Global Digital Store – Ebooks and Softwares

Tag: Severe

  • Top Reasons Why Athletes Should See a Sports Medicine Doctor

    Top Reasons Why Athletes Should See a Sports Medicine Doctor

    [ad_1]

    The life of professional athletes isn’t easy. They have to participate in intensive exercises and training activities constantly to deliver maximum performance in front of an audience.

    While these activities are crucial for athletes to stay in shape, they can also damage their body.

    Sports medicine is a growing healthcare field dedicated for treatment of injuries related to sports and exercise like fractures, dislocations, sprains and strains, tendonitis, overtraining syndrome and degenerative diseases.

    Besides injury treatment, it also focuses on helping the athletes improve their performance prevent future injuries.

    Despite being a relatively new medical specialty, it has become essential for athletes thanks to its ability to address their specific needs and concerns.

    Who is a Sports Medicine Doctor?

    A sports medicine doctor is a licensed and trained individual who focuses on the diagnosis, treatment and prevention of injuries related to athletic activities.

    These specialists treat their patients using physical therapy, orthopedic surgery, massage therapy, exercises, and other techniques so that they can return to their desired activity level quickly, safely and successfully.

    They also teach the athletes on nutrition to help them maintain an optimal level of health and fitness and achieve their sports performance goals.

    The sports medicine team includes sports physiotherapists, sports massage therapists, sports orthopaedic surgeons, sports podiatrists, athletic trainers, sports dieticians, exercise physiologists and sports biomechanists.

    Common Sports Injuries:

    Some common sports injuries athletes suffer on the filed include ankle sprain, groin pull, hamstring strain, knee injury, tennis elbow, Achilles tendinitis, concussion, shoulder injury, hip bursitis, quadriceps strain and shin splints.

    They can also experience the exacerbation of pre-existing health problems like diabetes, asthma, allergies and arthritis.

    Reasons to Visit a Sports Medicine Doctor:

    There are many reasons for an athlete to see a sports physician.

    Let’s take a look at some of them.

    (1) Customized Care:

    Sports medicine doctors are specially trained healthcare professionals who have an in-depth understanding of what could be the impacts of an exercise on their patient’s body. They collaborate with physical therapists and orthopedic surgeons to develop a customized treatment for their patient.

    (2) Injury Prevention:

    Sports physicians can provide the athletes with expert advice on the how to prevent injuries during the practice or play and how to reduce the likelihood of resurfacing a previous injury. They also conduct pre-participation physical exams of their patients to determine whether they are fit enough to resume sports activities.

    (3) Pain Management:

    Sports injuries may lead to several orthopedic issues that often cause chronic pain, making it difficult for the athletes to return to the game and carry out their activities.

    While the primary aim of sports physicians is always to diagnose, treat and resolve the injury, they also use pain management therapies like electrical stimulation, spinal decompression, prescription medications and injected medications, to help their patients prevent or defer the need for surgery and continue their daily activities without any hindrance.

    (4) Rehabilitation:

    For an athlete, a return from an injury can be a complicated and lengthy process. If you find yourself sidelined by an injury, a sports physician can help you restore your movement and function and return to same or higher level of fitness quickly.

    (5) Improving Athletic Performance:

    Sports physicians diagnose and treat uncomfortable conditions to help you deliver your maximum performance, both on and off the field.

    They also suggest you exercises and techniques to improve your strength and balance that contribute to your success as an athlete.

    (6) Improving overall Fitness:

    Sports physicians help athletes prevent muscle sprains, strains and tears to keep their bodies in shape.

    They also conduct full body and musculoskeletal examinations to help them maintain their overall fitness.

    (7) Non-Surgical Treatment:

    Sports physicians try to avoid surgery in less severe cases and instead focus on treating injuries with non-surgical methods like physical therapy and acupuncture.

    These treatments are often non-invasive and require shorter recovery time.

    (8) State-of-the-Art Surgical Treatment:

    In the cases where surgery is indispensable, sports physicians use advanced surgical procedures, like arthroscopic ACL repair, platelet-rich plasma (PRP) therapy, hip arthroscopy, stem cell therapy and rotator cuff repair to restore the function of injured areas.

    (9) Education & Nutrition:

    Sports medicine doctors teach you how to fuel your body properly to deliver greater performance consistency.They also focus on each athlete’s dietary needs depending on his/her general health and athletic goals.

    (10) Rehabilitated Mobility:

    Sports injuries can impair your mobility and flexibility, thus preventing you from conducting your athletic activities. Sports physicians help you restore function, increase strength and flexibility, improve range of motion, and prevent injuries from occurring.

    (11) Improving Confidence:

    An athlete fights with different type of injuries on the field that could make him/her self-conscious. Sports physicians address their specific needs, thus helping them regain their confidence and enjoy their game.

    [ad_2]

    Source by Jexy Rodriguez

    Views: 0

  • Dislocations – When There Is No Doctor

    Dislocations – When There Is No Doctor

    [ad_1]

    The bones that form a joint are normally congruous and in apposition to each other. When this relationship is altered due to injury, it leads to a separation of these bones, called a dislocation.

    What you shouldn’t do is as important as what you should when someone has suffered a dislocation. Let’s discuss how to recognize when bones have gone astray, and the correct way to handle such an emergency.

    A fracture is often mistaken for a dislocation especially if it occurs near a joint, such as the upper end of the thighbone (femur) which is near the hip joint, or the upper end of the arm bone (humerus) which is near the shoulder joint. What distinguishes the two is that a fracture is a break in the continuity of any one bone.

    The elderly are more susceptible to dislocations because, with age, the muscles and ligaments that form the support system around the joints lose their tone, weakening their hold over the joints.

    Other susceptible groups, especially for shoulder dislocation, are those involved in active sports like gymnastics and cricket (bowling and fielding).

    SHOULDER DISLOCATION

    This is the commonest site of dislocation because the socket of the shoulder joint is shallow compared to the other ball-and-socket joint – the hip, which is deeper and hence more stable. The cause is usually an injury, typically when, during a fall, the person lands on his outstretched hand (thus throwing his entire body weight on it) and the rest of his body is thrown backwards.

    Symptoms:

    • When the two shoulders are compared, the affected one will appear flatter (the normal shoulder has a rounded outline) because the ball has shifted out its place.
    • There will be pain and swelling around the area, and the person will be unable to move the affected arm.

    First Aid:

    DO NOT

    • attempt to click the joint into place, especially if you are not trained in this, and the dislocation has occurred for the first time. In fact, do not even move the arm; let the person hold it in the position he finds most comfortable.
    • give anything by way of mouth, including a pain-killer (even if the person is yelling for it), in case anaesthesia is to be later administered at the hospital.

    WHAT TO DO:

    Your priority should be to transport the person to a hospital urgently. Sometimes if the circumflex nerve at the shoulder joint is injured, it could lead to paralysis of the deltoid muscles (of the shoulder), leading to an inability to raise the arm.

    If time permits (while transport is being arranged) the affected hand could be supported by a cuff-and-collar sling, i.e. a bandage gauze going around the neck and the wrist, or by a triangular sling.

    (At the hospital after an x-ray is taken, the bone will be set into position, very often under general anaesthesia.)

    Recurrent dislocations of the shoulder, in which the shoulder keeps getting dislocated as a result of trivial injury or even an action which involves raising the arm above the shoulder are common. The reason is a tear in the tissue surrounding the joint which becomes a weak area through which the bone comes out easily.

    As the frequency of such dislocations increases, the pain reduces to the point, where the person learns to click hi shoulder back into place without much ado.

    HIP DISLOCATIONS

    The hip joint has a deeper socket compared to the shoulder joint and has the body’s strongest ligaments surrounding it, which is why it is inherently a very stable joint. But it may dislocate as a result of a high-velocity vehicular accident. If a person sits in the front seat of a vehicle with his legs crossed at the knee, when the dashboard hits against the knee, the force is transmitted from the knee along the thighbone to the hip joint which usually dislocates the hip joint.

    Symptoms:

    • Severe pain in the area; the person will not be able to stand on the affected leg.
    • The leg will appear flexed (bent) at the knee and hip.
    • The limb may also appear shortened.

    First Aid:

    DO NOT:

    • attempt to click the joint into place or to move the leg in any way.
    • give the person anything to eat or drink in case he is required to be given anaesthesia later.

    WHAT TO DO:

    Immediately arrange to transport the person, lying on his back and preferably in an ambulance. If treatment is delayed and the surrounding blood vessels are disrupted, the blood supply to the ball of the hip joint may be permanently cut off, leading to early wear-and-tear of the hip joint and arthritis of the hip. If the dislocation is associated with an injury to the sciatic nerve which is in close proximity to the hip it could lead to a paralysis of the foot muscles or a foot-drop. (At the hospital, under general anaesthesia, the hip will be manipulated into position or surgery may be required.)

    Usually a hip dislocation is non-recurrent except in the case of an associated fracture of the socket. (In this case, to prevent re-dislocation, the fractured socket has to be reconstructed by surgery.)

    SPINAL DISLOCATIONS

    As a result of injury, the spine could dislocate either at the cervix (back of the neck) or in the dorso-lumbar area (the junction of the middle and lower back). It may or may not be associated with neurological deficit (paralysis).

    Symptoms:

    • Severe pain in the area.
    • If there is paralysis, there may be reduced sensation or a lack of sensation below the point of injury.
    • If the body is paralysed below the level of injury there will be a loss of bladder and bowel movement.

    First Aid:

    DO NOT

    • delay transportation in any way.
    • impart any movement to the spine.

    WHAT TO DO

    As soon as possible, rush the person to the hospital in the position that he is lying, as a change of position could worsen his condition. In the event of paralysis below the point of injury, early treatment plays a crucial role in ultimate recovery.

    OTHER DISLOCATIONS

    Other superficial dislocations include those of the elbow joint, finger joints and ankle joints.

    Symptoms:

    Pain, swelling and an inability to move the affected joints.

    First Aid:

    DO NOT

    • attempt to click the joint into place, however easy it may seem, as an injury to a nearby nerve or blood vessel during the process could bring on long-lasting complications or could produce a fracture of a nearby bone which was not initially present.

    WHAT TO DO

    The elbow joint may be placed in a triangular sling to provide support to it till the person can be taken to hospital.

    In case of an ankle dislocation, the victim should not be made to walk or to exert any pressure on the affected leg. He should be carried to the transport and, later, from the vehicle to the hospital.

    Finger joint dislocations may appear minor but they too need the attention of an orthopaedic surgeon who will usually click them into place under local anaesthesia. However, if there are complications involved, surgery may be required.

    [ad_2]

    Source by Andy G

    Views: 0

  • "Negotiator – Embrace Right Buy-In – Cure Stupid Hidden Disasters" – Negotiation Tip of the Week

    "Negotiator – Embrace Right Buy-In – Cure Stupid Hidden Disasters" – Negotiation Tip of the Week

    [ad_1]

    A good negotiator knows, when you embrace the right buy-in, you cure hidden disasters before they can occur.

    For almost a year, they secretly planned the rollout. They touted it as a facelift that would change the name and position of the association. Doing so would give it a fresh look and appearance for the 21st century. But when the rollout occurred, the backlash was severe. All the money, time, expenses, and efforts that went into the new face of the association went down a drain of despair. The question that buzzed throughout the association was, how could this have happened? The response was when you embrace the right buy-in, you stop hidden disasters. And this disaster was easily avoidable.

    First, as a negotiator, what do you think went wrong? What buy-in do you seek when thinking about the obstacles you might face in your negotiations? To the degree you obtain the right buy-in, you have a better chance for a successful outcome. To the degree you get the right buy-in at the right time, your chances of a successful outcome increases substantially.

    Problem:

    Secrecy – In the opening situation, the president of that association assembled a team of prominent members – all were members of the association. Their expertise stretched across the spectrum of branding, marketing, and social media. None were members of the vanguard that had watched over the association for decades. And the omittance of that group’s input was a silent blinking red light that foretold the death of the project.

    Negotiating in secret environments can be beneficial. It can prevent unwanted distractions from slowing the progress of the negotiation. It also serves to gather the buy-in of stakeholders that might torpedo the negotiation. Thus, secrecy can be a form of control – it can also be the deliverer of disaster if not used right.

    Forgotten power players – The name of the association had stood for four decades. And some of the revered founding members were still active in the association. When the new name was revealed, that vanguard was the catalyst that caused the committee’s efforts, and the new name, to meet a swift death. Had the committee consulted this vanguard, the committee would have known its efforts were doomed. They could have avoided a hidden disaster.

    Consideration:

    Had the committee charged with creating a new name involved the vanguard of the association and brought them along during the planning stage, at minimum, the new name would have stood a greater chance of becoming implemented successfully. At worse, the committee would have known that the new name was in trouble. Losses could have been averted at an earlier point and resources could have been spared.

    The challenge a negotiator faces when employing secrecy is making sure the right people are involved. If they’re not involved, hidden disasters may lie in wait.

    Always take into consideration who might be involved in a negotiation even if they’re not physically or visually involved in it. Seek those individuals that might have a stake in the outcome of the negotiation no matter how small you think their stake might be. There’ll be times when you won’t know the power source behind some people’s means – that’s something else to consider. There’ll also be times when smaller stakeholders will combine forces, which will present a more powerful force for you to contend with.

    Conclusion:

    Getting the right buy-in is a vital component of every negotiation – even when it’s just you and the other negotiator. Doing so when you have multiple participants is even more vital to the negotiation’s success. Therefore, when you assess the impact of the buy-in component during your negotiation planning stage, consider its impact thoroughly… and everything will be right with the world.

    Remember, you’re always negotiating!

    [ad_2]

    Source by Greg Williams

    Views: 0

  • Awe Inspiring Reports of Reiki Healing Severe Nerve Damage

    Awe Inspiring Reports of Reiki Healing Severe Nerve Damage

    [ad_1]

    As part of the Medical Reiki Master Community, I’m repeatedly amazed by the healing power of Reiki. This group continuously shares amazing outcomes of the healing capabilities of Reiki in multitudes of medical cases. There are even cases that are oftentimes documented medical issues where the patient is not given a lot of hope from their doctor for a complete recovery. I’ve been given permission by a fellow Certified Medical Reiki Master, Jody Wolfe, to share her own success story along with the success story of her client, which is very near and dear to her heart.

    This is Jody’s recap of her own personal Reiki success story:

    “I got involved working with a hand therapist because she watched me heal my own hand with Reiki, to her astonishment. I shattered my radius at the wrist in a compound fracture from a fall. My ulnar nerve was so badly damaged that I was told by more than one hand surgeon that I was unlikely to ever regain use of my right hand. The muscles in that hand became atrophied. I did Reiki every day, never giving up on its power to heal. My ulnar nerve spontaneously recovered overnight, and I went from completely unable to use my hand one day to full function the next morning. All my therapist had to do was help me rebuild strength and endurance. She understood that what happened was medically impossible and has been a champion for Reiki ever since. Like you, I remember every day the gift of recovery Reiki has given me. How can we not want to bring this gift to others? Reiki on, sister!”

    With such an incredible nerve damage recovery of her own, Jody is blessed to now have a certified hand therapist in her corner. She is able to share her gift of Reiki with others’ with a similar personal story.

    This is what Jody shared about her clients healing with Reiki:

    “I volunteer in a beautiful integrative working relationship with a certified hand therapist. Last week I started working with a long-time client of the clinic with severe Guillain-Barre syndrome. She was completely paralyzed, and after 2 years of hard work in both physical and occupational therapy, she has made minimal progress, with her hands being almost useless to her. While her nerves recently began showing some small initial signs of healing, she still had very far to go. After one short Medical Reiki treatment, her occupational therapy session, normally agonizing, was pain-free, and she spontaneously regained significant range of motion and functionality in her hands. She was able to perform every task the therapist gave her to test her new abilities. The client cried with joy, and the therapist was speechless, even though she was already a believer in Reiki. The occupational therapist did a periodic evaluation with her this week, and she did amazing – completing tasks in record time that she didn’t think she would ever be able to do again. Additionally, with Reiki, her pain during OT treatments has dropped from off the charts (with pain meds) to barely noticeable (with no pain meds). Oh, the wonders Reiki can do for patients! We are so blessed to be part of this important work.”

    Like so many others, I am so very grateful every day for the gift of Reiki healing in my own life after thyroid cancer, so I will continue to share the incredible power of Reiki. Today, I am healthy and whole and feel blessed to be able to share the gift of Reiki healing with others. We all deserve to have the gift and grace of Reiki, so please share this with anyone who can be helped by the medical marvels of Reiki Healing.

    A special thanks goes out to Jody Wolfe for allowing me to share two very personal and awe inspiring cases of Reiki Healing!

    Be well! Love and light to you!

    Nicole

    [ad_2]

    Source by Nicole Lawler

    Views: 0

  • Massive proportion of world’s population are living with herpes infection

    Massive proportion of world’s population are living with herpes infection

    Virus causing genital herpes may put millions of people at greater risk of infection with HIV

    About half a billion people worldwide are living with genital herpes, and several billion have an oral herpes infection, new estimates show.

    Authored by staff at the University of Bristol, World Health Organization (WHO), and Weill Cornell Medical College-Qatar, and published in the Bulletin of the World Health Organization,
    the new study estimates the global infection prevalence and incidence of herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) in 2016. 

    “Herpes infection affects millions of people across the globe and can have far-reaching health effects. We need more investment and commitment to develop better treatment and prevention tools for this infection.” says Dr Sami Gottlieb, Medical
    Officer at WHO and an author of the study.

    Prevalence and incidence

    An estimated 491.5 million people were living with HSV-2 infection in 2016, equivalent to 13.2% of the world’s population aged 15 to 49 years. HSV-2 is almost exclusively sexually transmitted, causing infection in the genital or anal area (genital
    herpes).

    An estimated 3.7 billion people had HSV-1 infection during the same year – around 66.6% of the world’s population aged 0 to 49. HSV-1 is mainly transmitted by oral to oral contact to cause infection in or around the mouth (oral herpes). However,
    HSV-1 can also be transmitted to the genital area through oral-genital contact – during oral sex – to cause genital herpes. Most HSV-1 infections were oral; however, between 122 million to 192 million people were estimated to have genital
    HSV-1 infection, depending on the assumptions used in the estimation model.

    Because herpes is a lifelong infection, estimated prevalence increased with age; HSV-2 prevalence was also higher among women and in the WHO African Region.

    Health and social impacts

    Most people living with herpes, caused by either HSV-1 or 2, are unaware they have the infection.

    When symptoms do occur however, oral herpes infection can lead to painful sores around the mouth (“cold sores”). Genital herpes infection can cause recurring, often painful, genital sores, often referred to as genital ulcer disease. 

    WHO and partners published a study in March 2020 estimating that around 5% of the world’s population (187 million people) suffered from at least one episode of herpes-related genital ulcer disease in 2016 (1). Most of these episodes were due to
    HSV-2, which can recur frequently over many years.

    Recurrent symptoms of genital herpes can lead to stigma and psychological distress, and can have an important impact on quality of life and sexual relationships. However, in time, most people with herpes adjust to living with the infection.

    “Genital herpes is a substantial health concern worldwide – beyond the potential pain and discomfort suffered by people living with the infection, the associated social consequences can have a profound effect on sexual and reproductive health”
    says Dr Ian Askew, Director of the Department of Sexual and Reproductive Health and Research at WHO. 

    Herpes and HIV

    A strong association exists between HSV-2 infection and HIV infection. In 2019, WHO commissioned a modeling study to estimate how much HSV-2 infection might contribute to HIV incidence. The study estimated that almost 30% of new sexually acquired HIV
    infections in 2016 worldwide were likely attributable to HSV-2 infection (2). 

    Evidence shows that people with HSV-2 infection are at least three times more likely to become infected with HIV, if exposed. HSV-2 leads to inflammation and small breaks in the genital and anal skin that can make it easier for HIV to cause infection.
    In addition, people with both HIV and HSV-2 infection are more likely to spread HIV to others.

    Women have higher biologic susceptibility to both HSV-2 and HIV. Women living in the WHO Africa Region have the highest HSV-2 prevalence and exposure to HIV – putting them at greatest risk of HIV infection, with negative implications for their health
    and well-being. 

    For people living with HIV (or who are living with other conditions that compromise their immune systems) as well as HSV-2, the symptoms of herpes can be more severe and more frequent. 

    Neonatal herpes

    Neonatal herpes can occur when an infant is exposed to HSV in the genital tract during delivery. This is a rare condition, occurring in an estimated 10 out of every 100,000 births globally, but can lead to lasting neurologic disability or death. The risk
    for neonatal herpes is greatest when a mother acquires HSV infection for the first time in late pregnancy. Women who have genital herpes before they become pregnant are at very low risk of transmitting HSV to their infants.

    No cure – better treatment and prevention needed

    There is no cure for herpes. At present, antiviral medications, such as acyclovir, famciclovir, and valacyclovir, can help to reduce the severity and frequency of symptoms but cannot cure the infection.

    As well as increasing awareness about HSV infection and its symptoms, improved access to antiviral medications and heightened HIV prevention efforts for those with genital HSV symptoms are needed globally. 

    In addition, development of better treatment and prevention interventions is needed, particularly HSV vaccines. WHO and partners are working to accelerate research to develop new strategies for prevention and control of HSV infections. Such research includes
    the development of HSV vaccines and topical microbicides. Several candidate vaccines and microbicides are currently being studied.

    “A vaccine against HSV infection would not only help to promote and protect the health and well-being of millions of people, particularly women, worldwide – it could also potentially have an impact on slowing the spread of HIV, if developed
    and provided alongside other HIV prevention strategies” says Dr Meg Doherty, Director of the WHO Department of Global HIV, Hepatitis, and STI Programmes.

    Related publications

    WHO guidelines for the treatment of Genital Herpes Simplex Virus

    WHO preferred product characteristics for herpes simplex virus vaccines

     

    ———————-

    (1) Looker KJ, Johnston C, Welton NJ, et al. The global and regional burden of genital ulcer disease due to herpes simplex virus: a natural history modelling study. BMJ Glob Health. 2020;5(3):e001875. doi: 10.1136/bmjgh-2019- 001875.

    (2) Looker KJ, Welton NJ, Sabin KM, et al.Global and regional estimates of the contribution of herpes simplex virus type 2 infection to HIV incidence: a population attributable fraction analysis using published epidemiological data. Lancet Infect Dis.2020;20(2):240-249. doi: 10.1016/S1473-3099(19)30470-0.

    Massive proportion of world’s population are living with herpes infection
    Read More
    https://www.who.int/news-room/detail/01-05-2020-massive-proportion-world-population-living-with-herpes-infection

    Views: 0

  • Indonesia firmly committed to eliminating lymphatic filariasis as a public health problem

    Indonesia firmly committed to eliminating lymphatic filariasis as a public health problem

    Indonesia recently completed the last of its annual large-scale treatment for lymphatic filariasis (also known as elephantiasis or Penyakit Kaki Gajah) in Malaka District located in its southernmost province, East Nusa Tenggara. Unprecedented
    progress by the National Lymphatic Filariasis Elimination Programme has strongly placed the country on the path to achieving the elimination of lymphatic filariasis as a public health problem.

    “We reached an estimated number of 40.7 million people living in the 118 high-risk districts during this month-long treatment campaign in October 2019” said Dr Anung Sugihantono, who recently retired as Director General of Diseases
    Prevention and Control, Ministry of Health Indonesia. “    Single doses of diethylcarbamazine citrate and albendazole facilitated by WHO were delivered to all eligible populations.”

    In 2010, an estimated 125 million Indonesians were still at risk of the disease and required treatment.

    But things changed considerably in 2015 when Indonesia mounted an annual national campaign to resolutely address transmission of the disease and to tackle the morbidity and disability associated with it. The results were apparent as early as 2017, with
    remarkable progress.

    In Indonesia, LF is considered a significant public health concern. In 2009, risk mapping identified a population of 124.5 million people needing treatment for LF. The country initiated a national level LF elimination campaign in 2015, addressing both
    disease prevention and management. 

    “In 2017 and in just two years we managed to achieve 100% geographical coverage of all people requiring treatment” said Dr Sugihantono. “It meant achieving more than 78% epidemiological coverage – much higher than the generally recommended 65% to stop transmission.”

    Transmission of lymphatic filariasis can be stopped through large-scale treatment (or mass drug administration – MDA) of entire at- risk communities with recommended medicines once a year. These medicines kill the microfilariae in an infected patient’s
    blood preventing mosquitoes to transmit1 the disease to others. Through mass treatment, the aim is to reduce the reservoir of microfilariae in the blood to a level insufficient to maintain transmission by the mosquito vector.

    This strategy to interrupt transmission is the corner-stone of the World Health Organization’s (WHO) Global Program to Eliminate Lymphatic Filariasis (GPELF). Indonesia has been using the GPELF’s strategy since 2002 using a district or city
    as its implementation unit.

    In 2005, it listed the elimination of LF as a national priority for controlling infectious diseases and the medicines it has been using in large-scale treatment programmes are diethylcarbamazine citrate (DEC) and albendazole2 which are
    largely distributed by volunteer community health workers3.

    “Community health volunteers are themselves members of the community and know how to reach people effectively to improve compliance” said Dr. Stefanus Bria Seran, the Regent of Malaka District, one of LF endemic district in Indonesia. “Besides ensuring every single person ingests the medicine given to them, these community workers help in disseminating information well before a large-scale treatment campaign and also assist in reporting activities related to each treatment campaign”. 

    Indonesia’s efforts to eliminate lymphatic filariasis began in the 1970s but faced numerous challenges including programme coordination in the many inhabited islands, conducting information, education and awareness programmes, lack of capacity and
    insufficient medicines.

    Furthermore, the situation in Indonesia is unusual than in many other countries endemic for lymphatic filariasis as the country is endemic for all three species of thread-like filarial worms – Brugia malayi, Brugia timori, and Wuchereria bancrofti –
    that cause the disease. Most of the infections in Indonesia, however, are caused by B. malayi.

    In the past, some of the factors that prevented access to the medicines (DEC and albendazole) were social stigmatization linked to the disease, the vast geography of the territory and challenges in reaching remote populations.

    With an estimated population of 242 million, Indonesia is the world’s largest island nation and consists of approximately 17,000 islands, of which 5,000–6,000 are inhabited. It is the fourth most populated nation behind China, India, and the United
    States.

    Indonesia is endemic for many other neglected tropical diseases and an estimated 110 million Indonesians are believed to suffer from at least one neglected tropical disease (NTD), including lymphatic filariasis and soil-transmitted helminth infections.
    Leptospirosis (not classified as NTD) is also widespread.

    Indonesia is the only country of WHO’s South East Asia Region with endemic schistosomiasis. Like many other countries of the Region, it also faces recurrent threats of dengue outbreaks.

    Global progress

    The world has made significant progress towards the elimination of lymphatic filariasis as a public health problem.

    Sixteen countries4 and one territory are now acknowledged by WHO to have achieved elimination of lymphatic filariasis as a public health problem.  

    Seven additional countries have successfully implemented recommended strategies, stopped large-scale treatment and are under surveillance to demonstrate that elimination has been achieved.

    The disease

    Lymphatic filariasis is caused by infection with parasitic worms living in the lymphatic system. The larval stages of the parasite (microfilaria) circulate in the blood and are transmitted from person to person by mosquitoes.

    Infection involves asymptomatic, acute, and chronic conditions. Most infections are asymptomatic, showing no external signs while contributing to transmission of the parasite. Although asymptomatic, these infections still cause damage to the lymphatic
    system and the kidneys and alter the body’s immune system.

    When lymphatic filariasis develops into chronic conditions it leads to lymphoedema (tissue swelling) or elephantiasis (skin/tissue thickening) of limbs and hydrocele (scrotal swelling). Involvement of breasts and genital organs are common.

    Manifestation of the disease after infection takes time and can result in an altered lymphatic system, causing abnormal enlargement of body parts, and leading to severe disability and social stigmatization of those affected.

     

    1Lymphatic filariasis is transmitted by different types of mosquitoes – e.g the Culex mosquito which widespread across urban and semi-urban areas; Anopheles, mainly found in rural areas; and, Aedes, mainly
    in endemic islands in the Pacific.

    2In 2017, WHO recommended an alternative three drug treatment to accelerate the global elimination of lymphatic filariasis. The treatment, known as IDA, involves a combination of ivermectin, diethylcarbamazine citrate and albendazole.
    It is recommended annually in settings where its use is expected to have the greatest impact.

    3Community health workers, also called ‘cadres’, are volunteers who form part of the communities they serve and work with local
    communities to educate families. Their contribution in promoting health has been significant in the country.

    4Cambodia, The Cook Islands, Egypt, Kiribati, Maldives, Marshall Islands, Niue, Palau, Sri Lanka, Thailand, Togo, Tonga, Vanuatu, Viet Nam, Wallis and Futuna, and Yemen

    Indonesia firmly committed to eliminating lymphatic filariasis as a public health problem
    Read More
    https://www.who.int/news-room/detail/29-04-2020-indonesia-firmly-committed-to-eliminating-lymphatic-filariasis-as-a-public-health-problem

    Views: 0

  • New estimates highlight need to step up the response to hepatitis D

    Lyon, France, 29 April 2020 – In a study published in the Journal of Hepatology, 1 Professor Anna Maria Geretti and Dr Alexander Stockdale from the University of Liverpool (United Kingdom), in collaboration with researchers
    from the World Health Organization (WHO) and the International Agency for Research on Cancer (IARC), estimate that worldwide, hepatitis D virus (HDV) affects nearly 5% of people who have a chronic infection with hepatitis B virus (HBV) and that HDV
    co-infection could explain about 1 in 5 cases of liver disease and liver cancer in people with HBV infection..

    To map the epidemiology of HDV infection in the world, Professor Geretti and Dr Stockdale joined forces with the WHO Global Hepatitis Programme and IARC, alongside investigators in Germany, Malawi, and the United Kingdom. “Infection with HDV occurs
    in about 1 in 22 cases of chronic HBV infection in the world,” Dr Stockdale says. “More high-quality data are needed, but we have identified several geographical hotspots of high prevalence of HDV infection: in Mongolia, the Republic of
    Moldova, and countries in Western and Middle Africa.”

    “Although it is less common than hepatitis B, hepatitis D is a serious disease that often affects underprivileged and vulnerable populations,” says Dr Meg Doherty, Director of the WHO Global Hepatitis Programme. Those who are more likely to
    have HBV and HDV co-infection include people who inject drugs and people with hepatitis C virus or HIV infection. The risk of co-infection also appears to be higher in recipients of haemodialysis, men who have sex with men, and commercial sex workers.
    Dr Doherty points out, “This information helps in identifying the groups with HBV among whom we should be looking for HDV.”

    HDV (formerly known as the Delta agent) is a small virus – one of the smallest that is known to cause disease in humans – and can replicate only in the presence of HBV, from which HDV borrows some of its structures. Compared with people with
    HBV infection alone, those who have a chronic infection with both HBV and HDV have a much higher risk of developing disease in the form of cirrhosis and liver cancer. “HDV is a significant contributor to severe liver disease and liver cancer,”
    says IARC scientist Dr Catherine de Martel. “The findings from this study inform our work on the association between viral infections and cancer, which is focused on developing improved prevention strategies.”

    Professor Geretti concludes, “HDV has long been neglected, because for decades the prevalence of infection remained uncertain and effective treatment was lacking. Mapping the epidemiology of the infection is just the first step. More efforts are
    needed to reduce the global burden of chronic hepatitis B and develop medicines that are safe and effective against hepatitis D and are affordable enough to be deployed on a large scale to those who are most in need.”

    1 Stockdale AJ, Kreuels B, Henrion MYR, Giorgi E, Kyomuhangi I, de Martel C, Hutin Y, Geretti AM (2020). The global prevalence of hepatitis D virus infection: systematic review and meta-analysis. J Hepatol. Published online 23 April 2020;
    https://doi.org/10.1016/j.jhep.2020.04.008

    For more information, please contact

    Véronique Terrasse, Communications Group, at +33 (0)6 45 28 49 52 or terrassev@iarc.fr or IARC Communications, at com@iarc.fr

    The International Agency for Research on Cancer (IARC) is part of the World Health Organization. Its mission is to coordinate and conduct research on the causes of human cancer, the mechanisms of carcinogenesis, and to develop scientific strategies for
    cancer control. The Agency is involved in both epidemiological and laboratory research and disseminates scientific information through publications, meetings, courses, and fellowships. If you wish your name to be removed from our press release emailing
    list, please write to com@iarc.fr. 

    About University of Liverpool

    Founded in 1881 as the original ‘red brick’, the University of Liverpool is one of the UK’s leading research-intensive higher education institutions. Consistently ranked in the top 200 universities worldwide, we are a member of the prestigious
    Russell Group and have a global reach and influence that reflects our academic heritage as one of the country’s largest civic institutions. For more information please visit us at www.liverpool.ac.uk

    Read More
    https://www.who.int/news-room/detail/29-04-2020-new-estimates-highlight-need-to-step-up-the-response-to-hepatitis-d

    Views: 0

  • New FAQs address healthcare workers questions on breastfeeding and COVID-19

    New FAQs address healthcare workers questions on breastfeeding and COVID-19

    Mothers and healthcare workers who support them have many questions and concerns about whether it is safe for mothers with confirmed or suspected COVID-19 to be close to and breastfeed their babies during the pandemic.

    To address their questions, WHO has released a list of Frequently asked questions: Breastfeeding and COVID-19. The FAQ complements the WHO interim guidance: Clinical management of severe acute respiratory infection when COVID-19 is suspected and draws upon other WHO recommendations on infant and young child feeding.

    The FAQs aim to provide information to healthcare workers supporting mothers and families in maternity services and community settings, and communicate how the interim guidance should be implemented. Additionally, the FAQs provide information about the protective effects of breastfeeding and skin-to-skin contact, and the harmful effects of inappropriate use of infant formula milk.

    Accompanying the FAQs is a decision tree which provides step-by-step guidance to health workers on how to support mothers with confirmed or suspected COVID-19 to breastfeed. It provides advice on what to do if mothers are not well enough to breastfeed, as well as appropriate hygiene measures for mothers, including wearing a medical mask if available, to reduce the possibility of the COVID-19 virus being spread to her infant.

    Benefits of breastfeeding outweigh potential risks

    The COVID-19 virus has not been detected in the breastmilk of any mother with confirmed and suspected COVID-19 and there is no evidence so far that the virus is transmitted through breastfeeding. Researchers continue to test breastmilk from mothers with the infection.

    WHO recommends that all mothers with confirmed or suspected COVID-19 continue to have skin-to-skin contact and to breastfeed. In all socio-economic settings, breastfeeding improves survival and provides lifelong health and development advantages to newborns and infants. Breastfeeding also reduces the risk of breast and ovarian cancer for the mother. Skin-to-skin contact, including kangaroo mother care, reduces neonatal mortality, especially for low birth weight newborns.

    While infants and children can contract COVID-19, they are at low risk of infection. The few confirmed cases of COVID-19 in young children to date have experienced only mild or asymptomatic illness.

    WHO’s recommendations on the care and feeding of infants whose mothers have confirmed or suspected COVID-19 aim to improve the immediate and lifelong survival, health and development of their newborns and infants. These recommendations consider the likelihood and potential risks of COVID-19 in infants and also the risks of serious illness and death when infants are not breastfed or when infant formula milk are used inappropriately.

    WHO’s Q&A on breastfeeding and COVID-19 also provides additional infection prevention advice to mothers with confirmed or suspected COVID-19.

    New FAQs address healthcare workers questions on breastfeeding and COVID-19
    Read More
    https://www.who.int/news-room/detail/28-04-2020-new-faqs-address-healthcare-workers-questions-on-breastfeeding-and-covid-19

    Views: 0

  • Maternal infections in health facilities

    Maternal infections in health facilities

    A clearer picture of the global impact 

    New research from the Global Maternal Sepsis Study (GLOSS), a major WHO/HRP initiative, shows that infection has a much larger impact on global maternal mortality and morbidity than previously thought.

    Logo of the Lancet Global HealthThe
    results from GLOSS, published in The Lancet Global Health, are the first to provide data on frequency of maternal infections and
    sepsis across the pregnancy and post-pregnancy period, in a large number of health facilities around the world. 

    Around 11 women per 1000 live births had an infection which resulted in or contributed to what is known as a severe maternal outcome – either they died or nearly died – during their hospitalization. 

    Urgent improvement is needed to manage this life-threatening risk faced by all pregnant and recently pregnant women, wherever they are in the world. 

    What is maternal sepsis and how does it lead to maternal death?

    Maternal sepsis is a life-threatening condition that arises when the body’s response to infection causes injury to its own tissues and organs during pregnancy, child-birth, post-abortion or the postpartum period.

    The latest global estimates place sepsis due to obstetric infections as the third most common cause of maternal mortality. However, this only includes infections as a direct result of pregnancy, such as endometritis or post-caesarean wound infections.

    Few
    previous studies include post-abortion infections. Neither do they address indirect infections such as respiratory and meningitis, which are aggravated by pregnancy but not directly caused by it.

    A better understanding of maternal infection

    GLOSS was a massive facility-based data collection effort led by WHO, accompanied by a ‘STOP SEPSIS!’ campaign to increase awareness among healthcare providers.

    The study gathered data on women who were admitted with suspected or confirmed infection during pregnancy or post-pregnancy over a one-week period in 2017. More than 2800 women participated in the study in 52 countries.

    GLOSS included healthcare facilities that care for women during pregnancy, childbirth or at the end of pregnancy, as well as facilities without maternity service but where women could be hospitalized during or after pregnancy, and data on infections
    which are not usually recorded as maternal sepsis, including post-abortion and indirect infections. 

    The result is a more complete understanding of the frequency and impact of maternal infections in health facilities. 

    GLOSS calls attention not only to the wider range of risks faced by pregnant women but also to the long period of time during which they are at risk. 

    Putting global numbers on maternal infection and sepsis

    Overall, around 70 pregnant or recently-pregnant women per 1000 live births were found to have a maternal infection needing hospital management. 

    Across the study, 11 women with either direct or indirect infection per 1000 live births developed a severe maternal outcome, but in low- and middle-income countries up to 15 women per 1000 births were affected.

    Infections were the underlying cause of most of the deaths recorded during the study, primarily post-abortion infection and indirect infections. Infections were also present in about a third of deaths attributed to other causes, such as postpartum
    haemorrhage.

    This suggests that the contribution of infection to global maternal mortality and morbidity may be larger than current reports of maternal sepsis mortality suggest.

    Preventing, identifying and treating maternal infection and sepsis

    Some of the most common maternal infections found in the study, such as urinary tract infections, post-caesarean and post-abortion infections, are largely preventable and treatable.

    GLOSS results suggest that current levels of monitoring and clinical care across health facilities are not enough to prevent, identify and treat levels of maternal infection effectively. 

    For instance, a complete set of vital signs was not reported for a third of the women in the study, on the day their infection was suspected or diagnosed. Delays in antimicrobial therapy were frequent.

    GLOSS also shows marked differences across countries, with the highest burden in low- and middle-income countries, compared with high-income countries.

    This may reflect the impact of broader health determinants in different country contexts. Challenges of overcrowding, limited access to water and sanitation and constraints to safe births by skilled birth attendants can reduce the ability of healthcare
    providers to manage the frequency and outcome of maternal infections.

    An opportunity to implement evidence-based practice

    GLOSS gives healthcare providers, policy-makers, and the public at large an opportunity: to mobilise around these data improve evidence-based practice, and save lives. 

    WHO has produced a number of resources which can support timely action to prevent, diagnose and treat maternal infection, as well as activities such as the upcoming SAVE LIVES: Clean Your Hands campaign
    on 5 May which celebrates the central role played by nurses and midwives in clean health care. 

    In addition, WHO will publish a global sepsis epidemiology report around the 73rd World Health Assembly (WHA) in May, as requested in the
    2017
    WHA Resolution on Improving the prevention, diagnosis and clinical managementof sepsis.

    Understanding why and how infection affects women is essential for equipping healthcare providers with life-saving knowledge and enabling health care systems to bring down global maternal mortality and morbidity.

    Related publications

    WHO recommendations for prevention and treatment of maternal peripartum infections

    WHO Clinical practice handbook for safe abortion

    Global guidelines on the prevention of surgical site infection

    WHO statement on maternal sepsis

    World Health Assembly resolution on Improving the prevention, diagnosis and clinical management of sepsis

    Health Topics

    Antimicrobial resistance

    Infection Prevention and Control

    Water Sanitation Hygiene

    Other links

    Global Maternal Sepsis Study

    SAVE LIVES: Clean Your Hands 5 May 2020

     

     

    Maternal infections in health facilities
    Read More
    https://www.who.int/news-room/detail/27-04-2020-maternal-infections-in-health-facilities

    Views: 0