-risk districts, with the target of administering polio vaccine to 36, 27,000 minors. In Peshawar city alone, KP’s health ministry aims to administer the vaccine to 816,000 minors, Private news channel reported. A total of 13 teams have been formed to execute the campaign. Children moving from one district to another, or even leaving for other provinces, will now be traced via specially designed tracking systems for which the government has empowered commissioners and deputy commissioners across the province, he mentioned. “We have always been missing children when they were not available at their homes during the anti-polio campaigns and this tracking system will help us find the kids wherever they are,” he added.