scholarly journals What’s new for the clinician – summaries of recently published papers

2021 ◽  
Vol 76 (09) ◽  
pp. 565-566
Author(s):  
Veerasamy Yengopal

To date, very few treatments have been demonstrated to reduce the burden of morbidity and mortality from COVID-19. Although corticosteroids have been proven to reduce mortality in severe disease, there has been little convincing evidence on interventions that may prevent disease, reduce hospitalizations, and reduce the numbers of people progressing to critical disease and death. Ivermectin is a well-known medicine that is approved as an antiparasitic by the World Health Organization and the US Food and Drug Administration. It is widely used in lowand middle-income countries to treat worm infections. Also used for the treatment of scabies and lice, it is one of the World Health Organization’s Essential Medicines.1 With total doses of ivermectin distributed apparently equalling one-third of the present world population,1 ivermectin at the usual doses (0.2–0.4 mg/kg) is considered extremely safe for use in humans.1 In addition to its antiparasiticactivity, it has been noted to have antiviral and anti-inflammatory properties, leading to an increasing list of therapeutic indications. South African authorities approved the use of a drug used to control parasites in humans and livestock to treat coronavirus patients. Additionally, in January 2021, the South African Health Products Regulatory Authority (SAHPRA) announced that ivermectin, would be allowedfor use on compassionate grounds in a controlled-access program. Ivermectin locally has been used for the prevention and/or management of Covid-19 infection. This has resulted in a huge black market trade of ivermectin in South Africa as many health professionals and others have taken to social media and other platforms to profile this drug as an effective treatment for the covid-19 viral infection. Roman and colleagues (2021)1 conducted a systematic review and meta-analysis to evaluate treatment effects of Ivermectin (IVM) on clinical outcomes and adverse events (AEs) in people with COVID-19.

Sexual Health ◽  
2018 ◽  
Vol 15 (6) ◽  
pp. 489 ◽  
Author(s):  
Ioannis Hodges-Mameletzis ◽  
Shona Dalal ◽  
Busisiwe Msimanga-Radebe ◽  
Michelle Rodolph ◽  
Rachel Baggaley

In September 2015, the World Health Organization (WHO) launched evidence-based guidelines by recommending that any person at substantial HIV risk should be offered oral pre-exposure prophylaxis (PrEP) containing tenofovir disoproxil fumarate (TDF) as an additional prevention choice. Since 2017, PrEP medicines have also been listed in the WHO’s Essential Medicines List, including TDF/emtricitabine (FTC) and TDF in combination with lamivudine (3TC). A descriptive policy review and analysis of countries adopting WHO’s 2015 recommendation on oral PrEP was conducted. As of June 2018, we identified 35 countries that had some type of policy on oral PrEP, and an additional five countries where a specific policy on PrEP is currently pending. A total of 19 high-income countries (HICs) and 21 low- and middle-income countries (LMICs) have adopted or have a pending policy. Most countries that have adopted or pending PrEP are in the European (42.9%) or African (30.0%) region. TDF/FTC is the most commonly recommended PrEP drug in the guidelines reviewed, although seven countries, namely in sub-Saharan Africa (6/7), are also recommending the use of TDF/3TC for PrEP. In sum, by the end of 2018, at least 40 countries (20.6%) are anticipated to have adopted WHO’s oral PrEP recommendation. Nonetheless, policy uptake does not reflect broader programmatic coverage of PrEP services, which remain limited across all settings, irrespective of income status. Enhancing global partnerships is needed to support and track ongoing policy adoption and to ensure that policy is translated into meaningful implementation of PrEP services.


Cephalalgia ◽  
2017 ◽  
Vol 38 (9) ◽  
pp. 1592-1607 ◽  
Author(s):  
Milka Jeric ◽  
Nives Surjan ◽  
Antonia Jelicic Kadic ◽  
Nicoletta Riva ◽  
Livia Puljak

Background The World Health Organization Essential Medicines List (WHO EML) contains two analgesics for treatment of acute migraine attacks in children, ibuprofen and paracetamol. Methods The Embase, CDSR, CENTRAL, DARE and MEDLINE databases were searched up to 18 April 2017. We analyzed randomized controlled trials (RCTs) and systematic reviews (SRs) that investigate the efficacy and safety of ibuprofen or paracetamol for treatment of acute migraine attacks in children. We conducted meta-analysis and assessments of evidence with GRADE, Cochrane risk of bias tool, and AMSTAR. Results Three RCTs (201 children) and 10 SRs on ibuprofen and/or paracetamol for acute migraine attacks in children were included. Meta-analysis indicated that ibuprofen was superior to placebo for pain-free at 2 h or pain relief at 2 h, without difference in adverse events. There were no differences between paracetamol and placebo, or ibuprofen and paracetamol. Ten SRs that analyzed various therapies for migraine in children were published between 2004 and 2016, with discordant conclusions. Conclusion Limited data from poor quality RCTs indicate that ibuprofen and paracetamol might be effective analgesics for treating migraine attacks in children. Inclusion of ibuprofen and paracetamol as antimigraine medicines for children in the WHO EML is supported by indirect evidence from studies in adults.


Curationis ◽  
1978 ◽  
Vol 1 (2) ◽  
Author(s):  
J.P. Kotzé

During the period 1970 to 1975 the world population grew at an average annual rate of 1,98%. At presentthe estimated world population is 4,2 milliard (4,2 x 109). Food production has the formidable task of feeding85 million extra mouths per year.A recent United Nations document stated that during 1974 already about 500 million people suffered fromsome form of malnutrition. Of these about 100 million children under the age of 5 years were malnourished.According to the Gomez classification, which is accepted by the World Health Organization, first degreeprotein-energy-malnutrition (PEM) is present in children who have body weights between 75 and 90% of theexpected weight for age and sex. Children with body weights between 60 and 75% of the expected weight forage and sex suffer from second degree PEM (moderate). Third degree PEM (severely malnourished) is foundin children who reached 60% or less of the expected body weight for age and sex or suffer from oedema.Data are presented for the incidence of malnutrition in Africa and other parts of the world.South Africa and its newly independent territories have a total population of 27,2 million for whom 122,111million hectares of land is available. A hundred million hectares can be used for agricultural purposes andonly 15% of this land is arable.South African food production managed to remain comfortably ahead of population growth over the pastfew decades. At present at least 25 210 kilojoules/capita/day and 146,9g protein/capita/day are available forevery citizen. Despite such an enviable food position we have a considerable problem of malnutrition in SouthAfrica. Firstly, obesity is endangering the health of a fair portion of all ethnic groups. Secondly PEM andvitamin deficiency diseases are frequently diagnosed in the lower socio-economic groups. During 1976 286district surgeons reported 48 783 cases of kwashiorkor, 37 855 cases of pellagra and 1 008 cases of beri-beri.Although some of these diagnoses are unreliable, such figures do give a rough estimate of the extent ofmalnutrition in South Africa. These figures indicate that less than 3% of the population under the age of 5years suffer from kwashiorkor, pellagra and beri-beri.The applicability of the Boston standards to other populations is questioned. It is indicated that thesestandards give false high values for PEM amongst obviously obese South African Indians.The compilation of specific sets of standards for the South African population is suggested.


2013 ◽  
Vol 89 (2) ◽  
pp. 171-178
Author(s):  
Helena Lutéscia L. Coelho ◽  
Luís Carlos Rey ◽  
Marina S.G. de Medeiros ◽  
Ronaldo A. Barbosa ◽  
Said G. da Cruz Fonseca ◽  
...  

2019 ◽  
Vol 29 (1) ◽  
Author(s):  
Christiana Okyere ◽  
Catherine Donnelly ◽  
Heather Michelle Aldersey

The international classification of functioning, disability, and health for children and youth (ICF-CY) developed by the World Health Organization (WHO) is a framework for understanding concepts of disability specific to children and youth. This framework has been used in countries around the world to support the education of children with disabilities. In this article, we argue that the ICF-CY has the potential to inform and support Ghana’s education system and to improve the implementation of education for children with disabilities, particularly inclusive education, in Ghana. Specifically, we use children with intellectual and developmental disabilities (IDD) as an exemplar to examine how the ICF-CY can support inclusive education for children with disabilities within its main components: Body Functions and Structures, Activities and Participation, Environmental Factors, and Personal Factors. Examining the ICF-CY in these areas is significant, as many similar low- and middle-income contexts have yet to adopt the framework and may draw insights and lessons for its significance in educational contexts.


2010 ◽  
Vol 138 (3-4) ◽  
pp. 225-229
Author(s):  
Gorica Sbutega-Milosevic ◽  
Zorica Djordjevic ◽  
Zoran Marmut ◽  
Boban Mugosa

Introduction. Combating nutritional deficiencies of micronutrients, such as iodine, represents a priority task of health care organizations. In 2003, the World Health Organization (WHO) published the publication: Global Prevalence of Iodine Deficiency Disorders (IDD), according to which some 2,2 billion people live in areas poor in naturally occurring iodine. Approximately 13% of the world population suffer from goitre - one of the IDD. The recommended iodine content in table salt is 20-40 mg/kg, which should satisfy the daily iodine requirements of an adult. Objective. The authors sought to ascertain whether iodization of table salt in Montenegro was carried out in accordance with the existing legislature. An assessment was also carried out of the attitudes and habits of the population regarding the use of salt in nutrition and the level of awareness in relation to the relevance of table salt iodization. Methods. The research was carried out in 2004 and was sponsored by UNICEF. A sample of 594 homes from the municipalities of Bar and Podgorica was chosen: 354 homes from urban and 240 from rural areas. The participants completed a questionnaire related to the daily use and intake of salt, as well as their understanding of the relevance of table salt iodization. Iodine content was tested in 15 samples of table salt at production level, 170 samples at retail level and 126 samples taken from domestic use. Results. The analysis of table salt samples showed an optimal iodine level in 73.3% of samples from production, in 81.2% from retail, and in 73.0% from domestic use. A lower level of iodine was found in 8.8% retail samples and 15.1% samples from home use. A greater concentration of iodine was found in 26.7% production, 10.0% retail and 11.9% samples from domestic use. Conclusion. Although the application of the WHO programme has led to an improvement in iodization of table salt in Montenegro, both at production and retail levels, this still falls short of the standards recommended by WHO to combat IDD. The levels of iodine in table salt in domestic use also fail to comply with the WHO criteria for elimination of IDD.


2020 ◽  
Vol 1 (2) ◽  
pp. 43-49
Author(s):  
Rochany Septiyaningsih ◽  
Dhiah Dwi Kusumawati ◽  
Frisca Dewi Yunadi ◽  
Septiana Indratmoko

The World Health Organization (WHO) states that maternal mortality worldwide due to complications during pregnancy and childbirth in 2017 is estimated at around 810 cases. Between 2000 and 2017 there was a decline in the ratio of MMR around the world by 38%. WHO also states that 94% of global maternal deaths occur in low and middle income countries. In Indonesia, maternal deaths due to complications from pregnancy or childbirth every year are estimated at 20,000 mothers died from five million births. Delivery assistance by trained health workers in health facilities can be an effort to reduce MMR and IMR. In addition, awareness of pregnant women is also important for the importance of having a pregnancy with a health worker. This community service aims to increase the knowledge of pregnant women about anemia and to detect early pregnancy complications by laboratory examinations. The target of this activity is 15 pregnant women. The dedication activity is conducting educational activities, laboratory examinations in Tambakreja Village, Cilacap Regency. Based on the results of this activity it was concluded that there was an increase in knowledge of pregnant women about anemia and found 2 pregnant women experiencing anemia from 15 pregnant women and urine examination found all negative pregnant women


PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0241899
Author(s):  
Barbara Bortone ◽  
Charlotte Jackson ◽  
Yingfen Hsia ◽  
Julia Bielicki ◽  
Nicola Magrini ◽  
...  

Antibiotic fixed dose combinations (FDCs) can have clinical advantages such as improving effectiveness and adherence to therapy. However, high use of potentially inappropriate FDCs has been reported, with implications for antimicrobial resistance (AMR) and toxicity. We used a pharmaceutical database, IQVIA-Multinational Integrated Data Analysis System (IQVIA-MIDAS®), to estimate sales of antibiotic FDCs from 75 countries in 2015. Antibiotic consumption was estimated using standard units (SU), defined by IQVIA as a single tablet, capsule, ampoule, vial or 5ml oral suspension. For each FDC antibiotic, the approval status was assessed by either registration with the United States Food and Drug Administration (US FDA) or inclusion on the World Health Organization (WHO) Essential Medicines List (EML). A total of 119 antibiotic FDCs were identified, contributing 16.7 x 109 SU, equalling 22% of total antibiotic consumption in 2015. The most sold antibiotic FDCs were amoxicillin-clavulanic acid followed by trimethoprim/sulfamethoxazole and ampicillin/cloxacillin. The category with the highest consumption volume was aminopenicillin/β-lactamase inhibitor +/- other agents. The majority of antibiotic FDCs (92%; 110/119) were not approved by the US FDA. Of these, the most sold were ampicillin/cloxacillin, cefixime/ofloxacin and metronidazole/spiramycin. More than 80% (98/119) of FDC antibiotics were not compatible with the 2017 WHO EML. The countries with the highest numbers of FDC antibiotics were India (80/119), China (25/119) and Vietnam (19/119). There is high consumption of FDC antibiotics globally, particularly in middle-income countries. The majority of FDC antibiotic were not approved by either US FDA or WHO EML. International initiatives such as clear guidance from the WHO EML on which FDCs are not appropriate may help to regulate the manufacturing and sales of these antibiotics.


Author(s):  
Afsaneh Noormandi ◽  
Mohammad Fathalipour ◽  
Reza Daryabeygi-Khotbehsara ◽  
Soheil Hassanipour

Background and objective: COVID-19 has since been declared a global pandemic by the World Health Organization (WHO), infecting millions worldwide. The use of Interferon (INF) subtypes previously examined in the treatment of SARS and MERS is also being initiated in some clinical trials. Although different clinical trials were evaluated IFNs in the treatment of COVID-19, their efficacy and safety remain unknown. Therefore, this study aims to systematically assess IFNs efficacy and safety in treating patients with COVID-19. Methods: The protocol has been registered in the PROSPERO International Prospective Register (CRD42020200643) on 24 July 2020. This protocol has been arranged according to the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) 2015 checklist. Discussion: Due to lack of approved medication for the covid-19 treatment and also various mutations of this virus, evaluated the efficacy and safety of medications by various studies could help for finding treatments with high effectiveness. IFNs are one of the medications that have been administered in covid-19 infection.  Moreover, the best time of administration and dose of this medication was unknown. Although meta-analysis is a potent source for assessing the accuracy of subjects, heterogeneity of articles is a potent limitation of our work.


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