Category: Health

{{Women preparing for fertility treatment typically get a series of daily, sometimes uncomfortable hormone shots to kick their ovaries into over-drive — but a new review of previous studies suggests one long-acting shot may work just as well.}}

For in vitro fertilization, extra follicle-stimulating hormone, or FSH, is used to trigger the ovaries to grow and release multiple eggs, which are then fertilized outside the body and re-implanted in the uterus.

In an analysis of four past studies including over 2,300 women with infertility, researchers found the women were just as likely to get pregnant — and didn’t have any more complications — when they got a single, long-acting dose of FSH rather than daily shots.

“Long-acting FSH (weekly injection) is a good and safe alternative to daily injections in the first week of ovarian stimulation for IVF,” Dr. Jan Kremer from Radboud University Nijmegen Medical Center in the Netherlands, who worked on the review, told Reuters Health in an email.

However, he said there is still limited data on how the weekly hormone shots work in certain groups of women, including older women with less of an ovarian response and those with fertility problems because of polycystic ovary syndrome, whose ovaries might over-respond.

The long-acting shot is used in Europe but not currently available in the United States, because it hasn’t been approved by the Food and Drug Administration.

The new findings are published in The Cochrane Library and include all high-quality data Kremer and his colleagues could find on the shots.

Out of 2,335 women included in the analysis, 987 got usual daily FSH shots for a week and 1,348 had one long-acting shot at a range of doses, along with the usual course of other IVF hormone injections.

In studies that used the lowest dose of the long-acting hormone — between 60 and 120 micrograms — fewer women in the one-shot group got pregnant than in the daily FSH comparison group.

However, at slightly higher doses (150 to 180 micrograms), pregnancy and birth rates didn’t suffer: 343 out of every 1,000 women getting one long-acting shot had a baby, compared to 336 out of 1,000 in the daily-shot group.

And the long-acting shot didn’t seem to come with a higher risk of miscarriage, having twins or developing a pregnancy-related complication, including swollen ovaries.

IVF typically runs for about $15,000 a cycle. Kremer said the cost of the two types of injections is “more or less comparable.”

Dr. Samuel Pang, medical director at the Reproductive Science Center of New England in Lexington, Massachusetts, said the main advantage of the single shot is convenience.

FSH shots are simple injections that women can give themselves, similar to insulin, he said, but the process can still be a hassle for some.

“In my mind, based on the studies that have been done and based on my own experience, it is a safe and effective product,” Pang, who wasn’t involved in the new review, told Reuters Health.

“The only caveat is it really needs to be used in well-selected patients.”
Like Kremer, he cautioned against using the long-acting shot in women who are unlikely to respond to the hormone — or those who may over-respond.

A week after getting the long-acting shot, many women still need a few daily injections of FSH before they’re ready to have their eggs harvested, he added.

Pang worked on research that has been submitted to the FDA on the hormone shot, but says it’s at least a year or two away from being available in the U.S.

“At this point in time, while it’s very promising based on the studies that have been done and the experience in Europe, it’s not anywhere near market here.”

So-called post-marketing studies in Europe and Australia continue to suggest the drug is safe and works well, according to Dr. Arthur Leader, from the University of Ottawa and Ottawa Fertility Centre who also didn’t participate in the review.

“It simplifies the whole process, makes it easier for the woman while not compromising her health or the health of the children that are born,” he told Reuters Health.

Source: {The Cochrane Library}

{{The African Development Bank will host a high-level ministerial conference on health financing in Tunisia, on 4 and 5 July, 2012.

This conference is organized by the Harmonization for Health in Africa mechanism (HHA), in collaboration with the African Union (AU) and the United Nations Economic Commission for Africa (UNECA).}}

It will emphasize the urgent need to get the best out of available resources in order to accelerate progress towards the health MDGs and beyond.

Participants will include ministers of finance and health, parliamentarians, civil society organizations, private sector enterprises and representatives of bilateral and multilateral development partners.

The conference aims at discussing how investing in health is key to sustainable and inclusive growth in Africa, and must be done in a manner that makes the best use of resources in the context of good governance and enhanced accountability.

As witnessed in North Africa, citizens increasingly demand transparent and equitable social services.

Africa’s economic emergence is changing the way we think about health financing. The future will be marked by making use of transparent evidence-based planning and budgeting and result-based financing as well as progressing towards universal health coverage and optimizing the opportunities provided by rapidly changing technologies, such as e-health.

The 2010 World Health Report estimates that globally, 20 to 40 percent of all health spending is wasted through inefficiency. In addition, more than half of total health spending is paid out-of-pocket by African households and plunges the poorest into further poverty.

The reduction of development aid to Africa additionally warrants increased domestic spending and greater domestic accountability.

Ministers of finance and health therefore share the common objective of seeking the highest value for the money spent on health services.

The conference aims to create a common understanding of the causes of ineffective and inequitable health financing.

It also aims to forge consensus on remedial measures, in particular by raising awareness of successful experiences from Africa and promoting South-South learning.

The conference is expected to result in the adoption of a framework for engagement and action, which would be used by governments to engage relevant stakeholders in concrete programmes to move the health agenda forward.

The conference will also stimulate dialogue and enhance leadership and collaboration between ministries of finance and health as well as other national stakeholders like parliamentary committees, civil society, professional associations and employer organizations.

Key topics of the conference include planning and budgeting for results, improving performance, health insurance, results-based financing, as well as sustainability of programs related to HIV/AIDS and maternal and child health.

{{In India, a 75-year-old man had a 5 inches long worm removed from his eye after a thrilling operation at Mumbai’s Fortis Hospital this week.

After thorough examination, the surgeon Dr V. Seetharaman pin-pointed a threadlike creature under a microscope on Wednesday.}}

The patient had previously complained of persistent pain in his eye for more than two weeks with redness and irritation.

“He was also confused and very much disturbed,” said Seetharaman.
The eye expert was shocked by the highly unusual sight of the writhing parasite and had to operate speedily to remove it before serious damage was caused.

“It was wriggling under the conjunctiva,” Seetharaman said, referring to the thin membrane lining the eye. “It was the first time in my career of 30 years that I had seen such a case.”

The specialist removed the 13-centimetre (five-inch) worm by making a small opening in the conjunctiva — a 15-minute operation that was observed by the patient’s horrified wife, Saraswati.

“It just kept moving and jumping; it was scary for a bit,” she told Indian Press.

The patient was relieved of his symptoms while the worm, which was alive for another 30 minutes after surgery, was sent to the hospital’s microbiologists to be identified.

Seetharaman had previously only heard of worms of about two to three centimetres being removed. “Probably this is a record,” he said.

He suggested the creature could have entered the patient from a cut in his foot or from eating raw or improperly cooked food, before entering the bloodstream and travelling to the eye.

“If the worm was not removed it could have gone into the layers of the eye and caused visual loss,” he said. “It could have entered the brain and caused major neurological problems.”
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{{Towards the conclusion of Army Week medical services to the communities of Rusizi and Nyamasheke,12,232 people received treatment.}}

The number exceeded the target of 10,000 that had been planned, with two days ahead for completion of the Army Week.

The achievements have been due to great dedication and cooperation from local authorities, Security Forces and Rwanda Military Hospital (RMH) Medical Team in the field.

People have responded by turning up in big numbers since the launch of medical services on Monday 25 June.

The population has appreciated the opportunity for them to have specialists’ doctors in their communities as they had to make long distances to the main Hospitals at Huye or Kigali City.

Kigali is about 6 hours from Rusizi by road transport. Many people using “mutuel” or medical insurance can benefit from services at main Hospitals only when they are recommended by Districts Hospitals.

However, during the Army Week, residents had specialist doctors at their Health Centers.

The outreach program organized by Rwanda Military Hospital is done by a multidisciplinary medical team of orthopedic surgeons, general surgeons, ophthalmologists, physiotherapists, dermatologists, radiologists, gynecologists and others.

It is being conducted at different health centers of Bushenge, Kibogora and Karengera in Nyamasheke district and Gihundwe, Nkanka, Muganza, Mibirizi and Bweyeye in Rusizi district in commemoration of 50 years of independence and 18 years of liberation.

{{Ineza Umugisha Ange is a young baby girl of 18 Months. She was born with a hole in her heart and this has been the cause of her frequent illnesses.

Her condition can only be handled by specialised hospitals found outside Rwanda.}}

It’s upon this realisation that a campaign was launched to raise funds for her treatment abroad.

Good samaritans managed to raise the required funds and Baby Umugisha flew out of Rwanda to India on Tuesday.

She is expected to spend between two weeks and two months at the hospital undergoing this specialised treatment of her condition.

Her father Tuyizere Jean Baptiste thanked all the good samaritans especially the staff of the central bank of Rwanda who raised funds to ensure that Baby Umugisha would undergo a specialised heart operation in India.

{{Microbiologists have revealed the dirtiest spots in a hotel room.

Surpsrisingly it’s the TV remote control gadget and the Bedside switch which were found to be contaminated with higher volumes of germs than any other spot in the hotel rooms.}}

So if you want to stay away from germs during your next hotel stay, don’t turn on the TV or lights — new research shows that TV remotes and light switches are among the most contaminated items inhotel rooms.

Researchers from the University of Houston took bacteria samples from several items in hotel rooms in three regions of the United States.

While the toilet and the sink were expected to have high levels of bacteria, researchers also found more surprising items with high contamination levels, such as the remote and the switch on the bedside lamp.

Hotel rooms “don’t have to have it ready for surgery,” said study researcher Jay Neal, a microbiologist at the University of Houston, but there certainly is room for improvement in their cleanliness.

The amount of bacteria on the remote may not mean that it’s “any dirtier than at home, but there’s a stranger factor” in a hotel room, said Neal, who oversaw the research performed primarily by student Katie Kirsh.

Housekeepers clean spend about 30 minutes cleaning each room, Kirsh said. If the researchers could pinpoint the most contaminated parts of the room, the cleaning process could be made more effective.

The highest levels of contamination were found in the maid’s cleaning cart, specifically, on the mop and sponge. That’s a problem because it means that bacteria are being carried from room to room, according to the researchers.

Such cross-contamination could be reduced, though, by replacing cleaning liquids during housekeeping shifts, they said.

The lowest levels of bacteria were found on the headboard, curtain rods and bathroom door handle.

The researchers tested for bacteria in general, and did a separate test for cloriform bacteria, which are found in feces and are more likely to cause illness.
Both tests showed that bacteria levels in hotel rooms were between 2 to 10 times higher than the levels accepted in hospitals.

The presence of bacteria’s doesn’t guarantee that people will get sick, but it makes it more likely.

The study was limited in that it was small — nine hotel rooms were tested in each of three states: Texas, Indiana and North Carolina.

The research was presented today (June 17) at microbiology researchers’ conference in San Francisco.

{{A new study suggests that middle-aged and older people who regularly sleep less than six hours a night may be significantly raising their risk of stroke.}}

As much as a fourfold increased risk was seen among normal-weight people who didn’t suffer fromsleep apnea but got fewer than six hours of sleep each night, the researchers found. Both obesity and sleep apnea are known risk factors for stroke.

“Sleep is important,” said lead researcher Megan Ruiter, a postdoctoral fellow at the University of Alabama at Birmingham’s School of Medicine. “There is evidence that insufficient sleep -increases all sorts of abnormal responses in the body.”

Lack of sleep increases inflammation and causes increases in blood pressure and the release of certain hormones, all creating a greater stress response that can increase the risk for stroke, Ruiter said.

The results of the study were scheduled to be presented Monday at the annual meeting of theAssociated Professional Sleep Societies in Boston. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

For the study, Ruiter’s group collected data on more than 5,600 people who took part in a larger study on geographical and racial differences in stroke.

Over three years of follow-up, the researchers found that sleeping fewer than six hours a night was associated with an increased risk of stroke in normal-weight people beyond that related to other risk factors.

They didn’t find any association between stroke and short sleep among overweight and obese people.

Although the study found an association between shorter sleep and stroke, it did not prove a cause-and-effect relationship.

Dr. Michael Frankel, director of vascular neurology at Emory University and director of the Marcus Stroke & Neuroscience Center at Grady Hospital, both in Atlanta, commented that “although difficult to define why this may be occurring, one can speculate about a possible mechanism linked to changes in cortisol levels, an important stress hormone that may be in higher levels in people who have shortened sleep.”

Elevated levels of this hormone may trigger dysfunction of the cells that line and protect people’s blood vessels and set in motion the cascade of events that leads to stroke, he explained.

This finding may explain why people without traditional vascular risk factors such as obesity, hypertension and diabetes occasionally have a stroke, he added.

“We know that in about a third of patients with ischemic stroke, doctors are unable to define a cause,” Frankel said. “Reduction in sleep may be contributing in some of these patients.”

“For those of us who chronically work long hours, we may need to listen closely to these findings and adjust our lifestyle to reduce our risk of stroke,” he added.

Controlling blood pressure; eating a low-calorie, balanced diet; exercising; not smoking; not drinking heavily; having regular checkups; and closely following doctors’ advice remain critical for vascular health, Frankel said.

“But attention to proper sleep may be equally important,” he added.

Another expert, Dr. Keith Siller, medical director of the NYU Comprehensive Stroke Care Center in New York City, agreed that sleep is an important factor.

“I see this as part of a general message that along with exercise and a proper diet, a good night’s sleep should be included in a healthy lifestyle,” he said.

{{Burundi is seeking US$349 million for its National Strategic Plan (NSP) to fight HIV/AIDS over the next five years.}}

The Global Fund to Fight AIDS, Tuberculosis and Malaria has pledged $90 million for 2012-2014, and the US Agency for International Development (USAID), through Family Health International, has pledged $10 million, specifically for the prevention of mother-to-child HIV transmission.

The government has promised to provide about $3 million per year until 2014.

“We know that Burundi is poor but we are going to ask it to redouble its efforts,” said Jean Rirangira, the permanent executive secretary of the National Council for the Fight against AIDS (CNLS).

The promised funds will leave a significant gap in funding for the plan; the government says it is hoping more donors – specifically those in the private sector – will provide additional money.

The plan’s elements include prevention, care and support, reducing the impact of HIV/AIDS and monitoring, compliance and follow-up evaluations, said Rirangira.

The prevention component aims to reduce the “HIV prevalence in the general population and among high risk groups by 50% “, he said. In addition, the plan also aims to “reduce mother-to-child HIV transmission from 23.7 % today to 2% by 2016.”

Under the plan, condom use in young people and other vulnerable groups will also be increased, making them available at places such as hotels, schools and social spaces such as dance halls.

The government intends to raise the number of sexually active people accessing screening services from 788,216 in 2012 to 1,738,445 by 2016, and increase the amount of blood screened for HIV and available for use in health facilities.

The NSP says, “90% of people living with HIV/AIDS will benefit from comprehensive services, including home care.”

Rirangira explained that care and support was the most expensive component because it includes helping HIV-positive people with income-generating activities; for example, 25,595 poor patients on antiretroviral therapy will benefit, as will 15,180 infected orphans or affected heads of households.

Orphans will also be assisted with school supplies and fees and street children, numbering about 1,500, will be assisted and sent to school.

{{The World Health Organization announced (Friday) it was set to approve a new target to reduce premature deaths from chronic illnesses such as heart disease by a quarter by 2025.}}

Cardiovascular disease, diabetes, cancer and chronic respiratory conditions are known in medical terms as noncommunicable diseases (NCDs) and represent the world’s biggest killers — accounting for 63% of all deaths.

About a quarter of victims die prematurely, between the ages of 30 and 70.

WHO member states meeting in Geneva has made a “landmark” decision to fix the 25% reduction target which is expected to be formally adopted on Saturday, the UN health agency said.

It was agreed along with a raft of measures to address the prevention and control of NCDs, which have rocketed in developing countries in recent years.

About 80% of premature deaths from NCDs now occur in low and middle-income countries.

“The focus of attention of the world community on the largest killer is now on course,” said Douglas Bettcher from the WHO’s chronic diseases unit.

“The architecture to support developing countries in addressing NCDs and their risk factors is now in place.”

NCDs also constitute a massive financial burden. A recent Harvard study found that left unattended they could result in lost productivity in low and middle income countries worth $7 trillion up to 2025.

“This is something that would, in an era of globalisation and ongoing financial crisis, have major effects for the entire world,” said Bettcher.

In the resolution adopted by WHO member states but yet to be formally approved, countries also backed further work aimed at producing targets on NCD risk factors, namely tobacco use, alcohol abuse, unhealthy diet and physical inactivity.

They called for a formal meeting to be held before the end of October to conclude work on a “global monitoring framework” to prevent and control NCDs.

The World Heart Federation said the adoption of the target would be a “significant milestone” but much work remained to be done.

“Although we applaud the progress made at the World Health Assembly this week, the global target in isolation is not enough to tackle one of the most complex health challenges facing the world today,” said chief executive Johanna Ralston.

“Further targets are needed to shape a framework for action against NCD risk factors, and we urge world leaders to agree on these targets promptly.”

{{Legislation on maternal and children health should be enacted in all EAC member states in order to help curb child mortality and morbidity rates in the region.}}

The regional leaders have been urged to show political will and ensure enforcement of such laws as the region strives to realise the Millennium Development Goals (MDGs).

The appeal was made by the Speaker of the East African Legislative Assembly (Eala), Abdirahin Haithar Abdi, on Saturday while addressing Parliamentarians during a two-day seminar on improving information to secure women and children’s health and health related MDGs.

The Speaker noted that there was huge information gap on mother and children health and called on stakeholders to put the issue on their agenda.

He further remarked that information on women and children issues remained core and at the centre of development and urged the East African Inter-Parliamentary Forum on Health to double its effort in advocacy around the same.

Abdi called for more endeavour to ensure information and data collection strategies were in place.

The seminar organised by Eala, the East African Inter-Parliamentary Forum (IPF) and the Inter-Parliamentary Union (IPU) attended by Eala MPs and parliamentarians from the National Assemblies of the partner states.

The meeting hopes to ensure revival of the Maternal New Born and Child Health (MNCH) activities of the IPF and update them by incorporating certain considerations from the recently adopted IPU resolution on the role of parliaments in ensuring MNCH.

It further wants to safeguard previous efforts by Eala/IPF to improve MNCH by developing an action plan for consideration by the incoming third assembly of the regional Parliament.

In his remarks, the director of programmes at IPU, Martin Chugong, said the IPU would continue to work with all Parliaments in the region.

“We hope that Parliaments would be able to access more resources, and ensure accountability so that access of health services by women and children is fully achieved,” Chugong said.