Protecting young women from cervical cancer may be even easier than experts thought.

A virus called HPV causes almost all cases of cervical cancer. Vaccines can protect girls and women from some of the most threatening types of HPV. However, the vaccines are given in three doses, and in the United States most women don't complete the three-dose regimen
A new study suggests they may not need to.
In the study, reported in the Journal of the National Cancer Institute, researchers looked at thousands of women who received one to three doses of an HPV vaccine. The researchers followed them for about 4 years, taking note of women who had an HPV infection that lasted at least 10 months.
The vaccine seemed to be about as effective whether women had one, two, or three doses. As a result, the researchers point out that one or two doses might offer as much protection as all three. However, more research is needed to show whether the three-dose schedule offers longer protection, and whether these results apply to other HPV vaccines.

HPV Test Spots Cervical Cancer Earlier Than Pap Smear: Study

THURSDAY, Dec. 15 (HealthDay News) - To catch cervical cancer or the lesions that can lead to it, a human papillomavirus (HPV) test is the best option for women over 30, Dutch researchers report.
Using it in conjunction with the more traditional Pap smear resulted in earlier detection of precancerous lesions and prevented more cervical cancers from developing, said study author Dr. Chris Meijer, a professor of pathology at VU University Medical Centre in Amsterdam.
The study is published online Dec. 15 in The Lancet Oncology.
Nearly all cervical cancers are caused by HPV, a virus spread through sexual intercourse. Some HPV strains are more strongly linked with the cancer than others.
The superiority of HPV testing over traditional Paps at finding precancerous cervical lesions is established, Meijer noted. However, his team wanted to see if HPV testing also offered better protection and detection long-term -- in two screenings done over a five-year period.
They found it did.
While five years may sound like a long lag time between screenings, it is not, he said. "The Netherlands already has a screening interval of five years, starting from 30 years of age until 60 years," he said. The program is inexpensive and effective, he added.
In the study, Meijer's team evaluated nearly 45,000 women, aged 29 to 56. Women in one group got a traditional Pap smear and an HPV DNA test. The women in the other group got just the Pap test.
Five years later, all women got both tests.
The researchers looked to see whether HPV tests resulted in fewer high-grade cervical lesions and cervical cancer in the second screening, due to earlier detection and treatment.
In the first screen, the HPV tests found more of the early changes that can precede cervical cancer than the Pap smear alone did.
Five years later, far fewer women in the HPV group had more advanced lesions or cervical cancer than did the Pap-only women.
Four women in the HPV/Pap group were diagnosed with cervical cancer, while 14 in the Pap-only group were.
When they looked at cervical cancer or advanced lesions, 88 in the HPV arm of the study were diagnosed with one or the other compared to 122 in the Pap-alone arm.
The improved protection against advanced lesions, the researchers said, is due to the earlier detection of the precursor lesions. When they were treated, it helped prevent them from progressing.
In an accompanying commentary, scientists from the U.S. National Cancer Institute wrote that the Dutch trial does show the five-year screening interval is safe. But they added that it is unclear if the same results would hold true in a different population with different testing guidelines.
The HPV test can be done using the same specimen collected for the Pap test, Meijer said.
Costs of the tests differ. Meijer said Pap smears are about $38 in the Netherlands, while an HPV test costs about $64. However, the Dutch Minister of Health recently recommended lowering the cost of an HPV test to below that of the traditional Pap.
The new study is "further defining how we can incorporate HPV testing into our screening program," said Dr. Elizabeth Poynor, a gynecologic oncologist and pelvic surgeon at Lenox Hill Hospital, in New York City.
She noted that she doesn't think the HPV screen will replace the Pap test completely. "It may turn out to be a first-line screen. Stay tuned for more," she said. "Certainly ask your physician if you've had HPV."
In October, three U.S. cancer groups proposed new guidelines for cervical cancer testing, extending intervals between screenings and making other changes. These guidelines, issued by the American Cancer Society and others, call for combination HPV/Pap smear testing for women aged 30 and older.
After three normal Paps, women over 30 can have the test ever two to three years, according to the American Cancer Society.
However, the U.S. Preventive Services Task Force remains cautious about the use of the HPV test, standing by the Pap as the best bet for now.
The Dutch study was funded by Zorg Onderzoek Nederland (the Netherlands Organization for Health Research and Development).
SOURCES: Elizabeth Poynor, M.D., gynecologic oncologist and pelvic surgeon, Lenox Hill Hospital, New York City; Chris Meijer, M.D., professor, pathology, VU University Medical Centre, Amsterdam, the Netherlands; Dec. 15, 2011, The Lancet, online

One Malaria Episode Early In Pregnancy Triples Miscarriage Risk

According to the largest study on the effects of malaria and different anti-malarial drugs in early pregnancy to date, just one episode of malaria in the first trimester is linked to a three-fold greater risk of miscarriage. Researchers also discovered that women treated with anti-malarial drugs did not suffer any serious side effects or increase their likelihood of miscarriage. The study was published Online First in The Lancet Infectious Diseases.

According to estimates each year, 125 million pregnancies are at risk of malaria. During pregnancy, malaria can cause both severe anemia and parasitic infection in the fetus and increase the risk of low birth-weight, preterm birth, and maternal death.

Until now, scientists know little about the effects of malaria in early pregnancy or the benefits and harms of anti-malarial drugs during the early stages of pregnancy. The treatment of all falciparum malaria is artesunate-based combination therapy (ACT), however, it is not recommend during the first pregnancy trimester as it has been proven toxic in animal studies, potentially causing birth defects or miscarriage.

Leading author Rose McGready from Shoklo Malaria Research Unit in Thailand, explained:

"Both vivax and falciparum malaria contribute significantly to avoidable fetal and infant death. These results suggest that the adverse effects of malaria in the first trimester substantially outweigh any adverse effects of its treatment...[and] emphasizes the importance of early detection of malaria and prompt effective treatment for all pregnant women."

McGready and his team set out to provide more evidence and reviewed records of pregnant women who attended antenatal clinics of the Shoklo Malaria Research Unit on the northwestern border of Thailand between May 1986 and October 2010. They compared outcomes of 16,668 women who no malaria during pregnancy with 945 women who had only a single episode in the first trimester, i.e. at less than 14 weeks into their pregnancy, and discovered that asymptomatic malaria, showing no noticeable symptoms, was linked to almost a three times higher risk of miscarriage compared with those who did not contract malaria, whilst the risk of miscarriage for those with symptomatic malaria tended to be at least four-times more likely. In women with vivax and falciparum malaria the risk of miscarriage was similar.

The researchers discovered that the chances of miscarriage was comparable in women who received chloroquine (26%), quinine (27%), and artesunate (31%) during the first-trimester, with no substantial difference reported between treatments in other birth outcomes, such as still birth or low birth weights. Unlike the findings from animal studies, the researchers detected no additional toxic effects in women treated with artesunate.

The authors comment: "Miscarriage in 24 first-trimester episodes of hyperparasitaemia or severe malaria was high but artesunate did not result in higher rates of miscarriage than did quinine," and conclude saying, that: "These findings have serious implications for malaria treatment and prevention policies, which currently ignore the first trimester...A randomized trial of first-trimester artemisinin-based treatment is now needed to make firm recommendations on the safety of first-trimester malaria treatments with this class of anti-malarial drug."

Meghna Desai and Stephanie Dellicour from the Kenya Medical Research Institute/Centers for Disease Control and Prevention, Kisumu, Kenya write in an associated comment:

"This study provides a level of reassurance regarding the potential risk associated with artemisinin exposure in early pregnancy, compared with the established risk of malaria. This study, combined with data from ongoing studies done in sub-Saharan Africa, will for the first time allow an informed risk/benefit assessment of disease versus treatment with artemisinin combination treatments in pregnancy."

Docs to spend more time with patients soon

The Medical Council of India (MCI) may soon specify how much time doctors should spend with their patients so that the regimen of medicines being prescribed to them is clear.
A recent World Medicines Situation 2011 report brought out by the World Health Organization (WHO) — as reported by TOI first — had recently said that doctors, on an average, in developing countries spend less than 60 seconds in prescribing medicines and explaining the regimen to their patients.

Consequently, only half of the patients receive any advice on how to take their medicines and about one-third of them don't know how to take drugs immediately on leaving the facility.
Union health minister Ghulam Nabi Azad said on Friday that the government proposes to issue an advisory to the MCI to disseminate appropriate instructions among all registered medical practitioners.
According to WHO, the dispensing process greatly influences how medicines are used. The WHO database shows that the dispensing time is a minute. "In such circumstances it is not surprising that patient adherence to medicines is poor," the report said.
Azad said, "The doctor population ratio is not favourable in our country. Hence, there is tremendous pressure on the doctors serving in public sector hospitals. This may be the major reason for patients getting less than adequate time for consultation."
MCI's own assessment says India has just one doctor for 1,700 people. In comparison, the doctor population ratio globally is 1.5:1,000. MCI has set a target to have 1 doctor for 1,000 people by 2031.
The assessment note, available with TOI, also looked at the situation in other countries. Somalia has one doctor for 10, 000; Pakistan has 1:1,923 and Egypt 1: 1,484.
China's doctor population ratio stands at 1:1,063; South Korea 1:951; Brazil 1:844, Singapore 1:714, Japan 1:606; Thailand 1:500; UK 1:469; the US 1:350 and Germany 1:296.
Kathleen Holloway from WHO's department of essential medicines and pharmaceutical policies said, "Irrational use of medicines is a serious global problem that is wasteful and harmful. In developing countries, in primary care, less than 40% of patients in public sector and 30% of patients in private sector are treated in accordance with standard treatment guidelines."
The report cites, only about 60% countries train their medical students on various aspects of prescribing medicines and only about 50% require any form of continuing medical education.
The basic training for nurses and paramedical staff, who often do a bulk of prescribing, was even less — only about 40% of countries give them any basic training on how to prescribe.
Original article

Bahrain jails 20 doctors after democracy protests

(Reuters) - Bahrain jailed 20 doctors on Thursday for between five and 15 years on theft and other charges, the state news agency said, in what critics claimed was reprisal for treating protesters during unrest in the Gulf kingdom this year.
A security court also sentenced a man to death for killing a policeman by driving his car over him several times and joining illegal gatherings for "terrorist goals," the BNA news agency said. Another man was handed a life term for his involvement.
The doctors, who denied the charges, were among dozens of medical staff arrested during protests led by the island's Shi'ite majority demanding an end to sectarian discrimination and a greater say in government.
Bahrain's Sunni Muslim rulers quashed the protests in March, with the help of troops from fellow Sunni neighbours Saudi Arabia and the United Arab Emirates. At least 30 people were killed, hundreds wounded and more than 1,000 detained -- mostly Shi'ites -- in the crackdown.
The doctors were charged with stealing medicine, stockpiling weapons and occupying a hospital during the unrest and in addition were jailed for forcibly occupying a hospital, spreading lies and false news, withholding treatment, inciting hatred of Bahrain's rulers and calling for their overthrow.
"We were shocked by the verdicts because we were expecting the doctors would be proved innocent of the crime of occupying the Salmaniya medical complex," defence lawyer Mohsen al-Alawi said, adding the hearing had lasted no more than 10 minutes.
The doctors say the charges against them were invented by the authorities to punish medical staff for treating people who took part in anti-government protests.
"Those doctors who have been found guilty were charged with abusing the hospital for political purposes. Nobody is above the law," a spokesman for the government's Information Affairs Authority (IAA) said.
Ten of the doctors, including senior physician Ali Al-Ekri, were given 15-year terms, two were sentenced to 10 years in prison and the rest to five.
"After today's verdict and those issued yesterday we feel pessimism," Alawi said, adding they would appeal against the decision.
On Wednesday a military court upheld life sentences against Shi'ite opposition leaders for organising protests in a trial described as a "sham" by Amnesty International, which also called the latest proceedings a "travesty of justice."
In Washington, a U.S. State Department spokesman said the United States was "deeply disturbed" by the sentencing of the doctors.
"We continue to urge the Bahraini government to abide by its commitment to transparent judicial proceedings, including a fair trial, access to attorneys and verdicts based on credible evidence," spokesman Mark Toner said in a statement.
The British government voiced concern over the sentences.
"These sentences appear disproportionate to the charges brought," British Foreign Secretary William Hague said on Thursday.
"These are worrying developments that could undermine the Bahraini government's moves towards dialogue and the reform needed for long-term stability in Bahrain."
OPEN FOR DISCUSSION
A senior Bahraini official said the government was still prepared to hold more talks with all opposition parties on political reforms to try to end protests that threaten to hold up the economy and scratch its business-friendly image.
Sheikh Abdul-Aziz bin Mubarak al-Khalifa, a senior adviser at the IAA, also said Bahrain had begun receiving some of the $10 billion in economic aid promised by fellow Gulf Arab nations.
"Everything is open for discussion except regime change. That doesn't mean it has to be discussed today (but) the king said reforms are not going to stop," he said. "Other issues can be brought to the table -- when and how, I'm not sure."
Bahrain says it will expand parliament's powers of monitoring government ministers, recommendations that came from a national dialogue held after the U.S. ally crushed pro-democracy protests earlier this year.
But Shi'ite opposition groups, headed by the Wefaq party, want the elected chamber to have real legislative power as well as a new prime minister. The current incumbent, an uncle of the king, has occupied the post since 1971.
The conflict dragged in regional powers; Bahrain accused the opposition of pursuing a sectarian agenda backed by non-Arab Shi'ite giant Iran, just across Gulf waters. The United States, whose Fifth Fleet is stationed in Manama, says the government should talk to Wefaq. SOURCE

doctors at dilemma

The care

Raised nitric oxide levels may cause atonic postpartum hemorrhage in women with anemia during pregnancy

Soltan MH et al. – Even moderate anemia can raise levels of NO and enhance its biologic effects, which in turn can result in uterine muscle relaxation and atonic postpartum hemorrhage (PPH). Preventing or treating anemia during pregnancy could avoid these complications.
Methods

• Of 319 women admitted to the Department of Obstetrics and Gynecology, Dayrout General Hospital, Assiut, Egypt, for delivery in July 2010, 200, who were not considered to be at risk of atonic PPH, were eligible for inclusion.
• Plasma levels of Hb and nitrite were measured on admission.
• The third stage of labor was actively managed.

Results

• A total of 22 participants had significantly raised PN levels (P<0.001), 12 of whom developed PPH—with Hb levels of 9g/dL or less and nitric oxide (NO) levels of 180μM/L or greater.
• The other 10 women underwent over 6hours of stressful labor prior to hospital admission.

International Journal of Gynecology & Obstetrics, 11/28/2011

Aspirin for primary prevention of vascular events in women: individualized prediction of treatment effects European Heart Journal, 11/17/2011 Clinical Article

Dorresteijn JAN et al. – Aspirin was ineffective or even harmful in the majority of patients. Age was positively related to treatment effect, whereas current smoking and baseline risk for cardiovascular events were not. When the NWT is 50 or lower, the aspirin treatment strategy that is associated with optimal net benefit in primary prevention of vascular events in women is to treat none.
Methods

• Randomized controlled trial data from the Women's Health Study were used to predict treatment effects for individual women in terms of absolute risk reduction for major cardiovascular events (i.e. myocardial infarction, stroke, or cardiovascular death).
• Predictions were based on existing risk scores, i.e. Framingham (FRS), and Reynolds (RRS), and on a newly developed prediction model.
• The net benefit of different aspirin treatment–strategies was compared:
• Treat no one,
• Treat everyone,
• Treatment according to the current guidelines (i.e. selective treatment of women >65 years of age or having >10% FRS),
• And prediction–based treatment (i.e. selective treatment of patients whose predicted treatment effect exceeds a given decision threshold).

Results

• The predicted reduction in 10–year absolute risk for major cardiovascular events was <1% in 97.8% of 27 939 study subjects when based on the refitted FRS, in 97.0% when based on the refitted RRS, and in 90.0% when based on the newly developed model.
• Of the treatment strategies considered, only prediction–based treatment using the newly developed model and selective treatment of women >65 years of age yielded more net benefit than treating no one, provided that the 10–year number–willing–to–treat (NWT) to prevent one cardiovascular event was above 50.                                                                                                                      http://www.mdlinx.com/read-article.cfm/3835678

Tot left brain damaged after doctors fight in delivery room

Tuesday, 31 August 2010

A baby was born with suspected brain damage and his mother needed emergency surgery after two doctors began fighting during the delivery in Italy.

The country's health minister went to Sicily today to deliver a personal apology to the mother.

Laura Salpietro (30) also had to have her uterus removed and her son, Antonio, suffered heart problems and possible brain damage following his birth last Thursday in Messina's public hospital.

Health officials and Ms Salpietro's husband, Matteo Molonia, said the two doctors disagreed about whether to perform a Caesarean section and then began punching each other while Ms Salpietro was in labour.

Mr Molonia said that the brawl delayed the C-section by over an hour, leading to complications for both mother and son.

The fistfight occurred at a state hospital between a doctor who works there and a private physician who Ms Salpietro paid as her gynaecologist. Prosecutors have placed five doctors under investigation, and Health Minister Ferruccio Fazio visited Ms Salpietro in the hospital to apologise.

“I tried to give her words of hope, and above all I tried to tell her that the government was with her and her family at this time,” Mr Fazio said. The incident was the latest evidence of medical mistakes frequently reported in southern Italian hospitals and it underscored Italians' increasing use of private doctors.

Italy has universal healthcare, but some Italians use private doctors to avoid long waits for procedures. 
 Read more:

Effect of oral phytoestrogen on androgenicity and insulin sensitivity in postmenopausal women;

A study was conducted by Lee CC, Bloem CJ, Kasa-Vubu JZ, Liang LJ; published in  Diabetes, Obesity & Metabolism (Nov 2011) to determine and compare the effect of treatment with transdermal estrogen and phytoestrogen on insulin sensitivity and SHBG levels in healthy postmenopausal women.
Materials and Methods: Forty-three healthy postmenopausal women age 68 ± 7 (mean ± SD) years who were not receiving hormonal replacement therapy completed a three month randomized drug therapy study. The participants were randomized to one of four groups: 0.05 mg or 0.1 mg transdermal estrogen/day, or 40 or 80 mg oral phytoestrogen (Promensil)/day Insulin sensitivity was indirectly measured using the Quantitative insulin sensitivity check index (QUICKI). Sex hormone-binding globulin (SHBG), total testosterone, estradiol, and fasting glucose and insulin levels for calculation of insulin sensitivity were obtained at baseline and at monthly intervals during 3 months of therapy.
Results: In healthy nondiabetic postmenopausal women, the rate of change in QUICKI was significantly different between the red clover based phytoestrogen and transdermal estrogen groups, so that after three months of therapy, QUICKI with red clover based phytoestrogen therapy was lower than that in the transdermal estrogen group, p = 0.01. Red clover based phytoestrogen therapy was not associated with any changes in SHBG levels whereas transdermal estrogen therapy significantly increased SHBG levels, p = 0.05.
Conclusions: In contrast to transdermal estrogen therapy, oral phytoestrogen therapy does not decrease androgenicity and is associated with a decrease in insulin sensitivity. These effects are similar to those of raloxifene and consistent with phytoestrogen's selective estrogen receptor modulator (SERM) properties.

Easy-to-Treat Condition Can Disrupt Breast-Feeding . Up to 10 percent of newborns have ankyloglossia or 'tongue-tie'

A "tongue-tie" condition in infants that hinders breast-feeding can be quickly diagnosed and treated in many cases, an expert says. The condition, also known as ankyloglossia, occurs in 4 percent to 10 percent of newborns. The most common type is easy to identify and occurs when a tight band of tissue causes a heart-shaped tongue indentation at the front of the mouth.
Another form of the condition is harder to detect, according to Dr. Dale Tylor, an assistant professor of pediatric otolaryngology at Vanderbilt University Medical Center in Nashville, Tenn.

"For an infant to properly breast-feed, the baby needs to move his or her tongue to their lips to allow sucking to occur," Tylor said in a Vanderbilt news release. "If there's a tethering, the baby has a hard time latching on and uses his or her gums or lips. It becomes painful for the mom, and can even cause bleeding."

Other indications of tongue-tie include a baby who breast-feeds for up to an hour at a time, is frustrated during feeding, or falls asleep before becoming full.

These problems can cause mothers to supplement breast-feeding with formula or give up breastfeeding altogether.
But Tylor said more than two-thirds of mothers of babies with tongue-tie can successfully breast-feed their babies after a simple, outpatient tongue-tie-clipping procedure called a frenotomy.
Tylor also said her research shows that early treatment of tongue-tie reduces the risk of speech problems. Left untreated, tongue-tie can cause other problems.
"They may have problems taking a spoon," Tylor said. "Or they may not be able to lick an ice-cream cone or stick out their tongues with their brother, sister or peers. They could even have problems into adulthood with common social activities like brushing their teeth or even kissing."
SOURCE: Vanderbilt University Medical Center, news release, Nov. 10, 2011

HealthDay

When does pregnancy begin? Doctors disagree

(Reuters Health) - Though most doctors will give you a definition of when pregnancy begins, it's not always the same one, according to a new survey.

Most of the polled obstetrician-gynecologists believe pregnancy begins when the sperm fertilizes the egg. But a minority say it doesn't begin until a week later when the fertilized egg implants in the uterus -- the definition given by the American College of Obstetrics and Gynecology (ACOG).

"People say that the medical profession has settled on this," said Dr. Farr Curlin, the senior author of the study and a professor at the University of Chicago. "And what our data show rather clearly is that it is not at all settled among the medical profession."

The definition of pregnancy can have a major impact on law and policy.

For example, embryonic stem cells are often derived from surplus embryos that aren't implanted into a woman after in vitro fertilization.

And some contraceptives, such as intrauterine devices, prevent implantation. So if pregnancy is considered to begin at fertilization, "then you see why any technology that prevents implantation would be problematic," Curlin said.

Federal policies have used implantation as the beginning of pregnancy.

For the survey, published in the American Journal of Obstetrics and Gynecology, Curlin and his colleagues sent questionnaires to more than 1,000 ob-gyns. The questions asked whether pregnancy begins at conception, at implantation, or if the doctor was unsure.

Most of the doctors, 57 out of every 100, said that pregnancy begins at conception, while 28 out of every 100 said it begins at implantation. The rest were unsure.

Implantation happens about a week after fertilization. That's when the blastocyst, a tiny group of cells that will later become the foetus, embeds itself into the wall of the uterus.

Physicians who responded that they were religious or opposed to abortion or contraceptives that prevent implantation were more likely to believe that conception is the start of pregnancy.

Curlin said he was surprised that most of the doctors in his study disagree with ACOG, which is the leading organisation for this field of medicine.

ACOG did not respond to requests for comment.

"In this case, the science shows exactly what happens, but what you define as pregnancy is not what science can settle," Curlin told Reuters Health.

One of the weaknesses in the survey is the use of the word "conception" rather than fertilization in the questionnaire. While conception is usually defined as fertilization, others interchange it with implantation, Curlin said.

The length of pregnancy -- typically 40 weeks -- remains the same regardless of how doctors define the beginning of pregnancy, because the 40 weeks are not counted from the time of fertilization or implantation, but from the time of the mother's last menstrual period.

SOURCE: bit.ly/uyX2P4 American Journal of Obstetrics and Gynecology, online November 9, 2011.

Doctor Is Guilty in Michael Jackson’s Death

 

Dr. Conrad Murray during the final stage of his trial on Thursday.

LOS ANGELES — Michael Jackson, among the most famous performers in pop music history, spent his final days in a sleep-deprived haze of medication and misery until finally succumbing to a fatal dose of potent drugs provided by the private physician he had hired to act as his personal pharmaceutical dispensary, a jury decided on Monday.
The physician, Dr. Conrad Murray, was found guilty of involuntary manslaughter nearly two and a half years after Jackson’s shocking death at age 50. The verdict came after nearly 50 witnesses, 22 days of testimony and less than two days of deliberation by a jury of seven men and five women. The trial had focused primarily on whether Dr. Murray was guilty of abdicating his duty or of acting with reckless criminal negligence, directly causing his patient’s death.
Dr. Murray, 58, faces up to four years in prison and the loss of his medical license. He sat stoically as the verdict was read and did not react as he was led out of the courtroom in handcuffs. Judge Michael Pastor ruled that he should be held without bail until his sentencing, set for Nov. 29.
Jackson, who had become a star as a child in Gary, Ind., singing with his siblings in the Jackson 5, grew into one of the best-known performers in the world. Though increasingly eccentric in his later years, often living on a secluded California estate he called Neverland, Jackson always had a fervent core of fans and, despite scandals, his lavish lifestyle and persistent money woes, always seemed just a comeback away from a return to the top.
Hundreds of fans showed their devotion by gathering outside the downtown courthouse throughout the trial — many of them sporting Jackson’s signature single white glove. On Monday, they chanted “Justice, justice” and spent hours after the verdict dancing to his hits, from “Beat It” to “I Want You Back.” Huge crowds had also gathered outside the California court where Jackson was tried, and acquitted, on child molesting charges in 2005.
The singer’s parents, Joe and Katherine Jackson, and siblings La Toya, Jermaine and Randy were in the courtroom for the verdict. The family left the courthouse without speaking to the hordes of reporters gathered outside, simply saying they were “very happy” with the verdict and flashing a thumb.
Dr. Murray, a Houston cardiologist, was paid $150,000 a month to work as Jackson’s personal physician as he rehearsed in Los Angeles for “This Is It,” a series of 50 sold-out concerts in London that he needed to pay off hundreds of millions of dollars in mounting debts.
Testimony showed that Dr. Murray had stayed with Jackson at least six nights a week and was regularly asked — and sometimes begged — by the insomniac singer to give him drugs powerful enough to put him to sleep. Jackson, Dr. Murray told the authorities, was especially eager to be administered propofol, a surgical anesthetic that put him to sleep when other powerful sedatives could not. Testimony indicated that propofol, in conjunction with other drugs in the singer’s system, had played the key role in his death on June 25, 2009.
More..

BIRTH CONTROL SOLUTION

Was this baby born Monday in INDIA the seven billionth human? Statistically possible, say United Nations demographers. India has over one billion of the world's roughly seven billion people. 
A United Nations report released on Tuesday projects that world population, instead of stabilizing at above 9 billion by 2050, will keep growing and may hit 10.1 billion by 2100.
The population of Africa, for instance, could more than triple, rising to 3.6 billion by century's end. Nigeria, the continent's most populous nation, could see its population increase from 162 million today to 730 million by 2100. Accelerating rates of growth are already evident: world population is expected to pass 7 billion in October, only a dozen years after reaching 6 billion.

How will the world accommodate this growth? What have we learned from history about how countries adapt to feed and house ever more people?
Partly for that reason, the world’s population just raced past the seven billion mark this week, at least according to the fuzzy calculations of United Nations demographers. It took humans hundreds of thousands of years, until the year 1804, to reach the first billion. It took another 123 years to reach two billion, in 1927. Since then, we’ve been passing these milestones like billboards along a highway. The latest billion took just a dozen years.
In 1999, the United Nations’ best projection was that the world wouldn’t pass seven billion until 2013, but we reached it two years early. Likewise, in 1999, the U.N. estimated that the world population in 2050 would be 8.9 billion, but now it projects 9.3 billion.
What’s the impact of overpopulation? One is that youth bulges in rapidly growing countries like Afghanistan and Yemen makes them more prone to conflict and terrorism. Booming populations also contribute to global poverty and make it impossible to protect virgin forests or fend off climate change. Some studies have suggested that a simple way to reduce carbon emissions in the year 2100 is to curb population growth today.
Moreover, we’ve seen that family planning works. Women in India average 2.6 children, down from 6 in 1950. As recently as 1965, Mexican women averaged more than seven children, but that has now dropped to 2.2.
But some countries have escaped this demographic revolution. Women in Afghanistan, Chad, Congo, Somalia, East Timor and Uganda all have six or more children each, the U.N. says. In rural Africa, I’ve come across women who have never heard of birth control. According to estimates from the Guttmacher Institute, a respected research group, 215 million women want to avoid getting pregnant but have no access to contraception.
What’s needed isn’t just birth-control pills or IUDs. It’s also girls’ education and women’s rights — starting with an end to child marriages — for educated women mostly have fewer children.
“In times past, the biggest barrier to reducing birth rates has been a lack of access to contraceptives,” the Population Institute notes in a new report. “Today, the biggest barrier is gender inequality.”
The seven billion population milestone is also a reminder that we need more research for better contraceptives.
One breakthrough is an inexpensive vaginal ring that releases hormones, lasts a year and should not require a doctor. Developed by the Population Council, it has completed Phase 3 trials and seems highly effective. It could even contain medication to reduce the risk of an infection with the AIDS virus.
  When contraception is unavailable, the likely consequence is not less sex, but more pregnancy.
Contraception already prevents 112 million abortions a year, by U.N. estimates. The United Nations Population Funds promotes contraception means that it may have reduced abortions more than any organization in the world.
Contraceptives no more cause sex than umbrellas cause rain. So as we greet the seven-billionth human, let’s try to delay the arrival of the eight billionth. We should all be able to agree on voluntary family planning as a cost-effective strategy to reduce poverty, conflict and environmental damage..

Correct Postures

Here are some correct postures which should be used while using a computer to reduce stress and other ill effects.

The World at 7 Billion

31 October 2011 | The World at 7 Billion

The arrival of the 7 billionth person on 31 October presents a rare moment to reflect on the slow but relentless demographic trends that shape our lives and our environment.

Population is growing fastest in the poorest countries, where people are least able to fulfill their basic needs. Indeed, ninety percent of the largest generation of adolescents in history live in the developing world, and they are now entering the childbearing years.

This number of adolescents entering their reproductive years means that high-quality, voluntary family planning services are more important than ever. They must meet the needs of this new generation of clients. This surge of young people requires accelerated investment in human development, particularly girls’ education. Educating girls is a powerful way to reduce birth rates. Data have shown that when women are educated they usually opt for smaller families, are more capable of overcoming obstacles to family planning use, and have more opportunity to become employed.

In their own voices, Council president Peter Donaldson, demographer John Bongaarts, community health physician Saroj Pachauri, and researcher Kelly Hallman describe the far-reaching implications of investing in family planning and young people. Read more >>

A world of 7 billion is both a challenge and an opportunity. We are focused on the opportunity to improve the lives of the world’s most vulnerable people.

Intrauterine Devices Might Prevent More Than Pregnancy.

Meta-analysis shows that IUDs provide protection against cervical cancer.
Because intrauterine devices (IUDs) pass through the cervix, concern has been raised that use of these highly effective reversible contraceptives might affect risk for cervical cancer. To explore the possible associations between IUD use, cervical cancer risk, and presence of cervical human papillomavirus (HPV) DNA, researchers pooled international data from 10 case-control studies of cervical cancer and 16 survey studies of HPV prevalence. Information on IUD use was obtained via interviews, and HPV status was determined with polymerase chain reaction–based assays. The case-control studies involved 2205 women with cervical cancer and 2214 matched controls without cervical cancer; an additional 15,272 healthy women participated in the HPV prevalence studies.
In meta-analyses adjusted for factors such as number of previous Pap smears, cervical HPV DNA status, and age at sexual debut, a protective association was found between ever use of an IUD and cervical cancer (odds ratio, 0.55; P<0.0001), whether squamous-cell carcinoma (OR, 0.56; P<0.0001) or combined adenocarcinoma and adenosquamous carcinoma (OR, 0.46; P=0.035). This benefit was not related to duration of IUD use. Among women without cervical cancer, IUD use was not associated with detection of cervical HPV DNA.
Comment: The mechanisms by which intrauterine device use might lower the rate at which human papillomavirus infection progresses to cervical cancer remain unclear. The authors hypothesize that IUDs might exert this protective effect by inducing a chronic, low-grade, sterile inflammatory response in the endocervical canal that could modify the course of HPV infection. Alternatively, preinvasive cervical lesions might be removed when the device is placed or removed. Although the authors controlled for many confounders, the possibility remains that screening bias led to residual confounding. Although types of IUDs were not specified in this analysis, in the countries where these studies were conducted, few women use hormone-releasing IUDs; thus, future work should be aimed at examining whether levonorgestrel-releasing IUDs prevent cervical cancer.
Published in Journal Watch Women's Health October 13, 2011

Malaria Vaccine: Interim Results Show Promise

Each year, malaria occurs in approximately 225 million persons worldwide,
and 781,000 persons, mostly African children,die from the disease. During the past decade,the scale-up of malaria-control interventions has resulted in considerable reductions in morbidity and mortality associated with malaria
in parts of Africa. However, malaria continues to pose a major public health threat. A malaria vaccine, deployed in combination with current malaria-control tools, could play an important role in future control and eventual elimination of malaria Worldwide.
Study of the efficacy, safety, and immunogenicity of candidate
malaria vaccine RTS,S/AS01  conducted in seven African countries showed an efficacy of 56% in interim, phase III results published in the New England Journal of Medicine. The study was partially funded by and included scientist-employees of the vaccine maker. After 12 months of follow-up among 6000 African children vaccinated at age 5 to 17 months, the incidence of malaria was 0.44 per person-year among RTS,S/AS01 recipients and 0.83 among recipients of a control vaccine. Meningitis was more frequent among RTS,S/AS01 recipients.
An editorialist praises the work, while wondering about the duration of the vaccine's protection and its cost.
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Clean Care is Safer Care .

SAVE LIVES: Clean Your Hands

The My 5 Moments for Hand Hygiene approach defines the key moments when health-care workers should perform hand hygiene.

This evidence-based, field-tested, user-centred approach is designed to be easy to learn, logical and applicable in a wide range of settings.

This approach recommends health-care workers to clean their hands

Pharmacokinetics of antimalarials in pregnancy: a systematic review

Malaria is a serious parasitic infection, which affects millions of people worldwide. As pregnancy has been shown to alter the pharmacokinetics of many medications, the efficacy and safety of antimalarial drug regimens may be compromised in pregnant women. The objective of this review is to systematically review published literature on the pharmacokinetics of antimalarial agents in pregnant women. A search of MEDLINE (1948-May 2011), EMBASE (1980-May 2011), International Pharmaceutical Abstracts (1970-May 2011), Google and Google Scholar was conducted for articles describing the pharmacokinetics of antimalarials in pregnancy (and supplemented by a bibliographic review of all relevant articles); all identified studies were summarized and evaluated according to the level of evidence, based on the classification system developed by the US Preventive Services Task Force. Identified articles were included in the review if the study had at least one group that reported at least one pharmacokinetic parameter of interest in pregnant women. Articles were excluded from the review if no pharmacokinetic information was reported or if both pregnant and non-pregnant women were analysed within the same group. For quinine and its metabolites, there were three articles (one level II-1 and two level III); for artemisinin compounds, two articles (both level III); for lumefantrine, two articles (both level III); for atovaquone, two articles (both level III); for proguanil, three articles (one level II-1 and two level III); for sulfadoxine, three articles (all level II-1); for pyrimethamine, three articles (all level II-1); for chloroquine and its metabolite, four articles (three level II-1 and one level II-3); for mefloquine, two articles (one level II-1 and one level III); and for azithromycin, two articles (one level II-1 and one level III). Although comparative trials were identified, most of these studies were descriptive and classified as level III evidence. The main findings showed that pharmacokinetic parameters are commonly altered in pregnancy for the majority of recommended agents. Importantly, first-line regimens of artemisinin-based compounds, lumefantrine, chloroquine and pyrimethamine/sulfadoxine may undergo significant changes that could decrease therapeutic efficacy. These changes are usually due to increases in the apparent oral clearance and volume of distribution that commonly occur in pregnant women, and may result in decreased exposure and increased therapeutic failure. In order to assess the clinical implications of these changes and to provide safe and effective dosage regimens, there is an immediate need for dose-optimization studies of all recommended first- and second-line agents used in pregnant women with malaria.SOURCE

Obesity

Obesity means having too much body fat. It is different from being overweight, which means weighing too much. The weight may come from muscle, bone, fat and/or body water. Both terms mean that a person's weight is greater than what's considered healthy for his or her height.
Obesity occurs over time when you eat more calories than you use. The balance between calories-in and calories-out differs for each person. Factors that might tip the balance include your genetic makeup, overeating, eating high-fat foods and not being physically active.
Being obese increases your risk of diabetes, heart disease, stroke, arthritis and some cancers. If you are obese, losing even 5 to 10 percent of your weight can delay or prevent some of these diseases.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Ibuprofen may ‘raise miscarriage risk’

Women who take even a small dose of painkillers such as ibuprofen early in their pregnancy more than double their risk of suffering a miscarriage,” reported The Guardian.
This news story covered a study that looked at women who had miscarried in early pregnancy and compared their use of non-steroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen, diclofenac and naproxen) with that of pregnant women who had not miscarried. The researchers found the risk of miscarriage to be 2.4 times greater in women taking any type of NSAID, compared with women not taking these drugs.
The findings of this large well-conducted study are likely to be reliable. NSAIDs are already known to carry potential risk in pregnancy, and the British National Formulary states that they should be avoided during pregnancy, unless the potential benefit is expected to outweigh the risks. Other potential risks that have been associated with NSAID use include delayed onset of labour and failed closure of the ductus arteriosus, which forms part of the foetal heart circulation.
Paracetamol is regarded as safe to take during pregnancy, when pain relief is needed. Pregnant women who are in need of regular pain relief, or who are finding paracetamol insufficient, are advised to consult their doctor, as the cause of pain and the most appropriate course of management require proper medical assessment.
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SC/ST officers promoted on quota basis to be reverted

Updated Wednesday, 01 June 2011 18:06:30 - IST (UTC +5:30)

JAIPUR: Rajasthan High Court has debarred SC/ST officers promoted on quota basis from writing the annual confidential reports of their "subordinates" who are otherwise senior to them.
The High Court took the action in the light of Supreme Court's judgement against promotion on quota basis. All SC/ST officers are likely to be placed back on seniority list as they were before being promoted. All such officers in State Government Service are to be reverted. However State Government is reluctant to implement SC order for political considerations.
The Apex Court passed an order on December 7, 2010 upholding Rajasthan HC order striking down the state government's notifications to grant reservation in promotions and consequential seniority to SC/ST employees and held that benefit of reservation unlawful in promotions to state government SC/ST employees.
It was argued before the single bench of justice M N Bhandari that the February 5, 2010 HC order categorically held that no reservation was permissible in promotions in the state services since the Rajasthan government had failed to fulfill the conditions laid down by the Supreme Court in the M Nagraj Case judgment on the Constitutional provision of reservation in promotions in October 2006.
The HC had also struck down the state government's notifications of December 28, 2002 and April 25, 2008. The state government then filed a special leave petition against the HC order, but SC dismissed the government appeal on December 7, 2010.
The petitioners argued that the reserved category officials who had been promoted before December 7, 2010 in the PWD and other departments were now due to be reverted hence they should be stopped from writing Annual Personal Reports of the officials who are likely to become senior after implementation of SC order.

Green-glowing cats are new tool in AIDS research

Chicago — U.S. scientists have developed a strain of green-glowing cats with cells that resist infection from a virus that causes feline AIDS, a finding that may help prevent the disease in cats and advance AIDS research in people.

The study, published Sunday in the journal Nature Methods, involved inserting monkey genes that block the virus into feline eggs, or oocytes, before they are fertilized.
The scientists also inserted jellyfish genes that make the modified cells glow an eerie green color — making the altered genes easy to spot.
Tests on cells taken from the cats show they are resistant to feline immunodeficiency virus, or FIV, which causes AIDS in cats.
"This provides the unprecedented capability to study the effects of giving AIDS-protection genes into an AIDS-vulnerable animal," Dr. Eric Poeschla of the Mayo Clinic in Rochester, Minnesota, who led the study, said in a telephone interview.
Poeschla said that besides people, cats and to some extent, chimpanzees, are the only mammals that develop a naturally occurring virus that causes AIDS.
"Cats suffer from this all over the world," he said.

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Just as the human immunodeficiency virus, or HIV, does in people, FIV works by wiping out infection-fighting T-cells.
FIV infects mostly feral cats, of which there are half billion in the world, Poeschla said. It is transmitted by biting, largely by males defending their territory, but companion cats are affected as well.
In both humans and cats, proteins called restriction factors that normally fight off viral infections are defenseless against HIV and FIV because the viruses evolved potent counter-weapons. But certain monkey versions of these restriction factors are capable of fighting the virus and the team used one such gene from the rhesus monkey.
For the team, which included collaborators in Japan, the trick was to get the monkey gene for the restriction factor — known as TRIMCyp — into cats to block cells from becoming infected with the virus.

Maternal preeclampsia is associated with an increased risk of retinopathy of prematurity;

Ozkan H, Cetinkaya M, Koksal N, Ozmen A, Yildiz M; Journal of Perinatal Medicine (Aug 2011)
To determine the effect of maternal preeclampsia on development and severity of retinopathy of prematurity (ROP) in preterm infants This prospective study consisted of two groups: the study group, which is composed of preterm infants (≤32 weeks) born to a mother with preeclampsia, and the comparison group, which is composed of preterm infants (≤32 gestational age) born to normotensive mothers. We used the International Classification of Retinopathy of Prematurity Revisited for classifying ROP. The first eye examination was performed at postnatal age of 4 weeks. Results: A total of 385 infants were included in the study. ROP was diagnosed in 109 infants (28%). The incidence of ROP in infants born to preeclamptic mothers (40.5%) was significantly higher compared with those born to normotensive mothers (22.4%) (P<0.05). The number of infants with stage 1, 2, and 3 ROP was significantly higher in infants born to preeclamptic mothers compared with the control group (P<0.05). In multiple logistic regression model, preeclampsia was found to predict ROP (odds ratio 1.78, 95% confidence interval 0.66-1.90). Conclusion: Maternal preeclampsia was found to be associated with increased ROP development risk in premature infants. ROP was also more severe in infants born to pre-eclamptic mothers. The role of maternal preeclampsia in the occurrence and severity of ROP remains to be elucidated.

Surgical repair of spontaneous perineal tears that occur during childbirth versus no intervention

Trauma to the perineum of varying degrees constitutes the most common form of obstetric injury. The perineum is the area between the vagina and rectum which can tear during childbirth. In clinical practice these tears are often sutured. However, small tears may also heal well without surgical interference. If pain is experienced, this can result in decreased mobility and discomfort with passing urine or faeces and may negatively impact on the woman's ability to breast feed and care for her new baby. Our review included two randomised controlled trials (involving 154 women) comparing surgical repair of first-degree (involving only the perineal or vaginal skin) or second-degree tears (also involving muscle) with leaving the wound to heal spontaneously. These trials showed no clear differences in clinical outcomes between the groups. The studies did not find any differences in pain immediately and up to eight weeks postpartum. One of the trials reported no difference in wounds complications, but the other showed differences in wound closure and poor wound approximation in the non-sutured group. There was no information about the effect on long-term outcomes such as sexual discomfort or incontinence. More research is needed to provide a strong evidence-based recommendation for clinical practice.

The Cochrane CollaborationCochrane Reviews

Does Exclusive Breastfeeding Prevent Eczema? It Appears Not

There is no clear evidence showing that exclusive breastfeeding for at least four months reduces the chances of a baby eventually developing eczema, researchers reported in the British Journal of Dermatology. The authors, from King's College London, say that in view of their findings, the UK's breastfeeding guidelines with regards to eczema should be reviewed.

This study was a joint collaboration between researchers from King's College London, the University of Ulm, Germany, and the University of Nottingham, England. They gathered data on 51,119 children aged 8 to 12 years from 21 nations.

The investigators collected data on breastfeeding, when the baby was weaned, and eczema. Parents had to fill in questionnaires. The children were given a skin examination for eczema, as well as a skin prick test to determine whether they had any allergies.

Previous studies had indicated that breastfeeding might protect from eczema. WHO (World Health Organization) and the UK Department of Health recommend six months of exclusive breastfeeding to reduce eczema risk.

However, in keeping with the findings in this present study, the researchers reviewed more recent articles and found no evidence showing that exclusive breastfeeding for four months or more reduced the risk of developing eczema.
original article

Newborn Death Rate Higher In USA Than 40 Other Countries !!!!

The USA is in 41st place worldwide regarding newborn mortality rate, a drop from 29th place in 1990. America's newborn death rate today is equal to that of Croatia, Qatar and the United Arab Emirates, according to a new report published in PLoS Medicine. The article is a collaboration between WHO (World Health Organization) and Save the Children, which covers all 193 WHO member nations over two decades. Don't believe Read the ORIGINAL ARTICLE .

Thin Children Have More Energy-Burning 'Brown Fat'

THURSDAY, Aug. 18 (HealthDay News) -- Brown fat, also known as "good fat," burns more energy in active, thinner children and may help fight against obesity and diabetes, according to a new study.
Unlike white fat, which stores energy and appears to promote inflammation, brown fat actually burns energy.
These findings could help develop medications as well as drug-free ways to boost brown fat activity in overweight children, according to researchers from the Joslin Diabetes Center and Children's Hospital Boston.
Being able to evaluate brown fat's activity through non-invasive PET imaging "may possibly provide insights into the treatment of childhood obesity," the study's first author, Dr. Laura Drubach, of the Children's Hospital program in nuclear medicine and molecular imaging, said in a Joslin news release.
After conducting PET scans on 172 study participants ranging in age from 5 to 21 years, the researchers detected active brown fat in 44 percent of the children. They pointed out that boys and girls had roughly the same amount.
Children aged 13 to 15 years old had the highest levels of brown fat and brown fat activity. Those with the lowest body mass index (the thinnest teens) showed the most energy-burning activity in their "good fat."
The study authors said the inverse relationship between body mass index and levels of brown fat activity -- and the increase in brown fat activity from childhood into adolescence -- suggests "good fat" may play a significant role in children's metabolism, energy balance and weight regulation.
And contrary to previous studies that showed brown fat in adults was more active in cold weather, the researchers found outdoor temperatures had no effect on brown fat in children.
The researchers concluded that their findings could help develop ways to combat obesity by boosting brown fat activity in children, such as lowering indoor temperatures in homes where obese children live. They noted, however, that more research is needed to explain whether thin children have more brown fat because they are thin or whether having more brown fat makes them thin.
"That's the billion dollar question," concluded the study's senior author, Dr. Aaron Cypess, assistant investigator and staff physician at Joslin. "But we do know that brown fat is a core component of pediatric and likely adult metabolism," he said in the news release.
The study was released online Aug. 12 in advance of publication in an upcoming print issue of The Journal of Pediatrics.
SOURCE: Joslin Diabetes Center, news release, Aug. 11, 2011
http://www.nlm.nih.gov/medlineplus/news/fullstory_115536.html

Serial Killer' Immune Cells Put Cancer in Remission

The patient was dying of leukemia. One hundred seventy out of every 200 cells in his bone marrow had a cancer-causing mutation, and his lymph nodes were swelling, a sign the cancer was getting worse. He'd already been on multiple courses of chemotherapy, but his disease showed few signs of improvement. Then, in July 2010, he enrolled in a clinical trial for an experimental treatment, designed to turn his own immune cells against his cancer. Months later, all signs of leukemia had vanished, his physicians report today
Levine and his colleagues designed a new gene that can be inserted into T cells to trick them into attacking cancerous B cells, the cause of chronic lymphocytic leukemia (CLL). The new gene encodes a receptor that, on one end, can bind to a molecule that's unique to cancerous B cells. The other end of the receptor sets off a chain reaction when such a B cell is bound, eventually leading the T cell to destroy the cancerous cell. "Essentially, we're converting T cells that would normally recognize other types of cells to be tumor specific," Levine says. ORIGINAL ARTICLE

IIM-A asks AYUSH to follow Chinese medicine example

AHMEDABAD: In a set of recommendations that Indian Institute of Management Ahmedabad (IIM-A) has given the ministry of health and family welfare's department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) recently, the latter has been suggested to learn from the Chinese examples. IIM-A recommended AYUSH introduce farming of medicinal herbs and commence mass scientific validation of medicines like the Chinese did.
ORIGINAL ARTICLE

Blood Donations from Men Who Have Sex with Other Men. Questions and Answers

Men who have had sex with other men are currently deferred as blood donors. To know more Visit; http://t.co/ZBXWDjb

Approval of Complera: emtricitabine/rilpivirine/tenofovir DF fixed dose combination

The FDA has approved a new fixed-dose combination — emtricitabine/rilpivirine/tenofovir DF (FTC/RPV/TDF) — for use in treatment-naive HIV-infected patients.
The treatment, marketed as Complera, is a single pill that should be taken once daily. The pill is contraindicated with some anticonvulsants, antimycobacterials, and proton-pump inhibitors (see the FDA alert for a full list).
Approval for the combination was based, in part, on data from previous phase III studies for rilpivirine, which the FDA approved in May. In his HIV and ID Observations blog, Dr. Paul Sax writes that data comparing rilpivirine with efavirenz demonstrate a trade-off between safety/tolerability (favoring rilpivirine) and efficacy (favoring efavirenz), and he wonders whether "this efficacy difference [will] be reduced now that the single-pill treatment is available — a question now being tested in an open-label clinical trial."
ORIGINAL ARTICLE

TB Rapid Test Performs Well in Children

Overall, the Xpert MTB/RIF assay demonstrated high sensitivity and specificity; in smear-negative cases, a second induced specimen increased sensitivity from 33% to 61%.
The Xpert MTB/RIF, a new molecular test to identify Mycobacterium tuberculosis and rifampin resistance, performs with high sensitivity and specificity in adult populations (JW Infect Dis Apr 27 2011). Might it also work well for children, in whom diagnosis is complicated by low numbers of mycobacteria and difficulty in obtaining good specimens?
Original Article

Study: HIV risks rise with some birth control

ATLANTA — In what's being called the first research of its kind, a study found that HIV-infected women in Africa are more likely to spread the AIDS virus if they use hormone-based birth control.

The women studied were about twice as likely to transmit HIV if they were on the pill or taking a hormone shot like Depo-Provera, compared to those not on the such birth control. The research is the first to look at this question, according to Renee Heffron of the University of Washington, one of the researchers.
Their research also found that uninfected women were about twice as likely to catch AIDS virus from their infected partners if they were on hormonal contraception, compared to those who were not. That finding echoed a phenomenon seen in earlier studies.
The researchers checked to make sure there were no significant differences in condom use, sexual behavior or other factors that would account for the differences.
The research was presented Wednesday at a meeting in Rome of the International AIDS Society.
The researchers said the findings need to be confirmed in follow-up studies, and should not cause women to immediately change birth control practices.
The increased risk of HIV infection also must be balanced against the consequences of unintended pregnancy, which in Africa can include maternal mortality and financial squalor, they explained.
"Contraception is incredibly important to economic and social development of women and children worldwide," said Dr. Jared Baeten, another University of Washington researcher on the study team.
Hormone shots release progestin, which keep a woman's ovaries from releasing eggs and also thins the lining of the uterus. Birth control pills contain progestin or progestin and estrogen and work the same way.
It's not clear exactly how the hormones may help spread the virus, but the theoretical risk has been known from earlier studies. A Kenya study found an increase in HIV-infected cells in cervical tissue after women started using various hormonal contraception.
The new study was done from 2004 to 2010 in seven African countries — Kenya, Uganda, Rwanda, Botswana, Zambia, Tanzania and South Africa.
It included nearly 2,500 women with HIV whose male partners were not infected. About a third took hormonal contraception at least once. Most of them were on the shots, which are taken once every few months.
The men had a 2.61 percent chance of becoming infected in a year's time if their partner was on hormonal contraception. If not, their chances of infection were 1.51 percent.
The research team also looked at about 1,300 couples in which the men were infected but not the women. About 20 percent of the women were on hormonal contraception, mostly injections.
The study found those women had a 6.6 percent chance of becoming infected in a year, compared to 3.8 percent for woman not on that kind of birth control.

High court warns against use of ‘Dr’ without valid medical degree

CHENNAI: Putting a pause to the tug-of-war between physicians and physiotherapists over the use of the prefix 'Dr,' the Madras High Court has asked the authorities to take action against persons who use the prefix in their prescriptions and advertisements without a valid medical degree.
Passing orders on a writ petition filed by the Indian Medical Association's Quackery Eradication Committee, the first bench comprising Chief Justice HL Gokhale and Justice KK Sasidharan said the IMA must furnish details of people prescribing allopathic medicines and administering allopathic treatment and using the prefix 'Dr' to the authorities.
The IMA wanted the court to consider its two representations to the government, and to initiate criminal prosecution against paramedical technicians, practitioners and physiotherapists who prescribed allopathic medicine and used the prefix 'Doctor (Dr).'

The government pleader assured the court that the authorities would take necessary action in accordance with law.
The state government had passed an order last year that a physiotherapist cannot use the prefix 'Dr' and should not prescribe drugs. However, paramedics and physiotherapists have been maintaining that the use of the prefix 'Dr' is more a matter of courtesy rather than adherence to law.
Referring to a similar petition filed in the court by IMA a few weeks ago, the first bench said that on January 5 the court had asked the petitioner to furnish the names of persons who are practising medicine without any valid licence. The court also asked the authorities to take stringent action such persons on receiving any information.

Finance ministry approves launch of National Health portal

The ambitious National Health Portal, a database proposed by the Union health ministry for storing the medical records of all citizens, has got an approval from the finance ministry.
The proposal will now go to the Union Cabinet for its nod, Minister of State for Health and Family Welfare Dinesh Trivedi said here today, while inaugurating 'International Conference on Medical Electronics: Partnering for Access and Affordability' organised by FICCI.
He said the health ministry adopted a three-pronged initiative two years ago to put in place a National Health Portal, a 24-hour, 3-digit National Emergency Media Service Number and an Indian Health Information Network.
The National Health Portal, recommended by the National Knowledge Commission, would make optimum use of technology for establishing a database for the medical records of all citizens and other health related issues.
The portal would put information on standardisation and protocols in the public domain. The effort would also be to ensure that the medical records of all citizens are electronically stored for easy access by pathologists and doctors for diagnosis and treatment of patients.
The Minister lamented that the Health Ministry's proposal for acquiring railway land for setting up diagnostic centres at the 8000-odd railway stations has been hanging fire for the last year and a half. His suggestion that a beginning could be made by taking up 20 pilot projects has also not seen the light of day, he remarked.
Published: Thursday, Jun 2, 2011, 19:08 IST
Place: New Delhi | Agency: PTI