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World Diabetes Day to be observed today in Pakistan

F.P. Report

ISLAMABAD: Like other part of the globe, World Diabetes Day will also be observed in Pakistan on Wednesday to create awareness about the disease and its prevention and treatment aspects in public.

The theme for World Diabetes Day 2018 is The Family and Diabetes.

Various activities have been planned to raise awareness of the impact that diabetes has on the family and support network of those affected. These activities will help promoting the role of the family in the management, care, prevention and education of diabetes, Dr Wasim Khawaja, a public health expert at Pakistan Institute of Medical Sciences (PIMS) said. Sharing the global figure, he said over 425 million people are currently living with diabetes.

Most of these cases are type 2 diabetes, which is largely preventable through regular physical activity, a healthy and balanced diet, and the promotion of healthy living environments.

He said that families have a key role to play in addressing the modifiable risk factors for type 2 diabetes and must be provided with the education, resources and environments to live a healthy lifestyle. Dr Khawaja said one in two people currently living with diabetes is undiagnosed. Most cases are type 2 diabetes.



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Cholera outbreak kills 175 in Nigeria

NAIROBI (AFP): Suspected cholera cases have jumped in northeast Nigeria where Boko Haram violence has forced tens of thousands of people to seek refuge in crowded camps, the Norwegian Refugee Council said on Monday.

The humanitarian group said 10 000 people have been affected by the fast-spreading cholera outbreak and 175 people have died in the northeast states of Adamawa, Borno and Yobe as of early November 2018.

“One of the major causes of the outbreak is the congestion in the camps that makes it difficult to provide adequate water, sanitation and hygiene services,” said Janet Cherono, the NRC’s programme manager in Maiduguri, capital of Borno state.

“The rainy season has also worsened the conditions. If more land is not urgently provided for camp decongestion and construction of health and sanitation facilities, Nigeria is steering towards yet another cholera outbreak in 2019.”

Nigeria has seen regular cholera outbreaks since Boko Haram took up arms against the government in 2009.

More than 1.8 million people have been displaced by the bloody conflict, which has claimed more than 27 000 lives and shattered daily life in the Lake Chad region.

Maiduguri, the birthplace of Boko Haram, is housing 243 000 displaced people in crowded camps with poor hygiene facilities, creating a fertile environment for cholera to spread, the NRC said.

Cholera is caused by a bacterium transmitted through contaminated food or drinking water. It causes acute diarrhoea, with children particularly at risk.

Nigeria, Africa’s largest oil producer, suffers from a high-rate of water-borne diseases as a result of dilapidated infrastructure and under-investment.

On Thursday, President Muhammadu Buhari declared a “state of emergency” in the country’s water sanitation sector, describing the statistics on open defecation and access to piped water as “disturbing”.



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World Pneumonia Day passed unnoticed

Rifaqat Ullah Razarwal

CHARSADDA: As all the attention of health departments is on polio this year World Pneumonia Day passed unnoticed here at Charsadda. However most of the people who use cell phones received an SMS from family’s doctors that people should vaccinate their children against pneumonia.

World Pneumonia Day is observed on November 12 each year to raise awareness of pneumonia, promote prevention and treatment, and generate action to fight the illness. “Pneumonia claims an innocent child’s life every 20 seconds making it the number one global cause of childhood mortality”, World Health Organization.

In Pakistan alone, it is responsible for the death of 92,000 children of less than five years of age annually and contributes 18 per cent to the total child deaths. Pneumonia is a form of acute respiratory infection that affects the lungs. When an individual has pneumonia, the alveoli (small sacs in lungs which fill with air when a healthy person breathes) are filled with pus and fluid, which makes breathing painful and limits oxygen intake.

Infants and children up to two years of age are at higher risk of contracting pneumonia as their immune systems are in the process of being developed. Children Specialist Dr. Amjad Zahoor while talking to The Frontier Post the symptoms of pneumonia in children includes rapid or difficult breathing, cough, fever, chills, headaches and loss of appetite.

He said the Pakistani government had introduced the pneumococcal vaccine in 2011 in its Expanded Programmed on Immunization (EPI). “However pneumonia can be pneumococcal or non-pneumococcal. It can be viral, fungal. Pneumococcal vaccine should be given when a child has hyperpyrexia, flue, wheeze,” he said.

“Children and aged persons are mostly affected by pneumonia after inhaling virus. Most frequent factor of pneumonia is smog as virus becomes stagnant in the air along with breath. There should be hygienic environment in houses”, he said. He stressed the children should keep in their rooms at dawn and evening, because at this time the children’s organism capacity are not wealthy to resist environment effect.


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Antimicrobial resistance causing 700,000 deaths annually

F.P. Report

MUZAFFARABAD: The world health organization (WHO) has characterized the antimicrobial resistance (AMR) as one of the biggest threats to public health claiming approximately 700,000 deaths per year around the globe which could increase to 10 million each year by 2050 if appropriate measures are not taken to address the alarming issue, health experts said.

“AMR is a sought of complication eventually arises from the excessive and improper use of antibiotic drugs creating resistance against these drugs by the bacterias and the illness becomes incurable,” Dr. Ejaz Ahmad Khan, child specialist in Shifa International Hospital explained in a press briefing after a conference organized by Multinational Pharmaceutical company (Pfizer) in connection with world antibiotic awareness week 2018 here in a local Hotel.

“AMR can affects anyone, of any age in any country. It occurs when pathogens change and find ways to resist the effects of antibiotics. The pathogens survive, grow and spread their resistance and this process of adaptation leads to AMR,” Dr Khan further elaborated the complication saying the consequences of the complication could be devastating if no solution is found. He said minor infections and injuries could become life threatening and serious infections such as pneumonia could become impossible to treat while many routine medical procedures could be too risky to perform because of the risk of becoming infected while in hospital by a multi-drug resistant pathogen.

Dr Khan who is also the member of multi microbial infectious disease society of Pakistan (MMIDSP) said MMIDSP has launched the initiative in the country to curb AMR through “Antibiotic stewardship initiative in Pakistan (ASIP)” in collaboration with Pfizer Pakistan and other stake holders however, he stressed a mass awareness campaign and legislation at government level to deal the problem and avoid severe consequences.

“The society has organized multiple events in collaboration with other stake holders for creating awareness and imparting training at both institutional and community levels to address the injudicious overuse of antibiotics with ever increasing AMR,” Dr. Khan remarked saying his organization reached out to major stakeholders, professional societies and policy makers within and outside the government for collaboration in taking AMR at national level.




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Cigarette smoking rate declines in US

NEW YORK (AFP): Cigarette smoking is losing popularity in the United States, where health officials Thursday announced just 14 percent of the population now smokes, the lowest level ever recorded in the country.

Some 34 million US adults smoke cigarettes, according to a 2017 survey by the US Centers for Disease Control and Prevention.

The 14 percent cigarette-smoker rate is down from 15.5 percent in 2016.

The current rate marks a 67 percent decline since 1965, the year the National Health Interview Survey (NHIS) began collecting annual data on smokers, said the CDC report.

“This new all-time low in cigarette smoking among US adults is a tremendous public health accomplishment,” said CDC Director Robert Redfield.

The NHIS report also highlighted a significant drop in young adult cigarette smokers in 2017 compared to a year earlier.

About 10 percent of Americans aged 18-24 smoked cigarettes in 2017, down from 13 percent in 2016.

Meanwhile, e-cigarette use is rising fast among young people, and US regulators are considering a ban on flavored nicotine that is used in the battery-powered vaping devices.

The CDC said one in five US adults (47 million people) still use some form of tobacco product —  including cigarettes, cigars, e-cigarettes, hookah pipes or smokeless tobacco — a rate that has remained steady in recent years.

Cigarette smoking is still the top cause of preventable death and disease in the United States, killing an estimated 480,000 Americans each year.

About 16 million Americans suffer from a smoking-related illness.

“For more than half a century, cigarette smoking has been the leading cause of cancer mortality in the United States,” said National Cancer Institute director Norman Sharpless.

“Eliminating smoking in America would, over time, eliminate about one-third of all cancer deaths.”



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Conjoined Bhutanese twins separated in Melbourne

MELBOURNE (AFP): Australian surgeons on Friday successfully separated 15-month-old Bhutanese twins, Nima and Dawa, who had been joined at the torso.

The team of more than 20 doctors and nurses spent six hours operating on the pair, who shared a liver but no other major organs, to the relief of the surgeons.

“We didn´t find surprises,” said Joe Crameri, who led the surgery at the Royal Children´s Hospital in Melbourne.

“We are here earlier because there weren´t any things inside the girls´ tummies that we weren´t really prepared for,” he told reporters.

“We saw two young girls who were very ready for their surgery, who were able to cope very well with the surgery and are currently in our recovery doing very well,” he told reporters.

He said the next 24 to 48 hours would be critical to their recovery, but was optimistic about the outcome.

Nima and Dawa, and their mother Bhumchu Zangmo, arrived in Australia a month ago with the help of an Australian charity, but doctors had delayed the surgery until Friday to ensure the twins were well-enough nourished to support the operation.

The girls were known to share a liver, but it was not known before Friday whether they also shared part of the bowel, which would have complicated the surgery.

Crameri said the girls´ bowels were a bit intertwined they were not connected “in any major way”.

A photograph released by the hospital showed four surgeons carefully lifting one of the twins away from the other on the operating table as the pair began their independent lives.

The girls and their mother spent the past month at a retreat outside Melbourne run by the Children First Foundation, which raised money to bring the family to Australia for the surgery.

Elizabeth Lodge of the foundation told national broadcaster ABC before the surgery the twins already had their own personalities.

“Nima´s the robust one. She tends to … always be on the top, pulling rank, as we say, and Dawa´s more placid,” she said.

“It will be really interesting to see what will happen once the girls are separated,” Lodge said, adding that the twins were “good mates”.

Bhutan is a poor Himalayan kingdom where doctors did not have the expertise to separate the girls, who were joined from the chest to the waist.

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Govt wants to make Pakistan polio-free: PM

F.P. Report

Islamabad: Prime Minister Imran Khan while directing chief ministers, governors and chief secretaries of all four provinces to speed up campaign for elimination of polio in their provinces said eradication of polio is our national responsibility.

PM vowed that they will make all out efforts to make Pakistan polio free.

PM was heading the meeting  of anti-polio task force at PM secretariat on Friday.

Chief Minister Sindh Syed Murad Ali Shah, Chief Minister Khyber Pakhtunkhwa Mehmood Khan, Chief Minister Gilgit Baltistan, federal minister for health Amir Kiyani, and PM assistant for polio Babar Bin Atta, secretaries of all four provinces and world representatives attended the meeting.

Provincial secretaries of all four provinces briefed the Prime Minister on efforts  made to eradicate polio and also presented a detailed report to him.

PM while addressing the session said federal and provincial governments are determined to eliminate polio that is a good omen but provinces have to gear up the efforts for complete eradication of polio.

He said federal government will continue to provide assistance to all provinces for the eradication of polio, because government wants to make Pakistan polio -free.

PM urged that making  Pakistan polio -free is our national obligation.

Federal Government will take every possible step in this regard.

He said that Pak Army will provide complete security to make successful this drive so that country’s future architects could be saved from disability.

PM also thanked international institutions for their participation in this important objective  of polio eradication.




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Sleep deprivation to cause dehydration

PENNSYLVANIA (Agencies): New research suggests that insufficient sleep may cause dehydration by disrupting the release of a hormone that is key to regulating hydration.

Sleep deprivation has a wide range of adverse effects on a person’s health.

Not only does insufficient sleep impair attention and judgment, but prolonged sleep deprivation raises the risk of type 2 diabetes, high blood pressure, obesity, and respiratory disease.

More recently, some studies have found that sleeplessness increases the risk of kidney disease and premature death. The kidneys play a vital role in hydration, and drinking more water improves kidney health.

However, few studies have examined the effects of sleep deprivation on the body’s hydration levels. New research has aimed to fill this gap. The leader of the study was Asher Rosinger, Ph.D., an assistant professor of biobehavioral health at Pennsylvania State University in State College.

The new study, which examines the effect of insufficient sleep on hydration levels among adults from the United States and China, was recently published in the journal Sleep.

Rosinger and colleagues analyzed the data available from two large studies: the National Health and Nutrition Examination Survey and the Chinese Kailuan Study.

Overall, the researchers examined the records of over 20,000 healthy young adults, who had provided urine samples and completed questionnaires concerning their sleeping habits.

The scientists examined the urine for two markers of dehydration: specific gravity and osmolality. Rosinger and the team also applied logistic regression models to evaluate the link between hydration and sleep duration.

They found that people who regularly got 6 or fewer hours of sleep each night had more concentrated urine than those who got about 8 hours per night. “Short sleep duration was associated with higher odds of inadequate hydration in [American] and Chinese adults, relative to sleeping 8 hours,” the authors explain.

More specifically, people who reported that they regularly slept for 6 hours or less each night were 16-59 percent more likely to be dehydrated than those who slept for 8 hours a night. These results applied to both population samples.

Finally, the study found no association with getting 9 or more hours of sleep per night.

Commenting on the findings, the lead author noted, “If you are only getting 6 hours of sleep a night, it can affect your hydration status.” He added:

“This study suggests that if you’re not getting enough sleep and you feel bad or tired the next day, drink extra water,” Asher Rosinger.

Although the new study is purely observational and does not prove causality, the researchers think that the hormone vasopressin may be responsible for the link between too little sleep and a lack of hydration.

Vasopressin is an antidiuretic hormone that controls the body’s water balance during the day and night.

“Vasopressin is released both more quickly and later on in the sleep cycle,” Rosinger explained, adding, “If you’re waking up earlier, you might miss that window in which more of the hormone is released, causing a disruption in the body’s hydration.”

Researchers should further assess the relationship between dehydration and sleep deprivation, the authors note. Longitudinal studies, for example, can determine hydration levels at baseline and re-examine them after a week of insufficient sleep.

Dehydration has various negative health effects. It can cause muscle weakness, headaches, and fatigue. Being dehydrated may also impact mood and impair cognition.


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Superbugs could “Kill Millions” by 2050, warns experts 

PARIS (AFP): Millions of people in Europe, North America and Australia will die from superbug infections unless countries prioritise fighting the growing threat posed by bacteria immune to most known drugs, experts predicted Wednesday.

The Organisation for Economic Co-operation and Development (OECD) warned of “disastrous consequences” for public healthcare and spending unless basic hospital hygiene is boosted and unnecessary antibiotic use slashed.

Drug-resistant bacteria killed more than 33,000 people in Europe in 2015, according to new research published separately this week.

In a landmark report, the OECD said 2.4 million people could die from superbugs by 2050 and said the cost of treating such infections would balloon to an average of $3.5 billion (three billion euros) a year in each country included in its analysis.

Michele Cecchini, lead on public health at the OECD, told AFP that countries were already spending an average of 10 percent of their healthcare budgets on treating antimicrobial-resistant (AMR) bugs.

“AMR costs more than the flu, more than HIV, more than tuberculosis. And it will cost even more if countries don’t put into place actions to tackle this problem,” he said.

“Enormous death toll”

As humans consume ever more antibiotics — either through prescriptions or agriculture and livestock products given medicines to stave off infection — strains of bacteria are developing that resist the effects of drugs designed to kill them.

In low and middle-income countries, resistance is already high: in Indonesia Brazil and Russia up to 60 percent of bacterial infections are already resistant to at least one antibiotic.

And the growth of AMR infections is predicted to be between four and seven times faster by 2030 than currently.

“Such high resistance rates in health care systems, which are already weakened by constrained budgets, will create the conditions for an enormous death toll that will be mainly borne by new-borns, very young children and the elderly,” the report said.

“Even small cuts in the kitchen, minor surgery or diseases like pneumonia could become life-threatening.”

Perhaps more worrying is the prediction made by the OECD that resistance to so-called 2nd- and 3rd-line antibiotics — break-glass-in-case-of-emergency infection treatments — will balloon by 70 percent by 2030.

“These are antibiotics that as far as possible we don’t want to use because we want these as back up,” Cecchini said.

“Essentially, we are using more when we should use less and we are running out of our best options in case of emergency.”

How to avoid disaster

The group, which advises the World Health Organization on public health initiatives, said the only way to avert disaster was to implement immediate, sector-wide changes in behaviour.

The report called on healthcare professionals to ensure better universal hygiene standards in hospitals and clinics by insisting all staff wash their hands and conform to stricter safety regimes.

It also suggested resistance could be fought with better and quicker testing to determine if an infection is viral — meaning antibiotics are useless — or bacterial.

New swab tests can give a result in a matter of minutes, and Cecchini also put forward the idea of “delayed prescriptions” to dent antibiotic overuse by making patients wait three days before picking up their antibiotics — roughly the time it takes for a viral infection to run its course.

In trials of the technique, two thirds of patients given delayed prescriptions for antibiotics never collected their medicine.

The OECD said such changes would cost as little as $2 (1.7 euros) per person per year and would save millions of lives and billions of dollars by mid-century.

“They would decrease burden of AMR in these countries by 75 percent,” said Cecchini. “It would pay for itself in a few months and would produce substantial savings.”


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Vehicle pollution may increase risk of childhood obesity

Monitoring Desk

CALIFORNIA: From ear infections to loss of intelligence, it’s become increasingly clear that air pollution can affect more than just our lungs.

Now, a study from University of Southern California researchers suggested that early exposure to traffic pollution increases the risk of childhood obesity in later life, adding more evidence that dirty air is a public health threat to children.

As the Guardian reported from the study, babies exposed to high levels of nitrogen dioxide in the first year of life gained weight much faster, according to the analysis of 2,318 children in southern California. By the age of 10, those children were on average 2.2 pounds heavier than those with low exposure.

The researchers came to this conclusion after adjusting for age, sex, race/ethnicity, parental education and other factors.

“Beyond mid-childhood exposures, early life periods like in utero and first year of life represent critical windows of air pollution exposure that may significantly alter childhood growth trajectories,” the study states.

Nitrogen dioxide is produced as a result of road traffic and when fossil fuels such as coal, oil, gas or diesel are burned at high temperatures.

The researchers were unable to exactly explain how air pollution causes weight gain in children.

“The most common thought is inflammation of body systems like the lungs which may spill over into the entire body [and] the brain, which regulates appetite and changes in fat metabolism,” Jennifer Kim, who led the research, told the Guardian.

This is not the first study to make this connection. Last month, the World Health Organization issued a report that said that air pollution kills an estimated 600,000 children every year and causes a range of symptoms, including obesity and insulin resistance in children, Reuters reported.

“This study showing an association between increased body mass in children and exposure to air pollution from roads is important since it is compatible with previous studies showing an association between type 2 diabetes and air pollution in adults,” Jonathan Grigg, a professor at Queen Mary University of London who was not involved with the research, explained to the Guardian.

“However, more research is needed to explain how toxins inhaled into the lungs affect fat cells throughout the body,” Grigg added.