Moringa oleifera : Nutritional and Medicinal Properties for preventive health care

Moringa oleifera, commonly known as ―drum stick‖ or the ―horse radish‖ is cultivated all over the country as it can withstand both severe drought and mild frost conditions. It is a good source of protein, vitamins, fatty acids, micro-macro minerals and other essential phytochemicals. Due to its high nutritional content, the extract of leaves of Moringa oleifera is used to treat malnutrition and supplement breast milk in lactating mothers. Because of its medicinal value, it is also used as anti-inflammatory, anticancer, antioxidant, antidiabetic, cardiovascular hepatoprotective, anti-ulcer, antimicrobial agent. The pharmaceutical effects of Moringa oleifera makes it useful in therapeutic remedy in traditional medicinal system. Each part of the tree is useful in one form or another due to high nutritional and medicinal value. This paper reports the results of the study made on how these can help boosting the immunity level in individuals.

Article 24: The Right to Health

Article 24 reflects the perspective of the drafters that the right to health cannot be understood in narrow bio-medical terms or limited to the delivery of health services. Rather, in its reference, for example, to food, water, sanitation, and environmental dangers, it recognises the wider social and economic factors that influence and impact on the child’s state of health. Thus, the text of Article 24 sets out: a broad right to health for all children combined with a right of access to health services a priority focus on measures to address infant and child mortality, the provision of primary health care, nutritious food and clean drinking water, pre-natal and post-natal care, and preventive health care, including family planning the need for effective measures to abolish traditional practices harmful to children’s health a specific obligation on States Parties to cooperate internationally towards the realisation of the child’s right to health everywhere, having particular regard to the needs of developing countries. The right to health is a prime example of the interelatedness of child rights as it is contingent upon and informed by the realization of so many other rights guaranteed to children under the convention. This chapter analyses the child’s right to health in relation to four essential attributes. The first attribute of the child’s right to the highest attainable standard of health emphasizes what an exacting standard this human rights norm contains. Taking a social determinants of health perspective the right entails not just access to health services but programmatic supports in sanitation, transportation, education and other fields to guarantee the enjoyment of health. The second attribute focuses on the Basic minimum criteria of the right to health as reflected in Article 24(2). A third attribute is the insistence upon child health accountability mechanisms using the Availability, Accessibility, Acceptability and Quality Accountability Framework. Finally, given the wide discrepancies in enjoyment of children’s right to health across the globe, a fourth attribute focuses upon international cooperation to ensure equal access to the right to health.

Missed and Delayed Preventive Health Care Visits Among US Children Due to the COVID-19 Pandemic

Objective: The COVID-19 pandemic led to a substantial drop in US children’s preventive care, which had not fully rebounded by the end of 2020. We sought to estimate the overall prevalence of missed, skipped, or delayed preventive checkups among households with children in the last 12 months because of the pandemic. Methods: We used data from the US Census Bureau’s Household Pulse Survey, Phase 3.1 (collected April–May 2021). The analytic sample included 48 824 households with ≥1 child or adolescent aged <18 years. We estimated both national and state-level prevalences, examined associations with sociodemographic and household characteristics, and described reasons for missed or delayed preventive visits. Results: Overall, 26.4% (95% CI, 25.5%-27.2%) of households reported that ≥1 child or adolescent had missed or delayed a preventive visit because of COVID-19; percentages varied by state, from 17.9% in Wyoming to 37.0% in Vermont. The prevalence of missed or delayed preventive visits was significantly higher among respondents who reported material hardships (ie, not caught up on rent/mortgage, difficulty paying usual household expenses, children not eating enough because of lack of affordability) than among respondents who did not report material hardships. The most common reasons for missing or delaying preventive visits were concern about visiting a health care provider, limited appointment availability, and the provider’s location being closed. Conclusions: Programs and policies could reduce gaps in children’s preventive care caused by the pandemic, with a particular focus on addressing social determinants of health.

Interventions to Address Potentially Inappropriate Prescriptions and Over-The-Counter Medication Use Among Adults 65 Years and Older in Primary Care Settings: Protocol for a Systematic Review

Purpose: To inform recommendations by the Canadian Task Force on Preventive Health Care on potentially inappropriate prescribing and over-the-counter (OTC) medication use among adults aged 65 years and older in primary care settings. This protocol outlines the planned scope and methods for a systematic review of the benefits and harms and acceptability of interventions to reduce potentially inappropriate prescriptions and OTC medication use.Methods: De novo systematic reviews will be conducted to synthesize the available evidence on (a) the benefits and harms of interventions to reduce potentially inappropriate prescriptions and OTC medications compared to no intervention, usual care, or non- or minimally-active intervention among adults aged 65 years and older and (b) the acceptability of these interventions or attributes among patients. Outcomes of interest for the benefits and harms review are all-cause mortality, hospitalization, non-serious adverse drug reactions, quality of life, emergency department visits, injurious falls, medical visits, and the number of medications (and number of pills). Outcomes for the acceptability review are the preference for and relative importance of different interventions or their attributes. For the benefits and harms review, we will search MEDLINE, Embase, and Cochrane Central Register of Controlled Trials for randomized controlled trials. For the acceptability review, we will search MEDLINE, Embase, PsycInfo, Cochrane Central Register of Controlled Trials, and the NHS Economic Evaluation Database for experimental and observational studies with a comparator. Websites of relevant organizations, other grey literature sources, and reference lists of included studies and reviews will be searched. Title and abstract screening will be completed by two independent reviewers using the liberal accelerated approach. Full-text review, data extraction, risk of bias assessments, and GRADE (Grading of Recommendations Assessment, Development andEvaluation) will be completed independently by two reviewers, with any disagreements resolved by consensus or by consulting with a third reviewer. The GRADE approach will be used to assess the certainty of the evidence for outcomes.Discussion: The results of this systematic review will be used by the Canadian Task Force on Preventive Health Care to inform their recommendation on potentially inappropriate prescribing and OTC medication use among adults aged 65 years and older.Systematic review registration: PROSPERO (KQ1: CRD [tbd]; KQ2: CRD [tbd]); Open Science Framework (link TBD).

Impact of the “First Wave” of the Pandemic on Social Rights in the Countries of the European Union

While news of successful vaccine trials is encouraging, the prospect of long-term restrictions underscores the magnitude of a number of problems and challenges faced by all EU member states during the first wave of coronavirus infection. European leaders have come together in a series of measures and policies to support the European economy and society at the time of the declaration of the emergency. This situation underlines the particular importance of respecting the social rights of citizens. Social rights offer protection in many of the areas that most define our daily lives, including legally binding standards in education, employment and health care. This gives EU citizens the right to education, fair working conditions and access to preventive health care. The article traces the practice of how European countries apply the lessons learned from the first wave in order to minimize the negative impact on human rights. Several European governments have decided to expand income support schemes. To date, the authorities have expanded access to testing for COVID-19 in nursing homes, migration camps and other institutions. The authors highlight how the pandemic has affected fundamental rights, especially the social rights of society as a whole. The article describes some of the measures that EU member states have taken to protect the most vulnerable segment of society as Europe faces the second wave of the coronavirus pandemic.

“They Wait until the Disease Has Taking over You and the Doctors Cannot Do Anything about It”: Qualitative Insights from Harambee! 2.0

African immigrants make up a large subgroup of Black/African-Americans in the US. However, because African immigrant groups are typically categorized as “Black,” little is known about their preventative healthcare needs. Differences in culture, life and healthcare experiences between African immigrant populations and US-born people may influence preventive health care uptake. Thus, policymakers and healthcare providers lack information needed to make informed decisions around preventive care for African immigrants. This formative study was conducted among the largest East African immigrant communities in King County, WA. We recruited religious leaders, community leaders, health professionals, and lay community members to participate in thirty key informant interviews and five focus group discussions (n = 72 total), to better understand preventative healthcare attitudes in these communities. Through inductive coding and thematic analysis, we identified factors that impact preventative healthcare attitudes of the Somali, Ethiopian and Eritrean immigrant communities and deter them from accessing and utilizing healthcare. Cultural beliefs and attitudes around preventative healthcare, mistrust of westernized healthcare, religious beliefs/views, intersecting identities and shared immigrant experiences all influence how participants view preventative healthcare. Our results suggest that interventions that address these factors are needed to most effectively increase uptake of preventative healthcare in African immigrant communities.

Evaluation of Child Emergency Department Utilization: Differences Between Refugee and Resident Children.

Objectives: Evaluation of emergency department (ED) utilization by Syrian refugee children will provide important information about their health care needs and utilization as a prerequisite for improving preventive health services and outcomes. We aimed to compare ED utilization of refugee and resident children in a tertiary university hospital in Istanbul, Turkey.Methods: Electronic medical records of Syrian refugee children ≤18 years old presenting to the ED between January 2013 and July 2019 were retrospectively reviewed and compared with the resident children.Results: The study population consisted of 7299 refugee and 690127 resident children admitted to the ED. Emergent cases were more frequent in Syrian refugees (2.2% vs 1.0% p<0.001). One third of Syrian children were under 12 months of age (31.0% vs 17.4%, p<0.001). Syrian children were more commonly hospitalized (7.9% vs 3.1% p<0.001). Rate of intensive care unit hospitalization (13.4% vs 9.4%, p=0.001) and neonatal hospitalization was higher in Syrians compared to resident children (29.3% vs 12.0%, p<0.001). Respiratory and gastrointestinal diseases were the most frequent diagnoses which were similar in both groups. Conclusion: Refugee children as compared to native children are more likely to present to the ED with high acuity conditions, at a younger age resulting in higher rates of inpatient admissions. Strategies to increase access to preventive health care services for young refugee children should be explored to decrease ED and hospital services and improve health outcomes.

Metabolic Syndrome Among Physicians: A Pilot Study from Chattogram, Bangladesh

Background : Although the information on Metabolic Syndrome (MetS) in the general population from different parts of Bangladesh is available, the information regarding the same is scarcely available from physicians of Bangladesh. This study was aimed to assess the prevalence of MetS among physicians working at Chattogram Medical College Hospital, Bangladesh. Materials and methods : Data was collected for this cross-sectional study from 255 working physicians of Chittagong Medical College Hospital in 2018. The participants filled a structured questionnaire followed by physical and biochemical measurements including waist circumference, blood pressure, lipid profile, and fasting blood glucose. National Cholesterol Education Program’s Adult Treatment Panel III report (ATP III) defines criteria were used to identify physicians with the MetS. Results : Among 255 participants (males - 192 and females - 63), 100 (39.2%) were with MetS. Prevalence of same was higher in females (41.3%) than males (38.5%). The elderly physicians (>40 years) had a higher prevalence compared to the younger (£40 years) physicians [72 (50.3%) vs. 28 (25.0%)]. In the males, low High-Density Lipoproteins-Cholesterol (HDL-C) was the major contributor to the prevalence of MetS followed by high blood pressure. However, in females, low HDL-C and greater waist circumference contributed the maximum to MetS. Conclusion : This study showed a high prevalence of MetS among physicians of Bangladesh, and thereby warrants the urgent implementation of preventive health care strategies to reduce both morbidity and mortality related to this medical problem. Further studies ought to focus on the working conditions and lifestyles of individuals in these high-risk groups. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 65-68