Study backs chest compressions in resuscitation

 

Official guidelines show that 30 chest compressions should be followed by two rescue breaths

 

Concentrating on chest compressions rather than mouth-to-mouth when giving emergency resuscitation can produce better results, says research published in The Lancet.

A study of 3,000 patients found that chest compressions alone increased chances of survival by more than 22%.

But training in how to give both chest compressions and mouth-to-mouth breaths is the best option, experts say.

The UK Resuscitation Council is due to produce new CPR guidelines next week.

Cardiopulmonary resuscitation (CPR) is a combination of chest compressions and mouth-to-mouth breaths, given in a life-threatening emergency like a cardiac arrest or heart attack.

The study, compiled by doctors from the Medical University of Vienna in Austria, looked at the survival rates of people treated by untrained members of the public taking instructions from the emergency services over the phone.

Dr Peter Nagele, from the department of anaesthesiology, critical care and pain therapy at the Medical University of Vienna, said that if untrained bystanders avoided mouth-to-mouth breaths during CPR, they were more likely to perform uninterrupted chest compressions.

That then increased the probability of CPR being successful.
 

Different techniques
The research in The Lancet involved two analyses.

The first used data from three randomised trials involving more than 3,000 patients.

It showed that chest-compression-only CPR was associated with a slightly improved chance of survival compared with standard CPR (14% v 12%).

In the second analysis of seven observational studies, researchers found no difference between the two CPR techniques.

The study authors maintain that continuous, uninterrupted chest compressions are vital for successful CPR.
Dr Jas Soar, chair of the Resuscitation Council from Southmead Hospital in Bristol, said: "Any CPR is better than no CPR. If you witness a cardiac arrest, dial 999 immediately. Those trained in CPR should follow existing guidance of 30 chest compressions followed by two rescue breaths.

"Those not trained should start compressions and follow instructions until an expert arrives," Dr Soar said.
Dr Meng Aw-Yong, medical adviser at St John Ambulance, acknowledged that rescue breaths could be off-putting.

"The current advice is that if you're unwilling or unable to do full CPR then chest compressions are better than nothing.

"The best solution, however, is for people to get trained in how to carry out chest compressions and rescue breaths so they can be the difference between a life lost and a life saved," he said.

The British Heart Foundation says that being able to do CPR more than doubles the chances of survival.
Claire O'Neill, community resuscitation programme lead at the BHF, said: "For someone who is untrained in cardiopulmonary resuscitation, doing both chest compressions and rescue breaths really can be difficult.

"We also know that uninterrupted chest compressions are very important for increasing the chance of survival. So being directed to focus solely on chest compressions could make people more willing to attempt resuscitation, which could ultimately save lives," she said.

 

Continue reading →

Deadly disease major threat to global public health

 

 

The number of cases of a deadly disease has more than doubled in the last decade, according to the World Health Organization (WHO).

Dengue outbreaks are now a major threat to global public health.
The UN health agency warned that unless countries act now then the situation will only get worse.

Two fifths of the world's population are at risk of the disease, with the majority living in the Asia Pacific region.
 

Cases double
Dengue is a serious flu-like illness that is transmitted by mosquitoes, and can develop into dengue haemorrhagic fever, which can be fatal.

The disease is spread by the aedes aegypti mosquito.
The WHO has warned that the increased number and size of dengue outbreaks in some countries in the Western Pacific region, as well as cases recorded in previously unaffected areas, are signs that firmer action cannot be delayed.

The WHO's regional director for the Western Pacific, Dr Shin Young-soo, said:

"National resources need to be mobilized to sustain dengue prevention and control, and the disease's profile needs to be raised on the global health agenda to stimulate the interest of international agencies and donors.
"The fight against this disease is everybody's problem."

The number of cases in the Western Pacific Region has more than doubled over the past 10 years.
 There has been a significant increase in many countries this year alone.

The Lao People's Democratic Republic and the Philippines appear to be particularly affected.
2.5 billion at risk

Two-fifths of the world's population is at risk of the disease. Out of these 2.5 billion people, more than 70% live in Asia Pacific countries. The warning was delivered at the WHO's Regional Committee for the Western Pacific. The increased number of outbreaks may be caused by a number of factors; including higher temperatures and rainfall which produce perfect breeding conditions for the mosquitoes that carry the disease.

Growing populations, particularly in cities, and greater international travel by infected individuals could also explain the rise.

The WHO says there is as yet no clear evidence that the increase in cases was due to global warming.
But changes in climate do affect mosquitoes which spread the disease.

At a local level eliminating breeding sites like water jars, building sites and discarded garbage is essential in reducing the number of mosquitoes.

But a concerted international effort is vital, with urban planning and improving sanitation essential to reducing the number of dengue cases.
 

Continue reading →

Love can ease pain, say brain researchers

 

Love hurts, at least according to many a romantic songwriter, but it may also help ease pain, US scientists suggest.

Brain scans suggest many of the areas normally involved in pain response are also activated by amorous thoughts.

Stanford University researchers gave 15 students mild doses of pain, while checking if they were distracted by gazing at photos of their beloved.

The study focused on people early in a romance, journal PLoS One reported, so the "drug of love" may wear off.

The scientists who carried out the experiment used "functional magnetic resonance imaging" (fMRI) to measure activity in real-time in different parts of the brain.

It has been known for some time that strong feelings of love are linked to intense activity in several different brain regions.

These include areas linked to the brain chemical dopamine, which produces the brain's feel-good state following certain stimulants - from eating sweets to taking cocaine.

"Light up"

The Stanford University researchers had noticed that when we feel pain, some of the same areas "light up" on the scans - and wondered whether one might affect the other.

They recruited a dozen students who were all in the first nine months of a relationship, defined as "the first phase of intense love".

Each was asked to bring in a picture of the object of their affection and photos of what they deemed an equally attractive acquaintance.

While their brains were scanned, they were shown these pictures, while a computer controlled heat pad placed in the palm of their hand was set up to cause them mild pain.

They found that viewing the picture of their beloved reduced perceptions of pain much more than looking at the image of the acquaintance.

Dr Jarred Younger, one of the researchers involved, said that the "love-induced analgesia" appeared to involve more primitive functions of the brain, working in a similar way to opioid painkillers.

"One of the key sites is the nucleus accumbens, a key reward addiction centre for opioids, cocaine and other drugs of abuse.

"The region tells the brain that you really need to keep doing this."

Professor Paul Gilbert, a neuropsychologist from the University of Derby, said that the relationship between emotional states and the perception of pain was clear.

He said: "One example is a footballer who has suffered quite a painful injury, but who is able to continue playing because of his emotionally charged state."

He added that while the effect noticed by the Stanford researchers might only be short-lived in the early stages of a love affair, it may well be replaced by something similar later in a relationship, with a sense of comfort and wellbeing generating the release of endorphins.

"It's important to recognise that people who feel alone and depressed may have very low pain thresholds, whereas the reverse can be true for people who feel secure and cared for.

"This may well be an issue for the health service, as patients are sometimes rushed through the system, and perhaps there isn't this focus on caring that might have existed once."

Continue reading →

Hunger index shows one billion without enough food

By Ania Lichtarowicz Health reporter, BBC News

 

 

One billion people in the world were undernourished in 2009, according to a new report.

The 2010 Global Hunger Index shows that child malnutrition is the biggest cause of hunger worldwide, accounting for almost half of those affected.

Countries in sub-Saharan Africa and South Asia were shown to have the highest levels of hunger.

The report's authors called on nations to tackle child malnutrition in order to reduce global hunger. The Global Hunger Index is produced by the International Food Policy Research Institute (IFPRI), Welthungerhilfe and Concern Worldwide.

The UN Food and Agriculture Organization (FAO) defines hunger as the consumption of fewer than 1,800 kilocalories a day - the minimum required to live a healthy and productive life.

Despite the number of undernourished people in the world falling between 1990 and 2006, the report's authors say in that number has crept up in recent years, with the data from 2009 showing more than one billion hungry people.

The most recent figures from 2010 suggest the number may again be falling but this data is not yet complete.
The Global Health Index (GHI) is calculated for 122 developing and transition countries. Twenty-nine countries - mostly in sub-Saharan Africa and South Asia - have levels of hunger described as "extremely alarming" or "alarming".

The GHI shows hunger increasing in nine countries; North Korea and eight sub-Saharan African nations. The Democratic Republic of Congo saw the biggest increase; GHI rose by more than 65%.

The scores are based on the proportion of people who are calorie deficient, the proportion of children under five who are underweight and the child mortality rate.

The global food price crisis and the worldwide recession have contributed to the recent rise, says the report.
Children under the age of two are considered to be at most risk. Malnourishment at this stage harms physical and mental development and its effects are mostly irreversible causing life long damage.

In some sub-Saharan African countries, for example Burundi and Madagascar, about half the children have stunted growth because of they do not have access to an appropriate diet.

The authors argue that improving child nutrition would have the biggest effect on reducing global hunger.
They estimate that child malnutrition could be cut by about a third by providing improved health care and nutrition, not only to young children but also to mothers during pregnancy and breastfeeding.

Marie Ruel, director of IFPRI's Poverty, Health and Nutrition Division and co-author of the report, said many countries had to accelerate progress in reducing child malnutrition.
"Considerable research shows that the window of opportunity for improving nutrition spans from conception to age two," she observed.

"After age two, the negative effects of undernutrition are largely irreversible."
The report adds that reducing the numbers of hungry people will also significantly improve productivity and economic development.

 

Continue reading →

Angka Bebas Jentik

Pemeriksaan Jentik Berkala

Continue reading →

Angka Bebas Jentik

Pemeriksaan Jentik Berkala

Continue reading →

First human trial of embryonic stem cells

US doctors have begun the first official trial of using human embryonic stem cells in patients after getting the green light from regulators.

The Food and Drug Administration has given a license to Geron to use the controversial cells to treat people with spinal injuries.

The cells have the potential to become many of the different cell types found in the body, including nerve cells.

The trials at a hospital in Atlanta will check if the treatment is safe.Pivotal research

Geron, a biotech company based in "silicon valley" south of San Francisco, has spent $170m on developing a stem cell treatment for spinal cord injury.

The research will use cells coaxed to become nerve cells which are injected into the spinal cord.

In animal trials of the treatment, paralysed rats regained some movement.

But it is not yet known if it will offer any benefit to people with spinal cord injuries.

Every year around 12,000 people in the US sustain spinal cord injuries. The most common causes are automobile accidents, falls, gunshot wounds and sports injuries.

In the trial, patients who have sustained such an injury within the last 14 days will be given the experimental stem cell treatment.

Geron president Dr Thomas Okarma said: "When we started working with human embryonic stem cells in 1999, many predicted that it would be a number of decades before a cell therapy would be approved for human clinical trials.

"This accomplishment results from extensive research and development and a succession of inventive steps."

But it will take some time to get the results.

And there are many years of rigorous testing ahead before it can be known if the therapy is safe and effective.

Professor Sir Ian Wilmut, director of the Medical Research Council Centre for Regenerative Medicine at the University of Edinburgh, said: "This is very exciting news, however, it is very important to appreciate that the objective of trials at this stage is to confirm first of all that no harm is done to patients, rather than to look for benefits.

"Once that has been confirmed then the focus moves on to development and assessment of the new treatment."

Ben Sykes, executive director of the UK National Stem Cell Network, said: "This is indeed a significant milestone in our journey towards the promise of stem cell-based medicines.

"The global stem cell and regenerative medicine community will be awaiting the results of this safety trial with much anticipation."

Continue reading →